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Home My WebLink About14252-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-'22565 Date SEPTEMBER it 1993 THIS CERTIFIES that the building ADDITION Location of Property 75600 (a/k/a 717) FRONT ST. House No. Street County Tax Map No. 1000 Section 48 Block 1 Subdivision Filed Map No. GRR~NPORT~ N.Y. Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 23~ 1985 pursuant to which Building Permit No. 14252-Z dated SEPTEMBER 6~ 1985 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 DW~r.T. ING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED RAYMOND & LINDA BELANGER Rev. 1/81 r in spector TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date z4~ z .............. .,.,. ..................................... . ,,......- Permission is hereby granted to: ..... ~.i.~.k...~...~ ........ ..%.~.~?~.c ........ ......... ~.~.~f.~..~.~.c~,. ....... !E,.~ ......................... ,o ............ c....~.~.,.s.~:± ....... ,~.~ ....... ~.,!.k!.*..~ ...................................................................... at premises located at ............................................................................... r ............................................ County Tax Mop No. 1000 Section ........................ Block / Lot No.....~.. ........ Z./.~s . pursuant to application dated ...................................................... 19... and approved by the Building Inspector. Fees ...~.,.~.., O0 Building Inspector Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~NSULATION FRAMING [~'] FINAL COMMENTS '" ~" i,'IELD INSI'ECTION' : ~OUNDATION (2nd) :{OUGH FRAME & PLUMBING '~. INSULATION PER N. STATE ENERGY CODE RDD )NAL COMMENTS: 7GS-:~80~ BUILDING DEPT. INSPECTION ] FOUNDATION IST [ ] ROUG/H~ PLBG. ]FOUNDATION 2ND [/] I/IMSULATION~/ ] FRAMING [//~ FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1502 Disapproved a/c ..................................... Received ........... ,19.. · (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted 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 issued 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 ~t 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 taws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary indirections. __ (Signature o~ appncanr,~or na , ' p · 7./7..~----~. ,,..~...-r~.~.~.. ....... (Mailing address of appliYant) I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ,/~ J.'flc~q..rt .~<A.. l.~.g .~ F~, q .~. &.. G ~..~ .~ .r~ r .............................. o (as on the tax roll DY latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~x,,w~...~~. ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on wh~gh proposed work will be done .................................................. .~.? ..... .. ,qr:~.~:~. ~ .......... .~..~. ~. e ,, p. o ~.d: ........................................ House Number Street Hamlet County Ta× Map No. i000 Section . .~----S...7~ .... Block ...... /. ........... Lot..~...~...,..2~...,. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and oe upancy... . b. Intended use and occupancy ................................... · ~,.~;~.~, .%.!'~'. · ~ -~ ................ 9. 10. 11. 12. 13. 14. , . applicabie): New .......... .... ..... .. I~r ,..~'.. f.Z:.~.[~mo~al .... Demoht,on .............. Other Work .......... '~, :,,, ~~ ' . ~ . ' ~.t ~,~o,t ~.&. ................ r~ ............... [ ~~n~U L} ~ ~' (to be paid on filing this application) s.~~~m.~ u~it, ............... ~ ct a~ unit~ on ~ ~oo~ ............... If garage, number of cars ...... ~. [ ............................................................... 6. If business, commercial or mixed,occupancy, speedy nature and extent of each type of usg .................. 7. D~ensions of existing st~ctures', if any: Front.. ~ ~.. Rear . . ~. ~.~ ~. Depth . .~ .~... Height ............... Number of Sto~es ..... ~ ................................................. D~ensions of same structure with alterations or additions: Front ... ~ ........... Rear .. ~ ............. Depth .... ~ ~ ............ ~. Height ...................... Number of Sto~es. .~ ..... D~ens~ons of entire new const~ctlon Front .. ~. '. .... ..... Rear...~.7 ........ Depth . .~ ......... Height ............... Number of Sta~es ...... ~ ................................................ Siza of lot: Front . ~'.q Q.... ~ .......... Rear ...~.q,. ~.~ ............ Depth . .~ ~ ~.~ ............ DateofPurehase ...]~,....................' Name of Fo~er Owner ~t.~ea~.hg.~ Zone or use district in which premises are situated ........................................ Does proposed construction violate any zoning law, ordinance or regulation: . ~ ~ ........................... WiI1 lot' be regraded . ~. P ......... , ............. Will excess fill be removed from premises: Yes N~e of Owner of premises ~ ~ ~< ~e(~g E Address 7Z2 qen~g~,..~.~ ~.. Phone No..~ ~. ~.&~ ..... N~e Of ~chiteet ......... ~ ................ Address ................... Phone No ................ N~e of Contractor ......................... Address ................... Phone No ................ PLOT DIAG~M Locate clearly and distinctly all] buildings, whether existing or proposed, 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 comer lot. STATE OF NEW YORK, COUNTY OF..5~,~.(1<. ...... i S.S · ../, ~ ~,&.. g.¢ I. ~ r. .......................... (Name of ihdividual signing contract) above named. being duly sworn, deposes and says that h.e is the applicant He i,,; the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is di~ly authorized to perform or have performed the said work and to make and file this application; that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manfier set forth in the application filed therewith. Sworn to before me this ............ ~..~ ........ day ~f ..... ..... · ~ .... County .zSP m /9 .... ..... ....... i ~'[~t~m ~'~,'~ ' (S/gnature of applicant) t