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Home My WebLink About5321-zF01~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ..l~/li .liar. bot. La .......... Street Map No....X~. ........ Block No....X~ ..... Lot No .... ~....C. tltehQ~le,t. .N,][, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... May..19 ..... , 19.75 pursuant to which Building Permit No.. dated ........... May.. 2.~ ..., 19..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 .. l~'l.V&t®. Qne. fa~iiy, dwelling ..................................... The certificate is issued to .Elb.~'.t..& .l~,e.~l'. ~,~.tl~ .... 0~lers. ............... (owner, lessee or tenant) of ~he a~oresaid building. Suffolk County Department of Health Approval House 1.70 FO~ NO. 2 TOWN OF $OUTHOLD 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? 53 1 Z Permission is hereby granted to: at premises located at ............. ~.~,...~.~..f.~:,..,.~et ............................................................................ .......................................................... C%~c.~o~'~e. ......... ~.,~4.,....? ......................................................... pursuon~t to opplJcotion doted ............................... ~'~.~ ....... ~¢........, 19.~.~,.., and opproved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date October 14, 1971 Bldg. P~rmit No. 5321Z TO WHOM IT MAY CONCERN: The sewage disposal facilitie~s at Harbor Lane~ 425' S/O Route 25, Cutchogue (Give deed location) for a structure located have been inspected by this department and found to be satisfactory° Chief of Gem OCT 1 4 1971 ;ral Engi{bering Services TOWN OF SOuTHOLD :BUILDING DEPARTMENT ~ ~ _/-- ' - ' . ~ / "~ TOWN CLERK'S OFFICE ~ ~UTHOLD, N.Y. ~'~ . , Application No.....~...~ ........ ~. ...... APPLICATION FOR BUlL,DING PERMIT 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 premises o~ public streets or ~) 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 of Building Perrnit. 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 pa'rt for any purpose whatever until o 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, as herein described. The applicant agrees to comply with all applicable laws, ordi nonces, building code, housing code, and regulations. (Signature of applicant, or name, if o corporation) State whether applicant is owner, lessee, og~ent,' architect, e;~gineer, general contractor, ,elec~riEian; plumber or builder. ..... .................................................. ;.J..,,.'.Z....: ......... ;..l...j.....j ........................ Name of owner of premises .~'~..:~'..~...~.d:,.....~"'"'"'"""""'"'"'"'""'"'"'"" _ If applicant is a corporate, signature of duly authorized officer. ~,~ (Name and title of corporate officer) '' ' · ' .% 1. Location of land on wh ch. proposed work,.w be done Map No · ~-- /,~ lu,, -- - ~ .',l · ~ ' ',;'~ *'"'7 ......................................................... / Street and Number ..t-'-~.~.~ ....................... ~.~.~mjj~'~,¢.~ ............................ ()~Aunicipality ' " . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExisJting use and occupancy ................................................................................................................ b. Intended use and occupancy ...... ..~.....~.. · , ............... Approved ~ k Disapproved o/c ...... ~ ...................... _ lBuilding Inspector) 3. Nature of work (check which applicable): New Building ....~............ Addition .................. Alteration .................. Repair ............ ; ..... Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost~.~.~.~ ................ ; .................... Fee .......................................................................................... (to he paid on filing this application) 5. If dwelling, number of dwelling units ......... ~/. ................ 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 ................ .' ........... 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 ....~ ............. 8. Dimensions of e.~tire new construction: Front ...~~...~* ............ Rear ......~'...~..~..,.... Depth .c:~l~'..~:. .... Hmght ../.~..~...~. Number of Stones ...... ~ ........... .~ ........................................................................................... 9. Size of lot: Front ..' ./..~..,~..,.-- Rear ...~....~..~.-- ........ Depth ...~...Z.~'....'~"'.~...,. 10. Date of Purchase "'"'"~'~'"'~'~'- ~f- ........ ~'"/' ......... ,~L~ . , ' -,-. sName of Former Oven. er .~.~.~,/~ .............. 11. Zone or use district in Which lYremises are situated . ... ....................................................... 12. Does proposed construct on v o ate onv_zon rte aw, oral nonce or regu at on 13. Name of Owner of prem,ses~..~. .Acldress'-~.m~'.~'~"...'..--.-~..~.--..~.~-~ne No...~..Z/?.::.~..~$ Name of Architect ....~ ....................... ......Address ............................................ Phone No ..................... Name of Controcto~z~'//'----~.~.....Add~.~,.~#~ Nc~7~'~...-:..~',,7~. ~ , ~ ! PLOT DIAGRAM , //'~'. Locate clearl i and distinctly all buildings, whether existing or proposed, and indicate al~ set-bock dimens OhS from property lines. GJ 'e street and block number or description according to deed, and shawl street names a~d indicate,. whether interior or comer lot. V' ~ ! 7 STATE OF NEW'YORK, . t,-. ,- COUNTY_ OF -.~4~-l.J~- .......... ~'~.~_ ~ ............ ¢~V~I.&<~..'.....I~...,..~., ......................... being d.ly swam, deposes and says that he is the applicant (Name of individual signing 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 and file this application; that all statements contained in this application are true to the best of his knowledge and bel el; and that tJ~e work will be performed in the manner set forth in the applicatiort filed therewith. Swam to before me this .... ...... ............. ,,,/.1.... . ................. ......... Notary P~blic~.k~cr, d~;.~..._~&~-~, ....... County,(r ~ ~lef~l~ (Signature of applicant) ......... U ELIZABETH ANN N~/.~L£ .. NOT/~RY PUBLIC, StBte of Hew TOfK No, T2,8125850. Suffolk Term Expires Mirth