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Home My WebLink About15364-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17965 Date APRIL 24~ 1989 THIS CERTIFIES that the building Location of Property 165 ROGERS ROAD House No. County Tax Map No. 1000 Section 066 Subdivision FOUNDATION MOUTHOLD~ NEW YORK Street Hamlet Block 02 Lot 22 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 30, 1986 pursuant to which Building Permit No. 15364-Z dated OCTOBER 6~ 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is FOUNDATION UNDER EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 HARRY C. ZIMMER~ J N801318-APRIL 1, 1987 N/A · / /~ui~ding Ihspector FORM NO. I~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDiHG PE~iT (1-HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15364 Z ........ ................................. et premises located at ..Z...~e..~.~.....~..'~,~.....~ .......... ~ ..................... County Tax Map No. 1000 Section ...... ~:~...(..q.~. .... Block ..... .(~....'~:... ..... Lot No...-'~-..~ .......... pursuant to application dated ....s~.~.J~c~.~......~ ....... , 19..~..~..., and approved by the Building Inspector. Fee $.....~,.-. :...."~,. ..... ' "Building Inspector ..... ~ ......... Rev, 6/30/80 TOWN OF SOUTHOLD BffILDINU DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK ?65 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EX~ST~NG BUiLDiNG. ..VACAN~ LAND ........ Location o~ Property ...... Subdivision ....................... Permit No. ~.~...6.L/~.Date of Permit Health Dept. Approval .................. Filed Map ........ Lot .......... .. ~.:. :..:..App~ ~ ~.a~ t ~~~.~ Underwriters Approval .............. Planning Board Approval ............... o Request for Temporary Certificate ....... Final Certificate~. .............. APPLICA rev. 10/14/88 BUREAU OF ELECTRICITY -- only the electrical equipment os de~cri~ed~below and~intr(,du ed b t a pi' t named on the above a lication n SERVICE DISCONNECT ~10 OF ~S /E ~ I ~YPe ~E~ER R ~ AML i AM~"' I TYPE EQUIP, ~,'~w ,e'~w 3,6'3W 3,~4W NO'O~EECC~COND, OF.~C.WC~qD. HO, OFNEUTRALS COOKING ~ECKS OVENS DISH WASHERS NO OF FEET V I C E ~. ^ w o o. OF .I ~EO o~ EXHAUST FANS DIMMERS OF NEUTRAL Paul Bu~s 275 Town Harbor La. Scuthold, A/.Y, 11971 GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY FOR BUILDING DEPA ENT. THIS COPY OF CERTIFICATE PERED IN ANY/vtANNER. FIELD I~S?EC?iON__~ FOUNDATION ( 1 st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD NAME: ANGtE ZIMMER 165 ROGERS ROAD ADDRESS: SOUTHOLD RE: BUILDING PERMIT SEC. 66 DATE: APRIL 3, 1989 15364Z foundation expired 4/6/88 BLOCK 02 LOT 22 This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code. Please contact our office, this matter must be corrected. Victor G. Lessard Principal Inspector Examined O~..~...., 19 ~.¢ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 'I~E L.: 765-1803 Approved O ~'~ff--.~......~. ·., 19~.¢. Permit No. 1..ST. ~..6.q. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... 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 of a 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 herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signat,.ure of ap2li~carlh_or n~ame, if a corporation) (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prelnises ....... ~~n~:' ~} i~t~t. ~dd)__ ......................... if applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No .......... . ............... Electrician's License No ....................... Other Trade's License No ...... ' .............. ... ~. I. Location of land on which proposed work will be done..~.~.. . County Tax Map No. 1000 Section ...... .~..~ ......... Blockc/ ........ ~ ........ Lot . · · ,~. · .Zx. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construcQ0n: a. Existing use and occupancy ........ ~ .............................. ~. ............. /2* _._. // .. ,') b. Intended use and occupancy .............. /tq, o:-t,6¢~_ ....... ~ ....... 3. Nature of work (check which applicable): New Building .......... Addition. ! ........ Alteratio Repair .............. Removal ............ Demolition .......... i .. Other Work ....... ~ ~ (Description) rL q ¢. q Fee 4. Estimated Cost ........................................ ~ ............................ (to beipaid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ....... ......... If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ...... i ....... Depth ............... Height ............... Number of Stories ........................... ; ............................ Dimensions of same structure with alterations or additions: Front ..... i Rear Depth ...................... Height ...................... Number oi Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear .............. Depth ............... Height ...............Number of Stories ............ . ............... ..................... 9. Size of lot: Front ...................... Rear ........................................ 10. Date of Purchase ............................. Name of Former Owner 11. Zone or use district in which premises are situated ........................ : ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .. .: ............................ 13. Will lot be regraded ............................ Will excess fill be remove~d from premises: ~ Yes No 14 Nam fO of pr mi Add i Pho eNo · e o wner e ses .................... ress ................... n ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ............... i ....Phone No ................ 15. Is this property located withinl.00 feet of a tidal wetland? *iYes ..... No ..... * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shoW street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ....... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~above named. rile 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 all statements contained in this application are true to the best of hi,, knowledge and belief; and thai: the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................... ; .... day of ..... ~ ........ , Nora Public . Count' ~~~.appli cant)