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Home My WebLink About9662-z(THIS PERN~IT MUST BE KEPT ON THE P~,EM SBSUNTIL FULL~ ,~ COMPLETION 'oF THE WORi(AUTHORIZED) ~ '~ · Permission is hereby granted to: to t~bb O~,ITO at premises located pursuant to application Building Inspector. i , 1 .., and approved by the THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001093 BUREAU OF ELECTRICITY ~ ~ ES JOHN STREET. NEW YORK. NEW YORK 10038 THiS CE~IFIE$ THAT in ~h~ollowin~ Ioe~tion; ~ Basement ~ I~t FI. [] ~d FL .~,ctlon Block Lot rea~examlnfdon ~Ovmmb~ ~0~ ~-9~7 andfoundtobeincompllance~rlththeretlUi~mentsofthlsBoard. MRS SMIVICI mSCONNECT S E Il v I C OTHER A~AIIA?US: NO. COND. O~ CC* COND. O~ G~7 Dot o~kt 425 ]~mM11 ~. Cutcho~ue, 11935 1/C.~2941-~ P#r This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FC~ BUILDIHG DEPARTMEHT. THIS COPY OF CERTIFICATE kgJST HOT BE ALTERED IH AHY MANNER. PAGE 1 r~ ~{~:~ ~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~te ~ppllcutlon No. on,lie THIS CE~IFIES THAT MATTITUCK FIRE DEPT., PIKE STREET, HATTITUCK, OUTSIDE ~ examin~ on andf~nd to be in cornpllance mira the requi~menls of this ~rd. DRYERS FURNACE MOTORS FUTURE APFUANC! F~D~IIS S~RVK~ D~S~ONNBCT I NO. OF I S E OTHER AF~ABATUS: RANGES V I C EXHAUST FANS DIMMERS P.O. BOX 602 LAUREL, NY, 11948 This ce~f~ate must not be altered in ny ma~er; r~urn to the office of t~ ~ard if incorre~. InspKtors may be identified by t~ir credentlak. COPY FOR B~LDII4G DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IH ANY IdANNER. ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~/'/~ 7 ,0' ~ Disapproved a/c .............. ~.~~.................7 ........ L.~.t ................ Application No. .............. ....... ................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building 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 or public streets or 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. 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (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 ................. ~ ............................ ~ ............................................................ .~...~.. ........................... if applicant is a corporate, signature of duly authorized officer ~:~.~`.-~`~.~:~.;.:~c.~.~/~.~4~.~.~'.~`~:~?.~:~?.~./.~.~Z::~~ : (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No....~.~.~.~.../.~...~.....~....c~.... ............... Other Trade's License No ............................................... Location of land on which proposed work will be done. ~v~,ap I~1o.: ..... , .................................. Lot No ......................... Street and Number ..~./.~........~..~.., ........ Z~.~.~..'.~...~..(..'..'..~....gr.C~.~...~.,.'...~..~ ........................................ Municipolity State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ....~.~...~....~.. ...... ~...f~.~'~',~'~ .................................................................................. b. Intended use and occupancy ~..~/~../.~..,~'.. ftC., '¢/6 ~..~..=..~.~. ~ ~ ~ . .. 3. Nature of work (check which applicable): New Building'. ................. Addition ..... Repair .................. Removal .................. Demolition .................... Other Work ................................................ . x~, (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 ............................ 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 ................... , ................ Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 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 . ........................... Will excess fillbe removed from prem!ses: ( ) Yes ( ) No · .~r.£C.'.&... 14. Name of Owner of premises~....~.~¢.~......~/.~.;... Address ~~.... Phone No. Name of Architect ................................. : ............................ Address ................................ Phone No ....................... N~me of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing o~ proposed, and indicate all set-back dimensions from prope~y lines. Give street and block number or description according to deed, and show s~reet names and indicate whether interior or corner lot. / I;~-ATE OF" NEW "YOm<" ' - t~ ~ IcouN?_OF. ¢~. ......... ':.~;? ..... ,, (Nome of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn ~'o~efore me this ,~/ , r - - /~/' b,, ........ ~o~ o~ ......... L.~. ..... , ~.:7~.. W /: ~.. Y: I/~' ......... ~w~.~'.~.t.~ - t ~ ~ ~,7, ~,-~~..~.r ~o~ ,.~ o,. ........... ................... co,,~ ,,~'....~¢..,,.~ ........ -,: ....... :...: .................................... /~ , (Signature of applicant) .................. being duly sworn, deposes and soys that he is the opplicom