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Home My WebLink About2018-zF~I~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THIS CERTIFIES thor the building located at ....... ~/~-.~,~l~tt..j:~,l~t.-~o&d ............ Street conforms substantially to the Application for Building Permit heretofore filed in this office dated~' dated ................................ .AJ:~..'I. ....... 3'" 19....6~j was issued, and conforms to all of the requiremen{s of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ....... The certificate is issued to .......F/..:S.;....~TOI~.e!~h..Te..~OTr2T~.....: ........................ : ....... {)wt~e~ .......... - cowner, lessee or tenant) of the aforesaid building. FOK~I NO. ~ 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,° 2018 Z Date ........... &JJJ'].~L....4~ ........................... 19.6,~.. Permission is hereby granted to: t/~. Beebe....Jk/C..i~s... ~ose~h...~o~ ..... ............ Cntchc~ue .............................................. ~o · .~u;~.~.d...a~ ..a~d~.t .~ ..o~ .. ~n..~x.~.s *.$r~.. ~ t.~.~r~ ....................................................... ~t premises Iocated at ...... .~.Gt...~4~ ........ l~s~a~..Po.l~lt...e.l, ul~..pr~ ........................................ ............................................. l~a~sa~.-~.~t...Roa~ .......................................................................... ...................................................... C~te.ho~.u~ r ,... I~. Z.o .................................................................... pursuant to application dated ............................ il, p~';1.~....;~ ................ 19.~.~.., and approved by the Building Inspector F~e $...~,OO ........... Building Inspector / FORi~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ......... Approved ........................................ Disapproved a/c .......... ...................... i/~ii~ii~;~"iW;~';;i~ ....................... App,cat,on .... APPLICATION FOR BUI~.DING PERMIT Date .................................... .:~,~....., 19~.....~... 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 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 po rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA,DE to the Building Department for the issuance 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, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. .... ................................................ (Signature of applicant, or name, if a corporation) .. ........................ ........................... ;"i'~;:i~;;;;;';;~"~'~'~i'~i ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pIumber or builder. ........................................................................ ....................................................................................... Name of owner of premises'~J./~,~..L..~D~....: .~.~( .~..,~/~--~ ............................................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) ~,_ .~.~¢..~, ~ .. ~, . .~. ]. Location of land on which proposed work will be done. Map ~u .......................................... L.or p~o ...... :5.:~,., ........ Street and Number .....~./.~.~....~Z.~.~'Z......~..~..:....~.f:~'-.~ ............ .~.~..~..~..,~.'d',,~....~.~,~.. ................................. / / Municipality/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy .............. ..L?..~....~.....~..~;t~.:~..~,/.....C~.L~).~,Z'~,.~..¢ ...................................................... / (.. 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 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 ......... .z"~2.,~.. .......... Rear ........... /..~ ....... Depth ......~.~ ............... Height .............................. Number of Stories ............/ ................ 9. Size of lot: Front .............................. Rear .................................. Depth .............................. 10. [)ate of Purchase .......................................................... Name of .Former Owner ........................................................ 11. Zone or use district in which premises are situated ................. ~.....'T..x(~-~.~[ ............................................................... ..:;~. 12. E)oes proposed construction violate,~,,, -- , ~ ~,,any zoning law, ordinance or~)_~_,cregulation? ......... 13. Name of Owner of premises/.//~?.~'~.~. /~ddress ...(.,~¢~..~.~'~..~....~'...~r~.... ............ Phone No ................... Name of Architect ..............z,J~/z~- z-' / .~......,¢..~.,./~..~./.~'..Y....-~v.../____, Address ...............................................-- Phone No f Contractor ...................... ............. dress ....................... Name o ~----~. Ad ?./~......~- ............ Phone No PLOT DIAGRAM Locate dearly and distinctly ali 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 NE~/V,/~'~D~I~/'~ ) S S COUNTY OF ~., ...... ) ' · .................. ~/.~./.~../~.../.~.~..~'.'~.~.~...~_~ ................................... being duly sworn, deposes ond says ,hat he is ,he applicon, (Name of individual signing 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 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 be~ me this -- ............ ............. ..........., ~'/. . ~ ~.~ ~ ~ ,~,,..,,..:.~:,,~,,::.~'.'~..(_.f/.:....Z..~ ............. Notary Public ..~....~..~~,.~o~2~s2'°~476a, sufr,l~ ~5'l~ature of ~pplicant)