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Home My WebLink About1741-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the build,ng located at ...~.O~..A.Y:.f~ .................................................. Street Map No .... ~ ......... Block No ...... ~ .......... Lot No ...... ~ ....... ~.~...~..e...z'.~...~.s...]...a..~...d: ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................... lV[a~r ....... ~.~...., 19..62.. pursuant to which Building Permit' No ..... dated ................................ ~,~ ....... ~.~..., 19...~, was ,ssued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is issued is ........ ....~_~J.~'ata..oz~e.. J~amil~.. ~lw~3,1i~ ........................................................................................... The certificate is issued to ...I~{gJ~t..~o~]r~.e]L'l ..,]'= ...................................................................... (owner, lessee or tenant) of the aforesaid building. FO~]~ 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? 1741, Z Permission is hereby granted to' ~'ishers to ..ttmt--l~[...em .eddStl. om..tm..en..eml, s.t~-dwelt!~ ..................................................... at premises located at ..~l;~;:.....&ve.l ............ ]i~.l~hef~B...[~lT.a~,.~...~,.~.~ ..................................... pursuant to apphcat~on dated ............................ ~ .... ]..~ ............... 19.~.., and approved by the Building Inspector Fee $..~ ................. Budding Inspector FOR~[ ~qO. J. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, E×om,ned ........... ~pprove~ ........................................ ]9 ........ Permtt ~o ............................... Disapproved o/~ ....................................................... ..... :"*"~'*'""~';;~;;~(Building In~ ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and suJ)mitted 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 o detailed description of layout of property must be 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 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 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, additio.ns or oJt~retions, 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, electrician, plumber or builder. ............................................................................... .............................................................................. Nome of owner of premises ............. ]~M'IJIiJi..JI, tHJ.JI:MI~'ll...~....~ ................................................................................................ If oppljclantt is a co~orote, signotg(e of duly outhorizedgofficer. (Name and t~le of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .......... ~.o..~...~.e..n..~..e.....,...~.s.~.e.~.s.....~.s...~.a...n.c].,...~....~... ......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and Besidential occupancy ..................................................................................................................................... b. Intended use and Eesidential ' occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ...... ~ ............ Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ............ ~.0..0..0.....0...0. ................................. Fee ....~.~..O~... ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..........1. ..................... 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 .............................. t 40 7. Dimensions of existing structures, if anv: Front ............. ~ ........... ~ear ............ ~..~ ............ Depth ............................ Height _..~..~.! ................... Number of Staries ..... ~ .............. ' ..................................................................................... Dimensions of same structure with alterations or additions: Front ...~..2.t. ........................ Rear Depth ....S..~..m..e. ................... Height .....~ ................. Number of Stories ..~ ...................... 8. Dimensions of entire new construction: Front ......... J.2.! ............... Rear 12~ Depth 20~ Height ....~.......i..2.! ........... Number of Stories ..... ...~........1. ........... 9. Size of lot: Front .......?.~.~.7..6..I. .......... Rear .....~..~.:.~:).t. ........... Depth ......1..~..9.t....'~.. ........... 10. Date of Purchase ......... .1..9..5..0. ....................................... Name of Former Owner ]~ty Harbor Rel~%3r Coz3:). sit. -t-~ ~esident~al 11. Zone or use district in which premises are uu =u ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ..... .~.~.q ........................................... 13. Name of Owner of premises...D~. ;~J~..$..~.o..ct..]~...e...]~..(~...:..Address ~.h..e.~.s...~.Z.~.n..~.~..!!.'..~..'.....Phone NO..2..6..1 Name of Architect ............... .'.. ...................................... Address ............................................ Phone NO ..................... Name of ................................................... ~ ........................................... NO. 25~ Contractor Fishers Island'F~m~ InC~,ddres ishers I~land~ N.~r Phone .................... 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 NEW ~ORK. ) S S. COUNTY OF ...... !~,,~ 9.~ ......... ) ................ .~.*.....]~...e...~.e.~ .~.....o~..~..~..rt ......................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....... ..P.~.~.~;~.el~.~..,..~.;tltJ~l~'~..];l,~l..~.az~a~..~g~ ........................................................................ (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 bes~ of his knowle~l~ and belief; and that the work will be performed in the manner set forth in the application filed,~herewith. Sworn to before me this A~t~ I ~/,J .......... Notary Pubhc,' ~ ~ ~~s~ o] · ..~,...'...~ ~..:'. e~ .~~,,s./,.~. ...... Counh/