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HomeMy WebLinkAbout17900-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-18250 Date AUGUST 7 1989 THIS CERTIFIES that the building ADDITION Location of Property 4225 PE4UASH AVENUE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block 02 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 1989 pursuant to which Building Permit No. 17900-Z dated MARCH 9, 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 DECR ADDITION TO E%ISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ALAN & BARBARA G. DWORKOWITZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uilding Inspector Rev. 1/81 lOEM NO. 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~ 017900 Z Date .......~.c,,~~......5' 19..x.9 Permission is hereby gr ted ~..n.Ny...:.y - 1~.. . to ..~!sl~:t:nM-~S..f.~-:....~1......~. ~:443...~::~:a....~-t?.....~'.''~?...... ..t~. . U ct premises located at ~.1'Z~.......~~"'~-°~J• • ~.A~G.:. 1~..~'~./.:~~ Cvunty Tox Map No 1000 Sectio~n~-.~./.~. ,I, ~.~~...f~~../ Block ~ Lot No pursuant to application dated !.~!!LS,F'~ ~P. 19d ~ and approved by the Building Inspector. 1 Fee ~ ,~9 U't.. ing Inspector Rev 6/30/80 TOWN OF SOUTIIOLU ~~~~~y/!. ! l BUILDING DEPARTMENT N~1u ~ ~ TOWN HALL S4DG DEPT SOUTIIOLD, NEW YORK 11971 TOWN OPSOUTHOi.0 . 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY / ~~y ~Y r /DATE.. NEN CONSTRUCTION __._...OLD OR PRE-E%ISTING HUILDING.~C....VACANT LAND....._.. Location of Property... HOUSE NO. STREET r,, HAMLET Owner or Owners of Pro ert A'14~ av~~,-~jar.~a.+~-`Cs'1~k~aYKDuI; I Z P y......--•-••-•-- i,3'l. c~ oa.o~ oi'l o00 County Taz Map No. 1000 Section Block Lot Subdivision Filed /Map ........Lot.~..,J./~...../.~ Permit No. ln1©~._..Date of Permit ..~~91.~~..Applicant~(~h~:W./~~" "~~~YtiiJ(I~~. Health DepC. Approval Underwriters Approval._._...._..... Plaaning Board Approval Request for Temporacy Certificate Fiaal Certificate .v s ~ Fee Submitted: APPLICANT... 1 rev. 10/ 14/88 r~ ~ C' f1~.~3~y17 j( / ~ e n ~ rs~,~sn :I~LD~i;.S..,~.~~.:~ If1inTE ~ C:-iMCNTS .r -v ~ m a H - H FOU;IDATIOIJ (1st) ~ cF N FOU1dDATIO:J (2nd) _ _ m: 2. 0 P,OUGH FRAh1E & PLUMBING C 3. ~ m m IIJSULATIOPI PER N. Y. • • STATE ENERGY CODE a _ y Y / % C~ H - FI;IAL - - f ~ ; ADDITIONAL COMh1ENTS: x . m x ^a H y - H H O z m A r H b m •a H 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: ~C a DATE ~ 3 INSPECTOR BO.1RD OF HEALTH 3 SETS OF P ANS FORM NO. 1 SURVEY ,~y TOWN OFSOUTHOLD CHECK BUILDINGDEPARTMENT SEPTIC FOR:1 ' TOWN HALL SOUTHOLD, N Y. i1~J71 NOTIFY . TEL..7G51802 CALL Exam,ned ~~S-Yl ~ 19 ~ t ff p MAIL TO : . Approved ~~CJ!1 .R...., 19p9 . Pcnntt No 1.7. t ~ ~ ry~ Y Disapproved a/c ~ ~ ~ U 1~W (Building [nspector) TOWN 0 SOUTNOt n APPLICATION FOR BUILDING PERMIT Date ....~d:~...`-.., 15~ INSTRUCTIONS a. This appl,cat[on must be completely filled in by typevvnter or to tnk and submttted to the Build,g Inspector, witi sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showtng locatton of lot and of bu,dtgs on prem,ses, reIattonship to adloming premises or public stre or areas, and g,vutg a detailed descrtpt,on of layout of property must be drawn on the diagram which [s part of this ap; cation. c. The work covered by this applicat,on may not be commenced before issuance of Building Permit. d. Upon approval of the application, the Building Inspector will sued a Building Permit to the applicant. Such pen, shall be kept on the premises available for mspect,on throughout the work. e. No building shall be occup,ed or used ,n whole or to part for any purpose whatever unt,l a Certrficate of Occupan shall have been granted by the Bu,ldtng Inspector. APPLICATION IS I-IEREBY MADE to the Bu,ldmg Department for the ,ssuance of a Building Pertnit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New Yark, and other applicable Laws, Ordinances Re~ulat,ons, for the construction of buildings, add,ttons or alterat,ons, or for removal or demol,t,on, as herein descnbe The applicant agrees to comply w,th all applicable laws, ordinances, budding code, housm~ code, and regulations, and adm,t authonzed inspectors an premises and in bu,Iding for necessary mspect,ons_ ~j - (S,gri~ture of agphcant, or name,,f a corporation) .~q~ ~ ~ . Vie:,... Y.. N ~1.. ~RQ • (Ala,ling address of agphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electnctan, plumber or bu,lde ,lame of owner of prem,ses !:'.~4 ~~V.h DW I ~ 0~~ ~1-L~t I~eG- -L11'~~VKUUI i ~2i (as on the ta:c roll or latest deed) (C applicant ,s a corporat,on, s,gnature of duly authonzed officer. (Name and tale of corporate officer) Builder's L,cense No. . Plumber's L,cense No . . Ek,ctuctan'~ License ido . . Other Trade's License No . . ! Location of Land on wluch proposed work ~wll be done. . House Number Strcet~ Hamlet 1 , County Tai htap No 1000 Sccuon .....~:3~.'~...... Block ~e?»,4V Lot ..Q~~,.~~...... , Subdrv,saon Filed tap No. Lot . ....(Name) ! State c~,sung use and occupancy of prcroses and m nded(use ~nQd occupancy of proposed constn,cteon. a. Exshng use and occupancy Qht! Gf(i.~t'.-~ f~.. . . e~ url onX b. Intended use and occupancy • • • • • • • • • • • • • - • ~w~-! ~tr-t 3. Nature oC work (check «hrch appltcable) New Burldmg Addrtron • • • • - ~Vteratron Repur Removal Dcmohtron O[hcr ~~'ork . (Dascnphc 4. Esttmatcd Cost Fee........ (to be patd on ?irng thrs apphcauon) 5. If dwelling, nurnbcr of dwellrng units . , Number of dwclliug units on each Moor . If garace, number of cars . 6. If busyness. cornmereral or mr~ed occupancy, specrty nature and eeten[ of each Type of use . 7. Dymennons of cxuhng structures, tf any E'ront ..'f.~ , Rear ..y°l:......... Depth :x.~.~...... Hey,ht , . Number of Stones . . 1....... . . . Dimensions of same stSUCiurc wrth alterations or addttrons. Front . H Rear . Depth ...3•c~',' Ilcight . ! J:: . Nuntbcr of Stones ..I . Dimensions of cnttre new constnrcUon Front Rear .?1 Depth . . Hetgtrt Number of Stones . 9. Stze of front $ ~ Rear ~ Dcp[h 10. Date of Purchase ,-1UF1C....L`~~.8 Name of Former Ovvner . L.-GC.vVa....COI (a•V.!S . 11. Zone or use distract to wFact~ premscs are situated . 12. Does proposed construction violate any zoning law, ordinance or rc~u(ation. , . h . . . 13. Hill lot be regraded n0 ......rt.`..1"~~....... SV it excess it be removed fro ,p~remtses: Yes 14. Name of Owner of premuesR~uN• .t .L+prt~!"; ; I~W~?rK~~c i3i~~ss N3;~ . ~z ~c~nHJ}?c tv~Iibn No. :,~~3s~ Name of Archttect ~ ~ .....................Address ...................Phone No............. Name of Contractor A~`1 ~Y Address ...................Phone No............ . lS.Is this property located within X00 feet of a tidal wetland? *YES....NO.?.. *If yes, Southold Town Trustees Permit may be required. _ PLOT DIAGRAM Locate clearly and distinctly alI buddtngs, whether exrsting or proposed, and indicate all set-back dunensions fry property lines. Gtve street and block number or descnption according to deed, and show street names and indtcate whefi intenor or comer lot. I y 3TATL OI' NE~V YORK ,3c~>^b~ ,~ll/a v-~o W t`~-Z- • • • • . berng duty sworn, deposes and says thatstte is the appiica (Name of mdrvrduai signing Contract) bove named. 5fcistlrc (Contractor, agent, corporate officer, etc ) f card owner or owners, and rs duty authonzcd to perform or hevC performed the Bard work and to make and file t! yph~anon, that ull statements contained in tfus apphcatton arc tnic to the best of lus l.now[edge and belief, and that tl irk will be performed m [he manner set forth in the apphcauon t,lcd thL`rL'\Vlt}t. •vom to before me Clio Scv.v,b da of !E:lr?l?C.e`~.......... 19 ~.l ~tar}•Public, ~4u'`r~ ~~,~~e.v~........... County/'~~'!~~'L'~ DAVID SWARTH / 7i'*G'L'~ ~ru~~ z~~" Notary Pubhe, State of NeW YDrk • • • • • • • • • . No. 31-0426852 Qualified m New York Cauniy (Si,nature of applicar Commtss~on En, ~~es 1~, nl 25, 1990 a ` ti ~ ~ ~ ~V i \ ^ ~ ` r r_1 ` r~. t ~ ~ ~ i - v _ I r ~ ~ A n w' I It J; ly Y t ~ ~ ` ~ • i - ,i ~ ` f i ~ l ~ ~ ~,,.,,---F.-~ ~ ,y I I t .V~r ~ L_ . _ ~ 'J ( ~ _ 1 ~ : ~ ~ ` ~ ~ it y - t \ ~ ~ ! ~1 I~ ~ ~ 1 r r, u~ l / ' ~ y 1 i~I nl ~ ~ ' \ ~fl ; - i 7 ~ _ . ti~ ,.r - ~ '~r . , .~j~ - ~ ~i o~ ' ~ QN~Dp~~ >~00 ~ N;sxN g \ 'may I ~a~~--'z~s~c a>_~~ ~$<^o ~ ~ ~ R M ~ I O O O y m i n i > iN_o KZ=~ i<y I , ~,ZZ.TOq~ pm ~o rQ~v oL !f£~ O O ~ > Z G ~ ~ O T ~ Fn ~ ~ ~ ~ S z9?3-~ s . ~ ..r _ - GrnZe _a~.~~_r?-y-, 7.. ~ ~ 1 _ f f.._ I ,,~r" , ~ iir` ii; E!E'U: !{'l nr.,~_ ..,J~w. .__}2_~' '.t U l r J J4~.f.;, ~Ce..l.~_14~1'`~~-. J G'o', __--ill----- i~'Q~~ - . "~'roposed ~l.eclG'~Y Fl.~-3~wovlG,ol,,11-I'z .~...r;ts'finJ~. y~" ~7:~~,;;;'~~enr~Fes `~^ropased `1~eck. `C~1LOs--wlll hcu3e~ WhGVG,'bR!p1Y~S bU~"13n.%`~t~t. T>~~~, ~..>f z ~ d _ LL Y _ w.....,.s.,_,..~._ _ /9'$" r _ - - ~ - - _ _ ~ _ i .~C ~ ~ ~ _ ~ I ~x~fCCh ~ I~j~ s~, Z s{ ~ CC fl ~ ~,~y^~'' ~-~~,NCre.~'~ APPROVED AS NOTED L DATE: ~9~R.Pq~ ` ~'~4IC-f_.Y~M1N;,~ ~_~ra~ ~ FEE' S'D. RY1,G.L:_ I NOTIFY BUILDING DEPARTMENT A7 ~ 765-1802 8 AM TO A PM FOR THE ' 1 ~ ~ i~ FOLLOWING INSPECTIONS I ~ " "rj ~ ~ I ~ 1. FOUNDATION ~ TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING R PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N V. pCCUPANCY OR STATE CoNSTRIICRON S ENERGY CODER. NOR RES?ON5IBLE FOR USE IS UNLAWFUL DESIQN OR CONSTRUCTION ERRORS w~TOF OCCUPANCY ~