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Home My WebLink About17572-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17476 Date NOVEMBER 1, 1988 THIS CERTIFIES that the building Location of Propert[ 335 SOUTH DRIVE House No. County Tax Map No. 1000 Section 106 Subdivision SHORE ACRES ACCESSORY MATTITUCK Street Hamlet Block 11 Lot 19 Filed Map No. Lot No. E conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 31~ 1988 Building Permit No. 17572Z dated NOV. 1~ 1988 pursuant to which 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 EXISTING ACCESSORY SHED IN REAR OF THE HOUSE. The certificate is issued to VELJKO J.. KRSTULOVIC (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~LTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ~/A ~Building Inspector Rev. 1/81 ~O~Wr NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ g17§72 Z Permission is hereby granted to: ............. ~,.., ~I,M... ~.¢. ....... · :.:~..~.:..~.;.t -'.?./.....: ........................ ..... ~...~..~,.~..., / ................................... &... ...... ot premise, {o~ated at ............... ,-~3.~.. ............... ~....~--~.. ................................................... County Tax Mop No. 1000 Section ..~..0..~. .............. Bilk .... //. ............. Lot No ..... /.~.. ............. pursuant to application dated ................ ~.,~.'...,..~../. ...................... , 19....~...~., and approved by the Building Inspector, Fee $ ........................ Rev. 6/30/80 FORM TOWN OF SOUTHOLD BUILDING DEPARTblENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ........................ ,19. PLEASE TAKE NOTIC~ that your application dated .. ~.O/./.k ........ 19 af~dO Location of Property ....... -].3,9'~ ~ 4 .~..~. House No. Street Hamlet County Tax Map No. I000 Section . ../.Q.~a..' .... Block ..... /I Lot . ~/~. Subdivision ................. Filed Map No ................. Lot No. ' · ........... RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ CALL .... Examined .~..$~.: / ., 190~(~ MAIL TO: Approved ...~.t~....(. ....... 19 .~Pe~it No..O/]~X~ . ~ Disapproved a/c ..................................... ................................ ........ Buildin= Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in 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 of 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 throughout 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 issuanc~ 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, additions or alterations, or for/'emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec~tions. ^ . ~ (S~nature ot apphcant, or name, ff a corporauon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises [/~ ~. X~ ~ (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 ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................ '. ................................. 33 " ,c'e<_ / ffC ce_z . House Num her Street Hamlet County Tax Map No. 1000 Section ..... .~../ ......... Block~?¢/~ Lot ~7' ..... Subdivision ..................................... Flied Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... '' b. Intended use and occupancy ................................. 3. Nature of work (check winch ,apphcable): New Building .... Addition .......... Alteration ...... Repair .............. Re oval .............. Demolition ............. Other Work 4 Estimate'd Cost ' ~ (t fill gthi ppli ) I o be paid on n s a cation 5 Ifd lliqg f d ' · welling, number of dwe units ............... Number o welling units on each floor ............ If garage, number of cars ...I ............................ ' 6 If i:~ fly ......................................... · business, commercial or m ed occupancy, spec nature and extent of each type of use ..................... 7. DimensioI ~a[~q~f~(~;s. truCtu:res, if any: Front ............... Rear ....... De~th Height . [~I[~VS:!,~j~,;. lqqmber of Stories ............ ' ...... ~' ............... Dimensio~ [~[:~[[~fie structure With al,terations or additions Fro-* ................ ~- ..................... ~D. . ' ' Number of Stories ..... . 8. ~aimenmm i:~t[~ntii"e'We~'~SnstructleA; 3Front ~ ~, ' ............. w ',,h~ mmm x, I , u.r~. · ............. ,,ear .............. uepth . . 10. Date of P~ . ,. ~ · .,~ Depth 1 1. Zone or use district in which premises are situated ................. ; .................................. 12. D°es pr°posed construction violate any zoning law, ordinance or regulatinn: ............................... 13. Will lot be regraded ... I .............. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises i ' ·. Address ......... Phone No ........ Name of Architect ......... i ............ ; ..... Address ................... Phone No ................ Name of Contractor ........ i .................. Address ................... Phone No ............ i... 15.Is this property located within 300 feet of a tidal wetland? *YES .... NO .... T · If yes, Southold o~n Trustees Permit may be required. .,. PLOT DIAGRAM Locate clearly and distinctly ~I buildings, whether existing or proposed, and, indicate ail set-back dimensions fr~m property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. iS'S ............................. i .................... being duly sworn, deposes and says that txe is the applicant (Name of individual sign ng contract) above named. He is the ...................... ! ................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application; that all state~nents contalined 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 HELEN IL I)E VOE ~ NOTARY PUBLIC, Sta~ d New No. 4707878 Suffolk Cgunt~ Term Exp ms March 30, (Signature of applicant)