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HomeMy WebLinkAbout16436-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTI~ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17520 Date NOVEMBER 16~ 1988 THIS CERTIFIES that the building. Location of Property 4960 HORTONS LANE House No County Tax Map No. 1000 Section 054 Subdivision Filed Map No. ONE FAMILY DWwfJ.ING SOUTHOLD~ NEW YORK Street Hamlet Block 03 Lot p/o 21.1 Lot No. conforms substantially to the Applicatzon for Build3_nq Permit heretofore filed mn this office dated SEPTEMBER 4, 1987 pursuant to which Building Permit No. 16436-Z dated SEPTEMBER 7t 1987 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 WI~H GARAGE & ATTACHED WOOD DECK The certificate ms issued to CHRISTOS & CHRISTINE VERVEIqIOTIS (owner, of the aforesaid bumldlng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 11/4/88 - 85-SO-80 UNDERWRITERS CERTIFICATE NO. N 027805 - AUGUST 15~ 1988 PLUMBERS CERTIFICATION DATED JULY 25~ 1988-HEIqRY J. SMITH & SONS~ INC. ~ Bu~ldlng Inspector Rev. 1/81 lvOEM NO. ~ TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALl. $OUTHOLD, N. Y. BUILDING PERMIT a'HIS PERMIT MUST' BE KEFT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .................. ..................... ~...~.....~_.....t./..~.7..I. .......... . ~ ............................................... ~ ........... j~ ........... ~:~ ....................... .;, ........................... at premises located at .......... ~..~..~...~......~:~~ ............................ County Tax Map No. 1000 Section .... ~...~--.-~. ...... Block ........ I;::~.'~ ..... Lot No ........ ~..J :.~: . pursuant to application dated ......~..~...~.....~. ..... , 19..~.'/., and approved by the Building Inspector. Fee $...~. ~;.?....~..... Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC Instructions A. This application must be filled in typewriter OR ink, and submitted ,~ ~ to the Building Inspec- tor w~th the following; for new buddings 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 d~sposal-(S-9 form or equal). 3.Approval of electrical installation from Board of F~re Underwriters. 4. Commermal buddings, Industrml buddings, Multiple Residences and mmilar buddings and mstalla- tions, a certificate of Code comphance from the Architect or Eng,neer responsible for the building, 5.Submit Planning Board approval of completed rote plan reqmrements where apphcable. B. For existing braidings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-ex~stmg" land uses' 1. Accurate survey of p~operty showing all property hnes, streets, buddings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent mforma- tlon required to prepare a cert,f[cate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1, Cer~lhcateofoccupancv New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2 Cert~f,cate of occupancy on pre-exist~ng dwelhng $ 50.00 3. Copy of certfflcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20 00 5.Updated C.O. $ 50.00 Date ..~'..~.~.-.~,~. ......... Newcons%ruction. .[~.. OIdorPre-exmtmgBuddlng ......... Vacant Land ............. Locat,on of Property....g'~ .~.~ .0 ............. ~Dr 1L~. n~ .~d.~ ............. House No. Street Owner or Owners of Property .. ,~,~,~$.3cQ.-~ ..~', Ck '$h.n, .c~... Jj~_. f',~',e~'l, .1'~. ,TL, ,/.~. ............ County Tax Map No. 1000 Sect,on .. ~ .... Block .... .~.:.-~ ....... Lot.. !~...~/.*. I .... Subd~ws~on ............... Fded Map No ........ Lot No ............. Perm,t No/.~.~/.~.~..~-~. Date of Perm,t '.~/"7/~.~. Apphcant .LL~; ~J.'.~.~.?..~-.zj.t~? Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ..................... Planning Board Approval ..... ~. ............. / Reque? for Temporary Cert,flc?]eI ................... F~nal Certificate .... . .Y'.. ............... Fee Subm Itted $..-2'. ,~,, ,~(~,,..~! . ,~. ~(~------C ~. ...... Construction on above described budding and permit, meets all a~phcable codes and regulations. Applicant ............... Rev 10 10-78 HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N Y, 11971 (516) 765--3690 IFIC. CERTIFICATION Building Permit No._k~3~ ........ 0wner__~i~_V_~lI~p~i~ ........... Plumber__~H~Br_z_~_~S~!~h_~_~o~n~ Inc. I certsfy that the solder used in the water supply system contasns less than 2/10 of 1Z lead. Sworn to before me this _p_5_th_day of _J~zlJa ...... ~9_~_. Notary Puh/I i c Notary Public, Suffolk County TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTtlOLD, N.Y. 11971 TEL 765-1802 To W~May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. ~An application for Certificate of Occupancy is not on file. ~/ No Underwriters Certificate on file. ~ The check is(outdated/not on /~/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this Thank you for your cooperation. Building Permit # _~ _~ ~ _~ .~ Z Building Dept. matter. ***//No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION FOUNDATION 2. ROUGH FRAME / PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDIT COMMENTS:6~u~ 765-~.802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~INAL DATE INSPECTOR 765-*1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~FINAL ~ DATE INSPECTOR ~~.~ 765-1802 BUILDING DEPT. NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 765-XS02 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. [,~INSULATION FINAL DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND ~ ]INSULATION / ~/FRAMING [ ]FINAL REMARKS: ~'~ (~/~------- INSPECTOR ~-~ *~/~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T I ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING FINAL REM~ 765-1802 BUILDING DEPTi INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATE INSPECTOR REMARKS: 765-1802 BUILDING DEPT. INSPECTION [,~/J FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE INSPECTOR THE NEW YORK BOARD OF FIRrE UNDERWRITERS 1,001071 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1003B .~OUST ~i'~,]9~8 ~4261888/~8 N 02?gOB ~ ~ppl~ation No. on THIS CE~IFIES THAT CHRIS VERVPiNIOT[S, HORTONS I.,ANF, ~2/S, SOUTHOLD~ N.Y. ~ exami~ on ~ndfound to be in ~m~iance with the ~quirement. of ~ ~. Rx'ruRI iqxTuRls ILA, I~R)IS COOKINODiCKS OVENS DISHW~ IXBAUST FAH$ OUTtMS SWlTCHIS F~UO~SCENT 26 32 26 (;.F JO. I:-3 SHORE DETECTOR :- 2 S E R V I C E o~/~c~o. ~. o~ HI-L~G A.w.G. . %1¥o,,o. 4/O G & S CONTRACTOR BOX 2] 5 .e.(')ltTHObD, NY, 1.1.9't~. LLCENSK ti{}. ~,38-E P#r Y-,"~//J rids be aherecI in any manner; return to the office of the BOard if be ~ '' credentials. Dmapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEl-.. 765-1802 , , i9gq Penmt No. J (Budding Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HE LTU ..... _.. 3 SE S OF SURVEY..~.°: ?.% . ., CHECK :~..3.~.'/. ..... S~]~F 0 RM ............. : NOTIFY' CALL,--~. ,./ ~P~. -~. ~ .-~ ! ~.~.. MAlL TO' BLDG DE, PT. TOWN sOUm, Om INSTRUCTIONS a. Ttus apphcation must be completely filled m by typewriter or ~n ~nk and submitted to the Bml&ng Inspector, w~t sets of plans, accurate plot plan to scale. Fee accordmg to schedule. b. Plot plan showing locatmn of lot and of buildings on premmes, relationship to adjoining premmes or pubhc stn or areas, and g~vmg a detmled descnptmn of layout of property must be drawn on the dmgram which ~s part of th~s ap cahon. c. The work covered by flus apphcat~on may not be commenced before ~ssuance of Building Permit d. Upon approval of th~s apphcat~on, the Bmld~ng Inspector will ~ssued a Building Permit to the apphcant. Such pe~ shall be kept on the premises available for mspechon throughout the work e. No bufldmg shall b~ occupied or used ~n whole or ~n part for any purpose whatever until a Certfficate of Occupa, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Braiding Department for the issuance of a Bmldmg Perm[t pursuant to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordmance- Regulatmns, for the constructmn of buildings, additions or alteratmns, or for removal or demohbon, as hereto descnb The apphcant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulataons, and admit authorized inspectors on premises and m bufldmg for necessary ~nsp?t~on~s (Stgnature of apphcant, or nam'e~if a corporatmn) (Mmhng address of apphcant) State whether apphcant ~s owner, lessee, agent, architect, eno~neer, general contractor, electncmn, plumber or bmld Name ofownerofprem~ses ~ ~?-'. ' .~~,k~<, ///~¢.q-~*'~(--~ .... (as on the tax roll or latest deed) If apphcant ~s a corporanon, s~gnature of duly authorized officer (Name and t~tle of corporate officer) ALL CONTRACTOR'S MU.~T BE SUFFOLK COUNTY LICENSED Budder's Lmense No. /.~-5 ~ ¢ % . ./at~ . Plumber's Ltcense No /~ ~-//~ Electrician's L,cense No ~..~ </~.~7. Other Trade's L~cense No Location of land on which proposed work will be done House Nuh~ber Street County Tax Map No 1000 SecUon ~)~.-'--t~ Subdivision (Name) Hamlet lock .. .Lot FdedMap No Lot .. State exmtmg use and occupancy of premmes and intended use and occupancy of proposed construchon a Ex~stmg use and occupancy ..... ~5/..~.~ .......... b Intended use and occupancy 3. Nature of work (check which applicable) New Budding . . .t~.. Addition .. Repair . Removal .......... Demolition ... A~teratlon ... · Other Work .......... (Descnpllon) 4 Estimated Cost· . ~7~ ....... Fee · (to be paid on filing this application) 5. If dwelling, number of dwelling units . . [ ....... Number of dwelling units on each floor . ./. If garage, number of cars . . ~Q~ ....................................... 6 I/~i~t~m~e, rc~at or mixed occupancy, specify nature and extent of each type of use . , ........... 7,.~~tructures, ifany Front '7 i .... Rear .... .'7 Z... Depth .. ~-- .... ~~! Number of Stones . ~-.. ,.' .......... ~. .......... Dii~s~o~ ~m:e~cture with alterations or additions Front 'w~: ...... Rear ............ De~h . ~ ' ...... : ..... Height ............... Number of Stones .............. ~-8.1~!~lgl:lgas;onsofent!~/r~[vconstructlon Front. .~/'~.. .. Real'. ..~..~.... Depth ~.~ ...... I-[eight ..[.~ ..,[ .Nu. mber of Stones ~p/?t" /~gt.'~/ ................. ...~.,, ..... 9. ~ize of lot Front '~.~/5~r ...... Rear ...~./.fi/..¢.~," .... .~.De. pth .'~.c~.~'~ 7,~, ...... 10 Date of Purchase ................ N,ame of Fo_rca. er Owner .~ ~'./t~e~ .r~'-F¢ 'tJ~-.r4 ~X .... 11 Zone or use district in which premises are situated ~.c0~. ~ ...................... 12 Does proposed construction violate any zoning law, ordinance or regulation ,~.~ ................. 13 Will lot be regraded . . ~O ....... ,... Will excess fill be removed from premises', Yes 14 Name of Owner ofprewlses .Ckr(~ (JCf~e.~l ~o~t'~ Address .. . ~ .... Phone No Name of Architect .~.~r~'.~..~.p.£anS~ ... Address ~.a,~ ~-~.~ .~.~x{~Phone No. 7.~.~.-...~.~.[ Name of Contractor .. Address ~9.~". f~£~ .~... Phone No ,~7.~.~... 15. Is this property located wzthin 300 feet of a tidal wetland? ~Yes ..... No ~<.~.. *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all bufldmgs, whether existing or proposed, and. mdlcate all set-back dnmenslons rrm property hnes. Give street and block number or description accordmg to deed, and show street names and indicate whethe interior or corner lot. being duly sworn, deposes and says that he is the apphcan He is the ........... ~ ] ............................ agent corporate ;'ffic;r, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi application; that ail statements contained m this application are true to the best of his knowledge and belief, and that th work will be performed in the manner set forth m the application filed therewith Sworn to before me this ..... .~.~.~.... dayO~u.,~ 19 .~ Notary Public ....... ~ ..... ~. _~ ~Co nty ~ ,,~ ~~ TC)k~'N Of-- LICENI~D LAND SURVEy(NI~S GREJ;;';,"~RT N~W YORK SUFFOLK CO. HEALTH DEPT. A~"ROVAL H.S. NO. STA. TEM~NT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL. SYSTEMS FOR THIS RESIDENCE WILL co~o~ TO t.~ STA.~AR~ OF I SU~FO~O~O. ~,~_~ .E~L.,,T. ~.V,C~S. ~ff~J CO. TAX MAP [SIGNA~ION: mST. ~CT. ~K ~C. ~NERS ADDR~: (Z~) 874' ~ST ~E MA,P OF F:'I2OP.EJ~,T'Y. ~,P ~¢ v E'Z',t'_ .E._..E. F'or~ ¢: :!i~l'-; - ' '!ZVt NI',..)' 1~ ;..,, ,,'/N 5F ¢/J'J; *iOL[.), l,,J y. GREENPORT NEW YORK ~UFFOL~;~). HEALTH DEPT APPROYAL ,,~. THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL, CONFORM TO THE STANDARDS OF THE: SUFFOLK CO DEPT OI- HEALTH SERV~F5 APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE APPROVED .... SUFFOLK CO TAX MAP DESIGNATION DIST SECT BLOCK PCL OWNERS ADDRESS: '. ~2,) 574- DEED: L. TEsT HOLE STAMP OCCUPANCY OR USE IS UNLAWFUL SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I%/-EAD. WITHOUT CERTIFICATE OCCUPANCY ' t O.~CUP^~IC¥ OR L~S-E IS UI~L~¥~'FUL \?~iTI-IOUT CERTIFICATE i'~,i~' ©CCUPA~ICY .I