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Home My WebLink About8802-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupnncy No. ZT~9.~. ...... Date ............. P.~r.. 3~ ...... , 19..~ THIS CERTIFIES that the building located at .. '01d' 8hipF~t~l' I~ne ..... Street Map No. Fore,tiers..gZl~ock No ........... Lot No. 99 .... t~o~thol~l. - 1~,¥, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. I~1~.. ~[0 19.76. pursuant to which Building Permit No. ~02Z.. dated ............ &~..]9..., 19'/6.., was issued, and con.forms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~l~.ate. zw~Lng, pool. ~r~th .fence. &. aceessol'y~ ................. The certificate is issued to . Joseph. Slavol~k-.&- ~dife ...... Owners ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~,R, ............................... UNDERWRITERS CERTIFICATE No...ll3~)8~2... $1ax,. ~4-. ~77 ....... ~ ........ HOUSE NUMBER ..... ~ .~.~. ..... Street .... Old. Sh:l, pya~d-Lane ..... Seutl~old. ·. ' ]~il'~ing ' i~p~;t;~ .......... FORM NO. ~ 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) No. 8802 Z Date ......................... .~ .......... ~,9 ........ , 19..~.. Permission is hereby granted to: ..... 122.0.....~ud. ae..JBw/ ......... .(~elm:Lgne.....L.I, 11726 at premises located at .~.~...~.....F~S..~&~:~. ........................................................... Old 8k~ ~,d I~e Bourbon.d.. ~.**.Z...,. pursuant to application dated ........................&3~,.....%0. .............. , 19...~.~, and approved by the Building Inspector. Fee $.~. ~,*.~0. ........... '~ ',,') ~',:',THE'~,NEW,:,YORK' BOARD, OF; FIRE :,UNDERWRITERS FIYTIle~ - I -: ' I '" ,":-" ...... F XTURES ' " zv RANGES , C~)OK NO DECKS ' OVENS DISH WASHERS EXHAUST FANS DRYE~ '' t h 1~ F~RNA~EJ~OTOR~ ,- I FUTURE APPUAN~E FEEDERS SPECAt~E~'P~] TIMECLOC~S ~ BELL~UNITHEATEaS ~MU;TI-OUT;aTI DIMMERS ~T K W' OIL~ H P I~P~ H P , ~T NO A W ~ ~P ~T ~PS, I ~1 [ , F ~ NO OF FEET ~T WATTS INs ce.,f,c=le must not be aller¢8 .n uny monner, return to the off.ce of the Boord ffqncorre~ la.pealers ~en~e~r credit,els. NEW"YORK BOARD* OF, EIRE, UNDERWRITERS only ~he e~t~a~ equip~en~ ~ ~mcri~d below and intr~uced by t~ applicant ~mkd on' t~ ab~e applicat,on number in the premises of ' ' "' k~?'Old Ship ~Yard, L.,I:. .... ~ ~, ,~ ~Jos.~',S~avon~ Lane~] Southold~ . ,, in th~folMwinglocation; ~ B~m~n~,, ~ ls~ Fl. , ~ ?nd Fl~.,_ h~ ~. ~ i~'~ O~s~e$ecdon ~ ~lock Lot ~exam~nedon :1, :~ah ~7,~ ~9~ ' ' 7 an~found~ob~incompHan~ewlththereq.,rementsofth,sBoard OUTLETS , , , INC~DESCEHT FLUORESCENT ' ~Y ; ~t ' K W ~ ~T ~ K W ~T ' K W ~T K W ~T H P ' , .... ' ..... ' ~T' . ,, , ' ...... ; ....... { DRYERS ; J + ; FURNACEt MoTORs-` ~ :/J FUTURE APPLIANCE FEEDERS JsPECli(REC'PTJmMECLOCKS J, hELL r JUNIT HEATERS JMULTI'OUTLET J DIMMERS ,. ,. , SYSTEMS SERVEL DS'CONN~GT'2~ ~6.'6F'J',~-{lI/,:dj'- .... h~"."- -"U--~-~'.i:~,:E;{ "" m q V='':" ...... -';:'~i"-;,}=~ ~ '' E' ' ' ' ' ' ' , 2 ~ETER ......... : , ' (Swimming Pool'):~?T~is,,{certificate <covers compliances'at~,thel date of inspection ,only~o~'~,Be~cause~ of unusual, environments ~_t ~-is: advisable to have~ _frequent~test'and/or repairs/made, ,bY' a qualified{,, _, person. ~ '. , ,~ _, ,~- ~,f ~ ~t' ~,~ {,If , , ', ,I m ~ , I~ *~T ' ,'- -'- ~,~" " Cutchogue,'.~iN.Y. I ~1 11935 ,; .... , ,,,, r , ~;~zC~vw~= ' _ ,, -~ {, , , :,t "~; q u~_~l, ~ ' ~ " , ." ' ,,* - ,, ~ ~' 'Per Th,s cedificate must not be altere~ in any manner~ return to the off,ce of ~he Board ,f mcorred. Inspectors may be zdent,f,ed ~,r credenhals TOWN OF SOUT.OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved 191~i~.~. Permit No...~...~....~.....~....~.. APPLICATION FOR BUILDING PERMIT Date ......... A~)~sJ;...L0.~...L9.7.6. ......... 19 ............ 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, relationship to adjoining premises or public streets os 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. 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 Occupancy 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 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. (Signature of applicant, or name, if a corporation) ...... 9..k ...S.h ....................... ................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................... ~.s~J;>.h..$~,e, yg~£k ................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ 8. .3. .8. . . ~ .[. ................................. Plumber's License No ................................................. Electrician's License No ................~.~.. ....................... Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: Street and Number ..lO.ld...Shit~,,8.r.d...La,....Sau. t, hold .............................................................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........... .d..~..e..1..1..~..~.~......A.l~.~.9.¥....2.~....~..~)..5. ................................................................... b. Intended use and occupancy .......... ~.v,Jm.~.o.o.L ........ I]..X.~3. ............................................................................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..... .~lll~ll~. ~J~lJ,...~ ............... (Description) 4. Estimated Cost ....... ,~29,,~JQ0, ...................................... 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 ................................ 8. Dimensions of entire new construction: Front ...... J,J..;f~,~ .................. ReartLZ.~..'~5 ............... Depth .~J'~.~.~. ............ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ................?.~ .................................... Rear ........... ~.~. .......................... Depth ........ .2..!,..2. .................. 10. Date of Purchase ........................................................ Name of Former Owner ' 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~ ............................................ 13. Will lot be regraded . .......... ~ft~ ........... Will excess fill be removed from premises: (X) Yes ( ) No 14. Name of Owner of premises ........ JJ;~..h..~[~.~J~JJ,.~ .............. Address ....O.~.~..]..l~i~.l~l....[~. Phone No...[~}..~ .... Name of Architect ...Z~...Z~II~IIaJlIIII ................................ Address .J,§..JJiff~l~l~..l~# ......... Phone No. ~.~..L~.~.~ .... Name of Contractor ..¢~JE.~t..LmJk'~L.~JgL~..~.~.ll .................. Address I a~ ~...~Phone No. ~2 I)~J0 . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate ;vhether interior or corner lot. STATE OF NEW,.,Y.~),.~,I~ ~ S S COUNTY OF ...~.~..~.~ ............... ~ ' ..................... .~.9.~}.j..;~..~1~t[~ ............................................ being duly sworn, deposes and says that he is the applicam (Name of individual signing contractO above named. He is the ~ ......................................................................................................................... ............................................... ~fr~ctor, agent, corporate officer, etc.) of sa d owner or owners, and is duly authoriz~to perform or have performed the said work and to make and file th s app cation; that all statements contain~ i~ this application are true to the best of his knowledge and belief; and that the work will be performed in the manor ~ foffh in the application filed therewith. Sworn to before me this ~ ~ ................. g ..... aay OT ........................ / ........ , ........ ~ .... ......... ............................ / ~GAR~(.UI~ ' ~/ (~ignature of applicant) / // ~ff. FUN In N;~ .ounty ~ C~mission Expires Ma;ch 30 19 /~