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Home My WebLink About17436-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18013 Date MAY 10, 1989 THIS CERTIFIES that the building Location of Property 1260 BAY AVENUE House No. County Tax Map No. 1000 Section i43 Subdivision ALTERATION MATTITUCK~ MEW YORK Street Hamlet Block 3 Lot 20 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 13~ 1988 pursuant to which Building Permit No. 17436-Z dated SEPTEMBER 16r 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 ALTERATION TO EXISTING COTTAGE AS APPLIED FOR The certificate is issued to GERTRUDE KOOP (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALE APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 017436 Z at promises located at ./....'~.....~....~.......~--.-..'~ ......~.. .................................................................. Count,/ Tox Map No. 1000 Section ................. ./..~..'~ Block ..... ~ ...........Lot No. ........................ pursuant to application dated ....... ~,.//,.,~ .................................. , 19.1~..~, and approved by the Building Inspector. Rev. 6/30/80 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPAN~ TOWN OF '~OUT(~OLD ~ NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING,..~..VACANT LAND ........ Location of Property ...... ' ............ ~ ~ f'7~ HOUSE NO. STREET HAMLET Owner or Owners of Property .~. ~'-~-~ ~ ~ ~ f? f. County Tax Map No. lO00 Section ...... Block ....... Lot' . ........ Subdivision ....................... Filed Map ........ Lot .......... t L.~Date of Permit ................ ~ Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate .~.. .... Final Certificate Fee Submitted: $ ........ fey. 10/14/88 Co£ ?'iELD ~,,S,~lO~ IIDATE II COM~4g~?s FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: OCCUPANCY OR USE IS UNUWFUL WffHOUT CERTIFICATE OF OCCUPANCY ~ ¥o~ LI TEL.: 765-1B02 Examined '~'~'/"~ , 19Oc~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ................ SEPTIC FORM ......... CALL . . ~. .......... M~TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 ,'sets of plans, accurate plot plan to scale. Fee according 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 I/~yout of properW 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 shal/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 Btdlding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, a.,d, ditions 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 itt~l~d{o~ dh: prdhhs~s and in building for necessar~spections. . ,. '~' ~ ' ""~(~nature of applicant, or name, ~41 a corporanon) ~,-~.,', ~ ~, ", · ~, (Mailing address of applicant) State whether appl~j~C~(O~ut~0r~des~;ee,,,~gent, architect, engineer, general contractor, electrician, plumber or builder. ......... .'";.-F.' :.T :N- ....... ~'I~')f;~'¢~ Ji ,;-L V ......................................................... Name of owner of pr~q~s8~)~ ~q~l~&~.~'~./~'W.O. ~..' .~.--.zx Q.O.p. ...................... '. ..................... ~ ~,1~ ~9,~?~H~,,(tO Ji.< ' (as o~t't~e tax roll or latest deed) If ap pli c a r~~IV~;_~¢!~/,a u thorized of ricer. ........ ~~~ ~?~'~?- % ......... Builder s L'cense No..I.~.'r .5.O.c~.-. Il I .... . .~.~.~ :J~O'FL Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............ ' .............. House Number Street Hamlet Co,n,y Tax No. lO00 Sectiou .... ...... ' Binck .... ........... ............ Subdivision Filed Map No Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 0~, (d J~r) .]'.~ .~-~ .~. ,~/Y?, .~ 4 b. Intended use and occupancy 3. Nature of work (check ~vhich alpplicable): New Building .... Addition ... :'... Repair Removal ............................ Demolition .............. 4. Estimate'd Cost ,, .... Fee ............ (to be paid 5. '.. If dwelling, number of dwellin~ units ..... 4 ...... Number of dwelling units on each floor...l .... ' ........ If garage, number of cars .... , ...................................................... 6. n e if t re nd xt feacht~pqfi . 7. ,'.~ ' ,t ' '' ' ' ' : ' / .......... -~ J~ .... Depth..al.~ . . nei=nt ..gl ............ Nu,~nberofStohes. /. ....................... '.~ ~ ~ Dimensio~sofsamestmcturewithalterationsora~,,: .... ~_, '' ]~ I ..... ~'' ' ~1'~ ti' ' ' Depth ~ ~ .... Ite,,ht l/ t ,, ~ ........... ....... ~ · · .- .................. ~ulnber of Storms,..~ .............. 8. Dimensions of entire new construction: Front ............... Rear ..... ; ......... Depth ............... ~.m=ht ........... },...~. Number of Stones Size of lot. Front //.~..~.~ . Re~. ~ ~, ~ t ..... ~0.~ ~ I " Date~CPu~h~ ~ I~'"ihh~ ............ ~"~ ........ ~pta ;~.{~.,../. ......... ..... {' .... , ~. t ........... Name of Fo~er Owner .~K~gO.~..~. Koo~ ~one or use restrict m wmcn premises are situated . K ~ I ~.~.~T~A "~ ....... r' · · ~oes proposed Construction gi~ate any zonino ~,,, ~-~, ...... ' '.' '~)h ............................ wm ~ot ~e regraaed . ~Z~ ,,,., ' ...... . .............. ~::~;~;;:~ ' .' /~*'~ ................. wnlexcessfillberemovedfromprem,ses: Yes No ..... ~ ............. Address ................... Phone No ................ N~e of Contractor ........ ; .................. Address ....... : ........... Phone No ............ '. '.. 15.Is this property located within 300 feet of a t~dal wetland? ~YES .... NO.~2. ~If yes, Southold Tow~ Trustees Permit may be required. ~ PLOT DIAG~ Locate cle~ly ~d dist~ctly ~ bulldogs, whether ex~sting or proposed, ~d, indicate ~1 set-back d~ensions from prope~y Dnes. Give street ~d block number or description accord~g to deed, ~d show street names and indicate whether interior or corner lot.. 10. I1. '12. 13. 14. AI PROV£D A9 NOTED -- 'FPP' ~ ~/~?~' N~)~IF¥ ~UILdlNG O~PA~N~ AT 765-1802 9 AM ~ 4~POR ~E FOLLOWING I. FOUNDAT~N - ~UIRED FOR ~URED 2. ROUGH - ~AMING 3. IN8U~ 4. FINAL ~N~U~N M~ 8E ~ ~ C.O. STATE OF NE~V YORK, COUNTY OF ....... ,'S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ................. , SHe is the ~ ~. ~.. ......... , ' al 'tl;fr ;; ;'t i ........................... ontractor, ent, o ra c , . of said owner or owners, and is duly authorized to perform or have performed the said work and to make hnd file this application: that all statements contpined in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannelr set forth ill the application filed therewith. Sworn to before me this ............ ' ......... day o ................ I . Not,ary Public ...... .~ ..... County HELEN/( DEVOE NOTARY PUBLIC, ~'~ of New Ymt ~ No. 4707878, Suffo k Counll~ Term Expires M~rc:q 30, (Sionatu~ of applicant)