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HomeMy WebLinkAbout18135-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218406 Date SEPT. 22, 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 725 CRITTENS LANE SOUTHOLB House No. Street Hamlet County Tax Map No. 1000 Section 70 Biock 11 Lot 04 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1489 pursuant to which Building Permit No. 181352 dated MAY 25 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 ACCESSORY DECK. The certificate is issued to MARJORIE & JOSEPH BENSON (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buildi g inspector Rev. 1/81 rows 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 813 5 Z Date . 19.9 Permission fs hereby granted to: . , ....~:a:s..... '..~,.~:...~.l.~c GZ2~(~e'~G4i ro ..44."~<rtilt ,.....G~........~....~~ at premises located at .....~J.ll~...~`..'.......~~'~rlr/~sP!1.~.....~ County Tax Map No. 1000 Section Block Lot No...........T.......... pursuant to application doted .............`.,~..,f..:.6............................, 19.~, and approved by the Building Inspector. ~ oa Fee .yay,1!: boa ~rsui "ng"nspec~ Rev. 6/30/80 / (p ~ - I TOWN OF SOUTIIOLD ` BUILDING DEPART2IENT O TOWN HALL SOUTIIOLD, NEW YORK i 1971 SEP ~ 21999 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY 1 / DATE .l....~ . NEW CONSTRUCTION ...V.,,OLD OA PRE-EBISTING BUILDING..._..VACANT LAND........ Location of Property. , , , ~ ~N.S . ~Q~-r~~ HOUSE NO. _ -STRnEEnT HAMLET * Owner or Owners of Property. ~Sc./-~~{ L~~SQ' `1 •~G N ~Q 'County Taa Map No. 1000 Section .,/.v , Block J.,. Lot Subdivision.. Filed Map ........Lot.. ~Jf . Permit No. .Date of Permit~~~.~Applicant~ OSC~~~_N..~~~,SO,~ Health Dept. Approval Underwriters Approval......,,,,.,., Planning Board Approval Request for Temporary Certificate Final Certificate Fee Submitted: $.~~~d.O APPLICANT.. ?;L2_=.. 1 I ~.3 C_ v z~~ yo6 'ev. 10/14/88 '1G~~ 1~.v:'L~.11)~i IIJnl I LJd~M t:N T~ ' / b J' _ _ H 1 OUIJDATION , (1st) ?OUNDATIOtJ (2nd) _ _ m 2 e~ LLL o ',OUGH FRAME & r,, PLUMBING 3. H 77 y C+J CTJ :IJSULATIODJ PER N. Y. , , ~J, STATE ENERGY CODE Q~ r / - y ti FI;JAL f ~ ADDITIOPJAL CO ENTS: e~ . co ' x ~ ro H 9 (A H N O ' A r \ H T C7 .D H ~ BOARD OF HEALTH 3 SETS OF PLANS FORM N0. 1 SURVEY . TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 CALL 7b~S.-.`{/6a : m •3 y3 y Examined .V/~.°?:' 19 t1 p MAILj~TO(~•7(0-7,~ ~u,t'~a~va.~ a`~p~. Approved ~.'/.y~.~........, 19 Permit No..~0.~"'~t.~r.~ ti=!.1~, ,j f# Disapproved a/c €,i ~ MAY 1 ~1~ o Frt.,.c; ue~ ravui~~ sourNaLti / (B din Inspector) APPLICATION FOR BUILDING PERMIT Date ~a~ /f ~D........., 15 INSTRUCTIONS f a. This 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. 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 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, build' g code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe ions. _ _ _ _ _ (S' attire t" applicant, or name, if a corporation) • (Mailing address of applicant) ~r~c~•ria-~~.e~ , -may: //97l State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................~W.N,~}2:............................................................. Name of owner of premises ......~®`~~p~:~. ~'~~`~~t~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and titl of corporate officer) Builder's License No. D(,~/1~~~.L........... . Plumber's License No.Q/~, r~~s~~~ . Electrician's License No.dU~!~~ . N~ Other Trade's License No~. . 1. Location of land on wltich proposed work will be done . . House Number Street Hamlet County Tax Map No. 1000 Section ~r.~.......... Block Lot ~ . Subdivision ~OV'77-3 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 J.f'.~a•i'"?• • •f--}pM r b. Intended use and occupancy ~ nAr~+tN V ~O ~ i^ ~~ra i .j 3. Nature of work (check which ap'plicable): New Building Addition V^... Alteration . Repair Removal Demolition Other Work . f (Description) 4. Estimated Cost ~J dtJ. . Fee . (to be paid on filing this applic~aftion) 5. If dwelling, number of dwelling units Number of dwelling units on each floor Nfi4 , . ~ If garage, number of cars .....j M.`.,,e4 . 7.' Dimensions of a 'stin structure occupancy, specify nature nd extent of each t pe of use . . . . . Hei ht , ~s> if any: Front ......./.?.~i!?:... Rear Depth . 6. If bgusiness, c~ m~ i~l or Nue ber of Stories N../F . De th ; , , , , , - th alterations or additio}~: Front /.'r/>aa" Rear ....../n/,",~ , , , , , . . p ~ , .Height ........f1~/.i.~......... Number dt~ Stories ........,/l//~........ . " 8. D me lions of ent' eneuwtconstrtrction: Front , Rear De th ' p Height Nurr~ber of Stories . . 9. Size of lot: Front .......:d?~ Rear Depth ~Y//L........... . 10. Date of Purchase nS p'T ..f.~~.~.......... Name of ormer Owner 4.~'.S . 11. Zone or use district in which remises are situated ...............r<'ES!~~5-:JTa.A:'~-................ . 12. Does proposed construction viol';ate any zoning law, ordinance or regulation: , fJ .4 . . 13. Will lot be regraded ./xJ' ,E(: ,Will excess fill be removed from premises: Yes j/~N.o 14. Name of Owner of premises o,£kt~ot . ~f%~{&'iu~Address ..~~5. C~:°TT~`S.. Phone No. 7.C.T -^,il, Name of Architect ................Address ...................Phone No............... . Name of Contractor . If yes, So thold Towq. " • Address Phone No..... * ted within 300 feet of a tidal wetland? *YES.. .NO.... e IS.Is this ro ert loca Trustees PLOT DIAGRAM a required. Locate cleazly and distinctly all ~I~ buildings, whether existing 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 interior or corner lot. ©~G(,c `t"a g~ ~u~~? 7;Z.S Clet^rTt~S ~f"f'~lRtoOZ G.dT C Ktr°f'Y~L-N S .Art L-~ T, P~'~~~~ V ' I J ~ `"f ~ \ e p~cPrC ~~8 1- b 1 I ?Sd--f 4~. ~ ~ r L ~zo i ~ R6 pewT~~ ~ N ~ STATE OF NEW YORK, S.S COUNTY OF Sv.RPRR~ ~ p ENSO i r/. s.~na .N.... ' (Name of individual si ni ~ ~ ~ ' ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant ng contract) above named. ~ lie is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this I .:S1rY.?'4'~.~!!?~f~'............ y of'~,.!'"!/9.y 199 Notary Publi7~~ County FF~e~"~`E J. WF.ISS . C~// . Notary Public S.rte of t`lew Yark Il. Na. 4.1-4206! 30 Qu.~nns Ca'unty (Signature of applicant) Comm. Expires !i 30, 19~y' ~Vn/d I s ~ ~ z ~ ~ m` ~ ~ i-_ ~ - - , 1 o Q ~ t ~ Z fi ~ ~ i ~ s i~ j ~ ~ s R ~ ~ ~T ai ~ ~ - - ~ ~ ~ ~ 1 ~ ) ; - - - - 3 ~ ~ L~'J t-s+ ~ ~ Z - - \ ~ ~4 N D n - - - - - ~ \ ~ s _ t , . ~ - . 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