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Home My WebLink About4420-zFORM NO. 4 TOWN OF SOUTHOLD BIJ-ILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate O[ Occupancy No.~[ .~)~ ..... Date ............... ~'o'-' ~.~. · , 19..~ THIS CERTIFIES that the building located at . '~t~' ~ ............ Street Map No. ~ ......... Block No..~ ....... Lot No.. ~ .....I~. 8~£olk.. I.Y, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .........&~ ..... l~., 19.~ pursuant to which Building Permit No..~. dated ...........&~.. ]~..., 19.69., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .. l~l~ate. ~. f~$1~, dw~ll~ .................................... The certificate is issued to . .Ja~l & J~ .J&~obS ..... Ow~ .................. (owner, lessee or tenant) of the aforesaid building. .J~. · ~0~. 19.~0. -1~ .ii,. Viii&.. Suffolk County Department of Health, Approval Unde ito s 1853 98 House d~ 68~ ...... FO~M 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? 420 Z Dote ........................................................ , 19 ........ Permission is hereby CutohosUO to at premises located at ............................................................................................................................ ~ew Suffolk pursuan¢ to application dated ............................................................ , 19 ........ , and approved by the Building Inspector. Building Inspector 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 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 alteratlom, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Wm. Beebe (Signature of applicant, or nam, if a corporation) (Address of applicant) Name of owner of premises ...~ti~,QI~...~..~.PAT~..~KGI~ti ................................................................................................. ~ If ~licant is a co~e, slg~m of du~ ~Hz~ off,er. ~ (Na~ a~ title of co~ ~r) 1. L~ati~ ~ la~ ~ ~Ich p~ ~ ~11 ~ ~. ~ No.: ....~ ............................... ~No;: .~,~.~....,.,;,.:w st~ a~ ,,~r~.~L~.....~e~:gA~...~gA~ ............ ~..~.~.re~.'..'. ............. : ........ ,....:....~.:.'...j.::..::...':: 2. StYe exi~ing u~ a~ ~c~ of p~i~ ~ 'lnt~ u~ ~ ~ of p~ ~lm: ~. ~.~ ~ ~ ....... ,.,~.,~ .......................................................................... L ..................... ..: 3.Nature of work (check which applicable): New Building ~.~.~.~, ...... Addition .................. Alteration .................. Repair .................. Removal .................. ~ Dern0ii~ion.;.;..~;...~.i.. Other Work (Describe) ........................................ " (to be paid on filing this application) 5. If dwelling, number, of dwelling units ........ D13.~ ............. Number of dwelling ~un!ts on each floor ......................... If garage, number of cars ...........D~ ................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..................... ..;.... D~ear ~ ...... ~ ...... ~.....~ .......... Depth ............ L...~... 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 ....~)~r.: ............... i ......... P-,ear ..;..~.~ ................... ~{~ ........................ Height .................... Number of Stories ....... oz~e ........................................................................................................ , ~1 + 9. Size of lot: Front ....(~. ................... Rear ....; ....... 9.~ ................... Depth .... ~ .~.~.1- ................. 10. Date of Purchase ......... .1.9&.2 ..................................... Name of Former Owner ........... .~.......~.a...~..~..~.c...~. .................... 1t. · Z~he or use district in which premises are situated ........... ."..~..~....~..~..$.~. ....................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) .......... ~.~. ............................................ 13. Name of Owner of premises ,,.~m~..~O~*~B.~r. ;,~.*~ ............... P~ No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..~..m..t...~.e..e...b..e...i ........................... Add~ ...~i...'..i ...... C..1~..~...~..~...o.~.~...e. ..... Phone No ..................... PLOT Locate clearly and distinctly al! buildings, Whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according~ to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW' YORK~ tS.$ COUNTY OF ...~.13!',~O'1.1~ .......... ~ ' (Name of individuat signingapplicotion) above named. He is the C.o.D..tractor (Contmcto~ agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sqid work and to ma~e and file this aPPlic~tibn~' tha~ dil' statements c0ntoined in this aPPlication'are trim fo th~ besf of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed t~rewith. Sworn to before me this . / ~-, ................. of .................. .................. , ~,~_ a.,,~ tQ ..... ,O:h_.:.~... · .......................... ~..1~..~..~,..£...~i-....~ ........................ ~o. 52-8125850, Suffol~ Cou~t~ lerm Expires ~a,'ch 30, lge~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH D a t e ~z'/~ 0 Bldg. Permit No. ~(~-~ ~-- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give d~ed location) have been inspected by this department and found to be satisfactory. District Engineer RECEIVED 1~70~l/Iy II /11410:15 BEPARTMENT OF HEALTH RI,/ERHEAD c,JAME3 ~. ,4NO ulOA/V ,A. C,/ACOZ::3.--~ AT