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Home My WebLink About8727-zNO. 4 TO~VN OF $OUTHOLD BUH.BING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. ~7~Q.8. ..... Date ............. ~.eVt...t ...... , 19.7.6. THIS CERTIFIES that the building located at . .N./.S...g.a.i.n...R.o.a.~. ........... Street Map No... ~ ...... Block No .... :g~...Lot No. ~... H~t..t~..tu.e..k...~.; .~.. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........J~l~y .... 8.., 19.. 76 pursuant to which Building Permit No...8722Z dated ............J..u.ly....~ .~.., 19.7.6., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which thi.~ certificate is issued is Pr;L.v.~'~e..(e¢.c.e.s.~.ory.).. ~.w.~..m?.~n. g. p. qo.~. ............................... The certificate is issued to ....~/.~..~..r.e.d..B.:..R..u~..ap.cl. ..... .~..e.l*. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .I~,tL, ............................... UNDERWRITERS CERTIFICATE No. 72966.1.9 .... ................. HOUSE NUMBER...1 ~955 ..... Street ....~a~ .l~o~.... ~ttit~e~r ............ Building ln~ector I (THIS PERMIT MUll' BE KEPT ON THE PREMISES UNTIL FULL ~lOhl OF THE WORK AUTHORIZED) 8727 Z P.n. nmion is hereby granted to: ............ ~g;~..3,6~ ......... ,.~e~ma... SLs ~a..~. ~ ................ .................................................... ~ .t..t ~,.t,.',,W,k.. J. ,.~ ,. ........................................................................ pure, ant t~ ,:~:~kat~on dined ..................... Build~ In~c~. MOTEs Meed tu~er~ters ce~t~£1cate to ~et DISH WASHERS ExHAusT FANS TiME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF (Swimmln inspect [0~ ~l-~i-]"~U~k, 'k':,l~'.;:' ':'1r'1952 ' ~T --. ]] "' ' 'LIC' 242 Th~$ certificate must not be altered in any manner;, return to the offtce of the Board if incorrect. Inspectors may be identified by t~ FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. Permit No. C~.~2 .~...?J.~ ....... Application No ......... ~. ........ .~. ........... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter o~. in ir~k and submitted in triplicate to the Building Inspector, with 3 sets of plans, accdrate plot plan to scale. Fee according t~ sch~edu!e,. b. Plot plan showing location of lot and of buildings on premises, relatioinshi~ to a~joi~ing premises or public streets or areas, and giving a detailed description of layout ofproperty must be dro~n an the diagram which is part of this application. c. The work covered by this application may not be commenced I~efd?~'i~s~g~nc9 o~_Buildlng Permit. d. Upon approval of this application, the Building Insp&cror will issue o Building'Permit to the applicant. Such permit shall be kept on the premises ovailclble .for inspection throughout the Wor~. e. No building shall be occupied or used in whole or in part for any purpose whateger until a Certificate of Occupancy shall have been granted by the building Inspector. APPLfCATION IS HEREBY MADE to the Building Deportment for the issuance of. o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, end 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 necegSrb-f~, in.~e~ctij~i~ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .99./..~..~..~...~..~...~..:....~....~..~.~...~...!..~. .............................................. applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ................ ,~,,.~-....,,,~,..~...'. ...... Plumber's License No ................................................. Electrician's License No ........ .'~...~,....7~:..~i ................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot N,o ......................... Street and Number .......... ~..../..~-.~.~/..~...ff~....~Z~.('...~....J~:)..! ............................... ~'~'.'~-" / ff ~/..5" 5'~' Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................ ~..~.~.'..~. ............................................................................................... b. Intended use and occupancy ....... .~.kP..4.~..~../...~...~c;:...........~'..~--.....~:.. ...................... 3. Nature of work (check which applicable): New Building,. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitio~ .................... Other Work ..................................................... (Description) 4. Estimated Cost ......~.......~7...?....~.....:.? ......................... 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, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........~j~.-- ............. Rear ....... ~..%..~. ................. Depth ...3...0. ........... Height ........................ Number of Stories ............'"./..~.~......~.~..~..Y. ............................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ j..r~.. ................. Rear ............ ,~..~. .......... Depth ....... .,~L~ ........... ~i~h~t ..:~..~.~..! ........ Number of Stories ..................................................................................................................... 9. Size of lot: Front ........"/.2.:...~...~.. ................................. Rear ..... :?..~.:...~..i). ...................... Depth .....~.....c7~...;...°..! ............ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ..~....~.. ....................................... 13. Will lot be regraded ..........z~...?, ............. Will excess fill be removed from prem?~se~s~,(~x~Y~e~.~ ( ) No 14. Name of Owner of premises ..~.!..~.f.,..~...%..~..fl.~....~...~,..u.~?...~.. ........ Address I.~..~(..~.~.....~....~.~...P...R.~:. Phone No...~.~.~...~']..~....~ Name of Architect "J~ ~'~ '~ Address Phone No. Name of Contractor ...~.?....~...'....~....o~....~ .............................. Address/&.~.~.~...z~.~....'~...#~.¥..~.~..~-~one No....~..~...~...'.~..~..~'~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Jot. > STATE OF NEW YORK, COUNTY OF ................................ ~'~ .......................... ,_.-.'.z~,..~....~).....~.'......~....~...~..~./..~/...7~.. ........................ being duly sworn, deposes and says that he is the applican~ (Name of individual signing contracO above named. He is the ........................................................... .~.~,~.,~ .................................................................................................. (Contractor, agent, corporate officer, etc.) 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 ar~ t~he b~f his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the applic~0n f~d ~with) Sworn to before me this .............. ........ Noto~ Public~.~ ........ Coun~ ...... ~..~.;~ ......................... ~ ~/ ......... ~ ' (Signature of applicant) i f PI-RN tfWEE BRAC~' SECT'i: OIV ~ I-*'¢-I oz, ~w,,,,z,r,~