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Home My WebLink About13492-z ~o~r NO. ~ 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? 13~92 Z Permission is hereby granted to: ...~...~ ~.~.......u...:., ...... I J ~ ~ .... ., ............. ] ................... 1 ............... I"g' .......... at located o,..~. ~.~ ...~...~.. ~.. ~.~- '~~-~ premises ....................... ~......o.m .......................................... County Tax Map No. 1000 Section .0.....~:'......~.. .........Block ......... ..~ ......... Lot No ......~ .............. pursuant to application da,ed ....~..~......~. ...................... , 19.~...~..., and approved by the Building Inspector. Fee $ ....................... Building Inspector Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... g 1.49.4. Q ..... Date ..... 9.c.v.o..b??..2. ~ ............... ,19 ~.6. THIS CERTIFIES that the building ....O.n.e...f.~.m.~ .1.y..d.w..? .i.l.~.n.g...w±th deck L~flnn~fP ..... *- 2175 Stars Road " East Marion~ N.Y, House No. StreBt Hamlet County Tax Map No. 1000 Section 22 .Block 4 .Lot 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Oc.tober.4 ~ ... 13492 Z ................... ,19 84 pnrsuant to which Building Permit No ...................... dated . .0..c ?.o.b.e..p..2.4.: ............. 19 .8.4. ,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 ......... dwelling with deck ...o.n.e., .c.a.m.~.~..y ................................................................. The certificate is issued to glefterios Pi. ttas. .................... ?o¥,,a;, ~d~¥~w .................... of the aforesaid building. Suffolk County Department of Health Approval 14. -S O- ~ 94 UNDERWRITERS CERTIFICATE NO. lq ? 0267 ~ Plumbers Certification dated September ~7, 1986 tg Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted tor with the following; for new buildings or new use: 1.Final survey of property with accurate location of all buildings, property lit 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 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 p~operty 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 $1 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.UpdaLed C.O. $15.00 Date ........ ' ................. New Building ... Z ....... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property ......................................... County Tax Map No, 1000 Section ... ~..~. ...... Block .... .~. ......... Lot....c7.. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.J~..~.~ ~, ~ Date of Permit J ,°/~.~./.~.t'JL..Applicant . .C~...t~...'~..~..T.I.~).O..~....'-~?...~-..~..O. ,~... Health Dept. Approval .?Jl.~,,,,~,.... !~,.'-.~.?,~. [~, ,~.Labor Dept. Approval ........................ olrt Underwriters Approval . ~/,~. ~. .............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~.. ............... Fee Submitted $..~..: .O..(~. .................... Constructk~n on above described building and permit meets all applicable codes and regulations. Applicant .C_J;~ ~N) .~.Tt~"~.~..~. ~...'~.. E~..~N.i~ ............ Rev. 10-10-7a TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~..,E~-~ ~[ ~ 0 S (please print) Plumber C_OI%5ThNTI (please print) - um.q:k a% 2t? I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~(~_ ~ XJX~4~Z~ _ (plum~r' s signature) sworn to before me this / ? day of ~ 19 ~q~ · Public, ~ County Notary Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS ~L0010'~L BUREAU OF ELECTRICITY ~ 8~ JOHN STREET, NEW YORK, NEW YORK 1OO3~ THiS CERTIFIES THAT only the electrical equipment as described belo~ ~ introduced by the applicant named on the above application number i~ the premlses of ~. Pi~s~ S~s ~d, W/S, ~st ~ion, N.Y. in the foll~[ng location; ~ B.sement ~ 1st Ft. ~ ~nd FI, Section BIoe~ Lot was examined on ~ly 25 ~ 1985 and Jound to be in compliance with the r~quirements of this Board. 29 28 31 29 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS ~UNIT HEATERS MULTI-OUTLET, DIll. HERS SYSTEMS SERVICE DISCONNECT OTHER APPARATUS: Track Lighting 14' 11 Lites. S E R V I C E 1 4 1 4 G & S Electric Box 215 Southond, N.Y. 11971 Lit. 578 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors >may be their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY.OF C£RTIF TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 1197'I TEL. 765-1802 To Whom This May CQncern, We are unable~to complete your Certificate of Occupancy because ,of the following reasons. /_~ An application for Certificate of Occupancy is not on file. /_~/No Underwriters Certificate on file. /_~The check is(o~ed/not on file.) /~/' NO Health Dept2 Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # I _~ ~ ~ ~ Z Building Dept. ***/_~No Plumber So~der Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) ,1~ ~ ~LD~.NSPECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~,ODE 7GS4802 BUILDING DEPT, INSPECTION, [] FOUNDATION xST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE ii ~) iNSPECToR ~/,~ :~ 76S-1802 BUILDING DEPT. INSPECTION [ UNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR L 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL ~State 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved O.~..~...~ .... 19~.~. Permit No. ! .~...~.~l..~r', .'~:'.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted 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, ~elationship 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 issued a Buildin~ 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...C.O.~.Sm~.tC.Z/.~..O~ ..... -~¢.2..~..o.~... (Signature of applicant, or name, if a corporation) (Mailing address o~applicant) whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. \ ~.~. ,~'.~..[55..~.'.~..L-:~ ' .~ O. IX~-' '('7-.i. ~..~.(:' "-- · ................ ...... ..... ~ .oR..~,.~ ,~.~ ........................ Name of owner o f premises . .~.[,-~ ~..~. ~. ~'~ 0.~ ..... .P.[..~F.~..~. ....................... (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 ..... ~'~.~5 ................ Plumber's License No .... ¢5 .L[ .~... 't.'~. .......... Electrician's License No..~.Q ~ .(3. B. .......... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. ~T'¢~S ~(D~tD , ~]- ~4~iO~x~ .... .~. 1..~..~ .......... .&~.r.a..~.:~ .... ~.~..~.~ ............ F.-.i~T.. :.~..¢..~.~..a. ~. ~.,~,.. I~ 3.~. ftouse Number Street Hamlet County Tax Map No. 1000 Section .... c~.'.~. .......... Block ... ~ ............. Lot...t.7 .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... .~.P3.'~>~. .................................................... b. Intended use and occupancy. ....... 125.~..E~...~..V35.~..~ ..... g.'~ .~ ............................... V., 3. Nature of work (check wMeh apphcable) New Building Addition Alteration R/pair ~l~ ~ ,i, ~l~ RemoVal Demolition Other Work ~tm~ C9 "~ i' ~c,' . ............... Fee ...................................... .., s ted, st,.;: . .. i ..... - *" (to be paid on filing this application) If dwelling, number of dwelling u~nits.. ~ .'~X .~X.. . Number of dwelling units on each floor ................ If garage, number of cars ..... ~l..C~¥ ........................................................ 6. If business, commercial or mixed~ occupancy, specify nature and extent of each type of use ..................... 7 ..... if any: Front Rear Depth · Dtmenslons of existing stmcture~, ............................................ Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i.. Height ....................... Numbqr.of Stories ........... . ..... Dimensions of entire new construction Front. ~,~1~.~,(o.~! .... Rear . ~O'.~1~'° . .. Depth SO'(*" ...... eight ..~"~.~.)t~? .... Number of Stories..~ ...... i..i ............ i i.ii..i.; .... i i iiii ...... sHizeof lot: Front ...[i].~' -O..; ........... Rear .... It 6,.0 t ........... . J.Zd, eL. i .... ' ..... Date of Purchase .... ~. t. ad~ll~ 1~..OIiII~ ........ Nameof Fo?~, er. Owner ~Y'~.~ .......... ' ..... Zone or ~use district in which~rernises are~ituated .... .,.*..~ ................................... Does proposed constructipn viol~te any zoning law, ordinance or regulation: .. ~. O ......................... Will lot be regraded ... ~. D.... ......... . . Will excess fill be removed floP) premises: Yes Name of Owner of premises ~gJ l~[,~qS....~. ~T.~.~'.%. AddressqP:.~,~'- gq~.~.tho~l~e~Zl~hone No~J~. qgO-[.~.~.~' Name of Architect .~Oh.0. ~ I I tl~ .............. Addres~ t.Q~.6 .~.~k D.,Y,..c,-i6.t0-. lt~one No ................ Name of Contractor D} I~l{l.~.. ~2,-,~[~.X/O~> ........ Address~,O,lk~XSl~.j~',~a,~.}~%~. Phone No..t/:.'.7').'.l?. ~-'-'~ .... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether 10. 11. 12. 13. 14. property lines. Give street and block interior or Corner lot. I STATE OF NEW YORK. ................. being duly sworn, deposes and says tha~he is thq~pljcan,t,~ (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is daly authorized to perform or have performed the said work and to make and file this application; that all statements contained 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 .~...'~. · ......... day;f .... (~.C~.O ~.~.. .... ,19 .~..~ LINDA F. KOWALSRi NOTARY PUBLIC, Stat~ of New York No, 52.4524771 Qualified in Suffolk County ,,v ~ommlssJon Exp~r~ ~arc~ 30~ 1~ (Signa--ffir~ of applicant) SUFF .THE WA CONFOF SUFFOL SUFFOL $ER¥I CoNsTI; DATE,~_ H. S. RE AF~9~O~ sUFFOLK CO. I-~ALTH DE. PT. A~fl~ROVAL ~ ~ ~, ~ g '~ --~ SUFI ~LK COUN~ HEALTH DEPA~MENT ~T~NT OF ~NT~T * · ' ., . ~INGLE FAMILY DWELLING ONLY sY ;TEMS FOR THIS RESI~NCE WI~ ~~ ~_~,. ~ ]~ ~ , , FOUNDT~E~ORY~ ~ O~ SE RVICES -- FOR APPROVAL OF ~ ~' ~ .... ~ .' /~hlef of W~t~ater Man~ent t~ u~ TE: , , t ~ SUFF~K CO, TAX MAP DESIGNATION: LICE~D LAND ~EYOnS ~EE~RT ~W Y~K