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HomeMy WebLinkAbout11958-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING D£PARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte. Of Occupnncy No..g..1.1.~.3.5. ......... Date August 8 1983 THIS CERTIFIES that the building ..: ............................................. · 23780 Main Road Orient Location of Property ........................................ House No. Street .................. ~r~[oi County Tax Map No. 1000 Section . .0.1.8. ....... Block 05 .Lot .. 0.1.?. Subdivision....X ........................... Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated .... D. 9.c.e.m.b.e.?' .2.0, .... , 198..2. pursuant to which Building Permit No...1.?.5..8..Z. ........... dated .... 3..a .nB.a.r, g..7 .............. 198.3.., 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. ~.?y.a?.e...o.n.e.z r..a.m.~).¥..d.~.e. ~..~.i.n.~... ........................................ The certificate is issued to EDWARD G. & CATHERINE A. LOPER (owner, '/esEee-or 'te~arrt) of the aforesaid building. St~ffolk County D epartm ent of Health Approval . 1 ¢ .-.S.Q -..1.6.6. ~. ~/.2./. 8..3 .,..R .o .b .t... ~ :. ?.~ 1. ~ .a.,. ?. E. UNDERWRITERS CERTIFICATE NO ......... N....6.0.9. 4..5 .8 ................................ t¥ Building Inspector Rev. 1/81 ' TOWN OF $OUTHO~D BUILDING D~P~RTMEHT SOUTHOLD, N~ y. ~ N°. BUILDING (THIS PERMIT MUST BE KEPT ON THE PI~E/~IS~S UNTIL TULL COMPLETION OF THE WORK AUTHORIZED) ~s z Date....~,~.~V~.......7... .......... Permissior~ is hereby granted to: ...... ~ ............ ~ .~.,~.~., ....... ~..~...~'/..~......i.~ ........ ....~ ................. ...... ~.~~.~..~:~.i...../.~ ,o .............. ~ ~. ....~... . .~.~... .~.~. .. . ..=,~ mm~. (~ ...... ~, ..................................... ...... , ......... ~ ....................................... at p~'emise, located at. ~'~.Z~........~.. ~.~.~..,. ~'~':' ~1 ........... ~' '*~"'/t/~' '~'~' · · County Tax Map No. 1000 'Section: 81o~k ii~ .............Lot No. pursuant to application dated ~J.~.(--,~ ...... .~...~. ............... h-'."....., 19 and approved by the 8uildlng I~spector. Rev. 6~30/80 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. Bo 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 lc 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 requ ired to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 ! Certificate of occupancy on pre-existing dwelling ~r :2. 3. Copy of certificate of occupancy $1.00 ! land use $/s-/$5.00 Date .. August 8~ 1983 .. New Building . .X~.. ......... Old or Pre-existing Building(Z) ......... = ZVacant Land ' Location of Property .... 2~7~80 Mgin Road~ Orient~ New York House No. Street Ham/et Owner or Owners of Property Edward G, & Catherine A, Lbper y T p N O18 05 017 Count ax Ma o. 1000 Section ............... Block ............... tot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No 11958Z Date,of Permit 1/7/83 .Applicant INLAND H?I. ES, I.N.C. Health Dept. Approval . 8/2/83 .Labor Dept. Approval .,. N609458 Underwriters Approval ........................ Planning Board Approval .................. ~ .. ~ Request for Temporary Certificate ..................... Final Certificate ........ - ....... Fee Submitted $..5...~ .O.O. ...................... Construction on above described building and perm}~mee~s all app~ca~fe_,co_de¢ and regulations. Applicant. ~~./-~_... ........... = ..... Robert E, Hzltz -"l~land Homes, inc. looo174 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- l"b~ 85 JOHN ,~TREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT in the following location; ~ Basemer~t ~ 1st FI. ~ 2nd FI. Section Block Lot was exarnlned on ~ ~~ ~ artd found to be in cotnpliance with the requirements of this Board, FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 19 18 DRYERS SYSTEMS NO, OF FEET OTHER APPARATUS: 1-~moke Detector S E R C AW, G, OF HI-LEG E.E.C.O. Elect. COz~, Cliff Cornell 325 Will~ Point P~. So~thold~ NoY., 11971 LIC. ~2816 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto~r COPY FOR ~UILD[NG DEPARTMENT. GENERAL MANAGER their credentials. II~~PECTI N FIEL~ ~ 0 FOUNDATION (1st) COMMENIS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSHLATION PER N. STATE ENERGY C,ODE FINAl, ADDITI COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RouGH PLBG. [ ] FOUNDATION ZND [ ] iNSULATIoN [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN HALL SOUTHOLD, r.l.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT INST RUCTIONS a. This applicatioa must'be completely filled in by typewriter or in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee hccording to schedule. b. ?Itt plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giwng a derailed description of layout of property must be drawn on the diagram which is part of this ap. 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 pen shall be kept on tile premises available for inspection throughout tile work. e. No buildi;~g shall be occupied or nsed in whole or in pad: for any purpose whatever until a Certificate of Occupar shall bare been granted by tile Building Inspector. APPLICATION IS ItEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to ' Building Zone Ordinance of the Town ~>f Soutbold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein deserib The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. INL.A_ND HOMES~ INC, (Signature of applicant, or name, if a corporation) Box 117, Ma'~tituck, N. Y. 11952 (MaUing address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build ............................. General Co~tra~tor ' Nmne of owner of premises . .. F~.d.w..~.~qt..G.... ,~..C..a.t.h..e.r.5?.e...A... ,L, 9p?.r' ................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer. : Rober~ E. HJ. ltz~ President; (Name and title of, corporate officer) Builder's License No .......................... Plu nber's License N.s... 517-P Electrician's License No. 2148-E * Other Tradc's License No ...................... Location of land on which proposed work will be done. . . . . . . .e/s o£.....................Rte.25 e/oTabor Rd...,~ o~:ien'l;,N.Y, House Number Street Hamlet ~ , . e/O(lTal8) County Tax Map No. !000 Section 18 - Block Lot ............ Subdivision ..................................... Filed Map No ............... Lot .............. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant ' 1 family dw¢!!.ing ....... Repair Rcli~oval Demoli~io~ Other Work (to be paid on filing this application) If d~9.elling, number of dwellin~ un/ts .... ] ........... Number of dwelling unRs on each floor ................ Ifgarage, numberofcars ...~ .......... 1 .................................................. If business, commercial or mix:ed occupancy, spec~y h~ture and extent of each type of use .............. Dimensions of existing structures, if any: Front ........ , Rear Depth Hei ht N n b r of Storles Dimensions of same stmcrure With allera~ons o~addifions: Fr6nt ................. Rear ............. Depth ...................... Height ................ ...... Nnmber of Stories .................... Di ~ensions of entire ne v can't tion Front ~ ' . ' ' Rear 5~ Depth i1 % ruc ' .' x ....................... ~ ' ' ~.~ -'~ i '. ~'.:~ ..... H ght 18 .~ ~b faf Sro ' ~.~ Size oflot: Front .........150 [....'.~. ....... .. Rear.......~50.... .......... Depth ................. . . . Date df Purchase ~ N~me of Fonuer Owner . ;. Zone or use district in which ~remises are situated ~ Does proposed construction vi~olate any zoning law, ordinance or regulation: ..... BP ........................ Wi~ lot be regrfded ....... ;..' .................. Will excess fif[ be removed from premises: Yes Nc Name of Owner of premises ~4~$r~..LgPgX'. .... Address~Q. [~.ng. ~Y.' ...... Phone ~T~.~ ........ Name of Architect ~ ' ......................... '.. AddressQr$~P~%~..~. X* .... Phone No ........ Nme of Contractor I~[,~N~ HpM~. ~5~ . Addre~s~q~. .............. ll7,MattitUC~hone No. ~.~ .... PLOT DIAGRAM Locate clearly ~d distinctly ~1 buildings, whether existing or proposed, and, indicate ~1 set-back d~ens~ons fron' roperty Hnes. Give street and bloc.k number or description according to deed, and show street names and indicate whethe: :terior or corner lot. TATE oF NEW YORK, OUNTY .OF .... ..~r./F. FOLJq.....~ S.S ....... ' ........ P, ober:l:..E, !. H:L'Ltz ............... being duly sworn, deposes and says that he is tile applican (Nanie of indMdual signing contract) )ove honied, is the ............... .................. ~ ............................. : (Contractor, agent, corporate officer, etc.) said owner or owners, m~d is duly autho~zed to perform or have performed the said work and to m~e and file )plicatioh; that all statements contained in this application are true to the best of his knowledge and belief; and that th 'ark wfli be performed in the man,er set forth in the application filed therewith. worn to before me this otam Public · '~ 7~' 14.o i"d A~N ' ~OAO $.7:54 50 ~ f50,00~¢ LICENSED GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H. $. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISMAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (si APPLICANT SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE: H. S. REF. NO.. APPROVED: DEPT. OF HEALTH APPROVAL OF SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL, 'OWNERS ADDRESS: 8.50 I(ING, ~'F~EET DEED: L..4S~4 TEST HOLE SEAL "It should be noted that since this property is located in on agricultural ~area, the possibility exists that the w~ater supply may contain trace amobqts o[ pestiddes and/or nitrates· RODERJCK VAN TUYL, P.C. G~EEN~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 STAND.~DS OF/THE ShIFiOL~G ~. D~E~DT. C~F HE/~ZSTH/SEt~ICE~. 4. / SUFFOLK COUNTY DEPT. OV HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: I~ 12~ ~ 2 H. S. REF. NO. APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL ~OOO ;8 5¢'Io ~, -~ ,5,,' OWNERS ADDRESS: DEED: L. 45:,! TEST HOLE ~TAMP SEAL ill 4" ' ' 14'; ,4-" 'ktV!H~ ~ooH t5 ~Pg~OOH * f D CDANCY OR OF OCCU?ANCY If copper tubing ~s use, for water distributing sys:em; piping shall be of types K or L only .A,QpR~.~-D AS 'NOTED .^,~:,hI23 .,~. ,,, NO~ B¢ILDING CPARTMENT AT 765-1802 9 A~ TO 4 P~ FOR THE FOLLOWING J. FOUNdATiON - 2. ROUGH - FRAMING & pLUmBING 4. FINAL - CONSTRUCTION ~UST ALL CONSTRUCTION SHALL ~ET 'THE REQUIREMENTS OF'THE N.Y. ~ATE CONSTRUCTION & ENERGY ' '' " ~DES, NOT RESPONSIBLE FOR ' .D~iGN OR CON~RU~ION ERRORS. -I 4L4." l:;ZI414T -~L~=---VAT/C~ M