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HomeMy WebLinkAbout6833-z1~O]~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .W/S .Pecolltc. Lane. N~RR.. Street Map No. ~ .... Block No.. XX.. · Lot No. XX~C · .Peconie..H,~, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~t~Ag. 3,019..7~ pursuant to which Building Permit No.. {~833Z. dated . . . A~$g 31...., 19 7.3., 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 Mixed occup~c~ .Business..build~_.~n~ ~tore.&. 0fft~e .w~.th.apa~tment The certificate is issued to ]t.o.b.e~.t..Ad~.p~e~;r~ .... .~e~ ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N,R, .......... UNDERWRITERS CERTIFICATE No. ]~.~.96~9 .... Dec.. 2..19~.~ ................ ItOUSE NUMBER .. ~81~ . . Street .... Pemanlc .Lane ...... P. econte ......... .... .... FOlt-.~/ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTltOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6833 Z Date .............. A13~rt~Z.~ ....... ~e. ............... , 19..~..~. Permission is hereby granted to: .................... .: ~ob.e.~'.~ ..,~d;L~ ~e.t rn ............... .............. ,l~ee~ ~¢..;[,az3e .................................. ........................ P.e~o:~ie. ...... ~N...~.. ...................... to ...~ke..~Lt;ex&1;io~a..on..ex£s~..b~,l&~g...(.B~r~ ~s..e~ ~ ........................... ~t premises located at .... .~/S..~.~o-.-ol~o..~a~.~e ................................................................................ ............................................... .r...e..~.o..n..~.e.. ......... :~...×.: ............................................................................. pursuant to application dated ..........................~kl~g.....~.Q ............ , 19~..., and approved by the Building Inspector. - Fee $..1.~..;.~ ........... ...... .............. Building Inspector ~/ THE NEW YORK BOARD OF FIRE' UNDERWRITERS BUREAU OF ELECTRICr~ - . STREET NEW YORK ' ~Ki00~8 THIS CE~IFIE5 THAT was eraminedon NOYe~ID(~P ~'.~ j£~.~ [ q SWITCHES iqXTUII~ 17 13 [] 2~ r~. outEldS Section Block · n~foun~ to be in compfi~nce with the r~quirements of RANGES FUI~IAC~ MOTORS TIMI C~OCKS SERVICE DISCX)NNECT S E R V I C OTHER AFPA~T~: 'Furnace.:l-1/Shp,~-l/12hp ~otorE:l-1/2hp Panelboards:l-Scir 125amp Joseph Crocombe Box 1175 C. ~oriche~,L. I. 1193h DIPAItTMINT. THIS COPY ' ' ;7~' TOWN O~ SOUTaOU~ ~ ~,,,,~ ~ ~ ,~r~_~ ' ~- BUILDING DEPA~HT~ ~ ~ ~ ~< ~~ TOWN C~RKS~FI~ ~ ~ ~ ~- ~.:- ',u -. ............. ............ .'" ~i~,,,~ ./< ........................................ ~~ .. , ~'4 ~~::~ :.~ ............................................. ..... ............ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi 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 areas, 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 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. .... gs, ~ .,?. s or .alt.erat,.ons, or. for removal or demolition, as herein described. The epplicant agrees ~o comply with ell applicable I~' um,nances, ouHamg coae, housing coae, and regulations, and to admit authorized inspectors on p~emises and in buildings for necessary inspections. · (Address Of applicant) if applicant is a corporate, Signature of duly authorized Officer. fName and title of corporate officer) Builder's Lice~lse No ............................ ..~ .............. ~ ....... Plumber's License No z~....~'_..~.,,~;'.....~.. .... '~' ~,'~--~,-~---~.--~-~ ........... *~'Z"42m~/*'~ ~ /~'~ Electrician's License No7,7.......~...;.~..:-..:.;...:....:....:i: .......... Other Trade's License N~ .................... 1. Locetion of land on whigl~ proposed wOrk w bedone MapNo ............. .. . Lot~U,, // -~. ~ n - '"'":'~ ......... : .................................. Street and Number ...Z~'~.~,~I~Z .......... ,~,~,: ........... ,~.~,~..~,~,/..,~.~ ...... X~...,~,,~ ............................................... MunicipalitY 2. State existing use and occupancy of premises e/nd intended use and occupancy of prolx)Sed construction: a. Existing use and occupancy .........'..~..~..-~.~......~..".....~.~.~.~Z~....)/__ .. , -~------ ........................... , ...... ' ......... i.. b. Intended use and occupancy .......... ~..~ .~..~.......~..,t...,,.~//j~.~.Z~..(~ ......................................... ',~ 3~ ~.Na~ure of work (check which apolicable): New Building ....................... Ad, dition ..................... Alteration...., ' Repair ~ Removal ............ Demolition ........................ Other Work ............................... ............... · ....... (Description) ~r . 4. Estimated Cost .......... ~.~..~....~..~.. ................ Fee .. ~...~.. ~. Y.. ................... · ' '(to I~; pai~l o~'~iling this apl~ii'cat'i'~;1) ..... 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 occuoanc¥, specify nature and extent of each type OT 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Number of Stories ................................ Height .......... · · Dimensions of same structure with alterations or additions: Front ....................... Rear ......................................... - -~ . .. Hei-ht ...................... Number of Stories ..................... , ................. 8. Dimensions of entire new construction: Front ..~..~..,..~ ........... Rear ../....?.;~...~- .......... ueptn ......~ax .................. Height ............................ .-_'"'= ............. Number of St~or~es .....~... ................................ .).~-Z~ .................................. 9. Size of lot: Front ......... ~...~,.. .................... Rear ...,~....'~. .................... ~::...~.: De~th ..;.(.-~..:~..j~..~.~ ................... lilly Date of Purchase · ..'~.-.~.~..~-.-~.~.-~. ......... Name of Fornje:r Owpar..~·'...l~-[..~..~.......~f...~-....//~l.-~ .................... 10. 11. Zone or use distri~['i~ which premises are situated ..... /..~.~·/.X~...l~.~..~.. ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... Will 1o, be re~'aded ~-*~-.~....~,~-~--.-.*,_-.. W!~ e ~ ~ss f. il~.,.be re~.r./;.o.~.rP~..P.~.~..mlz2·~;; [..,~..~/.:.~.[ ..]....N.~.~.~..~_ 1134: Name of Owner of premises .a~z(,~?~..~...-..~. '~'~/~.~/'~'"'"iA~iress) ..... '~ "' ~'f~;': (P~o~ No., Name of Arc'tact ...................................................................... i~&i;~';;i ............ : ...................... i~'~"~'~:~ ............... Name of Contractor ......................................................................................................... ~ .......... [~'l~'i~i ............... (Address) PLOT DIAGRAM Locate clearly and distinctly all bu~ d~ngs, whether ex,sting o 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 wheth- er interior Or corner lot. I I ' L. I, F.*['~' ~ I I l cou. , .................. ) I I ~*~ '~ n 'u sworn de o~s and says that he is the applicant a~ove na~ .................... He ~s the ....................................................................... ~'traCtOr, ~, coyote o[~cer, etc.) of said owner or owners, and is duly authorized to ~dorm or have perfor~d the said work and to make and file this application; statements ~ntained in this application are true to t~ bes~i~E~l~ belief; and that the work will ~-~6or~ in t~ ~n~ set forth in the application filed t~rew~th. ~ PuSl[:, Slate o~ ommi~res ~erch 30 ................... .... ...............