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Home My WebLink About15494-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certi[icate Of Occupancy No ..... Z 1 ~.1.o.o ...... Date ..... N. qv..e.m.b.e.¢..1.4.~ ............. 19 8.6. THIS CERTIFIES that the budding ..... ~. c.c e.s.s. 9??...b .u.~.~.d. ~..n.g ..................... Location of Property .2.~q 95..I~ .a.zn..R..d :..&., 4.'.5..Y.o..u .n~.s .R.d......OF.~.e.n..~ ~..N.: .Y: .......... Hou*e No Street Hamlet County Tax Map No 1000 Sectmn q q..8 ....... Block .... 0. ! ......... Lot 14 Subdiwsion ........................... Filed Map No ........ Lot No .............. conforms substantially to the Application for Budding Permit heretofore fried m this office dated l~9~r.e~b.~r..16., ....... 19.8.6. pursuant to which Bmldmg Permlt No. 15494 Z dated .. ~ 9y.qm.b. .e?.. [ 6. ~ .......... 19 .8.6 , was ~ssued, and conforms to all of the requirements of the apphcable prowslons of the law. The occupancy for which flus certificate is issued m ......... Construct an accessory building EDWIN J. BLESCH The certfficate ~s ~ssued to ..................... /o~,,'~;-~$Xt~{?y× x ................... of the aforesmd building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N/^ Braiding Inspector Rev 1/81 ~ro]B,~ NO. J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER, MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15494 Z PermJsston ts hereby granted to. ..... ..~..,...?.......~.~.....~ ................ ..~-,~.~..~.:~../.~..~.~.V.. ......... . ot pre,~e, ~o~ated at ...~..~...q:..?.~.....~/.~.--.'..~.~ .'/.~. ~..~ ......... ~.~.. County Tax Map No 1000 Sect,on ... CS).J...~ . . Block .... ..0....! ........ Lot No ....LL'J. ............ pursuant to apphcation dated .~ .e'~'~'s-"Tt~....~. t ~ ...... , Jg.~..~e., and approved by the Building Inspector. Fee $.. .. .... Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICA"rlON FOR CERTIFICATE OF OCCUPANCY NOV I 4 1986 Instructions A Thru application must be filled In typewriter OR Ink, and submitted I~ to the Budding Inspec- tor w~th the following; for new buildings or new use I. F~nal survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic features. - 2. Final approval of Health Dept of water supply and sewerage dmposal-(S-9 form or equal) 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the budding. 5 Submit Planning Board approval of completed site plan requirements where applicable. Bo For existing buildings (pr[or to April 1957), Non-conforming uses, or buildings and "pre-exmtmg" land uses: 1. Accurate survey of pZ"operty showing all property hnes, streets, buildings and unusual natural or topographm features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- non required to prepare a cert~hcate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exmtlng dwelhng 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 NewCons truc t zon. ,X ... Old or Pre-ex~sting Building $15.00 Date Nov. 14 1986 .......... Vacant Land ............ Locat[on of Property 22495 Main Rd. & 45 Youngs Rd. Orzent, N.Y. House No. Street Ham/et Edwmn J. Blesch Owner or Owners of Property ............................................. County Tax Map No. 1000 Section 1 8 Block 1 Lot 1 4 Subd~ws~on ............... Fded Map No ..... Lot No ........ Permit No ....... Date of Permit ........ Apphcant .. F..~.e.d.e.~..~.c.k..J. :..~e. d. e.s.c.h, z ....... Health Dept Approval N/A Labor Dept. Approval Underwriters Approval .... N../.A ............ Planning Board Approval N / A Request for Temporary Cert~hcate .................. F~nal Certificate .X.X. ................... Fee Subm,tted $ · 5. (}0 ............ Construction on above described budding and permit meets all applicable codes and regulations. Frederick J. Tedeschz Apphcant ................................ Rev 10 10-7a FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y 11971 TEL.: 765-1802 Examined /00-q, Jt-~u,~ /.5/, 19 ~ Approved ]O~Y'v. Jq~[t~., I ~/ , 191~ Permit No Recezved ........... ,19... Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 1 1/14/ , 19...86 INSTRUCTIONS a Tins apphcation must be completely filled m by typewriter or m ~nk and submitted to the Bufldmg Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordmg to schedule b. Plot plan showing location of lot and of buddings on premises, relahonsh~p to adjoining premises or public streets or areas, and giving a detaded descnptton of layout of property must be drawn on the diagram winch is part of flus appli- cation c. The work covered by tins apphcatxon may not be commenced before ~ssuance of Budding Permit d. Up~n appr~va~fthmapphcatmn~theBm~dmg~nspect~rw~ssuedaBu~dmgPerm~tt~theapphcant Suchpernut shall be kept on the premmes avadable for mspectlon throughout the work. e. No bmldmg shall be occupied or used in whole or in part for any purpose whatever unh~a Certificate of Occupancy shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmlding Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demolmon, as hereto described. The apphcant agrees to comply w~th all apphcable laws, ordmances, bmldmg code, housang code, and regulations, and to admit authorized ~nspectors on premises and m budding for necessary mspectmns Frederick J. Tedeschz (S~gnature of apphcant, or name, ff a corporation) State whether apphcant is owner, lessee, agent, architect, en~neer, general contractor, electnman, plumber orburider. Edwzn J. Blesch Name of owner of premmes .. (as on the tax roil or latest deed) If apphcant ~s a corporatmn, signature of duly authorized officer 2 (Name and title of corporate officer) Builder's hcense No. Plumber's License No Electrician's License No Other Trade's hcense No Location of land on which proposed work wdl be done 22495 Ma~n Rd. & 45 Youngs Rd. Orient, N.Y. ttouse Number Street County Tax Map No I000 Section .. Block Hamlet · Lot. 14 Subdivision .. Fried Map No Lot (Name) State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construchon a Extstmg use and occupancy One famzly dwetl~ng .... b. Intended use and occupancy Shed .. X 3. Nature of work (check which applicable) New Building .. Addition Alteration Repmr ....... Removal ....... Demolition .......... Other Work .......... (Description) 4 Estimated Cost .................... Fee ............................ (to be paid on filing this application) 5. If dwelling, number of dwelhng units ....... Number of dwelling units on each floor ..... If garage, number of cars ................................................... 6 If business, commercml or mixed occupancy, specify nature and extent of each type of use ..... 7 Dimensaons of ex~snng structures, ffany Front ....... Rear ........ Depth ....... Height ..... Number of Stones ............................ Danenslons of same structure with alterations or add~taons Front ...... Rear .......... Depth ....... Height ...... Number of Stones ................ 8. Dzmensions of entire new constructaon Front .... Rear ......... Dep[h ........ Height ...... Number of Stones ..................................... 9 Size of lot Front .......... Rear .............. Depth ............ 10 Date of Purchase ............. Name of Former Owner ................ 11 Zone or use district m which premises are situated ......................... 12 Does proposed construction vmlate any zoning law, ordinance or regulation ....................... 13. Will lot be regraded .......... Will excess fill be removed from premmes: Yes No 14 Name of Owner of premases ....... Address .......... Phone No ............ Name of Architect ...................... Address ................. Phone No .............. Name of Contractor .............. Address ............ Phone No ........... 15. Is thzs property located withinl00 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and dlstanctly all buildings, whether existing or proposed, and mdmate all set-back dnnenslons from property Imes Give street and block number or descnptlon according to deed, and show street names and mdmate whether interior or comer lot STATE OF NEW YORK, S S COUNTY OF ........ (Name of individual mgmng contract) above named ·. being duly sworn, deposes and says that he is the applicant He as the .......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and m duly authorized to perform or have performed the said work and to make and file this ~pphcataon, that all statements contained m this application are true to the best of his knowledge and belief, and that the work w~ll be performed m the manner set forth m the apphcatlon filed therewith. Sworn to before me this .......... /.~.~...¢ ...da~.of...~/.0~.... ,t9 qotary Public, ... ' ............. County //~ · , Ne. 47078/8, Suffolk Ceunty mrm Exr~lres Match 30,