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Home My WebLink About7032-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z~89~ ....... Date .............. l~ay ....? ...... , 19.~. THIS CERTIFIES that the building located at . BI'ay ..,tv& ............... Street Map No. 6, I.,TmthlllBlock No ........... Lot No...79 ..... La~arel...I~, ]f.o .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Dec...lb,.., 19.73. pursuant to which Building Permit No...~0.32Z dated ......... Dec...11+ ..... , 19. ?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~lvaf, e. ona .family. d~e!ltn~ .with .additiolx .................... The certificate is issued to .P~ack .G,. l~errXll ....... ?.wrier ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. 1~.~1~o ............................. UNDERWRITERS CERTIFICATE No..N..1.~6039. ..... .Apr...26...1.97~ ............ HOUSE NUMBER .... 2.~.30 ..... Street .. l~ray Ave .............................. Building Inspector TM OF SOUTH(ND BUILDIN~ DEFA~T/AINT TOWN CLERIC1 OFFICE SOUTHOLD, N. Y. BUILDING PI_IU~r (THIS PERMIT MUST BE KEPT ON TH.E PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7032 Z [:)ate ............................. Mm ............... tl~ ]9......7..3 · ~e®..~e~,e..kA~le~...Z~e.-...a/g.... ~e~ Ne~,,zL,I.1 pursuant to application dated ........................... ~ ..........I~ ...... , 19....~:~ and approved by the Buikling Inspector. THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY j--- 85 JOHN STREET, NEW YORK, NEW yORK 10038 ~,.~12~. :97, App,~..~n~..on~,. 7121~0 'N156039 THIS CE~IFIES THAT Mack Me~t11. 1980 W/S B~ey Avenue~ Mat~l~uek~ L,I, 3 , 8 5 3 SPECIAL RRC'PT. ICOOKING DECKSI OVENS ]DISH WASHERS AMT. K.W. ii AMT. K.W. MT. K.W. TIME CLOCKS / BELL UNIT HEATERS MULTI'OUTLET SERV~'E mSCONNECT I NO. OF ] S E OTHER APgARATUS: R V I C E EXHAUST FANS AMT. H.P. DIMMERS W.B. Ruland ~ ~tttuekS L.I. m MANm~ Per COPY F___~OR BUILDI~,___DEP.___~TMEN___T, T___HIS CO~PY~OF CERTIFICATE MU~ST~HO~T B~E AL?R~ I~NN~ANY_ _/~'~N~N'R. Approved ........................................ , 19/..~... Permit No. ~'.~.].~.~.,m. ....... ~ u,~r~ a/c ............... ~ .......................................... ~ ................ ~ . ~ ~ r. ~ (Buildi~ APPLI~TI~ FOR BUILDING PE~IT .......... ........ I~T~l~$ b. Plot plon ~h~i~ I~ation of lot ~nd o{ bui~i~ ~ pr~mise~, rel~ion*~p to edjoining ~r~ ond ~ivi~ ~ detoil~ de~ripti~ o{ I~ut o{pr~ mu~t ~ dm~n,~ the di~flmm whi~ d. H~n *pp~l o{ ~i~ ~pplic~ti~, ~ 8ui~i~ In~or wiU issue a 8ullding ~*rmit to the ~plic~nt. SUch ~h~ll ~ ~t ~ tbe premi~ ~ailabl* {or in~fi~ ~ ~ ~rk. e. ~o building ~h~ll ~ ~cupi~ or u~ in ~o1~ or in pa ~ for ~n~ pu~ ~ot~ver until ~ ~i{ic~ o{ ~ou~ncy ~oll haw ~n Omnt~ by ~ 8ulldi~ In~r. i~ .A,P,.PLIC~^TIO~N ,!S HEREB. Y.MA_DE to .the Building Department for the issuance of o Building Permit pursuant to the uim~n.g. ~on.e u .mlnonce at t. he .own.o.t. 5outhol,d., Suffolk ,Cou.n. ty, New York, and other applicable Laws, Ordir~nces or egulahons, tar the construction of bu,ld,ngs, add,tlons or a,terahons, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ,~'.~...,.....~...~~/./,/,.. ............................................................................. 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 ............................................... Location of land on which proposed work willie done. Map Noi: ....... .~....~...../.. ............. Lot No.....~....?.. .......... Street and Number ......... ~..~,,~..~.'.~...,~.....~..~. ...................................................................... Munlcipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use ond occupancy ............... ...... ............................................... b. Intended use and occunnn~ /......~....~'. . ./...~..~.......~......~/...~..///~'~ / 3~. Nature of work (check which applicable): New Building .,~ .............. Addition .....~.... Alteration ...... , ........... Repair .................. Removal .................. Demolition ............. ~ ..... Other Work ...................................................... ..~..~....~.. Fee ~..~..'~...~ (Description) 4. Estimated Cost ..... ~.~..*'..~....~. ................. ~...~ i ....................................................................... ~ (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 ........~.....2~-..... Height .......... ~..~.. ...... Number of Stories ................ ~.. ................................................................ ~ ............................ Dimensions of same structure with alterations or additions: Front ............ ~.~... .............. Rear ...... ~J~...~...'~..... Depth ...................... Height ......... ~..~ ........... Number of Stories ............./. .................. ~i 8. Dimensions of entire new Construction: Fron~ ........ z~... ................. Rear ........ ~.~. .............. Depth ........~....c~. ........... 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 ................................................... '77, ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... /~...~. .......................................... 13. Will lot be regraded .........~.~... .......... Will excess fill. be removed from premises: ( ) Yes ~,(~'. No ,/,, 14. Name o Ow r o prem,ses ~.~9~..~/...~.~....'..~..'././.... Add ess ................ ~.:...~..['~l~J~o ....................... Name of Architect ............................................... ~'"'7 ....... Address .............................. ;. Ph,~/orm No ....................... Nome of Contractor .../~.......-~'...~....~.~.~..~'~../.~'... ......... Address ~.~6J'g~...~.¢/~..~one No~..~..T..~'.../.?..Z.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b<3ck dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, ~' ~ S ...................... ~l~....~~.~....being duly sworn, deposes and say~ thot he is the appli¢om (Name of individual signing c~trac~ ~ above name. He is the ..................................... ~. ........................................................................................................ (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contoin~ in this application are tree to the b~t of his knowledge and belief; and tha~ ~e work will ~ perfor~ ih the manner ~t fo~h in the application filed t~rewith. Notaw Public*~~~ ....... C~ ~...~~.~-..