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Home My WebLink About7028-zTOWN OF SOUTHOLD BUff.DING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificate O[ Occupancy THIS CERTIFIES that the building located at ti/~. ~e~ .lt$~ ......... Street Map No. ~ .......... Block No....x~.. ..... Lot No. x~...~;ChQ~...l~p~.~ ......... conforms substantially to the Application for Building Permit heretofore ~ed in thl, office dated ...........Dee...11..., 19~,, pursuant to which Building Permit No. 702~.. dated ...........De~ · .1t .... , 19~'~., was issued, and conforms to all of the require- m~nts of the applicable provisions of the law. The occupancy for which this certificate is issued is . A~l~,eu~tura~. (fa~e~). btt:lJA,in$ .tr~t,h .a~ addi.t~o~t ................. The certificate is issued to .Frazlk. Me, Bride ....... 0t~eF. .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N,R, ............................... UNDERWRITERS CERTIFICATE No. 1~ .................................... HOUSE NUI~ER ....... 10~.~. Street ...0~o~. ~tO~ .......................... ........ .... Z'O~B,~ 'NO. ~ 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) No. 7028 Z Permission is hereby granted to: .£~.~..!~ ......... ~ ......... ~.......~:~..~.-'.... ...~:~......~...~....../..~ .2.. .................................. O~E~4 ~ b t~uv~o~' I ~).3~~ to ....~.~.~ .......... ~......~7.~.L~.t ~.~ ........ ~.~.~ ......... ~'.L~.m.t.~ ........................ pursuant to application dated / ( ~)~ 19..~....., and approved by the Building Inspector. Fee $.../...~...~i ....... Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~y t~ ~ ~ ~u~t ~ ~c~ ~ ~ int~ by t~ ~t ~ on t~ ~ ~ numar in t~ p~m~s of ~ran~ ~. ~euPlde~ a/~ Oregon Rd., 1000 e/o gll~aha ~ane, Mattltuckj L.I, in the foll~ing ~at~n; ~ B~e~nt ~ lst Yl. ~ 2~ Fl. ou~slde ~r~. e~ ~t ~.~o. Septe~be~ 6, 1973 a~foundto~incompliancewitht~requlrementsofth~B~rd. fiXTURE FIXTURES OUT~ETS SWITCHES FLUORE$CEI~ 1 DRYERS FURNACE MOTORS FUTURE APPUANCE RANGES OVENS SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E 1 2 1 ~ John M. Lademann, 1200 Harbor Lane, Cutchogue, L.I. 11935 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined ......................................... / .. / ! ~ Approved ........................................ , 19 ........ Permit No ..................................... Disoppraved o/c ............................... } .................... =~...._~ .............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT -7/ Application No ................................. INSTRUCTIONS o. This application must be completely filled in by typewriter of in ink and submitted in triplicate to the Building Inspector, with 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 o~ areas, and giving o detailed description of layout ofproperty must be drown 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 issue o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the' work. e. No build ng shall be occupied or used Jn whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY M~DE 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, and to .admit authorized inspectors on premises and in buildings for necessary inspections. ....... ..... 2 ..... ./.,.! ,.. . ' (SignatuLe o_f op_olica,~r name, if a corporanonl'"~'"'~'T ........ ......... ......... (Addres~ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .................................................................................... ; ......... 6~....-r.~......~...~.~...-~.......,a~..~,e~ ........ 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 ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... lC 5-, .. · ":.. , Street ond Number ................................. ~,,....~, ....................................... ~ ........................................................ Municipality 2. State existing use and occupancy of premises and intended use ond occupancy of proposed construction: a. Exisiting use ood occupancy ......................./....'.~......~ ............... ; ........ '..'[...~ ...... ~:..:".~i .............................................. b. Intended use ond occupancy ................. .x,......~ .................... i..: ........... .'i'....../.....:......'...~ ............................................ 3. Nature of work (check which applicable): New Building .................. Addition ~ Alteration Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) 4. Estimated Cost ..................... .~. ........ ~ ........................... Fee J ~ ~ (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 ............................ ~f 7. Dimensions of existing structures, if any: Front ............. ~.. ............ Rear ......... ~'..: .................. Depth ......~.( ......... Height ............... ~ ........ Number of Stories .................................. J. ............................................................................. Dimensions of same structure with alterations or additions: Front....................................~- ~ Rear ..... c:.....'. .............. Depth ........... (,,;.~ ................ Height .................... ,~ ...... Number of Stories I 8. Dimensions of entire new construction: Front ....................'? ............... Rear...... ....... ,~...............i Depth ...... ,.. .............. J ( Height Number of Stories ...................................................................................................................... 9. Size of lot: Front /~( ~ "~: Rear Depth 10. Date of Purchase ........................................................ Name of Farmer Owner ................................................... ~... 11. Zone or use district in which premises are situated ~' / ~ .... '~ ' ' ~' ]2. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded. .............. ~; ........... Will excess fill be removed from premises: ( ) Yes ( ~'~1o 14. Name of Owner of premises ........................................ ; ........... Address ...................... Phone '/5 Nome of Architect ............................... ~;.'..~ ......................... Ad~ess,~. ................................, Phone No ~ il v ~. , ,., ~/:~, .... ~ .... Nome of ~,ontroctor ....;....~ ....................................... ': ......... Address ................................ Phone No ....................... PLOT DIAGRAM t~ ~:,, /~ ~ /-n, ~ / -,;~ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensio~%j[rem-,"' property lines. Give street and block number or description according to deed, and show street names and ~ndicate whether interior or comer lot. STATE OF NEW YORK, ~ S S COUNTY OF ...................~..~.! ;,....~' ' ................................................................................................. Dmng duly sworn, deposes and says that he is the applicant (Name of individual signing controcf) 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 rn~ke and file this application; that all statements contc~ined in this application are true to the best of his knowledge end belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this Nota ........ ............. ....... ....... ....... / (Signatu~ of applicant) JUDITH T. I~lofar/ Public, State of New York 1~o.52-0344953 Suffolk County.~. Co~mi~ion Expires March 30, 19__~.~