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Home My WebLink About15924-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No ...Z~5.7~2~... Date .., M~y.~p.,..%gp? ....... THIS CERTIFIES that the bmldlng . .a.d.d.z.'cmon. to..ex.i, st..ing..a, gc.ess. 9.rX ,b..Z.d.g.... Locatmn of Property 30.3~ ....... ?.a.c..to.rx. bv.e... ........ Ma..t.tAt, u..c.k.. . House No. Street Hamlet County Tax Map No 1000 Section . .. 1522....Block ...... 2. .... Lot ....2.0 .......... Subdw~smn ...... X ............. Filed Map No . X ..... Lot No... conforms substantmlly to the Apphcat~on for Budding Permit heretofore filed m tins office dated 15924Z .... Apr ii- 14 ,..~98 Y pursuant to Much Bmldmg Permit No ................ dated...Aprml... ....25 ~ 1987. .. was ~ssued, and conforms to all of the requ,rements of the apphcable provlsmns of the law The occupancy for winch ttus certfficate ~s ~ssued ~s . .. An addztzoh to an existing accessory building. FRANK ZANESKI The cert,hcate is ~ssued to ....... ?own'o~';~f~J~ ............... of the aforesatd bu,ldmg. ' N/A Suffolk County Department of Health Approval UNDERWRITERS C~RT[F[CATE NO. N/A PLUMBERS CERTI7 Rev 1181 rICATION DATED: N/A B mlq.ffig Inspector I~ORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15 9 2 4' Z Date .~.......~...~.~.. .................., Perrmss~on is hereby granted to: ..~...L. ........ ~.~.~. ..................... .....~..~..~.~.~ ............................................... , 0t p~m~,es I~oted ,t _.l...o.._.~.~_..~.S~,~u~..~..:...~~ ........... County Tax Map No. 1000 Section ....~,...~:.,~ ........ Block. ...... ~,.,.~w .......Lot No....,.,~,,,,?. ........ pumuant to application dot~:l ........ ! ................. , 19..~...'~.., and Budding Inspector. Fee $.~..:........~...,...~ i approved by the Rev. 6/30/80 ,/ lei Craft OUNDATIC.~ ( ls t) OU~DATIO~ (2nd) OUGH FRAME & FLU~[BtNG NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIO~AL COMME~TS: FORM NO TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL F, OUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined ~. Approved . .~.'~' .... 19'~"l Permit No Disapproved a/c ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ..~...~ .... CHECK .':~..U~ .... SEPTIC FORM · NOTIFY CALL ................ MAIL TO: Date ....... 19 INSTRUCTIONS a Ttus application must be completely filled m by Wpewnter or in ink and submitted to the Building Inspector, w,tl 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 premmes or pubhc stre or areas, and g~vmg a deta,led descnptmn of l~ut of property must be drawn on the diagram which ~s part of tlus ap~ c. The work covered by ttu~ apphc~ before issuance of Buildm= Permit. shall be kept on the premises ava~0[l~io'~ ql~c~'fi tjl~'~it the work. No building shall be~{l~l o~.~~&O~n part for any purpose whatever until a Ce~fficate of Occupm ehave been granted ~7~t~__~__~.l shall ~PLICATION IS H~~~ ~~ment for the lssu~ce ora Bmlding Pemlt pumuant to Building Zone Ordinance o~~t~Ffolk County, New York, ~d other apphcabte ~ws, O~m~ces ,. constm~~~hons or alteratmns, or for removal or demolitmn, as hereto descnb Regulahons, for the The apphcant agrees to com. p~~~~l~[~ hw~,~ord~nances, bu~dmg code, housing code, and regulatmns, ~d admit authorized lnspecto~ or ~s ~ bmld~ ~r necessa, inspections %x .. (S~gnature of apphcant, or name, ~f a corporatmn) (Mmhng address of apphcant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build- Nme of owner of premises (as on the tax roil or latest deed)~ ~ ~, ~ Ifapphcant ~s a corporation, signature of duly authorized officer NOTI~ ~ILD~NG o~PARTM~T AT 756-1~2 9 A~ TO ~ ~ ~R ~ FOL[ OWING IN~C~ON~ FOUNDA~IO~ ~O LICENSED (Name and title of corporate officer) ALL CON, TRACTOR'S MU.~T BE SUFFOLK COUNTY Plumber's L~cense No ...... Electrician's License No ......... Other Trade's License No .. Location of land on which proposed work wilt be done House Number Street Hamlet County Tax IVlap No I000 Section /~g'- Block .~ ...... Lot .a~.O a Exmtmg use and occupancy b Intended use and occupancy Subdlv~sion Fried Map No Lot (Name) State ex~stmg use and occuponcy of premises and intended use and occupancy of proposed construction ........... 3. Nature of work (check which applicable) New Building Repmr .. Removal .... Demolition 4 Estimated Cost .... ~2.~ ~. f.O 5. If dwelling, number of dwelling units .... / Addition ~:.~.~..c~;~.. Alteration ... .... Other Work .... (Description) · · .· · . . Fee..... ............. . · .. .... · .. " (to be paid on filing this apphcation) ..... Number of dwelhng 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 Dunensions ofexlstlng structures, if any Front ...... Rear .......... Depth .... Height Number of Stones ................ Dimensions of same structure with alterations or add~tions Front ...... Rear ...... Depth ........... Height ............ Number of Stones .................. 8. Dlmensmns of entire new construction Front .. Rear ........... Depth ........... Height .. . Number of Stones ................................... 9. Size of lot Front ........... Rear ................. Depth ............... 10. Date of Purchase ............ Name of Former Owner .................. 1 I. Zone or use district in which premises are situated .............................. 12 Does proposed construction violate any zoning law, ordinance or regulatmn ........................ 13. Wdl lot be regraded . .· .... ~....,.,. Will excess fill be removed from premises: Yes No 14 Name of Owner of premises .2~.x~-~ .~4~...f~4,~Address .~ .t~. rx-~.~r/~/~)'~.~s'~4h~neNo...o~?.~-,,.~:~.~.,g~ Name of Architect .......... /_./ .... Address .............. Phone No ........... Name of Contractor ............... Address ........... Phone No .......... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... Locate clearly and distinctly all buddings, whether exlstmg or proposed, and indicate all set-hack dimensions from )roperty hnes Give street and block number or description accordmg to deed, and show street names and indicate whether ntenor or corner lot. ;TATE OF NEW YORK, , S.S 2OUNTY OF ...... 1 ......................... being duly sworn, deposes and says that he is the_applicant (Name of individual signing contract) ~bove named. te is the >f~said owner or owners, and is duly authorized to perform or have performed the smd work and to make and file this pphcation; that all statements contained m this application are true to the best ofhm knowledge and belief, and that the ~ork will be performed in the manner set forth m the application filed therewith. ;worn to before me this ........... /..¥ ... dayor .... ~otary Public, .... 2~. ~.'.,..~..t./.~.~..~ .... County Tern F. xplr~ M~ch 30,, 19---~ /