The URL can be used to link to this page

Home My WebLink About16730-z~0~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No z17282 Date SEPT. 12, 1988 THIS CERTIFIES that the building. Location of Property 340 GRISSOM LANE House No. County Tax Map No. 1000 Section 78 Subdivision SLEEPY HOLLOW ONE FAMILY DWELLING SOUTHOLD Street Hamlet Block 01 Lot 10.4 Filed Map No. 6351 Lot No. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 22, 1988 pursuant to which Building Permit No. 16730Z dated FEB. 5~ 1988 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, ENCLOSED PORCH AND ATTACHED GARAGE. The certificate is issued to DAVID & CATHERINE KLOEPFER (owner, Y~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-233 AUG. 25~ 1988 UNDERWRITERS CERTIFICATE NO. N030854 AUG. 30, 1988 PLUMBERS CERTIFICATION DATED LARRY LISO PLUMBING & HEATING 9/1/88 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_I 6?30 Z Date ~ ~' .... Permission is hereby granted to: ~ / , ,e x ~ ,~~ ..~~...~.,..~ ........ ,o .~~...~....~....~~....~~......~ .............. ~ .~.~ ....... -. ~ ~ ....... .......... ~__. .......... ~-;~ ............................................................................ ~ ......... [ ........ ~,,,,~,,e,,~,,~ ~, ...... ~ ........ ~~....Z~ ....................................................... .............................................. ......................................................... co,.~ ~ ~ ~o. ,000 s.~,~o. ......... 7~ ....... ~,~k ........ ~/. ..... ~o, ~o....Z~,...~. .... pursuant to application dated ...... ~/~..~ ................................ , 19..~, and appr6v~ by the Building Inspector. Fee $ ....... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OC( Instructions A. This application must be filled in typewriter OR ink, and submitted .- emmmma.mm to the Building Inspec- tor with the following; for new buildings or new use: I. 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 Ptanning 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 $]0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ~.~,.~.l....j/ I.~ NewConst~uction..~... Old or Pre-existingBui}ding ............ Vacant Land ............. Loeat,o. ofProperty Ga; SS, House No, Street Nam/et Owner or Owners of Property County Tax Map No. 1000 Section ...'-/~. ......... Block . Subdivision ~.~.~3. -- · -,= .e.~.5.L,~.~.¢..~. ~¢. ,~_.q .t~. .... Filed Map No. ~.~.~.../ .... Lot No. ~- ........... Permit No./~..~.-~... Date of Permit ~3j, cz'/~..~...Applicant 2/'-~..~. ¢:~,,/~.-,~"~,., ~.o, .~..~,. ......... ea e . rova ................... Labor Dept. Approval ........................ Underwriters Approval..~J.~..~! .~,~. ............. Planning Board Approval ~ ................. Request for Temporary Certificat~_~ ................... Final Certificate · .V/~. · · ................. e 'Su mt,ed ... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Permit .o. /d 730 (Please p~ihE) (please print) l. certify that the solder used in the water supply system c.o~ltalns less than 2/10 of 1% lead. Ipl~m~¢ stgnature ) sworn to be[ore me this 1.'9 o~ o Notary Pub].[c, ~ .County Notary, Public DO~ORES L LISO Notary Publie, State of New York ~ffo~k C~unty - NO. 4841022,.~,9 ~,mmf~slG~ Ex~r~s 0~. 31, ~r./ FOUNDATION COM~gNTS FOUNDATION ROUGH FRAMe& -?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION F~MIN~ ~ ~ FINAL ~~~ DATE y;~'~[~ '~'~ INSPECTOR 1r65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [/~SULATION FRAMING FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION IST [ ] ROUGH PLBG. [,~OUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL INSPECI'OR ¢ ~/~, 7G5-1802 BUILDING DEPT. INSPEI TION, [ ] FOUNDATION IST [Vi/ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/,~FRAMING FINAL REMARKS: ~)~u~ ~, ~, , ,"' DATE INsPECToR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ~ I, [/.~NAL 7GS-3,802 BUILDIHG DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION THE NEW YORK BOARD OF FIRE UNDERWRITERS¢~-..~ BUREAU OF ElECTRICiTY 85 JOHN STREET, NEW YORK, NEW YORK ~OO38 23 40 27 23 MIlS ~ TOM A/C UN[T-I SMOKE DETECTOR :- {. R V I C E 4/0 1 4/0 THREE 'C" ELECTRIC RT. #1: BOX 45M SOUND AVENUE RIVERHEAD, NY, I,IC~NSE NO. 3327-E ~isce~atemustnotbeaitwedin a~mcJn~r;return ~ t~ $ ~ ¢ TI 01~1 (TYP) ,w,_ EL. EVAT/OH (-/~P) '0 0 49'00 SLEEPY HOLLOW LA. LOT t ~:,~//~¢ SURVEY OF LOT 2 "MAP OF SLEEPY HOLLOW" FILED FEB. 4, 1976 FILE NO. 635l AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y. I000 78 OI lO. 4 SCALE I" = 40' ~ JULY I , 1986 __?¢. ~ SEPT 23,1986 MAR. 22~!988 (F°u"o^'n°~"l 3'37- 44 ' ~ , % CERTIFIED TO; FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK. TITLE NO. 121 S 4374 DAVID KLOEPFER CATHERINE KLOEPFER Examined fi./~. .......... , 19.~. Approved .~./~. ........... 19 .~.~. Permit No./& 7.~.~.. · .~'" FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... Received ........... ,19... APPLICATION FOR BUILDING PERMIT 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 M/~DE 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. .... l-,.I..~ .o...c..o. ~.0,?.~.~.~.,.o.: .-,c..~..o. ~.e ...... (Signature of applicant, or name, if a corporation) ·. ~4..~..~..o,.?..~--~. ............. .. ..... .... .... (raail~ng address of app±~cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... C~..c.-..~..~..~.~.c,.....c...o..~.~.~ .o, .~.?.~..o..~..~ .................................................. Name of owner of premises .~.~.w .~ >>.. ~-..~. ~.-~ Y~,.~ ~. i..~.~.. [.~ L, O. ~ ~. 14~,0~ ......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· . Bu,ld~~.*,';} ;~?,,. .......... ~ ........... E1 e c t r iE~tl~E-ttc~i~e~NO .~.':O../..-..~. ............ Other'T~'~d~ s' L-icehse 1. Location of land on which proposed work will be done. ~..~..~.l.~.' .~.. q.~l...&.~. ~.g.-..~..~..~...~/~.-../-/.~(~..a,.~... .................... ~ ~).S.~.o.~. ~,: ........... .-9. q.~.-T...~.o...L.O .... ~!...Z... House Number Street Hamlet County Tax Map No. 1000 Section ...~.~.. ............ Block . .O. / .............. Lot/.~.~ .~.'. ........... Subdivision .~.~.P...a~:..5.~. ~.~..~ ~.. 14 .o..t-.LP..~d. .... Filed Map No. (~.3.~. [ ....... Lot .~, ............ (Name) 2. 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 . 3. Nature of work (check which applicable): New Building ...... Addition .... ,.., .... A[l. terahon...., ,i .... Repair .............. Removal .............. Demolition ........... ;..... Other Work ......... .~ ,, .... . Estimated Cost... './.~../. ...... ?.o.... ,, .... 4 ................ ~ . . t-ce ........................... ~/.~t.. (to be paid on fihng tMs a,pp~cagion) If dwelling, number of dweilin_g units .... ~ .......... Number of dwelling units on e~eh floor../.:q$. 5. If garage, number of cars ..'~,*~ .......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... · ' ' pth 7. Dimensions of existing structures, if any Front ............... Rear .............. De .............. Height ............... Number of Stories ....................................................... Dimensions of same structure With altaratlons or addltmns: Front ................. Rear ................. Depth ................... i. · · Height ......... · ............ Nu_mbe~; of Stories ............ ~..~.~.*.~ 8. Dimensions ofestire new consiruction: Front...~.~. .......... Rear..7..~. .... Depth3 .' .~....~.a. eq~, Height .../.~ ......... F/umber of Stories../.,5.~7.~..~. ~ ./ .......... i. i i. i i. i Size of lot: Front../.',f~4~....; ............ Rear.../. ~..~. .............. Depth ~.~ /. ~.o~. Name of Former Owner Date of Purchase Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction w~late any zomng law, ordinance or regulation: ./Y. ......................... ~.~. 13. Will lot be regraded ..... ~'. O. ................... Will excess f, illbe removed from premises: Yes CNo~ 14. Name of Owner of pr. em~sesP.~. ?.~O. ~.L-. eg.~.~/L... Address~..~,,a~,,,r,r~,~,~ N~hone No.O?~. Name of Archxtect .]~.~ ..... i ' '-~'~ t M~ .......... Address ~7, ~, ~. ~-... ~:. ..... Phone No ................ Name of Contractor ./-.L~.°...~.e.~.~?..~...o.~. p: ...... Address .Nl~/l~..~.~..~fi.,~_~ ,..~,,~P, hone No. 7~.~' .~.~'../. .. 15. Is this property locate~ withinl:00 feet of a tidal wetlan~[?~'~'x~--~ .... No ...w~-~.. · If yes, Southold Town T~ustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from 10. 11. property lines. Give street and blocl interior or corner lot. : number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, S.S COUNTY OF ............... .. ~.J~..~. O~ .m..t~.~.~?~...~-~ .~.~..q..~. ~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heisthe .~..q .~.?../~.~. ~.T.q~. ~..~ ~,&p~.~.~-7'~ .~.~'~.~..~r (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 cor~tmned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ~5~6 ~ P. O~ 8OX' 909 MAIN ROAD $OUTHOLD ~ RS i020 N.Y. 1!971 N.Y.S LIC. NO. 49668 ENGINEERS , P. C. SLEEPY HOLLOW LA, 0 ~0T 160' g 049 O0 "V/. LOT AI Prepared in s?andards f~r title the L L A~ L $. and approved and adopted for such use by The New York State Land o o-~ SURVEY OF LOT 2 "mAP OF SLEEPY HOLLOW" FILED FEB. 4, ~976 FILE NO. 6551 AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y. I000 78 OI - I0. 4 SCALE I" = 40' JULY I , 1986 SEPT~ 2,5, 1986 557-, %44 ' ' ~ MAR. 22~1988 (~:OU,O*T~ONI CERTIFIED TO; FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK. TITLE NO. 121 S 4~74 AVl D KLOEP,~E-~R ~ CDATHERINE(.~__EPFER~ AREA =40, 012 SCI. FT. EL.EVA TIONS ARE REFERENCED TO A/V ASSUMED DATUM. 86 382 P.O. B MAIN ROAD SOUTHOLD , N.y. 11971 The sewage disposal and water su[~pty facilities Jar location have been ir~ected by this other agenaes and feuad to be satidaclm~. 'o o N' 89° 160' ~ ,49 '00 ~' N.Y.S. LIC. NO. 49668 ENGINEERS , P. C. SLEEPY HOLLOW LA. ·-2~. ~,---"~ o. ~,¢o','~ tooo re ,,- ol - oL .? \ · SCALE I = 40' ~ ~ ~ ~ ~AR. 22,1988 ~OU~OAr, O,~ SURVEY OF , LOT 2 "MAP OF SLEEPY HOLLOW"- FILED FEB. 4; 1976 FILE NO. 6351 AT SOUTHOLD TOWN OF SOUTHOLD ,SUFFOLK COUNTY, N.Y. 10.4 337- 44 \o~o Prepared ih occordance with the m~ni~ ~'~ndcrds for title suweys as estc~t; ~or such use by The New York Stote Luna Title LOT I CERTIFIED TO; FIRST AMERICAN TITLE INSURANCE COMPANY ~ OF NEW YORK. TITLE NO. 121 S 4374 DAVID KLOEPFER CATHERINE KLOEPFER B. O. H. # AREI~ =40, 012 SQ. FT. ELEVATIONS ARE REFERENCED TO AN I~SUMED DATUM. 86 382 SUFFOLK COUNTY DEPARTMFNT OF HEALTH SERVICES FOR AP~P. OVAL OF CC~'..;R~L . .C,~ CNLY APPROVED ~ The water supply & sewage disposal =y~. lems for this residence will conform to the ~tandards of the Suffolk Counly Depart- of Heahh, N · 89050'$0"F" ' '0 0 P.O. BOX MAIN ROAD SOUTHOLD 0 1!971 N.Y,S LIC. NO. 49668 ENGINEERS , P. C. 049 ,00''W- ~ Prepared in accordance ¥4~,h the mir, lmum standards for title su~eys as e~te[~Nsh-~d by the LI.A.L.$. and approved and adopted for such use by The New York State Land Title Association. SURVEY OF LOT 2 "MAP OF SLEEPY HOLLOW" FILED FEB. 4~ 1976 FILE NO. AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 78 OI - I0. 4 SCALE I" : 40' ~ 'JULY I , 1986 ~ .SEPT~ 23, 1986 CERTIFIED TO; FIRST AMERICAN COMPANY OF NEW YORK. TITLE NO. 121 S 4374 DAVID KLOEPFER CATHERINE KLOEPFER TITLE INSURANCE AREA =40, 012 SQ. FT. EL.EVA TIONS ARE RE.C'EREA,~ED TO AN ASSUMED DATUM. 86 382 ' E N EP, GY 'C ODE CALCOL/",.TION5 ¢~-o~. *o,-~-**~.-,-,,.,~_ !) ~TING ~IP~ ~ ~ 7813.23 75% EFF. ~ ~E B~T OF ~ ~GE~ ~ 45 ~ 75 DE~ F~IT. ~ ~E P~S ~ 3) WAT~ H~TIN,: :,:~ 7813..31 T~U .38. ~ ~%I~E ~TH ~E CODE. 4) PIPE INS~TION 7813.19 5) ~S - ~LE G~S. 6) ~U~I~ ~ ~ N.Y.S. ~ ~DE .... El¸ Af~OVED AS NOT[~ ON LEAD CONTENT~EFORE r.~:,.F.~ ~ = - BY, ~ CERTIFICATE OF OCCUPANCY ,o'n~ IBU LDING DEPART~{~I_T_A~ ~T~ '"6f,*.1~O2 9 ~kM TO 4, PM FOLLOWING INSPECTIONS: FOUNDATION TWO n;~QU~REO FOR POUflED CONCRETE . INSULATION CONSTRUCTION OCCUPANCY OR USE IS UNLAWFUL WITHOUT ',CERTIFICATE 'OF OCCUPANCY /L Mnin R~)ad ON LEAD COiNTENT BEFORE: ,_,,.:__-..-' ,~ ~"- BY"p '~B~.~ ,_~..r CERTIFICATE OF OCCUPANCY No'n~' ~UtLDING DE ' FOt. LOW~NG iNSPECTiONS: - FOUHDATION 't~NO OCCUPANCY OR ~ ~mo*o.m,~ - ~ ~UGH FRAMI~ · ~U~Bi~G use IS ',' 'r~ .~Um~ S H CL. iI d Phone 4774~00: Phone, · j