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Home My WebLink About7180-zl~O~ NO. 4 TOWN OF SOUTHOLD BIJII.r)~IG DEPARTMI~.~ Town Cle~k'e Office $outhold, N. Y. Certificete Of Occupancy No.. Z6.h:./~ ..... Date ..............}lay .... 29-.- 19.?~. THIS CERTIFIES that the building located at .l/aeDoria3ct ,Rd ............. Street Map No. F~lge~e..P~lock No ........... Lot No. $0. &pt. ~)...Laurel .............. conforms substantially to the Application for BuiMi~g Permit heretofore filed in this office dated ............April · .11~19. ~ pursuant to which Building Permit No.. ~.1~0~. dated ............April .1%., 19..~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which tht~ certificate is issued is ...Private. one. family. · .~lwe~,ling. witll, an .adtlition ............... The certificate is issued to .. ~,¢,J.essttl~ .... flwner. .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . lt,R. .............................. UNDEEWEITERS CERTIFICATE No. N.1.~61~75... Appll. · I~9. 157~ ............... HOUSE NUMBER ... 1+.5~ ....... Street..P.v~. Rd./~2_..l/acl~onalcl. Road .......... Building In~pectoy lro~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7180 Permission is hereby granted to: ...... ...~.$.t~.~ .................................................... Ed enere Pk lot ~ ~ ~.~ . . at premises I~at~ at .....:~ ..................................................................................................... ................... .~a.~..~ri~ata~....~el ............................................................... pursuant to application dated .................. A~ZJ,I......1.~ ................ , 19~+....., and approved by the Building In.~tor. Fee ~.!,..~.. ............. Disapproved a/c ,.,.~..~..,.,.,.,~.._.,....,,..,,.,~;~.,..,,,,......~ / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Applicotion No. a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildil~ll Inspector, with 3 setg of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocatipn of lot and of buildings on premises, relationship to adjoining premises or public streets oj, areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicoti,on~ 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 part for any purpose whatever until a Cert f cate of Occupan~ 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 t~e Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appl cab e Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here .n descr bell The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulat ons, and'~. admit authorized inspectors on premises and in buildings for necessary inspections. /;J ........... , . (Signature of applicant, or (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................................... .~£~.d.e~. ............................................................ Name of owner of prem ses ..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 ............................................... 1. Location of land on which proposed work will be done. Map No.: ..~b~.~.~...~.~l;... ...... Lot No ......................... Street and Number ...................... '$~.'e~"&e~-,, ..................................................................... i ......................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............... 3...~j~&[~L~..41,w~JL~id~ ....................................................................... b. Intended use and occupancy ................. .~...~.....~...~..~.q ............................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration '~" ' ' - Repair .................. Removal .................. Demolition .................... Other Work ...~.~l~.....e~.~ ......................... . ..... (Description) 4. Estirnoted Cost .......~......~..'!.~...O~** ............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .................i. .......... 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ]~t**************************** Rear .....~] ................ Depth ........................ Height .................... Number of Stories ........................................................................................................ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or Use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation; ........................................................ 13. Will lot be regroded= .............. U ........Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises ....... ,~.~l~lllll~[ll~ ................... Address ~~.,~..** Phone No ....................... Nome o~ Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ...J~....~..?..~.~...a~...~.......'~.....l~....t....~..~?:... Address ................................ 'l~&,~ No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exkting 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 comer Iot~ / ........ '~"~l~JJJ'..~J~i-..'JJtJ~l"l'~-¢~ ................................................. being duly sworn, deposes and Fa/~thc(t he is the apPlicanl (NameJ,of individual signing contractO above named. ,"~. /ll I ler He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or 'owners, and is duly authorized to perform or hove performed the said work and to make and file this application: that oil statements contained in this application ore true to the best of his knowledge and belief; and tl',o~ the work will be performed in the manner set forth in the application filed therewith. Swornlt~before me this l~/'J I. ........................ da.y gf ~. ~'~ ~/~ ........... -;--/,~CC:'~"**"/"' ............ , 19J~.,~ ........ Notary Public,' i ...... /~'(....~";w'C. aunt .............................. i~;'i~l~'~'~ ............................. JUDITH T. BOKEN Natal' Public, Stole of New York No. 52-0344963 Suffolk Comm)ssion Expires M~rch 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS BW BUREAU OF ELECTRICITY . ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ' THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above appllcat~on ~umber ~* the prem~ses of Jessup, Pvt. Rd. off ?eoontc Bay Blvd. at Pole 02, Wemd¥ & So. Oakwood in thefollotvlng location; ii Basement ~ 1st FI. [] 2.d rt. outside Section Block Lot ,,~ e..,,,i,.,a o,, Apr/1 2 5 ~ 19 7 ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES 26 DRYERS FURNACE MOTORS RJTURE AFPUANCE I~EDERS TIMECLOCKS UNIT HEATERS MULTI..OUTIET DIMMERS SYSTEMS bIO. OF NET SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E 1 2 Robert A, Goodale 525 O~chard St. New Suffolk, New York 11956 11 COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER~