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Home My WebLink About8724-z· 0,~-~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPAR'I~rRNT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy .7.7 No..~....~.~...~..0 Date .. ........... ~ ............ , 19.. THIS CERTIFIES that the building located at....~..~....~..~...~. !?.~'....~..~.. Street Map No .... ~. ....... Block No .... ~ .... Lot NO...)( ..... .~..?. ?..~...~..~...~..~..~.~... conforms substantially to the Application for Building Permit heretofOre filed in this office dated .......~.il~, 19.?.~. pursuant to which Building Permit No..~.7...~.q.~--~ dated ................ , 19. ?..~, was issued, and conforms to all o! the require- ments of the applicable provisions of the law. The occupancy for which this certificate is .... ..... The certificate is issued to ........................................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ~...I.~. l ........................... UNDERWRITERS CERTIFICATE No...~.. ~ ~ ~' 7 / (~ ,~ .~.1../.~..~. ~ TOWN OF SOUTHOLD IUIU)IN~ WARTMINT TOWN CLERK'S Ofl~.E SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION Of: THE WORK AUTHORIZED) 1~17 8724 Z Permission Is hereby granted to: ~L~r:~t~Te .~ -t3 -~L~ ~' ~ ...... ~.u..!.s.~. .......... h ........... ..s..v..:.!.%~.:..~!.~ ....... ...~..t.s.= ........ .~.........g..{.~.,,c..~,~ ..................... at premises located at ................... .'7.. .................. ~ .......................................................................... pursuant to application dated .............................................. ....~...., ....... and approved by the Building Inspector. Fee $./.../.?...~.. ............. .............. .~..~......~ .............. Building Inspector ,THE NEW YORK BOARD .OF,- FiRE .UNDERWRITERS ' - 5 JOHN STREET, NEW YORK, NEW YORK 10038 ~;~July 29,'1976:~ ~,' ~,ti~;,~oo.r~i~ 867598 . , OTHER APPAR.~TUS: ,;'Panelboard/s: ,~-2ciP IOOamD;,' i G~C~ ( .wim~ing Pool) This certificate covers 'compliance at the date of inspection onl~;' Because of unUSual, environments it ~is advisable to have £requ,ent test and/or repairs made by a qualified person. ' Andrew G. Bowman Jr. 7 Heller Pl~' ' ' ' , Hauppauge, L.I. 11787 ic. 975E , T~i~ certificc:fe rnusf no1 be ¢:[fered in ony monner; re~urn ~o the o~i&e, of fhe 'Boord if incorrect Insgec¢ors m~y be identified b c Cn~ ~ s FORM NO. 5 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, I~. Ye ORDER TO REMEDY VIOLATION TO (address of owner or authorized agent of ~r) ~ ~ ~ PLEASE TAKE NOTICE there exists a violation of: on,n O ,n n e O~her Applicoblo k*ws, Ordin*nces'or Reoulotions ............................................ A~to charoctor of violotion) in v~ion of ~ ............. ; ....................................... (Stoto section or p~roflr~ph o{ ~pplic*ble I~w, ordin*nce or re~ul~Hon) YOD ARE THER[[ORE DIRECTED A~D ORal'ID to comply with the~w ond 1o remedy the .........................../~ ~ 19 .-.~ The promises to which this O~fiR TO REM[DY VIOkATIO~ refers ore situated ot Foilure to remed~ tho conditions o{oresoid ond 1o compl7 with the opplicoble provisions of Iow mo~ constitute on offense punishablo b~ fine or imprisonment or both. Buddm~ Inspector TOWN OF SOUTHOLD ~-~_'"" / ~ BUILDING DEFART~EHT ~ TOWN CLERK'S OFFICE y~ ~OUTHOLD, N. Y. ..... ...... .... ~ ~ ~. ~ ~ / ~,c,~,o~ ............................ ~ov,d ...... ~ ................. ,,~ .... ~,r~,, No ..................................... ~ APPLICATION FOR BUILDING PERMIT Date ...... .......... 7...~..~.....TzTT... ................ , INSTRUCTIONS a. This application must be Completely filled in by typewriter or~ inink and submitted in triplicate to the Building Inspector, with 3 sets of plans, ac~:urate plot plan to scale, Fee according to schedule. b. Pbt 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 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 Department for the issuance of o 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. P The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, end to admit authorized inspectors on premises and in, buildings Tar necessary inspections. .~,~ ............. .............................. State whether applicant is owner, lessee, agent~ architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's Ucc-se No ......... .~...~...~...~../....~... ............. Plumber's License No ......... ~ ....................................... Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of and on wh ch proposed work will be done. Mqp No.;....,; ................ ~ ...... w.,~,... Lot No ......................... Street and Number ......... ~....~..'~" ........ ..~...~.~.Z/Z....~.. ........ L;.~.~' "" ' -- .~U.~.~. ,~...~.~ ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: E×,s,,,ngu,eandaccupancy ............ ......... .............................................. b. Intended use and occupancy ................. .~./~.~:.~. ........ ..~...~..~,;j~.........~_.~..,~....L......~.....~....~,.~(....~,~ ............ 3. Nature of work (check which applicable): New Building'. ................. Addition .......... ,.~... Alteration .............. Repmr .................. Removal .................. Demolition .................... Other Work ....... ..~..~).~... ~ ................. (Description) Fee ............ ............................................................... 4, Estimated Cost ..............~. ......................................... (to be paid on filing this application) 5. If dwelling, number of dwetling units ............................ Number of dwelling units on each floor ..... . ...................... If 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, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations ar additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................... , ................ Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... Rear ........... /..~...~. ..................... Depth ....... ,/.. ~.~..~.../. .......... 9. Size of lot: Front .................... ./.~.~..'. ........................ 10. Date of Purchase ........................................................ Nome,of Former,Owner ........................................................ 11. Zone or use district in which premises are situated ~...~..-~'/. '¢/,~...~.//--~r-~ ~ 12. Daes proposed construction violate any zoning iow, ordinance or regulation: ........................................................ 13. Will lot be regraded . ........................... Will excess fill be removed from prerpises: ( ) Yes ( '~ No Name of Owner of remises ~..~ ~Z/)~, ~, 7' [~/~ Address ,~..~,~.~..~.~ Phone No. ~...J.....~..'T..,.~../....~.,. 14. p ................................ y ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ,'ed, and show street names and indicate property Fines. Give street and block number or description according to~d whether interior or corner lot. $TATE OF NEW YORK, [S S COU2xlTY OF ..... :,,:..~,.~,...~'~, ....... [ ' ..... .~.(.~.~,.,~.~...~.;~ .......................................... being duly sworn, deposes ?nd says that he is the appliccm (Name of individual signing contract) abow~ named. ~ ~s ~h~ .............. ~.~/~ ......................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have per~ormed the said work and to m~ke and file this application; that ail statements contained in this application are 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 Z~ day of ............... ~..~..f~ ....... ]~,~ /~/~ .... . ;.; ....................... ................................. ~ ' ....... ' .................., - ~ ~ign~ture of ~plicant) , ' ,