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Home My WebLink About4410-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. I~3.6~. ...... Date .............Nov ....6 ..... , 19.69. THIS CERTIFIES that the building located at ...Ii/S. llrma~e. Ro~5 ......Street Map No...1,096 ..... Block No... aox ..... Lot No. l ..... 8outl~otd- .}I~I.o ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............Y.~.lr .... ~.., 19 .6.9.. pursuant to which Building Permit No..~..1..(~.... dated ..........aug ....'7"" 19~9" 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 . .l~l, iv*~e, s~',n~.~, pool.. {aeee ~sory) .............................. The certificate is issued to .. J. oseI.,h .Oa.tes .Jr. & .~'l.fe ..... 0w~e,s ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...... N.,It. ......................... ....... 1, ~l.i~.*<..o: .~-..~ .... .t/. ~..-.':[ ....... Building Inspector ~ House ~ 2070 FORM NO. ~ 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? 4410 Z Permission is hereby granted to: .......... A.~,...]B~e,,J:t,e~beet~ .... A,,/G.... ~T et ell~.. ,~ tel ,T~I' to ................... e~e~t..imd,..ailai~,~a~.&..aw~..f~aoZ.. (Ae~e~aezar...~} .............. at premises located at ..................... I~....a~'~l:~..R(:~,..&..Wd~......b.~ld&li'..~:g~k~, ............... pursuant to application dated ................................. ~11~ ....... ~ ......... , 1969.., and approved by the Building Inspector. m NO. 1 TOWN OF SOUTHOLD IUILDING DI=PA~,TMENT TOWN CLEI~KI OFFICE ~TH~, N. Y. Approved ............................. ~* .......... 19 ........ Permit No..,.~'~,.,,~l..(,,.~...*.,~'.-..., Diseppraved a/c ................................................... APPLICATION FOR IUILDING PIRMrT ................................................ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted ~in duplicate to the Building Inspector. - b. Plot'l~lajlt showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and gilding a detailed description of layout of praperty must be drawn on the diagram which is port of this application. 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 issue a Building Permit to the applicant. Such permit shall 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 o 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, housing code, and regula,t~ons. (Signal~Jre of applicant, or name, if a cot~fration) (Addre~/of appliEant) ~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~K~,,~.~...~~.(~.~ ...................................... If applicant is a corporate, ~ignature of duly authorized officer (Name and title of corporate officer) 1. Locat_Lqn of and on which I;~rcxx~sed work will be done. Map No.: ..... ..~..~)...~.~ ................... Lot No' J. . /ri - ~0 ~/)" /') C"-- -. ' ...................... ond Number .~..Z.~.O~...~)~ ........ ~t!(~,,r~.~../.~.,~ ............................................................. Street ~/07o ~'~'~'r, (~ ~ f Municipality 2 State existing use and occupancy of premises and Intended use and occupancy of proposed construction: a. Ex st ng Use and occupancy ...~....~'.~-!~ ........................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ................................ Fee .................. (to I~e paid on filing this"~'l~ii;;~i;~i'""~'''~' .... 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of c, ors ............................................................................................................................................. 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............................ Rear .................................. Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! I. Zone or use district in which premises are situated ................................................................................. ; ................... 12. Does proposed construction do. late an,y_i~ning law, ordinance o~,,,gulation? ............. ~..~) ................................ 13. Name of Owner of premises~.,~ .......... Address~./.~'~.R0..t~.~.-~mne Nome of Architect ...~ ............. ~=./q. ............................ ~ddress .j.~_...L..../:)...~.~ ................... Phone No ..................... Name of Contractor~/~...~~~ddress~7~.~'~.~.~.~.z.~one Nc~.~..;~.~.~.oO. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YOR~,, COUNTY OF ~[.~.../...'T~~'~' 4 / / + " above named. He is the ............ ~.~..~~~.~t~ ........ ~.~~ ..................... ~ (Cont~r: ~g~t, co~orate o"icer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~d file this application; that all statements contained in this application am tree to the best of his knowledge and belief; and that the work will be performed in the manner ~t fo~h in the applic~i~ fil~ therewith. Swam to before me this Nota~ Public, .~<~.Z~.~~' ........... Coun~ No. 52~67~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Bate September 2e, l~?~ App,icatio. No.o./ile 0~,l:~3:S N'"50~,~ THIS CE~IFIES THAT in the following location; ~Basenwgt ~ ~ FI. was examinedon September Zq, [] 2nd Fl. o~side Section Block and found to be in compliance with the requirements of this Board. OUTLETS ECEPTA ES S CHES INCANDescENT FLUORESCENT v~ DRYERS FURNACE MOTORS [ FUTURE APPLIANCE FEEDERS AMT. K.W. 0I. H.P. GAS H.P. A/~T. NO. A.W.G. RANGES SPECIAL REC'PT, i 20 TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET AMT. AAAp$. TRANS. NO. OF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT biO. OF S E R V I C A~T. AMp. TyPE ~. 1 ~' 2W , ~' 3W 3 ~f 3W 3 ~' 4W NO. OFpERCC.~.COND. OF A'CC.W'COND.O' FaO. OF HI-LEG oFA' Hi.~GW' G. NO. OF NEUTRALS OTHEr AI~US: (Swimming Pool) Thi~ cer~ificate covers compliance at the date o~ inspection only. Because of unusual environments it is advisb!e to have frequeng test and/or repairs made by a qualified person. 11776 Lic.llOl Phil Gordon 12 DeanSt. Port Jefferson Station,N.Y. OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the ~oard if incorrect. Inspectors may be identified by their credentials. C~;~PT POK DUILOIN~ DEPARTMENT. THIS COPY OF ~KIIrlCATI: MU~)( NUT DE ALTEKEU IN ANT MANNEK. Lehr Lol I GRANGE ROAD NOTE *' · =MONUMENT MAP OF SUBDIVISION FILED IN THE OFFICE OF THE CLE. J~J( OF SUFF. CO. ON ~UL~ 14, 1964~ MAP NO. 4096. SURVEY JOSEPH LOT NO. I OF "SOUTH HARBOR HOMES" SOUTHOLD TOWN OF SOUTHOLD SUFF. CO., SCALE ~ I"= 40' DEC r:;5,' ,1~64 FOR P. OATES 8~ KATHLEEN M. OATES PRO F E SS IOI~[L---~E NGIN ~ AND LAND SURVEYOR, N.Y.~'. LIC. NO. 12845 RIVERHE'AD, N~Y.