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Home My WebLink About15997-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z3 9 ! ....... Date . .Augu?t. 17:..17.8.7 ......... THIS CERTIFIES that the buridmg ., . .Add.zt.r9.n ............ Locahon of Property. 17 9. 0, A.q.uav.i.ew. ,Ro a.d ........ .E a.s .t..M.a,r ~ .o .n ............. ~touse mo Street Hamlet County Tax Map No. 1000 Section 02.2 .... Block 02 Lot 08 Subdivision Fried Map No ..... Lot No ........... conforms substantmlly to the Apphcahon for Bmldtng Permit heretofore fried an tins office dated Apr:tl 2 I, 1987 pnrsuant to winch Building Permit No 15997Z dated . May 20, 1987 was issued, and conforms to aH of the reqmrements of the apphcabte provisions of the law The occupancy for winch this cerhficate is issued m ...... Declq addzt~on to an exzstinK one family dwelling The certificate ts issued to ROBE. RT .AND KATHERINE HALIKIAS (owner, ~I1~ of the aforesaid bml&ng Suffolk County Department of Health Approval PLUMBERS CERTIFICATION DATED: ZT iu,ida Inspe/to; ..... Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~5997 Z Permission is hereby granted to: , _~ ~.~...¢..3..~ ............................ ............... ~.....~,~...~...-.~..~.....~.1..~:~..~. to ..... ..~ .......... ...~'..~........o~. ...... ~ ' ~.~,....~.....~,~...'~. ................. :~;..~ ................. ; ............................ at premises located at ..~....~m- ~.~. ....... : ........ ..~...~ ......... .~.~ ......................... .................................. !.~.~....~..~,. .............................................................. .......~ ~~ ..... ~. ~' .,~,~ ................................................................................ ................ County Tax Map No. 1000 Sec,~_~,C~..~ .... Block ....... C~....~.. ...... Lot No .... .~..~ ..... pursuant to application dated ~~......'~...~ ............... , 19.'~.~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Recmpt ]l~j j~ ~ 32900 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Southold, New York 11971 Date Fee for talla- Fee for Fee for Fee for r_L.g.e~ff~cate [~] Yard Sale [] [] J~] H I C J -J Building Permit I/,'1 of Occupancy []Mi,c ~Jlng. · ~:~,~-' ~ .... Building Department .... ~J or ~c)ec- t]on required to prepare a cert~hcate. C. Fees' Additions $25 00 1. Cer~d~cate of occupancy New Dwell zng $25.00, Accessory ,$10.O0 Bus]ne.~s $50.00 2 Certificate of occupancy on pre-existing dwelhog $ 50. OO 3 Copy of certlflcate of occupancy $ 5 00, over 5 years $~0.00 5.Ug~te~ C.O. ~ 50 O0 Date .' ......... NewCons~uct~o~.~. . Old or Pre-ex~stlng Budding .... Vacant Land Owner or Owner~ of Property / ~~ .......... ~.. ,~ ~ ~ ............... ' co.~,~ ~.~ ~ ,o. ~0o0 S.~,,on . R~ ......... ,~o~ ~ ......... ~ot .~ ............ Subdw~s~on ........ ~ ........... Fded Map No ,.. Lot No ......... Health De~t. A~proval .................... ka~or De~t AO~roval ....................... Underwriters Approval ................ Planmng Board Approval ... ' '9 ............ Request for Temporary Certificate ............ Final Certificate .................. Fee Subm,tted $ ~5 .C~ V/~/~__. t g ~ Apphcant..~/~. ~ :~ ............... OUNDATIO:; (1st) OUNDATIO~ (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: ?~-?q? 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ FOUNDATION 2ND [ FRAMING REMARKS: ] ROUGH PLBG. ] INSULATION [ ]~FINAL DATE I NSPECTOR~~~ UL__.__,, BLDG DEPT i TOWN' ,OF SOUTHOLD,,,.,.,~,~ Examined .~.. ~-.~ . Approved ~F~ 1;~o Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y 11971 TEL.. 765-1802. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... S RVE .......... CHECK SEPTIC FORM ............. NOTIFY CALL ................ MAIL TO: ~ ~._' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a Tlus application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wit 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 strc or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by tlus application may not be commenced before issuance of Braiding Permit. d Upon approval of this apphcaUon, the Building Inspector will issued a Bmldmg Permit to the applicant. Such pe~ shall be kept on the premises avadable for inspection throughout the work. e No building shall be occupied or used in whole or in part for any purpose whatever untd a Certificate of Occupm shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Braiding Department for the issuance of a Bmldlng Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinance- Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demolition, as hereto descnb aTdhme i~paPult~rn~tzea~r~enesSpetcOtoCOrs%Fnl~reW~lhseasllana~2C~ublli~l lma~)trndeic~s%C~,lnbs;~dct~.~n~g c~a~ns, and (Signature of apphcant, or name, ff a corporation) (Marling address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contract,9~-~,r~r~leO-~n&l~Uc~lri~ build_ ..... (as on the tax roll or la~:'~~,r.~ Ot~'P~Rr~Vt~''Tr A If apphcant ~s a corporation, mgnature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK Builder's hcense No 7.'~ t ~'~'~.. ~ ,/'/.T COUNTY LICENSED Plumber's hcense No Electnclan's License No .. Other Trade's License No Location of land on which proposed work will be done lIouse Number Street County Tax Map No 1000Sechon Block Hamlet ~ Lot. J Subdivision Fded Map No Lot (Name) State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction a. E×,stmg.se and occupancy b. Intended use and occupancy C 3. Nature of work (check which applicable) New Budding ...... Addition ....... AJteraBon . .. Repair .. Removal Demolition .... ~, ............ i$ ll besc.pt,on) 4 Estimated Cost . ~t~, 5't~ Oo Fee " (to be paid on filing this apphcatlon) 5. If dwelhng, number of dwelhng umts ..... Number of dwelhng umts on each floor If garage, number of cars ........................................ 6. If business, commercial or mixed occupancy, spectfy nature and extent of each type of use ........... 7. Dimensions of existing structures, if any. Front ..... .. Rear ......... Depth ......... Height ... Number of Stones . [' . .......................... Dunens~ons of same structure with alterations or additions Front ........... Rear . Depth .......... Height .... -' 7 ...... Number of Stones .......... ' 8. Dimensions of entire new construction Front . . .q/~ .... Rear .. . g.~. r .... Depth . /. ~. / ..... ' Height .. Number of Stones ............................ 9. Size of lot Front ......... Rear ............ Depth .... 10 Date of Purchase ........ Name of Former Owner .............. 1 1. Zone or use district in which premises are situated .. 12. Does proposed construction violate any zoning law, ordinance or regulation ............... 13 WflI lot be regraded ........... Will excess fill be removed from prmruses Yes N 14 Name of Owner of premises ......... Address .......... Phone No Name of Architect ............... Address ................. Phone No ........... Name of Contractor .............. Address .......... Phone No .......... 15. Is thzs property located withzn 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dn-nenslons fro~ property hnes G~ve street and block number or descnptmn accordmg to deed, and show street names and indicate whethe interior or corner lot. STATE OF NEW YORK, S S COUNTY OF .... (Name of individual s~gmng contract) above named being duly sworn, deposes and says that he is the apphcan He ~s the .................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have perfonned the smd work and to m~e and file apphcatlon, that all statements contmned m this application are true to the best ofhm knowledge and belief, and that th work wall be performed in the manner set forth m the application filed therewith Sworn to before me tins NotaryPubhc, . .... ... County _ 4707878. Suffolk CeuFly~. q (Signature of apphcanl