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Home My WebLink About5178-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..-'.:'f.'; ..... Date 19 THIS CERTIFIES that the building located at ~f&eobB. ~ & ~eward. D~' Street Map No..~4&~,~ &,Block No .... Lot No. ~ .. ~~ ~ ...... conforms substanlially to the Application for Building Permit heretofore filed in ~is off~ce dated ......... ~. ~ 19. ~ pursuant to which Bulldog Permit No. ~. dated ..... ~ .~ ., 19.~ , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificaie is issued is ...~~ ~e. f~ ~~ ............................... The certificate is issued to .. ~~. ~9~ .~... ~R ................. (owner, lessee or tenant) of the Moresaid b~ding. Su~olk County Department of Health Approval ~ ....../.~~ (~., . ..... ......... 85 ~ ~ ............................ U~e~[~e~s Ceff[, ~ ~21988 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5178 Z Permission is hereby granted to: ........ II~?-'-'~Jl~m'-A~'~ ................................... .................. lll~e~ ~l!~J~ ......... ~,,~-, ..................... at premises Iocoted at ......... ~T~JJ~J,--~ ....... J~MJ/a~II~..~.~-~W.:....~;? .............. : ............ ............................ ~J..~e,e~..-l,~. ........... I!e~ ....... .1I~, .................................................... Building Inspector. S-9 $CHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. 5--'/ ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ~ ~ ~.~. have been inspected by this department and found to be satisfactory. District Engineer MAR '~ ? 1972 Approved .............. I~[ 19.....(.~ Permit Disapproved ale ........... ~ ................................................... Date .......... ~J~.c~.....J.~ ............................. , 194?.L ...... 5. This application must be completely filled in by typew,ter or in ink und submitted in duplicate to the Build I~oector. b. Plot plan showing location of lot and of bu_lldings on premises, relationship to adjoining premiere or public streets or areas, and giving a detailed description of layout of properly must be drawn on the diagram whlch Is part of thl~ application. c. The work covered bY this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will Issue a Building Permit to the applicant. Such shall be kept on the premises available for Inspection throughout the progress of the work. e. No building shall be occupied or used In whole or In port for any purpose whatever until a Certificate of C)cc shall have been granted by the Building Inspector. AP~I. ICATION IS I~REB¥ h~K to th~ Building Bepartment {or the t$,~uonce of a Building Permit ~ur~uant to the Building 7one Ordinance of the Torm of So.hold, Suffolk Count~, N~v 'fork, and other pppflcoble LOw~, Ordlr~nces Regulations, {or the construction o{ bulldin~, eddltlon~ or alterations, or for rem~al or demolition0 as her~ln ~rll~:l. Th~ ~pficont ~r~s to comply with all applicable ~aw$, ordinance, building co~e, hou.ing c~xle, and regulations, '~ (Signature'of applicant, or name, If a C6~I:NPmflon) ...... ....... ........ (Address of applicant) State whether applicant is owner, levee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... .(~ ~e~... ~....[~u. J..I.dez'. ................................................................................................................. Name of owner of premises ....L~e~e, rt.d..&cr:.~.,....l~, ........................................................ .(.~.~...~.:.J~). ..................... If applicant is a corporate, stgn. atuce of duly authorized officer. ~ ~ ............. (Name and title 'of'L-,6rporate officer) Lee~ve.rd Acres e~c ,, I. Location of land on Which prepasecl work will be done. Map No.: ....J~e~¥.v.~ ................... Lot No.: ..... Street and Number .............. J.e~.4~b.~...Lar~e ......................................... ,.%.o~1:.~4{ ..................................... ~........ ~ ~'..~ /.~-~4-~4 ~_ Municlpall~ 2. State existing use and occupancy of premises and Intended use and occupancy of proposed comtmctlon: o. Existing use and occupancy ............. vncnn.~...In~d ............................................................................................ b. Intended use and occapan~,' ............ ~..~or~e ................................................................................................. 3. Nature of work (check which applicable): New Building ~ ........ ye~a.. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .........~...I.~..~0~.; ............................. Fee ..; ....................................................................................... (to be paid on fi!ing.this application) 5. If dwelling, number of dwelling units .....9. P...e. ............... ~Number of dwelling units on each floor ............................ If garage, number of cars ...........~.~.o. ............................................................................................................................ 6. If business, commercial or mixed occupancy~ specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....... ~ton.e ........... 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 ....... .~.Q..~..~., ............. ,J~ear ,.~(~ 1~..~, . Death...3.2. ~:~c. ~O x :~ garage a~c~&ched ........ Height ........ ~.~...~.~ d~lumber of Stories ......4~.<~ ......................................................................................................... 9. Size of lot: Frc~t ....... ~.Q0..~. ........... Rear .......... ~0.0.~ ................ Depth ...... ~CI.0.~ ................ 10. Date of Purchase ................ I.~.0. ............................... Nome of Former Owner ...J~el¥.Y..J.~.~/...~.g.~ .......................... ] 1. Zone or use district in ~hich premises are situated ......... ..~.~.J..c;[~.D.~..~..a..I. ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.> ..~o ..................................................... ]3. Name of Owner of premises Lee.~a~.d..Ac~.e~ ......... Address;~.l.7....~mb~Z'.~m..~.V.~.. ....... Phone No..~...2.~...-.~.~,,~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ....... .s..a...m..e. .................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. ~,~ / ~o° STATE OF NEW~_ jJ,,/gJ COUN'ry oF ........... ........... f~'~"e4'~"~'"~' .-~k-...~-.-;.....(~.-'0...XR...~... .................... being duly sworn, d~oses and says ,~t he is the applicant (Name of individual signing application) above n~med. He is ,be ........................................... C~...~..~.'~..~..8...~..~..~.~ ........................................... (~ntmctor, agar, co~orate officer, etc.) ........ of said owner or owners, and is duly authorized to perform or h~e perfo~ed the said work and to ~ke ~d file this application; that all statements contained in this application are tree to the best of his ~owl~ge and belief; and that the work will be performed in the manner ~t fo~h in the application fil~ ther~ith. .... of ......... .......... NOTA~ PUBLIC; Sta~ of New York Ho. 52-8~25850 Suffolk Term Exp res ~ ~, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY December 28, 1971 ~..ti..,~o.,~o.o.z~t. 526208 ' ;~;,:~?~k.Bo~n g/E/O Leeward D~lve., & Jacobs La. Southold, FIXTURES OUTLETS SWITCHES -- 27 : DRY,RS: FURNACE MOTORS [] 2nd FI. outside ,%,¢'tio,t Btm'k .l~ot FUTURE APPUANCE FEEDERS TIME CLOCKS 1 2 OTHER 'A~PARATUS: - *FurnaCes: 1-1/8hp., 1-1/12hp., ~Fu~ur~' ,Appliance Feeders: 1-2#12., Mot~ql, s~ 1-1-1/2bp., C AW.G OF HI LEG NIT HEATERS MULTI-OUTLE~ I~MMERS SYSTEMS NO. OF F~T 1-3#10., 1-3#8., ~ ': Centereach, ~.Y. 117 0 ' ' , This' c;"ifi~~ 'us; not be oltered in any' manner, return to the office of the ~ard if incorrect Inspectors may be id'.fif e~/by their~edent~ls.