Loading...
HomeMy WebLinkAbout2761-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ]~¥~.~...Ro.a~..F~....el3c]....~..~.]3.t:.p,~..~.9,.~ ...... Street · Fishers islan~.e~t~tes Map ,~o ....................... ~,ock ,xto ....................... Lot No....xX~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................................. A~.~.~],....3.0 19..6.~. pursuant to which Building Permit No...~.~...~...~...$ dated .................................. ~. .......~0..., 19....~.~, was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...~i.va.t e...e~e ...f. am~.t.y.. ~wet.l.in~ ............................................................................................... The certificate is issued to ...~.~.IMi~.....~, ........................ .~.~. ................................................ (owner, lessee or tena,nt) of the aforesaid building. H.D.Approval Nov, 196~ by R. Villa ...................... .~:.~ ................ Building Inspector ~ FORI~I 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? 761 z Date .......................... ]~. ......... 20 ............ , 19.6.5.. Permission is hereby granted to: Robt...~/&dcU,~ t~n...J~...., d~.¢ .... ¢ ~ j.:k~r;l.e .....l~m .............. F~ ~he~.s...I~le. nd ................................ to ... ~d.. ne~z..one..$am~...d,,m~l.i~ ................................................................................... at premises located at .S/.~.....~l~t,..~ac%~...~'~.~e~s...][~.'l.~-~]...[8.tg..te~ .................................. .................................................. F~shezt~..~sland~ ....... ~,~., ........................................................... pursuant to application dated .................................. I~l~.:l.],......~O .... 19.6.~'.., and approved by the Building Inspector Fee $. '! O...C~ .......... Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH AREA SERVED November 9, 1965 Mr. Howard Terry Southold ~uilding Department 5outhold, Mew York Dear Sir: The following sewage systems in Fishers Island have been a~proved by the Suffolk County Health Department, ~u~lt ~ My. Ho~:ert Wadd~ngton, Jr., F~shers Island: Dona] d Cleveland Car]yle Maw Robert A. Villa District Engineer ,r,{AV:em FORM NO~ I TOWN OF SOUTHOLD BUILDING .DEPARTMENT TOWN CLERK'S OFFICE .SOUTHOLD, N. Y. Exom ned ............. ./ .... , Approved ................. i ........ ................ ............................... (Bui~in~ Inspector) Application No. ~ '~ ~' / APPLICATION FOR* BUILDING PERMIT Dote ...iii....'~....0...~, .p...~.,,. ...................... , ~9....~.~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building tnspector. 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 port 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 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 po rt for any purpose,~whatever until a Certificate of Occupancy shall have been gro:nted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for thei~ssuf~/ce 9~ a B/ilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New /~l~and/~ther~:~P.p~cable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, ~,,~9///em~zg~ o,~dzef~olition, as herein described. The applicant agrees to comply with all applicable laws, ordinances .......... " (Address o~ applicant) ~ ' ................... i'l~l~'~l title of c0rporat'e"~'~'i~;i" 1. Location of land on whir=lhgroposed wo~k will be done .~Agp Np: ....... ,., ....................... /. ........ Lot No: .... i: ........ ,c.~ Street and N u tuber..~.~. · .4..~?. i~'. · .d.. ~'. I.Q....~.~.....~....~5.....~...'..(G....~.... ...... i~.'-~...~........Ir~...~Z~.~.~ Municipality 2. State existing use and occupancYr~remises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................. ../x1? ...... ~"7" ........ '"/~'"'"Yx7 .................................. ~ .................................. b. Intended use end occuponcy ................... .............................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...~.~..,,...~..~.~.l.........-~ .......................... Fee ............. ..-~....C........-'~. ............................................................. (to be paid on filing this application) 5. If dwelling number of dwelling ur~ts/.......~........i ............ Number of dwelling units on each floor ............................ garage, number of cars ..... l~_.../..~..c.. ,~.~...~..~-/h £/-~: ...... ~. _~...~...~.~.~...~... .......................................................................... If 6. If business, commercial or mixed occupancy, specify nature .and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front .......................... Rear ..........................Depth .............................. Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............................ Height ................................ ~/-/ /~-/'--Number of Stories ..... ~.~.2~.~..i..~2~.... /<~.~..~.....~.... 9. Size oflot: Front ..... .-~.~,...~.~-. Rear ............................ Depth ........................................ 10. Date of Purchase ........................................................ Nom~f form~/~.~ ,Ow?er ........................................................ 1]. Zone or use district in which premises are situated ....... ~..~...~.~.~.[(..~../. ................................................................ 12. Does proposed construction vio~te ~ny XOl~,ng Iow, ordinance ~or ~l~gulati~?/......,.,..~.v.~. .................................... 13. Name of Arch tact ~..~.. '~"~'[~i~ Address ...~7..,/..~....L;~..~,~ ~...(~.,. Phone No~'/'/L2 .&/..~. (/~' 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 QR NF-..W YtDRK,~ ) COUN ......... ) ....................... a ............ being duly sworn~ deposes and says that he is the applicant (Contractor/a~nt :orporate officer, etc.) of said owner or owners and is duly authorized to perform or havex~e/~grrr ~ the said work and to make and file this application; that all statements contained in this application 9fe/fr.,~ t ;~the best of his knowledge and belief; and that the work will be performed in the manner set forth in th,~ C~lFi'i~ati~ , fi~ thxe~with. Sworn to before me this //// // / Notary Public, "~":~~~"2'" County ~/'' - / ~ig~re of applicant) ,/ I / I q.,fL c, ,/ G bL + ~,~ .... NL+g~ .) Il- 7 ~L .J I ' a~ J 'A --Ty? C ~D C DiN 'Zx~r )oo~ JAF, AF"D -T¥? -TyP f~ eL ~;~-~. 2;~,~ ~1° io lq^Lb C~f~T C · 2,,8 ~ 7I'o II crL, L, %4 ,, / · '?. x6 ,? F^~4DA /'~11 = Cto_ F,~ ~L lo ~'6' · ~, F, LL T~° ,z~e~ [-,~^T~. t~- 0 I TI'e~ "?.- -Th, r" Fu, sl.l ~.L T~'~ + ~,~ j lC' ~ F~s I'~LA~r'D ri"( Ir~ ~AR G6 A6 /Z J , / / / / / / /¥ ~/c © N~T~ALL :! 1- T I -tl -- I: l7, \ \ I /? /of /x`` \X \ / /,,~ \ / / ~' I x i / t / o o~