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Home My WebLink About17639-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18153 Date JUNE 28r 1989 THIS CERTIFIES that the building. ACCESSORY Location of Property 2305 ELIJAHS LANE & 125 TABOR RD. MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 04 Lot 7.13 Subdivision ELIJAI{S LANE ESTS. filed Map No. 6065 Lot No. I0 conforms substantlai1M to the Application for Bullding Permit heretofore filed in this office dated NOVEMBER 22r 1988 . pursuant to which Building Permit No. 17639-Z dated NOVEMBER 28~ lg88 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 & STORAGE BUILDING WITH NO ELECTRIC AND NO PLUI~BING. The certificate is issued to of the aforesaid building. (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Inspector 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) NR 017639 Z County Tox Mop No 1000 Section ..... /.~. {~ pursuant to apphcat~on dated .../././~...,.~T~... .... Building Inspector. ........ 19~.~., and approved by the Kev 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOHTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ......... NEW CONSTRUCTION ....... OLD OR PR VACANT LAND. E-EXISTING BUILDING ............. HOUSE NO. STRE~T HAMLET ............................... Owner or Owners of Property County Tax Map No. 1000 Sectlon~/~.~-. Block .~ .... Lot Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ . C~.~ . ............... APPLICANT~ ...... ..~~. ........ rev. ,10/ 14/88 '-OUNDATION (1st) fOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION ZND [ FRAMING ~NAL REMARKS: ROUGH PLBG. INSULATION DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING FINAL REMARKS: ~ ,, DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [_ ~'~IDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: . DATE ~ INSPECTOR' If copper tubing Is used for water distributing ~/stem; plpi~ng shaft be of types K__~ror L only_ / Examined ///~"' ~:: . Approved ///~ Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y 11971 TEL.. 765-18013 , 19 .~eermlt No /7~.~.~7~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ................ MAIL TO: APPLICATION FOR BUILDING PERMIT Date , 19. INSTRUCTIONS a Tins application must be completely filled In by typewriter or in mk and submitted to the Braiding Inspector, with - sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc street or areas, and g~vmg a detmled description of layout of property must be drawn on the diagram which is part of tins apph cat,on c. The work covered by tlns application may not be commenced before issuance of Budding Permtt d Upon approval of this application, the Building Inspector wdl issued a Budding Permit to the apphcant Such petrol shall be kept on the premises available for mspechon throughout the work e. No braiding shall be occupied or used in whole or in part for any purpose whatever until a Certfficate of Occupanc, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldmg Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of bmldmgs, ad&hons or alterations, or for removal or demolition, as hereto described The applicant ag~rees to comply wtth all apphcable laws, ordinances, budding code, ~smg code, and regulabons, and t~ admit authorized msnectors on premmes and m budding for neces~, i.nspecttons/~/) " '~ ( // (Signature of apphcan~or name, if a corporation) ?* I[13~¢13 '~l- jn,a ~ , ,, (Mailing address of applicant) / t ~/'~' 2. State whether applicant is o~r~r, lessee, a~gent, architect, en~neer, general contractor, electrician, plumber or builder= n~,~ ~ ~:til~.~W il,~O~" ........ Name of ............... ~lOa[ ~ ~ 2g.t*'~t3'" (as on the tax roll or latest deed) If apphc~~,,~l~*htlt~e 6Dtt~'I~ authorized officer (Name and t~tle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's License No .... LICENSED Plumber's License No Electrician's License No Other Trade's License No . - . Location of land on winch proposed work will be done House Number Street /*2 ^ 7'-7-1 Hamlet 2 County Tax Map No 1000Sectmn /O ~ Block ~.~. .. Lot. Subdivision/i/]A .~'[..,I,d./-t~S' ~A,I/~ ~ ~ Fded Map No ~ ~ Lot /~. (Name) State ex,sting use and occupancy of premises and ~ntended use and occupancy of proposed construction a. Existing use and occupancy ~5 / ~ ~.~ ~. .. b Intended use and occupancy ~...~ ~ .~ .... 4 5. Nature of work (check which applicable) New Building / Repmr . Removal .. Esttmated Cost ,~Oo oI o.o If dwelhng, number of dwelhng units If garage, number of cars .. Addition .. . Alteration Demolition . OtherWork ~f'~--,)/ '. (Des~np~tion) Fee ............. ' (to be paid on fihng this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify n,ature and extent of each type of use Dimensions of existing structures, lfanyt Front a~ Rear ~.=~P'=t9~ Height Number of Stories .. Dm~enslons of same structu~re_.w~kt~h alterations or additions Front Depth t~ ,-.1i~. Height . 8. Dimensions of entire new construction Front ',~q- O Height ~ 5. - ~ Number of Stones 9 Stze of lot Front Rear . . 10 Date of Purchase .. . Name of Former Owner .......... 1 1 Zone or use district in which premises are situated /~.~SL~47&a/.T-.~.~ ........ 12 Does proposed construction wolate any zoning law, ordinance or regulation ............. 13 Will lot be regraded Ad ~o ........... Will excess fill be removed from premises 14 Name of Owner of premlses l)/ttul-v~' tl>gt-,)/~, Address .~3o.r~,t.O,q~ z-a,,.gPhoneNo ~cl..~-F~'x-t;' - Name of Architect ...... Address .... Phone No. .. Name of Contractor ........ Address ...... Phone No ........... 15. Is this property located w~thin 300 feet of a tzdal wetland? *Yes ..... ~_~ ..... *If yes, Southold Town Trustees Permzt maybe reouzred. PLOT DIAGRAM Depth . ~... ..... Rear Number of Stones .. Rear ,2. ~ - C./... Depth . ~ 8~- Ct · Depth .. Locate clearly and dtstsnctly ali buildmgs, whether exlsttng or proposed, and lndtcate all set-back dwnenslons frou property hnes Give street and block number or descnphon according to deed, and show street names and indicate whethe interior or corner lot STATE OF NEW YORK, COUNTY OF SS (Name of individual signing contract) above named · . being duly sworn, deposes and says that lie ts the apphcan tte is the ....................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and ts duly authorized to perform or have performed the said work and to make and file th~ application, that ail statements contamed m this application are true to the best ofhts knowledge and belief, and that th work wdl be performed tn the manner set forth m the application filed therewith. Sworn to before me this ..... 03.. 2~--.. day of ~ O4/--.. .., 19 County ~ 4707878, Su~lk~u~ (Signature of apphc~, Te,m Exmres M~tch ~, 1, T