HomeMy WebLinkAbout18086-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217996 Date MAY 3, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 856 R.O.W. OFF NARROW RIVER RD. ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 027 Block 04 Lot 9.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 1, 1989 pursuant to which
Building Permit No. 180862 dated MAY 2, 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 FAMII,Y DWELLING.
The certificate is issued to KEN STRACHAN, JR.
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLQMBERS CERTIFICATION DATED N/A
/V/.ut~fl ~i~~
Building Inspector
Rev. 1/81
TOWN OF SOUTIIOLD
BUILDING DEPART?LENT
TOWN HALL
SOUTIIOLD, NEW YORR 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
/ DATE...~~//~9.----'
NEW CONSTRIICTION ._...._OLD OR PRH-E%ISTING BUILDINC~t._...VACANT LAND....._._
~ ~dMecri ,~,.N,,,,
Location of Property.... ~ .~.4f_~~:~.~.~ ~ _ ~
HOUSE NO. -~STREE HAMLET
Owner or Owners of Property..../. :':'..~~"~":'.~z:;-
9.3
County Taz Map No. 1000 Sectioa ~ Z Block .y Lot ,
Subdivision....//.~/~ Fi~le/d Map ........Lot../....._.
Permit No. ~~~a~?Z...Date of Permit !J.~/sg ..Applicant
Health Dept. Approval N/~.......... Undervriters Approval.._. N~!4....
Planning Hoard Approval
Request for Temporary Certificate Fiaal Certificate
i
Fee Submitted: ~,'.~L~.......,
APPLICANT.._~_._____________
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Gr.~arar~~°e G'~c~n~f?~rr1 ana ftrr- S~
ROB-yDER K VAN UYLxP C.
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ) FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
DATE '~02 INSPECTOR
3~~-~ ~i ~
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ~ `CJ
°OUTHOLD, N Y 11971 ~
q TEL.: 765-1802 ~ `
Examined , 198 t Received........... , 19.
Approved ~a--41 , 19~ PermitNo. J 8~ ~.(a~ Q-I,~,jif1-~-...~...,
Disapproved a/c . - ~
•
~ ~ ~ 1411
pg~- ,
~ (Building Inspec~zar) ; ~,i- ~ ~ J
APPLICATION FOR BU~~~i~NPG P~RI4~IT
Y.,~ H4C',it~ Date 7~ 19c
err is .
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INSTRUCTIONS
L ~ l
a This app~icatfon mus~b~~ioihpletely filled in by typewnte~ o~ in }u~C and gubmrtted to the Building Inspector, wrt
sets of plansr~accurate plat plan 1FO'a)'~,;,Fee according to schedule..rt t ~
b Plot plan shoving lob atio ;lot and of buildings on prem>rgs,relationship to adjoining premises or public stre
• or areas, and giving a de14.ailed`QnIe 'tion of layout of property tilt be drawn on the diagram which is part of this ap
cation. i . f+~ ~ w+~ ~ ,
c. The work covered by this application may not be commeii~e be{foie issuance of Building Perri~it.
' d. Upon approval of this application, the Building Inspector issuefl a Building Permit to the applicant Such pei~
shall be kept on the premises available for inspection throughout tjle v~COrltsr„ , ,
e. No building shall be occupied or used m whole or m part'iz~r' any purpose whatever until a Certificate of Occupaz
shall have been granted by the Building Ins~ieptor - '
a . ~ rY a { . n
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmlding Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authonzed inspectors on premises and in budding for necessary inspections
hAc vo.~~+-o woe,v woiz~iNc'...GO~:
(Signature of applicant, or name, if a corporation)
........y4 G... ~d~o...~°
o,G.~~'T N. t' iig~ 7
~~(mailing~address~of~applicant)~~~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or build
O~~-
Name of owner of premises ~ ~.i? F' i ~-j//~"~ ~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and true of c rporate officer)
Builder's License No.
Plumber's License No
Electrician's License No
Other Trade's License No
1. Location of lanP~Gn which proposed work will be done . .
House Number Street Hamlet
County Tax Map No 1000 Section ~ 2- ~ Block Lot .may /
Subdivision 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 ~ /
b Intended use and occupancy ~^%~-~-+~T ~ . .
3 Nature of work (check which applicable) New Building Addition Alteration
Demolition Other Work . P~' G'~. .
Repair Removal .
(Descnptron)
4. Estimated Cost ~S. aE?, o ? . Fee
(to be pazd on filing this application)
5. If dwelling, number of dwelling units . Number of dwelling units on each floor .
If garage, number of cars
. . .
6. If business, commercial or mrxed occupancy, specffy nature and extent of each type of use . .
7. Dimensions of existing structures, if any. Front Rear Depth
Height Number of Stones , . .
Dunensions of same structure with alterations or additions Front Rear , .
Depth . Height . Number of Stones .
8. Dimensions of entire new construction Front Rear . ..Depth
Height ..Number of Stones .
9 Sxze of lot: Front Rear . Depth .
10 Date of Purchase ..Name of Former Owner .
.
11. Zone or use district in which premises are situated . F3.-.! 11,~~,P~Fi!'T~r-~ . .
12 Does proposed construction nolate any zonrng law, ordinance or regulation . .
13 Will lot be regraded . N/'7.. Will excess fill be removed from premises: Yes No
14. Name of Owner of premrses . S,T~.~R. ~H~4 .Address .aF. ..Phone No....
Name of Archrtect . 2~dcjr~ss . Phone No. .
Name of Contractor . lr'/J~P.°.^':`~'~ ~~o'.~`~ . c~~'"dress Phone No........ .
15. Is this property located withini00 feet of a tidal wetland? * Yes No
* If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dunensions from
property fines Grve street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
'r „
' ~ ~ O /
~c~s ~ ~ ~r ~`°~h-'- APPROVED AS NOTED
DATE: ~B.P # g~
o_ 8 6"~
FEE: ` BY G'
NOTIFY BUILDING OEPARTngE'uT AT
T8S-1802 9 AM TO ~ r'v+ `r%~ >?E
OCCUPANCY OR ~~U
°ATSONP~~7TL~~o ~e~lu~ o
' USE IS UNtAWfUL FOR POURED CONCRETE
WITHOUT CERTIFICATE 2. ROUGH • FRAMING Rr PllMe.
Qf OCGUPANCY 3. INSULATION '
1 4. FINAL - CONSTR~ICTICIN T i
BE COMPLETE FOR C O
ALL CONSTRUCTION SYIALI h'~FET
THE REQUIREMENTS OF ryE v
>TATE OF NEW YORK, S S STATE CONSTRUCTION & ENEt-~aY
'OUNTXOF C~~O~~aqD~~ES. NOt RESPONSIBLE cc"i:~
being mny~ ~~~rdl~~s~~a[ he is the applicant
(Name of individual signing contract)
bove named
[e is the ~ .
. .
(Contractor, agent, corporate officer, etc )
f sazd owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~phcahon, that all statements contazned in this application are true to the best of his knowledge and belief, and that the
ork will be performed m the manner set forth in the application filed therewith.
worn to before me~#his`
1 day of 'Y! 19.~~
otary Publrc, )~e~ lv l~. ..~L U~"~... County
HQEH K DE VOE yy~~~
ROTARY PUfltiC, State of New York %c~~" . •
No 4107870,Su0alkCoutrtY ( rgnature of applicant)
Term fxptres March 30,181
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