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Home My WebLink About15550-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17787 Date FEBRUARY 22, 1989 THIS CERTIFIES that the building ALTERATION Location of Property 10290 COUNTY ROAD ~48 House No. Street County Tax Map No. 1000 Section I08 Block 2 Subdivision Filed Map No. MATTI%~JCK, N.Y. Hamlet Lot 01 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 2, 1986 pursuant to which Building Permit No. 15550-Z dated DECEMBER 8~ 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 ENCLOSE ENTRY TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to THOMAS P. SIDOR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING - DECEMBER 7, 1988 N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N] 15550, Z Permission is hereby granted to: .. l.o.......~. ......... ~ .......................................... ......... · "--C::~-. I~ ~ ......... at premises Iocoted ot ~ ..~ ............ .~.~.....,.~.~ ...........~~ ............ ~ .... .q~....~ ........... County Tax Map No. 1000 Section ..... ~...o...~. ........... Block ...... .~ ............ Lot No. pursuant to application date~J'-".~.....~.. ................... , 19..~...(~., and approved by the Building Inspector· Fee $.~...?.~ ...... Rev. 6/30/80 TOWN OF SOHTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ..... VACANT LAND ........ ocatlon of Froperty .................................... HOUSE NO. k3 STREET HAMLET Owner or Owners of Property ...... ' .............................. County Tax Map No. ]000 Section ..!Q~. Block ..~. .... Lot ..~ ...... Subdivision ....................... Filed Map ........ Lot .......... Permit No. [~.~...Date of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $.. .e ............. APPLICANT.. , · ......... .. . . rev. 10/14/88 TOgrN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX I 179 TOWN IIALL SOUTIIOLD, N,Y, 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the followinq reasons. /_~/ An application for Certificate of Occupancy is not on /--/ No Underwriters Certificate on file. No tlea].th Dept. Approval on file. /5/ No final inspection has been made. this matter. Please contact our office on Thank you for your cooperation. lh~ildir',g Permi. t $! _L_ ~_-~__ .~_ ~ z Building Dept. ***/~/ ilo Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ,] ~J~PLBG. FOUNDATION 2ND [ ~'INSULATION [ ] FRAMING [ ] FINAL · REMARKS. INSP£CTOR~ ~~I OUNDATION (1st) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING iNSULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examin d'77". . . .... ApproX..~...., 19~.~- Permit No. ! ?.~..'~...~.. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERIVIIT Received ........... ,19... 558- 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 unti~-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 ne_c.~ssaw inspections. (Signature of applicant, or name, if a corporation) State whether applicant is owner agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . '_ ,_ 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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ........ .... ................ ................ Itouse Number Street Hamlet xj County 'Fax Map No. 1000 Section . j.b??.,~..'...~;l~?./.... Block ..... .~. ........... Lot ....... /. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~..~..~.._.q-- ' ' *'2 7/ ~ ~ ~ .~a ~- .... ' ........................ b. Intended use and occupancy ..~t~/~ z~ ~.. ~../~[qo~,~, .... . .............................. :3. Nature of work (check which applicable): New Building .......... Addition .. i Alteration Removal Demolition ' Other Work Repair ........................................ : ................. t 10.o.o ' . ' (Description) 4. Estimated Cos ... , ........................... Fee ........... ~ ........................... (to be p,'aid on filing this application) I ' 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ify h typ~ 6. If business, commercial or mixed occupancy, spec nature and extent of eac 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 of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ......... ~ ...... Depth ............... Height Number of Stories ............ '... ' 9. Size of lot: Front ............... ,.: .... Rear ...................... Depth ............... ....... 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: ...~Q .......................... 13. Will lot be regraded ....... ~ o .................. Will excess fill be removedlfrom premises: Yes No 14. Name of Owner of premises ~. ~ .... Addressl)l~..~li~one No. ,~[g. ~'.~7oq,~ .... · Name of Architect ........................... Address ................ !... Phone No ................ Name of Contractor Address' i Phone No 15. Is this property located withinti00 feet of a tidal wetland? * yes ..... 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 shOwlstreet names and indicate whether interior or corner lot. STATE OF NEW YORK, S S COUNTY OF .,~z.~... ..... · .... ,2'/,0 ............... ............................ · .~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) )f 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 nowledge and belief;and that the ~ork will be performed in the manner set forth in the application filed therewith,k Sworn to before me this ..................... day o ..................... , . ....... ............ LI~DAJ ¢ ' / ......... (Signature of applicant) Notary Public, State of New Yol~'~ No. 4822563, Suffolk Coun~t~l~ Term Expires December 31, 19