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Home My WebLink About18809-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zi9760 Date FEBRUARY 27~ 1991 THIS CERTIFIES that the building ADDITION Location of Propert~ 1050 SMITH RD. PECONIC House No. Street County Tax Map No. 1000 Section 98 Block 03 Lot 28 Subdivision Hamlet Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 9, 1990 pursuant to which Building Permit No. 18809Z dated FEB. 27~ 1991 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PENDING SLIP 2/26/91 PLUMBERS CERTIFICATION DATED ROBERT HENN & JOANNE TEDESCHI K & K PLUMBING 2/27/91 Rev. 1/81 // ~uilding Inspector IPO~-M NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°" 18809 Z Permission is hereby granted to: / . ~. .............. st prernis~s located at ....~....'~.... -.~..~ ........ [~..~.~.../~.~..4. ..................................................... County Tax Mop No. lO00 Section ....... .~..~.. ....... Block .......... ~.. ...... Lot No ...... ~.~.. ......... pursuant to application datesI,. ,.~..~..~.~../..,~,., .......................... 19~...~.., and approved by the Building Inspector, ~ Fee Rev. 6/30/80 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! I971 TEL. 765-1802 TOW~ (: C E,,R T I F I C A T I O N Date (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. .~ (pLumber's signature) Swo,rn~o before me this/ _ ,,~da~, of ~e~,~/C~? ,, Notary Public, / County Notary Public Term FOU~ID A'T ! 0 ~'! ( 1 s t ) FOUUDATIO~'; 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FiliAL ADDITIONA'L COMMENTS: Z3 MAp O~ P~OPF.~TY.- ..... $~1ZV~¥¢, p ~o~: Jo~ ~2d_.LW~Ls ~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROU(3H PLBG. FOUNDATION 2ND [ ] INSULATION ( ] FRAMING [~FINAI. REMARKS:, DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~/]~NAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH P~-BG. FOUNDATION ZND ~I~TION FRAMING [ ] FINAL DATE~~ 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND I_ ] INSULATION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [~ROUGH FOUNDATION 1ST PLBG. FOUNDATION 2ND [ ] INSULATION ~,,~FRAMING ~r ] FINAL 765-1802 BUILDING DEPT. INSPECTION ] F~IDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR '~'~-/-~-i /~'~ 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE BLDG. DEPT. TOWN ,O? SOUTHOL~ . ..~...~.~ .9'75'.. ...... 19'~ Examirted - · · Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-180,'3. BOARD OF HEALTHA'A' ....... SURVEY ~'~ CHECK ..... .-&.~ ........... SEPTIC FORbl ............... NOTIFY~ MAIL TO: INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, will 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 stre, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is parr of tkis ap,, 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 pen~ 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 airy 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Re=ulations, for the construction of buildings, ad. ditions or alterations, or for removal or demolition, as herein describe Th~ applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspector~ on premises and in building for necessary inspections. (Signature o£ ~pplicant, or name, if a corporanon) (Mailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises '(~.O t~ ~_A"C {e~,~-v', ~ ~t -3'00_ 9q v't~' ~-~_ cQ ~ S C3,-1 'l (as on the tax roll or latest deed) If applicant is a corporation, signature or' duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ t..O ~ ~ fa' Plumber's License No Electrician's License No Other.Trade's License No ...................... 1. Location of land on which proposed work will be done; }louse Number Street, Hamlet County Tax Map No. 1000 Section Subdivision ..................................... Eiled Map No ............... Lot .............. (Name) 2. State existing use and occupancy or premises and intended use and occupancy of proposed construction: . a. Existing use and occupancy .. t¢ ........... ............. b. Intended use and occupancy · 3. Nature of work (check which applicable): New Building .......... Addition .......... Allcration Repair .............. R~moval .............. Demolition ............. Sw imrai, m~.. Tennis Court ......... Accessory Building .......... Fehee ....... otti'~r-wor}~.: .......... 4. Estimated Cost .~. [ 8.. / .~..~..O. .......................... Fee ..................................... · (to be paid on filing this application'} 5. If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of cars ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................ 7. Dimensions of existing structures, if any: Front.., ............ Rear ............... Depth .......... Height ............... Number of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ...................... Height ..................... '. Number of StoNes .................... Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories .............. ; ........................................ Size of lot: Front .~o.~ Rea~ 10~, / 8 t Depth !i ii¢ ii'ii 51 ......................... "" .... -' ........... Date of Purchase ..... t ..... Name of Former Owner . .T.C?..~ 10. 11. Zone or use district in whicli premises are situated ................... .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... · 13. Will lot be regraded ............................ Wil} excess fill be removed from premises: . Yes .... No 14. Name of Owner of premises ................ :.... Address ................... Phone No ............... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ................. i ........ Address ................... Phone No ............. 15.Ia this property located within 100 feet of a tidal wetland? mYES--.~2'NO-:.- ' ~If yem, Southold Town Truatees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate MI set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whethei interior or comer lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sxvom, deposes and says that he is the applica (Name of individual signing contract) above named. l-}e is the ........................................... .' .......................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe?orm or have performed the said work and to make and file ti application; that all statements contained in tills application are true to the best of his knowledge and belief; and that t Work wUl be part, mind in the m~ner set forth in the application filed therewith. Sworn to before me this , 2 ...................... day of ...................... 19.. Nora, Public.. ¢~'~ ....... un ............... (Signature of appHe-~,