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Home My WebLink About11123-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ 2350 Bayview Avenue Oreenport, New York Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ...0..5.~ ...... Block .... 0.3. ......... Lot.. p.B.? ........... Subdiws~on ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 22 19 .8.1. pursuant to which Building Permit No. 11223 g April 30 81 dated ............................ 19 .... 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 ......... Addition to Private One Family Dwelling Anthony Pappas end The certificate is issued to ..................... [ohSn'~)~'~}TkX ................... of the aforesaid building. Suffolk County Department of ttealth Approval 1J / R UNDERWRITERS CERTIFICATE NO. N530432 ~uildmg inspector Rev. 1/81 TOWN O~ S~oU*rH~o~p TOWN HALL SOUTHOLD, N, Y. BUtLm~G (THIS PERMIT MUST BE KEPT ON THE Pt~EMI~ COMPLETION OF THE WORK AUTHORIZED) !S UNTIL FULL N°. 11123 D~te .... ~.~.....~ Permission is hereby groqted to: ~z~. ~~ .... ~ .... ..... ........ .. . . ............... ....................................... ; ....................................................... .~...,. ................ ~ ......................................... s~.o~ ~¢~.. ~.... ~o~ ;... ~..~ ........ [o~ .o..~.~...~ ....... Coun~ T~x ~op ~o. 1000 · . · .~.~: ~ dot,d ~2~.~ ' 19 ., ~nd opproved by the pursuant to ~pplic~tion~ Buildin~ Inspoctor. Buildin Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions This apphcaUon must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~th the following; for new buildings or new use: 1. Final surYey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply end sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buddings, 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 Planmng Board approval of completed site plan requirements where applicable. 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 hnes, streets, buildings and unusual natural or topographrc features. 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 mforma- t~on required to prepare a certificate. Fees: 1. Certificate of occupancy $5 00 2. Certificate of occupancy on pre-existing dwelhng or land use 3. Copy of cerUflcate of occupancy $1.00 $5.00 .te New Build,ng ............. Old or Pre-existing Building ~.[:4' ./'..~.~.X./Vacant Land ............. Location of Property2¢).'~.¢./~.~ V?.O'.¢.~ .... ,~. ·/~.Q .... 'S;r'e;t ......... ~'"¢¢/~z/¢~' ............. House No. / Ham/et Owner or Owners of ProperW .... ~¢..: . . . '.~:¢._~/~¢.¢.~J~. ....................................... County Tax Map No. 1000 Section ...~.~..~%~. ...... Block .... .~..-~ ........ Lot .... .E~:~¢/. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /'./ /.¢,2_,7. ~ZDate of Permit .<.~../~/.Applicant.....~/.,./z,/,, ~.~ ......... Health Dept. Approval ..... /~../d,~.,~_. ............Labor Dept. Approval .... ,~/~?.,..'~ ..... ~) .... Underwriters Approval....d'.'.~..(2.,~'. ?..~_ ........ Planning Board Approval .... ./~.~./,~. ¢~... Request for Temporary Certificate ..................... Final Certificate ?../., ..... F88 Submitted ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ...... t¢~ .... .~./~. ,/ .......................... Rev. 10-10-78 ,ouo?O THE NEW YORK BOARD OF FIRE UNDERWRITERS ~':~ BUREAU OF ELECTRICITY ~ i~%u~ 5, 1981 es'JOHN STREET, NEW YORK, NEW YbRK I,~o3e ~ . 132621 - 81 in the following locatlon; ~ Basement ~ 1st FL ~ 2nd FI. Section Block Lot was examined on /~.~]~18]~ ~ ~ 1~. and found to be in contphance wtth the requirements of this Board. FIXTURE OUTLETS 6 IECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS NCANDESCENT FLUORESCENT 6 DRYERS FURNACE ! FEEDERS TIME,LOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT OTHER APPARATUS S E R ~V I C NO OF CC COND A W O NO OF HI LEG A W O pER ,~' OF CC COND OF Hi-LEG NO OFNEUTRAI AWG OF NEUTRAL This cerhflcate must not be altered in any Fnanner, return to the office of the Board if ' FOR BUILDING THIS COPY OF GENEI~AL MANAGER Inspectors may be identified by the,r credentials. IN ANY MANNER. FiELD~INS~C±±UN FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS BAYV~,~W . -AVENU FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~xamined ., 19 kpproved (~. ..... 19 Permit No.. . )isapproved _~-~--~.~ / / (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.../. ({.'. ~. ~.~ ....... 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 )r areas, and gMng a detailed description of layout of property must be drawn on the diagram which is part of this appli- 'ation c. The work coveled 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 ,hall 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 ,hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance cfa BuildingPermit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in buildings for necessary inspections. (S~gnature of applicant, or na4'fie, if a corporation) ....... (Mailing address of applicant) 4tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '~mne of owner of premises ... ~ ~'~ ZgJYa~.~/ ...... ?.~,~q.J.'.. ?.. .~/.~.' (as on the tax roll or latest deed tf apphcant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..*../..92.g. .................. Plumber's License No ..... Electrician's License No..~... ~. ~ ........ Other Trade's License No... ~ .............. 1. Location of land on which proposed work will be done. no. Tkh G, ................... /'"kt',kd' Hamlet County Tax Map No. 1000 Section .... ~ff~ ........ Block .... ~.~. ..........Lot ..... ~fi.~ ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~...,/~',~,:.~... ~.~.~. ........................................... b. Intended use and occupancy ........ ./~.~,'/~,.... (4g., 7/.O.. E'.C~t.C..x~r.k'..~, . ../.~.. ~./~. .................. .~.. 7..' 9'" 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration/Z~. ....... Repair .............. Rem6val .............. Demolition .............. Other Work ............... [. EstimatedCost...~/ ................................................... * ........... (to be paid on filing this application) L If dwelling, number of dwelling units ....... .'f.~ .....Number of dwelling units on each floor. ,,~'.../~../.~Y.,C. ..... If garage number of cars : 5. If business, commercial or mixed occupancy, specify nature and extent of each type of usc .............. ~r,, .... Height .... .~'. .........Number of Stories ..... ./ .................................................. Dhnensions of sam~_~tructure wtth alterations or additions: Front ....o~..¢....'~.' ..... Rear .... 4'?.-¢'../?~. ....... Depth ..... .~.d...,~. ......... 2.. Height ..... ./~...~.. :,., ........ Number of Sto, o,o~es ..... /..-q-/-~c/. .... ,~.... I. Dimensions of entire new construction: Front .... ~.,?./.~. .... Rear ..... .~-.~..'--: .... Depth .../...,~'..~. :.. '... Height ..... /.f..~/. ....Number of Stories ..... ./.~r,,~.,-~. ............................ ). Date of Purchase .... ,,St.~.~.../?.7./. .............. Name of Former Owner . <'/4.a~.. d-~,.o~ ................ I. Zone or use district in whicn premises are situated ..................................................... !. Does proposed construction violate any zoning law ordinance or regulation: ..... . .~-..o: ............ ~ ....... t. Will lot be regraded .... z~.~....[ ................... Will excess fill be removed from premises: C~'~s,) No PLOT DIAGRAM Locate clearly and distinctly all~ buildings, whether existing or proposed, and. indicate all set-back dimensions from -operty lines. Give street and block!number or description according to deed, and show street uames and indicate whether terior or corner lot. o ! $~o,~, ~ rATE OF , (Name of in acre named. ........ being duly sworn, deposes and says that he is the applicant .e is the ..................... ~! ............................................ .... ~r} agent', co;porate officer, et~.) f said owner or owners, and is'duly au~[h-6rized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. wont to before me this I fot_.~Y~Publtc, ........,..,-~-s ..... ~.. County ~ ,, ,~ ,,.-,~-~-~ __ ~OTARY PUBLIC, State of New York ,: ~ ;~Io, 52-8125850, Suffolk Cou~.,,.?-.--~ . ~IOTIFY BUILD~N£, ~ 765-1802 9 AM TO 4 ~. FoUNPATION "~O I FOR pCURFO coNCR~ ~. RoUGI~ - FRAMING~ ~' BE CO~?I ETE FOR THE REQUIREMENTS /2