HomeMy WebLinkAbout17506-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Cerfi[icafe O[ Occupancy
No. Z17504 Date November 10, 1988
THIS CERTIFIES that the building . .A.C.C..E.S.S. qg¥ ....................................
Location of Pro err 1610 West:wood Lane 6, 2375 Sound Drive,Greenport
House No. Street Hamlet
County Tax Map No. I000 Section 33 . .Block 02 .Lot 22
Subdivision..~ .a.s.t.e.r..n..S.h..9 .r.e.s ............. Filed Map No. 4426 .Lot No. 77
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... O..c.t....4. ~. ,1,9.8, ,8,, . pursuant to wkich Building Permit No. 17506Z
dated.....Oct' 6,'..........1988 .... ... was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occnpancy for which this certificate is issued is .........
ACCESSOR~ SHED.
The certificate is issued to ANGELO VASILATOS
..................... [o¥,,'~; ~;~i ~&~'~'~ .....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO ...... N./..A ...........
PLUMBERS CERTIFICATION DATED: N/A
FOBM 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)
N~ 017506 Z
Permission iS hereby granted to: .~ ;/~/
~...~ ....... :.-~ .......... ;,~.~ .........................
...~,.....,,~...~....~..~ .............................
. ..~..~~..~.,..,.¢..,......z/~ ~'
....... ...................
at premises located at ..... .~.../.~......~..,~..rf¢~..,..,¢~'-~. .......................................................
pursuant to application dated .... .4~.-~./.~.- ................................... , 19,~..., and approved by the
Building Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCI
Instructions
A. This application must be filled in typewriter OR ink, and submitted i ~ to the Building Inspec-
tor with the following; for new buildings or new use:
I. 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 (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual naturat 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 required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25 . 00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling. $25.(10, Accessory I$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0
3. Copy of certificate of occupancy $ 5.00, over 5 years St0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ......................... .
NewC°nstruc%i°n ...... Old or Pre-existing Building ............ Vacant Land ..........
................. o
Location of Property ..~ ............. .~..
Hou~ No. ' ·
Owner or Owners of Property . .
County Tax Map No. 1000 Section ..... .~-~
......... Block . .. Lot .........
Subdivision ~B~ .<~..~C¢.%. .~.~..(~ .'7..~
.............................. Filed Map No .... Lot No ..........
Permit No ........... Date of Permit .......... Applicant ....~ ...............
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ..........
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $...I.~..~.... ................. . ...
Const~'uction on above described building and pe~o~it me?~ll applica~pJ~,codes~sP~d regulations.
~/~o/f ~ ppi . ;~:'/*.~ .~".~.:~.(. ..~.~.~;~. ..¥.~..~) ..................
Rev. 10.10-78
VICTOR LESSARD
EXECUTIVE ADMINISTRATOR
(516) 765-1802
Town Hall, 53095 Main Road
P.O. Box 1179
Southotd, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October I1, 1988
Mr. Angelo Vasilatos
3181 Hatting Place
Bronx, New York 10465
Re:
Building Permit #17506-Z
1610 Westwood La. & 2375
Greenport, N.Y.
Dear Mr.
An
October
Sound Dr.
ground. When this has been
to set up an appointment for
Vasilatos:
inspection on your accessory shed was made on
7, 1988.
In order for us to issue the Certificate of Occupancy,
the shed must be anchored to the
done, please contact this office
a reinspection.
Thank you. for your cooperation in this matter.
Very tru~ yours,
SOUTHOLD TOWN BUILDING DEPT.
Gary Fish,
Building Inspector
GF:gar
FOUNDATION
(1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
-PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO, 4 ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N,Y~
Certificate Of Occupancy
No. Z962~
Date
THIS CERTIFIES that the building ................................. ~..,..
Location of Property .. ...........................
~ou~e ;Ye. Street
County Tax Map No. 1000 Section .~.~ ...... Block 2 ' · .... Lot ~ ~ '/22
conforms sabst~ti~ly to ~e App~cation for B~d~g Pemit horotoforo ffl~d
· F~arZ .~ 5 ........ 19 IR pursuant to w~ch B~lding Pemit No.
dated ~2U~ ~5 19 7~ was issued and co~form1
of the app~cable provisions of the law. ~e occupanc~
~e certificate is issued to . EdWl~ .4,. M. a3 0rh. QlO... ~ ............... . ..
of the aforesaid building.
Suffolk County Department of Health Approval .
Rev4~S
765-180Z
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ]/~NSULATION
/
FRAMING [)/] FINAL
REMARKS:
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ~SULATION
[ ] FRAMING [~] FINAL
.,MARKS: ~. ~ ~~d~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]-FOUNDATION 2ND[ ]INSULATION
[ ]FRAMING ~FINAL
REMARKS: ~/~-~ ~ ~,/"~
DATE
BOARD OF HEALTH ............
3 SETS Q~/ PLANS ! ' ~.':. ......
FORM NO. 1 SURVEY ."/,~..~..
TOWN OF SOUTHOLD r,u~r-K V"F~ ~-%~ ............
BUILDING DEPARTMENT ,~SEPTIC FORM ................
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Approved /O 19 0v~ Permit No
Disapproved a/c .....................................
BLDG. DEPT.
~, I'O~NN ~: SOOTHOLD , INSTRUCTIONS
NOTIFY
CALn .......... ~ ..........
MAIL TO:
Date ................... 19...
a. This application must be completely filled in by Wpewriter orin 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 lo~ and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of Dyout 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
shah 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 uniil ~ Certificate of OccQpancy
shall have been granted by the Building Inspector. · , ,, . -
APPLICATION IS HEREBY MADE to the Building Department for the issuanC~ Of a Building permit p~rs~dan~ to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York',' and othei' applicabldLawg, Or~iinahces
Regulations, for the construction of buildings, a.d, ditions or alterations, or for removal or demoliti0n,'as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, hous[cg codeoand~ regulations~, and t6
admit authorized inspectors on premises and L~ building for necessary inspections. ' '- ' ~ ' * ......
...... b ........... Cj
~, ~ ~(5- V: ..............
(Sh, nature ot apphcant, or name, if a corporauon)
.......... ....
· ' (Mailing address of apptic,ant) /I ~c~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..... i;;,;;' ............ ........
Name of owner of premises
............
(as on the tax roll or ~'~'J~
If applicant is a corporation, signature of duly authorized officer.
7~8o~ g ;J~ i~ 4 F~FOA 11~
..... ( ...................................... FOLLOWING INSPECTIONS:
(Name and title of corporate officer)
1
B drier s License No ......................... . ROUGH. ~A~I~G &
3. INSULATION
Plumber's License No ......................... 4. FINAL '-, ~{~II~T,I~J(YrlON f~l~T
BE COMPLETE FOR C.O.
Electrician's License No ....................... ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF THE
Othcr Tradc's License No ...................... STATE CONSTRUCTION & ENER~f
COOES NOT .EsPor~smu~ ;~
1. Location or land on which proposed work will be done ........ :... ..... ~j~ .QES'G~.Ot~.CO~J$I*UCTI.O.~..Z.~.n9..~...
...... .uZ. b .......................
House Number Street Hamlet .......
County Tax Map No. 100OSection ~"-~....... ......... Block ..~...~ I~ Lot
Subdivision ?.o.B..4-~7..O., .~D..?.r-.e.g..Q-O...Qo..~.~ .......... Filed Map No..t/(c/(...~.. ...... Lot...~...~. ........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing Use and occupancy . ." ....................................
b' Intended use and occupancy. ~:-.~f. Tx~. 5..~.. P--/'~ G..~_,. ~..~...~
3. Nature ofxvork (check which ~pplicable): New Building .~.:~.~a$C.~.'~Ad~i
........ a~tion .......... Alteration .........
Repair ............ Removal ....... Dcm lition
~ff ........ o .............. Other Work ............
4. Estimate'd Cost "--'- (Desc rich)
...... . ........ .... Fee .... /...
[ (to be paid on filing this applic'ation)
5. If dwelhng, number of dwellin units ........ Number of dwelling units on each floor
Ifg ~ ................
arage, num her of cars .... i ........' .... ~.. :': ..............
ed ify .......................................
6. If business, commercial or mix occupancy, spec nature and extent of each type of use ....... ....
7. le o s ng structures, if an rent ~.~.~
· ?ith ' ' .....
trUa, .... · ·
· mensions of same s urc ~ alterations or additions: Front ~ · ·. Rear . ...'777..
t Depth 0~'~. 1 .~ ~ :/.:..,... i. IIe ght . ...~"~-..
','f,'~ i' " '' ar ............. De th .
hase . .. ..,.
,, .-. . . · .' · .:-., ..... ZY/. ......... Name of ForrnerOwner .'w.~..5
~ i. z. one or use district in which premises are situated . i ........... ~[~{ [t .........
2. Does proposed Construction wolate any zonin, ~,,~ ~ ~' - , ~. [' ~ lk '~' ~ i'!l ?t .........
i o .~--, ,arumance or regina[ion: . ·. l.'t;.'~'"~. ~'... :Y;...~.ig. ....
13. Will lot be regraded ........ t1./.0 ................ Will excess fill be removed fr~9~ Pr.e.~..~ . ' 's
........ ...... .........
14. Name of Owner of premises .. i ................. Address ....-..'. yr..'..." ~3t~..L....' ..... i ......
Name of Contractor . '-- ---~---" ... ' .....
15.Is thxs property loc 'ted within 300 . . ........ Pho~neNo ................
~ feet of a t~dal wetland. *YES .... NO ....
· If yes, Southold Tow~ 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 hnes. Give Street and blocklnumber or description according to deed, and show street names and indicate whether
interior or comer lot.
OCCUPANCY OR '
USE IS UNLAWFUL
'WITHOUT
' OF OCCUPANCY
· ~ !lbl~(N~l~ed0'~i'tMl~.,~.~a. hflgn'i~ contract) being duly sworn, deposes and says that he is the applicant
~ ; (Contractor, agentF6~rporate officer, etc.) ............
of said owner or owners and is duly~: author/zed to perform or have performed the said work and to m~e and file this
app cation; that all statement~ contained in this application are true to the best of his knowledge and belief~ and that the
work will be performed in the m~ner~set forth in the application filed'therewith.
........................ day of
............. , 19...
Notaw Public, ~ ......... : ............... County
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