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Home My WebLink About15523-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17740 Date FEBRUARY 6~ 1989 THIS CERTIFIES that the building. Location of Property 2215 PINE TREE RD. House No. County Tax Map No. 1000 Sectio~ 098 Subdivision NASSAU FARMS ADDITION CUTCHOGUE Block 01 Filed Map No. 1179 Street Lot 14 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 21~ 1986 pursuant to which Building Permit No. 15523Z dated NOV. 25~ 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which thin certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to DAVID & LINDA KLEIN (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector FOEI~ NO. 2 TOWN OF $OUT~OLD BUILDING DEPARTNIENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15523, Z Permission is hereby granted to: .... at premises Iocated~ ' ~'at ...~...~=..I..~...~..~.....~...~.....~ ............ ~~......c~,.~ ............. County Tax Map No. 1000 Section ....... ..~....~/....~. ..... Block ....... .(~....! ........ Lot No ...... )...~. ............. pursuant to application dated ..... J~.~........;~...~ .......... , 19..~....~., and approved by the Building Inspector. Fee ,~....w~. ................ Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ............ NEW CONSTRUCTION ....... OLD OR PRg-RXISTING BUILDING. -.VACANT LAND Location of Property ..................... HOUS~ NO. ' ..................... J~ I~P~ ,STREgT HAHLET Owner or Owners of Property ........ County Tax Map No. 1000 Section ~.~.. Block Subdivision ................ ~ .... Filed Map Permit No.t~.~.?~.~....~. ate of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ..~.. Fee Submitted: $ ........ f ........... APPLICANT ............ . ............. rev. 10/14/88 OU~DATION ( ~ s t) OUNDATION ( 2nd ) iOUGH FRAME & PLUMBING 2NSULATION PER N. Y. STATE ENERGY CODE F I'N / ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [~FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ./Q~*,r,~..~.~.., 19 .'~?. Approved ~~. ~., 19~[.. Permit No./..~7.~7.g~...~..~ Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT NOV 2 11986 Received ........... ,19... 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 promises 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 issuancg of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appllcable 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. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Bu.llder Name of owner of premises ...D..~?.i.d...&..L.l.n..d.~..K.X...e .in ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. 543 Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work wiil be done .... .r?. ................. House Number Street Hamlet County Tax Map No. 1000 Section 98 Block 1 Lot,~. 14 Subdivision tgn ss~u F. rrns Filed Map No. 1 (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: P~tlo off Residence a. Existing use and occupancy ...................................... ~ ........................ .:~ Deck off Residence ~' b. Intended use and occupancy ........................... . .... , ...... .. .... ~.~. ,~ ........................ 3. Nature of~ork (check which ~pplicable): New Building .......... Addition .......... Alteration .......... Repair . ... ............ Removal ............ Demolition Other Work Dec.k. - $ 2,0 0 0,0 0 (Description) 4. Estimated Cost ....................................... Fee ...................................... (to be paid 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 na~r,e and extent of each type of use ......... t ......... 7. Dimensions of existing struct~ms, ifany: Front ............... Rear .............. 20 . Depth...: .......... ~ Height ............... NUmber of Stories ........................................................ Dimensions of same structure .with alterations or additions: Front Rear Depth .................. ~ ....Height ...... _30" ............. Number of Stories ............ 20" ....... 8. Dimensions of entire new construction: Front ............. Rear ............... Depth .......... ~ .... Height ................ N~mJoer of Stories .......... 1(~3; kk5 ................................ 9. Sizeoflot: Front... l~. 7.1 ........ Rear ................. Depth 52.01'?.0.. . .................... 10. Date of Purchase ......... : .................... Na[~neesO~fdF~o~l~,~wner ............................. i 1. Zone or use district in which premises are situated .................................................... 12. ' * ' · · ~1o Does proposed construction nolate any zomng law, ordinance or regulation: ........................ 13. Will lot be regraded .... .~.o.: ..................... Will excess fill be removed from premises: Yes No n · D~vid K~eln Pi~. Tree Rtl. 14. Nam,eof Ow erofprem~ses. ....... ':~ .......... Address ..... - .............. PhoneNo ............. ,~ Name of Architect . . %,..: .... Address .~O~c.e.l~6~rt~.e.. . Phone No. Name of Contractor h/t/g :r~0 'BO~k'e'~ ....... i i ..... 7~,'-*'.~2I ?'": ....... ................. Address ................. Phone No ............ 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... No ..... ''l · If ye.s, .Southold Town T~ustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and bloqk number or description according to deed, and show street names and indicate whether interior or corner lot. ~ Pressure greeted' deck (20'x30')" to be Rati'o- (20i x 20'),., , construoted above existing Distance to high W~ter mnrk to remain smme - ~oproxlm~te].y 100 feet, doors wi],l be replaced with new doors. STATE OF NEW YORK, S.S COUNTY OF ................ t (Name of individual signing contract) above named. ~ being duly sworn, deposes and says that he is the applicant He is the ~ ................... i ..................................................................... ~ i (Contractor, agent, corporate officer, etc.) 6f 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 his knowledge and belief; and that the work will'be performed in the manper set forth in the application filed therewith. Sworn to before me this ...................... day of ........ (Signature of applicant? Z Z 1: // (-q t, · ~ I