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Home My WebLink About3354-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFrCE SOUTHOLD, N. ¥. EIERTIFIEIATE OF FIBCUPANI~.Y No. Z .2961 Date December !~ , 19 ~7. THIS CERTIFIES that thc. building located at Crescent & Monta~k Ave Street Map No. XX Block No. ~ Lot No. X:K Fishers Is3~lld. R,Y,... conforms substantially to the Application for Building Permit heretofore filed in this office dated . NO~*, 2~ , 19 66 pursuant to which Building Permit No. 33~%Z dated J~n., 1! , 19 67 , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Religious. t~lild!ng .... -, Chu~eh ........................... The certifmate is issued to FIshe~s IsJ. ar~d. Iliqion. Chapel. ~o~iet.~ .... .0Mner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Ps~ld~.~g ..................... .... .... Building Inspector [ FORM 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? 3354 Z Permission is hereby granted to: .P...i..s..h...e..r...s....I..~.l..~...U...~;~l;~.~y....~.O.....~...~..~ Union Chapel ~ociety at premises located at ..~,l~l~t~3.~...~.,l~'Ltal,~lJC..JL~.e ...................................................................... Fishers Island pursuan$ to application doted ....................... N~I~'.....~-c~ .................... , 1t~3~..., and approved by the Building Inspector. NOTE APPROVED BI[ Bd Appexss Fee $...~...0..~..?. ............ SET of Pla~ reqtttred to be FOI~i~ NO. I TC~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.-Y. Application No ........................... Approved ...................................... ] 9 ........ Permit No ........................... ~... D~sapproved a/c .......................................................................................... ~ ....... .... .......................... ................................ APPLICATION FOR BUILDING PERMIT Date ..... A~ou. em.be~...zg., .......................... , 19..5.~... INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or m ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adloimng premises or public streets o areas, and giwng a detaded description of layout of propertymust be drawn on the diagram which is part of this application c. The work covered by this applicahon may not be commenced before ~ssuance of Building Permit. d. Upon approval of thru application, the Building Inspector will issue a Building Permit to the applicant. Suc} permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupano. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th= Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulahons, for the construchon of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all apphcable laws, ordinances, building code and regulations. E.i.,b.~r..~...t ~.l.e~d...tlt.i.[.i.~ y...C.e.,,....l[~c., ................... (Signature of applicant, or n~me, if a corporohon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................... ?......q ....L.c...o..n. .................................................................................................................................. Name of owner of premises ...l:.ishe~'.s...J.~i. aztd...tln, i.on.. C~hipe. i,..$o~=iety ............................................................ If applica~t--~ a corpo/'ate., si~ture f~ dul~/~,,uthonzed officer. (Name and title ,c~j~orporate ,~f~icer) Eober'~: M, L~elhot:t:,~.¥ic.e-Pr, esident: 1. Location of land on which proposed work will be done Map No ............................................ Lot No: ................... Street and Number .(~r. esc, er[t:..ancL.l~on~,auk..g.v, .... [.J.lil~.e.~..,.llJtzmd.~....T.o~,.,sa~...~osM;l~o.l.cl~ ....... Munic~pahty Suffolk Count:/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Ex~sting use and occupancy ...E..l~p.l:.y...~..J.eJI.d ..................................................................................................... b. Intended use and occupancy ..... g..h~lE.g.}~ ............................................................................................................. 13. Nature of work (chec ich applicable). New Budding .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... Est,mated Cost ...~.....~..0.~..0..0...0.~.0..0. ............................. Fee ....~ ...... J..0..,.~..0 .................................................................... (to be paid on filing this application) If dwelhng, number of dwelling units ....... ..%.'..'...'. ........... Number of dwelling units on each floor ..... '...'..'...'. .............. If garage, number of cars ...... .%'..%'...'. ......................................................................................................................... If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ....... -..'...%'t ................. D~mensions of ex~sting structures, Jf any: Front ...... .%'...'..'. ........... Rear ............ .'...'.~ ....... Depth .......%'..'. .............. Height ....... -...-..-..-...-. .......... Number of Stories .-..'t...-..-..~..-. ................................................................................................. D~mensions of same structure with alterations or additions: Front .............. ,-. ............... Rear ..... Depth ....... .-..'...'..-. .............. Height .......%'...'..'...'. ............ Number of Stories ....,-..-..-...-..-. ......................... D,mensions of ent,re new construction: Front .......... (~C ........... Rear ............ 6~f .......... Depth ....... ~..~ ............... Height .2..0..w .................. Nymber of Stories .......... .0. p.q. ........... ..... S~eeple 44 , ' e t Size of lot: Front ................... 4.~.3.. Rear ........ ~..~ ............. D p h ........ ~/.0...$4..~. ....... Date of Purchase ....N.~..v.~..m.~.~..~....L~.~.~ ...................... Name of Former Owner .E,...J.,,...IJ.C, LI.~.C.y...C.~,..,....I.n~, Zone or use district in which premises are situated .......... .R..~.~..i.¢l.~.~.~.i,~l.[ ............................................................. Does proposed construction violate any zoning law, ordinance or regulation? ........ .N...o. ......................................... Name of Owner of premisesF..,.J.,,.~llj.f~..gb,,~,.J...AddressF.]~beJZsj~.t~l.~'~d,.,H,.¥.,200 Phone No.?.~J~..',~..~.~.J~.. ....... ear/S~:ree~: , unar~es ~. ~n~ Addre s rt~,~.os:,d C=n Name of Arch tect ................................................... s .~J~ .... ,... ~ ........Phone No.$.~5..-.3.4.3.L Name of ~ntract~rF..".~!~:.~.U.~.~.~.~.~-Y..~.~..9.~*~.~.~1g.~AddressF.j.~/:'.'~a~d'~.~'~ ,Phone No. ].8~..-.~.~,5.1 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fron property hnes. Give street and block numbers or description according to deed, and show street names and indicat, whether interior or corner lot. I J J STATE OF N~ Yq~K~ ~ I -- COUN~ o~&~~ ............. ,~ ~'~' - , ~ ~ ~ ~.~ ............................ being duly sworn, deposes and says that he stheapp cm ~bo,, ..~ ,. ~. ,h~ ...Z~...~.~.=~:~ ...................................... (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 fi th~s application; that all statements contained in this appli?tion ore true to the best of his knowledge and belie and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this m .... ..... ................... , /// ............. X ~ ~ ~ ~. ~ ...... ~..~.g..g..:~:..~.c..~.~~2~ ..............