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Home My WebLink About3105-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTN~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ~oz 21+73 .. S~i~ 26 66 ........................... Dote ........................................................ , 19 ....... PVT R,O.W, Off ~/S ~ain ~.W E6a6 THIS CERTIFIES thor the building located at ............................................................ .......... Street Fishers Island Estates Fishers Island~ N.~ Map No ....................... Block No ....................... Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................... .~..~.~. ......... .~..~ ................... , 19..6..6.... pursuant to which Building Permit No3z05 Z dated May 26 , '9 66 ........................................................ i ......... was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ - P~l.V.~.~.e...~.~.,,1.~Bg ............................................................................................................................. The certificate is issued to Walker G. Buck~uer 0~er (owner, lessee or tenant) of the aforesaid building. FORUM 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? 3105 Z Permission is hereby granted to: F~ L Eft~l~.¢~..~....A/C.....~a;~.~.~'.~..~tte~r~ ............. ~... - - ..... ~.e~.e...~ ................................................... ...................... ~,h'~'~ ................................................. to Bttitc}-..~m...ad.ct:t J;$~'-'"o~" a~'"e'x~'s %fEn~ "d'~;,e'~'~ ........................................................ ct premises Ioca~ted at ....... ~I~'.~...B,,G,%f.~...ef.~...~/~.....y~..~ae~...t~..'~a~...~n~ ................... ............................. l~.~h~,~a... Z.~-~.em~l..-~.~.~et~es¥ ........ ~.~'~ ............................................................. pursuant to application dated ~ ' 19~,~..., and approved by the ......................... ~%y ....... t~ .................. Building Inspector Fee $...~tO ............ ..... ~...X.2;~.~:~.¥:."::;..~:; ......... .~,,~;~.::.V.:¥,:t~ ................. Building Inspector 1 IoOI~M ~l~O. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, NOTICE OF DISAPPROVAL File No ....................................................... Date .................. .... PLEASE TAKE NOTICE that your application dated ' ' ,~'-.-~.~ ......... for permft to eonstrueta..B_.l~.~O.f[.l;~..Ol:l ............. at thc premises located a~v..~g..~,.O.~,: ...... O~f..,~n..Rd...t o..Ea~ ..~ .............. Street Fishers Islahd Ma~ . .. ~j, .i.,.~;.S ~a~e.s ........... Block ..................................... Lot ....................... ~ ...................... is returnea herewith and disapproved on the followin~ grom, d~ .......... Ap~i~i~ ................. ~..,~ned o~ ne~a~z~ a~ ~ ~ ~nolcs.ad.. ................ Building FOI~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om,ned ........ Approved ........................... ~..~. ......... , 19.,~.~..Permit No..'~../...~.....~.......~,,.::~,... (Building Inspector) Application No. '~/ 0 ~' APPLICATION FOR BUILDING PERMIT Date ..... ~ ................. ~a.y....I.2~ .................... , 19...~6 .... 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 o 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 shah 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 o 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 Islsnd (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Genera I Con~rac~or Name of owner of premises ...... .~t~.[.~,e~'....G....Bu~krze~ ...................................................................................................... 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: ............................................ Lot No: .................... Street and Number ............................ [.i..~.h.~.~....L~..l..~qrl.d ......................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .D..w.e.J..I..j.n0 .......................... . ............ ;:. ........ ~.: ...................................................... b. Intended use and occupancy ...D.,e.l.~.i.no .................................. ~ ........................................................................ 4. 5. 6. 10. 11. 12. 13. L.ocat( property lb whether in! Natgre of work (check which applicable): New Building .................. Addition ....,~. ........... Alteration ...J~ ........ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................. Estir~ated Cost ......~. J..4~.g.g.g.~ ................................... Fee ...................................................................................... / (to be paid on filing this application) If d~velling, number of dwelling units ........... nne .......... Number of dwelling units on each floor ............... ......... If g~rage, number of cars ................... -..'...'. ............................................................................................................. If b?siness, commercial or mixed occupancy, specify nature and extent of each type of use ...... ':.-. .................... D~menmons of existing structures, if any: Front ..... ,~.~ .............. Rear ....3.~ ................. Depth ...4~7. ................ Height ..... ,?,.j..v. ................ Number of Stories ...... .T.t~l~....i ................................................................................ : .......... D~mbnsmns of same structure w~th alterahons or addmons: Front ...... ,~.~ ..................... Rear ..... 3.~. .................. Dap h ........... 3.?. .............. Height .....2] ..................... Number of Star es ..... .T, wo. ........................... Dim;nsions of entire new construction: Front .......... J.4 .............. Rear ..... [4, ................... Depth ....... [.2~...., .......... Hek, ht ...... J.9 .................. Number of Storms ....... T..~o .............. Size of lot: Front ....... 1.0~ ............ Rear ....... J~$D. ............. Depth ........... [.I.0G ............ Zon or use district in which premises are situated ............ ~..-.l~.~.i..~r~J~.i.~..I. ........................................ , ........ D~e: proposed construction violate any zoning law, ordinance or regulation? ........................................ , ......... Nam,'e of Architect J'J.u~...~o~e~, ............................. Address .Gu.i.l.£~,dr...Coan .......... Phone No. PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr es. Give street and block numbers or description according to deed, and show street names and indic ~rJor or corner lot. COUNTY ............ ........... ...~.. ~C~...~.~..~ ................................ being duly sworn, deposes and says that he is the applic, (l~lame of individual signing application) above narded. He is the ....~ ...................................................................................................................... j (Contractor, agent, corporate officer, etc.) of said owner or owners and is duly authorized to perform or have performed the said work and to make, and this applicption; that all statements contained in this application are true to the best of his knowledge and bell and that t,he work will be performed in the manner set forth in the application, filed therewi,th, Sworn to b'efore me this .... I f i'//~-/ .~, ........... .,......~..: ..... aay at ....Y.:.-r..-q__ ........... t~..L.~m¢~.~ ly.~:~.,..yu,~ ~"~. £. ' Z \ . ........................ ................. , ........ ..... Notary Pu~l,c, .~..~..~~y~:~,~w.m~,,~o nty (S g ature of applicant)