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Home My WebLink About5868-zFO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No.. 7.5280 ..... Date . .4~. ~...aS. ................. ,19.73. THIS CERTIFIES that the building located at 925 14¢C~m~ Lame Street Map No...g.021 ...... Block No ........... Lot No ...... .7. .......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated . .M~Y..].~ .............. , 197;~.. pursuant to which Building Permit No. ~.8.6.8. z... dated . MaY. 12 .............. , 19 ~., 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 Private Switching Pool (Accessory) The certificate is issued to ....E.r..i.e., .Ty.r.e.r. ........................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER92..~ ........... Street 14cgal~l Lalle! Ol'eellpori;! New Yol, k Building Inspector~ FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5868 Z Permission is hereby granted to: .... ~......~:~ ...... .~.t~.~ ................. at premises located at ....................................... ..~,..~. ........ ..~..~....~....A/.. ........... ..~..~...)~.....~.. .......................... ....................................................................... ~..4.~..P...o..~T.....~ ............................................... ...... ~...~ ........... ~....z...., ....... ~,,,,, ..................... / ....................................... pursuant to application dated ......................../../. ........ ..~...~....~......, 19..~Z.....,'~d approved by the Building Inspector. Building Inspector FORM NO.I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. ~ Approved ...................... ~ ............ , 19 ........ Pemit No ..................................... Disapproved a/c ......................................... ~~ ........... : .................. .............................................................. ......... ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT . --,/ -' Date ....... ~...,'. ....... : ........................ , i y,;.....;;... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector with~l~ 3 sets of plans, accurate plot plan to scele. Fee according to schedule. 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 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 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 bean~, grante~ 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, Suffo~ County, New York, and other al~pliceble 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, and to admit authorized insp~ ~:tors on prem~ ises an~_!~ buildings for necessary inspections. ~ ~ C~ f ............ ;..:.,;~.;'~.:..~.~...: ....... ~.,.v~..: ......... ~.,.~;.::.. ........... ; ..... (Signature of applicant, or name, if a corporation} ,..,/.~.,,..,.(.,..,,..... ..~. ........ .'...~ ................... Z'~. .'~.. . ~'~o~--~ ~ ~ ~ C<~,~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. .~.... ~..~,~ .~.~.~;.. ....... .~,v~'.. ,~.~..~.~. ,,.... ,.~.. ~. ................................................................................................... Name of owner of premises ........... ~,~:'?,4.,~,,e~... ....... ~,,~,,,."~.,~m~.. .................... ~ ................................................... If applicant is a comorate, signature of duly authorized officer. (N~i~h'e and~i~tl~f c0x~f~orate officer) -- ~ -7-'/' 0 -- ~'- '?- -- 1. Location of land on which proposed work will be done. Map No.: ..~.,~.J... Lot No ............ Z ............................ Street and ........ ~ ................... ~.-..,i,..-...,,..; ............. ,;~,~ , ........... -~-.:..,~... .... /~ Municipalit~f' 2. State existing use and occupancy of premises and intended use~and ,occu~pancy of ~)roposed construction: a. Existing use and Occupancy ................ .~... ~T,~f.~'. ~'~.~,.~....~ ~--~~~ ............................ .. b. Intended use and occupancy .................. ,.~:~,-4~::~...~... .......................................... ~ .............................. ~ 3. N&tur~ ~? work (check which applicable): New Building ....................... Addition ............... ,~... A[teraa~on.,.~ ....... Repair .................. ....... Removal .......... ............... Demolition ...................... Othe~~ ~..~.. /~- ~ 4. E~ima~d Cost ....... ~.~ ......... Fee ................................................................................................. (to ~ ~id on filing this ~pplication) 5. If d~lling, numar of d~liing units ................. Numar of dwelling uni~ on each floor ......................................... If ~r~, numar of cars ..................................................................... ~ ...................................................................... . 6. If busine~, commercial or mixed o~upanc~, s~ify nature and ex~nt of e~h ~ of u~ ..................................... ~. ~,~n,~on, o~x~.~,~c~ures.'~an~= ~ron, ..... ~,,5..,~r:....~.....~ ..... ~,th ......... ~....~. ............ Height ................... ~ ............................. Numar of S~ories ................ ~ ....................................................... Dimensions of ~me ~ructure with alterations or additions: Fro~ear ......................................... Depth ............................................. Height ......................................... Numar of Stories ........................................ s. ~n~o.~o~n~. n~wco.~c~on= ~ron~ ...... ~& ........ ..r ....... Z~ ............ D~.~ ............. ~ ............... ................................................. ,u ro, S or,e ....... ................................ ~. ~,z~o,,o,= ~ron, ........... ~.~....~ ........ ,.r ........... ~.~~~,th /~ ' Height .................................................... Numar of Stories ...................................................................................... ,0. ..................................... ............................. 1 I. Zone or u~ di~rict in which premiss am situat~ ........... ~~~~ ................................................. 12. D~s propo~d con,ruction violate any zoning law, ordinance or m~lation: .............. ~ ........................... 13. Will lot ~ m~ad~ ~ ......... Will exc~ mmo~d from pmmims: ~Yes [ ] No 14. Name of Owner of pmm~ ...... ~ ..... ~ ..................................................................... _.~..._...... (~dress) (Phone No.) Name of Archit~t ..................................................................................................................................................... ~ . ~ ~ = (Address) .~ ~ ~ (~hone No.} o, Con,re~ .. ' ............ ~.~.:....~~..' ...... ~ ........ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from proper'q/lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. _ STATE OF NEW YORK, ) COUNTY OF .......................................... .......... ) SS ~_~T_, - He is the ............................ ~ ........ i~...~..~ ........... ~~ ....................................................................... of ~id owner or owners, and is duly authorized to ~orm or have ~rfor~d the said work and to make a~ file this appli~tion; that all s~temen~ ~n~ined in this appli~tion am true t~t~knowled~ a~ ~lief; and that the wo~ will ~ ~dor~ in the ~nner ~t fo~h in the ap~i~tion filed therewith.