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Home My WebLink About11633-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property . .1.1..9.~.3. ............. S..o.tl.n.d.v..~.~?.. ~. y??.~.? .......... S..o??.h.o..~.d .... House No. $lreet H~mlet County Tax Map No. 1000 Section . .0.5.4. ....... Block . .0.5. ........... Lot .... 0.4. {~...3. ....... Nlnor Subdivision...O...L. :..P.~.n..ny.,..!.V ............ Flr~i~'M'a} No. J.7.3. .... Lot No.. ~ ........... conforms substantially to the Application for Building Permit heretofore ~ed in this office dated · ...~ p.v.i.!..8 .......... ,19 .8.2. pursuant to which Building Permit No...! ~./}.3.3...Z ........... dated .... ~.ay..3. .................. 198..~. , was issued, and conforms to all of the requirements of the applicable provisions of the hw. The occupancy for which this certificate is issued is ......... a private one-family dwelling. The certificate is issued to ...... .J.O.H.N...R.. .......................................... & IRENE MOUSI.A.D. ES of the aforesaid building. Suffolk County Department o f Health Approval . ! .2 7.8. 0. 7.~.9. :. ! .1/.3. 0../.a.a. :..~ .o?. ~ ... ~.....v.6.1.1. UNDERWRITERS CERTIFICATE NO. Pending Building Inspector Rev. 1/81 ~Ol~I ~o~ ~ BUILDING DI~PARTMENT TOWN HALL SOUTH'OLD, N~¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON' THE PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) ' Permission is hereby granted to: ~7~.~. pU~Uont t9 application dated ........ .,,... 19 and bpprov~ by the Building Ipspector, Building Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1, Finat 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 peoperty 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 ~ertinent informa- tiomrequired to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3, Copy of certificate of occupancy $1.00 $5.00 Date December 2, 1982 New Building .... XX Old or Pre-existing Building Vacant Land Location of Property . ~1.3,9...4;3..S.o. ~.t p.d.v..:[...e~.v..A..¥ .e~.~q ~ . .sp.q .t.~.o.Z.d. ~. ?.o..Y... ................... House No. Street Hamlet Owner or Owners of Property .... John & Irene Housiades County Tax Map No. 1000 Section 54, Block 5 Lot P/O G6 [Hinor Subdivision -G.L.Penny IV 173 Subdivision ................................. F;led Map No ........... Lot No .............. PermitNo.11633Z OateofPermit,.~./.8/.8..2 Applicant Inland ,H, om.e.s).Inct Health Dept. Approval 11/30/R2 . .Labor Dept, Approval Underwriters Approval...;; ................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 5. O0. Construction on above described building and permit meets all applicable codes and regulations. Rev, 10-10-7a Applicant .................................................... Robert _W,. Hiltz - Inland Home$~ InCo 0 0. 1153 FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF ~OUTttOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No .......... ~. .... ~ ............... To .............. .. ~.~..../~? ...................... ''' ~}~}~'~ ,~'~o;~' 2a; ¢'ili,~Sion dated.. ~ ~..~ ........ ,19 .~ for pe~it to construct... ~e..~F~.. ~~ ...... / ........... at Location o f Property ,h~. ~~Z~4~i .~:' .~.' ....... County Tax Map No. 1000 Section ...~... Block ...~ ..... Lot ..~.. ~o~o~ .... ~,~d ~a~ ~o..~. r.~ ..... ~o~ ~o.~./. .......... is returned herewith and disapproved on the following grounds .~ .~ Bulldog lnspector RV 1/80 ./ ~- APF'i~C×[h'!A,'f L~ 5 -- S TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Inland Homes Flan Review: for John Mousiades Show framing detail of cathderal ceiling--living room~ foyer and kitchen. Specifically detail the following: 'Bearing of ridge over windows in gable end of living room / ~ Bearing and ties of rafters to ridge Detail cross section through living room and porch. Indicate on Lower Foundation plan areas to be heated and how slab is to be insulated in areas that may be heated. Require plot survey showing location of house on property and set backs from property line. FORM NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 / , Examined ~."'~./~/..~...'.~. · .. 19... ' Disapproved a/c ....... : ................. ~..~... (Building Inspector) Application No.//f.~..~..~... ...... APPLICATION FOR BUILDING PERMIT Date April 8, 1982 19 INSTRUCTIONS a. This application must he completely filled in by typewriter or ih ink' and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according te schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre* or areas, and giving a detailed description of layout of property must be drawn on the diagram whicli is part of this apl; cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc','al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern 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 Occupan shall ~ave been gran, ted by tbe Building Inspector. Ai~PLICATION IS HEREBY blADE to the Building Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,~2)rdioances Regulations, for'the construction of buildings, additions or alterations, or for removal or demolition, as hewn describe The applicant agrees to cmnply with ail applicable laws, ordinances, building code, housing code, and reg~f!ations, and admit authorized inspectors on premises and in buildings for necessary inspections. ...... ................. (Signature of applicant, or name, if a corporation) ": BOX 117, Mattituck~ .~. Y. 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, General Contractor Name of owner of premises ......... '.~.~ ~ ~-).. . . . . . .'4 .i~ ?' ..¢j/.Ar~.''' ..../)! O (~..~. ( '.~ C(_..~,. ,.)... ~ ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Robert E. Hiltz, President (Name and title of corporate officer) Builder's License No .......................... Plumber'{ License No ..... .5.1.7.-.P. .............. ~ 2148-E Electricigal's Lisense No ....................... # Other Trade's License No ...................... 1. Location of land on which proposed work will be done...S.o..u.n.d.v..i. 9.w. ~v. 9.n~l.e.,.. $.o.u,l;hold.~..1No...Y.,, ...... ~tinor subdivision made for George L. Penny IV. House Number /,/,;7'~.¢~ Street ..... County Tax Map No. 1000 Section . 54 Block 5 Lot pp.l.:, p/.o. 46 S u b divisi o n ~,,'~../-r, .~.r~~ ....... Fited Map No. /..~.~. ........ Lot .............. 2. State existing usc and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacant ..,. .............. b. Intended use and occupancy ....... 1.-~ .Fanzilty. d. well.ing .................................... Nature of work (check which applicable): New Building ..X ........ Addition .......... Alteration .......... Repair Removal Demolition Other Work . Estimated Cost ........... (to be paid on f'fling this application) If dwelling, number of dwellinlunits ...~. ........... Nmnber of dwelling units on each floor ............... If garaoe,~' ~'number of cars ..................... ~ ............................................... If business, commercial or mixed occupancy, specify r~ture and extent of each type of use .................. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............ Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth ...................... Height ...................... Number of Stories .................... Dimensions of ~.ntire new construction: Front ............... Rear ............... Depth ............. Height ............... Number of Stories ........................................................ Size of lot: Front Rear Depth Date df Purchase ............................. Name of Former Owner .......... ,. .................. Zone district in which premises situated lqb' " or use are .................................................. Does proposed construction violate any zoning law, ordinance or regulation: .......................... ...,,....,-ex Will lot be regraded ................... . ......... Will exc~els.?~,~e Le_m. qvecl from premises_.'_ _ .¥e.s _ Name of Owner of premises . .~..o.h..n..l~..o~..s~..a~.e..~. Name of Architect .......................... Address ................... Phone No ............. Name of Contractor .R..oi~.e..l:.t..1~.:..H.i.l.t..z ........Address 315 W~stPh&li& Phone No. .2.9.8.-..9.6.9.6. .~attituck~ N. Yo PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether tefior or corner lot. ! 5TATI~ OF NEW YORK, ~ I~ SS ~ OU OF ................. ' ~ [ Robel:t E, Hiltz being duly sworn, deposes and say~ that he is the applicant (Name of indMdual signing contract) above named. He is the ...... C..o.n.t.~.a..c.t.o.~. ....................................................... : ................ (Contractor, agent, corporate officer, etc.) o f said owner or owners, and is duly authorized to perform or have performed the said work and to maki~ and f're this & ~plication; that all statements contained in this application are true to ~e best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. s ~orn to before me this ............... day of ................. , ffotary Public~ .... Robe~:t SUFFOLK CO. HEALTH DEPT. APPRovAL , %~. ., .... THE WATER SU~LY AND SEWAGE DIS~SAL ~, ~.,~.~ ~/ SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE ~UFFOLK CO. ~EPT. OF HEALTH SERVICES, APPLICANT CONSTRUCTION ONLY DATE: DEED: L. ~i~S P. :S:~ x:.=y - SURVEYORS NEW YORK i 5 -- ,o-.. EXCAVATIQN INSPECTION REQUIRED ~1 ~ ~' ," ~' "¢ 4~) =--' R~K VAN TUYL P.C. .... ' ::? LICENSED LAND suRvEYORS ~' " GREEN~RT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS Of THE SUFFO~ ~co.~[g~ ~[~H£~r~ S[RVI~S. SUFFOLK COUNTY DEPT. Of HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: ~ {,I APPROVED: . ~ su~oL~ Co: TAx ~A~ DIST. SECT. BLOCK ~L, OWNERS ADDRESS: TEST HOLE STAMP SEAL I~ATH ~ I A~, ~" FOUNDATIo:,~ II FOR POUR~_D' ,~ INsu~T~ON 4, FINAL ALL ~rGN O~ OWNERSHIP OF DOCUMENTS TItESE DRAWINGS AND EF'ECIF;CATIONS ARE INSTEUMENTS OF SERVICE FOR P,~OJECT NO. ~3'O"~'~AND SHALl. REMAR4 THE PROPERTY OF THE ARCHITECi WHETFIER THE PROJECT FOR WHICH THEY ARE MADE 13 EXECUTED OR NOT. THEY ARE NOT TO BE USED IN ANY OTHER PROJECI] EXCEPT BY WRITTEN AUTHORIZATION OF THE ARCHITECT~ -- i ........ -b --l- Oil __ Electric C. D. F. ~%g. & Coolin~ construction materials exceeded$ The contractor shall furnish and instail such that the following '~" walues are not 2. Floor o~ver U~heated Basement 7o Floor over Craw~ Space' Heating- Design 1N~00H kit Temperature shall be .split Design heat loss/heat ~ain through each e~terior facade in B~'J/H~* - SEE ATTACII~D sI~T "R" Values of lnsulatin~ ),aterials- ~s indicated on the Drain,s. install E~I ClF~NCY ~ ~ ~ ~'~r~ ~ ~ 5~/ ~ ~O~ D~YSs ~0 cheer No. 1 of ~ - Exterior joints around window and door frames; openings Between windows which have infiltration loss rates ( at 25mph wind velocity F~rnish and install ,./~ ~ . dampered duct in fireplace sides or sheet No, 2 of ~ -F AS NOTED 'IFY BUILDING DEPARTMENT 765~1802 9 AM TO4 PM FOR l_~,%?WI N G INSPECTIONS: , UNDATION . TWO FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN 3. INSULATION 4. FINAL - CON'~TRUCTION BE CO~4PI.ETE FOR C. O. ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE N. STATE CONSTRUCTION & CODES. NOT RESPONSIBLE DESIGN OR CONSTRUCTION OWNERSHIP OF DOCUMENTS THESE DRAWINGS AND SPECIFICATIONS ABE ~NSTRUMENTS OF SERV1CE FOR PROJECT NO, ~Z-~Z--AHD SHALL REMAIN THE PROPERTY OF THE ARCJ~[iTiLCT Vv,l, T ,; · T,'JE PROJECT FOR WHICH THEY ARE MAD5 I~ EXECUTED OR NOT, THE~ ARE NOT TO BE USED IN ANY OTHER PROJECT~ ~E~CEP_[ BY %¥RiTTEN AUTHORIZATIOi~ OF THE ARCHITECTj rI , r : , rj II H~M,-¥ .~1 A 4 I I _ I ! I :] ~ ~- ~ VAT IO *d 1'2. ¢--L~ e¢-1~ tP5¢~- i/IV.C-,,