HomeMy WebLinkAbout1055-zFord~ I~0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. ¥.
CERTIFICATE OF OCCUPANCY
No....~...~..~1,~.. ....... Date ............................... ~l~.~ell~bel~.., .,~19..~0
THIS CERTIFIES that the building located al ..N/..S...l~a:tn...S.~...@..S.eaol~d...Sl; ......... Street
Map No, ~ ......... Block No...XX:~ ....... Lot No..:!CK....}te.~...g~c[~olk~......K,X, ......................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .................. Ap~.:l,1..... 2~....., 1~6.0.... pursuant to .which Building Permit No...~..~.Q~. ......
atecl ..................... 19....~.~, was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is
......... .P..~. ,i..V...a...t..e....~.W~ ...f.~J~ 3~....d~e. lling ...............................................................................................
This certificate is issued to ...~.D...a.~i;.~,.....L0~.~J, ...................... (.o.~e~.) ................................................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FO]~M 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? 1055 z
Dote ....................... A~:t]L,.,,~6 ............. 19.60..
Permission is hereby granted to:
William Beebe.....A/C.....Dab.ti.. ,I~ ..................................
(~mt;e,.,~c,~u~ ~..... ~ ,.~r., ..........................................
to .....~f~ 1~.. ~ev.. ~o.. £amily.. ~l&l,~ .................................................................................
at promises located at ....~/~t.....~.~..~.~.~ .~..~..~ ....................................................
....................................................... ~.. ~;J~'~e~3~ ~ ..... ~.~ ~r., ...............................................................
purse/ant to application dated ....... ........................ ~;~.~7,~ ........... 1~0 .... and approved by the
Building Inspector
Fee $ el,0*,O~. ...........
TOWN OF :SOUTHOLD PROPERTY RECORD CARD
OWNER
FORMER OWNER
VILLAGE
DISTRICT I SUB.
~/~-~
ACREAGE
TYPE OF BUILDING
I
LOT
RES. m~O SEAS. YE. ",.~,,.~ EARM. ,-. COM~. I 'N~. I C~. I ~,SC.
LAND IMP. TOTAL DATE x
NEW
Ferm
Tillable 1
Tillable 2
NORMAL ' BELOW
Ac re
Value Per Acre
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total ~
ABOVE
Value
M. Bldg. /~ ,~/~ -- /'D~
Extension
Extension
[×tension
_,cD
:oundotion
Basement
Ext. Walls
Fire Place
Both
Floors
Interior Finish
Heal'
-~, ;~ . Porch '- Attic
Porch Rooms 1st Floor
,-'Patio Rooms 2nd Floor
/Drivewc~
Approved
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
.
Permit No ................................
Application No ...... ~. ~...~..'..'~.>. ~Z .......
Disapproved a/c ...........................................................................................
APPLICATION FOR BUILDING PERMIT
Dote .............. ....................... ,
INSTRUCTIONS
o. 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 drown on the diagram which is part of this location.
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 ava.ilable 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 issua,nce 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 applicab e laws, ordinances and regu arians.
.... ......................................................
(Signature of applicant, or name, if a gorporation)
"' ' (Address of applicant)
State whether applicant is ~ner, le,,ssee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises..~~.........~...~,..~..', ...........................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name end title of corporate officer)
which pro osed work wdl be done. Ma No ............................................. Lot No ........ .~. ..........
1. Location of land on ., p ,, ~p
St reef and Number.. ZC/.~. ........ ~'~' ~"~'"'"'Municipality ''~''''' '''~''Z~'''' ~L ~.... '.'~. f. ...... ~.....~....¢~...........~...~..~....~.'.-.:.
2. State existing use and occupancy of premises and intended ,use and occupancy of proposed construction:
b. Intended use and occupancy ............ .~.~ ........................................................
property lines. Give street and block numbers or description according to deec
whether interior or corner lot.
3. Nature of work (check which applicable): New Building.,,.................'~ Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost ..~..?...)...Cr~r:~-* .................................... 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 ................ . ............ 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 ....... ~....(e. ............. Rear ~ (b Depth ~:~ O
Height ............................ Number of Stories ................................
9. Size of lot: Front I O O Rear ,/ O O Depth ~' O O
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
] ]. Zone or use district in which premises are situated ........................... ~. ...........................................
12. Does proposed construction vio~te or~ zoning ~aw, ordinance or regulation? .............. /...~.....0.. ...............................
13. Name of Owner of premises,,..~?...~_"' -~- .a-~ ............. Address ..~......~....~'.(~..~- '' '~ ...... Phone NO
Name of Architect .................................................... Address ............... _.~_~.___._, ......... Phone NO .....................
Name of Contractor ..,.~,....(~..~...,.Address ....~..~. .......... Phone NO .....................
PLOT DIAGRAM
Locate clearly and distinctly alt buildings, whether existing or proposed, and indicate all set-back dimensions from
and show street names and indicate
STATE OF NE~/:~Y,C~t~/r ) S S
COUNTY OF .~.~..~T......) ' '
............................ ¢../...i ........ .......................... be,ngdu,y
sworn, deposes and says that he is the applicant
(Name of individual signino application)
above named. He is the ..................~~ .....................................................................................................
(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 ~iJe
this oppJication; that al/ statements contained in this application are true to the best of his knowledge and belief;
and that the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this ~ ~l)lic, stere of New Yom
~ot~rv Public,~C~..{~[~.~ ........... County (Si~n*ture o* ~ppl,cont)