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Home My WebLink About7891-zFOUM_ NO. 4 TOWiN OF $OUTHOLD BUrr.r~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z6(~ ...... Date ........... .87.p.~....~. ....., 19.?.~' THIS CERTIFIES that the building located at . .E/t~ .~ass&u. P.t .l~oa6 .... Street Map No,aSs,. P.t... Block No .......... Lot No..61 .... Cuteho~e.. }i,Y, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... P.a~ -~ 19-~.5. pursuant to which Building Permit No. dated ... . ...... .1~..y.. 5. .... , 19.~.~., 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 .... Prlv.~l;~..0I~e. ~.a_~. !~..dw~],ltng. with. l'.~taillillg. ~tali..~tc ....... The certificate is issued to ...D.l!gi~..l~.el, ...... .0W~e~. ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... .N.,.R.., ......................... .................... ................... · HOUSE NUMBER ............./7,;T Street....~....c~...~..~..~...~...~. .................. B ' ding Inspector FORM NO. 2 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7891 Z Date ........................ ~l~. ..... ~. ................ , 19.~.~... Permission is hereby granted to: ~..~.?......~.g...~..~..a...x... ~.~.~ ................. ............. ~.~..,.~.~ ............................................. to .~.!~.o.],~L..~.~.~..at~1~.~, ..;c.~ .~ .~.Alag..~a:L~ ................................................................................ al premises located at aT~te...~:L.J~.~J.(~.~13~.~.O~ tq~..~-~OJ~ ..................................................... ......................................... I/l//i..l~aasa~ ..... P. atnt..~oa~l.....l~~ ....................................... pursuant to application dated .......................]~]~ ............ ~ ........... , 19....~.~ and approved by the Building Inspector. Fee $..:J~[sl~J .......... FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............... ~.-...(...o.5 ..... , lg.~..~:PermitNo. ~"~/~-- A~proved .................................... Disapproved ~-..~...~. ~_.....~.---~ APPLICATION FOR iBUILDING PERMIT Application No ~....g~....~...~. .............. INSTRUCTIONS Date ................... ~.7.. ....... ~. ........... , 19. Z~.... a Th~s application must be completely filled in by typewriter or tn ink and submitted in triplicate to the Buildi[ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing location of lot and of buddings on premises, relahonsh~p to adlommg premmes or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatio~ c. The work covered by thru application may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector w~ll issue a Building Permit to the applicant. Such pern- shall be kept on the premises available for inspection throughout the work. e No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanf shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to t} Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herren describe The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessa~ inspections. William Beebe (Signature of apl~'licant, or name, if a corporation) ........... .Gmtcho~ue .............................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budd- buil~e~ .......... Name of owner of premises ..... ~]3,g~,]...~.Z:~.z~.l~ ......................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1 Location of land on which proposed work will be done. Map No ...... ]~[ft,$.~. ,~fg .............. Lot No .... .~.] ........... Street and Number ..~.~.~...~.~,1,1...~.~..~C~ ............. .C~tz~chO~te ............................................................... Municipality 2. Slate existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy ...... .C].1g.~l~q§ ............................................................................................ b Intended use and occupancy .............. .s..a.~.m..e.~..W.`~.i..th.~.r..e.~.a..r..~y...a..r...d.~..r...e..t...a..i...~..i.~..~.~ ............................ 3. Nature of work (check which applicable). New Bui~dmg ................ Addition ................ Alteration ....... Repair ............... Removal ............... Demoht~or ........... Other Work ...~.e.~&:J.D,iT~...~.8,3~], ..... (Description) 4 Estimated Cost .......................................................... Fee ..... .1. ~.t.0..0. ................................................................. (to be pad on filing thru applicahon) 5. If dwelling, number of dwelhng umts .............. .o...~..e. ..... Number of dwelhng units on each floor .......................... If garage, number of cars ........................................................................................................................ 6. If busmess, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 D~mensions of existmg structures, ff any' Front ....................... Rear ................................ Depth ................. Height ........................ Number of Stones ........................................................................................................... Dimensions of same structure with alterations or addmons: Front ................................... Rear ..................... Depth .............................. Height .......................... Number of Stones ............................ 8 D~mens~ons of entire new construction: Front ................................... Rear ............................ Depth .................... Height .................. Number of Stones .................................................................................................... 9. S~ze of lot' Front ........................................................ Rear ......................................... Depth ............................... 10. Dote of Purchase ..................................................... Name of Former Owner ....................................................... 11. Zone or use district ~n which premises are s~tuated .",~!~....E.i..~..t,.. ................................................................... 12 Does proposed construction violate any zoning law, ordnance or regulation: ..... ..~..O. ........................................... 13. W~II lot be regraded ..... y..e.~ ................ Wdl excess fill be removed from premmes: (X) Yes ( ) No 14 Name of Owner of prem,ses .D..~.~.a..~....?...zt..&...~..e.~ ..................... Address ...q.~..t'..~..°..t~...e. ......... Phone No ....................... Name of Architect ........................................ Address ................................ Phone No ...................... Name of Contractor ...... ?.'r...D...~.e..e..b.e. .................... Address .......0..~.?..~...o.~..1:1;.e. .... Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buddmgs, whether ex~st~ng or proposed, and red,cate all set-back d~mens~ons fron property lines Gwe street end block number or description accordmg to deed, and show street names and ind=catc whether mtenor or corner lot being duly sworn, deposes and soys that CTATE OF NEW Y~)RK~ ~-- [¢c EOUNTY OF ...... ~, .'~,. - ~-.0,, ..!.~.., ....... ~- ..,..-, .............................. Wm .E, ee.lae ....................................... (Name of ind~wdual signmg contracf) above named. hl~s the apphcon He is the .............................. D. QD, J~.cq.(~.~.Q~. ................................................................................................. (Contractor, agent, corporate officer, etc) of sold owner or owners, ond Js duly authorized to perform or have performed the sa~d work ~nd to make and this application; that al~ staCements contamed ~n th~s apphcat~on are true ~o Che best of h~s knowledge and behef; tha~ the work will be performed in the manner set fo~h m the apphcatJon filed therewith Sworn to before me thi,[vi .................. ~... day_of ./,. ..... ~ ..... ~..~., .... , 19 7~ ......... ............................ (Signature of applicant) JUDITH T BOK~N No}~ P~hc, Stale of New York No 52~3449o3 Suffolk Count}~ ~m~s~ ~plres March 30, I~