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Home My WebLink About11048-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z~3867 Date April 5 19 83 Addition THIS CERTIFIES that the building ................................................ Location of Property ...~ .7.~.0.../Ruth. 2~oad ................... .Mat~s.i.~;mck. ........... House No. Street Hamlet County Tax Map No. 1000 Section ~ 06 .Block 0~ .Lot 08 Subdivision Capt. Kidd Estates .Filed Map No. ?.0.6 .... Lot No. q?0 conforms substantially to the Application for Building Permit heretofore filed in this office dated February 2z~ 19 8q pursuant to which Building Permit No. q q OZ~SZ dated F~aroh q q 19 83 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 ......... Enclose existing deck The certificate is issued to George Halkias ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ...N./..A .................................... UNDERWRITERS CERTIFICATE NO .......... ............................... Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEP,~RTMEI~IT TOWN HALL SOUTHOLD, N~ Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREM SES UNTIL FOLL COMPLETION OF THE WORK AUTHORIZED) Permission;is hereby gronted to: ....... /~...~...~.~...Z.....;.L~.z.z~z,' ~...Z~' ~...~z.~:.:z~..~.~_.....-.,.~.!..~..," ............ ~o ......... ~ ........ ~, .................... .~ ....... .-*~ ...... -.. ...... ....... ?~ .......... ........ ~zZ,.~.~.q...,.....~,..~- ....... ~.~,~...~~ ........................... at premises located a~ ....................... Z~.~.~. .... ~,'7'""~ *" ~ ..... ~" ......... z'"": ......................................... Z-'": .......... . ..... ~/~.~;~...~~ ........ ~.~Z.Z~.-....: ........................... :: ........... Coun~ Tax ~ap No. ]000 Section ...~.~. .......... Block .... ~..~ ........... Lot No...~ ......... pursuant to ,pplic~tion d,tod ........ ~...~ ...... , 19 ~ ond opprovod by the ~uildlno Inspector. i / Buildir I Inspector Revt 6/3~/80 FORM NO. 6 ,t TOWN OF SOUTHOLD '! ~, ,, Building Department -1 Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 featu res, 2. Sworn statement of owner or previous owner 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. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of c~rtificate of occupancy $1.00 $5.00 New Building .J'..-~.~.?.~?~,~'.~.~, .~OId or Pre-existing Building ............ Vacant Land ............. Location of Property / 7.~.O'. .... ~?. ~/Z'...,~.P.~ ~O. ............... ~.~. 2~'. ,?~'..~-~",. ,4~::,,-...,x~.:. ~.- .... House No. Street Hamlet Owner or Owners of Property . ,~.~¢?..~, .~:. ,~. ....... V~.z'~.~,Z.('~.'~ ......................... County Tax Map No. 1000 Section . V~.. ~.,~ ....... Block .,. ~ .~/ ........ Lot .... 4~..~', ....... Subdivision .~,~..~.~...~'..~.~:~.z?.,..~.~..~.,~../,~"~..---~'. .... F lied Map No../..~/..~'....Lot No../~, .'~. ~/ ..... Permit No//.~./~..~.,. Date of Permit ~..~.//,/,~-~,//. ,Applicant,..~..~. ~-~. ;... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..... ................. Request for Temporary Certificate ..................... Final Certificate .... ~ ............... ...-,,,v,'"h /,I ,l.~ ~-. Fee Submitted $ ..... L/~.~.-~,. ,V..~, .~ ~..~... ...... Construction on above described building and permit meets all applicable codes and regulations. .. Z _ "~,'--'I/"L~, ~q ~ ~ Applicant... ~/~r~. ~.~~.~.%~ ................. Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~L00~J6(~l BUREAU OF ELECTRICITY : [~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT in the following location; ~ Basement ~ 1st Ft. ~ 2nd FI. Sect~ Bilk Lot was examined on and found to be in compliance with ~he r~quiremenZs of this Board. ~e~,e~r~r 05, 1985 FIXTURE OUTtETS ~L DRYERS FIXTURES RANGES COO~(ING DECKS OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNI1 HEATERS MULTI-DUll. ET DIMMERS SYSTEMS NO, OF FEET SERVICE OTHER APPARATUS: S E R V I C NO. O~pEEC~,COND A, WG OF CC, COND NO, OF HI-LEG A W.O. NO. OF NEUTRALS OF H~-£EG A, WG Of NEUTRAt This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by GENERAl. MANAGER Per ' ' "~ ,' THE NEW YORK BOARD OF FIRE UNDERWRITERS 100066.3 BUREAU OF ELECTRICITY THIS CERTIFIES THAT only the e~ctrical equipment as described belo~ and introduced by t~ applicant ~amed on the above application number in the premises of ,nthefollowinglocatlon; ~ Basement ~IstFL ~ 2nd FI. Section Block Lot was examined on 8C~)t;~'~'~' ? r ,i.¢8D and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS t DRYERS RECEPTACLE SWITCHES FIXTURES RANGES coOKING DECKS OVENS FLUORESCENT SYSTEMS NO. OF FEET E R NO O~EC~C~,C ON[~ OF CC, COND, C 1227 GENEI~AL MANAGER il Per~ This certificate must not be altered in any manner; return' to the office of the Board if i~correct. Inspectors may be identified by their credentials. COPY FOB BU LDING DEPARTMENT THIS cOPY~OF C~R~IFI~CA~,E [~S~T NOT BJE ALTERE~D IN ANY MANNER. TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR ' P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! I9?l TEL. 76S-1802 This is to advise you that the job unde Bui d' a f~! ~!~ or ~...~e..,~,,-~.~.~a~~cf~. is Commie%ed and ina± inspection ,as/--TIhas~been do~e. In order to complete this file, it is necessary that a Certificate of ~ - O~u~ancy be issued. Please fill out the enclosed form(s), rsturn same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspecgion date. Thank you for your prompt attention. Very truly yours, Victor Lessard AdministrAtor VL:ec Enclosures FI INSPECTION COMMENTS FOUNDATION FOUNDAT ION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined /C/~/d..., 19 .~./ Approved ~./d,f~fL~. ~/f..., 19.~t/. Permit No. f/~..6~. ~..~.~. Disapproved a/c ......... -...~VTWT....'..~-~. .... i ............ ' / (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No../../.r~..~..~. ....... Date..~../?..4(. / ......... 19M INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildh~gs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .of. . . . . . ?. . ...... /~O' 7't"/-/3'/~ ~ ,qP. (M ailing add tess o f applicant) //p6- 2_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .c°. 77,q .77..,g ........................................................................ Name of owner of premises .~.~'.~.~.'~..~.~--'... ,f'~.~.4 ~.~./.,q~.,q ................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... ~c,../.?./ ..... .t~??. ~.o.q~... Plumber s.License No ......................... Electrician's License No..~.,,~.,g..7~.,q.. ~+~.%.~'.,... Other Trade's License N~ ................... 2~ 5"~' ' 1. Location of land on whic, proposed work will be done..~2~ ..................................... House Number Street Hamlet County Tax Map No. 100~n .~. ....... A~... )TBlock .................. Lot ........... Subdivision ~-~ ,/O ,~ Filed Map No Lot / lQ (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: b. Intended use and occupancy ... v-5'..~'..'~../~. ~t~'.~-. ..... .,~.~ff.~/..~. ~-'¢"7.-:ff..~..~. ............................... 3. Nature of work (check which a~plicable):"bYew Building .......... Addition ..... CC.... Alteraff~n Repair .............. Rem6val .............. Demolition .............. Other Work ............... , (Description 4. Estimated Cost ..................... Fee ................ : (th be paid on filing this application) 5. If dwelling, number of dwelling iunits ... ~...~.~/~ ..... Number of dwelling units on each floor. ~.~..~-~-, ....... If garage number of cars 6. If business, commercial or mixed occupancy, specify nat,,ure and extent of each/type of u~e ........... "' )/ 7. Dimensions of existing structures, if any: Front...4/.,~. ......... Rear . .~.d'. .......... Depth . .21fi..~.o~..{..,.?(. ~'. Height ....~, .......... Number of Stories ........ ~. ~...~ .......... . .......................... = .,... Dunensmns of sCmeltrgcture wlth alteratmns or add~tmns: Front .... /7'~Y'. ..........Rear .. ~..,z~.,~ .... Depth .... -~[....~./.'. ..... 2.. Height ..... ~r..t... ? .......... Number of ~tories ...... .~..,~..~'. .......... .... '7' /,~ '/ 8. I)maenslons of entire new construction: Front... / .......... Rear .... A ~. ....... Depth ...5~ .......... Height . ~. .......Number of Stories ...... ~ ! .,~.~ : ' . .......,; 9. Size of lot: Front ...,(..~.~... i ........... Rear .... Z .~ .~. ........... Depth .... 7~ .............. 10. Date of Purchase ........... : .................. Name of Former Owner ............................. 1 1.Zone or use district in which premises are situated. ~.~,f.,g..7~. . t/~9~...~/~'~/<~. ~7. ~.. .......................... 12. r)oes proposed construction rio}}? any zoning law, ordinance or regulation: ............................. 13. Will lot be regraded ....... /Y~ .................. Will excess fill be removed from l~remises: Yes No 14. Name of Owner ofpremises ~..~r4,g¢~.. ~..~.'u.,~.(~..6. Address .Z2.4'~...~.~.F(-q...,~..O.~.~.I~h~o~o/.<. ......... -- . Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ..~,. ,~{.t/f..~.,~. ..... .-?/~. ......Address ~'. ~.~..k'? ......... Phone No. '.~.P.~.: .~.~.~..~:... PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or Corner lot. i\ STATE OFN~R~. -- ~( ., ' .... ,. · · .~. ~ .... ~. ~ ...... being duly sworn, deposes and says that he is the applicant (Name of individual sign!ng contr above named. He is the ....................... ~. i....~. ................................................... ' ( ~,~ (Contractor//agent, corporate officer, etc.) ' of said owner or owners, and is dulv~auth~rform or have performed the said work and to make and file this application; that all statements contain~ed~in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ e~.~.~ ........ day ofC'~ ,--..-..,'/~ r~.~.C~ ..... 19'/. Notary~bljc, ...... ... ,,~ ......k~/'.~.,.. County ~ £LIZABEFHr ANN/~IEVILLE · NOTARY PIJBLIC, Sta~ of New Yolk ~ (Signature Of apphcant) No. 52-81258~0, Suffolk Cou~tt~... Term Expi~'es iMarch SO, · · · 'THE sTAT~, cOD~S. D~s'~GN OR N.Y~ FO~ · · · · · · · · · ·