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Home My WebLink About9284-zFOi~ NO. & TOWN OF $OUTHOLD BUHI~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Z7718 June 15 ., lg 77 No ............ Date ...................... THIS CERTIFIES that the building located at . Sour)..d.R.d, .~.o~.,.~.d...~. .... Street Map No. xx ....... Block No .... ~... Lot No, xx Gmeenpo~'~; N.Y. conforms substantially to the Application for Building Permit heretofore fried in this office dated .. M. ay... '~?, 19.?.6. pursuant to which Building Pemit No..9.2.5.~.Z.. dated ... .J.~..e...6..., 19.7.7.., 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 ...I(.riv.a.~.e...s.w.i~!.n.~ ppp.1..¥.i.t.h..r.e.n. ?.e ?:...a.c.c.e..s.s??,y.s ................ The certificate is issued to of the aforesaid building. ~/iJ.li.s.~ .~..c.c~! o.s .....0~..m.e.r. ........................ (owner, lessee or tenant) N. R. Suffolk County Department of Health Approval .............. UNDERWRITERS CERTIFICATE No...~?.9.~.0..6~....J..u.l.y....2.~...~..9.7.6. ............... HOUSE NUMBER ... '115 ... Street ..... .Sp.t~qt...D~.~v.e .........C~.e. 9.n/~.q~.~ ...... Building Inspector / ]FORM NO. 2 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) Permission is hereby granted to: ~'-~ ~ ~ to~..a~...~i~..~~...~o~h..-~.~...~o~,~..&..~,~,o~ ........................ ........................................... ~.~**u.~..,~ ......... ~,~ .................. ,. .... ~ ..... and a~proved by the Building In~r. ~ ~ ~. ~ FOe ~.., ............ THE ~t~ July 71, THIS CERTIFIES THAT YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY o 85 JOHN STREET, NEW YORK, NEW YORK 10038 App,,ea,,o.~o.o.f,,e N 2940G4 only the el'ectrical equipment as described below and introduced by tim applicant named bn the above application number in the prem{~es of ~ ' ; 5(,und D~'Ive, Gruehoc, r ~,[.I i Wtllta~ Fucclll~, ,/o Sound -'.e.~ . was exa:,z,~ned on U I y 15, I ) 7 ~ and found to be in compllqnce ~ith the requiremen~ of this Board. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS OTHER APPARATUS. RANGES ]COOKING DECKS j OVENS JDISfl WASHERS I ' ,~ULTI OUTLET SPECIALEEC'PT. TIMECLOCKS BELL IUNITHEATERS 'u~''. . NO OF CC COND PER ~ OF CC COND A, WG O~ HbLEG EXHAUST FANS DIMMERS ~.wo MO OFNEUTRALS Of NEUTRAl ~ is certifica'le covers compliance at the date ~)f (~',:immlng Pool) inspection only. !.ccauce of unusual environments it Is advisa~l~ to have frequ~nt'-fC';~ and/c~r repairs made Ly a r, ual]ficd person. AMOUNT PLEASE REMIT BY CHECK OR MONEY ORDER TO THE ORDER OF THE NEW YORK BOARD OF FlEE UNDERWRITERS, AS CASH SENT BY MAIL WIlL BE AT RISK OF SENDER. 18.00 G ~ S Contr'. f'-,ox 215 ', Soufhold, L.I. t. lc.578E THIS IS YOUR BILL FOR SERVICE RENDERED AND IS NOT A CERTI'RCATE OF COMPLIANCE THIS BILL PAYABLE AT THE NEW YORK OFFICE, 85 JOHN STREEF, NEW YORK, N. Y 10038 Examined ..... ~.....~..~......~.. ........... , ~oproved ................ L~ :: .......~ ............ , FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~r~,~ ~o ..... .?...5~.~.~. ..... Disapproved a/c .............................................................. APPLICATION FOR BUILDING PERMIT /'~ ............. ........... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi, Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises ar public streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this apphcatio 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 Budding Permit to the apphcant Such pern 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 Occupan. 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and ir~ buildings for necessary inspections. ...... (Signa~cant, or name, if a corporation) (Address of applicant) State whether apphcant is owner, levee, agent, architect, engineer, general contractor, electrician, plumber or build~ -~,-, .~ ~_ , ..................................................... ~-? ................ i .......... ;';=;"~ ........ ~'"~"~ ...... : ............ ~'~ ........... ~"' Name of owner of premises ...... ~2~1.Z~...~¢..,..~:~....~..~.~:z..' ~..,...C:-~... ....... ..k.~.s~.~).~. , ,.~._.~:~.,. ~ ............. ;i ~ ~ I '.~;.~i. ;~. ]..~;;i~:.. i.i~,~];]~..~i..~.',~..~t, i~ii~;d Officer' ~4.~ ~ (Name and title of corporate officer) Builder's License No .... ..~.......'~-...~.....~......: ..................... Electrioan's License Noi". ........................................... Other Zrade's License No ............................................... .Z~.~ ~ Location of land on whic,h/proposed wor~l be ~do~ Map No' ...~_.;:.7.~ .~:/~:.~ ...... Lot No ..................... Street and Number .~] ...... ~ ...... Z.~ ........ ~..:....~ ..... ¢~.~.~ ......... ~ ................... ~ ~~ /~ ~~ ~ ~nicipal,~ State existing use and occupancy of p~ises and in~ended use and occupancy of proposed construction: ~ ~.i,i,,.,.,e~.,oc~.~.~. .... ~.¥..~.~ ............ .,.....~ .................... ~ ................ .,. ................................. ..... ....... ................. 3. Nature of work (check which apphcable) New Building ................ Addition ....... .~-..._.. Alter~ion .............. Repa,r ................. Removol ............ Demo,t,on .............. Other Work. ........ /_/ ~:~ 0'~.~ ~ / ~ ~ (~cnption)l 4 t'm dCs ......................................................... e ................................................................................... (to be p~d on illin9 thru application) 5 l{ dwelling, number of dwelhng units .... ~ ................ Namb~r o{ dwelhng units on each floor ......................... [{ garage, number of ~rs ......................................................................................................................... ~ J{ business, commerc~ol or m~xed occupancy, spec~fy n~ture and extent of eoch ~pe o{ use .......................... 7 Dimensions of exmtmg structures, if any Fron~ .................... Rear ................................Depth .................. Height ........................ Number of Stories ........................................................................................................ D~mensions of s~me structure with ~[teratlons or add~hons Front ................................... Rear ..................... Depth ................................Height ........................ Number of Stones .............................. 8 D,mens,ons of ent,re new construct,on Front ......... f..~. ............. Rear ....... ........... Depth .~.~ ......... Height ................. Number of Stones ......................................................................................................... 9 S~ze of lot Front .................................................. Rear .......................................Depth ............................. 10 Dote of Purchase ................................................. No~ff, of~mer ~ner ..................................................... 11 Zone or use district in which premises ore situated . .1..~ _A)~.....~ ....................... ~ ..................................... ]2 Does proposed construchon wolate any zoning law, ordinance or regulahon' . ........ ~.~ .................................. 13. Will lot be regraded ..... ~ ........... Will e&cess fill be removed from pre--Yes ( ) No 14. Name of ~ner of premises ..~~.~....~~Address ..~~..'.. Phone No ..................... Name of Architect ............................................ )Address .............. ~ ................ Phone No ..................... ,om o, Co,,r c,o .................. ........... ,hon, ,o ..................... PLOT DIAGRAM Locate clearly and d~shnctly oil buddings, whether ex~sting or proposed, and intimate all set-~ck d~mensions froi prope~y hnes Gwe street and block number or description according to deed, ond show street names and in&ca; whether interior or corner lot STATE OF NE_Vi~'POI~,~' ~ S S ................................................... betng duly sworn, deposes and says that he ts the opph¢c '(Name-bt Ind~wdual'~sigmng contract) above named. ' He ,s the ................................... ~.~ ................................................................................................ (Contractor, agent, corporote officer, etc) of sam owner or owners, and ~s duly Quthonzed to perform or have performed the sam work and to make and thru application, that oil stotements contained ~n thru apphcation are true to the best of hm knowledge and behef; f that the work w~ll be performed[ Sworn to before me th,s ix ................. ~... day of ......:~. Notary Public, . ......... ~ the manner set forth in the application filed therewith.