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FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217983 Date APRIL 28, 1989 THIS CERTIFIES that the building ADDITION Location of Property 350 MATHEWS LANE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 084 Block 01 Lot 21 Subdivision NORTHWOODS Filed Map No. 5469 Lot No. OS conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 4, 1989 pursuant to which Building Permit No. 180302 dated APRIL 12, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to CHRIS & ELIZABETH FZNNE (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r- Building Inspector Rev. 1/81 roses xa s TOWN OF SOUTHOLD 6UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Na Z Dare ...........kl~.-....~.~ t9.g.9 x.8030 Permission is hereby grant ~ ~ to .Ca~~....41.....s.....bi,&~t:o>n...~1'~.... a^'?.....:^:`P.l....t~l~ ! 4 at premises located at ~ ~"~?......'71.94stf.+~:!: ° ..r~"~a. ..................~4:~!.~,,........... County Tax Map No 1000 Sectio~. $.T....... Block ......0.~.......`.~. Lot No Z . pursuant to application dated . ~ 19.X and approved by the Building Inspector. Fee S••*~:•. Building Inspector Rev 6!30!80 TOWN OF SOUTIIOLD C ~ BUILDING DEPARTHCNT fR'R JJ 'T'-xy~ TOWN HALL F`"~ ~ SOUTIIOLD, NEW XORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY p~j' DATE. . , o.L NEW CONSTRUCTION ~._.OLD OR PRE-E%ISTING EUILDING......VACANT LAND..... LocaCion of Property HOUSE N20. q STREET f, H[A~MLET Owner or Owners of Property.~~~..©©MC1~E~W.~..~N~J.~Y.~.CFJQC.~:~1:........ County Taa Mnna((p No. 10//0.-0 Section ..Q~. Block ._.I.... Lot Subdivision.IQpV.Q~~~~77W4:~~~...... Filed hhMap~J~l...Lot...~...... Permit No.~.v~.~J.v/r..Date of Permit ~/~c~r:D~Applicant~l'y~~~Z't~G~".~T:?.~~hY Health Dept_ Approval Undcrvri ters Approval....._._._._.. Plaan ing Board Approval Request for Temporary Certificate Final Certificate .._Y............ 6b Fee SubmiCted: APPLICANT....//~ ..1,,1..~~~~~. G`d z /~/1~3'3 rev. [0/24188 5~/.'~j 1nLD ~,.:,I c ~IU,.a ~~MMLNT~ H y ^OUIIDATI0:1 (1st) ~ c ; c OUNDATIOt1 ( 2nd ) m z 0 ROUGH FRAME & PLUMBING 3. a m ~ n IIISULATIOII PER N. Y. 'j STATE EIIERGY CODE I _ 4 . ~ m H . FINAL ~ 4 ADDZTIOIIAL COMMEIJTS: x O m~ ' x ro H a • a H i H O c m ~ c- H ? O [7 -n H ~'r~R~s a Q~T~Y ~in~ ~ 35a ~Prthe~.}s Cu+cl~~~tt ~ OCCUPANCY OR USE !S UNLAWFUL • WlTNOUT CERTIFICATE ax 8 ~e ~ ~ ~xy~ P~`rs OF pCCUPANCY a x ~ ~c ~ 34" ~~...~.-a X ~ C ~ ~ ~AJPPR06tED AS NOTED DATE ~.~'.3....BPN~pO~l!~ f ~ a ~ C ~ FEE b~ . ~ $Y ~ t . NOTIFY 6UILDtNG DFP~>F2TMENT AT S~ X ~ C'o+~l C't'c~~-2 (~PCk, ! n~ 765 1802 9 /.M Tr r °Yt FrJR THE y FDLLOtN3Nu r?v.aF`_r ~1(3a~~z ~ ~g - recos /~x~ - ~x g ! 1, FOUNDATION TW(}REQUIRED f / FOR POURED CONCRETE ~ p i 2. ROUGH -FRAMING L4 PLUM84NG CTS` ~ t ~ L° ~ts 3. INSULATION ~ 4. FtNA1 - CONSTRUCTION MUST Z. f}-9 ~o I.tS BE COMPLETE FOR C.Q ' J! ALL CONSTRUCTION SHALL MEET j S THE REQUIREMENTS OF THE N Y. STATE CONSTRUCTION 8 ENERGY R~ J e Z j}' ~ ? X coo>cs. NOf RESroNSteLE fOR DESIt3N OR CONSTRUCTION ERRORS Deck js ~~,t,~ gur//~T oF~ ~~oc~ri~ i LUi7Ml Ctl~ ST~p QDtnltl rrt Y-ker1T"- ff-C(.. a~y(a ~loott Tot S /(l," ~'~tl r+~R w~f~ ~~'l~ SG+f,',~~1 5 -~''~J(S Le gek Laqq -lo hoKSe .vrtti recc5r we~~FtoWfRS 1L" on CP~fttL FdR F~aoP~ Sc~ST 1Nw~tl rx?~4ndP4~/rC4~ ~ I ay/ Fr2AmC- axG FGooR 3orsT' ~ a ~ ~ ~ a F ~ I` _ ~x ~ k h you aL~ ax s GtRde~ _ ~ ° ~ z ~ , > a / 1~ a ~ 1'~ p ~ y ~ A k yx4 Sup~o4r ~o$"r5 1 < r ~ lV _ fi CA lL ~ ' _ _ . - _ _ _ - ~ C n T X ~ Cc.^1 Ce~r}r(~P(Kr ~Iq _J v,Sr ~ ~ v 1N `4 J s d y N ~o b K \ ~ ~ ti DoKSLt ax8 ~~tt~e+;. ~ ~ ~ yk~( SNYt'awT pests ~ ~ FKR vn C°. nn u•~er nn.,• e., dJ_n-. O_rr Cr. 30 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] iNS~1LATION [ ]FRAMING [ FINAL ~y~ REMARKS: DATE INSPECTOR - .r - - a V / V ~ P ' / V QOM , , x bx~ ~ ~ ~ •'a~y O W y \ s CMS' • 2'7.:; ~ \ N} ml \a b + aapci ~ p y v R-.S~ "~MQ h . pb0 \ 1 ya C/1 ~ . N ~qq}}}1~~~ 1 ~ PAC ~ Z ' m m yO=m ZO oiioo° 5rv~i2 9 10~ t\ ?~t~ _ o~ i~i: m$m3 i~wF 9 `~O~yN ^n N ca~z`~m <oz wig" ~ _ya a y amzo a 1 Z ° ~22~4Y-I lm~l <°°1 -1< 'Tp 1 '"m-~°oma~"u '~m~°z m<o ,s. V 'M no t~ Z °s-~o"~ ego °amu ~i°a 30 ~ \ r OI zm=x°imai ~c~oa 4a^ -tee O \ ~ ~ m m-miz ~^~z oim maam oz's I ~H ~ _ NY @~~Y onm acs ~ 0~~~ ioni~<°iEm '<-Imva ,'n~°z~ 7c 1 ~ S Q' 0 0 ~ m ~ o-ziuozwiz mmy m*a \ RCS R1 z~u ~iri Yii arm nor \ ~~04 mm m'-'r a r cos o ~ bqS ~ ' Y . N ~ N. (b ~ SI ? ~ N A ~ ~ .~iV Z ~ N ~ no i. _ to GI N O~~ ~ ~p sY~ v. CS p n O 1 r n ray ~ o ~ 1 0. O~ C >ar. \n m i ~i~j < °°mm c° ~ p { cuZ I ~ to \ ~ C 'p Q~ T m=E I /~6 .p C O ~ n ~ _ m m O ~ p O ~ ~ : z o_ s j O nOj O~ o° AC a~~,~ p00~' L j0~ O < Z `~io~ ' o ~ u m Mn\~2 n-• ~ O ~ m ~ 1pm0; za D ~ O ~ = C 2m ~ a 2 ~00 ~~Op ~ni ~v ~ ~ ~n~2 v, t z ~ ~ foC~l ruy K ~ N o.P 2 y ~OF o i f ~ 2 ?c ~ ON o n 2 -A'~Oy ° A p D n C v+ 2 O B0,1RD OF HE.\LTH 3 SETS OF ELF\NS FORM N0.1 SIJRVCY TOWN OF SOUTHOLD C1iECK ~ . BUILDING DEPARTMENT SEPTIC I'ORPS ' TOWN HALL SOUTHOLD, N.Y 11971 NOTII'Y TEL..7G5T802 CALL Etamined . ~.•d~-q/~L~Y. 199. MAIL TO : 3$O '~4i ~ \pprovcc3•,,~,11I,'~,•~... r 19~. Permtt No ~ O 'L 2 V Kam DtsapProved a/c I ~ ~ ,a~R ..a BLDG. DEPT. TOWNUFSOtJTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 15 ~ INSTRUCTIONS a. Tliis appitcahon must be completely filled m by typewriter or m ink and submttted to the Butldmg Inspector, wdi sets of plans, accurate plot plan to scale Fee accordtng to schedule. b. Piot plan showing location of lot and of buddtngs on premtses, relattonshtp to ad)otmng premises ar pubhc stre= or areas, and giving a detmled description of layout of property must be drawn on the diagram wkttch is part of ttus app cation. c. The work covered by this application may not be commenced before tssuance of Building Permit. d. Upon approval of this appltcauon, the BuIIdmg Inspector will issued a Building Permtt to the apphcant. Such peril shall be kept on the premises evadable for inspection throug}tout the work. e. No building shall be occupied or used m whole or to part for any purpose whatever unto a Certificate of Occupan~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the tssuance of a Building Permtt pursuant to t. Building Zone Ordinance of [he Town of Southold, Suffolk County, New York, and other appItcable Laws, Ordinances Re_ulattons, for the construchan of buddmgs, addthons or alterauons, or for removal ar demohtton, as herein describe The appicant agrees to comply with all appltcatile laws, ordinances, budding code, houstn~ code, and regulations, and admit auihonzed inspectors on premtses and in building for necessary t ttozzs. Signature at apphcant, or name, tf a corporauon) • (Mailing address of apphcant) ! l /?z State whether app]cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or butlde ~WN~R.. Name of o•.vner of premises ...~{~~l Gtt'1d ~ ~-.1.~~ 1~~'H ..i~ F!n/.AJ.~ . (as on the ta:c roll or latest deed) 1C appltcart is a corportton, stgna[ure of duly authort~ed officer. (Name and tale of corporate officer) Butldci s Ltccnse Na ().~ly,~•J~; . Plumber's Ltccnse No . . Electrtctan's Ltccnse No . . Outer Trade's Ircensc No . . 1. Location of land on winch proposed work will be done . 3 s a M ~-~Y~? ~...i,RN.~ ~~.~t rJa.e(1 . Flouse Number ~~jj 1St~reet, Hamlet County Tai 1f.tp No 1000 Section 0. '1 , Black ...I Lot . Subdrvtston ..N.Q.R"T1:1.1N.Q(~.~.5 Fded Itfap No .~~.~p~ . Lot . (Name) Stale e~tsLng use and occupancy of premtses and intended use and occupancy of proposed constntcnon: a. Ertsttng use and occupancy p~l~t . b. Intended use and occupancy .....~~~.t.RCN~,~y• 3. Nature of work (check w hrch applicable). New Budding Addition ~Uterauon . Repair Removal Demolition Other 14ork ..Q E (DcscnpUOr m so 4. Estimated Cast......~.l,P:~+? Fee (to be paid on filing this application) 5. If dwelhn„ number of dwelling units ........1 Number of dwelling units on each floor . Ifgaragc.numbcrafcars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use AJ.~f~. .i. , , , , , 7. Dimensior~~ of existing structures, if any Front ...~.5'?... Rear . , ,5.3 Depth . ~:7...... . Hcigki~'~q .~g . Number of Stones f . Dimensions of same structure with alterations or~r`~~dytions Front ~ 3........ Rear ..ter..'.? , , . Depth ~.1.~ 1 cig}itR~f.'rot`..4 Number of Stones . oZ.,r............... i i 7 r g. Dimensions o~e`trrc new tbrtst~ckf>~n Front ....a,a. Rear .....c~u~....... Depth y', , , , , , Hcigltt yJ c.4..... Number of Stones a-.. 9. Size of lot. Fron 1 `J.J Rear ~ S J............ Depth 1 3(~ 1, . 10. Date of Purchase Jet Name of Former Owner .~-~.~.4~ • •~,ly~?N~ S I1. Zone or use district m whuh premises are situated ...~.P~! R~.1;?T?.W 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. 1Vd( lot 6e regraded lsu ........1Vit1 excess fill be removed from premises: Yes t 14. Name of Owner of premises .CE1~',tS. ,F(EJ N L~-.... ,Address 35c? .M.i°tf.~f~Uls .4k ..Phone No.73~(: 7$~~ . Name of Architect ..........Address CUfLC-{~':~'".... Phone No . Name of Contractor ..........................Address ...................Phone No............. . IS.Is this property located within X00 feet of a tidal wetland? *YES....NO~. *If pes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or propo-~~ ^.nr~ :r~t~ zll set-baci• dunensr ins fry property lines. Give street and block number or descnphon according to .a sh ~w strc't n.~, i•as anc md,caie whet; intenor or corner lot. „ STATE OF 1E1~YORF:, COU:vT/Ya OF . uS? t~.iS-, _ S S •1-.~.~ <<~...~-. ~ ~,N ~%J being duly sworn, deposes and says that he a the applrc: (Name of individual signing contract) above named. ficist}re (Contractor, agent, corporate officer, etc.) of*sr~ti owner ~i Deers, and a duly authonzcd to perform or have performed the said work and to make and file t applicatwn, that al! statements contained m this applwyuon are true [o the best of his Lnowlcdgc and belief; and that t work will be performed m the manner set forth m the apphcauon filed thercwrth Sworn to before me this C~11 ~ .......:1:~'~....c....aayof ....12,14-........., 197 tiotary Public, ~UF~,c>t; t~....... County .(~~G~~ ~~~~?'t!v`f/ ~?.~,L ~i. l . EtEZABE7H A. NNNB ~aotnm ?usuc, &a» of tlrr Yedc (Signature of applica No. ~6i3466 . Eu(»k CeeMy i~rm Expim Nw. 3Q, 11?