HomeMy WebLinkAbout18614-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218513 Date OCTOBER 31, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 2325 VANSTON ROAD CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 06 Lot 04
Subdivision SEC. D NASSAU PT Filed Map No. 806 Lot No. 355
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCT. 30, 1989 pursuant to which
Building Permit No. 186142 dated Oct. 31, 1989
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 ENCLOSE EXISTING PORCH ON A ONE FAMILY DWELLING.
The certificate is issued to ELEANOR NONE
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
~:/1 (A..l.
Bui ding Inspector
Rev. 1/81
Y08M NO. A
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ x.8614 Z Date .....c'~.~:.::.....~:.! 19.~`~
Permission is hereby granted to:
....~i. 'Y.....T7 i......irT.~ O.ii. ~ ..................r......
ta ...~iri.S.r!4e•:F~-.....,:Q,~:~:5:~^~.q......1......~'~..~..:~..,Uh....Q?.,....:..~ ....y..::..:?.`^?~r~!-'^^~
at premises located at :......,..1,M~.:4:i.A,...,
..................................................................................................................................111..............................
County Tax Map No. 1000 Section Black Lot No....
pursuant to application doted ..Q.~r:....+.3r.~.•..•..•.••..•...., 19~.~.., and approved by the
Building Inspector.
Fee $...`~i
Building Inspector
Rev. 6/30/80
FORBI NO. 4
. ~
TOWN OF 50UTHOLD
BUILDING dEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPAPlCY
No.....Ti7.5~.+.9............ Date ..................Eeburgry......1G........, t9.b3..
. Street
THIS CERTIFIES that the building located at .SG&Y18tOri••$oad•••••••••••••••"•"""""""""'" i
N sau Point ~'~fb~c No...XXX7G......... Lot No. 3.75•~t.......Cutahogate.~...Ift..Y..
Mop~o
conforms substantially to the Application for Building Permit heretofore filed in this office doted
••••••••.•.•„•,••,•.••••.........Q1S:~plj~X',..,,,2~,,.„•, 19(?~... pursuant to which Building Permit No...zi~.g,22..
dated .......................Q~cixf~bex..a4......., 19.6x.., 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
...........k'x:~..V.at.~...Qns..~'ami.11!.. dW+~lling....
The certificate is issued to .~alaS.ea:1As~..)`te138xSdx...&...Wo.Swfneer, •~essee or teOno~nt~$
of the aforesaid building.
H.D.Approval Feb 1, 1963 by g.vslla
~d~-~.~.~~.:~... •
Building Inspector
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TOWN OF SOUTIIOLD
BUILDING DEPART2tENT
TONN HALL BLDG. DEPT,
N OF SOU7HOLD
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE.
NEW CONSTRUCTION ..J,?~+,,.OLD OR~P)~R"E-E%ISTING BUILDING.~s~ ..'}VAC/ANT LAND..t~Q...
-----LocaEi-on-o f- Property--d 7: 9~~ ,
_ ;r:~-:-oic:~~~~ --~~a_„///..-.. L.%2.~~4~~--
HOUSE NO. STREET HAMLET ~L~~,
Owner or Owners of Property..
Cou ty Taa Map No. 1000 Sectio~~ Block ~ X.K Lot- ~
Subdivision Filed Map ........Lot..........
Pervit No. ..........Date of PermiC ..........Applicant
Health DepC. Approval Underwriters Approval.........._...
Planning Board Approval
Request for Temporary Certificate Final Certificate
~~~r-='~ ' S~~ J - -
Fee Submitted:
/ ~ ~ X y~Sd CPL ~~7 y
APPLICANT. !~';9..~ . e~`~_~_,. .
,o~~,~~y
rey• 10/14/88
LLuJ lu~~~~y,~V~• IIJtla._. II ~C:YMENTS
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.',OUCH FRAME & y.,
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.PLUMBING
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IIJSULATIOJJ PER N. Y, y
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STATE EPJERCY
CODE
4 . ~0~3/ , O m
FI;1AL
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ADDITIOIJAL COMMEIITS: x
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BOARD OF HEALTH
3 SETS OF PLANS
' ~FORMNO.1 SURVEY
TOWV OF SOUTHOLD CHEC1: • • •
BUIL`D.INGDEPARTMENT SEPTIC FORPI
TOWN HALL
SOUTHOLD, N.Y. 11~J71 NOTIFY
TEL.:7G5~1B02 CnLL
MAIL T0:
Examincd.Q~;.~~.,19~,1.. -Y, '
!
Approved r?~.4:~!`?".'..`~.~.., 19g4. Permit No..~.Q.~o.~.7.,Z.- .
Disapproved a/c
. (Building [nspecior)
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 Itspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
` b. PIot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detai]ed 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 IvfADE to the Building Depaztment 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 necessary inspe~Tcti-ons.
(Signature of applicant, or nam~b, if a corporation}
(i4failing address of applicant)
State whe[her applican/,t is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
D ~~N N T,~
Name of owner of premises ..!~!:~'.:~`....:~'L~.'~°:~...~a~.~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
:1~~ n. .
• (Name and title of corporate officer) '
pLL CO?7TRACTOR'S MUST IIE SUFFOLK COUNTY LICENSED
Builder's License No . '
Plumber's Liccnsc No .
Electrician's License No .
_ i
O!her Trade's License Nc . . .
1. Location of land on wftich p oposed work will be done . '
alas ......~~3~TG~....~,...........~•~~0~'~!-r......
House Number Street PP Hamlet • ~ • ~ ~ ~ ~ "
County Tax Iv1ap No. 1000 Section ......I ~ I , Block ......~+..~P........ Lot ~ •F . .
Subdivision Filed Dlap No. Lot .
~(Namc)
State existing use and occupancy of premises and intended use and occupancywf proposed construction:
,
a. Existing use and occupancy ~?J;-S... ~ n~q v.~ra?U r~o,cc.~ .
b. Intended use and .....t.`.......`.~..........°i..... ...4 ~ . .
occupancy .....~!;r~o ga. c+,C. , . • .
3, Nature of work (check which applicable): Iv'ew Building Addition Alteration
Repair Remoival • • • • • • • • • • . Demolition .Other Rork . • • •
~ (Description)
4. Estimated Cost ...e~S?'~??? , I • , , , ,
Fee.
(to be paid on filing this application)
5. If dwelling, number of dwelling nits Number of dwelling units on each floor
If garage, number of cars ' • • •
6. If business, commercial or mixedloccupancy, specify nature and extent of each type of use . . , , , ~ • • • •
7. Dimensions of existing structures, if any: Front Rear Depth . ~ • • •
Height Num~er of Stotics . - .
Dimensions of same structure ~vit t alterations or additions: Front Rear . • ~ • ~ • • •
Depth Height
. Number of Stories .
8. Dimensions of entire new construction: Front Rear . .Depth . • ~ • • • • • • •
Height Numb~ar of Stories _ .
9. Size of lot: Front Rear....................................................
Depth
0. Date of Purcftase ....Name of Former Owner ~ ~ • •
l . Zone or use district in which premises are situated . ~ • • • • • ~ ~ • • ' ' ' • ' '
Z. Does proposed construction violatje any zoning ]aw, ordinance or regulation: NP .
3. 11'illlotberc~aded
°r L • • • • • • • • • 1Vi11 excess fill be removed from premises: Yes No
4. Name of Owner of,premises • , , , , , , , , , , , , ,Address . r
Name of Architect . l . .Address . • ~ ~ ' ' ' ' ' ' • • • Phone 1\0 .
.PhoneNo..
IJameofContractor. ••••••Address .•••'•••••••••••..,PltoneNo.
5. Is this property located w}thin 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustlees Permit may be re uired.
I PLOT DIAGRAM
Locate clearly and distinctly all b~rildings, whether existing or proposed, and. indicate all set-back dimensions from
~operty lines. Give street and block number or description according to deed, and show street names and indicate whether
;tcrior or comer lot.
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7[: ~T1 OF
~•••••••••:•••yr,•°~•••••~•` ••'i bcingdulysworr„deposes and says that he isthGapplitant
i:~~,r,c in_>•idual sirnin~ contract)
ovc named. ~ ~i
:isthc
(Contractor, agent, corporate officer, etc.) • • • • • • • • •
said owner or owners, and is duly au horizcd to perform or have performed the said work and to make and fle this
nlieation: that all statements contained in this application arc true to the best of his knowledge and belief; and that the
,rk will be performed in the manner set ~'ortlt in the application filed therewith.
orn to before me this
......................day ot....l,.................,19... '
wr}• Public . ~ County
• I'~ ~ . .
HELEN K. DE VOE ` ~ "n,~~
i~:,~J. • • • ,
PSOiARY PUBLIC, Stafe of t3ew York 4?rtgnature of apphcant)
No. 4707878, SuKoIN Coun
ierro Expires March 30,18 ,