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HomeMy WebLinkAbout17608-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218348 Date SEPT. 6, 1989 THIS CERTIFIES that the building WOOD STOVE Location of Property 585 OAR AVE. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 077 Block O1 Lot 16 1/2 of 241, Subdivision GOOSE BAY ESTATES Filed Map No. 1176 Lot No.240,239,238 237 conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 4, 1988 pursuant to which Building Permit No. 176082 dated NOV. 16 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 INSTALL A SOLID FUEL STOVE. The certificate is issued to BARBARA M. BROWN & FRANCIS E. STEPHAN (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building Inspector Rev. 1/81 M-HM NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)- N o G 17 6 0 8 Z Date ..,~.l..o.:~ :~~-s.........!~ 5~..........., ) 9.~? g Permission is hereby granted to• \~,,, s ...~~... ~~- .~1..L........... ~ee~~ ...' ..~,...N:.u......t.~~o 1...... ro .4~4..... 4r... ..............4~.f...~.........5.~:~...~,/~//cX~SA~X/... ..................................................................... ............ ............................................ ct premises located at .s~~...~e.....~..:`.'.~ ............... . ..... .... .C-!:.-................... . ............................................................ ................................................................................ . County Tax Map No 1000 Section . 01 ~f' ,. n- . Blo~c/k .... Q.~........ Lot No ~ Vii .... pursuant to apphwtion dated ....~Z"~::"i!s`~.h... T.... ....., 19.X $., and approved by the Building Inspector Fee ;...0~.2. S :. ~D?~ .. ~PUdL~, .. ....................... Inspector Rev 6/30/80 ~~Q~ 765-1802 BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST [ ~ ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION-" [ ]FRAMING [~NAL ~`~ REMARKS: DATE ~ INSPECTOR t ~ ' .~/~-~ -- __ __ TOWN OF BUILDING TOWN SOUTIIOLD 765 SOUTUOLD ~~~y DEPART2iLNT HALL NEW YORK 11971 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY r. _ au~ 3 t ~~ ;;,:~, DATE. ~ .•3 ~.. ~~.. _ . . NEW CONSTRUCTION ._....r.OLD OR PRE-E%ISTING BUILDING.~..VACANT LANID....._.. Location of Property..Jgs'©JaY.K~V€,._,._,__~?oo5_e u. ~S_t3_t_~_r,,,_.~otit/~i.~fc~._.. HOUSE'NO. 1 St~ttT~~RE~7ET ~ • . llAMLET c~.c~ Owner or Ovners of Property.....1:=~.Y'~'Zc'3. Y:l. fJ1~G"J .Y.. Fr3r~~!s_ ->T }1 1~ County Taz Ma//p~~ No. 1000 Section . _ /.~ Block ....{.. _ Lot .. /~.... Subdivision..`°~S~_~~_~S'tp2~":eS Filed Map .r~~~,r._.Lot.~.2.~j?~~.1?~/~~~39~ j Z 1 / .23,237 Permit No. p67~~~Date of Permit ,II:.I~F'_~~AppLicant .~c~e.har,1.~.~}32Y-i~~ Hea1Ch Dept. Approval .................. Undervriters Approval..._...__.._._ Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $.~S';~_........... APPLICANT .................................... ~`e-c ~ a k/6 7 co ~i~3y~ 9~/'~ rev. 10/14!88 -1cLD I;.S:ECTIU;7 ~ ~UATE ~I COMMENTS ~ 1 . .. - . ^v a ~ ___ H y OUNDATION (7st) c~ =OUIJDATI0IJ (pnd) ti, m 2 . z 0 pOUGH FRAME & PLUMBING H 3. ~ ra ra IIISULATION PER N. Y. '~ STATE ENERGY CODE x 4 . r m .a FI;dAt/ o s ADDITIOPIAL COMMENTS: z ~ x ro H • 9 H H O 2 [TJ a c^ H v m '- o H a i~t, ~7tu.E L'~__~~~ FORM NO. 1 11 ~ ~' TOWN OF SOUTHOLD NCN - ~ ~ ~ BUILDING DEPARTMENT ~_' TOWN HALL ,J, _,, :-i ~` ~ SOUTHOLD, N Y. 11971 4___...~I_. _~._-'~-.e...~_,.._, TEL.. 7651802 Examtned JV ~.? ~t , 19 ~~ Approved ~ ~?~!»~ ..i 4 ., 19x~ Penntt No ~ ~ ~~~~ BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. .... CHECK .............. SEPTIC FORM ............. NOTIFY CALL .................. MAIL TO: Dtsapproveda/c .. ................................. ....... .............. . .. .. ..... ...... . . (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ..oC i ...~~......, I' ' a. This appflcahon must be completely filled m by typewriter or m ink and submitted to the Butldmg Inspector, w sets of plans, accurate plot plan to scale. Fee accordtng to schedule. b. Plot plan showing location of lot and of butldmgs on premtses, relarionshtp to adlommg premtses or public s~ or areas, and grvmg a detailed descnphon of Iayout of property must be drawn on the dtagram whrch is part of thas canon. c. The work covered by ttus apphcatton may not be commenced before tssuance of Budding Permit. d. Upon approval of thts apphcatton, the Butldtng Inspector will tssued a Butldmg Perrntt to the applicant. Such p. shall be kept on the premtses available for mspectton throughout the work. e. No Butldmg shall be occupted or used m whole or m part for any purpose whatever until a Certtficate of Occup shall have been granted by the Butldmg Inspector APPLICATION I5 HEREBY MADE to the Butldmg Department for the issuance of a Btulding Permtt pursuant t« Butldtng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appltcable Laws, Ordmanc Regulations, for the construction of buddmgs, addttrons or alterations, or for removal or demolttron, as herein descn The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an admit authorized inspectors on premtses and in building for necessary inspections. (Stgnature of applicant, or name, tf a corporation) 0 ..3~ /~1/.N/tiST+CgN,j, P4..gMt?'Wtcc6 N`./ • (bfailing address of applicant) 1 i' U State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or burl ~ LJ rVr:le ' ....... ..... ..... ... .. .... ...... .............. ...... ....... ..... a+rwr ... .,,~ Name of owner of premtses ..~~!~~!g'~'i9.. M ~~Qued ,t! d- F/2f}~~ t S: ~. STt= F'H,q ~ . , • . , _ (as on the tax roll or latest deed) IFapphcant is a corporation, Stgnature of duly authorized officer. APPROVED A$ NOTED .......... ... .. ... ...................... O~'~' 7 DATE iF ~ tt !T ~ B P H (Name and title of corporate officer) ~ ~ ,_ ,, PEE ~~ ~ "~~BY ~ fir, C... Builder's License No NOTIFY BlNL01NG DEPARTMENT A7 ` ..... • • , • • • • • • • • • • • • ' • .M TO 4 P;U4 FOR THE 785 1$Q2 9 1 A~ Plumber's Ltcense No. ......... • wG~PA~G~ O~ FOLLOWING ENSPECTIONS 1 FOUNDATION - TWO REQUIRED El n' t L ~N~A~~G~ N ~~ ~ !S ~R R ricia ec s tcense o. .... y', • • ~Y1T~{O~~ I~~~r~f~GA~~ 2. ROUGH FRAMING >it PLUMBING INSULATION 3 Other Trade's Ltcense No .......... Q~ ~~~~'~~GY . 4 FINAL - CONSTRUC?ION MUST BE COMPLETE FOR C.O 1. Location of land on which proposed work wtll be done. .. ... .. .. .ALL.CON&TALLCTlON. SHMLL .AA~ET, , THE EOUI:REMENTS OF THE N.Y. ~ ~ ~8~ CI gtC ' . ...... .. ........ ... .... ... ... .. .. Tf EJC7LON St .ENERGY. . House Number Street COOAScnIA'I~OT RESPONSIBLE FOR ~7 ~ Z DESIGN OR CONSTRU ERRORS . J• ...... Block ..... County Tai hlap No 1000 Section .... .... Lot .. ... . , . . Subdrvtston G-uoSE. ~Y. Fs %~~ .... ... Filed ;1tap No i J ( ~~ ... Lot . ~' :f .ail ,t Sic (Name) .t3y, .z38, a_3~ 2 Stale existing use and occupancy of prenuses and tnte ndcd use and occupancy of proposed construcrion p ~ '~~~M ~~ '1 ~S7,D En/~ a Existi • ng use and occupancy b. Intended use and occupancy ...~.ui~ N[E+L...~G~ i Dcit1C ~' ,..__ _/ „7~ ,,, 3. Nature of work (check which applicable) New Butldtng .....~.... . Repair .... ..... ... Removal ............. Demolition , °t /rJST!}tt, (,JvoD s7"CVC tq1 ~:3SE>hCn1T 4. Estimated Cost . :~..7.s%sa • .. • ..... ................. Fee Addttton ... .. Alteration ...... ..... Other 1V-g~ ~. ` rl1R (Descnpuc ..... ...... .... ............ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......:' ...... Number of dwelling units on each floor .. ~ ..... . If garage. number of cars .. .:-.... ....... .. ............ .............................. . 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .... ~........... . 7. Dimensions of existing structures, iF any• Front ....~£ /......... Rear .... ~~ ~ .... Depth .. ~,t, , , , , , , Height .~~~ .Rr„Fe~l'K„ Number of Stones .. 4'$!~ ...... ... ...... ...................... ... Dunensions of same structure with alterations or additions Front ..~:`r1JE.......... Rear . , rS'9M.~.. , , , , Depth ......~ !tME.......... Height ....r`4~1 C ............ Number of Stones . BH>:' ............ . 8. Dimensions of entire nevv construction Front . .. .. ..... Rear ... Depth .......... . ..... . Height ...............NumberofStones...._..... ................... ... ............... 9. Size of Iot Front .... .. !.W. ~ ......... Rear . 6S. ~ .!.......... Depth / z G ', ..... - - . . If). Date of Purchase ....~:.~-.?~ ............... Name of Former Owner u!N1: ti:"?~€€r:~..~1/H4~ .... 11. Zone or use district in ~vhicli premises are situated ........................ ...... ................ . 12. Does proposed constructron violate any zoning law, ordinance or regulation• ...t!1t1.. • .............. ..... 13. Hill lot be regraded ..nt R .................... .Will excess f"il] be removed from premises: Yes 14. Name of Owner of premises F.5-~raRAl i- ~,,,'3Row.d• Address 35V,3NNoSrRn~), Pt , . , , ,phone No...? `/~'z~`~4 Name of Architect ........':~.~-:- '........ Address .. RM ~.~"~.'vif-r-E !Y!C/ phone No. ........... ............ Name of Contractor ......... :':- .............Address ...................Phone No............ . iS.Is this property located within 300 feet of a tidal wetland? *YES....NO.f! *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 f property lines Give street and block number or descnption according to deed, and show street names and indicate whe intenor or corner lot. J NSTRt,.r_Fj-ri aA) L' ~ WO t>1~ ~ T n ti' E l ~ C e~y EnJT ~`s'c,^~ENT a x~ U Gal rE ~ TNT v ~X t S'7-/ a G C H t M rt/EY z~~~ a r, V' - r s 4 1 l f w~Ar! rj ~ PvtgO 7grJK \ cvUV~ srvu~ ~ ,~ ~ 1 P { ` {~ - l ~. ~ r ~ ~~ .. ~•.ai ° a ~r C1M w3 ~ ~' 1 Q• -_,~ _~r f " ~~ 2 --- ~ ~~„j 1_ ..~ . ~ .~ __ STATE OF NEIV YORK, S S " " t ' ~+'a1~`t'f! ~~ COC~NI'~' OF ..,.5~, PFatK i - ~ , `il+'• Y ';~~ ~t1?h~. ~• ' • • • • • .. ..... being 4~iN s~orn, deposes and says that3he is the apphl (Name of mdfv'idual Signing contract) ~F .91e ist~}iej..,i iAN:~. e~'?1"zC~?'f::'t,~....!h ....... ....... ....................... . y M ~'li ~!? 2T1i3i4"~FI;ln9~ ~`{7 (Contractor, agent, corporate officer, etc ) 9 of sa~ r~~~~~~'y x~ t u $~authartzed to perform or have performed the said work and to make and file ppl o a fn,'~s{'a~,r~,negj~~,pjained m this application are true to the best of-kts•knowledge and belief; and that worn ~~ p r orme m the manner set forth m the application filed therewith. WP`' Sworn to before me this S'r ......... 3.1........... day of . ...OC-'TD~4E+4...... , 19 Notary Public, .. ~e~y,!-~-~- SuFFd..hC 1 ~tl'~W~.. O .t.... count ! •~ r, PN1LLfP 1 BAYER v / ~'~ ~ v "" "" " ................................ NUTARY PUBLIC, State of NeW Yo"rk No 97~Dt9aio0 sufroik Count (Signature of apphc Y 7etm £xpues August 31; 19