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Home My WebLink About4419-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. Z .3821 ..... Date ............ Jtme. -8 ........ , 19. -70 THIS CERTIFIES that the building located at 'Rocky 'Pt' f~oad' ' ' ......... Street Map No.. ~x ........ Block Noxx ......... Lot No...XX. East. P. arion... I~o¥o ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... AU~... lb~ -~, 19.69 pursuant to which Building Pemit No. I~I~.I~Z.. dated .......... Aug ..... .11~.., 19 69., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Pr$.vate. one..f, am~.lF .clw~.l..~g .................................... The certificate is issued to .. Gus" K?rkostas ...... Ovr~er ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval -..N.I~, ............................. ......... ........... House ~ 3870 l~O~ NO. ~ TOWN OF SOUTHOLD 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? 4 19 Z Permission is hereby granted to: to .......... .llll~.. ~.~~.&..~..~~..m.. ~..m~ ..... at premises located at ................... ]~..~..~l~ll~t,..~ll~ ........................................................ pursuance to application doted ............................. &l~ ......... '~' ........ , 19...~, and approved by the Building Inspector. IUlLDIHI t)IPAITMINT ~ (/? ~ ' ~tT.,~ DiSapprovecla/c .......................... ........................ ~ .................................... ~ ...... ApPlication No ........,...~, .............. ~ APPLICATION FOR IUILDIHO PEP. Mn' ~ o~ -- ~ · ......................................... , 19 .....>d · INSTRUCTIONS a. This appllcation must be completely filled in by t~jpewriter or in ink and submitted in duplicate to the Building Inspector. · b. Plot plan showing location of lot and of buildl .r~? on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propet~/~Uit be d~mm on the diagram which is part of this application. c, The v~,r~.¢oyered by this applioation may nat be c~cenced before ~ of Building Permit. d, ~ Ltpen~ c~:thls,~pplicot~on, 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 Certificate of Occupancy shall have been granted by the Building Inspector. RB .A..P. PLI~CATION IS HEREBY MADE to the Building _Department for the i~uance of a Building Permit pursuant to the u,a!n.g. :one, 0~lnance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulahons, for the construction of buildings, add!tlor~ or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances , ~ r~ulatlons. ........ .~.~..~.~..~...A......~.~.~ ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nam~ o{ owner of preml~ ........ ........ .. ........................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ,~. on wh,~h p.~o.a wo~_wi,,~, d~ ~0,.o.: .......... ~..~.Z~ .............. ~.,~: ~ ........... !. Location of Street and ~u~d~r.....~...?....?....~....: ...... ~......~~..~.......~..?...~..:. ........ ~.~.....~....~:"' .......... Munk!ml.V /\~ 3. Nature of work (check which applicable): blew Building. ~;.....~ ........ Addition .................. Alteratio~ .................. Repair .................. Removal .................. ': Dem0lifio~,.....i ........... Ofher Work (Describe) ........................................ 4. Estimated Cost ....... .~..O.....O......~... ................ ?'::~.~'..i~...~.Fee :"~.a.~.i ............................................................................ '(to be paid on filing this application) 5. If dwelling, number, of.dwelling units ..... ~ .......... Number of dwelling,unrfs on each floor ............................ If garage, number of cors ............................................. ~ ...... ~"'~"~:"'",;""~?~7"?'"'~ ...................................................... 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 olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ................... .. ........ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~..~.....~... ......... ~ ....... Rear 'i"../....~... .............. Depth ..!.~ ............. Height .................... Number of Stories ....... ~ ............................................................................................. 9. Size of lot: Front ....~.~...O.. ............... Rear ,...L.,67......: ................ Depth ,,.~......0~....~.. ............. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ I1. Zone or use district in which premises are situoted ...~.....~.~ ........................................................................... 12. Does proposed construction viqJe, te ar~,.zoningJaw, ordinance orj~guJgtion? ....._/~......O.. ............................................. Name of Architect .............................................. Address ............................................ Phone No ..................... Name of Contractor ........... .-~.~ ...................... Address ............................................ Phone No. .................... PLOT' DIAGRAN~ Locate clearly and distinctly all buildings, whether existing or p.mPosed, and indicate all setd~ack dimenSions from property lines. Give street and block number or description according to deed, and show street names and indicate whether Interior or comer lot. STATE OF N~ (Na~ of individual ~i~licmi~) a~ve name. He is the ........... ~,~~ ................................................................................................. (Contractor).ngent, corparate officer, etc.) of said owner or owners, and is duly a~ttherized to perform or have performed the.said work and to make and file this aPPlication; that all statements conteined in this application am true to the be~,t '6f 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 ~_ . ~ --~ / // _ · .. . ... ~ NO77~RY PUBLIC, State ~ New&fo~ ~ ~ ~ ~Jo. 52-8[25850, S,u'/Idtl~ Cou.~ Tim ,E~x~es ~ar~lCL t~