HomeMy WebLinkAbout10003-z s7o Na a
TOWN OF SOUTHOLD
BUILDING DEPARTNM
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. . Z9514 . . . . Date . . . May. 5•. .1979 . . . . . . . . . . 19. . . .
THIS CERTIFIES that the building located at . . .1220 Greenhill Lane. . . . . . . . . . . . . . . . . . . . . . . . . Sltasioo�
Map No. . .5234. . . . . Block No. . . . . . . . . . .Lot No. . . . . .139
. . . . . . . . . . . . . . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in,this office
dated . . .Ootober . .26 . . . . .. 19.715. pursuant to which Building Permit No. 10,,003Z
dated . . . Ontober. . .31. . . . . . .. 19.78., was issued, and conforms to all of the require.
ments of the applicable provisions of the law. The occupancy for which this certificate is
Private One Family Dwelling
issued is . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . . . George & Li
. .11i. . . .an. Levendis. .. . . . . . . . . . . . . . . . . . . .
(owner
of the aforesaid building.
Suffolk County Department of Health Approval . 8-50-130 April 27, 1979
t26b&rt"A. - Vjila" . . . . . .
N430153
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . .1220. . . . _ . . Street . . . . . . .Greenhills Lane
Greenport, New York
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. . B ! .� br
. . . .
B
County Tax Map Number
1000-33-3-5
FOEM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 10003 Z
Permission is hereby granted to:
pursuant to apl~cation dated ......................... f~'""/~:~' .........., 19~O~;~.;:and approved by the
Building Inspector.
......
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southoid, 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:
I. 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing a{I property ~ines, streets, buildings and unusua~ natura~ 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.
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 .... /.. ~. ................
New Building ....~... ..... Old or Pre-existing Building ............ Vacant Land .............
Location of Property . /~. ~.~2 ....... .~..~..~.~.~/?. · .z/~/~ .~..../~'~'~./c?~~· ..... .C~i,~.~/~°, ,/°,,~, ~ ....
House No, Street Hamlet
Owner or Owners of Property ,.. '~'~ ~/,'~ . ~ ./?~..L~./xq4?... ,/.~../~.U././.~/~. ...................
County Tax Map No. 1000 Section ............... Block ............... Lot..,~..'~.. ~. ........
Subdivision.. ~./~.,~.'.~_,~'~/.2~/.. ~_~.~Z,7~z~,/~_~~. ....... Map No, .~.~..'~.~. .... Lot No ...............
Permit No. ~L2. ,~.~. Date of Permit .,/. ¢,Z//~/~.Applicant . .
Health Dept. Approval . ,. ~.~.; .~.O..-.--.x/,'.~.~ ..... Labor Dept. Approval ........................
Underwriters Approval .~../~. L~).~'.J~. ........ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .... ~ ...............
Fee Submitted $ ..... ( .~,~..o..~. ................
Construction on above described building and permit meets all aj~plicable codes and regulations,
Applicant ...... ~~,., ..................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
eb BUREAU OF ELECTRICITY.
85 JOHN STREET, NEW YORK. NEW Y ORK 10038
Date April. 16, 19T931 Application No.onfile 003a0U N4111173
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the promises of
George Levendia, E/8 Green lail L•.nes 235t N/0 Inlet Pond Rd, , Oreenport,
in thefollowing locatio � aelrpent st Ft. ❑ End Fl. L0t#139 Section Block Lot L,I
was examined on n pri `g 1 � and found to be in compliance with the requirements of this Board.
OUTURE EC@TACl6 SWITCMES RXTURlS RANGES COOKINO.DECKs OVENS DISH WASt1ER5 EXHAUST FANS
OUTLETS INCANDESCENT FwORESCEM v AMT. K.W. "T. K.W. AMT. K.W. HAT. K.W. AMT. H.P.
19 36 19 19 1 11e5 3 '�
DRYERS FURNACE MOTORS FUTURE APPUAW-11 FEEDERS SPKIALRECPT TIME CLOCKS BELL UNIT NEATlRS MULT14MM DIMMERS
AMT. K.W. ON. H.P. GAS H.P. "T. NO. A W.G. AMT. AMP. AMT. AMPS. TRANS. AMT: M.P. NO.OFSYST FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R v 1 C E
AMT. TTPE METER 1$CW 1,!3`N t X 3v/ S.e lW �. CC COND. A.W.G. NO.OF HIAEG AF W.G. NO. NEUTRALS A.W.G.
EOUH. PER! OF CC.COND. OF NIIEG OF MUTRAI
1 10 CB X 1 2 x
0T03rdffs:peteator
1-GeFeCale
Coram Elea*
Route 112 Box 242
Coram, L.IoN, f, 11727 Lie: 733-E MANAT R
Il F
Per
This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified b their Oredentials.
COPY FOR WILDING DRPARTMENT. THIS COPY OF CSRTIFICATS MUST NOT BE ALTI UID IN ANY MIMMIL
TEL.
TOWN OF ~OUTHOLD
OFFICE OF BUILDING INSPEOTOE
TOWN OLERK'S OFFIOE
SOIITHOLD, N. Y, 11971
I~O~,M[ ~0o 1
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exam,ned .................. ....... p,ieat,on ........
praved .................. l ' ermit
Disapproved a/c ....... ~ ~ .............................................................
...................... ....................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ........ ~........~......~. .............. , 19....~.....~...
INSTRUCTIONS
o. This application must be completely filled in by typewriter o~ in ink and submitti~d ~in triplicete 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 ofproperty must be drawn on the diagram v~hJch JS part of this application.
c. The work covered by this application may not be commenced before issuance of I~[lildJng 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 port 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 oil 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 o corporation}
............................... iX~i~'~ ~:~'~ii~;f~i ..............................
State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, e]ectrician, plumber or builder.
...........
Name of owner of premises .................. .~./~.X.!.f~.~./.~.. ....... ?....~..;.!t!:.~./../..~.('.~. ....... ./.7.~'~..~.,.~.?...~.../.~,~. ....................... ~ .............
If applicant is a F,~:l~te,~ignature of dul~uthorized officer.
(~/(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
1. Location of land on which proposed work will be done. Mop No.: ....~ .............. ..~..~,.. Lot No...../..~..~.....~.. .........
Street and Number .......... .~.,~.. .................. ~.. ......................... ~ .................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy .................... ..~....~..~.'~...../?....~..........~....~...,/'~...~. ...............................................................
r; ~- ..................... ~..~././.~-~ Z)...~X..~..~',~'~ ..
b. Intended use and occupancy ..................... ~...~..
3. Nature of work (check which applicable): New Building.. ......... Addition .................. Alteration ................
Repair .................. Removal .................. Demolition .................... Other ~rk ....................................................
(Description)
4. Estimated Cost .......... ~....~ ........................................ Fee ..........................................................................................
(to be paid on filing this application)
5. if dwelling, number of dweNing units ........ ?.. ................. Number of dwellin~ units on each floor ............................
If garage, number of cars .................. .~[ ................................................................................................................
6. If business, commercial or mixed occupancy, specify natgre and extents,of each ~pe of use ............................
7. Dimensions of existing structures, if any: 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 ......... ~.~.~.~. ..........Rear ....... ~.:~.... Depth ..~.~. ..........
Height ....~ ....... Number of Stories ..............~ ..................................................................................................
9. Size of lot: Front ........... ~.~ ............................... Rear ........... ~.~ ..................Depth ~.~...~ ............
10. Date of Purchase ......... ~4~.~.....~ZZ. ....... Name of Former ~,er ........................................................
11. Zone or use district Jn which premises are situated ................................................................ , ....................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ............ ~..~ .................................
13. Will bt be regraded' ......~ ........... WiJI exce~ fill be removed from premises: ( ~Yes ~
14. Name of Owner of premi~ .'....~.~.....~.~. Addres~::~..~:~.~.~'.~h~;ne ~:.~= ......
Name of Architect .............................................................. Addre~ ................................ Phone No .......................
Name of Contractor ~.7~.~.~....~¢~.~....~ ......... Address
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from
...... prope~y lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF N~W Y[ ~)~l~,~/, ~.~ t.S.S
................. ..~'....~.~..~..~...~..~.?..../~/..~'~.~ ............................ being duly sworn, deposes and soys that he is the applicom
(Name of individual signing contracf)
above named./~z~~
He is the .~..~.~.~~ ........................................................................................................................................
' ~ (Contractor, agent, 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 thebest of his knowledge and belief; and
tha~ the work will be perf~ed in the manner set fo~h in the application filed therewith.
Sworn to before me thisx
.
Not~ Pub~~~,~~ ...................... :.:~: .............. -,...; ..................................................
~ ~ ..... ~ .~~- - ' / (Si~n~tur~ of oppli~onf)
/ -. -._.- .��.. .! _eSe✓vices 1 _"-- --- _
t'11� ��er s/fi�irove! o�' won.-.f✓..�-fien ea/yr. � — �� _ (�i= .
x.we AZOJ(W
WZW WVAM
F/. S. .E6 I✓O. .- __ - ; C.`..0. LJ/�/ .� I
/AY
Afb� 2*11-,003 MAP c PeC�PeI7TY
F0'N SNAIL
' a. TT T
M G2EENPC� T
L T 13�3 _____ _- ,iOc J rkCX ra fV_Y
�YecorifJ Georges ¢ LiJ/pan 46YQK013
2S/9 33ed ,St.
zsz-s?+r-7f6i
j i lI O Gt+� Z s Scale c 40 /..
ilk
I y LOT ! 9
X. d
� � t IJolr : t..eff t'ra,+�,brtrrr shown /�e fer- fo
bit, enle rK - 5*c*sl"
' � 7 i�lQ'p t � _ , y� J 0 f t loot �n tlrc 3u�at� Gourrte' G6ev-�$
,j bl"t N �`? off`rcr•u3 Math /Yo.5234.,. �
Disf:.1000y 5eef'.03�,E'�lxk.JJ,C;of'-S
o I T+OL" lvb.Li
u
� I Gtb'�'rrrrlred 'ha fhe.
6Y6fAOkW* 1 Coe+xjncr at� .
t N a su.tier ftd 40t . I
.615
C7rlQ JQ�Lf09G dt.?�OdrP'� � I
50' - .sysfams fer h/s re6/o/erste cui//' car forte: / AOE lZrclG ✓ ?LYl_,PC. 1
I 4 Jo t,the St4HQCO/pS of tti� 6✓ roJ �Count�r J�G' 1Vq _
flf,`?f O� 8'1BG+/lift S ✓/c6$
• �s
c apt
r GH .CVIY f
...� - ✓r,rc s ,. �L..�, �.- Chi>i
i T:O u 1 s A V4",AVok OF. �� ���
ZX
s T:ov cF I:.I E.�:•Yoe STATE
,y �► ll'VVa� ®f doAlOtrtictieM ea/y..
[UuTIQN IAw u/♦ (,col
BE
of to = ID-26 (o d Ca(� . 3
fTi GLA CF T CR G L c J
T E SVD T R ' m. S. Q`�. ��. . J��.,�3V '
GOES D S n 1 T BE A Vs _ ':D..".ED + {.{./PV S.1 : • '�_. /�-- _ j E (F I.At� l.jR��/�/[PYK.�. Tr�iG. ! jy
Ly TO f 4! I RUN
IIL SUR f 41'� �� rvpw
IS R0.E A E A la •T�T,fi ?. '
iME OGId S Y N V \A .y/��((/�'���//.�� y�r^' /I jE'^^y` (/�++�(ppp�q(r) /{
v
E DHE i 1 N 1H Y .. 1+F�uC 0 G �f�'"T1`,/1,� l.�[..� V/i i • Fv`F
T rHE ASS:_..:ES CT iT'E onD !
,R T ION.GUARANTEES A^ �GT T AY( i AT.
i- 10NAl INSTIYUliGAH3 Oil EQUENT
-ENS. VATM Y RrC
J t
08
f�� i f� � ( Gsdrye � 6;/lion Levsadss
Z5.,9 33rd ✓'Y'. .
IP'
K
!39 !
� �• { -�` Q � �ijeef iH tf/M. � Cilurrhf lKw�§
z '
a ► ! � .� • � � �4 olfiCe a�a ArlpEp,eWa.Sz3�f,
1 I, !{� � � �• sR,,�lk.�. -rrrx �e,igrncMxa►,:
�Z �� ' C7voroEr/vaCo( *'n 'Pllet
6. .GryR 19kfi" Aufmm
` os ZWeVft�&d .met i9'W.
r 7*6. 440140r. 0 !y. and o 40 & d1#oso/
rr- sysfsms pwpl An. peolf ante will conl'onr, VAN TLY4 ,P.C. {
to Poke S't4ndurds o�� l hs 6u�r�olk Gourd �. ✓ate---
13.e f' of !-lda/fir Sdr ices
_' 8,93
/T ' SDo tC TCef{ ��-�nT .. ✓vJ Cd.a ; _ _. _ __ _. _
• e.
COPIES Oi THIS SURVEY MAP OT BEARING 1/ y /QOY O I"bVOI Of �ansfruc-lien oAr/ i t THE 1A10 SURV YOR IN�iD EAL 0I
EMBOSSED SEAL SHALL NOT BI CONSIDERED / - 1
70 BE A VALID TRUE COPY. �-
GUARANTEES MDICATED HEREWjN SHALL RU 1 /�/.
1 ONLY 70 THo YED ON HIS 4ALF THE 5U ET y6a y._`__a} ✓Oy0/ 9 /� ���
TITLE
PREPARED.AND ON HIS REI�AIF TO t i �J`_ 9 -- I IAR"'" V,.{^• (� -, i ��-TITLE COMPANY, GOY4RNMENrAL AGEN AND
LENDING NJSbTUlION LISTED H:REON, 0
I i0 THE ASSIGNEES Of THE LENDING TU i
j TUTION.GUARANTEES ARE NQT ERAK! _
TO ADDITIONAL INSTITUTIONS OR
� ��T._ .-_I�� -_l 4 •�WN -,� max..` ♦�
u,
I VG Y ;L '� r.. ,Jr: L.c it.•r:7.
z
I i 3D5 1 � /79.99 �rS � c , , •ri� , :�. , .
I �11
JILI
1 �
Jth 0 Mop rrI T*"rr( ahcrY.l . -...,ct J^
�y SUFFOLK COIRITT'HEALTH DE e 0 1c d "tl rl r
y, �z .. R 2 71979 ��? 4 <Jp
�aTE14P H. D. R
,./�pW s. laldrR #8-so.l3CI
7"'��`{W -Vol
. q supply
i M +t' SutxolL: Co.. '';rx rtila ,' ",�JrcY. ro• i
1 �� s f411! cacti-flies fof /location htjve teen 0511"000, 5ec'f'.037, G'.•x:x
y k : tnspacted by this departmentand found
V rI
o f 4° t 1 to be satisfactory n
1 a.e o �-- =-LET' !•1► Q�
Chief of General Engineering �'
10 = Servia abroR+(>°Ie<��
--
cis
�
r- — so' -_- yrf� " ar r ,tR ram. • car .r.,. 2oormir-x .VAN ?Lv�,r?G.
' A
vie
L icAwxd I-acid sr '. vefy�d'rs J
zxl� J�
Z40* sF Ate. TaaS 6V \ B ilo' 0
_ --- ZaG S.. lbO.l mlllS
\N SU 41�-ct l�
\ N
Q
III
cK I-.tt OVErz 15 FELJ
PtYs coQU I zxSo 4�oo.C,
I
i
— j &v.-TEo "co Fo�ND ATw'
. a
W AVER PR-QF
E F -T -T t u N ( 1 _U 1 H T L 1 _T i o N eE�a �RAUF
J V, �Q
CIA
- - -- - - -
I
I
- AP ROVED AQ/$-
DATE: !O/ 3 NO ED�
_
! : �EE: BY
N OTI Y BEI LDIN G DEPARTMENT i J AT
6
t I 7 - q0 AM PM FOR kE UI 1 � to 4 Q R,
��-__ _L�L--_�- I�SPEC IONS
LPL L_ _ _—_.�
2. FRAM GISTARLIiNti-"MING DA-
_ START FRAMING
- - ---- _ INSPECTION
3. BEFORE COVERING PIPES OF ANY KIND
A. FINAL WHEN JOB COMPLETED
NOT RESPONSIBLE FOR DESIGN
--T-- - L L �� F\ �" ` ".� ;\,� i OR CONSTRUCTION ERRORS
5, ALL CONSTRUCTION MUST MEET
S�ta�-F -G REQUIREMENTS OF N.Y. STATE CODE
AND TOWN HOUSING CODE & ZONE r,
i
RE. NO. 4 4 c:)
DRAWN BY DATE `( joy 1
OF
CHECKED BY �, GATE �
c
Zl -O
rGRc \-A ,
I
71 sltiu. I 2e
Zp _I��)) 10-0 .I�--. -- - .STov_ - � �F—D �M � 1✓ N -- CD
! INS
0.E E.
x�
g
D a 'x m
o �
O �: F�• �iEnOF"K `O �rL2e-1-9'�. N \D
6
—d-i �2�
pOWpl M I ennRE.02 - I -N 1
0
UP
A "A,- FRG wAtiti _" 1 1 10� O < n
a
X �
0
I
4°x 4 4oX 34
Lo
I.__
I
I I „
I
11
SCALE �n= 11-o
RE. NO.
T
DRA N BY L, N DATE �I )'j Z Of
CHECKED 8Y I DATE
f s
I � I
i
4 54 q 6 111
i
PIEFS l'J 6RPDE ' 1
t
IPA 1CO
4 2 x 14' 2B>t 14
m _
_ N- U Z _
I r+ -
C z 0 , � ' -- - - �
�-ram
i
i � - T
A -zx + co 0
N qq(9 3%" V.-a,o-y c.ol.ins,
UP [. - - z ,� ix 12 Pc FTC,
I — -co
a - —
`fl G - wn I 51LL T"401
� �9I gori
i f � I Fttc ; -conPA'<T EoiR Sl.q(3
2'9x 1�
�o V nJ D A i 1 c) hl I �/i A N
SCALC_ 1 '._ r—On
4 — 1
RE. NO. q
DRAWN BY FL�
r CHECKED BY DAIS