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Home My WebLink About17597-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17942 Date APRIL 13~ 1989 THIS CERTIFIES that the building. ALTERATION Location of Property 1330 DEEP HOLE DRIVE House No. Street County Tax Map No. 1000 Section 115 Block 12 Subdivision Filed Map No. MATTtTUCKr N.Y. Hamlet Lot 18 Lot No. conforms substantially to the Application for Building Permlt heretofore filed in this office dated NOVEMBER 1r 1988 pursuant to which Building Permit No. 17597-Z dated NOVEMBER 10, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certlfzcate is issued is CLOSE IN EXISTING PORCH OF ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 MATHIAS N. & EVELYN J. BREWI N/A N/;~ Building Inspector TOWN OF SOU'I'HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 517597 Z Permission ~s hereby granted~to,' ..~..o....~...~...~..~.. .... ~:~....~ ...... ~~~:..~.~....~.~ ..... ~~ ..... ~..~~:~ .......... : ....................................... ~ ~,,~ ,=~ ~, .z~....~ ~~ ..................................... ................................. .......................................................... Coun~ Tox Mop ~o ~ooo s,ct,o. pursuant to apphcahon dated ....~//~ ... Budding Inspector. ............ l .9~.~,, and approved by the Rev 6/30/80 k TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 _ APPLICAtiON FOR CERTIFICATE OF OCCUPANCY DATE NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND HOUSE NO. STREET HAMLET Owner or Owners of County Tax Map No. Subdivision ....................... Permi~ No ........... ~ate of Fermi Health Dept. Approval .................. Underwriters Flanning Board Approval ................ Request for Temporary Certificate ....... Final 1000 Section .C~.~.. Block .Z~'~... Lot /.~ ..... Filed Map ........ Lot .......... Approval .............. Certificate ................ 3 ?0 3 rev. la/14/gg BLDG. DEPT. TOWN OF SOUTHOLD FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL.: 765-1802 D~sapproved a/c ................................ BOARD OF HEALTH 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORM .............. CALL ............... MAIL TO: Date .................. , 19 FOR I~JREO C-ONCRE~E INSTRUCTIONS , 2 J~QUGH - FRAMING & PLUMBING ao~ tlon must be completely filled in by typewriter orin ink and submltted to the Building Inspector, wit sets ~t.acc. u_r,~.O~lJg~t0~rlONsll~ll~TFee according to schedule. .. b. ~3~tC~l~R~llo~;ion of Iot and of braidings on premises, relationship to adjmmng premises or public str, or arg~fit, aL~l~Otl~dg'l~Ol~al~t~el~c~t~n of layout of property must be drawn on the diagram which is part of thas ap caLto~HE REQUIREMENTS OF THE N Y C6T~i~ v6~~ tt~s ~[~5~Yion may not be commenced before issuance of Building Permit. dco¥~ al~ovallEgR~N~catq~i~, the Building Inspector wall issued a Budding Permit to the apphcant. Such per shall bet go3~oRt~IO~tt~TIl~kE~JLC~} mspectmn throughout the work. e. No building shall be occupied or used in whole or xn part for any purpose whatever until a Certificate of Occupaa shall have been granted by the BmldiJag Inspector APPLICATION IS HEREBY IviADE to the Building Department for the issuance of a Braiding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- Regulations, for the constructmn of bmldmgs, a.d. dmons or alterations, or for removal or demohtlon, as hereto descnb Thc applicant agrees to comply with all applicable laws, ordinances, braiding code, housing code, and regulations, and admit authorized inspectors on premmes and m bmldmg for necessary inspections (Signature of applicant, or name, if a corporanon) (Marllno'd'"" address of applicant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or braid ....... 0. . . ...................................... Name o£ owner of prem~lses .P..~.~.~ If apphcant is a corporation, s~gnature of duly authorized officer Budder's, LicenseNo .............. ~ ¢ ~.~..~lc-'"" .... Plumbers License ..... ....... EIectncmn's License No.. -c/ .................. Other Trade's License No ..................... I. Location of land on winch proposed work will be done .......................................... ,.t.9 a ..... House Num her Street Hamlet County Tax Map No 1000Secaon ..'~../..~'~. ........ Block . ./..'~. ........ Lot.../.~ .......... Subdtv~s~on ..................... Fded Map No ............. Lot .............. (N'aln~) 2.State ex,sting use and occupanc~ of plienuses and m~nded us.e and occupancy ~f pro, p~osed, i:onstructlon b. Intended use and occupancy ............ 3. Nature of work (check winch apphcable) New Budding ......... AddJtJon ......... AIteratzon ...... Repair ............ Removal. . ......... Demolmon .......... ,= . Other Work ....... 4 Estimated ~t~.O ~ ~ ........................... Fee .................. (to be prod on ~hng ttnsapphcanon) 5. If dwelhng, number of dwelhng unns ......... Number of dwelhng urals on each floor .......... I~ garage, number of cars ........................................................ 6. If bus~ness, commercml or m~xed occupancy, specify nature and exten~ of each type of use ............... 7. D~mens~ons o[ ex~stm~ structures, ff any Front ............. Rear .............. Depth .......... Hmght .............. Number of Stones ............................................ Dtmensmns of same structure wlfl~ allerahons or additions ~ro~ ................ Ru~r Depth ................... IIm~t .................. Number or Stones ........ ~.,..,. 8. Dm~ens~ons of enUre new constmcnon' Front .. ~.~ ....... Rear ............. Hmght .. ~..~ ........ Number of Stones 9. S~ze of lot Front .... qi ~ ............ ' ..... ~ ................................... Rear..~ ................ Depth ................... I0. Date of Purchase ....................... Name of Fo~er Owner ........................ 1 1. Zone or use d~strict m Much premises are situated ............................................ 12. Does proposed constmcUon vmlate any zomng law, ordinance or regulatmn' ~ ................... 13. Will Io~ be regradefl ....... ~ ................. Wall excess fiI1 be removed from premises. 14. N~e of Owner of prmmses .................. Address ................... Phone No ............. N~e of Architect .................... ~. ..... Address .................. Phone No ............ N~e of Contractor ......................... Address .................. Phone No .. *If yes, Southold Town Trustees Permit may be required, PLOT DIAG~ ' Locate cle~ly ~d d~stmetly ~I buddings, whether ex~stmg or proposed, ~d, ind~cate fll set-back prope~y hnes Give street ~d block number or descnptmn a~eordmg ~o deed, ~d show street nines and interior or corner lot. COUNT~ u~ .~ d~ ~ ......................................... being duly sworn, deposes ~nd s=ys that he ~s t~e ap~l[c above named ~ ~ ~ He ~s the (Contractor, agent, corporate off~cer, etc.) of sa~d owner or owners, ~d zs duly =L~thonzed to perform or have perfo~ed thc sa~d ~vork and to m~e and file apphcat~on, dmt ali sta[ements contmned mttus apphcat~on are /rue to the best of hts knowledge and b~he~;and t~at wor~ w~l be pertom~ed m the m~ner set forth m the apphcatmn filed therewith Sworn to before me this ................... day of. NELEN K. DE NOI~RY PUBUC, S~te o~ New.Ym'k ............. ] 9 co= y o .tL , . (Signature of apphc~