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Home My WebLink About15427-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15123 Date November 24 .................................................. 19.86.. THIS CERTIFIES that the building ...... .O.n.e...f.a.m.i..ly..d..w.e.l.l.i.n. g ................... L~+~o~.~ert_ Demares% R.O.W. off Main Road Orient --' House No. Street Ham/et County Tax Map No. 1000 Section ..... 0.1.3. .... Block...........02 .... Lot ...........P/° 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~..u~I.... 2. .1 .........1,9,8~ 5.pursuant to which Building Permit No....1.5.4. .2.7.Z ............ dated ...O.c.~.....2.7. ................. 19.8. 6., 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 ......... One family .d.w.e.l. 1..i.n.g. including deck. The certificate is issued to CONSTANTINOS & HEDWIG ZERVOS of the aforesaid building. Suffolk County Department of Health Approval ....... 8. 5. 7 .S.O.-~ 1..3.1... N..oy.... 2. .1 .,.. 1. 9. .8 .6 ....... UNDERWRITERS CERTIFICATE NO ........ N7 5 0 5 4 8 Plumbers certificate Nov. 24, 1986 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 No. Z15424 Date November 24-- 19 86 THIS CERTIFIES that the building .... G.~.rg.q9 ..................................... Location of Property .... D.emar~.at. R...Q ,~/..o.f.f...M.a.~.n...R.o.a.d. .......... O.r..i.o.n.% ...... ~.-. House No. Street Ham/et County Tax Map No. 1000 Section ... 0..[.3 ...... Block ...0..2 .......... Lot ...p~/P..7.. ;-. .... ' Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · Aug. 21 1,,9.8.5. pursuant to which Building Permit No. . J-.~4 2 7Z. dated ....O.c.% :..2.7. ................ 19..8. 6, 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 two car garage. The certificate is issued to CONSTANTINOS & HEDWIG ZERVOS ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ........... ~ .N./..~ .......................... UNDERWRITERS CERTIFICATE NO ..................... ~.7..4.3.0.8. 0. ..................... Rev. 1/81 Building Inspector ffOl~3~ NO, ~ TO~N OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 15427 Z Permission is hereby granted to: ...-~.~×..tz.(. ..................................................... .~..~.~........~~....~.-.~.:.....u..?..~.fl. ...... to ..~....~ ................... '~;,~""!'"~ ........... ~ ~'~ ..................... F.. ............ at premises located at ..},~.~g,4,~'. ......... ~b' ................ ~ ........................ County Tox Map No. 1000 Sec~:~......C~..!..,~.. .......... Block ...... '~""~"i ..... Lot No... ~./.~.....~. ......... pursuant to application date~ ~.~....~...~.....~...~.)...~..t~..~.....~..~--1~: ....... , ~,,.J approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hal~ Southold, N.Y. 11971 765- 1802 NOV Z 419 iS :"'! 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 iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz~perty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 oc_cupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.C. $5.00 5.Updated C.C. $15.00 Date NewC°nstruction.. ,~... Oki or Pre-existing Building ............ Vacant Land ............. House No, Street H~mlet County Tax Map No. 1000 Section .......... Block .......... Lot ............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No [~ ~.7 Z Date of Permit~..%7; f~Applicant..~~.~ Health Dept. Approval ..................... Labor Dept. Approval ........................ Unde~riters Approval ~- ~. g B d App Request for Temporary Certificate ..................... Final Certificate .... ~. ................ Foe Submitted $. 5...O~ ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant . . .................... .. Rev. 10-10-78 Z FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~, ~e ' ~' )r~' & ~ This application must be filled in typewriter OR ink, and submitted m ~ tO the Building Inspec- tot 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 featu res. 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- lions, 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. 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 featu res. 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: I. Certificate of occupancy $5.00 ~-~ v'r~P~.~ 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 I'~%~' 'J?.~o 5.Updated C.O. $15.00 Date ..)! .............. / New C on s 1; r uc 1; i on..Nz(... Old or Pre-existing ~Luilding ............ Vacant~ Land ............. Location of Property ~, ~I~IC['~C-~,,... , ~,,; ,l~, .... ,G,~,, .~'~U~t~. ,~,,:...(~, ~,t.~ ,1~,,, ........... House No, Street Ham/et Owner or Owners of Property ...~__~...~. ,~...~-~..'~. t. [~..O~... ~ ~'~..~lr~.. [..~....' . .~-. ~,,~.0. ~_~ ....... County Tax Map No. 1000 Section ...~.~..~. ....... Block ... ~.~ ....... Lot./~.O..7 .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~.~..~.~..~.~-. Date of Permit(~0,,~ ,..~%~(~.Applicant. ~--.~ .t~).~.. ~.~"~.~..~ ........ Dept. Approval gS-so-I£1 Health ~'/~-~o B'O .Labor Dept. Approval .... Underwriters Approval ,~J~JJ~ ................ Planning Board Approval ..................... Request for Temporarv Certificate ..................... Final Certificate ,, ,~, .................. Fee Submitted $...~..,.~..O. .................... Construction on above described building and permit meets all applicable codes and regulations. C, O. z f S"'f .2 $/ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~000771 BUREAU OF ELECTRICITY ~t 85 JOHN STREET, NEW YORK, NEW YORK 1OO:38 THIS CERTIFIES THAT only the alee trlcal equipment o~ described below and introduced by the applicant he,ned On the above application number in the premises of Constan~inos Zervo~, n/$ Hai~Rd.(Rt:.2S)~opp: Narrow Rivez Rd, i,,theyoUo,,iu~loc, tlon; [] Ba~ment [] ~tm. [] Znd #l. o~$ide se~tlon Bloc~ ~ot was examined on ~ ~ I'C~ ,~ ]~ ~ ][ 9 ~ (~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS E OTHER APPARATUS: E R V I C NO. OF CC, COND PER ~' OF CC COND. 4 HI.LEG NO. ~ NEUTRALS AW, O, OF NEUTRAL 4 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~{~{y' ~l~ ].~ 85 JOHN STREET, NEW YORK, NEW3~38 ..t, ~"~"~" ~' ~"i"~ N 750548 THIS CERTIFIES THAT only the electrical equipment as described bel~ and int~duced by the applicant ~med on the able application number in t~ premises o and fourtd ~o be in compliance with the requirements of this Board, ~IXTURE RXTOg~S ~ RANGES COOKIN~ DECKS OVENS EXHAUST FANS OUTtETS 3B 39 39 DRYERS E R V I NO OF CC, COND, A, W G, I NO' OF HI.LE~ PER ~ OF CC, COND, 1 2/0 OTHER ~otoz~ ~-,1/3 PAr Ha~dle~ l-t, Air hm~dler~ 1-3/4 Jacu~ 1-1bp Parco lb~v~L~: 2-G.F.C,L 1-~ Detector '[Wack Llghtina ~8 C E OF HI-LEG NO. OF N~TRAL: AW.G Ruland Elec~r/c Co. ~f~f~~ P. O. ~x 143 must not ~e oltered in ~ny monner; return to the office o~ the Boord f incorrect. Insoectors mo be ident" This COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERVle'"~" "" '~ ........ ' ' - ~,~ '= ~v~u~/~UI U~ ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.~~- Owner C~b ~-~ ~-~ MOa (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ' (plUmber' s sYgnature) Sworn to before me this 19~.. Notary Public,~:~County Notary Public 'OUNDATION (1st) ~OUNDATION (2nd) tOUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 0 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined · (;2~g-'~c.°~':~-...~.3,., 19~ [o. Approved .o. %.~'. Oi~4~..2%.7. ., 197§. Permit No..I. ~'.~, .~..'7..--~7 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. Tins 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, Ordinance.s or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with ail 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) L ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, eneneer, general contractor, electrician, plumber or builder. ............ O. ColqEfi....-r.. G[b~E;gB.L-...CO.h3TK.hC .T_b.~. ................................ Name of owner o f premises .... .CJ.~..~.~. ~.~.~! ~.O..~.. ~. ~q..~..~.~,] I .~. .... ~ .~.~.g ................... (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..../~ ~ ................. Plumber's License No....~....~. ~.. ~ ........... le t icia 's License No. O... Other Trade's License No ...................... Rcc~s~ 1. Location of land on which proposed work will be done. C~.F. "THI~ .FJ.~)b,).~...,) ......... ~..~. o.ff ~.~ .... House Nmnber Street HamIet co~v ma~ ~ ~o. lO00 S~c~ion . .0.~3 .......... ~ock .... ~ ........... ~ot .~,.~ .~. ........ 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 ~ trot ~ ~,... ! .O.' .~.~:'~' ..... :.: ....... :. .................... b. Intended use and occupancy' i" 'i i ii ii ii [~.'~.g'~l [ .Xl...'...~)..0~..~.'!.. ~.~....: .................... 3. Nature of work (check which a~plicable): New Building ... ~... Repair .............. Removal .............. Demolition . Addition .......... Alteration .......... ............. Other Work ............... (Description) 4. Estimated Cost...~..|.{.0.).0.°.0.' ~..~..(~ .................. Fee ............................. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units.. .~ .... Number o f dwelling units on each floor .............. If garage, number of cars .... ~ .~-O~ F. ......................................................... 6. If business, commercml or m~xe:d occupancy, spec~y.nat~re and extent of each type of use ..................... ' : ' .~" ( pth 7. D~menmons of existing structures, ff any Front ........ Rear ............. De ............. Height ............... Number of Stohes ........................................................ D~ensions of same structure ~ith alterations or additions: Front ................. Rear .................. Depth .... ;. HeiSt ............. Number qf S~pfies ...................... 8. D~mensions of entire new constmctton: Front . ~ ~ ~ Rear . ~ ........ Depth ~}.6 .......... Height ...~. P. 7 .... Number of Stories .... ~ .................................................. 9. Size of lot: Front .. ~ 5.~.~ ........... Rear .... .~ 15 ............... Depth .. ~0~ ............... 10. Date of Purchase .doNq. J~.~l.~ ~ ............. Name of Fomer Owner ~EH~.~.. 11. Zone or use district in which premises are situated ...... ~. ~.~. ~.~.~ .............................. 12. Does prnposed construction w01ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ [.~0 ................ Will excess fill be removed from premises: Yes 14. Nme of Owner of premises CO~TI~ ~Address¢.O,.BoX}/5, E, ~g~l~ Phone No. Nme of Architect ~..~S~O~I ~T~.~ .... Address~ ~O~9g0.~... Phone No. ~5~B.~. Nme of Contractor~[~ .~YO~ ............ Address~t~X ~).ff, H~.q~. Phone No. ...... pLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing o? 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. ST^TE OF NE~)RK, COUNTY OF~ ...... (Name of individual si~fifng contract) being duly sworn, deposes and says th.~ne is the applicant above named. ~Hith I (Contractor, agent, corporat' e officer, etc.) of said owner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements col rained in th!s application are true to the best of 't~knowledge and belief; and that the work will be performed in the man] ter set forth m the application filed therewith. Sworn to before me this .......... ~...day ,f....O.~... Notary P.ublic .... ,.~.....~-,..~...,.. *~..~. ~ ~' /. ELIZABETH.ANN NEVILLE ' , N~TARY PUlilLIC, Stere of New Yo~'k ~. 52.,81~2§1150, ~f~olk CeuAt'g County (Signature of applicant) ~-- [~ I SUFFOLK CO. HEALTH DEPT.~OVAL ~ STAT~ENT ~ INTENT - .............................................. SY~EMS FOR THIS RESIDENCE WILL ~ CONFORM TO T~ STANDARDS OF THE SUFF~_ K. C~NTY DEPT. OF HEALTH DATE' [; L ~c c~Z z ~ o:z '7 ..... ~. ~ODE~ICK VAN TUYL, LAND SURVEYS GREE~RT ~W YORK BEEN COUNTY HEALTH DEPARTMENT FAMILY DWELLING ONLY ~ection VAN TUYL. P:C. SUFFOLK CO. HEALTH DEPT. APPROVAL CONFORM TO TE ~A~R~ ~FFOLK OF HEALTH SUF'FOLK~ COUNTY DEPT. OF SERVICES -- FOR A~PR,OVAL CON~T RUCT ION ONLY OF APPROVED: .... ~ $1~'FFOLK CO, TAX DIST. SECT, ~SUFFOLK CO. HEALTH DEPT. APPROVAL ~ x ~ ~ .g. ~FFOLK CO. DEPT. OF HEALTH ~RvI'CES. ....................................... ~t- .... CONSTRUCTION ONL~ DaTe ~ TEST ~E , ~P ~DERiCK VAN TUYL, P.C. LAND S~V~ORS :T GREEN~RT NEW YORK # lelNl tuldng II u~ed ~ dl~J'lbuflng Wing ehlll be M tjllee K or L only, SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY APPROVED ~g NOTED D~.TE: I ~/~_.l/~_ NOTI~ BUILDING DEPA~TMBNT AT 785-1802 9 AI~ TO ~ PM FOR THE FOLLOWING FO~NDA'rIoI~ '~(3 ~QUIRED FO~ PO~LO ~ ROUGH FRAMING ~ PLU~BING ~, INSULA ~10~,~ 4, FINAL CO~STRUCT~OI~: MUST OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY proJecl title: l :" -Ct . ' ='i -' [ I II I t I Il iff ,-[ ~ t l- .... i J r ELE'VA'Ti ON~ I or'ti ~ L~VA'TI ON NOTIFY BUILDING L~EPART~iF. NT AT 765-1,~02 9 A~ TO 4 PM ~R THE ; ROUG~ ~b~,IVI~NG & PLUMBING CODES ~T ~SPOflSI~E ~R OCCUPANCY OR USE iS UNt. AWFUL WITHOUT CERI'IFIC/(I'E OF OCCUPANCY 14) NO OGOROQPVENTO /.40 AePIMLT 9HBIOLEJ ON #OIB ~ELT OYES I/I PLYW'O 8H~.ATN I Xe CLE&R ~I~DAR I).° OI,EAR,QE DAR OVIS 4 OE~VII., Mr: '.0)4 IOXO I· IXf:~ [FRONT ELEVATION J 2X4 AOPHALT 9HINILEf: . Oil NO 19 PELT OVER I/3~ PLyW1) 8Hr, AT#, f: , OR 8XlO FLOOR JSTf: 4" DIA'f:OL. I IXl C:LfA8 OLEA80E G~.R (2) f:X4'8 f:X4 8TUBB 18'"' O0 BOLT I:O O0