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HomeMy WebLinkAbout10580-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall South old, N.Y. Certificate Of Occupancy Z-15341 March 12, 1987 No. ..... .... ........ Date. . ........ ......... ... ... .., ...., Addition to existing accessory building THIS CERTIFIES that the building . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1705 Fleetwood Road Cutchogue, New York LocatIOn of Property ............................................................... House No. Street Hamlet 137 04 036 County Tax Map No. 1000 Section ........... .Block .............. .Lot . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. ....... .Lot No. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated February 7, 1980 i0580Z ............ ........, pursuant to which Building Permit No. ..................... dated . .':'?;.c.~. .1.1.,.. ~ ?8.0.......... 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 . . . . . . . . . ADDITION TO EXISTING ACCESSORY BUILDING " .,........ .,-...... ,.................,... ,..... ,.......,.. ...... '" ...... ..... WILLIAM L. NICOL The certificate is issued to .......................... 'ls'Ie't~&I!;tr't . . . . . . . . . . . . . . . . . . . . . (owner, I of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . PLUMBERS CERTIFICATION DATED: N/A ..~4~.~.&............. Bu' ing Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTH OLD 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 AUTI-IORIZED) N? 10580 Z Date Yd/.(,:<::H........I.f........."......,.., 19.Jb Permission is hereby granted to: .......illtllt.;;;M..4....M~Q.t.....,.... .. , , -::fI/.:ps:....#~;zr.w.CJ.o.o..I(6 -4,;,,),.. ...LS.Tc:.f.I().?~"=,,/.Y,' -7'~"'''' '.... to W~7A;:Clr;,,7:...4P./.J..f..t:/.()41.7:0. .FY./$.r./.M6)....dJ<;C.$:.~.o,r<7..... " , . / ......ls:LaCJ...............................,...,....,...,........"'." ,.. ..,'... :~::.............................,.......................... , at premises located ar#..!.7(j~~~~'j:lz:E7tvooo,..,t:Q,..<:.)Or(bnw.c.yvETJ.J. r. ................................................................................ . . ........................................................................ ............................................................................. ... ,......................................................................... . pursuant to application dated .;;;i!i;PICG!)f'7'" ..7..,.... . .." 19./.b.., and approved by the Building Inspector. Fee $./O.!#?....... .~.............,.. Building Inspector " ..., ' Iii.' i j, ,~t ~2.~ FIELD INS~BCTION DATE COMMENTS .. ".~... 1. -~----'" - - - f-3~ FOUNDATION (1st) zC::; - -------.....-- 0 . N -- FOUNDATION (2nd) b~~ roo 'K:, 2. ROUGH FRAME & :z: ' o ...... . '" PLUMBING 11', cn}l 3. q~ - en ,( INSULATION PER N.Y. ill t IT " 0 STATE ENERGY '\) CODE W " :~/, ,Ip'} e;/ ~ I'.t m ,J0tf7.At.J ~ . . ~ 4. p0 - f f ~ /" tl,~ ~"'\ FINAL , - ~ fl' :::; - ~~ ADDITIONAL COMMENTS: " <:\ .--- J I , -- , ~~ .....' 'i"- P> '" IT\ f-'. g~ ; - :r: (]) , P> ~ ~'" . :Y('1 t.:J, ~ IT . I "" , ,',-".:; , ,II '. ~ ' . v, ~. .",-,- . ,t~., it FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ExaminedlfQl!:ctf. ((. . . . ., 19fo Application No. IV s:"pQ. .2:. . . . Approved H:1(t,('f/.. /( , . ., 19.& Permit No.I(J.~ .?c? '2 Disapproved a/c. . . , . . ':. . . . . . ........... . -...~-- .....-.............................. . APPLICATION FOR BUILDING PERMIT Date. !".e.b.., .'Z,........., 19 ~P. 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 necessary inspections. ........................................ ...... (Signature of applicant, or name, if a corporation) ,~?~. ?.I.,. .~~~~~YI.o.o.~ "!'?~?'" .c.~~c:1:?!S~.e.,. J~~'!~.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Applicant is owner. ............................................................ ...... .,... ,. -..... ,................ Name of owner of premises ,. William. L 0 . Hi.c.ol . . . . . . . . , ...................................,.. ...... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized offICer. ..... ............. . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License 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. ,........,.....................,................. .. ..1.7 0 ~ .. . . .... . .... . F~?~.t.\~o,!<!-, \<o!,.d, , . . . . . . . . . . . . Q\lt9P..o,f;4E! . . OJ.e.c.tq .u?~!<:} . . . .. House Num ber Street Hamlet County Tax Map No, 1000 Section. , . . J.J..7. . . , . . ,. Block.. {).'-I.. . , .. , ... Lot... 0. 36. . . . .. .. .. Subdivision. . , . , . . . , . , . , . .. ..,.........,...,." Filed Map No. .............. Lot.........,..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: E'f d Ii' .U.x<?CCE~ ~7 a. XIS mg use an occupancy...."...... B.sJ.deJ:lce. . . . .. ........7................ ..:............ b. Intended use and occupancy .......... P:?,;,~. .s.t.~X:C!6y. !".h,e,4 .l19t. t:.o.r. .q<;<;1,1P1'P.c.y.. . . . . . . . . . . . . . . . . . . p(}1.:C<i"55r::rKI:'J IsI?OG; /Cl/./a,-//oh ' .{i..s 0, < , ~ . .h ,it._""L. , 3. Nature of work (check which applicable): New Building .. . . . . . . . . Addition. . . . .x. . . .. Alteration .......... Repair .............. Removal . . . . . . . . . . . . .. Demolition ........... ,. . . Other Work. . . . . . . . . . . . . . . , 1 (Description) 4. Estimated Cost. . . . . . .1\3.5.Q .99. . . . . . . . . . . . . . . . . . . . . . . . Fee. . .1.0..,. C<.t!. . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this applieation) 5. If dwelling, number of dwelling ~nits . . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . . . If garage, number of cars .... .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixe4 occupaney, speeify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structure~, if any: Front. . . . .6! . . . . . . . . Rear ...... 6.'. . . . .. Depth.... '?! . . . . . . . . . Height ....... 7" . . . . . . Num:ber of Stories. . . . . . . DIl.e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ; . . . . . Dimensions of same structure with alterations or additions: Front . .17! . . . . . . . . . . .. Rear... 1.7.'. . . . . . . . . . . . Depth. . . ,7,'. . . . . . . . . . . . . . .1. . Height. . . 7.'. . . . . . . . . . . . . . . . . Number of Stories. . . . OJ;l~. . . . . . . . . . . . . . . 8. Dimensions oJ;:;t"tire new constf}lction: Front. . . .1.~'... . ... " Rear... .1.7.'. . . .. ., . . Depth.. . .7.'...... .... Height' . . . . . . . . . . . . . . . Number of Stories. . . . .~~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front .. t~O.'. . . . .:. .. . .. .. ... Rear..... $9.' .. . . .. .. . .. '" Degtfu.nt!> .~if. ~iC01' . .. . .. . .. . 10. Date of Purchase .... .1.9.~~ . .'. . . . . . . . . . . . . . . . . . ~me of Former Owner . ~:'. . . . . . . . . . .J. . . . . . . . . . . . . . . II. Zone or use distriet i~w~ich ~rdmises are si~uated . . . '. ~ldfU>.f.iA.l.:.. /i6 . . . . . . . . . . .. . . 'l;;J.' . . . . . . . . . . . 12. D?es proposed.constructlO~~te any zomng law, ordma~ce or re~latlOn: f. .io. . (Jilt'. ~I\t!\t 'tIe... . . . . . . . . 13. Wtlllot be regraded ..... . . . . . . . . . . . . . . . . . . . Wtll excess fI ~e :Jov~d from premIses: es No 14. Name ofOwn~r of premises . ~Ulo,(YJ .L. .~J~P.l. . Address r:?O)l..~.. .e~ .r..: .~:j'.!f,JPhone No. 7.$.l~J17~ Name of ArchItect.. . .. . ... I~""""'" Address.... . ., . ... . .. .. . .. Phone No. . . .. . " .. . . .:. . Name of Contraetor . . . . . . . . .; ~.......... Address " . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . ! , PLOT DIAGRAM Locate clearly and distinctly alII buildings, whether existing or praposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. ' f1,u.-woo':-' ~. , , ";I:".m:IG1ofl-. loT w 0 f , ~ - 'd "?- 2S' !t) '" , ... . S. S ~ B r- ., ,'f ! ~ t F - \J\ - z. 50' ~ I" ~ , _16.t I--\zo- ~tCNe'> ~C STA TE OF NE~Y~~ S S COUNTY\ OF . ..1( . ."lle. . . . . . . . . . . . . .. tl.1./ //4/'(1. . . L ,. . fI/.;.c"q I. . . . . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (Name of individual sign~ng contract) above named. He is the , . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, 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 all statements cont&ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' ....... .::2U? <~...... .day of,. .E~r:lI.q'i""'" 19fQ. "'''' No_ Po"",, ..... 5.~n7,y:\"'iIf6" .. . ... Co""~ : ~~ , WARI} WHITNEY / f{~ 1:.D IC State of Mew York . . . . . . . . . . . . .... ... ...... NO)'AR~t~2~\575, Su1folk co~ N1~erm Expires March 30, 19