HomeMy WebLinkAbout18523-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218417 Date SEPT. 26, 1989
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property 17095 MAIN ST. & 705 2nd ST. NEW SUFFOLK
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block OS Lot 09
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. I8523Z 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 GARAGE (AS BIIILT)
The certificate is issued to RITA KNEUER
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
.SG~dEti~Il~+'~' SCr-S
Building Inspector
Rev. 1/81
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
fTH15 PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
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N _ ~ ~ 2 3 Z Date I9.~:~
Permission is hereby granted to:
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...r'~.LLZ•..~1...L..•....~~...~!!Cr~....r?.••rrvy~~/~I. ~r.././.r..,,~GG. 1.
to ..a.~..... I/
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at premises located at .....(...,7...~.~..~.:.ll.L.,riO!?!R~. ,,......~..~a~~!~1~...~~.~~/
.........................................................................................................f......................................................
County Tax Map No. 1000 Section ..f...~~........ Block ..nn..~,,,Z'...........QLat No........G~
pursuant to application dated ..............~,..~e~......, 19.x! r, and approved by the
Building ~Ijnspce-ctor.
Fee 3...d.~..l...p.~~
Building Inspector
Rev. 6/30/80
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TOWN OF SOUTHOLD
SEP i 21989 IIUILDINC DEPART:SENT
TOWN HALL
"_tx~, "-p,Y. _in , SOUTIIOLD, NEW YORK 1 1971
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7b5 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE
NEW CONSTRUCTION _......OLD OR PRE-E%ISTING'/HUTLDING !y~-:?.VACANT LAND........
Location of Propertyf7~=~.~.MLQ!/}~`-.'( ,..,/,K~!4(:7i~JFaL?C...~~~__~/_~/JJ~.
HOUSE NO.~ STREET HAMLET
Ovaer or Owners of Property, , .2 :.?r9 . , ~nl~ v
CounCy Taz Map No. 1000 Section B1ock ..D._.. Lot ..L......
Subdivision Filed Map ........Lot..........
Permit No. ._....._..Date of Permi[ .....,....AppLicant
IIealth DepC. Approval Underwriters Approval__.._..__._.._
Planning Board Approval
RequesC far Temporary Certificate Final Certificate
Fee Submitted: $
APPLICANT... ~
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rev. 10/14/88
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~ TOWN OF SOUTkIOLD
J33UILDING D>rPARTriRENT
'M'OWN CLERIC'S OFFICE
SOUTFIOLD. N. Y.
CERx'YFICATE OF OCCUPANCY
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No..Z1433............ Date .:...:....,.:....:.........Qc~;.alac~.'..;..J......; 19...{x2
TI31S CERTIFIES that the building located at Id~S...Hi2i.i1...8.$. ci...L:,tks .k:ric1...C°.~: Sheet
!atap `io. ..7~i~:={........... Bloch No. a::.:3G............i.of AJo...;t:L':.....I:?Ctl..;:.P.Y'T'.u?.1t~....il..Y.u.........
c•onfnrms subsiantia]]yj to the (Application foru.Buildinf; Peraxit heretofore filed in Utis office
dated ............................~ta7iy.••••;?0~ 19...(jg pursuant to which Building Permit No, .!1,~,~;',1......
dated ................................5ta~.g..2C1 19•..•63 was issued, and conforms to all of the rcr}uirc-
meuts of the applicable provisions of'ttre law. Tl+.e occupancy for xvhich this certificate is
issued is ...prly:a:~,...iseao...i't.!i1:5....~•tre133ng
'Phis certificate is issued to ..~aYite..:...LpPt1 ................pzlnei.............................................
(owner, lessee or tenant)
of the aforesaid building.
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Building inspector ~
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1i ~ ~ ~ ~ TO'WN OF SOUTHOLD ~
• IiUILbING DEPARTMENT j
• TOWN CLERK'S OFFICE ~
SOUTIiOLD. N. Y. I
i .
CERTIFICATE OF OCCUPANCX ~
No. ...~e...{~~.7....... ; .;;:`.:."_pate .:::............................&e.p.temkzc°s;....,~9..6p
THIS CERTIFIES that Lbe building located a) ,,,N/,.~i...Y~[ttin..C,~..L~?..S.eaond...St.......:. street
37ap No. %'•?~X,Y..Y,..,.,.... I~IocI:.Not ..~(i~7c.w.6r..inpt+-~q`;~t~`;:.Nc~t~i.,S11~f.o~.k~.....N...Y........':
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conforms substantially, t.n the A~plicatigh'fq}! ~St}IldAlg' i'crmit heretofore filyd in this office
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..A,.x~.1...., fi...: 19~i.C?,..:,. ursuant t
gated r! , was: issµR which Building Permit No...~a..~.Q~Jr.......
dated { Q `itnd Ronforms to a? of the requirements
n ~ . I'.~........p '
April 26 60
of the appiicab]e provisions of the law. The gecp~R~Gy foi• which this certificate is issued is
Privat
e tr;9 ~'~to~.a3'...dVtaJ.lixLg
This certificate is issued to ...Da?1:G.~......TaAxti.~,,,~,~~~~~,~~:........1.avmc:r..)
(owner, lessee or tenant)
of the aforesaid building.
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o~~c~~FF~(k~o TEL. 765-266D
~ ~ TOWN D~ SOUTH?LD
OFFICE ~F BUILDING INSPECTOR
~ ~ TQWN CLERK'S ?FFICE
~DI ~ ~~0 5DUTHDLD~ N. Y.
January 28~ 9972
I~Ir. Richard Cron, xttorrey
~~ain Hoed
Cutchogue, il.Y.
Dear Sir,
as requested. in your letter of Jan 26 th I am enclosing
copy oi' original C/0 anc. copy of C/G for addition on premises ~ d~;~el-=ing
of 1-ante Lorti~ second r: main Sty Ne`~r Suffolk T'i.`i,, for ~,~rhich r,lec.se
remit fee of ~ for copy of Toti~'n recores,
7:'r.e t,,ro family dwelling meets tl~~e requirements of t:~.e
housing code,
Enclosed please find. an °informGticn sheet" or_ n~t:~ orcir.=.nce
procedures, fees etc,
Yours truly
1
builcirg Inspector
0 ~ ~ O M 12 L ~G_.,eN BOARD OF HEALTH • , .
l! l5 M""'~ 3 SETS OF PLANS - • • • • • -
FORM N0. 1 SURVEY .
S~ 121989 TOWN OF SOUTHOLD CHECK • - • • • • • - - -
F ~ BUILDING DEPARTMENT SEPTIC FORPI
• TOWN HALL
BLDG. DEFT. N O T I F Y
TOWN OF SOUTHOLD .~.OUTHOLD, N.Y. 11971 CALL - - • • • • - - - - - - - • • -
TEL.: 765.1802
MAIL T0:
Examined .................19...
Approved/~~l~C.... ` . 19~ Permit No..1.~
Disapproved/a/c
(Buildinglnspector)
APPLICATION FOR BUILDING PERMIT
Date . ~ 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 azeas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app
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 peiit
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 Occupam
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
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ=
The 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 inspect!io~.
(Signatttre of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build=
Name of owner of premises ..../.4?!1'.a!. , l(~ .
(as on the tax roll or latest Bleed)
If applicant is a corporation, signature of duly authorized officer.
.
(Name and title of corporate ofFccr)
ALL CONTRACTOR'S S BE SUP OLK~t'C~lJNTY LICENSED
Builder's License No.~. . ~i~~~?Za
Plumber's License No. .
Electrician's License No. .
O[Etcr Trade's License No . .
1, Locatio d o w}ric prop sed wo wiu be done
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House Number Street pp Hamlet
County Tax ltilap No. 1000 Section ....j 17 , . , , , , , , Block G............ Lot , ,
Subdivision Filed \lap No. Lot .
(Nmne)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .~'.'.L .
b. Intended use and occupancy ...4?:!`t.~ !.`l: ~ .
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal Demolition Other Rork
4. Estimated Cost . ~ d'~ ~.~`r.~.~ Fee
` (to be paid on filing this application)
5. If dwelling, number of dwelling units . Number of 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 .
Heigttt ...............NuntberofStories........................................................
Duttensions of same structure with alterations or additions: Front Rear .
Depth ......................Height Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth .
Height ...............NuntberofStories.........................................................
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 .
! 2. Does proposed construction violate any zoning ]aw, ordinance or regulation : .
13. 1Vi11 lot be regraded ............................Will excess fill be removed front premises: Yes No=
14. Name of Owner of.premises ....................Address ...................Phone No............... .
Name of Architect . .........Address ...................Phone No................'
Name of Contractor ..........................Address ....:..............Phone No...............
15. Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit may be reqgu~ired.
PLOfi DIAG1tAM
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 show street names and indicate whether
interior or corner lot.
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iTATE OF NEW YORK, S.S i
_ ,-.-..-~u+.-.n./ . being duly sworn, deposes and says that he is the applicant
(\amc of indir•idual signing contract)
hove named.
is is the ~ G?i!._?:L-..~ . .
(Contractor, agent, corporate officer, etc.)
f said owner ar owners, and is duly authorized to perform or have performed the said work and to make and file thie
^plication: that alt statements contained in this application are true to the best of ltis knowledge and belief; and that the
ork +vill be performed in the manner set/~jth in the application filed therewith.
worn to before me this / '
~ .`.......day 19
otaryPublic, ' Y
~ ~ Count
Notary Pum~ , 5reu,of New Yak (Signature of applicant;
No 2.2959800
QL'nliriHO it Suffolk County
Commission Expiros March 30, t