The URL can be used to link to this page

Home My WebLink About1009-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No. ,~(~ ........... Date ........................... ~kllg~. 2 .............19..~1 THIS CERTIFIES that the building located at .]~!].~le~]~.g{~.~-.. L~ ........................ Street Map No...~ .............. Block No ...... ..~..~..~ ........ Lot bro...~3..-.1.~.....Flshe:e.s...Island ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ]~.]~.~...~'..~.......2~., 19...~.0.. pursuant to which Building Permit No....~.....~... .... dated ....................... ..M~.q..h.....,~.~..., 19...~.0., 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 ..P~i.v~e:..c~le..l'amil~...dw~l!i~lg ................................................................................. This cert';ficate is issued to .A:l.b.~l~.~...Ch&p],8,8]~[ ...................... 0~1~1~,,~ ............................... (owner, lessee or tenant) of the aforesaid building. FOI~FI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1009 Z Date ........................ ~:~..~.....~. ............ 19..~..~.. Permission is hereby granted to: Albe~.t ..~hapl~k~. .................................................. ....... itL~he~..Islan~,~ ....... N~X~ ................... to ..... Move.. hui. lding.., and...make... ~..one.. ~am~lF.. restdem~e ................. ; ........................ at premises located at Lo~..~..~..l~A~.....~.~.l~.ne.~s...p~i~t~ .......... ~ .................................. ................................. /~lsheae. s... I,~.l~nd,..~a¢~s.. ~]~..,.. ~1~.~®1 ..~L~8,..,..:(.. ~. ~ .~,D.~A, ) ..................................................... Fisher.~..~Isl~l ............ l~,,X~ .............................................. pursuant'to application dated ...:..~ ........................ /~ehl,lS/V-~.....,~O ...... 19~O...., ond approved by the Building Inspector Fee $.l~O.....p~d Check Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. Application No....(...0.....O....~ ........... Disapproved o/c ......... ~'~;~' "kZ~ ............... 2: ......... ........ ........................ (Building inspector) L APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector, b. Pict 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 Building Permit. d. Upon approval of this epp[ication, 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 port 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 issuonoe of o 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Albert Chaplask2 (Signature of applicant, or name, if a corporation) zshe~ o Island New Yoi, k (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................................... Ge r~o ~'.~],...C ~ n.t;.:~m,.~ l~ ~i~. .............................................................................................. Albe~t Chaplaski Name of owner of premises ..................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. F~_shez's IslaDd Ooz~p Location of land on which proposed work v~Jll be done. Map No?.8~...~.~t~.~.~.l...~¢.Q ............ Lot No.~.:].¢,,.~ P~.~ate road Wilderries~ ~otnt Street and Number ....................................................................................................................................................... Municipality State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................................. ~.~.e..;~..];.~,~?).~..]_. ........................................................................... b. Intended use and occupancy ............................. ~.~.fLC]~.~l~ .................... i ...................................................... 3. Nature of work (check which applicable): New Building ........ .~ ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .......... ~.0.00.,.00. ................................ Fee .............. $10...013. ............................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... .1.. ................... Number of dwelling units on each floor ........ .~. O If garage, number of cars ..................................................................................................................... ....................... 6. If bus,ess, commercial or mixed occupancy, specify nature and extent of each type of use........lJZ .................. 7. DimensiOns of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height .. .......................... Number of Stories ............................................................................................................. Dimensions of same structure with aKeratJons or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front....41~..£~, ............ Rear ........ 415..~.~ ........ Depth.. ......... Height ....~.~...~.t~ ............ Number of Stories ...], ...................... 9. Size of lot: Front ..... 'tl~6...f.t~ ........ Rear ....... ~.6~..£.~ ......Depth ~,l~...f.t~ ............. 10. Date of Purchase ....,,T~3.g.~.;I;'~...~.~....],~.~. ............... Name of Former Owner ....~.~...~.....~.~.~?..e.. .................... Rea~dental 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ..A'lO. ............................................ 13. Name of Owner of premises/k..~b, lig]J,l~.~$, ............. Address ..I~.~.$.aJ3.~.~....T,~,;L~I3.Q ........ Phone NO ..... .~.0.~. ........ Nome of Architect .................. ' ........... ~ ................... Address ............................................ Phone NO ..................... Name of Locate clearly and distinctly ali buildings, property lines. Give street and block numbers or whether interior or corner lot. // PLOT DIAGRAM existing or proposed, and indicate all set-back dimensions from 'iption according to deed, and show street names and indicate STATE OF NEW,,~YO,8.K, ,, ) S S COU~NTY/'/~. ~ 0 i.~.~ .. ~t~., .,o..{./.<..., .)//~ .~..~ .,~ . ' .... ~,~r:..~ ......... ~.~.~-~/..~.' ....................... being duly sworn, deposes and says that he is the applicant (Name of indiv~ual signing application) above named. He is the ......................................... .(,<~..~~'./....~..... .......................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this a)plication; that all statements contained in this application are true to th~ best of his knowledge and belief; and that the work wilt be performed in the manner set forth n the application filed therewith. Sworn to before me this ...... "Z..~ ......... ~ay of .,.,,.~,,Z'~.~.,'i~i,~,'~'./,':r'~c~r ,.~,~,.~1~,¥o., (Signature.of applicon,) . OJL ..,..;: Notary Public, ..~,.....~.:. .......... ,,,~, ~'~t~,, ....... ,',.,eo~y FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTNtENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examinea ........... ~,....L..:.~; ............ ~.. ~ y ........ Approved ............................ '..~....:....19....]:..Permit No......~...../...0...?...~ ........ Disapproved a/c .......... (~j~,'~"~ Z~~ ............. .................... i§'~i'l~'i'~'~"i~;'~;~;;;i ......... [' ...................... Application No. / 0 c> ~( APPLICATION FOR BUILDING PERMIT Date ........... ~.~]3~. B.e~.~...~,0... ]...9. ~.0. .......... 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewri.ter 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 property must be drawn on the diagram which is part of this location. c. The work covered by this application may not be qo~menced before issuance of Building Permit. d. Upon approval of this application, the Building ln~p~ector will issue a Building Permit to the applicant. Such permit shall be I~ept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in p art for any purpose whatever until .a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building D, epartment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffblk 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. Albert Ohaplask[ (Signature of applicant, or name, if a corporation) Fishers Island New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ~ene~..C~t~,a~te~ ...... ':, ...................................................................................... Albert Oh~plask~ Name of owner of premises ..................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Flshe~,s Island Oo~p ~,a.~ . _ 1. Location of land on which proposed work will be done. Map No~a~..~ee;l....~48...J ........ Lot Nc~;5..~.~:4~..1~ Mun!cipa!ity 2. State existing use and occupancy of premises and intended use and occupan~cy of proposed construction: Residental o. Existing use and occupancy ............................................................................. : ....................................................... b. Intended use and occupancy ............................. ~e~.~,.d,e.!0.$.~t,~ .................... j ...................................................... property lines. Give street and block nur whether interior or corner lot. 3. Nature of work (check which applicable): New Building ........ ..X. ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .......... ~.4, O.QQ.,.Q.O ................................. Fee .............. ~,I.Q.,.Qg. ............................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... .]'. .................... Number of dwelling units on each floor ........ ~ .................. 0 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....z~,5...,l]~ .............Rear ........ &,5...?.t; ........ Depth .......... 2.6...f.:t ...... Height .....l...8.....f.~ ............ Number of Stories .....)-. ...................... 9. Size of lot: Front ..... ~.~5...I'?., ........ Rear ....... JL.~5...~.t. ...... Depth 28~...£.~ ............. 10. Date of Purchase .....J..s..P..U..g.?..~.....2..9.....],.'c).~.O.. ............... Name of Former Owner .....t~.a..g..e...~.c....~.U..~. .................... tie~ ~ de ri'hal ] ]. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...2P ............................................. 13. Name of Owner of premises.~k...~hP~,12.],.~.~.]f.:[L. ............. Address ..~.~,~t.~..~....~[.?,~J2~3.~ ........ Phone NO ...... .4..0...9. ........ Name of Architect .................................... : ................... Address ............................................ Phone NO ..................... Name of ...... Address NO....4...0..9.. .......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from or de." 'iption according to deed, and show street names and indicate STATE[ OF NEW.,.,YO~,](, ,, ) S S · (Name of indiv~al signing application) above named. He is the .......................................... ~~.. .......................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authori[ed to perform or have 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.~.~to before me this a of ..... ~f~ T.~.m.. ~w,,,. ~ ~. ?o'~ ~--~--.(Signature'°f applicant) Notary Public,