HomeMy WebLinkAbout12003-zFORM NO. 4.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Zl1764 Date July 6 198.3.
THIS CERTIFIES that the building ................................................
~485
McCann LaneGreenport
Location
of Property
....................... .......................
County Tax Map No. 1000 Section . . 9.3.3 ....... Block . .0..3 ........... Lot 024
Subdivision Eastern Shores .Filed Map No, 4021 .Lot No. 12
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· . .0. c..t.o.b.e.r...2.0. ...... , 198.2.. pursuant to which Building Permit No. 12003Z
dated ..... hl p y.m.e.b..e r..5. ...........19.8. 2., 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 .........
...... .a..p .~.iy.a. ~..e..o.n.e. 7.~.a.m.~..~ 7. fi.~e. ~.~.~.n.g.: ......................................
The certificate is issued to JOHN TSOLIS
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval .3..2.-.S.0.-~!.37 5/9/83, Robt. A. g±1la, P.E.
UNDERWRITERS CERTIFICATE NO. ~ 598786
Buil~ting Inspector
Rev. 1/81
TOWN OF SoU'r~oI~D
,UILDING D~PARTM~N~
TOWN HALL
SOUTHObD, N.~ Y.'
N?
Permission
~2003
BUILDING PERMIT ~
(THIS PERMIT MUST BE KEPT ON 'I:HE PREMISES UNTIL ~ULL
COMPLETION OF THE WORK AUTHORIZED) ~
I~t_a.e "'~t ...~ ....... ,
is hereby granted to: ~ / ~ ~
........
...................... ..:..i-'..i.....' ............ ~
tO
....... : ...................... ~ ............ '~ .............. ~ .........
..: ~. ..~ ........ .~.. ......... ~...,~.~.....,,~....., ..........................
County To~' Map No. '000 Section .~.~..~ ......... Bl~k, .?~.~ ...... ... i~t No. r.~..~. .......
Building Ihspector
Fe~ $../.S~,.~. .....
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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, 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.
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
topograph ic featu res.
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. '
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 .., .N?.y...~.1.,.3:.9, .8.3. .........
New Building .~ .......... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .., .1.4..8..5..FI.c.C.~..~.n.s..L..a.n,e.x . .G~.e.~ .~p.o,~..1;:~, ~,,. ,¥~ ......................
House No. Street Ham/et
Owner or Owners of Property Hz', & Mz's, John Tsol:[s
County Tax Map No. 1000 Section 033 Block 03 Lot... 024
Subdivision., .F% .0~, .~.~'.,/';?.~./...~, .~. ~..~'.~.~ .... Filed Map No....4.0.2..~...Lot No....2.4. ........
. 120032:
Permit mo ........... Date of Permit 11/5/82 .Applicant Inl&nd H.otaes, I.n..,?t'
519183
Health Dept. Approval ........................ Labor Dept. Approval ........................
.N598786 Planning Board Approval
Underwriters Approval .............................................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $. ,5.,.O.O. .......................
Construction on above described bu ildt~~et~all ~pplicable cod~d regulations.
1000174 THE NEW YORK BOARD OF FIRE UNDERWRITERS
[".Et BUREAU OF ELECTRICITY
~ 8.5 .JOHN STREET, NEW YORK, NEW YORK 10038
Bate April 12, 1983 ~..llc.~ion ~o. o. fle 199720--83 N5 9 8 7 8 $
THIS CERTIFIES THAT
only the electrical equipment a~ described below and introduced by the applicant named on the above application nu tuber in the premises of
Tsolis~ Joigt, 1485 k~Oar~ Lane, Gre~port, N.Y.
in the following location; [] Basement
was examined on Aprii ?, 1981{
FIXTURE ;
OUTLETS RECEPTACLES SWITCHES
~1 44 24
DRYERS
~ 1st FI. [~ 2nd FI. Section Block
and found to be in compliance with the requirements of this Board.
FIXTURES OVENS
FLUORESCENT
MUlTI-OUTLET
SYSTEMS
NO. OF FEET
Lot
EXHAUST FANS
E R V I
A~ W.G. NO O~ HI-LEG
2/O
OTHER APPARATUS:
2s
1-G.F.I.
~tors = 1-F.
2-S~ke Degectors
1-4.5 K.W. ~ Wager
C
AWG
OF HI-LEG
NO OF NEUTRALS
OF NEUTRAL
2/0
, $-.75 K.W.~ 2-.5
J:;.~.C.O. ~leut. Corp. (Clif£ Coraell) ~/~f~~~~z~~ ~
This certificate must not be qltered in any manner return to the office of the Boa~d if' ncorrect nsp~t~s moy b~ d~nt~ ed by t~ e r credent a s ~ ~
COPY F0R BUILDING DEPARTMENT. TH~S COPY OF cERTIFiCATE MUST NOT BE ALTERED ~N AMY MANNER. ~ '~
FIELD INS~ECTISN COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
Lot
Lot 12.,
Area ~ 17',6UC'
sci.#.
COUNTY DEPARTMENT OF HEALTH SERVICES
APPROVAL OF CONSTRUCTION ONLY
.~¢/~ ,~_~. No. / ~,, 3'~ //~
I TO TH~ STA#D&RDS OJ' THE SUFFOLK (:OUHIJ~T~ OEPA~TMITME#T
SURVEY FOR
,/O/.IN 'TSO£1S
~N ~ SO.HOLD
SUFFO~ COUNTY~ NEW ~
DATE: .,4~,~. ,~
SCALEs / "= ,
No. ~3 -H
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, I',I.Y. 11971
TEL.: 765-1802
Examined ~...~... ~ ....19...~''/'
^pp oved .... l .. ermit O..0..$. Z'
Disapproved a/c . ~ -" '"~ /
(Budd,n~ Inspector) '~
APPLICATION FOR BUILDING PERMIT
Al~plication No ....
Date .O.c.t..o.b.e.r..2..0~..1.9.8.,219
INST RUCTIONS
a. This application must ~e completely filled in by typewriter or in ink and subm'itted in triplicate to the Build
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 sire
or areas, and giving a detailed description of layout of property must be drawn ou the diagram which is part of this ap'
cation.
c. Tile work covered by Ibis application may not be commenced before issuance of Building Permit.
d. (Ipon apprc'.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen
shall b~',kept on tile prcnuses avalhlble for inspection throughout the work. - ' j
e. rc o build/ag shall be occupied or used in whole or in part for any purpose whatever until a Certificate o~'Occupar
shall bare been granted by the Building Inspector. ~
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town %f Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for tile construction of buildings, additions or alterations, or for removal or demolition, as herein describ
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulation,~, zmd
adnfit authorized inspectors on premises and in buildings for necei, sary inspections.
INLAND HOMES, INC.
(Signatnre of applicant, or name, if a corporation)
...B. qx...1.1.7.~ Matt.:i. tuck~. I'4. Yo .1.1952.
(Ma/ting address of applicant)
State whether applicant is owner, Iessee, agent, architect, engineer, general contractor, electrician, plumber or build
General Con~rac~or
Nmneofowmrofprc~rises.John Tsolis
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly attthorized officer.
· ~, ........ .~.o.b?.~..t. E'..:.~?-~.~.:..P?.~..~.d?t. .....
~ (Name and title of corporate officer)
Builder s L certs. No ..........................
Plumber's Licens~. No. 517-P
2148-~
Elactrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done .... .L. qt...~.1.2.,..r.,..a.sAe, r..n' .S.h.o.r. ?.s..a.t.. ?.r.e.e.n.p..oy.t..
..... ,: .................. .. ........ "h;;;l' er' ..............
House Number Street
County Tax Map No. i000 Section 033 . Block OS Lot 2..4.
Subdivision...~.ap. fi.l.e.d, in. th.e office of Filed Map No. 4021
................. c le:r'l< ................ Lot ..............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy '
.!. family dwelling
Repair Removal Demolition Other Work
~ .~..~ O O O .... ~.t".~..~. ~ (Description,.
~:.:..:.:..: j..: . . .~ ....................... F..: ........................
(to be paid on filing this application)
If dwelling number of dwellb? units ~ Number of dwelling units oy eacJ~
If garage number of cars ~ ............
If business, commercial or raised occupancy, specify hature and extent of each type of use ...................
Dirnensions of existing stmctu!res, if any: Front .......... ' ..... Rear .............. Depth .............
Height ............... Nthn her of Stories ......................................................
Dimensions of same structure bvitb alterations or additions: Front ................. Rear ................
Depth .................. ~... Height ...................... Number of Stories ....................
Dimensions of entire new constrttction: Front .. 46 ' , Rear ~ Depth ~T ...
Height ............... Nt~mber of Stories .............................................
Size of lot: Front .............. ' .......... Rear ...................... Depth ......................
Date df Purchase Name of Former Owner
district in which ~remhes are situated '
ZOBe. or Hse .................................................
Does proposed construction vi,olate any zoning law, ordinance or regulation: ...............................
Name of Owner of premises .$9D.~ .~9~.~ .. .... aad .... 147-~$ Roosevelt
Name of Archkect ........ ~ ....} ......... · . Address ............... . ....Phone No ................
Nam orContractor Address .......
rATE OF NEW YORK.
OUNTY OF SUFFOLK .l S.S
II
....... i ........ Roher t. K,.i .H~.l.tz. .............. being duly sworn, deposes and says that he is the applican~
~ (Nan/e ofindMdual sighing contract)
)eve named.
: C6ntractor
is the ...................... i ....................................................................
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is dt!ly authorized to perform or have performed the said work and to make and file thi:
)plicationl; that all statements contained in this application are true to the best of his knowledge and belief; and that th~
· ork will be performed in the manffer set forth h~ tbe application filed therewith.
worn to before me th¢_~ .
......... .... day 6f ...... .~.~.,
19 .q~..,~2----
Nota'ry ,P, ublic, St'at~ ~ un
,..No, 52,-0344963 Sufolk Co t~d/~l, . . ~ ...... ~..~ ,'7 .......... / .... -,~ ..
SU~Y FOR
" LOTNO. I~, "EASTERNSHORESATGREE~PO~T" MAY 3, 19B3
";. AT GREE~POBT DATE: APR. ~E, 19~2
~N OF SOUTHOLD scaLE= / "= 40 '
SUFFOLK COUNTY~ NEW YORK NO. 82-/~
HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUCT AaO ~ HIS aEHALF ~THE T TLE C~P~Y, eOV~g- '
ADDR[~ * "
~Or~: ffi = ~O~M~r ~ = S~K~ ALDEN W. YOUNG, PROFESSIONAL ENGINE ER
SUBDIVISION M~P PI~ED IN rHE OFFICEOFTHECLE~K
AND LAND SURVEYOR N.Y.S UCENSE NO. ~284~
HOWARD ~YOUNG LANO ~URVEYOR
N~ L~T~ ~ W~L(W)~PTIC TANK(ST)a CE~OLS(~) ~N HERE~ N.Y.S. LICENSE N0.4589~
SURVEY FOit
SUFFOLK' COUNTY OEPA.TMENT OF H~LrH ~RVlCES
.... '
FOU APPROVAL OF CONS~UCTION ONLY AT GREg~RT
1. The contractor sh~ll furnish to the o~ner written maintenance
instructions for all equipment which requires preventative
maintenance for efficient operation.
2. The contractor shall l~rnish and install adequate ventilation in
accordance with NoYo State Building Construction Code and N,¥o ~tate
Building Construction Code ~!anual~ latest editions°
3. AIR LEAKAGE~
sheet No. 2 of ~
LOCATION
sheet No. ~ of~.,
· , 7
II
:4(~1k14 I~.Z2~d
~HES~ DRAWINGS AND $~(I~--ICA~ION$ ^ti~ INSTrUmENTS
THE PRO'PERTY OF THE ARCHJIECI VCH~THER THE PROJ[-f3'
7OR WHICH THEY ARE ~,'~ADE 15 EXECUTED OR NC)I'. IEIE¥ /
ARE NOT TO BE USED IN ANY OTHER pROJECJ ..EKCEI~ BY
....... ' .... _ AWP4TTEN AUTHORiZATiON OF THE ARClfl'fEC~
IISE B I IIL VIFUL
OF OCCII? ltC¥
L~ ~,-~-'~' ~ ~-~-
NOTIPF BUILDING D~RTM~ AT
785]802 9 AM TO 4 PM FOR
' FOLLOWING IN&~ECTIONS:
~l. FOUNDATION . ~O REQUIRED
FOR POURED CONCR~
2. ROUGH - F~MING & PLUMBING
~. INSU~T~ON
4. FINAL - CONSTRUCTION
BE COMPLETE FOR C.O.
~LL CON.RUCTION SHALL ~
THE REQUIR~ME~S OF ~E N. Y,
CODES. NOT ~51~
DESIGN OR CON~ION
I-
If copper lubing is used
for water distributing
system; piping shall be
of types K or L only
II
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B
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