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Home My WebLink About11064-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate Ot: Occupancy No .... .Z J .0.5.9..2 ...... Date ....... g u.l.y. 2.1., ................. 19 THIS CERTIFIES that the budding ................................................ Location of Property ,0~}~'. E.l.lJah~..bane., ....... k}/~tl~a t ~..Suc k.,..New. County Tax Map No. 1000 Section ... '1(>8 ..... Block . .04 ........... Lot ..... 0.07 · .1.7 ..... Subdivis~onEliJ~.h :s. L.ane. E~.I~e .t.e.$..~ .e.c...~iled Map No ......... Lot No...1./, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... Ma.r:cl~..1.3 ...... , 1981. pursuant to which Building Permit No ..... 1.~@64..g ......... dated Mzt~.ch..1.9 ................. 198.1.., 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 ......... .... .?.~J, va.te. One.-,F. ami~-7. Dw~.lling ................................... ~ ...... The certificate is issued to .. Ia~land..Home~..In¢ ....................................... (owner, lessee or tenant) XXXXXXXXXXX of the aforesaid building. Suffolk County Department of Health Approval 11-$0-11 7/21/81 ltob~et /~. l/illa P.E. UNDERWRITERS CERTIFICATE NO... N5.2.3552 ...................................... Rev 1/81 FOI/SX NO. ~ ~ TOWN OF S~UTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N~ Y. BUILDING: P,ERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL 11064 7_ Date .....~,.'~.~d, .C. ~... !...~...~. .................. Permission is hereby granted to: pursuant to application dated .... ~.~.~.:'..-..~..~ ........ J. ........ 19. ~.~., and approved by the Building Inspector. Fee $....~;'..w~. ............. / B6ilding Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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- 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, 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 unusual natural or topographic 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- tion required to prepare a certificate. C. 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 July 22, 1981 Date .......................... New Building × Old or Pre-existing Building Vacant Land Location of Property ,. E.l£jah.'.s .Lane .M~t. titu.ck,. N,Y ......... ~,o¢c..~14. Sec, l.'t ..... House No. Street Hamlet Owner or Owners of Property ~nlan~]_~ Mom~s~,,~%r~. ~ County Tax Map No. 1000 Section ........ ]~OD ..... Block ..... ~..~ ....... Lot .... ¢,~.4 ........ Subdivision ................................. Filed Map No ........... Lot No: ............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval 7/21/81 .Labor Dept. Approval Underwriters Approval . N523552 .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ................. Fee Submitted $...5 oO0 ...................... Construction on above described building an egulations. Applicant ........... r..~ .~...-~...~..~... :..1'~ ................... Robert E. H/ltz, INLA~ES, INC. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 only ~he electrical equipment as described b~lo~ and introduced by the applicant named oft the able application number in the premises o~ in the follou:tag ~catlon; ~ Base~**e~tt ~ 1st Fl, ~ 2nd FI, Section Block Lot was examined on [~tlr~ tJ ~ J.~&JJ~ and found to be tn compliance with the requirements of thts Board. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS SWITCHES INCANDESCENT FLUORESCENT DRYERS SYSTEMS NO OF FEET OTHER APPARATUS' S E R C NO O~F CC COND A W G NO OF HI4fG A W G NO OF NEUTRALS A W G pER ,~' OF CC COND OF HI [~G OF NEUTRAL GENEI~AL MANAGER Th,s certificate must not be altered in any manner; return to the office of the Board if ,ncorrect. Inspectors may be tdenttfled by their credenhals. COPY,FOR B~I/DING DEPARTMENT. THIS ~COPY OF CERTIFICATE MU~T NOT BE ALTERED IN ANY MANNER, FIELD m~NSPECTION COMMENTS FOUNDATION (1st) FOU~DATION 2. ROUGH FRAME& PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY co E FINAL ADDITIONAL COMMENT~,: -ti ~ ~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ^pproved X ermit Disapproved a/c ....................... >,~ ......... Application No..//. ~..~..~. ........ APPLICATION FOR BUILDING PERMIT Date March 13 19 81 INSTRUCTIONS a. This application must be completely fdled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, a~curate plot plan to scale. Fee ~ccording to schedule. b. Plot plan showmg 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 Buildmg 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 m 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 Budding 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 de~nolition, 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 m buddings for necessary inspections. INLAND HOMES, INC, (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N.y. 11952 (Mailing address of applicant) State whether appl,cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of pre~nises .!n..l~.n.d...H.o~le.$,..In.q, .................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ...... R.o.b.e.z.t.. ~.,...H.i.~.~.~. ...................... (Name and title of corporate officer) Builder's L~cense No .......................... Plumber's License No. 517-P 2148-E Electrician's License No .................... Other Trade License No ' 1. Location ofland on which proposed work will be done. Elijah's Lane, M&ttituck, N.Y. House Number Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.17 Subdivision ..................................... Filed Map No ............... Lot ....~. .......... (Name) . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Vacant a. Existing use and occupancy ..................................................................... 1 - Family Dwelling b. Intended use and occupancy .... ~ ............................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... 1. ........ Number of dwelling units on each floor ....... ~ ........ If garage, number of cars .... 1 ................................................................... 6. If business, commercial or mixed occupancy, specify nature and ~xtent of each type of use ...................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure 'with alterations or additions: Front ................. Rear .................. Depth Height Number of Stories , 8. Dimensions of entire new construction: Front ...5.4...8. ..... '... Rear .... 5..4...8. ......Depth ....2.8. ~ ........ Height .. J..8. .......... Number of StbHe~ ..... J, ....~'. .................................... 9. Size of lot: Front .... t~... 161 Rear.. 161 Depth 153.91 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~9 ................ ~ ......... 13. Will lot be regraded .YeS ........................ Will excess fill be removed from premises: Yes ~No 14. Name of Owner of premises .I.n..lg.n.d...H.o.m.q~.,..I.n.q~_~ldress . .Bp.x...1.1.7..M..a.t.~..... Phone No.l~.9..8.-.9.6.9..6 ...... Name of Architect ........................... Address ................... Phone No ....... ' ......... Name of Contractor ....... Ir~t~.P,~..ITlppl~, ~I~c. ~ddress . I~.o.~. J~7.,..iYl~..'c.t. q . Phone No.~tg$ ."9.6.96 ...... Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ........ ....2.. Removal .............. Demolition .............. Other Work ............... · ~,j_ .~.~.~. (Description) Estimated Cost . $5.,.0.~0.o.0.0. .......................... Fee ............................ ; ......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing 'ok~-- proposed, an&indicate all set-back dimensions from property lines. Give street and block number or descril: > deed, and show street names and indicate whether interior or corner lot. ko(' STATE OF NEW YORK, COUN'rY OF . .$u./../.o.l,g ....... S.S ......... :R..o.b??.t...~.o..H. ~.l.t.z. ...................... ting duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Contractor He is the ...................... , .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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. Sworn to before me this 17.,.. day of... ~larch'~ 198..1 Notary Pul~lic, ....... .~ ...... ,~uf£o. lk .......... ELIZABETH ANN ~VILLE ~.. HOTAR~ PUBLIC, Sta~/of New York No. 52.8115850, S~ffo~k C~nty Ttrm ~x~]res ~arch ~0,,19~~ H£ALTH DEPARTMENT-OATA FOR APPROVAL TO CONSTRUCT N NEARESF WATER ~AIN__MI -~ N SOURCE OF WATER PRIVATE ~_pUBLIC N SUrF CO YAX M&P I~T lO00 SE(:TION jqe. BLOCK ~4~ LOT 7~17~_ ADDRESS TEL SUBDIVISION MAP FILED IN THE OFFICE OFTNE CLERK OF SUFFOLK COUNTY OF/ FEB J4~ 19T4 AS FILE ND 6065 II1: MON'UMENT CJ= STAKE ~ THE LOCATIOn4 OF WELL(W)~ SEPTIC TANK(SI')~ CESS~OOLS(CP) SHO~N HEflEOR ARE FROM FIELD OBSERVATIONS AFID OR DATA OBTAINEO FROM OTHERS SURVEY FOR INLAND HOMES, INC. LOTI4~"ELIdAH'S LANE ESTATES, SEC~I" AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK JULY 21. 1981 dUNE I~ 1981 DATE FEB. 9~ 1981 SCALE I "· 40* NO. 81'42 YOUNG e, YOUNG ALDEN W YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y-S UC£NSE NO 12845 HOWARD WYOUNG~ LAND SURVEYOR NYS LICENSE NO 45893 400 OSTRANDER AVENUE RIVERHEAO~ NEW YORK HEALTH ,SERVICES FOR APPROVAL OF CONSTRUCTION ONLY R*THERI[ ARE NO DWELLINGS WITHIN I00 FEET OF THIS PRORERTY OTHER THAN THOSE gHOWN HEREON 1~o× ii7 ,.. Matthuck, N. ¥ # TH~ LOCATER OF W~L.L/M)t ~EPTIC TA HR( ST~'8~ CESSPOOL$iCP).IHOWR HERES SURVEY FOR .INLAND 'HOMES, INC. LOT 14, 'ELIdAH'S LANE ESTATES, SECT. I" AT MATTITUCK. DATE FEB. TOWN OF SOUTHOLD SCALE 1"=40' SUFFOLK COUNTY, NEW YORK NO. 81-42 N UN&UTHORIZED ALTERATION OR AOOITION TO THIS SURVEY · ~ VIOLATION O~ SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW / H COPIES ~ THIS SURVEY~ NOT BEARING THE LAND / SURVEYOM'~ INKED SEAL OR EMBOSSED SEAL SHALL / ~' '/~'~r~ ,,,~'~ NOTBE CO~SlOEREO TO ~ a VALI0 YRUE COPY / H~&RANTEES INOI~TEO ** 'HEREON ~aLL RUN ~LY ~ / T~ ~RS~ FOR WHOM THE SU~EY IS PREPAREO / AND ~ HI~~ BEHALF m THE titLE C~P~Y, COVEN- / MENTAL AGENCY AND LEN01NG INSTITUTION LISTED PUR~SE AN0 ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR~THE ERECTION ~ FENCES V~l IKl~ ~ V~l IRIS" ~NDERAVENUE I m / 'LO~N W.~UNG, PROFESSIONAL ENGINEER L., ~ N*Y.~.LICENSE N0.4589~ ,oF No. / of NOTIFY BUll_DING DEPARTMENT AT 7~5-{802 ~ A~ TO 4 P~ FOR THE FOLLOWING INSPECTIONS: ~. ROUGH - FRA~NG & PLUMBING STATE CONSTRUCTION ~ ENE~6Y CODES, NOT RESPONSI~LE FOR DESIGN OR CONSTRUCTION E~, iI 1 I I L~. VAT lo k