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Home My WebLink About6704-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z~6.?.~ ...... Date ............ Sel~t... 22 ..... , 19.75. THIS CERTIFIES that the building located at lt~ar~n~ .Pl&ee ........... Street Map No...~ ....... Block No. xx ....... Lot No, ~ ...Gt'aenpo~.t.. iI,~ o ......... conforms substantially to the Application for Building Peimit heretofore filed in this office dated ............... July..~ ~9.~.3. pursuant to which Building Permit No. ~.0~Z. · dated ............. Ju].~...~.., 19.7..3., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... Pl';~Vatz..o~®. ~aln~,14t..dweJ. 1:[lag. ~lh. ladd~];],oll .................... The certificate is issued to ~(ni .P~?AJ, ti;. ~,; .:.f;~1'~ .... .4.¥~.~$ .......................... (owner, lessee or tenant) of the aforesaid building· : Suffolk County Department of Health Approval . .~ :.lt.. .............................. UNDERWRITERS CERTIFICATE No. t~elld~[r~ ...... ~ ............................ HOUSE NUMBER.. ~.~ ........ Street .... ftt®l'l~n{I· P3,aee ..................... ':Build · g spector ~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT, TOWN CLERK'S OFFICE SOUTHOLD, N.. Yo BUILDING FERMIT i (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N9 6704 Z Permission is hereby granted to: ....... ~:. F.,~r.:l..,;~ ............................... ~ .................. ~B...~.....~.... ~ ,~.....q[,}.<~ .i..~ ~ g..n....g.~}...,~ X:t S.~ ~ n g...~'~,e 1 l~*,t~ ....... '. .......................................................... et premises located at ................ .~.~.~'~'J ~.-~, ...................... ...................................................... ........................................................ g~.e e. npo~'.t, ....... .~.4 ..: ........................................................... pursuant to application dated ..................... .~. ......... .~.--..; ...... , 19.~.~..., and approved by the Building Inspector. Fee ~15.~.9..0. .............. t ~'~ : Build~m'g- Inspe~or THE NEW YORK BOARD OF FIRE UNDERWRITERS $~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT Wm. Prultt, 527 Sterltr~g Pi,p ~}reenport, L.I. in the following location; [] Basement [] 1st FI. [] 2nd FI. Section Block Lot · ' ~l~Pil ~ 1(~7/g and found to be in compllance with the requirements of thls Board. was exammea on ' FIXTURE FIXTURES RANGES ~OOKING OECKS OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 2 DRYERS )THER APPARATUS: S E R C c~c# ^.w.o. NO.O, .,~EO ^.W.O. ^.W.~. NO. E COND. OF CC. COND. OF HI-LEG OF NEUTRAL Wililal~ Pruitt .,~ 7 ,~terllng Pl. ~reen~ort~ New York Pe~~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. APPLICATION FOR BUILDING ~ PEP. MIT a. _0 INSTRUCTIONS b. Plot plan showing I~ation of Iot and of buildi~s ~ premises, relati~ship to adjoining premiss or public struts o~ areas, and givi~ a detailed de~ription of layout ofp~ must be drawn on the diagram which is ~ ~ this ~plicati~. c. ~e work c~ered by this a~licati~ may n~ be comme~ed before i~e of Bui~ing Pe~ t d. Upon approval of this applicati~, ~e Building Ins~tor will issue a Building Permit to the applicant. Such permit shall be k~t ~ the premis~ available for in~i~ th~h~ the work. e. No buJlding shall be ~cupi~ or u~ in whole or in part for any pu~e whatever until a Ce~ific~e of ~c~n~ shall have been granted by the Building Ink,tar. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Perm t 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, addJtJorls or alterations, or for removal or demolition, as herei.n described. The applicant agrees to comply with all applicable laws, ordinances, building code, houslng code, and regulations, and to ,~' admit authorized inspectors on premises and jr~ buildings for necesso ry~i~oectjons. ......... ..... ~gnazure Ol pp Ican, or na~e, Jt d' corporation) ..................... '(,~'~' ~ appli~i~'"7'" ...................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~..P,~I~I.~.I~..&..~T~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 ............................................... Location of land on which proposed work,will be done. Map No.: ........................................Lot No ......................... St reet and N umbe r .................... Sterlin~..~ ....... .~ ~...Z)2 .......... G~.e.e~.~.~'.~ ................................................................ . . ~:~'~ c.~ -~-~,~ ~ ~-~'~' Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~?,~,],;~1~ .......................................................................................................... b. Intended use and occupancy ..... ~J~../~l..a~..~;~.~i~o~, ........................................................................ 3. Nature of work (check which applicable): New Building ................. [ ~litiof~~ ,~=*';.~[~t.....-Alteration .................. Repair .................. Removal .................. Demolition .................... Other'~V0rk-.-w,..; ......................................... 4. Estimated Cost .............. :e~a.~.(~.Q ............................... 4, Fee 1 5.00 (Description) (to be paid on filing this application) O~.e 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 .................... 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 ............ .1:5. .................. Rear ...... .~.. ................. Depth ..2..2. ................... Height .................... Number of Stories ...~1:~ .................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth .......... : ..................... 10~ Date of Purchase ........................................................ Name of Former Owner ....q~...~..'~...~...~.....~..!..0 ~ U ........ 11. Zone or use district in which premises are situated ts ~ 12. Does proposed construction violate any zoning Iow, ordinance or regulation: .......... ~ ........................................ 13: Will lot be regroded .........~ ............... Will excess fffl be removed from premises: ( ) Yes ( ) No Name of Architect .............................................................. Address ................................ Phone No ....................... Name of ContractorA' Dzez~ko~skl ~ Peterson Address ~' Y~rion ............................................................................................ 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~r description according to deed, and show street names and indicate w.hether interior or comer lot. 5 STATE OF NEW YORK, I¢ e COUNTY OF .... ............................ ~'l~'~..~.l~,~,gl~q,S.~'l ........................... being duly swart1, deposes and soys that he is the o~plican! (Name of individual signing controcY) ,-, above named. Builder 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 make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and ~hwa~ the work will be performed in the manner set forth in the application filed therewith. orn to before me this .................... ............. ,,...,...,....._ .. , //_ '// l Notary Public, ...... County\% ........ ~.~...... ~/......~/<,_~ / (SignatUre of' al~licont) TERRI LEE ELAK IIOTARY PUBLIC, State of New York No. 52-6168295 (~elified in Suffolk County ; I[Immi~ion Expires March 30, 19 '~ ,,