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HomeMy WebLinkAbout2012-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. CERTIFICATe OF OCCUPANCY No. Z..~l~.~.6 ............. Date ..................... ~CtL~......~. ............... , I~3 .... THIS CERTIFIES that the building located at ..C.ett.~:.]:...A,~re ......................................... Street Map No...~r~ ............ Block No ......... :X;~Z. ...... Lot No~L~"A .......... F$~Ae~.~...[g3,:~q~ .................. conforms substantially to the Application for Building Permit heretofore filed in this office doted ............................................ ~t?.~,}L..~.~..., 19~.~... pursuant to which Building Permit No...~2.0[~. doted ................................ ]~L-~e,~.....;~.~..., 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 ........ ................. .P.~t .~'Rt e...one...t~ ~"~ti11)~...¢tw~ it lil'~= ............................................................................... The certificate is issued to .~2:~...(~...C[B~.,~.~.~3?. ........................ CB~'. ................................... (owner, lessee or tenant) of the aforesaid building. Building Inspecto~ FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BI: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2012 Z Permission is hereby granted to: at premises located at ....~.l~...~t~t~&'l ..,kl/~ .................................................................................... pursuant to application dated ............................. ~'~1. ...... ~,~ ........... 19.~,,~.., and approved by the Building Inspector Fee $...~..:...O~... ........... Building Inspector FORMNO~I . , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... : .......... .............................. Application No...~../..~ ....... APPLICATION FOR BUILDING PERMIT Date ............ ~..s..~..a..b:....2, ~ ........................... , 19.~ ........... INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. ,, b. Plot plan showing I~Cotion of 10rand of buildings an premises, r~la_~tio~g.s_hiP' t?_adjpi_n_ing premises or public streets or areas, and giving a detailed description of layout of property must bedrawn on thediagr0~ ~vl~J~:-~-J~T:~-~'~f this application. c, The work coverecYby 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 appllcarff. 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 pa rt for any purpose whatever until a Certificate of Occuponc~ shall have been granted by theiBuilding Inspector. APPLICATION IS HEREBY ~ADE to the Building DePartment;for the issuance of a BuUdi~D-Permit pursuant to the Building Zone Ordinance of the Town of Southeld~-Su~-f~lk C~ur~-Jq~ Yad~_and_other_a~El_i~_able Laws, Ordinances or Regulations, for the constructidn of buildings, additions or.; a I~'-~}ions, or for removal or demolition, as he~e~..,described. The applicant agrees to compl~ with all applicable laws Jordinances and.re, gu_Jations. - .... ........................................ ....... ~i~t~ture of applicant, or flame, if a corporation) Fishers Island. New York (Address 9f applicant) .. / State whether applicant is owner, lessee, agent, architect- engineer, general contractor', electrician, plumbdr or builder. Genera~-~gntraetor ' Name of owner of premises ......... ..y~'..s.~:~.~.?:..1~.....~..:....C..~.e..s.~.e.r.~.~..d.~......~..~...~.a.~.e...~.~.! ................ i .......................... If applican~~signatu~ly authorized officer. '"'"'". ................. ................... 1. Location of land on which proposed work will be done. Map No: ......................... -. .................. Lot No: .~ .................. Street and Number Central Avenue, Fishers Island, N.Y. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Residential a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy Se~e 3. Nature of work (check which applicable): New Building .................. Addition..................3~ Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ....... .~.1.0..0..0..*...0~... .................................... Fee ~ ~. ,. .0. .0. ................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling un ts ....9.~e. .................. 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, if any: Front .... 55~-2" ....................... Rear ...... ~......2. ......... Depth ~gf~t 24~ +- Number of Stories 2 Dimensions df same structure with alterations or additions: Front 55t-2" Rear 5~.~-2" .~,:Depth 2c)~ Height ....2~..~......+17. .................. Number of Stories 2 8. Dimensions of entire new construction: Front.....1..0. ........................ Rear ........... .lQ? ............ Depth ?......'[ .................... Height...........12~ ............. +- .... Number of Stories ........ ,1. ........................ 9. Size of lot: Front 161'82= Rear 150~ Depth 100 ]0. Date of Purchase ...... .C...::~...c.,a...,1.c).~.0. .............................. Name of Former Owner ,~.~.~.~.~.~..~.s..]:..a.~..?...a~....z~,.~...[~...c.... .... t a Residential 11. Zone or use district in which premises are s u ted ........................ . .... 12. Does proposed construction violate any zoning law, ordinance or regulation? ? ' 13. Name of Owner of premises .H~'...e..:,..C..'....~........C~...e..s.~.e.~....Address ...G.?..e...e.9.w.i..c..b.s....C..o..n..n... .......... Phone No....-. ................ Name of Architect ...~.o...~..e ............................................. Address ............................................ Ph~;~e'No ..................... F. I. Farms Inc. ishe~s Island ~.Y Name of Contractor ..... ~ Address~. ~ .~ ~'~Ph,~,,~ ...... I~,~ 251 Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all ~iet-back dimensions from property IJr~. Give street and block numbers or description according to deed, and show street names and indicate whethyerior or corner lot. ~/ . 0.31 STATE OF NF~ ypRE, ~ )ss COUNTY oF~ ............. ) ' ' ................ !4:..~......~ ............................................. being duly sworn deposes and says that he is the app cant (Nome of indiWdual signing application) above named. He is the ..~..P..r..e.~.d..e..?..:....~..*....Z..*...[.a...z~...s..s....Z..n.?..'. .............. (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 stC~tements contained in this application are true to the bes]} of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed t, Kerewith. Sworn to before me this . / .................. .................... ... Notary Public, .~.l~.~....~.~,,~,.~[.~o,z_~unty '"v'~'~u~'~a'p~lican,) ........................