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HomeMy WebLinkAbout2933-zTOWN' OF SOUTtIOLD I~UILDING DEPARTMEDIT 'I,"OW'N CLERK'S OFFICE SOUTHOLD, N. Y. No. Z. 2~.~. .... Date ................ ,I.%lJa~ ·. 2~+ ...... 19.66. THIS CEiqTIFIES that the building located at S'/S'' .~4af~r~. ttoa¢t..Ea.s~; ...... Street ~A...~r~.s..I..s.Z.a..n.d..E. ~&%ei%o ...... .~¢ .... not No. 6,.. ?~,..~.2~...S.l. sne~s..;s.~ana.~ ~.~. conforms substantially ~o the Applicati.on for Building Permit heretof, oee filed in this office dated ............ I~OV,....l.~.., 19.6~ pursuant to which Building Permit No. '29'~' ?~ dated ............. ~O~",' '3.8"" 19 [~., was issued, and conforms to ~ the require- fac.uts .of the applicable provisions of the law. TI~e .occupancy f. or which this certificate is issued is . .PDtYi~.~;e. o19~¢t..i.~amity .el;~elt.iD.¢ ......................................... The certificate is issued ~o . M:F,' '&' MI'S',. 'Collgy '¢l~s~;~:p'. ...... {~W~el'S/.' .......... towner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval ......... ~ ........... ~ ................... Building Inspector FOKM 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? 2933 Z Date ................... jjO~relltbe~......%~ ........... , 19.~.~.. Permission is hereby granted to: A. ~. Oede....AJO.....l~..&-.l~s..~l. by..l~heste~ ............ Fisher s...t~a~d .................................. ...................... lt~.~. ................................................ to ..... ~Z:J~" new" one" P ~m i'ly" ~t'~ t.~n~ .................................................................................. at premises located at ..l~z,k..A..~'~e..l~'t,.$...1.~'-'~t...t.~-~l...'l..~-t@ ............................................ ...................... Fi~he~ ~' .'Z~t~mct" .~L~j t~t~ '~ ........ Fi~h~r~" '~'.~ t~d' ~"' ~t'~ '~ ~ .............................. pursuant to application dated ............................... ~e~'l~e~'......'l.~, 19..6~., and approved by the Building Inspector Fee $I0';'00 ........... FOItM NO. 6 TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, o certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. 3. For existing buildings (prior to April lg57), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. xlew Building .~.9...6..5. ........... Old or Pre-existing Building ............................ Vacant Land ............................ .ocatlon Of Property Fishers Island, N. Y. )wrier Or Owners Of Property Coib~ M. ChesCer ;ubdivision ................................................................ Lot No ............. Block No ............. House No ............. ~ermit No ..................... Date Of Permit .................... Applicant .................................................................. ~ealth Dept. Approval ............................................ Labor Dept. Approval ................................................ Jnderwriters Approval .............................................. Planning Board Approval ........................................ (equest For Temporary Certificate Final Certificate :ee Submitted $ .~.,..~.0 ........................... ;onstruction on above describ~l building aJ3d.perr~i~t n)~ts all applico~e~.cpdes j~nd regulations. Ap ~ozoy ~n~ter ' ' A pp t ..... ~ ...... /~~ ............................. ... to b fora thi / ......... ~ of ~ ~~.~/ ~'- ........... -~ P~li~ ..(~., [,;'X~7~ ....... C---+,, ~ -- 1/~/ ,~ . ~ Publi~Stateefg~ / ~ Qu~I, ~m, Ex~l~ TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined ~. ....................................... Al~proved ........................................ , 19 ........ Permit No............................,....~ ~ '~----' D~sopproved o/c ........~?,r. ..... y.?~: .... ;.~,;; ...................... Application No......P)T....~.,.~...,~. ...... (Building Inspectlr) APPLICATION FOR BUILDING PERMIT Dote .~......l~I~N.~.~.l~f~...~5 ............................ , 19.6..5. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in in'k ond'~ob~nitted 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 o detailed description of layout of propertymust 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 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 ~or any purpose whatever until a Certificate of Occupancy shah hove 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. Ao John Gada General Contracting, Inc. ........................................... R r .~.~....-..T. ~,~..a..s.... ............................ (Signature of applicant, or name, if a corporation) Drawer B ........ ~.~ mb. ea ~...I~.1 ~nd ,...M.e.w...Ygr..k. .................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name al: owner of premises ........ ~.z.:....a.,n?....~.~?..:....C...o..1..b..y...,C.,.h..e..s..,C.,e.~. ................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done, Map No: Park Area ~,,. k1^.15-7½ 15-6 ......................................* .......... Street and Number .............................................................................................................. [.'.........i[..[...[...: ................ . ,Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed con,strU~tion: a, Existing use and occupancy ......................................................................................... : ........... ; ......... f ................... b. Intended use and occupancy ........... l~.e..?.%,.d..e..n..c..e. ................................................................................................... 3. Nature of work (check which applicable): New Building .....X.. ........... Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) (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 bosiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dima. nsions~of existing structures, if any: Front .......................... Rear .......................... Depth Height ............................ Number of Stories Dimqnsians of same structure with alterations or additions: Front ................................ Rear Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Dote~ of Purchase ........................................................ Name of Former Owner 11. Zon? or use district in which premises are situated 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? Cont~act~ng~ PLOT DIAGRAM Locat~ c early and dist net y a I buildings, whether existing or proposed, and indicate all set-bock dimensions property hr]es. Give street and black numbers or description according to deed, and show street names and whether interior or corner lot, STATE OFi NEW YORK, ) COUNTY ;OF ..... .~.tJ;(,t';~J,~; ........... j S.S. ............... ,.A.e....~..o..h.,n....~{~t~ ....................................................... being duly sworn, deposes and says that he is the c (Nome of individual signing application) above nan~ed. He is the ....................... f;.O,1;PP~.~.fl..ID;~;~[g..~ ................................................................................... (Contractor, agent, corporate officer, etc.) 'of said ortner or owners, and is duly authorized to perform or have performed the said work and to make and this opplidation; that all statements contained in this application are true to the best of his knowledge and be and that t~e work will be performed in the manner set forth in the'application filed therewith. Swam to before me this~ ~-~ n ,,~ ..... ........ xdo ........ ...... , ~ ~ m.~ ~o~' ~' '~ ~ ~Zor t~'w '~.~ ....... ~.. -~x. u~..~ ;.... ,~,~,~.~ ..... ; Notary Public, .~.~..,~~ ............. County (Signature of applicant) ~0~0 pL,~,N oF pRoPERTY OF -'COLBY Fl. CHESTER FISHERS ISLAND- NE~ YORK ~C.,~LE: I"-' IOO FT. CHANDLE'P.. ~, PAL~,ER,~ K{NG, NOR. WICH, CONN. MOV 19'f2_ ,'1 .P --1 PAil ON/.. PLA N . _ DF&A'v"V 1 N Ii. -4 _Z_' ........ N,O_I:~TH F':~,ST_ 1~ LF___V,ATI ON ¸i" 7.- ............................ i , ¢ -j. 't / ..".'F_AVF_ AT_L V kid ROo_.~_?' HALL .__;D _A.~!~. f~ ,L-O ....