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Home My WebLink About8808-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's DJ[ice Southold, N. Y. Cerfi[icate O[ Occupancy No. ~.7~73. ...... Date ............ ..~.~ ......~. ....., 19..~.7 THIS CERTIFIES that the building located at ~..RQ.~..d ................ Street Map No.F:.I.'E$.t ..... Block No.. 3.1'... Lot No, 3. . F~.sher. s.Island.. N,~ .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... &lAg..18 , 19.76. pursuant to which Building Permit No...~0.8~ dated . .. A.ug.. 23... , 19.7.6., was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P.r.iv.a. te .ore..f .a~l...1.y..d..w.e.l.1..~. g .................................... The certificate is issued to .~..O]~...~e.~.ie.~, ........ .0W~.9t' ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 1~. y... 26~ .].~]...b.y..R.,' ?.i. ll.a .... UNDERWRITERS CERTIFICATE No. ~.3~. 7.~ 02 ..... D.$~.. 17:...[97~ ............... HOUSE NUMBER ...~one .... Street ...... P..v$..R.o.~d...P.,~[.,E.a~; ................ F~RM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8808 Z Permission is hereby granted to: Date ........................... .......... Zt~dter~..:LB'!~_n,~ .............. ~.Y... .......... Building Inspector. at premi,es located at ...~,l,~.o~..3.~.....LQ.~..3.....Pish~r~..Z, al_,t<l...F_,a~at~a....~,:..7. ....................................... ~,:~:~,...r.,~,..~,,,,,,..~,o~ ....... 't.:.. .......................... :.~x..:~} ............... .............. ............ .................................................. ~(% ................ ~'.y , - ~ ~}~ . pu~uant ~ application dated ~ '--- 8 , 19 ~6 · an~ aPFr~ ~ 'bY the ....................... __ ......... -!-~ ......... _ .- , ~? .. Fee $.~.~.~(~ID...P~J~ IMJ;J ~ee lee :[e%te~ ez~:Loaed ~LJ'~,VE,¥ TF-..I.6.~GUL,L.T IO~.a ~T~-.TIQt-4 ~he :;ewage disposal s~d water supply facilities for this l,c~,tion have been inspocted by thinz department and foun~/~ ~o be satisfactor~.. ~,~ 0 Chief of General Engi~eeri~ Se~ic~s THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN,,~T~T/J IdI~N/¥OJR~ FiIE~I/ YORK 10038 Bob IIell~e~, F~she~l~~ ISland, L,I, inthef~ing~at~n; ~ B~ht ~ 1stFI. ~ Sna FI. Outside ~,i~ s~k ~ezami~on December, 1]~ 1~76 a~fou~t~i~compl~ht~.~ntsofth~B~. RXTURE FIXTURES RANGES OUTSetS SWITCHES FI.UO~ESCENT 23 13 15 DRYERS FURNACE MOTORS 1 ~SN WASHERS EXHAUST FANS *Speci&& Receptacles: *Unit Heaters: 3-F hp. MotorS: t-1/3hp. 1-15amp G.F.C.I. 1-F bp. Compactor 1 4/0 4/0 1-30a~r,p, 2-~0amp. Boutoh Services Corner ~ox & Crescent Fisher~Island, ;~.Y. 06390 45.90 Lic#1142~ 11 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter oe 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 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· 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 neces~ ~r~.echons. / __ / ~ ,~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ge .n.~.~R[ (~g~,T,~P,~ ~' .......................................... Name of owner of premises ......... .~.9)X~.~.~,~,~,~.~ .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... .2..~.8..~I,]~ ..................................... Plumber's License No .... .~.$~...~. .................................. Electrician's License No. ..2..L,.O.~..]-...~.~:..~,.~.:'.~ .......... Other Trade's License No ............................................... · ' Mo Block 34 3 Location of land on wh:ch proposed work~ll be done· p No..: ........................................ Lot No ......................... Street and Number ................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... .~J~d~-..e...~.n..m..~.~.~...~.~.~. .......................................................................... b. Intended use and occupancy ........ S..~[~...e....~.n..m..~...~.~.~,~,~. .......................................................................... 3. Nature of work (check which applicable): New Building' .....?. ........... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) 4. Estimated Cost .........4. .S. ~. .0. .0. .0. ........................................ 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 .....1. ....................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...... ]~Qil~ .............. 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 ...... ~.4 .......................... Rear ..... ~;.4 ................... Depth ....;~6 ................ Height ...!.4..~ ............ Number of Stories ..~ ................................................................................................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner .....B.~.o.~..~.d..d. .............................. 11. Zone or use district in which premises are situated ....~e.~id.e~tt~ial .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .N..o. ................................................ 13. Will lot be regraded' ....N..o.. .................... Will excess fill be removed from premises: (×) Yes ( ) No 14. Name of Owner of premises ..~.o...}~....[J.e..1..1.~.e.~ .......................... AddressYy..s.~..c~...C...o.~.?..~ ....... Phone No..C.2..0..3.~...5..3..6.:.6.425 Nome of Architect ...~OA~.~ .................................................. Address ................................ Phone No ....................... Name of Contractor ...B..o..u.~.o..Tl....S..e.~y.i..c..e..s.~....l..~..c.:. ................ AddressF..i..s..h..e..r..s....I..s..1...a~....d.~...NJ~hone No..(.S..1..6.)...?..8..8..~?.268 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. STATE OF NEW ~OEK... [¢ S COUNTY OF .... . .O.?.f~ .L.I.e.. ......... f-~- ............... ..~..g..~.~DD.~.....3~.........~.. £.~...~.~.!....; ....................... being duly sworn, deposes and says that he is the applican, (Name ~ individual signing contrac~ above named. He is the ........ ~.~.~C...~.~.~.~ ........................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application fired therewith. Sworn to be[ore me this - ~ .......... ............ . / ........... .................. ....... ~ ~) ~1 ~ ~ ~ ~gnat~e of applicant) ~. b. l~'~ ~ - / '' MA~ B. PANKIEWICZ ' ~ ~M ~usuC, SmT[ OF ~EW Y0~K . ~0.'~-~a0 - SU~ m..~v APPRQ~'ED AS NOTED NOTIFY BUIL,gING iDEPARTMENT 765.2:66~ 9AM"~O 4pM FOR REQU '~, ~INAL WHEN JOB COMPLET~.~