HomeMy WebLinkAbout6320-zFO~M NO. 4
TOWN OF SOUTHOLD
BUr~.nlN(~ DEPARTME, NT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z..~708 ..... Date ............De.c... Il. ...... , 19. ?~
THIS CERTIFIES that the building located at .. ~.~ug. Street ............Street
Map No..XX ......... Block No .... XZ ..... Lot No.. z:Z... 0~.ev_t..I~,Y, ...........
conforms substantially to the Application for Building Pemit heretofore filed in this office
dated ........Dec...29 ...... , 19.72. pursuant to which Building Permit No.~ ~,~.
dated ......... Dec.. 29 ....., 19.72., 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 ... l~$vate .o~e..f.a~.~y. ~lwetl~mg... i .................................
The certificate is issued to ~ .~. ¥,rs. ~L;LZf~m. ]~ia~, .... J~mera ..................
(owner, lessee or tenant)
of the aforesaid-building.
Suffolk County Department of Health Approval . .D.?.C....2.~...~..9.7.3....by..R.;..V.~.l..l.a...
UNDERWRITERS CERTIFICATE No .... lq..1.32782 .... ~ee...13..~.~7.3 ............
HOUSE NUMBER ...1320. ...... Street .. ,~.~ng. ~; ...............................
..... .....
TOWN OF SOUTHOLD
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)
6320 Z
Permission is hereby granted to:
....o~x~.:~C...e..~..;~jZ.G.....1~,l~1~m..~.,.. ~ &
pur~!~At. ~o application dated ................................ D~o.....~L~ ........ 19...~, and approved by the
~ulldlng Inspector. ~IO~E! unf~.n~.oh®d eeeond flooF
~OM ^BORE PREMISES BY
~G INSTITUI'IOH LiSTeD HE~/OH, M~D
--, ~ltE ~SS~Ga~S oF THE ~)4D~G tram-
/YL4 /m 0 ,~
W~... ,j. ¢/SABEL,_LE KANZ
AT '~
-0--
I¢.0 ,¢¢ re, ~t'. ~orn(e ell or,
TO~VN OF SOUTHOLD
BUILDING. DEPARTMENT
TO~VN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ........ ~-~o~...~.....~. .......... , 19.?..P "
Approved
Disapproved a/c ....... ~..~
.............. ..... ,n.p to ...................
INSTRUCTIONS · .
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises relationship to adjoining premises or public streets or are~Cs~"~and
giving a detailed description of layout of property must be drawn on diagram Whl~h 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 ke~bt
the premises available for inspection throughout 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 I$ HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buildir~Zone
Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constrdction 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, and to admit authorized inspectors on premises and in buildings for necessary inspections.
(Signature of applicant, or name, if a corporation)
Orient
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......................................................... ...............................................................................................................
Name of owner of premises ..,,NZ'...~..~L.~&..T~.Lll.'La~..~e.. ~s,-n~. .....................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................................................
Plumber s L~cense No .........................................................
Electrician's License No .....................................................
Other Trade's License No ......................................
1. Location of land on which proposed work will be done. Map No....~[~13.{~r....~.3:~&C~.....,..,Lot No...,~..O. .................
Street and Number .....~..~;[~..~.~..~,..~[,~[O~.-~..~.Q~..~QaJ[ ....... ~'fLe~.~; ..................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~ ....... .~...a;.c....e~...t.....]:.o...~. ....................................................................................................
Intended use and occupancy .........
3. Nature of work (check which applicable): New Building ....XXZX~ ...... Addition ..................... Alteration ...............
Repair ............. Removal ................ Demolition ........................ Other Work ....................................
..................... (Description)
4. Estimated Cost )+8,_000 .+_ ....... Fee ....... .~ ........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ......o~..~. ....... Number of dwelling units on each floor .........................................
if garage, number of cars ................................................................................................. ~ ..........................................
6. If business, commercial or mixed occuoancy, 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 .........................................
Depth ..................... Height ......................................... Number of Stories ................
8. Dimensions of entire new construction: Front ....... ~ ............. Rear ...... ~ ................. Depth .......b~.~.6 .................
Height ................................................. Number of Stories ....1.~ .......................................... ~ ......................................
9. Size of lot: Front ...................................... Rear .......................................... Depth ..................................................
10. Date of Purchase ..................................... Name of Former Owner ........... .................................................................
11. Zone or use district in which premises are situated ........ ~k ...... .:[§.~. ............................................................................
12.* Does prop°~ed b0nstruction violate any zoning law, ordinance or regulation: ....hQ ...................................................
13. Will lot be regreded .................................... Will excess fill be removed from premiSes: [ ] Yes [ ] No
14. Name of Owner of premises .l~a~...~T.9...K&lL~..~.~f.a .................... ~ ............... ;',~. ..................................................
(Address) (Phone No.)
~.B WiLls ......................................................................
Name of Architect ...............................................................................
(Address) (Phone No.)
Name of Contractor .....Q~;L~tD,~..~,LnJ,~;;LI~g..~;.-J~.gilLS.~]~...~,~Cn ....... .~.~f~ .......................................................
(Address) (Phone No.)
PLOT DIAG RAM
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 indicete wheth-
er interior or corner lot.
........................................... ..~.0. ,b...~....~. ,o, '. .~.. ~ .]-. ,~...s..~.i....i....'i ................ being duly sworn, deposes and says that he is the applicant above named.
(Name o/individual signing contract)
lie i$ the ................................................................ ~t~,~T'~.~'~.. ........................................................................... : .........................................
{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 apl~lication; that all
statements contained in this application are true to the best of his knowledge and belief; ~-nd that the work will be performed in the manner
set forth in the application filed therewith.
........................ d.y of , -'-
THE NEW YORK BOARD OF FIRE UNDERWRITERS
CS BUREAU OF ELECTRICITY
I-- 85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by t~e. appllco~t ~me~ on t~e. ~ove application nut~l~er in the premise~ of
Kanz· e/o M.a,lo~'s Pond & King ~., urxen~,
in the following location; [~ Basement [~ ~st FI. [] 2.d FI. 0 Ut Slde Section Block Lot
wasexaminedon Decelrlber 10 · 1Q. 73 andfoundtobeincompliancewiththerequirementsofthisBoard.
FIXTURE
OUTLETS SWITCHES
DRYERS
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
TIME CLOCKS
MULTI-OUTLET
SYSTEMS
NO. OF FEET
E R V I C
NO. OF CC. COND. A.W.G. NO, OF Hi-LEG A.W.G. NO. OFNEUTRAL$ A.W.G.
1 ~/o 1 4/0
4-2.0kw, 3-1.5kw· 6-i.25kw, 1-1.Okw, 1-.75~
OTHER A~ARATUS:
Electric room heater/s; 2-4.0kw,
Panelboard/s: 1-25ckt.200amps.
Water heater/s; 1-Ji.Skw
G&S Contracting Co.
PO Box 215
Southold, L.I. 11971
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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BARRY
WILLS " ' '
ASSOulATES,
L V I tN~rC1
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ROYAL BARR~Y 'WILLS. A~SOC ATE,-
E, MINOT, ~ l, A, =
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'R,OYAE BARRY WILLS ASSOCIATES,
A R O H I T E C T