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Home My WebLink About4447-zFORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate C~ Occupancy THIS CERTIFIES that the building located at .I~/$..Reeky .Pt. l~oad ....... Street Map No .... xx ....... Block No... ~X ..... Lot No .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ 8®pt. .... ~..., 19~. pursuant to which Building Permit No.. ~.:!:.~:.?..Z dated ......... ~®pt'" ~ .... , 19. '69 was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... Pr.i. vate..one. £amll.y .dwelling ..................................... The certificate is issued to . .T-heo- Sta~o8 ....... 0~ner ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ........ N,R, ........................ ..... ....... l~ou.e ~ ~,8~0 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? 4447 Z Permission is hereby granted to: at premises located at .................... ~(~....~Al~klr..~.~t,.Jk:~l~ ..................................................... ....................................... ~t,.~ml~ ......... m.~:. ........................................................................... pursu~ to application doted ................................ ~{}~ ...... ~ ........ , ]9.~., and appraved by the Building Inspector. Fee $...~ ........... Disapproved a/c .............................................................................................. APFLIC, ATION FOR BUILDING PERMIT ~e t ............................... ......... E. .............. .... INSTRUCTIONS a. This application must be completely filled in by tl~ewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of bu.lldings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of praperty must be drawn on the d agram wh ch s port of this appllcat off. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upofl approval of this opplicatJon, 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. 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, ordinances, building code, housing code, and regulations. Theo Stamos (Signature of opplicaflt, or name, if a corporation) ............ .............. (Address of applicant) State whether applicant is owner; lessee, agent, architect, engis~eer, general contractor, electrician, plumber or builder. ............................................ ........... .............................................................................................................................. Nome of owner of premises ....~,fi.QA..~.~.~tL~.,~ ................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. ,Map No.: ..3~ ................................. Lo~ No.: ..~.~:. ................ Street and Number ..................... 1~.~g~..~.j'D`~/.~.~.~"~..E..a.~..~...~...:r.~.e~t. ................. '~. ............ 2. State existing use and occupancy of premises und intended use and occuppncy of proposed construction: a. E~isting use and occupancy/ .......... A~/P.~L~,,~.o~,~;~i~I~, .............................................................................. b. Intended use and occap~ncy O~ l'i~S~ 1'1o0r 'C~ be rer. o~ed ~o second 3. Nature of work (check which applicable): New Building ~...;,. ...... ~..... Addition .... ~ ......... Alteration ..... ~ ........ Repair .................. Removal .................. Dem0!Itior,~ ......... ,...~ir Other Work (Describe) ........................................ ~fb be paid on filing this appliootion) 5. If dwelling, number of dwelling units ....o~e..~... ............Nu~t of dwelhng un.ts on each floor ............................ If garage, number o c~rs ............................................................................................................................................. 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 entire new construction: Front ........... ~0 .................... Rectr ....... ~.Q ................ Depth ...... .L~ ............. Height .................... Number of Stories ..... f,~go .......................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... !~,.....~l,J~.~ ....................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;' ........... ~D. ............................................ ~eo Stamos ~ E. Ma.r.i.o.n ... Phone No ..................... ]3. Name of Owner of premises ..................................... ;..Add .......................................... Name of Architect ...................................................... Address ......... ~ .................................. Phone No ..................... Name of Contractor ...~.¥...W.~L1Lt.a~s ....................Address .~.i..~.~O.tl.~hol~l. ................. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setd~ack dimensioe-~ from property lines. Give street and block number or description aCcording to deed, and show street narnes and indicate whether interior or comer lot. P STATE OF NEW YORK, COUNTY OF ..... Suffolk .......... $~'~' Theo Stamo~ ................................................................................................. being duly swam, depases and says that he is the applicant (Name of individual signing application) above named. He is the .......... .;~...O~Z3eZ~ ............................................................................................ ~ ................................ ~. (Contractor, agent, coq3orate officer, etc.) of said owner or ownelrs, .and is duly autll~'~, jzecl to perform or have performed the said work and to make and file this application; that all statements cOtttoined in this apislication';'iVe"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