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Home My WebLink About5523-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~.~.~86 ...... Date ............. 141~rO~t..~ ~ .... , 19~... THIS CERTIFIES that the building located at . De.].l~..DF ................ Street Map No..~.O1.. C.~o~.~atll ..Lot No. ~ ... ~el. ~.~. .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~t...~.., 19..~ p~suant to which Building Permit No..~. dated ........... ~ep~...~3.., 19..~, 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 ... Prl~ate..~ne..f~y. d~ell~g ..................................... The certificate is issued to ~1~ .~es. ~ull~r.. for .Wal~r. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~b.,..~..~ ,..1.9~2...bY. Unde~r~ters Cert. ~ N~7~ ~'~a~/~'~ ~use ~ 1980 De~r D~ ./.'' Building Inspector / 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? 5523 Z Permission is hereby granted to: .............. II~.e..Cetmtl,~,.. ~i ......................... ................... · el.~e~ ......... 1~ ........................... to ...... ~l~l,3A..,~e~..J~..~t~j~..~l,~e~.~t.~ ............................................................................. at premises located at ............... ~llrl;..l~....j;,illl:l~...~lj~ll~,..l~.jj~ .............................................. .................................. D®~.DI' ......... ~mre:[.....~,¥.~ ................................................................. pursuon¢ to application dated .............................. ~j~ ....... ~r ........ , 19..~t.., and approved by the Building Inspector. Fee $...tO,~)~ ......... Building Inspec7 Disapproved a/c ..................... ~ ....... ~ .......... ..~ .......... :>,.~... ................................................. .......................... t"'~'i'~'i;'~" I;spector) / ....................... APPLICATION FOR BUILDING PERMIT ~ Date .............. ..~....~......~.../......, 19..?../..!. INSTRUCTIONS 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 ofproperty must be drawn on the diagram which is part 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 Deportment 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, housing cede, and regulations. ................ ................................ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. .................. ......... 1 Location of land on which (>posed work "be dane Ma No' ~ ~ ~ bEL/~I/~T~ ;b~. Municipality 2. State existing use and occupancy of premise'~'~,,,~ ,,,:=:~..ad use oho occupancy or proposea construction: Exisiting use and occupancy ................................................................................................................................. Intended use and occupancy ........ J...'T......~..~.. ........... ~.. " ........................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal ................. .. Demolitio~.....:.......~.._. Other Work (Describe). ....................................... 4. Estimated Cost ....... /~..~::~ ...... : ...... ~ ................... Fee ....... ~/..~ ......... ~ .................................................... ~ ............. / (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .C~... ............... Number of dwelling units on each floor ............................ If garage, number of c~rs ............/. ................................................................ Z.J.,,,~ ...... , ............................................ 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 ."....]~1~...~.~). ............... Rear ....~...~ ................. Depth ....~.....~.. ............. Height .....,/....~.. ....... Number of Stories ......... /. ........................................................................................................... 9. Size of lot: Front ........../..~..~ ......... Rear ........ ----/...~..~ .................. Depth ........ /...~'..~,~ ............. 10. Date of Purchase ........................................................ Name of Former Owner .....'~k~..~.~.~ 11. Zone or uSe district in which premises are situated ..................................................................................................... 12. Does proposed construction\ ^/lc~J~j°late any zoning I/aw, ordinance or 13. Name of Owner of premises ..."~..~...,~--~,o..Ack:iress __1 .................................. Phone No ..................... Name of Architect ................... ..~.~ .............................. Address .............. ~..~.~ ........................ Phone No ..................... Name of Contractor .................. .'T..~ ............................. Address ................ ~../. ....................... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate nil set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names_and indicate whether interior or corner lot. ~~~t~--/. ~/ ~.~. ~ ~..,,.~f-'~w~r~?~~ ~t~ STATE OF NEV~O~K~ ~ ! c c~ ........................................... ~~~~ing duly sw~m, depnses al;Id says that he is the applicant (Name of individual signing application) ~ [ ('~_ ~-~._ ~i 0~, above named. He is the ........................................... ~...~..~.~ ................................................................. (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 that the work will be performed in the manner set forth in the,eeld~atkxt filed therewith. Sworr~t_ c~ before me this~f~ ~ ~ - ~ ~ ..... ............. THE NEW YORK BOARD OF FIRE UNDERWRITERS a k BUREAU OF ELECTRICI'I'Y Ba OH, STREET..EW YOR . ,EW ,OO B 3757 v~t~February I~, 1972 AppllcationNo. onfile 557711 N THIS CERTIFIES THAT o~dy the electrical equipment as described belotv and zntroduced by the applicant named ow the above appflcatlon number an the prer~ises of Walter Kosianowski, s/e/cDr. Joseph & Delmar Drive, Laurel, L.I. was exarnltted on Feb r u a r y I 6 ~ 1 9 7 2 and.fo.nd to be i~t cornpliartce mith the requirements o~ this Board. RANGES OVENS DISH WASHERS FANS FIXTURES FIXTURE SWITCHES iNCANDESCENT FLUOR~$CENT OUTLETS I$ 25 18 DRYERS OTHER APPARATUS: E R V I C pE~CC~CONO, NO. OF HI-LEG OF HI-LEG , 2 Motor/s: I-I/2hp *Furnaces: Oil I-I/Shp, 2-1/12hp *Future appliance feeder/s: 2-3#8, I-2#14 4 George Zimlinghaus, 4 Park Place, Patchogue, L.I. 11772 ~!. ~ ri?~,,.r.~ ,~,.~ r,~,~ be altered in any manner~ return to the office of the Board if incorrect. Inspectors may be id MANAGER 12 by their credentials.