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Home My WebLink About26767-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27935 Date: 09/11/01 T~IS CERTIFIES that the building NEW DWELLING Location of Property: 1700 pLUM ISI2~ND LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 6 Lot 8 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 28, 2000 pursuant to which Building Permit No. 26767-Z dated SEPTEMBER 12, 2000 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 SINGLE FAMILY DWELLING WITH DECK, PORCH AND SINGLE CAR GARAGE UNDER The certificate is issued to ROBERT HILTZ of the aforesaid building. ( OWNER ) SUFFOLK COIR~T~f DEPART~qT OF H]~_L~ ~PRO~L R10990138 EI~-~IC~kL CERTIFICA~ NO. N 567847 PLI~48~ C~TIFICJ%TION Dky~3 12/07/00 GALE KASKE 07/11/0¢ 08/24/01 Rev. 1/81 Authorized ~re FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PE~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PE~I~ NO. 26767 Date SEPTEMBER 12~ 2000 Permission is hereby granted to: ROBERT HILTZ 315 WESTPHALIA RD MATTITUCK~NY 11952 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH DECK~ PORCH AND BASEMENT GARAGE AS APPLIED FOR. at premises located at 1700 County Tax Map No. 473889 Section 01S pursuant to application dated JUNE Building Inspector. PLUM ISLAND LA ORIENT Block 0006 Lot No. 008 28~ 2000 and approved by the Fee $ 679.60 Authorized Signature COPY Rev. 2/19/98 Form No. 6 TOWN OFsouTHoLD BUILDING DEPARTMENT TOWN HALL '765-1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in. by ~ypewriter OR ink and submitted.~t-o the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines,' · streets, and unusual natural or topographic features. 2. ~inal Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.' 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect Qr engineer responsible for the building. '6. Submit Planning Board App~ogal of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and "pre-existing" land uses: ~ 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. " ' 2. A properly completed application and a consent to.inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant;' Fees 1. Certificate of Occupancy - New dwglling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building , $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy Residential $15.00, Commercial ,,r ~ ~w Construction..~f,~ .... Old Or Pre-existing Building ................. ~cation of Property...~7~Q......Plug.Island L~. Orient House No. Street Hamlet Inla~d Hom~s n~er or Owners of Property .................................................................. ,unty Tax Map No 1000, Section...P3.~ ...... Block..·.06 ~ q~ py the sea Fil ~.3444 ibdivision .......................... ed Map ............ Lot...$.~5 ............... 26767 Z .... 9/12/2000 Inland homes rmit No ................ Date Of ~ermln ............... Applicant ............................. · _ r~va~ ~115050 O0 alth Dept. Approval..~.q.??..ql~P ......... Underwriters App £ ......................... arming Board Approval ...................... quest for: Temporary Certificate .......... Final Cer ticate ........... e Submitted: ~~ Hilt Homes "'~ 9~ .. Robert z,Inland APPLICANT 53095 Main Road C Box 1179 N'ew York 11971 T,)lep'/one (51~'. 7( 5 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: 12/7/00 Building Permit No. 26767Z Owner: Inl~ Homes (please print) Plumber: Gale Kaske (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( g ) Sworn ko before me this ~'¢'¢ day of /~/~¢:~bz..~--/¢'~ ¢ m~/ Notary Public, ~&6~/~z-wC- County Design CPiteria 6,000 Oegree'.Oaye S UBS Y $'i'~M ~EA "U" ~TI NG Ceiling/Roof (Opaque) // Skylights % Foundation Walls Slab Insula ~ion [~lo ~e s: I3uildlng Envelope Systems to meet requirements of 7~i5.2 ~lVAC Equipement to meet requirements o~ 7~15.11 HVAC Systems ~o mee~ requiremen~s of 7815.r2 Ouc~ Systems to meet requireme~ts o~ 7~15.13 Ventila~io~s Systems ~o meet r~quireme~ts o~ 7~15.~4 Insula~iu~ of Piping Systems to m~et requirements of 7~15.15 Service Wa~er lleating Systems & Equipment to meet requirements of 7815.21 Slectrical & Lighting Systems & EquipmenZ to meek requirem~uts oE 7~[5.31 To the bes~ 02 my knewledge, belief, & professional judgement, these plans are compliance wl~i~ the code. Applicant/ Engineer: SCTM : I Ocalion . Reviewed: Date Submilted: Subdivision~ ~ ce~iflcalion (.?e_s / No) -- [1 [or~l Yard ~O Pro.sod -- Project Description: AGENCY PERMITS REQUIRED FOR REVIEW N.A. NO Suffolk County Health Dept. New York State D.E.C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: Permit YES STATE OF NEW YORK ) ) SS: couNTY OF SUFFO,K / /]_ /~,, ~-..~, ~. b- ~-"'/o/1 //( being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at ,/ That on the ? day of (/,¢ ~) '~ ,2000 deponent architect/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- 0 *~' street address I-) (~ '--'~/k)v-v'~ ..... '" Architect/Engineer Sworn to befCre me this '-)'~ day of ~.~/.~.~_¢._ ,2000. O Notar~ Public NO'IRRY PUBLIC}, ~e ~ ~ ~1~ ~ S~o~ ~, ~: ~ppli~nt Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/13/00 Transaction(s): Septic Permit - Construct - Resid. Receipt#: 3160 Subtotal $10.00 Check#: 3160 Total Paid: $10.00 Name: Inland, Homes 315 Westphalia Rd. Mattituck, NY 11952 Clerk ID: LIZS Internal ID: 12524 765-1802 BUILDING DEPT. INSPECTION [ ]~FOUNDATION 1ST [ ROUGH PLBG. INSULATION FINAL [ I FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY --~i ~~ ~ ~ II DATE /0[/0/~ INSPE~OR ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU~GH~.BG. [ ] FOUNDATION 2ND [,~-.~ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY . REMARKS: -/__~,~ ~.~ "~ C~v/ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING ,~ISULATION FINAL [ ] FIREPLACE & CHIMNEY ,DATE ~//,~// I NSPECT~~ / t ,~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING [ ] FINAL [ ] FIREPLA/OI~& CHIMNEY REMARKS~// ~DATE//~/~//~~JlNSPE~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND I ] I~ON [ ] FRAMING [/.~qNAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INS~I,ILATION / [ ] FRAMING ,//~ [~NAL [ ] FIREPLACE & CHIMNEY DATE INSPECT~/~~ 765-1802 BUILDING DEPT. INSPECTIO [ ] ~U~ATION 1ST [,~ROUG" PLBG. [ . ~)~il~ATION 2ND [ ]INSULATION [~,~AMING [ ] FINAL [~/] FIREPLACE & CHIMNEY..--- R~:I~ARKS:~ 76S-1802 BUILDING DEPT. / ISPECTION [t ~OUNDATION 1ST [ ] ROUGH PLBG. [~'] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIRE~'~CE"~ CHIMNEY 765-1802 BUILDING DEPT. INSPECTI? [ ] FOUNDATION 1ST [~]' ROUGH PLBG. [ ] ~U.J~IBATION 2ND [ ] INSULATION i~FiRRAE~N;cE&CHiMNEY[ ] FINAL ,DATE /~:/~' '"SPE~OR~ ~ 765-1802 BUILDING DEPT. INSPECTiO~N~ [ ] FOUNDATION 1ST [/"] ROUGH PLBG. [ ~EOUNDATION 2ND [ ] INSULATION [,,/J/~MING [ ] FINAL [ /]' FIREPLACE & CHIMNEY .DATE INSPE~OR 76S-1802 BUILDING DEPT. INSPECTIO~~ FOUNDATION 15T [ ~'~ROUOH PLBG. [ ] F~F~OUI~ATIoN~ 2ND [ ] INSULATION i-~C [ ] FINAL E & CHIMNEY UND^T~O~ ~ S~ ~ ~~ UNI)ATION (2ND) 7SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ........ ',.;':,rowd ~)Z~/ ........ j,~..~c~. Permit No.',~ 6.?~.7. ~ '; ~ u)proved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL 298.9696 ........ MAIL TO: (Buildin= Inspector) "-'-'--~J !'~ APPLICATION FOR BUILDING PERMIT Date .. INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building inspector, with .ts 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 stree areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app: c. The work covered by tbJs application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wilt issued a Building Permit to the applicant. Such perm h:d! 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 Occupant x!l have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to, the Building Department for the issuance of a B~Iding Permit pursuant to ',uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances i',cguiations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto describe [i~..' applicant agrees to comply with all apphcable laws, ordinances, buiJdingcode, housing code, and regulations, and 4mit authorized inspectors on premises and in building for necessary inspections. .... .~9.b.e.r..t..a.~, M:~ ....................... (Signature of applicant, or name, if a corporauon) ...Pg..B.q>~. kl.7 ~Matc. t, ituc.k, 119.52 ......... (Mailing address of app[icanU t..te ',~hether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiide Gene. r~$.qQngr.~cgor ................................................ ~.:. ............. ::::.z of o,,~ner of premises ........ Inland. Homes ............................................. (as on the tax roll or latest deed) i1 u l>?lioant is a corporation, signature of duly authorized officer. Roher¢...g$!ka ........................... (Nameandtitleofco~orateofficer) ALL CONTRACTOR'S ~UST BE SUFFOLK COUNTY LICENSED Builder'sLicenseNo ..... 19,136~I-L1. .......... Plul~ber s License No. , .2451:-.1E ............... E[cctrician'sLicense No. ..363.5-~E ............. Other Trade's License No ...................... Loc:~[ion of land on which proposed work ',viii be done .............................................. Plum .!S!~ad .Lane ................. orient ...................................... t louse Nu~ bet Street Hamlet ('utmty Tax Map No. 1000 Section .... O.15 .......... Block . ,. 06 ............. Lot...0@ .......... 6ubdi, ision !)r.~-erkta.by..the. s.ea,saction~.2... Filed Map No. &3444 ....... Lot 9~. . (Name) S~.ate ex~sting use and occupancy of premises and intended use and occupancy of propose.d construction: a Existing use and occupancy . . . V~cant. '~and' ....... ~eYw. t.'~5~ '-' :& '"- ' '" ........................ . b Intended use and occupancy New single famaly ', ~,~ature of work (check which applicable): New Building . .XX. ..... Addition .......... Alteration ........ Repair .............. Removal .............. Demolition .............. Othe[ \Vork ............. (Descriplion) ~ £stimated Cost .... $~-5.Qt. 000..,Q0 ..................... Fee ..................................... " (to be paid on filing this application) :. 1 f dwelling, number of dwelling units ...1 ........... Number of dwelling units on each floor ............... IF garage, number of cars .... J- ................................................................ If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stor/es ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... · Dimensio~l~£entire new construction: Front . ,53, .......... Rear . .53.' .......... Depth .34.' .......... Height ..'73~ .......... Number of Stories ...2 .................................................. '> Size of lot: Front ..180 ................ Rear .... 1~0 ............... Depth .122 ................. '~ Date of Purchase ... 9,,Z. 1.7/9.9 ................. Name of Former Owner . .ilar. ri. et. ~12. ieck ........ I Zone or use district in which premises are situated .................................................. 2 Does proposed construction violate any zoning law, ordinance or regulation: . t~o .......................... 3 Will lot be regraded ..... Ires .................... Will excess fill be removed from premises: noyes N : Name of Owner of premises .. 'R be 't: .Hi'l'cz' ' ' Address ................... Phone No .............. Name of Architect ...G.o.o, .rg'p..~.. J:.s.~.e.r. ......... Address ................... Phone No .............. N:m]e of Contractor ...~.rl .l'.a.n.d...hp.m.e.s. ......... Address ................... Phone No ............... ~. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..XX. *If yes, $outhold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dknensions flor ;,~operty hnes. Give street and block number or description according to deed, and show street names and indicate whethe ntenor or corner lot. SEE ATTACHED HEALTH DEpt. SURVEY ;\IH OF NE\;' YORK, S.S ' ;CNTT OF ................. · ~ROl~Pr,~..1~_~_.[~ ............................. being duly sworn, deposes and says that he is tile applican (Name of individual signing contract) tile ............ .C o ~...~' a c.t.o r ............................................................... (Contractor, agent, corporate officer, etc.) sa/d owner or owners, and is duly authorized to perform or have performed the said work and to make and file : ?Jcation; that all statements contained ~ this application are true to the best of his knowledge and belief; and that th. ~gl be perfomned in the m~ner set forth ~ the application filed therewith. ',om to before me this .... 43 ........... ....... 5;7.7 , ................ ............ T~Expi~ , - ~ ~gnature of applicant A4 , 0~' , t,v~ .ZO _q ,0 'UZ l ,0 J 'Or' ~ ,0£ ,t,b .gO N