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Home My WebLink About7163-zNO. 4 TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z. ?.~5.F. ...... Date ............... .A.u.g .... .~...., 19..?.~ THIS CERTIFIES that the building located at .W/8...gth .Sgl'est ......... Street Map No. ~X ........ Block No.. ~ ..... Lot No .... ~3~...G~.~p..~.~; .... N..,.Y.o ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Apr...9.., 19. F.I~ pursuant to which Building Permit No.. dated ............ April . .9., 19..~1,, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P.T$.~.~..o.a~. ~.a~L~y..d..~.e~.l.i.ng..~.t.h. ~.l.t.e..r.a.t.~.o..n..&..a..d.d.~.t.$.o.n. .... The certificate is issued to .. Ar~. l~rie, l~e~.soI1 ..... 01~.er ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. I~ oR, ............................. UNDERWRITERS CERTIFICATE No. p.e.r~dSa~ ................................... HOUSE NUMBER ..... %1~0 ..... Street . .gth. 8t ..... Oreanpor.t ................. ......... /" Bui~''~' 'c~i~l ~'~;~t;; ..... f .... FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7163 Z Permission is hereby granted to: Pi b D '7-0 at premises located at ............. ~.,..,,~..,h/,. ...... ,.~._,,'~,,.,~,,.~..,E...'~,. ....................................................................... ........................................................ ~.~.~.~....>,.¢.~.~ ..................................................................... pursuant ,o appliCi3t,on dated ............................... .?.....~...?..../~.../...L.;., 107....?.., and approved by the Building Inspector. Fee $o_ ?_~ .~..~.. ......... , _~)/ ,-7" / Building Inspector I~OR,M NO. 1 TOWN OF SOUTHOLD ,5'/I ~ ~//.~ ,.BUiLDiNG DEPARTMENT ;'~-/, '~/? '/, TOWN CLERK'S OFFICE ~ // ~'~ MU HOLD, N. Y./-7' xomJneo ...................... ~.....~ ....... , 19 ........... ~/ ~ - _7' ~pmJcofion ~o ................................. ~prov~ .......................... ~ ........ , 19 ..... Permtt No ..................................................................... .............. (Buil~ng I~tor) ~P~IG~TI~ FOR BUDDING PE~IT . . .................... , IN~eU~IONS a. This epplicetion m~be completely fill~ in by ~ewriter o~ in i~ ~ s~mi~ed in triplicete to the Building~ ~-. P ~t plon showing ~ton of lot end ~f bu Id ngs'~n prorates, re~ onsh ~ t~ ~djoining premises or pub ic streets o~~ erees, end gNi~ e deteil~ description of leyout ofpr~e~ must be dr~wn on the diagram which is ~ of this epplicetion. ")h'~ I "' ~' *' ........ ' ....... Upa ppmw of th~s opphcoflon, ~e Bu~ d ng nspector ~1 ssue ~ Bud ng Permit to the opp ~cont. Such permit shell be kept on the premises ~veil~ble for inspection throughout the work. e. No building shell be ~cupi~ or u~d in whole or in pa~ for eny pu~ose whatever until . Ce~ificote of ~cup~ncy shell hove been granted by the Building In~ector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oll applicable lows, ordinances, building code, housing code, and regulotlons, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~..~..~.~..~.,~ ................. : .................................................................................................................................................. Name of owner of premises ....... ,~X~.~.....,~.~,~J~.....~..~.~l~.~.~. ....................................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No ..................................................... ~1 Plumber's License No ...... ~......{~....~.......--T.....,~.... ............ Electricion's License No../.....q~.....O..~......~.....~... ...........~ ~-D,-r~_~ ~ ~ ~_~ Other Trode's License No ............................................... L Location of load on which proposed work will be done..~.~p. No.: ..... : .................................. Lot No ......................... Street and Number .~z~..~ "'~-'"'../~.,(~,~. ........ .~....~... '~.., .................... C~.,~.~----,,~...~..~?'.,~.~ ............ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use on~ occupancy ...... /.~......~,~..~.,.....~':...,~.~.,,~/,., ........................................................................ b. Intended use ond occuponcy ....,~......~)~.~....., .~.....~.~./.. ......................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .......~... AlteratiOn .................. Repair .................. Removal .................. Demolition .................... Other Work ....................................................... ~.~, ~-- (Description) (to be paid on filing this applicatilon) 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 ....i ....................... 7. Dimensions of existing structures, if any: Front ....... Y..'~.......~.. ....... Rear ...... ~ ....................... Depth ~..~.....~'.. ......... Dimensions of same structure with olterations or additions: Front Rear 8. Dimensions of entire new construction: Front ...~'~.../....~...././. ......... ! /" J ! 11. Zone or use district in which premises are situated ....... ~.. ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... ..~C~...~ ................................... 13. Will lot be regradec~ ......../~..C~. ......... Will excess fill be removed from premises: ~ Yes ( ) No Name of Architect .............................................................. Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dlmensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YO~K.//,,/ t ¢ ~ COUNT'/' OF ...~:..~""~ obove nomed. He is the ................... ~.~..~.~.~..~.~.~ ...................................................................................................................... (Contmc~o5 ~gen~.,corp~re~epffi~r, etc.) of seid owner or owners, end is duly euthorized to perform'or h~ve performed the seid work ond to ~ke end file this epplicetion; thor ell statements contained j~ reis o~licotlon,~e t~¢,to the best of his knowledge end belief; end thet the work will be performed in the monner ~et f~h in the eppticetion filed therewith. Sworn to before me t~is ...................... ...... JUDITH T, BOKEN BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003e ..tv Ju~y 23, ~976 Appi,cotio~'o.o. Sile 867033 N 294334 THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the appllcal~t narrted on the above application number i~ the prernlses of Robert Nelson, Cherry Lane, end of 9th St., Greenport, L.I. in the following locatlon; ~ Basetnent [] Ist FI. ,~., e~..,i.~d o,, July 15, 1976 [] 2nd Fl. OUtS i de Section Block Lot and found to be in compliance with the reclairements of this Board. ' FIXTURE FIXTURES OUTLETS ~ECEPTACLES SWITCHES INCANDESCENt' FtUC~ESCI~NT ~vE~~ 12/ 16 15 12 A~T!YER~w. OIL ]U~N~t MGO^jOES H,,, FUTjEE APPLINAo~CE FE~DwER~' RANGES ~PEClAL REC'PT R COOKING DECKS OVENS DiSH WASHERS TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET · . ,RA__.s. ~ ...'O;'O'~'~,~T NO. OF CCCOND. SE.~ICE DISCO..ECT~__ Panelboard/s: 1-15ctr. 125amps. I-6k~ Sauna 2 G.F.C. I . EXHAUST FANS DIMMERS NO. OF HI-LEG FORDI NO. $ TOWN OF SOUTHOLD , Building Department Town CJerks Office Southold, N. ¥. 1197] APPLIGATION FOR CERTIFICATE OF OGC;UPANG¥ Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-confarming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ............. New Building ................ Addition .......~... ...... Old or Pre-existing Building ................ Vacant Land .............. Pr ope rt, ..... . .¢. . . . .......... Z . . . . . . /. ........ Location Of Owner Or Owners Of Property..~.,~.,........-~...¢~.¢.~.~....../~¢,¢'~.c~..1-:..~ ..... ~./.-r~--~ ............ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. ..x..x.. Permit No. Of Permit .SZ.¢ .~.~....~..Applican,' ..~....../~..'~....~~ ...................... Health Dept. Approval ................. .............. Labor Dept. Approval .............. ../~..(..%../..~..... .................. Underwriters Approval .............................................. Planning Board Approval ...... ,/~...;..% .................... Request For Tempo?~ Certificate ........................................ Fincd Certificate .......................................... Fee Submitted $ ...... ~.~...;..~..'...(.;..~.J ........... Construction on above described building and pew'nit ,.meqts all applicable codes and regulations. Sworn to before me this ................ day of ......................................... .......~.....~..... Notary Public ............~... ...... County (stamp 't I I:5 P_OWI4 O.b~ ~v. r~4 y MA .lg AT OF LALID Fog HEL$OU TO',VU OF GOUT,qOLI'), U.¥. 5CAt. g: 50'-- I" ~,i2gA ,= t2.i +- AC[2E~3 TO TU,~ TITL[ GuA~AUT~ ¢o~pAu¥ '1