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Home My WebLink About16281-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-18150 Date JUNE 28¢ 1989 THIS CERTIFIES that the buildin~ Location of Property 6500 MAIN ROAD House No. County Tax Map No. 1000 Section 038 subdivision ADDITION EAST MARION~ N.Y. Street Block O1 Lot Filed Map No. Lot No. Hamlet 1.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 1987 pursuant to which Building Permit No. 16281-Z dated JTJLY 28~ 1987 was issued, and conforms to all of the re~airements of the applicable provisions of the law, The occupancy for which this certificate is issued is DECK ADDITION & FENCE TO EXISTING ONE FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOSEPH & SUSAN CHEREPOWICH NO42909 - OCTOBER 31{ 1988 N/A ~uilding Inspector Rev. 1/81 · o~ NO. o TO~VN 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) Permission is hereby granted to: ...~.~..~;.~..~....£~d.....~. ~ at premises I~ated at .~.~....~~....~.~'..,. ................................... ................................ ...................... ~o~ ~ ~ ~o. ,000 ~,o~ ..~.& .......... ~,~ ........ Z ........... ~o, ,o..../,....Z ....... Building Inspector. Rev. 6/30/80 TONN OF SOUTHOLD BUILDING DEPARTMKNT TO~N HALL SOUT~OLD, NEW 765 - ~802 ll971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE.o~/~.~/.~. ....... NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Proper . IIOUSE NO. STREET HAMLET Owner or Owners of Property. .. .. . ......... County Tax Map No. 1000 Section ~.. Block .~).Z... Lot' /,Z/. ..... Subdivision ....................... Permit Health Planning Board Approval Filed Map ........ Lot .......... No ......... Date of Permit .......... Applicant ................... Dept. Approval .~/~. ..... ~ ...... Underwriters roval..~/~. ....... App . Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... rev. |0/14/88 FIELD INSFECTION~ FOUNDATION (1st) FOUNDATION (~nd) ROUGH FRAME & ?LUMBINO INSULATION PER N. Y. STATE ENERGY CODE COMMENTS FINAL ADDITIONAL COMMENTS: IGz~l 765-~802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] FOUNDATION ZND [ ] FRAMING REMARKS: ROUGH PLBG. INSULATION [ ~]~NAL INSPECTOR 'FORM NO. 1 TOWN OF $OUTHOLD " ' ' ' ~ ? ~ BUILDING DEPARTMENT · "" ~ ' '' ';" ' .... TOWN HALL $OUTHOLD, N,Y. 11971 TEL,: 765-1803 Exan, ined .?~. ~..7.., 19~. Approved~ .~..'7....l~.TPermit No.I ,d~...~'~ Disapproved a/c ..................................... BOARD OF HE~LT,H ....... 3 SETS OF PLANS ....... SURVEY ..~..~...~ CHECK .. SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: APPLICATION FOR BUILDING PERMIT ~ / __ ,Date. d~/k'...Z.. ?. ...... i9 ~7 INSTRUCTIONS a. This 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 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 oFa 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code,,j~ufiing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i~e2~ ~7_)~ (Malting address m appficant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of prelnises .~to~-.~h .~ &-q~/~,~.. C~.cq~,O~/~.X.' · '~' IP[}~OIqI~D 'AS' I,~.~, ........ " ~' "' (as on tl(e tax roll mlji~ht~.ji~/,4~ ';g~ · · 765-1802 9 AM TO 4 PM (Name and title of corporate officer) FOLLOWING INSPECTIONS: ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED I. FOUNDATION . TWO Builder's License No.. ~ ............. FOR POURED CONCRETE 2. ROUGH .' FRAMING & PLUMS!NG Plumber's License No ......................... 3. INSULATION 4. FINAL_ , CON"STRLcT ON - Electrician's License No ....................... BE CW,,~m ~TE FOR C. O, ALL CONSTR'ICTION SHALL. Other Trade's License No ...................... THE REO~ · S~T_ATE CON'.STRUCTION & I. Location of land on which proposed work will be done ............. CODES . ·. NUT ' -~z · · ./t ............. .... d0~o~, x%;~. _~. ....... F~ ~ r../ffn~,;~,J ..... ?.~J'2N. ,, 7 ....... House Number Street Hamlet County Ta× ~ap No. 1000 Section .... O 3.~ ........ Block ...... / ........... Lot..Z/ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 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 ,,%/4'//'/.~. .~,, , ~ ~ , ~, '* 3. Nature of work (check which applicable): New Building .......... Addition .. Alteration ...... : .... Repair .............. Rem~vai ........ : ..... Demolition .............. Other Work . · :,: .~. ~. . .*l~.~., ~, JJOescrip.tiqn) 4. Estimated Cost ............ 4 ..... *~..' .......... Fee. ~ ~ .f~.~.~. ~.. ' ~ (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................ If garage number of cars ~ 6. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ....... . .......... .... 7. Dimensions of existing structures if any: Front.. :.,,.:~.0 ...... Rear ...'.,.~& ...... Depth .~0. ..~ .... Height ............... Number of Stones :.. ~ ..... ;...'. :'. ...................... .... · ..... . D~ensions of same structure ~ith alterations or additions: Front ... ~Q ........... Rear . .~9 ......... ............ Number of Stories .................. Depth ..... ~ ........... ~.. HeiSt ........ ~ . '-- 8. Dimensions of entire new construction: Front ...... q~ .... Rear ....... ' ........ Depth ........... :. Number of Stories [ ~. Height ................................................................. 9. Size oflot: Front ...... ~..'.. ..... .. ~.... Rear...~..~l. ~}~.:.,....,. Depth .~.~..~.~ .... 'i' 10 Date of Purchase ~ ~ Name of Fomer Owner : 1 1. Zone or use district in which pr~m~ses are situated ..... ~. ~O .......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~ .................... ~ .... 13. Will lot be regraded ..... ~ ...... ~ .... ~ W~I excess fill be remove~ from premises: Yes No 14. N~e of Owner of premises ~O~.~ ~d .~g~e~s~...&~,~.~.. Phone No. ~ 2~O~ .... Nme of Architect ......... ~ ................. Address . . .~3.s.W~ .... Phone No ................. N~e of Contractor I Address .... ; .............. Phone No. 15. Is this property located~within 300'feet of a tidal wetland? *Yes ..... No ~... · If yes, Southold Town TrUstees Permit maybe required. PLO~ DIAG~M Locate cle~ly ~d distinctly ~i bulldogs whether existing or proposed,~.~dicate ~1 ~t-back d~ensionslfrom property Hnes. Give street and blocE number or description according to deed,~--~---~ --.--~g~ nines and indicate w~ether STATE OF NEW YORK,. S.S COUNTY OF ................. , being duly sworn, deposes and says that he is the applicant (Name of individual sighing 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 ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this · ............ .... Count No, ~a.!~4u~ . ~*-/" (Signature of applicant)' Quelifl~d Cemmlstienl ExpIrel Aplrl!