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Home My WebLink About13730-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14276 Date March 12 1986. THIS CERTIFIES that the building ....... .O .n .e. . f. .a .m .5. 3:. y, . .d y. e. 3:..~.i.n.g... ................. Location of Property ........ z[ 90..¢.~D..A~..B.I..~.C.~...~.O.&D. ................. 0..I] .~.E.~ ? ...... House No. Street Ham/et County Tax Map No. 1000 Section 9.1.5 ........ Block ..... .8 ......... Lot . .2.6..: .3 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J.~ a .,..3. (} ........ , 193.5.. pursuant to which Building Permit No....1.3.7.3. .0 .Z ............ dated ...... MavcX .5 .............. 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 ......... Qne Family. dwe3.3.±ng amended Lo ±nc3. ude deck. The certificate is issued to .. g ~1 lq~.. X/.~.~. ....... b~,,'o'r,~dgdr~ti~t;'t) ...................... of the aforesaid building. Suffolk County Department of Health Approval .... .1 ).nS. 97.2.5. 9. ........................... UNDERWRITERS CERTIFICATE NO ............ ?.E.N..9..I.IxI.G. ............................. PLUMBERS CER?IFTCATE 2/20/85 Building Inspector Rev. 1/81 FO]B~ NO, ~1 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) N~_ 13730 Z County Tax Map No. 1000 Section ..... ..(~.../ ............ Block ..................Lot No....~..-. ............. pursuant to application dated ~~ ...... .~..~. ............ , 19~...~..~., ond 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 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY //3 ?d Instructions 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. Finat survey of property with accurate ~ocat{on of a~l 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 p~operty 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 hbusing code or safetv inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 Date ......................... .~'.'//..-//.~. / New Building . .~.. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~. ?.q ....... .~.4 .... t.~..~..~... .~./~..L~. .....~..~./..~..,~/.7~.. .......... House No. Street Hamlet Owner or Owners of Property.//~a'......................(~)/~f'~/~ .................................. . County Tax Map No. 1000 Section . .~..~ ~ .O. ~.... Block . I~..~.'.~..~. ..... Lot....~.~.~..: .~ ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approvai ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000170 BUREAU OF ELECTRICITY /~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO,38 only the elec trical equipment ~ described below and introduced by tl~ applicant ~med on the able application number in the premises of J~ V~'ga, 490 C~ar '~' '~ in the following locat~on; ~ Ba.ement ~ lst FI. ~ 2nd ri. Section O15 Block ~ Lot 20 was examined on ~l ~6 ~ ~86 and found to be in co~npliance with the r~quirements of this Board. OUTLETsEIXTURE SWITCHES FIXTURES RANGES COOKING DECKS OVENS DRYERS FURNACE FLUORESCENT VapOR TIME CLOCKS MULTI-OUTLE SYSTEMS NO. OF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT OTHER APPARATUS: R V I C E AWG. OF CC, CONu NO, OF HPLEO A W.G, iNa. OF ~UTRAL$ A,W G. OF HI-LEG OF NEUTRAL ~22S8 /~ G~E~AL MANAGER This certificate must not be altered in any manner; return to the office of f~e Board i~ incorrect, inspectors may be identified by their ILDI~ DEPA T~IJ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765q 802 CERTIFICATION Date Building Permit No._J_5 Owner_ /J~ (please' ~rln% [ Plumber C~¢) ~' ~,.Lc (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 _~ t day of~/~,~7~ '/%3 19 ~__. Notary Public,.~~ . County (~bse~ ' s signature -~' No[~ry FIELD INSPECTION FOU_3D&T~O_~ _ FOUNDATION ( 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~0DE 4. !DATE COMMENTS st) ADDITIONAL COMMENTS: .__ ,, ~.Z~ .. ( -2~-------.~ : TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This May C~ncern, We are unable~to complete your Certificate of Occupancy because ,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. /~_~o Underwriters Certificate on file. /5/ The check is(outdated/not on file.) ~_/~ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # I ~ 7 _~ 0 Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND'[ ] INSULATION [ ]FRAMING ,~INAL REMARKS: ~ ~ ~ ~* ~'~ ' , ti . L It I BUILDING DEPT. INSPECTION,' FOUNDATION '~ST [ ] ROUGH, PLBG. FOUNDATION, 2ND ~ INSULATION [ ] FRAMING FINAL Approved "FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ., ., 19~..~. Permit No../.~.~. · .~.~: Disapproved a/c ..................................... (Building Inspector) APPLICAT:ION FOR BUILDING PERMIT Received ........... ,19... Date January 30 19 85 ..... ,~. :INSTRUCTIONS a. Th/s application mu~t b~e co~npletely fill~d in bY' type~vriter or in ink and submitted t° the BuildingInspect°r, with 3 ~ets 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 3r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 appticant. Such permit shall be kept on the prbmises 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 IHEREBY MADE t(~ 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. ............ ~I.e.i..d.t.m.a..n.h..&..Sp.n.,. l.n.c. ~,, ....... (Signature of applicant, or name, if a corporation) · p,..O,. X1,9. t5.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises Jack Virga (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Henry G. Heidtmann (Name and title of corporate officer) Builder's License No ......... .19 ............... / Plumber's License No .... .M.a.~..t.i.hu. 9.k' .p..1 .u.m.b.i. Bg 7' Electrician's License No ..... G..&..$..C.o.n..t F.a.c.t. Pr Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............................. . :,. ~ ................. ~.~ ~ Cedar Birch Road Orient ltouse Number Street Hamlet o~ ~. 3 ? *~ County Tax Map No. 1000 Section .Q1..5 .............. Block . .8 ................ Lot ..... ~ ....... ' . . Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy oxf prp(nises and intended use and occupancy of proposed construction: E ' a. xisting use and occupancy ..... ~. ~ ............................................................ b. Intended use and occupancy New Reszde~, l~:~r~,~t~ ~:~ .. 3. Nature of work (check which applicable): New Building .... .X ..... Additior .......... Alteration .......... Repair ............ ;. Removal .............. Demolition ........., ..... Other Work .............. 4. Estimated Cost .. 160 t 000 t 00 ..... Fee .............. ~' (to ~e paid on filing this application) 5. If dwelling, number of dwelling units,..9 .n.c, .... Number of dwelling Units on each floor ............... If garage, number of cars ................... 6.. If business, commercial or mixed occupancy, specify nature and extent of each itype of use ..... 7. Dimensions of existing structures, if any: Front ............... Rear ..... , ......... Depth ............. Height ............... Number of Stories .......................... i ............................ Dimensions of same structure with aRe, rations or additions: Front ................. Rear ................ Depth ...................... Height ...................... Number]of Stories ......... 8, Dimensions of entire new construction: Front .69 ' n~.. 69 ' ~.+~ '6'0 ~ ...... Hmght ...2.6. .......... Number of Stories ....2. . . 9, Sizeoflot Front, ..2.7.0.~. Rear ~?0' ............ ~)~,~.~[ .... I50" ............. 10. Date of Purchase ............................. Name of Former Owne~ ............................. 11. Zone or use district in which premises are situated Residential 12. Does proposed,construction violate any zoning law, ordinance or regulation: .: n.o . . 13. Willlot be regraded EqS. . . · ' ~ ........................... ...................... Will excess fill beremoved frompremmes: Yes x No 14. N,'une of Owner of premises . ~I.a. ck Virga Addra~ 21-10 ~2ncl Stre~,r- .. ............................... .... rnone INO .......... , ..... Nmne of Architect ......... aaa .....lackson [tet'~hts i9 . s .............. ............ ......... Name of Contractor He man on, l~nq,a ..... CutclSogue~ N.. .. · ...... ................... ~'~uu~ ............. ~ ...... l:'none iNo ................ PLOT DIAGRAM : Locate clearly mid distinctly all buildings, whether existing or proposed, and?indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street naraes and indicate whether interior or corner lot. :OUNTY S.S ' ' ................ ' ..... being duly sworn, d6goses and says that he is the applicant (Name of individual signing contract) bove named, Agent le is the , .tr~ .~ [ ~:~ (Contractor, agent,icorporate officer, etc.) ( said owner or ownem, and is duly authorized to perform or have performed the ~aid work and to m~e and file this p~cation; that all statements contained ~ this applicatipn are true to the best of his ~,or k will be performed in the m~ner set forth in: the apphcation filed therewith)~ ~ knowledge and belief; and that the worn to before me this ....... ~ I~(~ ....... ~ o~5~~/ ...... , ~9~~ ~~ - . , ~z~.~~ ......... : .... ~e ~e fac~I~ ~ns~e ! / / / [B ,18 1986' a~e diapoaal and water m~pply ted ~ this depa~aen~ sa%t~faet °~ a~ ' SUFFOLK CO.* HEALTH DEPT. H.S. NO. ' ' '~TATEMEN~i' ~ 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 ONLY DATE: H. S. REF. NO.: 14- '50 _25¢j APPROVED: DEED: L ? p. TEST SEAL