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Home My WebLink About8665-zFOI~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O/~ice $outhola, N. Y. Certificete Of Occupancy No..Z~.~ ..... Date THIS CERTIFIES that the building located at ...8°..u~..d, .A..v.e ............... Street Map No. Pg~.o.n.$.e. .8.hq~k No ........... Lot No, . .2..0~..2.~ .... ,P.e~.q~..~.e .............. c%nforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~.u~..e.. 22., 19 .?~. pursuant to which Building Permit No...8.~..6.~. · dated ............ ~.~P....~.., lg..7.6., 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 Private one family dwell.%..ng ....................... THe certificate is issued to .g.q .~.ep.h. l~.arehe.~.e..' , .~..m.e..~ ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department o£ Health Approval .0.~,~...~...~ .9?.6,..~.Y...R:..V.~. ,1.1.~. ..... UNDERWRITERS CERTIFICATE No. 1~30~990 HOUSE NUMBER ] ~ Street Sound Ave Peconi~ FOKM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8665 Z Permission is hereby granted to: pursuant to application dated 'Jt)'t'J~ ~'~' 19.Z~, and approved by the Building Inspector. q?. 20 Fee $ ........................ ...... ..................... Building Inspector ~r;'' :~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ I ~ ' ~ BUREAU OF ELECTRICITY ;ql [ !!~.,:~,, ~'q' 85 JOHN STREET NEW YORK, NEW YORK 10038 '~ !;/~ili'.i~i;; iii:' ~i"-' i" ' ' ..Bill';.'.Rign°[a,. s/side Sound Ave., !00' w/o Mill Lane, Peconic, L.I. , m ~ts~ ~ ; ,Section Block ~.exa~inedon , SEptember:23, 1976 andfoundtobeincomp~ 18 *Special receptacles :, 1-50amps., 1-'30amps. Elec.room heate~,s:' 3-2.0kw, Motor/s: 1-1/2hp ' U.~'.C.I._ - ' : 1-~.Skw Hot: Water h~ter _Smoke Det6c.tor . .~., 2-1.5kw, 2-1.25kw, 1-1.0kW, 2-.75kw, 1-.Skw Rob e~'t'. Pale~m0, P.O.Box 38 ~ast ~at:chogue, L.I. 11772 , Lie. ShOE ~ ~ Th~ create must not b~.'~ltered in any manner; return ,o' the office of the Board if incorrect, inspectors mayPerbe ide~ C~ --by ,hei~eJ~ti~s. TOWN OF SOUTHOLD / BUILDING DEPA RTMENT/~., TOWN CLERKS OFFICE~ ~UTHOLD, N. Y.~ ~ ~ ~ '~ ~ ~. Examined ............. ~.: .................19.5~ ~ _~plication No..,~.~.~.,5,.~, ~ ~ /~ . ~ ~ / ' , ~o~ ................... ~ .......... , ~ ........ ~,, No ................................... .......................................................................... ......................... {Buildin~ In~poctor) I~STRUCII a. This ~pplicotien must be completety filled in by typowriter Inspector, with 3 ~ot* o{ pl~ns~ occur~to plot plan to ~olo. Feo ~ccordin b~ Plot plon showin~ Iocotion of lot ond o{ buildings on premises, relotionship to od~oinin~ premises or public streots oro~s~ ~nd Oivin~ o dotoilod doscription o{ Ioyout o{proper~ must be drown on tho dioorom which is port o{ this ~pplicotion. c. Tho work covored by this opplicotion moy not bo commenced bofore issuonce o{ Buildinfi Permit. d. ~pon opprov~l of this opplic~tion, the Buildino Inspector will sholl be kept on the premises ovoilable for inspection throughout the work. e. ~o buildino sholl be occupiod or used in whole or in port for sholl:h~ve been Or~nted by tho Buildlno 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, os 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 applicanK, or name, if a corporation) ................. .~..~.. ~ .....~_ .u..f~.,~.~Z.......~ .~.~ ........................... (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ ~.~.:..c..m.,..~.t~t :~. ....................................................... Name of owner of premises ................... ~t,,r..~ ................................................................................................................... If applicant is a corporate, signature of duly authorized officer. ........ ~.¢..~.<..~..~.....~:.~.~.~.~.~.~ .......... ,LL/.~.~...... (Name and title of corporate ~z~icer) Builder's License No ..................................................... Plumber's License No ......... Electrician's License No. /~ :~E;~-. '77~'Z~i ~,,~:,(~'., Other Trode's License No ............................................... ~ ~5 Lot 1. Location of land on which proposed work will be done. Map No.: z..~.~.~.f~.~.~ ....................... No. Street and Number ............. ..~'.,'.O...~.../.v...,O...,.....~...u,~.', ............................................. ~ ...................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~ 'Y ..... b. Intended use and occupancy ..... .~,,),,,x,,V,,,¢~,,....__,.~.~,./.~'~'. ,~:',,, ...... ........ ................................. .................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ..... , ........ Repair .................. Removal .................. Demolitior. ....................Other Work .................................................. ~' ~* L{ c~ ~ (Description) 4. Estimated Cost ...... ..~'...~Y..:':........ ................................. 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~ify nature and extent of each type of use ............................ 7. Dimensions of existing structures, ff any: Fron~ ............................ ~ 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 ..... ~.~ ........................ Rear ............................ Depth .................. . 6 Hei~ .................... ~umber of ~t~ne~ ..................................... : ............................................... ~ ............................. ~. Size ~ I~: ~ron~ ........................................................ ~e~r .......................................... Depth ................................ ]~. ~te ~f P~rch~e ..... ~.~..~..~ ..................................... ~e of ~r~er ~wner ........................................................ ] 1. Z~e ~r u~e district in whic~ ~re~J~e~ ~re ~ituate~ ..................................................................................................... 12 Does proposed construcHon violate any zoning Iow, ordinance or regulation: ....~ .............................................. 13. Will lot be regraded ..~'.~ .................. Will excess fill be removed frompremises: ( ~ Yes (~ No 14. Nome of Owner of premmses .~ ............... ~ ............................ Address "~*t'"~ .... e No ....................... Name of Architect .................................. ~ .......................... Address ...~R.(o~.b. KT((~... Phon~ No ....................... of Pho, No PLOT DIAGRAM ' L~6c~te~Clearly and distinctly all buildings, whether existing or proposed, and indJcate all set-back dimensions from property ,ll~s. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF: NEW YORK, .(SmS COLJNTY OF "'~'~'6~.]~ ............ .................uxu.,~ ~ ,,~u~.,~, ~,,,~,~r.~..~..~'~k'":f~"~~ ..................being duly sworn, deposes and says that he is the ~pplicanl above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or haw performed the said work and to make and file this application; tha~ all statements contained in this application m'e true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ................. day of .......................................... , 19 ....... ' ' INoTa ~ ~UOliC~ ......................... ~....~..~ ~ ........... ~oun~ ...................... : ....................... ~.; ........................................ (Signature Of opplic~nt) ELIZABETH ANN NEVILLE NOTARY PUBLIC, State o( New Y~' No. 52-8125850, Suffolk ~ Term Expire~ ~arch IF/AP t~C O/~//C ~ YOUl/I¢ U~N~ su~¥~¥~ o.4~ '~ Lepta