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Home My WebLink About3027-zFORM 1~O. 4 TOWN OP ~O~rI-IOLD 'fOWN CLERK'S OFFICE SOUTI{OLD, N. Y. CERTIFICATE DF OCCUPANCY THIS CERTIFIES that the building located at .... Smith. DI':L~e, Nor.f~h ..... Street Goose Nec~ Estat~ . Map No ............. ~oct~ No ............. Lot 1~-o. 8~.86¥ '~87. · Sou'tho~dw .N,.Y., · conforms substantially Go the Applicati~on for Building Permit heretof, o~e fried in this office dated .......... ~{al'~h...2~..., 19~. pursuant to which Building Permit No. ~02~..~,. dated ........... ~l~l'~h. ~..,., 19~., was issued, and conforms to ail of the require- ments ,of the .applicable provisi.ons of the law. The .occupancy for which this certificate is issued is ...Priva.te. o~e. 2amily..dwelling ........................................ The certificate is issued to .Fc~ste.1~ .B~ei.tenbecker. .......... 0w~er. ............... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appr, oval. .A~t~US.~ ...... 39~6 .. by .l~,Vi;Lla .... Building Inspector FOI~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERICS OFFICE $OUTHOLD, No y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3027 z Date ........................... ,J~a~O~....~..] ........... , 19~6._ Permission is hereby granted to: .......... /~t~t;ehog.,ae ................................. : ..... to :~n~.:Ld. ne~z ~e ~;t.~. ~ ,~e~.~.$r~ ........................................................... ot premises Iocoted at ..... .~..~'.,.8~...~..8~....~oo, se...]~te~..]~; ................................................. ........................ ~/~ .... ~,~.~.t,~...~L~z, ~,,~ez~h ¥ .....~z.~ho~c~T ...~ ~.¥~ ................................................. pursuant to application doted ........................... ~L~.Z~ ....... .~. ........... 19~..., and approved by the Building Inspector Fee $...]:.(~.(~) ......... Building Inspector '~ FOI~M 1gO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................ ..~...~. ................. , 19. . Approved ........................................ , ........ Permit No ............................. Applicotlon No, -~ r3~- -~ (Building lns~fector) APPLICATION FOR BUILDING PERMIT ,. ~ ......... .... I NSTRUCTI ONS 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 o detailed description of layout of property must be drawn on the diagram which is port of thi~ application. c. The work covered by this application may not be commenced before issuc.nce 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 port 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, b~ilding code o _,,~d, regulations. (Signature of applicant, or name, if a corporation) ............. .......................... (Ad~i~ess of opplicant~' State whet~e~'applicont is~wne~]~ssee,~?gent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~Q.~. ~ 1. Location of land on which proposed work will be done..Map,No.: ........................................Lot No.~'..~..:..~.]~.~.~'...~ Street and Number .......... '~..~/.~.~..~ .................... ~~~ ................................ Municipality 2. State existing use and occupancy of premises and intende~ use and occupancy of proposed construction: a. Existing use and occupancy ....... ~ .... ~....~ .................................................................................. b. Intended use and occupancy ......... ~..R~..~..= ................... 4. 5. 6. Nat~Jre of work (check which applicable): New Buil~ding ,4 ............... Addition .................. Alteration Repair ............. :L~' Removal .................. Demolition .................. Other Work (Describe) ........................................ Estir~oted Cost ....,~...~/~...(....¢~.....,..~ ........ Fee ....... /.....~...L..~....¢~... .................................................. ............. (to be paid on filing this application) If veiling, number of dwelling units ............ /......' ........ Number of dwelling units on each floor ,,,. ,~', ..................... If g.~rage, number of cars ............................................................................................................................................. if 'usiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dim' nsions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dim~ nsions of same structure with a,lterations or additions: Front .................................... Rear ............... ............. Dept ~ ................................ Height ............................ Number of Stories ................................ ] Dimensions of entire new construction: Front ........ .'9~...~... ............... Rear ..... ,~....~... ............ Depth 2~ ~ ............ Height- ./. ~.. ~ Number of Stories Size ,Iof lot: Front ...Z.&.~....~.~.. .......... Rear ........ /..~..~.....~.., ............. Depth ...... Z..'-~.?....'~....~..' ......... ~ ,_/, ,¢ DateI of Purchase ......./...~..~..~.. ..................................... Name of Former Owner .....~.-..,-~...~.?.~?~z,d ~ ..... Zon~t_or use district in which premises are situated ...... /~.,,~.......-m. .................................................................... ~ Doeslproposed construction violate any zoning law, ordinance or reguJation?~,..,J~'~.....'7~.. .............................. ............ Name of Owner of premises .~.~.'..~.Address .~..~...~..~...~..'..~../.XJ~h~n'e No ......... i ............ Nam~ of Architect ...................................................... Address ..... '5 ..................................... Phone No ......... I ............ Nam o, Co,troctor ......... Address PLOT DIAGRAM ~learly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from ,'s. Give street and block number or description according to deed, and show street names and indicate 10. 11. 12. 13. rior or corner lot. Locate property lin whether int~ or owners, and is duly authorized to perform or have performed the said work and to make and file that all statements conta:Jned in this application are true to the best of his knowledge and belief; and be performed in the manner set forth in the filed t (Signature of applicant) Notary Publi~ of said owne this applicati that the work Sworn STATE OF~Z~/'~ ~/~,~''~l<''//' ,~ ~ tSS COUN iT F ...... ' ' ....... . .~......~...,,~~~..t.~~, .......................... being duly sworn, deposes and says that he is the apl~licant (N ~me of indiw~i~uol'~]n~g"~p']~otio~)-,j ~, above named He is the ............. '~J~,,,~...,.~.~..~ ......................................................................................... i ......... " (Contractor, agent, corporate officer, etc.) '