HomeMy WebLinkAbout22638-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24085 Date DECEMBER 18, 1995
THIS CERTIFIES that the building NEW DWELLING
Location of Property 395 HENRYS LANE PECONIC, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 74 Block 1 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 8, 1995 pursuant to which
Building Permit No. 22638-8 dated MARCH 21,1995
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 WITH ATTACHED GARAGE & FRONT DECK AS
APPLIED FOR.
The certificate is issued to INLAND HOMES, INC.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-95-0032-JUNE 29, 1995
UNDERWRITERS CERTIFICATE NO. N-372710 - DECEMBER 12, 1995
PLUMBERS CERTIFICATION DATED DEC. 15, 1995 - GALS KASKE
B ilding Inspector
Rev. 1/81
FORM NO.3
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)
~
Date 19...........
NP 22638 Z
Permission Is hereby r ted to,
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1i/t`i..f c1........~/....~.q.. 9s"
..y r:.... ......,9 s.-./.1. r
to ......&Z.4~4'
.,...................................../..............~..a...........
~r..Q.e.............,.....
.
................................................,..q.........................
at premises located at .............w .1. ....4...
r~ . .
County Tax Map No. 1000 Section Block Lot No.
pursuant to application dated 19....e...3.... and approved bythe
Building Inspector,
Fee $..C/G
.,,.,,..d
Building Inspector
Rev. 6/30/80
FIB-Lb IiSPECTION REPORT IIDATE II _ OMMENTS
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FOUNDATION (1ST) If
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FOUNDATION (2ND) ra
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ROUGH FRAME S i ri O c~~N
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11 II
II II c~
11~ I T~ C GI/ ~ ~
INSULATION PER N. Y. ii it I y
STATE ENERGY
CODE ii
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62
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11
II II
II II
II II ~
II II
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FINAL if
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ADDITIONAL COMMENTS:
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TEL. 765-1802
S~FF~L/r~pGy TOWN OF SOUTHOLD
~c OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
v' y'c TOWN HALL
SOUTHOLD, N.Y. 11971
1
C E R Tj F I C A T I O_N
Date 12/15/95
Building Permit No. 22638-Z
Owner Inland Homes it 1"J
(please print)
Plumber Gale Kaske 419,95
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber's ignature)
Sworn to befo a me this `
2day of
19~/ Notary Public
p/ VERONICA F. CIDONE
Notary Public, ~(y-L4 County NOTARY PUBLIC, State of New Yolk
No. 52 -4661406
Qualified in Suffolk County
Commission upirae Dec. 31, 19 1•~
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IDYM rosy N84329
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [---FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: Q
DATE L' INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE` & CHIMNEY
REMARKS:
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST LoOt ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ FRAMING4. [ ] FINAL
REMARKS:
5
DATE _INSPECTO
Pl- ,1
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ OUCH PLBG.
[ ] FO NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS: ~6 0'?~"
4417
DATE INSPECTOR i
765-1802
BUILDING DEPT.
INSPECTION
[ ] FO DATION 1ST [ ] ROUGH PLBG.
[ OUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: n~,/
41) 117
r
DATE L6109 ~ INSPECTOR
a 3
765-1802
BUILDING DEPT.
NSPECTION
[ FOUNDATION 1ST [ I ROUGH PLBG.
[ j FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / [ ] FINAL
REMARKS: Cam/~l~cf~
r
DATE INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
r1195099 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
'Bate DECEMBER 12,1995 Application No. onfile 88048695/95 N 372710
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
INIAVO HOMES, HENRY'S .LAND, POLE 482, PECONIC, N,Y.
in thefollowing location; ® Basement T let Fl. ? 2nd Ft. GAR/OUT 3ertion Block Lot
was examined on DECEMBER 0-7,1995 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W AMT K.W. AMT KW. AMi. K.W. AMT. H. P.
19 29 2.6 19
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS 9Ell UNIT HEATERS MULTI-OUTLET DIMMERS
AMT K. W. Oll H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP AMT, AMPS. TRANS. AMT H P SYSTEMS AMT. WATTS
NO.OF FEET
1 F 3 - 1
SERVICE DISCONNECT NO. OF S -E - R- V 1 C E
A W G
pMT. AMP TYPE EQUIP. PER9 OF CC.COND. METER I A, 4W I a. ]W 3 R tW 3,e' 4W NO.OF CC WND A W G NO OF HbIEG OF A HI W-' G' LEG NO. OF NEUTRALS OF NEUTRAL
1 150 CB I K 1 I 1. 1
OTHER APPARATUS:
WELL PUMP-1
MOTORSEI-F H.P.
G.F.c.z._.,
SMOKE DETECTORS-1
JIM SAGE ELEC. INC. LTC.#3635-E
350 MARINE PLACE
GENERAL MANAGER
GRESNPORT, NY, 11944 11
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
BOARD OF HEALTH
r4 f~ 3 SETS OF PLANS
x~,15 l7 D U L FORM NO.1 SURVEY
TOWN OF SOUTHOLD
C FORM"
MAR ~'-1995 BUILDING DEPARTMENT SEPT!
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY 298-9696
Ri roc, X-1 r'TEL.: 765.1802 CALL .
MAIL TO:,
8xantined 9 .`T °J 1
Approved rrlL4!~ . 19? Permit No-4 .
Disapproved a/c
.
(Building Inspector) .
AP CATION FOR BUILDING PERMIT ;
r . 3%8/95, 19
Date
INSTRUCTIONS,! t
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
r cts 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. , . 1 p.
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"fbr'ahy purp6gd (dha£6ver until a Certificate of Occupancy
sliall 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.
Inland Homes Inc.
(Signature of applicant, or name, if a corporation)
P.O. Box 117,Mattituck,! .J,.IAS?5?..,..
(Mailing address of applicant)
State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
General Contractor
Inland Homes Inc.
Name of owner of premises
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
Robert E. Hiltz .
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No .
#2451-Pf~
Plumber's License No . .
#3635 -F :F;
Electrician's License No. .
Other Trade's License No.
1. Location of land on which proposed work will be done. Hent L.. ,Cutehou. r..... .
[louse Number a.f I•. Street s , Hamlet,
~
County Tax Map No. 1000 Section P Block ....I.............. Lot....
Subdivision Filed Map No. Lot .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction! ' h
a. Existing use and occupancy .
b. Intended use and occupancy ~in~le FamilAr Dwelling. , , , , , , , , , , , , , , , , , ,
3. Nature of work (check which applicable): New Building I\. Addition Alteration
Repair Removal Deitnolition Other Work .
(Description)
4. Estimated Cost 75 %000.00..1........ , Fee
(to be paid on filing this application)
5. If dwelling; number of dwelyng units .....i.......... 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 type of use
7. Dimensions of existing structures, if any: Front Rear Depth .
Height Number ofStories
Dimensions of same structure with alterations or additions: Front Rear
Depth . . Height Nutrfb r of Stories , .
8. Dimensions entire new construction: Front . !a;9 , Rear 4 , , , , , Depth
Height ...........120. Number of Stories
9. Size of lot: Front Rear 120 „ 1, Aeglr WrI j6 =0......... .
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated I . . .
12. Does p ~esviolate any zoning law, ordinance or regulation: N0 , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
13. Will proposed
lot be,regraded p • • • Will excess fill be removed from premises: Yes -.I'
14. Name of Owner of stremises Ip.T.aud. RR»}QP Address . . . ...Phone No............ - .
.
Name of Architect . Address Phone No.. .
Name of Contractor 13~11iACI.19PJ4 48 , I;q , , , Address Phone No.298-9696... .
15, Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit ma be required.
PLUT' DIAGRAM
Locate clearly and distinctly, all buildings, whether existing or proposed, and, indicate all set-back dimensions flo
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or corner lot. '
Bee, 'Attached 8urvej
,
STATE OF NEW YORK, S'S
COUNTY OF Btzffolk.....
Rqb Hi
(Name of individual tt z idual signing ' ' . • ' ' • • being duly sworn; deposes and says that he is the applican
contract)
ibove named.
Ile is the QA4`t7 'VLGtOr.,.
Y.......
(Contractor, agent, corporate officer, etc.)
„f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi
application; that all statements contained in this application are true to the best of his knowledge and belief; and that th
work will be performed in the manner set forth in the application. filed therewith.
Sworn to before ire this
............day of .q:44, 197ii
'Votary Public ,yn......... . . County
` LIND/1J. COOPEfi Signature of a licant
Notary Public, ssgtqof}'N4wYgMt ( pp
No. 4822563, Suffolk County
Term Expires Dersmber 3t,1>
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for water distributing tributing PLUMBERCERnF/CAT/ON
@ystem; piping shell bs
of types K or L only I shell be ON LEAD CONTENT BEFORE DO NOT PROCEED INNI
1221K CERTIFICATE OF OCCUPANCY FRAMING UNTIL SURVEY
OF FOUNDATION LOCATION APR VED S NOTED
SOLDER USED IN WATER BEEN APPROVE I onrE: L2 f_ B R n ~?4 3#
PLUMBING IG SUPPLY SYSTEM CANNOT IHIAS Fee: 4f_ 3_ a _Sy -
ALL PLUMBING WASTE WASTE EXCEED 2110 of I% LEAD. NOTIFY BUILDING DEPA ENT AT
tf WATER LINES NEED TESTING BEFORE COVERING 765-1802 9 AM TO 4 FOR THE 1 NEED FOLLOWING INSPECTIONS:
:OVEpING I- FOUNDATION - TWOREQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION 4. FINAL - CONSTRUCTION MUST -
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
CODES. NO TRESPONSIBLE EFOR DESIGN OR CONSTRUCTION ERRORS
I
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COAIC.
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y JIV "E IS UNLAWFUL
G of 16THOUT CERTIFICATE
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Dow - N.Y. STATE BUILDING CODE. I
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PROVIDE OPEI !*IIS[QE111NOS FOR PROVIDE OPENINGS FOR ( { pE AS I f
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