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Home My WebLink About21234-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22188 Date MARCH 10, 1993 THIS CERTIFIES that the building ADDITION Location of Property HEDGE STREET/FOX AVENUE, FISHERS ISL~ND~ NY House No. Street Hamlet County Tax Map No. 1000 Section 6 Block 2 Lot Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 9, 1993 pursuant to which Building Permit No. 21234-Z dated FEBRUARY 22~ 1993 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 36'x 43' ATTACHED GARAGE "AS BUILT" TO EXISTING ONE-FAMILY DWELLING. The certificate is issued to of the aforesaid building. ALFRED R. GREBE, JR. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. RENDING PLUMBERS CERTIFICATION DATED N/A MARCH 9~ 1993 · Building I~specLo Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMt:NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N? 212~ Z Permission is hereby granted to: ~o :;.~.~...~.z~.,,....~....~... ,o ......... ~ ......... ~...~..~.~....':~..~~ .................... cou.,~ Tax Map No. ~000 Sec,,o. ........ ~.. ........... B,~k ........ ~ ..... ,o, No ..... /....~ .......... pursuant to application dated ........ .....~~ ........... .~. .......... , 19..~.~.., and approved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPAHT//ENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NE;/ CONSTRUCTION ''''~-.-OLD OR DATE... ~.~.~.~.? ...... Location of Property ........... PRE-EX~Tc BUILD~NG... .... VACANT LAND ........ HAMLET ' .......... "' ney Tax Hap No. 1000 Section . ~ .~ '"~"~ ......... . . . '~- Block ..,~_~. Lot ../.~... Subdzv~s~on .......................Filed //ap ........Lot .......... Health Approval .................. Under~rlters Approva 1~' Planning Board Approval ..... Request for Temporary Certificate ....... Final Certificate .... THE NEW YORK BOARD OF FIRE UNDERWRITERS WE ARE IN THE PROCESS OF iSSUING CERTIFICATE OF COMPLIANCE FOR THE ELECTRICAL NSTALLATION AS COVE E IN AN APPLICATION NOTED BELOw, xE.~;){ APPliCATION NO. __ ~__~_~ rev. 10/14/88 (1st) IDATION (2nd) %OUGH FRAME & .PLUMBING I~SULATION PER N. STATE ENERGY CODE FI~AL ADDITIONAL COMMENTS: xamincd ................. 19,., .ppro,.ed . FORM NO. 1 TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .... I P .~.ff Permit No ......... BOAgD OF HE*~LTII ~ 3 fiF_.TIi OF' PLAH'~ fiURv£Y CIICCK ................... SEPTIC F 0 R,'l ............. NOT~PY: CALL ................... HAIL TO: isapprovcd a/c ..................................... ~r Curtzs Horton . (Building Inspector) APPLICATION FOR BUILDING PERM IT INSTRUCTIONS Date ?ebr uar ................. 19 a. Tiffs application must be completely filled in by Wpewdter or in ink and submitted to the Building I.nspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appLi- iON. C. The work covered by this application may not be c'~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 11 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 11 have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depm-tment for the issuance of a Building Permit pursuani to the lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :ulations. for the construction of bu;ldings, additions or alterations, or for removal or dot, elation, as herein described. : applicant a_~ree~, to comply with all applicable laws, ordinances, buildin~ cffde, ~hO~.l~RUg/cod~, gad.regulations, and to ,,it authorizec~ inspectors on premises and in building fo r~ necessary ~.a~j~/¢~~ . .... .-.~ (Si,,n.~l,~fe ol~ applY, cant, or name, ff a corporanon) ~c/X~',~ Bbx~ :~'~; Fo~f avenue · 5o.r .q ..379. ........ (Mailing address of applicant) :e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner and Geq~ral Cg~tr~gtor '. ne of owner of premises .......................................................................... (as on tile t~l roll or latest deed) )plicant is a corporation, signature of d~[7,tim0~}i~c~i~.P, li~ " ........................... ' " Plumber's License No ........... '. ............. Electrician's License No ....................... 1 32L~5-HI Other Trade's License No ...................... .ocation of land on which proposed work will be done .................................................. ... UP..~ .? p.x..A..y .e.n.Rq ................... F. i~h.e.r.~. I~.la~¢ .................................... Duse Nmnber Street Hamlet .)nnty Tax Map No. 1000 Section ....... .~ .......... Block .... ..~; ......., .... Lot .................. :bdivision Filed Map No ' ' ~ ' Lot (Name) ate existing use and occupancy of premises and intended use and occdpaficy of, proposed construction: ' R..e.~.~.d.q O:~.~.~ ' Existing use and occupancy ............... :' d Res i~Q~j~l ' ,. ':' (,,v,~'/,,,,~ ~','~ - Intended use an occupancy .... ,.. · ................ t¢:~.. ;, t t,. ,. ,t ~,,~.. ~. ~,i ..,y~,; ~ ~,~!~ ....... ,. 3. Nature of work.ck which apPhcable), New Budding ......... · Addition., ......... , ..... ,\lteranon . Repair .... · ......... Remowll .............. Demolitmn ........... .'.. Other Work ............. $15 000 I $214 60 GARAGE (Dcscnptionl 4 Estimated Cost ' i (to be paid on illin,; this application) 5.. If dwelhng, nu~,ber of dwelling units ..l~lgR .......... Number of dwelling umts on each floor ......... Ir garage, cumber of cars .~.*~ ~ a.~' ..... 6. If business, commercial or mixe 1 ' ' . · occupancy, specify nature andextcntofeach ypeof se . . .......... .7. Dimcnsionsot'existingstructures i'f--- =- · 46' · "~, ..... -,,-, ' height . .4.,Y ........... Nun] lei' o 'Stories one ' ' ' · ' Dunenst°"Lsgfsame stn'cture with{alterations or addit;,-,ns, e,,--* /$~; ............ ,~',~,' ' "¥q'; ............ of entire new construe(ion: Front . , g.~., .......... Rear .... /-i~: ........ Depth ...}6,' ..... ' .... Height . .l.~: ........... Number of Stories .... o~o, ..... 1. Zone or use d,stnct ,n wh,ch premiles are situated...l~{%~.d. 9 .n.'tj..a. 1../3j.g.h-li;' 0p. nlr0e~y.e.i.~% 2. Does proposed construction violateiany zoning law, ordinance or regnlation: . .N'6, 3. Will lot be regraded .8.O ........ ' ....................... ................ Will excess fill be removed from premises: ~ No 4. Name ore,vnet Ofprcmisqs ,]:ed . Grebe t,,la~,,~, Fox Avenue Phone No ....... Name of Architect ...................... Address ................. Phone No. Name of Contractor........same .s.s., owner ................. .............. Address ................... Phopc,c~No ................ 3. Is this proper~y within 300 feet of a tidal wetland? *Yes ........ No...~.~. .... ~If yes, Southold Tow Trusgees Permit may be requirod. .... I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from :operty lines. Give street and block number or descriptioh according to deed, and show street names and indicate whether :terior or corner lot. f T~- or, NmX ¥OR~, ' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Alfred R, Grebe, J~ .............................. { ............... behlg du[y sworn, deposes and says that hc is thc applicant (Name of individual signing ctlntract) c named. { Owner / General .Ciqn..t,r.ap.t. gr i (Contractor, agent, corporate officer, etc.) id OWner or owners, and is duly aufiionzcd to perform or/lave perfon.ed tile said ~vork and to make and file tiffs -'atica; that all statcmants contained in this application arc true to the best of his knowledge and belief; anti that th0 will be performed in the manner set ferth in the application filed therewith. a to before ~n¢ this . ........ 1.? ....... davof PUBLIC, NEWIYORi( STATE ~/ . (Sig~ture of applicant) NO, 01_WA9509,185 QUALIFIED IN ~tUFFOLK COUN?Y~ TERM EXPIRES OCTOBER 31, 19"~°r-- /