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Home My WebLink About6882-zF~F,,M NO. 4 TOWN OF SOUTHOLD BU~,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificnte Of Occupnncy No... Z~'c)~ .... Date .............,/tine.. 12 ..... , 19.. 7.~ THIS CERTIFIES that the building located at . .Jackson .Si; .............. Street Map No.. xxx ....... Block No... xxx ....Lot No...xxxx.. N. ew. ~llffolk..I~...Y.,... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........Sept.. ~.9 .., 19..7.3 pursuant to which Building Permit No.. 6.l~82Z.. dated .........Sel~t.. 21~. .... , 19.-73, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...Garage. apart~nt, wlth. add,trion ................................. The certificate is issued to .. ,~a~ez .Go. l~lll ..... o~n.~ ........................... of the aforesaid building. Suffolk County Department of Heaith Approval (owner, lessee or tenant) UNDERWRITERS CERTIFICATE No.. t~endin~ .................................. HOUSE NUMBER .... 660 ......Street ...Jaeksor~ ~t ........................... 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) Ne 6882 Z Permission is hereby granted to: T o..n.z...o....~....~:k.....~Z.c......~...~...~.~., ~...t..x..1 .............. ........ ~.u.~_og~e ................................................. ~ rage to ..to.. t~u$ld., am.. a~d.i.l.i.m.. 6...ma~e...att e ~a C..i-oris.. er,.-e ~ ~$!mg .......... '--- ............... at premises located at ........ ~../.,~......~.a..,~..~..~..~.....S..~. ................................................................................ ....................................... ~ ~.~.. :9...',~.. ~'.~.! k ......... ~..~..,. ............................................................................ pursuant to application dated ..........................~.,.~.~.,~. ..... ]~. ........... , 19.~'~..., and approved by the Building Inspector. Fee ~.~,QO ............. Building Inspector Examined ......~.....~....~. ........ ,19........~-~ ^ ved ......', .................................. , 19 ........ Permit No ............................. Application No ........................ ~L.. Disapproved a/c .............................................................................................. .......................... '('~uil~ing '"""-'"'""'"' .......................... APPLICATION FOR BUILDING PERMIT Date .................. ~ ..................... · Iq , 'L INSTRUCTIONS ~,~ a. This application must I~e Completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. \ b. PIo, t .pi.an sba, win.g. Ioc.ation. of. lot and of buildings on premises, relationship to adjoining prem ses or public streets or ~, areas, ana g~wng a aeraded descr,pt~on of layout at property must be drawn on the diagram which ts port of thie 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 port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY MADE to the Building Department for the issuance of a Building Perm t purauont 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 re .naval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building ~ <1~ and regulations. (Signature of J&akaon plicant, or name, if a corporation) L ~treet, New Su£folk, N.~. ~ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O~®r Name of owner of premises ..... ~I'&IJelL.G.....Dt.J..L .............................................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of co~orate officer) I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ....... .~ ................ Street and Number ..... ~..q.q~.R.~.ll...~.~r..q~.~.J;. ............................... .~.l~...~M~..g,~ ......................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ...G~..~'...J..~,~I,,I..~I3g...CN.,~I).~g~,~)~L,gI,~....~ c'C~'~'/~,":; ....................... . ....... b. Intended use and occupancy ..... G~.~,..& ~lre~.l~L~ ~..~...~... ~.:.. 3. Nature of work (check which applicable): New Building .................. Addition ....~ ........... Alteration ...... ~. ........ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........... ~O~OOOL ............................... Fee ........... ~],~eOO ................................................................ (to be paid on filJ~ng this application) 5. If dwelling, number of dwelling units ....... ~ ............. Number of dwelling units on each floor ............................ if garage, number of cars ........................... ~1~ ........................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..... ~;:8..~. ........Rear ~\~O~....8.e~. .............. Depth ~l.l...~ ...... Height ........................ Number of Stories r~,<~ ..~...~.. ................................... Dimensions of same structure with alterations or additions: Front ...... ~O.e.~.?.: ................ Rear .;~O.e....~?. ............ Depth ...~?....~.? ............... Height ............................ Number of Stories ....-t,~ .................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ...... ,~.~..e. ............ Rear ........ ~.". ..................... Depth ..... 10. Date of Purchase ....~./jt~Jt...~'...~,.~..~,~ .............No.me of Former Owner .11~'.~..~1131;~11~' ............................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ~1~ ........................................... 13. Name of Owner of premises ..~'.~ll~..l~,..i);Lt~......Addresslll~.~ll~'f'~l.~.~..ll,.~,.... Phone No~"~m~t.~01... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..~...~.~.lJl~...t~.l~ll,.llill~ .................. ^ddressC.~l.~.lBlil~ll.~..J~.l~ ......... 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 i,nterior or corner lot. STATE OF NEW YORK,,., COUNTY OF ..'~.u.~..Ee.~..t~: ............. ....................... .~.,.Q1/~. ....... ..~..:...~..~.~..~ .................................. being duly ,sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ...~.~.'YJ~.~, ......................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly aut~ibHz~d to p~rform or ha~'~ ~erf~r~ed the said work and to ma,ke and file this application; that a~t statements conta:ined in this application are true,to the best of his knowledge and belief; and that the work will be p~'~formed in the manner set forth in the application ~ I'ed therewith. Swam to before me thi~l _ ...... ..... , ' ............................. Nota Pub,c, No. 52-5758570 Qualified in Suffolk Coun~ 0ommission Expires March 30. :~g74 THE NEW YORK BOARD OF FIRE UNDERWRITERS 5W BUREAU OF ELECTRICITY " [~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 ,,,e Aprl~ 3o, ~974 A,p,,.,,o. No. o.,,,e 700--8 N 156554 THIS CE~IFIES THAT ~ly t~ ~t~ ~u~nt ~ ~scdb~ ~ ~ int~ by t~ ~t ~on t~ a~ ~pl~ num~ in ~ p~m~ o~ L.I. in the fM~ing location; ~ ~nt ~examin~ ~P~ ~ ~7~ andfoundtobeln~mplia~ewlththersqui~mentsofthis~. flx~ ~AC~[ SWIT~ [ flXTU~ RA~ [~KI~KSI OVENS [m~W~ ~HA~T FANS DRYERS mRNACE MOTORs ~T.' K.W. ~L H.P. G~ H.P. MT. ~* A.W. G* MT. MP. MT. ~. TIA~. H.P. ~.~F~T MT/ WA,S SERVICE [XSCONNECT i ~o.o~ 1 200 CB S S R V I ¢ I~'2W l~r3w 3~'3w 3~'4w OF CC. COt. iD. 3/0 1 1/0 Water.tiea~e;~.~-~.SKW Motor/e: Slec. Room Heaters: 1-1.75KW, 1-1.SKW, 5-1.0KW, 1-.SKW Mattituck, New York COPY FOR BUILDING THIS COPY CERTIFICATE MUS~ ALTERED IN