HomeMy WebLinkAbout17960-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCOPANCY
No Z-18369 Date SEPTEMBER 13 1989
THIS CERTIFIES that the building ADDITIONS
Location of Property 1770 STARS ROAD EAST MARION N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 22 Block 4 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Peruut heretofore
filed in this office dated MARCH 24, 1989 pursuant to which
Building Permit No. 17960-Z dated MARCH 28, 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 DORMER & 2ND STORY DECK ADDITION AS APPLIED FOR
The certificate is issued to WILLIAM P. & AMELIA S. HUKILL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. H-011553 - SEPTEMBER 1 1984
PLUMBERS CERTIFICATION DATED N/A
ilding Inspector
Rev. 1/81
!'OFFS NO. ~
rowN oP souTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST SE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N o 017 9 6 0 Z Date a 19.R..L.
Permission ~s hereby granted to•
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ro ..1.1.%~.`.^~9,/~!?:~S,L.X........9r.:....y.:~~!^.:!:!-!:..`~-....Z.N...!~....~rYr.,..~... .....1:
n1Q..~.5......Q9...4~ n:~~
ct premises located at ..~.~.Z.d......~?:S.S*:!:s!...Fr:SJ,...... ~~P'~.a!-!-~!1
Counh~ Tax Map No 1000 Section Q~'-~"' Block ....Q.~. Lot No
pursuant tc applicotion dated ~ L1.1.~ . 19.8.9., and approved by the
Bu i ldingc~I,nspectar.
Fee
Bui ding Inspector
Rev 6/30/80
. ~ : ~
. ' ~ MAY 2~~~89
TOWN OF SOUTIlOLD J
BUILDING DEPART2SCNT ~ u_ g1pG
OEpT
r01h~N OF SOIfiHOLD
TONN IIALL
SOUTIlOLD, NE47 YOI2R 11971
765 - 1802
APPLZCATION FOR CERTIFICATE OF OCCUPANCY ~5.~
NEH CONSTRUCTION .......OLD OR PRE-EBISTING BUILDING ~f7 .._VACANT L'A//ND...._...
Location of Property. ~ .~~0 _.5~~!]~ .:Ws.. CF}STf!/f~('2iai?,./1~_ y _ _
UOUSE NO.~~~ P STREH/ETy/ IIAMLET/ .
Owner or Owners of Property..Cil:~~.~~lm`:4`~~:!~i~~lA~r..~~.~~.1~.~:
Couaty Taz MCa,„p No. 1000 Sr'eJction .e.~'~.~ Block . _ Lot . d ~7
SubdivisionY"U~.J?C/~ESr/Vbd„Z1S._._ Filed Map ~~~-~~..Lot.
v r i
Permit No. ~(P ~.Z.Date of Permit ..........Applicaa.~~.....
Health Dept. Approval Underwriters Approval._._......_...
Planning Board Approval
Request for Temporary Certificate Final Certificate
q o r~
Fee Submitted: $.h-:5."'-
AP P L I C A N T ~~^~:l:f.'~!' ~t .
eon igab9 ~ ~.'Y?1-
rev. [0/!4/88
fi } h
TEL 7G5-iBQ~
~ "c~~C ~
~t~
~`r r
o~ c,~ Toy rr or souTUO~,~
,:4"21t~,~ ~ ~`c~- OCE'iCf; OI" TsUILDiNG INSPECTOR
. ~ ~y 1~'~`f3
ji ~ TOiVN ISALL
~ 't' SOiJ'I ItOLD, N.Y. 1 1971
~^x s « y
To S4hctn This, May Concern,
Fte are unable to complete your Certificate
of~/Occupancy because of the follot~ing reasons.
An appla.cation for Certificate of Occupancy
v is not nn file. C,~=!~+?--~~
*1o Under~rrzters Certificate on file.
't'he check L:, (:~9srt~la~~*tl/nut nn file.) ~aS.~-.~
No !!na7.th Dept. Approval on file.
Nn final insi~ection hug been made.
Please contact our office on this matter. -
Thank you for your cooperation.
Ilutldtncl Permit f! ~ Z 3 ~ O Z
Building Dept.
~t'`/ I t!o Plumber Solder Certificate on fa.le.
( all permiLS involving plumbing being
i~sucd after .1pri1 1,1984 )
TEL. 7G5-! 8c1
~Fp
~"J`'
`~4 ~ f~,, ~0,~ T0~'N Ur SUUTIiULD
lY~6u~~ Orf'ICL• OF £sU1LDING INSPECTOR
i~ 4~R °4 z i'.O. IiOX 1 1 7 9
t''';°r~ ~ TOWN IfALL
~ V„"y~~~' SOUT'IIOLD, N.Y. 1 [97t
X41 rys 7~ 'Y•"~~ t % l'it' 3
~x sa y
_ east n~~.~..•,,,-~ ~ y 119 ~5~
To 49hcm This May Concern,
47e arc unable zo complete your Certificate
of/O~ccupanc;r because of the folloc~ing reasons.
I4n application for Certificate of Occupancy
is not on file. ~..,.~a~,-<-~-
*to IJndenorrters Certificate on file.
'I'hc chr_c}: is f~zr~taL-rd/nut on file.) 9aS.='y
iJO health Dept. Approval on file.
No ft.nal ~ns[~ec:t_ion has been made.
PI ease contact our office on this matter.
Thank you for your cooperation.
thttl<]1ncl Permit- ik ~ Z ~ 1 D 2
f3uilcliny Dupt•.
*i~J / tlo Plumber Solder Certificate en file.
( all pc:rrtiL-:; involve ng plumbing being
i~aucd after r'1pri1 1,1984 )
1 ~ ~
"'"$'1802
BUILDING DEPT.
1NSPECTIQN
[ ]FOUNDATION 1ST [ } ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING FINAL
? b di G~ ~3 b
REMARKS:
DATE ~ ~ ~ INSPECTOR
1 ~ ~~o
T65-1802
BUILDING DEPT.
1 NSPECTIO?N
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] F UNDATION 2ND [ ]INSULATION
FRAMING [ ] FAIN/AL
DATE 7 5 INSPECTOR
1~~~0
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ } ROUGH PLBG.
[ ]FOUNDATION 2ND [ INSULATION
[ ]FRAMING QQ[~~{{]--FINAL
REMARKS: <~~""~""'~G~r~
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD,N,Y.11071 NOTIFY
- TEL.. 7651802 CALL
~,,j MAIL T0: ~c2 ~,~Q
Examined . YC4?-!'~! `~'-8 19 ~ ^
I ~ ~ U w ~-o~
\pProved .~'Y.~A.~SOx.~~.. , 199. Permit No) Et ~ !lq 3,
Dtsapproveda/c
~
.
(Budding Inspector)
APPLICATION FOR BUILDING PERMIT
Date .......3~ .1f...., 15 rY.
INSTRUCTIONS
a. This appltcatton must be completely filled to by typewnter or to ink and submitted to the Building Inspector, with
sets of plans, accurate plot plan to scale Fee accotdmg to schedule.
• b. Plot plan showing locatron of lot and of butdings on premtses, relattonshtp to adjomtng premtses or public stree
or areas, and grvmg a detarled descrtptton of layout of property must be drawn on the dragram which is part of this apps
catron.
c. The work covered by this appltcatton may not be commenced before issuance of Building Permtt.
d. Upon approval of this appltcatton, the Building Inspector will issued a Butldmg Permrt to the applicant. Such perm
shall be kept on the premises available for inspection throughout the work.
e. No building shall 6e occupted or used rn whole or rn part for any purpose whatever unttl a Certtficate of Occupant
shall have been granted by the Burldurg Inspector.
APPLICATION IS HEREBY MADE to the Burldmg Department for the issuance of a Building Permit pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c
Reaulattons, for the construction of buildings, addtttons or alterations, or far removal or demolition, as herein descnbe~
The applicant agrees to comply with all appltcatiie laws, ordinances, building code, housm~ code, and re^ulatr s, and t
admtt authonzed inspectors on premises and in building for necessary inspect s ~ hr^.7~i'/
'7 (Signature of applicant, or name, tf a corporation)
• (Matting address of applicant)
State whether appltcant is owner, lessee, agent, archrtect, engtneer, general contractor, electrtcran, plumbec or burldea
u/.cl~r2
.
Name of owner of premises , ~J/h</9.~/... ~/f!~~~'!~.. • • ~U~~~L
(as on the tax roll or latest deed)
[f apptcant is a corporatton, stgnature of duly authorrzed officer,
(Name and title of co orate office? N ~
~,~.`a~ 1 G ~f
Bwlder's Ltcense No. 0... a .
Plumber's License No . .
Electnctan's Ltcense No .
Other Trade's Ltcense No . .
1. Location of land on whrch proposed work wilt be done .
~ ;7.7.0..... ...5.~
~.~1-S, ....~1.~ ~.AST~?~9/7/<?~!.. .
house Number Street Hamlet
County Tax 11,tp No ~fo000 Section . p~~.......... Blsrck ~ ~ Lot ~ ~ , .
SubdivistonSDUN.~7.LR4~rSTY.v4L?.T~S FdedDtapNo. Lot
(Name)
State evtstmg use and occupancy of premises and intended.~use and occupancy of proposed constntcuon•
a. Existing use and occupancy dN?:.'~~!h!t~!. S!?4'.~4L/h/ly• •
6. Intended use and occupancy CU4'7"iNv1 / F/UC L-- `
..~...~~r,9
k~
~
3. Nature of work (check «hich applicable) New Budding Addition .'Uteratton .
Repair Removal Demohtron Other tVork .
(Dcscnptton=
4. Estimated Cost Fee .u~.'. r
(to be paid on filing flits application)
5. If dtvelhng, number of dwelling units ...~!t'•:~ Number oC dwefltng units on each (loot . .
If garage, number of cars .
.
6. If business, commercial or mired occupancy, specify nature and cetent of each type of use . , • , , , ,
7. Dimensions of existing structures, if any Front .....3 Rear Depth : 2 .
Hugh[ ..........Number of Stones . ~ .
Drmensrons of same structure with alterations or additions. Front rl"............ Rear ~f~.~....... , .
Depth . Z~' Ilcight .:Zl?............. Number of Stones . .
Drmensrons of entire new construction Front Rear .Depth ,
Height Number of Stones . .
.
9. Size of lot Front lR~... Rear f `f.~ Depth .l .
l0. Date of Purchase r,~;~af -z9 ;(9~.?'.. . , , , .Name of former Owner
11. Zone or use dtstnct m which premises are situated . .
12. Does proposed construcrrtr~~on violate any zoning law, ordinance or regulation: l~° .
13. Will lot be regraded ./u0..~*:. ~¢~~,y~...... tVrll excess fill be removed from premrses: Yes 1`
14. Name of Owner of premises . . , ~~llJ(e~.t_..... ,Address 177U,S>i4~pSR3 ,,Phone No.rf.7~:.aof^(,, , ,
Name of Architect .........Address ..Phone No.. . .
Name of Contractor ~~~,6! •~..!~J.z .....Address ~!4l11/~[2 ~J`l.~t r:~~p.1.`,. Phone No. r~~l.~ ~.i °.7
15.Is this property located with in~00 feet of a tidal wetland? *YES....NO.IJ~
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro
property fines. Give street and block number or descnption according to deed, and show street names and uidicate wheth
intenor or corner lot.
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STATL OF NE1V YORfi, S S
COUNTY OF
• • • • • • • • • . being duly sworn, deposes and says that he is the applica,
(Name of individual sr;ning contract)
above named
fletsthe
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authonzcd to perform or have performed the card work and to make and file tl'
application, that all statements contained in this application are true to the best of tits 1,nowledge and belief; and that tl
work will be performed to the manner set forth m the application f"ilcd therewith.
Sworn to before me tyhu q
...............oS~~/~~.... d-a~JY o/f'~ . /./`~:12?^.'.`:~.......... 19 ~l.
rotary Public, .....!:°-~:~-..iS -..VJ.t' .V?~ County 9E~~-~c~_/~~-F'
NELEN K OE 40E C .
P60TAR'tPUOIIInStateofNewYark ~ (Stgnarureofapplicar
Nu 4707878,SuflolNCcunty
Term Ezpues Merch 30,19