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HomeMy WebLinkAbout8986-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ottlce Southold, N. Y. Certificate Of Occupancy No Z7~97 Date A~ril ~ 19.?? THIS CERTIFIES that the building located at .T.h..e?.e.s..a..D.r..&. p. Qn.V{. )~.x,... Street Map NoPee. n..H.ol~. Ol~lock No ........... Lot No, .30 ..... I~Ia.t.tltu~k.. i~...Y, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~.o.v..23i~ ~, 19. ?6. pursuant to which Building Permit No..8986Z · dated ............. ~{qv....2.9.., 19 ...., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. P.~lY~.e. O~le..family. d.~.ellxng. The certificate is issued to .L. 9.rP.Y...~:..B.a.~.n,~,~.,, .0..~..~, ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .g~*.. )+...1.977...by. R~. Villa UNDERWRITERS CERTIFICATE No..I~..~.2.~.~..~. .... }:{~r..2J...1~.7.~. .................. HOUSE NUMBER 1010 Street Donna Dr ...... Inspector / / TOW~ O~ S~UTUOi. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8986 Z Permission is hereby granted to: · i~l~. · ~0.2.....b' .,...~ ,"a<i~.ng...R-~.ve.:v.. ~oa~i ........... to .b.u:l,:Ld..~e.~....~a~..£.aucl. LY...d-~'z~]-:Lag .................................................................................... at premises located at ,.,LO~...~O,...~Oe~.,.JI.~Le..~]~;..T~,~ ............................................................... ..................................... ~ .1.)o~na 9~!.ve l~atA:&~,-aek pursuant to application dated .......................~['OV""'~' ............... , 19..~6,., and approved by the Building Inspector. Fee $..(~.2,.~ .......... ~udd,ng Insp'~cfor' --~ -;,,-;:ii~ ~,,?~HE,iNEW 'YORK BOARD OF. FIR ~l- UNDERWRITERS' t_, ~ ,:;~;; :,h~ L-~i,l:~; : -BB JOHN STreet NEWYORK NEW Y~RK~O~38-'::: 4 ::~- , ' -] F~L: ,' , DRYERS .:~: This certificate must not-be al{~red ~n"~n~,' r~anner;, return t~the office' of~h~ oard if'incorrect..tnspectors may be identified their credenfia{s. TOWN OF $OUTHOLD .,,,~.~-,~.~,L. C-~/c~ - BUILDING DI:pARTMI:NT . ~ ~UTHOLD, N.Y. ~ ~ ~ ~ ... ~-- ~ ~ ~3 Application-mo ............ {Build~n~ InspectOr) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 location of lot and of buildings on premises, relationship to adjoining premises or public streets or 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 application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 issuance of a Building Permit pursuant to thioq 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 removal or demolition, as herein described.~,~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to_~ admit °uth°rized inspect°rs °n premises and i~ buildings f°r necessary i~ectiOj~.,',/// --~ ~.-~ '~"~ % ................ ................ (Signature~-- ~ -- --of op~lican, t, or name, if a corporation) ...... ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ .......... ........ ................................................................................ of owner of premises Name If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ..'~..~.......~.~.~../.~.~::/.'.~ .............. Plumber's License No ....... .?...':...~../.'i~.~ ...................... Electrician's License No ...... [~ .................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ..... .?...~._%.?..~...~. ............. Lot No.....-~'..~.?. ............ Street and Number .......... .~..-./'./.~../.<....-:;..~.~/~'~ ........ ~..~;'.!...~./~.' ........ ~ ............ .~.~..A4'...A~...~........~...~.{.....~'~/ .......................... ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructiot~: a. I:xisiting use and occupancy ,.~...~../.~5../., ~,/./( ...... .~..~. ~. /. ~. .... ~..~.;~...~. /. .......................... b. Intended use and occupancy .................................................. ;~ ....................................... ~. ............................. 3. i~]ature,of work (check which applicable): New Building. ................. Addition .................. Alteration ............... Repair .................. Remevol .................. Demolitior, .................... Other Work ................................................... 4. Estimated Cost '~'~ ~ ~ Fee .... .'~;."' ~ ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ...... ~.'. ................. If garage, number of c~rs .................................................................................................................................... 6. If business, cornmercbl ~r mixed occupancy, specify nat~ure and extent of e~ch type of use ............................ 7. Dimensions of existing sm~ctu~es, if any: Freest ............ :: ............. Rear ......... ~:: ..................... Depth .... ::':~ ........... Height ........................ Number of Stories ............................................................................................................. Dimensions of same shucture with allerations or additions: Front .................................... Rear ' Depth ~ Height ................ ' ............ Number of Stories ................................ 8, Dimensions of e~tire new construction: Front .................................... Rear ............................ Depth ........................ Height ~ 2 Number of Stories / -..z,,.~ ~ "4"~'t Size of lot: Front 1/6' ' ~ ~) ' Rca: !'/ &' ' ~ ~) Depth "' / ) ' ~'(' Date of Pu,-chase ........ ,.:...: .............................. '.....r....ma~, of Former Owner Zone or use district in which premises are ~ituated ............ C....:L:'..:.C...~...:'..~ ............................................................ Does proposed construction violate any zoning law, ordinance or regulation: Will lot be regraded ~' t~ S Will excess fill be removed from premises: ( ) Yes ~ ) No Name of Owner of premmses .................. ~ ........ ,~.~ ........ ; ...... Address .............................. Phone No ...................... Name m A~chllect ...... ~ ................................................... Address ....... ~ ...... ; ................. Phone ~o ....................... Nome of Contractor -/, ~/,)J> /[', :2 ,~/0 Address t.~/- ./Z.. .......................... : ..... Phone No..~...z ............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate 10. 11. 12. 13. 14. property lines. Give street end block number or description according to deed, whether interior or corner Iol. STA'TE OF NEW YOR, I(,_ / c c COUNTY OF ..... ~U£ .Zz..~...L.~ ...... f.,.o · ~J, ' A/ ~ deposes and soys that he is the applicom ....... .4...~k...'.~. ...... ~£....~...F. .......................................... be,og d~,b ~worn, (Name of individual signing contract) above nome& ..~..~...~.. He is the ................ 6:.d~:'J./...~..~..(.~.,.Iq..~,.. .......... ~.. ............. .~...~'-T'.Z.'~"~"~ ....... ~.i~:~.~.7..~..~ ...... t.~./..(.)..~..~../..¢ ........ (Contractor, agent, corpor<~te officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application ore true to the best of his knowledge and belief; and tha~ the work will be performed in tl~e manner set forth in the application filed~herewith. Sworn to ~efore me this ~' / ~' /'1 "fl ~ ........ .m ....... of ......... /k'..a.a.. ..................... , , z4 ..... X/, . ....... z--. ................... '~'":"7 ....... ( S i.~n'~'t'~'r $ -st applicant) Zo o DWELL - WEI.L N S 87°19'20"E 182 00 (21 O) (19-7) N. SyoIg'20"W · ~,.o - 4-0.0 - - - d (20 0 (19.8) 182.00 LOT NUMBER 3! DWELL WELL DATUM APPROXIMATE LOT AREA 20,020 SG. FT. NEAREST WATER MAIN IN EXCESS OF 1OOO FT. 50.0 U (19.3) j J © (18 4)~ jz RNAL 5VP.',/E',( 3-2'7- 1~t77 fOUNDATION L SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE .......... HS REE NO ...... APPROVED .... THE WATER SUPPLY SEWAGE DISPOSAL FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES NAME ADDRESS TELEPHONE GUARANTEED ONLY TO CHIC~4GO TITL£ t/V&UPA/1/C£ CO. t~/Vff tFHC.4D ~,4WINGS L~ANK ._ NY.S. LIC NO. 048992 H/~,ROLD F TRANCHON JN.PENN LIC. NO. 21115-E JOB NO 76-529 FILE NO DEEP HOLE CREEK SURVEYED FOR LOT NUMBER 30 MAP OF DEEP HOLE CREEK ESTATES $1TUAFED AT MATTITUCK tOWN OF SOUTHOLD-SUFFOLK COUNTY N.Y SCALE: 1" = 40' DATE 11- 24-1976 FILED MAP NO. 4266 DATE, 1-28-1965 BOOK NO: LOOSE LEAF PAGE HAROLD E TRANCHON JR. PC,-- LAND SURVEYOR SUCCESSOR TO WILLIAM G. MEIER NORTH COUNTRy ROAD- WADING RIVER NEW YORK 11792 (516) 929-4695 ALT. 473-3626 ~'1 E~ ~tT ~'r~l D~_. -E. L.E,VAT 10t,,J 1 ! l 4- T L, 1vl ~c4 ~¢-'- lC) ~J t ? i ~" :,/.c ~