The URL can be used to link to this page

Home My WebLink About6057-zFORM NO. & TOWN OF SOUTHOLD BUILDING DEPARTMI~,NT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No...Z.6.2.Q.8 ..... Date ...........N..o~ ..... 2~...' .... , 19.~.. THIS CERTIFIES that the building located at .. I~/S .Bell.Hill. i~ ......Street Map No...~. ........ Block No ..... 3~ .... Lot No..333:...F. $~be.~,~..Z.~ .l{~.r_.~[.. ~.:Y. ?.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............~.tt;ty...21~, 19. ~.2 pursuant to which Building Permit No.. {5.0.~. dated ............Azl~...1.0.., 19..?2, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.~$y.~.~.e...~..e...t'.~..i.l.y..d.w.e.~..~.[ ....................................... The certificate is issued to ....~. ,~,...Ot~J,1;l,&l'd .......... .0~er. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....pe~d, ll~g ........................ UNDERWRITERS CERTIFICATE No..N..0.9.!32~.....~r. 27... !973 ................ HOUSE NUMBER ..... .~1..e .... Street .......................................... // '" Building InspectS/ I~OF, M NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THt~ WORK AUTHORIZED) 6057 Z~' Date ........................... J~.~l.~l~$, .....~ ..., 19....~'~ Permission is hereby granted to: 7,6~ .... ¢o~t ~ae.t.~.~g...l~.,.L.,Ga.~.t~al~! ..... ............ F~she~s..t.s-~e~ .................................. at premises located at ............. ~/~.-~e.~...fi~,.t~.--A,~e, ....... N'~..~:h~or..8~l~ ............................. ......................................................... F.~.s he ~ ...~.s-taz~t ......... .1¥~.~ ................................................... pursuant to application doted ............................. ~'~.~ ....... ~1......, 19..r~., and approved by the Building Inspector. Fee $..$3~¥1~ ....... Building Inspector / NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE .~.... SOUTHOLD, N, Y. Examined .... ...~.....?....., 19....7....~ Approved ..V....~,~....~....~......., 19.7...~' Permit No...~...,.0...,.~...~...........~ DJsppproved a/c .................................................................. Application No.~...?...~.....~. ............. APPLICATION FOR BUILDING PERMI'I' 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, relationsh p to odjo n ng premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is port 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 NtADE 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, housing code, and regulations. /~~f ~ant, or name,; a corporatiol~ ....... State whetherappl,~i~t is owner,, les~ect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .../~......~..~~ ........................................................................................ IfLooDlic, x~t iS a corporate, signature 9f~uly. authorized officer. (J~SmeVand title~f corporate officer) 1. Location of land on whicl~ proposed work will be done, ]V~ap I~o.: ........................................ Lot No.: ........................ Street and Number,~.~W~....,~--~../..~/.~/._...~.....-,/.~.., ..~.......~ .......... i Municipality ......................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ....................... .. ..................................... ~// ..~ .~ .................................................................. b. Intended use and occupancy ..... ..~.~....~~ ................................................................. property lines. Give street and block number or description according to deed, and show street names and whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................. Additio .................. Alteration ............. :.~.. Repair .................. Removal ................... Demolition .................. Other~ork (Describe) ........................................ ~ DOo 4. Est mated Cost ............. ~.....~ ........................... Fee ... ~. ..................................................................... (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 ................................ 8. Dimensions of entire new construction: Front ....... ~'.~... ................... Rear ..... ~..~7~ ............. Depth ...~...e~ ........ Height ..~...~...~. ...... Number of Stories ................. ~ .............................................................................................. 9. Size of lot: Front ...... I..~,~.~..~. ......... Rear ......... ~.,~,/~)..~. .......... Depth ...... .~..~..~.../. ............. 10. Date of Purchase ........................................................ Name of F, ormer Owner ........................................................ 1 1. Zone or use district in which premises are situated ..... ..~..~.~ .............................................................. 12. Does proposed construction violate any zp~ing law, ordinance[ or regulation.;> ............ ~'..~. ..................................... 13. Name of Owner of premises ~./.,.~-Y':..~....Address ~..~.....~.:_.~.-. .............. Phone No ..................... Name of Architect ~...~ ................ Address~.~.... Phone No/,~,~5'~'.~'.~...4~ Nome of Contractor~..~..~.~..~ .......... Address .~'......~......~...:..~... ................ Phone N~7~.~....'~'..~.... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end indicote all set-back dimensions rom cate STATE OF NE~F"Yq)P~,A j/ t c e '~~i ................. being duly sworn, deposes and says that he is the applicant 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 Jn the manner set forth in the application filed therewith. .S..w..~.r~..~o.~f..o.r.~ ~[~eyt~s .....~ .......................... , 19....~..* ~~....~...~ Notary Public, ...~~~..,~.~ ........ County "~'~-~' (Sig~~~) No. 52-0028880 Que~fied in Suffolk Count~ Term expizes Mazch 30, 19 "~ ~ THE NEW YORK BOARD oF FIRE UNDERWRITERS 5/21/73'£1 BuREAu OF ELECTRICITY' ~R~.~'~'~*C~ OF ~6763 ~ 85 JOHN STREET, NEW YORK, NEW YORKIO~---- N 091'325 THIS ~1~1~5 THAT ~e'ami~d'~rll 25,1973 a"df°u~ihcompliancewiththerequim~nts°fthisB~* RXTURE LECEPTAC I WIT H [ FIXTURES 36 /' ,~ ~ I 3~ I I DRYERS I I~JRNACE MOTORS ] m~'U~E APPUAN~E FEEI~EE~ SERVICE DISCONNECT ] NO. OF J S E 1 ,,'.,,'ER ! .o ,, AMT. A~p. TYpE EGUIP. I.~/2W I.~3W 3~'3W 3~'4W ,O~ERCC.~CON ' !09 C-~ ! OTHER APPARATUS: RANGES ~'OAL REC,pT, R 2 COOKING DECKS OVENS DISH WASHERS A~T. K.W. I A/~T. K.W. , MT, K.W. L: '" NO. OF FEET V I C NO, 0~: HI-LEG A.W.G. EXHAUST FANS DIMMERS I ; ? Panels: 1-20 C.B. 100 amp~ Z & ~ Conch. Box 202, Fishers Island, N.Y. ~ 06390 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.