The URL can be used to link to this page

Home My WebLink About2035-zFORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .... '~'O'~ ~'~ ~c..~.]?~.?.](~.&.~.~...~,.~.~ ......... Street Map No....~.~...~ .........Block No .....~i:X: .......... Lot No...~.... .....~ ~,).lez:,~..~s ~,.,~¢1,. ...... , ...... conform~ substantially to the Application for Building P'ermit heretofore filed in this office dated ................................. &~.~,~.....$~. ........... , 19.~.. pursuant to which Building Permit No. "~0~.~.. dated ...................... .,~:J,.]. ........ ~.~. ....... , 19...~.~,., was issued, and conforms to all of the requirements of the oppiicable provisions of the law. The occupancy for which this certificate is issued is ........ .......... · 7.z~.~.v~.~.,.~.~e...;~:~.~.~.y...~t~.~.~ ........................................... ~ ........................................ The certificate Js issued to ...~]~.~e.~.~..~..O,,~¢~, ........................ .~.~....~ ....................................... (owner, lessee or tenant) of the aforesa, id building. FOP. M NO. ~ 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.o 2035 Z Date ....................... April ....... Permission is hereby granted to: ~lsha~..I~latut..Fa~ms..A/C..~.aacis.. ............ Fl. shers-..I, sland ................................... to .... Bui. td...a~., d~di.t .l~m. ~,~.. e~.. exi. s ~l~.. ~dwe t.1.~ ....................... ; ............................. ot premises located at ....F~..&.~®.l.1..~ll.1...A,~e.~...-.-l~shel,~--leta,~d .................................. pursuant to application dated ....................... A~r~l .......,],~f ................. 19.6.~.., and approved by the Building Inspector Fee $.. ~..a .0~. ............ Building Inspector FO~M NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ...... Approved ....~ .................... ~..~- ........... , ] 9 ........ Permit No ................................. Application No ............................. APPLICATION FOR BUILDING PERMIT Date ................... .AP.r..i, .1....~,7. ..................... , ] 9....6.~. ......... 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 location of lot and of buddings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this application. 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 P?mit to the applicant. Such permit shaU be kept on the premises available for inspection throughout the progress o~the work. e. No building shall be occupied or used in whole or in po rt for any purpose whot~'~ntiI a Certificate of Occuponcy~ shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or nome, 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. ................................... .q ............................................................................................. Francis G. Goer Name of owner of premises.? .................................................................................................................................................. If applicant is ~lc~rporate,/signature of c~uly authorized officer. (Name and title of ~lorporate office) Leo Forgu~o~, ~o Fresicl~t 1. Location of land on which proposed work will be done. Map No: ........ -. .................................. Lot No: - Street and NumberFo.~. ~.V,~, & B~%% Hi%~ Ave. Fi~.~.ers Island, N.Y. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing gsa and occupancy ........ .~.9.9.~c~.9.~$~..!!.~..".~,~.~ ..................... b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ....... .~. ......... Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated cost ....... ...................................... Fee ........... 8,5..:0.0. .................................................................... (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, if any: Front ........ .25. .............. Rear ..~.~..t. .................. Depth ...,~..2. ..................... Height ..... .2..2.! .................. Number of Stories ...... ~ .................................................................................................. Dimensions of same structure with alterations or additions: Front ........ .~) ................... Rear ....~.2. ........................ Depth ..~(I~12.~ ................... Height ........ .2..2.! ................... Number of Stories ......~ ................................ 8. Dimensions of entire new construction: Front,..l?~! ........ Rear ~ ~-" .................... 1.;~. .................... Depth .~.....6.. ................... Height 5~ Number of Stories .................................. 2~ 12.3~ 160~ av. 9, Size of lot: Frorl,~ ................................ Rear ............................ Depth ........................................ 10. Dote of Purchase .... .1.~..0..! ............................................ Name of Former Owner .I..~.?.~.m..g...?.:...~..~...r~..i.~. ........................ 11. Zone or use district in which premises are s tuated Reeidential ~A" 12. Does proposed construction violate any zoning Iow, ordinance or regulation? ...... ~,o. ............................................ 13, Name of Owner of premises2~.~.1.~...G..:G..e..e.~..~.*..?.:.`.~Address1..4`1....3..:~.2.~.t..~.~.:~:.~: ........... Phone No ....... -. ............. Name of Architect .................... .T ................................ Address ............................................ Phone No ..................... F,I,Farms~. Inc, A"re Fishers Island NY Name of Contractor ................................................... aa ss ............................................ Phone No. 251 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 NEVtL, YO.R,K, /1, ) S S COUNTY OF .'"~'~'"4~ ...... ) '' ............ !~.,.~.~....k~ ....................................... being duly sworn, deposes and says that he is the applicant (Nome of inkiividual si~ning application) above named. He is the .~~' ............................................................................................................................ (Contractor, agent, corporate officer, etc.) o~ 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 his knowledge and belief; and that the work will be performed in the manner set forth in the application filed t~e'rewith. Sworn to before me this ~ / ...... J..~....~. ....... cloy of ~ ,s~.o~.a~wv,.~o~l 9 ......... h ~ ~.,~-0~,~,~o ................. /..~-.~.~:~~ ................ Notary Public, ..~..~[~~t~ ....... County (S~gnature o' ~' ' f~plicant)