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Home My WebLink About10767-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18428 Date SEPTE~BER 27~ 1989 THIS CERTIFIES that the building. Location of Property__4.635 PEQUASH AVENUE House No. County Tax Map No. 1000 Section 137 ADDITION Street Block 04 CUTCHOGUE~ N.Y. Hamlet Lot 006 Subdivision FLEETWOOD COVE Filed Map No. 1263 Lot No. 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 8, 1980 pursuant to which Building Permit No. 10767-Z dated J~LY 8r 1988 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 DI~ELLING The certificate is issued to JOHN T. WETZEL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED .N/A Rev. 1/81 Inspector FORM~ NO. ~ TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTrL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10767 Z Date ...... ~..f,,~ ......................19 Permission is hereby granted to.~,~-, . ....... ~.;::~_.~~z_ ........... ....... ¢..~,~. ....... ~~.....~. ....... .~(~z~:~.~,,,~ ....... ~ ....... ~'~""'~'~ ....... ~~~ ............ 2 ............................................ ~,,~em~e~ ~oc~,,~ ~,....~ ............. e~ .... '~"' 7:" ......................................... ..................................................................... .C.... .......................... ~~.~.~....~..;.~.. ~z~:~.~.....~.~'..~. ............................ ~.~:....~.z.~ ....................... ~...... Building Inspector. Building Inspector TOWN OF SOUTNOLD BUILDING DEPART.tNT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NE}/ CONSTRUCTION -ff~....OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ ........... ~ous~. No. STR~E~ ...... ~£;.~''~ ....... Owner or Owners Of Property ..N~.~ ...~. ....... Count, ~a~ ,ap No. '000 Seetlon /'~'7'' H'oe~ .~.. Lot ~-e~... Subdivision. ~.. ~/~-~.. Filed .ap --/-~.-~..Lot .......... Permi~ Ho. /4 '~.~.2...Date of Permit ~ealth Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ............ Fee Submitted: $ ......... t~f..o~.~.~..~..~F7 ~. 3~3S~ rev. 10/14/88 FIELD-INSPECTION COMMENTS F01ffNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO· 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ...... .......... .......... · APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 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 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 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 necessa~ inspection~s. ,,_,~,~ ,~ , ,(Sf~aturer/_~/~' of applicant, or name, if a~6rporation) · (Mailing address of applicant) ~, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises '~7~/,, ,~ .7.: ~ ~- . ................. (as on the tax roll or latest deed) If applic~t is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~..f',~ ............... Plumber s License No ........................ Electrician's~, ,License No .... ;~.. ............... Other ,rades License No. . . .' .............. 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet o¢' ., ..... County Tax Map No. 1000 Section ..... ~.. ...... Block .................. Lot. Subdivision~.'~'. ~.~.(?.~...~.~. ~d.~ .......... Filed 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 .... ZJr~.~.-....~'~.'~.' .~fl.~..~ ............................ b. Intended use and occupancy ,.~,,47~. '.. ~..~.. ,~.f~. ,~..~. ~?~'. ~,~:D.~.O. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work. a0,~..~-<.~-- ........ . .~. ~. ' . .'~..37 (Description) 4. i.stlmated Cost Fee .,. (to be paid on filing this applic!ation) 5. If dwelling, number of dwelling ~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 lype of use ..................... 7. D~nens~ons of existing structures, if any. Front ............... Rear .............. Depth tones ............................................... Height ............... Number of S ......... ' .... Fro Rear Dimensions of same structure with alterations or add~tlons: nt ................................... ' Height ...................... Number of Stories ...................... Depth .................... i · ' 8. I)imen'sions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stones ........................................................ 9. Size of lot: Front .......... i ........... Rear ...................... Depth ...................... I0 ' fF · Date of Purchase .......... ~ .................. Name o ormer Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. I)oes proposed construction violate any zoning law, ordinance or regulation: ..~'.~. ............................ Will fill be removed from premises Yes 13. Will lot be re-faded ~ excess 14. Name .of Owner of premises :Jk~/,F..7. ,..~.~-.~.~*-... Address ~.4 .,~. ~.,e,.~r!.~..~ .~..r.o(~: l~ffone No .............. '.. Name of Architect ........ t-//? ................ Address ................... Phone No. Name of Contractor ....... fi(/.'"~ ............... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al! buildings whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocki number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, i S.S COUNTY OF .... ,~.~.~.' ~..~/.~ ..... ....... ~.~..~.....~. ~.~'..7-..~.~ ................... being duly sworn, deposes and says that he is the applicant (Name of individual sigrting contract) above named. He is the .. .......... O..¥..~t~..e4C_i .................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements con[ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannler set forth in the application filed therewith. Sworn to before me this ............~ ./'~~~'~' ...... . _day, if.. ~.~..ff~. ........... , 19 ~.~. ~ ,~J:~ taa~ch ao, i,'~-'z~' // d~';~'gna~ PP )