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Home My WebLink About7080-zNO. 4 TO~ OF SOUTHOLD BUU.DI~G DEPARTM~T To~n Clerk's O~ice Southold, N. Y. Certificste Of Occupency No. Z.601~_ ..... Date ............. J.141,9' .... 19 .... ,19~.. THIS CERTIFIES that the building located at . ]~.$. ~L~lyclOln, .Dr:L.Y.~ ....... Street Map No. ~e~d. cm. ~h. Block No ........... Lot Nopt.l.8 ./L>0 .... $.o.~,t, ho~.c],..N:.Y..: ...... conforms substantially to the Application for Building Permit heretofore filed in thi~ office dated ..........~Za~.. '$7"', 19.7%. pursuent to which Building Permit No.~.OSOZ... dated ............ Feb...l~..., 19~..., was issued, and conforms to all of the require- ments of the applicable provisions of the law, The occupancy for which this certificate is issued is .. ?r. tW.~.e..o.u.e..~..~. ~.~y...~.v.e.~.~.~Ug' ~i..t.h...~...e.d.d.~..t.~.o.n...(.e~p..r?.v.e.d...~ .m The certificate is issued to . .¢ha~.3.es. ~{o¢oz'~.ack .~. ~;iI'~m ..... . .o~er{I. ............. (owner. lessee or tenant) of the e/oresaid building. Suffolk County Department of Health Approval .. N,~, ............................. UNDERWRITERS CERTIFICATE No. 1~1(~3.~. ..... J.~..e..~.. J.~.7.~ ................. HOUSE NUMBER..~.00. ........ Street ..... R..ey.d.o.n...D.r.~,v..e ....................... ........ IFOBM NO. i~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7O80 Z Date ......................... Eeh.....t.~. ............. , 19.~..~.. Permission is hereby granted to: Roht,.. 1 .~..fl~.a.tt,..Tn~ .... ~/.Q .....C:b~ a., ..L~c ~.orma¢l~ ......... ~o~th~ ................................................... to ..hu~Ld..~..a~.d.L~Lo~..Qn..exlat, J~$..dwe~l ~r~ .............................................................. ............................ ~p,~veal..lay.. ~d...~14~p e~ ~. s.). .......................................................................... at premises located at . T.~ts...~w.~a~.~t~?.Q.....~e~...-~.....~e-~l~;>....~Le.~'d.o~..~ho~ .................. .............................. ~e.~lo~..~,'l,we .............. ~e~he~.<~ ......... ~;.~ ................................................. pursuant to application dated .......................... ~a~.....$~. ............. 19~)~..., and approved by the Building Inspector. Fee $4.~G ........... Building ~spector / ( TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN-CLERK'S OFFICE ~OUTHOLD, N. Y. {Suildi~ In--tot) ~ ¢ APPLICATION FOR BUILDING PEmlT IN~RU~I~S complexly fill~ in by ~ewriter ~ Jn J~ and s~mi~ in tripli~te ~ ~eBuildi~ This aPPlication Insp~tor, with 3 ~ 0f pl~s, ~cumte p~ plan ~ ~le. F~ ~co~i~ b. Plot plan shying I~ation of lot and of buildings areas, and givi~ a detail~ d~ripti~ of I~ut ~p~ must be drown on the diagram which is ~ of this applicati~. c. The work cover~ by th~ a~licati~ m~ n~ be comme~ berate iss~e of Building Permit. d. Upon apProval of ~is applicatiOn, the Building In,tar'will i~s~e a BuildJn~ Pe~it to ~e ~plicant. Such pe~it shall be kept on the premises ~ailable for in~t ~ ~h~t ~e work e. No building shall ~ ~cupi~ or u~ in Whole or in pan ~r any pu~e whatever until a ~ificate of ~cupan~ shall h~e been gmnt~ ~ the Building In~or. APPLICATION IS HEREBY MADE to the Building Department 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 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 in buildings for necessary inspections. Reheat L. XTatt T'ne (Signature of applicant, or name, if a corporation) Seltho3,d. N .!. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................... .................................................................................................................................. Name of owner of premises ....J~I:tAX,.~JI..~..J~LG~,--~J~e~...~.....~..~.~.q .................................... 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. McpNo.:Re,.~..ej' ~tOZ'el F LotNo. ~'18~19t20 Street and Number ..~.S.~rd. QI~.,~:L'J..T.&..~..~I,~IJJ[ ......... 8.Ql[t~.Q~ ....... ..~.:.'I~'.... ......... i ................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dw®lliag b. Intended use and occupancy SSJSO w:[th an &dd:[~:[o~ I 3. Nature of work (check which applicable): New Building Addition ......~ .......Alteration ~ ........ Repair .................. Removal .................. Demolition .................... Other Work ................................................ ...... (Description) 4. Estimated Cost ..................Z.O./...~.....~... ................ Fee ..~.~.~). ............................................................................ (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 ................................ Ir 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10:. ' Date of Purchase '. ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in Which premises ore situated ....... ~.....~.~L.~,~; ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .~'~11 ................................................ 13. W. ill lot be regraded ........ /~S ............. Will excess fill be removed from premises: ( ) Yes (Z) No 14. Name of Owner of premises .~l~,~.~(~l~olr,..&..~. ....... Address ....~.~.~'.~.~.~. ...... Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....~.l~.~.~..~,..J~&~.~..~,~l~ ............ Address ...~11~1~1~.~ ......... 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 whether interior or comer lot. STATE OF NL:~Lv~oJ~K.~ I c c CO[~N'r'~ OF ~..z..?~ ............... ................. ~.~.~.~.~..~.gA~. ................................................ being duly sworn, deposes and says that he is the applicant (Name of indiv~du'al signing contract9 above name&. He is the ............................... .~.~.~,~l~t3~..~..A~llL~,..l~.~...ell~e3~ ................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Swam to before me this Notary Fublic,,,~i~-~t~...~.~,~~ ~,oumy .... .~.-.-..~.;;,.:....... ....... ~.;.,. ..................... ~' ....... [~gnarure o~l~canr~ JUL)Ifil T. BOKEN Notary Public, Stole of New Yor~ No. 52-0344963 Suffolk Counh~ ~, ~ Commission Expires March 30, 19__~ , THE NEW YORK BOARD OF FIRE UNDERWRITERS ~" BUREAU OF E/ECTRICII"~Y ~ ~ 85 JOHN STREET, NEW YORK, NEW :YORK 10038 THIS CE~IFIES THAT o~y the e~t~ ~u~nt ~ ~cd~ ~ ~ int~ by t~ ~Ji~nt ~ on t~ a~ ~i~tbn numar in t~ p~s of Charles Mcgo~ack, 2120 Reydon Drive, s/side, Southold, L.I. inthe/oll~ing~ation; ~ B~emeat ~lstFI. ~ ~ Ft. outside ~,~i~o. ~y 30, l~Ttl andfou~beln~mplia~e.iththerequlrementsofth~e~rd. SERVICE DISCONNECT I NO. OF S 1 100 CB 1 ~AN~ES ICOOKING DECKS I OVENS I mSH WASHERS ,AMT. K.W. [ AN~T. K.W. ~MT. K.W. TIME CLOCKS BESL UNIT HEATERS MULTI-OUTLET ~T. ~PS* TEANS.~H.p. N~$.Y~I~ET EXHAUST FANS .. DIMMERS V I C E Elec.room heaters: 1--2.0l~R 2-1.25kw, 1-1.0kw W.B. ~uland, Mattituck, L.I. COPY FOR THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.