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Home My WebLink About8789-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18113 Date JUNE 13r 1989 THIS CERTIFIES that the buildin~ Location of Property 585 DAISY ROAD House No. County Tax Map No. 1000 Section 106 Subdivision ADDITION MATTITUCK~ IqEWYORK Street Ham]et Block 8 Filed Map No. Lot 41 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9r 1976 pursuant to which Building Permit No. 8789-Z dated AUGUST 9r 1976 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 DECK ADDITIONTOEXISTING ONE FAMILY DW~.LLING~SAPPLIEDFOR The certificate is issued to (owner) of the aforesaId building. Sh~'~'OLKCOUNTYDEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION D~£MO N/A Rev. 1/81 GREGORY A. COUTURE ]?OR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8789 Z Permission is hereby granted to: ~T~E~e~;V h ~' ~^UL ~.~-- H Cot} Td premises located at ...................................................................... , ...................................... .~ ............. pursuant to application dated j3t 0 ~, ~:~ l~r...~., and approved by the Building Inspector. Fee $ ........................ Building Inspector TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 197 I BLDG, DEPT TOWN 07, SOLI*~ HOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ...~./....OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ HOUSE NO. STREET HAMLET County Tax Map No. I000 Section ../P.~. Block ..~ .... Lot ...~.~. .... Subdivision ....................... Filed Map ........ Lot .......... Permit No .......... Date of Permit .......... Applicant Health Dept. Approval .................. Underwriters Approval Planning Board Approval ................ Request for Temporary Certificate ....... Final Certifitate ................ Fee Submitted: APPLICANT. rev. I0714/88 FOUNDATION ( 1 s t ) =OUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............. .... ............... Disapproved a/c ............ ~ ..... ~ ............................ ..................... : ............................................. ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... ...~........~..~f'(~J~ .'~'....~.. ............ ,10..Z..~... INSTP, UCTIONS a. Th,s application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocaho~ of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this applicahon may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl ~ssue a Building Permit to the apphcant 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 issuance of a Building Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and dther applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal', or demolition, as herein described. The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signa ure of applicgnt, or name, if a corporation) ...... ............................. IV State whether apphcant is owner, lessee, agent, architect, engineer, general contract6r, electricmn, plumber or builder. Name of owner of premises ....... G.}C..~..~...~..}C..~ ...... &~....~....~.i.~-.~.~-~ ...... .~..., ...... If apphcant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Budder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's L.cense No ..... Location of land on which proposecLwork w II be.z[o~ e. p ................... ~ Lo No .............. Municipality State existing use and occupancy of premises an.~:~ intended use and occupancy of proposed construction' a Exisiting use and occupancy .... ~--~_.. ........ ! ............................... I ................................................... b Intended use and occupancy .............................................................................................................. 9 10. 11. 12 13 14 property hnes G~ve street and whether inter,or or corner lot Nature of work (check which apphcable). New BumMing .............. Add,tion ............... Alteration ...... Repair ................ Removal ............. Demolmar ........... Other Work..~..g. Jg..~.~-~k ................ -~ (Descnphon) Estimated Cost ....~....~....~...0..~...(~)....0.. ............................ Fee ....' ./..~..C ................................................................... (to be prod on filing th~s apphcabon) If dwelling, number of dwelling units ...... N.J.}/~ ...... Number of dwelling umts on each floor ..... If garage, number of cars ....... N..I.Pi .................................................................................................. If bus,ness, commercial or re,xed occupancy, spec,fy nature and extent of each type of use ....... ..~.L..I..~ · .. Dimons~ons of ex~shng structures, if any. Front.. g~. ............... Rear ........ ,,~/.~.. ................ Depth .............. Height ........................ Number of Stones ............ I ....... "-~'.~'.~- ................................................................. D~mens~ons of same structure with alterahons or addmons: Front .................................... Rear '""i ............ Depth ................................Height ...........................Number. of Stones ............................. I I */z X ~'~ D,mens,ons of ent,re new construct,an' Front .............. ./..,.Y~. .........Rear ...... ~..../...I./..Z.. ......... Depth ................... Height ................... N1~.ber of Stories .............................................................................................. Size of lot' Front ........ ~ ...... /~(~R..b.-. ........................ Rear ........................................ Depth ............................... Date of Purchase .................................................... Name of Former Owner ............................................... Zone or use d~str,ct ,n which premises are situated ..... ~.c3~Ll.'~k ............................................... '. ' .... Does proposed construchon violate any zoning law, ordinance or regulation .... /~.J.~. ........................................... Wdl lot be regraded ........ ~ JJ~J. ......... Will excess fill be removed from premises. ( ) Yes ( ) No Name of Owner of prem,se~.~¢~'Z~KL4 Al .~)~. i,~,F'~_ Address ~-~):2~:s ut J~c(Phone No. Name of Architect ..................... Address ................................Phone No ....................... Nome of Contractor ...~:..'.'ii.~.'.. ii ]iii.ii ] i '". ................. Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~st,ng or proposed, and md~cote all set-back d~mens~ons from block number or descr~phon according to deed, and show street names and indicate STATE OF NEW )F(~tRK-~ ~ c ~ ........... ~.'~.~..k.~....'~....~. ............. ~.g.~..~...~..~:.~. ........... be,nD duly sworn, deposes and says that he ,s the apphcom (Name of individual s~gnmg contrace , above named. He the ....... '~'~""~"~'~ ........ (Contracto~,"~gent, corporate officer, etc ) IS of said owner or owners, and is duly authorized to perform or have per~ormed theJ sa~d work and to make and file this application; that all statements contained m this apphcahon are true to the best of h~s knowledge and behef; and that the work wdl be performed m the manner set fo~h in the apphcation filed therewith. Sworn to before me th~s ~R'Y PUBLIC, State of New Y0r~ No 52-8125850, Suffolk f~,~ Exmr~ March 30,