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Home My WebLink About7487-zFOIhM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Occupancy No. z628.1 ....... Date ........... ,/aa ....6 ........ , 19 .~. THIS CERTIFIES that the building located at .... Ruth' ~o&d ............. Street Map No.. Ca. pt. K-:l,-d~ Block No ........... Lot No...20-1 ..... l~tt:l..t.~ak ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Aug..2t..~, 19. ~+ pursuant to which Building Permit No.. dated ............... Aug-..21, 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.x, iva.te, one .fam$1y. al. welt.lng..with .an. &d~li.tlQn ................. The certificate is issued to .. Ecl.ward. &. Ce.lia. Y, oisa ....... (-~ners ................ of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .l~.,~t, .............................. UNDERWRITERS CERTIFICATE No.. ~. 4.97389 - .. Dee.. ~. · 19'~ ............... HOUSE NUMBER ... ] ~h-~ ...... Street ...Ruth..~lQad- ............................ ! [ ~Building Ins~ctor ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7~$7 Z Permission is hereby granted to: at premises located at ..Ie~li.~J ....... J~lt~.J[,[ll~..l~l.t~:l~J., ..................................................... ....................................................... ~..Jle~ .............. ~,.t~l~ ............................................... pursuant to application dated ................... ~ ....... ~1 ................. , 19...~1J~, and approved by the Building Inspector. Building Inspector/ Application No. APPLIC~TIOfl FOR BUILDING PERMIT gl Date AGg~st 2~ 19.....~..~..? INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building~ Inspector, with 3 sete of plans, accurate pla* plan to ~ale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on prem scs, relationsh p to adjoining premises or public streets os areas, and giving a detailed description of layout ofpraperty 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. d. Upon approval of this application, the Build!ng Inspector will issue a Building Permit to the applicant. Such pormit~'~-' 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 Occupant,s_. shall have been granted by the Building Inspector. - B .A,P,.PLI ~CATION IS HEREB. Y MADE to the Building Department for the issuance of a Bud ng Permit pursuant to the u.amg Lone Ordinance at the Town of Southold, Suffolk County, New York, and other applicable Lmvs,~ Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demalitian, 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. ............................. ................. (Sig~t~_r~ ? ~l~yli~q~/t, orientate: ifa c°q~oration) ...... ~').~ -- ~--,.,~ (Address. ofac)~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. Name of owner ~f ~re,~,a- ~.dvarc~ & Cci. ia Mois~ If applicant is a corparate, signature of duly authorized afficer~ 201 (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No .... ?.~.,~.,,,0~,. ............................. Other Trade's License No ............................................... 1. location of land on which proposed work will be done. Map No.: Capt Kidd , . Lot No. Street and Number ....~'~.._l~oa.(j. ........... ~,~L.~'i f,~lr .................................. Municipality 2. State existing use and occupancy of premises and intended use and accuponcy of proposed construction: a. Exisiting use and occupancy ..... ..~.q.~.~l~ ............................................ b. Intended use and occupancy ................. .G. JI~,fi...'K'~.$,~..~I.,,~...~,i~I,i~,.~.~0~ ............................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition .....~ ........Alteration ....~.;~; ...... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ..................... ~'.~(~,~..0..~-- ...................... Fee ...~..~..~....0~.. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...O...~.$. ................... 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 ......2..2. ............... Height .................... Number of Stories ..O.~. .............................................................................................................. 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 .....t.~A.a....d~S:~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..Z)~ ................................................ 13. Will lot be regraded ....,1:~ ...... ; ........... Will excess fill be removed from premises: ( ) Yes (Z) No 14. Name of Owner of premises ...$..~..~.....~...O.~..S..~.....~.....~...~ ............... Address ................................ Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No. ...................... Name of Contractor .~1,~]:~],..]~I.],~.....: ...................... Address .....~l~.~g.~/~...., 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. see attached plan STATE OF NEW.YORK. ~ ¢ c COUNTY OF ...11~.1~;~.9."~1,~ ............ ~-" ................... ..~.~..~.~..9.~.....~.,1~,.9~ .............................................. being duly sworn, d~es and says t~t he is the applicam (Name of i~ividual signing c~tmc~ above name. b~ider He is the ................................................................................................................................................................................. (Controctor, og~t, co.rote officer, etc.) of seid owner or owners, end is duly ~ut~rized to ~Horm or hove Performed the seid work end to ~ke ond file this opplicatlon; ~t ell stotements cont~n~ in this opplicetion ere tree to ~e ~st of his ~ledge end belief; end t~ the work will ~ parroted in the menner ~t foffh in the epplication fil~ ther~ Swam to ~fom ~ this ................... ................. Noto~ Public, . .................... ~ ..... C~n~ .............................. ......... NOTARY PUBLIC. State of New Y~ No. 52.4522'~26 - Su~foi~ Co~nf~ Commission ~xplres March 3~, of applicant) / THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELEGTRICI'~'Y . ' '--- 85 JOHN STREET, NEW YORK, NEW.YORK 1003B was ~amine~ on ~eo ~mb e~ ~ · 19 74 and found to be in compliance with the requirements of this Board. .x-I DR~ RJIINACE MOTORS [ m.J~ AP~UAH(:E PIEDHS 1 ~L/8 RANGES COOKING DL~KS OVENS 1DISH WASHERS OTHER APPARATUS.' R V I C EXHAUST FANS DIMMERS RR fl, 227 East Breakwater Rd., Nattltuck, L.I. 11952 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU~ST..I~T B~ ALTERED IN ANY MANNER. ., .