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Home My WebLink About3289-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 3 28.93 Date ., O~ta]3e~' 20 ..., 19.67. THIS CERTIFIES that the building located at l~t~atham Path Street Map No. ~ Block No. ~ Lot No. ~ · .$o~gholel~.l~.~'.... conforms substantially to the Applicabon for Building Permit heretofore filed in this office dated 0~:t0be.~ 27. , 19 66. pursuant to which Building Permit No. 32~t8. Z. & 3289 :; dated O¢~t.c~e~ 27 ,19 66', 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 On~ £amily d~elltng, a~d .a~c~o~. l:~ut3~din~; ................. The certificate is issued to .... ]1~ Dsl~a~ia .................................... (owner, lessee or tenant) o£ the aforesaid building. Suffolk County Department of Health Approval ]~/i~ .................... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEP~IT (THIS PERMIT MUST B,E, KEPT ON THE pREMIS'ES UNTIL FULL COM,PLETIQN ,07 THE WORK AUTHORIZED) N? 3289 Permission is hereb~ granted to: ~ .~~..,w..,..~. ..................... ,o ..... ................................. at premises locat~l at .... J~.JJ,:...~~l~.~]ll~ .......................................................................... '~ · ~.~.~ ..................................... , ................... :..; .................... ............................ ~ ~ , ; ..... .~t~.e;~.~., , pursuant, to ~pplicotion dated ............................ : ,Jj~J~j~J~,~ ,.... ,~_.;...,,, , _ _ 19..,",~, ,, , , a, nd, approved by the F~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ~.....~.....~.. ....... , 19...~...~.. Application No. Approved ........................................ , 19 ........ Permit No ........................ ;.....%.. Dzsapproved a/c ..~ ........................... .............. ........................ APPLICATION FOR BUILDING PERMIT Date ............ ..,~...,.~... ....... ,.~.,.Z. ................... ,19.~.~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in mk and submitted in duplicate to the Buildir Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and gw~ng a detailed description of layout of propertymust be drawn on the d~agram which is part of this apphcaho c The work covered by this apphcat~on may not be commenced before ~ssuance of Budding Permit. d. Upon approval of th~s application, the Building Inspector wdl issue a Building Permit to the applicant. 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 Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to tl Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances . Regulations, for the construction of buddings, addit,ons or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all appl,cable laws, ord,nan%e~ding~code and/Treg, ulations. (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrfcian, plumber or buildc ..................................... ........................................................................................ Name of owner of premises ./..~'.' ~ ~'7~*'~ ~ ~' If applicant ~s a corporate, signature of duly authorized officer (Name and title of corporate officer) Location of land on which proposed work will be done. Map No' . ........................................... Lot No: ................. Street and Number ................. /..~..;~~..~........~..~ .............. ~.....~. ............................ Mumc~pality State exzstmg use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy .... /.....~.~.~.'.~.......~ .~Z...~....~.. ............................................................................... =u onc, ......... 3. Nature of work (check which applicable). New Budding .................. Addmon ~/ Alteration Repair .................... Rem;val ................... Demohtion .................... Other Work (Describe) ................ ~.....:.~ 5000 4. Eshmated Cost ...~..'.. .................................................... Fee ......................................................................................... (to be prod on filing th~s application) / 5 If dwelhng, number of dwelling units ............................ Number of dwelling units on each floor ........................... if garage, number of cars .......................................................................................................................................... 6 If bumness, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7 Dm~ens~ons of ex~sting structures, ff any: Front .......................... Rear .......................... Depth .......................... Height ............................ Number of Stones ............................................................................................................. D~mens~ons of same structure w~th alterahons or additions' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. D,mensions of ent,re new construction: Front O' /~' ~ ~ ._ ~, ............................ Rear ............................ uepm .......................... Hmght ............................ Number of Stories ............................ $ ~ 9. S~ze of lot. Front ............................ Rear ........................... Depth ................................ 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... 11. Zone or use d~strict in which premmes are situated ............................................................................................... 12. Does proposed construction wolaSe any zoning law, ordinance or regulation:~ .................................................... 13. Name of Owner of prem,ses .... .~...~.....~..~'...~.~../..~.. ....... Address ............................................ Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...~...4.~..f...~...:-------'~ ....................... .CZ..-~...~...~.?.?...~.... Address ........................ .~..~. ~')~/i/~.~/ : .................. ~.~../.~/~'..~?...~.?Phone No. .................. PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fro~ property hnes. Gwe street and block numbers ar description according to deed, and show street names and indicat whether interior or corner lot. 2.2:0" STATE OF NE~~ ~ ) S S COUNTY OF ...'~...,,~./..,: ................ / ' .............. ..................... be,ng sworn, deposes ...... (Name of individual signing above named. He ~s the ................................................................................................................................................... (Contractor, agent, co~orate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this apphcation; that all statements contained m thru applicahon are true to the best of his knowledge and be and that the work will be performed in the manner set forth in the applicgtion filed therewith. Sworn to before me .........................