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Home My WebLink About14475-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No ...... Z.1. 447.4 ..... Date ......... J. un¢..4 ................. ,19~3~. THIS CERTIFIES that the building ........ o n erf. am il,Y., d w~.ll ~ u ~ .................. 1415 Stars Rd. East Marion Location of Property h3Os$ h/'o~ .......................'S't/ebi ........... Hamlet 31 3 1 County Tax Map No. 1000 Section ............ Block ............... Lot ................. X X X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 18 19 8. .S pursuant to which Building Permit No. 14475Z dated.......December..........16 .... ... 19 .8. ? , 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. PETER & DEMETRA BROUNTZAS The certificate is issued to ..................... /oi;n'o),~3~g~r~th)'. ..................... of the aforesaid building. SuffolkCo tyDepartm ntofH althApp al 85-S0-182 un e e rev .......................................... UNDERWRITERS CERTIFICATE NO. N 7 5 0 5 2 3 Building Inspector Rev, 1/81 ~OB,I~ NO. ~' TOWN OF $ou'rHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM 14475 Z Permission is hereby granted to: ..... .~.-..~.......~.....~.L.~.... ................. ,o ..... .CO..~.~.'C.~..~ .~T.......O.~c~.....~F/~.c .4,~.....~....~.~.:~...c,. ~/....~...c~ ................. ......... .~..1.~ .......... ;....~'.~fA......L.~...m~.~~..~. ................................................... ot premises located ot .......l...~,.l.,~-~,,. ........ ~,'~, ,t~.,~,.,......~.~ .......................................... ............................................ .[. .............................................. ~.~..~,,'~,.~.~=.~.7..~., County Tax Map No. 1000 Section .....(~.'.'~-..t ...... Block .....(~)....~. ......... Lot No. '~'l ........... pursuant to application dated ...~.~...~......~..~ ........................., 19.~.~Vond approved 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 OCCUPANCY 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 survey of property with accurate location of all buildings, property lines, street% 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 sih~ilar 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 pZOperty showing all property lines, streets, buildings and unusua~ 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 $5.00 2. Certificate of occupancv on pre-existing dwelling $ 3_ 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ...~.~7.~.~.~1..0~.(~(~c~/ ..... New Building .... ~. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ]H~5 .......... ~T~.. ~. ~. E~ .~5.~r ~0.~% .~.,Y, House No, Street ~ Hamlet Owner or Ownersof Property ~ ~ ~1 ~ County Tax Map No. 1000 Section ...G~ ......... Block...~. .......... Lot .... [ ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ..... Date of Permit . . cant .................................. Health Dept. Approval-~///~,/~,....~..5 ;~ ~.[~abor Dept. Approval ........................ U nde~riters Approval ~ [~' '' ~ 7~5~5 Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ., ,~ ................. Construction on above described building and permit meets all applicable codes and regulations. ......................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000708 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.t~ ~ ~, ~-~ ~pplic~tio.~o.o..~ile ~0~0/~ N75052 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Bronzes, Stars Roa~d East ~arion, N.~o in the followittg location; [] Basement wasexamined~Y ~5~ J.9~ FIXTURE OUTLETS ~ECEPTACLES SWITCHES 23 34 23 [] 1st Fl. FIXTURES [] 2nd FI. Section Block Lot and found to be iN compliance with the requirements of this Board, RANGES ~'OOKINGOECKS OVENS DISH WASHERS EXHAUST FANS FLUORESCENT DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1-G.F.C.I. 1 -Smoke Detector 8al ~=ato, Electrician W/gq/ns Lane Groe~)o~t, N.Y. 11944 E R V I NO, Oi~C~CONO OF A' W O CC COND. NO* OF HI-LEG C E ~t~c.c~at.~e.~m~s.~.t n.~o., be altered 'n any manner;, return to the office of the Board if incorrect. Inspectors mav be identified TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ' ' (please prin~ Plumber CC5~.% %'~%~-I k%fS~ (p-l~a S e prih~) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~~3 ... (plumber' s signature) Sworn to before me this ~ ~ day of Notary Public, Notary Public FIELD,~.INSFE~TIO~ COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION FERN. Y. STATE ENERGY 2?DE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~FINAL DATE ~INSPECTOR ~ 7GS-t80Z BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] ROUGH PLBG. []FOUNDATION 2ND NINSULATION []FRAMING [ ] FINAL .INSPECTOR 765-18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION ZND [ ] INSULATION ]FRAMING ~(~FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B02 Disapproved a/c ~- --. ·. · (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. TOWN OF ,SOUTHOLD Received ........... ,19... Date..~.O.k/.' ~ ............. 19 .~.5. 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 applicaiion 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 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 building for necessary inspections. ~ ~ ........ (Signature of applicant, or name, if a corporation) - ~ (Mailing addres! of applichnt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... .G..~..u..~.¢..~. ~ .... ~..o.U.X~.[.~C..T~..~ ..................................... N~me o~ owner of premises . ~ E-5.. ~ B....B. K~t~.~' .T2~ ~% ......................................... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... .~ ~ ~ ............. Plumber's License No ..... ~..~..~.~..~. Electrician's License No...~..~.~. ?...~..~.~...Ci .'T~. · I Other Trade s License No ...................... ! c//~" I. Location of land on which proposed wor~ will be done.. S.~.g.g~,S....~ .Ch.~D. ~. Z .,. ~.6 ~ ~9. B ...... .......................... ~'~g~...~a~ ............. ~%...H ~.~.0.~ ......... ~, ~ , ~amlet House Number Street~ ~1~ ~'~ ~ County Tax Map No. 1000 Section ..... [.~ .~.. Block .......... Lot ............. Subdivision ..................................... Filed Map No ............... 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 ... ~,';~'/'/~.~ ./,.¥;~', ;, ..';~, ~ · l ................ 3. N lure of work (check which ~p~licable): New Building ....... 'Addition .......... Alteration .......... R. pair .......... ~ . Removal .............. Demolition .............. Other Work ............... 4. ....... ........... ......................... ' ~ (to be paid on filing this application) 5. If lwelling, number of dwelhng~mts ...[. ~3. Number of dwelhng umts on each floor ................ If garage, number of cars .... ~.~ ~.. ~*.r.g~ ................................................ 6. If business, commercial or mixed occupancy, ~pecffy nature and extent of each type of use ..................... 7. D~ensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... D~ensions of same structure With alterations or additions: Front ................. Rear ................. Depth ......... HeiSt .................. Numar of Stories ............ ~..~ ...... Dlmensmns of ~a~re new construction: Front ...~.~. ......... , Rear . ~ .......... Depth . ~ ~ ~ ...... Height . ~ ~ ...~.. NuCber of Stories ...... J.. ~ t.X¢ .................................. Size of lot: Front ... ]~t ,O~ ............ Re~ ..... ~.~] .,.Q.[ .......... Depth . J.~.~, ~ ........... 10 Date of Purchase" Name of Foyer Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: ...~ ......................... 13. Will lot be regraded ........ . ..................... Will excess fill be removed from premises: , ~ei , No 14. Nme of Owner of premiies ~ ]¢~. ~ ~.~ ~ ~ .,. Address ................... Phone No/~lg). ~.~ ~7~ N~o of Architect ~l,.~t ~g~.t~.~Q.. Address ~~.I.~L... Phone No ..... ~. ......... N~e of Contractor ~[~. ~O~ ...... Address~,~lSp~,H~J0~hone No. ~.~. ~ .... property lines. Give street and blocl interior or corner lot. pLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether ilq'TE t o g $ LOT 1 6 STATE OF NE~'~RK/ / ~., ....... 1 .......... being duly sworn, deposes and says that he is the applicant above named. of said owner or owners, and is dCy authorized to perform or have performed the said work and to make and file this application; that all statements cogtained 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 County ......... - Ii'll~-I~. _ flC~!t~..~_l~_sw'(?k (~ (Signature of applicant) i~ ~pires March 30, 1 ~ ..':AT SUFFOLK COUN~ DEPAflT~vlENT OF HEALTH SEgV~CES~/,[ ~ ~ ~- ~ ' J FOR AFPPOV~L f M'le F 2>¸ '.4, l t RODERICK VAN TUYL,-P.C. LICENS£DLANDSURVEYORS GREENPORT NEW YORK SINGLE FAMILY DWELLING ONLY Be se~ disposal ~d~ter supply fac~litiesfo~dt_~S~oca~enhavebeen inspected by this department and found Chief of ~eral Engineertna Services i)iNO% ~E ~-.VOS ~ j ..... k i ' / ! / RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H. S NO. 85-~'|82 STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICAI~T SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE DEPT. OF 'HEALTH APPROVAL OF H. S. Ref. NO.. APPROVED' SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. /CO0 .:~ / .7' I OWNERS ADDRESS: DEED: L. /~'~A P. TEST HOLE STAMP r, ~ ~...~.,,~,~I SEAL r OCCUPANCY OR USE IS UNLAWFUL WITHiJ~JT CEP, TIFICATE OF OCCUPANCY NOTIFY BUILDING D~AT 765-]802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: ]. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING 8, PLUMBING 3, INSULATION ,4. FINAL - CONBTRUCTION MUST BE COMPLETE FOR C. O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGy CODES, NOT RESPONSIBLE FOR l,J,~'X. ~",.~¢~'~ONSTR UC Ti O N ERRORS, F'"q F' ~3F~ OU'Z A S I1' ¢,,Jppm ,ubi~l is used fur water distributing s¥~ ~m; p~ping shall be oF types K or L SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXC/EED ,~/IO of 1~, LEAD. '/MBER CERTIFICA~IO.~ CERTIFICATE OF. OCCUPANCY r~