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Home My WebLink About16297-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16304 Date October 19, 1987 THIS CERTIFIES that the building ....A.e.c.e.s..s p.r.y. .................................. Locatinn of Property 430 Grove Road Southold House No. Street Hamlet County Tax Map No. 1000 Section 051 .... Block 06 .Lot 19 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .J.U.~.y.. 29, 1987 pursuant to which Building Permit No. 16297Z dated . ..l.q 1. 7..3. I. ,...1.9.8. 7. ............. 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 ......... Accessory building. The certificate is issued to SAVAS & TOULA ARAP ..................... Y i/x'xX ............... of the aforesaid building. Suffolk County Department of Health Approval ........ .N./.~. .............................. UNDERWRITERS CERTIFICATE NO ............... N/A PLUMBERS £ERTIFICATIOlq DATED: N/A Rev. 1/81 FORM' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ]6297 z Permission is hereby granted to: /.~/-/6 / =~ rM. / ......... . at premises located at ...~......~.........~..~..~....;. ....... ...~..~ ................................... County Tax Map No. 1000 Section ...... .(~.~....I ..... Block ...... .¢~1..~. ...... Lot No ..... !..3 .............. pursuant to application dated .... ~...,.'~....~ ........................ , 19.~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 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 I I to the Building Inspec- tot with the following; for new buildings or new use: 1. Final survey of property with accurate location of all builidings, 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 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. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.0,0, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-exlsting Building ............ Vacant Land ............. Location of Property . ..~J. ~. ~......~..,~. ~.~'~...~.~.. .... ~ Z ~ ~...~:'~ ¢~ J: ¢ .............. House No, Street Ham/et Owner or Owners of Property . ~'~ ~.~..~. ~.~ ~ .... ~.~ ........................ County Tax Map No. 1000 Section . .~ 5-Z ~-~.. Block D~T.~; ..... Lot. ~Z~.~, Subdivision ................................. Fired Map No ........... Lot No .............. ~erm]t Nol I i [ate of ~erm i~a[t .................................. Health ~eptl Approval ........................ Labor Deptl A~prov~l ........................ 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 Applicant ................. . ................................... UNDATIO.~; ( 1 s t) UNDATION (2nd) UGH FRAHE & FLUMBING SULATION FER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 7~-11102 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. INSULATION DATE 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1803 CALL MAIL Examined...~.~t~..,~ I., 19 Approved. .~. ~. .gl., 19~..'~Permit No. Disapproved a/c ..................................... BOARD OF HEALTH .../~-/-~. 3 SETS OF PLANS -~-f-~-.. SURVEY ...... Po.. : ........ : (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... 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 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin Building Zone Ordinance of the 'Town of Southold, Suffolk Regulations, for the construction of buildings, additions The applicant agrees to ~omply with all applicable laws ordin a.dmit.authorized inspectors on premises and in building Certificate of Occupancy the Ordinances or as herein described. and regulations, and to name, if a corporation) (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... ~ ............. Plumber's License No ...... .~..'. ............... Electrician's License No ..... ~.. ............... Other Trade's License No. Name of owner of premises . .~0~/.~ 5 ..... /. O.(~./.gL..././..1 .(.~ ................................ (ason th~a',x roll or 1~ .xt{~.d eed ~?_~'~j~.~ If applicant is a corporation, signature of duly authorized officer. FFJ. ~?~L...~.'~- Location of land on which proposed work will be done~ ................ House Number Hamlet 000 ......... ' ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premise5 and intended use and occupancy of proposed construction: a Existing use and occu anc b. Intended i~se and occupancy . .x{[,~. ~.q~ .................................................... 3. Nature of work (check which aPplicable): New Building ..... ' ..... Addition .... ,.,.3Jle/gtirm... .. Repair .............. Ren~oval .............. Demolition (Desc~plio~ 4. Estimated Cost....o//.~.(-/.(/ .......................... 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 ..~ ............................................................. 6. If business, commermal or m~x occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any Front ................ Rear ..... · ......... Depth. ~ ............. Height ............... Nu~nber of Stories ....... ' .... . ....~... Dimensions of same structure with alterations or additions: Front ................. Rear .................. D pth i He'ght Number of Stories Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ... :,__Number of Stories .... ' .............. ...................................... Date of Purchase . ~..o~.~/,,/t~. ~.~ ......... '. Name of Former Owner .~..~ 9t. Zone or use district in xOhich premises are situated ....................... ocs proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... .~. I ..................... Will excess fill be removed from premises: .Y~e,s 14. Name of Owner of premises i~OVO~&. -/~(P~../17I ./~/'O/6~ddress f-i~'~. CO V~ ~5/d. .... Phone No. ~.t~.. Name of Architect ......... ! ................. ~. Address ................... Phone No ................ Name of Contractor ........ 1 .................. Address .... : .............. Phone No ................ 15. Is this property locatedi within 300 feet of a tidal wetland? ~Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali 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 interior or corner lot. 9. 10. 11. 12. K STATE OF NEW~YOR .,~! ,f/ I- -- OF. ! ·. ?= ............ . .4~OcZ/'ZIG~.. ~ ....... ! .................... being duly sworn, deposes and says that he is the applicant (Name of inflividuai sign ng contract) above named. He is the ..................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dully 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 mannelr set forth in the application filed therewith. Sworn to before me this HELEN IL DE NOTARY PUBL C, State of NeW York No. 4707878, Sulfelk ~u~ty,~_ ~ (Signature of applicant) Tem~ Expires M~roh ~0,