HomeMy WebLinkAbout18458-z ' FORM N0. 4
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18414 Bate SEPTEMBER 26, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1850 SMITH ROAD PECONIC N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 98 Block 03 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 23, 1989 pursuant to which
Building Permit No. 18458-Z dated SEPTEMBER 8, 1989
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 UTILITY ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to AGNETTA EWER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Buii
di~pector
Rev. 1/81
rosac xa s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
N 18 4 5 8 Z o~te ..D'~..~-~.~.......:~..........., i 9. ~ 4
Permission is hereby granted to:
. . : . . . . ~
. , .
- ~~-v
. . . . .
N ........~a~.~.........
Op ---11~ ,
at premises located at ...~..,R.~~....... .:.............J...~i,.G..f.:Y.kS..s.r............................
0.
....c,...... q.,r:.........:K..~.--
County Tox Map No. 1000 Sect' ......~.`.j.$........ Block Lot No.......~
pursuant to application dated a3..........., 19.?~~., and approved by the
Building Inspector.
Fee 5..,~~
B ing inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
r
BUILpING DEPARTHENT $ ~ ~ l~~ l,~' ~ ~
TOWN HALL ~
SOUTHOLp, NEW YORK 11971 ~'J'.'~ c ~ 2 ~
765 - 1802 ~ ~
_
APPLICATION FOR CERTIFICATE OF OCCUPANCY
igW GONSTRUCTIOA .......OLD OR PRE-EXISTING BUILDING......VACANT LAND........
.scat ion of Propsrtr 1950_ SMith_ Road . . Pec~onic. • ~ . .
YpUgi NO. STREET HA1fLET
~waar or Oxnera of Pcopsrtq.aFinetta ~wer
:ewaty Taa Map Mo. 10@0 Sactioa o,9,$... slack 03. Lot 19
M~aiN~.l{~Q4......~~rk~.~*sr....... Flled Map ........Lo[..........
aralc xo. 18,y,5,8~ ~ w,~A;l,~ of Permit 9~b~84 ..Applicant Epvi,rggrr}ent ~ast,~ Inc.
For Owner
salth DepC. Approval .......:~J.`~....... Uaderxritera Approval.,,~N~A.."
laaaiag Board Approval .....~~A........
x
equsst foc Temporary Certificate Final Certificate
Submittad: $...~~aQQ............
APPLICA ...;gyres:.....
Environment East, Inc.
10/14/Bg
C~e~~ 3ff 33~
~ o 181{
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~OUGH FRAME &
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II75ULATSOPI PER N. Y. . •
STATE EPIERGY
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D ~ ~ BOARD OF HEALTH
3 SETS OF PLANS .
•.i~~ FORM NO.7 SURVEY
M! i•~ TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
Lam' BLDG. DEPT TOWN HALL
TONJNOF50UTFfOtD EOUTHOLD.N.Y.11D71 NOTIFY
• TEL.:765~1802 CALL
E.iamincd ..°~.~~p"."~^. ~ 19 t MA i L T 0 : •
Approved~~!•. 19~. Permit No. ~ ~S~ ~
Disapproved a/c
Y ~ (Buildino Inspector)
APPLICATION FOR BUILDING PERMIT
' Date ~a 1 I ~^t 15
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Buildino Inspector, wit
sets of plans, accurate plot plan to scale. );ee according to schedule.
b. Plot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public str=
s or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this aF
canon.
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 pet
shall be kept on the premises available Cor 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 Occup?
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
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance-
Regulations, fot the construction of buildings, additions or alterations, or for removal or demolition, as herein describ
I.1[e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary inspections.
G U 113 t~ti~)M&~NT•~~s~r- ; 1,?~,„ .
(Signature of applicant or name, if a corporarton)~
3o75~"tJD~a0.[J ~Vl3C,C t~4NE3
....f'~'Rn.1.:c ...N.y .1145.x.... .
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or build
Vame of owner of Premises ~ lX ~
.T~ . F.r4 .
(as on the tax roll or latest deed)
f appli ncS t is 5 a i g ature of duly authorized officer.
,
(Name and title of corpo to officer)
Builder's License No. S,.t .J./a...~l
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
Location of land on wl[ich proposed work will be doge. ~ .
R
HouseNumbcr Strcet\ Hamlet
County Tax htap No. 1000 Section ..94 . • • • • • • •1 • • • • • Blpck • • Lot .
Subdivision . Filed Dlap No. , Lot
(Name)
State existing use and occupancy of premises and in[endcd use and occupan/cy of proposed construction:
a. Exis[ing use and occupancy ~ .k
: lA'•t'cti1~ • • ~ ~Q'~~ •~!J~• !~J ,C !tip! ~ i~(..S.I1?~....
b. Intended use and occupancy •~•~`Am•1.1•~•1~1~•e~?•~:t11~~~.•t'`~l•~p•~k.[i~+ 4-1..:1:ljll'~.~p.~h.~l:[.:
C~ ~ i t' i.~ p3 Z i~ (T~'--4~
3. Iv`ature of work (check which applicable): Nety Budding Addition Alteration
Repair Removal Demolition ~r~~...........
~,g~~ ~ (Dcsctiptio.
4. Esiimatcd Cost ..."!v,[(i,1G2~ Fee .
11~_ (to be paid on IIling this application)
5. If dwellin„ nurnbcr of dwelling units Number of dwelling units on each floor .
Ifgara;e.nuntbcrofcars
5. IC business, commercial or mixed occupancy, specify nature and extent of each type oC use .
1, Dimensions of existing structures, if any: Front . . Rcar Depth , .
Height ...............NumbcrofStorics.....................................................
Dimensions of same structure with alterations or additions: Front Rear .
Depth IIcig}tt , ..Number of Stories , , , ,
i. Dimensions of entire new construction: Front , .'l~. Rear .....t~..~~• • Depth , , , ,
Hci~tt Number of Stories
Size of lot: Front Rcar...................... Depth
Date of Purchase . Name oC Former Owner , .
L Zone or use district in which premises ate situated . , ~i.~s ! ~~:h?a:4~( . .
floes proposed construction violate any zoning law, ordinance or regulation: N Q
Will lot be regraded ~t~ Wi11 excess GII b r moved from premises: Yes
1. Name of Owner of premises ~ .~.t,.78~.......... Addressstn l~ ~ ~SWt~aC~l~ Phone No
Name of Architect ......::.....Address Phone No..............
.FnCart7 rG. ......Phone No..3.`/,. j`I7.~.:.
Name of Contractor ~.dVE+2~1n•2~.E~1~?-:~~.. Address~~~~aN~.~.4/A~~ ~
S.Is this property located within 300 feet of a tidal wetland2 *YES....NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildintrs, whether existing or proposed, and. indicate all set-back dimensions frc
operty lints. Give street turd block number or description according to deed, and show street names and indicate whetY
terror or corner lot.
ATE OF i;GW YOIZ}:, S.S
,LINTY OF .
being duly sworn, deposes and says that he is the applica
(Name of individual signing contract)
rve named.
istEte
(Contractor, 1?enE, corporate officer, etc.)
said owner or owners, and is duly au onze to perform or~have performed [he said work and to make and file tl
lication; that all statements contained in this application are true to the best of his knowledge and belief; and that t
k will be performed in the manner set forth in the application filed therewith.
~m to 6cforc me this q
..........day of 19 ~l
ary Public, C"~:`:e.'Y... ~ .~¢..~,~.II....... County
HELfNK~ d~NewYak (Signature of applica:
tllll'11RY PUBLIC, State ~yq ~