HomeMy WebLinkAbout2913-z TOWN OF SOUTHOLD
BUILDING I)EPARTMENT
'I"OWI~ CLEI1K'S OFFICE
SOUTHOLD, N.
BERTIFIEIATE OF EIE:I~IJPANEIY
No .... .Z.2.4..3.0... Date ................. ~T~..2 ........ 19..6.6
THIS CERTIFIES that the building located at ...-?.'..~.-.-..-?.-..-.-.-. ............. Street
Map No~.~.~.~..1~... Block No. ~ ...... Lot No..
conforms substantially to the Applicati, on for Building Permit hereto~o.re filed in this office
dated ......... .0~..~..O~.~.~....2.~. ....19.6.~.. pursuant to which Building Permit No...2.9.~..~..~.
dated ........ .0..~.t;.O.]?.~.~., .2.~...., 19.~..~., was issued, and conforms to all of the require-
ments .of the applicable provisions of the law. The .occupancy f. or which this certificate is
issued is .... l~.. Ola~. ;~t~ltt~i,y ~e~clell~o ...........................................
The certificate is issued t~o ...... ~..:1..1.~..~.~...B,...1t.O.~..~,.i~.~,..~M~IC ........................
(owner, lessee or tenant)
of the afore.said building.
Suffolk County Department of Health Appr, oval .........................................
~ FORM ~O. 2
TOWN OF $OOTHOLO
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.° 2913 Z
Permission is here~y granted to:
' ~, Z. t~t~,t~.t~:.,oe ,.:.~..,:~'C....~,:~ee~.i~bS~ ....
· ............ ;~,he~.s,..I~:~e~a......, ..: ......................
,. ................ ~,.~., ............................... L: .......... ,..
to ~Bu~,I~... net~ ..eme,. ~tam$3,~'.. ~,,eel.~J .............. ; ............ .ii .............. , ............. :........~ ..................
ot premises located at .. ~.~..~. ~.~..~.~.. ....... ~.~.~J~.~.~.~ll.,..:.,..' ....................................................... ·
.:.,..... ........ r.~.~...~.~,...~.~.:~,~ ........................... ~..:.....i ................. .: ......
pursuant t~ ~pplic~.dtion dated'. ...... .: 0~ : ,~.)......' .... 19~..., ~nd approved by the
Building I ,nspector
FOI~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ~ ~q~ ~" 19...~.?,T
Approved ........................................ , 19...~.,.,Permit No........,..,..................,,.¢~ ~/'~ 7~
Disapproved a/c .................~*.,,..~,.,/..~.,..,/.......(/. ...................
Application No. ~-
0c~cober
21
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 buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed description of layout of propertymust be drawn 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 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 part 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 or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code and regulations.
Fishers Island UJ:ili~;y Company Inc.
(Signature of applicant, or name, if a corporation) .
Fishers Island, Ne~v York
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Genera Con~ract~or
Eileen B. Roblns
Name of owner of premises .....................................................................................................................................................
If applicant is. a/corporate, signature of duly authorized officer.
...... ........... nar, President
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ..... .E.~..s.~...E..n...d. .................... Lot No: 20-?
Street and Number .......................................................................................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....V...a.~.a...n.~ .................................................................................................................
b. Intended use and occupancy ........ .~...e.,~..j..d...e.n.,~,.e. ...................................................................................................
3. Nature of work (check which applicable): New Building x Addition Alteration ...............
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................
4. Estimated Cost ~6~ 000.00 - SJO.00
(to be paid on filing this application)
I
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 .......................... Rear .......................... Depth ........................
Height ............................ Number of Stories ...........................................................................................................
Dirdensions of same structure with alterations or additions: Front ................................ Rear ............................
Dep? .............................. Haight .............................. Number of Stories ........................................
8. Dir~ensions of entire new construction: Front .,..(.8.~:.~.~ .............. Rear ...4.~.: ................... Depth ........................
He~!~ht ............................ Number of Stones ............................
9. Size of Jot: Front 320' +- Rear 280' -k- Depth 380' I r'r, egu I ar,
10. Dote of Purchase ..... .S...e.P...~.?.,m.b..e..c...!.~.(3..~ ................. Name of Former Owner ..E..s..~...a.~..e.....E.,m.,m.a....~.V.~...c..k..o..~?.. .....
· R I
1 1. Zon, e or use district in which premises are s~tuated .............................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? .....n..o. ........................................
' - ...... El leen B. kob~ns--- Dar~en, 0¢.
13. Na~e of Owner of pr,m~es ........................................ ,~aaress ............................................ Phone No ...............
: W. and G. Pla'cC _.. 101 Pa~'k Ave NYC M. .U. .5. ~'. .3. .8. ?.
Name of Architect ...................................................... ,~aaress ............................................ Phone No
' F. I ,tl~.i I i~y Co. No~8.8..2.~.~!
Nome of Contractor .................................................... Address Fishe, ~s I $ I and NY Phone
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fl
property lines. Give street and block numbers or description according to deed, and show street names and indic
whether in}erior or corner lot.
m
STATE afl NEW. YDRK,. 1
bul-'r'o i K S.S.
COUNTY iOF ................................ ~
Freder ck T. War.n..e.r be n~ duly sworn, deposes and says that he is the appli~
(Name of individual signing application)
above named. He the Co. Con c o.
(Contractor, agent, corporate officer, etc.)
of sa~d owner or owners and ~s duly autho,zed to p.erform r have performed the smd work and to make and
this application; that all statements contained in th~s application ore true to the best of his knowledge and
and that ~he work will be performed in the manner set forth in the application filed therewith,
Sworn to before me this
............. .......... ........... ,,, ........ /J
~ .... ,~O~,--~l~':t~.~ . AE 0i- ~EV~ ~.. ' ............................. ;;.: ................ '; ....... : ....... J ...................... 'i .....
Notary Public, .....;;.~;.;L..~.~;.{;,~'~.~n¢,~£~;~? ............... County [5~gnature at applicant) II
~er.., e.:pi,c.:, M=ci:, 30. tg/~ ]J
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HOUSE FOR
MR. & MRS; THOMAS
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HOUSE FOR
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WILLIAM ~ GF,~JFFREY PLATI"
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