HomeMy WebLinkAbout13458-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N,Y.
Certificate Of Occupancy
No...g.l.q86~ ........ Date September 10, .,19.86.
THIS CERTIFIES that the building Add ition
Location of Property . .5.0.0...T.e.e.D .e.e' .T.r..a.i.1. ................... Southold, N.Y.
House No. Street Hem/et
County Tax Map No. 1000 Section 087 .Block 02 .Lot 023
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
S.c.p.t.e.m.b. ?. ,2,0~ ~ ...... ,19 84 pursuant to which Building Permit No. 1345.8Z
September 27, 84
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 existing one family dwelling.
Secretes & Daphine Spirakis
The certificate is issued to ...........................................................
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval N / A
N7144.38
UNDERWRITERS CERTIFICATE NO .................................................
Flumbers Certification dated September 3, 1986
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 13458 Z
Permission is hereby granted to:
......... ...?~.~.~.......~.~..~ ..................
.......
....
,o ......... C~.~.~c:/. ......... ~.~~.. ....... ~...~~....~...~~.
at premises located at ....,~..(~. ...... ../..,..~.~:~/~..~-.-.~/'~.[.~ ..................... / · ..........
........................................................................................................................[ ~./..~.~.~...
Co.n~ Tax Map No. ,000 ~ectian ...~..~ ...... S'~k ....~..~... ....... Ut No..a.z~.. .........
pursuant to application doted ..~,~~..~....., !~...~.., and approved by the
Building Inspector.
Fee $...~.~..~......
Bu ding nspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BLDG. DEPT.
TOWN OF SOUTHOLD
Instructions
This application must be filled in typewriter OR ink, and submitted a Ilmmm~aa 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, pmpertv lines, streets, and unusual
natural or topographic featu res.
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 comp eted s tep an requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1, Accurate survey of p~operty 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 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.
ees:
(l~ Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $ [ 5.0 0
3. Copy of certificate of occupancy $1.00
5.Updated C~- $15.00 Date ...............
New 8ui{ding .. ~ ......... Old or Pre-existing Building ............ Vacant Land .............
Hou~ No. Stree~ Ham;er
Subdivision ................................. Filed Map N6 ........... Lot No ..............
Hea~th Dept. Approval .I ....................... Labor Dept. Approval ........................
Request for Temporary Cert[ficate ..................... Final Certificate ..../~... .............
Fee Submitted ~ ...... ~ ....................
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-78
THE
October
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
8~ JOHN STRE~ET~ NEW YORK, NEW YORK ~0038
28,1985 ~fi~,,,ion N,,. ,,,,f~ 320043 / 85 ~ ~
rlcql ~liitpmet~t as descr,bed below a.d ,ntr~d~ce¢l by
~ocrates Spirakis, 500 Teepee Trail n/o Wigwam Way,
)ctober 21,1985
FIXTURES
Southold, N.Y.
Lot
[i] e,,a r~. garage ,%,,,io,, i~o~,~,
UNIT HEATERS MUlTI-OUTLET
SYSYEMS
NO, OF FEET
APPLIANCE FEEDERS
S g R V I C E
a W O NO OF NEUTI~ALS A, W G,
OF NEUTRAL
/ 1 A .........
, ,.: ,' ,' . 110.#138 . ~ ~
::~ I ,; ', ,,Eastbrl~ge m±ec. GENERA[ MANAGEE ,~ 7 ~
I' ~' ' ; I' i ''' ~ . 29ii.LakeAve. ,/,~' ~-,~
i'~{' ~' '[~; ' I' ~ ' ' ' ' .... tO t~e offc~ of the Board ff incorrect, inspectors moy be ide?,fied ? d~ei[ credTC~p.~q~
thl '{~fi;~te eust not,be altereo in any ~anner, re~u., . ~ ~~~r
310 MERRICK AVENUE, MERRICK, NEW YORK 11566
(516) 623-4811
Town of Southold
Office of Bufldiug Inspector
Southold, N.Y. 11971
September 3, 1986
Re: Socrates Spirakis
~00 Teepee Trail
Southold, N.~.
This is to certif~ thatSolder Used ~or plumbing work at above
address under permit #13[~58Z dated Sept~mer 9, 1984 was
90% Tin and 10% Lead.
-Ve. ry truly
SWORN TO BEFORE M~ THIS
EDWIN C, AUMULLER
~TAI~¥ PUBLIC, State o! New
No.
Qualified in N~ssau County
'r~ommi~sion ~xplr~ ~eb~,v¥ 28, 19~'~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date ............... ,19 .....
PLEASE TAKE NOTICE that your application dated ...~...~ ............. , 19 .~.~..~.
Location of Property .~'~-~. o ...,~.,~ ..~..~ .... .~.~ ~ .........
h~us'e ~o~ ' ' ' ' Street Hamlet
County Tax Map No. 1000 Section · · · .(~, 9..-Z. .... Block · · .,~...~. ...... Lot · · .~, .~'.. -~. .....
....... Filed Map No ................. Lot No .......... ; ~ ......
Subdivision .......... ,
is returned herewith and disapproved on the following grounds..~ .~....-L~./..~~...
........ i .... £ \ J ' ' '
~ ' Building Inspector
RV 1180
COMMENTS
FIELD INSPECTION ......... ~_~___--___~---.__-----I
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
FLUMBING
INSULATION FERN. Y.
STATE ENERGY
C,ODE
ADDITIONAL COMMENTS:
!
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
. ~o./~../.~o..,,~,. ~ .~ .~....~.....
PLEASE TAKE NOTICE that your application dated . .~ .~:.~..'~[....~ .(? .......... , 19~.
County Tax Map No. 1000 Section . .0~ ~ .... Block ... 0.~. ..... Lot ..0. ~F g~. ....
Subdivision ................. Filed Map No ...... ~T-. ........ Lot No. ' -'
is returnea herewith and disapproved on the following grounds. ~ Q~..~ ~
. ~...[~...~...~.v-.~ ......... zo ..... do .... Q ............
.3d~/~... z ~.. ~/~...~...~~ .......
.~ ~.~5 o/~ .'..a ............ =. ....................... ~.
..................... .. ~. ~ · ~ ..................
RV 1/80
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION'XST [ ] ROUGH FLBG.
[~/~OUNDATION ZND [ ] INSULATION
FRAMING
RKMARKS:
[ ] FINAL
DATE,.
USE
OF
OR
C~T~RCATE-
2. ROUGH ~ FRAMING & PLUMBIng!
3. INSULATION ·
4. FINAL - CONSTRUCTION
BE COMPLETE FOR C,.O, '
ALL CONSTRUCTION SHALL -MRE'T~,}
THL: REQUIREMENTS OF THE N,
STATE CONSTRUCTION &
CODES. NOT RESPONSIBLE"
DE,SIGN OR CONSTRUQTION ERRORS,
Examined~ .~.'~ .d.~...
Approved .~.~.- .~O..
Disapproved ...........................
\
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL,: 765-1802
uilding Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ,19..
Date ............. 19..~
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with:
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 street
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl/
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. U~on approval of this application, the Building Inspector will issued a Buildlng Permit to the applicant. Such permi
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 pbrpose whatever until a Certificate of Occupanc~
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 th~
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances
Regulations, for the construction of buildings, additions or alterations, or for remq~al or demolit~m, as herein described
The applicant agrees to comply with all applicable laws, ordinances, building code,\~ous,~ng co0~, aqJ:l regulatig~s, and tc
admit authorized inspectors on premises and in building for necessary inspections, ld~t,,~ [/
[5 t 6] 5.~o°- 7048 (Mailing address of applicant) ' '
State whether applicant is 'owner, lessee,~architect, engineer, general contractor, electrician, plumber or builder.
...... i'i .........................
Name of owner of premises.. {1'~.. XC. ...... ~.~1¢ ~-'--~ ~. i ~-(
(as on the thx roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
( amc and title of corporate officer) .. ~.
Builder'i License No.~.°.~./. -.~.*.~...~., ¢~...~ ~ ~
Plumber s L:cense No
,' ....................
Electrician s, License No ...................
Other Trade s License No ......................
1. Location of land on which proposed work will be done .................
.....................
· .. ........... ....
House Number Stree; ..................... Hamlet
County Tax Map No. 1000 Section ' . ........ Block ............. Lot '~
Subdivision .......
(Name) .... Filed Map No. · -' ............ Lot .....
2. 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 . .~:~.1-~..~..~../~.5 .... ~M..~...~'.,~:,~:~.. ~..~: d /o//'J, eM/~l,,~,,t,t <,/'
( ' h ~ppl' ')
3. Nature of work checkwh~c ~cable: New Building . ......... Addition .......... Alteration ........
Repair Renloval Demolition
................ Other Work
~ i (Description)
4 Estimated Cost .~. '~.O ,co .
' ' ' ' ~ ~ N (to bo paid on filing this application)
5. If dwelhng, number of dwelhn: units ......... umber of dwelling units on each floor. ~. ~
arage, number of cars ...~ ......... ~ ................
6. If business, commercial or mia ~d occupancy, specify nature and extent of each type of uso ... ~ ......
7. Dim. ensionsof~istingstmctu~es, ifany: Front.. ~. ~Rear ~ n~.,~ ~'
Height ... ~ .~ ..... Number of Stones ...~. "'
. Dimensions o' f sam~mcture Oith alterations or additions. ~ ~ ' ' j~]~,~ ........ .'~20~ .... ))~' .......
8. ~:menszons ~re new ~onstmchon: Front .... ~.~,~ Rear .... ~g, oo B,~*h ~
Height ~ ',~ ........ -'~ ~ ............ r ................
19'0' S,ze6flot Front.. [.qO,e¢ " ~'3a;"- ' ' ' ' '- ' .....
Date of Purchase O~L~ .:.(.~2 ....... ~ame of Fo~ ~' ~"5 ~' ' ............
............ eruwner ..~ ......................
11 Zone Or use district in which premises are situated
Does proposed construchon wolate any zomng law ordinance or regulation.' . .
13. Wflllot be regraded . ~ ....... ,,,, ...... .
. , · · · · , -~. · .......... nm excess HII ~o removes/rom premlses: Yes
Nme of Ardhitect Address . ~ Phone No
Nme of Contractor ........ : .................. Address .......... Phone N0
... PLOT DIAG~
Locate clearly ~d distinctly ~ bufld~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions iron
.pr°perry. lines.. Give street and block; number or description according to deed, ~d show street names and indicate whethe.
interior or corner lot.
...................(Name (f {;~ividual' .... i~;~ ~7~act)" ....... being duly sworn, deposes and says that he is the applicant
above named. ~
He is the ................. . ......................................... . ............... , ...........
ontractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly authoHzed to perform or have ~erfo~ed the said work and to m~e and file this
application; that all statements contilned ~ thi~ application are true to the best of his ~owledge and belief; and that the
work wffl be perfom~d ~e m~ne? set forth in the application filed therewith.
Sworn to befor~m~i~
Nota~ Public ................. '~/~/f .~/~Yf .~ ~ ~. [
~Q ~RY PUBLIC, Stato of New York / [ M.
Con misdon ~xplres March 30, 19~] ~ I~ -- (Signature of applicant)
U .