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Home My WebLink About11823-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z. 11398 Date Decmeber 23 ................................................. ]982 THIS CERTIFIES that the building 150 ................................................ Greensfield Lane Location of Property . .1.Q 2. O ............. ..T.u.c..k.e.~.. L..a .n.e .......... S o u t h o 1 d House No. $~'eet Ham/er County Tax Map No~ 1000 Section ...0.5. 9. ...... Block 04 .Lot 005. 005 Subdivision Greenfields at Southold .Filed Map No. 6313 .LotNo. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... J. uly. 2.Q ....... , 19 ~.2. pursuant to which Building Permit No...1['1..8.2.3..Z. ........... dated ....3 .u.~.X . 2. 7 ................. 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 grivate one-family dwelling. The certificate is issued to Andrew Passadakes of the aforesaid building. Suffolk County Department of Health Approval . .1 ?.-: S..0.-.7.7. ,..1.2.(2. ! ./.8.~. ~..R.o.b.t. :. ?... Villa, UNDERWRITERS CERTIFICATE NO ......... ~..5. 8..6 ~.~.0. ........................... Z~~....~.. Building Inspector F.E 1/81 BUILDING ' D~PAR.T~N! TOwN~HALL~ ! SOUTHOLD, N~ Y. I (THIS PERM T MUST BE KEPT ON COMPLETION OF THE WORK ^UTHORIZE~i No. ~t1823 Z eermission is hereby granted to: ' S, UNTIL ~ULL at premise~s located at .4 COu~nty Tax Map No. 1000 Section ..... p~rs~uant to application dated I~il~lng Ihspector. Rev.! 6/30i80 NO. ~....~.~... and ,approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall SouthoJd, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink and sub~ tted in duplicate to the Buitding Inspec- tot 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 topogreohic features. 2. Final approval of Health Dept. of water supply and sewerage dispose --(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar building~ 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" tend uses: 1. Accurate survey of peoperty showing all prooerty lines, streets, buildings and unusual natural or topograph[c 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. t/on required to prepare a certificate. ./ Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 g ........ ~/~,~OId or ~re-existing BuJlding{~) ........ ZV~cant Land -:,,, Location of Propertv /'~ ~ f~ ~ ' "-~ ................... ~ ~e~r)~k."~.U~..~: ...... Hou~ No, Street ................. Ham/et Owner or Owners of Property ~2~W ~h~ ~5 ' County Tax Map No. 10~0Section ...¢,~T.? ....... Block .... ~ b~ ~ ' .... ,o, .... ........ Permit No. //¢.g ..... Date of Permit .~/g ?/~.,Applicant .~.J~,'.lJ.. ,~ 9~.5~,. ............. ....................... Labor Dept. Approval ................ Unde~riters Approval ........ ~2~, ..... Planning Board Approval , ' Request for Temporary Certificate ..................... Final Certificate ................ Fee Submitted $ ............................. Construction on above describetbuilding endure'it-meets all apP~cabl~odes and ragu lations. .... ,.,.,o.,o.,~ ~-0. ~ l(~q~ ' '" - ...... · ..... :[ooo35s THE NEW YORK BOARD OF F, UNDERWRITERS BUREAU OF :ELECTRI~I~ ~,~eI' ~-'~s 1~5 JOHN STREET, NEW YORK, N~W'~YORK~: 10038 THIS CERTIFIES THAT only the electrical equipment ~ ~scr~bed belo~ and introduced by the applican~ no,ed on the above application number in the premises of ~11 ~t., s/e/c Gr~i~ ~ ~r, ~, N.Y. ~n the follo~ng location; ~ ~asement ~ 1st FI. FIXTURE OUTLETS SWITCHES 20 27 FIXTURES NCANDESCEHT FLUORESCENT 2O ~ 2nd Fl. : Section Block Lot and found to be in co~r~pli~nce with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1-G.F.C.I. 1-Smoke detector E R PER V AW, G OF HI-LEG NO, OF NEUTRALS OF NEUTRAL Electricei Ventures P.O. Box 151 Center ~oriches, N.Y. GEN~ 11~34 Per_ .~ Ths cert fcate must not be atered n any manner return to the off ce of the Boa~d f nco~rect nsoectoYs may be dealt ed bCthe r credenta s FIE~D I~?EC~ION 1. FOUNDATION ( 1 st) FOUNDATION 2. ROUGH FRAME & PLUMBING {~nd) INSULATION PER N. STATE ENERGY qODE FINAL COMMENTS ADDITIONAL COMMENTS: Examined.C/.~'~. ~. · '~'7 ' · · Approved ~./~.. l;57.'7 .... FORM NO. 1 TOWN OF SOUTHOkD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 7654802 ., 19 ., 19~.q~. Permit No. APPLICATION FOR BUILDING PERMIT Application No//. ~.~..ff.. ......... Dat/¢ .~.0. ', ' INSTRUCTIONS a. This application must b~ q0mpl~t~Jy .fi.ll,ed~ ia by typewriter' 9r 'ii ~.k ~1' sub,mltted' in triplicate to the Building Inspector, with 3 sets of plans, ~ccur~te 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 applb 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 issue a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted 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, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein 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 buildings for necessary inspections. (Signature of gjpplicant, or name, if ffcorporation) .... (Mailing address of app ' ) State whether applicant is owner, lessee, agerlt,~architect, cng · ......... (as on If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..~..~..~..~..,..~.,..~." t ...... ~neer, general contractor, electrician, plumber or builder. he tax?p.3l ?,~3~,~e~,cEss FILL FP. OM ABOVE PR. EMISES BY REGRADING LOT ____~ DRIVIJWAY CONCl'RUCTION CESSPOOL COt',]Si RUCTICbJ ___ ~ CELL^R CONSTRUCTION __ ~ Plumber's License No....~..~..~.....~.~ ......... Electrician's License No.. ........ Other Trade's License No ...................... ~/~ i~on of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. t000 Section .... ~.' .k~..-~. ....... Block . ~'(i ............. Lot....~ .~.r..~ .'~. ....... Subdivis,on ~~.~.~ .' .~?Na~e)~. ~.~.. Filed Map No ............... Lot....~. .......... 2. State existing use and occupancy of-'-~t ~ .,. ~ ,{-/~ , _ ,~premises and intended use an);~Tpancy of proposed construction: a. Existing use and occupancy ...~~.~7. ~ .W. ................................ b. Intended use and occupancy ..................................../~'~1"~' '~~'~' ,. ,~t~1~ ~ ~j ...... 3. Nature of work (check which applicable): New Building ...... Addition .......... Alteration ....... ,... Repair .............. Removal .............. Demolition .............. Other Work ............... : (Description) 4. Estimated Cost .......... ~ ............................ Fe ......................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ..../. .......... Number of dwelling units on each floor ................ If garage, number of cars ..... i ...... /. ........................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurds, ifany: Front ............... Rear .............. Depth ............... Height .... ~ ...... Number of Stories~.. ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ~.. Height ...... ~, .............. Numbe~r of Stories .................... ~,, 8. Dimensions of e_.n)ire new construction: Front..x~.. ~.. ....... Rear . .~,~..~.. ........ Depth ~(,~7..'~/~.. 4~..6. Height / .J~,. . Number of Stories..~'. .................................................... 9, Size of lot: Front . ./~2~./ .............. Rear .~.~.~ ............... Depth /.~.~. · .............. 10. Date of Purchase .../'~. ~. ~ ................. Name of Former Owner ............................. 11, Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...................... .~_,-., ...... 13.Will lot be regraded ...... ~t~a~Will~,e_,xc2¥~f~l be,.r2m, o_~d~r~o.m~r~¢)~,i~: ~ No Name ,of Architect .~..~-/,~^Sfr~ ~:.~.. Address'-~ ~g,~FI/g.~-L//j:/~. ·. Phone No ................ Name of Contractor~t,o,//~{....~A'--~. ~.. Address <~.~.' .~. ~Phone No~,.~ ~'.Ti) .... 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 corner lot. STA~rE OF NE~t~¥/ORI¢,/ -a , COUNTY ~~. \...,~].S'~2~'V~"~,/~ S ........ ~. ~.~; ~.~. ~.~.~ ~.~ ~ .... being duly sworn, deposes ~d says that he is the applicant (Name o~ in~iviauai signing contracr~ above named. ~ ~ ~ (Contractor, agent, co,orate officer, etc.) of said owner or owners, ~d is dOly authorized to perform or have perfomed the said work ~d to m~e and file this application; that all statements cohtained ~ this application are true to the best of his knowledge and belief; ~d that the work will be perfomed in the m~fier set forth in the application filed therewith. Sworn to befo~ me this ....... ~ ....... day~f .... ~.~ ....... ,19~ (Signature of applicant) ~' '" ' ......... '~ ' ....... : I SUFFOLK Co. HEALTH DEP'f. H.$. NO, ~ ................. ~ ........ '. ~ T~ ~ATER su~LY AND ~WAGE DIS~AL ~ /' ' t . ~ x ; ~ SyST~S FOR THIS 'EESI~NCE W~L ~ f '' ' J~ ~'"' SUPFOLK CO. DEPT, OF HEALTH ~RV~ES, . . - .. : . - . . ~S P~PAR~D, AND ON z~, -.,,..,~ ~ ~ , , ~; ~... r"~ ~ ~ "'Y~2-'~'?'~:/ .~"~ _?~>~z:; ~'~, ~' C~ LICENSED,LANB SUR V. EYORS 6~[~T N[W ~O~K SUFFOLK CO. HEALTH DEPT. APPROVAL H S. NO. ..... LOT' 5 LO? 6 RODERICK. VAN TUYL. P.C. LICENSED LAI'~D SURVEYORS GREENPOR T NEW YORK STATEMENT (~F' *INTENT TH~ WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO T.HE STANDARDS ~F THE SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE: H. S. REF. NO.: * APPROVED: DEPT. OF HEALTH · APPROVAL O-f TEST SEE 'F~£EF HAP SEAL SUFFOLK CO. HEALTH DEPT. APP~O'VAL H.S. NO. Gruhill Construction Corp~ 3300 Route 112 Medford, L. I., N.Y. 11763 ..~ STATEME;NT OF INTENT I THE WATER SUPPLY AND SEWAG, E DISPOE~,a~L SYb~EMS FOR THIS ·RESIDENCE WILL ,.J~O [CONFORM, TO THE STANDARDS OF THE t SUFFoLK~.CO~ D~PT. OF 'HEALTH S~RVt~S. ..... AFFLicANT t SUFFOLK coUNTy DEPT.' OF HEALTH, 'SERVICES -- FOR · ~PPROVA~'. OF . CO~I. STRUCT ION ON~ ~C~ / ~JA~'I'JOt, I~-~D ALTERATION gl[ · SEE SEAL 'RODEI~.ICK. VAN TUYL: P:C. , .. LICENSED LAND SURVEYORS GR EENPORT NEW YORK /£~0 R// '1 0 :f *' :U' % FRONT ELEVATION DESIGN: PP DRN BY: D.V~O. CKD BY: DATE: 12-29-T5 REVISIONS: GRUHILL CONSTRUCTION CORR 3300 RT. 112 MEDFORD~N.Y,;it765 CONCORD RANCH RESIDENCE FOR: SHEET )OF 4 PLUMBING DIAGRAM ~OT To %cAg~ REAR ELEVATION DESIGN: DRN BY: D.W.O. CK D BY: DATE 12-29-T5 ~'EVISIONS: TYPICAL ,SECTION _ ~4~;:,]'~_~'_' :_ LEFT SIDEELEVATION GRUHI.LL CONSTRUCTION CORP. 3300 RT. ll2 MEDFORD.,N.Y/II765 ,RANCH CONCORD ALL Al~ouI, J D "LALL¥~CoL 5~ ~ I~" E~R R C. FTC~ RIGHTELEVATION Vga'-o JRESIDENCE FOR: SHEET (~)oF 4 , ,4-5; 4" qLq" 7L4" DESIGN: DRN,B¥: DWO CKD. 13y: DATE: 12 -29-75 REVISIONS: - _4fOp.i. [ ObJA, L. x4-~ . . PO aCF~, FAMILY ROOM / KITCHEN ,/ + LIVING ROOM DINING mM A~CH 4L,-Z" LAUNDR/ rq GARAGE '2o'- 4" /i / / / 14.:o" FLOOR PLAN BATH. GRUHILL .3500 RT ) 4L10" (2) 5'- o".,, 14Lo,, MASTER BED RM?I I BED RMv2 i CONSTRUCTION ~12 CORP. MEDFORD~ N.Y.~It 76 3 '23'- 8" CONCORD RANCH RESIDENCE FOR: SHEET r DESIGN; RP. )RN BY: D.W,O. CKD BY: DATE: 12-29 -TS REVISIONS: 14: $" PocK~ tSL I I" BUILT-UP WD. _J U N EXCAVAT ED FULLY EXCAVATED BASEMENT '2/'- o" FULL BASEMENT PLAN GRUHILL CONSTRUCTION CORR 3300 RT tl2 MEDFORD.~N.Y,/I763 LIJ J 8'-1" _ 8'-I" &'-I" 37t o" ~ '6 CONCORD RANCH SHEET I~)OF 4