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Home My WebLink About11422-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..ZiD.9.27 ...... Date ..... t~P.Y...1.0 .... ................ 19.8.2. THIS CERTIFIES that the building ................................................ Location of Property . .1.5.4..5 .............. ~.n.d..:t.a.n..~.e.c.k..L..o.n.o. ........ Pecon±c House No. Street Hamlet County Tax Map No. 1000 Section . O.a6 ....... Block ...05. .......... Lot .... q 0..8 .......... Subdivision...X ............................ Filed Map No...X ...... Lot No. conforms substantially to th? Application for Building Permit heretofore filed ir~ this office dated .... .0.c.t.q ~..e ?..8. ...... ,19 .B3. pursuant to which Building Permit No...1. ~..~ .2~.. Z. ........... dated .... .o.c3.o.b. ?.v' .1.4. ............I98. !., 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.r.~y.~.~.e.. 9.n.o.-..f.a.~.~.~. ¥..d.~.o..~ yy.n.~.;: ........................................ The certificate is issued to Theodore & Marion Jam~s (owner, les~e.e¢. of the aforesaid building. Suffolk County Department of Health Approval . .4/.2.2./..8.2.... 1. 1..-.8.0.7~.6.,' . R. p.b.~ :. ?... UNDERWRITERS CERTIFICATE NO .... .hl..5555.q~ .................................... Building Inspector Rev. 1/81 FOB~ ~0. Town TOWN HALL SOUTHOLD, N. Yi (THIS PEP, MiT MUST BE KEPT ON TH.£ P~EMI~ES COMPLETION OF THE WORK AUTHpRIZED) No. il122 Z Permission is hereby granted to: : ..... ./..~.~..4~..-....~.~.~.~..7~.~.~...,....i.. ......~.~....~,/..z ........ : ........... ::...;:~ ................ i:. , ~o .....C~ ~z.z¢~....~.~.~.~.....~.,~..~%...~ .',~..~ ................ ..... , ........ ~...~.:..~~....~:.~¢~.......~..~..: ................... at I~remisSs located at .~........../..Y.~..~..//.~.ef~...,Z~...~ ~,..~ ........................... Cou:nty T~x Map No. I000 Section O ,..~..~... Bl~ck :.,..~ ;~>'" t Lot No ......................... pursuant to app cat on dated ~nd approved by the Bull:ding Ihspector. ............ '""~'~fi'f-'~';,~ ............................ · Building !-InspectOr 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~ 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 topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3o 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 unusua~ natural or topographic 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. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwel)ing or land use 3. Copy of certificate of occupancy $1.00 $5.00 May 3, 1982 Date .......................... New Building X Old or Pre-existing Building Vacant Land Location of Property ....... .[.n.d.i..a.n, .N.e, .c.k, .L.a..n.c.,....P.e.c.o.n..i.c.~..N. ;. ¥; ,House No, Street Hamlet Theodore & Marion James Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 86 Block 5 Lot..8. Subdivision ................................. Filed Map No ........... Lot No .............. zo/z4/Bz HOM S, NC, Permit No .... Date of Permit .......... Applicant .................................. Health Dept. Approval . .~.~..2,/.8.2. .............. Labor Dept. Approval ........................ H555503 Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . yes Fee Submitted $ 5°00 Construction on above described buildin i~d per~ts~~ations. R~.lO-lO-?a C.~D, ~ /O~ R~ert E~I~, ~ND HOMES, INC. 1000744 THE NEW YORK BOARD OF FIRE UNDERWRITERS ..~~ch 30, 19~ ~..~c~,o,,N..o.f.~ 16173~ - ~ N 555503 w.sexamlnedon ~rch 25, 1982 and/oundtobeincotr~pl~ncewlththerequire,nentso/thisBoard. FIXTURES RANGES OVENS EXHAUST FANS 17 16 DRYER~ MULTI-OUTLET SYSTEMS NO. OF FEET E R I C 1 2/O 1 Elco.Room F~eater/s: 1-2.0, 1-1,5, 1-1.0, 3-.75, 2-.5 K.W. }Dtor/s: 1-F 1-G.F.I, 1-4.5 K.W. ~i; Water ~a~er Yo~g's ~C ~ctit~k GeNiaL M~ P.O. ~x 372 ~el, N.Y. 11948 lic,2148~E This certificate must not be altered in ony m~nner; return to the of~[ce of the 8oord COPY FOR BUILDING DEPARTMENT, THIS COPY OF ~ER~i~JC~ ~ST~NOT B~ A~T~RED I~ ANY M~~ FI~'LD INSPECTION FOUNDATION FOUNDATION ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL DATE COMMENTS ., ADDIT!gNAL COMMENTS: ,, (1st (2nd FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1805 Disapproved a/c ............... .... (B6ilding Inspector) APPLICATION FOR BUILDING PERMIT Date October 19 INSTRUCTIONS a. This application must be 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 to 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 which 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 Bnilding Inspector will issue a Building Permit to the applicant. Such penx shall be kept on the premises available for inspection throughout the work. e. No buikting shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS tlEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, 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 describe 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. INLAND HOMES, INC. (Signature of applicant, or name, if a corporation) BOX 117~ M.a.t. tituck: N..Y. 11952 · (Mailing address of al~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, General Contractor Nane of owner of premises .... .T.h.99.dg.r.e.. 5. M~.~' .i.~.q .Jgt%e.~ ........................................ (as on thc tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....... Rober.t..E.. Hiltz,. P. res ............... (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.. 517-P Electrician's License No.. 2148-E Other Trade's License No ...................... 1. Location of land on which proposed work will be done..Iiadio, n .Ne~h .Lan~,. .......................... ~4~50 I~'~ Indian Neck Lane Peconic blouse Number Street Hamlet County TaxMap No. lOOOSection 86. Block 5 Lot ~ .~ ~. ~ Subdivision ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccnpancy ~f pr~p~sed c~nstructi~n: Vacant a. Existing use and occupancy ................................................................... Family dwelling b. Intcnded use and occupancy ... ,1 .............................................................. I Nature of work (check which applicable):; Repair .............. Removfil ..... Estimated Cost .. .~ %. 9?... ..... 4ew Bui/ding X Addition Alteration ........ Demolition .............. Other Work ............... .~. ,~.~..~ (Description)_ ................ Fee .............. , ........... (to be paid on filing this application) If dwelling, mnnber of dwelling units ................ Number of dwelling units on each floor ................ If garage; number of cars ...... ' ...... If business, commercial or mixed 0ccupanc Dimensions of existing structures,iif any: Height ............... Number of Sro Dimensions of same structure with alterati~ Depth ..................... ~. lleight Dimensions of entire new construction: F~ Height ............... Numb!er of Stc Size o£16t: Front ...... ~..~.~. ...... Date 6f Purchase .................. Zone or use district in which prm{dses are Does proposed construction violate any z¢ specify n~ture and extent of each type of use ................... ront ............... Rear .............. Depth ............... ms or additions: Front ................. Rear .................. ~nt . .. Rear ...¢...'~-. ..... ;. Depth .. ~ ........... ......... Name of Former Owner tuated .................................. ;'. ................. n~ng law, ordinance or regulation: ............................... ¥,'il.~ lot be regraded ........... ! ................. Will excess fill be removed from premises: Yes No Name of Owner of premises .'{.~?ig~r..e.: ,l.a.r..x.a.n.. Address 1450. .It~,~n. li~[~.f21ifi~[~ne No. 7.3.4. :.5.6.z.q ..... Name of Architect ........... ~ ................ Address ................... Phone No ................ Name of Contractor I.N..lr~..N.D. .17I. 971.~.~. ~. ~.C.. Address Box117-Mat t itu ck Phone 0298-9696 PLOT DIAGRAM whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether Locate clearly and distinctly all buildings roperty lines. Give street and block number o: terior or corner lot. rATE OF NEW YORK_ OU T¥ ..... S.S ........ ................... (Name of indMdual signing cont; ~ct) ~ove named. Contractor e is the ...................... : ..... £ said owner or owners, rind is duly autho: ~plic/~tion;.that all statements conthined in 'ork will be performed in the manndr set for worn to before me this ~]OTAR¥ PUBLIO, State of N~ RO, 52-8125850, Suffolk Term [xpires March 30, ounty ~~ 'Contractor, agent, corporate officer, etc.) ized to perform or have per, formed the said work and to make and file this this application arc true to ~he best of his knowledge and belief; and that the h~ the application filed therewith. being duly sworn, deposes and sayg that he is the applicant · ,rE ~f ..... ?_.65.O ~he sewage dts¢osal and ~ater_ su~p}y inspected by this department to be satlsfactc~ Se~tces~ 30c)~66 ~ ..... .SCALE- ': ".:,-0': E~..Oiq' ?l' PE- . - .AP..F_A ' ' RODERICK VAiN T~IYL, P C LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. Il - $O-,_qb STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (si APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL Of CONSTRUCTION ONLY DAte: H. S. EEl. NO.: APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. .. LOCQ 5 8, OWNERS ADDRESS: DEED: L. P. TEST HOLE STAMP SEAL -.~]-.~_: .... ,: ,r" SUFFOLK CO. HEALTH area, the possibility exists~ that the ! ........ ~ 4' ~ ~ ~ ~*~ ~'~ ~AR' OF P~O"~'~PT / ' ' .~ ~ ~ ~.* ~ water supply may cohta{n trace : ~, , , .... i , ,~ ~ ~ amounts of pesticides and/or nitrates. ~. ~Y~ ~0~_ Special analysi~E~ I~' .r~gked. .... ~ ' ~-~ E~P ~., . ~~, , . ., ~ LICEN~D LAND SUEV~QRS ~EE~RT ~ YORK q ih, ow*t) As NOTED DATE: '~J.'~/~l B.P. '~~ FEE: ~ BY: ~ NOTI~ BUILDING ~Ep~?MENT AT 765-T802 9 AM TO ~ PM FqR TH~ FOLLOWING INSPECTIONS: 1. FOUNgATION "~0 REqUI~ED FOR POURED CONCRETE 2. ROUGH - F~MING & PLUMBING 3. INSULAT~O~ 4. FINAL - CQNfiT~UCTION MUST ALL CON~qPr]CT~QN SHALL MEET TH[ REOU~PFE~ENTS OF THE N.Y. ~ATE CON.RUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ~RRORS. i1' i ~L.~VAT I0~1 I f 'i