HomeMy WebLinkAbout28764-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28909
Date: 10/02/02
'r~fS C~I(TIFIES that the building ADDITION
Location of Property: 1070 MINNEH3kFIA BLVD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 87 Block 2 Lot 8
Subdivision Filed Map No. __ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 19, 2002 pursuant to which
Building Permit No. 28764-Z dated SEPTEMBER 23, 2002
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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FPR.
The certificate is issued to FREDERICK P AUMAN JR & WF
(OWNER)
of the aforesaid building.
SUFFOLK COOl~l"f DEPART24EI~T OF t{E~J~TI{~_PPROV~J~
ELEt-rRICAL CERTIFICATE NO.
PLUMBERS C~TIFICATION D~r~3
Rev. 1/81
N/A
N/A
N/A
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28764 Z
Date SEPTEMBER 23, 2002
Permission is hereby granted to:
FREDERICK P JR & WF AUMAN
1070 MIWNEHAHA BLVD
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN "AS BUILT" DECK ADDITION AS APPLIED FOR
at premises located at 1070 MINNEHAHA BLVD SOUTHOLD
County Tax Map No. 473889 Section 087 Block 0002 Lot No. 008
pursuant to application dated SEPTEMBER 19, 2002 and approved by the
Building Inspector to expire on MARCH 23, 2004.
Fee $ 300.00
Rev. S/8/02
COPY
Ao
Co
2o
Fee Submitted: $ ..............
APPLICANT
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONlST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ] I~ULATION
[~/}/FINAL
[ ] FIREPLAC/E-&~HIMNEY
!FI~J.,D INSPECTION REPORT I DATE I COMMENTS'
FOUNDATION (1ST)
FOUNDATION
ROUGIt FRAMING &
PLUMBING
STATE ENERGY CODE
ldl~ ~0~_. !~, ~
A.DD1TIONAL COIVlM~ITS
t70i~H NO. I
TOWN OF SOtlTIIOLD
BUILDING DEPARTNENT
T01~ HALL . _
SOUTHOLD, N.Y. 1197 I
TEL: 765- lB02
L
,o ....
Appro~
Di ~pproved a/e .................................. ~
..............................
.... .......
, R~G i',F~T S
~..~,~ i:. ~, :~*~OLD INSTRUCTION '
3 SETS OFfaL&NS ....... .j;.'...? 4.
Cn~C'K~ .~..: .... :.;. ,.'7..,:.
SEP'rlC FO~ ....................
DEC ............. ~ . . ~
TRUSTEES ............
' NOT~FY: 734~7492
CALL .. FA~ ~P. ~ ~
~ZC TO :, ~ · ~....9O~.,Z~O~...
Da re .$ ep.%e ,mb~.. 17, .20.02.
· = '=' a. 'Ibis application nust be m~ietely'filled in'by tTpe~iter ov in ink'~d 'aulni£ted £o-ther tkfit'ding lnSl~Cto~ l~
3 ~eta of plans, act,,rate plot plan to scale. Fee according to ~l~lule.
b. Plot plan ilmuing location of lot and of buildings m premi~ea, relatleo~hip to ~joinin~ praises or ft~lic
streets or areas, and giving a de£ai!ed de~crip£ioo of la~ouC of property mint be drnm on the diagram ~dfich is par~ of
this application.
.... c. '11~ uork c~vered by [his application my not be comaenced before issuance of ~ilding Permit.
d. Dixx~ approval of thia applicetim, I:be l{uilding Inspector ~dll iesue a auildins Permit to the app]icaht· Such
pemit 8hall be k~pt on r~e i~'emisea available ~or inspection throu~hour r_be ~ork.
e. No building shall be occupied or used in vi~ole o~ in part for any pm-pose ~hatever u~til a Certificate of
Occupancy shall have been granted by I~e Building Inspector.
AI~L][C.~Ti(t{ IS ~ tlA~ to the {{uildin8 Depa~l~ent ~or r~e iss~auce o[ a Building PemJ£ pursuant to the
I{uilding Z~e Ordinance o~ r~e To~n o~ Souchold, Suffolk Ck~n~y, Hey Yurk, and o~ber applicable l~a, Ordinates or
Regulations, for r~e co~truction of buildings, ~ditien]{ or alterations, or ~or ~,~val or de~{ition, a~ he.rein
described. The applicant a&qreea to c~ply uir~ all applicable l~a, on~inances, building code, housing co4e~-
regulaticos, and to ~,n!t authorized inspectors on premises and in Imilding for necessary ina~ections.
(signature of applicant, or frame, if
P.O. Box 1033 ~',,~' ~ '
· Ouq:eNogm~,' · 'NY.-" -t [<3 S5 ....... , ? "." ~ ~ ~': ~' --
(Maihng uO~__ress of applicant)
State tt~ther applicant ts ~mer, le~e, agent, architect, engineer, general eontrector, electrician, pl~..or build,
ENGINEER
REv. FRED AUMAN -
Name of o~er of premises ...........................................
(.s on rt~ ~.x roll or latest deed).
If applicant is a corporation, signature of duly authorized officer.
(l~m~ and title of corporate officer)
Builders License No ..........................
Ph~bera Licenae Ho ..........................
Electrieiarm License NO ......................
Other TruA~'s License No .... ~ ................
I. location of la,~! co ,ahich proposed ~ork ~ill be duoe ..............................................................
1070 Minnehaha Blvd· Sout. hold
Ii,use 1~ ~er Street N~let
' County T~x mp ~o'. 1000' 'Se~i~i'
Subdivision ...,,,...,,.~.,: ..... ~.,.~.,~ ........ Filed Map.NO ................ l~t ...............
2. State existing use and occupaoc7 of premise~ and intended use ~ occulmoc7 of p~olj!o~ coaatructioq{ ? :
Two s~ory One family residenoe
a. Existing.use and occupancy ................................................ .
b. Intended use and occupanc7
'P.~cure o[ ~od~ (cimc. k ~hich applicable): ~.l~uilding .......... t~diCio~ .......... MCeratio~ · .........
I~pair ............. ll~,o~al., ............ Dea~liticm .... '].'~'~'~ ~'.. 0[i'~dr I~ork ~9.Q0.(Beacriptioa).P.~g.}~ .....................
Estimated Cost ......................... (to be paid on filing Chin application)
If &~lling, nmimv of ~tli~ ~mlts ............ t~r o~ &~lltng traits ~ ea~s ~r ................
I~ garage, ~l~r of ~ra ............ · .........................
If I~i~ss, ~rcial or mi~ ~a~, s~ci~ ~cura a~ ~tenC qE ea~ ~ of u~ ...............~ .......
. ~ · ~ ~ 40~
Di~nsi~s of ~lating atom--s, if ~: ~c ~ ...... ~ar ..~.~ ........... ~ptl .................
I~i~t .......... 24.' ........... ~ of 8tori~a ...... T~o ............
Di~nsi~ of ~m at~e ~th alteration ov ~tci~s: ~nC~ . .............. ~ar ...............
, ~r o[ S~ories ..-.- ............
~pch .................... l~i~C ..................
Di~asi~ o[ entire ~ ~at~ci~: ~t .~ ...... ; .... ~ar ............... ~pth .. .:~6.' ....
I~i~t · ~2" ~r o[ Storiea ................ : ....
· - Si~ o[ loc: ~t~ ..~, ................... ~ar ..7~..~3 .............. ~pch ~,~.'-9~'~'~8~'39'
~e o~ ~r~m~ .................... ~-of Four ~r · ·
R-40' · ....................
~. ~s ~o~ ~t~ti~ violate a~ ~lng 1~, o~i~ or re,latin: .......................
{. 9ill loc ~ ~ ..... N'Q ............ ~ill ~ss Jill ~
~ of ~E.~ra~'~''~am~ch'sr ...... ~ress RO..B~-.A~3 .............. H~ m. ]3A=24;gz
Cutchogue NY 11935 .H~ ~ .............
- m~ress ...............................
~ o[ ~tr~tor ............................... X
5.Is fids p,oimr~ wifldn ~ [~t o[ a ti&l ~tl~] * W~ ........ ~ ..........
PLOT DI ~GRAH
l~ate clearly ~ disti~tly MT ~ildi~s, ~mUmr ~isting or ~ro~,
~ue pr~r~ li~s. gi~ st~t ~ bl~ ~imr or ~scripti~ acco~ing to ~, a~ ~ strut ms mi i~tcate
~mtlmr interior or ~r lot. ~
X/
..... ~ia, F~¢rt. ~ ,..$Rr~.~.~b..$~, ...................... bein§ duly ~x~n;, deposa~ aM ~ys flint he is tie a~l. iant
(~ of i~lvid~t signing ~tract)
PROFESSIONAL ENGI~EE~ ...................
I~ ~'u the ....................... ~, ..................................
(~,tractor, ~t, cor~rate o[[icer, etc.)
o[ ~id ~mr or ~rs, a~l is.&~ty ~thori~' to ~rfom or h~ ~rfo~'tbe ~id ~ m~ to rake a~ fJ[~' this
a~l. icatlaq flint all statmnts ~tai~ in fl~ia a~lieati~ are rna to fl,e Imago[ his ~l~ m~ ~[ia[i a~
that ~e ~rk ~il[ be ~r[on~l in the mmmr ~t '~orth in fl*e a~lleati~ ~IM tlm~fll.
.%om. to before m this
...... $ e.~ .b,~atal.b ~xlay of
.' fT ....... joy=
(Slgn~mre ~ff ^ppticant) ;?