HomeMy WebLinkAbout17889-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218567 Date NOVEMBER 16, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 170 LAUREL AVE. SOIITHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 56 Block 03 Lot 04
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 3, 1989 pursuant to which
Building Permit No. 178892 dated MARCH 8, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING.
The certificate is issued to RODRICK FOSTER
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N084708 AUGUST 3, 1989
PLUMBERS CERTIFICATION DATED N/A
B ilding Inspector
Rev. 1/81
108M N0.
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°_ 017889 Z Date ..~~~~(J 1 .Q.
9 V
Permission is hereby granted o:
.,ice G
ct premises located at .....1.I..s~........!L ~-i
County Tox Map No 1000 Section .V~-~ . Block .....:3..... Lot No T•• .
pursuant to application doted 19... ,and approved by the
Building Inspector.
Fee 3.~a
.O.y . ~l S...l
Bull ng I 'tor
Rev 6/30/80
, ~ _
~1~~~
TOWN OF SOUTIIOLD D Tj
BUILDING DEPART2IENT 5
TOWN HALL pp~j~~
SOUTIlOLD, NEW YORK 1 197 f T0~~P6 011TF1
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY pfi9
DATE. 1! a. o!
NEW CONSTRUCTION .._....OLD OR;(P~R~E~-~E%ISTING BUILDING. ~..,f}V CANT LAND........
Location of Property.!/.~p....L!~7~":`:'!~::~..~............~54~t'~~~'~
IlOUSE NO. . ~ ~ ~ST,REET EIAMLET
Ovner or Ovners of Property~t.~rL~4~!~~~V'v1-t"K-c
Couatp Taz Map No. 1000 Section Block ._`.-3.... Lot ...~7.....
Subdivision Fil//ed Map ........Lot?fy.~.~.)......
Permit No. f.[~~9z..Date of Permit :~f.~/~9...Applicant /lU/!~:`~y~.-:='T'=':":Y"`
HealCh Dept. Approval .._...J/........ UndervriCers ApprovalCP.~:j9~?~~L...
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: ~
APPLICANT. v ~
~ -3 ~6 ! ~
Ca z /k~6 7
7I~iGf~f
'rev. ]0/14/88
THE NEW YORK BOARD OF FIRE UNDERWRITERS pAr,E 1
1001071
r BUREAU OF ELECTRICRY
0s JOHN STREET. NEW YORK, NEW YORK 40038
AUGUST 03,19$9 Applicotion rvo. on file 613406$9/89 N 084708
THIa cERTlweg THwT
owly the electrdcal egalpasent KR dnerlhed 6doKO ersd Introdrsaed 6y the epplteartt nerrled on the drone application wumher in the premwx q/
RODERICR rOBTER, LAUREL AVE., 80UT80LD, N.Y.
in tkefdkncinR kTCattQpF.. ~+Belerpent ~ lxt FI. ? Ynd Fl. Section Block Lot
toaR exeminel Gn JUI+i 1~! 198`1 endfound to 6e in rnmplianee with the reyuirernentx of thL Board.
AG6 RYlit71K ~T cooKRto a[CKS O W RXNAUST FANS
NCANCESClM r1U011FSUNT OTNER AMT. K. W. AMT. K. W. NAT. K.w. AMT. K. W. AMT. N, r.
3 s Z 3 1 r
RN4M6! MOTORS lU411R! AMaAlIq RNBS SFlgAt pCM NMCIOCKS W INai IMA/p6 MIA14011TtRf DIMhtRRS
AtN: R. W. pl N. t. GAS N. r. AMT. NO. A. W. G. M1t. AAV. AMT. AMrS. TRANS: ANT. M. r. ~
~I AMT. WA715
W S ! R V 1 C R
NAT. Awv. Tne MBM! t.r xw i l ew t i tw t,t .w No. a~
~
a+u. A. w. No. or wrtG of rwx~6 No. a NeunAU or F
e4noiAl
011NRAlN1KA7YSo .
6 & 8 CONTRACTOR LiC.r578-2
BOX 215
SOUTROLD, NY, 11971
11 b
Per /L
Tha car411kPM m!M not b~ olNrad in any awnnarr retwn to tM office d the bard 8: itrcorrecf. MNyctGrs be ' dnir credemials.
COPY FOR BUILDING DEPARTMENT. TIUS COPY CER ICA ...NOT /ttT! D'Qi ANY R.
l~U~~
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL
REMARKS: ~
DATE 5 L INSPECTOR
1 ~
tss-isoz
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND INSULAT{ON
[ ]FRAMING [ ]FINAL
REMARKS: ~~~X 6' ai
_ ~
DATE .3 G INSPECTOR ..G~
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION iST ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] fNSULATION
[~RAMING [ ]FINAL
REMA/RKS:
DATE ~ ~ O INSPECTOR
C ~
765-1802
BUILDING DEPT.
INSPECTION
[t~]~`OUNDATION 1ST ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
v
DATE ~ ~ INSPECTOR ~i Y
'iELD I;.S:EC:iU;i ~'UnTG ~I i;OtYMLNT° _
^v -
, . - 3 a
I _ _ _ y l
FOUt1DATI0:f' ( 1st ) ~
c-
FOUNDATIOtJ (2nd) _ m
2. 33 `
z
0
ROUGH FRAME ~ -
PLUMBING
3
` -
3. ~
m
m
Ii1SULATION PER N. Y. 'j
STATE ENERGY
CODE
x
Sa _a r
4. y
FINAL
o .
ADDITIOPIAL COMMEPlTS: x
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~ iMAdIK FINNE GENERAL CARPENiR
dome kripcavarnents -Additions
51dtn Custom Homes
1Lighthouse Road
SAfl'f~ltilt). NEW YORK 11971
(516) 765-4330
~Oa~/P/G~ ~05 %c2
~1~
BOARD OF HEALTH
3 SETS OF PL,\NS Y
FORM NO 1 SURVEY • . I~. • .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FOR:t .
' TOWN HALL
SOUTHOLD, N Y 11971 NOTIFY
TEL.. 705-180 CALL
E~3mined ~ 19 MAIL T0:
~j . I a ~ ~ a~~
Approved ..~~4..... , 19 Penntt No. ~.7 a .a.7 ' j
'is
Disapproved a/c y M~ ~ 3'~j~~~
_
B!GG DEPT
~ ~~3~~ lt~
/ ~ TOWN OF SCUTHOLO
ildtng Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~ . 1L/•
INSTRUCTIONS
a. Tlus apphcahon must be completely filled m by typewnter or m ink and submdted to the Building Inspector, with
sets of plans, accurate plot plan to scale Fee accordtng to schedule.
s b. Plot plan showing location of lot and of butldmgs on premtses, relationship to adlommg premtses or public stree~
or areas, and gtvtng a detailed descrtptton of layout of property must be drawn on the diagram which is part of this apps
iron.
c. The work covered by tktts application may not be commenced before tssuance of $utldmg Permit.
d. Upon approval of tlns application, the Building Inspector will issued a Building Pcrmrt to the apphcant. Such pet7rts
shall be kept on the premtses availabte for inspection throughout the work.
e. No butidtn; shall be occupied or used to whole or to part for any purpose whatever until a Certificate of Occupant
shall have been_granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Butldm; Department for the tssuance of a Btul¢ir}g P~ymtt pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Reculations, for the consttvction of buildings, additions or alterations, or for removal or demolition gas herein descnbe~~
The applicant aerees to comply with all applicable laws, ordinances, building code, housing code d regulations, and t.
admit authonzed inspectors on premtses and to building for necessary mspectio ,
.~~Gl/l/~ G:ZLjG:Lf.-.--......
(Signature of apphcant, name, tf a corporation)
r •
h4athng~ dress of apphcant) ~f
State tvhethez~ppltcant is owner, lessee, agent, architect, engine ,general contractor electrician, plumber or builder
. . . .
~.~~.~.~:~P...... C. ~4--
pQ ~
iv`ame of owner of premtses / /L?`?!.`:`:':-.*~'~' ..1~.~."cd?'t-r!c-- .
(as on the tax roll or latest deed)
If applicant ~s a corporation, signature of duly auihortzed officer.
. .
(Name and tale of corpo~~rllateQofficer)
Builder's Ltcense No ~~.V .l. • •
Plumber's Ltcense No
Etectrtctan's Ltcense No .
Other Trade's Ltcense No . /
I Location of land on which proposed work will be done ..U~. (~t?!1: G~ G~-L, ; • , , ~~?-t~~
I{ouse Number Street Hamlet
County Tai btap No 1000 Seaton Block , • • , , • , , Lot .
Subdivision Fi]ed Dtap No . Lot .
(Name)
State e~~shng use and occupancy of premises atnd intended use and o cupanc,y/of proposed construction-
s. Ertsting use and occupancy ` ~..L-~'! ^~!~1 .
f f t .J
b. Intended use and occupancy • • • • • • • • • • • • • • • •~'3•~'""~• • • .
3. Nature of work (check vvhrch applicable) New Building AddrUon • . • • . • ~Uteration .
Repair Removal Demolition .Other IVork .
(Dcscnption.
4. Estimated Cost .........C T.~. ~OU Fee .
(to be paid on filing ilia application)
5. If dwelhn„ number of dwelling units .~4 ~-.~.~:•.r; . , Number of dwelling units on each floor .
If garage.numbcrofcars
b. If business, commercial or mi~cd occupancy, specify nature and ceient of each type o£ use .
7. Dimenswns of existing structures, t£ any Front . , , , , , Rcar ...J~.~. Depth , , , , ,
Her_ht ...~1?........Number,ofStones .
Dimension~`ol'same structure yvith alterations or additions Front Rear .
Depth Iieigh[ Number of Stones .
G
Drmensrons of entire new consfructron. Front . ..a0. , , , , , , Rear Depth . 1~ .
Height G...... 1`Itumber of Stones ~ .
9. Size ofIo[. Front ....i~4 Rear rP4.~ Depth l.~?P............
10. Date of Purchase .....Name of Former Owner , ..S/.°.!?~.~:.............. .
11. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: , !GS" .
13. will lot be regraded !1% ~ ................1Vill excess fill be removed from premrses: Yes
14 Name o£ Owner of premrses P~9 ~t~/.4~:.a~S~c(yAddress : BUY?h.R /,Q Phone No .
Name of Architect ...........................Address ...................Phony: No............. .
Name o£ Contractor ..........................Address ...................Phone No............ .
15.Is this property located with in~00 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,mdicate all set-back dirnensions fro
property fines. Give street and block umber or descn lion ccordmr to deed, and show street names and indicate whe[h
intenor or comer lot. ~d o"
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STATE OI' NE1V YORK, S.S
COUNTY OF .
• being duly sworn, deposes and says that he is the apphcai
(Name of individual signutg contract)
above named.
Ilcistfre
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authonzcd to perform or have performed the said work and to make and file tli
aPPbcauon, that all statements contained in this apphcanon arc true [o the best of his knowicdgc and belief; and that tt
work will be performed in [he manner set forth in the application Gicd therewith.
Swom to before me itus
•...........WSJ....".~(.,,.dayof~/..`!~'rl~/ , 19~~
`otaiy Public, h~_
i~•~ I1 L. County ._,.-~jy,~O~/
- NELEN K. DE VOE r.: 'try.......... .
N4TARYPUBIlC,StateotNeNYmk ($ignature of a bean
Na 4767818, Suffolk Cannt~p PP
Term kxpues Marsh 3tt, t9_..C.J