HomeMy WebLinkAbout18999-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southotd, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19176
Date JULY 2, 1990
THIS CERTIFIES that the building
Location of Property 2010 OREGON ROAD
House No.
County Tax Map No. 1000 Section 100
Subdivision
ADDITION
MATTITUCK, N.Y.
Street Hamlet
Block 4 Lot 4
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 30, 1990 pursuant to which
Building Permit No. 18999-Z dated MAY 8, 1990
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 DWELLING AS APPLIED FOR.
The certificate is issued to MARTIN SIDOR
(owner)
of the aforesaid building.
SOFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
// B~ilding Inspector
//
Rev. l/B1
FOB, M NO. ~l
TOWN OF SOUTHOLD
~UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
18999
Z
Permission is hereby granted to:
......~.~.~.~....~.:~.~....t.?.?.:~' - - ~- " ' " ..... ~ ,
,o.~..~..~.~......~.~.~...,.:.~.~....~...~....~ ~- - ~ ~ ~ '-' "-' .~.'..~.~ ..........
......... ............ .....................
County Tax Map No. 1000 Section .~=.../....d~... .......... Block ....... .~.....~.. ....... Lot No ......6.....~. ............
application dated ....... ' ......... ..~...~.. ................ , 19.~..°.., and approved by the
pursuant to ~
Building inspector.
~'~~ ~uqldlng Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPART?lENT
TOWN HALL
SOUTHOLD, NEW YOHK
765 - 1802
11971
,,Y°wN OV soumo~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING./....VACANT LAND ........
HOUSE NO. STREET HAMLET
0 -
vnet or Owners of Property..
Subdivigiom .......................
Filed Map ........ Lot ..........
.
Health Dept. Approval .................. Underwriters Approval ..............
Planning 8oard Approval ................
Request for Temporary Certificate ....... Final
Fee Submitted- $ ~
Certificate
rev. 10/14/88
<~,~c,, ~,ill7
co ~FllT'~
TOWN OF SOUTI~IOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
3Lr~ 14, 1990
To whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
~/ An application for Certificate of Occupancy
is not on file. ENCLOSED
/~/ -No Underwriters Certificate on file.
~/ The check is(l~not on file.) $25.00
/~/ No Health Dept. Approval on file.
/Z/ No final inspection has'been made.
Please contact our office
Thank you for your cooperation.
Building Permit II } 8 9 9 9
Building Dept.
on this matter.
Z MARTIN SIDOR
DECK ADDITION
NO Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FOUNDATION Ilst)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING [~FINAL
REMARKS:
DATE
' 'Ns?£C.TOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITy
STREET, NEW YORK, NEW WORK 10038
Date ~pplicatio~ No. on file
THIS CERTIFIES THAT
in thefoltowing h,ca.~io~._..~ B.scmp~f ~ ~ Ist FI. ~ 2nd ~7. ' ]~
EXHAUST FANS
DRYERS FURNACE
FUTURE APPUANCE FEEUERS
TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO, OF FEET
SERVICE DISCONNECT $ E R V I C E
OTHER APPARATUS:
NO, OF CC, COND. A, WG.
PER ~ O~ CC, COND,
! .~/0
AWG
OF HI-LEG
NO OF NEUTRALS A- W, G,
OF NEUTRAL
'/!0
GENERAL MANAGER
This certificate must not,be altered in any manner; return to the office of th~ Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR I i:CopY OF CERTI! I' NM BE ALTERED INANY MANNER.
JCTION L~ E'NERrJY !
NOT RESPON$1BL~-
3. Nature ofxvork (check which appticabte): New Building .·.......- Addition ......... . /alteration ...........
.?.°;:lc ..... fi7 ".7.
Repair .............. o n . .. ............ Swimming poet ............
Tennis Court essor ng . .Fence ....... Other Work. ~.~,-~..
4. EstimatedCost..k.~O.Q~.: .................... · .. · -.. · Fee .................................... . · ·
(to bc paid on filing this application)
5 If dwelling number of dxvclling units ' Number of dwelling units on each floor
If garaee number of cars ...........
6. If business, commercial or mixed occupancy, specify nature and extent of cach type of use ....................
7 Dimensions of existing structures if any: Front ' Roar Depth
............. Number of Stories .......................................................
Height . .
Dimensions of same structure w~th alterations or additions: Front ............... Rear
Depth ...................... Height ...................... Number of Stones .....................
8. Dimensions of entire new constn:ction: Front ........... Rear ............... Depth
Height_ ........· ..... . .Number of Stories .......................................................
9 Size of lot: Front Rcar Depth
10. Date of Purchase ............................. Name of Former Owner ...........
11. Zone or Use district in which p¥cmises are situated ...........
12. Does proposed Construction violate any zoning law, ordinance or regulation: ...............................
13. Will lot be regraded .; .......................... Will excess fill be removed from premiseS: Yes .... No.
14. Name of Owner of premises ~..~t.'-~ t~l...,~(~t~.t'~ Address ~o.A ~'.q/.. [~n.'r~.;.T~t. lCPhone No.~'.~'~'D.P.~,....
Name of Architect ................. .......... Address ................... Phone No ........... . ....
Name of Contractor ' Address Phone No >'... '
IS.Ia this property located within 100 feet of a tidal wetland? *Y~S .... NO.~..
~:If yes, Southold Town Trustees Perm~Lt may he required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro;~
property lines. Give street and block number or description according to deed, and show street names and indicate whethe.,~'
interior or comer lot.
\0 \
STATE OF NEW YORK·
COUNTY OF ~.~..F-~..a.f(~....... S.S
·.. l ............................ being duty sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above nam'ed.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to pegform or have perfo~ed tile said work'and to m~e and file this
aoptication: that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be perforated in the m~ner set forth in the application filed therewith.
Sworn to bet'ore mc this . ,.~
. ....... ......... ..........
{Signature of applicant)
TOWN OF SOUTHOLD
~' BUILDING DEPARTMENT
.! ",', TOWN HALL
: '~0UTItOLD, N.Y. 11971
TEL.: 765.1802
Examined ....... 19 ,CJ.O.
Disapproved afc . ....; ....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH :...~-. .
3 SETS OF ~L,\~S .'~...
SEPTIC FORH
NOT[FY ~
CALL ...................
HAIL TO.'
INSTRUCTIONS
"Date ..... 19q'~.
a, TIQs application must be completely filled in by typewriter or in ink and submitted to the BuildingI~ector, with ~
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location o'f lot and of buildings on premises, relationship to adjo mag prcmx~ or public streets
or,,areas, and giving a detailed description of Dyout of property must be drawn on the diagram whichi~pan of th.is appli-
catoR.
· 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 app//canL 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 Ceffifica~ of Occupancy
shall have been granted by the Building Inspector. '
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a BuiIdlng Permit pursuant to the
Building Zone Ordinance of thc Town of Southold, Suffolk County, New York, and other applicable:~La~. Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for {emoval or demolition, as ~tein described.
The applicant agrees to comply with all pphcabte laws, ordinances, building code, housing code, and reg~la[ions,-and to
admit authorized inspectors on premi,~cs and in building for necessarg inspoetions.,. .
(Signature ct applicant, or name, if a corporalmn)
·. ... .... q .......
(Madmg address of applicant) /
State wh~ther applicant is owner, l~ssee, agent, architect, engineer, general contractor, electrician, plnmber or builder.
' . .'.S?,' cl., &
Name of owner of premises .. )~'J.~). ~ .~'.. j. F~. .
";ah' 'o'li ;; lit;it' ~;/~) .........................
(as on thc r
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
I. Location of land on which proposed work will be done;
.ot.o. &oa
ouse Number : Street Hamlet .................
: /.qo. ' ' .~ ~.
COunty Tax Map No 1000 Section .............. · BlOck ............... Lot .................
Subdivision .....
....................... , ..... l~iled Map No ............... lot ............ ~..
(N'a'nie) '
· S!atc existing nsc and occupancy of prcmisc~ and intended use and occupancy o£ proposed constructiom , ~ "'"'
2. E.,is,,g u,e a,d occupanc . .~ nq/~..'.~'~ m:.):y...b.4 ~.e..
Y
b''ntendedusea..occupa.c~ i.'~ .~..Eq*.;. J~¢.e.... :.4,g'..~,~..,, ...........