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Home My WebLink About6419-zFOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z,621~ ...... Date ............ I~.o.V. .... .2.~ ..... , 19. ?.~. THIS CERTIFIES that the building located at ]~q. ue$~;r, ia~l. Av.~ ........... Street Map No..xx ......... Block No...XX ...... Lot No, Y.X. ,Fiz. h~.r~..I.$.l.a.n.d....N.:Y.: .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ;t4ar .....16., 19 .?3. pursuant to which Building Permit No...6br~ dated ............ ],~e.r...20..., 19. ~., 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 .. Pl~-ivata .ol~e..fam:tD.y./t.~.el[ ling...~.~.~ .~..~.~ .d.~.~.:~9 .~ ................ The certificate is issued to .l{~'s....gllmox'e..~ .. P&~;~er$om ...... Owner. ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~.,.~..* ....................... UNDERWRITERS CERTIFICATE No.. N.~3.9~70 ..... Jan. 22...~ 9F!~. ............... HOUSE NUMBER ...l~or~e. ...... Street .......................................... 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) N? 6 19 Z Permission is hereby granted to: ...~. &.~hez~s...3;.sta~d ............................................ to ..~uil~..~n..~¢t~o~..~..ex.~.~%l. ng..6,~14.img ......................... i .................................... at premises located at ...... .E~.~/~S~.tn~Tt..-~V~ ................................................................................... ............................................... · I~.~.~seI, s... I.e .~ emd.. .--N.,.¥-, ................................................................. pursuant to application dated ................... ~a~- ......... '1'6 ............... , 19...~3., and approved by the Building Inspector. Fee $.1.~'~,~0 ............ ' ' :Building InspectOr / THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY :- ,:a,:..¥ ~., ~?~ Jo.. sT.E.,.~w ~o.~. ~ ~o. ,oo~ ~ 2793 THIS CE~IFIES THAT was examin~don anuary z (~, lp !'~ ~xz~/ ri. out,*side Section Block Lot and found to be in compliance with the requirements of this Board. RXTURE OUTLETS 19 DRYERS tECEPTACLES SWITCHES RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST 30 21 Ii SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I C NO. OF CC. COND. A.W.G. NO.OF HI-LEG A-W.G, NO. OF NEUTRAL$ A*W.G. PER .6' OF CC. COND. OF HI-LEG 1 2 1 2 A. John Gada Oen. Contr. Inc,, Drawer B, Pishers Island~ L.I. 106390 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED, IN_ANY MANNER. golt, M'NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC:E SOUTHOLD, N. Yo Examined Approved (( ~ ]9 Permit No. .~..L..~ Disapproved a/c .......................................................................................... ;... ................. APPLICATION FOR BUILDING PERMIT Application No, ..C?..L.!.~. ............... Date .,.~¢.~...1.6 ..................................... , 197.3 ....... INSTRUCTIONS a. This application must: be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo n ng pram sas or public streets or areas, and giving a detailed description of layout of property must be drawn ~,n 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 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 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 Bud ng Perm t pursuant to the Building Zone Ordinance of the Town of Southold Suffolk County, New York and other app icable Laws Ordinances or Regulations, for the construction of build ngs, additions or a rotations, or for removal or demo ition, as here n described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, ......................................................... .(:; ~T~ ~.~.. ~ ~L.. f~¢~.~;{; ~ ~,~; ~ ~,. ........................................................................................... Nome of owner of premises .......... z,~£~,4~,,,~'L,~'~,,~';o,,:~i~,~,,{;¢~-':~ ............................................................................. If applicant is,amcorporate, signature of duly authorized officer. 1, Location of land on Which proposed work will be done, Mop No,:~a~;,.~,,,T~,cq~£),,:~,O,,~ Lot No,: ........................ Street and Number .... 4¢~;~e.z~t;~.~z~.,,.~m~.t~a~.,,~'~.s?;~a~'~,,~.,~l~ ................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~CCf~:.:i.~,~,~J;[~1 ........................... i ................................... ~ ....................................... b. Intended use and occupan¢:y ......~7..~,%J,f~.~t;,~t4 ............................................................. i ........................................ 3. Nature of wo~k (check which applicable): New Building .................. Addition ....2 ........... Alteration ..~:...~ ........ Repair ................. Remora! .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......... $4Q,.D.00.o. OD. ......................... Fee ......... $.15...0D. .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling umts ...... 1 .................... Number of dwelling units on each floor ............................ If garage, number of c<~rs ................................ : ............................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing st~ructures, if any: Fron~ ......... 20 ............... Rear ........ 2.(] ................... Depth ......~ ......... Height ......... 2.~ .......... Number o~ Stories .......... ,~. .................................................................................................... Dimensions of same structure with alterations or additions: Front ...... 2,4 ......................... Rear ...... 3~, .................. Depth ........... 28 ................. Height .....2~ .................. Number of Stories ..... :~ ......................... 8. Dimensions of entiro new construction: Front ...,1/~. ........................... Rear 1~ D~th 18~6" Height .....2./ ........... Number of Stories ....... 2, ............................................................................................................ 9. Size of lot: Front ...... :LI~,0.~. ............. [),ear ......... 59 ...................... Depth ..... 2.8.0. ................... 10. Date of Purchase ..A~.gu.s~,...J.9.'/.1 ......................... Name of Former Owner ....~fiL~;i,~...~..~. ........................... 11. Zone or use district in which premises are situated ............. ~.e.~J. rte~.tJ.a.1. ............................................................. 12.,, .D°es proposed construct;on ~iol~te any zoning law, ordinance or regulation? ........ J~O ........................... ~Zt'2~ .......... 13, Name of Owner of premise',t,~s...~...C,...~ttersol~ddress l~ew..?Zo.r~...~[,.~ ........... Phone No.9.8..8..-..8.9..6..6.... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~.,~o..gada...G~n.!l ..~c~n. tr.~ddress ~..:L~hl~t::~...Z~.].i[m~...~1.~one No..7..8..8...-.~..2[.3..1.. PLOT DIAGRAM Locate clearly end 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 ~vhether interior or corner Jot. See Attached STATE OF NEW ]~ORI~ · ~ ! S.S COUNTY OF .~..,.$ · ................ A~....J~hct..~.a~la,...~r.,......i-' ~[' ' ' ................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ..................................... C~Dk.1:~.~O~. ........................................................................................... (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 file this application; that oil statements contained in this application are 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\ ......... doy f ................. , J ,,,., _ ......... notureofopp,, " ........................... EILI~N G. WALL Term Expires March 30,