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Home My WebLink About5274-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southolcl, N. Y. Certificate Of Occupancy No. I~9.~. ...... Date .............. .P4~Y....1 ~. ..... , 19 .~.. THIS CERTIFIES that the building located at .. (~,e~tal .i1~ ............ Street Map No. xx ......... Block No... xx ..... Lot No.ll~X.. Fishers. Island..II,Xe... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... April .... 8, 19. ~.l pursuant to which Building Permit No.. dated .......... Ilar....3 ......, 19..7.1, was issued, and confoms to all of the require ments of the applicable provisions of the.law. The..'occupancy for which this certificate is issued is . lal~i,a.i;e. 91lc. l~llY..cI~re~L:LjLI~...(.E.&~..e.e.t..t.ai:e. ) ................... The certificate is issued to . Patel'. Rega~ .... lltlnelP. ......... : .................... : (owner, lessee or tenant ) of the aforesaid building. . Suffolk County Department of Health Approval ...... lq,l~, .... UNDERWRITERS CERTIFICATE No. p~tndil~ ............... : .................... HOUSE NUMBER .............. Street .......................................... ,, Building TOWN OF $OUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRF. MISES UNTIL FULL COMPLLmI"ION OF THE WORK AUTHORIZED) 5274 Z Permission is hereby granted to: ............... ~.&t~e~...~e~ ..................................... ...................................... to ~Ila.~L · ~1, · ~J~. Lt, ~,~,-. ~a-. 4aG~ ab ~.. ~e~ .~..,~i~ ............................................................. Oriental ¢ .~..,s~e~ at premises located at ......... ~ .......................... ~ .................... ~ ..................... ........................................... · ~l~.a..~.a~ .............. J,.~., ........................................................... pursuane to application dated ............................... AJ)~'.J,J,....~; ...... ;.., 19...~/.$, and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Exomined ..... ..~~ ~ 19..'~..I SOUTHOLD,, N. Y. · .., ....... Application No.......~....~....7.....c~.. ...... Approved ........~.g..k~7;'~.......~. ......... ,19.?.....(..Permit No......~...~....2~...~. APPLICATION FOR BUILDING PERMIT Date ................................. , ...... 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 tkept on_the premises available for in. spec, tion throughout the progress of the work. e. No building shall be occg~ied or ose~'in whole o~'~ pOrt,T ~e~ a. qy~lurgo~e~~h~atever until a Certificate of Occupancy shall have been {~ranted by the Building InspectOr. '., ? ~. ....... . --_ _ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone O~'dinance of the Town of South~d, Suffol~ (~ou~ty, New York, and other applicable LawsJ Or, dinances or ~lo~icm~, for'the construction of buildings, ~dditio. r~,"or'dlte}atiens, or for removal or demolition, as h~re~n described. The aoplicant agrees to cor~ly with all appli~a~'T~' laW~, ~°rdinances, building,~lode and regulations.,, ":'~" " , ~, '~ I t---, ,. :......,..: ...... :~...~;..~ ............. .~ ~-~-. ,, - T .... i . . "' (Signature of opplicant, orname, 0~a~o~o~tion) ..._t___. ......... ~. ................................... ~.*..~....~.,,,. ................ i I1__-~.-~. (Address of applicant) State whether a~plicant is owner, lessee, agent,~architect, ehgineer, general contractor, electrician, plumber or builder. ' O ~/e-'~ ' Name of owner ~f 'Pr~mi~es .-'~ .8~ ........ ~.~ ......................................... ~ ................................................ If applicant.is a corporate, signature of duly auCJaSrized.~f,~er. _~ · .................................................................................................(Nome and title of corporate officer) '' ''~e~ -~,~l~--~'ZA~z~?'~O~l~'~ /'~l~e~r,~ ~ 1. Location of land on which proposed work will be done· Map No; ............... ~. ......................... Lot.No;. .................... Street and Number ........................................................................... .~, ......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: s...o~..~, ~.~, - u~.~ .~ . ../..~.~ .... o. Existing use and occupancy ........................... ~ ............................... ~. .... .~. ..... ./~... b. Intended use and occupancy ............. ~.~.~'.. ..........~..; .......... ~ .......................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ....,,~'. ......... Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ........... ..~.~..~.¢:?..,~... ............................... Fee "~'~-~-" ......... - ~. (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 business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front .......... ~,~D ......... Rear ........ ~...~.r. .......... Depth ...~,c~.(. ................. Height ......... ~.~, ............. Number of Stories ....... J. ..................................................................................................... Dimensions of same structure with alterations or additions: Front ............ .~..O.. .............. Rear ....~..o.. ....................... Depth .......... ~..z~./. ............ Height .............................. Number of Stories ....... / ............................... I ......... ...~.(. .......... Depth ...~.~../. ................ 8. Dimensions of entire new construction: Front ......... ..,~. ~. ............ Rear Height .; ......... ../.~..../. ........ Nu~l~er of Stories ...... /. ................... 9. Size of lot: Front .......~,.~.a~...~. ....... Rear .......... ~..~../. ....... Depth ........ J/...~'..g. .............. 10. Date of Purchase .............. ---./..?./(~ ............................. Name of Former Owner ...... .~'...~../~......./'/T..~...~'./~d ................. 11. Zone or use district in which premises are situated ...... .4~./. ................................................................................... 12. Does proposed c~tructig~n~ ~vi,o~,at~,any zoning law, ordinance or regulation? .....~'.~ ..................... Name of Architect ...................................................... Address t .................... ..................... 1. ...................... Phone No. Name of Contractor * ~ .................................................... Address ............................................ Phone No .......?. ............ PlOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior at corner lot. COUNTY OF"...~' (.ome of ,ndiv,d-a, above named. He is the ..... ~:.~...: ......................................................................................................................... (C~ ....-=-...,' c:~:r:t: :ff]~, ~.) of said ~ner or ownem, and is duly authoriz~ t&~f~m~v~r~rmed the said work and to make and file this application; that all statements contain~ in this application are t~e to the best of his knowledge and belief; and that the work will be performed in the manner set forth ~ ¢he~ appli~tion filed therewith. Sworn ~efore me this A , ' .................. ..... ~.. ) / .~ ~ . ~.~:.~._;;: ..... : ....... ~. ....... ~ .......................... ~ota~ YUDnC, ..~ ..................... ~'~'~" L~,P~lic, State.~.~ew ~nature at appl,c~t/ ~ ~ ~ ~ I *~ No. 52-95u~ma