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Home My WebLink About14096-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z. 1.4.2.7.8 ......... Date March 13 19 86 THIS CERTIFIES that the building New Dwelling Location of Property 390 Linda Rd. Mattituck )v'ol ........................................................ Street Hamlet County Tax Map No. 1000 Section ....19.6 ...... Block .... .0.1 ......... Lot .... .0 .1.3 .......... Subdivision. Captain Kidd Est. · 123 .............................. Fded Map No..1.6..7.2...Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 14 19 8.5. pursuant to which Building Permit No. 14096Z dated ......... .J.u.l.y. ..... 2. ........ 19 .8.5., 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 ......... ...... New Private One Family Dwelling ....... The certificate is issued to ... BALLAS, LAMBROS .................. ..................... of the aforesaid building. Suffolk County Department of Health Approval 85- SO- 77 UNDERWRITERS CERTIFICATE NO. N 7285 40 Building Inspector Rev. 1/81 ~1~ NO. ft TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (I'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 14096 Z County Tax Map No. I000 Section ..... )...O....~. ......... Block ........ .(~..I ....... Lot No ........ I...~ .......... pursuont ,o application dated ....... ...~....~...~.~. ....................... , 10...~..~../., and approved by the 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 OCCUPANCY BLDG. DEPT. TOWN OF $OUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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. Approva~ of e~ectrical 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. B. 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 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 requ ired to prepare a certificate. C. F~es: . 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacan~c Land C.O. $5.00 ~,l.,.l~.~l./~t Date .................... New Building ,....~. ........ Old or Pre-existing Building ............ Vacant Land ............. 3?0 Location of Property . ...,.. .............................................. House No, Street Ham/et Owner or Owne~s'~f Property ...J~(~ 193 ~r.0.~ .... .~.~1.1~. ................................... Z i3. County Tax Map No. 1000 Section ............... Block .............. Lot ............. . .t.z.3 ...... Subdivision .... p~,,,'t ......................... Filed Map No.. J~/-, . .Lot No... Permit No. J.L.k ,O.?G.~. Date of Permit ?.%% .~..J~.,~p~plicant...~/.~C~'. 6'.~....~..~G.T.~.,%-I~.'.~.'~ .'.~...~A... Health Dept. Approval .~..~.'"~J~ -- ~J'J Labor Dept royal Underwriters Approval .............. Plannin card royal ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all ~applic~able codes and regulations. ~gl~ ~, ~,~ qq ~ Applicant ..... : .................... MATHIS CONTRACTING P.O. BOX 668 STONY BROOK, NY 11790 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY, 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ described below and i~troduc~ by t~ applicant na~ned on tl~ able application number in t~ premises of I~xos ~l~.~.s~ 8/S I,in~ ~d lO0' E/O O~p~in Kidd ~ad~ ~tii%~ck~ was examined on .~k'~I~O~Z .[~ ~ FIXTURE OUTLETS RECEPTACLES ~ 2nd FI. Section Block and found to be in compliance with the requirements of this Board. Lot SWITCHES FIXTURES RANGES OVENS EXHAUST FANS FLUORESCENT VAFOR DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R V I C NO OF]CC COND..,~/OA W. g ) PER ,e' OF CC COND, NO OF HI-LEG OF HI-LEG JNO, OF NEUTRAl 1 AW, G OF NEUTRAL ~ithtcw;n, N.Y. 11787 This certificate must not be altered in any manner; return to the office of the Board if incorrect. may be by their credentials. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. ~ ~ o g& ~- Owner ~6~o~ ~1~ (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 befo~ me this /~. day Notary Public, ~ County TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, Januar'y 28, 1986 We are unable to complete your Certificate of Occupancy because ~of the following reasons. ~ An application for Certi~ficate of Occupancy is not on file. Application enclosed, //~/ No Underwriters Certificate on file. The check is(outdated~not on file.) ~ ~o_. Health Dept. Ap_p_roval on file. ~ /5/ No final inspection has been made. Please contact our office on this matter° Thank you for your cooperation. Building Permit 1 4 0 ~ ~ Z Lambros Ballas Building Dept. ***/5/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 )~ ~'IEL~ INSFECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING COMMENTS iNSULATION FER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: 7GS-J.802 BUILDING DEPT. INSPECTION 'row. Approved.... me it No (Building Inspector) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y, 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT Received ........... ,19.. · Date .... J.u..n.c..1.4, ....., 19..8.5 INSTRUCTIoNs a. This application must b~ completely filled in by type~vriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to ~cale. 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 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. .... ~TEI~. CDNTRAC.TING.,..INC ................ (Signature of applicant, or name, if a corporation) 5..B. oYlS.t, on. S.t., ,. Gaxde~ .Clt~r.,..NY..1.Z .5~0- · (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .~.n.e.r. ~.1..q .o.n.e.r.a. q .e 9.r. .................................................................. Name of owner of premises .... .I_~..M.B.R..0.S..B.A..L.L.A.S. ..................................................... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. ..................................... P..r .e.s.5.~. 9 .nt ~ (Name and title of corporate officer) Builder's License No ..... 5.8.2 .................. Plumber's License No..S.a.v. 9.n.-.O.n.. ,F~..e.1...-..W.i..1.1lam Debarl Electrician's License No..S.p.u.d.d..E..19.qt.r..~ 9 ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................... ... :. ........................... '~ L~nda Road, Mattltuck House Number. Street Hamlet County Tax Map No. 1000 Section . . 1. 9.6. ............ Block .... .1 ............. Lot ..... .1.3. ........... Subdivision...C.ap.t. ai.B..K.i.d..d. ~t..a.t.e.s... Filed Map No..~..62.2. ........ Lot . . . 3-2.~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... [f¢~..~.../~. ?. .... .~.g'.l.fi~...~ ....................................... b. Intended use and occupancy One fatally dwel],;13g. 3. Nature of work (check which a }plicable): New Building ...X..' ..... 'A, dition ...lt~j [~l.l.B!.t~ratioll; < i } .i ...... Repair .............. Rembvai .............. Demolition ......... ~.: .!.I~i~ ~0r~l('~. ~'.~. iJ,[ ] !1. ..... Esima 90,000,00 . ~ ~ . 4. t ted Cost..~ ......... ? ......................... Fee ........................... l;.l ...... , ~' (to be paid on filing this applieati0n) 5. If dwelling, number of dwelling: units .... ~. .......... Number of d elhng units on each floor..~.-.~.-. If garage, number of cars . . . J'i .................................................................... 6. If bus{ness, commercial or mixed occupancy, specify nature and extent ( f each type of use ..................... 7 Dime ' of ' ' truct ' ,if any: Front Rear Depth Height ............... Nunhber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ............... Rear .................. i Height I~ umber of Stories Depth ................................................................ .~ 18. pth .~.6 -' 8. Dimensions of entire new construction: Front ............. Rear .............. De .............. ~ N tuber of Stories Height .................................................................... 9. Size of lot: Front ..... 6.5,5.?. ........... Rear ..... 7.0 ....... 10. Date 0fPurchase Sep.g. Jl. 98/~ . Name of Form( 11. Zone or use district in which p~emmes are situated ................. 12. Does prpposed construction violate any zoning law, ordinance or regulat 13. Will lot be regraded .... Ilo.. i .................... Will excess fill 1 14. Name of Owner of premises Lg~0~7o.s..t}~.~.a.q... Address Name of Architect D. 9.n.a.I.d-...A....D..o.n.t.q ......... Address Aqtuebl Name of Contractor .M.a.~h..i .s.j.qqn..g.l'.a..q g..5 pg...I .n.eAddress '~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos property lines. Give street and block number or description according to dee, interior or corner lot. STATE OF NEW YORK, · being duly COUNTY OF S.S ........ (Name of individual sil :ning contract) above named. He is the .' .G. qr~T'..3.. QgB. g.17a. 9~ q~.. ............................. ;" -' (Contractor, agent, corporate'~ of said owner or owners, and is dttly authorized to perform or have perfo application; that all' statements co~tained in this application are true to th~ work will be performed in the manner set forth in the application filed there Sworn to before me this .......... /ff.(fL.., .... day 9f .... ~ .......... , 19 ~.'. NotaryVublic, . .... ..,.~.......,..-..~....... ...... County .... HELEN K. DE VOE ' NOTARY ?HBLIC, State of New York .... ~ ',. ' · {ge; 4707,878, Suffo))~ County I ' lam) E~p}res March 30, 120 ....... Depth ...................... Owner ............................. ,e removed froma~mn~i~s: Yes XNo , .C ~..e.a.r.v..i p.w.~ h'"~ n'"e~ o'?.1.8. -. 4..2.3.-. O..9.1..1.. ,~lle , Iq~ . Phone No..~.~..2.7~.~.1'.1. ..... i~ Jc'O't;i '~1;"'. Phone No. d, and, indicate all set-back dimensions from and show street names and indicate whether ~vorn, deposes and says that he is the applicant rficer, etc.) :mad the said work and to make and file this best of his knowledge and belief; and that the eith. (Signature of applicant) PLEASE NOTE It Is the applicant's responsibility to maintain adequate sanitary distance between all water supply and sewage disposal facilities. -'~r~F~Le~t'(~K VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK 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 SUFFOLK CO. DEPT. OF hEALTH SERVICES. (s} APPLICANT SUFFOLK COUNTY DEPT, Of HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION O N l Y~-'"~. DATE: APPROVED' SINGLE FAMII ~ SUFFOLK CO. TAX MAP ~NATI~N: DIST. SECT. BLOCK PCL, ADDRESS: TESt HOLE ~ STAMP SEAL ~, suFFOLK CO. '~ H.s..o~.~q~ .... .¢~EB 201980'. ,. ~. ~. ~~~7 ~ ~ ~e sewa~ disposal and ws,~ e~ supplU ~ FA~"~' ~.¢~m~' faeilitle~ for this loe~:~:.on h~ve been ~ ~ STATEMENT OF ,I.N~EN~ inspected b~ this department ~ fou~ ~ ~ ,, Ohle~ o¢ ~a~aZ ~gtnee~ ~ ,,""~ CONFORM TO -THE STANDAR~ OF THE Settees _: ,r" SUFFOLK CO. DEPT* ~ HEALTH SERVICES. ~ A~LICANT j ~ ~ ~ SUFFOLK COUNTY DEPT. OF HEALTH ~ ~ ~ ) SERVICES -- FOR APPROVAL OF , ~ t ,~'~'O~)~_[~ ~ ~ CONSTRUCTION ONLY ~ . ~_,~ ,~ , ' ,, ,,, ' -.~;?~'~¢~ E. -~0,0 i / ~ '" ' ' ~FFO. LZ ~. TAX . . --~ , ~, , .~ ......... ; ',/ ,/,7, ~, ......... ', '~ -~~-~-~~ ..... -4 ~ ~ a )~ /, ~::~7~,,:,~..:: / ~K VAN TU~; P.e. ~EEN~RT NEW YORK