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Home My WebLink About17637-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Offzce of the Bu~tdlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17686 Date JANUARY 18~ 1989 THIS CERTIFIES that the build~n~ ADDITION Location of Propert~ 3580 STILLWATER AVE. House No. Street County Tax Map No. 1000 Section 137 Block 01 Subdivision Flled Map No. Hamlet Lot 14 Lot No. conforms substantially to the Application for Buzldzng Permit heretofore f~led in this offzce dated NOV. 22r 1988 pursuant to which Bulldlng Permit No. i7637Z dated NOV. 25, 1988 was issued, and conforms to all of the requzrements of the applicable provlszons of the law. The occupancy for which this certificate ~s issued is ADD TO EXISTING GARAGEf ATTACHED TO A ONE FAMILY DWELLING. The certificate is lssued to HENRY FOURNIER (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NrA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 ~ NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIU~IT Q'HIS PERMIT MUST BI:: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~17637 Z Permission is hereby granted to' .,~.,,.¢~ q~. J ~ .................. ~...a.~.. ~...... ~...~..~.~.~.,~.~.o~.~,~....~.....~.....~---- .......... ..... .................................................. at prem,ses located at ...~.~....~..(~ ....... ...~... ~.~ ....... ~~ .................................................................... Counh/ lox Map No lO00 Section 1..~'] . Blc~k ..... ..c~.J. ........ [~t No ...I.~ .... pursuant to application dated ...~,~.~~....~'2- ..... 19.~...~.., and approved by the Budding Inspector. Building Inspector Rev 6/30/80 TOWN OF SOUTROLD BUILDING DEPARTHENT TOWN RALL SOUTROLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION L/ .OLD OR PRE-EXISTING BUILDING.. .VACANT LAND.. ROUSE NO. STREET RAI~LET Owner or Ow. ers of Property..~JE.~l.~Cd....~.~.V44.~. ......................... couut, Ta~ ,ap Ro. 1000 section !.3.f.. B~oe~ 9.! .... Lot .~.~. ..... Subdivision ....................... Filed Map ........ Lot .......... Permit No. ~'.l.~.~.7.Date of Permit ~.O~.~..~./.~.{pplicaut I.~P.~.}.~. i~.~t~ .... Health Dept. Approval . J~.'..~' ........... Underwriters Approval. N.~..~: Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ . .~g~.~.~P.~ ........... APPLICANT .... ~ ...................... ~/~ rev. 10/14/$8 ~lELD II, S~iON~ FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) COM~£RTr INSULATION PER N. STATE ENERGY CODE FINAL ~DDITION~L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] IN,~ULATION [ ] FRAMING [~FINAL REMARKS: DATE for wster distributing ~ystem; piping sh~tt t~ &PPROYED AS NOTED DATE' ~ . V. ~. L, FEE ~ ~ BY NOTIFY BUILDING DEPARTMENT AT 76~ 1802 9 AM TO ~ PM FO~ THE FOLLOWING INSPECTIONS 1 FOUNDATION ~O REQUIRED FOR POU~ED CONCRETE 2 ROUGH -FRAMtNG &PLUMBtNG 3 INSU~TION 4 FINAL CONSTRUCTION MUST 8E COMPL~E FOR C.O, ALL CONS~U~ON SHA~ ME~ THE REQUlREME~ OF ~E N.~ ~A~ CONS~U~N & ~ERGY CODES. N~ ~8~IB~ ~R DESIGN OR ~~ ~R~S t 'FORM NO. 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL °.,OUTHOLD, N,Y 11971 TEL . 765-1B02 CALL MAIL BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... FORM ............. : Disapproved a/c ... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . INSTRUCTIONS a This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wit sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showmg location of lot and of bufldmgs on premises, relationship to adjommg premises or public str, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of ttus ap cation c. The work covered by ttus application may not be commenced before issuance of Braiding Permit d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcant Such shall be kept on the premises avatlable for mspecUon throughout the work e. No bmldmg shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupa, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding 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 construction of buddings, additions or alterations, or for removal or demolition, as hereto descnb The applicant agrees to comply w~th all applicable laws, ordinances, bu.,tiding code, housm~.i.ode, and regulations, and admit authorized inspectors on premises and in building for necessary in,~.~ ~_ (Signature offapphcant, or name, if a corporation) (Mallmg addres~of applicant) ' State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build .......... ..... ,. ........ Name of owner of premmes ~4~-'~ r' '/.. E° .'~."/ b ~. ~ ?. ...... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S M SI BE SUFFOLK CO~L[ITY LICENSED Builder's L,cense No. ,ti ~t?O'''~ f~' r~' Plumber's License No ........ Electrician's License No Other Trade's License No ........... Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section . (.3 7 ct ~.~J~ o ~, Hamlet · Block / . Lot . / Y. Subdivlsiou .. Filed Map No Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a E×isting use and occupancy '~C'x¥ Oc. 7 e-- ........... b. Intended use and occupancy (~"a ¥' ~ ~ ~.. ......... 1 3. Nature of work (check which applicable) New Budding . .. Addition .~".. . Alteration .. Roper .... Removal ....... Demolition Other Work .......... 4. Estimated Cost ~ t~ t~O ~ ~ Fee ....... " (to be paid on filing this application) 5. If dwelling, number of dwelhn ug,.~ts ......... Number of dwelling units on each floor ....... If garage, number of cars . ~ ................................ 6 If business, commercial or mixed occupancy, specify naturte and extent of each tyl~e of'use .... 7. Dlmenslonso~x~l~tlngstructures, lfany Front z" ]';~'~ . Rear [.'~ ..... Depth -[~t'iJ'. r.. Height ]d"~ .. Number of Stones . .~t .... . Dimensions ofsa~e structure with alterations or additions Front .,7 ~./ .... ''i 't{eJr' i . i7.~. ! '..'.. Depth . ~"-~ . . . Height . . ].~P-, . r ' . Numbe,r of Stones ..... - 8. Dimensions ofentlrte new construction Front.. ~..~ ... Rear./-/. ....... l~e/t{~ i .~. Height . ] ~z, .... Number of Stones .... t ........ 9 Slzeoflot Front ./O. ~ ... Rear ...t/9/) ...... Depth . '~$-Jvl.g. ........ 10 Date of Purchase ............ Name of Eormer Owr~ ............. 1 1 Zone or use district in which premises are situated ~ ~ I~ * ~ ~-- vt ~T'ct . . 12 Does proposed construction ~late any zoning law, ordinance or regulatmn ..................... 13 Will lot be regraded ./NJ'. .~ . ~.. ~ . · Will excess fill_be removed from premises: Yes 14. Name of Owner of premises ~-t'e~t~.,., 1~.~¥ .he.}/¥'ddress .C%.~7~,j~x.~t~ .... Phone No ~.~4/.~ ..... Name of Architect .., . .......... Address . O~.~Lt,_F'm/.~ A,~,L. ', Phone No .... ~.,. Name of Contractor ~c,.¥.q,.e~ .j[~.~l~co Address ~ Phone No. ¢~., ~. f .Z_~ 15. Is this property locate~ wzthzn 300 feet of a tid~I ~etl/and? ,Yes ..... ~ ..... ,if yes, Southold Town Trustees Permzt maybe required. PLOW DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dnnensions fr, property hues Give street and block number or description according to deed, and show street names and indicate whetl interior or corner lot. STATE OF NEW YORK,-- COUNTY OF.. (Name of individual signing contract) above named being duly sworn, deposes and says that he is the apphc. He is the ..................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file application; that all statements continued m this apphcatton are true to the best of his knowledge and belief, and that work w~ll be performed ~n the manner set forth m the application filed therewith Sworn to before me this ..... 05'..`2 ..... day of Notary Pubhc, .~.~-~. ~ . .~./_ ~7~4~. ~. ...... County HEL~ IL DE NOTRRY PUSL C, State ot ~ew Ye~k Term ~mtes Me,ch