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Home My WebLink About15292-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Budding Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No . .z.-. 16 .ST) ...... Date May 16, 1988 THIS CERTIFIES that the building ACCE SSORY SHED Location of Property , 250.C.e.nt.r.a.1. Dr.iv.e. .... .M. at..ti.tuck, N.Y. rcou$e NO Street Ham/et County Tax Map No, 1000 Section , J.0,6, ...... Block ,9.3 ........... Lot l 9 Subdivision ........ Filed Map No . Lot No. conforms substantially to the Application for Budding Permit heretofore filed in thru office dated Septem, b..e.r. 9.:. 1986 pursuant to wluch Bmldmg Permit No 15292 Z dated . Se. pt.em.b, ar 20, 1986 was~ssued, and conforms to all of the requirements of tile applicable provisions of the law The occupancy for winch this certificate is issued The certificate ts ~ssued to .MICHAEL, . . MOSHOURIS of the aforesmd building Suffolk County Department of Health Approval N / A ................. UNDERWRITERS CERTIFICATE NO ..... N/A ........................ PLUMBERS CERTIFICATION DATED: N/A Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, bi. Y. BUILDING PEIU'A IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15292 Z Permission is hereby granted to: ..~.~........~... ~.~ ......... .~~. ~ :.~.,.....~..m.?..~ .... premises located at .....~,,.~..~.,....~.~.,~...:,., .~~~ ................................ County Tax Map No I000 Sect,on .[...C:~. (e . Block .....C~.....~. ........ Lot No. 1...¢[ ......... pursuant to (3pphcahon doted ~C:~'-~ C~ ...... , lg-?(P, ond approved by the Building Inspector. Fee Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD l~u~lding Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcatlon must be filled in Wpewr~ter OR ink, and submitted m ~ to the Bui{d[ng Inspec- tor with the following; for new buildings or new use: 1. Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposel--(S-9 form or equal). 3,Approval of electrical installation from Board of Ftre Underwmters, 4. Commercial buddings, Industrial buildings, Multiple Remdences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmbte for the building, 5.Submit Planning Board approval of completed sit~. plan requirements where apphcable. B. For ex~stmg buddings (prior to Apml 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of property 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 cond~bon of buddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent reforma- tion required to prepare a certificate. C, Fees: Addztzons $25.00 POOLS $25.00 ALTERATION $25.00 1. Cert~fmate of occupancy New Dwellzng $25.Q0, Accessory ~$ lO.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3 Copy of certlficate of occupancy $ 5.00, over 5 years $10.00 5.upd&ted C.O. $ 50.00 Date .................... NewConstructzon Old or Pre-exmtlng Building Vacant Land Location of Property . .~..~.~....~..E./~. ~.~. ,~7....~.~.l.J~.~ .......... .~..~.K?../..~../~..C./.~,x . ./~. :~/.'.... gou~e No. Street Hamlet Owner or Owners of Property .... ~./.C ~..~./-~ ~ ~)A~.. J~ ~. CoIJnty Tax Map No. 1000 Sect[on ... ,/.~).~. ...... Block .... 3 ......... Lot.../.~. .......... Subd~vm~on ......................... Fded Map No .......... Lot No ............. Approval -~ Labor Dept Approval ~ Health Dept ............................................ .. .. , Underwriters Approval ~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................., Fee Submitted $ ............................. Construction on above descmbed budding and permit meets all apphcable codes and.jregulat~ons, Rev. 10 10-78 TOWN OF SOUTtlOLD OFFiCI.; OF BUILDING INSPFCTOR F O [lOX 728 TOWN IIALL SOU I IIOLD, N.Y. 11971 May 5, 1988 TEL. 765-1802 Mr. Mzchael Moskouri 250 Central Drive Mattituck, New York 11952 To Whom This flay Co, cern, We are unable r.o complote your Certificate of Occupancy because of the following reasons. ~/ An application for Certificate of Occupancy is not on fil~. (ENCLOSED) /_--/ :k~ Under::ritcrs Certificate on file. /~/ The check innoVated/not o:~ file.] $]0.00 /-/ Nm ![oalih Dept. Approval on fzle. /~/ ::o fznal lI]spoction ha~ been mado. P]ea:~e contact our office on this matter. Thank you for your cooperation. Bultd~nq Permit t~ 1 5 2 9 2 Z Dui ldlz.-[ Dept. ,~**/--/ No Plumber Solder Certzficate on file. ( all permits involving plumbing being issued afte~ April 1,1984 ) ?IELD INSI~ECTION IDATE COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH F~AME & INSULATION FERN. Y. STATE ENERGY CODE FZ~A~ ADDITIONAL COMMENTS: ,. I..11 1 .c.--_ /¥ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [/~NAL DATE INSPECTOR ~_~ FORM NO. 1 TOWN OF SOU'I'HOLD BUILDING [DEPARTMENT TOWN HALL $OUTHOLD, N Y. 11971 TEL 765-180:2 D~sapproved a/c .. (Budding Inspector) APPLICATION FOR BUILDING PERMIT Recen. ved ........... ,19. Date .............. 19 INSTRUCTIONS a Ttus 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 accordmg to schedule b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pubhc stlx or areas, and giving a detaded description of layout of property must be drawn on the diagram which is part of tlus ap cahon. 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 pe~ 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 Occupm shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the msuance of a Bmlding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable 12ws, Ordinances Regulatmns, for the construction of buildings, additions or alterations, or for removal or demohtion, as hereto descnb The applicant agrees to comply with all apphcable laws, ordinances, building code, housmg code, and regulatmns, and admit anthonzed inspectors on premises and m bmldmg for necessary inspections. (Slgnat~se of ~j~hcant, or na~.~ a cqrporation) ...... (Mailing address of applicant) State whether apphcant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build; Name of owner of premises ................................ (as on the tax roi1 or latest deed) If apphcant Is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's L~cense No Plumber's L~cense No ........ Electrician's License No Other Trade's License No I. Locahon of land on winch proposed work ~dl be done House Number Street County Tax Map No 1000 Section ] 0 ~ k.'~ '~ .. Hamlet Block. ~ ....... Lot . <.~. 2 Subd~vis~on .... Fried Map No .. . Lot ... '(Name) State existing use and occupancy of premises and ~ntended use and occupancy of proposed construchon a Existing use and occupancy b Intended use and occupancy 4 5. Nature of work (check which apphcable) New Bmld~ng ~,~ Repair . Removal ...... Estimated Cost . . ............ .... Addition ...... A/teratzon . Demohtlon_~ ...... Other Work ......... . ~ .-- ~ (Description) .... Fee .~.~ '. ..................... (to be paid on filing thzs apphcatlon) If dwelling, number of dwelling units ...... Number of dwelhng units on each floor .......... If garage, number of cars ...................................................... If business, commercial or mixed occupancy, spemfy nature and extent of each type of use ................ D~menmons of ex~stmg structures, if any Front ...... Rear ........ Depth ............ Height ......... Number of Stones ................................. Dunenmons of same structure w~th alterations or additions Front ............. Rear .......... Depth ............ Height ........... Number of Stones ............... 8. Dlmensmns of entire new construction. Front . .~,~ Rear . .[.7 ~ ...... Depth .[.L; .! .... Height ............. Number of Stones ~. ........... 9 Size of lot Frt)nt ......... Rear ................ Depth ................. 10. Date of Purchase .......... Name of Former Owner ................ 1 1 Zone or use district in wtuch premises are situated ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation ............................ 13. Wtll lot be regraded ................... Will excess fill be removed from premzses Yes 14 Name of Owner of premises ..... Address ............. Phone No ............. Name of Architect ........... Address .............. Phone No ........... Name of Contractor ................... Address ................ Phone No .............. 15. Is this property located wzthin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permzt maybe required. PLOT DIAGRAM Locate clearly and distinctly all buddings, wlxether e×mttng or proposed, and, indicate ail set-back dtmenstons fron property hnes. Give street and block number or descnpt~on according to deed, and show street names and mdmate whethe interior or corner lot. STATE OF NEW YORK. S S COUNTY OF ! · . //~ [£',t114~,/ /f/.~f'/?~/~/-~... be~ngdulysworn, deposesandsaysthathe~stheapphcan (Name of ~ndlwdual mgnmg contract) above named He m the ........ ~..~ ~.~ ................................. (Contractor, agent, corporate officer, etc ) of said owner or owners, ~d m duly authorized to perfom or have performed the said work and to m~e ~d file apphcatmn, that all statemenB contmned m thru apphcahon are tree to the best of h~s ~owledge and behef; and that th work will be perfo~ed ~n the m~ner set forth m the apphcatmn filed therewith Sworn to before me thru .~ ...... day of. ~ ............ 19~ Nota~ Pubhc .... . .... ... ~7~. County , . N - ~8~NNN~ (S~gnature of apphcam · -81~8~, 8~ ~ Term ~ ~r 31, I ~