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Home My WebLink About13505-zFORM NO, 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No...Z...~.3.5.0.5. ....... Date ......... .~.o.v, e. .m.b.e. r. . .2.6. .......... 19,85.. THIS CERTIFIES that the building .... o..n.e.-.~.a..m.i,l.y,, .d.~.e.~.~ ~p.q... .................... 105 Sunset Dr. Location of Property .... 2.455 ............... R.B .~.h...R..d~ ............ .~.a.~. ~.&t.u.c..k ...... House No. Street Ham/et County Tax Map No. 1000 Section ... }.0.6. ..... Block ......... .7 .....Lot ..... .2 ........... Subdivision..8. t~r~.s.e.g...Kp, ql..1.s..S.c..c,..2. .... Filed Map No...5..4.4.8..Lot No ....... .1.2 ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...O.q ~9,b.e.r...1 ........ 19 ~.4. pursuant to which Building Permit No. 13505Z dated ....... OctDt~er. 2.5 ......... 19 13.4, 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 ......... Private one-family d~ellin~. The certificate is issued to GUS & SOPHIA TIBAS ..................... ?o¥,;o; ..................... of the aforesaid building. Suffolk County Department of Health Approval ............... i. .3 7.8.0.-: .1.9.2. ................ UNDERWRITERS CERTIFICATE NO ........................ .N.6.9.1. 5. 9.6 .................. Rev. 1/81 Building Inspector 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) N-° 13505 Z Building Inspector. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy , J,'~J. ..,e ~..~,~.,~ A,.,.,,~.,,o.,No....S,,e ~7~/~ N 691506 GUS Tibas~ s/e Corner Sunse~ Dr~ ~ & Ru~h Rd. ~ ~atti~.uck~ New York ~as exa~ined °n ~a y 9 ¢ ~ ~ 8 ~ a.d ~ound to be in co~plia~cs wlth ~he r~qulre~er~ o~ tl~s ~o~rd. FIXTURE FIXTURES RANGES OVENS 16 25 DRYERS DISH WASHERS EXHAUST FANS OTHER APPARATUS: Future Appliance Feeders-- smoke Detectors- 2 S E R V I E 1-3-8 Eeco Electric Corp,(Cliff Cornel. l) 325 Willow Pt. So~thold, N0¥.~ 1,1971 lic.#2816 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified . C°P¥?OR B~ILDI"0 _ R~MENT. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date April 15, 1985 Building Permit No. 13505Z Owner Gus Tibas (please print) Plumber Frank Pazienza d/b/a Bay (please print) Plumbing & Heating I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn tO before me this ~day of ~-~ · Public, ~ Notary ~ County ~tary Public SALLY BLADO$ NOTARY PUBLIC, State of NeW York No, 4799955 Qualified in ,Suffdk County Comml~,,Ion Expires Ma~ch 30, I~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ............ TOWN OF SOUTHOLD 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 ail 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. B. For existing buildings (prior to April 1957), Non-conforming uses; or buildings and "pre-e.xisting" 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 ~r 3. Copy of certificate of occupancy $1.00 _/ land use $/~/$5.00 Date .. July. _ 8' 1985 New Building XX Old or Pre-existing Building(X) ~/Vacant Land Location of Property Rut~, ~Road...&~ Sunset,Drive~, Ha~tituck~ N. Y. 1195,2. House No, Street Ham/et Gus Tibas ~ Owner or Owners of Property .................. - ..................................... County Tax Map No. 1000 Section 106 B~ock 7 Lot p'cl. 2 Subdivision Map of Sunset Knolls .Filed Map No. 5448 .Lot No. Permit N o!. 3. .5 .O.5.Z. .... Date of Permit .1. O. ./ .2 .5/. 8. ,4Applicant INLAN.D.H.O~. ES., I.N.C, Health Dept. Approval 6/19/85 .~5- ~0-/6~2 .Labor Dept. Approval .,. N 691.506 ' Underwriters Approval ................. Planning 8oard Approval .................. ~ ~.; Request for Temporary Certificate ..................... FinaJ Certificate ........ - ......... * ,iubm,tted ,b ....... Construction on above described building anj;~mee.ts all app~cable~co, Ce~ and regulations. ~ppdcant ., .~~-'~-../~C,6~%T~--~,~'7~,, ................ Rev, 10-10-78 FOUNDATION ( 1 st FOUNDATION (2nd) PLUMBING INS~L~TION PER N. STATE ENERGY ADDITIONAL COMMENTS: FORM NO. 1 '~TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. ~.~.T...~/~....,19 ~ Approved (~C'~/'"- ~5- 1' .~..mermitNo./.~..~...~..~'. ,~.'~' Disapproved a/c ....... _ ~ ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date Octobex i 19134 INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or~in 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. G~neral Contractor Name of owner of premises . .G.u.s...& .8. gp.h.~.a...T.i.b.a..s ................................................... (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 .......................... 517~P Plumber's License No ......................... Electrician's License No.2816 ~/ 5~ 1. Location of land on which proposed work will be done .... .R.u.l:.h...R.o.a.d. ~.. ~ !. ~....."fi~..... i ......... House Number Street Hamlet Pcl. 2 County Tax Map No. 1000 Section ....1.0.6. ........... Block ...7 ............... Lot ................... Subdivision....H.A.P.. 9.1'..S.U.N..S.E.T.. K..N.O.L.L.S...S.E.C..T...2.. Filed Map No...5.4.4.8. ........ Lot .. ?..~. ......... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... '..~,4~..~./.~....~.~...'~. .................................. I Family D~elling b. Intended use and occupancy ........ . ............................................................ 3, Nature ofwo~ (check which applicable): New Building .......... Addition .......... Alteration .......... Repair' .. !.:... ~ ...... RemOval .............. Demolition .............. Other Work ............... 4. Est/matedCost .. ;./_ .~.~?. .9 ...................... Fee ................................ ", ..... : (to be paid on filing this application) 5. If dwellhlg, n(lmbe-r~Of dwelhng units ............... Number of dwelling units on each floor ................ If garage, number of cars ...1..; ................................................................. 6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurSs, 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. Dhnensions of entire new construction: Front .... .4.6. *. .......Rear ..... 4..6 ........ Depth ...2.7 .......... 'ght mbe~of Sto' )~ ]Itel ............... Nu nes .................................................. 9. Size oflot: Front ...~..S.~.'?g..~.%.~:... Rear .................. Depth 2.00! ................. 10. Date of Purchase ........... i .................. 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: ................................ 13. Will lot be regraded ............................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises G~. &..$qpl3~-~ .T;J-b.a~ddress/~i~3rt~;${g... Phone No. 298-9542 Name of Architect ........... ~ ................. Address ................... Phone No ................ Name of Contractor . .I.N..L.~..lq.D.I .H..O.lq?.S. ~..t.N.C...... Address I~qX..10, 7 ~ lq.~; l:i[.t.~l~l~lao~tt~..N/¥....g98.-.9.~90 .... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block Inumber or description according to deed, and show street names and indicate whether interior or corner lot. , H STATE OF NEW YORK. 'S.S COUNTY OF...S.U.F?. 9.Lg ...... ................. Ro.b~;r.t..li[ ~. ~i 1 .ti~ ............... being 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 saki 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 mannek set forth in the application filed therewith. Sworn to before me this ' ............. -., , 'r' I ~o~m,~,, ~,~ ~r~ a0, t~t~ Robert 1S. H il tz ~Si~nature of applicant)