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Home My WebLink About1106-zFO'R~ NO. 4 TOWN OF SOUTHOLD I~U~LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF'OCCUPANCY THIS CERTIFIES that the building located a~ .l~ox..Ave~ue,...Fi~l~ers..~slanel.. Street -Map No .......... ,.**..... Block No ....... **.,......Lot No~,.~ ................................................................... : ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................... J~e...9 ............ 19.~0,.. pursuant to which Building Permit No ....... Z.~10fl.. 4areal ............. , ........ J~e-.9 ........... 19.60., was issued, and conforms to all of the requirements of the app!icable provisions of the law. The occupancy for which this certificate is issued is .......................... ~H~I~ATE.. ~., FAMILY..Df6ELLXH(~ ................. ............................................................. This certificate is issued to ......... i (~O...~."~I"O'.~..~..~....~..~....°.W~...~.~. (owner, lessee or tenant) of the aforesaid building. 2'-" Building Inspector f ' FOI~I NO. 2 TOWN OF SOUTNOLD 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? 110§ Z '.Dote .......................... ~e,....9 ......... : .... 19.60. Permission is hereby granted to: at premises located at "']~I~'""A~t~ ............... ~h~I"JB'"~'S'~tD/]Jj'"'"~'~'~--'-'~ ............................... pursuant to application dated ............................ tT~'.',':'~'"'"'"" .......... 19..(~).~ land approved by the, Building Inspector , ~' $ '~ l~J cheek ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit ~o ................................. Disapproved O/C ~ . ~ ui oing inspector? Application No.. 1APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This al~plication 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 adioining 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 n6t be commenced before issuance of Building Permit. d. Up.on 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 p.urpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ADP41CA'T[ON 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. FI~HEI,.~: IoIaND F/~MS, INC. (Signature of applicant, or nome, if o corporation) Fishers Island, N. Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. General Contractor Name of owner of premises/ ......... : .......................................................... G..o..r..d..o..n......Gr..a..g.d. .................................................... tf applicant is a corpora7 signature of duly authorized officer. . . .~~,H. Lee Fergus0n, Jr. President I ('[Name and title (Jr corpbmte officer) Location of land on which proposed work will be done. Map No ................................... Block .................................. , Fox ~ve. Fishers Island NY Street and Number State existing use and occupancy of premieses and intended[use and occupancy of proposed con*truction: Residential a.Existing use and ~ ,,-one, b. Intended use and occupancy ................. , .a.$..e. ............................... .................... Addmon .................... Alterabon .................... 3. Nature of work (check which applicable): New Building ' ' ' × ' Repair .................... Removal .................... Demolition. ........... ~ ....... Other Work (Describe) .................... $100.00 . ........ i 5.00 4. Estimated Cost ............................................................ tee ...................................................................... (to be paid on filing this application) FEES: umts ............................ Number of dwelling unfts on each floor ............................ 5. If dwelling, number of dwelling ' one If garage, number of cars ..................................................................................................................... : ................. , 6. If business, commerica[ or mixed occupancy, specify nature and extent of each type of use......~. ........................ 7. Dimensions of existing structures, if any: Front ......... i ........ .~..8..t..... Rear ..................... .5_8.!, Depth ..... : ......... 2.8. ......... Height ..................... ~.0.!..Number of Stories Dimensions of same structure with alterations or additions: Front ..~.8..~. ........................Rear ...... '..~ ........... ~.8.! ........ Depth .......... ~..4.'..'?.6.~! ........ Height ..~.0..~. ...................... Number of Stories ........................ ..2~.... .... ~ r t ~ 6~-6" 8. D~menslons of enhre new construcOon: Front...9. ....................... Rea ..9. .................. 4.... Depth ............................ 4'-6"" Height ................ : ........... Number of Stories ....................... .S..b..ed( ~ 9. Size of lot: Front ?8r Rear 1;~,~t ' Depth rea id ential ]0. Zone or use district in which premises are situated ........... ./. .................................................................................. 11. Does proposed constructio~ violate any zoning law, ordinance or regulation? .......... ../~.....O. ......... ~.o. ..................... 12. Name of Owner of premises ...... .O.~..~..d.o..~...6.~.~.~.d. ......... Address .~.J:.~..b..e.~.s....Z.~.d:.....~r...,. ....... Phone NO. ,~.~.~ ............. . ~on~ Nome of Architect ...................................................... Address ............................................ Phone NO..~ ............. Name of Contractor..~.&..s...h..e~.s....Z..s..Z..a.~.d...~.~..m.?....Z.~.O..Address .~.J:.~.h..e.~.s....Z.~.d..~-~ ......... Phone NO..~.1..,,.. ......... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) COUNTY o, ...................... ~. ~e Z*e~on~ ~.. ., bein ............................................................................................ g duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............. R~aaiden~ ........................................................................................................................... (Contractor, ogen}, 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 application; that all statements contained in this application are true to the best o/t' his knowledge and and that the work will be performed in the manner set forth in the application filed therewith, belief; / Sworn to before me this ~ ,/~ ~ ...... .8...~..b. ........... day of ............. .'J7...1~...e. ................... 19......6..0.... (Singature of a~plicant) Notary Pub I lc,....~, w .~.~,~ ............................County FORi~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ~ ~h .,':r.: ~:x',~. ............. 19 o : Approved...; ......................... ~..: ........ 19 ........ Permit ~'~o ................................. Disapproved a/c ........... .~. ....... ::;~~' ' ' · ' ~:'"":~'" '"~' '-z ................. ................. ~.~ ...... x.,~.:.... :....::....~ ....................................... ~ (Building Inspector) Application No...l..L...~....~, ........... APPLICATION FOR BUILDING PERMIT 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 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 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 Paws, ordinances and regulations. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of Go~"dor~ premises ............... . ........ / If applicant isa corporate, signatur~of duly authorized officer. ~I. Lee Fer~on, Jr. _ ............... '(Name and titFe of corpc~/c~tg"~'i'~'ri .................. 1. Location of land on which proposed work will be done. Map No ...................... : ............ Block .................................. Street and Number FOX A~eo 2, State existing use and occupancy of premieses and intended use and occupancy of proposed constructiOn: a. Existing use and occupancy ~{e~:[do.~,~,..~.. b. Intended use and occupancy ~a~e 3. Nature of work (check which applicable): New Building .................... Addition ............ .x.......Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ................................ ~..1[.0..0.~.(~.. .............. Fee ...~i.~.O..0. ...................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ................~..~.D ....... Number of dwelling units on each floor ............................ 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 ................... ~...!.... Rear ..................... ~.~.".. Depth ............... ~ ......... Height ..................... ~.O.?..Number of Stories ........................ ~. ................................................................................. Dimensions of same slructure with alterations or additions: Front ..~.8.! ........................ Rear ................... ~.8.~ ....... Depth .......... ~4.!...'~.". ....... Height ...~...~ ...................... Number of Stories ........................ ~1:... 8. Dimensions of ,entire new construction: Front...9.~. ..................... /Rear~"9! ............... --n ~% ...... Depth ................. .6..~...'~..#.. Height ......... ..4:.l....'~..~ ........ Number of Stories ....................... ~))ll(i ~.~Oi ~C,v-~)) 9. Size of lot: Front ..."/8! .................... Rear ..'12~! .................... Depth ............................ 14'/t n~'* 10. Zone or use district in which premises are s~tuarea ................................................................................................ 1 1. Does proposed constructlan violate any zoning law, ordinance or regulation? ........................... .~.? ..................... 12. Name of Owner of premises ....... I~.:[t~l)...G~l)~ ......... Address .~.~#~kOX'II..~Z-I)~,~(~..~I(. ........ Phone NO..,~5(¢ ............. Neme of Architect ................. ~.o..~..e. ............................. Address ............................................ Phone NO. Jilt. ............ Name of Contractor...~.~.~..L~.~....Z.~.]~..~..~....Z~..~.Address .~'.~R~.(~...~,~t,i4~..~ ........ Phone NO..~.'1 ............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF N[W YORK, COUNTY OF ..~.~ ........... S ~. ~e P~o~ ~. bein duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .............. JtEoO.'l-don:t, .......................................................................................................................... (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 application; that all statements contained in this application are true to the best of h~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ....... .1~. ~. .......... day of .............. ~,,~ .................. 19 ...... .,~,.,. i Count Notary Publ c ............ ~.~..~ ,~, .................... y