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Home My WebLink About17371-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~4ENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17832 Date MARCH 10~ 1989 THIS CERTIFIES that the building Location of Property 1750 SMITH ROAD House No. County Tax Map No. 1000 Section 98 Subdivision PECONIC, NEW YORK Street Hamlet Block 3 Filed Map No. Lot 20 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18, 1988 pursuant to which Building Permit No. 17371-Z dated AUGUST 30¢ 1988 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 CLOSE IN EXISTING PORCH AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A KATHERINE M. RAYNIS Building Inspector Rev. 1/81 FOR~ 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) 01737! Z Coun~ Tax Map No. 1000 Section ......... .~..~.. ....... BIo~k ...... ,~... .......... Lot No ....... ~ ........ pursuant to application dated ............... ~..././.~.. ....................... , 19~..~,, and approved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTROLD BUILDINC DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ATE. ....... N~W CONSTRUCTIOH ..... OLH OR PRg-gXISTI~G B~ILDI~G ...... ~A~T LA~D HOUSE NO. STREET HAMLET ' O~aer or Oaners of Propert7 ............... .~ ............ Subdivision. .. Filed ~ap ........ Lot .......... /ZS TI ~ ~o. ..~......~ o~ ~ .... ~ ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificates ............... APPLICANT~..~ . . ~ev. 10/14/88 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION 2ND [ ] INSULATION FRAMING [~'~NAL DATE INSPECTOR ~~ ~ 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~SULATION [~FRAMING [' ]FINAL REMARKS: ~ 7~- ~ ,~ DATE FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME &~/ .PLUMBING INSULATION PER N. STATE ENERGY CODE FI~{AL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD Approved . .¢?. ..... '.. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19 ., 19 .~..~Permit No / Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ....................... SEPTIC FORM ................ CALL ........ "(Buii~sz~g Inspector), APPLICATION FOR BUILDING PERMIT & INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter orin ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and 9f buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 permit shall be kept on the premises available for inspection throu~hout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, a,d, ditions or alterations, or for removal or demolition~,~us.,,herein described. The applicant agrees to comply with all applicabie laws, ordinances, buildings, code, housin~ code~nd regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necesi~ ~_~~ State wh~iL.a~l~a'nt 4~ o~n~r/!e~ee, 9gent, arcintect, en~neer, general contractor, electnczan, pluml~r or bmlder. ~'~ ', ~, [~ [ (as on tile tax r~l or latest deed) ' If applicant is a corgo.ration,.signatta~'e30~*duly authorized officer. ....... t- M' ~-,a'.. t4) · ~ ~ ;~,< ~i~i~.~L;~L. ~, ............ ~ ..l(~0De ~d,~ti:ff~ao~o~orat~ bffieer) Bu ~lo, eaae No ..~ : ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... OCCUPANCy 0R USE iS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCy I. Location of land on which pro~sed work will be done/~-~x'x ............ ~ ,/~f~) ..................... ...... House Number Street Hamlet County Tax l'.).~ No. I_000 Secti~,. ~,.. ~.¢-~.,~..f[ y~,.,, .,fi-- ..... Block ....... , .,~-..,.. ....... Lot ................... Subdivision (Name) .... 2. State existing use and occupancy of premises and intended use and oc.qupancy of prop~d construction: "' '"' "~.11.~'' '~'~" '~ b. Intended use and occupancy ................................. v~ 7,,.-.. < <i "'/' ........ i o a "i-t~ ......... Demolition .............. Other)%~J~.l.~l~.. 'i ~.. 4. gstimated Cost /..~...v. ~ ........ t' · · ...................... vec ................. I / (to be paid on filing ~n) , this applic'ati 5. If dwelling, number of '~ · dwell,ng nmts ...... Number of dwelling units on each floor If garage, number of cars ; ...... - ............... 6. f business, commercial or mixed occupancy, specify nal_t~e and extent of each type of use ............. 7. Dimensions of existing structures if any: Front [.~.. ' r~,r d'~"'~' / Depth.. t~.q. ;' ...... Height ............... Number of Stories ............................ Dimensions of same structure with alterations or additions' Fro~t"i' .~i'i . i r~ar... ~.Z4'.' ......... ~D?th .....~a~ ~.../ ......... [ .... Ileight... ,~. ~j~ ......... Number of Stories ...... -unensmns o~ entire new construction: Front . ."w;..(-/. Rear ...... . ."TT'. .... Depth ..... .-7 ....... Height ............... Nmnber of S~gries ..... ..... ... ,, ........... Size of lot: Front ...... ../-(--~ ' e_p.$h/ ~/.~.~:'.. ' ....... : m. : ........... DateofPurchase ...u3;;..i .. · ...... a e of Former Owner ......... Zone or use district in t i h premises are situated .................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ...... ......... Will eX, ceos fill be zemove~ from premises: Yes. .Nc Name of Architect ....................... Address, ~. ?..~.. ~ ....... Phone44o. /~0..'T.~....~.o~-. ~. Name of Contractor ....... ~ .................. Address ................... Phone No ............ i... 15.Is this property loeiated within 300 feet of a tidal wetland.* ~YES .... NO .... · If yes, Southold Town Trustees Permit may be required. ... i PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block interi~o~rner lot.. -- ! number or description according to deed, and show street names and indicate whether ' 8. 10. 11. '12. '13. 14. STATE OF NEW YORK; i COUNTY OF....,, ,: _... :,. .... -. (Name of individual s~gnlmg,contract) above named. FEE: ~.~... ItY:. ~ FOL~WING INS~ONS: 2. ROUGH - 4. ;tNAL · CON~NM~ THE REQUIR~E~ ~ T~ N.~ STATE CONS~U~N DESlON OR ~ffiU~ ERROR$ ....... being duly sworn, deposes and says that he is the applicant He is the ; ;' (Contractor agefit corporate officer etc ) of said owner or owners, and is dul~ authorized to perform or have performed thc said work and to make 'and file this application; that all statements contdined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this i Notary Pub ic ~ . .~.,g ~'~' n