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HomeMy WebLinkAbout7859-zFORM NO. 4 TOWN OF soUTHoLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. Z6731+ Date Oct 8 19..7.~. THIS CERTIFIES that the building located at . .L.~..e.~.~.e.w..T..e??.a.e. 9..' ~ .... Street Map No. ~ ......... Block No..x~.. .... Lot No x~ East blarlon N,Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... .Ap.r.~..~...2.9, 19..7.~. pursuant to which Building Permit No. ?.8.~.9. Z... dated .......... .Ap.r%.~....2.9..., 19.7.~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one family dwelling with an addition The certificate is issued to .. ?.~..1.t.e.r...6.a.l.p.a. ..... . .0~1..e.~ ............................ (owner, lessee or tenant.) of the aforesaid building. Suffolk County Department of Health Approval .. ?!., .R., ............................. UNDERWRITERS CERTIFICATE No. ~..~.~.~.7.°.!? .... s.??.t..~..~...!??~ ...... HOUSE NUMBER .... .~.6..0 ...... Street .... . .L~..e..v~..e.w., .T .e.I?. a. .e .e ................... ..................................... Building Inspector FOE~ NO. ~ TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7859 Z Permission is hereby granted to: ....t~ ~..~.~z...g. ct ~. ............................................ .......... · .~ 5..... ~ la~.k...Rd, ........... ~o~;hold ........ to ~.t...Z.~....a..n.....a.:~.~ L .t..Lo...n.....o.~....e..z..$.,s..t. Ln..g....D..~:~.~;L~ ............................................................... at premises located at ..[~k~.~l;t~.~'...~.~,~.ct~ .................................................................................. ........................................................... .Ea.~,~..l~,a~$or.z .......................................................................... pursuant to application dated ........................~,p~.~L]~....,2~ .......... , 19.~.~..., and approved by the Building Inspector. Fee $...~.~..R.O...O. ......... Building 16spect~or ( ......... ,~, ,' ' ;,,',THE" NEW YORK BOARD,OF FIRE UNDERWRITERS, I THIS CERTIFIES THAT .,I, L,-,h ~h ,,'} ¢, '.' ' ; ," J, d J,~',,'' "r" ¢' ~ ,' ,," '~. ,, t , , ' , J ~,~ ,' , .'~'~'¢" only t~ electrical eqmpme~t ~ described below a~ J~trodu~ed by the applicant named o~ the above application ~umber i~ the prem~e¢ of ', '~, ', David M. Brawner,,.1/{i mi.w/o'Orien8 point, s/s.ide,Main Rd. ' ,',, jjj- jj ~...,.~,,~¢o. ' September,,25. ~975 , and found to be ln comphance with the requlrementz af th~s Board, 4, , '1' t,I ~,Xf,,Re ' ' ' ' ' FIXTURES { RANGES COOK NG DECKS J ' OVENS [blSH WASHERS ['EXHAUST FANS OUTLETS ~C~TA~SJ SWITCHES JI~CA~D~SCEN~JFLUO~ESCENT ~ ~w J, ~T J KW ~ ~T ~ K W~ ~W J ~T j K W ~T. J. 'm3' , ,., m 17.,' ~RYERS ~URNACE ~OTOR5 , FUTURE APPLIANCE ~EEDE~S' SPECIAL[EC'?T TIMECLOCKS J BELL [UNITHEATERS MUCTI-OU E DIMMERS' 6oo : '' 1 0 ' ', , .- , ~ , " ,U - -~ ' i t , , . ,, { , , , ,,, J{ ~1 : ~, { ~I_.itl :1 ~,' ' , ,, ~' q ti hi iii " ¢, r, ~ .i h' .I ,,! h , ,' ,d ,~ iL, h' , L, ' , 'J ,I .... Theodore,Rohlo£ ~, , ~ ..... :~ ,l , ,. i , ~., , , ,, , r Orchard Street, , ' ' ~ ,.': ~ I~ , '._.~ t~ , ,,, ,,~ , ,Orient,'L.I.. 11957 ' - ' ' Th~s oerhflcate must not be altered tn on¥ manner, return to the 'off ce o'~ the Board {: incorrect' Inspectors may be idenhfied by .II '" :~ I~ ',, h, THE~ NEW ;YORK' BOARD~OF' FIRE UNDERWRITERS' o.,.,Septembe~:23.~ 1975,, ~ ;~p.llc. tlo. No~o.yil. 805739 THIS CERTIFIES THAT ill [ · i '~. ~ ~1 ~1 ~ [ =: ~ , ~ I =' ? 'Walter Gaipa, Lake:VieW. Terrace Bay Ave & End, Eas~ Ma~ion, ~ ~..i.~a.., September h~18 ,.u 19 7 5 : . .,,~y...~ ~. ~ ~. ~..~..~.~.,~ OTHER APPARATUS: · Furnace/s: 1-I/8hp~ 1-1/15hp Th,s cert,f,cat, must no be a tered ,n any manner; rett,lrrl to the off,ce of the Board ,f ,ncorrect ns~ectors may i 75'~ L/~ I~F. VIELU LIVItq~ ....... ~¢' 0" (Building Inspektor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter 0e in ink and submitted in triplicate to the Building ~ Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. ~. b. Plot plan showing location of lot and of buildings on premises, relationsh, ip to adjoining premises or public streets o~ ~. 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 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. L 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 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 in buildings for necessary inspections. ~ (Signature of ~pplican(, 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 "J~'~"J~[~l~ ..................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...~.~.(,/4.~...~.~.~.J~/~;Z~.~. ................ Plumber's License No. ff~..~.1.~.~.~.....~.~U~J/V.~ ~, Electrician's License No.G.~..t3d.....~./~./.~... Other Tmde's Licen.~ No ............................................... 1. Location of land on which proposed work will be done. M~p No.: ......... ~ ......................... Lot Ho..I~. ................. Street and Number I~..,~EIII~...J~I~F&~. ......... ~J~l~..~.~ ............ ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...]JJ~l~ll.[~J~q~ ......................................................................................................... b. Intended use and occupancy ................................................................................................................................ ~. Nature of work (check which applicable): New Building.. ................. Addition ......~ ...... Alteration .....~; ...... Repair .................. Removal .................. Demolition .................... Other Work ................................................ . (Description) 4. Estimated Cost............ ....... ~'......................../'~'~:~2"O ..... .~.. .... Fee-.-~e~ ........................................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ....~1~111 ................. 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 ............................ Rear ................................ Depth .................... 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 .I~1~8-...,~ ............ Rear ....... ~/l~..m..Q ...... Depth .-...~8 ............... Height .................... Number of Stories ..... ~ ......................................................................................................... 9. Size of lot: Front ..~[ ................................................. Rear ........ '~.~ ............................. Depth ..... ~l(~2..~ ............... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....~.11...(~t,,~ .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... M ............................................ 13. Will lot be regraded' ......~ ................ Will excess fill be removed from premises:~(, ) Yes ( ) No 14. Name of Owner of premises ....JllJJ~l~.....~j~J.JJ& ................Address ............ ~ctu~tl/J,~... Phone No~,(~.~.../,.~..~...'~.. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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 .YOEK. COUNTY OF .... ~..~.g~ir!~.....i~'~ · ..~;c.r~.~. ................. being duly sworn, deposes and says that he is the applicam above named. He is the ............... :~.ii...'.......O~ll~. ............................................................................................................................... :~ (Contractor, agent, corporate officer, etc.) of said owner or owners, a~d is duly author zed to perform or have performed the said work and to make and file this application; that all sf~tements contained in this application are true to the best of his knowledge and belief; and that the work will be perforn~ed in the manner set forth Jn the application filed therewith. Swor.~e~,e~/~ me thofiS · ..... .............................