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Home My WebLink About4716-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No...Y~..~.6.~. ..... Date ............ .A~.I'..~... 9 ...... , 19.7..6. D THIS CERTIFIES that the building located at . .BI~..~rl.~ .& Delphi. ~eet Map N~i~. ~ Block No ........... Lot No..1.8 ..... Gre/npor~. [,I,. ( $~t~ld confoms substantially to the Application for B~lding Permit heretofore fried ~ this office dated .............. ~. ~9 .~0. p~suant to whi~ B~ding Pe~t No...~ dated ............ ~prtl. ~., 19.7~, was issued, ~d co~orms to ~ of ~e r~ ments of the applicable pro~sions of the law. The occup~cy for which ~s certificate ~ issued iPrl~ate, e=e. f~ly. dwsl~l ......................................... The certificate is issued to . .~ .~ ..... ~ ............................... (owner, lessee or ten~t) of ~e ~oresaid b~ldEg. S~olk Co~ty Department of He~ Approval J~. 2~. ~ 9.~.. ~y. R,..~1~ ...... UNDERWRITERS CERT~ICATE No.~9~0..F~ .~..~.9~ ...................... HOUSE NUMBER ..... 10~ ..... S~eet .... ~l~a ~a~.D~ .................... ~0 Dolph~ D~ N0~I ~th to b® f~l~ by ~er I1 ~~ ......... ....... B~l~g ~spector ( TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No..Z~'~I~ ..... Date .............. F®b... 6 ..... , 19.7l*. THIS CERTIFIES that the building located at .~.1~ .)la~d~. & .Doli~zI~. D~treet Map Nol~otttheZd .&hBlock No ........... Lot No..$8 ..... Gl~enpo~.t. ll.,][.. ~[llm/tho/d conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Apr.l.~,. · 2.$., 19. ~0 pursuant to which Building Permit No. 1~7.1.6Z.. dated ........... &l~, .... 27., 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 Prlvaf;a .one..falltJ. y, d~l],l/~l, ....................................... The certificate is issued to . Neal. [~.e ..... .0t~el, ................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Jl~. 28.. 19~.~. · · h~. R...VilLI .... UNDERWRITERS CERTIFICATE No. I~llld~ ............. : ..................... HOUSE NUMBER .. t O~ ........ Street ... ~l.u~. 14a~l:i.n ......................... ~0 Do~ph~ ~ ~ mg sp~t~ [ ...................... , ....... . .. A~li~i~ ..... , .................................. , 19 ........ Pe~it ~ ..... ~ ....... ~,,.~. ........ Di~ a/c .~ ........................................................... ... ............ ~....? ............... ~ ............. / ~ ~ ~ ~ ~ APPLI~T,ON ~ ,UILDIN. IN~RU~ n. ~is ~plicoti~ mu~ b~ c~pla~ly fill~ in by ~e~ritar or in ink o~ submi~ in b. ~ plan ~o~i~ I~oti~ of I~ ~ o~ ~ildin~ ~ premiss, mlati~ip.to ~i~ p~ c. · ~a work c~d ~ this a~[i~ion ~ ~ ~ c~menced ~ora i~u~a o~ Buildi~ d. U~ ~ol o~ this oppllcoti~, ~ Buildl~ In~ctor will i~ue o Buildi~ Pa~ to ·all ~ k~t m t~ pmm~ ~llab~ for ~ ~m~h~ t~ p~ of ~e~r~ e. No bui~ing s~ll ~ ~cupJ~ or u~ 'in w~le or in po~ for ony pu~ ~r until sholl have been granted by the Building Inspector. ~_ ._ APPLICATION IS HEREBY MADE to the Building Department. for the issuance of a Building Pen'nit:lmmUe~ ~ the ~ Buildir{g Zone Ordinance of the Town of Southold,. Suffolk County, New,York, and other applicable La~ (~ or ~ Regulations, for the cons~uction of buildings, addttlor~ or alteratioffs, oF for removal or demolition, The applicant agrees to. comply with all applicable laws, ordinances, building code, housing code, and regulatlont~ ; (Signature of app icant, or name, if a ¢orporat'mn) .~ ~--/,~ (Addres of opplicone State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................. :: ..................................................................... '.-. .................................. ~ame of owner of premises ....~......~...~...~... ........ s~...~.....~......~...~.. ............................................... ~ applicant is a corporate, signature of duly ,authorized officer. t (Name and title of coq~orate officer) II. Location of land on which proposed work will be done. Map No.:~.~..~..~../~...~..~..~.....~.~....i..~.....~.'..~..,Lot Nb:~.~../...~....,a a.~ ......... 3. N~'fure of work (check which applicable): New B Iding ...... Addition .................. Alteration ~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) .......................... .~ ............. Estimated Cost ,~,~.~..o..~. ....... ~...~...0.....G. ........ ~Fee ~.../....~ ............................................................ .~..... /'/' ~ (to be paid on filing this application) 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 indicate whether interior lot. If dwelling, number of dwelling units ...... ./.~.'~:;~ ............... Number of dwelling units on each floor ......~.. .................... 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, if any: ~ront .../~. .................. Height .~ ...................... Number of Stories ................................................................................................................ Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Rear' ......~.....~.. ............. / Depth ...~.~.'~...~ ......... 8. Dimensions of entire new construction: Front ........ .-,............ .............. Height ./.. ............... Number o,f Stories ..... ~. ....................................................................... 9. Size of lot: Front ....... ./...~.....<~.. ......... Rear ........ .~....o. ..................... Depth ...~.....~...~..:~..,.~..~ .... 10. Date of Purchase .' ..~.... ........................ ~../..~../...~..2.....Nome~"~,._ .: -'--- '>, /J ~°f Former Owner .~./~. .......................................... 11. Zone or use district in which premises are situated . .,/~....,~_..../...~...~'~..../....~-T.....~4..~-,t...~./../.,g.~6'....~ ........................................ 12. Dales proposed construction violate any zoning law, ordinance or regulation? ...~.....~ ............................................. 13. Name of Owner of premises ~..~..~../.......~.P..~..?.~....Address ..... .?...J..,~._~..:~...o...~/....~....._~....-~.... Phone No/~...Z...~..~.....O.~.~- Name of Architect ...................................................... Address ............................................ Phone No ..................... Name 'of C~ntmctor ......... '~ Phone No .....................: ........................................... Address ............................................. ,PLOT DIAGRAM STATE OF NEW' ~ .......... ............. ........................ ,ng (Name of individual signing application) /-) ,e'/ u o duly sworn, deposes and says that he is the appl'icant above named. He is the ............................................................................................................................................... ,- ......... (Contractor, agent, corporate officer, etcg of said owner or owners, and is duly authorized to perform or have performed the said work and to m~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mc~er set forth in the application filed therewith. Sworn to b,fnre me this ~ .... Notary Public, ..~~nty~'' ~ = [:~lgna~ur, o1' appllcant~ '-'----- '" ............ No, 60 - [484~00 · e~m l~xplres March 86. N.Y. !~' CESSPOOL5 ! , NOTE-LOT NO'..% 12EFE~TO"?C, pOF ¢.O~.'rHq2Lr; 5NOI.2. E~'' ~Posa~ ~d ~ater suppl~ for this location have been by this department ~d fo~d Services THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICffY **' ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..te"e~,'..'*¥ ". ~7" A..,,.,~..~,o.o.,,~50~3~ N 141930 THIS CE~IFIES THAT in the followlng location; u~s examined on J ~t T~ L~ ~ ~ ~ 3 l ~ 1 ~. 7 I{ and.found to be in compliance with the requirements of this Bo=rd. fiXTURE LECEPTA I iT E I fiXTURES OUTLETS r~ c~sI sw CH S ,NCANm$CENT FLUORE~CENT ~VEt~qRY ~ /33 ~ I~3 I I I DRYE~ ~RNACEb MOTO~ mTuRE A~A~E ~~ ~. ~.w. ~r H.~. ~S H*~* ~* ~* ~.W.~* SERVICE DI~NN~ ~ ~. OF I S R ]COOKING DECKS OVENS DISH WASHERS ~T, K.w,ilAMT. K.W. ~T. K.W. TIMECLOCKS BELLiUNIT HEATERSUNIT HEATER$ MULTI-OUTLET . TRANS. .~ SYSTEMS EXHAUST FANS DIMMERS Elec.~oom heaters: RANGES L 13 9 ~PECIA[ REC PT V I C E A. W.G. r~'O. Of NEUTRALS A. W, G. 1 ~/o 1-2 Okw, r'_ r: · ? 1.~kw, ~-l.25kw, 1-1.Okw, 1-. 75kw · l~eal Kohle, 95 Stone ,t.~ Elmon~, L.I. 11003 Per ' ' C COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.