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Home My WebLink About10734-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25426 Date: 12/16/97 THIS CERTIFIES that the building ADDITION Location of Property: 1230 CRITTEN LANE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 70 Block 12 Lot 7 Subdivision Filed Map No. Lot Ne. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 13, 1980 pursuant to which Building Permit No. 10734-Z dated JUNE 16, 1980 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JEROME & SELMA A. POLATNICK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10734 Z Permission is hereby granted to' ......... ...... ...... ~ ~ . . . . ~ c~.~. . . .~.k--~,c . . X~,~.~ . ..... ~~..~..~,..~. ................. ~o ...~..~.T~...~.~.~....~.~ ~.~.~,~...~...,.~y~.7~. ............ ~.~ ........... ~.~ .......... ~~..../~~.~ .......................... ~t premises [oca(ed at ~Z~. ........ pursuant to application dated .... ~'4~.~'~4.~ .......... /..~ ................. , 19.C~'.(.~, and approved by the Building Inspector. } tl BUILnlNC · TOWN ID\gL : , ~PLICATION FOR CIRTIFICAT~ OF OCCUPANCY unusual natural or ~opograph~c fAn,urea. i. Carclficaau of Ocaupancy - New dwelling $25.00, Additions ~o dwelling Al~racion~ C~ dwull~n~ $25.0Q, ~w~lmning peel $2~.00, Accessory building 4. Ui)dacad C~rc~flcace of Occupancy - $50.00 5. Temporary Certificate 0f 0ccu{~a~tcy - Residential $15.00, Commercial $15.00 ~ ac,c, essory deck Cen.~rucc£on..as_b+]lt~~ ~ld 0r Pra-uxl:'~ln, Buildin~ ................ Crittens Lane, Southold [.ocac~on of Property ...... }230 ............................................. {iou~c No. }l~mlu c ... PO~ICK ..................... ':ouncy Ta~ Map No i000, gucczon..O7O~PP ...... alock..~..QO ......... Loc...QOT,QQQ ............ Southwood Map .'urmic No... 10734.. .DaCe Of Perm ................ AppL~can~ .................. .......... ic 6/16/80 ici D AOP 1 ' APl 'lannlng I]eard Approval ........................ FIELD ~NS~CTION COMMENTS FOOm~DATi0N (lsd) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY 4. FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]FRAMING [ ]~ULATION [ ~ FINAL ] FIREPLACE & CHIMNEY INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ..~.~-.. .~ SOUTHOLD, N. Yo ........................... , ........ App,icotlon .......... Approved ~.~.~.../$'.~ ...... /.~?. .......... , 19...??... Permit No..../.<..~.~.....~.....~..'.. .... D,sapproved a/c ~ ~ //~ ~'. .... APPLICATION FOR BUILDING PERMIT Date ...... ............ , ..... 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 drown 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 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 shah 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 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 authorized inspectors on premises and in buildings for necessary in. ions. .......... .................................................... ( 'g aure of applicant, or name,'ifCb¢corpora;i;~) ....... / ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ses /)-/~ ~'-~ / , .~.. -'~'~- ...ff. ~...~. ' ' ' '.~.'%~'~.~ ~ ';z~ i'iii~i.~.'i~i "i' ~.~i~i .............. -~. ~.~.~.=..'~ ........... ,,sw~,~. r.x .-. ~ ................ ~y..~..~ ..................... ~ .......... ~ .................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's bcense 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. Map No ........... ~r ........................... Lot N~ ........ Street and Number .... .............................. .(,~.~ .. ~.~ ..~.. ..................... .,~' ..~~'.' Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................. b. Intended use and occupancy .................. 3. Nature of work (check which applicable): New Building .................. Addition ..~ ..... Alteration ........... ,k Repair .................. Removal .................. Demolition .................... Other Work ..... ~. ,~..~ .~, ,/..~,.~. .................... 4. Estimated Cost .l~.~cl~.~O:~ ................................. Fee ................ ~ .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelli'ng units ............................ Number of dwelling units on each floor ........................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or ,mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........~..."~. ............. Rear ........... ~.7~¢. ............. Depth ......~. ......... Height ...... Z.¢, ............. Number of Stories ............... ~. ............................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ........................... Depth ................................ Height ........................... Number of Stones ................................ 8. Dimensions of entire new construction: Front .......... 2..'], ................... Rear ...... 2...3.~. ............ Depth ...~...~.. ............... Height ...... ~.~. ......... Numbe~ of Stories ............ Z ..................................................................................................... 114 Zone or use district in which'premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............. ../?..~. .................................... 13. Will ]lot be regroded ........ ~. ............. Will excess fill be removed from premises: ( ) Yes ( ) No Nome of Architect .......................................................... Address ................................ Phone No ....................... Nome of Contractorr~ ,.~.~...,~ ......................... Address~'~l~¢...l~(¢~..~. Phone No. ~" PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ' property lines. Gwe street and block number or description according to deed, and show street names and indicate whether interior or corner lot STATE OF NEW~/~,P,J~/,~, ~'/~ ;~S S ....................................................... ¢ ......................................... being duly sworn, deposes and says that he is the applicam , (Name of individual signing contracf) above named. He is the ..................................................................................................................................................... (Contractoh agent, corporate officer,' etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that ali stateme~ts contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed injthe manner set fo~hdn the application filed therewith. swo . ........ ......... ......... , ..... ................ ................... JUDITH T. TERRY Nota~ Public, State of N~ ~ ~xp~res March 80,