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Home My WebLink About5819-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z..h..~.~.? ..... Date ............ Oct. 26 ........ , 19~. THIS CERTIFIES that the building located at . .W/8.15®11. Itill. A,~re ...... Street Map No.. ~cx ........ Block No...XX ..... Lot No. x~x... F.~sb.ers. Ialan¢l...1~.¥,.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ &lar~l..7., 19~/2... pursuant to which Building Permit No..5819~-.. dated ........... A. pr.~...~.~..., 19..~2., 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.~vate .Guest. Cottage .(~,ecessor~..build4ng) ..................... The certificate is issued to .. 6....[tonald. & .Charlotte. F~se ...... Owr~or! ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .Pel~ding ......................... UNDERWRITERS CERTIFICATE No.. P. elld.~rt~ ....................................... HOUSF. NUMBER. ]2~1~ ....... Street ................................................. . , ,... :,.,,/ .... Building Inspector / FORM NO." TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5819 Z Permission is hereby granted to: .............. F~EO'~'~"T~I~'~'"'I~;][~ ................. to..~.xA..~.e..w.....oA~....t.~..z~....~_~..?.?:.z..~. ................................................................................... at premises located at ....w~l~..T:i~,l,~..li~%l..A~'~ .............................................................................. ............................................. :~i~h~rs...~d.' '"~?'vY"/ ................................................................... pursuant to application dated ........................A~,'I,.....].~ ......... , 19..~.~.., and approved by the Building Inspector. Fee $3J~.~.~ ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ b~ Date I~oveitlb~r THIS CERTIFIES THAT 5464:g only the electr~al equi~prnent as _eLeacrlbed belo~ ~ int~u~ ~y ,t~ ~l~nt ~ on t~ a~Dl~at~n n~m~r iff t~ p~mlses of inthefollowinglocation; [] Basement [] lstFI. [] 2nd Fl. o~tside Section Block Lot · . Novezaber 3. 1972 was exam~nea on . and found to be in compliance with the requirements of this Board. FIXTURE LEPTA ] I FIXTURES SERVICE DISCONNECT I NO. OF S 1 100 NCB x 1 METER. AMT, AMp. TYPE EQUIP 1~'2W 1~'3W 3,~3W 3~4w NO'O~aECRC~,CO~4O' OTH~',~AT~o[~ heaters: 1-1 kw 1-11.2kw Dwyer Unit RANGES SPECIAL EEC'PT. E R EXHAUST FANS DIMMERS 1 600 COOKING DECKS OVENS 1 DISH WASHERS AMT. K.W. AMT. K.W.I , MT. K.W. TIME CLOCKS ULL UNIT HEATERS MULTI-OUTLET V I C A. W.O. NO. OF NEUTRAL~ NO. OF HI-LEG OF HI-LEG 2 1 OF CC, COND. OF NEUTRAL 2 A.F,. L~reb e Eed~;e Etreet Box 356 ~6390 COPY FOR BUILDING DEPARTM~~ENT. TH__IS COP~Y O__F CERT__I:FIC~AT~E M~UST NOT BE~ALTERE~D I~N ANY MANNER. r T 1'OWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....,.~..~....~. ......... , 19....~...?" ,, Approved . · ~ '* 19 ........ Permit No... Application No.....~-.-.~.../-..~'.. ........... Disapproved a/c ~...~ ....... :~ _ APPLICATION FOR BUILDING PERMIT 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 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 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, housin~code, and regulations. ..................... (S'g tue of a~l~'.cant, or name, if a corporation) (Address of applicant) /~ -~ ~ 0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General aontrac~or · G. Ronald and Char~lotte p. l~z',,e ............. Name of owner of premises ....................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of ' ' Tax ~ land on which proj:~ed work will? do, ne. Map No.: ................ .~...~.~1 .............. Lot No.: ........................ Street and Number ~ ~ ..... 5....' .................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........................................................................ .............................................. SUmmer aottage ' b. Intended use and occupancy ......................................................... ?~._';..... ........................................................... 3. Nature of work (check which applicable): New Building ][ Addition Alteration Repair ............... ;.. Removal .................. Demo it on ............... Other Work (Describe) ........................................ 4. Estimated Cost ......~...0..!..0...0..0. ....................................... ~Fee ..~.8..i.~..~. ......................................................................... (to be paid on filing this application) 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 ............................ Depth ................................ Height ............................. Number of Stories ................................ /~2' 6" ~ ~2'6" 8. Dimensions of entire new construction: Front .................................... Kear ............................ Depth 20w Height l~g . Number of Stories ]- 9. Size of lot: Front ~90e Rear~.~..~..?..~..t...~.~...0..e. ........ Depth ~00w ~.v.e.~.~e 10. Date of Purchase .~.l~Pe.t....~...0..,...~.~,l, ....................... Name of Former Owner ..d'....9..~...e.~)..h....~..?....C.~...O.~.]... .................. 11. Zone or use district in which premises are situated ....0.....-:....~ ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~..~.. .................................................... G. R, Furse -JJ F~.,,her,, 13. Nome of Owner of premises ........................................ ~aaress ............................................ ~'~o~e No ..................... Name of Architect ..H..u.~......J[..o.~.e...~. ............................ AddressGgJ~f.O,l~l,,...C[gllll, ......... Ph~o0n~ No.~.~.~3.-..~.2...]:.~.. Name of Contractor ..t~...:....J'.........F..a/.~.....~....~.?..~. ................ Address .F.[.s...h..e.?...s....~.~...]:...a~....d..e..N.......y.: phO~n~e~/~lo. ~..8..8..~..8..~..~J .... 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 corner lot. ................................. ,.....~',,~...c~J.....~.....being duly sworn, deposes and says that he is the applicant (Name of individual signing ~pplication) above named. He is the ..... ~ ........................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make end file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth Jn the application filed therewith. Swam to before me this k.O.. ....... dd of ... \ ........ / morary up ic, ......~....~.~.~ .................... Counb/ (Signat0fe of applicant) ....... LU~¥ NotaW public, ~tate of _l~'ew No~ 52-002888u Quolifiect Te~ G i ,i . ',FJ t'c ur= N I i~ II FS,,E O ~o 0 1,4 MP-..WlE"5, G,,E:, F'UZ5 E-' . HU{ NES, ARCHITECT A:IA ',. - . GUILFORD, CONN,