The URL can be used to link to this page

Home My WebLink About6568-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z..~..3.6. ...... Date .............. .S.e.p.~....tO..., 19 ~.3. THIS CERTIFIES that the building located at .~q./S..P.V..~. R. qa..d..~i 8 .H.y.a. t~. ]~¥eet Map No. I.[ya.¢.t ...... Block No. 0D.A ..... Lot No. .$.o.~l;h07~.~l...~.oY.~ ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ .M.~y.. ~Q , 1973.. pursuant to which Building Permit No. (5~.68Z. dated .... May. .. 14. ., 19 73., 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.r.i.¥a.~e 9.n.e..f.~.~m_.i./.lr..d.w.e..1.1.tng ................................ The certificate is issued to K. ev..Ed.w.ard. of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval N,R, ............. UNDERWRITERS CERTIFICATE No.. pc..gl..ing .................................. HOUSE NUMBER ~ .... Street . .l~rJ;. Rd .#..~.8~.. H~ra~.~..'Ad .............. Building/~pector / FOH NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N? 6568 Z Permission is hereby granted to: to ..~ld.. &u..a~d&tt~n.. ~1~-. ~t~t--~g - dwet.l.~g ............................................................ / at premises located at ,~//~,,l~y~tt...Read..,~est;...{..pv~c..i~d.) ..................................................... ................................... lt~con !.a..P.~Lut ............. ~u~14.....I$..¥.. .......................................... pursuant to application doted .......................~y ...... -$0- ............. 19~.~. .... and approved by the Building Inspector. -Fee $:J.~oO0 ............ Building '"n~e~to~ THE NEW YORK BOARD OF FIRE UNDERWRITERS -~w 85 JOHN STREET, NEW YORK, NEW YORK 10038 [~..*, BUREAU OF ELECTRICITY THIS CERTIFIES THAT inthefollowlnglocatio.; [] Basement [~ IstFL [] £nd FI. OutsJ. de was examined on ~"~8.~}q 11~ 1D~ and found to be in compllance wlth the requirements of thls Board. FIXTURE FIXTURES RANGES COOKING DECKS I OVENS DISH WASHERS EXHAUST FANS OUTLETS rECEPTACLES SWITCHES NCANDESCENT FLUORESCENT MERC RY I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT, TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS SERVICE DISCONNECT NO. OF S E R V I C E I 100 CB x 1 3 1 5 I ~attituek, ~']ew Yo~'k COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPAP, TMENT TOWN C:LEItK'S OFFIC;E SOUND, N. Y. INSTRUCTIONS~ This ~l'(cation must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, witl~ 3 sets of plans, ~urate 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, andjl giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work hovered 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zon~~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnances or Regu at ons, for the construction 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 ragu at ons, and to admit authorized inspectors on premises and in buildings for necessary inspections. If applicant is a corporate, signatu.re of duly authorized officer. ~, (Name and titl~l~orpora-te officer) 1. Location of land on which proposed work will be done. Map Nq,: ............... ~ .................. .~ ........... Lot No...~ ........ Street and Number ......~...c.../..~ ....... .).~..~5..__z.._~... ........... ~. ................ ~.o.. ......... ~ ..................................... /.-/~..,:..l~'~f~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ./~.E.~.....J..~...~..Z~...C.~ .............. :; ..........'2"~' .................................... b. Intended use and occupancy ..... ~..~....,,~.. ~.. '~.. ~.. ~....~ ~7 ........~./..... ............................................. ~, er Anterior or corner lot. 3., 'Nature of work (check which applicable): New Building ....................... Addition ..~ ......... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... , ~-' ~ Description) 4. Estimated Cost ...~.~..~....O.~. .......................... Fee ....~,~..z...o~. .............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .~2~.... 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 usa ..................................... 7. Dimensions of existing 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 ......................... Rear ............................ Depth ................................. Height Number of Stories .............................. 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or usa district in which premisas are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded .................................... Will excess fill be removed from premisas:[ ] Yes [ ] No 14 Name of Owner of premisas ............................................................... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.} Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Eocate clearly and distinctly all buildings, whether existing or proposad, and indicate all sat-back dimensions from property lines. Give street ana block number or description according to dee~; and show street names and indicate wheth- ................ ~~ ........................ being duly sworn, deposes and says that he is the applicant above named. (Name dj inatvta~ st~tng con.,*~A,~ t~-..~ He is the ............................................ ~ ................--i ................................................................................................................... {Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said ~tork and to make and file this application; that statements contained in this applicatic>n are true to the best of his knowledge end belief; and that the work will be performed in the manner set forth in the application filed therewith. .......................... .......... .................. ............. ...................................................................... .... .............................. Notary Public