HomeMy WebLinkAbout18082-z s FORM N0. 4
•
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18280 Date AUGUST 14, 1989
THIS CERTIFIES that the building ALTERATION
Location of Property 3331 ROW OE'F' GRAND AVE. MATTITIICR N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 107 Block O1 Lot 11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 27, 1989 pursuant to which
Building Permit No. 18082-Z dated APRIL 28, 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 RE-CONSTRIICT ON EXISTING PORCH AS APPLIED FOR.
The certificate is issued to ELLEN BLACK GUYTON
(owner}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
~/.,vL _
Building Inspectar
Rev. 1/81
togas xo. ~
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 _ ~ Date ..........L.A.~CI..W 19../J.
° ~.8a82 V a ~
Permission is hereby gmnted to:
...~,~....~x:.. ~.~.~f
.
at premises located at ...sr~l~:~.~......1~...°..:.~..:...~~~.....~..~.~a-~...1.~4f.:~R.:.....~.T~
~~.....~.~~:>.....~.,.~I .
County Tax Map No 1000 Section ..1.A..1. Block Lot No.
.
pursuant to application dated 19.A..9., and approved by the
Building Inspector.
Fee 5..~~•.~..D.:•.•
~ C:lllh.Z-........
Bui g Inspector
Rev 6/30/80
_ PD p~~~ ~~~//`~y~ l/9~?
A TOWN OP SOUTHOLll ~u~'K"
BUILDING DCPARTaCNT
TOWN HALL
SOUTIIOLD, NEW YOlt1C 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY nn ?
DATE . Q~~ . 7~ ~ . _ . .
HEW CONSTRUCTION ....._.OLD OR PRE-E%ISTING BUILDING.~..VAJCIANT LAND.{...__..
Location of Property..3~11. ~qJ~~/
HOUSE NO. _ "L' ~ STREET UAMLET
Ovner or Ovners of Property...(.~~~~:.~yx'{-.r-_h~-.
County Taz Map No. 1000 Section .~U Block ~ Lot
Subdivision Filed Map ........Lot...._..._.
Permit No. ..........Date of Permit .._.......Applicant
IIealth Dept. Approval Undcrvriters Approval__._._._._._._
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: $
Lan.
APPLICANT_. .....`~:~"Yv_"'"------••--'
n _
/"FLohre. 1~k° Ue%menf
rev. 10/iL/88
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c fl ! ~ a 3" C~
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' TEL 7G5-1801
~5~FF01.~{CC, To~~rr or sou~ruoLa~
l
~ ~ ~s Or1'ICI; OI' PiUILDING INSPECTOR
~ 'I~°t"~ ~ TOWN ISALL
O,y ~~t- SOU"I IIOLD, N.Y. i 197t ~ ~ .4. `
~ M!6 f 4 i9B9
~ ~ TOWN
OF SOUTHOLD
To 4ahom This May Concern,
We are unable to complete your Certificate
of occupancy because of the following reasons.
An application fo_r Certificate of occupancy
is not cn file. \/E~/~-~
> / / AIO Undertor~.ters Certificate on file.
'['he citccFc t:. (---•'/nut on file.) ,~o~,S:~J
DIO Flcalth Dept. Approval on file.
/ / No final inst.cc:t.ion has bectt made.
Please contact our office on this matter.
Thank you for your cooperation.
lkttlcltr,<1 Permit- Il 1 ~ Q ~ ~ Z
Builcitnc3 Oopt.
/ Ila Plumber Solder Certificate on file. '
( all pcrmiL:, involving plumbincl being
>ssuccl afL•er .1prs1 1,1984 )
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765-1802
BUILDING DEPT.
1 NSPECTI4N
[ ]FOUNDATION 1ST [ J ROUGH PLBG.
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[~RAMING [ ]FINAL
RE ARKS: ~~ia-t Q ~ ,
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DATE ~ L l INSPECTOR
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ~ l ROUGH PLBG.
[ ) FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING (~'F`~AL
REMARKS: ~ ~~D
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B0.1FD OF HEALTH
3 SETS OF PLANS .4~........
FARM N0. 1 SUftV EY .
TOWN OFSOUTHOLD CHECK ...tom
BUILDING DEPARTMENT SEPTIC FORhI
TOWN HALL
SOUTHOLD,N.Y. i1~J71 NOTIFY 7~
TEL..7651H02 CALL
E~ammud . ~i ~.g . 19~Q~. MAIL TO
Approve.. 8 19 0~. Pcrmtt No. ~ a $.ll. ~r~ r~
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' ' ' ' ' ' ' • ' ' ' ' ' • • • • • • • TOWN O SOUTriOLD
(Bwldmg Inspector)
APPLICATION FOR BUILDING PERMIT
Date . 15
INSTRUCTIONS
a. Tltis application must be completely filled to by typewnter or to ink and submitted to the Building Inspector, with
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, reIatronship to adlommg premtses or public stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app
ca4on.
e. The work covered by ties application may not be commenced before tssuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the appltcant. Such perm
ahalI be kept on the premtses available for inspection throughout the work.
e. No budding shall be occupied or used m whole or to part for any purpose whatever until a Certificate of Occupan~
shall have been granted by the Buddtng Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the tssuance of a Bwldtng Permit pursuant to ti
Buddtng Zone Ordinance of the Town of Southold, Suffolk County, Nety York, and other appttcable Laws, Ordinances
Rc__^_ulaLOns, for the construction of buIldmgs, additions or alterations, or for removal or demolition, as herein descnbe.
Tlie applicant agrees to comply with all applicable laws, ordinances, buildmc code, houstn~ code, and regulations, and t
admit authonzed inspectors on premtses and to budding for nee scary inspection
~~o(v tC.~~~~c Ld~~~w?..rv~.T'.'
(Si~na[ure of applicant, or name, tf a corporation)
• (Matting address of appltcant)
State whether appltcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
......~`':~'1~ .
Name of ownec of premises ~:C~'.~....t:JL~?~":...~~. 1 .
(as on the tar roll or latest deed)
iC applicant s a corporation, ngnature of duly authorized officer
(Name and tale of corporate officer)?
Builder's Ltcensc No ~ ..?~..U... .
Plumber's License No .
Electrician's License No . .
Otlter Trade's License No . .
1. Location of land on which proposed work will be done .
Eiouse Number Strcct HamIM }
County T.i~ Alep No 1000 Suction ....l.d. ~ Block 1, • • , • , , • Lot ! • • , • , . , , , , • ,
Subdivision Filed t,lap No. Lot .
(Name)
State e~tsgng use and occupancy of premises and intended use end occupancy of proposed construction:
a. E~ctsting use and occupancy ......~i.~-:t:^."?"4J1~:... ~.Q1'~'£r .
b. Intended use and occuoancy .
3. Nature of work (check which applicable) New llutldmg Addtuon .Vteratton .
Repair . Removal Demohuon Other A'ork .
~r-- - • (Dcscnpnor
4. Estimated Cost ~2 6.0p : ~ Fee
(to be paid on filing this apphcauon)
5. If dwelling, number oC dlvellmg units Number of dwelling units on each Ooor . , • , .
If gara;e, number of cars .
6. If business. commercial or mt~ed occupancy, specify nautre and cetent of each type of use . .
7. Dtmenstons of e~ctsttng structures, tf any Front Rear Depth .
Hetgftt Number o(Stoncs .
Dtmenstons of same structure wdh alterallons or addrttons• Front Rear • • , , . ,
Depth . Ilctght Number oC Stones .
•
8. Dtmenst~e tety construction Front Rear Depth .
Hct;ht ...............NumbcrofStoncs............
q. Stzeoflot.Front Rear................. pth
De
10. Date of Purchase .............................Name of Former Owner .
11. Zone or use dtsfrtct to whtctt premtses are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation .
i3. Ndl lot be regraded ~1Vill excess fill be removed from premtses. Yes i
14. Name of Owner of premtse~t..~~J~~.`.~4'7tfldress . Pltonc No............. .
Name of Archttcct • . Address hone No... .
a
Name of Contractor~l.~L~~~:.. ?LJ:...~,~~~. Addresst~..~.•..[~. ?t Jam.
, rt":.. Phone No..~. 1~ 5~.. .
IS.Is this property located within 300 feet of a tidal wetland? *YES,Y~..NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAbf
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dtmcrstons frc
property lines. Give street and block number or descnptton according to decd, and show street names and indicate wheth
tntenor or corner lot.
~ti~~~
STATLOF\El4'Y'ORI:, SS
COU~.TY OF .
• • • • • • • • • • • • • • • . bang duly sworn, deposes and says that he is the appitca
(Name of individual signing contract)
above named. .
'ietsthe
(Contractor, agent, corporate officer, cic.)
~f sold owner or owners, and is duly authonzed to perform or have performed the sold work and to make and file tl
tpphcauon, that all statements contained to this application are true to the best of lus ].nowlcdge and belief, and that t.
work will be performed to the manner set forth to the application filed thcrcwrth.
sworn to before me this
• ........~.7. dayof.. 19~y.
j,~ n ~ /
.otar}• Pu61tc, Yl /lJa-.4 CountY :~CA . .
HELEN K DE UOE ' ' '
?14TARYPUBUC,SteteofNewYork ($tgnature oCappitcar
No 47D7S/6, Suffolk Cour~tYr .
Term Extnres ARetch 34,19_•-~