HomeMy WebLinkAbout17956-z FORM N0. 4
a
TOWN OF SGUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17976 Date APRIL 28, 1989
THIS CERTIFIES that the building ALTERATION
Location of Property 640 CASES LANE CUTCHOGUE NEW YORK.
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block OS Lot 08
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 22, 1989 pursuant to which
Building Permit No. 17956-Z dated MARCH 27, 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 REPLACE EXISTING PICTURE WINDOW WITH BAY WINDOW AS APPLIED FOR
The certificate is issued to FRANK & JANET MOORE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
U..l 0..l
Building Inspector
Rev. 1/81
MEM NO. f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON TtiE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ° 017 9 5 6 Z Date ..........~.c.~: c.~.....~...7 19
Permission ~s hereby grante`d~to•
.l~......~
ro . out ...~~........tl~ .~k..
ct premises located at ~.~........~-.'°!:A~.....(~.
M~4,-..... ~,..s~td.S..t41.R,..,
.
County Tax Map No 1000 Section 1. Block Lot No .
pursuant to application doted ~OL~-S~ .wZ.Z:... 19 Q.9 and approved by the
Budding Inspector.
Fee S..S'4:•
~
B din I for
Rev 6/30/80
TOWN OF SOUTHOLD ~ , ~ ~ ~
BUILDING DEPART?IENT ~ '
TOWN HALL II ~ ` ~ ~ i
SOUTHOLD, NEW YORK i1971
7 6 5 - i 8 0 2 LLLIII IIISSS BtAG. DEPT.
L TOWN OF S0U7H0t-D
APPLICATION FOR CERTIFICATE OF OCCUPANCY /
DATE ~J'.~~.?: C~.~~. .
NEW CONSTRIICTION __.....OL~cD OR PRE-E%ISTING BUILDING......VACANT LAND..._....
Location of Property... ~.....2rk" f4-Q.......
HOUSE NO.,~~ STREET ~~77 HAMLET
Ovner or Ovners of Property..././?fL~!~1. ~.~f. ~~T~f~c~7` `?1:::~2:'°'-
~-r
County Taa Map No. 1000 Section l `.9 Block .E~.sS.. Lot .U~...._.
Subdivision Filed Map ........Lot..~.^.......
Permit No. ~~1A7`C:_ZZ.Date of Permit ~.Z?: ~~Applicant 1..~:'?~!?~~.fr~.•~'c°1~~,
Health Dept. Approval Underwriters Approval..._...__._...
Planning Board Approval ~
Request for Temporacy Certificate Final Certificate
~1'~ o
Pee Submitted: $
/
/ .
APPLICANT..... ...u.....
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rev. 10/14/88
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II75ULATIOi1 PER N. Y. '
STATE EI7ERGY
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765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
( ] FOUNDATION 2ND [ ]INSULATION
[ RAMING [ ]FINAL
REMARKS: ~ ~
DATE l~ INSPECTORS
D ~ ~ ~ ~ L'I 15 ~ 30SETSOOFHPL INS •
FORM NO.] SURVEY .
'`12 ltfnty TOWN OF SOUTHOLD CHECK
~W BUILDING DEPARTMENT SEPTIC i'OR[•!
TOWN HALL
BLDG BcFt: SOUTHOLD, N Y. 11971 NOTIFY
TOWN OF SOUTHOLD TEL.. 765 1802 CAL L
--nn ee~~q
Examinzd .~a!•'y-W 194 } MAIL T0:
,~pproved~ ~:~,i.,>:`~ „ 19~~ Permit No ~ ~ R.S?!:ti1.^.
Disapproved a/c .
• U,~ ~ .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .rr1~`. `~.o?L,jc~',/r15..
INSTRUCTIONS
a. Tliis apphcahon must be completely filled m by typewnter or m ink and submitted to the Building Inspector, with
`sets of plans, accurate plot plan to scale Fee according to schzdule.
b. Plot plan showing location of lat and of buddmgs on premises, relationship to ad~ommg premises or public stree
or areas, and aivmg a detailed descnption of layout of property must be drawn on the diagram which is part of this apps
cation.
c. The work covered by ties 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 apphcant. Such perm
shall be kept on the premises available far inspection throuetiout the work.
e. No budding 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 Bwilding Permit pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances
Re;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe~
Tlie applicant agrees to comply with all applicafile laws, ordinances, build code, housing code, and regulations, and t
admit authonzed inspectors an premises and in building for necessary m i s?~~i jJ
~ .~..`~0`Jt--+ .
(S ~naniy at apphcant, or na ~ if a corporation)
• r " ~ (Mdilinb address of applioarft) ~~~iJ~
State whether apphcant is of~~s~gssee,°;a~
F h,~ architect, engineer, general contractor, electrician, plumber or builde,
•r
Name of owner of premises Y f~~ ~~!l'i-~- 1`~'`1-~:~-~-~ '
(as on the tae roll or late$T_~ized) ,
If apphcant s a corporation, signature of duly authorized officer y y y1 ~ ,
to ~`~\l,L. ~ tic. ~ 'k I _
YN 3,llf ~ 4"TN•+}"'dt,i ,A 1
(Name and title of corporat~e+ o~~ffyyiceyr) , f/T "~1it3N] r~ NGi~'.1i,'~.s:N~ F ~ ~'",i
7 Qx..7../. . ~7 -F- st03 ~.lllit~.Y~~' rs 3`1.4 ~ i^. ,
Builder's License No. . ~ cNONR~ NOl'~uPT~.4^;.l.t r~.`. 'v i•' ,
Plumber's License No. ~
Electncian's License No . .
Other Trade's License No .
1 Location of land on which proposed work will be done . .
I{ouse Number Street Hamlet
County Tax A1,ip No 1000 Szction „/~9......... Block , • , , , • , Lot r~ .
Subdteision Filed Sap No Lot
(Name?
State e~isLng use and occupancy of premises aJnd intended use ,ind occupancy of proposed constnicuon
a. Existing use and occupancy 1 G% • • • • • • • • .
b. Intended use and occupancy • • • ~ Q~ ?
3. Nature of work (check whrch appircable) New Budding Adddron Alteration v.~.
Reparr Remoe•al , Demolrtron Other 1York .
a (Descnptron
4. Estrmatcd Cost ~®~i.~.J. Fee .
(to be pard on Fling thrs apphcauon)
5. If dwelling, number of dwelling units Number of dwclirng unrts on each Cioor .
If garage,numbcrofcars
6. If busrness• commercral or mr~ed occupancy, specrfy nature and extent of each type of use . .
7. Drmensrons of cxrstrng structures, rf any Front Rear Depth .
Hergitt ...............NumberofStoncs....................................
Drmensrons of same structure wrth altcrairons or addrttons Front Rear , , .
Depth Iierght .Number of Stones .
Drmensrons of entrre new construction. Front .Rear Depth , , .
Hcrglrt ..............NurnberofStones.....................................
9. Stxe of lot. Front Rear Depth .
10. Date of Purchase . . • Name of Former Owner
11. Zane or use drstrrct rn whrclt premrses are srtuated .
12. Does proposed constructron vrolate any zoning law, ordinance or regulation . .
13. wrll lot be regraded \Vdl excess fill be removed from premrses: Yes ~L
14 Name of Owner of premises ....................Address , ....Phone No .
Name of Archttect ....................Address ...................Phone No............. .
Name of Contractor .........................Address ...................Phone No............. .
IS.Is this property located with in~00 feet of a tidal wetland? *YES....NO~/.'
*If yes, Southold Town Trustees PermiC may be required.
PLOT DIAGRAM
Locate clearly and disturctly all burldrrrgs, whether existing or proposed, and,rndreate all set-back dimenstons fro
property hues. Give street and block number or descnptton accordtng to deed, and show street names and tndreate wheth
rntenor or comer lot.
U ~ t~ L.~+lt~k- Cc. IJQ.t.} (iU,(iytp~U-La"' ~ ~Ivt.2
Z (k/J ~E
~R~yt U
APPROVED AS NO'CED
DATE ~,^I ~ B.P. ii~~-~' ,
FEE - pCCUPANCY OR
NOTIFY BUILDING DEPARTMENT AT ,t
765•[802 9 AM TO 4 PM FOR THE us•~ ~S tlNtAWFUt
FOLLOWING INSPECTIONS y~1T1{4UT CERTIFICATE
' 1 FOUNDATION TWO REC1UiRED OF D~CI~pAIKGY
FOR POURED CONCRETE
2. ROUGH • FRAMING & PLUMBING
3 INSULATION
4 FINAL - CONSTRUCTION MUST
8E COMPLETE FOR G.Q.
A41. CONSTRUCTION SHALL MEET ,
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION! ~ ti~ERGY
DEOS
GN OR GpNS'TptJCTlON ERRORS
STATE OF NEN YORK, S S
COUNTY OF .
• • • • • • • • • • • • • • • • • • • • • • • • • . • • • • being duly sworn, deposes and says that he rs the applica
(Name of mdrvrdual srgmng contract)
above named.
Eierstite
(Contractor, agent, corporate officer, etc.)
of Bard owner or owners, and rs duly authonzcd to perform or have performed the card work and to make and file tl
apphcauon, that all statements contained rn this applrcatron are true [o the best oC lus knowledge and belief, and that ti
work will Ue performed m the manner set forth rn the apphcauon Gicd therewrth.
Sworn to before me taus
c~U. day of ..C:~..... .19d.~
r
tiotary Public, ~.~C-..!'!4.(!~"4-~-....... County
HELEN K DE'10E (Signature of applrcar
N
N~oR4708878~Suffo{kCourrtYd
Term Lx{wces March 30,19~~