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HomeMy WebLinkAbout12678-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~..1¢.5.1.7. ......... Date.· June 7 ............................... 1984 THIS CERTIFIES that the building .-:-:r~e.w..clweJ,%i~f ............................... Location of Property 2155 Greenway East Orient County Tax Map No. 1000 Section ...0.1.5. ...... Block ....0.1. ......... Lot .... 008 Subdivision... Gr.eert. kcres..e,~. 9r.~,e¢l~.. ·Filed Map No...3.5.4.Q..Lot No...4.2. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Qcg.o.b.e~7..7 ....... , 19..8.3pursuant to which Building Permit No .... 1.2. 6. .7.8..~. .......... dated .... Qc..~9.b.e.r...1.0 ............. 19.8..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 ......... ~ p~.~¥~te ~Be-famil~ dwelling. The certificate is issued to ....... V.~$.]~!9.S..T. $.I.S.I.N..O.S..a...~.NAS.? .~.S.I.~., .T.S.I.S./..N.O.S. ...... (owner, of the aforesaid building· Suffolk County Department of Health Approval . .].$r~.q': .1.3~,,.. 5,[3,1,/..8~,~..R.o,b,.~....~:..V..J:.l. 1..a, UNDERWRITERS CERTIFICATE NO .......... ~. 6.4.5. 7. O ~- ............................... Rev. 1/81 F~I~ 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) 12678 Z Permission is hereby granted to: .... ~~..~....~; ............... ......'7~.~.~...U...q. ................................................ ......~..~~....~...%....J..L~.~....~ .... at premises located at .m~....'~..~......~-.~e~d~.~...- .~.-.~....J.........~.~ ................... ..... ~ ...... ~i.~...~....~~..~.~..~~~ ............................... County Tax Map No. 1000 Section ...... J~.~..~'. ....... Block ....... ~ ......... Lot No ........ .~ ............. pursuant ,o application doted ...~..~.....~. ....................... , 19.~J.~1~., and approved by the Building Inspector. Building Inspector 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 featu res. 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 topographic features. 2. Sworn statement of owner o? 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 nforma- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / / 2. Certificate of occupancy on pre-existing dwelling ~r land use $/5'/ $5.00 3. Copy of certificate of occupancy $1.00 Date ..June_~, 1984 .. New Building X.X. Old or Pre-existing Building(Z) ......... ~/Vacant Land -' Location of Property .... 2~];,5,5 Greenway ~:ast, O~c±ent,..N.ew ¥or.~.11.957 House No, Street Hem/et Owner or Owners of Property V&s±lio$ T$i$ino~ &Ana. stas±a Ts~sinos County Tax Map No. 1000 Section ...0.1~5. ......... Block .... .0~ ......... Lot ..... ',8. ......... Subdivision ................................. Filed Map No. 3540 .Lot No. 42 Permit No .......... Date of Permit .3;0../'.~.0./.8..3Applicant . Inland Homes,. Inc. Nl.2678Z ................................. ~/31/84 App Health Dept. Approva ........................ Labor Dept. royal ...................... ,.. Underwriters Approval . .N. 6.?. .5 .7 .0. ~. .............. Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate .... ¥.e.s._. ........ ' ' . 5.OO Fee Submitted $ ............................. Construction on above described building and pern3~e~l~ all app~cable_.codes j~,,d regulations. Applicant .; ...... ;" 'NC; ...... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100S8 THIS CERTIFIES THAT only the electrical equipment as described bel~ and introduced by t~ applicant ~d on the above application nu tuber in the prem~es of in thefollowinglocation; ~ Basement ~ 1st FI. ~ 2nd Fl. ~d. ~1. Section Block Lot was exa~nined on ~ ~ ~ ~ and found to be i~ compliance witk the requirements of tbis Board, FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT I~G .F.C. I. 2-Sm(A~ ~etectors S E R V I C E OF CC, COND. NO. OF HI-LEG A W.G. NO OF NEU A W G, OF HI-LEG TRALS OF NEUTRAL . ~co ~l~t.Co.-Cli~ Cornell 3~ %'~lllow Pt. i~t. GENERAl. MANAGER, Per ll/. This certificate must not be aJtered in any manner; return to the office of the Board if ipcolTect. Inspectors may be identified by their cred~n~iaJs. COPY FOR ~IT. THIS COPY ' BE ALTER 765-1802 BUILDING DEPT., INSPECTION FOUNDATION ~,ST [ ] ROUGH ,pLBG. FOUNDATION 2ND [] INSULATION DATE 'INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST .~[/~ ROUGH PLBG. FOUNDATION 2ND [ ]~INSULATION FRAMING REMARKS: FINAL FIEL~ INSPECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & ?LUMBING (2nd) INSULATION PER N. STATE ENERGY qODE Ye FINAL FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined. ~'.~..I. 9.., 19~. Approved . ~ . .~...a~..../. I.., 19~.*. Permit No.. ] ,:~.~.") .~'~-- Application No .................. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date October 7 198..3. INSTRUCTIONS a. This application must be completely filled in by typewriter or }n 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 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 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 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 building for necessary inspections. ........ ................. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises Vasilios & Anastasia Tsisinos (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's License No. 517-P Electrician's License No. 2816 Other Trade's License No ...................... 1. Location of land on which proposed work will be done..L.o.t....~.4.2. ~.. [.M.a.p.. 9.f, .G.r..e.e.n..A..c.r.e.s...a.t..O.r..i.e.n.t.'~:. ...... ..............C3 .................. ......... Street Hamlet House Number County Tax Map No. 1000 Section 015 Block O1 Lot. 8 Subdivision ..................................... Filed Map No. ...3.5.4.Q ....... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a: Existing use and occupancy ...... .V..~..~./~..~..i. .................................................... b. Intended use and occupancy 1 family dwellin9 .. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remoyal ........... Demolition .............. Other Work ............... i (Description) 4 Estimated Cost L} O / o ~ .Q Fee ~ (to be paid on filing this application) 5. If dwelling, number of dwelling dnits... 1 ........... Number of dwelling units on each floor ................ If garage number of cars ~ 6. If business, commercial or mixed" occupancy, specify nature and extent of each type of use ..................... 7 .... ~ if any: Front Rear Depth · Dwaensmns of ex~shng structure~ ............................................. Height Number of Stories iih ' Dimensions of same structure w alterations or additions: Front ................. Rear .................. Depth .................... :.. Height ..... ~161 .... iiii ...... Number of Stories ........ ga ............ 8. Dimensions of entire new construction: Front ......... Rear ...5.6. .......... Depth ............... Height ............... Number of Stories ..... 2 ....................... ' ' ' )"~2;~?i ..... pth .15.7.: ............ 9. Size of lot: Front ......... 1,3..27 ......... Rear .................... De ....... 10 Date of Purchase ' Name of Former Owner 1 1. Zone or use d~stnct m which premises are situated ..................................................... 1 2. Does proposed construction violate any zoning law, ordinance or regulation: .............. 13. Will lot~ be regraded ......... ; ....... ............. Will excess fill be removed from premises: Yes. No 14. Name of Owner of oremisesAnastasia .Tssi~°SAdrlr~ 2g,12.~8t[% ~'c. phnn~Mn212-9g2 2582 - '' '. ...................... l~l~ol~o-'ai 'm','r ~ ........................... Name of Architect .......... i ......... ilq~'. ....Address ................... Phone No ................ Name of Contractor . .Ily...L~...D.i.H..O1~..~.~., .......... AddressB.o.x...1.1Z,.M..a.t.t.!t..u.e?ehone No..2 0. .6 .0.6. ..... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, COUNTY OF..S..U.F.F.O.L..K ....... ........... Roher t. Ii,. Hiltz ~ .................... being duly sworn, deposes and says that he is the a ?plicant (Name .... " of mdiv~dual s~gmng contract) above named. · ! C0ntrac. tot Ho is 'the of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this ......... ..... day o, ....., 19 No_t a~ Public ................ County _ _ ' ................. ' ~o1~¥ ~S~te.?!. ~w Y.~ Robert g. Hi(~}ttBa~re of applicant) ~I0. 52.8125850, Suffotk County,/ Lot Lot 39 - Lol q ~8 Lot [XCAVATIO! CTION REQUIRED ........ 5. __ - ...... , SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~0R APPROVAL OF CONSTRUCTION ONLY ,J / ' HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT · **REss ..... -;;¥' x^}~ :T"/=~''''"'~'/' // ffi Box 117 ~, Mo~tituck, N, Y. ~952 ~ ~- ~ NOTE: 0= PIPE SUBDIWSION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON APB. I$, 195P AS FILE NO, 3540, 41 Lot 42 Aro°~ 19,961 s.f Lof 4J 132. SURVEY FOR PAS/L/OS T/SS/NOS ~ ANASTASIA T/SS/NOS LOT NO. 4P, *"MAP OF GREEN ACRES AT ORIENT" AT OI~I£NT DATE: TOWN OF SOU THOL D SCALE: SUFFOLK COUNTY, NEW YORK NO. N UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION O~ SECTION T209 OF THE NEW YORK STATE EDUCATION LAW OWNER~ WDISTANCES S~WN HEREON FROM PR~ERTY LINES TO~XISTIN$ $TRUC~E$ ARE FOR A SPECIFIC PURPOSE AMO ARE NOT TO BE USED TO gSTABClSH I! YOUNG 8 YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOW~ARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE N0.45893 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK Lot 4O '- ,, Lot Lot 42 e°= 19,961 0 ~ o~ (;eneval . WILL C~FORM~ ~ THE STAN~ OF THE SU~K gOUTY DEPARTMENT ~ H~LTH I~ICEI. NO?g: O¢ PIlE SUBDIVISION MAp FlIED IN THE OIrFICE OF THE CLERK O~ SUI~OLK GOUN ~Y ON APH 13 ~ 196~ AS PIL~ NO 3~40, SURVEY FOR VASI£/OS TS/S/NOS ~} ANASTASIA TS/S/NOS /OT NO. 4~, "l~IAP OF Gt~E£1V 4CR£S 4T ORIENT" AT ORIENT OAT[: ~WN ~ SOurHO:D SCA~E: SUFFO~, , COUNTY,. NEW ~RK ~o. MAY 25, 1984 0C7~ / O, 1985 $£P7: 29, 1983 I'-' 40' 83 ' 808 ff UNAOTH(~I~IZEO &LTERA,TIDH DR ADDITION TO THIS MENTAL'AG NeY AND LEN 'lNG INSTITUTION LISTED ALDE~ W.~UNG~ PROF/~IONAL ENGINEER A,o ~o SURVEYOR ~.Y.S. UCE,SE ,0. HOwAko W. YOUaG. LA,O SURVEYOR N.~ S,~LICENSE N0.4589~ 400 OSTRANOER AVENUE RIVERHEAD, NEW YORK