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Home My WebLink About15408-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate No .. Z 15.136... Of Occupancy D te December 29 198,6. THIS CERTIFIES that tile building .... AI)DITI0~ .................................... Location of Property ~90. ~L~.~ .P,5bP ...................... House No. Street Hamlet County Tax Map No. 1000 Section . J?~ ........ Block . .0.3 ............ Lot . .6: ) ............. Subdivision Filed Map No Lot No . . conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Dc£... 9 ........... 19~6. pursuant to which Building Permit No 15408z dated .o.ct. 17 19 8.6. wasissued and conforms to all of the requi ................ , , rement$ of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... An addition to .an e.x.is.tin~ .a.c.c.e.s.sp.ry .g.ay.a.g.e The certificate is issued to . MITCHELL WILCENSKI .................... :Y, ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... .~f/~ .................................. UNDERWRITERS CERTIFICATE NO .............. ~.//x ................................. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJvUT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 1540S Z Date ....¢~..~ .......................... I.'7 , 19 ....... Permission is hereby granted to: ...~.~....~.:......~..~~ ....... ..~.~..,...~ ...... ~..~.....~ .................................. ...~....~ ...... ~.:..y...: ...... /./.z.~.~ .............. .llV \ ~ at premises located at ....~:~.~..~. ~ ..C~...~j~ ......... ~.....~ ............................. pursuant to application dated ...... ~.....~....~.....[....~.. ............ , 19.~...~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 T, OWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Receipt ~11~O. 5 1 0 1 (~ Town Hall Southold, New York 11971 ., , ... Received of ........ ~.~ ~~_~: ....................... i ...... ........................................ ~....~ /...(.o~ ...................................................................................... /100 Dollars /~ ~,.~.~/0,4 - , For .......... ~.r....:......~..~..~.~.~. ..... ~ .~_, ~,~,~._ .. ~,.-~ · ~r .....~/~ ........... -. ~.~*~:~--....~. ~ .-~., ......... Fee for Fee for Fee for Fee forj~, .tihcate ~ Yard Sale [] [] [] H.I.C. [~ Building Permit L~J of Occupancy []Misc. cCheh ~; q.~. ........ 5.Updated C.U. NewConstruction ...... Old or Pre-existing Building, ... .'.,'.. Vacaht-L'and '" Location of Property ..'~....~. ?..0. .................. ............. .. , Owner or Owners of Property ........ ~,~ ....... : ...... County Tax Map No. 1000 Section . )~ ~' Block Lot...~.: Subdivision ................................. Filed Map No ........... Lot No ......... I ..... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval... ...~-'~... . .. ............ Flequest for Temporary Certificate ..................... Final Certificate ................... Fee Submitted $... P.-..~..ff .................. i Construction on above described buil~permit meets all al:~licable c, odes ,arid regu latio,~. Rev. 10-10-78 'OUNDATION (1st) // 'OUNDATION (2nd) iOUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL ADDIT] : ,i FOUNDATION PLAN (turned down slab) ~'¢ O, b ~, 114" '~ I~-o~' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - ~°OUTHOLD, N.Y. 11971 TEl..: 765q 802 Examined .9..e-,~....o~.,, ).']... 19 .~.{q. Approved .C~..~....~....I.~..., 19~..~. Permit No.~. .~-..~..o.~..~.. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 strew or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Buikling Inspector will issued a Building Permit to the applicant. Such pern shall be kept on the premises available for inspection thronghout the work. e. No building sbalt be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan 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 Building Zone Ordiriance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for thc construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply With all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necerssary, sin~sp?cti, on (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde (as on the tax roll or latest deed) If applicant is a corporation, signatnre of duly anthorized officer. (Name and title of corporate officer) Builder's License No .......................... Other Trade's License No .................... ... 1. Location of land on which proposed work will be done....--r..o. ~..cO.. ................................. ................... .... ....................................... House Number Street Hamlet County Tax Map No. 1000 Section ..... / ~..C ..... Block ...... .~ ........... Lot .... .~./. ( ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... Z~. l~d~.~?a~V~ b. Intended use and occupancy .................. ~$9~,~lIIrt~ g~,~l .................. 3. Nature of work (check which applicable): New Building ......... Repair .............. Rembval .......... Demolition 4, Estimated C0~I~} L~ .~. ,O..~ ......... Addition . Alteration ............. Other Work....- ..... - ...... (Description) (to be paid on filing this application) 5. If dwelling, number of dwellinglunits .......... 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. Dlmenmonsofexmtmgstructures, ffany: Front .... .% .' ....... Rear .............. Depth ....... Height ............... Nmfiber of Stories ........ [ .............................................. Dimensions of s, am,e-structure with alterations or additions: Front ..... .o.¢..5/. ........Rear ................. Depth ........ .tr~...t . .:.. Height ...................... Number of Stories / 8. Dimensions of entire new construction: Front .... ~'{ ........ Rear ............... Depth ...~.~. ........ Height ............... Number of Stories .... /. ....... . ........................................... 9. Size of lot: Front ........... . .......... Rear ...................... Depth ..................... 0. [)ate of Purchase ........... ~ .................. Name of Former Owner ............................. 1. Zone or use district in which premises are situated ......... ¢~.~.( c.q.l-.F, qlC~.L..../~.~..~.1~.~.,?.~?/~. .............. 2. Does proposed construction vioiate any zoning law, ordinance or regulation: ..... X~..O. ....................... 3. Will lot be regraded ......... ! ................... Will excess fill be removed from premises: ~ No . . 4. Name of Owner of premmes ................ Address ................... Phone No ....... Name of Architect ........ .~.~ ..~. ......... Address ................... Phone No. ~:~.' .~.*-.' ~.'~.'~.2<'. Name of Contractor ........................... Address ................... Phone No ..... ~. ........ 5. Is this property located withinl.00 fe~et of a tidal wetland? ~ Yes ..... No .~f... * I.f yes, Southold Town Trdstees Permit may be required. P, LOT DIAGRAM buildings, whether existihg or proposed, and. indicate all set-back dimenmons from number or description according to deed, and show street names and indicate whether Locate clearly and distinctly all roperty lines. Give street and block derior or corner lot. 'ATE OF NEW,YORK,/ ~.d ~, ,~ )UNTY (Nfim"~-'~ individual signing co~ eve named, x / ' being duly sworn, deposes and says that he is the applicant is the ,~a.¢- ' (Contractor, agent, corpdrate officer, etc.) said owner or owners, and is dui9 authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the irk will be performed in the manner set forth in the application filed therewith. corn to before me this J .......... /.~/?~'....~-.dayof]...'..~x>~..,19.~.~. . )tary Pubhc, .... ~ ........ ~ . .~~Count~----'~ _ , ' ' 1~1~8~ ~ ~ 111, 1 ~ P~ooF ~/~" TI-Il ._SECTION 'I4A" (turn down slab) R_~_OOF SHEATHING LAYOUT .e,o,.~. ~ ~, ~' ~'~' ~/g,": I'-o" // ~* ,,, SEC'T/ON '4C" ~ I O~UPANCY OR SECTION "4B" (formed foundation USE IS UNLAWFUL WITHOUT CERTIFICATE OF ~¢UPANOY 18 4 SHEET TOTAL 4 5