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Home My WebLink About3684-zFO~V~ ~0. 4 TOWN OF SOUTHOLD BUH,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy : Nay 27 19..~.? No. Z.76.8.0. ..... Date ...... ...................... , pe~ininsula-lit (Pvt; Rd),,. . THIS CERTIFIES that the building located at ..... ~ .......... . .............. ~ree~ Map No. Penn~s~l,a Block No ........... Lot No. 3~/~6 Fishers Island conforms substantially to the Application for Building Permit heretolore ~ed in this office dated ........... ~P~..a~.. r, 19..67 pursuant to which Building Permit No. ~6~Z dated .........~}.. !7 ..... , 19.. ~ was issued, an~ conforms to all of the require- ......... ments ol the applicable provisions o~ the law. The occup~cy for which this certificate is issued is .. P~ivatt .one..family. d~illing ........ ~ ............................. The certificate is issued to ... B~?F~ .~ ..... ~ ....................... (o~ner, lessee or ten.t) of the aforesaid building. Suffolk County Department of Health Approval ..,~ .~. ~.~...~, ~[ .~a .... 1976 U~W~[T~S C~[~Zd~ ~o ................ ~ ............................. Pe~zula ~d HOUSE NUMBER t~one Street ' TOWN OF $OUTHOLDi BUILDING DEPARTMEN~ TOWN GLERK'$ OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES .COMPL.~/'ION OF THE WORK AUTHORIZED) UNTIL FULL N? 368~ Z Permission is hereby granted to: ..........--- --- ~.~.~...~: ............... ~, ................... t°I ~ ~ · '1~'~" ~4~ · · ~ ~t~ ~" 4/,~ '~'~'~ ....................... i ................................................ : .......... at premises located at ....~/*~*.J,~,J~l~.& ............ Ol~.~-'g~..~'~ ............................................... ........... ~ .......................... ~1~..~;~.1~ ........... .~.~,.....~.i ..................................... : ..................... pursuant to application dated ....................... ~Jli~l~ .............. ~,~i ....... , 19~..., and approved by the Z.~~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONg a. This application must be completely filled in by typewriter o~ in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, ?elationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be d~.own 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 o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the p'rogress of the work. e. No building sh.oll be occupied or used in whole or in port for o6y purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment'for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, N~w York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, '.or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code and regulations. '. ........ .............. ........ ........... ..................... (SignC~ture of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, les~see, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of a" ner of premises ......~..?..~..C(...,,~,~..~..~.. ...... ..~....Q.../',.,Pt,.,~,~,~ ...... ,... ........................................................................... If appli i signatur of duly authorized officer 1. Location of land on which proposed work will be .done..Map No.: .: ....... , .............................. Lot No.: ...?....~....~...~....~ Municipality 2. State existing use and occupancy of premises end intended use,qnd occupancy of proposed construction: o. Existing useand occupancy .......... ~.~..~...~..~..~. b. Intended use and occup0r~cy · 3. NQture of work (check which applicable): New Building / Addition Alteration Repair . ................. Removal .................. . Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... 2./~..~...~.. ...................................... Fee ......... /.~. ............................................................................ (to be paid on filing this appUcation) ~. If dwelling, number of dwelling units .......... / ................ Number of dwelling units on each floor ............................ If garage, numbe~ of cars ...... ~4~.~ .......................................................................................................................... 6, If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... ~0~.~. ...... 7. Dimensions of exlstin~ 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 ................................ 8. Dimensions of entire new construction: Front .......... ~ .................. Rear ...... ~ ..............Depth .....~ .............. ' Height .....~.~ ......... Number of Stories ............~ .............................................................................................. Rear ......... ..................... Depth ....... Z.~ .'..C~.~C~ ~ 9. Size of lot: Front ...... ~.- ........... 10. Date of Purchase ........................................................ Na~e of Former Owner ........................................................ 11. Zone or use district in which premises are situated ......... ~.S..~ ................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~.~ ........................................... ~3. Name of Owner of premises ~¢~ ..~.~Address ,..~.~¢~.,..~.~?~.Q ........... Phone No ............... PkOT DIAGRAM koc~to de,rig ond distinct~ ~11 building% whether existin~ or proposed, ond indicoto oll set-bock dimensions {rom property lines. Give street ~nd block number or description ~ccordin~ to Oeed, ond ~how street n~mes ond indicote whethor interlor or corner lot, III. O COUNT OF ' ' .......... .I..~.~.,~,/')~,..,q..l~.~ .................................... being duly sworn epos~s and says that he is the app icant (Nome of indivicluol signing applicot)on) t~ , ' above named. He is the .......... ~..~....~..~....C..~.L..~.......?...~.[.!,~.~..-/~, ....................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have pe~rmed the said work and to make and file this application; that all statements contained in this application ore t~bg~ to,he be~t gf ~s~knowledge and belief; and that the work will be performed in the manner set forth in the appiicatig(n/file~tljere/;;~.///~/ .Sworn to before me thisr~- ..... ...... ................... , .......... ....... ............................. NOT~ ~'f P~-BL~C, STATE OF NEW