The URL can be used to link to this page

Home My WebLink About13569-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date .... June 1, 1987 THIS CERTIFIES th deck accessory. at the building ............................................... Location of Property ..... 5,~ 0 ............ .T,h.e...S.t.r.a.n..d ...............E.a..s.t..M..a.r.i.o.n..., House No. Street Hamlet County Tax Map No. 1000 Section ...... 2. ~. .... Block ....... 5. ....... Lot .... .2 ............ Pebble Beach Farms 6266 132 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 22, 1984 13569Z ....................... pursuant to which Building Pemlit No ...................... November 21, 1984 dated ............................. 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 ......... Deck ac'cessory structure. COSTAS BOUKLAS The certificate is issued to ..................... A~n'e;,~~') ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ....................... PENDING N/A PLUMBgRS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK AUTHORIZED) 13569 Z .....~.~.~.e....~.../.~...r~a...z~. .................... .~..~.~ .................. ~=..~..z~..~ .... County Tox Mop No. lO00 Section ....0.~5. ......... Block ..(~....~.... ....... Lot No...~......~...;. ........ pursuant to a,pltcation dated .O.~.~ ...... -~....~-.. ............... , 1~..., and opprov~:~ by the Building Inspector. Fee $.Z .~.. ............... Rev. 6/30/80 TOWN OF $OUTHOLD Building Department Town Hall ~uthold, N.Y. 11971 Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 property showing all property lines, streets, buildings and unusual natural or topographic features. 2, Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10./~0 / 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..... New C on s t r u c t i on ...... Old or Pre-existing Building ............ Vacant Land ........... ~. L. ocation of Property..~.$.~. ............. ' ....~..~ .................. ... Owner or Owners of Property .................................................. . County Tax Ma No 1000 Sect on ~.Z..! Bock ~)..~.. t p. ..................... Lo .. ........... Subdivision....~f~.. ~.~-,~ .......... · .... Filed Map No. (~..~.~ ..... Lot No...~.:~. Permit No. '.J'.~.(.~.f.~.. Date of Permit .J"l~.'.I~. ~..Applicant...~.~'..~....~.~./.l~,~ .............. Health Dept. Approval ....................... Labor Dept Approval ............ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate / Fee Submitted $.o. /0' .~.~.....~....~.! .~. ...... Construction on above described building and permit meets all applicable codes and/regulations. .......... .............. Rev, 10-10-7S FIELD I~SPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no, 13569Z issued to Costas Bouklas on ~__2j~84 for Accessory is completed and a final inspection has ( ) has not ( X ) been done.- In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.OOpayable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Victor Lessard Executive Administrator VL:gar 765-1802 BUILDING DEPT. INSPECTION · [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~F~NAL REMARKS: INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined /~Ca/7...~../...., 19~.C~ ..... (Buil/ding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF SOUTHOLD Received ........... ,19... Date . .~Q/..~..~. ............ 194.~. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to ~chedule. 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 nos be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing co. de, and regulations, and to admit authorized inspectors on premises and in building for necessary-inspgj~tions, iQ '" ' ' .....;o'; ..... (Signature o f ~jplicant, o~,~q~n e~, if a p t' ) ....... ?g.$'.. ................. (Mailing address of applicant) State whether at~plicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. ....... Name of owner of premises.· dQ~'.~.~ .... Sf~.[ k! .~. ................................................... (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 ....... ................. Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000Section .................. BlOCkM~;.~..~.&~.~... Lot... /[ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~.....,~,,-.-t,,~ ........ r,.' ........ ,r~ ........................... b. Intended use and occupanc ............ ' ........................................... 9. 10. 11. 12. 13. 1'~4. Repai~ ......... W'a t°~al "t: .......... Demolition ....... Other Work./,.~}.g~ ....... ~ (Description) ....... i-< .. ................... Fee /.(~ .~ :. lzst~mated Cost .- ...... i ........................... i r~ ,. ', ~ ~ :' ~ ' .: .;~ )'r ~ ~-- (to be paid on filing this application) ] f dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structurSs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimansions of same structure with alterations or additions: Front ................. Rear .................. Depth . Hei t .......... Number of Stories ..................... · '. ' ...... , .......... r". ~ ......... Dimensions of entire new construction'. Front. ~ ,, , ..... .~. . ~?: ./.: ..... D .he, pt ........ . Height . .~/.~, ........ ~...Numberof Stories.. . i .... Rear i ..... .Z .~ .. ' Size of lot: Front .... 7(~,..°~. i ........... Rear .... .~ ........ .'.. ~)e~it~ .... ~i~. ..... Date of Purchase ............................. Name of Former Owner ............................ Zone or use district in which pr~mises are situated ................... Does proposed constructmn wolate any zoning law, ordinance or regulation: ..:..~h-'.. ...................... Will lo:t be regraded ....... ,~ i .................. Will excess fill be removed from premises: Yes Name of Owner of premises .Q' ~O~5.. L~ru,~.~:~ ..... Address . .'TJ(~'. ~-/~v./~ ...... Phone No .............. '7. Name of Architect ... ~ ................ Address ..... Name of Contractor...' .~/Ir~ id~t~t£~. ........ Addre~ ~.~..~.~0.~l~.'..""" PhonePh°ne No..N° ................ .~.~. ~'.'TZ~/.... : ',:PLOT DIAGI~h.M Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property tines. G~ve street and blocklnumber or descnptmn according to deed, and show street names and indicate whether interior or corner lot. STATEDF }(EW YORK~ ,~ ,~ C · .~ .~....~, '. '. being duly sworn, deposes and says that he is the applicant (Name of individJ~] sighing contract) above named. (,.J : He is the ....................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have peffomed the said work and to m~e ~d file this application; that all statements conthined ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~n~r set forth in the application filed therewith. Sworn to before me this Notary Public, .:~:~ .............. County( }t~ ~ ~