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Home My WebLink About2354-zNO. 4 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, iq. Y. CERTIFICATE OF OCCUPANC~' THIS CERTIFIES that the building located at ..]~/.~..~(:1~0~.~...,,:.I ............................... Street Map No ........~ ........ Block No....:~;~ ...........Lot No..-~--~.,.~...~s~e.~8...]~s.~.~.j.....~¥.~i.. conforms substantially to the Application for Building Permit heretofore' .!{lied in this office dated ............................................ A.~'t:L]......~LJ~, 19~J~... pursuant to which Building Permit No..2~1~,g .... dated .......................... .~1:1~.~.~ ....... ~.~....., 19.~t,.., was issued, and conform~ s to all of the requirements of the applicable provisions of the Iow. The occupancy for which this ~ertificote is issued is ........ (owner, lessee~{5?~na:nt) of the oforesoid building. ~' Buildir ~, Inspect/:)r x FOEM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. y. BUILDING PERMIT (THIS PERMIT MUST BE K~.PH ON THE PREMISES UNTIL FULL coMP-EETI~)N-OF THE ~/ORK AUTHORIZED) No. -'2-3~ Z pursuant to application dated ........... Building Inspector Permission is hereby` granted to: ~ St~,S..:;~te~-,,~ ..~,,.,,~.¢,,,..(~e~e,,~,, ~O],e ...~'i~i,;:. ~,~he~. e,~..[s~tl ..................................... to ,...~.~,l~t,,,~,,a~ti~:t,c~i ~.,~,~.,~,,.~[~elZ~ ........................................ at premises located at .]~/.~.....];][e~ 85,.~.~ ................................ ~ ..................................................... ~.....~ ............................. i....~.....i ...... ~....z~ ~.~i..z~.,~.,: ................................................... .. ............. : ....... ,.; ................ ~.]p~.~,~..,...~..; ...... 19.~[t,., .and approve~ by the ........................................... ;;i;T"-'~ ................. ' , Building Insp Fee ~.~ .~.1~. .......... NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved IL '~ ~, 3 '~'/-~ ~ ........................................ , ]9 ........ Permi~ No .............................. Disapproved a(c ..... ~ ............................... ¢ ~ ~~p J ec~or) APPLICATION FOR BUILDING PERMIT Application No. Date ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plon showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or oreas, ond giving o detoiled description of layout of property must be drown on the diogrom which is part of this opplico~ tion. c. The work covered by this app]icotion m~y 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 buiiding shall be occupied or'used in whole or in pa rt 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ~I~_L2,Lo Z~L~*ND FATS, o, ZN~. (Signature of applicant, or nome, if o corporation) Fishers Island, New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p~umber or builder. Genera~ ~ Contractor Name of owner of premises .............. !.~.z..s..:....0.o..r..'.z.~t.~..e....~.:....O..o.~.e. If applicant is a carp,et/ate, signature/of duly authorized officer. ............... ............ (Name and titl~ of corporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ...................... Street and Number ...~hedge ........ o,reet~ ........ ; ..... t!]ishers ................ 'Is]_and ~ ........... ~ew ................................................. York Municipality State existing use and occupancy of prem,ises and intended use and occupancy of proposed construction. a. Existing use and occupancy Residential ., b. Intended use and occupancy Same .......................................... [ ................... ' ......... 'i, 3. Nature of work (check which applicable): New Building .................... Addition ..... .z. ........... Alteration ............. Repair .................. Removo! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .~,1200,00 Fee ~,~5.00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... (~.~.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 ......... ~.7...~, ........ Rear ...~...~,. ............. Depth .~!..':9~! ............. Height 28~ Number of Stories l~- Dimensions of same structure with alterations or additions: Front ~?~ Rear Depth .~.~-3" Height 28~ Number of Stories 1;{ 8. Dimensions of entire new construction: Front ....1..4. ....................... Rear .............................. Depth ...~.~. .................. Heig'ht ....1./,J ..................... Number of Stories ..... .o.q.e. ................... 10. Date of Purchase ................. ?..6.4. ................................. Nome of Former Owner .....~.~Z..~:...~!.'.t~..~b..~. .................. 11. Zone or use district in which premises are situated ..... .~!.e.~..~.q~.~,~_ ......................................... 12. Does proposed construction violate any zoning ~aw, ordinance or regu orion? ...~9 ................................................... .... ~. G. Clay _,, Niantic, Conn. Nome of ~rcn recr .................................................... ~aaress ................................................ Phone No .............. r~,~ ,~ F. I. Farms~ Inc. AHdre~ f'ishers Island~ N.Y. ,. 788-725 Name of ....... c .......................................................................................................... Phone ixo .............. . ~ PLOT DIAGRAM Locoie clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions fr "~'ropert~ lines. Give street and block numbers or description according to deed, and show street names and indic whether irfferior or corner lot. SmAT dF' ) COUNTY OF ............................ )S.S. ................... ~-t,...~f~fl..]~.e.;c'gB~P~3.,..~., ..................................... being duly sworn, deposes and says that he is the applicc (Name of individuai signing application) above named. He is the ....... ~f.,'fl.J:.~.q~...~R.b..e.~.~...Z...~.]._.a...~.cl....~flE~p.,....O..o.p~E~g~.o.E ......................................................... (Contractor, agent, corporate officer, etc.) of said owr~er or owners, and is duly authorized to perform or have performed the said work and to make and f e t application~; that oil statements contained in this oppJJcation are true to the best o~his knowledge and be et; that the W6rk will be performed in the manner set forth in the application filed therey4'th. Sworn to before me this~ .............. .1 ~..~.~.... day ~OT ~ ~¥ PIIBL~C STATE OF NEW YOi~R ..................................... · ....... ~ ............................................. Notary Pub c .............. ~..~,0~ ............................. County (Signature ~of applicant)