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Home My WebLink About4127-zFOBM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z. 3.611 .... Date . .October...25, ......... , 19.~9. THIS CERTIFIES that the building located at .Ha~zb.o.z. La. ac ............ Street Map No ............. Block No .......... Lot No..¢u~/~hoq~e.,...~e.w..¥.o?]~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...Nove~ube~ .... lB.,.. , 1968.. pursuant to which Building Permit No. 4!2.7 .Z. dated ...Nov~-aber..14, ..... , 19 6.8., 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 ...pz ~.x~.at~. one..fia~uil..y..d~ellinq ..................................... The certificate is issued to .. ~heshe~..o;c.l~.~k$ .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .October. ?.0.,.. 19.6.9,. Building Inspector tto~ae ~ ...920 Ha~'bo~ Lane FOE~ NO. 4 TOWN OF $OUTHOLD, BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~..3.6Z. ~ ...... Date ... O.Ctobe~¢... ~A~. ........ ,19.6.9. THIS CERTIFIES that the building located at Harba~: .;Dane ............. Street Map No ............. Block No ........... Lot No. Cu~hog. ue,. ~eu. ~o~k ......... conforms substantially ~o the Application for Building Permit heretofore filed in this office dated .. ,~9~... ~.,..., 19 ~.~. pursuant to which Building Permit No. 412.8. Z.. dated ...~¢~¢~...[~.,. · ., ~9.68~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .... ~.~. ~90~..~. ~X~g .................................... The certificate is issued to . ...Chez.te~. Q~X~eki .... ............................. (oWner, lessee or ¢enant) of ~he aforesaid building. Suffolk County Department of Health Approval ~tobe~ .......... ...... t ..... House % 1920 Harbor Lane FOR~ NO. 2 TOWN OF $OIJTHOIJD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, BUILDING PERMIT (THIs PERMIT MUST DE ,KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WOR,K AUTHORIZED) N? 127 z Permission is hereby granted to: ..................... ~..~.t,.e.b.~ ..................................... to .~l~J,],d..ne~..~...fe,~i,~..~e2~l,~;. at premises I~ated at ~/~ ~OF ~ pursuon~t to application dated NO~ ~ .. , 19..~, and approved by the Building Inspector. Fee $..~.0..~, .(~. .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTR Permit No. ~1.~,'~.;~ ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities fo~fa structure located (Give deed location) '/ have been inspected by this department and found to be satisfactory. Dist-,ric% E~.~fn~ ~z~ District Engineer ~ 19..!.!.. Permit No. ~ Approved ........................................ , Disapproved a/c ....................... ~ ..,..~.~ ....... ......................................................... . ........................................... , ............... /~a I ?~ APPLICATION FOR BUILDING PE~I~, ............................... , 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 pr.emises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this application. c. The work covered by this application may not be commenced before issucmce 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 part for any purpose whatever until a CerUficate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HF-~EBy 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. "- '*"'*i (S~g~a ure at applicant, or name, if a corporation) (Ad~ of applicant)/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of.duly authorized officer. (Nome and title of cOrporate officer) .~..~..~~. 1. Location of Iond on which proposed work will b~one. Map No.: ..... Lot No.: ....... . .... Street and Number ...~ ..................................... ~...~ I..~'JJ.:..~., .............. /~/ e/~ ~ O Muni~pallty / 2. StYe exi~ing u~ and ~ou~ncy of promises and ~~ and ~cu~ncy of p~ con~mction: a ~i~tl~ ~ a~ ~cupancy ..... .............. ~-.~ .............. ~ ........... ~ .... 3. Nature of work (check which applicable): New Buitdlng .;...,~, ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demoliti(~ .................. 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 ...~:T3t~:w~ ......... If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and 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 ................................ Rear ...... ~, ....(~.. ........... Depth ..~../. .............. 8. Dimensions of entire new construction: Front ....... ....~...~....( .............. Height ...~.. ........... Number of Stories ...... ~ ............................................................................................... 10. Dote of Purchase 11. Zone or use district in which premises are situated ...(~1~..~1~.../~.~"~..~;'~;.~ 12. Does proposed construction vio~lat~e any zoni~ncj law, ordinance"~0 or regulation? ...... ~ ................................. Name of Owner of premises dress ........ Phone No~.~.~.,-.'.(,~..~ Name of Architect ..................... ~......¢:7..>.....~ ...... ..~.....;.Address ............................................ Phone No .......:~ ........... Name of Contractor .................. ~..~....-7.. ........ Address ! 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 comer lat. ·r ! STATE OF NEW YORK, ! c ¢ .... ,. (Name'of individual sign~ 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 o~d 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 before me this , ~ .... ..............