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Home My WebLink About7620-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~.~.~..~ ....... Date ................ J..'0~..~..2.~. .... , 19.??. THIS CERTIFIES that the building located at N/~. .N.~.~. R.~:~.d...(.~.R.2.?)... Street Map No. G.O.o.d.q]~0..e.~.OBlock No ........... Lot No, ...~..05. ~.~ ..... . .~,e.~..np.o.r.t~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .E.o..v...4[. .... , 19 .?~.. pursuant to which Building Permit No.. dated ............ I~..oy .... .i~..., 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 .. ~i~..0~. ~.~i~[Y..dw~l, li~g. ~h. ~ddi];i.O.~..(.ff~.qk. ) ............. The certificate is issued to .J.O..h_4a., ~...~...~.@, .~. :.1~..~.~.h.~. .... .0..~e.:~.~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No.N.:R~ ........................................ HOUSE NUMBER ..... ~6~. ~a~.... Street .... ?.~..x~..h..~.o..a,d..{ .ff~..~.). ................. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PER/~IT Ne 7620 (THIS PERMIT /9~LIST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION o~THE WORK AUTHORIZED) Permission is hereby granted to: ........... Jg~.f,h..~qd ............... Gree~pc~$, ............ at premises located at~.B.~.,m,~..~.J~.~......l~.. ~.. ~..0...~..~....~..i~....~....~.1 ................................................................. lior th Road z'eenl~o~'t .......................... pursuant to application dated ..................... NO.~. ......... ~ .......... :...., 19~Jl,..., and approved ~by the Building Inspector. Fee ~..t..O...O. .............. · Building inspector t ' THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.k BUREAU OF ELECTRICITY. · NEW YORK. ~ ' K 10038 ,~,., ..,pp,,e.,o. No. o.,.,-,,. . N 197419 THIS CERTIFIES THAT in the follo~ing ~ation; ~ B~emen* ~ lat FL ~ 2~ FI. ougstde S~tlon B~k ~t ~ exami~d on ~ ~ ~ e~ ~ ~ ~ ~ ~ ~ ~ ~ a~ found to be in compliance with the requirements of th~ B~rd. ICOOKING DECKS OVENS DISH WASHERS TIME CLOCKS / MIl~UNIT HEATERS MULTi-OUTLET OF HI-LEO EXHAUST FANS AMT. H, P. DIMMERS Electric heaters: 1-2.5kw, 1-1.25kw O~lent, N.Y. 11957 MNIbL~ , COPY FOR BUILDING DEPARTMENT. THIS copy OF CERTIF~TE MUsT NOT BE ALTERED IN INSTRUCTIONS a. This application must be completely filled in by typewriter or, in ink and submitted in triplicate to the iJuilding'~ Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to ~hedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public str.~., o~ areas, and giving a detailed description of layout ofpraperty must be drown on the diagram which is part of this apphcntlon. 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 th. roughout the work. e. No building shall be occupied or used in whole or m 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 ..,~-, s, or rar removal or aemOlltlon, as heroin described. The applicant agrees to comply with all applicable laws, ordinances, building ca~e, housing code, and r~gulatlons, and to admit authorized inspectors on premises and In buildings for necessa~ inspactions. (S~gn-'~t~e of app cant, or rmme, If a corporation) - State whether applicant i , lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. Builder's Lic~se No ..................................................... P umber's Ucense No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which prgposed work will be done, Ma~>No.~ %0 .~...%.?0 LotNo...~......~..?~...I . Number ..... - .,~./~.. e ~ . )'.."/. ...~...., ~r ~ T ~'""~'~. ........................................ . , Street and .............. ~.~i ........ ~ ............................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ................................ .~..~... ...... ~1~.. ...,y...% ~'... b. Intended use and occupancy ............................................ J~ ~'r..~ (Description) 4. Estimated Cost ............................................ Nature of work (check which applicable): New Building.. ................. Addition..................L'/ Alteration ........ ?...,.,.._. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... -, (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, sp~d;ify nature and extent of each type of use .............. ; ............. 7. Dimensions of existing structures, if any: Front ...... ..-~......L~.....~ ........ Rear .... ..~.....L~..' ................... Depth .'~,.U~. ......... Height ...... ~-C~..~. ........Number of Stories ........................................... .~.~ .............................. ....; ....................... Dimensions of some structure with alterations or additions: Front ....~ ...................... Rea~ .................... Depth ..... : .......................... Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .....~....~. ......................... Rear .....~?... .................. Depth ...~.~..~ ............... Height ....~....~..~.~ ...... Number of Stories ...................................................................................................................... 9.10~ Size, Dote°fofl°t:PurchaseFr°nt "~ ............... ......... ~....! .................................... ~' ...~. ............................ ~"~ NameRear .......................................... of Former Owner ......................... Depth ................................ , ................ .............. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does prop~)sed construction violate any zoning law,.ordin~nce or regulation: .......................................... : ............. :13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .~J~4t~:Ik~.....~'~...~....~. ..... Address~.'~.,..~.~..~'.~l~t ........ Phcme N~..~......~..~..~...~....~ Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ng to deed, and show street names and indicate property I'ines. Give street and block number or description ,,oc~co~d whether interior or corner lot. STATE OF NE~..~/(~/~/~ [.c; c; C. , ~.-~ ~o'~ I~o.~' ~ · COUNTY ~~-)-'- .~ ~-.~. .............. ~ ............................................................... being duly sworn, d~es and soys t~t he is the applicom (Name of i~ividual signing c~trec~ above name. He is the ................................................................................................................................................................................. (Contractor, agent, cat.rate officer, ~c.) of sa~d owner or owners, and is duly aut~rized to perform or have performed the said work and to ~ke and file this application; t~t all statements contained in this applicati~ are t~ to the best of his knowledge and belief; and that the work will ~ performed in ~e ~nner set fo~h in the application fil~ therewith. Sworn to ~m~ me this .. .~~~~ .......... ?' Nota~ Public, ~....~; . . . ~ ............. ~ JUdaH T. ~KEN ............. ture O~' applic;nt) ....................... ~ ~b~, Slate of New York No.5~-0344963 Suffolk Cou~ ~6~isston Expires ~arch 30,