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Home My WebLink About12930-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z ]5140 D. ece. m.b. er. 2.9. 198.6. NO ............. .. . .. Date .......................... . THIS CERTIFIES that the buffding ..... A.c.c.~qr.~ .................................. '. Lo tion of P or rty ! ~..7. ~. L.A.N.D.S. END ROAD ORIENT ca r e ................................ . ...... . .............. House ~vo. Street Hamle~ County Tax Map No. 1000 Section 015 B1 9 [ 9. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Mar. 6. 19 .8.4 pursuant to which Building Permit No 15~93Q~ ....... dated. .~ar... .. [4_..-. · · · · · .. · · · · · -. -. 19.8.4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued i~ ......... ROBERT 3 ~lq~.s The certificate is issued to ............. - ........................................... (owner, ~~XX of the aforesaid building. Suffolk County Department of Health Approval ................ ~/.A. ....................... UNDERWRITERS CERTIFICATE NO ....................... ~/A ....................... Rev. 1/81 FOEM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~o z .... .~.:~ ............................................. , ,,.~..~! Permission is hereby granted to: ~ C~/'~'~'~/I ~' ~/t , c~ ,o....~~~......~. ...... ~;~~~ ........ ~.~~..,..~ ............. ............. ~'""F'"'~ ......... ~) ................ J;"""' :'"~"'i ....................... : ........................... County Vox Map No. 1000 Section ...... ~.!..~.~. ......... Block ......... ..~. ......... Lot No ....... I.!..~. ........... pursuant to application dated ..... ..~.~\....~.. ......................... , 19.~.~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 APPLICATION FOI~,M NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 FOR CERTIFICATE OF OCCUPANCY Fleceipt No. 31013 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Southold, New York 11971 ...... .................... Fee for Fee for Fee for rr.~.~t~flcate [] Yard Sale [] [] [] H.'.C. [] Building Permit L~ of Occupancy [] Misc. ng nd nd For ral Date .: .............................................. Garage New Building ....~ .......... Addition ................ Old or Pre-existing Building ................ Vooant Land .............. 1275 Lands End Road, Orient, N.Y. Locotion Of Property ..................................................................................................................................... Owner Or Owners Of Property ...~..o.~..e.~.~....5.;...,~.?,..c.~?, .................................................................... , ........... Subdivision Lar',d S ~nd L-t ~"- 1.9 Block No. 9 ................................................................ u ~u ......................... House 3/14/84 Heidtmann & Son, Inc. Permit No. 12930 Z Date Of Permit .................... Applicant Health Dept. Approval ............................................ Labor Dept. Approval .......... ....... i .................... :'"'" ...... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........... ' ............................... Fee Submitted $ ........ .5_...0..0. ................... ' Construction on above described building and permit meets all oppl cab e codes and regulations. ApplicatOr Glenn F. Hetdtmann & Son, Inc. Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County 765-X~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS: ~~'~ DATE INSULATION PER STATE ENERGY qODE FINAL FIELD ~NS?ECTION IDATE !1 COMMENTS FOUNDATION ( lst~ FOUNDATION ( ~d) ADDITIONAL COMMENTS: "FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-160:3 E×amined .... , Approved . ...~ ...... Permit ...... Received ........... ,19... DisapproYed a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date March 6 19 84 INSTRUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted 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 tins application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 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 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections· Heidtmann & Son, Inc. (Signature of applicant, or name, if a corporation) · .~, .o.,..~. 9.x.x...9 3.2.,..C.u.~.c. bpgu .e ~..~., y.... ! .~ 9.~.5. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Nameofownerofpremises ..I, Jr, Robert Hicks ................................ (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. 10 Plumber's License No ........ .M.: . pp.h. ql ........ Electrician's License No. Rober~ Guerello Other Trade's License No ...................... 1. Location of land on which proposed work will be done ......... [L.a.n..d~..~ .n.d.,...OT.i.e.n..t .................... / ............ ............................. ~. O.n.d.s.. F,.n.4. !~.o.~ d. ........................... House Number Street Hamlet County Tax Map No. 1000 Section 015 Block 9 Lot .~ Subdivision Lands End Filed Map No. 5909 Lot 5k~y, (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Single Family Dwelling b. Intended use and occupancy G~rage 24 ' xx .B.Q, . o 10. Il. 12. 14. Nature of work (check which applicable): New Building Repair .............. Remqval ............. Estimated Cost 11 ,!000,00 property lines. Give street and block interior or comer lot. See att ached x 'Addition Alteration Demolition .............. Other Work ............... ~,~ (Description) ...... Fee . ~.1~ . .0T-CO. ............................. (to be paid on filing this application) If dwelling, number of dwelling units .............. Number of dwelling units on each floor ................ If garage, number of cars ...3.i .................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dmaenslons of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stones.. .......... . ............................................. Dimensions of same structure width alterations or additions: Front ................. Rear .................. Depth , Height Number of Stories Dimensions of entire new construction: Front ....3.0 ' Rear 30. '. . Depth 24.' Height ....... .1.~.' ..... Numlber of Stories .................................. Size of lot: Front . .2.1..1.' ..... i ......· .... Rear..2.~..[.' ............ . .... Depth ~['9'01 ............... ':"i: .............. Date of Purchase ...... i .................. Name of Former Owner .......... Zone or use district in which pr~mises are situated ..... .R.e.s.~ qI .o.n.~ ~. a..1 ................................... Does proposed construction viol~ate any zoning law, ordinance or regulation: ...n.q ........................... Will lot be regraded Y.e~ ...... I ......... : ......... Will excess fill be removed from premises: Yes NS Nmne of Owner of premises . . .It.o.b.e..r.~.. H..~.c.k. ~... Address ................... Phone No ................ Name of Architect )^.7~ ~ 77.m..b~.c.h. .............. Address ..... , ..... Phone No ... - He~Ldtmann & Son, I c. Cfiuhl/ogfi'e ......... Name of Contractor ......... : ............. w... Address ................... Phone No .......... PLOT DIAGRAM Locate clearly and distinctly allI buildings, whether existing or proposed, an& indicate all set-back dimensions from mmber or description according to deed, and show street names and indicate whether survey. STATE OF NEW YORK, COUNTY OF ................. ............................. 1 ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... j ................................................................... (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 ha 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 .............. ~...1~.. .... day o~. ~..~B~... .......... , 19 .~.'7 Notary Public, . .......................... Co HELt:N K DE'I!OE NOI'AF/Y PUF~LIC, State of New Yo~ ' ' No, 4']07878, Sulf01k Cotl,tw ~ (Signature of applicant) T~rm £×p~rea Ma{',h 30, 1~,~