HomeMy WebLinkAbout18061-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218700 Date JAN. 9, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 387 WOOD LANE PECONIC
House No. Street Hamlet
County Tax Map No. 1000 Section 086 Block 006 Lot 029
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 20, 1989 pursuant to which
Building Permit No.18061Z dated APRIL 20, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for wha.ch this certificate is
issued is ONE FAMILY DWELLING, ATTACHED GARAGE AMENDED TO INCLUDE DECK.
The certificate is issued to JOHN R. DEMPSEY
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-04 1/5/90
UNDERWRITERS CERTIFICATE N0. N103962 NOV. 20, 1989
PLUMBERS CERTIFICATION DATED GALE KASKE PLUMBING INC. OCT. 18, 1989
ui ding Inspector
Rev. 1/81
roam xa s
TOWN OF SOUTHOLD
6UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ~ $ U ~ Z Date 19.cE~.
Permission is hereby grant~~o--•__ aa~~ QQ
...~J~.!!i'.~:A:....L.. G' .
....31.a:....~
Y'""' \
at premises located at ~...(.......'~.:f,l.v'S?:SY.... ..a.:±:~--...~~? 4.~1.5,~
County T/lox Map No 1000 Sect~/onn ..~.~~a. Block ......Q.`P.......ppLot No....~x,~......
pursuant to application dated 19..1„ and approved by the
Building Inspector V
Fee S.
Building inspector
Rev 6/30/80
TOWN OF SOUTIIOLD
- ~ BUILDING DEPART?LENT
TOWN HALL
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
nnTE December 13,. 1989
NEW CONSTRUCTION XX._...OLD OR PRE-E%ISTINC BUILDIHG......VACANT LAND........
Location of Property...~B~.~OOd.Pi~1e~.PCQQS~ICi.~a.~:
HOUSE NO. STREET HAMLET
Owner ar Owners of Property..JOhn.&,.DempSey.....__.._..
CounCy Taz Map No. 1000 Section OBEi__. Block Ei_..... Lot A47...2R..
Subdivision Filed Map 9~~~-2..Lot._........
Fermit No. ].$SJ~J.7~._..Date of Permit~~?Q~89..._Applicant~~`~D.HOt'"IF~St_INC_..
Health nepL. Approval Underwriters Approva1.1y1Q~~Fj2
PLanninU IIoard Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: 2.5..DD
APPLICANT.
Robert E. Hi1tz - INL91V~ ~FI ~ , ~ iNC.
.~r~Y irk
z / ~~G~ IS `I..:J
BLDG.UEPT
o~ya TO1uN OF SOUTHOtD
~ ,3 X83 ~
rev. 10/14/88
r ~ ~
TEL. 765-1802
~pS~~F~~~pG TOWN OF SOVl'HOLD
y.'c OFFICE OF BUILDING INSPECTOR
z P O. BOX 728
~ yc TOWN HALL
''O~y~o~ ~ SOUTHOLD, N Y. 11971
C E R T I F I C A T I O N
Date ~ 1 - ~ q
Building Permit No. ~ a b ~a ~ Z
Owner ~ rv~--~.-~ ~ 2
(pliease`print) ~\J~~ ~ ~S~L~-, ~
Plumber ~C.~\~ 1~C~S~.~ ~ 1a ~~v\t~ ~ ~-,"9
(please print)
_ _~e ~
BLCG LzL-uf~~ 4
TOWN U'r 54U]TiUe-~'
I certify that the solder used in the water supply system
contains less than 2/10 of 1$ lead.
(plumber's signature)
Sworn to before me t 's
1~day of ~~//~~'~l~C~ /~~c~
19 c~ ~ Notary Public
Notary Public, ~ County DOIiWIiyEHpppISON
PuMe, SMW of New Yak
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CUSTOM BUILDERS
eox iii
315 WESTPHA LIA ROAD
r MATTIT UCK N Y 11952
516 296 9696
r ~ une 26, 1989
1t~tNN
OF
' OEi+~;
SOUTHO~p
Town o£ Southold
Building Department
Town Hall
Southold, N. Y. 119'71
Re: Building Permit #180612
Dear Sirs:
T am enclosing herewith a survey £or 3ohn R. Dempsey, at
Peconic, Town of Southold, N. Y.
The Building Permit #18061.
Thanking you in advance.
Very truly yours,
f ~~,~G
Robert E. Hilt
Tnland Homes, Inc.
RIIi/gh
enc.
T6S-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
FOUNDATION 2ND ~ ]INS ION
(]FRAMING [ FINAL
REMARKS: ~ Z-
o
DATE « ~ O( INSPECTOR
' 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ~ ] ROUGH PLBG-
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]~FIN,(AL
REMARKS: ,C~~Q.diL.~.~.~/ CA~1 , ~5
O
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G~~~l~ ' ,
Y
DATE ! INSPECTOR ~ .w
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
C~RAMING [ )FINAL
REMARKS: ~
DATE (J l0 INSPECTOR
1 f 7~s-~BOZ
BUILDING DEPT.
INSPECTIQN
[ ] F UNDATION 1ST ( J ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE (0 ~ INSPECTOR `
s
a
765-1802
BUILDING DEPT.
INSPECTIQN
[ OUNDATION i5T ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ] JJFINAL
REMARKS: 7J 'I ~ C~_~-m~?
~/a f~
DATE 2~ INSPECTO ~ Fy
T _ _ _ _
.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PArx z
1.1951.12 BUREAU OF ELECTRICITY
8E JOHN STREET. NEW YORK. NEW YORK 10038
Date NUY$MB$R 20 ,1989 Application No. un file 64247189189 N 103962
TMtS GERTIFIE3 THAT
only the electrical putpment a descrihed helots and introduced 6y the appNcant nomad on the o6aos apptleatton nurtt6er in the pnatGss of
t
JUHN D$NPS$Y, INDIAN N$CR LAMB, P$C(?NIC, N.Y. ~
in thefolbtatng l°`~891s~tBbtJ;"f~~9 ~ Ist Fl. ~ 1'nd F1. GAR/OUT SerNun Block Lot
tcaa examined un and found to he in tromplianre Leith the reyuirements of this Boord.
IIRTIIRR % RAfllfRf COORRIO RlCltf O. qfK W T FANf
OUT{fTf A~ fWITCMRf INCANOltCFM IlUOtltClNT OTX6R AMT. K. W. AMT. K. W. AMT. K.W, AMT. K. W. AMt. N. 1.
39 9 39 39 1
t%tTUR tylafitce unoTORS wTIRn kMtIkNCR tRwRf fMC1AlRRC1T Ttftrt:logtf Rnt uM1TtRUtTrf t~ TUT twtultuts _
AMT. K. w. at N. r. OAt X. 1. AMT. NO. A. W. G.. AMT. AA1P. AMT. AAtIt. TRANS. AMT. n 1. ~ IRRT AMT. wATn
~ 1 2 12 2 1
IIO.q f R R V 1 C G~ E p~
AMr, AAV. TTIt p~yp, I l ]w t l sw 7 / 7w t,e Aw NO.Oi s
~cauo. A.~
. No. or N4ua a m't~o NO. a MURRYL a 'IlYTRAt
1 200 CR 1 R 1 4/0 1 2/0
OTi1M MMRATUfi
NUTURS:1-.75 H.P.
G.'P.C.I:-6
SNO$F. D$T$CTOR: ••2
TRACK LIGHTING:-4
SAG$ i LADSNANN INC. LIC.13635 $
P.O.BOX 1.768
SOUTHOLD, NY, 11.971 oRfIIRAt MANAORR
11 ~
Per
TMs arfilkata TMlft not he alNnd in arty mamtary return to tM ofliu of tM Roord if ttecarrect. IRSpedors may M idetNiliad hY fMir txedentialt.
COPY FOR BUILDING DEPARTMENT. TINS COPY OF CERTIFICATE MUST 6E ALTERED IN ANY MANNER.
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM -f
TOWN HALL NOTIFY pp O
SOUTEOLD65. 801971 CALL v?lg'. • q~Df~P• • • • - - -
ct~~ MAZL T0:
i,xanuned 19~.g1 p t
ipproved ....°~'o. , 19 ~ !Permit No.~ ®~~.L.
!lIJJJ ~I
ftisapproveda/c I
. . . . .
' ' ' ' Bi.DG. DEPT.
^ TOWN OF SOUTHOLD
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19..
INSTRUCTIONS
a. Tlus applrcatron must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
Sets of plans, accurate plot plan to scale. Fee according to schedule
b Plot plan showing locatron of lot and of buildings on premrses, relationship to adjoining premises or public strec
or areas, and grving a detailed desorption of layout of property must be drawn on the dragram whrch is part of this app
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d Upon approval of this applrcatron, the Building Inspector will rssued a Building Permit to the applicant. Such perri
shall be kept on the premrses available for inspection throughout the work.
e No building shall be occupred or used in whole or in pazt for any purpose whatever until a Certrficate of Occupan~
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to tl
Burldrng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulatrons, for the construction of buildings, addrtions or alterations, or for removal or demolrtion, as herein describe
'fire applicant agrees to comply wrth all applicable laws, ordinances, building code, housing code, and regulatrons, and
admrt authorized inspectors on premises and in burlding for necessary inspections.
....INLAND HOMES, INC.
(Signature of applicant, or name, rf a cotporatron)
Box 11? t Mattituck, , N,., ,Y., 1~1g52, , , , , ,
(Marling address of applicant)
State whether applicant rs_owner, lessee, agent, azchitect, engrneer, general contractor, electrrcian, plumber or burlde
General Contractor
. .
Name of owner of premrses ,john. R.. Dempsey.... .
(as on the tax roll or latest deed)
If applicant rs a corporatron, srgnature of duly authorized officer
k~ob~rt, 1+;.. Ha.7.tz,..l'resa.dent.... .
(Name and trtle of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Burlder's Lrcense No . .
Plumber's Lrcense No. ...24'511' .
Electncran's Lrcense No. ..3635E.. .
Other Trade's Lrcense No .
~ Locatron of land on whrch proposed work wrll be done. .at P~44riC., TOW.rt .of. Southold,. AI..Y_..... ,
. ~ s ~ .
House Number Street Hamlet
County Tax Map No 1000 Section ..08Fj . Block ~ Lot ...pC1....2~...... .
Subdivision , Filed Map No . 9122 Lot
(Name)
? State existing use and occupancy of premrses and intended use and occupancy of proposed construction.
a Exrstrnguseandoccupancy Vacant„
b Intended use and occupancy 1-Fan?ily .A~e7~a..zn~, , , , , , , , , , , , , , , , , , , , - , , , , , , , , , ,
3 Nature of work (check whrch appircable). New Building . ~ Addrtron Alteratron
Repazr Removal Demolition Other 1Vark .
(Descn Sror
O, a o o Fee . .
4 Estrrnated Cost
r (to be pard on filing this apphcatron)
5 If dwelling, number of dwelling units 1 Number of dwelling unrts on each floor .
If garage, number of cars .
6 If liusines~r ~5 ~ xed occupancy, specify nature and extent of each type of use .
7 Dunerisrons oT~etx
sting~p~es, rf any: Front .......Rear Depth .
Height Number of Stones .
Dmrensror~~ture with alteratrons or addrtrons• Front Rear .
Depth Herght Number of Stones .
8. Drmensrons of entrre new construction: Front Rear Depth .
Herght .........NumberofStones
9 Srzeoflot:Front Rear...... Depth
10 Date of Purchase ...Name of Former Owner .
i 1. Zone or use drstrrct m which premises are sduated .
12 Does proposed constructron violate any zoning law, ordinance or regulatron• ,no, , , , , , , , , , , , , , , , , , , , , , , ,
13 Wili lot be regraded . GVrll excess fill be removed from premrses: Yes
I ~l Name of Owner of premrses JgYIn, Dempsey, , , , , , Address ~T~~a;~8~~ ~PT..Y•... Phone No..']. ~4r.FiQ~8. .
Name of Archrtect ......Address Phone No............ .
Name of ContractorlNLAN.lI .$CM.FiS ~ . ~Q.... .Address $Px M~ttitupI~o,2~8;~96~6 , ,
15. Is this property located within 300 feet of a tigidal wetland? *Yes No
*If yes, Southold Town Trustees PermitPm_y~D1AGKAMed.
Locate clearly and distinctly all buildings, whether exrstmg or proposed, and, indreate all set-back dimensions f.
property lines. Grve street and block number or descnphon according to deed, and show street names and rndreate whe
interior or corner lot.
4
S PATE OF NEW YORK, S S
('OUNTY OF . . Siik'F0~ .
RObert, E. Iiiltz, , , , , , , , , , , , , , , being duly sworn, deposes and says that he rs the applrc
(Name of mdrvrdual srgmng contract)
,above named.
Ilcrstfre.... Contractor
(Contractor, agent, corporate officer, etc.)
~~f said owner or owners, and rs duly authorized to perform or have perfonned the said work and to make and file
ipplrcatron; that all statements contained in thrs apphcatron are true to the best of hrs knowledge and belief, and that
work will be performed rn the manner set forth m the apphcatron filed therewith.
Sworn to before me thrs
~~~kr.. ......day of April........., 19 89
NotaryPublrc, ..........Suffolk,,,,,,,,,,,,,, Cour~I~`~
k ~ HEIEN K DE VDE . • .
NDTkRYPU611C,StateofNewyork Robert E. Hiltz rgnatureofappirc
Na 4767818, Suffolk County
Term Expires March 3D,19~`I
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