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Home My WebLink About17849-z r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17839 Date MARCH 13, 1989 THIS CERTIFIES that the building ALTERATION Location of Property 28350 MAIN ROAD CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 102 Block 06 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 16, 1989 pursuant to which Building Permit No. 17849-Z dated FEBRUARY 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to WILLIAM J. SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NJA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ' A< ~"~`~L./ Building Inspector Rev. 1/81 FOEM NO. A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ 017 8 ~ 9 Z Date ~ 19.~.~. Permission is hereby granted to: , ....1: . ~ . ~ . ~ ~ . . . . ~.q.~A~........... n to ..Q.Q.~9.ti+.....5)7.~..t•-. ri......Q~'.w..~0.:nan.Q.~.` :,J..>.c?1„R..e.Kt!%9 .:A.~a.....9.~f1~4:?:!!'.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u. . . V. . . . . . . ct Premises located at .P~.~..s~l.~.~.......~.~?:!~a~...1~.r .............Aerr.~--~..................... ~.....c,.~~:,..~ Caunty Tox Map No. 1000 Section ...!•O.1'.•••.•. Block ......~.~P......... Lot No..I..~ pursuant to application dated ....~..~ri 19y and approved by the Building Inspector. Fee Building Inspector Rev. d/30/80 • ~a~,,6p3~~S~CI rynati,.,4.cQ. t _O+na.~yjy~ ~IR3.s ' F' TOWN OF SOUTHOLD d BUILDING DEPARTMENT ~ I;.6 TOWN HALL SOUTHOLD, NEW YORK 1197 TOWN OF50UTHOLD 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY RATE NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING. .VACANT ND........ Location of Property HOUSE N0. STREET s HAMLE Owner or Owners of Property-. fj`~tf J ~ " .................~.~r~................. County Taa Map No. 1000 Section Block Lot Subdivision Filed Map ......-.Lot.......... Permit No. ..........Date of Permit ........-.Applicant Health Dept. Approval Underwriters Approval.............. Planning Board Approval i Request for Temporary Certificate Final Certificate Fee Submitted. /~///i~~~ U ` APPLICANT.Y:.......... .~S!/l~i:~~~.......... 3G~q ~ CO ~-17839 rev. 10/14/88 ' ecz-; . ef? ~ ~ w Z erA ~ii~'(gp~ ~ ~r oc m ~ ~Wwe-s e~J ~ Ewa ® QLLey°~d ~R' ~ a~' A ~ z~tanzna`~cz~~i=Wr O ~ ~ p2 zap. t~.7~-+OpdV ~ LL~g5~Of=h,42wVD:wwV' a uao~n-~-~®~~z"m j=~pw B ~~ro o.- tV maP firth tJn c3 'a un n . x y v ~ v c C n n , ~ N J O W m ~ , Vp 2 D+ .o v n p •d ll N * N ~ Y ~ t'+ ti ~ N ~ h J O C H p ~ . i~ V y ~ O ~ 'O O N • X : : N•.1 r! C ~ 'O ~ u ~w . 'O 7 c! O • 4: : y ~ b I p V ai ~ ~ ' ~ °a, b ~ f ~ : ~ ~ ~ ~ : N ~ O O ~ T ~ ti: w :w.o a~ u m 0... CD O u C\ a v .n w L Q Yom. V 4 V C . V ~ ^ p N .NQ ~X N \ ; C n . O^NF+ a) 0 "I.l ~ ~ C n ~1aa ~.C o v'v a N .C ti V .c v 3 .d Y o a Y ~ m y~ VCJ •Y ~ ~ L: b N a •D ~ c • o ~ L• O Ey p ~ ~ p ~ u0. 1: O O .O X ~ I Uj ~ ~ G vui `1 O O OV V ~ C ~-J v A b v .d - - ~ V L. _ _ _ : ~ : V ~f n E N O w ~ • 'U ~ C u N n ~ C7 aCC~i v O n~ V y '41 U O ~ lt' ~ : u > C a ,a H ~ .n p y F 7 u = ;a ~T-~ /i/ r, UG! n / o ~i 3 to ~/~i"~~~ ass-iso2 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ )FINAL REMARKS: Y DATE ~ ~ INSPE~C'TOR !~"~n1 , ,PoAD ~A/N. _ _ _~l'~._-.....J---> J ~ Fy f Eck , ^Vl ( 1 ~ ~ ~J 1 ( l ~ ~ ~ b ~ ~ , ,P1 ~ p .h RU,~~ ~ I { ~ ~ ~ . ~ ~ ~ do Fr^x~ , ~ b . ~ , ~ ~ ~ ~1 ~ ~ , C-- . ,-5'ca ' BOARD OF HEALTH 3 SETS OF PLe1NS FORM N0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC roRM • TOWN HALL vOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 CALL Examined ~.p.., 19~g. MAIL T0: , Approved4M!\4 .J.(P, 19~q. Permit No. ~ ~ 7. ~ 's t ~ Disapproved a/c .....`Q D ' I ~a FEB I ~ i989 ` ~ t Ls' SLUG.UEPT . TOWN OF30U7HOLU (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS 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. Tlie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, a regulations, and to admit authorized inspectors on premises and in building for necessary ins e i s. . (Signature o ~ appli , or nom a corporation) • (Mailing address of applicant) • State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ - Name of owner of premises ~ ~v~~. (as on the tax roll or latest deed) f ap o/ant is a corpoa io~n,~g fiat of duly aut~r~~ fficer. S.' Na~and le of corporate officer) v~u 1 er's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . / 1. Location of land on which proposed work will be done . ll/~/ House Number / Street, Hamlet County Tax Map No. 1000 Section Q c~ Block ....~i.... , . , • , , • • • Lot ...l.. ~ . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended/use/~apnd occup~a~ncy~f proposed construction: a. Existing use and occupancy .~~~c~c,~t~!!P • • ~ ~~".i Jest b. Intended use and occupancy 3. NRet air of work (check which ~lapplicable): New Building • • • • • • Addition Alteration . c • • • • • • moval . Demolition Other \Vork . t7 I~ , • , • . • • , • • . • • (Description) 4. Estimated Cost Fee number of dwelli (to be paid on fling this ap lication) 5. If dwellin" rjg units , / , , , , , , , , Number of dwelling units on each floor , , , , , , , , , , If garage, number of cars l . 6. if business, commercial or miffed occupancy, specify nature and extent of each type of use . r~%?'?•~ ~/t~ . 'D,iii~bYP~~(~~~~~~ structures, if any: Front . z--3 ~,~5, , , , Rear , ; , , ' ,rtf ~ Number of Stones . De Dimensions of same} # ) ~ • • / pth . ~ , • • . a r st cture with alterations or additions: Front ~ • • • • ' ' ' ' ' ' ' ' Depth , . 9• :'t..::: j IIeight . ...s~n~ Rear_ . . Nu -E ' • ' ' ' • • Number of Stories . g traction: Front . ;5 .~~?1 ' ' " ' ' ' Rear Depth Hc,i ht ns o onttrre new cons • • • • • • • • ; . • Rcar " " " " " 9. Size of lot: F. mberofStories..,,,,,,,,,,,, Depth 10 Date of Purchase (,~,9, , d',`j, , , , , , ' ,Name of Former Owner~.~'N:~, , , , , , 11. Zone or use distract ih which premises are situated . . . ' ' • • • ' ' ' 2. Does proposed construction vrplate any zoning law, ptdinance or regulation: • 13. ~Villlotberegraded " " " " 14. Name of Owner of remi es • r~ • a~ e • • Will excess pill be rem/p~~ved frpm remises: Yes p ~ ; i ~/t . ~ ?j~.. Address !1,'1i`/,~,.r- l~f~co.vic. P} one No.7~ f';Sd~ j No Name of Architect .Address . .Phone No. . Name of Contractor ~oP,/ p~O~ , . • ~g . Address . ..................Phone No............ , . IS.Is this property locted with n~00 feet of a tidal wetland? *YES....NOF::. *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 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. I ~ ~ I ~ ~ ~ y~ I i ~ STATE OF NE1V YORK, S S COUNTY OF I • ' ' • • • ' ' ' ' ' ; ' ' ' • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (flame of individual signi~tg contract) above named. He is the . . ...................1.........,,.................................:..................... (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 fle this application; [hat 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',sct forth in the application filed therewith. Sworn to before me this ...~..........~.`-t ........dayof ~ 19~~. ~ ~~,II_ Notary Public, /~:~~:1!; , ,1.5.: ,l~¢2 ; • , , , County ~ \ HEl[:N 1(. DE VOE ~~r~ . . . NOTARY PUOLIC, SMte of Nuw Yak h / ' ' ' ' ' No.A707S7A,SuffolkCcun { (Signature of applicant) Term kxplres Mewh 30,19