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HomeMy WebLinkAbout1917-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ].763 No. Z ~ Date ~ovember 4 19 63 THIS CERTIFIES that the building located at ...]3.~.~.~...D~..~.'~'.~, .~.~..~.~.~t~ .............. Street bIoose Cove Mop No ....................... Block No .......... .?~ ........ Lot No ............. .-~..4 ................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated October ].8 I9 6:~ pursuant to which Building Permit No. ~; ]Lg].? doted ....................... ..O..e.~.o..t?...e.~...~.8. ......... , ] 9....6..P..., was issued, ond conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ Chris~ophe~ Rasmussen, owne~: ~he certificote is issued to ................................ ~ .................................................................................... (owner, lessee or tenant) of the aforesaid building. FOI~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.° 1917, Z Date ................ O~ t~]~l~.....~! ~, ............... 19.(~/,.. Permission is hereby granted to: Wm...Be~be..... A~.C.....~hr~ ~to~he~... ~asw~ssen ....... Cutatmg.u® ................................................... to ..S~td...mew..ome...f..am~.l.y..~lwe~.l.n~ ................................................................................... at premises located at ..get..~..t..5-_..~....~oese..geve .......................................................................... ................................................ l~ee~e...]~.~.vet. ......... (~t~hogue .................................................... pursuant to application dated .......................... Oo.to~l,......'l8 ........... 19.~2.., and approved by the Building Inspector Fee $.t0.00 ........... Building Inspector S-9 SUFFOLK COUNTY ~EPARTMENT OF HEALTH Date, .,Decemb~,r 3~ ,~.,96~ .......... Building Permit No.., 1917Z TO WHOM IT MAY CONCER~: The sewage dispesal facilities for a structure located at ..... ~/s Beebe Drive~ opp~t? Fawn Lanes Cutchogue (GiVe ............... deed location) have%een inspected by this DePartment and found to be satisfactory. District Enginee~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~...../..~......., 19..~.....z~- ,, Approved ....................... t..~. .............. , 19 ........ Permit No .............................. (Building Ins~(;r) Application No ..... . ./..~...../....~ ......... APPLICATION FOR BUILDING PERMIT Date October 18 19,6,,2, .... 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 applica- tion. 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 appliccnt; 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 pa rt 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 c~plicable Laws, Ordinances or Regulations for the construction of buildings, additions, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if ~ corporation) Cut chog..u...e. ............................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician., plumber or builder. .............. .c..o~r ac.~or .................................................................................................................... Name of owner of premises ....... ..C..~..$.$.~.0.RileI'..~asmusaen .......................................................................................... If applicant is ~ 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.: ..~o. os2..D.o~.e .............. Lot No.: ....~ ............. Street and Number ....~.e.~...D~.iW.e.~ .......... C.~.a~e ...................................................................................... Municipality 2. State existing use and occupancy ~ premises and intended use and occupancy of proposed comtruction. a. Existing use and ~cupancy ...... ~aaa~t ........................................................................................................... b. Intended use and ~cupancy ........... ~.~.~ .................................................................................................. 3. Nature of work (check which applicable): New Building ....... ~ ...... Addition .................. Alteration .................. Repair ................. Remora! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ~,.0.~.O..O..O ~he]~]_ ..................... Fee 10 (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... f)Z~ ............... Number of dwelling units on each floor ............................ If garage, number of cars ..............2 ............................................................................................................................ 6. If business, commercial or mixed occupa'ncy, specify nature a:nd 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 ........ ~..~. ................. Rear ......... ~...~.. ................ Depth ......... ..~..0.. ............... Height .............................. Number of Stories ....Q/'A~ ................... 9. Size of lot: Front ..... ].Q.Q ................. Rear .......... ~Q..O. ................. Depth ......... 3.~.O....~q../..~. .... 10. Date of Purchase ....]-..9..62 ..... Nam~ of Former Owner Mason & Beebe ! I. Zone or use district in which premises are situated ..... '~..~.L..rlis.t .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regu arian? ............. ~ .................................. 13. Name of Owner of prem ses ~: .~..~.s...~.l~.~..s..e...~. ......... Address ................................................ Phone No ................... Name of Architect .................................................... Address ................................................ Phone No ................... Name of Contractor W/~, ,~.~.9~.9 ................ Address ................................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly a!J 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. ST^TE OF COUN' OF ........... .............. )S.S. ............................... .Wm,,..l~e.eba ....................being duly sworn, deposes and says that he is the applicant (Name of individua! signing application) above named. He is the ................ aozttz'.aa.toz' .................................................................................................................. (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 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 (-~ ,, ~ ~"~"~ ~ ,--day of ................... Q.¢.~.O.~..~.,.T. ........ , 19..6.~,. ....... ~/lJ'""~'~J~'///'/"-I"~'"~/t"_ ~ .......... ...................