The URL can be used to link to this page

Home My WebLink About17744-z TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Seuthold, N.Y. CERTIFICATE OF OCCUPANCY No Z17855 Date MARCH 16, 1989 THIS CERTIFIES that the building Location of Property 395 DOGWOOD LANE House No. County T~xMap No. Subdivision ALTERATION SOUTHOLD Street Section 054 Block 05 Lot 28.1 Filed Map No. Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 3, 1989 pursuant to which Building Permit No. 17744Z dated JAN. 6, 1989 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 ALTER INTERIOR PARTITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JAMES & ELANE KELEMBELIDIS (owner, of the aforesaid building. SUFFOLK COUN~f DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~uilding Inspector FOBS[ NO. ~ 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) NO_ LilY'[44 Z Permission is hereby granted to: ..~.~..~...~.~....~.....~ .......... ! ' , ....G~.~..,....~.,~.;.....J..L m~..~. .......... ~ , ~.~.'-..'.~'...~~~~ ........ ~ ....... ~ ................... ~.. ....... ~-.~.~. ........ ot premises located at .,.~.~..~-..,...~..(~~.....~,.~ ......... '~'~ .............. County Tax Map No. 1000 Section ..... .o...~,']..,~, ........ Block ...... .~,,..,~,,, ....... Lot No....,.~,,..~.:../ ......... pursuant /ti Building Inspector. Fee $...~.~...:.......'~... .... Building Inspector Rev. 6/30/80 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTROLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DING ~ V NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUIL .... ACANT LAND ........ ' HOUSE NO. STREET HAHLET Owner Owners of Property~.~..~.~.~:. /' or .~-f/~-.~.`, ...........~:.I~+/<~ ~ , ............. Couat~ Ta. ~ap No. 1000 see,ion ..~.~.. Hloek ....~... Lo, ..~.!. Subdivision ....................... Filed Map ........ Lot .......... Permit No. '.'77.~.~ :~..Date of Permi, -//~-/~-.-ioplleant ..~f.~.}.~O.~. ..... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... rev. 10/14/88 laDD i,S, mb~mO,~ IfDATE ~ff~4£NT~ FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDtTIONA'L COMMENTS'. /INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION ;ZND []INSULATION FRAMING []FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/~RAMING ? ] FINAL REMARKS: DATE ~'~//~'~/~ INSPECTOR ~~ '~ Examined · . ~,. Approved . . '.~ ....... 0~... FORM NO. 1 TOWN OF $OUTHQLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19 ., 198.~J. Pennit No.. l .'2..'7. q.~..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOB BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..... CHECK /2.' .'ii3 61111.i.i . SEPTIC FORH ................ NOTIFY CALL .-?. 5 5; MAIL TO: a. Tltis 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 ~hall be kept on the premises available for inspection through~ut th~ work. e. No building shall be occupied or used in whole or in,part.flor a[w purpose whatever until ~ Certificate'of Occupancy shall have been gralnted 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, NBw York, and other applicable Laws~ OrOh~ances or Regulations, for the construction of buildings, additions or alterations, or for 4;emoval or demolition, as hereil~ 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 necessarvtins~ectionm ,/ (S~gnature oI apphcant, or name, l~'a corporanon) ~ I~ UE-',~,~tg~It (Maifing address o~ appficant) , State whether app]ican~l~0~h'~r'n~.~J~t, architect, engi~leer, general contractor, electrician, plumber or builder. Name of owner of premises .~...r~ .~q .e.5.. ?..¢ ~.~q;..~.d'....~)~~~i~. (as on the. tax roll or lai~ifL~eed) If applicant--^ n . ~tr ____is a co~poration, signature of duly authorized officer.. ~EE: ....O-'~, ~ _BY' ~.~,. {~2/~. (Name and title of corporate officer) ~...'~_~ ~~.~~'* ~ FOLLOWING765~1802 9 INSPECTIONs·A~ TO 4 PM FOR THE Builder's License No... ] 3 ~.~../J-J./... ;~ : FOR POURED CONCRETE ~9~.~~g !, 2. ROUGH - FRAMING & PLUMBING Plumber's License No. "' ' ' x ,i 3. INSULATION ........... ' - CONST, UCT,ONMUS Electrician's License No ............. ~ BE COMPLETE FOR C.O. ALL CONSTRUCTION ~HALL MEET Other Trade's License No ............. IHE RE~UlI~EME~r$ OF THE N.¥. , ,~ STATI~ COIII~I~II. ICI10~ & ENERGY 1. Location of Iand on which proposed work will be done. .. ..... ' . ' CODF-~..N.O~.....I~-~.P0~..~.LE FO.R ..................... ....... b .......................... }louse Number Street Hamlet County Tax Map No. 1000 Section ...... 5.t~. ........ Block .... ~-7'. Lot...~.7.v / Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy . b- Intended use and occupancy 5 ~(. ~ ~o~ ~//~/[) ..... ( ppli ) ' 3. Nature of work check whicNa cable: New Building ..... Addition . Alteration Re r ...... , · · :,. .... Re oval ............ Demolition ........... Other Work ............... · ' §tSs"O c8 (Desc ption) 4,Estimated Cost /. t o be paid on fihng th~s application) 5. welhng, number of dwelh un:ts ..... Number of dwelling units on each fie .. If garage, number of cars i ........ , .97 ~, ......... ify ................... 6. If business, commercial ormix occupancy, spec nature and extent of each type of Use'... e . :. 7. Dimensions of existing structdres, if any: Front ·" , H ght N~ be of Stori , ....'.,.,..,... ear .............. ';,. epth ....... · .. R D Dimensions qti~qlq&stm.,qture iwith alterations or additions· Front 8. ' ' ' ..... ~ .................. Number of Stories .............. Dimensions of entire new conttruction: Front ............... Rear ............... Depth ........ Height ............... Nffmber of Stories ......... , ' eo et: Front ......... ; · . ' Rear ........... De · ............... pth Date of Purchase .................... Z ......... : . · ....... Name of Former O tnct m wmcn .premises are situated ................................................. ocs proposed construction violate any zoning law, ordinance or regulation: ................. Will lot be regraded ..... ~ ............... N f 0 ' ' i .................... Will excess fill be removed from premises: Yes No me o wner o remises ............. Address ................... Phone No ............... Name of Architect ..... ,~ ................. Address ..... ~'~ ')-4¢. ........ Phone No ................ 15.Is this property located ~*ithln I00 feet of a t£dal wetland.* *YES .... NO .... ~If yes, $outhold To~n 'lTruatees 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 comer lot. 10. 11. 12. 13. 14. COUNTY,OF., . , .' ,,~". S.S" -' - .... ' .~,'/*>,, . ..... . · ·., :4f~..,b~.f~g ~(~? sworn, deposes ~d says that he is the applicant Heisthe. *.. ~~ ~~ : tcontractor, agent, corporate officer, etc.) of said owner or ownem, ~d is dul~ author/zed to perform or have performed the said work and to m~e and file this application; that all statements contalned N this application are true to the best of his knowledge and belief; and that the Work will be perfo~ed in the m~ne~ set forth in the application filed therewith. Sworn to before me this ' .................. day o ...... 19... Nota~ Public, State of N~ Y~ - No. 4822563, SuffolkCou~ (Signature ofapplic~t) ~erm ~ires De,emir 31, 19~ ~