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Home My WebLink About15019-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15238 Date February 2, 1987 THIS CERTIFIES that the building .... .a .d.ct.~. t. ~. 9 P ................................... Location of Property 775 SHORE ROAD GREENPORT House NO. Street Hamlet County Tax Map No. 1000 Section . 0. ~ ,7 ........ Block 0 2 .Lot 2 0 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 24, 1986 ' ., . pursuant to which Building Permit No. 15019Z dated . .J.u.n.e...2.4.,.. ! .9.8.6. ............ , 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 ......... .... IJDh.e.a,~ e.d..p.o..r.c.h..a. ,d.d.i.t. ~. p.n..t.q..a.n..a..x~.s.t.J...n~g..o.n..e..(a.m..~ ~.y., d..w.e.l.l: ~ .n.g.. ...... The certificate is issued to NICHOLAS & STELLA VAFAKOS ..................... ioYn'o;-, ...................... of the aforesaid building. Suffolk County Department of Health Approval ......... .N./,A. ............................. UNDERWRITERS CERTIFICATE NO ................. ?.e,n.d. ~_ p~ ......................... PLUMBERS CERTIFICATION DATED: B.P. #15019Z replaces B.P. N/A Building Inspector Rev. 1/81 TC~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDilqG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 'NC 15019 Z Permission is hereby granted to: G ~ s~ A/. '~'-~,.,~,~/~, ~ ~//(: ..~.e..e.....~.~..~ .............. ~.~....~.,......LL.L~I .............. ,...~.~....~..~.~... ~.~....~...~......~ .............. · ...................................................................... o,,,,~,,,,~,,,~,..~.~z...~~ ......... ~.~ ........ ~:.~: ........... County Tax Map No. 1000 Section ...... 0...~...~. ..... Block ..... .~..~.. ....... Lot No.......":~..,~). ............ pursuant to application doted ........ ...~.....,,L,,l,~:'~e.~...~.~. ............ , 19.~..~., and approved by the / Building Inspector. Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 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- 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 (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 features. 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 requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 s.u. dated c.o. $ 5 0.0 o Date.. .............. NewC°ns%ruction ...... Old or Pre-existing Building ............ Vacant Land ............. House No. Street Hamlet Owner or Owners of Property , , ~, ,~,,$, , , I~. , ~., , ,~-, ..................... County Tax Map No. 1000 Section . .0..~.7 ......... Block . .O. ~ .......... Lot..~..O. .......... Subdivision '- Filed Map No '-- Lot No Permit NoJ,,~O.i.~ .~-... Date of Permit~7.~. ~J.(~,..Applicant .G~', {~. ~ 7. J~,'7';.~ ............ Health Dept Approval Labor Dept Approval ' ' Underwriters Approval Planning Board Approval Request for Temporary Certificate .... ~ ............. Final Certificate ....................... Fee Submitted $..~-,~....0.~ ................... Construction on above described building a~d permit meets all applicable codes and regulations. · :~t--.w-r-~,~E~,..~...~.~.~/¢~~ ........................ Applicant Rev. $0-10-78 ~.~/~-"~ L/¢!¢'- FOR,~ NO. 0 TOWN OF SOtJTHOLD 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? 13298 Z Permission is hereby granted to: .....~.~F~....~......T~.~....~ .................. ..~....~~..o~.~.....~.~ ....... ....~.a~z-.~(~.....--....~....~..... ........... ./..(ZT i ~a~.~.~.~z. to ...... ...... ~~z~......~....~.~.~.~..Z.~ ........... ~.....~....~~...~=~ ~.~ ~ ~~'""~~'~~'"~°~-- at premises ,~ated o, ....... .~..Z~ ........~~.....~..~....~~~.~ County Tax Mop No. 1000 Section ...~.-....~.'.7 ..... Block ...~.~. .........~Lo, No..~....~'..~.. ......... ~.,~o., ,o o~,,~o,,on ~o,~ ......... .~.~.......~-- ................... ,,,~.'~ ~ o~,o,~ ~, the Building Inspector. Fee *.~....~.......~...... Building I~tor Rev. 6130/80 FIELD IN~FECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N,Y. 11971 TEL.: 765-180:3 Examined ?.~t~ 1~.. Approved.. ./. .......... l . eermit No./4 . Disapproved a/c .... ~ . '.' Y". 5 ................ · ' (Building Inspector) APPLICATION FOR BUILDING PERM IT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 Penmit 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 H.EREBY MADE to the Buil~ling Departmeht 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 ~sl~ections. , ~ applicant, corpora.on) (~t (Mailing addresS'of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '.- ..................................... Name of owner of premises . ~.{x;~J//2~...¢.,'~..~//,~..V~..~'. · .~'~. ·~. ..... ..... ' ........................ (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 ......................... Electrician's License No. jtj/~ ~/.~7¢~'~.C: ...... Other Trade's License No ................. ..... 1. Location of land on which proposed work will b~ done .................................................. ..... ....................... ................... ................. House Number Street Hamlett O' County Tax Map No. 1000 Section .... ~ ......... Block ~2 Lot Subdivision ..................................... Filed M~;';:. ' ¢~¢;;~... (Name) 2. State existing use-and occupancy of premises and intended use and occupancy of proposed construction: a. Existing us~ and occupancy . . ~ ~.~ .......... b. Intended use and occupancy . ~ ~.~ ~J~ ~ ~ . .~ ~ ~'~ ......................... 3. Nature. of work (check which ap licable): New Building,. ......... Addition .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost.. ~.~q.'"'l~)t~.C~.,~ 1~. ~) ............. Fee,.~ ....... : ..... , ...... (to be paid on filing this application) 5. If dwelling, number of dwelling mits ...... /. ........ Number of dwelling units on each floor.. [ ............. If garage number of cars '--'"~ 6. If business, commercial or mixed o. ccupancy, specify nature and extent of each t~pe of use . .~ ................. 7. Dimensions of existing structure!s, if any: Front..*,-q,~ ......... Rear ~ ......... Depth.~..~.. ( ........ Height .. ~../-/'.. ~. ........ Number of Stories ..... f ............................. Dimensions of sawe structure with alterations or additions' Front .~/.' f~ t Ra~ ,2~2(~ I .......... Depth....~..d~.. '. ........... .. Height.. fi.d-/. ! ..... j ...... 8. Dimensions of entire new construction Front ~/.O. ! ...... Rear ...~.~( ....... Depth .~/~. ! ......... Height . . t .~..w ......~... NuN:bet of Stories ........... /. ............................... . .............. 9. Size of lot: Front . ,~...~..r .....j. Rear·..7~..( .......... De~th . .! O 10. Date o~ Purchase ........... i .................. Name of Former O~v~l;; 11. Zone or use district in which promises are situated ~-~..,,¢/o}~.~, 12. Does proposed constru_clion vmlate any zomng law, ordmanceorregulatlon..]~o. ................ ~ ........ 13. Will lot be regraded .[~..0. 3/ ...2. v._: .~ ..,e~t...~.,. ..... Will excess fill be removed from premises: CYes~ No 14. Name of Owner of premises VaI~~ ~ ......... Address ................... Phone No ................ Name of Architect .......... , ................. Address ................... Phone No ................ Name of Contractor ......... i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block dumber or description according to deed, and show street names and indicate whether interior or corner lot. ..7 5r-" STATE OF NEW_.YGILK. S (Narn~ of individual signing co¢~lract) above named· ~ 7J' '~ ..... being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this ' ......... ~ ......... day of.! ................... 19 · : Notary Pubhc,~~~,~d./t~~) ......... .,~, .!, .,..~/-~.,:t'~7/~.x . Count ~.,q~.~y_ ~ ~"~ ~ ..... Blgl~llRINltffill~ ~ ' ...... : ' ' '~ ..... ~ ~J0, ~ ~ ~ ~ (Signature 0p'a'~Iicant ) Teffil Expires March 30,