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Home My WebLink About3056-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . ~/S. R.e. 8.e.~..el..r. ~(.qa..d..(.P.V. TS]treet Map No.. F~..~'~i~ht Block No ........... Lot No..X..X~....F.i.~..h.e.~.~. ~.s.l.a.~.4...N..,.Y.:.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............Apt. il...].2 19.66. pursuant to which Building Permit No..305.6.Z.. dated ........ April. ·. 1 .~.. ·., 19.6t~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . p?.!¥.a.t~. 9.n.c..fa..m~.l.y...d.w.e.~.l.i.ng ....................................... The certificate is issued to .Iie~eth of the a~oresaid building. Suffolk County Department of Health Approval Owl~er (owner, lessee or tenant) NDERWRITERS CERTIFICATE No. N. 4681~6 ...... June..28.. ,197.~ ............. HOUSE NUMBER .'.. ~.o,1~ ...... Street .......................................... Building Inspector FOR~/[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3056 z Date ............................... .~.~11.....]L~. ....... , ] 9...66 Permission is hereby granted to: .... ~e~ne'~h...A.o....De'~Vee~ ............................. ..:W~dkm~ ge~..x.~ ..................................... to ..t o...~ ele~ a.~e... (, same .. ~v emiee $-) .. eh.: e:~.~.e %,t.n~.. b-~.td.i.~ ..a~d...m~ ................. al~m~ a~;:~nrl~t. · a,v~d...ad¢~ J~;ion...a,~..z;~e e~ s ~a~?.y. ......................................................................... ct premises located at .~/~.,-..]~GSG~'.~O.J,~.-.-.~e4~ ............................................................ L ................ ................................... z~J. ehe~-.s...lsZand~ ........ i~.~Z~ ............................................................ : ............. ............................................ : ............................... ~ ............................. ~ ............ ~'~"t ................... : ................ pursuant to epplication dated ~ ................................. AP2'~,i....1;~ .... 19.~6.:, and approved by the Building Inspector Fee $..~. QO..~}~;... I~YI~f NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..................... Approved ........................................ , !9 ........ Permit No ................................ Disapproved a/c ...........~'i ............. ...................... ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT D~t~ April 12, 1966 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 layout of propertymust be drawn on the diagram which is part of this application. ¢. 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 issue a Building Permit to the applicant. Such permit shah be kept on the premises available for inspection throughout the progress of 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 Building 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, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ...~i ~.~ fllq. ,.~.. [J.~?~ ~ ~. ,...~ .9.~D., ............................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ownel~ Name of owner of premises ...~..~.9..~..~..e.~.~..A.,..~..~.t~.¢~..~.o.~. .................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Mop No: Liber 5661 Lot No: P~Ge Municipality State existing use and occupancy'of premises and intended use and occupancy of proposed construction: -' ' '- .......... Storaf,~e Unoocu'ozed Naiure of work (check which applicable): New Building .................. Addition .................. Alteration .......... ~ ....... 3. Rep~3w ................... Removal ...~. ............... Demolition .................... Other Work (Describe) ........................ , .............. ' (to be paid on filing this application) ' 5. If welling, number of dwelling units ............................ Number of dwelling units on each floor ..... ]. ....... .............. If arage, number of cars .......................................................................................................................................... 6. If ~usiness, commercial or mixed occupancy, specify nature and extent of each type of use .................. , ............. 7. Dir ensions of existing structures, if any: Front Hei ht Dirt msions of' same structure with alterations or additions'. Front r q ~ ',~ Del: th 26 ' Height ...]:..-5..~. ...................... Number of Stories ]' 8. Dirrensions of entire new construction: Front . ..~-~... .................... Rear ~' ..................... Depth .~ ....... i ............. Height :L,5 ' Number of Stories Z Owner ii. Zo~el or use district in which premises ore situated....~.,o.I;t).~,, ................................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ..~,~ ................................. ] .............. 13. Nar~e of Owner of premises ~e~et, t'z ~o ]?et, ez~lf~r,,, Nar ~e of Architect ...................................................... Address ............................................ Phone No ..................... ~ PLOT DIAGRAM / Looat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensi.ons from property lihes. Give street and block numbers or description according to deed, and show street names and] indicate whether in~rerior or corner lot. / STATE OF COUNTY '/ ¢. ._ ,., ?~/~-~i~..;,.,, ,r.:~.,,,,,, Z~',, ,¢-~ ............... being duly ame of individual signing application) sworn, deposes and says that he is the gpplicont above narr ed. He is the . .~r?~,.-r~. ,~.~?~-~:~.,~.~ .................. ' .... (Contractor, agent, corporate officer, etc.) of said owper or owners, and is duly authorized to perform or have performed the said work and to rnake 'and file th s cpp icbtion; that all statements contained in this application are true to the best of his knowledge an;d belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn~to~1~. ere me this ,-~> / /7 19.~...~. /~ .,~/"" ' ......... ...... j ......... day of ...... ~,, ................... ~. . "~'-..~'~ ...4~ ~ ~"-~"~ Notary Pu,! '~,~,~.¢~,,~,,~,.,~' ~ ...... .~..~County"'"~'c'"~~~ .......... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY [~ um 88 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT Kenneth A. Peterson Reservoir Road Flsber~ Island, SouthOldRL.I. in the following location; [] Basement [] 1st FI, w.~exa~.i.~ao. June 25, 1974 [] 2nd Fl. Section Block Lot and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 9 8 DRYERS TIME CLOCKS OTHER APPARATUS: R V I C k. W, G. NO. OF NEUTRALS A.W.G. A.R. Grebe Grebe Electric Fishers Island, N.Y. !o63~n COPY FOR BUILDING DEPARTMEHT, THIS COPY OF CERTiFiCATE MUST HOT nE ALTERED IF/ ANY MAHHER.