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Home My WebLink About11751-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupency No. ll .~ 3.ag .......... Date ..... .l).e.c.~..~.b.e.~...~ ............... ,19 .8.2. THIS CERTIFIES that the building ................................................ Location of Property q615 Anchor Lane Soul;hold House No. Street Hamlet County Tax Map No. 1000 Section . .0.7.~ ....... Block .. p.4. .......... Lot. p.0.6. ............ conforms substantially to the Application for Buildin~ Permit heretofore fried in this office dated ·..J..u.n.e..3. ...........,198..2. pursuant to which Building Permit No. 11751 [ dated .... J..u.n.e..2..4 ................198..2. , was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... .a..p. ~.:L.v.a.~e...o.n.e.-..r.a~ !y..d.w..e LLi. n..~., ....................................... The certificate is issued to RIHHARD & JANE HILTZ of the aforesaid building. Suffolk County Department of Health Approval ..... 1. 2. .-.~.0.-. 5..1 ............................ USOERWRrrERs CERTIFICATE NO .............~...~.S.0.Z.e..6 ............................ Rw. 1/81 (THIS PERMIT MUST BE KEPT ON ~H,E PREMISES UNTIL ILL COMPLETION OF THE WORK AUTHORIZED) N? ~1751 z · I~ate ......... ~ ............................. 19.. Permission !s hereby granted to: ........................... -....Q ! ....... ( ........ ~ - ., ~ . ., ~ .. ,...:, ~ .,~i/~,. ~o ................................... , ...... ~ ~...,...,~,~,,~ at premise~ located at '- Coun Tax Map No. 1000 Sect on ,~ B ~ ; ............. pursuant to apphcat,on dotod ........ .............?.....~ .., pprovod by tho FORM NO. 6 TOWN OF SOUTHOLD Buildlng Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 featu res. 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 peoperty 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 pertipent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date November 3, 1982 New Building ...X.~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~.6..~..5..A, qc.,.~.o~..I.~.~p.e.,. Southol,d., No. Y. House No. Street Ham/et Richard & Jane Hiltz Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 079 Block 04 Lot. 06 Subdivision ................................. Filed Map No..~..3..0~ ..... Lot No .............. 6/24/82 .Hiltz Permit No. 11751Z Date of Permit .......... Applicant R. Health Dept. Approval . ]0/29/82 App · .. ................... Labor Dept. royal ........................ N580226 Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate .... y.e.s. ............... Fee Submitted $ , ,5;,0,0,, .~.. .................. Construction on above described buildin~~ations. App,cant __ ...... 10O0744 THE NEW YORK BOARD OF FIR~ UNDERWRITERS BUREAU OI~ ELECTRICITy o.~ ~ ~1, 1982 ~..~i~.~o.~o.o./i~ 18~ 82 only the el~trical equipment as described below and introduced by t~ applicant na~ed on the ab~e application nu tuber in the premises in the following location; [~ Basement [] 1st FI. [] 2nd Fl. Section Block Lot w.s ox.m~..d o. O~obar 14, 1982 and fou.d to be in compliance with the rFquirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH OUTLETS 20 35 ~ 20 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT OTHER APPARATUS: 1-G.F.C.I. 1 --Smoi~ Dete~t°T 1-15.0 I~. ~ R V o~2/0 I C E NO OF HI-LEG A W, G, OF HbLEO OF NEUTRAL 2/0 Rtchie Relyea P.O. Box 372 lm,_~el, N.Y., 11948 This certificate must not be altered ' , manner; return to the office of the THIS COPY GENERAL MANAGER Per__ may be identified their credentiab. ANY MANNER. FI~LD~INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY C~DE FINAL ADDITIOI COMMEN~ FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved .......... ~. ~. '...( 19-:.. Permit No ............ Disapproved ......................./,/~..<,_. ~.. -...~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. / it 7 9--/ DateJ. U..n.c..3.~...1.9.8.2. .... , 19... INSTRUCTIONS a. This application must be~co!np!etely filled fin by typewriter or in ink and submitted in triplicate 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 issue 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 Occupancy 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 code, and regulations, and to ~admit authorized inspectors on premises and in buildings for necessary inspections. .......... ............... (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N. Y. 11,9,52 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... .G.e.n.~. r..a.1..qgp.t.r.a.q .t 97. ....................................................... Name of owner of premises ...R.ig.h.~r..d..H. 2:..1~?..&...J.a.n.o...H.i.l.~ .~ ......................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ................. R. 9.'9.e.r..t...E....H..i.l.t.z. ~...P??.s..i.d.e. nt (Name and title of corporate officer) Builder's License No .......................... Plmnber's License No. 517-P Electrician's License No ..... 2.1. .4 .8.-. ~ ........... Other Trade's License No ...................... l. Location of land on which vrovosed work will be done Harbor Lxthts Estates, Sect. 1, oouthold~ ............................... House Number Street Hamlet County Tax Map No. 1000 Section 079 Block 04 Lot.. ?.6. Subdivision /-J,q,,~Ytn, ~ J~ ,~c_ / Filed Map No. 4362 Lot 13 &13A (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacant Family dwellinwG ~ .... ~.,~ .... .~ .~ ........................... b. Intended use and occupancy ...................... 3. Nature of work (check which applicable): New Building . XX Addition Alteration · ' Repair .............. Removal .............. Demolition .............. Other Work ............. ~.. ~ (Description'-' 0..O.b 0'3' 4. Estimated Cost ............. ,-,¢...~ ................. Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... 1. ........ 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 ifany: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ....5.2. ~. ........ Rear .... 5..2.~ ........ Depth 44 ' Height ............... Number of Stories ............... 9. Size of lot: Front ....... .1.O.O.. i ......... Rear ...... ~'{J0 ................. ................ Depth ................. 10. Date of Purchase ............. ................ Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ~ . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Richard H:i. Pcz . Address :l'~l*~ng~]°nv$~:° Phone No.5~2[.-7.5149. Name of Architect ........................... Address ...... .. ............ Phone No ................ Name of Contractor .t?.t~..~..[~..x~...l°~.N..1~..~.~.x. ...... Address..M.a.t.t.~...t.u. qk.!.N.o.Y.: Phone No.g. 9. .8 .-.9.6. 9. .6 ...... INI~ND HOME$~ INC. Ti [WORK Oe p~;fonned in the manner Jet forth in the application meat erewith. Sworn to before me this ............ ,o(/-/-4"'"-"' .day of.' Notary Public,, ................... . ' . County '" ~. ~,, S~ m~ " (Sign~plicant) 30. t'~-6z-'C ~ ..... ~- ',,~ ~' ; "~. ,, ~., .~ . ~-~¢. ,,~ ~ , ~ ~ .... · ~? .g~ - ,,., (-~,~ a ....... t. ' ' . .... l~Fi~~. o,~.~. ROOF OT~R To~ , . aheet No, /off IHSP[CTIOH REQUIRED LOf ~ 13 PiPE ~ KMW),FIC TA~I~I~E~) WN ~ NY.S. LI~NSE NO.4~g5 SU~ F~ RICH~HI~Z ~ ~NE NKTZ SUFF~ CO~TY~ NEW ~ SURVEY ~ A VI~ATION ~ SECTION 71H ~ TNE N~W ~K STATE E~CATI~ LAW~ ffC~IES ~ ~IS ~VEY NOT ~nm THE LAND L SUnVE~n'S ~EO ~AL OR EMBOSSED ~ ~ALL ~T N C~SlDE~0 TO ~ A VALID TRUE C~Y ~AR~B ~I~TED HE~ON ~L ~H ~Y ~ '~RTMrN~b .-~TA ~ ~ ~ C~ST~CT ~ ~ ~R w~ THE SU~Y IS YOUNG YOUNG ~TE : ~ = STAKE 0: ~ ~IVISION M~ FI~O IN ~OF~ ~ T~E ~E~K ~ AL DEN W. ~NG, P~FE~I~AL ENGI~ ER ~FF~K ~ ~ ~, 1~5 ~ FI~80. 43~Z ANO ~ND ~VEY~ NY.S. UCENSE ~. HOWARD W. YOUNG, ~ ~VEYOR ~ c~g~ ~c(w),~tc ~(~ cE~(~) ~N ~ N.Y S. LICENSE M0.4~9~ L '0 klVlk~,.5 ~ O'~td i-/I. ~," OF OCCUPANCY DATE:,~ 'ROVED AS NOTED NOTIFY J :UILDI'~NG DEPARTMENT AT ,1. FOUNDATION _ TWO .REQUIRED -T D P ~× CAVATF-- P fOU ,F '7'o/ SUB //? z. sheet q · , ~ , ...... ,.-,~,~.~ _, 4. FINAL . CONSTRUCTION MUST BE COMPLETE FOR C. O ~,LL ' CONSTRUCT ON SHALL MEET -~-.--~;~I' ~ .~___ .. ,. : ,, ,'~' THE REQUIREMENTS OF THE N. ¥. ;, ~TATE CONSTRUCTION & ENERGy . ~.~,'. ~.,, NOTED 4 PM FOR TNI ' INSPECTIONS: $ ~OR POUR~ DESIGN OR CONSTRUCTION ERRORS, USE'IS UNLAWFUL coDEs. ~oT RE,~ON,,~LE Fo~ L.j J !1: . ,FT~ ¥ ,bP---,FT V, , :' -- ............... . : ~M-TO 4 PM FOR THE -t : "~, , ~ FOLLOWING INSPECTIONS: ? . ,l. FOUNDATION . TWO REQUIRED ~,. * ' FOR POURED CONCRET~ ' ~' ~'~' ~ ' ~" ": ~ 2. ROUGH FRAMING & PLUMBING ' - "~,." 4. FINAL . CO~TRUC~ION MUST .- BE COMPLETE FOR C. O. '" A~ CONSTRUCTION SHALL MEET , ,' . ,: . ~ .~ ,~---~.~ ........ , ,, , . ~',* ~" . .: . : . THR 'REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY I F / ~ ~ T ~ o. ~o,~.c~,o, j o ~ '"" '"" WITIIOUT CERTI~ICAE ' ~ : ' ,, ,, , ,i - : ' -~ ~ ~.~ ~~---- ............ , ,,~,, ,' ,,, , , , ~' , OFOCCUPAt~Y ..~,. ilL4~ AT,Io.M ,l~ LAkJ