HomeMy WebLinkAbout15479-zFORM NO 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N Y.
Certificate Of Occupancy
No
Date Faz ~ ~78~ ........
THIS CERTIFIES that the bmld~ng 2nd .8..t 9YY. A.dd.z.t..~.on..&...A.l.t.e..r at.i. on .......
Locatlon of Property 345 I.n. let D.r.xy.e . Mart*tuck, N.Y.
House No Street Hamlet
County Tax Map No 1000 Section I 06 Block 2 Lot 22
Subdlvlmon..M/o C. apt, a. in, .Kzd, d Ests. .... Filed Map No 1672. .... Lot No 9.0 ........
conforms substantially to the Apphcat~on for Budding Permit heretofore tided ~n th, office dated
...N.o.v.em. ber 6, 1986 pursuanttowtuchBmldmgPermitNo...15479., z
dated N.qve.mber 8, 1986
was issued, and conforms to all of the reqmrements
of the apphcable provlsions of the law The occupancy for wluch tlus certfficate lS issued ~s ........
.2n.d STORY ADDITION & ALT.E.RATION TO F.I.RST FLOOR OF EXISTING ONE FAMILY DWELLING *
HELEN ZOGRAFAKIS
The certificate IS ~ssued to . . .
(owner~q~ret~ t~i~t~E~ X
of the aforesa,d building
Suffolk County Department of Health Approval .... N/.A ........
UNDERWRITERS CERTIFICATE NO .PEND I .N.G..q ..~/ f.8./..8.8 ..............
PLUMBERS CERTIFICATION DATED:
April 25, 1988 - MASTER PLUMBING
/
*Door from kitchen to rear stoop to be
barricaded untilrailings on stoop installed.
Rev 1/81
FORM~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERA41T
fTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 15479 Z
Building Inspector
Build,ng Inspector
6/.30/80
FORM NO. 6
TOWN OF SOUTHOLD
Bufld~ng Department
Town Hall
Southold, N.Y. 11971
765 - [802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructlorls
Th~s apphcatmn must be filled in typewriter OR ink, and submitted m~ to the Building Inspec-
tor w~th the following, for new buildings or new use:
I. FmaJ survey of property wIth accurate location of all buildings, property hnes, streets, and unusual
natural or topographic features.
2. F~nal approval of Health Dept of water supply and sewerage disposal--(S-9 form or equal).
3. Approvat of electrical ~nstal[at[on from Board of Fire Underwmters.
4. Commercial buddings, 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. Su bm ~t P lan n mg Board approval of completed site p lan requ lrements where app hcable
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses.
1. Accurate survey of property showing all property lines, streets, build,ngs and unusual natural or
topograph ic features
2 Sworn statement of owner or prevmus owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety ~n~pection of buddm§s or premises, or other pertineht mforma-
t~on required to prepare a cert~fmate.
C. Fees
1. Certificate of occupancy $5.00
2 Certificate of occupancy on pre-ex~stmg dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00 yate
New Budding .......... Old or Pre-existing Building ........ ~ Vacant Land ...........
Location of PropertyHouse' '~'L~' '~" ' 'No. ' "~"~' '~" ! '~?' '
County Tax Map No. lOOOSect,on . .(O~ ..... Block .....
Perm,t ~o. [ ~.~ Date o[Perm,t .[[/~/.~. Apphcant ~~. ~~ ........
Health Dept Approval Labor Dept Approval
Underwriters Approval .................... Planning Board Approval ....................
Request for Temporary Certificate ................ Final Certificate .......................
Fee Submitted $ .................
Construction on above described budding an~~t~~and regulations
Apphcant .............................
Rev 10 10-70
OUNDATION (1st)
OUMDATION (2nd)
OUGH FRAME &
PLUMBING
NSULATION BER N. Y.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
TOWN OF SOUR*HOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. i 1971
TEL. 765-1 gO2
To Whom ~cern,
We are unable to complete your Certifxcate
of Occupancy because of the following reasons.
_/
/~/ An application for Certificate of Occupancy
is not on file.
--~_~- No Underwriters Certificate on file.
, /_~ The check is(outdated/~.)~2~--
/~/ 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 # _~ 5 ~ 7,c{;' Z
Building Dept.
***/~No Plumber Solder Certificate on file.
( all permits xnvolving plumbing being
issued after April 1,1984 )
Occupancy or use is unlawful without a
of Occupancy. Clear up this matter as soon
so that legal actzon does not have to be taken.
Thank you for your prompt attention.
Certificate
as possible
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P O BOX 728
TOWN IIALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom ncern,
We are unable to complete your Certificate
of Occupancy because of the following reasons.
/? An application for Certificate of Occupancy
is not on file.
/_~/ No Underwriters Certificate on file.
The check is(outdated/~.)~2~--
/~/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit ~ I ~ q .7 ~ Z
Building Dept.
***/~/No Plumber Solder Certificate on f~le.
( all permits involving plumbing being
issued after April 1,1984 )
Occupancy or use is unlawful without a
of Occupancy. Clear up this matter as soon
so that leEal action does not have to be ~aken.
Thank you for your prompt attention.
Certificate
as possible
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
7G5-:l.802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
~/FF~MING [ ] FINAL
REMARKS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000062
BUREAU OF ELECTRICITY
PAGE I
~tP Application No. on file
THIS CE~IFIE$ THAT
PETER ZOGRAFAKIS, 345 INF~T ~"~VE, "ATTI~CK~ N.Y.
~ examln~ ~ and~ound to be in eomplian~ with the r~ui~ments o~ th~ ~.
FIXTUIW EXTUIEES RANGES OVENS DISHWASHIIES EXHAUST FANS
16
~-4 10 16
MOTORS KITUIE ,M~JANCI FileRS
TIME croats
~R~rsENSCOMNICT S E R
$ROKE DETECTOR: -1
-1
GUSTAV BARTRA
227 g. BREAKWATER ROAD
HATTITUCK, NY, 11952
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thuG' credentials.
COPY FOR BUILDIHG DEPARTMEHT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED INM4Y MAtGIER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P O. BOX 728
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No. 'I ,".~7 q
(pleage pr~n~;
Plumber ~r~-~ ~/~ --
(please ~r~n't~ .
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
19~ .
~tary PubLic
Notary Publi~ ~U ~;kCounty
:~ENNIFER D. LAPPE
J~OTARY PLJB£)[:, State o~ NeW
Suffoll~ County ~.-~. 4785140
C~o'mmJss~on F. xp~res,,.-4~C ;~l , 19~
TOWN OF SOUTIIOLD
Old ICl ()1 BUILDING INSPECFOR
I'O BOX 728
'IOWN IIALL
St)UlllOl D, N.Y. 11971
December 2, 1987
TEL 765-1802
Mr. Frank Zovlch
125-09 13th Ave
College Point, N.Y.
11356
3rd notification
Lo are unnblo re complete your Certificato
of Oc~ up,~ncy becau,;e of the following reasons.
for Certificate of Occupancy
Ccrtzficate on file.
l',(outd,lte(l/~kx~x{~ $25.00 PLEASE SUBMIT
Approval o~e.BOARD O~ HEALT~ APPROVAL
ln[l[)oc~ ion has beeu made.
Th,Ink
EU r ]~
yOh £or you~
Permit
;;,: Plumber :3older Certificate on file.
( ail porto[t:, ~nvolvtng plumbing being
lsguod a~ter April 1,1984
our office on this matter.
cooperation.
:~ Occupancy or use ts unlawful without a Certificate of Occupancy.
Clear up thr~ matter as ~oon as possible so that legal action does not
lb,ink you.
50TERiS,5,0:
_M^TTII
TOV~N OF,SOU,
(B ~- II::~ON p,
-CI/ARAI~TE.E_.D TO THE' SECUI~i 'I
~L~O~T~ ~E ~VE~HF~~I
A,,.% ,~{i iii;", lik""-,/]~ ~r",
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
£OUTHOLD, N,Y 11971
TEL.: 765-1802
Approved k)~ ~ , 19~.h, Permit No l~q~l°k*c~. I
D~approved a/c ... O~ ~ / ~
............
(Budding Inspector)
APPLICATION FOR BUILDINC PERM IT
Recexved ........... ,19.
Date
INSTRUCTIONS
a Tlus application must be completely filled m by typewriter or in ink and submitted to the Budding Inspector, with
sets of plans, accurate plot plan to scale Fee according to sclxedule.
b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stree
or areas, and giving a detmled description of layout of property must be drawn on the dlagrmn which is part of tlus app
cation.
c. The work covered by tkts application may not be commenced before issuance of Buildmg Permit
d. Upon approval of this apphcation, the Bmlding Inspector will issued a Bmldmg Penmt to the applicant Such perm
shall be kept on the premises avmlable for inspection throu~out the work.
e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant
shall have been granted by the Bmldmg Inspector.
APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Building Permit pursuant to tl
Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmances
Regulations, for the constmchon of buddings, addltmns or alterations, or for removal or demohbon, as hereto describe,
The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and t
admit anth°nzed respect°rs °n premises and m building f°r necessary lnspecti~',,f~~ ~.~
(Signature of applicant, or name, if a corporation)
............. At,~,ERICA*I EYG t-~, ~ .................
Box
~A~TFVU .........
(mai±lng a~crr~ss oz appixcant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or buddex
. ex.ax Co . .......
Name of owner ofpremises D/IK k ~ I~S ~-~ .o 6- t~l~ ~'/q-~l~, ....
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
Builder's License No
Plumber's License No
Electrician's License No
(Name and title of corporate officer)
Other Trade's License No
Location of land on which proposed work will be done
House Number Street
County Tax Map No 1000 Secnon /'.O .~
Subdlv1slor~(~' lcd; a~
(Name)
mock Lot ,'?. i
F,ledMapNo [~-"/'~ Lot ~9 ..
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy ~' C~'" (~ .~,"%.'~, C~. ~. ..
Nature of work (check whtch apphcable). New Bmldmg ........
Repair ...... Removal ...... Demolition
Estimated Cost .... '~'Ot (2 O. 0. ~
5. If dwelling, number of dwelling units ..
Addltmn ......... Alteration .......
......... Other Work ..........
(Descnphon)
(to be pard on fihng this apphcahon)
..... Number of dwelling umts on each floor .........
If garage, number of cars .......................................
6 If business, commercial or mixed occupancy, specify nature and extent of eac~ type of use ..............
7 D~menslonsofe[mtmgstmctures, lfany. Front .,, ~.0 .... Rear ........... Depth /7~. ---..~..~Z,
Height / ~t% . .. Number of Stones ,~, '.~i~_ .~ ............... , ........
Dunenslons of same structure with alterations or additions' Front . ~.~ .... Rear ..........
]Depth ,~ O. ..... Height . · ~ .. Number of Stones .. ~. .........
8 Dunensions ofenhre new construction Front ........ Rear ............ Depth .........
Height . Number of Stones
9 Slzeoflot Front .... Rear ............ Depth ......
i0. Date of Purchase ............. Name of Former Owner .f~-.~ .~..~.5 ........
11 Zone or use district in which premises are situated .... ~/~..~ I .~.~ I~ ]-I/ff [_, ..................
12 Does proposed construction violate any zomng law, ordinance or regulation ............ /k3.~ ...........
13 W~ll lot be regraded .... ik~k ........ Will excess ~l be removed from premises' Yes No
14. Name of Owner of prom,scs 2 .~.~J'fff-~'l'-l/~ .l~ . Address~-,~ IXT. IdI. IJ~ fJ~hone No..~2.~
Name of Archttect .......................... Address .~ ........... Phone No .............
Name of Contractor ~l~-g[ ~ ~.Ol ~ q.~'h P~-~.. Address [~ ~ &-/ ]r~ ,hz',~., Phone No~.
15. Is th~s property located withinl00 feet of a tidal wetland? * Yes ..... ~ .....
· If yes, Southold To~m Trustees Permit may be required.
PLOT DIAORA~
Locate clearly and dmtmctly all buildings, whether existing or proposed, and, indicate all set-back dunenslons from
property hnes. Give street and block number or descnphon according to deed, and show street names and mdtcate whether
mtenor or comer lot.
STATE OF NEW YORK,
COUNTY OF.
SS
................................................ being duly sworn, deposes and says that he ~s the applicant
(Name of individual signing contract)
above named
He is the .......................
(Contractor, agent, corporate officer, otc )
of smd owner or owners, and is duly authormed to perform or have performed the said work and to make and file tins
apphcatlon; that all statements contmned m this application are true to the best of his knowledge and behef, and that the
work wall be performed in the manner set forth m the application filed therewith.
Sworn to before me thru
......... .~ . . day of .. ..~...~t~ ...... , 19
_ ~ ~ raiiii~__~? (Signature of applicant)
If for copper water tubing d~str~butmg~S use
LEAD CONTENT B~FORE
CERTIFICATE OF OCCUPANCY
sOLDER USED IN WATER
S'UPPLY SYSTEM CANNOT
EXCEED 2.710 of 1% LEAD.
USE tS UNLAWFUL
W~THOuT CErff~FiO/tTE,
OF occuP,~Ncy: .-.
' , THE .R?C~I¢[~j:i~I$ 0¢, FH~ N Y
?lOU