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Home My WebLink About7182-zFOI~! NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~,6~) ...... Date ............. Dee.. ~. ....... , lO. ~. THIS CERTIFIES that the building located at .. ]{/.8. llo~eth. Roa4..(.Cl~9~.). Street Map No.. ~ve ........ Block No ..... ~l~ ....Lot No. ~ .... G.z'~e..~l~.O.~.t....N:Y.: ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Ape'S...19. 19..~lt~ pursuant to which Building Permit No. 7.¶.8~.. dated ......... Ap~.~ .... ~.., 19 .~t~., 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 . .l~X~te. omc. £&mXl.y..dwe&l~ng. w&th. an .ad~Xtio~ ................. The certificate is issued to D&~rJ.d. E .. Dl~.J. eeoll ....... 0~l~ale ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N. :.R.: ............................ UNDERWRITERS CERTIFICATE No. ~17~..~.... A~g. 7..~9~.. ................... HOUSE NUMBER ..... ~.~... Street .... Nol, tl~ .Rgad, .(CR~) ................. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, BUILDING PERMIT ('rillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7182 Z Permission is hereby granted to: .~.'...~......~.......u...9....~!..~.......~.. at premises located at ...JJ~J[.]Jg,l~,..~g&~...(.l~J~.~. ...................................................................... ........ : ............... .~.~..~.~.....~.:.~..........(~ .o. Ld.... ~ ... ~. :2. ... ~. ...................................................... pursuant to application dated ........................A.g..~...~.~ ....... .~l.~. ........ , 19...~...., and approved by the Building Inspector. Fee $..~.~....e...t~... .......... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Ex°mined ....... Approved ........................................ 0 ]9. . Permit No ......... Di~opproYed a/c ............................................................................................ Application No .............. (Building Inspector) (~ APPLICATION FOR BUILDING PERMIT t,~ Date ................ ../....)~...., ]9 ,. ~j~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relat onsh p to adjoining premises or public streets or areas, and giving a 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. cl. 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 Jn whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bu ding Department for the ssuance 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 jr~ buildings for necessary inspections. (S:gnature yf apphcant, or r~n pp icont) ~/ Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work, wi[l be done,, Map No.: ..~ ........ Lot,l~lQ~ Street and Number ~, ~ .,~.~ .~.. . '" ..................... .~,.,.[~. .................................. ~ ...... ,.,~.. - .~ ~., ~,..,.,,~.;.~.. ....................... ' Municipality State existing use and occupancy of pre~ nj i.nt~d~ed, u~s~ a/nd occupancy of proposed construction: a. Exisiting use and occupancy .......... ~ ....................... ~ ................................................ b. Intended use and occupancy If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... 3. Nature of work (check which applicable): New 13uilding ................... Addition .................. Alteration ................. Repair .................. Real,va I .................. Demolition .................... Other Work .................................................... -- c~ ~ (Description) 4. Estimated Cost ..~....~00 Fee ............... ~ ....................................................................... , (to be paid on filing this application) 5. If dwellir;g, number of dwelling units ..... ~ ............... Number of dwelling units on each floor ......... /. ................. If garage, number of cars ................. ._..~ ........ ~....,5..~ .................................................................................................... 6. If business, commercial or mixed occupancy, speci'fy nature and extent of each t~pe of use ........................... 7. Dimensions of existing structures, if any: Front ...........~.....~.. ........ Rear ......... ~...~.. ............... Depth .i~ ....... Height ........ ./...~... ....... Number of Stories ...... ~ ................................................................................................... Dimensions of same structure with alterations or additions: Front .... ~.~... ................... Rear ..~.~... .............. Depth ;..~.....~...../....c~....,~/. ..... Height ..../...,,.~.. ............... Number of Stories ............~ .............. 8. Dimensions of entire new construction: Front ...... ~..~.-. ................ Rear ........'~......~. ........... Depth ...~...~......~.. ....... Height ...~/~.. ......... Number of Stories ..... ~ ........................................................................................................... 9. Size of lot: Front ........ ./....~....~.. ..................................... Rear ........... ../....~?....~.. .................. Depth .....~7~..~.. .................. 10. Date of Purchase ...... ~....~....~.....~.. .............................. Nome of Former Owner ..... ~. ....................... 11. Zone or use district in which premises are situated ............ ~ ................................................................................... ul t~ n / ~' 12. Does proposed construction violate any zoning law, ordinance or rag a 'o : .......... ~... ......................................... 13. Will Iotbe regraded...~ ....... :...yIWille.~ess, fill b.e,,removedfrorr)premi~es:,(,~) Yes (/1~) No 14. NNa ~f nerme o Ow r of premises f...~..~....~.,~.. Addre~..~.. Phone No.~..~.~..~' Name of Architect .............. ~: ......................... ';~' ......... , ........ Address ..~j~.~~.. Phone No.: .......... 7. ......... Name of Contractor ~ .......... ..~....~ ......... Addre~..,w'4;w~r~... Phone No.~.~..~..(...~.~/' PLOT DIAGRAM Locate clearly and distinctly all 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. '....z~ 1- ' · ~.~ e'/ ~ ~ ' - I STATE OF NEW Y~)RI~,/ . / [,, COUNTY OF ................................................................................................. being duly sworn, deposes and soys that he is the applicam (Name of individual signing controcf) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work end to make and file this appIication; that all statements conta:ined in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the appJication filed therewith. Sworn to befor~ me this ,. '[] . // , Notary Public~~.~unty .. ~~~ ........~....?.....~....~.~..~.~:... cz - (Signature of applic6nt) JUDITH T. BOKEN Ne, 52-0344263 Suffolk Countj~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.W BUREAU OF ELECTRIcr'rY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT o~y t~ e~t~ ~u~me~t ~ ~sc~ ~ ~ ~t~ by t~ ~t M~ OR t~ a~ ~p~a~ num~ in t~ prem~s of David E. D~iscoll, n/~ of No, th ~d., Southold,L.L ~n the following location; ~ ~ement ~ 1st FL ~ 2nd Fl. ~ction B~k ~t ~exami~don ~U~t ~l ~ andfou~tobelncompliancewiththerequlrementsofth~B~rd. SERVICE DISCONNECT NO. O~ RANGES ICOOKING DECKS OVENS i~,,~ WASHERS AMT. K.W. I AMT. K.W. U~T. K.W. ?IM, CI. OCKSA~i: ~S '~BELI~$ ~ NO OF I~E?UNIt'HEAT'RS MU$[y~OUEMTSI. E? v i c EXHAUST FANS AM, T, H. P DIMMERS OF NEUIRAL Ele¢. Room Heaters: 1-1.Skw, P-l.25kw, 1-.75kw Paul Burns Town Harbor La. Southold,L.I. 11071 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.