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Home My WebLink About5898-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z~87~ ...... Date ......... .0.C.~.. 26 .......... , 19.72.. THIS CERTIFIES that the building located at .. lq~l~..E.q,tto$~;r.~,al~. &~o .... Street Map No..~ ......... Block No. ~ ....... Lot No..xX ...FLs. hers..I$1&nd.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... /tpI,~.l-.-al.., 19..?2 pursuant to which Building Permit No. dated ............. l~&y...23.., 19..7~ 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 . .PlUo~I~t ............................................................... The certificate is issued to .... Hendr. L..Fer~uso~..ltusetm ......... 0~1' ....... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...P.$1X~g ......................... UNDERWRITERS CERTIFICATE No... pslad:~lg ....................................... HOUSE NUMBER..llOllO ...... Street ................ : ................................ // Building Inspector / FOB,.M NO. ~' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5898 Z Permission is hereby granted to: ........... ~J~r~..X~X~. .................................. ' ................... II.Xo ................................................... to .....J~...$.l.~....n.~:..~.s.~...~ ............................................................................................. at premises located at ....... JJ~-.~J~,eJl41~:~lli~..Jl,~ ......................................................................... ......................................................... r.i, aha~a..lz:l.a~ ............ I~.,,X.~ ............................................... pursuant to application dated ........................ ..~.J~'~,~,.....~ .......... , 19.~..~...., ond approved by the Building Inspector. Fee $....~-~ ........ ' ' BUilding Inspector ~ NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEyV Y(~RK 10038 13, 1~72 §01~02 Application No. on file N THE ~ bk Date THIB CERTIFIES THAT 54639 only the elect ' ' nt ' ' ' t o p ' ' bet ' t prem/~# u~asexamlnedon ;~ ~V~][flDer 0 ! [] 2nd FI. Ot~t 8 id~ Section Block and found to be in compliance with the requirements of this Board. b ~ 5 2 16 DRYERS mENACE MOTORS mTUEE APPUANCE I~EDEE~ AMT. K.W, OIL H.P. GA~ H.P. AMT. NO. A. W, G. RANGES ' SERVICE DISCONNECT I NO. OF I S E METER No OF CC COND TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS 2 EXHAUST FANS DIMMERS Fiuhers Fishers I~land Electric I:~land N.Y. 063P0 Per ~ ' ,, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examin ...... Approved .................... ~J. ........ :~ ........ , 19...'.'.... ~ 7~ Permit No ............................ Di~ppr~ed o/c .............................................................................................. ........... ................................ Application No......'.'~...~....~.. ,~.. ......... APPLICATION FOR BUILDING PERMIT Dote ..................... ~....~:.(. ......... , ~ ~..~ .... 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 property must 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 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 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, housing code, and regulations. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~enera~ Con~ractor Her~y L. Ferguaon ~useum ~ame of owner of premises ................................................................................................................................................... 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 ]~.queetr£an Avenue Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......................... ~.~ ............................................................................... ' b. Intended use and occupancy ~useu~ 3. Nature of work (check which applicable): New Building ...... Z. ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 20,000 $5 .oo 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 c~rs ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing 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 ................................ 40' 52' 26' 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height 15t Number of Stories 1 9. Size of lot: Front ...1...~..~...~..0...~. ........... Rear .................................... Deptha'...~....?..~..~......~:...?.....~..~...blai~;1;e([- October 1966 Nome 10. Date of Purchase ........................................................ of Former Owner ..R.~.~.~......'~....~..~....~.....K..~.I~.~.?..~..~..~.I~...~... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation? NO H~n~y ^ ~[~M~8~e~Address1~`~e~~?~[~a~?~*~ Phone No. 13. Nome of ~wner o~ premises .................... Nome of Architect ...................................................... Address ............................................ Phone No ..................... ~ . . W. J. Faulkner -,, Fishers Island,N.Y. ph~le~8.~.~.8...6.3 ....... Name of ~onrracror .................................................... ~aaress ............................................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~R~i ~ / [c,c COUNTY..~ ~ ~~____-~___OF ,~...1' ~"' · ...T..~ be,n dui sworn OS S ha (Name of individual signi~ application) above named. He is the ......... ~~ ................................................................................................... (Contractor, ag~t, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~d file this application; that all statements contained in this application are true to the best of his knowle~e and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to bef~e me this ~ , ~oto~ Public,~ ........... :~~~ ......... ,I :!