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Home My WebLink About11511-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy Date Sept. 30 .8.6 THIS CERTIFIES that the building ..... .O.n.~., .f.a.r.~i..ly..d.w..o.l.l.J:.n. 9: ................... Location of Property 955 Bay Home koad Southold h~6s'e ~id ...................... 'S't/e~i ....................... fi~rhiel County Tax Map No. 1000 Section 056 .Block 05 .Lot 034 Subdivision...W.i.l. 1..o.w..P.q~..n.t. .............. Filed Map No. 4652 .Lot No. 30 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .1.2./.3. ............ , 198..1. pnrsuant to which Building Permit No. 115117. dated. 12/11 19 81, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One family dwelling. The certificate is issued to . FRANK & DAVORKA ANTOLOS towner, ~~ of the aforesaid building. Suffolk County Department of Health Approval ...... .1.17.S.O. 7.1.3.1. ......................... UNDERWRITERS CERTIFICATE NO. N59529 $ Rev. 1/81 FORM NO; ~ TOWN 'HALL SOUTH'OLD, N~ Y. N°. Permission 11511 Z is hereby granted to: ~ / BUILDING P,ERM!Ti (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT L ~ULL COMPLETION OF THE WORK AUTHORIZED) Do;e ..,~..~.¢.~.,~:....~. '2~,,~.....:././.. ....... , ]~.~../. ..... '. ......... i .............................. ..~.Z.c~/.v.~... at p~'emiseb located at ..~:.~./.~ .................................... ,.:~...:~: County Tax Map No.. ]000 Sect, ion .:..~...~....~....? Block V.~.~'~.....: Bud~lng I~spector. ~, , Lot No. ~,..~',.~.-~.,~:,.. ........ ..ff and ~pprove~ by the nspectoit FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall ,~,[outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte .'.d-~. _~.p, Hc~tc~to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S.9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property 'lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owne~ as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2'Certificateofoccupancyonpre-exstngdwelling/landuse--Pre-Existing C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C.O. $ 5.00 Date .......................... New Building ..... ~ ...... Old or Pre-existing Building .... Vacant Land ............ House No. ~ ' ~ ......... Street ....... ' Owner or Owners of Property ~.-.J~/")-JVtC ~.-.~..,~..~.~../~.~_j2; ,~jV~.-C2LO Namlet County Tax Map No. 1000 Section . .(.~. C~. ~ ....... Block ...~).'. ~ ........ Lot...~7.~..~. ....... Subdivision ' ................................. Filed Map No ........... Lot No .............. Permit No. 11.5 iL 2, Date of Permit . J).~¢.. J./, ~./.Applicant ...~.,. 5......~.C'~.. '"?.~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. THE NEW YORK BOARD" OF FiRE UNDERWRITERS BUREAU OF ELECTRICITY ~'~:'; 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.,. ~,,..,,o. ~o. o.~,,. N 595298 THIS 6ERTIFIES TNAT only the electrical equipment ~ described below a~ int~duc~ by the applicant na~ on the ab~ application r~umber in the premises of ~as examined on ~( ~ ~ l ~ and four~d to be i~ complia~ce with the require.~ents o~ thls Board. FIXTURE OUTLETS DRYERS RECEPTACLES SWITCHES FIXTURES RANGES OVENS EXHAUST ;~1 30 FLUORESCENT OTHER APPARATUS: 1-G.F. t · NO OF CC CONO, A, W O PER ~ OF CC, COND 1 2/0 R V I C E NO, OF HI-LEG OF HI-tEG NO OF NEUTRAl 1 OF NEUTRAL 2/O ~alTe~ ~ott Elec. 11779 ' MANNER. FIELD IN~ECT%ON FOUNDATION FOUNDATION ( 2. ROUGH FRAME & INSULATION PER N STATE ENERGY CODE o DATE COMMENTS st) , , PLUMBING ADDITIONAL COMMENTS: ~ .... ~ .... ~..~- ~ FINAL 78S-X802 BUILDING* DEPT. INSPECTION: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION AND [ ] INSULATION FRAMING [/J/FINAL DATE ,INSPECTOR 76S.1802 BUILDING DEPT. ~~o~INSPECTION DATION ~ST [ ]ROUGH PLBQ. FOUNDATION 2ND [ ]~. INS~A~ON FRAMING ['"~] FINAL REMARKS: ~)~ DATE .... ~///'"'g'~//~ INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, r.l.Y. 11971 TE~_.. 7(55-1802 Approved . ..., ...... ., ] 997'. ~.'. ?ennit No..l.t. ........ Disapproved a/c ....... : '..~..~ .~.. (Bu~l¢li~ Inspector) ' '~ APPLICATION FOR BUILDING PERMIT At~plication No. ~/,/¢~'.[ ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'aI of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen shall be kept on the premises avaikd)le for inspection throughout the work. e. No building sbalI be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupar shall have been granted by the Buikling Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town ~)f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, mn.d admit authorized iuspectors on p~emises and in buildings for nece.ssary inspections. zZ.:. .......... (Signature of applicant, or name, if a corporation) .... (Mailing address of applicant) /~'q,' ~' t' State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build (as on the tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer. (Na ne and t tie of corporate officer) Builder's License No.....z/'.¢.'.4'.. 7.. :-....,?'_Z'~ .... mlu,nber's Licens* N.o../.-fi~, '../.7~... Elactrician's License No.' .z.- ..... z.( ] ........ ~... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. House Number Hamlet County Tax/vial, No. iO00 Section ....Q ~ ......... Block ....~...D~. .......... Lot .... ~ .....~].. Subdivision..~. ('~F'..6~......~.z'./c/.'-~..'. ............. Filed Map No..~..(~-.~. ....... Lot. ~.0 ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~..~..~.,:,~.../,-/.7. . .~q¢...,~j../? ' Na~t~-e oF~erk &hec-k ~hich,~ppli'cab[¢): l~¢w B~din~ .......... Add(fion .......... A[~ra{i'on ....... Repair Re,bm'al Demoliiion Other Work E~fi~aged' CosL ~ ~ ~ (Description) . ....... /L~/ .................~e ........................ . ........... ; (to be paid on filing this application) IF dwelling number of dwelling units Ntnnber oF dwelling units on each floor If garage number of cars . ' ~at d f t typ f If business, commercial or mixied occupancy, specify ure an extent o eacl e o use .................... Dimensions of existing stmcm:res, if any: Front ..... ~ ...., ..... Rear .............. Depth .............. Height Ntlm her of Stories ....................................................... Dimensions of same st~cture With alterations or additions: Front ................. Rear ................ Depth .................. ~... Height ...................... Number of Stories .................... Dm~ensmns of entire new con~trt ctmn: Front ...... ~ ........ Rear ...... . ......... Depth ............. Heigh t Nu'm bet of Stories ' Size of lot: Front ~ ' Rear Depth Date 6f Purchas~ ......... ~ ................... Name of Fenner Owner ........................... Zone or use district in which Dremises are situated ' : Does proposed construction vi:olate any zoning law, ordinance or ~egulation: ............................... WiU lot bo regraded ....... ~ · .' .... . .............. Will excess fill be remowd from premises: . Yes Nc Na,n~ or ard~it=ot .~..W~ ...... ... Aaar~~ ...... P~on~ No .... ~ ..... ' ...... N~e of Contractor~:. 5.,. ~,~~. ~r~ .... Address ................... Phone No~ ~. ~ ..... PLOT DIAGRAM Locate clearly and distinctly all buiklings, whether existing or proposed, and, indicate ail set-back dimensions fron- ,-(> roperty lines. Give street and block number or description according to deed, and show street names and indicate whethe~ interior or corner lot. $1'ATEOFNEWVORK . ,.. cou~Y OF...~..~F..F~.*':&...'.. s.s .. .~..}.C/.....~.~... ~./l~.~:lM/ ?. ................... being duly s;vorn, deposes and says that he is the applican ~ (Nan/e of indMdual s~dning contract) ~ove named. ; e is the ' I (Contractor, agent, corporate officer, etc.) f said owner or owners, and is d[dy authorized to perform or have performed the said work and to ,hake and file thL )plf. catim~; that all statements contained in this application are true to the best of his knowledge and belief; and that th · ork will be performed in the manner set forth h~ the application filed therewith. worn to before n,e this , ............. day 6f ...... ,19 p: ~- ,_, ~Z .... . ~. , ~ota~ ublic, ~..~ ~~ .U~h ~sKI ~ ' ~ ~ . . - j .H~TARY PU,~LIC, SXate ot U~ ~ / /~ ~ __ #~uTNQRIZI~D ALTERATION OR,M)DITiON TO ~!1 SURVEY ~ A V~A~ON ~ SECTi0N ?~0~ ~ rH~ KW ~ SMT[ E~CATI~ LAW ' ' HE~ DE~RTMENT-~TA ~'A~ ~ C~S;~CT ~ ~'~ W~ THE SU~Y ~S P~PA~EO YOUNG, & YOUNG ,,oo~'r..,.~.,~, ALDEN W.~NG, PROFE~IONAL ENGINEER ~D ~D SURVEYOR N.Y~. UC~SE N~. I~ HOWD W. YOUNG, LAND SURVEYOR N.Y S. LICENSE NO. 45~93 SUFFOLK COUN~ OEPARTM~ OF H~ALTH ~RV~C~ ~ ~~ FOR APPROVAL OF CONSTRUCTION O~Y AT ,,~, .- YOUNG YOUNG ~u~Jvl~N MA'~ ~ ~ ~N -~ ~ ~ID~ ALDEN W.~N6, PROFE~ONAC I~ff~ A~ ~P~ NO, ~ HOWARD W. YOUNG, LAND S~VEYOR ~ ~ ~,? ~T.~s ~ ~. OAT* o.z~,~ ?T.~ S , ,,