HomeMy WebLinkAbout17898-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17821 Date MARCH 8, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 5550 NEW SUFFOLK AVE. MATTITUCK, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Biock 10 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Buildinq Permit heretofore
filed in this office dated MARCH 7, 1989 pursuant to which
Building Permit No. 17898-Z dated MARCH 8, 1989
was issued, and conforms to all of the requirements of the applicable
prova ions of the law. The occupancy for which this certificate is
issued is REPAIR E%ISTING DECK ADDITION T6 E%ISTING ONE FAMILY DWELLING
The certificate is issued to JAMES A. MALONEY & JANET HUGHES MALOMEY
(owners}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
dY,
ilding Inspector
Rev. 1/81
sows xo. s
TOYVN 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)
ICJ o 017 8 9 8 Z Date ......~..l~.S.Y..I......P 19..C.~
Permission is hereby granted o•
...~i
ct premises located at ..a~....~.... ~.4-fr.J....~-c.~ :....~..1..!L..
County Tox Map No 1000 Section . Block .......~.U... Lot No
pursuant to application dated .~.9~r~-LKt ~ 19~~.., and approved by the
Building Inspector.
Fee Z..:J~.'.. ~
~ C~~
. . .
Building Inspector
Rev 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY 22
DATE ~J~~~~.
NEW CONSTRUCTION ....._.OLD OR PRE-E%ISTING BUILDING_.~ .VACANT LAND.._.....
Location of Property...~.~5~.......~~`J..~':41::./~...~':..../~~'-'f/: Lb°~.L~~
HOUSE NOS ~j STREET ~ HAMLET[,(/ /
Ovner or Owners of Property:-.-tU/~1~../.t.._~I/6C+~t:~.~`~.......-,/."N.e.~..!'.~~i~..lt~c~r~e`
i
County Taz Map No. 1000 Section Jl.S.. Block Lot
Subdivision Filed Map ....._..Lot........_.
Permit No. ......._..Date of Permit ..........Applicant
Health Dept. Approval ......yy1~~: g~........ Underwriters Approval.._!!~/Z..___..
Planning Board Approval l:!!.........
Request for Temporary Certificate Final Certificate
Fee Submitted: $
APPLICANT...
3 458
Co~17sa1
rev. 10/14/88
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STATE ENERGY
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y~ X~ 0 BOARD OF HE.\LTH -
n ~ ~ ~ ~ ~ D 3 SETS OF PL.1N5:,•'..•'•'.
U FORM NO.1 SURVEY
TOWN OF SOUTHOLD CHECK .
T ~ BUILDING DEPARTMENT SEPTIC FORM
' TOWN HALL
BLDG DEPT SOUTHOLD, N Y 11071 NOTIFY
~TOL`JNOFSOUTHOLD TEL.. 7551802 CALL
~ 19... MAIL T0.
Erammcd .\•K[ 4 ° t q 1
Approved . !',~G~.CX1 . ~ 14~ . Pcnnit No ~ Q ! ~ .1', yam= t~"E~ t
Disapproved a/c . , ~A ~-r- +
. . .
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..t~A.c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 15~? r
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in 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, relationship to adjoining premises 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 appl
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 pentt
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupanc
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
Re=ulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herein descnbe~
The applicant agrees to comply with all applicable Iaws, ordinances, building code, housing code, and regulations, and L
admit authorized mspectois on premises and in building for necessary mspecho s~z~-L%a
(Signal e of apphcan//t, or name, if a corl~rat~.
~i
• (Mmhng address of applicant) ~/t~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde,
....~Gl~ N~~
Name of owner of premises
(as on the tax roll or latest deed)
[f applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builder's License No. ......D~h:E= • • • • • • -
Plumber's License No .
Electrician's License No. .
Oilier Trade's License No .
1. L,o~cation of land on wh~ic~h proposed w~or/k will be done. .
Iiouse Number Strcet Hamlet
County Tai &lap No 1000 Section • • • • • Block lG Lot 5~
Subdivision Filed Afap No Lot .
(Name)
State e~istmg use and occupancy of premises and/intended use and occupancy of proposed construction:
a. Existing use and occupancy ........~4<~ilf'.... ,/,`?d;'•`~'~ e~~°?
b. Intended use and occupancy ......=~i ........./............s~`~'Gt?~,~ .
3. Nature of work (check whsch applicable) New Budding Addstson Alteration .
Repur Removal Demolstson Ojher Work .
~ (Doscnpuon
4. EstsmatedCost ......~~~d.U Fee
(to be pmd on rhng thss apphcatson)
5. If dwelling, number of dtvcllrng unsts Number of dwelling amts on each floor .
If garage. number of cars ~ '
6. If bussness. commeresat ar msxed occupancy, specsfy nature and extent of each type of use ,
7. Dsmenssons of exsstsng structures, sf any. Front Rear Depth .
Hesg}tt ..............NumberofStones..................................
Dsmenssons of same structure with altcratsons or addstions• Front Rear .
Depth lIcsght Number of Stones .
g, Dimenssons of
enure new constructson• Front Rear Depth , , .
Height Number of Stones .
9, Size of lot Front Rear Depth .
10. Date of Purchase . ......Name of Former Owner .
11. Zone or use dsstrsct sn whsch premsses are sstuated .
12. Does proposed constructson vsolate any zonsng law, ordsnance or regulatson . .
13. Nsll lot be regraded Nsll excess fill be removed from premsses: Yes t
14. Name of Owner of premsses . .Address ...................Phone No. - .
Name of Archstect ...................Address ...................Phone No.. , , .
Name of Contractor ..........................Address .Phone No.... .
(S.Zs this property located within 300 feet of a tidal wetland? *YES.':'.~.LIO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAhI "
Locate clearly and dsstsnctly all butldmgs, whether existsng or proposed, and indicate all set-back dtmenssons fro
property fines. Gtve street and block number or descnptson according to deed, and show street names and indicate wheth
interior or comer lot. .5.~~
s,//f'r~2 L
STATE OF tiE1V YORf~, S.S
COUNTY OF .
• besng duly sworn, deposes and says that he is the applsca;
(Name of mdrvsdual ssgnmg contract)
above named
flesstlse
(Contractor, agent, corporate officer, etc.)
of sand owner or owners, and ss duly authorized to perform or have performed the sand work and to make and file tl'.
apphcatson, that all statements contained m tlus apphcahon are true to the best of hss knowtedg~ and belief, and that tl
work wdl be performed an the manner set forth m the applscahon G1s:d therewsth.
Sworn to before me thss c,
~..~~.//..~~...day,~olf . 19 S. {
tiotary Public, ER`T:c~~!-!. !`.'...~L !/~-Z...... County
i',h
HELEN K OE YOE (Ss,
NOTARY PUBLiO. Shte of New York gnat a of applscar
Nu 4707878, Sa(fa{k Coussty
Tcrrr Lzpsres Mach 30,18