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Home My WebLink About11642-zN~ 1~16 ~.2 Z Perrhission is hereby granted to: TOWN OFiSOUTH(~L~ BUILDING DEpARTME~IT Town SOUTH'OLD, BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMIS,~3 uNTIL F~LL COMPLETION OF THE WORK AUTHORIZED) ~;:i :~ Date .i...~...;. ................... .~.'.., Rev. :6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS R~(;~: :~ ~J~[~"(~ BUREAU OF ELECTRICITY ~ S5 JOHN STREET, NEW YORK, NEW YORK 10038 P~IT THIS CERTIFIE~ THAT o~y the el~tric~ equipment ~ ~scribed below a~ int~uc~ by t~ ap~GKt ~ oR t~ ~ ~p~t~ ~m~r i~ t~e prem~s of RICt%~RD NOR~LU~, 8~ P~VATE ROAD~21~ SOIPI~OI~ in the followlng location; ~ Basement ~ Ist FI. ~ 2nd FL rJ~R/OUT . Sect;on Bilk Lot n~s examined on 1)~ICEt,~ER .[ 9 ~ [~ and found W bo in compl~nce with the National Elect~cal Code. ORYERS FURNACE MOTORS FUTURE APPLIAH~E FEEDERS PECIALREC'P1 IIMECLOCK$ ~ BELL UNIT HEA~RS MUL~ET DIMMERS OTHER APPARATUS: 800 PRIVATE ROAD SOUti'~K)I,D, NY, 11971 OENSRAL MANAGER Per This ce~iflcote must not be altered in any manner; return to the office of the Board if incorrect. Inspect6rs may be identified by their credentials. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Approved ..... Disapproved a/c ~?... ~~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No./. ?. ~.c./. ~ .... 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 of property must be drawn on the diagram which is part of this appli- cation. 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 necess~on~ ' ~ (Signature of app!icant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, enl~neer, general contractor, electrician, plumber or builder. ..................................................................................... Name of owner of premises .~[/..C..~../~.~...~..O..~..~.L..~.. ............................................... (as on the tax roll or latest deed) If applicant is a corporation, 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 ...................... 1. Location of land on which proposed work will be done .................................................. .o. .o. ................... t v .Ta. . .............. . ................. House Number Street Hamlet C~unty Tax Map No. 1000 Section ....... .7..~.. .... Block .......... ~. ...... Lot....~..~..'~.. ........ Snbdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 10. 11. 12. I3. 14. property lines. Give street and block, number or description according to deed, and show interior or Corner lot, Nature of work (check which applicable): New Building ...... Addition .......... Alteration .......... · _' 1 moliti . Other.W rk_._ (D ripti ) Repair ........... Remora .............. De on .... ii.I .... . o ............. :'t~ " esc on ~ (to be paid on filing this application) If dwelling, number of dwelling! units ............... Number o f dwelling units on each floor ................ If garage number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures if any; Front Rear Depth Height ............... Number of Stories ......................................................... Dimensions of same structure With alterations or additions: Fr6nt ................. Rear .................. Depth ................... I... Height ........ i. ~ ............ Number of Stories ............. ! ........ Dimensions .of entire new construction:~ Front . . .,/~ ....... .... Rear .../.~..: ........ Depth . ./.O. ......... Height // ,N,r~nber of Stories . /... . ..... Date of Purchase ~q. ~.t/,:...t.~ .~ .............. Name of Former Owner ...O-,~.~.~4/.. '. Zone br use district in which pr~mises are situated.../~.-f..~?..~.~ ......... .................. ...~ Does proposed construction vioiate any Zoning law, ordinance or regulation /,d.O .............. Will lot be regraded ... ~.o,~ ................ Will excess fill be removed from premises: ~Y, es No. Name of Owner of premises ...................... Name of Architect ......... i ................. 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 street names and indicate whether --.. x...,---, _, STATE OF NE~RK, covey . ..... . (~ame of individual sign~g c~tract) above named. He is the ...................... ~/~ ..................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file ~is application; that all statements cont~ned ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n{r set forth ~ the application filed therewith. Sworn to before me this ............_ ......... , '~ ~[lC, St~0[~ '' ~ ....................... ~''~' . /