HomeMy WebLinkAbout17966-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217902 Date MARCH 29, 1989
THIS CERTIFIES that the building ACCESSORY
Location of Property 405 EAST GILLETTE DR. EAST P4ARION
House No. Street Hamlet
County Tax Map No. 1000 Section 038 Block 04 Lot 11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 29, 1989 pursuant to which
Building Permit No. 179662 dated MARCH 29 1989
was issued, and conforms to ail of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ACCESSORY SHED IN REAR YARD.
The certificate is issued to GEORGE MECCAS
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Y C.3~a.-e.
Building Inspector
Rev. 1/81
B08M NO.
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)
N fl 017 9 6 6 Z Date ......~./..1.4~:4M.....cx.d 19..4
Permission Is hereby grante~..to•
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t~-~c~ ~F^ rl......
lUJ . ~~__,,.tt,.,//.. ~
ct premises located at ~ ~.~.....~~:5~..~a .G~1.it.~. J..~~......-~:°-.:~~
...a`n
Counhj Tax Map No 1000 Section ~ Block Lot No
pursuant tc opplrcat~on dated .f,~t.S.Yn a'~ 19.~~„ and approved by the
E3uildmg Inspector.
Fee $
wilding Inspector
Rev 6/30/80
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO 1 SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
' TOWN HALL
SOUTHOLD, N Y 11971 NOTIFY
TEL.. 7651802 CALL
a,~ 198 MAIL T0:
Examined r+' i
Approved ~:~I. , I9~~ Permit No ~ ? 94~i~
Disapproved a/c
~ -a;~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 15 .
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 stree~
or areas, and giving a detailed descnptron of layout of property must be drawn on the diagram which is part of this appl
catron.
c. The work covered by this application may not be commenced before issuance of Budding Permit.
d Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm
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 Occupant
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmlding Permit pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the constructron of buildings, additions or alterations, or for removal or demolition, as herein descnbec
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t
admit authorized inspectors on premises and in building for necessary inspections.
G~o~.~'c...m~ ~...>r~g... .
(Sigr~ture of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builde,
7
.~I=ay.
Name of owner of premises a.°.'K- 1'QS. , : ~ . r; _ .
(as on the tax roll or latest de,rd) ~ , , 1
H ~py~ ~~tx~~ T°...~r.i I4. +IM,it7 wAt1~~3'1tQ'.l
If applicant is a corporation, s haat~i5~*b~y_a+yorized officer y,~ y~ ~,y 4
`~i ;rr 44 7~ ~ V~ ]rt• '1'si ~.1,~{t;Jf~~ 'i'i
.
. Vc'1s!a«1] M Y~tifiT8YlO3 ?7' `
(Name and title of taq ororate officer) '
Builder's License No. . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No .
I. Location of land on which proposed work will be done ,
. . . .
House Number Street Hamlet
County TaK M.ip No 1000 Suction Block . Lot . .
Subdivision Filed Map No Lot . .
. .Name) .
2. State eristmg use and occupancy of premises and mud use
amend occup/ancy of proposed construction
a. Existing use and occupancy ...5! a • •""t'•~y• ' •'•i'v'¢`4 .
.
~.v.,-,
b. Intended use and occupancy~~. !!!'.G: ~~`?'a'l ..J r-~z u~~ ~ .,D(„ , ~
3 Nature of work (check which applicable) New BuAdmg ~ Adddion Alteratson
Repazr .Removal Demolition Other Work . .
(Description)
4 Estunated Cost... Fee
(to be paid on filing this applscatson)
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. Dunensions of existing structures, if any Front . Rear Depth .
Height Number of Stones .
Dunensions of same structure with alterations or additions Front Rear .
Depth Height Number of Stones .
8. Dimensions of enure new construction Front Rear Depth
Height ...Number of Stories.
.
9. Ssze of lot. Front Rear Depth . .
10. Date of Purchase Name of Former Owner .
.
11. Zone or use district m which premises are situated . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation .
13. Will lot be regraded ....Will excess fill be removed From premises: Yes N
14 Name of Owner of premises ..Address ...................Phone No .
Name of Architect ,Address .........Phone No .
Name of Contractor . ....................Address ...................1°hone No .
15.Is this property located within 300 feet of a tidal wetland? *YES....NO....
*If yes, Southold Towa Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fro,
property Imes. Give street and block number or description according to deed, and show street names and indicate wheth.
interior or comer lot.
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II'~ ~ J ~9 1
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APPROVED AS NOT~E~.Dp ~
DATE 3 1 ~ B.P fii~~~,
~
FEE ~S'' BY
NOTIFY BUILDING DEPARTMENT AT ~ •
765 1802 9 AM Tp ~ PM FOR THE ,
FOLLO~'YING fNSPECTIpNS
1 FOUNDATION TVVO REQUIRED '
FOR POURED CONCRETE '
2. ROUGH • FRAMING & PLUMBING ,
3. INSULATION
4. FlNA1 - CONSTRUCTION MUST w~
All ECON PSTRUCTfON SHALL MEET VyvUPANCY UI~
THE REQtI1RHY1EfiTS OF THE N.Y. (1SE IS l1NLAW'~tlL
o~'oo~Ea Nc~ ~ ,roi WITHUUT CfRTiFtCATE
uES~Na+coNaTnucr~i tiF {iC~UPJAl1Clf
STATE OF NEW YORK, S S
COUNTY OF .
• • - • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicai
(Name of individual signing contract)
above named
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and ss duly authorized to perform or have performed the said work and to make and file th
application, that alt statements contained m this application are true to the best of his knowledge and belief, and that tl
work will be performed m the manner se[ forth m the application filed therewith
Sworn to before me this q
. ~~.......day oyyf . ~11k•4~:!~.. , 19 ~I.
Notary Public, , n,-, .~;L County
MJ.EII K DE MOE .
4~7~,p~ypp~p/ (Signature of apphcan
lkw Ezpka Wrdi 30.17--W