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Home My WebLink About9479-zFOB,~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No.. Z9.0./4. ~ ..... Date . .~Tlff~e... ~. ................ , 19.?~. THIS CERTIFIES that the building located at .2. ~5.0 .B.e.e.l~e. D~.~,¥e ........ Street Map No...~2. ~.0. ..... Block No ........... Lot No ........ ~ ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated . .O0~c.o.b.e.r....~ ....... , 197.7.. pursuant to which Building Permit No. 9./479.Z... dated . .0c.~cp.b.e..~...~. ......... , 19.7.7.., 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 ..... P~'.~.ye~.e..0~.e..F .am~.l.y...Dw.e].;l..~,r~g..w.l~h..~d~l;~.t.0n .................. The certificate is issued to ....... .J.o..bB...C....&. LJ,~].~,.~ ~.~:~f.e.r.~h .................. (owner~t) of the aforesaid building. Suffolk County Department of Health Approval ........... i~/R ..................... UNDERWRITERS CERTIFICATE No .................... ~I/.R. ..................... HOUSE NUMBER ....2.~.50 ...... Street ....... .Be..e.b.e..D..~.~.v.e. ..................... ............................................. .C.u..rob. o.b.e.,..N..e+v..York. ........... Building Inspector BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH.E P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9479 Z Date .............................. 0~ ......... -3- ....... 19...~.~ Permissi°n is hereby granted to: pursuant to application dated ........................................................ , 19 ........ , and approved by the Building Inq~c'tor. Building Inspector FOE~ NO. $ TOWN OF SOUTHOLD Buildlng Depa~tment Town Clerks Office Southold, N. Y. 11971 APPMGATION FOR GERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 farm or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance fram the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nan-conforming uses, or buildings and "pre-existing" land uses: ]. Accurate survey o~c property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to ~se, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...... z~..¢.¢ ...... ~.~./...~..Z~- New Building .................... Old or Pre-existing Building ....... ~ ................. Vacant Land ............................ Location Of Property ..~...oo,~e, ~Ue i3ee,~..~ k' z/e,, ,///--c-: oz2z/e Owner Or Owners Of Prope~y ..... .,~..a~:.~.~....C~....~..~/.. ...... ./., :. /. ./.'. .<.V. ....... 2'.'.~I*.....~Z.. ............... Subdivision ................................................................ Lot No. ~....~...... Block No ............. House No.~:)7~) Permit No. $...+..Z?.Z. ~ate of Perm~t~.C~&..ZZ....^pp,cant ~,..d,....~.~.'.'//,.~......~..C.,;.~.'..~ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .:~.'~ ..................... Construction on above described building and per~m.~, ~ all ap, pli~a~b~c, odes and regulations. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) 7~.'~/~ ~ Approved TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. ¥. 192 ~/ 19.../....:. Permit No. ~ ' ; APPLICATION FOR BUILDING PERMIT ~ Date .............. . .0..°. ~..°.~..e.r.... ~ ............ , 19..?.~ ...... ~ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicote to the Building~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets m areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance 6f Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept an the premises available for inspection throughout the work. e, No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shell have been granted by the Building Inspector. APPLICATION IS HEREBY MADE 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .............. ............ (Sigr~tur~ of applicant, ~//name, ,f~a 2~)' Beebe Dri(e ............ (~ '~ ,~hegu.e ~.,,.,. 1~¥,,,~ ,$9,~.5 ,,,,.: ............................... (/Kddress or applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. John C. and ~illian Sei£erth Neme of owner of premises .................................................................................................................................................... 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. ocat on of land an which proposed work wm be done. Map ................. Lot ................. Street and Number ...2,~5.C)...~f~.e.~...~,~..~.~f~ ................................................................................ ~L~.~C]O.Q~.~ ..... Municipality State existing use and occupancy of premises and imended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ~.si.~al .............................................................................................. b. Intended use and occupancy .................................................................. ,..~./ ...................................................... X 3. Nature of work (check which applicable): New Building'. ................. Addition ....... ~ ......... AlteraHon ................ Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... (Description) 4. Estimated Cost ~800. ~,,,, (to be paid on filing this application) 5. If dwelling, number of dwelling units ....N/.A ................. Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....N.../..A. .................. 2t ........ .~...2. ................... Depth 24 ............ 7. Dimensions of existing structures, Jf any: Front .........~. ................. Rear ........ Height ........................ Number of Stories ...... 1 ......................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 28' x 12' 8. Dimensions of entire new construction: Front .................................... t~eer ............................ Depth ........................ Height ...3...O.~.l.....a.P..P,.XN-mber of Stories ..................................................................................................................... 9. Size of lot: Front .............. .1..0.0..~ .................................. Rear ...q.O. ................................... Depth ..3.5.3..~. ..................... 10. Date of Purchase ....... J.9.7.~ ........................................ Name of Former Owner ..]~th~z'Ze,,~l~.~t~'~l~,,,l~Cr ............... 11. Zone or use district in which premises are situated ........ .O..~t..o...h..o...~...e.. ....................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .N...O. .............................................. 13. Will lot be regraded . .......N. LA. .............. Will excess fill be removed from ~)remises.: ( ~ Y. es ( ) No · Sei£erth 23~0 Beene ~rzve ~734-6928 14. Nome of Owner of premise~T.°...h..n.....C..:....&.....~..z...1..1...i..a.~ ............. Address .8t~.'8¢.~e~e .......... Phone N ........................ Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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, lc ¢ COUNTY OF ................................ ~'~ ................................................................................................. being duly sworn, deposes and says that he is the opplJcam (Name of individual signing contracf) above named. He is the 0 9¢A'/'(k~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 thaf the work will be performed in the manner set fo~h in the application filed therewith. Sworn tsbefore d~;tho~ ~ , 9J ~ ~ J ~ , ~, ~ Db .................................................. ................. .............. o, ................................ NI)TARY~U~IC, State of ~ew York No, 52.4643721 Su~fo/k Cou~ Term ~p res ~arch 30, 19~ /