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Home My WebLink About7619-zFOB,~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~ ...... Date ..............Sep.t.. 1~. .... , 19.~.~. THIS CERTIFIES that the building located atll/S, l~meon~ .Bay. ~Blvd ....Street Map No. ~ ........ Block No. ~ ...... Lot No...xx~ ·. · Lau~®~.. ~o~, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. .~.o.?...~.., 19. ~.. pursuant to which Building Permit No. ~.~.~'~.. dated ............N.o.~.....~..., 19. ~.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P~.%~'&~.e .one..£u~ly. d~.ellLug ....................................... The certificate is issued to . 8h~mecod .&. Ba=bra .R~b~,u~o~ ...... ;,wn~re ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval &tlS..22...197~...by. ~,. ~:l, lla ..... UNDERWRITERS CERTIFICATE No. !11[~.~72 ..... Sel~t. 1 ~... ~ 77.~[ ............... HOUSE NUMBER . .~.~ ....... Street .. P. eeo~c. Bay. .B:l.~d .................... ............................................ ............. Building r-.~pect~r FORM NO. 2 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ ¥. BUILDING PERMIT 7619 Z Permission is hereby granted to: to ...Z;~t~L3~..~e.~..~..$,a,m,S,3-.~..(~e,T~.;b~g. .................................................................................. at premises located at ..... ~a(~.~..~d~.~'...~lYd..~...l)eluo~..rJ~:J.Y~ ................................................ :.. ............................................. ~T~a;L ...... ~. .................................................................................. pursuant to application dated ......................... ~OV. ...... ~ .............. , 19.~?)~.., and approved by the Building Inspector. Fee $....:~.~..~ ..... BUILDING DEPARTMENT / TOWN CLERK'S OFFICE ........ ....... . . . ~ ~ / APPLI~TIOH FOR BUILDING PE~I~ e. ~ ~ork ~r~ by thi~ ~ppllc~tion m~ not be ~omm~ne~ be{ore i~u~ d. U~ ~al of this application, t~ Building Inspector will l~ue a Building Permit to'he app/lcant Such ~it ~all ~ k~t ~ ~e pmmtm available for i~ction throughout the p~ress of the work. e. No building s~ll ~ ~cupied or used In whole or in part for any pu~ose whate~r until a Ce~ifl¢~ of ~cu~ncy shall h~ ~en gmnt~ by the Building In~r. APPLI~TION IS ~REBY ~DE to ~e Building Depa~ment for the issuance of a Bu Idlng Perm t pumuant to the Buildi~ Z~e O~inance of the T~ of Somhold, Suf~lk County, N~ York, ond other applicable La~, 0~l~es or ~ulatlons, construction buildings, additions or al?rations, or for rem~al or demolition, for the of · a~llcant ~r~s to comply with all applicable laws, ordinance, building c~e,~ousing c~e, and ~ulatl~s. (Addtess of a~pllcant) State wh~her a~licant Is ~ner, less~, agent, architect, engln~r, general contractor, el~trlclan, plu~er or builder Name of ~ner of pmmlNs .~...~..~.~..~.~'.~....~...~.~.~.~.~...~.:....~..~...~..C~..~.~.~. .................................. If ~plicant is a co,orate, signa~re of duly outhorized officer. (Name and title 'of corporate officer) 1. Location of land on Which proposed work will be done. Map No.: ~..~...Cm...~.....~.~.~..~ ........ Lot No.: ........................ Str,,t ond Number .~.*.~.~.m,~.~....~..~.~.~..i..~....~.~..~.~.~L~.~.~./.. ~. ~.~.,!.~.~.~.~.r.,.~..Z.~t..~l. Munlclpallh/ 2.State existing use and occupancy of premises and intended use and occupancy of propo#d construction: a. Existing use and occupancy ................................................................................................................................... ' .~.s:. /- ~;~,, ,/./,-..,-,--- b. Intended use and occupancy . ......................... ./,...., .................................................................. 3. Nature of work (check which applicable): New Buil~ting .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost , ,~,~,,d,~,~,~ .................................... Fee ,,, ~ ............................................................ (to be paid on fi!lng this application) 5. If dwelling, number of dwelling units ........... ,/, ............... Number of dwelling units on each floor ...... ./,, ................... If gorage, 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 ...... ~...e..~..¢~. ....... 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 ....... /~.~.:.~..~..(~.:.~.~.'~:~aaar ~.R:.~.:j.~./.~.:..~...~C..?..'~th ....~...~...~ ............ Height ~'~7......~...... Number of Stories .../. ...................... .......... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ./.~/.~.,~./D.~/ ....................................... Name of Former Owner ..~...~c (.....'~.../o..~.~..~..;. ............. ! 1. Zone or use district in which premises are situated ..... ~>..~..~..~ ......... 12. Does proposed construct[on violate any zoning aw, ordnance or regtl o~t on~ ,/~.~. ~ ~ , ~.?:~ ~r~. ~ ~. ~.,~'~'~: ............................................... 13. Name of Owner of premises//~R~R,~.:4^.~i~/~ca.~. ...... Address .~Z.~/...~_/~..,e~.../...~.,~. ........... Phone No. 7~..Z~3..~.~.4..~. Name of Arch tect ]~..e44. i...~...b..~....~,:..~/.,s.~..r~.. ......... Address ~..R .~...Z..aO.~ ............ Phone No. Z.~..~..-.4.?.?..~. Name of Contractor . .~...r.~..'..L~....~..:..q....R.~..'.~ ............... Address Z'~..4:.T/T; .2T..~ ~/.~...../,~,.y,.... Phone No.-?...F..~.:...~...~.. PLOT DIAGRAM Locate clearly and distinctly oil 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 whether interior or corner lot. STATE OF NE~ZO, R~',~ / ~/ ! c~ ........ ................................................................................................. being duly sworn, d~oses and says t~t he is the applicant (Name of individual signing application) above named. He is the .................................................... (Contractor, ag~t, co~orate officer, ~c.) of said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to ~ke and file this application; that all statements contained in this application are true to the ~st of his knowl~ge and belief; and that the work will be performed Jn the manner set fo~h in the application filed ther~ith. THE NEW YORK BOARD OF FIRE UNDERWRITERS ak ' BUREAU OF ELECTRICITY ' , , , 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~ v.t, September 16, 1975 ~Jppllcati,.,~o. onfile 782211 N246072 , ', THIS CERTIFIES THAT , ' "."*~ Charles Robinson, n/w/cur. Peconic Bay Blvd., & Delmar DRive, ,, w~ examined on S ep temb e r, 12, 19 7 5 and fo,sad to be ia compliance with the requiren:ents ,ff Ihis Board. I I Ed FIXTURE EIXTURES RANGES COOKING DECKS ' OVENS DISH WASHERS EXHAUST FAN5 ~0 ~1 [ W. ~t H.P. OAS H P ~' NO A.W.G. ~T, ~. ~' ~P5 TRANS.~HP.H e. N~%E~ET ~I WATTS *Furnaces: Oil 2-1/Shp, 1-1/4hp Motor/s: 1-1/2hp l-lB amp. Uacuum, W.B. Ruland, i Box 143 Mattltuck, ' L;I; 11952 GENI:RAL his certificate must not be ~,;;'red in a~y'manner:; retur; 'or'he office of the Board if incorrect. ,nspec,or, may be identified .® LDT I -o '!LAUREL COUN T'I2Y E, DTA,'T'ES · ~- ~,6' I ./ / / AT !OWN OF..,u: / AND Z LDT I 'o D,,I~ONUMENT' 23 O A~T TNE N,W. CO~NE~ OF (V~C AN T) ~ SUFR CO M~P N0.5¢86, / / / MAP OF P~OPEP--¥Y 5UP.,.VE Y ED FOD.. -, ' F-r" F' ~/' " P..OBINSON TOWN OF 50UTHOLD 5CkL,.E=50"I. 7.~,0 ~,T TI4E N,W, CO~NEI~ OF LOT. 14'- 4-" DI t /2,