HomeMy WebLinkAbout13508-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-27816
Date JULY 19, 2001
THIS CERTIFIES that the building
Location of Property
5860 HORTON LANE
ONE FAMILY DWELLING
County Tax Map No.
Subdivision
SOUTHOLD, N.Y.
House No, Street Hamlet
1000 Section 54 Block 3 Lot 19
Filed Map No, Lot No,
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 21, i984 pursuant to which
Building Permit No. 13508-Z dated OCTOBER 29, 1984
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 ONE FAMILY DWELLING WITH A1-FACHED 2 CAR GAPJNGE & WOOD DECK.
The certificate is issued to VINCENT F. & VERONICA C. REGAN (owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-S0-16i - DEC 2, 1987
UNDERWRITERS CERTIFICATE NO. N679784 - FEB. 22. i985
PLUMBERS CERTIFICATION DATED JUNE 28, 1985-MATTITUCK PLUMBING & HEATING
*NOTE: THIS UPDATES CO Z16463
Rev. 1/81
DATED DECE~ER 7, 1987.
FOB, B[ NO. O
TOWN OF SOU'ir'HOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
fl'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLL~ION OF THE WORK AUTHORIZED)
13508 Z
Permission Is hereby granted to:
.~, / ~-
.......... ~.. .......... .'.~.~:.....~ ............................
to ..... ~.~...~.~,~..~T.......a.~..~.......~.~.~..~......~.~.=...4...Z.../.....~.. ...................
................ ~ ............ ~,~-c.~..~.~.. ~'....k~.,,~.~..~.~......~..,.../~..,~..n....~...
o, p,,m,,,, ,oca,ed a, ...~a......~:-~.~.....Z,~_,~..~ ......................... .l.... ...........
......................... ~..~.Z~..~: ............ ~ ~
Counfy Tax Map No. ]000 Section ..~..~...'Y..~... ..... Block ..~..~.. .......... Lot No. QZ..~.. ...........
pursuant 'o application dated ..~.,,~,--,~ ............ ../...?... .............. , 19 .c~...~.~ amd approved by the
Building Inspector·
Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
M~PLICATION FOR CERTIFICATE OF OCCUPANCY ~'~;'~7~ ~';~ ...... J
This applicat±ou mdst be fill. ed in by Eype~r±ter OR ink and sub~±~e~--~b--(~e
inspector ~ith the Eollo~ing: for ne~ building o~ ne~ use:
~inal survey o~ propert7 ~ith accurate location o~ all buildings, property lines,
streets, and u~usual natural or topographic fieatures.
2. Einal Approval from Heaith Dept. of ~ater supply and sewerage-disposal(S-9
3. Approval of electrical installation ~rom Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of i% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-existing"~nd uses:
i. Accurate survey of property showing ail property lines, streets, building and
unusual natural or topographic features.
2. A properly completed applicatiom and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
6. Fees
1, Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $I00.00
3. Copy of Certificate of Occupancy - ~ .25¢.
4. Updated Cartificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. ..................................
New Construction .......... Old Or Pre-existing Building.. .X .
Lane, Southold
Location of Property.............5860 Hor~qn... ...................................................... .
House No. Street Hamlet
nce L'. .~r nlq. . .
Onwer or Owners of Property..¥~ .... ~. & o a C. Reqan ·
County Tax Map No 1000, Section .... P~.{ ...... Block...g~ ........... Lot..g]? .................
.Sobdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
50.00
Fee Submitted: $ ............................... ~
Paul A. Caminiti ...
APPLICANT
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z16463 Date December 7, 1987
THIS CERTIFIES that the building ...0 ¢ e.. f. a..m.i.l.y...d .wp. 1.1..i .n.g... .....................
Location of Property 5860 Horton Lane Southold
hiness ~iol ....................... 'S'tr'~; f ....................... ~emlot
County Tax Map No. 1000 Section .. 9 .5.4 ....... Block 03 .Lot 0 19
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Sept. 2 I , 1984 pursuant to which Building Permit No. 13508Z
dated ...... .0 .c .t.... 2. .9 .,.. ! .9 .8.4 ....... 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 .........
.... 0~e..~L~.Y.. ~.e.~, ~..i.n~ .w..i.t.h..a..t.t.a. qh..e.d..2...c.a.r.. $ .a.r.a.~e.: ....................
The certificate is issued to VINCENT F. & VERONICA C. REGAN
..................... x x' ..................
of the aforesaid building.
Suffolk County Department of Health Approval 14 - S O- 16 1 D e c.. 2, 1987
UNDERWRITERS CERTIFICATE NO. N679784 Feb. 22, 1985
PLUMBERS CERTIFICATION DATED: Matt. Plumbing & Heating Corp.
6/28/85
Building Inspector
Rev. 1/81
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This apptication must be filled in typewriter OR ink, and submitted i ~ 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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property 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
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
$15.00
Date .... ¢~.~§!.~.?§? ......
New Building ....~. ........ Old or Pre-existing Building ............ Vacant Land .............
Location of Property 5860 Horton Lane Southold
House No. Street Hamlet
Owner or Owners of Property .... .~/j b~.~.~ .~...~.'.. 4..~.~¢S ~¢¢.. ~, .....................
Countg Tax Map No. 1000 Section 05& Block 03 Lot. 019
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo. 13508 Z Date of Permit 10/2/4/8b~"~'lr~"* Heidt:mann & Son, Inc.
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ ...... ~
Construction on above described building and permit meets all applicable codes and regulations,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
[00107[ BUREAU OF ELECTRICITY ·
THIS CERTIFIES THAT
D. Regan, Hortons Lane, ~ou~hol~ ~Y
in the/ollowing location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block
was examined on ~ ~ ~ ~ t ~ and/ound to be in compliance with the r~quirements of this Board.
EXHAUST FANS
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS
TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R V I C
OT"E~.~P~F'![S~
1-~moke detect;or
NO O~E~CC~COND] A W.O NO OF HI-LEG A W O NO. OF NEUTRALS AW O,
1 Z
Southold, Ng 11971
This certificate must not be altered ir, any mann,r; return to the office of the
COPY FOR BUILDING DEPARTMJ
Li¢~578
may be
credentials.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date 3une 28~ 1985
Owner
Plumber
Building Permit No. 13508 Z
Vincent F. Regan (please print)
Mattituck Plumbing & Heating Corp.
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
Notary Public,
County
(plumber' s signature)
Notary Public
,JOHN p' B RISO'[~'I
No. 473261~
FIELD INSI, ECTIbN DATE COMMENTS ~ ,_. · ~ __ ~,~
FOUND ATION ( 1 s t } -----------
_ ~ ~//.~...~/~ ~__ ~ .~
FOUNDATION (2nd) ~ ~
FLUMBING
STATE ENERGY
~ - . ~
ADDITIONAL COMMENTS:
Phone (516) 734-7484
Night (5~6~ 765-1!28
GLENN F. HEIDTMANN & SON, INC.
BUILDER
COX LANE, CUTCHOGUE, NEW YORK 11935
MAIL ADDRESS
P.O. BOX 932
CUTCHOGUE, N.Y. 11935
August 30, 1984
Town of Southold
Hain Pond
Soutbold, New York
11971
lie:
Vincent ~egan
New !~esidence
Hortons Lane
Southold, New York
Energy Code Resistenee -
AIiL roof acea to receive 6" insulation 2 19 factor
All exterior walls to receive 4" insulation g ll f~ctor
All basement area to receive 4" insulatio~ R ll factor
AIl exterior window openings to be Perma-shield windows
manufactured by Anderson Corp.
All exterior door openings to be hollow metal installed~
manufacture~ by Benchmark Corp.
.All extesior sliding door openings to be Perms-shiel~
manufact~re~ by ^nderson Corp.
Glenn F. Heidtmann & Son, Inc.
Memorandum from .... /
BUILDING INSPECTOR'S OFFICE
TOWN OF SOUTHOLD
TOWN HALL~ SOUTttOLD, N. Y. 11971
765-1802
October 2, 1985
Dear Mr. Heidtmann:
In regard to the C.O. for the Regan house,
we
ment approval since
sent to you in June
received it.
?lease send
up. Your
will soon
have been waiting for the health depart-
March. A note was
but we still haven't
it to us so we can clear this
check is dated June 28th and it
be outdated. Thank you.
Yours truly,
7~-~,802
BUILDING DEPT.
INSPECTION
[~]//FOUNDATION :ST [ '1 ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
f ] FRAMING £ ] FINAL
REMARKS:
DATE .i ,//~//~/~/ INSPEG~rOR
76S.'t802
BUILDING DEFT.
INSP C?IO
[,~FOuNDATION IST [ ] ROUGH pL~BG.
FOUNDATION 2ND [ ] INSULATIOk,
FRAMING
FINAL
REMARKS:
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTIO'N
[ ] FOUNDATION SST [~/j~ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ '~]/~RAMING [ ] FINAL '
REMARKS: 0/~
INSPECTOR
~FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,~OUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined .......... , 19
(Building Inspector)
APPLICATION FOR BUILDING PERNIIT
Received ........... ,19...
September 19 8/4
Date .................. ,19...
INSTRUCTIONS
a. This 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 is~{mnce'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 ali applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
He.Ldtmann & Son, Inc.
(Signature of applicant, or name, if a corporation)
P.O. Box 932, Cutchogue, ~:y.. 1.1~.}5
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~uilder
Nameofownerofpremises Vincent F. & /eronzca Co j]e.g.a.n. .................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
G. & S. Electric
Electrician's License No .......................
Other ~rade's License No ......................
1. Location of land on which proposed work will be done ..................................................
orton lane/ Southold
House Number Street Hamlet
County Tax Map No. 1000 Section .... ~4. ............ Block . :3. ............... Lot .... ..19 ..............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name) ,
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy
Nature 6 f work (check which
5;¸
10.
11.
12,
13,
14.
applicable): New Building .. x Addition Alteration
Repair .............. Rem?al .............. Demolition .............. Other.__._Work ...............
, ' .~..?O,~ .~.' '- (Description)
Estimated Cost $ .8.0,0.i00 ..0.0 ...... Fee
, I *" (to be paid on filing this application)
If dweiling, number of dwelling units
..... 1.2 ........ Number of dwelling units on each floor ................
If garage, num her of cars ..... i ..................................................................
If business, commercial or mixe~t occupancy, specify nature and extent of each type of use ....................
Dimensions of existing structure, s, if any: Front ............... Rear .............. Depth ..............
Height Number of Stories'
Dimensions of same structure w~th alterations or additions: Front ................. Rear .................
Depth'. ................... i"' Height ....... 6 ~ ;' '6 '~ ........ Sun~ ~f o.~. ,S, tories ....................
Dimensions of entire new construction: Front .............. Rear ............... Dept ..............
Height ..1..8.' .......... Number of Stories ....... i1 ..............................................
Size of lot: Front .... ~ .50...1./~ ........... Rear ...... .1,5.0. ............ Depth . .1..7.1 .................
Date of Purchase ........... i .................. Name of Former Owner .............................
Zone or use dmtnct' ' ~n' whxch' pr~mises' are situated R esldant
Does proposed c0hstruction violate any zoning law, ordinance or regulation: .... n<~ ......................
Will lot be regraded ......... i ........ .Y.¢ ~ ....... Will excess fill be removed from premises: Yes x No
Name Of Owner of premises . .V,..[~ a. g.a.n. ........ Address .3..? .3..H.a.
Name of Architect W~ Sfimbach Address Phone No
Name of Contractor He±d~m.an.n...& ~on.' Address Phone No
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.
S~e Plan
STATE OF NE~RK, ~,~
.~~~.~-d~. ...... being dnly sworn, deposes and says that he is the applicant
'~ndividual ~igning contract)
above named.
i x~..'' (c°ntractsyr, agent, corporate officer,
etc.)
6f said owner or owners, and is du]y'"~ ~'auth'~rized~'6~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
Notmw Public .. ~- .... ~..~ County /
0
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~ 0
~ Z
T
U
0
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d
· pe!!.He^ uegq ~,ou e^eq
~,jedoJd roll1 UO Sel}!l!oeJ I~sods!p e~Aes
JO/pUt~ AId'dns Jele~ eq~, to suolleoo| ell&
/SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE~
' SI~GtE FJ~J~ILY DWELLING ONLY
DAT~FC 0'? ~g~TH.s. REF. NO. ~
The sewase disposal and water supply facilities for thi~
location have been inspected by this Oepartment a~d/~
othe~asen~es and found to be satisfactory,
?~. ~ ,n~ ~ ,,,
_ ~h~re~, 6f ~t~r ~anagement
FOR APPROVAl. TO CONSTRUCT
S~ ~AL SyST~ ~IS ~
'
H~O F~Q~'O?HER S
=PIPE
VINCE1VT' F, BEGAN ~ VERONICA C, BEGAN-
SUFFOLK COUNTY~ NEW ~RK
DATE: F.~8. '~/.. 1985
SCALE: /#=40'
NO. 84 ~P55
~T~Uc~eS~eFO. A SPEClF~
ARE NOT T~ BE USEO* TO ESTABLISH
NES OR FOR THE ERECTION ~FEHCES
YOUNG
~UN~; pROFESSIONAL ENGINEER
SURVEYOR N.~S, UCENSE NO. tZ845
LAND SURVEYOR
~0.4§895
4000STRANOE R AVENUE
RIVERHEAO, NEW YORK