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Home My WebLink About4714-zFOItM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ~ AV~ ................. Street Map No.. ~ ........ Block No... ~l~ ..... Lot No~... MI[~;~I~I~ ~ .]le][.e ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Apl'.~. · ~., 1970. pursuant to which Building Permit No..~.~.~. dated ........ ~]~l'~ ' '~" ', 19~][., was issued, and conforms to all of the require- ments of the applicable provisigns of the law. The occupancy for which this certificate is issued is ... :~e' ~l~e' ~1~ '~'YI~ .................................... The certificate is issUed to . ]1~..]Bl~l~$e~ ..... ~ ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~. ~-- q~-..b~.l[,..~.~. - · Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~..~..8.~.~. .... Date ............. .J..1~ ......~7..., 19. ~.0 THIS CERTIFIES that the building located at .... fl.e&..n4. A.~.. ............. Street Map No..~ ........ Block No..~.. ....... Lot No.. ~....~.~.t~k...~,~., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... .~.Pr..~!....27.., 19.7.0. pursuant to which Building Permit No. dated ............ ~.p.l'.~.!.. 2~, 19.70., 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 .Pl'~vate..one. ~am~l~..dwelling ....................................... The certificate is issued to ...~[~[[~[..~,O~...l~,l~.~h ...... ~ ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... .P.E.~D.I.~.~. ....................... TOWN OF SOuTHOLD BUILDING. DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ...~ ....................................... J--'--' (Budding In~_pector) Application No ............................ ~(,..7.../..~... ~' APPLICATION FOR BUILDING PERMIT 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, end giving a detailed description of layout of property 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 Laos, Ordirmnces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations. (Signature o applicant, or n~me, if (3 corporation) ............. ................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... .~../(-/~LDA$ -'~1~ I.J--~ I ~ /'1' If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of lal:il;L, on which proposed work will b~ done. Map No.: ............. .~. ........................ Lot No.: ...~ .................... Street and Nun~ber//~'/ ./.....~...~....-~...... .?....~.....~...~1..../~....~... ,~ ..~'...~... .~..~' ~/'/'//c-_/..~ .................. ~;i/~i~'l'i~' ................. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... .~J..~.....~'.. ~ ~ ........................................................ b. Intended use ond occupancy 0/~/~ .~.~...~..../~.../.../.r...~.. ~., ..i~...~":...~:~... /A./~ property lines. Give street and block whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair, .................. Removal .................. Demolition ............... ~Ot~_g Work (Describe) ........................................ Est mated Cost ' ~' ~- ~) 00 , "~ ~ 4 ......................... .~ ................................ ~ee ....... ~,. ................................................................. (to be paid on filing this application) 5. If dwe ng, number of dwelling units ..~..jv~Ic- ~umLer of dwellin units on e ' If garage, number of cars ~. ~ ~ ~ . ' ...... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ...... ~ ..................... Rear ................................ Depth .................... Height ........................ Number of Stories ....................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height .................. ~ ......... Numb.er of Stories ............ '"'" .............. 8. Dimensionsi/al erltire, new construction: Front ...........~.~....~'~/.-"-- ............. Rear ~'..,~,. ......... Depth ...... "~..: ./~....° .......... Height ....../....~. ........ Number of Stories. ...................... .......~../..r....~. ................. :.., .. 9. Size of lot: Front .......... ../....~..?. ........ Rear .......... ~....~...~...~. ............ Depth ........... .?...~.'.'.:~.ii'./. ............................................ 10. Dote of Purchase ............................................... Name oft Farrier Owner . . 11. Zone or use district n wh ch premises are situated .....................~ ........ ..~....~...~.../.....~......~....'~../....~....L,.. .......................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ................. ~.: ......................... 13. Name of _,, ~ ~ .......................................... Address ............................................................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name Of Contractor ~'..~..~'/J'J'Y ~.. ~'OA/~'Address ..~...~. -J7-/7-//.~....~ /J/,~', ,.~&~"_ ~'~c~,.~. ........................................................................................... Phone~lc~ ..................... PLOT DIAGRAM Locate clearly ond distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from number or description according to deed, and show street names and indicate ' 56, Ida' STATE OF NE-V~O~J~, COUNTY Of ~ ........... I ' ..................... · '~"'~.~"~--.~...~....~.. ....... .-~...4~-/....L~...~.- ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .......................................... ~///J" D-/'- ...~... ............................................... ............................. ,.. '(Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ...... .......... '- ....... . ........ ...................... r~orary ~UDllC~/.~,~,~.//./~,.,~v:; ......... .'~;ounty (Signature of applicoj~t) ........ No. 52-8125850, Suff01k C~( Term Expires March 30, 1 S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~//.~ Bldg. PermTt No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give deed loca~on) have been inspected by this department and faund to be satisfactory. Dis-trici Engineer Dfstrict Engineer BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 4p FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by W. BARKER P.O.BOX 728 MATTITUCK, NY 11952 WILLIAM BARKER 1705 GRAND AVENUE MATTITUCK, NY 11952 Located at 1705 GRAND AVENUE MATTITUCK, NY 11952 Application Number: 2062624 Section: Block: Lot: Described as a Residential 0-599 square R. electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen addition, Outside, Certificate Number: 2062624 Building Permit: BDC: ns11 occupancy, wherein the premises electrical system consisting of A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the Sth Day of January, 2006. Name QTY Rate Appliances and Accessories Cooking Deck 1 0 Oven 2 0 Wiring and Devices Outlet 14 0 Fixture 14 0 Outlet 15 0 Receptacle 12 0 Switch 8 0 Receptacle 2 0 Rating Circuit Type 30 Amps 5.4 KW Fixture Incandescent General Purpose General Purpose General Purpose GFCI ~ seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by W. BARKER P.O.BOX 728 MATTITUCK, NY 11952 WILLIAM BARKER 1705 GRAND AVENUE MATTITUCK, NY 11952 Located at 1705 GRAND AVENUE MATTITUCK, NY 11952 Application Number: 2062624 Certificate Number: 2062624 Section: Block: Lot: Building Permit: BDC: ns11 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen addition, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 5th Day of January, 2006. Name QTY Rate Appliances and Accessories Cooking Deck I 0 Oven 2 0 Wiring and Devices Outlet 14 0 Fixture 14 0 Outlet 15 0 Receptacle 12 0 Switch 8 0 Receptacle 2 0 Rating Circuit Type 30 Amps 5.4 KW Fixture Incandescent General Purpose General Purpose General Purpose GFCI seal I of l This ceRificatemay not be altered in any way and is validated only bythe presence of a ~isedseal atthe location indicated.