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Home My WebLink About15988-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No zi5764 Date May 19, 1987 THIS CERTIFIES that the bmldmg Ad d. ~. t i.o.n, ........................ Locat~on of Property 10720 Soundvzew & 900 Hickory Road Sou~hold House No Street Ham/et County Tax Map No, 1000Sechon 054 .Block 06 Lot 005 Subd~wmon ............................. Fried Map No ......... Lot No .............. conforms substantially to the Apphcat~on for Bmld~ng Permit heretofore filed in ttus office dated Hay 8, 1987 pursuant to wtuch Bmld~ng Permit No. 15988z dated . .~ay.. 12.,.. 1 ,9.8.7 was ~ssued, and conforms to all of the reqmrements of the applicable provimons of the law. The occupancy for which tins certfficate m assued m ....... .... ~.t.rqgt..de. ck. t.o .a.n. ,e.x.ls.t.x.ng one. f. am..~.y..d.we.l.~.i.n.g.. .......... Thecert~ficate~s~ssuedto . LESLIE WEISMAN, ET AL, ...... ............. of the aforesaid building Suffolk County Department of Health Approval Iq/A N/A UNDERWRITERS CERTIFICATE NO ............................... PLUMBERS CERTIFICATION DATED: N/A Bmldmg Inspector Re~ 1/81 I~O~ NO. ~ 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) N9 15988 Z Permission is hereby granted to: ~..~..~.~ ...~_~.-......~.~...: .............. ' ~..~.~...~.....,y~.:.,~: .................................. ;.:. ........................................ . ~t ~re~,, I~,t~, ........................ ~.....~ .................. ~ ......... .~ ....... ~un~ T~ Mop No, 1000 Section ...... pursuant to apphcation doted ..... Budding Inspector. ............. , 19..~...'~.., and approved by the Rev 6/30/80 OUNDATIO:~ ( 1 s t) OUNDATION (2nd) OUGH FRAME & PLUMBING :~SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL CO~MENTS ' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING BOARD OF HEALTH ...... 3 SETS OF PLANS .-.~... ~+ FORM NO I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N Y. 11971 TEL . 765-1802 Examined..'~'~.' ~-.., 19'.'~ Approved .--'- ~'~]'~. , 194'1 Penmt No..].~-~ Disapproved a/c ......................... (Bmldlng Inspector) CALL ..... MAIL TO: APPLICATION FOR BUILDING PERMIT ; ' ....... INSTRUCTIONS a Tlus apphcahon must be completely filled in by t~pewnter or in Ink and submitted to the Budding Inspector, wlth sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showmg location of lot and of bmldmgs on premmes, relationship to adjmnmg premises or pubhc stree or areas, and glvmg a detmled descnphon of layout of property must be drawn on the dtagram which ~s part of thru appl cation c. The work covered by tbs apphcatlon may not be commenced before msuance of Building Permit d Upon approval of th~s apphcanon, the Bmldmg Inspector wdl xssued a Building Pe~t to the applicant. Such peru shall be kept on the premises avmlable for mspectxon throu~out the work. e. No budding shall be occupied or used ~n whole or m p~t for any purpose whatever uhtfl a Cernfieate of Occup~c shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Dep~tment for the ~ssuance of a Braiding Pemtt pu~uant to tl Building Zone Ordinance of t~e Town of Southold, Suffolk County, New York, ~d other apphcable Laws, Ordm~ces, Regulations, for the constmc~on of buddings, additions or alterahons, or for removal or demohtton, as herren describe The apphcant agrees to comp~ w~th all apphcabl~ laws, ordanances, budding code, ho~mg c%de, and regulatmns, and admat authorized ~specton on )rem~ses ~d ~ bulldog for necessa~~~ (~ ~pphcant, or name, ff a corporation) ' . 5 (Mmhn~ address of applicant) State whether apphcant zs owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bullde · .';~5-~. is...~....~..~...o~., .~.. ................................... Name of owner ofprem,ses ~-',,,~-'--,~:~'-.1,~-- ~]~'5~rT~'~, ~)-~+, fiZ:/g'f.. (as on the tax roll or latest deed) If apphcant ~s a corporation, s~gnature of duly authorized officer (Name and t~tle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Bmlder's L~cense No ........... Plumber's Lmense No .............. Electrlclan's License No Other Trade's License No ............ ' 1 Locat,on of land on wtnch proposed work wdl be done / O. ?&. ". ~...?,~..O..~....~-..q ~. ~ ...... .~.-... ~.~..~::..:~-~..~ .,,,~, ~T, O~O ''~ House Number Street County Tax Map No 1000 Secnon Sub&wsmn ..... (flame) 2 State existing use and occupancy of premises and intended use and occupancy of proposed construchon b Intended use and occupancy ........... Hamlet 0~, oo 5- Block .......... Lot ............. Fried Map No .. Lot ...... · Nature. of w~rk (check which applicable) New Building ._, Remov_~l, Estimated Cost If dwelling, number of dwelling umts. If garage, nmnber of cars ..... Addition. . Alteration .. T~.J~ .... Demolition . .. Other Work ........ (Descnpt:on) ....... Fee .................. ' (to be prod on fihng tins application) .... Number of dwelling units on each floor ....... If business, commercial or mixed occupancy, specify nature and extent of each type of use Dm~enslons of existing structures, ~f any Front Height .... Number of Stones Dnnenslons of same structure with alterations or ad&tlons Front Depth ....... ~.. . Height .. D~mensmns of entire n~v'constructlon Front .. Height .......... Number of Stories S~ze of lot Front ........ Rear Date of Purchase rvt~' I~ '[.q. ~'..~.4-~ . . Rear .. Depth ...... ....... Rear .. Number of Stones .............. ·. Rear ........ Depth ....... ......... Depth ............ Name of Former Owner ...................... Zone or use d~stnct in which premises are situated .'~.~ ./~..~ '. Does proposed construction wolate any zoning law, ordinance or regulation /J/..O ........................ Will lot be regraded . 4kfo WH1 excess fill be removed from premises .Yes No Name of Owner ofpremlses~~-~cz '~.'e~ .t?5~... i Address .............. Phone No ........... Name of Architect ............. Address ................ Phone No ........... Name of Contractor ............. Address .............. Phone No. -Nc~. · · · Is this property located withzn 300 feet of a tidal wetland? *Yes ..... No-~C~.. · lf yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dunenslons from 3petty lines Give street and block number or description according to deed, and show street names and indicate whether enor or corner lot ATE OF NEW YORK, S S )UNTY OF .... · . /r~/-~/?f~'g~ "~/'--'~ ~. . . . .... being duly sworn, deposes and says that he is the applicant (Name of individual s~gmng contract) ove named (Contractor, agent, co,orate officer, etc ) said owner or ownem, ~d ~s duly authorized to perform or have perfo~ed the smd work and to m~e and file t~s ohcat~on, that all statements contmned m thru apphcat~on are true to the best of h~s ~owledge and behef, and that the ,rk w~l be perfo~ed m the m~ner set forth m the apphcatmn filed therewith. om to before me thru ...... D ...... of ......... P~bhc ....... ~.~. County