HomeMy WebLinkAbout17922-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17877 Date MARCH 23, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 8525 NASSAU POINT ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 118 Block 4 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in than office dated MARCH 13, 1989 pursuant to which
Building Permit No. 17922-Z dated MARCH 16, 1989
was issued, and conforms to all of the requirements of the applscable
provisions of the law. The occupancy for which this certificate i.s
issued is ATTACHED DECK ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to ARNOLD BLAIR
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
B d ng Ins for
Rev. 1/81
rows xo. s
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)
N4 017922 Z Date ~ 19~?/...
Permission is hereby granted to•
..y~?.~.~-. . s,7...~, l~D ~ 7
.......C~:rJ.... .
~ ~j. . / .
ct premises located at ~-5..%~.4`z .....~.O..r:~C.A,~ ....~~G~~r.~.....v(/ p„/ .
Caunty Tax Map No T000 Section ...~~0... Block ........57,!`• Lot No .
pursuant to application doted . 19(1/ and opproved by the
B u i l d s ng~jl nnsp ecto r.
Fee ,.?Cy??
lfi,~....... ..4s~~.....
ilding a or
Rev 6/30/80
TOWN OF SOUTIIOLD 15
BUILDING DEPARTMENT 1VI ~;S
TOWN HALL ~ ~ 3 [~`~{Cl t
SOUTIIOLD, NEW YORK ! 1471 BLDG UENT 4"
765 - 1802 tOWN OF SO'J1M"
APPLICATION FOR CERTZFZCATE OF OCCIIPANCY
DATE--------------•--
NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING.?/.VACANT LAND........
Location of Property..
HOUSE N0. STREET HAMLET
Owner or Owners of Pro ert ~ ~
t~~,/
County Tax Map No. 1000 Section . Block ._.7... Lo[
Subdivision Filed Map ........Lot........_.
Permit No. ..........Date of Permit ..........Applicant
Health Dept. Approval Underwriters Approval._._.._.....__
Planning Board Approval
Request for Temporary Certificate Final Certificate
i~
Fee Submitted: $.....:5
y / ~
APPLICANT../_`..~~ ~_C"~~-c~LF ..:t..........
3 ~s'6g'
Cr7~'. I"?g~~
rev. !0/14/88
765-1802
BUILDING DEPT. Z? G~
INSPECTION ~23/~
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ION
[ ]FRAMING [ INAL
REMARKS:
0
a~~
~l1
DATEc3 INSPECTOR
~!J axe Cc~ ~R~~ ~
~v~rH LlX ~ ~c~ ~o~~ ~~rD S/~~~ r°,
~~c,~
y ~6~
~`J /fl
S~~-
~4 ` ~c~R ~
4
2
f
~ ~XrsTr NC-
r
~~~~~~~CY R }
~ ~ ~JNLA~VF~I~ ~rS _
i
~ ~o7Z
~J -
r~~7~C~:'~ ~'1 ~ 1~;
~ , ,
M
° D ~ ~,w',~ NASSAU
z l.IC
- sti P01NT ROA D
- JOSFgyFa N 3°55~10~~W !00 25'
2 ~
2 ~ ~ ~ ~ ~ ~I fl. /ne e 1-..
~ ~ fi) ~ I /off ,m
~ l0. RI ON~~aC wp <yuso~ c~rvc 603-"
- /A Z
flo (n
r 39' z
m c
m ° o
Z N torpor/ Z ~
^ ° N
G7 z ° /r ~ o ~
z o o er~y F' o O
m ~ o P,rr ~ s o D
D
A ~ o ~,2, O r o°
cn ~
-!os«_- m ~ n1
i ~ ~ r ~ ~
m r- ~ o ~ V a`n A
~TDn.~ ° ~n~ `
c ~
o ffi r o
N
~ o n 7C D C7
T°-a o. D ~ ~ ~ t~ ,7 ,~aTg
°
a v p m z .T G,. ~
f xo m W ~ ~Sa~~ ml
is o ~ o m v a'~ o~ ;ti ~k n
O ~ ~ 0 ° D ° O N br 4 ~t
N~ d S ~ z -
a~ a3 m~ ""4 ~ r
aa~= f'" ~ ono ~ ~ _ ~
~ _ ~ ~J
z4s~ ~
tnD3 r ~ ^232 C y ~
~~n o y2 0 363'
~~v-f
omD~ " w
x _ ' 3 ~ + 32 °p n~
b
CJb OT tm*~ on q V
ON D y ~ 9p ~
x ~
1 D ~ T n
r- x v t ~lO,l~~
mmo it ~ \,ji` ~,,,~er°t~~~
i
N T T D ? ~ " Y~ 6 ~ ~ ~ 1
3
O ~ ~ 3 ~ /op Of bluff R ~ m
-m _ W
m ~ (n rn
' o C ~ ~ a ~
o "ri C "
'n Q Z ~ 4 wood bulkhead 49'
~zD m
~ D n - ~ ~ ~ ~ /ie /ine 4/ony NryWH
v j m X 0 0 C --1 ~ S 3° 44~OO~~E~= _ f0028~=_
~ ~ o Z ~ ~ ~ L 1 TTLE PECONf C BAY
~ ~o A~-Ci O O
o Z ~
1 Z ~ ~
_ • v
N
~
' BOARD OF HEALTH
"k 3 SETS OF PL.~NS ..'f........
FORM N0.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING QEPARTMENT SEPTIC FORD!
• TOWN HALL
, SDUTHDLD, N Y 11971 NOTIFY
TEL.. 7657802 CALL
Eeammed .~~~o 19~~ c ~c/ MAIL T0:
.\pproved //t!/.~~ 1~ Permtt No. ~~r.~O~.p"
Disapproved a/c
.
.
(Bu ding pector)
APPLICATION FOR BUILDING PERMIT ~ ~p,~,,~' ~
Date/!i~~•%.' 6.. 15
4 INSTRUCTIONS
• Tliis application must be completely filled m by typewriter or m ink and submitted to the BuAdmg Inspector, with
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showm~ location of lot and of bulldmgs on premises, relationship to ad~oming premises or public streei
or areas, and givtng a detailed description of layout of property must be drawn on the dtagram which is part of this apps
cotton.
c. The work covered by ttus application may not be commenced before Issuance of Building Permit.
d. Upon agproval of this application, the Bu4dmg Inspector wdl issued a Building Permit to the applicant. Such perms
shall be kept on the premises available for inspection throughout the work.
e. No bwlding 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, other appCicable Laws, Ordinances o
Regulations, for the construction of build' s, aildi[ions or alterations, or for r o al or demolition, as herein described
The applicant agrees to com~{Ily~t~blt$41a~'3iic3[ile laws, ordinances, buiIdin od hausm~ code n regularions, and t~
admit authorized mspectois on pr and to building for necessary tnsp c ns. ~
_ ~ r,_._-„
y~ 1<..
,y" p~~~~}}1 ~,Mtt# tt ~ (Signa e of applicant, or name, ~f a corporation)
pCta A~ ~ t7t rStA k . f . ! 7
• ~~~qpq~ itt`MTdt t (Mailing address of applicant)
R'h4["' B ~a r"~ 1i1~~1
State whether appLca~~gp~}~}y~~i~ ~+~~entar~i~i~tect, engineer, general contractor, electrician, plumber or builder.
u(rtt,~5 ail^s~1} F.
Name of owner of prert!'{~pt ,I,}~R~~~~~`t ` • • • • • • • • • • .
yy~ ~Qt !'l7ll' ~ ]1A~ ,(as on the ta:c roll or latest deed)
1f applicant is a torpor ~tlyhoBz}edsdfficer
(Name and title of corporate officer)
Builder's License No . .
Plumber's License Na . .
Electrician's License No .
Other Trade's License No . .
1, Location of land on which proposed work will be done. .
liouse Number Street Hamlet ?
'i
County Tav ~fup No 1000 Section Block , • , , , , Lot ....'':.F .
Subdivision Feted ~fap Na, l5 ~f'....... Lot .
(Name)
State e~ishng use and occupancy of premises and intended use and occupancy of proposed construction'
a. Existing use and occupancy l'i S : .
gn~t~ ~~(.)t
b. Intended use and occupancy •
r `
3. Nature of work (check ahtch appitcable). New Budding Addttton Alterati7o~n .
Repair Removal Demohtton Other Nork . ,,d.~ Ct~ .
~ (Descnpuon
~y_-
4. Estimated Cost l.~fl~'~O.r . Fee
(to be paid on filing thu apphcaiton)
5. If dwelling, number oC dwelling units .....r- Number of dweitmg units on each floor .
If garage, number of cars . .
6. if business, commercial or mt~ed occupancy, specify nature and cetent of each type of use . .
7. Dimensions of existing structures, if any Front . , , , Rear ...4-~ Depth . .
Height Number of Stones ........;?.!tys''-~, , .
Dimensions of same structure with atterattons or additions FronC .Rear , .
Depth . . Iletght Number of Stones .
Dimensions of enure new constructwn Front Rear . Depth
Hctght ..............NumberofStanes
4. Size of lot Front . . Rear .
Depth
10. Date of Purchase .....................Name of Former Owner .
11. Zone or use district to which premtses are situated .
12. Does proposed construction violate any zoning taw, ordinance or regulation . .
13. Hill lot be regraded ~Vtll excess fill be removed from premtses: es~/
14. Name of Owner of premtses ,'~-~6.'
-t.i(~ ..,c~JH~~ ...Address .......Phone No..?3~~T.~:~
Name of Architect .Address , ..................Phone No............. .
Name of Contractor ..........................Address ...................Phone No.
15.Is this property located within 300 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 extshng or proposed, and,indmate all set-back dunenstons in
property lines. Give street and block number or descnptton according to deed, and show street names and indicate when
tntenor or comer lot
' z
• APPRb p AS MOi'~D
DATE /6 B.P. M ~1~~
Z~
NEC3ETtFY 8UI ING 6EP%UC 1~~NT' AT
785- f 802 9 AM 'tID 4 PM fi~OR Tt~
FOLLOW[NG INSPECTIONS:
1. FOUNC3ATION 1WKIFIECUNtED
fOR POURED CONCRETE
2. ROUGH • FRAMlNIi ~ PLUUABING
3. INSULATION
4. FiNAI - CONSTRUC'iN)N MUST
BE COMPLETE fQR C.O.
ALL CONSTRUGT#f~! St1A1.L MEET
THE REQUMEMENTS Of YFIE N.Y.
STATE CONBTlItiCTf0~1 a HIl113V
CODES, NO!' ~ PO/)
DESIQN OR CONSTtiUCfgN 68110!!8
STATE OF NE~V YORK S.S
COUNTY OF Suffolk ,
,1~pnold, Blair , , . , , , , , , , , , , , , , , , _ , , , being duly sworn, deposes and says that fie is the appltc:
iNamc of individual stgnutg contract)
~1•ave named.
Owner
rst}te....
(Contractor, agent, corporate officer, etc.)
xxt7il~Ir~xtF}F3t~ftXs, and is duly authonzed to perform or have performed the said wort. and to make and file t
=pphcatton, that all statements contmncd m this application are true to the best of lus l.nowledge and belief, and that 1
'•vork wdi be perforned to the manner set forth m the appttcauon filed therewith,
Sworn to bctore me this
.......11th .........day of......March,......,.,19.89
\otaryPubhc, ....,Suffolk..~,,,,,,,,,,,,,,,,, County / ~ ~~f`~~~
~ ~n X.,,~. : .
(Signature of appltca
UOT
~ ryi91,1C, lbik~q .
Commissiat ExpiraNOwnlbRr3Q 18.1