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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCOPANCY No 219736 Date FEBRUARY 20, 1991 THIS CERTIFIES that the building ADDETIONS Location of Property 955 SOUNDVIEW AVE. EXT. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 050 Block 02 Lot 011 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 23, 1990 pursuant to which Building Permit No. I9538Z dated NOV. 26, 1990 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 TWO CAR GARAGE ADDITION AND DECK TO ONE FAMILY DWELLING. The certificate is issued to JOHN A. & STELLA SCOURAKIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N171696 JAN. 30, 1991 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 I roams xo. TOWN OF SOUTHOLD 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 a 19 5 3 ~ Z Date ...N...a.:!:I:~!:n!"~:4r....... 19..Q Permission is hereby granted to: i ~3.~.?~......~.1~ ..~i~-:~?-:...: ~ :y...... i.1.9..7..r....... pp at premises located a4 .:J.S~.....~......... U.~4~?r.4r.S? .....:...ai'.:':v:!.,........ . Q. ~:...5~~::~:~.~............................................................................. County Tax Map No. 1000 Section. `~...n 5~.......... Block ....4.zx:........ Lot No..... a..~~........... pursuant to application doted ....N11'a?::~':A!~-i.~. 19.x.4.,, and approved by the Building Inspector. Fee 5...1+~~.:.. Building Inspector Rev. 6/30/80 i~~z THE NEW YORK BOARD OF EIRE UNDERWRITERS rncx 1 x 11309020 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JllLX i.9T199'1. APPlieatianNo.onfile 76902t~92/92 13 E97.,05 - THIS CERTIFIES THAT only the electrical equipment as described 6elou+and introduced by the opplicant named on the obove opplication number in the premi»ea of ANTHONY A(.IE'IsftT%, 5Ei35 pRFCTON ROAE)r CNTCHO(rC1Fl N.Y. in thefollorvinR location: ? Basement ® lst F'!. 0 2nd F1. ATTIC .Sertian Block Lot wos examined on APhIE' ~~t1~~? arzdfound to be in rontpliance with the requirements o/'this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OURETS ECEPTpCLES SWITCHES INCANDESCENT FWORESCENi OTHER AMi K W. AMT. K. W AMi K.W AMT. K W AMT. H P 10 50 7.G 1d3 DRYERS FURNAC@ MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ggLL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G, AMT . AMP. AMi AMPS. TRANS. AMT. H P SYSTEMS pMT. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V 1 C E y AMT. AMP. TYPE METER I A, ~W I ~W 3 KW 3,»' 4W NO.OF CC. COND A. W. G. NO OF HI~LFG A' W G NO OF NEUTRALS A W G' EQUIP. PER% OF CC.[OND. OF HbIEG OF NEUTRAL OTHER APPARATUS: r,.r.c.z:r-3 _ ~ TONY AGTC@~ttTi. BOX 199 aHI'Rt,Ll'r NX, 119$7 GEN6RAt MANAO@R 7.1 ~ Per This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by tfieir credentials. COPY FOR BUILDING DEPARYMENT. THIS COPY OF CERYIFICATE MUST NOT BE ALTERED IN ANY MANNER. r,., „ s..,., Form No. 6 ,,~~F i`,' TOWN OP SOUTHOLD C~~pp µ~hF BUILDING DEPARxMENT a'~', t rGO ~ 9 ~$t , ' ~ TOWN HALL ° 'i;i Zs,as t1 765-1802 ~ F(',O: ~~rt ~ ~ APPLICATION POR CERTIFICATE OF OCCUPANCY ~A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certi.':icate of Code Compliance from architect or engineer responsible for the building. b, Submit Planning Board Approval of completed site plan requirements. 3. For existing buildings (prior to April 4, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. v. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 v Date ....?-.~~.`~.,g ~ 'few Construction....^..... Old Or Pre-existing Building....,..^.~.......,. m Location of Property..~.r~2.tJ..... C-;~?VN'D.~IC.~.AJG'..C~.1:..`~.°.`~:."~~:1.'~........ House No. Street .Hamlet Onwer or Owners of Property.~o.~aCC.°.~.~'~ S~\-~q ~CovrZ~~G \.S county Tax Map No 1000, Section...:1~.......Block.... Z .........Lot....` ~ subdivision ....................................Filed Map............Lut....... permit No.!~rJ.38 ...Date Of Permit. ~~(Z~.(9n.....Applicant.~~~ ~~~``S (ealth Dept. Approval ..........................Underwriters Approval.{.?::54 ~ ?1,1.1.~........ N l-7lCo°~ Co Tanning Board Approval equest for: Temporary Certificate........... Final C~erti~cate. ee Submitted: s,'„(;~~,° . i L'`s`~~-w~/'~J 0o G'/~~'v + ~ Y~ ' - ~a~~%l73~ ~ -A~-crcAh~x-------------- =1cLD Ii:S:c,.._U:i ~~Un: I :;C)?~(:'4ENT° • -o ~ - m i 1 . ~ _ a y W - - oG FOUtJDATION (1st) ~ c ti m FOUtJDATIOtJ (2nd) 2. z o .o P,OUGH FRAME & PLIJMBING N H ~ G 3. m~ ra .3 IIJSULATION PER N. Y. STATE ENERGY CODE x M m4 13 y 4. FI;JAL ~ °s ADDITIOIIAL COMMEPlTS: ~ --A . , N m • - x N 9 H H O „p Z p' T C m a .r "j S v 1 `7 BUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ~NAL REMARKS: ~ DATE INSPECTOR t ¦ 'AMERICAN SPECIALTIES, INC A.S.I. Fax #9144760688 441 Saw Mill River Aoad, Yonkers, NY 10701 (914) 4769000 Telex: fi46889 ASI YNKRS YKS Town of Southold John A. Scourakis Office of Building Inspector 955 Soundview Avenue Ext. Town Hall Southold, NY 11971 P. O. Box 1179 Southold, LI, NY 11971 February 15, 1991 Gentlemen: Enclosed please find Certificate of Occupancy Application, Building Permit #195387_, Board of Fire Underwriters Certificate, and my check #1163 in the amount of $25.00 to cover the application costs. Please send this Certificate of Occupancy to the address indicated above in Southold. Thank you!! Very truly yours, ~ ~'L~ John A. Scourakis JAS:dw enc. ~ ~is~ ~.~ux...-~ . ".~.,^ae..~,..,.„~,m; :5 ),f it rF 92 Accessory SpeciaNies AMERICAN oIIPEMBfiR DBSEf[ flay PfOdUCC& M0O1PE' ascensens ~/J BOARD OF HEALTH f. D 3 SETS OF PLANS a^^h , ~°°`1 FORM NO. 1 SURVEY 'v.: tom.°, , , , , , , 2 g ~ TOWN OF SOUTHOLD CHECK , , BUILDING DEPARTMENT SEPTIC FORM TOWN HALL 70Wh~ ~~c c,~,'.7 .,OUTHOLD, N. Y. 11971 NOTIFY 3~ 3 3s a ~ -~-_•,*-....,_.np.,~~;~4?,Yt~lOr_i7...,., TEL.: 765-1802 CALL Examined /.V~'1~ a~4., 19 ~.C? MAIL T0: . - • Approved~C?".'a."`."~'.°Z~o., 199'V.PermitNo.~~.J.3.g..'~-. Disapproved a/c U,~c,~. , (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 15 . INSTRUCTIONS a. This 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, Ordinances or Regulations, for the construction of buildings, additions or alterations, r fo removal or demolition, as herein described. The applicant agrees to comply with all applicable law , o ina es, ild' co ,housing code, and regulations, and to admit authorized inspectors on premises and in building ~ r ece ry i spe ions , ,Oeg K.sN~ rs lkrn,c ~ (Signature of"applicant, or name, if a corporanon) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....~EaiC,O~~ Name of owner ofpremises -.~~..01~~~1. /as-'!~. 5~.~=~1'J~.. ~c? V ~~~~..\S, , , , , , , , , , , , , , (as on the tax roll or latest deed) If applicpnt is a corporation, signature of duly authorized officer. ~e:~ . x".1"7 ~.h(... U . (Name ahd title of c2orporate offi era , Builder's License No. . ~ . ~T®•~ ' Plumber's License No . . Electrician's License No . . Other Trades License No . . I. Location of land on which proposed work willpb~e done . , . House Number Street Hamlet County Tax Map No. 1000 Section ©rJ. O...... Block , , , , , , , Lot ....CJ, , , , , _ . , . . Subdivision Filed slap No. Lot . (Name) 2. Slate existing use and occupancy ofpremises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~Q1?,LCC rN~' b. Intended use and occupancy t~S°• • • ~ 2 3. Nature of work (check which applicable): New Building Addition • • • • • • Alteration Repair Removal Demolition OthawiliaQlc~ . t17~~ (Description) 4. Estimatcct Cost ~,16~ rc z • • • • • Fee . (to be paid on filing this application) S. If duelling, number of dwelling units tip....... Number of dwelling units on each floor N~........ . If garage. number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7, Dimensions of existing swctures, if any: Front Rear .3-~~......... Depth . Height a Y.`......... Nurnber of Stories . Dimensions of same structure with alterations or additions: Front ~ Rear . Depot Ileight ?:Y. ; , , • Number of Stories . 8. Dimensions of entire new construction: Front 3?~........ Rear 3.x~ Depth Hcigltt /.s.~ Number of Stories .....QN.4 . 9. Size of lot: Front l3:r.~ Rear ...Z?,7.•, ; , DzPth . /Y.~! 33............ . 10. Date of"Purchase .............................Name of Former Owner . 11. Zone or u:;e district in which premises are situated R'£ s .Q;e..T"~: • . . l2. Does proposed construction violate any zoning law, ordinance d'r regulation: !t!9 . l3. Will lot be regraded N.~ .....................Will excess fill be removed from premises: Yes 7~9 14. Name of Owner of premises .J°dNw s%~rcq. sc~K~~k~~ddress 718 svs 3syt ..9ss .r.,..o.~f~ Aut cxn. Phone No. ~s•-vyva...... . Name of Architect ...........................Address ...................Phone No............... . Name of Contractor ~6~N.~r. /{~nF.!^:~. 1:~!C AddressaF.svs,7nfy,AQ,.,~;~~TPhone No. ?i??..33?7...:,. ]S.Is Chis property located within 300 feet of a tidal wetland? *YES....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or 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 cornr:r lot. t c•. ,G . c~ - ; f~ , . ra ' - :'°._l; ~ = f ~ _ ~ ~ ~ F r _N ` ¢ .l " ;y. & A X O M1 ~ 5 STATE OF NEW YORK, r ~ ~ ~ n COUNTY OF . S.S being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; [hat all statements contained in [his application are [rue to the best of his knowledge and belief; and [hat the work will be performed in Ute manner set forth in ttte application filed therewith. Swom to be[ore me [his Notary Public, /'•'Ke.~'Q-os-~..~ County jl, ~Ry p~j~ ~af~C eMY°i~w~ (Signature of applicant) Tern expires h uch 30. +'-f" I i~; L-~~' ! ~ _p i • r.Jr ~ I 1 1 ~1~~. ~ ~ ~ I ' iA i ~ r. ! 1 ~i, I I 5,a ~ r , ~ ~"s ~n ' ti SQ%. ~ ~ - m S. ~ o. I ~ ~ g ~=i I cv ~P r, ~ .r ' ~F ~ U T i N H y I m F ~ ~ I ~ i n ~ _ _ _ ~ ~ ~ ~ _ . _-~rj- II I / ~ V f w F { r n 11 I ~ i m N ~ ~ 4 j W ~ ~ ~ ~ / f~ - c( :4 ~ ~ d ~ ~ ! \ ~ 1 t ~ ~ ~ u. O o -t`r ~ I i; ro c_: ~ m " d ui ~ a~ ~ 1 ct i' , ,f r i ~ - P ~r w I ~ d ~ / Q) / ~ 7 t ~~r~l~`c P -1 ~r r~ r; 3T EX.sT• s~ n ~,G'P ' ScF-~b r1 05° N -kk~tfoo4z~6'~Q~IJ ~ 5~-~-~ I .g~,Kp2 ,4,i m S~cvRAK\S ~T oho o ~.r= N SEe~o~ oSo ~ X . z ~ O 'L~ \ n7 . / ~..iN Sr..a 4 m m~v R,:~.,~ ~s ~ wm,r~n,t r ~i y ~'dP c~jn O Nf~i ~D K Kr,~~o~ 1.-~ m mo nr,~~. ran._s~au _ (E ~q~ ~ ~,,9~~ty ~ SEE. r~iflna siin~r•.: in.~~n~rt ns~mu0 _ _ M yr ~ . I_~, e~ _ ~ ,.3i an: n ~m iz unrulic~;.: ' I` a~ ~ Fer h-Ir u^, m.., { o xCIhoWUnm:.ktlloKMS,~ia9x'.Y.. C uv;oa. ~ ~ .;.'~it_P p..'., rL 9 N ~SC~ e.o ~ ~`\~4 GLJA12 ft~1'ST~F_~.1~ Two THE IIVTEf -COQ ~~TY C ~ y ~ 'k i TM'T I_F_ OF l.^+au TY_~ MO,RTfi A+'.E CD. AND 1 ~ ~ _ GUAGe/~I`d'I F_'Gi~i T~,> ~=N C_~~U7"NUr_V uA\!`J~IC.=~• C',J~d'lK AS SURVEY_f__P ~ ~~-'_J_UN~~`i!9"71 L_ , _ _ j (-%J'MC)Nl.}i/1,-F_.C~i % it . GG2 F'r-~4F~K;G1 ~ ' r x- I 4 1 r ` Y ? , e E J ! y } n d I { ' I L Ir z 2 , OCCUPANCY OR APPROVED AS nNr�IM- USE IS UNLAWFUL ��(3 DATE: . R.P q/9 S WITHOUT CERTIFICATE FEE: +�� — _RY V. NOTIFY --_ OF OCf;IIPQNC Y NOTIFY BUILDING Df muE-1 IT ;U 765-1802 9 ANY TO a p;i• e°O^ liiE t -- FOLLOWING INSVECII[TV'= 1. FOUNDATION TWOREOUM-r, ; FORPO0REDCOM1ICf;c7E ` + 2. ROUGH - FRAMING & PLUMRIPJ, ..iel�• 3 INSULATION �pF^- 4, FINAL - CONSTRUCTION MUST _F \\$9 ' ��fi>±=••.i f. !.' oI y f x 2$' +,?"'nieNCFa RE COMPLETE FOR C,O Ym` � jj,, _ FOR Mry''F g,-v 'T';v ALL CONSTRUCTION SHALL MEL-'T �+�,�;J��j+�f}r{"�,g, THE REQUIREMENTS OF THE NY. � !`s, f ' ' AlPEWED IR # ET. .tkr f S STATE CONSTRUCTION & ENERGY SCAM; /' D4WN � _ CODES. NOT RESPONSIBLE FOR - DAre DESIGN OR CONSTRUCTION ERRORS . y BOB KEHLS HOW 1NtfROV. AND.- 11(i C:.O 6d�S 920 SOUTHOLD,:NN 1071 ' . L - s I ! _ r L 4[$ Inti Ot 4G k up OIL ;I r I jI r� I E 00 4v LJA ty ,L fw syr `�f" al . tl,' �- IL� 1 r ,# ptEf to I 1 1 Flo_t t f PRoPo Sco 2Y'xa v' k1Tle,';«c yFJRFpt _ - FoA ^4 ,t MiFS SDfdN SC o4,QAKrS r SCALEy d! AMIIOv AYp DPAWN yY.j; if R:h! tt DA1F: EEVISED - f I BOB KEHIS HOME IMPROV. INC. _ - - - P. O. BOX 320 - $OOTHOLD, NY 1187f, ,. - fl foes wiQ�J 7"1'CM' El`' f2hu/ 141 '.Z CF .f 'Y i 9Y 1 T •f� 1 M t c' a poi, aP-F h, 1DP e"�� f. dtr4 E4 �. �'- - •il-_- ---�-� u' 1'' S - r f ` ; .B'r' B iPN u i Ago A'5,c av' xaYywArc 5GkE ., / A!! WED GY FAWN" DAiE - IJ s to EV D I BOe MLS NowrE iMr+NOV.aro. - . Qi TW04b. NY 11971 - WMD UMER . CKoS3 SocnAv ,� ,Q�