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Home My WebLink About16876-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17928 Date APRIL 6~ 1989 THIS CERTIFIES that the bulldmng FOU!~DATIOM Locatmon of Property 890 KOKE DRIVE PVT. RD. #14 SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 087 Block 05 Lot 08 8ubdmvmslon Filed Map No. Lot Mo. conforms substantmally to the Applicatmon for Bumtding Permit heretofore flled in this offzce dated MARCH 30r 1988 pursuant to whmch Bumldmng Permit No. 16876Z dated APRIL ir 1988 was issued, and conforms to all of the requirements of the apptmcable provmsmons of the law. The occupancy for whmch this certmflcate is · ssued ms REPLACE ROTTED FOUNDATION POLES AS APPLIED FOR. The certificate is mssued to HANNA SHAW (owner, of the aforesaid bumldmng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A umldinq Inspector Rev. 1/81 l~ NO. B TO~N OF $OUTHOLD BUILDING D~PABTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-16876 Z Permission ~s hereby granted to. County Tax Mop No 1000 Section ...~<~..,'~... 13lock ...... ~t.~.. ...... Lot No.C~.~.... pursuant to application dated ........ ~;~ .......... 19.~..~.., and approved by the Building Inspector. Fee $..'7} .~., ......... Rev 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 1197 I 8LPG OEPT TOWn'1 OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY HATE ................ NEW CONSTRUCTION ....... OLD OR PRE-EXISTING B~ILDIN~ ...... VACANT LAND ........ L ati f P p rty ~ ~7~o~D HOUSE NO. STREET HAMLET Owner or Owners Of Property .... ~fl'?~ %ounty Tax nap No. 1000 Section .Q~%. ~Ioc~ ..~.. Lot ..~... Subdivision ........ .D Filed Map ~ ~ .Lot .... Permit No. l~ ..... Date of Permit .~2'..~? .... Applicant ................... ~alt~ Hept. Approval .... ;~H .......... H~er~riters A~p~o~l...~R ....... Planning Board Approval .... ~.,o~ Request for Temporary Certificate ....... IFinal Certificat~ ................ Fee Submittad: $ .................... APPLICANT . . .~.~; ................. rev. 10/14/88 XDHMNM lPUa) ~lOIi¥~NflO NOI£¥a~lflO HANNA SHAW 890 KOKE DR. PVT. RD. SOUTHOLD TOWN OF $OUTLIOLD OFFICIz OF BUILDING INSPECTOR PO. BOX 1179 TOWN tIALL SOU'I IIOLD, N.Y. 11971 HARCH 28, 1989 TEL 765-1~(, ~' ~'~- To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. II'X_---'/ An aupl%cation for Certificate of Occupancy is not on file. ENCLOSED /_--/ NO Underwr;ters Certificate on file. l(~_/ The check [t,(outd,lted/not otl file,l $25.00 /~/ No Fca]th Dept. Approval on talc. /-'/ No fine! ins[;ecLion il,is been made. Please contact our office on this matter. Thank you [or your cooperation. F, uuld~r,<3 Pcrm[~. ~ 1 6 8 7 6 Z Bt~l l~l [Dq Dept. *~/~/ He) Ptu~b~2r bolde~ Certificate on file. ( ail permits Involving plumbing being issued after Apr,! 1,1984 ) SENT TO: GEORGE KOCH MT. BEULAH AVE. SOUTROLD, N.Y. 11971 T~?r"OF 7r' ' Examined Approved ,19 ~'g , 19~7 Permit No FORM NO 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL NOTIFY 8OUTHOLD, N Y 11971 TEL 765-1802 CALL MAIL .. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... .~. ~ l .... FORM ............. TO: ~ Dmapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date , 19. INSTRUCTIONS a Ttus application must be completely filled in by typewriter or in ink and submitted to the Budding 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 stre. or areas, and g~vmg a detailed description of layout of property must be drawn on the diagram whxch is part of this api- catmn. c The work covered by flus apphcation may not be commenced before issuance of Budding Permit d. Upon approval of this apphcaUon, the Building Inspector will issued a Budding Permit to the apphcant. Such pern shall be kept on the premises available for mspechon throughout the work. e. No bufldmg shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupan shall have been granted by the Bmldmg Inspector· APPLICATION IS HEREBY MADE to the Budding Department for the msuance of a Bmldlng 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 demohtlon, as hereto descnb- The applicant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing code, and regulations, and admit authorized inspectors on premises and m bmldmg for necessary inspectlons~ (Signature of apphcant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electnclan, plumber or build. · ~ntT,,~fie"ro~ .... Name of owner of premises /*/O~,x/~ ,~.dO ~. ..... (as on the tax roil or latest deed) If applicant is a corporation, mgnature of duly authorized olficer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No Plumber s License No .. Electmclan's License No Other Trade's License No Location of land on which proposed work will be done. House Num her Street County Tax Map No 1000 Section ~ 7 Hamlet Block . :~ Lot... ?. ...... Subdtvimon ~ Filed Map No ~- . Lot (Name) 2. State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction a Exmting use and occupancy ~Ft*r~. ~>~'~0~-~q~' .... b. Intended use and occupancy . .,~q,4 ~ ,,9...5.. .....Z a~ ..................................... 3. N,,~kE~of work (check which applicable) New Budding ...... Addition ..... Alteration .... I t~epmr '!. ......... R~em~ oval .......... Demolition ......... Other Work ........ 4 E'~nnated Cost .,5:'.¢.~ o ............... Fee ................................ ' (to be paid on fihng thxs apphcatmn) 5. If dwelling, number of dwelling units . , ! ..... Number of dwelhng units on each floor .. . ? ....... If garage, number of cars . ~."'~ & ................................... 6 If bus~ness, commercial or m~xed occupancy, specify nature and extent of each type of use .. ~ ........ 7. Dnnensionsofex)snngstmctures, lfany Front,.-~;i }: .Rear .,..a..o ..... Depth. ,.6.' Hetght .... /.,6 ........ Number of Stones q~ .................. Dnnens~ons of same structure with alterations or additions Front .~;m.q~. . Rear .......-'-7. ......... Depth . . . ~' ........ Height . . -- ......... Number of Stones ..... ~ ......... 8. Dxrnenslons of entire new constructton Front S.o, etS Rear ........... Depth ........ Height ......... Number of Stones ...................................... 9 Size of lot Front cio ..... Rear .... ~Sr.-' . ..... Depth ...... ./$.o. .......... 10 Date of Purchase . /.L~'geod .. Name of Former Owner . .3.qr{~¢.qJ .............. 1 1 Zone or use d~stnct in which premises are situated . ~.o',*,~Sqrv4*,~. .......................... 12. Does proposed construction violate any zoning law, ordinance or regulation .... ~/1~ ................... 13 Will lot be regraded .... /~. o .......... Will excess ~l be removed from premises: 14 Name of Owner of premises . blod~e.. ~dg.~1 Address ~¢r4..~?.~ . ?~.'q... Phone No ~¢?.~'7 Name of Architect ................ Address ........... Phone No ........... Name of Contractor .................. Address ........... >,.~,. Phone No ............. 15. Is this property located w~thin 300 feet of a tidal wetland? ~es) ..... No ..... *If yes, Southold To~a Trustees Permit may be required. PLOW DIAGRAM Locate clearly and distinctly all bufldmgs, whether existing or proposed~3tt~ indicate whether property hnes Give street and block number or description according to deed, interior or corner lot. APDf O' NOTIFY FOLLOWING FOUNDA~ FO~ PO(J ROUGH Notary Pubhc ........ ~ ..... County. ........ ~ ......... (Signature of applicant) ~-. 3 INSULAr i( ~ STATE OF NEW YORK, S S ALL GON~'cMd( Ti~tx~ COUNTY OF ..... ~ .... .. ,,'~ , ~ ~l ~ ........ G: ~ ~o*M ....... being duly sworn, de~l~O~'~at ae is the ap~t~ffh~t (Name of ~nd]wdual s~ng contract) CODES ~OT ¢~8: :'~,.~hh, '~ above named n~l~ ,~ OK COm~- * ,c. "'~ ' He is the .... ¢~reaCr, g ................ (Contractor, agent, corporate officer, etc ) of smd owner or owne~, ~d ~s duly authored to perfo~ or have perfo~ed ~e sa~d work and to m~e ~d file ~s apphcatmn; that all statements contained m thru application are true to the best of his ~owledge and behef, and that the work w~l be perfomed m the m~ner set forth m the apphcat~on filed therewith Sworn to before me th~s