HomeMy WebLinkAbout15524-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z17720 Date JANUARY 30, 1989
THIS CERTIFIES that the building ....S.A.T..E.L.L.I.T..E..A.N.T, .E .N.N.A. ........................
Location of Property 2615 WELLS ROAD PECONIC
House No. Street Hem/of
County Tax Map No. 1000 Section . .0.8.6. ....... Block . . .0.2. .......... Lot I . 2
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
NOV. 24 1986 pursuant to which . · · 15524z
............. : ....... Buff&nE Permit No ......................
dated..~. 9Y.-..2..8.<. ! 9..8.6 ........... 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 .........
SATELLITE ANTENNA (GROUND MOUNTED).
The certificate is issued to ltENRY & JENNIE PIERCE
..................... ?o¥,,'o;,'l'g~'X~f..~ ......................
of the aforesaid building.
Suffolk County Department of Health Approval ...... .N./.A. ................................
UNDERWRITERS CERTIFICATE NO ..... N/A
PLUMBERS CERTIFICATION DATED:
N/A
Building Inspector
Rev. 1/81
TOW~ OF $OUTHOLD
BIJILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 15524~ Z
Permission is hereby granted to:
...~.~......~,-~......'1. .............................................
.....
County Tax Map No. 1000 Section ...... ..(~....~..~. ....... Block ...... ,,,~...~ ..... Lot No ...... (.:'.?....; ........
pursuant to application doted ..... ..~...~~.......~h....~ ........... , lO.~....[e.., ond approved by the
Building Inspector.
Fee $ ............. ~ ..........
Building Inspector
Rev. 6/30/80
OUNDATION ( 1st
OUNDATION ( 2nd
OUGH FRAME &
PLUMBING
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [,~']'~1NAL
REMARKS:
DATE
INSPECTOR
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
DATE: January 24, 1989
NAME: HENRY PIERCE
ADDRESS: 2615 WELLS ROAD
PECONIC, N.Y. 11958
RE: BUILDING PERMIT # 15524z SATELLITE ANTENNA
SEC. 86 BLOCK 02 LOT 1.2
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
*** This permit requires an inspection and a certificate
of Occupancy.
FORM NO. 1
TOWN OF SOUTHOL. D
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined d0.o:r~.~..[u.~...~.~.., 19~.k
Approved .)0.~..~'.~.., 19 .~.[q. Permit No..} .~..' .~'..~.~/.' .'~-e
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ,19...
Date .................. , 19...
INSTRUCTIONS
a. This application must be completel~ 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 sc~il~dule.
b. Plot plata showing location of lot and of buildingsOk~eml~s, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout~r~9~ya~'~ ~chl~t~_on the diagram which is pa~ of this app,-
cation.
c. The work covered by t~s application suance of Building Pe~it.
d. Upon approval of this application~di~~ed a Build~g Pe~it to the applicant. Such permit
shall be kept on the premises availableA~~g~~k.
e. No building shall be occupie~se~in~le ~in~f~ purpose whatever until a Ce~ificate of Occup~cy
shall have been granted by the Building~n~. ' ~X ~ ' '
APPLICATION IS HEREBY MADE t for the issuance of a B~lding Pemit pursuant to the.
Building Zone Ordinance of the Town of ~,~ounty, New York, ~d other applicable Laws. Ordin~ces or
build~,'a~i~or
Regulations, for t~e construction of alterations, ~r removal or demolition, as here~ described.
S, ordinances, ~fld~g co~, h~g code, and regulations, and to
The applicant agrees to comply with all appli~l~
admit authorized in spec to rs on premises an d in b~ding for ne ce ss a~f~~
(Signature ~ applicant, or name, if a corporation)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
State whether applicant is owner, lessee, agent, architect, engineer, general contract~[q~t~tt~i~, ~rh3~r~'~ouilder.
................................................................
Name of owner of premises .... ~. ~ ~ ~ FEE: ........ B~" ~'E~$ A~'
................................ ~ItLO~NG' g~'~ ' ' '
(as on the tax roll or lat~2 ~ ~,, TO~ ~ ~R THE
FULL.OWING iN~C'~ONS:
F~NDATtO~ ~O
FO~ PO~ED CONC~E'~'~
3. ~NSULATI~
g, P~NA[, GOHs~UC~iON ~UST
~ c~PLETE ~R
A~ CONSTRUCT~N s~L M~
T~ REQUI~ENTS ~ ~ N.Y
STATE CONSTROC~ & ~N~
O~e~ ~de's ~cense ~o ......................
}louse Number Street Hamlet
000 S c io, ..... ........ ..... ........... 3 2 ...........
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 ..... ./.~..6'.~.. ~ .~..~"~Z.G..~. ...... .~ .......................................
b. Intended use and occupancy // ~/J~ ~m ~ ~.~
.3. Nature of work (check which applicable): New Building .......... Addition ..; ....... Alterhtion .~ .........
Repair .............. Removal .............. Demolition ........... J.. Other Work .-~..J~../.A~?.
4 Estimated Cost Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................
If garage, number of cars i
6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .....................
7 D' 'onsof 't' gst ctu if ny F nt R Depth
. lmens1 axis in ru res, a '. ro ............... ear .. J .......
Height ..... .A~a,O~,n~,~Number of Stories ................ ! .......................
Dimensions of ~--;i :,:"4:;ura with alterations or additions' Front .
De th ~. ~.&.¢'7~/ Heit .~. t~..e.~ ...... ""';L: ..................... .o~.~.,~..~..'. ~" '}''
p .............. gh ..... .............. l~lu ...... ,~,~,m~lL~.
8 Dimensions of entir stru tion: Fr R ' Depth
· e new con c ont ............... ear ....... , ....................
Height ............... Number of Stories ............................
D; i 'il ....................
9. Sizeoflot: Front ...................... Rear ..........................................
i 0 Date of Purchase Name of Former Owner
11. Zone or use district in which p,remises are situated .....................................................
12. Does proposed construction vinlate any zoning law, ordinance or regulation: ...............................
13. Will lot be regraded ......... ~ ..... ~,:.. ~.~ ...... Will excess fill~be removed, fro/n premises: Yes
14. Name of Owner of premises . t/~'.~.~....~te,'t ~' Address ~9,~ ,e~'e,//,n ~ Phone No
Name of Architect ........................... Address ............ ' .... i... Phone No.
Name of Contractor ........... Address ............ '
15. Is this property located w±thinl.00 feet of a t±dal wetland?''&'Y~'.....eN°No ............... .....
* If yes, Southold Town Trustees Permit may be required.
PLOT D~AGRAJM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fi:om
property lines. Give street and block number or description according to deed, and show street names and indicate whethe]
STATE OF NEW YORK,
COUNTY OF .................
S.S
................................................. being duly sworn, depos'es and says that he is the applicani
(Name of individual signing contract)
above named.
He 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 his knowledge and belief; and that thd
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
........... Otg.c/ ......... day of.. ...... .~....~'d~... ..... , 19~.
Notary Public, .~--..~.'~ ..... J~)¢. .~..~. ....... County
............. ...:..: .............
. so.31OTSlS, S~fo~k C~.ty~:? (S~gnature of applicant~
lerm ~xpires Igateh 30,1~ ,, /