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HomeMy WebLinkAbout13406-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15766 Date May 20, 1987 THIS CERTIFIES that the building .0..n.e..f.a..m.i.l.y...d.w.e. 1.1..i.n.g..w..i.t.h.. a..t.t.a.c.h..e.d..w.o..o.d..deck. 865 Depot Lane & Location of Property .. I.Q ~ .5..S.q h. 9 p.l.h.o..u.s.e.. R. 9 .a.d. .......... .C.u. ~. 9 .h.o.g u..e .,..N.: .Y.. ........ House lye. Street Ham/et County Tax Map No. 1000 Section . 102 .Block 0 I .Lot 028 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 31, 1984 pursuant to which Building Permit No. 13406Z August 31, 1984 dated ............................. 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 ATTACHED WOOD DECK The certificate is issued to . GREGORY & THEODORA LEPERIDES (owner, II~f~ l~O~tY~ X of the aforesaid building. Suffolk County Department of Health Approval 14 - S 0- I 66 N682084 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: March 13, 1985 Building Inspector Rev. 1/81 NOTE: This Certificate March 22, I985 of Occupancy amends CO Z-I3279 dated FOu'M' NO. 0 TOWN OF $OUTI.IOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13406 z Permission is hereby granted to:~l ~ ...~..o...~...i..l...'l. ............................................. ' County Tox Map No. 1000 Section ~..)..~....'Z~T... ..... el~k .......... ! .......... Lot No ...... ~ ........... pursuont 'o application dated ....... ~...~...~......~.1 ............ , 19~.~..~.~" ond opproved by the Building Inspector. Fee Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g..1.3.2.7.9. ......... Date March 22 19 85 THIS CERTIFIES that the building New Dwelling 865 Depot Lane Location of Property . .1.0.4. .5 .......... S.?.h.o.o. 1..h.o.u.s.o...R.d.: ............ Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section ...1.0.2. ...... Block 01 .Lot 028 Subdivision ......... .X. .................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.u.g.. .... .3.1. ....... 19.8.4. pursuant to which Building Permit No .... J:. .3 .4 . 0. 6. g. ........... dated ......... A.u. cj: ..... .3.~ ....... 19 .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 ......... .... .~.e.w.. v..r!Xa.~..e..o.n.e...v.a.m. ~..~y..~.¥.0.~.~.~..n~ ....................................... The certificate is issued to ........ INLAND HOMES, Inc. ............. ?o¥,'0), ¥~i,~'~ ...................... of the aforesaid building. Suffolk County Department of Health Approval ..... 14- SO- 166 682084 UNDERWRITERS CERTIFICATE NO ................... bJ. .............................. 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 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 buildin§s. 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 ! //$5.00~'/ 2. Certificate of occupancy on pre-existing dwelling ~r land use 3. Copy of certificate of occupancy $1.00 Date New Building X× Old or Pre-existing Building(X) ~ fVacant Land 1045 Schoolhouse & 805 Depot Cutcho ue~ N. ¥~. Location of Property .................... : .............. ! .......... c~. · ................... House No, Street Hamlet INLAND HOM~S,/. INC. Owner or Owners of Property .............. ; .-.- ¢ .................................... CountV Tax Map No, 1000 Section 102 1 pcl. 28 ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.1.3.~.O, 6..z ....Date of Permi~ ,/.3.1./.8..~...Applicant .,.I.n.l.a...n.d..H.o..re.e?.,...I.n.c,; ........... Health Dept. Approval 3/6/85 .Labor Dept. Approval .,. N682084 Underwriters Approval ........................ Planning Board Approval .................. ~ ,. ~ Request for Temporary Certificate ..................... Final Certificate ....... r ......... * ' - 5.00 Fee Submitted $ ............................. Construction on above described building and perm~t~mee~s all appl~cable~code~and regulations. ~klLE' ~t ~D..~~ APplicant ·; ..,. ~ ~¢-~- .~. .................... CO-~ Robert E. Hiltz, INLA~DX~OMES, INC. Rev. 10-10-78 ~ FORM NO, 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLiCATiON FOR CERTIFICATE OF OCCUP Instructions A. This application must be filled in typewriter OR ink, and submitted ~m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final surYey of property with accurate location of all buildings, property lines, streets, and unusual naturai 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 p~Operty 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 $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10,00 4.Vacant Land C.O. $ 20.00 ~I~-/~'S~'~ 5.Updated C.O. $ 50.00 Date .q~.7.' ........ NewC°nstructi°n ...... Did or,re-existing Building.. ........... Vacant Land ............. Street , Ham/et Owner or Owners of Property ~.~( .~.. ~.~¢~ .... ~ ~ r.l.~ ........... Subdivision ..................... - ............ Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .[<~. ................... Fee Submitted $ ~-O.~. '~''~ Construction on above described building~d~ermit meets ¢/~plicable codes and r~gulations. App cant~'l/fl t~,--~,V,~j~~T"~ l. , . Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date March 13, 1985 Building Permit No. 13406Z Owner INLAND HOMES~ INC. Plumber (please print) Frank Pazlenza d/b/a Bay Plumbinq & Heating (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Swan to before me t~s ~fJ day of ~ 0~f~)q~ , 19~ Notary Public,'~~%~:~ County Notary Public COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING okc w¢ INSULATION PER N. Y. STATE ENERGY CpDE FINAL ADDITIONAL COMMENTS: :moo:L?4 THE NEW YORK BOARD OF FIRE UNDERWRITERS O'J BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW ~ORK 100:38 THIS CERTIFIES THAT only the electrical equipment ~ described below and introduced by the applicant named on the abo~e application ~umber in t~ pre~ises of ~l~d ~s~ Inc N/W ~r ~I~ ~ ~ ~o~ ~., Cut~ N Y in the/ollowing location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was examined on ~h ~ ~ ~ and ~ound to be in compliance with the rdquire.~ents of this Board, FIXTURE FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS SW~TCHES FLUORESCENT VAPOR 18 31 19 18 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT R 'V J C E OTHER APPARATUS: S E OF CC, COND. 4 NO OF HI-LEOoFA Hi. LEoW'O /NO OF NEUTRALS / OF NEUTRAL 4 ~btors 1-Ft~ 1-GFCI, 1-~moke Detec. tor ~.oElectricCorp. (Cliff Cornell) 325 Willow Poin~Rd douthold: N Y 11971 Lie 28.1.6 E This certificate must not be altered in any manner; return to the office of the Board if !ncorrect. may be identified by their credentials. COPYFOR BU )lNG DEPARTMENT; THI~ IN ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION [~j/FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: INSPECTOR 765.zsoz BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH 'PLBG. [~/~/FOUNDATION Z'ND [ ] INSULA~rlON [ ] FRAMING [ ] FINAL RE:MARKS DATE, INSPEL'~rOR ~//C Approved . .(~.t:~.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 75§-t803 ., 19 .~.~. Permit No./..~.t~ .O..b..~. Disapproved a/c .......................... ' ........... ................................ ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date .A.u.~.u..s ~..S. 1. ........ 19~.4.. IN STRUCTION S a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 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 in whole or in part for any purpose whatever until a Certificate of Occupahcy 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 buildings for necessary inspections. INLAND H(2~IES~ INC. (Signature of applicant, or name, if a corporation) · .BOX. 2.],7 ,. Mat'~i.t,uck~. lq.. Y.... 11952 ....... (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 ...... I.I~..I~..ND...H.OM.I~ ,..I~IG, ............................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Robert E. Hiltz, Pres. (Name and title of corporate officer) Builder's License No .......................... 517-P Plumber's License No ......................... Electrician's License No ..... 2.8..19 .............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. Gg.r.n.~.r.. {3.6.5.. D.op.o.~.. L.a.rle. &..$qh.o.o.1.t10¢$.~ .L~II.~.~. Cutchogue, N. Y. House Number Street Hamlet ' C~unty Tax Map No. 1000 Section . .1.0.2. ............. Block ..... 1 ............ Lot.. ~{3 ............... 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 o~cupancy ..................................................................... b. Intended use and occupancy ....1..F..a..m.i.l.y...d.w.o. 1..1 .i.n.~.: ........................................... 3. Nature of work (check which applicable): New Building XX Addition Alteration * .... Repair RemoVal Demolition Other Work ' ipti .~, i _.& ~ - (Descr on 4. Estimated Cost .... . . ...... ........,.......... Fee........'...... ................. (to be paid on filing this application) number of dwelling Units 1 Number of dwelling units on each floor 5 If dwelling ................ If garage, number of cars ....1. i .................................................... ............... 6 If business commercial or mixed occupancy specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... ' Num,ber of Stories '. .............. Height ............... · ........................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth.. Height Number of Stories 8. Dimensions of entire new construction: Front .. 54 Rear 54 Depth 21.8 Number of Stories Height ....................................................................... 1.O. 1 ' Rear ~.O.1~ Depth Size of lot: Front of Purchase .; .... Name of Former Owner [)ate ..................................................... Zone or use district in which prdmises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regUlation: ................................ Will lot be regraded ......... i ................... Wall.excess fill be removed from premises: es No Name of Owner of premises . .I.R..L~...D..H..Old...~$, .~ .CAddress ~.o.~. ~;t.7. ~l~l~.t.~l:U.e~one No~98..-.9.690 .... Name of Architect .......... I ................. Address ................... Phone No ................ Name of Contractor . INLARD .I H.ClI~IE$ ,..IN¢ ..... Address BOX. J-;I-.7. ~l~l~.~.t;~ tu~l~h~one No. 29B..-.96915 ...... 10. 11. 12. 14. Locate clearly and distinctly all property lines Gtve street and block.number or interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether STATE OF NEW YORK, i S.S COUNTY OF ................. ' Robert E. Hiltz (Name of individual signing contract) abow~ named. : Contractor ' He is the i i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly 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 J day 6f 19 . ............................... ou2.' being duly sworn, deposes and says that he is the applicant SUFFOLK CO. HEALTH C~T. FT, APPROVAL H.S. HO. STATE~NT ~ O~ I SYSTE~ FOR THIS RESI~NCE WILL .' ~ f ~ ~ ~T CONF~M TO THE 5TA~A~ OF THE ~. ~..,;~ ~ .... ~F~OLK COUNTY D~. ~ HEALTH  ~ // SERVICES - FOR APPROVAL OF .~ ~. }.: . , CO~RUCT ~N ONLY ~ ~{ ~FFOLK CO. TAX MAp ~IGNATt~: G- lEON PIPE ~ter ..!