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HomeMy WebLinkAbout13665-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z13852 September 12 2~ No. Date ., 1977 THIS CERTIFIES that the buildh~g deck accessory. 1010 Donna Dr. Mattituck Location of Property ......................................................... House No. Street ' ' '~' ' ' Hamlet 115 15 17 County Tax Map No. 1000 Section ............ Block ............... Lot ................. X X X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Novembe,r 20 84 13665Z .................... ,19.., pursuant to which Building Permit No ...................... dated .... ...,....................January 9 19 ,~. .5 , 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 accessory structure for inground swimming pool. ROBERT & SHELZA t~Y,OS The certificate is issued to ..................... {o~,n.e;,,~,~jt~v~,~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 !~0z~xe NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 13665 Z Permission is hereby granted to: /2 ~ / ,~ · .~..~~..~......~...71.~-~ ............ ..... ,o ..... , ~. ~..~ ~ ~..... ~..~c~......~~q..~....~.....~Zc~... cZ...~..~ ~ ....... ......................................... at premises located at .~/,~. ,/.~. ........ ~/~.~(wd.~.......~..~ ........................ ~ ........ ... .................... ..................................................................................................... ~,~.xz..,..'./~....~.......-...~.~.~... County Tax Map No. 1000 Section ..././~..'~... ....... Block ....../..~....'~. ..... Lot No ................. ~.~.o.t ,o op~,,co,,o. ~ote~ ..~o~......~...o.. ............................ , ,,~..u, ond op~,o,.~ by Building Inspector, Fee *..~Z..~. Rev. 6/30/80 FIELD I~SPECTION COMMENTS ~OUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY 4. FINAL ADDITIONAL COMMENTS FORM NO. 3 TOWN OF SOUTltOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated . ~.~...~,r~. ........... 19 0~.' .~?.2 for permit to CO~g~g ,~ ~ ~. · · ~ .~ ~/~/~./4, · ~,~.''at Ho~se No, Street ~am et is returned herewith a~d disapproved on the following grounds . ~'. ~/ ....... Building Inspector , .(:241GAC..~O.'TtT[~, II"C~L~t~&AI"IOE ~I, LOT AR~A., '~:0~0~', . ~.:.. (~ o~ ~' -~$'i~~ ....... : ,.~.  ~ 182 OD ...... ",' ', ..... WELL 0 ~ m ~z~ ~ ~?~ . ,, ', ~F'~ ~l~ : ~u~r,o~ zoc~wo~/e-~-/~ .` OF HEALTH SERVICES THIS RESIDENCE WILL ADDRESS ' ' FOR ~PPROVAL OF CONSTR~.0TIgI4 CONFORM TO THE ' ,: , , STANDARDS OF 7HE -;,' ONLy ,~. SUFFOLK COUNTY " ' DEPARTMENT OF DATE .......... HS',REE NO ........... HEALTH SERV CE5 -- ~ ..... TELEPHONE' ',-' : , APPROVED '~,R,:,N,'Lr:'s .r r.r ~.rn~ MAP OF' DEEP HOLE ,CREEK ESTATEs eUARANTEEB ONLY TO: ' ',, ..C~I(~GO ,~/TZ~ IN~U~C[ (O. BOOK NO: LOOSE .i;EAF PAGE ,~/F[~ff[~ ~/~'~N~,~' ,,~c' HAROLD ~ TRANCHON JR PC,'' , ~ U OWEt.{. "WEI.L .J LOT OWELL WE;L.L 50 0 182 (20 0913) , SUFFOLK' COUNTY .DEPARTMENT OF ~'tEALTH SERVICES ' FOR APPROVAL OF CON~TRUC,? D,~TE,_~,. ',, ,;~ HS,REF:'HO. ;Z (18 4)~-3 SEWAGE DISPOSAL FOR NAME THIS RESIDENCE WILL ADD'RES5 CONFORM TO THE STANDARDS OF THE '",', ', SUFFOLK COUNTY ,::, DEPARTMENT OF ';". ', HEALTH 'SERVICES GUARANTEED 0 N LY ', TO,'.,,. ;' . ,. '.~ .: , .... ; HARO D E TRAN,CHON ,JR PC,' r',:': · "' " TELEPHONE; ,, , ,:,,¢~, .JOB NO: 76-520 .FILE NO ,DEEp HCDLE,;GEi~Eg LOT NUMBER ,30 ' I . ¢ MAP OF- DEEP HOLE' CREEK ESTATE SITUATED 'A~i: MATTITU'CK' r' ow., cOO FILED MAP, NO, .r. 256 · 'DATE' 1-28. lg65;' .):' hi .J O ,,,' S Z' U 0 (20 O) / (19 8] · ~,' DWELL SUFFOL~COUNTY DEP~RTMENT,~.~ O~, HEALTH. FOR'APPROVAL OF APPROVED WELL 182 O0 5O 0 (19.3) 8 THERESA DFRI VE FIt~AL SUR',,/E¥ 3-e7 - 1177 THE WATER SUPPLY & NAME SEWAGE DISPOSAL FOR THIS RESIDENCE WILL ADDREss CONFORM TO THE STAhiDARDS OF 7HE ', SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~U ,3? JOB NO: 76-529 FILE NO DEEP HOLE, CREEK SURVEYED FOR' :' MAP OFrDEEP HOLE CREEK ESTATES ' ' h,,'J'.7 ~ I&" 0,~, // jz ,J © L. 01 L)WELL NL N1FZER WELL N HEALTH S~RV~CES ONLY ,,t . - , WELL 18200 -400 -- (19 6)) 1~200 0 ,~ IN EXCESS OF' d ('~z. o 'scp P"[" TtdF-RESA DRIV~ ADDRESS THE WATER SUPPLY ,t,~ SEWAGE DISPOSALFO THIS RESIDENCE WILL. CONFORM TO THE STANDARDS OF' lite SUFFOLK COUNTY DEPANTME NT QF HEALTH SERVICES GUARANTEED ONLY TO;,.,,,, c,v/cA~o . 7'/7-zz' /,'v'.c/J'/~'4)VC£ CO.. /¢/VZ'/rH/'A$ 5A!F/GS'~H,,.,~', . :.. ~AR~-p, ~. ',~T~n~r*uu 'J~'~NN 't~' ~'~048992 50 0 (19,3) (18 4)L~ TELEPHOt, F JOB NO: 76-529 FILE, NO ,[)EEP HOLE C~EE SURVEYED FOR' .;' , LOT NUMBER ,30 , , ,4~r,, ~, MAP OF DEEP HOL£ CRff~K ESTATES "> SITUA/ED AT; MATTITUCK TOWN OF...-SQ.~THOLD-SUF~Oi.K COUNTY $CAdgt 1"= 40¢., '") 'ir DATE 11-24.1976r,;' ,'FILED MAP, N0:,4256 DATE, 1.20-196,5: , I~OOK NO: Loose LEAF PAGE ', ,':,,n', HAROLD F, TRANCHON ,JR P,C,' '"'LAND ' SURVE YOB .... SUCCESSOR ,TO 'WILLIA[,4 G, MEIER. i: NORTH C OUN,TR~,'., -ROAD, WAgING,,,,Rt ¥~R; NEW. -OR K.:/,",1t f 92 '-"" , ' (516) 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL .eOUTHOLD, N.Y. 11971 TEL.: 765-180~ ---, Disapproved a/c ~S. ~¢~'.~7~/~.. ~.~ ~ (Building Inspector) APPL!CATION FO~ BU[[DINGPERMIT INSTRUCTIONS Received ........... ,19... .... / Jo...,19gl Date /. · a. Tkis 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 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 Southofd, 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 building for necessalf.. · .~'..~".inspecti°ns' ~:i~2~.... ~Jy~.. ............../~. Le-2~e~' (Signature of applicant, or name, if a corporation) (Mailing address of applicant) /~_ Cl. State whether applicant i~ lessee, agent, architect,_ engineer,~ electrician, plumber or builder. Name of owner of premises. · · .~. · · ~ .... .~.~ .... / .~ .L.(25'/0~... ................ (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 w~l be done ...................... 1o. o. .............. ..47..o c. ...... ........................ House Number Street Hamlet /)6 ....... ....... Lot../..7. County Tax Map No. 1000 Section .................. . Block ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and(q~cupancy of pr?~struction: a Existing use and occupancy .~'~ ~..C_~. [~-~ b. Intended use and occupancy ...... : ~..~ · .~.~¢ .... · .~.~. · .~. ..... ~.~.~.~~-~ {-~.~ .... ~-..: . .Q3~ .... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .... Altera /~..,: .... Repair .............. Removal ............. Demolition .............. Other Wor~ .l...,~.'-~d~'~. 4. Estimated Cost ..~. [.~.. < ................................... (to be paid on filing this application) 5, If dwellingl 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 type of use .................. 7 Dim nsions of istingstructutes ifa y: Front ~ ' Rear D pth Height ............... Number of Stories ...... , ........................................... Dimensions of same structure th alterations or additions:Front' ...................... ' .... , .... )'Rear' .... ' , ....... Depth ................... i. · · Height .......... ' .............. Number of Stories ................... . Height ............... Number of Stories ....................................................... Size of lot: Front ....................... Rear ...................... Depth ................ 10. Date Of Purchase ! .... Name of Former Owner ......... 11. ~Zone or use district in which premises are situated .................................................... 12. Does proposed construclign violate any zoning law, ordinance or regulation: .... ~.. ~). ...................... 13. Will lot be regraded .. jk'.~. ~D.., .... ,., ......... Will excess fill be removed from premises: Yes Name of Architect . Name of Contractor i.~ ~ .~'~i i i i ~: ...... Address ................... Phone No ............ Locate clearly and distinctly all property lines. Give street and bloc~ interior or corner lot. STATE OE NEW YORK, l COUNTY OF ................. ] S.S PLOT DIAGRAM buildings, whether existing or proposed, and. indicate ail set-back dimensions from number or description accgrding to deed, and show (~ street names and indicate whether ' being duly sworn deposes and says that he is the applicant (Name of individual signing 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 con(ained 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. Sworu to before me this .......... ?.~..Zc~ ....... day o?..~...{~(~.. ............ , , NOTARY PUBLIC S' e~ of Ne v York i ~,~lgnature cz appncanu