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Home My WebLink About13972-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z1429B No .................. Date .. ~lac~k .2 ] ..................... 19 .8.6. THIS CERTIFIES that the building ...... Qne. £.amil;y..dwe.Lling ..................... Location of Property ...... 28~5. Bray. &..7.8 ~ 5..Eec o~ic. B~y. B Z.v.d ...... Ma~;.Li ~uc.k House No. Street Hamlet County Tax Map No. I000 Section ...1.2.~ ...... Block ....0.9. ......... Lot ..... ~..~: .2 ........ Subdtvisinn ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fded in this office dated .... N..ay..1.~ .......... , 19~5. pursuant to which Building Permit No...1.~97~.~. ............ dated ..... N..a y..~. ~. ................ 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 ......... .... O~..f. ami3.Y., d~.e. 1 ling ..................................................... The ce~tmcate is issued to ..... ~'~ ~ ~" ~ ~ ~ ~ ' ' /o¥.'~;, ~~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ....... 85 .-~.Q-: 55 .......................... UNDERWRITERS CERTIFICATE NO. N ? 13104 PLUMBERS CERTIFICATE 9/16/85 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13972 Z · ...... . · .~' . .~.~.!.~.. ,'.~..:...~ .... : ...... at premises located at ~P~... ~ ..... .~. County Tax Mop No. 1000 Section ...... J....~.....~. ...... Block ..... (~..~. .......... Lot No, ...J[.~.:...'~:'... ....... pursuant to application dated ........ .....~.....~.....~..~. ................... , 19.]..~.~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in dupBcate 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. B. 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 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 requ ired to prepare a certificate. Fees: I. Certificate of occupancy on pre-existing dwelling/r land use $ Certificate of occupancy $5.00 2. 3. Copy of certificate of occupancy $1,00 / .Date .February 24~ 1986 New Building ×× Old or Pre-existing Building(X) ....... ~/Vacant Land ] .... Location of Property 2.8,35 Bray & 7815 Peconic Bay Blvd. MattJtuck~ N. Y,.11952 House No. Street Hamlet Owner or Owners of Property Tb.q~,3.s. Keane. ..; ._.,,_ ................................... County Tax Map No. 1000 Section 126, Block O9 Lot. 13.2 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 139,7.2Z , 5/22/85 INLAND HOMES, INC. ......... Date of Permit .......... Applicant .................................. 1/28/86 Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. N713104 Underwriters Approval ........................ Planning Board Approval .................. no t~ yes Request for Temporary Certificate ..................... Final CertJfica ........ - ......... Fe '; ' ' ~ 5.00 e buDm tie(] ~ ............................. Construction on above described building and pe;~.~m~s a~llapj~.'~$ and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY Oo~)J3~r ~LT~ [~ es JOHN STREET, NEW YORK, NEW YORK 1OO~8 THIS CERTIFIES THAT o~ly the electr~al equlptnent ~ described bel~ and introduced by t~ appglca~t ~amed on the above application number in the premises of w~ exatnlned on ~ ~0 ~ 1~ end found to be in compliance with the requirements of this Bourd. FIXTURE OUTLETS DRYERS FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FURNACE MOTORS FUTURE ARFUANCE FEEDERS TIMECLOCKS JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECI: S E R V ! C OTHER APPARATUS: Motors: 1--3/4bp 2/O A]i'OD Electric Corp. (Cliff Oornell) 325 Wil~0~ Point R~d Southold, N.Y, llgfl L/c. 2~,16 GENF~AL MANAGER must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by the~' credentials, COlbY FOR[BU LDING DEPARTMENT THIS COPY OF CERT!FI~ATE M~STN0~ALT,ERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION September 16, 1985 Date Building Permit No. 13972Z Owner Thomas Keane Plumber (please print) Frank Pazienza (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before0me .this gs Notary Public, ~ County ~/ (plumber '~sig~ture) Frank Pazienza Public VFRO/VICA F. C/DONE 7'AR Y PUBL;C, $';'A T£ OF NEW FOR;¢ NO. 52-4651405 OUALI?I£D fN SLIFFOLtf COLI/V7~ COMM/$$/ON EXPIRES MARCH $0, FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & ?LUMBING C OMMEN TS ~ INSULATION FERN. STATE ENERGY ~ODE 4. FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [, ] FOUNDATION [ ] FRAMING 2ND [ ']INSULATION [ ~]/FINAL REMARKS: )U Iqq~. ~ ~ , INSPE~'OR :g'~, C BUILDING DEPT. INSPECTION FOUNDATION ~LST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING FINAL REMARKS: DATE FORM NO. 1 ~ ~' TOWN OF SOUTHOLD BUILDING DEPARTMENT ~' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined... ,~-~'x-A. ?". ~.., 19z~'/- ~ Disapproved ale ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date May 35 , .................. ,s. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 application may not be commenced before issuance of Building Permit. · d. Upon approval of this application, the Building Inspector will issue 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 Occupa~ncy shall have been granted by the Building Inspector. APPLICATION 1S 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 buildings for necessary inspections. INLAND HOMES, (Signature of applicant, or name, if a corporation) Box 117, Matt±tuck, N, y, 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor ................. Name of ownerofpremises...........,....Th°mas Keane? ........ .,...,., .......................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duty authorized officer. t · Robert E. Hiltz. Pres. (Name and title of corporate officer) Builder's License No .......................... Plmnber's License No ..... 5.17 :'? ............... Electrician's License No. 2816 Location of land on which proposed work will be done.&/3:r, aY. · A.v. enue.~(~c°lq lc. Hay.. Bl.~.d, Ma,ct i tu~-,k ~I~ House Number Street Hamlet · N 126 ......... : ........ Lot...1.~ ~..~ ............ Coimty Tax Map o. 1000 Section .................. Block 09 Subdivision ........................... Filed Map No. 85-90 Lot ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... 1 family dwelling b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): NeCz Building .. ,X~.... ... Addition . ......... Alteration., ......... Other Work Repair .............. Removal .............. Demolition ................ , ...... ' ........ .... . (Description) Estimated Cost 50,, OOO. O0 Fee · (to be paid on filing this application) $. If dwelling, number of dwelling units.. 1. ......... Number of dwelling units on each floor ................ If garage, number of cars .............. I .......................................................... 6. If business, commercial or mixed occupancy specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: F~ont. ............... Rear .............. Depth .............. Number of Stories ' Height .................................................................. Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height i'. ..................... Number of Stories ..................... · prI pth 27 8. Dimensions of entire new construction: ont... 62 .......... Rear .. ~5~ .......... De ............ Height...............1.6 Number of St6ries..~- ................................................... 9 Size of lot: Front See survey i Rear Depth ' Name of Former Owner 10. Date of Purchase .................. ' ....................................... I 1, Zone or use district in which premises are~~ situated .................................................... 12. Does proposed construction violate any zbning law, ordinance or regulation: ............................... 13. Will lot b(, regraded ..... .~ ...... .K.~a..n,c. . .. Will.excess fill be removed from premises: Yes No 14. Name of Owner of premise~:.n..°~.a, ·s. . , Adaress~l~. h~,ep~r~l~y. Phone No..4'B..7-,6,6.1..8. of Architect ,' Address Phone No Name ................ '. ............................................. Name of Contractor INLAND HOMES~ INC. a,t,~,,~oBox ll7,Mattituc~l~r~[~eYNo .2.qarg.69.6, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block numbe~ or description according to deed, and show street names and indicate whether interior or comer lot. ~ ~;1'4 - STATE OF NEW YORK, ,,'S.S COUNTY OF.. ~,U.F.F. O[,.I~ ...... Robert E. Hilt,z being duly sworn, deposes and says that he is the applicant (Name of individual sigfiing contract) above named. 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 this application;that all statements cohtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ...xT. ..... ....... Notary Public, .~/ ....... ~:~,-~,~,~:::,~,;,~2, ....... Coun OBSERVATIONS AND .QR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDEi WiLL CONFORM TO THE T NDA D OF THE SUFFOLK COUNT'~ or REAL,R SERV,CES APPLICANT: ADDRESS _ .8o~_ M_7..~ _M atti t,~/,..~ 9.B ~.- SUFFOLK COUNTY DEPARTMENT 0~. HEALTH SERVICES FOR APPROVAL OF coNstRuCTION OF Single Family Residence Only ~r~ b-~C~-9 ~" ~EF. No. .J REVISIONS NOTE ** ~ · .- MONUMENI~ SUFFOLK COUNTY TAX MAP DISI~ IO00'SECT. 126 BL. 09 LOT 15.2 "YOUNG & YOUNG 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK ALDEN W. yOUNG HOWARD W, ,YOUNg SURVEY FOR: THOMAS KEAflE AT MA T TI TUCK TOW. O~ .~SOUTHOLD SUFFOLK CO., N. SCALE: / ,,_. DATE' /FAR. I$, 1985. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR PROM DATA OBTAINED FROM OTHERS THE WATER SUPP£Y AND SEWAGE DJSPOSAL SYSTEMS FOR THIS RESJDENCE WILL CONFORM TO THE STANOARU$ OF THE SUFFOLK COUNTY oP ,EALTH SERWCES APPLICANT: ADDRESS TEl ,,,o - * ~ = MO~E~ SUF~O~ COUNr~ mX MA~ YOUNG' ~ YOUNG r 400 OSTRANDER AVENUE, R~VERHEAD, NEW YORK , AT MAI'TITUCK I GUARA TOWN oF ~SOUTHOLD SUFFOLK CO., N.Y. SCALE: / ,~__ 40 ~ DATE' MAR. 15,1985 '% ~ copper lubing is used for water distributing ~yslem; piping shall be oF types K or L only i~::~I~Z,U'MBER CERTIFICAT[OST "' ON LEAD CONTENT BEF. OR~ CERTIFICATE: OF 0CC5 SOLD£'R Lo~D'~': IN SU'PPLY SYSTEM CA .EXCEED 2/10 o.f 1% A,', , ;) AS NOTED ~EE.~9a,~,~ BY: V'. ¢,*~., NOqZlF~ B1 {II_DING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE /:OLLOW[NG INSPECTIONS: . [ FOUNr~ATION - TWO REQUIRED EOR EQUR~F~ CONCRETE ') ROUGH - FRAMING & PLUMBING 3. INSUI. ATIqN 4, Flit!AL - Cr~NS?RUCTION MUST BF C~P{ rTE FOR C, O. ALL CONSTRUCT[ON SHALL MEET THE REr~I~?CMENTS OF THE N Y. ~TATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DL~IGN OR CONSTRUCTION ERRORS. L .I