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Home My WebLink About6166-zFORM NO. ~ TOWN OF SOUTHOLD BUH.nING DEPARTM~,NT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. Z. ~9.Q[~ ..... Date ............. Eay..1 ~ ....... , 19.71~. THIS CERTIFIES that the building located at .. id/S. 0r~nta~. Ave ....... Street Map No. XXX ........ Block No... ~ .... Lot No.m.. l~.shers. [sl~u~..N,.~e... conforms substantially to the Application for Building:Permit heretofore filed in this office dated ............ Sept-- '3~ 19..7.2 pursuant to which Building Permit No.. 6.1.66Z. dated ............... 0¢t~..6., lg..72, 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.~-~.v~te. one. family..dvell~g ................. ~ .................... The certificate is issued to .. tIoL4Bogal'.t ....... 01reel, ....... i .................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · · .ILAR* ......i~ .................... UNDERWRITERS CERTIFICATE No.. ~. 118511 ..... &~...~...t 97~ ............ HOUSE NUMBER .............. Street .......................................... Building Iflspector TOWN OF SOUTI'IOLD 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) 6166 Z Permission is hereby granted to: ......... I'.t,J~e~..~,s'Z'~l ..................................... a~ premlses located at .Jl~A~k.~,~;..&..~r~a&,.A~'~ ............................................................ .............................................. J'~,ak~..[~lam~ ............ 11..I.. .......................................................... pursuant to application doted .......................~..e.~l~. ....... ,,~0. .......... , 19~......., and approved by the Building Inspector. Fee $15e,~ ............ ]~OBM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......~.~. ............. ,19..?....~' Approved ,I 19.?... ~' Permit No ....... ~...~..~.. ~-- Di.~pproved a/c ................................................................................... APPLICATION FOR BUILDING PERMIT Dat~~..." .................................. , 19 ./~.....~...... INSTRUCTIONS 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 of property 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 whale 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 Z'one 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 code, and regulations. ..... ~r (S'g~tur~of apl~cant, or name, if a corporation)~ ' (Address of appliEant) State whethejjapplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~':'""t If appli,o~'nt, is a corporate signature, of duly authorized officer. (~f~met'and ti~e of corporate officer) 1. Location of land on wh ch proposed work w be done Map No ' ~ Lot No Street and Number ~..~ ~'~ .......... "~":ii ................................................ ....... i ......................................................Municipality ................... 2. State existing use and occupancy of pr~'nises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ' b. Intended use and occupancy ............................................................................ [ .................................... ~ .......... ? 3. Nature of work (check which applicable): New fBui!ding. .................. Addition .................. I/ Alteration Repair .................. Removals9. .................. Demoliti~ ........ ~:~.~._Other Work (Describe) ........................................ 4. Estimated Cost .................... .:,,.~./.~...~.~..;.; ................ ;Fee ...... : ................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ;J. ............... 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 ........~...:..i..~. Rear ...... ~.,~1~ .............. Depth ,..,..~....~.......i 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 ..... ~,,~) .......... Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of F?rmer Owner ........................................................ ! 1. 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~..:Z/~ ....... Address .~.,~'..~....:-~.':~ ......... Phone No....~...~..~. ..... Name of Architect .~1~1/.~.....~..~ ..... ,.Address ~..~... ........ Phone No...~'...~/.~....~..~-.../..~. Name of Contractor ~..~.~..~ ................. Address .~.~....,~.'.~... Phone No.~.~..~....-~....~....~ PLOT DIAGRAM Locate clearly and distinctly all 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 corner lot. STATE OF NEV~Y~, , 1,, COUNTY, OF ............... .~...'~A~.~..~....', ............................. ~eJng duly sworn, deposes and says that he is the applicant (Name of ir~vid~al 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 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 Jn the application filed therewith. Sworn to before me this ~ ....... of ............... . %~ A U ......... ~.,~../.~.-~,,~1. .................................... Notary Public, ...'~...~...~:'¥..~..-...~~ ............. County / ,f~gno~e of ~plicant) Notaw Publi~ State pt New No. 52-00288B0 '- ''~-.: (~ualifiecl in Suffol~o~n~l''' THE Date NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ /Jpplication No. on file N 197~ 112498 only th~ elee~rieel ~qui~ment a~ ~c~d ~ ~ int~ by t~ ~l~ant ~ on the a~ ~pl~at~n number in t~ prem~es of Orintnl ~ve, [ Httr~.ck Street, F~her~ I~land, L.I. in t~ following ~catlon; ~ B~e~nt ~ 1st FI. ~ 2nd Fl. S~tion Bilk ~t ~ exami~ on X X a~d found to ~ ~/~nce with the req.ireme, ts of this B~rd. August 29, 1073 SERVICE DISCONNECI' OTHER A~ARATU$= S E R V I C EXHAUST FANS AMT. H.P. DIMMERS ? ," ,,~, -,. NO. OF CC. COND. A.W.G. NO. OF HI-LEG A.W,G, NO. OFNEUTRALS A.W.G. LaS Contractinc Fisher Island, Per ]. 1 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY' (~0~'~T~01~ OF Nl12498 ~--10/2/73-fl 8s JOHN STREET, NEW YORK, NEW YORK 10038 v.,e August 31, [973 ~,~,..,o.~o.o. fz, 6333[9 N118111 THIS CE~IFIES THAT ~ly t~ e~t~ ~ulpment ~ ~cHb~ ~ ~ int~ ~ t~ ~pl~nt ~ on t~ a~ ~pl~at~n num~r in t~ p~mlses of inthefol~inglocation; ~ B~ement ~ IstFL ~ 2nd FI. OU~ S~tion Bilk ~.~o. ~u~usC 29. 973 andfou~tobelncompliancewiththerequirementsofth~Board. SERVICE DISCONNECT I NO. OF METER (~uXTTLUETR~ hECEPTACLES SWITCHES ,.CANDESCGNTIFFLIuXo~TE~s~REENSi.I ~v~ /26 1 DRYERS Z FURNACE MOTORS ~TURE A~ANCE F~OERS ~r. ' ~. w, ~t~ ~P. OAS H, P. ~T. N0, ~ w. o, S RANGE ICOOKING DECKS OVENS DISH WASHERS AMT. K.W. ilAMT. K,W. U~T, K.W. 1LMTE. CLOC~KpsS' TRBAE~$' ~UNITHEAH:Ep~S ~O!I~oTF~F~T~L~TT V I C OTHER APPARATUS: OF CC. COND. NO. OF HI-LEG OF HI-LEG EXHAUST FANS DIMMERS 2 600 NO. OF NEUTRALS A, W. G. OF NEUTRAL Z & $ ELec. Contr. FLshers [gland, N.Y. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. i I _ t 1 'HUGH jONES ARCHIIEC1 t~JILFOItD, coNH,