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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-'22755 Date NOVEMBER 30, 1993
THIS CERTIFIES that the building ADDITION
Location of Property 345 DEERFOOT PATH CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 97 Block 7 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 3, 1991 pursuant to which
Building Permit No. 19847-Z dated MAY 9, 1991
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 UNHEATED SOLARIUM & DECK ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to EILEEN J. WHITEHEAD & MARY Y. HOFFMAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Bui ding Inspector
Rev. 1/81
i
l081H NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(YETIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CCiMPLETION OF THE WORK AUTHORIZED)
o
N- 1 9 8 4 7 Z Date ..:~.9.:r I9.~/
.
Permission is hereby granted to:
to ..G,"""Y`,.~1~~'~(e4r
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at premises located at ..~....:,1~,
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County Tax Map No. 1000 Section .............r~...7... Block ..............~...gLot No...a°~.~/..............
pursuant to appilcation doted ~~7-~ 19..f.
f , and approved by the
Building Inspector.
Fee S.:
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g. .~P..Sc:..................
Bui n I for
Rev. 6/30/80
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T65-1802
BUILDING DEPT.
f NSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ~ FOUNDATION 2ND [ ] INSU TION
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~a~~~~~~u~V~~w~~ a BOARD OF•HEALTH-...••••••.
FORM NO. 1 3 SETS OF PL.1:IS
~Y -3~) ! BU~DING DEPARTMENT ~ tECr;Y . .
°"'~"~"""".~;*~.,a.~,~~°! SOUT OLD,N.Y.L11971 SEPTIC ronrl
C~tT9ta. dJt.?~ T.
TOV~~s~
ran 3 ~ ra~~r.,r, ~ TEL.: 765-1802 r: oT I F7 ; JJ ff~~
~.,m,,. CALL .~JJ:sSS~~........
Examined 19 Din I L T o
Approved .~'./.9......... , 19 `~Pennit No.~~~.~?` . ~ ~ ~ ~ . .
.C-~.^~~.~~ y
Disapproved a/c 0/ %=3S' .
(Bui ing In ctor)
APPLICATION FOR BUILDING PERMIT
Date 19 .
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.
Fc. 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 pazt 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 building for necessa/ry~ inspections. ~~7J~-
(Signatu'a'e of applicant, or name, i a c ra ion)
~~...f....
(Mailing address of appli t)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.....4nwv1 e~ : .
- II// >
Name of owner of premises ~c'evi . ~/r . G~/h ! 2_``U' /"!Q/'~ ° !?'~,4z.v.1 . . . . . . . . . . . . . .
(as on the taR roYi or latest deed)
If applicant is a corporation, signature of duly authorized officer. •
~?~f~
(Name and title of corporate officer)
Builder's License No. a? a/, (~..~;--L .
Plumber's License No. . N.~/;!" .
Electrician's License No. .
Other Trade's License No . .
1. Location of land on (which pronnposed work will be done . .
.3.y~... ~~~r ~a~ Yoc~~ CJ ue
......................................~.ru.:~?:~.......,..........................
House NumberS-~t7reet Hamlet
County Tax Map No. 1000 Section 1......... Block ~ Lot .
Subdivision Filed Map No. Lot...............
(Name)
State existing use and occupancy of premises--aLLnd intended use and occupancy of proposed construction:
a. Existing use and occupancy ~e,~;nane.,.l . ~.Ume .
b. Intended use and occupancy ~~.~KS~ 4~:. ~1 y4':.f~.C'L~l SV: t'~G ,4~~~1:. ~ ~u;~.~f~t . SL4 k'L .I:G~~?~:'?..... .
ovr2t- et:
( pP Sdt-l+-K' Sun on Cur SiZF_
3. A'ature of work check which a licable): New Building , , , Addition_ ~ Alteration °F ~~-k S
Repair . .Removal . , . , , , , , , , , , , , Demolition ..............Other Wor1~ , •
} r., .
I~• ~Descr~ip°tion)
4. Estimated Cost .3. i?': i~> ~ . Fee !~.5'D , .
(to be paid on filing this application)
5. If dwelling, number of dwelling whits 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 Hein htsions of existing structures; if any: Front .Rear , , Depth , , . , , , , ,
g •••••••••......Numb;erofStories....,,,.,
Dimensions of same structure with alterations or additions: Front
Rear................
Depth Height , Number of Stories .
8 Hemh~sions of entire new construction: Front . Rear ...............Depth .
g , , Number of Stories ,
Ize of lot: Front .
1 O. Dor
z orP se
district i~ bath re Rear epth .
Ez 9..' . ...........Name of Former Owner .~.9:'~:•...`~.i0.~!~~ue;r-....... .
' p rises are situated , . .
12. Does proposed construction viola a any zoning law, ordinance or regulation: .~U . .
13. WIll lot be re raded NV - n ~rrec_essa , ,Will excess fill be removeSl rom remises: Yes
14. Name ofArohatectF4tmt-SS~.s~~~I.~GU~i!T~~s>;d~ress~Do.~o1F•%ZS:?-,7Cutf•~,~„>~No•73,Y,;SS~4~••,•
J15 .f~16/v~.. h... Address ~?n~nray+5. ldlNllr yr~7. PlCone No. -~63; 33 .
Name of Ifnyes,orSoutho d~To~n5 • • • • • • • Address ~~......../......Phone No... • .
15. Is this property within 300 feet of a tidal wetlandT *yes........~~~;,,,,
* wn Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
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STATE OF NEW YO~tK,p
iOUNTY OF :r-~4~~.~. S'~
~.er....T,.. I Q.~~
' ' ~ ~g g~~ • • • • • • • • • , being duly sworn, deposes and says that he is the applicant
(Name of individual si nin ,contract)
Ibove named.
-Ieisthe..........QQ.~'K1.~'.... I
~J (Contractor, agent, corporate officer, etc.)
If 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 containtd in this application are true to the best of his knowledge and belief; and that the
vork will be performed in the manner set forth in the application filed therewith.
.worn to before me this
s~~.....day of f.i.~ 19
dotary Public, `it.2aC.7vV:A~4-L1.!,/.t-• ; ,~,t,a.,~,., , County /~~/,~~7~~I-~~_
BARBARA E. DUNRIN ~ V~~-~;~.~G~r!•
fiDTARY PUBLIC, State of New York ~ • • , , , ,
No. A67s613 (Signature of applican
Qualified in Suffolk County i
Commission Expires June 90, 19~pZ.