The URL can be used to link to this page

Home My WebLink About5441-zTOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Cl~rk's Office $outhobt, N. Y. Certificate Of Occupancy No. Z669% ...... Date .............. Sep. t;...19. .... , 19..?~ THIS CERTIFIES that the building located at . .Wil~arth .Ave ............ Street Map No. Wash~tonBl~ck No ........... Lot No..i0 .... Gr~.e~lp0r.t..~...Y,t ........ C Ode ....... Z6~9~' dated ........... .3.ep.t....i.9..., 19 ~.~.., was issued, and conforms to all of the require- merits of the applicable provisions o! the law. The occupancy for which this certificate is ~,u~ ~ . ~i.V.~..~...~..e...r.~..i.:.y..d.w.~..:.:..~..v&t.h..a~.d.i.t..i.o.n.. (..k~..! .Z) ........... The certificate is issued to.. aostas .Sta~s ....... 0~ne~ .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval pr.e.-., exlst;LnE .................... UNDERWRITERS CERTIFICATE No. pr.e-, .e~Lsti~ ............................ HOUSE NUMBER .... //~0 ...... Street ...~/~l~artl~ .Ave ......................... FOF,~I NO. 2 TOWN OF SOUTHOZD 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? 5441 Z Permission is hereby granted to: .............. ~..~...~.*~'~ ..................................... at premises located at ......... [~411t,'""~O ....... l~llL1i~ll~t;~i"ll~B' ......................................................... ................................................. M .~l~m~d~..A~e ........... e~,ee~pe,~ ............................................... pursuant to application dated ................................... ~ ....... ~.., 19~1~.~..., and approved by the Building Inspector. TOWN OF SOUTHOLD /~ ~,~ ~ma*,,~ ~ */.t~ BUILDING DEPARTMENT ~) SOUTHOLD, N. Y. , p.cotio. ........... ...... Examined Approved 11 q 19..~.... Pemit No. '~...~..J ~ '/Cg4,~' _/~(,~tw,4~,Z~ ~'~ APPLICATION FOR BUILDING PERMIT Date ~T,,~,,.~, 2,~ 19..2.1 ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin~ Inspector. b. Plot p on show ng ocation of lot and of bu Id ngs on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram wh ch is part of th s appl cat on. c. The work covered by this application may not be commenced before issuance 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 port 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 L~ws, 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 oil applicable laws, ordinances, building code, housing code, and regulations. X (Signature of applicant, or name, if a corporation) ......... Mi~aam. th..&v.e ....... ~-=e .e~j~r.t .............................. (Address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~mer Costas Stars Name of owner of premises .................................................................................................................................................. ~ If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be done. Map No.: ...~...a..s..h....:~...l[~..°..B:i.,l~.~..s..... Lot No...1..0.. .................. ~ Street and Number ...8...3..O.....~.~...]~...e:~..~...h.....~.~e.. .G..~..e..~.~.~j~.~ ... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExisJting use and occupancy dweI'l..i~...~ ....... same with an addition b. Intended use ond occuponcy ................................................................................................................................ X8. 10. 11. 12. 13. Nature of work (check which applicable): New Building .................. Addition .....~.~.% ....... Alteration .................. Repair .................. Removal .................. Demolitio~ .................. Other Work (Describe) ........................................ Estimated Cost ...~. ...................................................... Fee ~'eO0 (to be paid on filing this application) If dwelling, number of dwelling units ...... .~_~.? ................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. If business, commercial or mixed occup0ncy,' specify nature and extent of each type of use ................ ; ........... 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 ................................ Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... Size of lot: Front. ........................... Rear .......... i ......................... Depth ................................ Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated "An d/st ~ Does proposed construction violate any zoning Iow, ordinance or regulation.;> .......... ~,Q ......................................... -~. Name of Owner of premises ...C...e..s...~..a..S....~.~.a.~.S. ......... AddreSS .....G...~..e.e.~..o..r...~. .................. Phone No ..................... ' Name of Architect ...................................................... AddreSS ............... ............................. Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or prOPosed, and indicate all set-back dimensi°ns from property lines. Give street and block number or description acco~rding to deed, and show street names and indicate whether interior or comer lot. ~ I.[,~ ~'h /~ STATE OF NEY~ YORK. COUNTY OF ........................................ C~S.~a&..$.~,~N~ ............................ being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ............................ (h4~e~'. ................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to rrmke and 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. Swam to before me this ............... · ~.~.... JSy of. .................. ~T~1,1~. ...... ; ...... i 19..?..."[..~Jf'~'~'~'"'~'" ~ A ,' .,~/.~-" ~ ~(Slgnc Notary Publi~~-~..~ C .....' ~J~ e of applicant) NOTARY pUBLIC State No. 52.'~1255.~,,. Suflotk Co~Jd~"' Te~m Expire~