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HomeMy WebLinkAbout18529-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218762 Date FEB. 5, 1990 THIS CERTIFIES that the building ADDITION Location of Property 32300 MAIN ROAD ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 19 Block O1 Lot ll.l Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 18, 1989 pursuant to which Building Permit No. 185292 dated SEPT. 20, 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 CONSTRUCT A DORMER ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ROBERT WEBBER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING SLIP 2/5/90 PLUMBERS CERTIFICATION DATED KING PLUMBING & HEATING 11/30/89 ilding Inspector Rev. 1/81 lOBat N0. f 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) x.8529 G N 0 Z Date ..~7~~'.° 19.. Permission is here granted to: ~ ~~'Si~C'I:C'.Lt.T.ti ~~.......4 ~.a.8 s.~P ..~,kx~tlr,.e~:l ro Ew'.flllO,~cl~.. .2rL.....F.zG~R..........~:~~.......fP:?'r-C~ G~~~or.-s~...s~ .....cZ~w%.u~.~ 3 7- 3 D o at premises located at ...G~' %""""'.'.....w~r~........................................................... ................................................~Z~~...................................................................................... County Tax Map No. 1000 Section ...........1.~..... Block ...........CJ..,l..... Lpot No......~1...l......... pursuant to application dated ...~,~,1~ 19..Q../., and approved by the Building Inspector. Fee $f..l....Y.... c=:~ .,1~j Buil nspec or Rev. 6/30/80 _ /~d .zGFI e `°""a ' TONN OP SOUTIIOLD q p~ BUILDING DEPARTaENT H Y TONN QALL BLDG. DEPT. ~ SOUTIIOLD, NEH YOt7K 1 197 1 TOWN OF SOUTHOLD 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPAt7CY / DATE _ . 3 ~ .~y. . HEN CONSTRUCTION .-././...OLD OA PRE-E%ISTING BUZLDZNG......VACANT LAND........ Location of Property...-~'~..7 :3 ~:.._.__....L~~l~~t~.~ ._._..._.~2:t~.~,--.~.,, HOUSE NO. f[<~ STP.EET HAriLET Ovner or Ovners of Property.._.l:)C)1?c12.~.._~G!~'~'~2........11 County Taz Map No. 1000 Section Block Lot'.Gr'.~.... Subdivision Filed Map _.......Lot._........ yy'' //a~ ~ Permit No.l~:~ZJ._..Date of Permit ..-J~~...Applicant .,:~-DHr~-_%3oR~.-_--. Hea1Ch DepC. Approval Undervritcrs Approval.__..__...._._ Planning Board Approval Request for Temporary Certificate Final Certificate JO Fce Submitted: APPLICANT....... 38y5~~ ~-~s ~9a ~d z~~~6~ rep'- 10/14/88 TEL. 765-1802 c~VFf OL~cp TOWN OF SOyJTHOd.,~ ~4.~. l% , ~c OFFICE OF BUILDING INSPECTOR ~ ,~"~~f ;T P.O. BOX 728 TOWN HALL "0~~ ~ J 0`r SOUTHOLD, N.Y. 11971 Cpl ~ ~b v_ ',--a~~°~_~ C E R T I F I C A T I O N III 3 ~ IB~9 . BLDG. DEPT. TOWN OF SOUTHOLD Date l~ ,34/~y T7 Buildinng [Perlmit No. /~~~-j Owner ~Cop~w7 ~ed~w (plea//se p/rint)//~~ Plumber ~ ~(u.,,, ~i ¢/Ja3h.~~ Ll~• ( lease pr t~ i certify that the solder used in the water supply system contains less than 2/10 of 1$ lead. (plumber's ignature) Sworn to before me this .3U day of yi6r!' ! K. ~LC/~K_ 19~• cc~~ Notary Public Notary Public,_`Z?~G~ County HELEN K DE VOE r 1k~,70787R, Sufle FtCOUntyur% term Expires hSarch 39,18 ~f II`in: jI .:G`fiE.NT~ ^a n 1. ~ H y FOUtIDAT20I7 s t) c FOUIIDATIO;I (2nd) m~ 2 . ~ /3 z 0 ROUGH FRkME & PLUMBING H 3. ~ m m IIISUL~TIOPI PER N. Y. STATE EilERCY CODE I _ ' ~ Y H I ~ c~ _ FINAL . ~ I o ADDITICi1AL COMMEpITS: x ro x . .ti H 7 H H O Rl • r H W b m -o H lc7 i'.. rt:( ~ ~s"z~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ } ROUGH PLBG. [ ) FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ~ FINAL REMARKS: Dl DATE I INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST UGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [~RAMING [ ]FINAL REMARKS: DATE INSPECTOR QCCUPANCY OR USE 1S UNLAWFUL ~ ~ITHCUT CERTIFICATE CF OCCUPANCY VEp ~g Nom DArE g e.R / FEE: o NOrtFV U! LNG DEFiggT~ 765.1802 9 AM 7~ 4 PIIA FOR THE FOLLOWING tNSPECTfONS: i, FOUNDATION - TyypR~IRED FOR POUREp ~Ok~RE7E 2. ROUGH , HtAMfNG 8 P!,(1MBlkQ PLUMBER C+~`RTYl~ICATION 3. fNSULArrON ON LEArQ CONTENT f3EFflRE 4• FINAL - CONS'tRU~7ok MGgT lCERT1FICATE Ol ~ OC~'UPANCY AL a co sTRUCtioni 7'HE RE~R~,IE SOLDER USEQ /N WAT~'R srArE caksrf~,~p~ ~ ~ kr. SUPPLY SYSTEM CANNOT coDES. kor EXCEEC) 2/1 U Of 1 ~ LEAD. UESIGN OR CpNg'~R~~ Bt~g rs Fear - ~ - i ? br`F/~zasut. kb ~ =~-r--ExrS`r1niC- scar^rt~s p , ..F. 2 2-X12 W~A-y (:41 i'GH C.C nfT,--~ 2'21(8 FfEADEI~ ` ~ ~--.I~, ` i 7PFF~T / ~ ~ 1 VE T ZxN ib` o.G r'rRr~~ W>st}- ~ ~ ~ t (n ~ r F/~ ! Su c . -rte" d Yzcox ~ EKrS,rNG ,~Nn rwo2 i /SFEt.T Ncw ~}nA1TOrJ Ya~tTj i "PR~EStG° i r_ SISTER TC ExIST~i t^~fi C E~ILtNG $MS• C-XrSTr~JG Lrwr-?L r cr F~ooR E.LE VAT( t7~ ~'j ~ ~ ~ BOARD OF HEALTH 3 SETS OF PLANS •Q:K:.. ~FORMNO.1 SURVEY $EP ~ 8 ~ ~ TOWN OF SOUTHOLD CHECK - • • • - • _ - _ BUILDING DEPARTMENT SEPTIC FORM • BLDG. DEPT. TOWN HALL ~T<7WN OF SUl17N!~l0 SOUTHOLD, N.Y. 1197'1 NOTIFY ,3~ 3 ~G7L TEL.: 765-1802 CALL MAIL T0: Examined .~..`Z,~, 19~~r / Approved 19~/..Permit No.1.~3a.9~ Disapproved a/c (Build. o Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS a. Tlris application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 peri~ shall be kept on the premises available far 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 Occupan• shall have been granted by the Building Inspector. APPLICATION TS HEREBY MADE to the Building Department for the issuance of a Building PerTrrit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. (Signetu" re of applicant, or name, if a corporation) (Ivlailing address of applicant) j tom/ 3q State whether applicant is}~owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises ~Qn~.RT I!?k.l.'~.~~-~' . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .C... ~s:~~l . . ( and title of corporate o ff leer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ! p. ~ ~ a.~.......... . Plumber's License No. ....E~. K ~ ~ Electrician's License No. ..'~!{?A~..~!-l+2rJ5....... . -riN~, A~Dy 14+~8 OF /Cc%~B rU1L'cFh4nlics na~•rrtTUCK Other Trade s License No . . I. Location of land on which proposed work will be done . . 3a3~o ...............................N1!ti~!..12?.................... ©~L~?J.1.................. House Number gStreet Hamlet County Tax htap No. 1000 Section ! Block Lot l,l, , _ , , , ; , Subdivision Filed ~1ap No. Lot . (Name) State existing use and occupancy oC premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ~N!=.... {-l~Yt'1 (~-~1... !ti'.~,'?-t}, , , {.iat2+'~.~?'~...~~D.i:re ~.N.... 3- Nature of work (check which applicable): New Building Addition ~ • Alteration , . , Repair Removal Demolition - , Other 1Vork:. jj ~ ~(DescripSion) 4. Estimated Cost ..........1 C%?~? Fee • (to be paid on films this application) 5. If dwelling, number of dwelling units . . Number otdwclling units on each floor . Ifgarace,numberofcars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ...............Rear Depth . Height ...............NuntberofStories....................................................... Dimensions of same structure with alterations or additions: Front . . Rear . Depth ......................Height ......................Number of Stories . 8. Dimensions of entire new construction: Front Rear Depth . Height ...............Number of Stories........................................................ 9. Size of lot: Front Rear...................... Depth ] 0. Date of Purchase Name of Former Owner . 11. Zone or use district in which premises are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded ........~.J .................Nil] excess fill be removed from premises: Yes N~ 14. Name of Owner of.premises C~C~YR.~..W.c~13'.7?, .Address ...................Phone No.............. . Name of Architect ..........................:Address ...................Phone No............... Name of Contractor 11'.~th~. ~c~P~, , , , , , , , , , , , , , Address i'4' Rrx.:~`~'.~. ~~~PtiJ Phone No.. 3.z 3": 7 15. Is this property located within 300 feet of a tigidal wetland? *Yes No .1::.' *If yes, Southold Town Trustees PermitPLOT DIAGIZAMted. Locate clearly and distinctly all buildings, whether existin; 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 anterior or cornet lot. ;TATE OF NET YORK, S.S 'OLiSTY OF . being duly sworn, deposes and says that he is the applicant (\ame of individual signing contract) .hove named. lc is the (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication: that all statements contained in this application are true to the best of }iis knowledge and belief; and that the ork will be performed in the manner set forth in the application Slcd therewith. worn to belore me Utis otaryPublic, .......,fy-`:~!.JS:.!~'?-.(i4'e-.. County ~L., It~''.-.' . HELEN K ~ VOE ? (Signature of applicant) NfYIARY PUBLIC, State of New Yak No. 4707878, Suftalk CauMy Terri Exn~res Mxrch 30, lu 4l