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Home My WebLink AboutZ-23201 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23201 Date SETEMBER 8, 1994 THIS CERTIFIES that the building ONE FAMILY DWE ING 1660 ARSHAMOMAQUE AVE.& Location of Property 25 HIPPODROME DR. SOUTHOLD, 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 HERMAN K. & ELIZABETH M. LIEBLEIN (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 *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspec r Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION• 25 HIPPODROME DR. -& 1660 ARSHAMOMAQUE AVE. SOUTHOLD, N.Y. number & street municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) HERKAN K. .LIEBLEIN' &.WIFE OCCUPANCY SINGLE FAMILY DWELLING type owner-tenant ADMITTED BY: ELIZABETH LIEBLEIN ACCOMPANIED BY:. SAME KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-66-2-31 SOURCE OF REQUEST: ELIZABETH M. LIEBLEIN DATE: 7/28/94 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME # STORIES 1 # EXITS 2 FOUNDATION CEMENT BLOCK CELLAR FULL CRAWL SPACE. PARTIAL TOTAL ROOMS: 1ST FLR. 7 2ND FLR. 3RD FLR. BATHROOM (s) 2 TOILET ROOM (s) UTILITY ROOM PORCH TYPE FRONT PORCH DECK DECK, TYPE PATIO BRICK SIDE (ROUND) BREEZEWAY 'LIVING AREA FIREPLACE ONE GARAGE ONE CAR ATTACHED DOMESTIC HOTWATER YES . TYPE HEATER ELECTRIC AIRCONDITIONING NONE TYPE HEAT OIL WARM AIR HOTWATER YES OTHER: OUTSIDE CELLAR ENTRANCE ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. . OTHER: ALUMINUM SCREEN AREA OUTSIDE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY(44 DATE OF INSPECTION JULY 29, 1994 TIME START 1:40 END 2: 10 Form No. 6' p . C� � C� OdC� TOlm OF SOUTHOLD BUILDING DEPARTMENT JUL 2 81994 R 'TOUN MALL 765-1802 BLDG.DEPT TOWN OFSOUTHOLD . APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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- ' 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. B. - For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings- and "pre-exSSEing" land uses: 1 . _Accurate survey of.-p-roper_ty 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. 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. (12 Certificate of Occupancy on Pre-existing Buildine - $100.'00 . 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.002 Commercial $15.00 Date . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. .XXXX. . . . . . . . . . . Location of Property. . . 25. Hippodrome.Drive. �. ) ��Q Q. .(*s6 �mo M9 9U4 �AU�:. • . • • . House No. • . •Street Hamlet. Onwer or Owners of Property. . . . . . Eiizabeth M..Lieblein County Tax Map No 1000, Section. . 966:00 . . . . .Block. 02:00. . . . , , ,Lot. . ,Y31:000 : . Subdivision. . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . ... . . . . . . . . . . . . . . . . .. . Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . 41 Planning Board Approval. . . . . . . . . . . . . . . . . .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. �.. . . :. . . Fee Submitted: . $. . .100..00 . . . . . . . . . . . . . . . . . . . Q,�•c,�{�3y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IrtWNTU ABETH M. LCvL.23a o/ ti,. N 1J�O R o' s o � A tS� 0 �� 0 0� moo. 10 PO \A,P a' 6p Q � { o^ ,pa to f�er, j- 0 P A'0 �P 9 \ 8 2 � O �01 ;de . -A0 0. ,2o roo vol on SUR VEY OF LOT 3 BLOCK 7 "MAP OF BEIXEDON ES TA TES" MW MAR A 60 FW NO M72 A T ARSHAMOMA QUE TOWN OF SOU THOLD SUFFOLK COUNTY, N. Y. 1000 - 66 - 02 - 31 Scale: 1" - 30' July 20,1994 CER TIFIED TO, �g��ME THOMAS F. CA TAPANO ROSL YN SAVINGS BANK �, y ADVANTAGE ABSTRACT �1 0.496A OF NE`�y ANY AL 7ER4770N W AWM4V r0 TW SLRVEY I4 A,VUA 170W OF SE'C7)W MW QF nE wr Yaw STATE m=nav LAI / E WT As PER SE'CM 72109-SUVIPM 2 ALL mumbw N.Y.S. L IC. NO. 49618 mwaV AW VAW FAR 7W YAP AM ass 7 MOEAF CM Y F SW MAPspa i,oaEaM PECONId §&PVEYORSj P.C. ALti17MUY TO aWEY M SW ur nE MW•ALTM er (516) 765 - 5020 Awr BE LW BY ANY AND ALL SUM TM UTLOW A COPY P. 0. BOX 909 OF AM 7MW gRVEYaP's YAP. MW SM AS WECW AND MAIN ROAD BWWff-Wiw7rAIE Nnr N auu Nx mm nE LAk SOUTHOLD, N.Y. 11971 94 - 237 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001433 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date AUGUST 10,1994 Application No.on file 06242694/94 N 323287 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of MRS. ELIZABETH LIEBLEIN, 25 HIPPODROME DRIVE, SOUTHOLD, N.Y. in the following location; ® Basement ® I At Ft. ❑ 2nd Ft. Section Block Lot was examined on AUGUST 08,1994 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 1 30 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP T METER 1 g 2W 1 0 3W 3 6 3W 3 0 4W NO. CC.COND. A.W.G. NO,OF HI•LEG A.W.G. NO.OF NEUTRALS A.W.G. EOU1P. PER B OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: PANELBOARDSa1-6 CIR. 100 ELEC. WATER HEATERSttl-4.5 K.W. f THOMAS J. BALL P.O. BOX 1708 SOUTHOLD, NY, 11971 GENERAL MANAGER ii, rr C' Per 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. COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 2 g 1994 I�)1. CONSENT BLDG.DEPT. TO TOWN OF SOUTHOLD INSPECTION ELIZABETH. M. LIEBLEIN - the undersigned, Ovmer(s) Name(s) do(es) hereby state: That the undersigned (is) UIPM the owner) of the premises in the Town of Southold located at 25 Hippodrome Drive, Southold, New York which is shown and designated on the Suffolk County tax map as District 1000, Section 066.00 , Block 02.00 Lot 031 .000 That the undersigned (has) ) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on Pre-existing Building That the undersigned doles) 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 Southold. 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 vio- lations. of the laws, ordinances, rules or regulations of the Town -f Southold. Dated: _ c (sfghatutki ELIZABETH M. LIEBLEIN (print name) (sijznature) (print name)