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HomeMy WebLinkAbout5123-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z b~381+' " Date ~el~t 1 7 , 19 71 THIS CERTIFIES that the building located at lgeSt Roa~ Street Map No. :r~ .. Block No. ~ Lot No. ~ Cut;ohogtlo N,~, conforms substantially to the Application for Building Permit heretofore filed in this office dated ~7at~ 2t , 19 ~;1 pursuant to which Building Permit No. 5~23Z. dated ..~a~ 2] , 19 7~[, was issued, and conforms to all of the reqmre- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is. Private garage..¢ A~eo.~s~ ~ldg). ................. The certificate is issued to ttarshall Frost of the aforesaid building. Suffolk County Department of Health Approval l ouse (owner, lessee or tenant) Building InspectOr TOWN OF $0UTHOLD BUILDING bEFARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT 'CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Building Inspector. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.ACE ~ S,.~7~90 .U.EAU OF E.EC*.,C,;Y -- 40 FULTON STREET, NEW YORK, NY 10038 Date OCT~]BER 09,1998 Application No. onfite 16910498/98 H 061684 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premtses of I~.RSH/J.L FROST, 435 WEST ROAD, CUTCHOGUE, NY tn the following location; [] Basement was examtned on ©CT~.)BER 02,199°~ [] 1st Fl. [] 2nd Fl ~3~ Section Block Lot and found to be in compliance with the National Electrical Code. FIXTURES RANGES COOKING FIXTURE RECEPTACLES OUTLETS OTHER OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE N~OTORS FUTURE A~PLIANCE FEEDERS SPECIALREC'PT TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO OF FEET DIMMERS SERVICE DISCONNECT S E R V I C E OTHER APPARATUS NO OECCCOND A W G NO OFHI-LEG. J A W G NO OENEUTRALS A W G li~.RSHALI, FROST 6 HUNTERS CIRCLE LEBAWAL, NJ, 08833 Per. IlGENERAL MANAGER This certificate must not be altered In any manner, return to the office of the Board if Incorrect Inspectors may be identified Dy their credentials COPY FOR E~UILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER I~B~ NO. 1 TOWN OF soUTHoLD ~-/~ '~ /7 / BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .. ., · ~ ........ Approved ........................................ , 19...t..~... Permit No............................. Appli~tion No ............................. Disapproved a/c ........~.-.-.-.-~.....~ · r) APPLI~,ATION FOR BUILDING PERMrI' INSTRUCTIONS "4 a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of bu.ildings on premises, relationship to adjoining premiaes or public itreets or~.~ areas, and giving a detailed description of layout at property must be drawn on the diagram which Is part of ~his application. K:~ 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 a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I,awl, Ordinances or TR~geulati.o. ns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described · applicant agrees to comply with all applicable laws, ordinances, building code, housin~ 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. Name of owner of premises .................. / .......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: .................... Street and Number ~..~....~... Municipality Store existing use and occupancy of promises and intended use and occupancy of prepos~J construction: a. Existing use and occupancy b. Intended use and occupan:', ~:~- ~J, AC-~'-- ~ . .~....~'....A.../~...~....~..C?.. ..~...h...~..A G'/'- 3, Nature of walk (check which applicable): New Building .................. Addition ................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ................... ..~.....?..?...O.. ......................... Fee ...... ~....e.~ ................................................................. (to be paid on fi!lng this application) 5. If dwelllng, 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 b/pe 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 ..~... .Y... Height ... [ ~-- Number of Stories ~ 7' ' 9. Size of lot: Front .......... .'~....~....'~.. ....... Rear ................................... Depth ,~,--~' CD 10. Date of Purchase ....................... ~ .................... Nome of Former Owner ....................................................... 11. Zone or use district in which premises are situated ............... . .'~....~-.~....~'.../.....~.. ................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises ~ ....... ~.O...~.....~.. ......... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... /~oaress ............................................ Phone .................... 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 accor~ding to deed, and show street names and indicate whether interior or comer lot. ~ STATE OF NEW YORK, tee [,~'~-"~ '7- ~>~t ~o~ /~ COUNTy. ,OF ................................ ' ............. .~.....'~. ............. ...'~.....A~...~....~'.....~... ....................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) 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 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 manner set forth in the application filed therewith. Swam to before me this ~~- // · .~ ............... day of .............................. Publi~ ~ t..,~,..~"~'p"~'~ ............... hlotae/ C~~r"~*~/'J~'_~'"'" %'OU~ItYELIZABETH ANN NEVILLE (Signature of applicant) ~~ NOTARY PUBLIC. State 0f New york No. 52-8t25850, Suffotk C0u_ntx Term Expires ~terch 30, tg~.~