HomeMy WebLinkAbout15797-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.Z. 1.6.0.6.2. ........... Date ...A. qgqs. t.. 1.7.,.. 1.9.8.7. ..............
THIS CERTIFIES that the building ........ ~,e. qe.s.s, qr.y. ...............................
Location of Pronertv 2750 Rocky Point Road East Marion
County Tax Map No. 1000 Section . .q3.1 ........ Block 02 .Lot 03
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 19, 1987 pursuant to which Building Permit No. 15797Z
dated ...l~.a.r. qh. ?.8. ,.. [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 .........
·..Accesso~:y .g~:ogq .qa .~gl~l, ~.qcl f.o.r... ............................
The certificate is issued to STEVE KALTSAS
..................... ?oYn'e;, ..................
of the aforesaid building·
Suffolk County Department of Health Approval ........ ~/.A. ...............................
UNDERWRITERS CERTIFICATE NO. N822088
PLUMBERS CERTIFICATION DATED: N/A
Rev. 1/81
lrOB~ 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)
N9 15797 Z
Permission is hereby granted to:
...~.~...~...~:...¢...~dL .................
..~..~...,~...~..~....*~.,..~.~, ......................
ot ~m,,~ ,o~a~ ot...~,~.~.....~...e~'.....~ ....... ~.~.......m.....~ .........
pursuant to application dated ........... ...'~ .~E~r.......~... ./..~ ................. , 19~.~.., and approved by the
Building Inspector.
Fee $.~....: ..............
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802 I
APPLICATION FOR CERTIFICATE C)F OC~..I IpA~V
TOWN of SOUTHOLD
OFFICE OF BUILDING INSPECTOR spec-
Town Hall usual
Receipt NO. 3 2 8 9 8 Southold, New York 11971
Date ............ ~ / [.~../.~.~. ....................
ieceived of ....................... ~ .................................................................................................. ~ing.
......................... -- ~'. ~ //.,O O ~ ............ /1OO OD ars ting"
................ .............. .................................................. a, or
~J Fee for
Fee for Fee for n;;~,,m'tificate
[] H.I.C. L._~Building Permit ~ of Occupancy [] Misc. ,rrna-
Fee for
Chcash
.............. /.4.,..~..0. .....................
Building Department
~.upaatea (J.g. ~ 50.00 Date ..'.-L.k.~ r.
NewCons t ruc t ~ on. ;,~... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ......... ~.7~-b 1~ .c.~. 1 ~,' .¥... ~..?~,,. ,.,.,. ~ .[':~.,
House No. ' ........... ~ Street ' ') .... ~ ~ ' ' '
Ham/et
Owner or Owners of Property ...~."~:~[.¥'.l. ,¥~.i'\L. ~,~:\.~ ............................. -
County Tax Map No. 1000 Section ...... .~. i ...... Block ....... 'i .~.
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. [ :.~.c~7. ~.., Date of Permit .......... Applicant . '..~J.~·.~,..' ~ j'.-;., 1 'I.~, ; .............
)
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate . .,,/. ...................
Fee Submitted S .............................
Construction on above described building and permit meets all applicable codes and regulations.
J ~,~ ,, , '-~
Applicant . .~.~.~ t-~. ~,.C~. ,~: ..?:%,.~¢).;> ..........................
Rev. 10 10-78
OUNDATION
OU~DATION (2nd)
OUGH FRAME &
?LUMBING
hUSULATION PER N.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
.L
1000771 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
{~1~ BB JOHN STREET, NEW YORK, NEW YORK 10038
July 2,,, 1987 .,,,,,,,c.,,o.~..~./,,. 485317187 N
THI~ ~E~IFIE~ THAT
o~y t~ ~t~ ffuipment ~ bsc~ ~w a~ int~uc~ by t~ ~ic~t ~m~ on t~ a~ ~pl~ati~ nu m~r in t~ prem~s o~
Steve g~ltsas, E/S Rocky Point Road, 2500' N/O Route 25, ~sr ~rion, N.Y.
Garage
~examlnedon July 9, 1987] and found to be in co.tpllance u'ith the requlrements ~f this Board.
FIXTURE FIXTURES RANGES ~.OOKING DECKS OVENS DISH WASHERS EXHAUST FANS
6 3 4 6
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TiME CLOCKS
DIMMERS
SERVIC~ DISCONNECT S E R
OTI~R APPARATUS:
Peuelboarde: 1-2cir.
70 a~ps
C
NO OF HI-LEG
HO. OF NEUTRALS
Ruland Electric Co.
P. 0 Box 143
Matti~uek, N.Y. 11952
Lic. 242E
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FO~ BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTtlOLD, N.Y. 11971
TEL. 765-1802
To Whom Th~s May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/_~/ An application for Certificate of Occupancy
is not on file.
/5/ No Underwriters Certificate on file.
/~ The check is(outdated/ot~q~~)[[O,°°
/~/ No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit # _~[ ~ ~_ ~ ~_ Z
Building Dept.
***/Z/ No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
Occupancy or use ~s unlawful without a Certificate of
Occupancy. Please clear up this matter so that legal action
does not have to be taken.
Thank you for your prompt attention.
7GS-1802:
BUILDING DEPT.
INSPECTION
[,~UNDATION 1ST [ ] ROUGH PLBG.
[ ] FRAMING
REMARKS:
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FINAL
DATE
INSPECTOR ~ ~"-~
7GS-~.80Z
BUILDING DEPT.
INSPECTION
REMARKS:
INSPECTOR
'FORM NO. 1
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC
TOWN HALL
NOTIFY
$OUTHOLD, N.Y. 11971
TEL.: 765-1802 CALL
MAIL
E×amined. · 19
Approved ...~...a~b~.....g~.~.., 19~. .-/. Permit No. J.~ ~ .~.7. ·~.
Disapproved a/c .....................................
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
FORM .............
TO:
(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 properW 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 Depaxtment 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 address of applicant)
State whether appIicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... ..... ........................................................
Name of owner of premises .~...'~'--~4-7'..t~----~-..; . ./~..~ .~. · .~. · ..... .~..~ .,q ~..5..0.~ .......................
(as on the tax roi1 or latest deed)
If applicant is,a ,corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CON~,RACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..... ~ ............
PIu~ber's License No .............. .~,. .......
1. Location of land on which proposed work ,vi,1 be done:..~..~. ~ .... ~ ~..~...~.~...P!~-~...
....... ....................................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...... .'-~.. ! ........ 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...~,'. J~.. l'-~.~. ........... .~...~:~'... ~...~/'...~ ..'~,'.. .....
b. Intended use and occupancy . ~.O .................... ./I1~I~1~.. ~ ;/,~,j~ . ¢"~ .v ......
3. Nature of work (check which applicable): New Building 1~{~ i~.~'~r'Addition .......... Alteration ..........
Repa/r .............. Removal .' ............. Demolition ',L ......... ~.. Other Work ............
~ (Description)
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 ........................................................ 7 ...............
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ...................... Height ............... Number of Stories ......................
8. Dimensions of entire new construction: Front .~*t.,,.~. '~'-~"" Rear ,~.-~ff Depth
Height ............... Number of Stories ........................................................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ]t ~.~) ....................... Name of Former Owner .............................
1 1. Zone or use district x'nXvhich premises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..........................
13. Will lot be regraded lq' .O. .... :. .....~---a.~ '*",-~a .... Will excess fill be removed from premises: Yes No
i4. Name of Owner of premises $.T.e,,~t~.. ~ .tr.~.*.,q. tff'.J.' Address ............. Phone No .............
Name of Architect ......... /~ .............. Address ................... Phone No ................
Name of Contractor .. ~.~,-.~.' .................. Address .... - .............. Phone No ................
15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .....
*If yes, Southold Town Trustees Permit maybe required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back din~e~sions from
)roperty lines. Give street and block number or description according to deed, and show street names and indicate whether
nterior or corner lot.
;TATE OF NEW YORK,
~'OUNTY OF .... S.S
............................................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bdve named.
te is the .........................................................................................
(Contractor, agent, corporate officer, etc.)
,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all siatements contained in this applicatibn are true to the best of his knowledge and belief; and that the
zork will be performed in the manner set forth in the application flied therewith.
,worn to before me this
(Signature of applicant)
NOT~FY 8U~LD~N~ L~EP~RTM~ AT
~R ~URED ,':ONO~E
ROUGH FRA~tN~ ~ pLLt~:~iNG
ALt CO
TH~ HEQL
A