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Home My WebLink About13503-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z- 15612 Date April 9, 1987 THIS CERTIFIES that the building ...~,d. d. ~.g.i.o.n., .t.o.. e..x.i.s.t. ~ .n.g. ,shed 3155 Bridge Lane Cutchogue, New York Location of Property ............................................... House No. '' 'S'ttJe~i .... h~r~/ol 085 02 1. I County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 25, 198/4 13503Z ...................... pursuant to which Building Permit No ...................... dated.....0 c t ...... o b e r .2 .... 5, ...198 ......... 4 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 ......... ADDITION TO EXISTING SHED The certificate is issued to HENRY ZANOWSKI ..................... ?o¥.'e;, x ................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N / A N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FOu~ NO. ~ TO~N O~ $OU~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 13503 Z Permission is hereby granted to: ...... .~.~ ....% ~,~ ..~ ....... :.~.1.~....~.....~.,.~....~. .................... ,o .....~<.%.~.~~.....~.......~...~..~k...~..~.&&:~.~.~.:~.. · . ~- ~ ~ . . ot premsses Iocoted at ....~. ............. ~ ...... ..r.;~......L~.., ................................................................... County Tax Map No. 1000 Section .....~.0...~...,~,. ........ Block ....~....~. ......... Lot No..C).J~..~.~..~ ....... pursuant ,o application dated .............. ~.~...~,.~.. .................. , 19..~.~., and approved by the Building Inspector. Building InSl~ector Rev. 6/30/80 .... ~ ~ ION ~ELD ~INS[ECT FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE COMMENTo FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICF. OF BUILDING INSPECTOR ILO. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the-anoSkiJ°bwunder building permit no. 13503Z issued to .~e on ___~5~_7~rr ~ddition-- is completed and o final inspection bas ( ) has not ( x ) been done. [n order to complete th~s file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00pnynblc to the Town of Southold. Please indicate to Whom the. Certificate of Occnpancy is to be mailed, and arrange w~th this office for an inspection (late Occupancy or nsc in nnlawful wlthout' a Certificate of Occupancy. Plense. help es to cl'enr np tl~is mntter ~o that legal ~ction does not have to be taken. Thank yon for your prompt attention. .. Very truly Victor Lessard Executive Administrator VL:gar /{[ll l II I[ I'll Ill I_l II./l II/iFl~l Ill//ill 1[ I~l/1' / i I l(il t ((l~i I I Ill. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:3 ~,pproved .~..~....6~.....~.[.,'~,., 19~.. Permit NO.]. .~...~..0...~.. 9isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by tlfis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Per, nit to the applicant. Such permit ,hall 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 ,hall 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 5uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tdmit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Maili~ address of affplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. ~'C'~X"k(Bk'x"~xr'"\ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .............. · '' Plumber s L~cen No ......................... Electrician's Licqnse No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ftouse Number Street Hamlet County Tax Map ~No. 1000 Section ...0..<~.~ ........ Block ...... (-). ~ ...... Lot....t~..~.~..~. ,~.} ...... Subdivision ............. .~.~..:.. ,, ................ Filed Map No ..... 1' ......... Lgt ............... (Nmnel 2. State existing use and occupancy of prenrises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~....~.C.~ ................. : ................................. b. Intended use and occupancy .......... .~ ..................... 3. Nature of work (check which applicable): New Buildim~ ..... '. · . 'Additiol~ . ..1~ . Al*oro*~,, . .... Repair .............. RemOval ........... ~32 ~Demolition ........ .'24~ 5~ vc3x~ ~ ~1 ~.. ~.~ jg~t --.0~. (Description) 4. Estimated Cost ....... ~.?. 7':~ ........... Fee~... ?..~. [.~. ~.e:~-(. ............. ; (to be paid on filing this application) 5. Il' dwelling, number of dwelling units ............... 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, if any: Front .............. Rear .............. Depth ............... Height Numlber 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 ' Name of Former Owner 11 Zone or use district in ' ~ ' ' · which premises are sttuated ............ 12 D l~t d' ' · ocs proposed construction vie e any zoning law, or manee or regulatmn: 13. Will lot be regraded ......... ! .................. i Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ... i ................. Address ................... Phone No ................ Name of Architect .......... ~ ................. Address .. Phone No Name of Contractor Address ' Phone No ... I PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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 comer lot. .sSTATE OF NEW YORK,. / cou ¥ OF... .......... (Name°filldi~tavfialsigniOgc°ntract) .......... being duly sworn, deposes and says that he is the applicant above named. ~ : He is the .............. (Contractor, agent, corporate officer, etc.) of said owner or owne~, ~d is duly~ authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contai~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth in the applidation filed therewith. Sworn to before me th~ ....... ~-~-..da of. ....... : .... ~8~N~Vo~ S~ ature of a 1 c~t