HomeMy WebLinkAbout17711-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217970 Date APRIL 25, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 490 OLD SADDLE RD. CUTCHOGUE
House No. Street Hamlet
County Tax Map No 1000 Section 095 Block 04 Lot 18.9
Subdivision OREGON VIEW EST. Filed Map No. 6241 Lot No. 9
conforms substanta.ally to the Application for Building Permit heretofore
filed in this office dated DEC. 19, 1988 pursuant to which
Building Permit,No. 177112 dated DEC. 21, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to PETER & SUDITH VICTORIA
~ (owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
[~
Building Inspector
Rev. 1/81
f'OH11t NO. f
rowN 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~ +v17~i 11 Z Dnte ....~~-~^.~.....a.~........., i9.~..~
Permission is hereby granted to•
.....................................................................
to ..~1.~'lr..Se~.:!:4.{J.!.. f?1....GSA.S.IF....Q.-.A;£4A-!!c-nr\.... rk...G~~!!.l...r~'.~...,r.~.......Q.'.'~-.....
~ ,
ct premises located at ......C..J..4r•••••• ......~.. .P..-r:~G..~..........~c:':1a~CX~4?~~+.-.. ..
County Tox ctio
Map No 1000 Se
k
n .. ~? ~ S .. Bloc . ..~.~ ........
Lot No ~.~.!. 1.... .
pursuant to ~
~
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q
nppl~cntion dated ...} .,?.1,2..CA<!^'\"`-~-1.... f. ! ...., o
19 ~ A, , and opproved by the
Building Inspector.
Fee $...~d.'~..:....
!l. y ....................
V w wilding Inspector
Rev 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FDR CERTIFICATE OF OCCUPANCY
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DATE. ~~ ~~~_...._...
NEW CONSTRUCTION ,,!_....OLD OR PRE-EBISTING BUILDING......VACANT LAND........
Location of Property.,...`.9d...~/~..t]:~.D~~.._ L/~_____._,.~U~~~UL
----------------
HOUSE NO. STREET HAMLE
Owner or Owners of Property. ~7-C'F.'~'~~17.1~1__~+.C~Y~t,,,,,,,,,,,,,,„___,.,___
cc~~ i / ~
County Taa Map No. 17000 Section .~J.~.. Block ~~... Lot ~~. J....
Subdivision~.`'.`~dL`~ .~~.~~'U.. ~/~`~... Filed Map ........Lot..J~.......
) Ir J `~~ 1 ~
Permit No. J.~~l./....-ate of Permit JJ`S'.}a1.....Applicant ~r..~l~~~l:`:.....
Health Dept. Approval .................. Underwriters Approval......_.......
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ................
Fee Submitted: $ ....................
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APPLICANT. ~" ::'...(d''~".' "'""
rev. 10/14/88
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FOUNDATIOtd (2nd) m~
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21dSULATION PER N. Y. y
STATE ENERGY
CODE
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ass-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATI)O~N~ ~
[ ]FRAMING [ INAL ``~--
REMARKS:
DATE ~ I ~Y"/ f / INSPECTOR ~~1 ~~J
~ ..''
~'~{ 11t i FORMN0.1
"~C ~ ~ ~~ ~ {~ TOWN OF SOUTHOLD
!~~~~~ ~' BUILDING DEPARTMENT
B(.DG ucpi TOWN HALL
TQi~:~ CF SCUTHOLD SOUTHOLD, N Y 11971
~~~ ~- TEL.. 765-1802
ApProved~.~0. ear"^`"4~, . ~..., ] 9'~~. Permit No ~ .~: ~ ~l2~. .
BOARD OF HEALTH .........
3 SETS OF PLANS .........
SURVEY ..................
CHECK ...................
SEPTIC FORDf .............
NOTIFY
CALL ...............
MAIL~~ (/~O
~vtd~-v .
Disapproved a/c ............... .... .............. 6• fl~
................. ............. .... ... ...
..i,r~.ftt.n'4. ... .........
(Budding Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date . ~FG .. ~.g ......., I`
a Tlus application must be completely filled in by typewnter or in ink and submitted to the Building Inspector, w
sets of plans, accurate plot plan to scale Fee according to schedule.
b. Plot plan shown; location of !ot and of buildings on premises, relationship to adloming premises or public s.
or areas, and giving a detailed descnption of ]ayout of property must be drawn on the diagram which is part of this •
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 p•
shall be kept on the gremises available for inspection throughout the work.
e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occup
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant t~
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Orduianc
Regulations, for the construction of buildings, additions or alterations, or for removal or demohtron, as herein descn
Tlie applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, an
admit authonzed inspectors on premises and m bmldmg For necessary i ~~ions. - /~
... .............................
(Signature of applicant, or name, if a corporation)
• (Mailing address of apglicant) / i4
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull
. ~Gt1/Jt~= . ............ .................................. ..............................
...
....................... ..................................
Name of owner of premises .~!'~ `~ a ~•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)
Builder's License No...<~',4F ................ .
Plumber's License No. .~yl :................. .
Electrician's License No ,~rCF .... ......
Other Trade's License No tS.~.1-.. • • '-I yC
1. Location of land on winch proposed work wdl be done. G1GD.. , S~?,II~e 1
.:~9~ ............................................ ~~7~~ ~,~
......................
House Number Street Ham et
,
~ ,
County Tai l~fnap No 100/0 Section ...~q,~ ....... Block ..Q . ............ Lot .. C ~. l........
Subdivision .tli~~S+7?~ . tl ~,~~':. ~~"'~- ~~s........ • .. Flied Map No Lot .... 9..... .
(I ............
(Name)
2. State existing use and occupancy of premises and intended usr, and occupancy of proposed construction:
a. Exisun~ use and occupanc ,I , ,f,'7.a~.1j!L , , I~WC~/~N
e .. .. .. ... .. ....... ........... ......
b Intended use and occunancy ... ~C,c~. • • • • •~~• • • • ~~' l~A/
3. Nature of work (check which applicable) Netiv Bwldmg .....•..... Addition ../~. • • • • • • Alteration ...... .
Repart .............. Removal .... ......... Demolition .............. Othc#.
cscnpnon.
4. Estrmatt:d Cost .....2. t~~ ... ..................... Fee .................................. .
(to be paid on Cilmg this application)
5. If dwcllin„ number of dwelling units ............... Number of dwelling units on each floor ............. .
If garage.numbcrofcars .....................................................................
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 ............ .
Height ...............NumberofStoncs.................. .......... ................
Dunensions of same structure with alterations or additions Front ................. Rear ...............
Depth ...................... Height ....... .....Number of Stones ................... .
........
8. Dimensions of Entire new constriction. Front .. ~..~o~. , :: Rear .1~.y :::::::::: Depth ::,1Z ...... .
Hcig}rt ? ........... Number of Stones ..... '...... ..........
9. Stzeoftot.Front ...................... Rear... .................. Depth .. ........
10. Date of Purchase ............. ...............Name of Former Owner ..... ......... , , ....... .
11. Zone or use district in which premises are situated ..................................... ............ .
12. Does proposed construction violate any zoning law, ordinance or regulation• ..... ....................... .
......
14. Namle of Owner of premises ~ ~ ~ ' ' ' ' ' ' ' ' • • • will excess fill be removed from premises Yes 2
............Address ...................Phone No. ........... .
Name of Architect ...... ..... ....... ..... Address .. .............. Phone No.... ........ .
Name of Contractor ......~ .................... Address .................. Phone No ............ .
]S.Is this property located within $00 feet of a tidal wetland? *YES....NO./~.-
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether extshng or proposed, and mdtcate all set-back dunenstons fry
property lines. Give street and block number or descnption according to deed, and show street names and indicate when:
intenor or corner lot
STATE OF;\ElV YORE, S.S
COUNTY OF ....... ...... .
.. .. .... .. .......... . ~ .. .. being duly sworn, deposes and says that he is the apphca
(Name of individual signing contract)
above named
He is the ...................:..................~.............. ..................................
(Contractor, agenf, corporate officer, etc )
of said owner or owners, and is duly authorized to perform onhavc performed [he said wort. and to make and file t:
apphcauon, that alt statements contained m Uiis application arc true to the best of his knowledge and belief, and that t
work wdl be performed m die manner set forth m the applicaUOn flied therewith
Sworn to before me this
.......... .. ~.~. ... day of ..... /J(~.~~ ......., 19 ~r~
\otary Public, .. ~~... f .:. ~~: v~ .... County ~.
~~~ /~~, Qi
HDTARY PUBE`N K. DE YOE .. ..... U. +":..... ........... .
NEL IC, StateoiNewYark tau„ (Signature of apphca
No. 47D78Y9, SuHotk CouMY~
Term Exfures Maich 3fl,18-~
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PETER /. V/CTOR/A B /UD/TH A. V/CTOR/A
LOT NO 9 , ~ OREGON V/EW ESTATES ~~
AT CUTCHOGUE DATE JULY 6, /9B8
TOWN OF SOUTHOLO SCALE /" =50'
SUFFOLK COUNTY, NEW YORK No. BB-0808
N NEYIfIT WATEII FAIN _MI ~ NSOUII<E OF WATEfl~ TIMTE _/UILIC_
N STIFF 00. TAE YAN qST 1000 SECTION O91 YOCN 21_ lOT //.9
Mnlelx AI1E M OWELLIIYL WITXIM 100 FEET OF TY! INOFENTT
OTHE11 TNAN TXOSE IXOWM HFSEOX.
X TXE W.LTEN EUFRY.ND SEYNYE OIEFd AL SYITFJI Fd1 TXb111[IIOEM[F ,I OI ltANtE3 SMOWM H[I1EOM FNON MnENTY LIMES
WILL CpIFOflY MTN[lTAMDMOL OF TMf SUROLM COUNTY OENANTMLMT TO ESVITMO STNUCNNES MC FOfl 1SNEUFIC
OF HE~LiN 1fINICff, FUfl NOSE AXp LFE NOT TO FE USEO TO ESTILLIIX
AHLItAMT N110FEIITT LIMES Ofl FO11 THE E11E[TIOM Of fEMtfE
TEL.
NU/L' ~ = MVIYUMC/Y/
SUBD/V/S/ON MAP F/LEO /N THE OFF/CE OF THE CLERK OF
SY/FFOLK CIX/NTY ON APR. 4,/975 AS FILE N0. 524/
1 TIE LOGTIJI IY wF1L(wl, IENTIC TANS(ErIN teIYOOLS(n) WGYN NENEOM
NE FlIOY FI[lD MLERYTIgI] INO OII DATA OLTYM[0 FIIpI OTMENf
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= ~fi;. <~ $~589af ~;
Yyr. NON.
f iuvN nY~'IT` .
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YOUNG a YOUNG R~RNEA~D"NEW YORKE
ALDEN W. YOUNG, PROFESS IONAI ENGINEER
AND LAND SURVEYOR N YS UCENSE NO 12845
HOWARD W. YOUNG, LANG SURVEYOR
N.Y: LICENSE N0,45593
f,N015 L SONS. INL 1618