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Home My WebLink About16583-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17500 Date NOVEMBER 10, 1988 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 515 COREY CREEK LANE SOUTHOLD~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 4 Lot 26 SubdivisionM/o COREY CREEK EST Filed Map No. 4923 Lot No. 20 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 28, 1987 pursuant to which Building Permit No. 16583-Z dated OCTOBER 29, 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 WITH GARAGE & ATTACHED DECK AS APPLIED FOR The certificate is issued to WILLIAM & SOPHIA HILLSDON (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-S0-197-8/25/88 UNDERWRITERS CERTIFICATE NO. N042919-OCTOBER 31~ 1988 PLUMBERS CERTIFICATION DATED 7/1/1987-STEPHEN O'CONNOR Bul ding Inspector Rev. 1/81 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) No_I 6585 z Permission is hereby gronted to: ...~.4.,..~.~.....~..,....u.~.~.~ ............. , ~ ,o .... at premises located at ...~......~. .......................... ...~...~.,~..~..~..~.~....~..~..~ ............................................................... County Tox Mop No. 1000 Section ...... ..(~....~...~. ....... Block ....... .q~...~ ........ Lot No..~-~b .............. pursuant to application dated ...... ..0....~....¢-~-,6~,.....~.~. .............. , 19.~..~.., and approved by the Building Inspector. Fee $..,.L~. .*. ..... Building Insl:mctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. ?OWEN OF~SOUTHOLD ,,,, Instructions Bo 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. 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 featu res. 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 or land use $5.00 3. Copy of certificate of occupancy $I.00 Date ....... //./,~/.~.~ .... New Building ///' Old or Pre-existing Building Vacant Land Location of Property ..... ,0'.'./..~. ........ ~ ...... . '.~/~). House No. Street Hamlet Owner or Owners of Property ... ~' .~ County Tax Map No. 1000 Section ...?..~ ......... Block ...~. ........... Lot,..?..~' ......... Subdivision.~)~.~..~...~....''~/'.~.FiledMapN°.,_ -~/.~---2'--~---L°tN°' ,,.'~, ......... PermitNo...~.:~.'.~..~?. Date of Permit ../..~/.~/.~?Applicant ...................~/~,~--~ ~,.4~ /~..~.,,):..~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an~~~ts al s. R.v. ,0-1o.7a Applicany .... -~...v..- .... THE NEW YORK BOARD OF FiRE UNDERWRITERS 1.00034'~ Bu~u oF {-- 85 JOHN S~. ~W YO~ ~W YORK 10038 THIS ~l~l~i ~ [[L[,]:~ HYLLSI~W, CORREY (',R~J~;K LANE, *S(~THOLI). ~IIYIGE ~ $ E It V I C G.F.¢.I:-4 SNO}iE DF, TECTOI/: -1 GOODAi, g MAq'Ti'{'UCI(, NY, ~1952 {',{~C}';NSE NO, 78E,) E ' TO,tN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner Plumber (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber'S signature) Sworn to before me this 19 ~7 Notary Public Notary Public, ~~ County THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 L00343 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 D.,e OCTOBER 31,1988 AppticationNo. on.file 53313888/88 N 042919 THIS CERTIFIES THAT only the electrical equlpmen t ~ ~scrlbed beio~ a~ ifltr~uced by t~ applicant ~med on the above application nrta bar in the prem~es of ~ILLIAM HILLSDOW, CORREY CREEK LANE, SOUTHOLD, N.Y. u~s exaodned on OCTOBER 24,1988 arid found to be in compliance with the req.irements of ti is Board 29 3 29 29 - ~1 200 CB 1 ~ X 1 __ RANGES 12.1 SPECIAL REC'PT A. WG OF C¢,¢OND 3/0 NO OF HI,LEG Lot EXHAUST FANS DIMMERS E MOTORS: 1-1 H.P. ELEC. WATER HEATERS: :1-4.5 K.W. G.F.C.I:-4 SMOKE DETECTOR :-1 GOODALE ELECTRIC 7355 MAIN ROAD GIEN~IIAL MANAGER LICENSE NO, 78E3 E P~r This certificate must not be altered in any manner; return to the off;ce of the Board if incorrect. Inspectors may be identified by their credentials, TOg N OF £OUTHOLD OFFICE OF BUILDING INSPECTOR iLO. BOX 725 TOWN HALL $OUI'HOLD, N.Y. I ]971 TEL. 765-1802 TO Whom This May Concern, We are unable to complete your Certificate of Occupancy becau.~e .of the following reasons. /-/~/An_ application for Certiflcnte of Occupancy /_~_ ./'l heJ-~' "' check /_~ No Health Dept. Approval on file. /.--_/ No final in.~;pect:ion has been made. this matter. Please contact: our office on Th~nk you for your cooperation.~ Buildinq P~;rmit # I _~ _~ ~, ~ Z BuildingS/Dept. 10 Plumber Solder Certificate on file. ( all permits involving plumbing bein~ issued after April 1,1984 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~,~' ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION. FRAMING ,r. ] FINAL DATE P ~- INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [*~FOUNDATION 2ND [ ] INSULATION r ] FRAMING [ ] FINAL DATE, INSPECTOR~I~,{ ,6 ~n FOUNDATION ~1 s t) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~NSULATION FRAMING [ ] FINAL Examined .~.~. 0-~..~.., 19~..~. ApprovedO..~. ~...~.~..., 15~?.. Permit No. I.~. ~..~;~.~. Disapproved a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ..~.... 3 SETS OF PLANS .~.. .. 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK ~- ...... ~ BUILDING DEPARTMENT SEPTIC' FORM ?'. ........... : TOWN HALL $OUTHOLD, N.Y. 11971 NOTI¥¥ ./. CALL ............. TEL.: 765-1802 ~'MAIL TO: INSTRUCTIONS · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sgts of plans, accurate plot plan to scale· Fee according to schedule. b. Plot plan showing location of lot and of buildh~gs 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 througCtout the work· e. No building shall be occupied or used in whole or in part for any purpose whatever uhtil a Certificate of Occupanc5 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 Soutliold, Suffolk County, New York, and other applicable Laws, Ordinances o~ 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 tc admit authorized inspectors on premises and in building for necessary ins,¢egtions. ? (Signatnre of applicant, or name,~if a o{Srporation) (Mailing address of applicant) State ~,hether app~cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Z-- (as on the tax roll or latest deed) If applicant is a.C. orffj~ation, siggatur, e off'duly authorized officer· ~- (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ....................... .. Electrician's License No. .F~r. ........ v~. .... Other Trade's License No ...................... ~ /"5. ~.--. ~'.~ .2' 'Z, 1. ocation o land on whioh proposed work will"be .................. ................................................. ................... ............. House Number Street Hamlet County Tax Map No. i000 Section ...... .~ ....... Block ...~ ............. Lot 'Subdivision. ~ :,.~(~ .~ .... Filed Map No...~ ...... Lot..~ ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................ ~i :~','.:F:r~ ' ' ~'': :"¢ ......... b. Intended use and occupancy ......... ~ ........................... g~*~;x ,,:o~,~,it 0;....e~,~z.:-.. ,,,~ ..... Nature of work (check which applicable): New Building ..... Addition .......... Alteration .......... Repair .............. Removal i .............. Demolition .............. Other Work ............... ~' (Description) Estimated Cost ...... /~..0.~ O.- '~,'...: ................. Fee ...................................... i " (to be paid on filing this application) :. If dwelling~ number of dwelling uuit,s ..... · · .... · .../ Number of dwelling units on each floor ................. If garage ~umber of cars ~ ' If business: .... ........ ' ' ' ,. ,~commercta. l'~r,~8-~ ~)¢~Ipaney specify nature and extent of each type of use ~tlr~cfara~; if an~: Front Rear Depth ........... Dlmenmons of existing Height ' Num bet of Stories Dtmenmons'of same stru ure,VCt0h alterahons or additions: Front ................. Rear .................. Depth ... ................... Height ...................... Number of Stories ...................... ;. Dimensions of entirte new construction: Front .... 2. ~...' ..... Rear ... P..o. ........ Depth . .~ .~77'. ....... Height ...... ~ ....... Nmnber of Stories . ~ ....... '. Size of lot:. Front ....../.~.~ .............. Rear .. .~. ... .......... . . . . Depth .~.N'.~' ............. .. . . ~. Date of Purchase .............. ............... Name of Former Owner ............................. · Zone or use district in which premisps are situated ..................................................... ' Does proposed construction violate any zoning, law, ordinance or re{,ulation' Will lot be regraded .... .... .... .... .... Will be PremiSes: Name of Owner of pre~nis~s~4/t/.n.'*~., i~t.~/~..~..~:]./4' .~.°~ddress~.~...:~..~... ~ ....... Phone No, .~'18..~. Name of Architect ....... ~ .............. Address ~1,,~ .. Phone No. Name of Contractor ............ r .............. Address .... : .............. Phone No ................ ;, Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southoid Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buiidings, whether existing or proposed, and. indicate all set-back dimensions from operty lines. Give street and block nun3ber or description according to deed, and show street names and indicate whether :er/or or corner lot. 'ATE OF NEW YORK, SS )UNTY O...~... L,-~" ........... 1~, [~ rY,'- ................................ . · ........... being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) ove named. is the .~. i (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the )rk will be performed in the manner se! forth in the application filed therewith. ,om to before me this ...... .c~. ~.: ............ day of..~ ........ 19 .°c.. (Signature of applicant) SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. ~%. T~ ~T[R ~Y A~ ~A~ DI~AL / ~K c~. ~/~ ~V~ES. [" SERVICES - FOR APPROVAL OF C~R~T~Ly / ~FF~K CO. TAX MAP DE~GNATI~: ~$T. ~CT. ~K ~L. ,, . ~ ~- ~ ....... --' TE~ HOLE ~AMP : ~AL ~R RI VAN T LICI[N~ED LAND SURIfEYOR~ GREENI~)I~T N~W YO~K SUFFOLK CO HEALTH DEPT APPROVAL H S NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL sYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFC)L.K CO. DEPT. OF HEALTH SERVICES. (si AJ~I~.ICANT SUFFOLK SERVICES -- FOR CONSTRUCTION ONLY DATE: H.S. REF, NO: APPROVED: COUNTY D~PT. OF HEALTH APPROVAL OF SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK P~L OWNERS ADDRESS: DEED: L,' 'Ca<, TEST HOLE STAMP SUFFOLK CO. HEALTH I~'l~r. k;at~have~ni~cle~byth~s~e~m~aM/~ ~FF~K CO. ~. ~ H~LTH SERVICES. ~ SERVICES - FOR APPROVAL OF ,'.,'.-. ":' 7'-',.'., '::"-' -' "'r,::>=, , ~[RI~ VAN TUYL. P.C.RI VAN T YL. P.C. "~"[~-:'-~ --'- ~ ,~ ,., ~-',~ /, kAND S~VEY~