The URL can be used to link to this page

Home My WebLink About565-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEP, K'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...g..3~,P, .......... Vote ............................. ,Z. tme.. ~.9 ............. ~9..~9.. THIS CERTIFIES that the buildin9 located at.l~V~.t;e...lto~.f...~-~i..gl~..eI,.l~...~.al~(~ Street ,~o....~ ............... ~ock No ....... ~ ............. Lo~ No....~..&..a .................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................... ~ll!lf~...~......, 19.~.C)..., pursuant to which Building Permit No...~...~(~ .............. dated ......................... J'~t~l*~..~.,..., 19.~)..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. (owner, lessee or tenant) of the aforesaid building. :},7 Building ~nspector FORi~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 566 Z Date Je,~nuaz'y 23 ~"' .......................................................... 19..d~.. Permission is hereby granted to: ............... ....... ~$~ ~ ~ I.~...L~..~ ..................... at premises located at FrlVat~i~ Roa. d~ ~],oek .~.~ Lcts i ~ 2, Fishers Island, New York, pursuant to application dated Ja~Ltar~.' ~1 19 ~'~ and approved by the Building Inspector Fee $.~..0..0.. ............. Building Inspector Howard M. Terry FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN omc SOUTHOLD, N. Y. Examined......~.....~.....~. ........ 19...~...~. ,~pproved ........................................ 19........Permit No .......................... Disapproved a/c .............................................................................................. ......... ......................... ' .... [Y~ ........ /'~BuildJng Inspector) Application No ..... .~..~..~i. ~ ............ APPLICATION FOR BUILDING PERMIT Januar~ 21 Date ............................................................. 19..~ ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted Jn 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 o 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 Buildi.ng 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 i~spection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until o 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 and regulations. (Signature of applicant, or name, if a corporation) Fishere Island, N~ York (Address of applicant) State wheth,er applicant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder. General Contraotor Name of owner of prem ses... Erard If appli~a.nt is a co/rporate, signature of duly authorized officer. ........... ~...[... l,~.~:~[......~.,~.. ·/~ ............................................. " (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No'Tax }4.aJ? Bhee¢ ~.2 Lot NoB[Ook 1,~ ............................................ Street and Number .. ' ~..~.~.~ ~td.~ .,E~ta~ End Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use ond occupancy ..................................................................................................................................... b. Intended~ use ond occupancy .............. .fi..e..e..~..d..e..n...t%...a~.. ............................................................................................ a].teo & addition to ~ist~ng poroh 3. Nature of work (check which applicable): New Building .................... Addition ..,..~. .............. Alteration ..... .~. ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.,~$100,O0 ........................................... Fee ..$~..~ ............................................................................. (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, ~f any: Front...T~ .................... Rear ...... ~0} ................. Depth ...~ .................... Height .....~ ................... Number of Stories ............................................................................................................ Dimensions of same structure with aJteratJons 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 ...... ~. ............ ~ee ~p 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...................... ~denZ~l ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..~. ............................................ 13. Name of Owner of premJses~..~,.~th~else~ddress .F~h~r~..~.~. ........ Phone NO.....w ............... Name of Architect~.~.~.~..~[..~..../. ....... Address ...]~..~.~..~..~.,..~.....Phone NO...~ ................. Name of Contractor~.~.~.~,..[~..[~..~g~.Address[~F~..~B~...~. .......... Phone NO..~] ............. PLOT DIAGRAM Locate clearly and distinctly aH buildings, whether existing or proposed, and indicate aH set-back dimensions from property lines. Give street and block numbers or description according to deed, a~d show street names and indicate whether interior or corner lot. /~ ' STATE! OF NEV~YqP~K,. ~ ) S S couNT, or ...... ) · , (Name of individu_al~ sig)~ir~ appli~otiog) ' above named. He is ,he...~...J:ff~.,.......~..~....~...~ ............................................................................. i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said ~ork and to make and file this a)plication; that all statements containe~ in this application are true to the best9f his knowledg~nd belief; and that the work will be performed in the manner set forth in the application filed thJrewith. "Sworn to before me this ~,~c~, ~. ~,~ ~ - J J) ~ ...... ~.)..~ ...... doy of ..~~;.;~.~...,.~19...~....~... ~ ' (Sig~ bf applicant) ~ ~ q~fi~i~ ~[ol]' ,.ou~t~ C~ , I , I.