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Home My WebLink About8614-zTO~N OF SOUTHOLD BUll,DING DEPABTMgNT Town Clerk% THIS CERTIYIES that the bulldin~ located at. a/.~. Fl&dclil~ ,IM. i.~... Street Map No...~.. ........Block No..~g .......Lot No, . ][XX.. P. lCOi3.t~..'~l.,l~, .......... conforms substantially to the Appltcathm for Bufldin~ Permit heretofore dated ............... .~Y.. ~19.76. pursuant to which Bu~t~ Pe~. t No...8~.~Z dated ............1.~. ~,...~..8..., 19.?.6., was issued, and contbrms to all o! the req~ merits of the applicable provisions of the law. The occupancy tor which this certificate issued.is . Pr:Iv. ate..one. £ami~..dveJ. lin{ ....................................... The certificate is issued to .................................................... John Bednoski .&..Wife wners .. (owner, lessee or tenant ) of the aforesaid building. Su~ol~ County Department o! Health Approval UNDERWRITERS CERTIFICATE No..pel~ltllg ................................... HOUSE NUMBER .... 3 .~.q ....Street ... ~I~44~..I~..GI~7.... P. eeo~/e ...... ,(THIS ERMIT MUST, BE, [(Ep~ oN :THE.rEE~SE§ UN~IL FULL . [ ~, , ...... ..., ........ , ................. THE NEW YORK BOARD OF FiRE UNDERWRITERS September 28, 1976 .~pp,lc,~,io.~'o.o,,f,i. 867158 N 30536~ Mr. John Bednosky, s/s North Road 1/4 mi. e/o Peconic Lane, Peconic. L.I. ,.,.~,~.,,,~,.,.~o. September 23, 1976 FIXTURE OUTLETS ~ECEPTACLES SWITCHES I FIXTURES 21 31 15 DRYERS [] 2nd Fl. Section Block 'Lot and found to be in comp{lance t~itit the requirements (ff this Board, RANGES OVENS ;H WASHERS EXHAUST FANS SYSTEMS NO. OF ~ET APPARATUS: 1-G.F.C.I. xI 1 2 G&S Contracting Box 215 Southold, L.I. 11971 Lic. 578E · Per~ Th~s certificate must not be altered in any manner; return to the office of the Board ff ~ncorrecf Inspectors may be identi{'i~ by their~dentie~{s, TnWN I-IF SEIUTHE)LD OFFICE: OF BUILDING INSPECTOR TOWN r~.LEI~K'=: OFFIOE Mr. ~, Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ..... has applied to the Town of Southold for a permit to construct a building on ..~.~. ~t4~L~e.. ,~...( ~.1,.... ~e.....~. ~X. ...................... as shown on the attached plot plan, submitted in triplicate, dated ...... ~...;~ ............................................ and titled ...... ~l~.~..,~-~.4~a~et we shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 230K. TOWN OF SOUTHOLD ~ ~.~ ~%,~, ~ TOWN CLERK'S OFFICE ............................................................. ......... APPLICATION FOR BUILDING PERMIT~'~ ~ ~ INSTRUCTIONS ~. This application must ~e completely filled in by ~ypew~ite~ o~ in ink and submitted in t~iplicote to the Buildin~ Inspector, with 3 sets of plo.ns, accurate plot plan to ~ole. Fee according to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to q~joining premises or public streets o~ areas, and giving a detaJl~ description of layout ofproperty must be drawn on the diagram which is pa~ 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 ~cupied 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 n~essa~ inspections. (Sionoturo o{ opplic~nt, or name, i{ o corporotion) ........ ..... (~ o~diri~'~i ............................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiider. / : "c~..~?~d./.X.~ ~F...V.~ ...... Name of owner of premises ......... ~,'~j~.}.,.....~.?.~.~..~-Lg..O',~.cZ ...................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Other Trade's License No ............................................... 1. Location of land on which proposed__., __ ~-,w°rk will be done. Map No.: ............. ~.,.. ........ :.....,., ; /~. a/'L°tN° ................. x~... Street and Number ............ ~/...ZZ~..<..~£.....~...~.Z. ......... .,Z.~.<:,~r',,Z..~'..~ ...... ~/:~'.~i.~m~.C~'..~'. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............ /J~..C~l.~/~.]. ....... ].~...~....~.'.~.. ........................................................................ ............................~4/. ,: ~/:,~).z?..~/ ............................................................. ./Dw~L~l~/.~ ..... b. Intended use and occupancy / 3 Nature al' work (check which applicable): New Dui!ding, .....,,~...~..... Addition .................. Alteration .............. Repair .................. Removal .................. Demolitior'. ................... Other Work ................................................. ~ (Description) 4. Estirna~ed Cost ............. gZ.,,.~.J,,,/~,,.~,.~., .......................... Fee ..J./....(...,...~ .............................................................. (to be paid on filing this application) 5. if dwelIjng, number Of dwelling units ............................ Number of dwelling units on each floor ............................ Jf 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 .................................... Re, ar ............................ Depth ............... ~ ................Height ............................ Number of S[rorJes ................................ 8. Dimensioi~s of entire new construction: Front ............. ~,~. ................. Rear .......~..~.]...2. ........... Depth ....~..-~..../.. ........ Height ....~....7. ......... Number of Stories ....... .~.. ......................................................................................................... 9. Size of Jot: Front ........... ~..~....~?. ................................ Rear '""~"~"7-- .......................... Depth ....~,.,~,~. ............... 10. Date of Purchase .............................................. :;'.....Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated. ........ ~.~[~./.~.~...~..~./.zt/J..~.z:... ...................................................... 12. IDoes proposed corlstruefion violate any zoning law, ordinance or regulation: ..~.~. ............................................. 13.Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No .1/2 of Owner of ..... Address ................................ ........ Name of Architect .............................................................. Address ................................Phon~ No ....................... bJon'le of Contractor ....J.,...~.~..:.....C~/.3~.].~..~...~...~ .............. Address .~...~..Z~'~..O.~. ........ Phone No. PLOT DIAGRAM Locate clearly and distinctly ~ll buildings, whether existing or proposed, and indicate all set-back dimensions fron~ ,~ropcrty lines. Give street and block number or description according to deed, and show street names and indicate ,v~ether interior or corner 1at. .............. ~....'~......~.,. ................. being duly sworn, deposes and soys that he is the appJlcorJl , (Na,~/'CF/' individual si~i~qg contract) ooove no, med. ~ 1 / /'~t/ /I/~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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; a";d tk~at the work will be performed in the manner set forth in the application filed therewith. ................ ........ ....... .................. NOTARY PUBLIC, State of New Yor~ NO. 52-8125850 Stltfolk Coun~.~/ ~-~?~":-.~',~"'-/~ ;', - ..... FOR :APPROVAL ~F CON~I'~I~U~PrlON <:}N.L,Y ~/~ I' H. ~. RE~. NO.: , , ~, , :~ 8TANO~ OF SUFFOLK CO. O~. SEP ~ 3 1978 ~j~_~ ~e se~e d~spo~8~ and ~e~ facilities for this location have been tnspect~ tht~ department ~d ~ound to be sat t Chief of General En{ineerin} ~ervi'ces ' '- ~ ~ ~'= t," APPROr.V-,F.~ AS NOTED NOTIFY BUILDING OIPAETMEN~ ~ ~R ST~T ~ING ~., ~ ~ ~B CO~LET~ L