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Home My WebLink About10860-z4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector I own Hall $outhold, N.Y. Certificate Of Occupancy No Z-16347 Datc October 28, 1987 'Fills CERTIFIES that the braiding ADDITION of Pro crt 2505 Bray Ave & 40 Wells Rd Laurel, N Y Location p, y ............ : ................. : ................ :..' ........ House No. Street Hamlet S, 126 9 9 County 'Fax Mail No. 1000 ~ cchon .......... Block ............... Lot ................. Subdivision ............................ Filed Map No ......... Lot No .............. conforms substantially to the Application for Btfilding Permit heretofore filed in this office dated September 9, 1980 pursuant to which Building Permit No. 10860 z dated . S .e p t.e.m, b e r . ! .9, I 980 .... was issued, and conforms to all of the requirements of the apphcable provisions of tile law. The occupancy for which this certificate is issued is ......... ADDITION TO EXISTING ONE FAMILY DWELLING The cert~hcate is issued to ARTHUR & LORRAINE STELLMANN (owne/ , levee or tenant) of tile aforesaid building N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CF, R'FIlFqCATF, NO. N546427 N/A PL[IM?,EI{S CERTIFICATION DATED: · ' g Inspector FO~I ~0. ~ BUILDING D~PART~I SOuTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE P-RE~IS~S COMPL~ION OF THE WORK AUTHORIZED) 10860 Z UNTIL F~ULL Permission is hereby granted to: : V~ATTITIZOI, N.Y. 11 ..................................................... :..?....~ ................. tO ...................................................................................... '""~""~ .............. ........................................ ................... ~ .......... ;"T'": '~o~ ~ ~.~ · ~0~ ~. ~ .......... ~ ~.~, ~t promisos IOCOtO0 ot ............................................ ;. ........... ,.?.-~ ................. ~ .................................... ~26 ~ . Bloc~ ?...~. ................ cot ~o ......................... Coun~ Tox ~op ~o. I000 ~S*ction ............. ~ ........ ,44 8~ 9 ~ 19..~.., and approved by the -pursuant to app,ication~ate. .......................... ,..,. ....... ,..,f ........, ~BuiJding ~lnspector Building Inspector. _ ~5.oo Fee ~ ........................ Rev'. 6/30/80 THE NEW YORK BOARD OF FliRE UNDERWRITERS 1.000744 BUREAU OF ELECTRICi, ITY ~,~{) 85 JOHN STREET. NEW YORK, NF.L~/ ¥~ORK ~O03B THIS CERTIFIES THAT in ~he foHowlng loca~ion; ~ ~asemen~ ~' 1st FI. ~ 2nd Fl. Section Block Lot SERVICE DISCONNECT NO. ~ S ~ R ~ V I C a ~THER RPPARRT~ ~OD G FI Examined .............. (., 19 ff~. 9 Approved .......... 7/.t~, 197.~ Pemfit No. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Disapproved a/c ........... -- ~ ......... LL;;~ ..... (Building Inspector) APPLICATION FOR BUILDING PER~tlIT INSTRUCTIONS Application No .................. a. This application must be completely filled in 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 Pel~nit 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 apphcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspect, ors on premises and in bnfldings for neces ' ' . _ (Signature of applicant, or name, if a corporation) . . :':.,r. ./ ;./c. ............ (Mailing address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signaiure of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ 3. ff X~../c ........ Plumber's License No ......................... Electrician's License No ...................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ... C.r . . fi. r: .h. v. . (al..,,. s ........... :. . ........ r./. /. r /.< ..................... House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~..~./..~/1: [.~....~.~. ~. . . ./y .4 7. ./ .% ? ................................... b. Intended use and occupancy ...... .~./)./v.4' ....b. v.~. ~.~497.~/.o?.. ¢...ff~.?.~.~ ......................... 3. Nature of work (cheek which apblicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemoVal ............. Demolition .............. Other Work ............... ~ /~,~r~ ,79' o ~a,: t' ~,-- (Description) 4. Estimated Cost~' ~', .~.~.Q Fee ~.c.C .~. ~..~.~...~..(~..-7. ................. (to be paid on filing this application) 5. If dwelling, number of dwelling finits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front...%g.-?. ........ Rear ...~. 4.'?. ...... Depth. ~.~.: .~ ......... : Height g.L-.q .......... Number of Stories.. ~ .................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ,.. Height ...................... Number of Stories..d ................... 8. Dimensions of entire new constr~ction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................ ~. ............... 9. Size of lot: Front . ./,~.$.'r.c4 ............ Rear ../.-2-~.. r..~. ........... Depth . .~..~.7~ ............. I0. Date of Purchase ........... . .................. Name o. fForm~r-,Owner ............................. 11. Zone or use district in which Premises are situated ........ '~. ) :../~r.~'~-,qx.~.~'~,,U. ~ ................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regmded . .,~d. ~....' ................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ..................... Address ................... Phone No ................ Name of Architect , ........................... Address ................... Phone No ................ Name of Contractor ' Address Phone No 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 number or description according to deed, and show street names and indicate whether interior or corner lot. h) STATL OF NEV3[YQRK, COUNTY OF..')Pr P2v. v.v.v.v.v.v.v.~:. 'P.,~ .)f.-.. S.S :/t t ; , ..... ....... ; ..... ; ........... ~.f~,{,/-.P.. ~.O/~9. being duly sworn, deposes and says that he is the applicant (Name of individual sign. ing contract) above named. 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 the best of his knowledge and belief; and that the work will be performed in the manne~ set forth in the application filed therewith. Sworn to before me this Notary Publi Commlsmon £xp~r~s March 30, 19g~ (Signature of applicant)