HomeMy WebLinkAbout17915-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17987 Date MAY 1, 1989
THIS CERTIFIES that the building ALTERATION TO AN ADDITION
Location of Property 1480 SMITH DRIVE NORTH SOUTHOLD, NEW YORR
House No. Street Hamlet
County Tax Map No. 1000 Section 076 Block 02 Lot 34.3
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. 17915-Z dated MARCH 14, 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 EXTEND AN EXISTING DECK TO E%ISTING ONE FAMILY DWELLING
The certificate is issued to HERBERT & MARION HOFFMAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
' Building Inspector
Rev. 1/81
FORM NO. ~
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° 017915 Z Date 19..4..1
Permission ~s hereby granted to•
~
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to ..a.~"~..... p......~!I.....Q. .,-St.^Gi ..l~.w:~r:JK ..7:W....01...~3)1A..~.~4t~*.R,QQ,I..rxq.
ct premises located at . ~.`~.~.4.....~P.,...~.r~ K1.vt.~i.. ....L;J.tk~srflitL.l~.~.,...... .
~~....l:N.:. . .....o~ ~ o .
Counh~ Tox Map No 1000 Section Block ............1'"....uu. Lot No. a~.'(:~
pursuant to applicotion dated ~.~i4hr5.Y.f ~P 19 R.~., and approved by the
Building Inspector.
Fee ~ .
~
Building Inspector
Rsv bi30I80
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TOWN OF SOUTIIOLD O~OH.I~ U
BUILDING DEPART?LENT 7
TOWN HALL ! 17~J f lppn
SOUTIIOLD, NEW YORK (1971 ~7R7
i I
76s - laoz ]~~~~)~~4~~
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
D/ATE 3! i!.': 1... .
NEW CONSTRUCTION .......OLD OR PRE-E%InSTING BUILDING. Y ...VACA/NT LAND......._
Location of Property.~fl'.'....~~4~~ K!C:'
HOUSE N0. ['~q,.,{~[/;j, STREET HAMLET
Owner or Owners of Property...~..`J':K!?:~"~
County Taa Map No. 1000 Section ~9... Block Lot
Subdivision Filed Map ........Lot......_...
Permit No. ..........Date of Permit ......_...ApplicanC
Health Dept. Approval Underwriters Approval._..._._._....
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: $
APPLICANT ~
Rex, 371~8~
c.o ~ ~ 81
rev. 10/14/88
TL'L.'GS-18(7?
` To~rrr or sou~oi.D
o
• n~
,?'f•:.~j~;~~ y~ Ol~f'ICI:OF' isUILD1Iv~G INSPECTOR
v~ °c,"'~;'' ~ ~ TO~YN !SALE
~~d r~~~ SOIJ'I IIOLD, N.Y. 1 1971
APRII. 27, 1989
To pihom This, May Concern,
h
47e arc unable to complete your Certificate
of Occupancy because oL the following reasons.
,fig/ An application for Certificate of occupancy
is not nn filC. ENCLOSED
/ ( ;to UndcrG~r:.t-crs Certificate on file.
'Chc cheep: t. t. (~ut.clitnd/nut on file.) $25.00
No 1lca7th fJept. Approval on file.
Nn :final ~nsl.r_c:t.ion has been made.
Phase contact our office on this matter.
Thank you for your cooperation.
ttu L ltl u,c~ Perm a t- }e 1 7 9 I 5 Z E%TPND E%I STING DECR
H. HOFFMAN
Duilc7inq Dept.
t1o Plumber Soldci Certificate on L•i1c. '
( all I~ermiL:. involvincl plumF~incl briny
iasucd after .1pr~l 1,1984 )
SENT T0:
EDGENE J. ORLOWSRI
]250 MARLENE DR.
MATTITIICR, N.Y. 11952
...._..ssi.:uf.
.R,
1~LD I; ~ ECR=~.+ ~~L`;,TE ~uKMEN7~
7. m
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FOUI7DATIOII (tsty ~
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FOUNDATI0;1 (pn~) m,~
2.
0
P,OUGH FRAME &
PLUMBING
y
3. ~
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m
II7SULATIOPI PER N. Y.
STATE EIIERGY
CODE I _
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a ti
FIidAL
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ADDITIOI7AL COMMENTS: x
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7ss-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
[ ~ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL -
REMARKS:
DATE ~ ~ INSPECTOR
BOARD OF HEALTH
3 SETS OF PLANS
FORt6tN0.1 SBRVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FOR"1
' TOWN HALL
£OUTHOLD. N Y. 1771 NOTIFY
• TEL.. 7G5-1802 CALL . .
Etanuncd ..Y?.~.a-~I=~.1. ~I..., 19.1. MAIL T0: Qiz.~ecv,_;
1,,,, ~ p q , f d sa YY1a-r_eo-,c` ~
Approved . Y} ~:4'~. 19~ 1. Pcrmtt No ~..nz'.. 'J,nay.V
~~4'1'a/,,r
Disapproved a/c ~1qi 1 i~
.II:`~~~•.......
(Budding Inspector)
APPLICATION FOR BU1LDtNG PERMIT ~f Q'~
Date .~A/!~ .6..~!.-.!., I
INSTRUCTIONS '
• a. TItis application must be completely tilled in by tgpewnter or in ink and submitted to the Building Inspector, v
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 ad~otntng premises or public s~
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this -
cahon.
c. The work covered by this application may not be commenced before issuance of Buildmg Permit.
d. I3pon approval of tlus apphcatton, the Buildmg Inspector will issued a Building Permit to the applicant. Such p.
shall be I.ept on the premtses available far inspection throu^Itout the work.
e. No building shall be occupied or used to v,~hole or in part for any purpose whatever until a Certificate of Occup
shall have been granted by the Buildmg Inspector.
APPLICATION IS HEREBY bfADE to the Buildmg Department for the issuance of a Buildmg Permit pursuant tr
Building Zone Ordinance of the Town of Southold, Suffolk County, Nety York, and other applicable Latvs, Ordmanc
Regulations, for the constnicUon of buildings, addrttons or alterations, or for removal or demolition, as herein descn
Tlie applicant agrees to comply with all applicable Saws. ordinances, building code, housing code, and regulations, an
admit authorized inspectors on premtses and m building for necessary inspections.
OCCUPANCY OR • • ~ ~`•~~2~~~s~'
USE !S UNLAWFUL (Sign cure of applicant, or name, if a corporation)
WITHOUT CERTIFICATE - J-as'b. ~?'~C'~•1~•~:~ ~r?:~~`:~`"~r; ~~y
' OF OCCUPANCY <hlaning address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pIumher or buil
Q~~.. ~b~~ .
-ltPPftOVED ~1S•fiOfiEB.........
Name of owner of premises ..~.l.. ~'X ~F1~m.Q!J?........ ..........D.4TE•.._.._.~._..,t-. (3.? ,M.-r---, . •
(as on the tax roll or~~est deed) BY
[f applicant is a corporation, signature of duly authorized officer Nt7T4FV BUILDING DEPARTMENT AT
765.1802 9 AM TO 6 PM FOR THE
_ FOLLOVvtNG INSPECTIONS
• • . (A`ame and title of corporate officer) 1 FOUNDATION - TWO REQUIRED
yy,,// FOR POURED CONCRETE
Builder's License No. . 1. ~.~o2°Z l!~........ , . 2 ROUGH • FRAMING & PLUMBING
• . - . • , • • • 3 INSULATION
Plumber's License No. 4 FINAL - CONSTRUCTION MUST
• BE COMPLETE FOR C O
Elcctncian's Liccnsc No ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N Y,
Other Trade's License No . . STATE CONSTRUCTION & ENERGY
7~OODES RPON IBLE FOR
I. Lo~atiop of land on which proposed work will be done. . y~j~ORS
d O i
House Numbcr Strcet~ Harriet
/ t~ ,
County Tai Atop No 1000 Sccuon ~.v/• • • • • • • Block °j Lot r,~•~[ .
Subdivision . Filed niap No. Loi
(Name) 1'
2. State c~istin;r use and occup.ina• of prem~~is~e~s~a/rid intended use .Ind oc~cu/~pa~nc~y o/'f propoQsed consytruction:
a. Existing use and occupancy ....~X.:':':'~LE~' • . ~'~c ~$'~w~l~./ :t„~`;°,r?.4.4.~ 4~'. ;`p, . f6 'k r.~>.. .
b. Intended use and occunanty
3. Nature of work <check «htch applicable). New IIwldmg , Addttton ~V tcratron .
Repatr Removal , Demolttron Other 1Vork
hyp~ (Dcscnpnon
4. Esttmatcd Cost 1 ~ X 4. ~ i~ .rU
. Fee .
(to be patd on Comg this appitcatton)
5. IC dtvelhn~, number of dwelling units Number of dwelling units on each floor .
Ifgara~c.numbcrofcars
6. If business, comrnercrai or mixed occupancy, specify Hatt}re and extent of each type of use .
7. Drmenstons of existing structures, tf any. Front Rear Depth , , , , , ,
I-Ict~ht ...............NumbcrofStones.......................................
• Dimensions of same. structure with alterations or additions Front . Rcar , .
Depth ......................Iictght..................... Nur•.tbcrofStones...................
8. Drmenstons of enure new construction. Front Rcar Depth , .
Hcrght ...............NumbcrofStoncs...............................,.
9. Size of lot. Front Depth . , .
Rcar
10. Date of Purchase . Name of Former Owner , , .
I I. Zone or use district to w•htclt prcmtses arc situated .
12. Does proposed construction violate any zoning law, ordinance or regulation .
l3. Nill lot be re,,raded RhI] excess Eil] bu removed from prcmtses. Yes
14. Name of Owner of prcmtses ....................Address Plronc No.............
Name of Architect .............Address Phone No .
Name of Contractor ..........................Address -Phone No.......... _
IS.Is this property located within 300 feet of a tidal wetland? *Y);S....NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGR11hi
Locate clearly and distinctly all buddmgs, whether extsung or proposed, and indicate alI set-back dimensions fr
property fines Give street and block number or descnp[ron according to deed, and show street names and indicate whet
tntenor or comer lot.
jj
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STATL OF \}=1t' 1'O I:,/l S S ~ ~
~ ih• sworn, deposes and sa}•s that he is tnc applic
bcm~ di
(Name of ntdrvidual stentnq contract) rJv i
above named. ~ +n~ , ~ _t,t-P _
yy - ~ -
(Contractor, agent, corporate ofIIcer, etc.)
~f said owner or owners, and a duly authon7ed to pcrfor-m onhavc performed the sarS wor4. and to make and file
:pphcauon, that ali statements contained m tuts applicaucr~n arc titre to the best of firs Lnowledgc and belief, and that
work wdl be pertomted ut the manrcr set forth rn the apps{canon lilcd therenath
>tvorn to bcfOrc me [lets
•............1........ day of .~~~~.~,:.......19~~
.Diary Public, _ . F~?+!.. r.. • • • • County T~ /
HELEN K DE VOE (Signature of applic:
~N~70
878 SuflalkC~un111^j!
Term Ezwres March 30,1 •