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Home My WebLink AboutZ-23201FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PI~ EXISTIN~ u~TIFICATE OF OCuu~ANCY No Z-23201 Date SETEMBER 8, 1994 THIS CERTIFIES that the building ONE FAMILY D~I~ING 1660ARSHAMOMAQUEAVE.& Location of Property. 25 HIPPODRO~ DR. SOuT~OLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 66 Block 2 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23201 dated SEPTemBER 8, 1994 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 * The certificate is issued to ~ K. & ELIZABETH M. LIE~?.~IN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-323287 - AUGUST 10, 1994 PLUMBERS CERTIFICATION DATED N/A *P?.~%SE SEE ATTA~/~D INSPECTION REPORT. Rev. 1/81 - Building Inspe/r LOCATION: 25 HIPPODROME DR. & 1660 ARSRAHOHAQUE AVE. (number & street) SUBDIVISION MAP NO. NANE OF ONNER (s) HEI~iANK. LIEBLEIN & WIFE BUILDING DEPARTNENT ToWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT SOUTflOLD, N.Y. (municipality) LOT(s) OCCUPANCY SINGLE FAMILY DWELLING (type) (o~ner-tenant) ADMI'I-r~D BY: ELIZABETH LIEBLEIN ACCOHPANIE~ BY: SA[~ KEY AVAILABLE SUFF.CO. TAXMAP NO. 1000-66-2-31 SOURCE OF REQUEST: ELIZABETH M. LIEELEIN DATE: 7]28]94 DNELLING: TYPE OF CONSTRUCTION FOUNDATION CEMENT BLOCK TOTAL ROOMS: IST FLR. 7 BATHROOM (s) 2 PORCH TYPE FRONT PORCH DECK BREEZEWAY LIVING AREA DOMESTIC HOTWATER TYFE HEAT OIL O~I~R: WOOD FRAI~ ~ STORIES I [ EXITS 2 CELLAR FULL CRAWL SPACE PARTIAL 2ND FLR. 3RD FLR. TOILET ROOM (s) UTILITY ROOM DECK, TYPE PA_T~O BRICK SIDE (ROUND) FIREPLACE ONE GARAGE ONE CAR ATTACHED YES TYPE HEATER ELECTRIC AIRCONDITIONING NONE W.a~RH~IR HOTWATER YES OUTSIDE CELI~RENTRi~CE ACCESSORY STRUCTURES: GARAGE, TYFE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTIi~R: ALUMINt~iSCREENAREA OUTSIDE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DATE OF INSPECTION JULY 29, 1994 TIME START !:40 END 2:10 BLDG. DEPT. TOWN OF $OUTHOLD Bo Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to 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. Final 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 or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "PK.e-ex~sting" land uses: 1. .Ac~u[~ 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 0C~u~i~i~i~ denied~-~-~u~i'~-~pector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $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. , Certificate of Occupancy on Pre-existin~K Buildinm - $100.00 '-~. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .................. ~ ...................... New Construction ........... Old Or Pre-existing Building...X~,.~ ........... Location of Property. 25 Hippodrome Drive I ~[~O ~]b..~.~O~_.~..L~...a~.~..~ ........ House No. Street Hamlet Onwer or Owners of Property ...... ....................................... County Tax Map No 1000, Section..P9P~PP ...... Block .... 9 :99 ....... not...9 [ 997 ............ Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant .......... · ................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ ~ Request for: Temporary Certificate ........... Final Certicate.~.X~. ....... Fee Submitted: $ ........................... 100.00 · .............. ~7~ ~)'-~.2 ~ CERTIFIED TO' THOMAS F. CA TAPANO ROSL YN SA VlNGS BANK ADVANTAGE ABSTRACT SURVEY OF LOT 3 BLOCK7 '~144P OF BEIXEDON ESTA 1ES" A T ARSHAMOMA CiUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 66- 02- 31 Scale: 1" = 30' July 20,1994 P~ECONI~~EVE N.Y.S. LIC. NO. z19618 YORS, P.C. (516) 765 - 5020 P. 0. BOX 909 MAIN ROAD SOUTHOLD, N. Y. 11971 94 - 237 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE ~. 1(~14'~:~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date AUGUST 10 ~ ~ 994 ~pplication No. onfl~ ~6242694/94 N 323287 THIS CE~IFIES THAT o~y t~ el~trlc~ ~uipment ~ ~cd~ ~w o~ int~uc~ by t~ ap~i~nt ~m~ on the a~ applicat~n number in t~ prem~s of }fiRS. ELIZABETH LIEBLEIN, 25 in the followlng location; [] B~,ement AUGUST 08,1994 was examined on FIXTURE ,.. fiXTURES I RANGES DRYERS [ FURNACE MOTORS I FUTURE APffUAHCE FEEDERS ISPECIAL REC'PT --'1 "'" I- .o. HIPPODRO~ DRIVE, SOUTHOLD, N.Y. [] Ist Ft. [] 2nd Fl. Section Block and found to be in compliance with the National Electrical Code. COOKING DECKS OVENS DISH WASi~G~$ AMT. K.W. AMT. K.W. UT. K.W. T,..c,O.KS ..,, U.,,",EAT"S '~V~' ~T A~PS. TRANS. AMT. H.P. NO. OF FEET SERVICE DISCONNECT NO. OF S E THER APPARATUS: PANELBOARDS: 1-6 CIR. 1~ ELEC. WATER HEATERSL :1'-4.5 K.W. R V I C E A. w.G. NO. OF HI-LEG OF CC. COND. EXHAUST FANS AMT. H.P. DIMMERS A, W.G. NO. OF NEUTRALS Of Hi-LEG P.O. BOX 1708 SOUTHOLD, N'f, 11971 ~ MANAGE~ 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. CONSENT TO INSPECTION ELIZABETH M. LIEBLEIN · the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) ~l~) the owner(~) ~f the premises in the Town of Southold located at 25 Hippodrome Drive, Southold, New York · which is shown and desifnated on the Suffolk County tax map as District 1000, Section 066.00, Block 02.00 , Lot 031.000 That the undersigned (has)~[~i~) filed· or caused to be filed· an applica- tion in the Southold Totem Building Inspector's Office for the following: Certificate of Occupancy on Pre-existing Building That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all.of the laws, ordinances, rules and regulations of the Town of Sou/hold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for lations of the laws, ordinances, rules or reg'u~lations of the To~vn/of Southold. j~ (s ~gh-atu'~ t ELIZABETH 14. LIEBLEIN (print name) (signature) (print name)