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HomeMy WebLinkAbout17957-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCDPANCY No 218203 Date JULY 25, 1989 THIS CERTIFIES that the building ADDITION Location of Property 3650 OLE JULE LANE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section I22 Block 04 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Peraut heretofore filed in this office dated MARCH 23, 1989 pursuant to which Building Permit No. 179572 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 i.s ADD DECK TO EXISTING ONE FAMILY DWELLING. The certificate i.s issued to ROBERT & ELISA BELSTEN (owner, ) 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 LOSM NO. ~ TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HAlL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST SE KEPT ON THE PREMISES UNTlL FULL COMPLETION OF THE WORK AUTHORIZED) No 017957 Z Date .....~.cratic~....:~:.7 19.~~ Permission is hereby gran o. _ .....N.......~-....~?..:~.~..I.~S-~-. r '~(j ~ d- , J.fsrtx.Q~!::~,,...A.~ ~~~pp ct premises located at ...3,x.5.3? ....Ra!`:Sx ......R?.:~ .~rl,r . r~:~~......... . Caunty Tox Map No 1000 Section ~~^?cn- . Block ..Q~...... Lot No . pursuant to application dated ~ grt,S.~i. 19.A.~.., and approved by the Building Inspector. Fee S : . Building Inspector Rev 6/30/80 H i ' 1 r TOWN OF SOUTHOLD ~ ~ ~ ~ a ^n 5 ~ x-s ; ~ ~ ` BUILDING DEPART2ICNT U TONN HALL JUL ' ~ n~i SOUTHOLD, NEW YORK 11971 IOW 765 - 1802 BLAG. DEFT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCIIPANCY 11/ DATE../.(_~~~._.. NEW CONSTRUCTION ...OLD OR PRE-EBZSTING BUILDING.._...VACANT LAND....__.. (o .SAD ~ ~ C ~-F Location of Property HOUSE NO./~~~ kn/S ITQR_E•E.~T HAMLET Ovner or Ovners of Property_.J!::r.r.n~L!-a..:?~k':';1._~'~:1 County Taa Map No. 1000 Section Block Lot _ Subdivision Filed Map ........Lot.......... ~J ~ ~j J,((~'~ v !1~ pL~ Permit No. ! S~.Date of Permit ~~~~/.Applicant .Y`~.2':IC`<.-Y~ .~PTs` rn~y~ . Health Dept_ Approval ...../V~~1_........ Undcrvriters Approval. V:_~_._.__._ Planning Board Approval ..~1.~......... Request for Temporary Certificate....... Final Certificate ....1:..._...... Pee Submitted: APPLICANT... ~~Z';~^':~-/I'<`: ~_~Z.~ g ~3 ~ 3~ ,~a`7 ~ ~K Gb rev. 10/14/88 L ~:.D l~~.C.: ~,.~Uil 'i t)ni v:~(4~'t ~.N 1.. r s, .y . C'7 H ~ _ _ _ _ H _ OUIdDA'fI0*1 (1st} ~ - V. ~ t c ti FOUNDATIOIJ ( 2nd ) ~ o - - I o P ROUGH FRAME & i PLUMBING r ~ r 3. cn n I1ISULATIOA! PER N. Y. C STATE ENERGY CODE _ ©f~- f 4 . \ y It FIAAL i ADDITIOT3AL COI~7MEtITS: ~ ~ 1 ' x ^o H 9 H H O m r ~ H i d m -a H ~'Ir ; - N m K ~ 06 ~ T D7 `L_ r a. ` <o ~ ~ ~ r A N (X ~ -t ~ : x ~ ~ n ~ ~ - Y ~i T 1T ' V W • ~ N 3 , , W N N 0~ ~ ~ ~ n o n ~ ~ ~ ~ _ R R tr ~ r O S k• n ~ P ~ ~ D P ~ ~ 1 ti` , tEH"" M~-' X1;1 ~ , ~ df.., ° w ~ ~ f. Transfer thls to th~Urement utslde • ~ Y~• ~ Set to het°w 1ing/deeHkln9 1 inch tae sure dec °pr level ` %wnch pp fo°olsg ab°ut ~ II 0 I: II 01' II C.1 L T H 3 SETS OI' PL,\NS FORM NO.1 SUE:VI:Y TOWN OFSOUTHOLD CIICCK F3UILDING DEPARTMENT SEPTIC roltrt . ' TOWN HALL ~OUTIiOLO.N.Y.1197T NOTLFY - TEL.:7G51802 CALL _ (n~ q PIAIL T0: E~amincd . . ~-t~t .~.Z 19~ Approved 19~. Permtt No. ~ ~ .Z, - - Duapproved a/c y 23 ~ (Buddmg[nspector) ~'~:O'~~~,,,~,..:-:•^-""'""'~~ APPLICATION FOR BUILDING PERMIT /GG~ • Date 15~ • INSTRUCTIONS a. Tltis application must be completely filled in by typewriter ar in ink and submitted to the Building Inspector, w+t sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showtpg location of lot and of buildings on premises, relationship to adjoining premises or public s[re or areas, and giving a detmled descnption of layout of property must be drawn on the diagram which is p.trt of this ap canon. c. The work covered by this application may not be commenced before issuance of Building Permtt. d. Upon approval of this application, the Bwld+ng Inspector will issued a Bwldtng Pcrmu to the applicant. Such parr shall be kept on the premises avadable for inspection throughout the work. e. No budding shall be occupied or used to whole or m part for any purpose whatever until a Certificate of Occupy shall have been granted by the Building Inspector. APPLICATION IS HEREBY A[ADE to the Budding Department for the issuance of a Building Permtt pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, addtnons or alterations, or for removal or dcmobuon, as herein descnb The applicant agrees to comply with all apphca6le laws, ordinances, budding code, haustnn code, and regulations, and adm+t authonzed inspectors on premises and m building for necessary tnsp ,~,C (5+gnantre of phcant, or name, d a corporation) ~~s?? ~f Jam... LN _ /~a,'~,:%.ac.L • ~ (~fadtng address of applicant) /L'~ «ys State whether applicant is owner, lessee,- agent, architect, engineer, general contractor, eiectrtcian, plumber or build Ol(~N6<2 Name of owner of Premises ~,bcri ? , . G.we.. GnlL!'/2i ~ ~~~'«f1 . , . . . . (as on the tax roll or latest deed) !f appitcan[ is a corporation, signature otduly authanzed officer. ow,v~er ,01~.~ is - 6u:1~ (Name and title of corporate officer) Builder's Lteense No . ~j6de1'dlvE.P lv<O Plumber's Lteense No . G!5's.t.~ ~'~ct<aR . C•lectrtcian's License No . Outer Trade's License No . . 1. Location of land on which proposed~or ~ tvtll be done . . ........3. G,so.....a~ . , .JK,Ie . ~!r!......... !~s~i. iu~t~ ~ i~ps z_.. . Clouse Number Street, - Hamlet County Tai 11ap Na. 1000 SdCtl4i1 `0.~.°':......... Dock Lot ~ , Subdtvtston Filed is[ap No. Lot (Name) Stare e~tsung use and occupancy of premises and~mtendcd use and occupancy of proposed constntctton~ a. Ex+sttng use and occupancy ~`•`~'~~'~.........t-~ ~ . . b. Intended use and occupancy . ~u% ~ ,`J.~. `;~~'~`~'~j~o'~ m ~ 3. Nature of work (check ++h,ch applicable): New Dwldmg • • • • Add,t,on ~Vteranon . Repair Removal Demohtton Other \Vork . ,~l~• ~ (Dcscnp 4. C-sttmated Cost ...:7Y~: ~ .t~.DOD:. Fee . (to be patd on filing this applicauo, S. If dwdhng, mm~ber of dwelling units Number of dwelling amts on each floor . Ifgaragc.numbcrofcars fi, if 6usmess, commcrc,al or mrncd occupancy, spectfy nature and extent of each type of use . . 7. Dinrenstons of extsttng structures, tf any: Front Rear Depth , , Hu,g}tt ...............NumbcrofStones.................................................. D,menstons of same structure wt[h alterations or additions: Front Rear , , , • Depth 1[eight ~ ~ Nuh+ber of Stones , 8. D„nensions o enttr~~~~e+v consttuchon: Front . ..rP.P?..... Rear G.~: ~ Depth . lT. Ileight f !~rT~i~pf•!~umbcr of Stories . 9. Size of lot: Front 1.°. Rear !S3! ~ , , , . . . 10. Date of Purchase ....~RF.l. ............:~am~f F ,rm .Owner . D/'~~!~~~.. ~~!??~,yr.. . 1 1. Zone or use distrtct in which premises are situated . e7; ~ ~ , , , / . 12. Does proposed construction violate any zoning lalv,ordtnance or regulation: ..~v . . l3. Will lot be regraded /f/R ........will excess fill b~ remQvFtl,from premses: Yes 14. Name of Owner of premises . }-`z.'J , , , , , , Address~L$~?? , ...77"'!!.°. ,c:'~!. Phone No~.:p Name of Archi[cct ...........................Address Phonr. Nolt: Fg$:38.:~ Name of Contractor . .....Address . .Phone No.. . ]5.2s this property located viehin300 feet of a tidal•vetland?,*YLS~• _.,:SiQ,} *If yes, Sou[hold Town Trustees Permit may be required. • PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensio[~ property lines. Give street and block number or descnp4on according to died, and sho+v street names and indicate +v mtenor or corner lot. • - / i .,r / ~ / NrB Jr io /orfir~,y Ariy~r ~yuD'~es 04049 a ~i- 8 09~~~ p~%+~4+a ~f "x /J2~B, ~sQ'*. 004 ' L ~ , • /l [ ~ to CJ lid ~ . ~ c° I? . • , t: it x 4y+ a,+'? + o 'tt +i ~ d ' 'Lyy/ i Z p~" o _ _ E m . ' = n i. . • 0 • ~ P13,00• ~ ;8~ ' now or formerly ` '7 ' . Pau/ p;, g CordyJ ECtvords STAT[ OF \L•lV _ COUNTjYf 0 . ~ S'S w r(~~( ~ c . .•bein dt(~'y s+vorn, deposes and says that lie is the ~ _ (Name f mdivtdual signing contract) . ~ above named. b ~ /J ~ r o I lc is the ~f'~-t'.~4.t" ..,.(/,f'~ifS.~*e% . : •:~4-l~~;t r - ~ (Contractor, agent, corporate officer, etc.1 of said owner or owners, and is duly authorized to perform or have performed the said work and to make and appl,cahon; that all statements contautcd,in this application arc true to the best of lus knowledge and 6ehef;and work will be performed m the manner set forth m the applicauon filed therewith: Sworn to buforc me this ........9. ~ pp day of 19.?~ Notary Publ,c, . ,l~K:t'r~i... ...~n+'4':~::K!... County BER7}iA STARS N07ARY PUBLIC, State pr New Yol'f t " " " • " " " " " " " " " ' • No 52 4521450 SuNofk Coun~ (Signatufe of a' Comm,ss,on Exp,res Sept 30. 19 - - iI I, I. - - I I ~ ~ ~ I 1- I I~ I ~ I i- I II I I I l I I I I li I ~ I - I I ~ I I I I I i i I I I _ i I - I I - ~ I - - - I - I I I I I I ' I ~ - - I - - - I - I - ~ I ~ - - II I I ~ ~ I ~ ~ i ! 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