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Home My WebLink About5388-zFOI~M NO. · TOWN OF $OUTHOLD BUH,rHNG DFAPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...~..g~.~. ..... Date ............. . .!/~1~. '.i~1 ....... , 19.~'~.' ' THIS CERTIFIES that the building located at ~ll'ay..&ql~ .................. Street Map NoPsi oTli:th~].:L Block No ........... Lot No, .. ~ ......... Lauee1 ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... J1t~...6 .... , 197:1.. pursuant to which Building Permit No. ~388Z ~. dated ........... J1a~.. 6...., 197.¶.., 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 .. ~.l'~at~. ~. fmatly, dwlltn~ .~th .al~ ......................... The certificate is issued to C°~'..~"I~ ...... ~ ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~;~ ............................... UNDERWRITERS CERTIFICATE No.. ~33.~39~ ..... ~lay.. ~J~....~.9~'~ ............ HOUSE NUMBER . .. ~ ~ ...... Street ..... ~.. &~ .......................... Building Inspector ~Ol~tl NO. ~B TOWN OF SOUTHOLD BUILDING DEPARTMENI~ TOWN CLERK'S OFFICE , SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5388 Z Date ............ ............................................ , 19 ........ Permission is hereby granted to: ..~,~ ~/,. ~/~/~-/~'~ !f at premises located at ..................... : ...................................................................................................... pursuan¢ to application dated ................................. ~ ......... : .......... ;....., 19.]..., and approved by the Building Inspector. Fee $ ...... : ................ Building Inspector "UILDING DEPARTMENT ,c~,/l TOWN CLERK'S OFFICE SOUTHOLD, N.V. ~ INSTRUCTIONS --~ ~ uc--/-/-/-/~~ · ',~ a. 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 DePartment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town df Southold, Suffolk County, New York, and other applicable Lows, Ordir~nces or Regulations, for the construction of-buildings; additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordi nantes., building code, housing code, and regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ses ....................~..'..~.:......-~....~....~.....~...~.~.. ............................................................................................. If applicant is a corporate, signature of duly authorized officer. "~// ........................................(Name and ti~'l'"'"~e o ....................................... corporate officer) Locat on of and on wh ch propo~d work w be done Map No' /~' ~;>~ / Lot No.~..~.. 1. Street and Number /..'~'"~'~) ':"~.~..~'..~. ..... ............................................... ; ..................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................... ~..!..k/....E. ............... .~...~....I~.....I....L,..Y.. ............ ~.....~(....L..=...L...L..!..~I......~T;.. ................... b. Intended use and occupancy -'~ ~ ~) t~ (~/I-/-H 3. Nature of work (check which ppplicable): New Building .................. AzJdition .................. Alteration . .. Repair .................. Removal .................. D~molitibc .................. Ofl~r Work (Describe) 4. Estimated Cost ............................................................ Fee ......... (to be paid on filing this application) ONL -- 5. 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: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ............... ..~'..~ .............. Rear ........ ..'~......C). ............ Depth .............. '/'".~../. .......... Height ............ /..~.....~:.. ...... Number of Stories ........ ..~....A~....L,.-..'::.. ......... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................. 9. Size of lot: Front ................ ..~.....U. ..... Rear .............. ...~..0.. .............. Depth 10. Date of Purchase ........................ ~. ............... Name of Former Owner .................. ./:...L;....: ............. 11. Zone or use district in which premises are/situated ..... ~ ....... ...~....~...~.../....~..~.....~:....7:../..~.....L:~... .......... · ........ 12. Does proposed construction violate any zoning law, ordinance or regulation? ................ ../~.....0. .......... 13. NameofOwnerofnremises ~" ~'~' "~"~/-'~Y~¥ ,~,"~re,, [~(~ AO~GT ~ 7' ,..- Name af Architect ....... ' ............................................... ,~aaress .............. L..~..L ................... Phone Na ..................... Name af Contractor ........................................... ' ......... ,~dress ............................................ 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 comer lot. · - .. ~ . STATE OF NEW YORK, ! ¢ ¢ ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing applicotion).L 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 application filed therewith. .S...::..?..t..:..b.:.f..~..~y, t~s ......... 7'~ ..........'~...q.~. ¥,/~19.7../ ....... . Notary Public~.[-~c~,u~c~.e[~.... County - //I (Signature of appli~ .............. j~ .......... NOTAR¥ pUB£1C. State m..~,~._',~'" Ho 52.8125850, SUffolk CouJ)~V~ ' Up Mmch THE NEW YORK BOARD OF FIRE UNDERWRITERS .''~ [i i, :]'; "i ii: !? ' ~ '85 JOHN STREET, NEW YORK, NEW YORK 10038 ..... ' ' 338839 ..t. May 24, 1977 A...c.,~.,~o.o./i~ ;~910335 ~ 'N THIS CERTIFIES THAT; Clarence 5, ~ ~,, ~,,f...~.~ ~o~.~o.~ ~ s,.~..~ ~ ~- ~'~. ~ ~,,.~ r~, Outside.,; s~o. ~o~ ~ 56 ~ ~i~ K~ w. ~L K. W ~T [ w ~r ~, w EXHAUST ~ANS FIXTURE sWiTcHEs: FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS OUTLETS [ECEPTACLES ~ , ,LUORESCEN, ~;, P' NO. OFE~C CO~D.. R. NO. O" .,-LEG 0r~r W' G E R V C A. W.G. NO, OF NEUTRALS OF CC COND. OTHER APPARATUS: OF NEUTRAt GENERAl Clarence Barry Box 910, Bray Ave. Mattituck, L.I. 11952 Per h~ This certificate must not be altered in any manner; return TO the office of the Board if incorrecT. Inspectors may be identified by t