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Home My WebLink About8291-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupnncy No..Z. 7. ~.1.2. ..... Date ............... Feb.. ¶0 ..... , 19.~. THIS CERTIFIES that the building located at l~lle..R~ad ............... Street Map No. ~ ......... Block No. XX ........ Lot No.. XXX .... Lace. el.. II,Y, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ NOV...10.., 19.75. pursuant to which Building Permit dated ........... ~.(~.v...~.~ .... , 19. ~/~., 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 .. ~.l'.~.¥~...~.e..o..n.c..ff..a~..:l..1.y...d.w.e.l..1.~1~. g..w.~..'ch...&d..d.~.t.i.o..1~. .................... The certificate is issued to . .T.h.o.s...8~...e~.J~ls~, ......0~m.~l' ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Il .lt, ................................ UBIDERWRITERS CERTIFICATE No. ll3~.,~ ...... Jan .~?...197~. ............... HOUSE NUMBER ...1.0~. ...... Street ...~..1..l.z..R.o..a.d ....... .I~.~$'..~.1. .............. 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) 8291 Z Date ........................... ~l~lr ........ 1.3 .......... , 19...~. Permission is hereby granted to: .................. C,]~eeape~.t, ........................................ to .-.e~.~...~t~..~ eH.e.~o~ ..o~.. ex~.e e4.zt~ -. ~ve.~.:~ ~¢ ............................................................. at premises located at ........ h~'~"].'~"~oa~ ............................................................................................ ..................................................... · ~e~. ............................................................................................ pursuant to application dated ........................... '~o'v"'; ...... tO ...... , 19.~.., and approved by the Building Inspector. Fee $.:.1.,5'..t..0..0.. .......... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ' ' T 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~, I, 8335/-IA. ,,,,,~ Janua~:X'27, ,1977 ~,,,,,,.,,,.,u~o.o,,ru~ N322387 THIS CERTIFIES THAT o~dy the eJectric~ eq~ip~en~ ~ ~ecrlb~ below e~d introduced by' ~he applJcan~ ~amed on the above eppl~cation ~mber in the premises of ~Js ~ells Rd~ ~C, Albo ,. ~,~/...~.,~ ~.~,o.~ ~ ~.,~.~ ~ ~ ~.~ ~. ~ ~.,a r~. Outs ~de RXTURE FIXTURES 2 5 2~', 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT AWG OF NEUTRAL To~n ttatbo:Lane $oUthold; L,X~l1971 . ,, L:Lc. 282E , ~ cerhficote a~ust hal be oltered ir any mannerl relurn fo the office of the Board if Incorrect. Inspectors may be identified ~dentials, E, omin / ........................................ , 19.. Permit No .............. Disapproved a ........................................ / APPLI~.ATIOH FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or.in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee accord,ng to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is par~ 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 a Budd,ng 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. The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to-~ admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of appl!cant, or name, if a corporation) ....... ..... (A~lress. of applicdnt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~.....~'~.l~...'~c~ ......... ~.t~.~,,,),.[.~'.~.'! ......................................................................... .... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer)_ . , cl o c~uilders License No...~-.,~..~......~F. .................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be.done. Map No.: ........................................ Lot No ......................... Street and Number ..... ~h~..~,.~.~,.<~ ....... .~.~s~ .................................................................... .~.~.~A.~.C.~. ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use andoccupency ........~.....'~..,~'Jc~'J..~.V ....... -- --..~..~J..e~.~..~.~-'~. ....................................................... .... ............. - b. Intended use and occupancy ............ .~/. ................................................................................ / 3. Nature of work (check which applicable): New Building.. ................. Addition ................. Alteration ................ Repair .................. RemOVal .................. Demolition .................... Other Work ..................................................... 4. Estimated Cost ...~.....O....~...O...~....-~... ............................ Fee /~"' ~ (Description) (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 h/pe of use ............................ 7. Dimensions of existing structures, if any: Front ....... ~..7,.../. ........... Rear .......... ~...?,~..~. ........... Depth ....~..~../. ...... Height ....... I...~..~. ....... Number of Stories .......... .J. ..................................................................................................... Dimensions of some structure with alterations or additions: Front ........... ~..~...(. .............. Rear ....~..~,. ............... Depth .~ ............... 7. ......... Height ............................ Number of Stories ................................ 8. Dimensions of er~tire new construction: Front ..: ........ L~. ................... Rear ...... 1..~.. ................ Depth .j...z~.. ............. Height ....... J...~. ....... Number of Stories ......... ~ ........................................................................................................... 9. Size of lot: Front ........... .~..0.~....~. ............................... Rear ......... ~/..~...~...~ .................. Depth ..... .............. 10. Date of Purchase ................... '....~... .............................. Name of Former Owner ............ ~ ....................................... ' 11. Zone or use district in which premises are situated ......... ~'~.~.L.~..¢.~.~..~. ........................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... 13. Will lot be regraded ...... ..~.~.5 ........... Will excess fill be removed from premises: (/')/Yes ( ) No 14. Name of Owner of premises"~lr~t~.~s....sJ.~,,l'.~/.[..l('...~. ......... Address Ph. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor C~..,~t~......~l,C.~.':l'.~..~_~ .................... Address ..~,,%~..'/./~. .............. Phone No. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~'OE.I~ ~ ¢ ¢ COUNTY OF ~/'~ ............ ............... .~..'~.~,iC:~....,.... ,~., ......... ~..1: .~'~.~,.YZ:... .......... being duly sworn, deposes and says t~t he is the applicam (Name ~ ~iviaua signing comracr~ above name. 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 ~ke and file this application; that all statements contained in this application are t~e to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ...... ..... ..... ............. . Nota~'Public,. ............................ ~lg,.. C~n~ N.}.....~....~.Z~~~ ....................... N~ARY PUBLIC, S~te of ~