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Home My WebLink About15506-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .Z:16.q67 ..... Date August 18, 1987 THIS CERTIFIES that the bmldmg . ONE FAMILY DWELLING Locatlon of Property .. 1.5.60 Gr.een.H.ill .La?.e. ....... .G.r.e.e.n.p.o.r~., .N...Y.: ..... House Ire Street Hamlet County Tax Map No I000 Sechon 0 3 3 .Block 0 3 .Lot 0 1 Subdzwsion M/o Sec. 5 Eastern Shores .Fded Map No. 5234 .Lot No. ]35 conforms substantially to the Apphcatlon for Bmld~ng Permit heretofore filed ~n flus office dated · .N°vember........ 5, 1986 pursuant to wluch Bufldmg Permit No. 15506. . g. .... .. dated . N o v e.m.b e r..18, .1.986 was msued, and conforms to all of the reqmrement s of the apphcable provis~ons of the law. The occupancy ~r w~ch th~s certificate m ~ssued m .. ONE FAMILY DWELLING WITH ATTACHED GARAGE & ATTACHED WOOD DECKS ANDREW T. STAMBOULIDIS ~wne~ h~,~ t~Et~g~g~ Z The certificate ~s zssued to of the aforesaid building Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO 86-SO- 170 N821478 PLUMBERS CERTIFICATION DATED: July I, 1987 Budding Inspector Rev 1/81 FO~'M' NO. ~B TOWN OF $OUTHOLD BUILDING DE PART/~,ENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE. WORE AUTHORIZED) NO_ 1550G~z Perrmsslon is hereby granted to' ....-~. ~.~,.ZL.-I. ................................................ ...~~.~..~.~ :....~.~ ~.~ ~ ot prem,ses located at ...~...~..~...0......(~..~ ........................ County Tax Map No 1000 Section .....~.,.~....~.. Bilk ....... ..~.....'~ ...... Lot No......~...\ ....... pursuant ,o application dated ...~..~ . ~ ........... , 19 ~.~.., and approved by the Budding Inspector. Building Inspector Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Bu dd~ng Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANI ,..~_T.O.w~ Instructions A Th~s apphcat)on must be fdled in typewriter OR ~nk, and submitted ~n duphcate to the Building lnspec- tot wtth the following; for new buddings or new use' 1. Fmal survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographic features 2. F ma~ approval of Health Dept. of water supply and sewerage d~sposa~-(S-9 form or equal). 3. Approval of electrmal installation from Board of Fire Underwriters. 4. Commercml buddings, Industrial bulldmgs, Multiple Residences and smmdar buddmgs and installa- tions, a certlfmate of Code comphance from the Architect or Engmeer responsible for the budding. 5. Submit Planning Board approval of completed site plan requirements where apphcable. For ex~st~ng 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, buddings and unusual natural or topograph m features 2. Sworn statement of owner or previous owner as to use, occupancy and condmt)on of budd,ngs 3. Date of any housmg code or safety mspect)on of bumldlngs or premises, or other pertinent mnforma- t~on required to prepare a certificate. C. Fees: 1. Certificate of occupancy ,~' ~7~'~ ,~ / / 2 Certlfmate of occupancy on pre-ex~sting dwelling ~r land use $ /~'/ $5.00 3. Copy of certificate of occupancy $1 00 Date . -July 31, 1987 New Building ~ ........ Old or Pre-existing Budding(X) ...... = ~Vacant Land ........... Location of Property 1560 Green Hill D..a~.e Greenportt N. Y. 119~4 House No Street Ham/er Owner or Owners of Property ,~-~drew'. T. St~J~bol,t.~-±d±l). .............................. County Tax Map No 1000 Section . .0.~,~ ........ Block .. .0~ ........ Lot .O1 ............ Subdlwslon ~ia~ of. E, ect.')ozl, ~. $,aate.l:m. F,led Map No.. 52~ . .Lot No. 135 ....... Permit No. 155Q6Z.. Date-of Permit .].],/l~/.8~kpplicant . .][]~.l',.A.l~).~3~7,~. ,~i'0~ ........... Health Dept. Approval ~1~' 2[9 ~. 1.cji8? ..... Labor Dept. Approval ........................ Underwriters Approval . 1~821.~.7.8 ............ Planmng Board Approval .............. ~ , Request for Temporary Cert~fmate ................ Final Certlhcate ........ - ......... Fee Submitted $ ~5.00. ............. Construction on above described buddmg and per~.C~n~e~all appJ~,c~e~cod~s and regulations Apphcant .... .,./J~~., ~.-,,..: ......... Robert E. Hiltz,k~LAN~ HOHES, INC. Rev 10 10 7a TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date July 1, 1987 Building Permit No. 1550gz Owner Mr. Andrew T. 8~amboul~dis (please print) Plumber~,nW Pnz~,~z~ d/b/n Rnv Plumbing & ~eatinE (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, _(pi.umber ' sF~sign~ure) Maz~llz~ HAROLD COHEN NOTARY PUBLIC, State of New York County THE NEW YORK BOARD OF FIRE UNDERWRITERS ·HIS CE~IFIES THAT FIXTURE OUTLETS SWITCHES Sound D~.., FIXTURES RANGES OVENS DISH WASHERS EXHAUST ~ANS DRYERS FURNACE MOTORS $~RVIC$ DISCONNECT OTHER APPARATUS TIME CLOCKS ~JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET S E R V I C E NO OF CC COND A W G NO OF HI LEG A W G Park F% ct. Con~:. Par~. P!ac~ Patchog~ur*, N,Y., [%772 Th~s cerhf~cate must not be altered in any manner, return to the offtce of the Board tf incorrect Inspectors may be ~denhfied by their credenhcds COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MU,ST HOT BE ALTERED IH ANY IVLANNER. OUNDATION ~(1st) OUNDATION~'''' (2nd) OUGH FRAME & PLUMBING ~SULATION FERN. STATE ENERGY CODE FINAL 765-1802 BUILDING DE*PT. INSPECTION [.] ~ATION 1ST [ ] ROUGH PLBG. [~]~"FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INOCULATION FRAMING [ ]~FINAL 76~.t~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [v]/~NSULATION [ ] FRAMING REMARKS: FINAL ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FINAL DATE ~//////~ / SS~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~ISULATION / FRAMING [~ FINAL REMARKS: DATE INSPECTOR ~,~.~ ~ LtJ Z Z ~" :0 0 36 38 ( dwelling 38 5 S 69002, IO"W CERTIFIED TO. ANDREW T STAMBEULIDIS 370 94 Ol' ( vacant ) AIJ(~ 19 CAVATiON INSPECTION REBUIRED The water supply & sewage dpsposot sys- tems for ihn resMence wdl conformjto the standards of lhe Suffolk Co?~?y I~lppad. ;Sc oN E o, s P 0 BOX 909 MAIN ROAD SOUTHOLD , N Y ~971 S C Dr~T OF LOT 135 "MAP OF SECTION FIVE EASTERN SHORES" FILED DEC ,:31 , 1968 FILE NO 5234 AT GREENPOR'I' TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. fO00 033 03 - OI SCALE I" = 50' AUG 7, 1986 LIC. NO. 49668 ENGINEERS ,PC Prepared ~n accordance with the minimum Standards for title surveys as estabhshed by the L.I.A.L. $. and approved and adopted for such use by The New York State Land T~tle Association. 86 - 461 ~ N 7'40 ,, 4034 -~ : ~ ~;~-~ ./ ~ '- - - ~ ': - - -/~ ~ ~ I ( dwelling CERTIFIED TO SOUTHOL D SAVINGS ANDREW T. STAMSEUL DATE_ LgT . I37~ JUL,2g, fg~ THE SEWAGE DISPOSAL AND ,~W~TER SUPP _Y FACILITIES FOR THIS L~ATION .N~y~ ~EEN INSPECTED BY THiS DEPA~MEN~ AND ~E~ND ~ ~A~ISFACTORY Chef of Wastewater Management Section NYS MAP ,2~' O R S SOUTHOLD , N Y 11971 LOT 13 § ~F SECTION FIVE EASTERN SHORES" FILED DEC ;51 : 1968 FILE N0,5254 AT GREENPORT TOWN OF $OUTHOLD SUFFOLK COUNTY', N.Y. fO00 0 33 - 03 OI SCALE I" = 30' AUG 7', 1986 JAN 5~ 1987' LIC, NO, 49668 JULY 21 , 1987 ENGINEERS 86 - 461A Exammed k~ .~.qtsaw~.& ] 8, 19~ Approved ~~ t~ D~sapproved a/c . . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y 11971 TEL.: 765-1B02 ,19~ Permit No ! ~q'd k ~= (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tbas application must be completely filled m by typewriter or in mk and submitted to the Bmldmg Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatmn of lot and of bmldmgs on premises, relationship to adjommg premises or pubhc sim. or areas, and g~ving a detmled description of layout of property must be drawn on the dmgmm which is part of tim ap!- cation. c The work covered by ttus apphcatlon may not be commenced before issuance of Budding Permit d Upon approval of this application, the Bmlthng Inspector will issued a Bufldmg Permit to the apphcant. Such pen-, shall be kept on the premises avadable for inspection throughout the work. e. No bulldmg shall be occupied or used ~n whole or an part for any purpose whatever until a Certfficate of Occupan shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MA~DE to the Bmldmg Department for the ~ssuance of a Bmlding Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulatmns, for the construction of bmldmgs, addations or alterations, or for removal or demolitson, as herein describ, The applicant agrees to comply .with all apphcable laws, ordmances, bmldmg code, housing code, and regulations, and admit authorized mspectors on premases and in bmldmg for necessary inspections .. (S~gnature of applicant, or name, if a corporation) Box 117, Mattituck, N. y. 11952 ........ t aiiiAZ iaa a 'a ' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or lld~ ......... G~..ne~a .1.. Cont.r a. ctgr .................. Name of owner of premises An.d.few .T.. S.t.ataboul idis (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer Robert ~. Hiltz, President (Name and t~tle of corporate officer) Builder's License No .... Plumber's License No 517-P Electrician's License No 2816 Other Trade's License No ...... Location of land on which proposed work will be done. Greenport, N. Y. House Number Street Hamlet County Tax Map No 1000 Section 033 -03 -01 Block . Lot. 1.3.5 Subdivision "HAP OF SECT3~ FI~/~ . .. Filed Map No 5234 Lot EI~STE RI~ (Name) SHORES" /.q'-<~ -t~Jlmlla~B{~-. Gr. een H.i.I.1 .I. tape, ...... 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 1 Family dwellin9 ,~ XX 3. Nature of work (check winch applicable) New Budding ...... Addition ......... Alteration ....... Repair ...... Removal ........ Demohtlon ...... Other Work ............. ~ (Descl~ptlon) 4. Estimated Cost )..t570~ ~ ................... Fee ................................... (to be paid on f'fling tins application) 5. If dwelling, number of dwelling umts. · 1. ....... Number of dwelling umts on each floor ....... If garage, number of cars ........................................................ 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... 7. Dunenmons of exmtmg structures, if any. Front ......... Rear .......... Depth ..... Height ........ Number of Stones ...................................... Dunenmons of same structure with alterations or addmons Front ............. Rear ........... Depth ........ Height ............... Number of Stones ................... 8. Dnnenslons ofenhre new construction Front ............. Rear ........... Depth ......... Height .......... Number of Stones ........................................... 9. Size of lot Front ....... Rear ............. Depth ........... 10. Date of Purchase ............ Name of Former Owner .................... 11. Zone or use dmtnct an winch premises are aituated. .. 12 Does proposed construction wolate any zomng law, ordinance or regulation ............................ 13. Will lot be regraded .................... Will excess f'fll be removed from premises' Yes 14. Name of Owner ofpremmes Andzow T-$.tam. bou.lJ~ttl~ssBlei7c~0u4~s~.t~,~}.d,.llP~0e N~.6.5-54.O.2. Name of Architect ............ Address ............... Phone No .......... Name of Contractor i I~p .H.O~.~S.,. INC. AddressBOX...1.17.. ~..l~.at..t...Ny Phone No?.9.8.'~9..6.96. .... 15. Is this property located wxthlnl00 feet of a tidal wetland* * Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~shng or proposed, and. md~cate all set-back d~rnenmons fro property hnes Give street and block number or descnphon according to deed, and show street names and red,cate wheth mtenor or comer lot STATE OF NEV~,¥~R~. S.S COUNTY OF .?~.*.~' .~..~. .... ...... Robe. rt .E... Hilt. z (Name of md~mdual signing contract) above named. being duly sworn, deposes and says that he is the apphca He is the .Contractor . . (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 tl apphcation; that ail statements contained m thru apphcahon are true to the best of his knowledge and belief, and that t work wdl be performed in the manner set forth m the apphcatmn filed therewith· Sworn to before me tins Notary Public, · day of. November ., 1987 ~ 3C~/.U-$.u~f.°..1.k ...... County ~ ~8t~ Robert 1~. Hilt ( ature ofapphca OR IS UNLAWFUL' CERTIFICATE If c~pper tubing L~ used for water distributing .,,=,~m; plplng shall be ,OCCUPANCY, - , , i~ . pL~iVMER C£RTIFICATION · ,, ,, ' ,:~: . '/,CERTiFiCATE, OF OCCUPANCY: " "1~0ne:477-04oo ' ! CANNOT of' t% ~AD. , ] 'i