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Home My WebLink About13261-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z12929 Date Qcto~or 26 19~ THIS CERTIFIES that the bulldog .... 3ceessory garago Location of Property ............. ~ ~.~.t...~.vAo..n ...... ~3~ ~o~1' ~3'0' 'Street ' Hamlet 022 Block 1 Lot 2 1 County Tax Map No 1000 Section · Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J .u n.e .2. ~/ ..... ,19 86 pursuant to which Building Permit No. 1326 ~ Z dated Ju~y 3 19 86 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 ......... The certificate is issued to Geor~e K±ouzollis (owner, I~(~gj~ R~ ~O~R~ X X X X of the aforesaid building. Suffolk County Department of Health Approval ......... ~ ./g .............................. UNDERWF, ITERS CERTIFICATE NO # N 6625 14 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMt=NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13261 Z Permission is hereby granted to: ...~.~z~.~..~....~.~ ................ ~. , ~l.~.~ ,o,-,,~).,_ ~ ,,-, ....,03~.......~......~.....~....~....~.~...~...,,~....~.~....~ ............. ............................. .............. , .................. · "~ --) ~ ou,,~,~ rz~-. .... ~...~~ at premises located at ....... .................. ~.1~..~....,.~.~. .................................... County Tax Map No. 1000 Section ...... .~.. .............. Block ......... I ............ Lot No ........c~.....]. .......... pursuant to application doted .... ~_~.~.....~...~ ....................... 19~..~..., and approved by the Building Inspector. Fee $.../. ................... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTNOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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/ land use -- [~re-]~× ± s t in~ C. 0. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C.0, $ 5.00 · .0.~..., ~.. ~ I~/3 ~ Date ~ .... ......... New Building ............. Old or Pre-existing Building~ ............ Vacant Land ............ ~.ooat~on of Proparty. l .--q,~.O .... A.~ .~x ;:~. ~... ~,~,~.~..~ .~ c:.~t'. .~.o,~-.;.~ ~..~..~:. '.'L.,.. t t House No, Street Ham/et Owner or Owners of Property ..... 1.0~0 .................................. County Tax Map No. 1000 Section . ~)~.~.. ....... Block .... I .......... Lot... ~-.~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 1~2.G. ['Z-~ate o~..~mit ......... .A..~.a.t. . .~ ................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ................... Planning Board Approval ...................... ~equest for Temporary gertificate ..................... Final Certificate . .~ .................... Fee Submitted $ .~ ........................ Construction on above described building and permit meets all applicable codes and regulations. App,,cant. :.Z. THE NEW YORK BOARD OF FIRE UNDERWRITERS 077 '1 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equiprnent as described belo~v and introduced by the applicant named on the abOve application ntttnber in the premises of Gsor~ K~ou2~llis~ S/M Aquavi~v Drive, East ~lon~ N.Y. i,~ the);ollotvi,g Iocat~o,~; [~ B,se,nemt ~ ~t FI. [~ 2nd FI. Section Block Lot was exandned on and found to be in compliance with the requiretnents of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUS: E R I C E CRC~.COND ~A W.G. NO. O~: HI-J~G A. W G NO OF NEUTRALSJ A. W G PE I O~: CC, COND OF HI.LEG 1 O~ NEUTRAL Rulm~d Electric Co~ P.O. Brx~ ].43 ~tti2uck, N.'Y', 11952 Lic#24~E GENERAL MANAGER This certificate must not be altered Jn any manner; return to the office of the Board if inco[rect. Inspector's may be identified by their credentials. COPY FOR B~ILDING DEP~RTMENT. THIS COPY. OF CERTIFICATE MUST NOT B~E A~LTERED ~N ANY MANNER FIEL~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING 'REMARKS: [~']/rl NAL ~, DATE INSPECTOR ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ~eOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved .... , 19~. Permit No.I..~..7~..~J..~.. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received...~../.~.~ INSTRUCTIONS 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 schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining [~remises 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 wo~k 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 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, O~dinances 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. .. D .V.O.S .................... (Signature of applicant, or name, if a corporation) ?, o,fio~ 215 (Mai{ing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... co T , ,c.To, g ............................................ Name of owner of premises ....~.$.0.~,~ E .... K Io O. 7-,El~.15. ' (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 ......................... Electrician's License No ....................... Other Trade's License No ...................... ~ ~(~ 1. Location of land on which proposed work will be done..4.(~ U ~t .~.1.~..~....~ ......................... House Number Street Hamlet County Tax Map No. t000 Section ...... .~..gk ........ Block ... [ .............. Lot... ~:./. ........... 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 .......... ~,..¢ct.r... o rct ..................................... b. Intended use and occupancy ......... .~..C.:..O¥ .r'... %.~X ~ .O~.C~_,~ ..................................... 3. Nature of work (check which applicable): New Repair .............. Re~bval ....... 4. Estimated Cost .... .O.~. : .O..o ..... Building ' .... Addition..~. ..... Alteration .......... ..... Demolition .............. Other Work ............... -- (Description) ............. Fee ...................................... *-' (to be paid on filing this application) 5. If dwelling, number of dwelling!units .............. Number_of dwelling units on each floor ................ If garage, number of cars ....~t'O.W~..~.¢ g~..~. ..... . .'~.o.....~.c,.c~?....~q~g .~c~ ~ ..................... 6. If business, commercial or mixed occupancy, specffy natu. re and extent of each f'ype of use ..................... 7. Dimensionsofexistingstructur6s, ifany Front ;3t~t ..... Rear ...~0.I ........ Depth.~! ....... Height ..... 1.~'/( .......Number of Stories [ ................. Dunens~ons of same structure w~th alterations or addlt,ons' Front ~ O 1~,r ~t~l Depth .... .t~:[ ............ ~.. Height ..... !'~' ' ' i ........... Number of Stories ...................... 8. Dimensions of entire new construction: Front .... 3.0. ........ Rear .... $0! ........ Depth .. ].~.! .......... ....... Number of Stones ....................................................... t?ighi .... iV.~. ' ' 9. Size of lot: Front .... 0,O.[, .1~ .......... Rear...~15~.,.O ........... Depth ...... 10. Date of Purchase .......... ~ .................. Name of Former Owner . F.r.o~)¢...~. ~.. ~Aa, lo,~on~,... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............. ; ....... , ....... Will excess fill be removed from premises: Yes 14. Name of Owner of premises 6.~t.~. ~.~,.~.~1. t-~... Address ~qt~t}~ Jtl~e 9~fl~ltxr~,~hone $o.~.'/.~..~..q.~. Name of Architect ......... ; ................. Address ................... Phone No ................ Name of Contractor ~JNO$...~ .';~..K.VO.~ ....... Address~lO .Igee[<j .t~'~..lg.~,. Phone No..~ '2.~/.~.1.~.~ ..... PLOT DIAGRAM Locate cleariy and distinctly alli 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 intqrior or corner lot. C_.,O fM~l[~ F~ ~-oT . STATE OF NEW YORK, COUNTY OF ................. ~S.S " being d ly dep s and says that he is the applica t ........... , ................. ; .................... u sworn, ose n (Name of individual signing contract) above named. He is the ............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly autho~zed to perfom or have perfomed the said work and to m~e ~d file this application; that all statements contused ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this .~ 7. ~ day of~'. .... ~ ........... 19 .~ Nota~ Public ...... ~.. ~.~:~.. County NOTARY PUBU¢, State ~ilNew Yor~ .. ~ NO. 4107878, Su o k ~ou,~ (Signature of appli~t) : " Te i~ d