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HomeMy WebLinkAbout18119-z ti FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18048 Date MAY 23, 1989 THIS CERTIFIES that the building ADDITION Location of Property 750 OLD HARBOR ROAD NEW SUFFOLK, N.Y. _ House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 05 Lot 08 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 1989 pursuant to which Building Permit No. 18119-Z dated MAY 16, 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 REPLACE EXISTING DECK ADDITION AS APPLIED FOR. The certificate is issued to VINCENT R. & ELEANOR B. WIECZOREK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 goaa>< xo. s 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° 1O1..L~ Z Dote ...cS~~? 19~~ Permission is hereby grants to: , ......~,SQ....... . ~.°q!.... ~~~~.......~~y . of premises located of ...../..~Q y~.....,;~lx~~'eG,/ff~. G.....~1.~........................................... County Tox Map No. 1000 Section Block ........5~..-~`..~..C Lot No...... D.~........ pursuant to application dated ~y.~I,l/..y- 19.4, and approved by the Building Inspector. Fee G ~ Buil g 1 for Rev. 6130/80 TOWN OF SOUTHOLD BUILDING DEPART?PENT TOWN HALL SOUTIIOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY / DATE 3~/'"Z . NEW CONSTRUCTION ...,.OLD OR PRE-E%ISTING BUILDING......VACA/NT-- LAND....._.. r Location of Property.. '15~..a~-:~, ~'~l~_'I`Z~0.11Z..~pdt1~,.7-_~(~~--~~1=rB(~~~ HOUSE N0. 11,, STREET HAMLET Owner os Owners of Property.Y ~ ~G~zd1-`(- ~l.~t+~dC~/JZ., _~~-~~qq f,~.G-ya7llL~l~ ~A{ County Taa Map No. 1000 Section .4~~ Block .Q.3..__ Lot- 0 Subdivision Filed Map ........Lot.......... Permit No. f o .Date of Permit J~~~~~,_Applicant Ut~~~.~~ a~«C2od~~~ Health Dept. Approval Underwriters Approval...~~~`{_-.--.. Planning Board Approval - Request for Temporary Certificate Final Certificate x.......--- r~ - Fee Submitted: J.-.-..--.-.. APPLICANT.Y.~:`:~~':~4~.~~~.LA~ R~.3~ar6 - Cc,~is0+~~' reV- 10/14/88 ~1cLD I~:S:~EC_1Uii ~~DniF. i;OaYMGNTS m ~ 1. ~ ~ \y~~~'0. ~ ~ y "1 ?OUNDATION , (1st) 'OUNDATIOiJ (2nd) _ _ m~S ~ ~ \ o~,j ;O UGH FRAME & ~yl PLUMBING ti H 3. ~ ca CiJSULATIOPJ PER N. Y. y STATE ENERGY \ CODE a r m ~ . r y FIiJAL - ADDITIOPIAL COMMENTS: ~ x U m ' x ~ M ~ \ ro.\ 9 H O CS x c~ • A ' r H \ ' d m H 80.1 [:D OF HEALTH 3 SETS OF PLANS FORM NO.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC r•oart TDbVN HALL SOUTHOLD, N.Y. 11D71 NOTIFY • TEL.:7G51802 CALL Examined . J? 19 ~`1 MAIL TO . - - m,= , m..., Approved 19~Permi[ No. ~tS'~~~ ~ ~ ~ ~-<<~,~ Disapproved a/c . t ; y~y j j i,, >~1 ~ ~ ~ ~E~V{j . r~~!~ , o'y ~ ~ BLDG. DEPT. ' ' ' ' ' ' ' TOWN OF 50UYHOLD ~uil g Inspector) APPLICATION FOR BUILDING PERMIT Date 15.~~.1_ INSTRUCTIONS a. Tlris 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. e. 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 b1ADE 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 Rcculations, 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~ inspections. _ (Sicnature of applic~, or me, if a corporation) ~;,;s 7s~ oLa_ t1Vkt2~3o2 d'71 r~~ SUi=colic' N~Y (Mailing address of applicant) C(~s~ K H.,...~....,.... , State whether applicantgi~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ' ~:1~'rYfNft.E ~ ~~nY~~,l', ~(i a Name ofow,pGA;eF.'&}1d~iSes .Fa7.t;~;~~i'.•1'1':,......,.5.~'~~:..~.1MC_,~o.FT'...12,..~clzLZO~2~~ +•'~3z"3ir;^< .,"13=«,,~ ap ` (as on the tax roll or latest deed) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ • ICapplican`t"is4$3~cor'pofa'tion,~si~gnrzjUre of duly,•authorized officer. (Name and'ttle o,f corporate officer) Buildcr'~'Lic•.°,nscNp; '.fir"~~~LF?:,~<,-..... .,s .,r,:, , Plumber's Liccnsc No. Electrician's License No. . Other Trade's License No. 1. Location of land on which proposed work will be done. ' , ."r.~lQ d L ~ C1 uk J~;t3g t2, , Y`c.~ ..........~c?=(.2~ S v.FF~[.C~ House Number • ~ ~ Street Hamlet ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ " / r County Tax Map No. 1000 SeCIIOn 6. ~ ~1........ Block ....~~,g , , , , , , , , Lo[ O. Subdivision Filed t`lap No. Lot . (Name) State existing use and occupancy o(prcmises and intende4d use and occupancy of proposge~d construction: a. Exiumg use and occupancy b ~:~...FI~UA ~ 1~.4 D.(k~.FiL L.~(r.IL~~...(tJ~. ! J!vC:Y . b. Intended use and occupancy S{4~.F.-... R,t'` f G k-... 4(, t-~~ ~ 59~~, .5,~ ~ . i . ~ aPPlicable): New Building 3. Nature of work (check which Addition .Uteration Repair Removal D •m liti . ,~yP~~~" : y • • . Other Work . 4. Estimated Cost ~,~,©v, , , , , , , , , • • . ~"G~ 2~~~. - (Description) Fce If dwelling, number of dwe!!in (to be paid on filing this application) • • • • units Number of dwelling units on each floor.............. , If garage, number of cars , . ' 6. if business, commercial or mixgd occupancy, specify nature and extent of each type of use . 7. Dimensions of cxistin^ cs, if any: Front • , , , , , , , , , , , ,Rcar d structur Depth . Height Number of Stories . • • . Dimensions of same,_st cturewithaltcrationsoradditions:Front ~ Depth e:b'§ e": .Height . Rear . 8. imensions of entire new cdnst H~i_Itt Nuin • • Nurttbcr Pf Stories ~ . ^ iuction: Front , Rear Depth . - bcr of Stories . , , ' ' ' ' ' 9. Size of lot: Front. ~ 10. Date of Purchase Rcar Depth """p' •...NameofFormcrOwner 11. Zone or use district in which remises are situated , , , , , , , , , , , , , • • , , • • • • ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ocs ro osed construction vio p P . • • • • • . date any zoning law, ardinancc or regulation: ,VD• • • , , , • • • • l3. Nill lot be regraded ...G{(5, , , , , , , , , , , , ,Will excess (ill be removed Crom premises: Yes No l4. Name of Owner of prcmisestflintE!rr,R,,f;re{zero,F~/~Address7,S,v,n~~,H,y,p,,go~~•~t ,Phone No..~:3,~, Gp((, , . • Name of Architect ' .Address . Name of Contractor b (z ..................Phone No............. . If yes, Southold Tow~~ 'Address .......PhoneNo.........., ' 15*Is this ro ert located within X00 feet of a tidal wetland? *YES....NO.... Trustees Permit may be required. I 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 dumber or description according to deed, and show street names and indicate whether interior or comer lot. ( ~ l~' r- _ c9 I ~ [)RLE ~ • i~ xts~'t~~ 2~ti,~~~ w~~a~~ s~i=~ D E,,G 1< AP~ A8 NO~IED DATE: ~ M.R M i NbTIFY BU~BQEPA AT 786-1802 9 AM Yd 4 PM FOp THE FOLLOWING INSPECTIONS: t. FQUNDATION - TWOREOUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING Qr PLUMBING 3. INSULATION 4. FINAL. CONSTRUCTION MUST BE CQMPLETE FOR C.O. j ALL CONSTRUCTION SHALL MEET ' ~ THE REQUIREMENTS OF THE N.Y. i STATE CONSTRUCTION & ENERGY CQt3ES. NQT RESPONSIBLE FOR iTATE OF NE1V V'ORI:, ' pk'SICN OR CONSTRUCTION ERRQRS S.S =OUNTY OF . bove named: ,nrna. , . ~ ~ ~ • ~ ~ ~ ' ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant • • • • . , • •(l~amL of individual sip ~ • • contract) !c isthc (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 arc true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. wom to before me this • .............~e2}.[.;~..dayof. ,~'Yhu~~. 19~~ Mary Public, ~~?~?v~-:.. J~~, • ~Q- ~i4C; County HELEN K. DEYgE • • y.Y:.!,~~~~L , . NOTARY FUt3LiC, State of New Yurk ~ _ - • ' ' • • • • • • No. 4707878, Sutiol~Count (Signature of applicant) I. 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