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TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z7293 ..... Date ......... 0~ .... ].1~ ......, 19.76 THIS CERTIFIES that the building located at .0~k .~.c~t ............... Street Map N~a~ ~ay .... Block No ........ Lot No, . ~ ...... ~as~ .~rlon .......... conforms substantially to the Application for B~lding Permit heretofore filed in t~s office dated ...... J~...1 ~ , 19.76. p~su~t to which Building Pemit No. ~3~. · dated ..... ~..~ .... , 19.7~., was issued, ~d confoms to ~1 of ~e req~ ments of the applicable pro~sions of the law. The oceup~ for w~ch this ce~ificate ~ issu~ is P~ivate. one. f~ily .dwel.li~g.wlth. al. rotation & .AddStion. ...... ~e certificate is issued to . .Lgl~.. ~hD.~P ..... ~r ......................... (owner, lessee or ten~t) of the aforesaid build~g. S~olk County Dep~tment of Health Approval N~R· ................ UNDERWRITERS CERTIFICATE No.. ~28~7 ..... ~y..3.. ~.9~6 ............... HOUSE NUMBER ~ 8D . .. Street ... ~ .D~t ............................ Building Inspector FOR~I~ 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) 8355 Z Permission is hereby granted to: ................... tO .................... ; ...................................................... ¢, ~",~ _'~,'- pOrsUant to application dated '......~.,:,.'~... ' .~lljje~t' :: i~ 19.~.., and approved by the ~, -~, B~lding Insp~tor. . ~,~,,~ F~ ~K ~ YORK BOARD OF FIRE UNDERWRITERS J ' BUREAU OF ELECTRICITY 85 JOHN ~TREET, NEW YORK, NEW Y R 0 , ~ and in~r~ by t~ applicant ~med on the a~ve applicat~o~ nu tuber i~ ~he premgse~ oJ ~l~i~kl~6~pJ~j~Bay'aDr,,,~ ,Gaudiness Bay Estates, Old O~chard Lane, ,mFiXTURES ,- ~, ,? '"~ ~ RANGES ' cOoI(NGDECKS OVENS O SH WASHERS E~HAUST FANS Joseph Diaz, Builder WiZamrth Ave Greenpo~t N,Y, June 2., i 976 Dear $iri An inapeC%ion of Thorp Job~ Oak Court, Gardiners Bay Estates, yesterday~ I, leed~ vents in dqor to gas water heater unit to relieve heat and admit fresh air for flame, 2, unit too close to wall - ~ee~s some clearance - 2" minimum otherwise O.K. for C/O/ Yours truly ~!~ .ld~ ng Ins.pee~or [ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,pried ..~,~j,~j~, 19..~.~ Permit No........ .. ~ ~"" .........................." ~plicotion No ................................ DJ~pprove~~...,~~~ a. This apphcation must be completely hlled in by typewriter or' in ink and submitted in triplicate to the Buildin~ 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 apphcation, the Building Inspector wdl 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 a~terations, 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 tc edm~t authorized inspectors on premises and in buildings for necessary inspections. State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N f fp ' ' nme o owner o remlses ....... If applicant is a corporate, s~gnature of duly authorized officer. (Name and title of corl~ate ofhcer) Builder's License No .................................. Plumber's kicen~ No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... . /~ /~ /~_ ,,~/ Location of land on which proposed work will be done. Mop No~ ..~~~.. Lot No .... .~-~.. ................ Street and Number ..~~ ...... ~...~ .............. ~...'..~./4~~ ..................... Municipality State existing use and occupancy of pre~esand j.~ended use and occupancy of proposed construction: o Exisiting use and occupancy ...... ~...~:..m..z_.z....m.._ ~"'~ ............... ~ .................................................................. b. Intended use and occupancy ...... ' ......... ..~.. ......... .~...~....~..~ ........................................................ / 3 Nature of work (check which applicable) New Budding ............ Add,ban ...~ ....... Alteration ..~. ...... Repair .................. Removal .................. Demohhon ..... Other Work ......................................... (Description) 4 Estimated Cost ........................................................... Fee / ~'~ (to be pc=~d on filing th~s apphcahon) 5. If dwelling, number of dwelling umts ..... ~ .... Number of dwelhng units on each floor ........................ If garage, number of cars ............................ 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7. D~mens~ons of ex~stmg structures, if any' Front ......................... Rear ................................Depth ................ Height ........................ Number of Stories .................................................................................................... Dimensions of same structure with alterations or add,hans: Front .................................. Rear ............. Depth ............................... Height .................. Number of Stones ............................ 8 Dimensions of enhre new construction. Front ..... .~....~...~ ............... Rear ..... ~...~.. ............. Depth ................. Height .................. Number of Stones . ..~ ............................................... 9. S,ze of lot Front ....... ..~.....~.....-~.. .................................. Rear ...................................... Depth .... ..~.....?....0....?.. ....... ] ]. 7one or use d~stnct in which premises are situated .j~c.~m.~'~-~j~)' _~L ....................................................................... 12 Does proposed construction ~i?}te any zoning law, ordinance or regulation: .......... ~ ................................... 13 Wdl lot be regraded .......... ~ ................. Will excess fdl be removed from premises: ( ) Yes ( ) No Name of Architect ........................................ Address Phone No ..................... Nome of Contractor ... .r ......................... Address Phone No ..................... PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~stlliWg-m~c~a~p~osed, and mdmate all set-back dimensions fro~ property hnes. G~ve street and block number or descnphon accordmg~l~-~e~d¢ and show st~c~l~t names and indmat whether interior or corner lot ............. i'c, ............... e,ng du v sworn, eposes and sWs that he ,s the above named ~ He ,s the ............................~~~ ............................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to oerform or have performed the so~d work and to make and f~ thru applicahon; that all statements contained ~n thru apphcahon ore true to the best of his knowledge and belief, a~ tha~ the work wdl be performed m the manner set forth in the apphcation filed therewith Sworn to before 1~ this (~ ................... Z..'~'dayof~ .... , 19.2~ ~ /? /~' Notary Public, (~ / (Signature of ~ll:~icant) MAP OF PP.:,DPEP4TY 5 U P.V F_,.YE D F O~,., LO!,S 'FHORP AT EA.~7 MA, PD OI',,I TOWN OF 5OUTW~LD N~ "CALE-4© .b ~._] t'dONUt"I.E. NT_ O, 121 OAK