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HomeMy WebLinkAbout11129-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No....Z. 1.0. 7.5.0 ........ Date .... O.c.~ob~r..~9 ................. 19 BA THIS CERTIFIES that the building ................................................ Location of Property ...... 2.Q575..~oun.c~v.~,Ole..A¥~p.u. et ...... ~91&t. hg~.d.,..i~OK .Xo~R... House No, Street Hamlet County Tax Map No. i000 Section ...q5 ~ ...... Block .... q/f ......... Lot ...ql. ! ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Apv±l 29 19. ?1pursuant to which Building Permit No. .$;I,,t.~9 ~. dated ...H..ay..5. .................. 19.8 )., 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 ......... ....... v. ~..o.k..~. a..d.~.e.~. 9.n' .i.e., p.~.o.z. :[. ~.n.g. ........................................... The certificate is issued to ...... .,/9.~.0. p .h..H.: . ,.g.a?: t..c .k.:[.. ( ~ ,or.m' :..E,...C. 9 .v.w.~.n. ) ........... fownerx~C~xottt~tqcj~ of the aforesaid building. Suffolk County Department of Health Approval ........ ~./.~ .............................. UNDERWRITERS CERTIFICATE NO .... J';./.g. ........................................ Rev. 1/81 Building Inspector FO~ NO. TOWN OF~OUTH~D,~ TOW~ HALL SOUTH'OLD~ BUILDING (THIS PERMIT MUST BE KEPT OKI THE PREMI~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED). ~ Permission is hereby granted to: ........ ~.~z~o.~.~ ...... ~.. Buildlno Inspoctor. Building ~ectOr R~v. 6/30/80 ; FORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No..~.19.9.75... Date .... .MAY.. 7 ........ ' ............. ,19.8.2. THIS CERTIFIES that the building ~. .... (..2 .) ......................................... Lacat,n. nfPrnn~rtv 205?5 Sound View Avenue Souti~old House No. Street Ham/et County Tax Map No. 1000 Section . .0.51 ....... Block . 9.6. ........... Lot ...0.1. ? ........... Subdivision .... X .......................... Filed Map No..X ....... Lot No...X., . Requirements for a private one-family dwelling built pri'o/"'t'6'' conforms substannally to the ,~l~iea. t/on-fim,~l~thrg-Perrntt"lrer~tufbl'e-Tiredq~~ Certificate of Occupancy ·.. A~0.v. i 1. Z3 ......... 19 5.7. pursuant to which lh~ldm'g-P~rmit No.. ~ ~ .0~.?.~ ............. dated .... Ha.y. 7 ................. 19 .8.2., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r which t~s certificate is issued is .. ~ ...... .gp~.~¢~¥.dwelling and accessory one-car garage* *This Certificate of Occupancy pursuant to Building Permit # dwelling. The certificate is issued to ...... Fvo~ .M., .C. Oz:'~t Sr~ .................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ......... .n./.v .............................. UNDERWRITERS CERTIFICATE NO. n/v includes C.O.~f Z10750, issued 19/29/81, 11129 Z, to build a deck addition to Building Inspector FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME FLUMBING INSULATION PER N, STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined Approved /~...5.5~. ...... 19~../. Permit No..~../.../~. ~..- Disapproved a/c ................................... ...................... .... · ~ (Build'rog rhspector) APPLICATION FOR BUILDING PERMIT Application No. d~/~. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl: 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 tho applicant. Such pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demohtion, as herein desclib~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessa~ inspections. ~ . ~applica~, or pome, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildt .................................. .............. Name of owner ofprem,ses .~.. - .~.~. ~~ ........................... ~' ' (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 .... ........................... House Number. -- --,~-'~Stree~ County Tax Map No. 1000 Section .&~ .......... Block .......... ot... Subdivision ..................................... 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 ..... ~~~" ~5 '~"'~ ...................... b. Intended use and occupancy .... Nature of work (check which applicable): New Building .......... Addition ....... Alteration .. I ........ Repair .............. Removal .............. Demolition .............. Other Work ............... . .~./..~r~..~' ' (Description) Fee --. Estimated Cost (to be paid on ~ing this application) If dwelling, number of dwelling units ............ Nmnber of dwelling units on each floor ............... If garage, number of ca~ If business,~ commercial or mixed occupancy, specty nature and extent of each ty~e of use ................... D~ensions of existing structures, if any: Front ............... Rear ............... Depth.., ........... Height Number of Stories ' D~ensions of same structure with alterations or additions: Front ' Rear Depth ...................... Height ........ ~., .......... Number of Stories .......... .~..... Dimensions o[ entire new construction: Fron~ .... ~ ......... Rear .... ~.( ....... Depth .... .~..-.... Height Number of Stories Size of lot: Front Rear 'Depth Date of Purchase ............................. Name of Fom~er Owner .. .......................... Zone ...... , . .'.. or use d~stnct m which premises ar~ s~tuated .............................................. Does proposed construction violate any zoning law, ordinance or regulation: .............................. W~I lot be regrad~d ......................... Will excess fill be removed from premises Yes Name of Owner of premises ................... Address ............... ~ .... Phone No.~ N~e of Architect Address ...~.. Phone No Nmue of Contractor Address ~ Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~operty lines. Give street mad block number or description according to deed, and show street names and indicate whether :terior or corner lot. rATE OF NEW YORK, OUNTY OF..~ .~. A .Z-./.( ..... S.S ........ .~.9~..el?..,'/... ~ .... ~.~..t~. J. ................ being duly sworn, deposes and says that he ~s the apphcant (Name of individual signing contract) ~ove named. e is the ........................................................... ; ............................. (Contractor, agent, corporate officer, et~.) f said owner or owners, and is duly authorized to perform or have performed th~ said work and to make and file this 9plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this ........ ........... d of.. Zg? ............... , ./~7~ '(Signature of applic~ti ACCOUNTANT DATE AP~ 'IFY BUILt'lNG 'DEPAR IH,q ]Nc2ECTION$: FOR P©UP':r) CONCRETE ROUGH - ~~'C~lgrM'cihiG~ FINAL. - COr-.qqTPHCTION MUST CONS~RUCTIOH SHALL MEET CONSTRUCTION & ENERGY OR CONSTRUCTION ERRORS,