HomeMy WebLinkAbout1453-zFOI~M NO. 4
TOWN OF SOUTHOLD
i~UILDJHG
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..... ~.J~...~,p~.e..~ ................................... Street
Map No..~..?....?..~...~.~.~.... Block No ....... ~ ......... Lot No..~.~.t......(}~.~)D.~.~.~...~'~,~ ....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.......................................... ~.~1~. .... 2.0. ..... 19.~1.. pursuant to which Building Permit No..,~L~..~..~...
dated ................................ ,TllI'l~.....20.., 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 ..........
...D~iv&te...one..~amil~..~w~llir~ ............................................................................................
This certificate is issued to ...... .~...~.~.fj~r~..~.~..,~;.e.~,,(~.~ ............ ~, ...............................................
(owner, lessee or tenant)
of the aforesaid building.
FOEM 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.° 1453. z
Date ...................... .~.13D,~ ....... ~,.Q ............. 19.6...~....
Permission is hereby granted to:
Doug"]~eebe"&-- ~,o~-... A/C..2e~}..~e~eham ......
to ...-bui'td...a~..add.i.t i~ ..o~..a~..ex~.s~..~wet.l.$n~ .....................................................
at premises located at .....].o~..~,..~..~ie~ ...............................................................................
........................................ ]I/8--.-.~ai~:],.e.-~&~ ...... gx, eer~po~t ..........................................................
pursuont to application doted ............................... ~'1.1~e.....~0 .............. ]9.6],.., and approved by the
Building Inspector
Fee $~00 ..............
Building Inspector "~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ......... ...> .~.~.~.......~.~J... ] 9..
Approved ........ .'.i~.~?....~x.-...~?.... 19 ~../Permit No .......~'~../.., .~...~...~..~......
Disapproved a/c ..............................................................................................
........ ..................
(Building Inspector) ~.~
APPLICATION FOR BUILDING PERMIT
Application No ..... ':/~7 .......
{NSTRUCTIONS
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 location.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this oppllcation, 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 Buildin,a Department for the issuanc.e of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or
Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, os herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
~ouglas Beebe & Son
(Signature of applicant, or name, if a corporation)
Cutchogue, New York
(Address of applicant) '
State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Contractor
Ben~ amin Ketcham
Name of owner of prem,,s,es .................... ,~ ...............................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
................. ('l~'~'n~"~d title'~:l:"J'~'r'l~'J'~¥2 ~:['i'~i .................
1. Location of land on which proposed work will be done. Map No:E...~..t..,%..9.~..,?..~..9..~...a.~..-P.?..~?~ot No: ...... .~..~.. .........
Street and Number~../.~....~.:.a.?.?Z.?..,..S..t..~.e..e..'~'~...'G...~''e'''e.'~'~'O''~'~' .......................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ............................. .O...~..e....?...a..~..~.Z.~...~..~.?..1..~..i..~.~l'. .........................................................
b. Intended use and occupancy ............................ '.'. ............ i'. ............... '.'. .......... ?./.....a..~.~..'.z..~..'.z..o..~.. ..............................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. I=stimated Cost.,,,,~,,5,,,,.0.,.Q.O_:.0.,0. ................................... Fee ....~..5..:..0,.0. ....................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ........1. ....................... 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 '1
Dimensions of same structure with alterations or additions: Front 30' Rear 21'
Depth 58 ' Height .............................. Number of Stories
8. Dimensions of entire new construction: Front .......... .~..0..'. ........... Rear 30' Depth 26'
Height ............................ Number of Stories 1
9. Size of lot: Front 50' Rear 50' Depth l§0'
10, Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises ore situated ........ ~.~.A.?...~.e.~..L.¢..e..~.~..$.~.~,..,~....,~.,cJ,,~,~,~,q,r..~...]: ................
12, Does proposed construction violate any zoning Iow, ordinance or regulation? .... .~...O. ...........................................
13. Name of Owner of premise~..¢..~.J..~...~..i...q.~.e..~..~.~...~..~...Address ..~..~P.~ff...~.~..:.~.~.e.,.e.~.°.,.Z'~one NO .....................
Name of Architect ........................................................ Address ............................................ Phone NO .....................
~ ~ Douglas Beebe& Son .,, Cutchogue
Name of tontracror .................................................... ,~aaress ............................................ Phone NO .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW YC)RI~, ) S S.
COUNTY OF ...8..~..(~.o..~.~. ..........
.................... ~.J..~..e.¥.....~..e...e.~,,e. ....................................... be ng dui~ sworn, deposes and says that he is the applicant
(Name of individual signing application)
abow~, named. He is the ................. ~.o.~.r..~.a..~.o,~ ...................................................................................................................
(Contractor, agent, corlSorote officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
this oppllcation; that all statements contained in this application ore true to the best of his knowledge and belief;
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×omined ........... ...~,~,~ ~ ....... ~.. 19 ........
/ ~-~I?.~ ~ ~0 19.~Z..Permit No ~/~
Approved ........... ~ ........... ...............................
Disapproved a/c ............................... ~ ...... ~ ....................................
(Building I nspectod/~z-~
APPLICATION FOR BUILDING PERMIT
Date .............................. ~....~..~..e.....~...0. ............. 1 9.. G.~. .....
INSTRUCTI0i~ .... ~
a. This application must be comple/:ely filled in by typewriter or in ink and su~omitted 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 port 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 available for inspection throughout the progress of the work.
e. No building shall be occupied or t~sed 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 a Iterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
~ouglas Beebe & Son
(Signature of applicant, or name, if a corporation)
Cutchogue, New York
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Contr&ctor
Name of owner of premises Benjamin Ketcham
If applicant is a corporate, signature of duly authorized officer.
................ il~ame and title of
Est. Of Thomas ~rl~e. 44
I. Location of land on which proposed work will be done. Map No: ............................................ bar No: ..................
,, . n/s Maple Street, Greenport
Street and ~Numaer .......................................................................................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
One family dwelling
a. Existing use and occupancy .....................................................................................................................................
" " " W/ a~dition
b. Intended use and occupancy ................................................................................................................................
3. Nature of work (check which eppllcable): New E~uilding .................... Addition ....... X.. .......... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost.....$5.,.ID.CI0,~.0.0. ................................... Fee ....~Ii[,.0.0. ..........................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .......iL ....................... 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 ...... 2], ................. Rear ..... 2iL.~. ................ Depth .....~.~ ...................
Height ............................ Number of Stories ...iL ...................................
Dimensions of same structure with alterations or additions: Front ....... 3.0..~. .................. Rear ~iL! ..............
Depth .....~..~1..~ ................... Height .............................. Number of Stories ...........~ ...................
8. Dimensions of entire new construction: Front .......... .~.O. ............. Rear ....... ~.0. ................ Depth .. 26~
Height ............................ Number of Stories ,1.
9. Size of lot: Front 50' Rear $0' Depth '150'
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are s tuated .......... lll,....lt,~ll~.;I,(;]~lll~.;I,~l,1,..&..AglC~t,~iL.t,.tl;I;'ll,~ ................
12. Does proposed construction violate any zoning law, ordinance or regulation? .... ~.0. ...........................................
13. Name of Owner of premisedlilttll~J~Z0~..~lt.~fl~ll~.Address .~lllli).],e...lit.~,.,,.~tl;'.e. etl~l~,~l~one NO .....................
Name of Architect ........................................................ Address ............................................ Phone NO .....................
ougiLa~ B~ebe & ~on Cure, ague Phone NO.
Nome of Contractor.. .................................................. Address ................................................................
PLOT DIAGRAM
Locate clearly ond distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW YORK., ) S S.
COUN'rY OF ..~U~.~ ......... )
......................... ~..~...~...?.~....~...e..~...e.. .................................... ;.....be ng duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ................. .~9~g.~g~ ...................................................................................................................
(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 file
this application; that all statements contained in this application ~re 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.
Sworntobeforemethis ~otery pub,, ~.' ~ ~¢' ~"¢~f applicant)