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Home My WebLink About8173-zFO~ ~0. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Certificnte Of Occupnncy No..~.7.6.L~.. ..... Date ............ ~4.ay .... ~ ....... , 19..7.7. THIS CERTIFIES that the building located at . .8.~.g?~a):..Rg.a.O. ............. Street Map No. l~i,.t~ .Pk .... Block No ........... Lot No, . .~2A .... t~ti, i'~tel~ ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ 8cp.~ .. 2.., 19.75. pursuant to which Building Pemit No..8~ 73Z - dated ........... Oep~:...2 .... , 19. ~, was issued, and conforms to ~1 of the requ~e- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .P~'~.~$O..~n~. ~a~:ll~: .d~JLIing. ~l~h. ~a~aga .addi%io~_ ............. The certificate is issued to .~!i] t.ia~. & .Eleffiqor. Redersen ..... ~ers ............ (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval ~ ~.' ............................... UNDERWRITERS CERTIFICATE No..~2~39.&0 ..... ~IOV. 3.. ~ 9.~ ................. HOUSE NUMBER .. 21,70 ....... Street ... ~gzb~: .Road. ......................... B~lding Inspector FOBM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTME~4T 'tOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 8173 Z Perrnisslo~ is hereby granted to.'. to ...~.~l~..~...~.~.~e.c~h~d..g~ g~...o~...e xX~ ~J~..d~e~Ll ~n~ ............................................ at premises located at ..~...~ ....... ~:;~.t,~,t,u,~'~..~.2~'~..~:Z'~J:~1:.t~A ..................................... ................................................ ~:Lgahy...~ad~ ........ i,i~t t £t vf.J~....L. L ~ ........................................ p~rsuant to ~pplicatiom c~ted ...................... .~..~. ....... ~ ................. , ]9...~.~., and approval by ~he Building Insp~-~or. Fee $..~,g.Q ........... :- THE NEW"¥ORK;BOARD'OF. FIREiUNDERWRITERS ' .... .... ,: :, , . , BUREAU ELECTRIC)TY THIS THAT only the electrical equipment ~ ~s~dbed be~ and introduced by the applicant ~med on the above application t~umber in the premises of Wllli~ .$..i]PedersoH, 2470. Sigsbee Road.i Mattituck,- L;I..:. wasexamtaedon ~, .~ ; 1Q~ , ' '. andf°undt°~etnc°mpltancew~thtI~erequ~rements°fth~B°ard' - , ' ;- L } FIXTURE FIXTURES RANGES I OVENS EXHAUST FANS SERVICE This certificate must not be altered in any manner; return to the office of the Board if incorrect.-Inspectors' may b~ ~ed by their~ia~s.' Examined Approved .......~ ................... e~- , 19?...~..-~Permit No..~...L ....... ) ~.. ............. ~- '-- '~-'~..~,4~~y~-~~ // APPLI~TI~ FOR BUILDING tl~lT ~ ~ IN~RU~I~S a. This qpplication must be completely filled in by typewriter or, in ink and submitted in triplicate to the Building Inspector, with 3 sete of plans, accurate plat 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 o~ rn areas, and giving a detailed description of layout ofproperty must be drawn On the diagram which is part of this application, m c. The work cOvered by this application may not be commenced before issuance of Building Permit. d. UP°n approval of this application, the Building Inspector will issue o 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 pa rt for any purpose whatever until a Certificate of Occupancy ~7 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 ather applicable Lows, O. rdlnances or t~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here~n described. ~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to t admit authorized inspectors on premises and in buildings for necessary ir-~oections. ~ 40._ ....... ...... · ~- (Si .g. nature of applicant, ~r name, if a corpo~J~ ........ ~'~ .............................. ...... : ........................ . .S.t..:t..: ...w.h..: .t.~.: .r...: .~ .~' i.~ .: .: i. i:...o~...::::..,: ..s~...::....~: ~.t.:..:..~ .h. '.i' .~.t.:..: .~..:,..~ :.: .r:...:.:.~ .:r..:'....:...on.t...la..:t..:r.:...:,o..ec.:.ri.::.: .~:...:1..~..m..b..:r....:r....b..~ii .d..:r.: Name of owner of premises ......................... : ........ : .......... ~ ..... ~..~....~ ............................................................................. If 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 ............................................. Other Trade's License No ............................................... ~'~ Location of land on which proposed work will be done. Map No.: ~.:~.~.°.~.: ................ .~,~ ..... Lot No ..... ,.~.~...~.: ....... Street and Number ........ ~..~...~.(~. ....... .~.t~.~..~..e...~. ........ .~..~..: ............ ..~......~.~.k.: ....... i ....... i .......................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use ~nd occupancy ....... .~...% .............................................................................................................. use and occupancy ......... "..I~..~...~ :. ....... ' "~ ....L~../....~.....~..~.. ~_ -- .e~..~....~.~ ........................................ b. Intended · 3. ' Nature of work (check which appli~:able): New Building.. ................. Addition .......... ~... ..... Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~. t ~J~ ~c~ ~ Ii c'-' __ (Description) 4. Estimated Cost ....;.....~....~......~..,..~.: ............................ Fee ....... .'...~..~.. ....................................................................... (to be paid on filing this al~plication) 5. If dv~elling, number of dwelling units ........ .~... ............ Number of dwelling units on each floor,.;..'~.~....~...l~..:~.~ If gorage, number of cars ........... ~, ...... :~....J ......... '..'..ii ................................................................................................ 6. If business, commercial or mixed occupancy, speci!~ nature and extent of each type of use ............................ . I · / / 7. Dimensions of existing structures, if any: Front ...:..~.~.~.~..~. ......... Rear ......~.~....~. ............. Depth .~.1'....~. ...... 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 .....~,.~.. ........... Height .................... Number of Stories .............. ~. .................................................................................................... 9~ Size of lot: Front ............ x , -'~"~ ........................ i ........... Rear .......... ..~.~? ......................... Depth ....... /;~¢~....~. .............. Date of Purchase ..... Z-'..~...~.~?..[.....~.~.~...~.. ..................... Name of Former Owner ..... ---- ---- .~..'.~..7t'..~.~..~......L?,~.~.~..S...c.~ .... 10. 11. Zone or use district in which premises'~ are situated ..... A ..........................................................................................-- -- ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ~ Yes ( ) No 14. Name of Owner of premises b'Jl~ % ~-]~' ¢'~ Address ....~.¥..~..~......~.~.~....~'Phone No....~..~}../~....~.~ Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ......~..~....~.[~':~...~.......~...v~..E..~....L.~...~ Address ....~.....~.......~..~.'~....%~. Phone No..;~.~...?...~.?.:~...~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-Iz~k dimensions from property lines. Give street ond block number or description according to deed, ond show street names and indicote whether interior or corner lot. STATE OF NE~'~'~I[''4 t S $ ~ 1 ........ · .............................. being swam, d ases and says he {Nome of individual si~ni~contr~c~ above n~m~. He is the {Cantractor, agent, corporate officer~ etc.) of said owner or owners, and is ~uly authorized to perform or have performed the said work and to ~ke and file this application; that all state, rite contained in this application are true to the best of his knowledge and belief; and that the work will ~e perform~e manner set fo~h in the application filed therewith. Swor~.b~ore me this ~nl~F.~ , , ~ .~ ~ I ~ ....... ..... ...... ....... Nota~ublic, . ................... ~.~....~..~....;~.. Coun~ ...~...,~.....;..~ ......................................................................... ~~~E ~~/'' (Si~~ gnature of applicant) NO. 52-8125850, Suitability 14148 7 O.7 ],,'/ '~ r?7' / C,.'P;*Jt~'; Y - ' . ...... ,..,., ........... I" ¥I