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Home My WebLink About5636-zFORM NO. 4 TOWN OF $OUTHOLD BUrr.DING DEPARTMENT Town Clerk's Ot~ice $outhold, N. Y. Certificate Of Occupancy No..7-~.~26 ..... Date ....J..~....2?. ................ , 19.~.~. THIS CERTIFIES that the building located at ...2.~.6.~.0...~.a..~...R.o.a.d. ........ Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in this office dated . .N.o.v..e.m.b.e.x'...1.9. ....... , 19.7.1. pursuant to which Building Permit No...~.3.6.~. dated . .N.o.y .e.m.b.e.r...1.9. ........ , 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 ..... .P.x,.l.~.a..t.e..~1..u.b..B...u~.....d%LA~' .......................................... The certificate is issued to ..... N..o.r..~...~.o.r.k...C.o.uz..~ .t.zT..¢.1..u~. .............. i ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... Pending UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER 2~6~0 ~ Roacl .............. Street .......................................... Moo~es I, ane ..... .... B~ding Inspector \ TOWN OF $OUTHOLD BUILDING DEPART~AENT TOWN GLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ' ~- ..... ~. · ..~,e~,ke~.._~ ....t~21;,.~_~th,.~.e~'k. :~t,J~, Club .............. ~-t.~.~t~l~ ........................................... to ................................................. at premises located at .........~V~...~-,~O~.~t~...~g.~B .................................................... ; .......................... ............................... ; ............. Cut~tmi~,m ......... .!i.~.~ .......................................................................... pursuan~ to application dated ............................... ~i'~ .......~.~ ....... , 19...~J., and approved by the Building Inspector. THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICn~' -'- 85 JOHN STREET, NEW YORK. NEW yORK 10038 THIS CERTIFIES THAT only the electrical equipment os described below and introduced by the applicant named on the abo~e application number in the premises of North Fork Country Club, Moores Lane tvaSexanzinedon December 27, 1973 and found to beln compllance wlth the requlrements of th~s Board. DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS AMT. K.W, OIL H,P. GAS H.P, AMT. NO. A.W.G. RANGES &MT, K.W. SPECIAL REC'PT. COOKING DECKS OVENS DISH WASHERS TIMECLOCKS BELL UNIT HEATERS MULTI'OUTL/~T SERVICE DI~ONNRCT NO. OF I 200 C.~ METER A~4T. AMP. ~ EQUIP. OTHER APPARATUS: S E R V I C 1.,~2W I,~'3W 3~'3W 3,e'4w NO, OF CC. COND. A.W.G. PER ,g OF CC. COND. I 21o NO, OF HI-LEG A, W, G, OF HI-LEG EXHAUST FANS DIMMERS NO, OFNEUTRAL$ OF NEUTRAL Robert A. Ooodale, 525 Orchard St., New Suffolk, L.I. 11956 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~W BUREAU OF ELECTRICITY I-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and int~ ~ the applicant named on tim abo~ application number ~n the premises NOl, t;h Fork Country Club· ,'~ool'es La.· edrn. oi' Rte, 25&~oores La. Cutchogue~ in thefollowingloeation; L~ Basement [] fat FI. [] 2n~ Fl. otlts~.de S~ction Block Lot ~,. e.a,,,i,~d o,..TU ly 22 · 197 ti and found to be in compliance with the requirements of this Board. DRYERs FURNACE MOTORS SPE~AL RE~'FI SERVICE DISCONNECT NO. OF S E R i METER c A.W.G. 1 10 CB x 1 2 ]COOKING DE~K~ OVENS DISH WASHERS AMT. K.W. I .~T. K.W. '.'.Z. K.W. TIMECLOCKS / BELL UNITHEATERS MULTI-OUTKET V I C RXTURES K FLUORE~ENT Vta~C~ FUTURE AFPUANCE FEEDERS A~T, NO, A, W. G, NO. OF HI-LEG A.W.G. OF HI-LEG EXHAUST FANS AMT. H.P. ~ DIMMERS Robert Ao ~ood&le R.R.fl-Box 15a-Main Rs. Mattituck, L.Z. 11952 ~ MACAW Per 11 ~' COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... N.~.~ .~J~l~.~. l;..... ,1,.c)., .... 19...'/~1,. Approved " " 19..:~ .... Pemit No..5.63.6..~' .................... Application No ..... 5453.6 .................. Disapproved a/c .-..-...-..-...-..-.: ............................................................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Dore November 19 19...7..! .?1~ o. 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 orr-~ 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 o 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 bf 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 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. Co=t~ctor If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) 1. Location of land on y~c~ proposed work will be done. Map No.: .......... ..~....:J~.. ...................... Lot No...~ .............. Street and Number ..~.~.....~OO,l:'.fi~...~..~.~ .......... (~1;~]3.O~,~. .......................................................................... ~,~.~'&~'(-? ,/qg~.,.-, ~::)cO.~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...~],~l~..~o~se ...................................................................................................... b. Intended use and occupancy ........... ~.~.~,f~...~J~..~,~...~,f~.~.J..~D.~ ................................................................... 3. Nature of work (check which applicable): New Building .................. Addition 7.3c Alteration XX Rep6ir .................. Removal .................. Demolitio~ .................. Other Work (Describe) ........................................ 4. Estimated Cost ................ ~.f..4)(~).-...._~ ..................... Fee ]~,~..0.. ................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..~Q~. ................ Number of dwelling units on each floor ............................ If garage, number ofcars 6. If business, commercial or mixed occupancy, specify nature and extent of each type af use ...... ~...~...gl~... 7. Dimensions of existing structures, if any: Front ............................ Rear .................... . ............ Depth .................... Height ........................ Number of Storie~ t'"'7'. ....... 7'; ...................... t ....... ~ ......... ":u ......... : ...... ~'--':'"': .................. ~.-. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~(~ ..................... Rear ............. ~...0.. ......... Depth ...1...0. ................. Height .................... Number of Stories ...... or~e ......................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 I. Zone or use district in which premises are situated "A" d~st 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~.~. ....................... 13. Name of Owner of premises ..N~T.th..~'.o~'~..~,~.~.b..Acldress ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..,T.~..~J. eD.r. ko.~k~ ..................... Address ............................................ Phone No ..................... 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 YORK, }S S COUNTY OF ..~f~lk ............ ~ ' ........................................... 3:e&~..~g~e~'~g,~k~ ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................ .g. on~X'.~,.g.t~O~ .................................................................................................... (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 application, filed therewith. Sworn to before me this ................ .1.c).../~day of .......... ~.,~...11'O~.,.,.....: ........... , 19...~..! "~ .... G~ NOTAREyLIZp~B~ICH AS~,'/flofEV['~wE York /.,,/ ,ur , ae o New York No. 52-8125850, Suffolk C~L.L.~ Term Expires March 30, ].