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Home My WebLink About16749-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z16798 Date April 13, 1988 THIS CERTIFIES that the building One family dwe 11 ing. Location of Property 430 Highwood Rd, Southold House No. S~reet Hamlet County Tax Map No. 1000 Section .. 7. .8 ........ Block ..... .9 ......... Lot .... .4.5 ........... S ..... Highwood at Bayview 5 uoo~vlmon ............................... Filed Map No. 554.7 .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... F. e..b....2. 2.:..1.9..8.8. pursuant to which Building Permit No. ! .6.7.4.9. Z. ..... - dated P e b. 22, 1988 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 deck and garage. The certificate is issued to .... El)WARD TOBIA (owner, X~,~(tf~l'R~;lttYfX X X X of the aforesaid building. ~ Suffolk County Depa~ment of Health Approval 14-SO-46 April 4, 1988 UNDERWRITERS CERTIFICATE NO N853182 Feb. I 1, 1988 PLUMBERS CERTIFICATION DATED: Robert House 1/29/88 Building Permit 16749Z replaces Buildi, qg Permit #12973 Building Inspector Rev. 1/111 FOB~ NO. ~l 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°_16749 z Permission is hereby granted to: , .--, ~..~ ........ ~i~Y.~/......,.,. ............................................ ot p,emis.~ ~o~ate~ .~ ....~.~.....~~.-~ ....................................................... ........................................... ................................................................ Buildln0 Inspector. Fee $ ................. ./..,Fy.g, Rev. 6/30/80 l~Ou'M' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) [J~9~J Z Date ....... '.~.~ ...... ~[ ..................... Permission is hereby granted to: ....... ............................. o....~ ~.....~,. ~~ .m,~,' .~..~i:~ ...... ~,.~.. .... ~/~ ~ & ..~e~.. . a1~ prelY~tses IocaTecl OT ....... .~.. ................. ~. ................................ ,- ........................ County Tax Map No. 1000 Section ....... .~?..~. ....... Block ...... ..C~....c~.. ........ Lot No ....... ~.~..~.~.. .......... pursuant ,o application dated ....... ..~.q~.~,....J~. .................... , 19.~..~.., and approved by the 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 Instructions A. 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. 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 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 housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25. O0 ALTERATION $25 .00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, ove. r 5 years S 0 00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstructi°n ...... Old or Pre-existing Building /~ Vacant Land Location of Property ...~.'.~.~.. House No. Street Ham/et Owner or Owners of Property . . . .~>.. ,z~'..-~..~../._~.. ........................................... County Tax Map No. 1000 Section .... ~.. ,~, ...... Block .... ?i ......... Lot .... ~,' .~z_~,~,, ..... Subdivlsion ................................. Filed Map No ........... Lot No .............. Permit No.. , ate of Permit .......... Applicant .................................. Health Dept, Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ................. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and~,_~. ~per~it meets all applical~ cod.es and regulations. Ap pl ic ant ~,~..~~..'~..~...~..~.~,, ......................... x/O ~ TEL. 765-1802 'row~ ov SOUT~OU)~- h-~. tt~'~s~ OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL 8OUTHOLD, Iq.Y. 11971 CERTIFICATION Building Permit No. / ~> 7 ("/? Z.. Owner ~ ~ Plumber (please print) (please print) I certify that the solder used in the water supply sys%em contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this day of , 19 Notary Public, County Notary Public NOTARY P! ~BLIC, Stere of Ne-*, York No. 4/,£53'41 Su*f'~I& CcJnt,, ...... 30, 19~ FIELD, INSPECTION~ FOUNDATION (1st) COMMENTS~ FOUNDATION (2nd) ROUGH FRAME & FLUMBING 3. INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: Memorandum from... · BUILDING INSPECTORS OFFICE TOWN OF SOUTROLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 February 17, 1988 Dear Mr. Tobia, Re: B.P. #12973Z I checked with Tom Fisher. The amount required for your permit that has ex- pired is $400.90. Please send us your check and we will send you a receipt for the permit. I am enclosing an application for a Certificate of Occupancy which you will need when you are ready to file for it. Yours truly, Secretary TOWN OF SOUTIIOLD OFFICF. OF BUILDING INSPECTOR P,O, BOX 728 TOWN IiALL SOUTHOLD, N.Y. i 197] TEL. 765-I 802 This is to advise you that the job under building permit no. 12973Z issued to Edward Tobia on __4J~./B4 for 'New Dwelling is completed and a final inspection has ( ) has not ( x ) been done. [n order to complete this file, it is necessary that n Certificate of Occupancy be issued. Please fill out the enclosed fort,, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certlficnte of Ocenpancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupnncy. Pleat~e help u.~ to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly ~, Victor Lessard Executive Administrator VI.: ga r encl . BUILDINO DLq~,r. INSPECTION [ ] FOUNDATION SST ~ROUGH PLBG. [ ] FOUNDATION :~ND [ ] INsuLATIoN FRAMING REMARKS :~.~.., . [ ] FINAL DATE INSPECTOR F~.~ /-.-- ~' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION DATE ... mNSPECTOR · ~', ~-.~ Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF $OUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 I ~'' q 7 ~ ~ 765-1802 INSPECTION [ ] FOUNDATION 1ST ~ ] ROUGH PLBG~' REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION, [ ] FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING ~ ] FINAL REMARKS: *~*~ ~ -~ /~ - ~ -~ .~ ~i 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL INSPECTOR ~.~ ~/~/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~JLATION FRAMING [~/]' FINAL 76S-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [~INAL [ ] FRAMING DATE ,~/~/~ INSPECTOR:.--"~./~-*),-/~//...~ THE NEW YORK BOARD OF FIRE UNDERWRITERS I-- k[% BUREAU OF ELECTRICITY Tobia~ 4~ Hlghwood Rd.. 8~[:hold~ ~.Y~ fiXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES 19 32 22 19 DRYERS FURNACE MOTORS FUIURE APPLtANCE FE~DERS TIME CLOCKS [JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E 1 3 I 5 OTHER APPARATUS: MOTORS: 1 -lhp SMOKE DETECTORS~ 1 ~// Bi-County glecCr~ Corp. 1006 Jerusalem Ave. M~rrid¢, N.Y, 11560 GENERAL MANAGER This cert[f~<~te must not be altered in cln), mci~ner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT TH S COPY OF CERTIFICATEMUST NOT BE:ALTERED IN ANY COPY FOR:BUILD ................ : ...... ~ ;,: ,.~ ~ ~NNER. Examined..~Q~ ~.vi .~,~. ~':..~/ ..... 19~..(I . Approved .......... .Q..~.'.. .~ .... , t9~.~.. Permit No ......... ~.~.~ Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Received ........... ,19... Date/~.~.~ O 19 ~4 a. Ttfis application must be completely filled in by typewriter or in ink and submitted 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 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 for any purpose whatever until a Certificate of Occupanc~ shall 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 co~e, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.t~ DESIGN 8~ DRAFTffiG SERVICES (Signatt~ of appl me, if a corporation) ~0~ Roxbury Rd. So: Gar&On Cily N. Y. JOHN E. STUMPF 485-7923 .............................................. (Mailing address of applicant) State whether applicant is owner, lessee,~ architect, engineer, general contractor, electrician, plumber or builder. N~me of owner of p~e,~ises .. ~.~...~...e~.,,, .+.. ¢.q ~ ,..2;. ~ C., ......................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... 3.~0 ........ . .~..~./-J!.71.oleoc,ao Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... . I. Location of land on which proposed work will be done. . . .bx~.r. .~.t.~. . .d~. . . .~. .~,~,~. . ._t. . . . .,~-~--. 7-~:.j ............ ...... ..... ....... ................ House Number Street Hamlet County Tax Map No. 1000 Section Subdivision...-~..~/~....~...~.~k~.....~.O~..... Filed Map No. ~ ....... Lot ~ ...... 2. State existing use and occupancy of premises and intended use and occupancy oI proposeo construction: a. Existing use and occupancy b. Intended use and occupancy ......................... '..' ................................ 3. Nature of work (check which applicable): New Building .. ~ ..... Addition .......... Alteration .......... Repair .............. Remogal .............. Demolition .............. Other Work ............... 4. Estimated Cost. . .! ........................ Fee .. : ............................. I (to be paid on filing this application) 5. If dwelling, number of dwelling ffnits ....... / ....... 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.. ,~,[old~ ...... Rear ... Height . .~':%'~.. ·.. Numt er of Stories Dimensions of same structure wit ~ alterations or additions: Front . ~ ........... Rear .................. Depth ...... ~ ........... Height ..... ~ ............ Number of Stories. ~ .... ~ .......... 8. Dimensions of entire new c0nstru :tion: Front .... ~f~:'P.q ...... Hlght g).t~E' ~e' .'N b f St I e nm er o OrieS .... Size of lot: Front .... l 75 .... i .......... Rear .../?;5~. ............... Depth . .ll~. .............. Date of Purchase ~ Name of Former Owner Zone or use district in which pre~nises are situated.. 1~.,' .l~O~[. ................. ~ .................... Does proposed construction violate any zoning law, ordinance or regulation: ... ~..O. ........................ Will lot be regraded ... ~l~.... ~ .................. Will excess fill be removed from premises: Y~ Name of Owner of premises .~71~. ToOI~} ¥ ~oO Address ~. ~Se.~O Name of Architect .......... i ................ Address .................. 10. 11. 12. 13. 14. 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 r umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ,.S COUNTY OF ................. i ........................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor,~ 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewith, Sworn to b~fo.re l$l~his .~ .~ Notary Public ................ County .~ ..... ~;/30.,,104" ~,~ 1 '"(Signatur"---'-'e' ;; app ic~t)'--l"--' ...... -¢ . hdAP OF SUFFOLK CO. HEALTH DEPT. APPROVAL H. S, NO. STATEMENT OF .I NTE, N~ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL C,O~?[FORIMi TO ~'HE STANDARDS OF THE SUFFOLK CO, DEPT, OF HEALTH SERVICES. SUFFOLK COUNTY DEPT. OF HEALTH SER¥1CES -- FOR APPI~OVAL OF CONSTRUCTION ONLY J DATE' .. s. ;;Er; N&, I ur ~: ~_.o- ~', ', iAINGLE FAMILY DWELLI~)Ut~L': SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT, BLOCK PCL. ,OWNE:R'S ADDRESS: '1 1.1'; "~l 2~¢iiGE2~,~'D" 'A~{jf E~' p__.A~T, SEAL ;: , DCCI~?~I~CY'OR, ~'i'~i ~'~FICATE i~F ~PPROYEg ~ ~IOTEII~ If copper tubing is used for water distributing system; piping shall be of ~pes K or L only 207 R~xbury ,I · 'm--" I } 1 DESIGN & DRAFTIN~ SERVICES ~NEW YORK' STATE ENER6.iY COrN$.,ERVAT:ION GODE = (~7~ FOR NON ,~-CON~F,ORMING ,-% 5~.C'l'io~u - 78 DATE: ~B P. :ff :EE../~ z~.~.~,~/ ~.z~/, ~'_ BY: ~ ~O~IFY B~'~NG DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR TH~ FOLLOWIFIG %NRPECT ONS: 1. ~OUNnATION - ~O REQUIRED FOR pOUReD CONCRETE 2. ROUGH FRAMING & pLUMBiNG