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Home My WebLink About484-zFOBM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No ........ ~...~(~) ..... Date ........................ ~tt~'-Oh,.. 3.0 .............. , 19..~.~. THIS CERTIFIES that the building located at...~,,/.F~.....]~.~.V~t,e,..~O&~ ....................... Stre~t Map No..z].a~..~..~. Block No ....... B~e~...~.Lot No ......... {~e.~B...[~]~.~......~,.], ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... O~Ob~.....~. .......... , 19.~.., pursuant to which Building ~rmit No....~..~ ............. dated ...................... 0~O~"~ ....... , 19.~..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The ~cupancy for which this certificate is issued is .............. .................. ?rlva~e"'dw~'~l~g ....................................................................................................... This certJfJc~fe Js issued to "-Th~s"'Pa~r~2¢' ............ (~e~ ........ ; .............. : ........ :~ ..................... [~ner, lessee or TenanT) o~ the =fores~id building. 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) N.° 484, z Dote ........ .0.0..~.0.~r......Z..0.... ~ 9~..8. .... Permission is hereby granted to: Fi sher s...Island..~.arm~..Ine,.....~.C.....~ho.s,...Parrot ..................... F..~.b.~r .s.....z...s..z. ~.,n.~ .......................... ............................... ~...~.: ......................................... to ./~u&ld...an..e,~d£~;J~n...o~..an..~s.t.~.r, ~..~I,~]A£~ ..................................... at premises located et .?r.[.v~J;e..t~c~ct,...~hl~e.t..~l...tax ma~ ...................... ...................................................... F.i. sh~.~... Z.s.]. ami w.... ~ ,..~.. ......................................................... pursuant to application dated ........................... .O~.~b:'?~..~ ............... 19~J~..., and approved by the Building Inspector Building Inspector FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. Approved .......................... ~c) ~ Permit No ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote O¢'~ebe:~ 8 19 ~8 INSTRUCTIONS . a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 6. 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 location. 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 progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shah 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 ali applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises ............................. ~ho,,ma~. A,,..~a,~o.t.%..ata~ ~T,~'~. ........................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) H. Lee Fer~l~/~or~ Jr. ~iee i~resideat 1. Location of land on which proposed work will be done. Map No. Tax..F~,p .................... Block ...f~.e.o.~..~.l ............... Street and Number ........ ~'rJ,v~'~e ]{~ad ............................................................ 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occunancw ReeJ.de~ee b. Intended use and occupancy .................... ~,aa~,~r~qfl .. ................. % At t' 3. Nature of work (check which applicable): New Building ................ :.h.Addition .................... era on .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ............... .~.~..~..1~.:...0~.. ....................... Fee ......... .~..~.~. ...................................................................... (to be paid on filing this application) FEES: units ............................. N tuber of dwelling units on each floor .......................... 5. If dwelling, number of dwelling 01~e u If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front....~i.~....~'.. ............ Rear ,~.....+q'.. ............ .... Depth ...... ~,~,~.~'.. ............ Height ............... ~1.~.. ......... Number of Stories ...........'1.-.~.2 .......................................................................................... Dimensions of same structure with alterations or additions: Front ~1~ Rear ~Ot · Depth .................. .'~..! ....... Height ........ .1.~.I. ................ Number of Stories .............1..-..'1~..~ .......... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ..J,}~ .................. Rear ............ -fi-~?. .......... Depth ........... 1/~ .......... 10. Zone or use district in which premises are situated ................................................................................................ 1 1. Does proposed construction violate any zoning law, ordinance or regulation? ........ ]~ ........................................ 12. Name of Owner of premises.....~...~..~:..~tc..Address ,~Jl.~.~...~.~,...~,..W.,...~....~t~.~e NO ......... '- ........... Name of Architect...~...~..~..~...F.~...~*Address [..~[~..~.....~i4~.....IJkq~..~.~'~...Phone NO...~-~.~ ............ ............................................ Phone NO ..................... Name of Contractor..~',~l~l~'~..,~l,~l,lll~..]l'ill~'Jll .......... Address · STATE OF NEW YORK, ) S S.' 5,~.~ x. COUNTY OF ..... .~. ~?'...~.. ........ ) ''~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propose.~and indicate all set-back dimensions from property lines. Give street and block numbers or description according t~de~J, and show street names and indicate whether interior or corner lot. ~/-- ' ff. ~ F~ .~...o1~ .~.? ............................. bei~n/9,~ul)/sworn deposes and says that he is the applicant ............... I above named. He is the ........ .~..~ ........................... .;~? .................. ~ ........................................................ (Contractor, age~-c~me offic~c.) of said owner or owners, and is duly authorized to perform or have peff~d the said work and to make and file this opp ication; that all statements contained in this application are true to ~t of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed there~h. 8~ day of ................. (Singature of applicant) Notary Public,. ............................................................. County FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×amned ........ ........ Approved ........................................ ] 9 ........ Permit No ................................. Application mo ........... ~"'"l' .......... Disapproved a/c ...f....../n'~ ............... ~ ............... :~, ........................... ..,:.,~ .... ............................... ~ ~ (Building Inspector) / APPLICATION FOR BUILDING PERMIT ~ , October 8 ~ 5~ LJOte ............................ I ................................ ~ >, ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted 'in duplicate to the Building Inspector. 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 propert~ must bb drawn on the diagram which is port of this location. 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 througho? the progress of 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 Buirding 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 and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. General Contractor Name of owner of premises ............................ .~o.,~..s.....A.,....~.~:~.:Eq~.C....8,~C~..t~.if.e. .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) H. Lee Ferdztson, Jr. ¥ice President 1. Location of land on which proposed work will be done. Map No. ~..a~.~q? ..................... Block ....S..h..e..e..%...~.l. ............... Street and Number Private Road . 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: Residence o. Existing use and occupancy ........................................................................................................................... b. Intended use and nccunonr,, Residence 3. Nature of work (check which applicable): New Building .................... Addition ..... ..~. ............ Alteration .................... Repair .................... Removal .................... Demolition .................. ,Other Work (Describe) .................... $1500.00 4. Estimated Cost ............................................................ Fee ......... .$5.~...0g.. .................................................. (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ............ ~ff .......... Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ Dimensions of e.xisting structures, if any: Front....~..O.!...+...-. ............ Rear ~..0.!....+..-. ................ Depth ...... ~!.'k..-. ............ Height .............. .1..8..~ ......... Number of Stories ..........]..-.1/2~ .......................................................................................... Dimensions of same structure with alterations or additions: Front ................................ 501 Rear ....~.O.~ ....................... Depth ................. ~.0..'. ....... Height ........ .1_8.'. ................. Number of Stories ........... .1.ml/.~, ........... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ...1)..?.'. ................... Rear ............ 5~...I ........... Depth .......... ]4Q! ........... ~esidential 10. Zone or use district in which premises are situated ................................................................................................ 11. 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~1.9 ......................................... Name of Owner of premises.....~..b.9..~....s...~:....~...~..~9.tc.~..Address 3.5.1~..~..~,...N^W.,..W~,~,.D.I~&ne NO. - Name of Architect.~.b..e.~.~.....~.~.~..~..d....~...~....~s..~....Z.~..q..Address [~¢.~.[~...~l~,~fJ,..Jf,~' ...... Phone NO..2.51 ............ Name of Contractor.~..$~,V.~...$~,],~,~.~.~.~a .......... Address ....~ .............. ~ ...................... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proDos~-~l, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to ~l~ed, and show street names and indicate whether interior or corner lot. i STATE OF NEW YORK, ) ~ S~folk S S. ~ COUN~ OF ............................ ) .......................... ~,...~.~..~.~A..~.~ .......................... ~ d~y sworn, deposes and says that he is the opptlcant (Name of individual signing application) He is the Vice Presid~n~ ........................... ~,..~;.~.~ ............................................. .................................. ....... tc.) ................ of said owner or owners, and is duly authorized to perform or hove ~rformed t~e said work and to make and file this application; that all statements contained in this application are true ~ the best of~is knowledge and belief; and that the work will be performed in the mannerset forth in the application f. J~edtherew~h. ~ Sworn to before me this ................. ~. day of ............... ~' ........... 19.~.~. ...... ~ ' (Singature of applicant) Notary Public,. ............................................................. County