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Home My WebLink About17632-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bulldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17997 Date MAY 3r 1989 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 4905 PEQUASH AVE.&70 FLF~TWOOD RD. CUTCHOGUE~ N.Y. House No, Street Hamlet County Tax Map No. 1000 Section 110 Block 4 Lot 1 Subdivision F~led Map No. Lot No. conforms substantially to the Application for Building Permmt heretofore filed in this office dated NOVEHBER 17r 1988 pursuant to which Building Permit No. 17632-Z dated NOVEMBER 22~ 1988 was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is · ssued is ALTERATION TO EXISTING 0NEFAMILY DWF3~.ING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ANTHONY G. & H~T.~N M. NOWACHEK / ~11 Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT ('THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NE 017632 Z Permission is hereby granted to: ,/.,.~ /'.,/ ,~ ~,,-,~...~...~...,~...~...~....~~ ..~;.....~....,~......~.~.~ ................... ~_.~./ '"~~~~ ...... ~~....~...~~ ~...~ ................................................... ~ ~,~ ~ ~ ....~..~~~ ........................................................ ............................ z~....~~~.~ ............................................. .................................. .............................................................. co~/,o~ uop ~o. ~ooo s,~t,o~ ...2~ ..... ~k ............. M... cot ~o ....... ~ ........ pursuant to epphcahon dated ... Budding Inspecter Cee S ~'..~ ........ , 19.6J:~, and approved by the Rev 6130/80 TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN HALL SOUTIIOLD, NEW YORK 765 - 1802 11971 II L , TOWN OF $OUT~'~_O.,LD_ j APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRI/CTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property. ~ -~t( ',~& uousa NO. ~eT~o~Eg~ O~ner or Owners of r pe y ........ .~ qounty Tax Map No. ~000 Sectiom ;(0 Block ~ Lot Planning Board Approval .//.~. ......... Request Approval...~..~. ....... for Temporary Certificate ....... Final Certificate ................ Fee Submitted: ~c ,3?/(~ & co~l'~¢q7 rev. 10/14188 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] ~/~UNDATION ZND [ ] INSULATION / r/2/FRAMING [ ] FINAL REMARKS: DATE / / I,~ ~/~/~0~ INSPECTOR~~ ~/~ =OUNDATION (1st) fOUNDATION ~OUGH FRAME &/ PLUMBING (2nd) INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined ./.. ~ 19 Approved .............. 19_. Permit No Dmapproved a/c ........................... ~/ (B¢fldlno Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .......... 3 SETS OF PLANS .......... SURVEY CHECK .................... SEPTIC FORM .............. NOTIFY CALL ................... MAIL TO: BLDG. DEr. TOWN OF S~UTHOLD INSTRUCTIONS a. Ttus application must be completely filled in by typewriter orin ~nk and submitted to the Building Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showmg location of lot and of buildings on premises, relahonship to adjoining premises or pubh¢ str~ or areas, and glvmg a detailed descnphon of layout of property must be drawn on the diagram which is part of this al: cataon c The work covered by ttus apphcation may not be commenced before issuance of Bufldmg Perrn~t d. Upon approval of this applicatmn, the Building Inspector will msued a Buildmg Permit to the applicant Such pe~ shall be kept on the premises available for mspectinn throughout the work. e. No bmldmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa shall have been granted by the Bmldmg Inspector. APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Braiding Permit pursuant to Braiding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance. Regulations, for the construction of buildings, additions or alterations, or for removal or demohtion, as herein descnk The apphcant agrees to comply with all apphcable laws, ordinances, bufldmg code, housing code, and regulations, and m bufldmg for necessary in ction. admit authorized inspectors on premlses and ~.~..~ (Signature ,bf apphcant, or r~a~_e, if a corporation) ..... ~q..f4 ~. ~.Y-. ................... (Maih~_ng address of applicant) __ State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electmclan, plumber or build ..... .C..~. :.o. ~..~.~ ..... ~.,.w!. .... .~ r.(.....m...r.?~.~,:~ ..3..~..~ ..... ~ .................. o 'owner ofprem ses.. .. w. . 3... :... ................... (as on the tax roll or latest deed) If applmant is a corporation, s,gnature of duly authorized officer ...... .N..o.~ .... ..~. ~. ~:~.~...~.* .... ....... '(N~i'rne and title of corporate officer~ B, l,de 's L,cense . . ./. .o . . Plulnber's License No .................. Electrlcmn's License No~ ............. Other Trade's Lmenge No ............. /57 Location of land on wtuch proposed work will be done ~.z. _~_ . ~ '~'~ ....... ~ ...... .;. '~ '~ ...... ., . . ......... . .......... House Number Street Hainlet ~o 1000s~t,o~ . .~9 ...... ~io~k ....... ff ...... Lot County Tax M~~ ........... '~ .... .~. ' (Naine) u State eXlStmg use and occupancy of premises and intended use and occupancy of proposed construction a. Exmtmg use and occupancy . .Q.~ ~..~. } ~-' '~' -[' ~-~ ~-~. :.~(~Q,~ ................ ~ .............. - ~ ~3~~~. b. Intended o~anpan,v - ~- ·._~,,~-~-~,,a:6 ............. 3. Nature of work (check which apphcable) New Budding ......... Additmn ....... Alteration ...... Repmr ........... Removal .............. Demohtmn ........... Other Work ........... ~. (Descnptlm 4. Estimate'd Cost ...... ~ .................... Fee ............................. (to be prod on filing this application) 5. If dwelling, number of dwelling umts . O..~..O-Z'' ..... Number of dwelhng umts on each floor / ![,garage, number of ca, rs . .~...1/..~-~' .................................................... 6. u o. A3s;ge~;, commercaa[ or m~xect occupancy, specffyknature and extent o f each Woe of use ................ 7. DtmQq~ions of, existing strudgu, r~s, ifany Front . '/~.. ....... Rear ...~J'.f ...... Depth ~J..0v-.../~. ?... Helg[{ ;.~ ........... Number of Stones .................................... 9.~P'~-...k... Dmalr~sionsa~li~i~a,~,eure with alterations or additions Front .............. Rear ,~... ~ ......... Dept~!....~[.~.l[[~ll~ ..... Height ........ Number of Stones . J. ~ .. ~ 5 8. DlmkmsIons of entlre.~new..c, onstruction Front .............. Rear .... Depth ...... Height , I~lumber of Stones .................. . ....... ' ."' ....... ? ' 'b', .... 9. Size.of. lot Front .~/~...~ ............. Rear .~.'~..'~. ........... Dej>thl.f ..... [?.~:? ...... 10. Date of Purchase .~g~g~ ~e't~ 9.~ ...... Name of Fo~er Owner ...~Dff~.~ ........... 11. Zone or use dzstnct zn whzch premises are mtuated.. ~.7~ ........................................ 12. Does proposed constructmn wolate any zoning law, ordinance or regulation .. ~. ....................... 13. Will lot be regraded .... ~ ................... Wall e~ess Fill be re~ved from premises. . Yes ff 14. N~e of Owner of premises ~~~4.~ddress ~:e ~ ~ ....... Phone No ~.~. 27 ~ ~ ~ ~ .... ~'~ ~ e .... Nme of Architect . ~.~ ...... : ....... Address ............ ~/Phom.~ ............ N~e of Contractor ~< ~.~,~.... Address~ .~-. ~¢~e~o. ~ :. ~2 ~ 15.Is this property ~~n 300 feet of a tidal wetland~ *YES__ .... ~0 .... mIf yes, Southold Town Trustees Permit may be required.~~,~ PLOT DIAG~ Locate cle~ly ~d d~s~ctly ~1 buildings, whether ex~stmg or proposed, ~d. md~cate MI set-back d~ens~ons fi prope~y hnes. G~ve street ~d block number or descmphon according to deed, ~d show street n~es and ~d~cate whel interior or coruer lot. STATE OF NEWdgORK. ;4~.~- S S couNTy OF .... ..... ~~.f ~C~n~t;v~/~~ ......... being duly sworn, deposes and says that he is the apph¢ ( n~ ~ ~ ntract) above named (Contractor, agent, corporate officer, etc.) ~~d ~s duly authorized to perform or have perfo~ed the sa~d work and to m~e and file apphcatmn, that all statements contained m thru apphcatmn are true to the best of Ins knowledge and behef, and that work wdl be perfo~ed m the m~ner set forth m the apphcatmn filed therewith Sworn to before ........... , .,...- . .. Nota~ Pubhc .... _