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HomeMy WebLinkAbout6874-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~ ... Date ...... THIS CERTIFIES that the building located at . .. A~.Yah~ ;bane.. Street Map No..:X~ .... Block No.. ~ ... Lot No. ~ .... C.11.~.ql~.gl~. ~' . lt. oY.? ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . ~ept.t. 2/0 ., 19.73 pursuant to which Building Permit lqo. 687b~Z dated .... I~ep~;. 20, 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 . P~viva~e one. f.a.m, ily ~welling . .. The certificate is ~ssued to . S.talzl~y .Wall~y .... of the aforesaid building. .O,~e ~ . (owner, lessee or tenant) Suffolk County Department of Health Approval ...N. :.R: .......... UNDERWRITERS CERTIFICATE No.. po.l?a!~..g ............................ HOUSE NUMBER . ]03~ ... Street . AJ.v.ah.~. L.a~.~ ..................... Building Inspector 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) N9 6874 Z Permission is hereby granted to: ~..~.a....~.....~...~......~.a....~.. ~ ................................... ........... C~;~h~_~_ _~ ........................................... to..~.a....~....a.~.~.~.~..~.~..~...~.~r~..~.~...~...*.;~`~.~A~...~.~.~ .............................. at premises located at ....~..~....a~'~JJ3..l.,~...~J~J~ ............................................................................... pursuant to application dated ....................... ~e~.....~LO ............. , 19rj.~...., and approved by the Building Inspector. Fee $~J~a~ ............ Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS '~&b BUREAU OF ELECTRICITY. ' i ~ ~ 85 JOHN STREET, NEW YORK, NEW YORK~lOO38 ~,. De0embe~' 20. 1973 ~p~Uca,~,.~'o.o./i,.~388~' N 134429 THIS CEI~TIFIEB THAT ordy the electdc~ equipr~ent ~ de~rib~d be~o~ and int. rodueed b~ tl~. ~.'.ce~t ~ on [he.~bo~e.o, opl~,a~m ~umber i, ~ pmm~s of Cu2cho~e, .~....i~o. . ~oembe~ 17, 1973 a~foundtobein~m~ia~e~ithther~Uire.en~softh~. FIXTURE i~TA.=.I ~,..... I RXTURES ~ES ~I~KS O~NS ~SHWA~K EXHAUST FANS 2 30 8 2 I 1.'~ 1 ~. ,, I I I I I.I I I I DRYERS I KRNACE ~TORS I ~TURE A~A~, m~ms ~IM~ TIme. KS I "u lUNITHEATEK ~T~T ~E~ ~ , ffRVlff ~NN~ I~.O I s E n v i c OTHER ~ARAT~ mPu~naoe/sl Oll, 1-1/8bp 2'l/12hp especial Recept&elesl 1-30amp 1-50amp I Post lSght. Robert A.Bood&le 525 O~cha~d St, New Suffolk, L.I.11956 COPY FOR BUILDING DEPARTMENT. THIS COPY OF ~;EKPt',CATE MUST NOt' BE ALTERED IN ANY 'MANNER, T FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............... ? .c./... ........... Examined ..~'Z....~ ............ , 19.?,~.... Approved '~ ~'f ..~_.. No.~. ~C'7/-/'~-~ ........................................ , 19. Permit ..................................... APPLICATION FOR BUILDING PERMIT % Date Sept 20 19 73 ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate to the Building~ Inspector, with 3 sere 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 adjo n ng prem ses or publ c streets or areas, and g v ng a detailed description of layout ofproperty 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 ssue a Building Permit to the app cant. Such permitn shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or n 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, Or4inances 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 inspectors on premises and in buildings for necess~ry inspections.~_,, ........ A~vah ~ s La~ vCutcho~e (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner- Name of owner of premises ~.t;.~D,~.~. ~.~,~.m.~. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... I. Location of land on which proposed work will be done. Mop No.: ...... ~ ............................ Lot No......Y~... ................ Street and Number ......... W./.J~.....,~,.'R'~...,~..,T4~,D.~ ............... g. IJ,~Q~M,~ ............................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwel'ling b. Intended use and occupancy same with addition & Alteration 3. Nature of work (check which applicable): New Building .................. Addition ......;T~ ....... Alteration .......:~.....Z Repair .................. Removal .................. Demolition..: ................. Other Work ................................................ ..... (Description) 4. Estimated Cost ............. .1.:~..0...0..0.....~,+ ........................... Fee .....1.!.~......0..0.. ......................................................................... (to be paid on filing this application) §. If dwelling, number of dwelling units ........... .o...~..e. .......... 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 .................................... Rea~ ............................ Depth ................................ Height ............................ Number af Stories ................................ 8. Dimensions of entire new construction: Front ................ 2~ ............... Rear ............ 22. ........... Depth ..~. .................... Height .................... Number of Stories .................................................................................................................... 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 ....!.~.!!...~:Ln~ .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~.9 ................................................. 13. Will lot be regraded .....~G .................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..... I~.t;~zz3. eT...~.~e.~. ............. Address ......~,t,C:~.Q~,l~ .....Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... 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. STATE OF NEW YORK, I. S S COUNTY OF .... ~.~'.~...~,~ ........... ~ ' ......................... .~.l;;~:P,~...~;~.~'. ..................................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the O~,mer (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 fife this application; that all statements contained in this application ore true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................. o, ..................... Notary Public, . ................................................... County .... .,~.,,n~.~,x~e~..~F-t~-/F.~..~.~.~.~..:..~:..'::~.....,d ............................. ~' ~oture of opplica¢ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ..~]d'.....~. Approved ............... I: ..... .~...( .............. , 19..~.~... Perm,t No.~...~....Z....L./..~ ............ Application No ............... ~ Disapproved a/c ~::.~ ..... ~...._,¢~. ............... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled m by typewnter or in ink and submitted in triphcate to the Buildin. Inspector, with 3 set~ 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 adloinmg premises or pubhc streets o areas, and giving a detailed description of layout of property must be drawn on the d~agram which is part of th~s applicatioe c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of th~s apphcation, the Bu,lding Inspector wdl issue a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bulld,ng Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or far removal or demolition, as herein descrlbec The applicant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and t, admit authonzed inspectors on premises and in buildings for necessj~ry inspections. ................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises .... ~..l;.~Z~.~Z~...?./.ft~.~..e.,~r. .................................................................................................... If apphcant 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 ..... ~ ......................... Lot No ....~ ............... Street and Number ......... ~ ..... J~¥~q. ...... X~fiZ).fl ............. .O.~C~&L~.f~ .......................................................... Municipality State existing use and occupancy of premmses and intended use and occupancy of proposed construction: o. ~is,ting use and occupancy .~.~.~g.~. .................................................................................................. b Intended use and occupancy ...... 3. Nature of work (check which applicable): New Building .................. Addition ......~ .......Alteration .. :7~ * Repair .................. Removal .................. Demoht~an .............. Other Work ........................... (Descr,p'ti 'on) 4. Estimated Cost ............. .1..~..0...0..0.....~,+ .................... Fee ..... ?:~..~..0..0.. ........................................................ (to be paid on filing th~s application) 5 If dwelling, number of dwelling units ......... .0..~..e. ........ Number of dwelhng umts 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 ex~st~ng 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 ........... 22 ............... Rear ............ ;~2. ........... Depth. 8. ..... Height .................... Number of Stories ................................................................ 9 S~ze of lot' Front ........................................................ Rear ......................................... Depth .......................... 10. Date of Purchase ..................................................... Name of Former Owner ............................... 11. Zone or use district in which premises are s~tuated . . !!3.!]...~.~..1; ..................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation ..gq ............................................... 13. W~II lot be regraded .... .:~.~ .................. W~II excess fill be removed from premises ( ) Yes ( ) No 14 Name of Owner of premises ..... ~.¢.~z~3. e.~...~Z~.i~e.7. ............. Address ......~¢~]2f~'.g~ ..... Phone No ..................... Name of Architect .................................................... Address ................................ Phone No ...................... Name of Contractor ................................................Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether ex~stmg or proposed, and md~cate all set-back d~mens~ons fron property hnes. G~ve street and block number or descnpt*on according to deed, and show street names and md~cat~ whether interior or corner lot STATE OF NEW YORK, ~.., COUNTY OF .... ~.g~.~ ~,~!¢. ........... ~.~ ......................... .~.~.~g~.g~...![.(,~-g...~.~r. ................................ being duly sworn, deposes and soys that he ~s the apphc~n (Name of indw~duai s~gning contract) above named. He ~s the ...................................... ~. ............................................................................................................. (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make ~nd f,[ th~s application; that ail statements contained m th,s application are true to the best of h,s knowledge and behef, an. tk, a~ the work will be performed ,n the manner set forth m the apphlat~on filed therewith Sworn to before me th,s ~' ~~~~ ................. ~.~. day of ..................... ~.~ ......... , 19..~.~ ................................................... ..... .............