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HomeMy WebLinkAbout18516-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218405 Date SEPT. 22, 1989 THIS CERTIFIES that the building ACCESSORY Location of Progerty 6425 INDIAN NECK LANE PECONIC House No. Street Hamlet County Tax Map No. 1000 Secticn 086 Block 06 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT_ 12, 1989 pursuant to which Building Permit No. 185162 dated SEPT. 19, 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 ACCESSORY STRIICTQRE AS APPLIED FOR. The certificate is issued to HARRIET L. BAYLLS (owner, ) 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 ;.oBas xa s 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) No $ 5 6 Z Date .....ti.~.. ~.}-r.:~.~c.......F..`~......., t9...~.~ Permission is hereby granted ta: ~?:S,r.!?:!!:~:?~.... to ...~'...~1.`.~4.a~.~1:'.:~:51.~......4!-rm.....4~.C:......1~1.1-~i,f.R,.....41s:..~~(l{/1~-~".. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J. . J of premises located at .5~.°.'::^......'.'.!..Sl. ..~?L..........~.~~::.`.~ County Tax Map No. 1000 Section Q..g. Block .....0.~ Lot No....°1 pursuant to application dated .....°~A(~...)..9:l:rt~......f 19...1.., and approved by the Building Inspector. V i Fee S.~S.:~..... Building Inspector Rev. 6/30/80 TORN OF SOUTUOLll BUILDING DEPARTt1ENT TONN HALL $EP ~ 1~ SOUTDOLD, NE41 YORK 11971 ' 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE .."L/'ao2/d _ . NEH CONSTRUCTION . J::~:~tt/.~~hh.Op-LDO~R/~~PRE~-vE,%`/I/STIt7G BUILD I~N,rG,~_,~..~_ .VACANT LAND... _ . Location of Property~I?~`~.~~'L!~'~;=:~~^`:...~...~e~!~s".'=::.. UOUSE NO. STREET HAMLET Ovaer or Ovners of Propertp....~y~©©// County Taa Map No. 1000 Section CQ1P. Block ._~JR.. Lot- ..t~/_..._ Subdivision.. .pp. FilppedgqMappp ........Lot../.~..~..,/._. Permit No. .1P~~1Q.~Date of Permit ..L/~./~2~..AppLicaat G°?t~3'f4fG.~.~~_. Qealth Dept. Approval Undcruriters Approval...... PlaaninB Board Approval Request for Temporary Certificate .~P..._. Final Certificate Y Fee Submitted: $.~rl fi[~ APPLICANT.. CI~~..'~..__..._.... ~ 3 ~.~a s T r~~- [0/14/88 i~~~ 1.. L ..V.. Il ~.in.L ~I lf:'tl~i:N l.. • } i . 9 G. Ci . l/,oc. , m _ ~I - _ H =OUtiDATI011~ (1st) ~ ~ - - ?OU1dDATI0IJ (2nd) _ ~ - ~ ^ ~ o: .'.OUCH FRAME & PLUMBI;~fC 3. I a m n IIdSULATI0P1 PER N. Y. I '3 STATE EPIERGY CODE I _ ~ ~ ~ 4 . rn H FIi1AL ' ' o- ADDITIOtIAL COMMEtITS: x m • x b H 9 A . H H O m • ~ r • / y b m -e ~i • M • - BOARD OF HEALTH 3 SETS OF PLANS FORM N0. 1 SURVEY . TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM • TOWN HALL SOUTHOLD,N.Y.11971 NOTIFY Q TEL.: 7651802 CALL .~.3~ :(t Q.~."P..'...... . .~9., 19y ` MAIL T0: Examine Approved 19, 19g~. Permit No.l ~ ~ ~ ~ ~ ~ [y Disapproved a/c ~ ~l 3' SEP i 21999 A O.a+ ~Q' ~ ~i;.UG. DEPT. ' . ~!Y pn.::•s rlp S^ilTHOLD (Building Inspector) • • - APPLICATION FOR BUILDING PERMIT Date 15 INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wi sets of plans, accurate piot 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 st ror areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this a 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 pe 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 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 t. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descry The applicant acrees to comply with all applicable laws, ordinances, buIlding code, housing code, and regulations, an admit authorized inspector on premises and in building For necessary inspections.. (Si~npture of a pIi nt, or if a cor oration) • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bui .....~c~t'`~':~` Name of owner of premises ~?~ai..`?.SdL`~. J!' t~~. '~b ~ . (as 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 . . Outer Trade's License No . . 1. Location of land on which proposed work will be done. ,f:"."!~li.A;ti? ; • (/.Lt• ~,/~~~t+(~ . House Numbcr 6~i4~ Street Qaa~~, Hmnlet ~-~Cox~t1 1 , County Tax Afap No. 1000 Section Blpck . 6 Lot .:~I........... Subdivision Filed Asap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: > P Y a. Existing use and occu anc • • • • • • • • tt't S ; r:..... . b. Intended use and occupancy Yl~~.~~ • • • • • • •"~-/.~1/~kL+R?•'/h/ ~ ~,ej;~/~~-~~,~jjy J` 7 3. Nature of work (check which applicable): New pudding Addition Alteration . Repair Removal Demolition Other 1Vork , . (Description) 4. Estimated Cost Fee ([o be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor , , , , , , , , , , , , If garage.numbcrofcars 6. If business. commercial or mixed occupancy, specify na~rre and extent of each type of use , , , , , , , , 7. Dimensions of existing structures, if any: Front G.......... Rear .la............ Depth . ~ . Height G.` Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . Depth height ......................Number of Stories , h 8. Dimension Hof attire new construction: Front ~W Rear ../.odi.......... Depth . Height Q, , g Nu b r of Stories - ~ . 9. Size of lot: Front S®~ ' Rcar ~ d.~ • Dept ~ . 10. Date of Purchase ~ ~y 677......... Name of Former Owner . Lk:~Q~i . 11. Zone or use district in which premises are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ . 13. Will lot be regraded IVill exec fill Ue removed from premises: Yes D 14. Name of Owner of premises .p1Wl4e: ~ .r~ ~44 .....Address . .~87+cci'........... Phone No.'~ ~a 0.$S~... . Name of Architect ........Address ...................Phone No............. . Name of Contractor ................:.........Address ...................Phone No............ IS.Zs this property located within 300 feet of a tidal wetland? *YES....NO._t!: *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM , Locate cleazly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frc property lines. Give street and block number or description accorrlinn, to decd, and show street names and indicate wheth interior or corner Ibt. - 1 t4 ~ F fdtp-^ 6 t[as"' ~`'~j 1 ~ ~~r~~ ~ 1 2.32 . ~G . " 1 - .Y . J?~I ~f~"~4 *.1 ~ 4 ~RA air yin r~ ~`r ~'a ~ ~ CARRIAGE HOUSE ~ y ~ Our most popular model. An excellent "on Ic i 4 Lion sales office", pool house, or general slot. STATE OF NE1V YORK, ~ /'"ps~:~+e+ area for your home. A beautiful way to m COUNTY OF . , . • . S.S tw4 ~ your storage needs. Single or double doors J available on ALL MODELS. ......,tzla,ti'!+:e:~... : ?il~ being dul L (Name of individfral signing contract) Q above named. ' / ''f i(~% He isthe.....~!~lLs~ (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 Gle application; that all statements contained in this application are true to the Uest of his knowledge and belief; and that work will Uc performed in the manner set forth in the application Glcd therewith. Sworn to before me this p f.~n.....day of 19 ~,l No[ary PuUlic, G7V!,~. 4S-:. County MIS 11.8E~i0RA J-~n/tL/~, ry' ppgry pnblia, $tsts d lNw1Mk ! ~ ~ ~ . ?m•'~TSt p ( gnature oCapplic; nwilfisd>nJen. ~N7>~1 d Commifsfan EMpRM -