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Home My WebLink About18770-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19407 Date OCT. 2, 1990 THIS CERTIFIES that the building. Location of Property 300 PVT. RD. #t7 House No. County Tax Map No. 1000 Section I23 ADDITION TO ACCESSORY ~ATTITUCK Street Hamlet Block 06 Lot I6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 30, 1990 pursuant to which Building Permit No. 18770Z dated FEB. 2, 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 ACCESSORY STRUCTURE The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ROBERT & SHIRLEY ANDERSON Building' Inspector J Rev. 1/81 FOUISDATIO~! FOUNDATION 2. ROUGH FRAME & -FLUMBING 3. iNSULATION PER N. STATE ENERGY CODE IIDA?E ~ FI;;AL ADDITIO~A'L COMMENTS: 7-78.01 ~ '>,~1 :-t.. '..L', PI Y, 5__ o .~[~T MO~.~-~ ~ t] J~ ~ ~ ~--- TOWN OF$OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 ....... 19¢ . Permit Disapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .... ,19~(''/. .. a. This application retest be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 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 buildings for necess~ion~,~ · (Signature of applicant, or name, if a~corpor~tion) (Mmhnfa' ...... g address of applicant) State whether/lipplicant is owner, le,ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~.. (as~6n the tax roll or latest deed) ' ' If applicant is a 9orporation, 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 oflandonwhichproposedworkwillbedone../~'...~....~...~..~.&~~/ ·..~...C4 ...................... ¥77..~b~CJ ..... /. .............. . ....... House Number Street Hamlet County Tax Map No. 1000 Section .... J .~. :~ ......... Block ..... ~ ........... Lot.../.(~. 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 .... ~4A)~ .......................................... b. Intended use and occupancy ... ~..-.,~.~ ..................................... / ........ ; 4. ~stima[e6 uos[ ..... ~' ~' ~' 'i .......................... . · · · ~ 7 '~ , (to be pard on filing th,s apphca~lo~ / 5. If dwelling, number of dwelhng umts Number of dwelling units on each floor ., ..... If garage, number of cars ' ...................................................... 6. If business, commercz~ or mixed ¢ccupancy speedy nature and extent 0f each type of use .............. 7, D~ensions of existing st~ctures, ~if any: Front ............... Rear .............. Depth ............ '.'. · Height ............... Number of Stories ........................................................ D~ensions of same structure wit~ alterations or additions: Front ................. Rear., ................. ~pt~ ..................... ;.¢i¢t ...................... ~,m~, or Stori¢, · ~ .;&.; ;.:;::;:;: .... 8, Dimensions of entire new const~tion: Front ............... Rear ............... e ..... ~eight ............... Number of Stories ........................................................ 9, Size of lot: Front .¢~.¢ · ~ Rear ................... '... Depth ...................... 10, Date of Purchase ~. ~ ~ ..... ¢ .......... Name of Former Owner ............................ 11. Zone or use district in which premises are situated..; .................................................. 13. Will lot be regraded ........... i .................. Will excess fall be rem¢¢ed t~6m premises: 14. N~e of Owner of premises ~~ Address .... ~~. Phone No. N~e of Architect ........ Address ................... Phone No. Nme of Contractor ~~~~Address . .~ ....... PhoneNo. PLOT DIAGRAM Locate clearly and distinctly all )uildings, whether existing or proposed, and, indicate all set-back dimensions from lines. Gtve street and block number or descnptm according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ............................. i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, l He is the ........................................................ (Contractor, agent, corporate officer, etc,) y authorized to perform or have performed the said work and to make and file this of said owner or owners, and is dui and that the application; that all statements cont.ained in this application are true to the best of his knowledge and belief; be performed in the manner set forth in the application filed therewith. before me this , NOTARY puELBILIc, State o! New,Yolk "' ' ' " ' ...................... No. 4707878 SuffolkCe~n~, (Signature of applicant) T~rm Expires March 30,19.-.7.4-