HomeMy WebLinkAbout17294-z ~ FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17892 Date MARCH 27, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1475 MEDAY AVENUE MATTITUCK, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 9 Lot 5
Subdivision Filed Map No. 745 Lot No. 45 & 46
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 26, 1988 pursuant to which
Building Permit No. 17294-Z dated AUGUST 4, 1988
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to MARTIN GETTMAN
(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
roans xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON 7HE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No 017294 Z Date ..,1~~"....T 19.~ g
Permission is hereby granted two// /(J~
9....... .
ta ...C~.:.cS.T'"....a,...c~:c.~....~e.~~,e+~ia.. a..n....~~~~:-~=......... Wis.....
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at premises located ot ...!!..F....~.......mFr~u*:1
..................:....~......h. ..~~r........................
~i
Block ......Q~......... Lot No...4..5
Cvunty Tax Map No. 1000 Section ~
pursuant to application doted .....~....~-~P 19~p.., and approved by the
Building InspecYOr.
Fee
.
Building Insyector
Rev. 6/30/80
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2. ~U~ ~-`~n a TOWN OF SOUTHOLD V
~p ' BUILDING DEPARTLtENT
1, ~ TOWN HALL
'l~\~ &l.O~~pVTHOLO SOUTIIOLD, NEW YORK 11971
TOW[V O 765 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY /j~~J
DATE .,l D. [ .
NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING•.....VACANT LAND.._.....
7 ~ ~
.
Location of Property... / l e LYU J~O Mrl.7.~ ~EC~
HOUSE NO. REET HAMLET
Owner or Owners of Property..- ~Qr~~~-l?e"/~~h--p-••-••••--••(•~•••••••••-•••
County Taa Map No. 1000 Section 3 . Block Lot
Subdivision Filed MLa{~p ........Lot.1........f.
Permit No. J. / -Date of Permit ~1j~~0 (/...Applicant~!~f~~'!P.~• ~~~~"s
Health Dept. Approval Underwriters Approval..............
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee $ubmitCed; a~~°.~1~~V~
_ O~
A P P L I C A N T .~./~//~in-~/~
:ic~~~i
''a`~•t~,.~...... .
Rte. 389,3
ea ~ I~89~
rev. lOJ14/88
Martin and Florence Gellman
Meday Avenue P.O. Box 256
Mat ti tuck, NY 11952
March 23, 1989
Vi-ctor Lessard, Principal Building Inspector
Town of Southold
P.O. Box 1179
Southold, NY 11971
Dear Mr. Lessard:
Enclosed i.s our check in the amount of $ 25.00 in payment for the
Certificate of Occupancy fee on the approval of Building Permit
No. 172942.
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Very y yours, }
Y
Martin Ge11m {
MAR 2 ~
~I.DCs. TYcPT
~ow~ of sou~wo~o
=lELD I.:SPEC;IUIi ~~UiiTE ~ %ON(MENT°
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [~INAL
REMARKS:
DATE ~ J ~ ~ INSPECTOR.
765-1802
BUILDING DEPT.
f NSPE~TION
[ ]FOUNDATION i5T f ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ INAL
REMARKS:
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BOARD OF HEALTH ..,..,.tea .
'3 SETS OF PLANS
FORMNO.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDINGDEPARTMENT SEPTIC r•otzrt
' TOWN HALL Gam.-~ca C'_~°,li~aceG~
SOUTHOLD, N.Y. 11971 NOTIFY ~ ~s` •D,•,~F.y°°'
n pp TEL.:7G5~1802 CALL ..~:;,.;,u;~•;•l•;•••,.
19A.g MAIL T0: •
Examined / _ '
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~tPProvcd ~.-S~`:~•~ WJ~.. ~ 19~~ Penni[ No. ~ 7 a9. ~ ~
Disapproved a/c
.................................•hc.~~••.......•:~.......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
J~~.-c 158.
Date
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to t}te Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee accozding to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this 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 applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
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 the
Building Zone Ordinance of the Town of Southold, Suffotk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Sign,~nire ot" applicant, or name, if a corporation)
[O~l.. ~'tv2~: 'Rpr,~;n• •`-~ocsTNA,1;ty~j-p,N, lay ttgb&
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of Premises MA'RT1?a; ~~•.•3`.l A.t-1 .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . •
Electrician's License No . .
Other Trade's License No . .
t. Location of land on which proposed work will be ~one:`'..M.~"~?ES~.. ;A~~~•:., , MA'~I~;I•~ek; • ,t.1~(
So vT NOtI?• • ~O w tit . 2~~..................................... .
Itouse Number Streets Hamlet
County Tax Map No. 1000 Section Blyck .9................ Lot.s............... •
Subdivision . M~?.eF. F?~5.~.!9ig7/i'T(lc,e"• • • ~~+.F!a!~ • • F.ilcd Alap No . Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~'.k~1D~~.TL--• .
b. Intended use and occupancy •~'•~*'l~•~~^'' • • • • • • • • • • • • • • .
3. h;,:rrre d'f work (check which l~~applicabtc): New Budding • • • , , Addition ~p'L~r... • Alteration .
Repair Removal at:.w`.:~ , . Demolition Other \York .
' (Description)
4. Estimatcii Cost f%O~OCaD Fee .
(to be paid on Cling this application)
~g unrts ,
5. If dwelling, nurnber of dwellin Number of dwelling units on each floor . . . . .
IFgara;c,numbcrofcars
6. If business, comrnercial or mined occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structu~~es, if any: Front . . .Rear Depth .
Height ...............Nu'mbcrofStorics........................................................
Dirrlensions of same t ture with alterations or additions: Front Rear .
Depth , ~,1 ; , llcight . Nurnbcr of Stories . . . .
' Dirt~~~t&ipns of entire new co11~j~~ction: Front . Rear Depth .
Heigh .,.yS t~ :''hiit~iber of Stories . .
4. SizeSlf,~ ~
• • ~ ,'1,~,; . Rear . 75.x. Depth .~I'A~'~ . ,
I0. Date of Purchase Name of Former Owner '~e~~i".4+a2 fPRO~-. M.CLw.A.3l~. J&..
1 I. Zone or use district in which p~•emises are situated ....:13~t~ , . . . .
0 0 tytpt' late any zoning law, ordinance or regulation: ..f,IO .
13. WiII [ot bee raded truction vt~' lyiU excess fill be removed from premises: ,Yes ~o
14. Name of Owner of premises ..I, MA~('sCllt..Ctt3J~.t~tA~kl .Address . .'....Phone No. ~Po :~?Q .
Name of Architect ..1a*r~S~•~'xltN~t;F . Vx?9:A,.eSat, .Address 1b4,`~No4kr Ra?:?•. , ....Phone No. LPG: S.Z.TS.... , .
Name of Contractor ~ .Address . .Phone No.. .
15.Is this property located with in~00 feet of a tidal wetland? *YESV: .NO.... '
*If qes, Southold Town TrusCees Permit may be required. '
• PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block~,number or description according to deed, and show street names and indicate whether
interior or corner lot. 'I
CSC.. A^l't~.
I~~ Y~ .auto 'Su2v.~(
. .
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STAT@ OF NEw YORK, SITS
COUNTY OF .
r
r . 6cing duly sworn, deposes and says that he is the applicant
(hams of individual sr nin'o contract)
tb ve named. I
Ic is the , i./.l.tit,r>5c%~st?4a.... LaPG•NITI~!~:'-.Ari.~ .
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly ~ruthorized to perform or have performed the said work and to make and Gle this
pplication; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
pork will be performed in the manner set forth in the application filed therewith.
worn to bc(orc me this
Diary Public . County
..r.........
(Si;nature of applicant)
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