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Home My WebLink About12819-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17873 Date MARCH 22~ 1989 THIS CERTIFIES that the building Location of Property 4690 BERGEN AVENUE House No. County Tax Map No. 1000 Section 113 Subdivision AGRICULTURAL STORAGE MATTITUCKr NEW YORK Street Hamlet Block 07 Lot 2.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 13~ 1983 Building Permit No. 12819-Z dated JANUARY 3, was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is AGRICULTURAL STORAGE BUILDING pursuant to which 1984 The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED WILLIAM A. LINDSAY~ JR. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12819 Z Permission is hereby granted to: ......... ~ ................. ; .......... ~; ........................... Z~..~.. ...... ¥~?~ ......... ~~......~: ....... ...... ,~/~./..../..d/..~:~./..:~=...,~.t~:.: ................ ro ........... /~,.,~....~.~ . .~(.~../,~./../~...~.~,~Z ..[~ .~ .............. / / ...... .~.~.~:../. ~.~.~:~!~ ............................. at premises located at ....... .~;/~'..~ .......... ~../~..-.~/~?~/.~....~/~./~.,~~/ ........................................ .................................................................................................................. ./:.~.2~.z:~.~.~...,&~..~..~..t~~ County Tax Map No. 1000 Section ...Z../..~.~. .......... Block ...(..g.....~.. .......... Lot No. ~..~.~-../.[.. pursuant to application dated ..... ~..~ ....... .~'..~ ................... , 19Z..~. and approved by the Building Inspector. Fee $..,/..,%).....~ ...... Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN BALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Locatio. of Proper.....'/.~. 7.~ ............. ~..~.....~:.. ..... ~f~.~< HOUSE NO.STREET HAMLET Owner or Owners of Property County Tax Map No. I000 Section //3 Block ~7 ~_. I Subdivision ....................... Permit No. Health Planning Board Approval ................ Filed Map ........ Lot .......... [~/...-...~ 2~..Date of Permit ...... pplicant .. . .I ~ Dept. Approval .................. Underwriters Approval .............. Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (5 I6) 765-1802 FAX (516) 765-1823 Town ltall, 53095 Main Road P,O. Box 1179 Southold, NewYork 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD DATE: RE: BUILDING PER~IT # 12~1~'3~ s~c. I~ ~LOC~ 7 This Building Permit has expired. violation of the Town of Southold Please contact corrected. LOT Zoning Code. our office, this matter must be 2.1 ill Yours truly, Victor G. Lessard Principal Inspector 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ ] INSULATION DATE INSPECTO~ ~ FIELD INSPECTION FOUNDATION DATE COMMENTS ADDITIONAL COMMENTS: .... ,~'_.~ (1st) FOUNDATION (2nd) FINAL ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ?DE TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765.18o2 This is ro advise you Chat the job under buildlng permit no. 12819Z issued Co William Lindsay on 1/3/84 for Storage is completed a f'i~;~Y--~-~-~tion has ( ) has not ( x ) been done. and tn order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to thn above office with a check for $10~00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or u,~e is un]awfnl without a Certificate of Occupancy. I'leaae help u~ to clear up this~ matter so that leg~l action doen not bare to be taken. Thank you for y(mr prompt attention. Very truly y~, Victor Lesssrd Executive Administrator VL:gar encl. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. &.~: .... ^ proved Disapproved a/c ............... ~..'~'"~. ....... ~.~ .~....; (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 this 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 inspectior~s, , ~ /;7 ....... ./. /- .4 ;= . ./. ........... (Signature of)applican~or name,/ff/a~c.,orl~oration) ..... ...... , (Mailing address of applicant) State wheT)?plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· -------- ~ Or,~..~. ~.~e.%, ............................................................................... Name of owner orpremises ..... .~..)/(/../glt~O... '~.~:~.'~..,/.-?. './.~/~.-... -~f/.'~- *~./~/'~ ./'. .......................... (as on ff~e 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 License No ......................... Electrician's License No ....................... Location of land on which proposed work will be done .... .~. q~. *..~Y ·. · .&X¢..~.~.. · .( '~v~.'.-.~ .~. · ............ .. ............................ House Nm~er~ ~ ~-~. Hamlet County Tax Map No. 1000 Section ~ I ~) Block ~ Lot Z ~ ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... ' .............................................. b. Intended use and occupancy .......................................... 3. Nature ofwork (check which applicable): New Building .......... Addition .......... Alteration .......... Repa/r .............. RemoVal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost .......... i...~ .............. Fee ............................. i (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... 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..-~..... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ...... ~..c2 ...... Rear .... .~.-.e? ....... Depth .... ~t7 ........ 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viol'ate gny zoning law, ordinance or regulation: .......... . .................. 13. Will lot be regraded ......... i,J.~.d. . . . Will excess fill bo removed from premises' Yes 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 aumber or description according to deed, and show street names and indicate whether interior or corner lot. r STATE OF NEW. YORK. COON ,0~c-htr ~6 C..~,. . · TYO .... ~ ......... ~ , L' - ....... ~,.w ..... ~.,~ .................. being duly sworn, deposes and says that he is the applicant ' (Name of individuaI sggning contract) above named. He is the o (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file ~is application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~n~r set forth in the application filed therewith. Sworn to before me this .................. day ......... Nota, Publi~~: .... - ~ 0