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HomeMy WebLinkAbout13071-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Nc.Z?2911 Date October 22 19 .~fi. THIS CERTIFIES that the building One family dwelling 3510 Rocky Point Rd. East Marion, N.Y. Location of Property/Y~s~ ~Jd ....................... 'S't/eet Hamlet County Tax Map No. 1000 Section . .0.2. ] ....... Block ..... 0..4 ........Lot ..... .0.0.7 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.p.v..i .1..1.0.,..].9.8. 4., 19... pursuant to which Building Permit No. ] 3071 Z dated .,. gp:e.il. 3D ................ 19 85., 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 ......... 0nq family dwelling. The certificate is issued to ....... .Qqn..~ ~.a.n..g .i.n.qs...&..H.¢. cl..w.~.g . .Z 9.p.v.o. s' .................. (owner, ~ 29X ~X,~ ~ X X X X X of the aforesaid building. Suffolk County Department of Health Approval ..... ] 4 - S 0- 69 ~;N653804 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy N Z12912 October 22 o .................. Date ................................. 19 .8.4. THIS CERTIFIES that the building ....g.c.c.e.s..s 9.v.y.. g.a.r.a.g.e .......................... Location of Property .... 2.5. J.0.?.o.?.k7. Point Rd. East Marion N.Y. House No. ' ............. 'S't/e~i ...................... h~d*iel County Tax Map No. 1000 Section ...0.2.1 ....... Block..............04 .Lot .......007 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. fi.p .r.i.1.. ~. 9 ..........198.4.. pursuant to which Building Permit No..~ .3.0.7. ! .Z .............. dated ...A.p.v..i.1..3.0. ................ 198.4.., 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 ......... ..... .A.c.c.e.s..s p.~.y., g.a.r.a, g .e. . ...... The certificate is issued to Constantinos & Hedwig Zervos ..................... io7,.'o;. ..................... of the aforesaid building. Suffolk County Department of Health Approval .N //~ UNDERWRITERS CERTIFICATE NO ......... ~..N ~5.3.~ 05 ................................ Rev. 1/81 Building Inspector FOBM NO. ~ 'rowN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13071 Z Permission is hereby granted to: ...... .Co..a~..~.Y.,d,~!...[...~...~.,~..o. ~....,~ ~o~' .......................... ~o ...... ~.~.O~.~.~s~ ........ .~.,.~......~.~.....~~.~ ...... ~ ....... ~ ~ ~. ~ , ......... ~.~~ ..... ~C ~~.~ ....... ~~~ ............................... ~ ~m~,e, ,~o,~d ~...~..~.{~ ........ ~~...~.~.~.~ ........ ~ .......................... ........................................................................................................ County Tax Map No. 1000 Section .... .~.o~..~ ....... Block ...~....~... ........ Lot No...('~1~.[7. ....... pursuon, ,o opplicotion doted ...... ~,~r~..~.....!...~. ............. 19~..~.ond opproved by the Building Inspector. Rev. 6/30/80 FORM NO, 6 TOWN OF $OUTHOLD Building Department Town Hall ~,~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 peoperty 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use --?re-E×±st±n~ C. 0. $15 · 00 3. Copy of certificate of occupancy $1.00 Vacant, :].and C.O. $ 5.00 Date... ~..~..../.7~../~..~. ~. ..... New Building ..... .1~.. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. ~...02~ ?..~ .d'c~... ~ ~--~ ...................... , ............. House No. Street Ham/et Owner or Owners of Property ................... County Tax Map No. 1000 Section .. Q..~. f ........ Block ...0..~. ....... Lot...d..d. 7. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.l.~..d.~l~,.. Date of Permit .~./J~.~/[~..Applicant .~ ...~'~..~.. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approva .................... 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. Applicant ..... ~ ..... ~ ........................ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted~u;l!c~-'t~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 peoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling[ land use --?re-E×±st,±ng C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C.O. $ 5,00 Date..OC~ .*. ~) .~.~..~..1~ ....... / New Building ...~.. ........ Cid or Pre-existing Building ............ Vacant Land ............. Location of Property .~.~.[~ ..... t~.q ,.~.I(~... ~.~. ~[~:~".~) .~.'7, I~louse No. ' ' ' Street ' ~x Hem/et Owner or Owners of Property .C,O.~.~,'~I~.~.'tJ~.[~C~...."~'.?~.~.[.~'~... · · -"~'~.~)--~ ..... County Tax Map No. 1000 Section .. I~ .~..t ........ Block ...0.~ ......... Lot.. O.~ .~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. I~.0..~.IZ Date of Permit .~./~.~/'.~,Applicant .~.~...'~.~.~0.~. Health Dept. Approval. J.~,-, ..... · ..SC)- .~..~ ........Labor Dept. Approval ............. i ......... Underwriters Approval. · .~.~ ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ ............... Fee Submitted $...~,'..~.'.~.~ ............... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 KNSPECTION :DATE COMMENTS F~LD FOUNDATION~ (~st) ........ FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING ' INSOLATION PER N. Y. STATE ENERGY __ ~DE · '"' . A~ITION~L 0~MENT~: .... ',1~i I THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85[ JOHN STREET, NEW YORK, NEW 'YORK in the following location; [~ Baseme,tt was exatnined on ~ 1~1'~l ~J ~ -~9~4 [~ 1st Fi, ~ 2~td Fl. Cy~ Section Block Lot and found to be in complia~tce with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 10 4 DRYERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET C AW.G, OF HLLEG A. WG OF ~EUTRAL f~].m~d Elco, },~titu~.:k. N~Y, 11952 This certificate must not be altered ~n any manner; return to the office of the $oard if incorrect. Inspectors ma), be ~ COpY. FOR .pi[DING DEPARTMENT. THIS C · ' THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 ~00 ~?1 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO:38 THIS CERTIFIEB THAT only the electrical equip ~nent as described below and introduced by the applicant named os the above application number ir~ ~he premis? of in the following locatlon; [] Base,nent [] 1st FI. [] 2~d FI. Section Block Lot was examined on J~[ y 2~ ~ ]~.~' and found to be in compliance with the ~equirements of this Board. FIXTURE FIXTURES RANGES OVENS DiSH WASHERS EXHAUST FANS OUFLETS SWITCHES FLUORESCENT 34 63 a3 34 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MOLT -OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: i G.I Tr~ck I,ight ir~; 8' (Y' 3 Light,~ NO, ERCC~COND.OF CC, COND . 4/0 NO, OF Hi-LEG OF HI-LEG E INO OF NEUTRALSI A'W OF NEUTRAL 1 .4/0 Box 143~ k~ttituck~ N.Y. 11962 This certificate must not be altered in any manner~ return to the office of the Board if iocorrect. Inspectors may be COPY FOR~ BUILDING DEPARTMENT. THIS; COPY OF C~.~.. ,' ' IN ANY MANNER. r TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date~ Building Permit No.~ Owner (please print) Plumber I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~k~_day o~ ~~__, Notary Public ,~County ary Public ~[~ZA~TH BUS$~ NOTARy PUBLIC, Stot~ of Ne~t ~r~ No. 4755734 ~uatified in SuffoJk ~ounl7 ~mi~ion Expire~ Mor~h 30, 1~(~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ ....... , Approved ....... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No..I. ,D..O..~. ( ........ Date [ .... , 19 ~ 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 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 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 code, and regulations_, and to admit authorized inspectors on premises and in building for necessary inspections. ~ ~ .... ...... (Signature of applicant, or name, if a corporation) (Mailing add;es; ;~'a~[i~t') ..... g~9~ ii4~7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ OOo. U~.~... ~. BL~I.t-D~-. ...................................................... Name of owner of premises . .C-.O.IO.,$ .-TT~lg.qTI. ~ .0.5. ..... .~,...Cq..~..x~.O..~ ..................................... (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 .... .L~ 5. 5 ................. Plumber's License No. ~)"~ L~L ~> ' Electrician's License No. ~).[%.~, .~....~.[.~..C.~.?. ~..~., Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... .~...O.C.-.~.~."/ ....... ~..O. [ .~'.T. ....... .~...O.~.~. ....... .... ~.~..i.o. .................. ¢.9.~. ~.Y....~. ~.¥~ ~- . .~q_cs.. T...t~.~..g.l.o.g. ............... House Number Street ..... ~J .... Hamlet County Tax Map No. I000 Section .O.~\ .. B~ck .. i .0~...: ........ Lot .... O.O.~. ......... : 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 ........... ~.~.~.~.... [ ~.~.o. ......................................... b. Intended use and occupancy ........... .3.1......i..O,~. ............................................ 3. Natur~ of work (check which applicable): New Building . .xJE~.. Addition .......... Alteration .......... Repair.. ............. Rem6val .............. Demolition .............. Other Work ............... ' (Description) 4. Estimated Cost 605, to o el ~ o o ...... ~ ..... 1 ......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .. .~ .L.k. ..... Number of dwelling units on each floor .... [ ............ If garage, number of cars ..... l J ............... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... 7. Dlmenmonsofex~stlngstructures, lfany:Front...,~l~. ......... Rear~ ....4!¢~q.. ........ Depth' ~iiiiiiiii Height ............... Nun her of Stories ........................................................ Dimensions of same structure v th alterations or additions: Front ................. Rear .................. Depth. ..................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new const~ uction: Front . .. fo.$ .......... Rear . .. (o.B ! ........ Depth . . .q~-. [ ......... Height ...~l,J .......... Nun bet of Stories ...... I ...... : · '~ ............................. t ........... Size of lot: Front ... I.OO.o. 87 ............ Rear ...~3.~, {,~t. ............ Depth . .'B.ffS/ -. .&.'$ ............ ~ate of Purchase .AlOe, 1 ~.t.~.~ ................ Name of Former Owner Jh/5~t.TBIO~...?. Df'B.~./~Ohll}~l¢... Zone or use district in which pr~mises are situated... R[.5)0~. Ill .~. ................................... Does proposed construction violate any zoning law, ordinance or regulation: .... I4.O ......................... Will lot be regraded ...~. ~4.© ................. Will excess fill be removed from~remises:, Yes (~ Name of Owner of premises CO. ~,~fl?ct6.~O t0~ .~ .k~.~t)~. Address l g>{/0 .~16~.~ST4?~p .~.¥..fi.~oU[n°et'~o:~'. .~.~ 7~ 7.~ ~g. .... Name of Architect., ........................... Address .............. t, lt;,~ ' Phone No ................ 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block :number or description according tq ~lee~, and interior or corner lot. ~l/F fil~5'Vffle ~ E)(Cft V ~q~t ~JC5 cO show street names and indicate whether Lot, STATE OF NEW YORK, COUNTY OF ................. 'Ro*ky . County .~2xrty,,,~ . ? (Signature Of applicant) .,,.,~--' HELEN K. DE VOE NOTARY PUBLIC, State of New No 4707878, Suffolk Co~nt~ Ye ~ Exp es ~la ch 30, 19~3 ............................. : .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ! He is t, he . .~ .................... i ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul} 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 ./