The URL can be used to link to this page

Home My WebLink About6709-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMRNT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~.~977 ....... Date ................ .J..~......~..., 19..~'.. THIS CERTIFIES that the building located at T~I~Ja .p&~l]ll~. (~ .R~) .... Street Map No..:g~. ....... Block No....~1~. ...... Lot No...~.....E.a.$.t...1~.~..~..~...'.]l...~.? ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Apr'],.. ~.., 1~.~.. pursuant to which Building Permit No.~.~.0~.... dated ....... .J..u~y .... ~ ...... , 197~.., 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 .. Pr. iv&.~ .a~.el~J. (m.ter&le)..but3~l~l ........................... The certificate is issued to .,Txtl,t~. ~l*ga ..... J)~I~I~F .............................. (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .lq.,~, ............................. UNDERWRITERS CERTIFICATE No... ]i.,R, ..................................... HOUSE NUMBER .... .~.~.0 ..... Street.. ~..P.a..t~. .......................... FOR~ NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6709 Z Permission is hereby granted to: ~..~.~.~L... ~.~.ri~...%...A~ .................................. ......... · .mmaas...2&t~ ......................................... .............. ....................................... b~l~l~ new accessor bulldin (~.~o~.~ ~Jg~l~ to ............................................. ~. ................... ~ ................................................................ at premises located at ...~./.IL...~JJ~JJgJ~ll...J~t~ ................................................................................. pursuant to application dated .............................A~.~.~..1.. ...... ..~.....'...., 197.~...., ~nd approved by the Building Inspector. Fee $.~-*q .~* ............ ~ [~ ttli BUILI,ZiN~ DEPAICrMENT ~ : TOWN CLERK'S OFFICE Exam ned ....................... , 19.?...?.... Approved ...................... , 19..~.... Permit No. ~..i .~......'. ...... Disapproved a/c ............................................................................................ ., II~sTRUC71oNs ltl a. This upplicatio~must be completely filled, in by typewriter oe in ink and SUblimed in triplicate to the Building Inspector, with 3 Set~ ¢~ plans, accurate plot ~ to scale. Fee according to.schedule. ' ' b. Plot Plan showing, location of lot and of buildings on premiSes~ ~'elafi0nship to adjoining premises or public streets areas, and giving o detailed description of layout ofproperty must be drawn 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 a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa rt 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 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. ~'(Signoture of applicant, or narr~ ~ a~corpo~i~i ........ (Address of applicant), State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ............................................................................ Name of owner of premises ..':~l...~...(~.._~l~..q~.('~. ................................................................................................................ 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 Trode's License No ............................................... Location of Iond on_~i.ch propo~,~:ll~ork ~ill~b_e done. ~ No.: ......... [l..-.t ................... Lol No ..................... Street end Numb~.~.:/~L.~.~.l~..~'~(~.. --~-- --'~-'"'-- ..~..~._~ ."~/. "" -- ~ ~4:':i'-';:::F-'Z: ........ State existing use and occupancy of premises and intended use and, occupancy of proposed construction: o. ,s,t,ng use and occupancy .............. b. Intended use and occupancy ....~..~J~,,:~....~.~...~...t~,~ ............... ;~..Nature of work (check which applicable): New Building .................. Addition .................. Alteration ....... % ......... Repair .................. Removal .................. Demolition .................... Other Wa r~:r~ .~:3).~. .............................. .~. 4. EstilJ~llted Cosf ....':'~.....~(.. ........................................... rea ...,¢.; ................................................................................... (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 .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories .............. ~ ................ 8. Dimensions of ~ntire new construction: Front ...... /.~.. ....................... Rear .../..~... ................ Depth/~.... .............. .....~.~K...-~-'~I'~' ...... --,J~um(ber of Stories ....~(~x~.~ ......................... ~.. ............. '. ..................................... ? .................. Height 9. Size of lot: Front ...~.~j~,..r[ ................................ ; ......... Rear ......~....C. ............................ Depth ./..l~J~ ..................... 10. Date of Purchase .~.~.J~J /'"~"l Nome of Former Owner ..~......~....~......~..~.../...~..~.. ....................... 11. Zone or use district in which premises are situated!~./~...~[.~ .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: '. ........... ,,.: ....................................... 13. W~ill lot bo ~'aded ........... :~.-.~ Wil. l.~x.c~.~t~ill ~ r~emo~ll~m'n ~r~is~s: ( ~ Ye~,,~,~ { ) No Name of ^rchitect .............................................................. ''~'~' [~^ddr~."...'~.~'...~.,.i:~ ...... I~non~ No ....................... Name of Contractor ............................................................ Address ................................ ~hon~ No ....................... PLOT DIA~RP, M Locate clearly and d st ncr y aU buildings, whether exictina or nrt'~-'~q~,~'t and indicate oil set.-tmck dimensions from property hnes. ~we streat and block number or descr ~t on accord ng tO d~d, and show street names and indicate whether interior or corner lot. ..................... ....: .......................................:.being du~/sworn, deposes and says that he is the applicant ~bove n~::~l. He is the ........................ ~...~..'~.~.. ............................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform Or hove perfo~m~l the said work and to make and file this application; that all statements contained in this application a~e true to the best of his knowledge and belief; and that the work will be performed in the manner set forth Jn the opplicat~ filed therewith~ Swam to before me this ~'~ ,~ / I ,~, f/ .... ........... fl.: No,o ...... ................................... ~' ~No,o~ J~!TH_T. ~O~(EN // //~ ~l(~nature or, applicant) · / THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THAT [] 2nd FI~.'tlt$ t de~ Section Block and found to be in compliance with the requirements of this Board. Lot / 2 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT [ NO. OF I S METER t I00 CB x 1 OTH~I?'~T'IIII~'~C [~oom heater/s; 3-2,0~w, RANGES ;PECIAL REC'PT R TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS ~AT: ~V~PS' TRANS' NO. OF FEET V I C S EXHAUST FANS DIMMERS OF HI-LEG NO. OF NEUTRALS A.W.G. OF NEUTRAt Truman I!. Cook Champlin Place Greengort, ?IoY. 11944 ",. / Per 11 ~( : COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. - loc 0