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Home My WebLink About8627-zTOW~ OF SOUTHOLD BUILDING DEPARTMRNT To~n Clerk'~ O~ice 8outhold, N. Y. Certificate Of Occupancy ~IS CERTIF~S ~at ~e b~d~g loeat~ at -S/S..~est- 6t~ets. ~ .... co~o~ subst~ti~y to ~e Applica~on ~or B~ding Pe~it heretofore ffl~ men~ of ~e applicable pro~sio~ ~ ~e law. ~e ~cup~cy for wM~ ~e certificate is hsued to ~ond .Do~ .& athera. ~e~s .................... (owner, lessee or ~n~t ) of ~e ~or~d bulldog. S~o~ Co~ty Dep~ment of He~ Approval N,R, ............................... ~~ITERS CERT~ICATE No. ~3~8~ ~ .... J~e. 29..1977. ................. HOUSE NUMB~..none ....... Strut .......................................... Bffild~g ~or T--uW)I OF SOUTHOLD BUILMN~ I)KPARTMInn CLERK'S OFFICE SOUTHOLD, I~. Y. (THIS PERMIT MUST BE K~PT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8627 Z Permission i~ hereby granted to: ~.~...o.p.~..~.g;z.~,..&..~.t,~.a .............................. .............. ~J,~]~a..;~ ................................ Fishers Island N.Y. pursuant to application doted ..................... .~..~.~.......1..Q. .................. , 19~..6....., and approved by the Building Ir~oector. Building Insi~Ct~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF: ELECTRICITY B$ .JOHN STREET, NEW YORK, NEW YORK .1003B THIS ~CERTIRIE~ THAT ~y~ond ~ye~ 'Xe~t Avenue~ F~.~he~s Island, L.i, inthefoll~ingl~atlon; ~ B~ement ~ lstn. ~ 2nd n. O~lt~de S~tlon Bilk ~t w~e~.~i..do. JU~e 2~ lO?? andfoundtobeincompliancewiththerequlremen~ofthlsB~m. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS K.W. OIL H. P, GAS H. P, AMT. NO. A, W. G. SERVICE DISCONNECT I NO. OF METER RANGES R 2 TIME CLOCKS BELL UNIT HEATERS , MULTI-OUTLET AAaT. AN~p$. TRANS. NO. OF FBET I ¢ NO. O(: HI.LEO A- W. G. EXHAUST FANS DIMMERS ~re Is!and, L.I. IE~ Th,s certificate must not be altered ,n any manner, return to the office of the Board ,f Incorrect. Inspectors may be iden~'~'J~'~'redentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY .MANNER. Lle.92~E emrm~t MANAGER, r APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 at areas, and giving a detailed description of layout of property 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 Deportment 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 ali 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 nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................... .~*z~e~ ................................................................................................................................. Name of owner of premises ~a..;~o~_~[...Doy~..~..~tt}.~o.~..~ .............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~.,.[~.,....~'~...~..Q....~...~...-. .......... Plumber's License No .......... ~.~,~:.-.~,...*...(~-. .................. ;( Electrician's Ucense No ..... .................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........ ~ ......................... Lot No..,. '~I~: Street and Number ..... ~.t,..~-.~..~t~ee~+at~...A~,e .......... ~.~'s'~e~'s...Z.s,:t:~ct, ......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ~zs~-~e.~,s...b=i3~L~,~s ..................................................................................... b. Intended use and occupancy ..... sa~e...~rf,~;~..acl~rl.t,;[,O~ ................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition ...:Y,,~O~ ....... Alteration .... Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) (to be paid on filing this application) ,5. If dwelling, number of dwelling units ....... ~.0~1~ ............ Number of dwelling units on each floor ..... , ...................... If garage, number of cars ............................................................................................................................................ 6. If business, commerclol 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 ................................ y~8. Dimensions of,,en?ire new construction: Front ............. __'~": ' ' '\ Height .................. ~ Number of Stories ...... /. ............................................................................................................. 9. Size of lot: Front ........ 2br9/....~9.~ ............................. Rear ...... .1.0.1./...26.7 ................ Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..!!~-.1.!! ....................................................................................... 12. Does proposed construction via{ate any zoning law, ordinance or regulation: ............... hO .................................... 13. Will lot be regraded . ......... ~ ............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...~c~,.,Do.~:e~..&..~).tb.e~. ..... Address ........ ~..,~.. .............. Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...~,..~...~..,. ............... ~ ................ Address ~' ~- Phone No. locate clearly end distinctly oil bui~dings~ whether existin~ or proposed, end indicate a~ set-Back dimensiorm~ fi'o~r~ property }ines. Give street and black number or description according to deed a~d show street names.*ffd-~indicai~e whether interior or corner lot. STATE OF NEW YORK, ~ S S COUNTY OF ...~ ............ f ' ..........................(Name~idu~O ~".~ ye~signing ...................................... contrac0 being duly sworn, deposes and says that he is the opplicam above named. He is the .......................................... ~O~ ........................................................................................................................... (Contractor, agent, corporate officer, otc.) 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 that the work will be performed in the manner set fo~h in the application filed therewith. ................. ~(~.. day of ........ Noto~ Public, . ..................... ~g~ ............. Coun~ .~.~..~Ef ........................................ ~ .............................. /~ (Signature of app~nt)