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Home My WebLink About7079-zTOWN OF SOUTHOLD Bt~LDINC, DEPARTW~IT Town Clerk's Office Southold, N. Y. Certificate Of Occupency THIS CERTIFIES that the building located at .~00.5..~..~..~.. ~.&b/~. ....... Street Map No ...... ~ .... Block No.. ~. ....... Lot No. X .... ~'O. VI .~.Of-..~..../~.,I/..... conforms substantially to the Application for Building Permit heretofore fried in this office dated ....~'.e ~.. { .~ ...... , 19.q'~. pursuant to which Building Permit No. 70. ~.~. ~- dated ...... . .~.~.I5. .... ! .~...., 19 .-/.~., was issued, and conforms to all o! the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . ~ ~-.j U. A T.~'~...O. ~.1~..~--,4.1Aa. I. L I/. ~)/,J.l;/-C. I.[lJ.~...Lq ~. ~/q. ,t~2] oM The certificate is issued to. ~.1~{/ ..... ~J0. A.M - - · ~.r../J hJ.fv ................... i .... (owne~, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .~..' ]~_ ............................ ERWR TERS CERTIFICATE No... ~ ......................... HOUSE NUMBER ...l~a-~ ..... Street..R'.T.~ D...7//....~e.~-. £A.-/~-- · · vt, FOBM NO. ~ TOWN OF SOUTHOLD BUILDING BlfAitTMBq~T TOWN CLERIC'S OFFICE SOUTHOLD, ~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7079 Z Permission is hereby granted to: R,L~&~,t,..~.~,...~eu..,Zeh~.~un~ ....... , ...... ~e~tl~e.~ ......... ~,.~., .............. .* .......................... ~o .~..X..X,~......m....~.4.Lt...Lo.,n.....o...n.....e..x..X..s**~.Ln,.~.. ~.w**.e.L~ l~g ................................................................ at premises located at ...0iOD~il~...~.E.e~...~il~ ............~.V.~i~ ...................................................... ~outho~.d. I~, ~. pursuant to application dated ...................... F. eh .......... 1.~. ........... , 19.~.., and approved by the Building Inspector. THE NEW YORK BOARD OF F!RE~UNDERWRITERS 8.'N BUREAU OF ELECTRIG~ ~ ' '~ · ~ THIS CE~IFIES THAT '"'" ~ was examined on ~O~ ~ ~D O~* ,k ~l ~ ~ ¥'( q and found to be in compliance with the requtr~ ntents of this Board. RJRNACE MOTORS DRYERS RXTUR~S RANGES IC:C~dNG~CKSl owNs pOSHWASHm AMT. K.W. I AMT. ~(.W. , MT. K* W. EXHAUST FANS DIMMBIS 1-O.F.I. Panelboamds: 1-~clr lPSamp W,B.Rulond Mattttuek~L.I. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST~ B! IN ANY MANNER. ' ........................................ , 19 ........ Permit No .................................... Disapproved a/c ..................................................... .~ ...... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.....?....~....~...E ............. a. This application must be completely filled in by typewriter o~ in ink and suSmitted in triplicate to the Buildin~ 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, relationship to adjoining premises or public streets ce 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 ByJlding 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 Certificate of Occupancyi shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu Iding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable LAWS, Ordinanc~i~ Regulati.o. ns, for the construction of buildings, additions or alterations, or for removal or demolition, as here n descrlbed[~. 'l'~,e .a. pph. c, ant ag. rees to comply with all applicable laws, ordinances, building code, housing code, and regulations, aam~ au~norizea inspectors on premises and in buildings for necessary inspections. Rebert L. Hyatt ]:nc . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...R~...?...~..o...h~......D...e.../~...~. .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's kic~se No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ............. ~ ...................... Lot No ........ ~ ............ Street and Number ..... Bo,~s~..¢~.e~lc..~,~ne.....~t..~o~d .......... S~.thcd.cl....~.~Y.. .................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ~I,~'~.~,~T~,T~ ..................................................................................................... b. Intended use and occupancy .......... ~l}~l...~j~..&~l,~,~,~.0,1~. .......................................................................... 10. 11. 12. 14. 3. Nature of work (check which applicable): New Buirding .................. Addition ....~ ...... Alteration .................. ~. Repair .................. Removal .................. Demolition ................... Other Work .................................................... (Description) .4. Estimated Cost ....................... ~).~.(~{)..~+ ................. Fee ..1..~..e...O..O...0. ......................................................................... (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, 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 same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... .1~ .................... Rear ....... .1.~ ................ Depth ....~.~. ............... Height .................... Number of Stories .... ..~....e. ......................................................................................................... Size of lot: Front .............. ~..(~ ..................................... Rear ...... 50. .................... ~...~,D~.~..~.Q...'h. ................. Date of Purchase ........................................................ Name of Former OWner ...~.~..~~ ......................... Zone or use district in which premises are situated ....~&.e...~l.:L~; .............................................................................. Does proposed construction violate any zoning law, ordinance or regulation: ....... U ............................................ Will lot be regraded ............ ~ ............ Will excess fill be removed from premises: ( ) Yes ( ) No Name of OWner of premises ....... ~..T....~..~.....~..q...Z~..~. ........... Address ...~..~..~t.....~. ~.e...~..~..o...°.'~l~leTNo ....................... Name of Architect .............................................................. ,~lress ................................ Phone No ....................... Name of Contractor ....~..~...~.......~.~r~....~...t;...~..e. ..................... Address Bell.~,,~o~Ld 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 whether Interior or comer lot. or description according to deed, and show street names and indicate lock number \ STATE OF NEW Y. OP~ . tS.S COUNTY OF ....:~,~..X~. ......... ~ ............................ .~....R~b.t..~.~;~ ...................................... being duly sworn, deposes and says that he is the applicant (Name .of individual signing contract~ above named. He is the ................ ~ ........................ ~J~,0,.~.~ ....................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfori~ed the said work and to make and file this application; that all statements contained Jm this application are true to the best of his knowledge and belief; and tha~ the work will be perfo, rmed in the manner set forth in the application filed therewith. Sw°m t° "b"~f'~'r"e m~th°~s i~ ~ ~~2t~__ __._ '~' 19 .... ~.~ ~;~ ~' ~o~'H 1'. ~o~-~,~ ¥ ~ (Signature or Cornmls~ion Expires