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Home My WebLink About15793-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z15553 Date March 27, 1987 THIS CERTIFIES that the building .... D..e.c.k...a .d.d.i.t..i 9.n ............................. · 445 SMITH ROAD PECONIC Locahon of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 098 .Block 04 ...... Lot 05 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated M a r. I 5, 1987 pursuant to which Building Permit No. 15793 Z dated ...M.a.r.....................26' 1987 ..... wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Deck addition tq.'.exist.i.ng, on.e family dwelling. The certificate is issued to W. KENNETH SMITH JR. (owner, I~;gY~l~Ir~Xtllt~l{t~ of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N /A N/A PLUMBERS CERTIFICATION DATED: lng Inspector Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-° :~5793 Z Permission is hereby granted to: ......... County Tax Map No. 1000 Section ..... .~...~...~.. ...... Block ..... ..~...~. ........ Lot No ......0...~.. ........... Building Inspector. and approved by the Rev. 6/30/80 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Recei,t NO, ~ 1 54 ? Southold. New York 11971 ........................ .......................... ................ ................................................. ;;/;;;";; or ~: :. ~ ..?...?..,~..~. .... ~ .q...~). ;Z '~ ~'o '. ............ ~ '~' 5~' T~'; i'o';.. Fee for Fee for rT_~m'Fee for r..:q C~e~tificate ~ Yard Sale [] [] [] H.I.C. L~JBuilding Permit L_/~of Occupancy [~]Misc. [~,,aC hsh ~ :alia- .................. 7.~.`.~~.~. ................ . ................... Building Inspector ~ ling" '~"[~ccurate survey ~-f property ~h-6~ing -all-ptop~rty lines, streets,' bullchngs' ana unusua~ natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safew inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy New'Dwelling,S25.00, Accessory ;$10.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ~'-/5~- ~'Z 5.Updated C.O. $ 50.00 Date ......................... New C on s % ~uc ~ i on ...... Old or Pre-existing Building . .~. ......... Vacant Land ............. Location of Property . .~ ....................................................... Owner or Owners of Property ~... ............. · .... ' .......................... · · .. County Tax Map No. 1000 Section ,0.~2 ....... Block .... Y. ........ Lot ..... ;5, .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit ......... Applicant . . /o Health Dept, Approval ........................ Labor Dept. Approval ............. r .......... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................ Fee Submitted $. ~.~....~..~....cf..~.7. ........ Construction on above described building and permit ~neets all appli.c, able co. des and regulations. Applicant ..... ~. ,~,, ........... ~ ........................ 7 OUNDATION OUNDATION 2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL · ADDITIO}~L COMMENTS: 'f&xA,'txt 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .... ~ .... CHECK .~- ~47.. SEPTIC FORM ............. NOTIFY ~N CALL .............. MAIL TO: No. '.J..~..-/.~ .~...~. pproved ...rJr.]..O~..c-J~..;kiP.., Permit isapproved a/c ..................................... (Building Inspector). APPLICATION FOR BUILDING PERMIT INSTRUCTIONS · l a. Tiffs application must be completely filled in by typewriter or ~n ~nk and submitted to the Building Inspector, with 3 ts 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 ' areas, and giving a detailed description of layout of property must be draw~n on the diagram which is part of this appli- tion. 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 all 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 ~all 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 ailding 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. he applicant agrees to comply with all applicable laws, ordinances, building code, hous~g code, and regulations, and to lmit authorized inspectors on premises and in building for necessary2~~ (S~gnature of applicant,~q~n'a~ne, if a cgrporation) (Mailing address of applicanO tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................. rune of owner of premises (A). · .].~ ~..~.~.~..~ · .?.~.:/~. ~. · · ~.~'. . . · ./~. .~ .... - ./~..~.~..C-~. - · · .~. - · · .~<''2: .' '/~ .......... (as on the tax roll or latest deed) 'applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done~ .~ .................... /.~ ........................... . . ........ ........... ?. .4. . . ............... x. .o. . .,,. , ............ House Number Street Hamlet County 'Fax Map No. 1000 Section .................. Block .. .... ~ ... Lot ................. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, use and occupancy .... ~ ......... ./ ........ .AJ~C~. ................................ b. Intended use and occupancy ........ .~.'./"~. · .~...//. ~.. ~..~ ................ ' Additi ' Nature of work (ch,eck which, applicable): New Building ........... on .......... Alteration,~_ .......... ' ' ' ' ' . ......... ~. Other Work ~ ........... Repair .............. Removal ...... <. ....... Demohtion ...... Estimated Cos .I'~...~...O~)., ..................... Fee ............................ ' (to be p~id on filing this application) If dwelhng, number of dwelhng units ............. Number of dwelling units on each floor .............. If garage, number of cars ' If business, commercial or mixed occupancy, specify natu, re, and extent of each ty, p~, of uso ............... .... . z ~ z ; '~..~."'... Dnnenslons of existing strUctures, if any. Front ...... .~..~ ...... Rear ..... ~ff. ..... Depth .. Height ............... Number of Stories .... ~ ....................... ~ ...................... Dimensions'of same strUcture with alterations or additions: Front .~..,~T.7).~.. . !. Rear Depth ...................... Height ...................... Number of Stories .................. Dimensions of entire new construction Front · Rear Depth Height Number of Stories : ; Size of lot: Front ...................... Rear ............... ' ....... D~'pth ...... ~ ............. ~ate of Purchase ....... /~lge~ ................. ,oName of F. ormer Owner . .&' i .~.~.~ .//~...../~.d.~../.¢-. ........ Zone or use district in wh. ich p. remises are situated.. ~'? D~.e?, 7/;'.~. ~ ....... ~..,. .......................... Does proposed construction violate any zoning law, or&nance or regulation: . .A(Q.: .............. ./ ......... Will lot be regraded .... ~:,17: .................... Will excess fill be remoxed t'rozn premises:/u/,q' Yes No Name of Owner of premises .................... A ./~. ~ ..... . ....,... 1{ on ......... ,7 . Name of Architect ' /o o,4;e..', Address ..... ,. Phone No Name of Contractor (~ .t.t~.&;. ?.~. Address ' ' Phon6 No · Is this property located within 300 feet of a tidal wetland? *Yesi ..... No ~P... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM : Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all ~perty lines. Give street and block number or description according to deed, and show street i crier or corner lot. ~ /~pcg, / / t dimensions from nd indicate whether , ~,IE OF NEW YORK, S.S UNTY OF ' ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) , , ~ve named. is the .............................................................. i ..................... * ..... (Contractor, agent, corporate officer, etc.) ! ~ said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~lication; thaf all. statements contained in this application ,~re true to the best of his 'knowledge and belief; and that the rk will be performed in the manner set forth in the 'application filed therewith. - i om to before me this { ~. day of gELEN IL DE VOE I~ff~'/kqtY PUBLIC~ Slate of NeW Yodc No, 4707878, Suffolk e~n Expires I~rch 30, ~ ,~'/ / (Sib~mtfire of applicant)