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Home My WebLink About5789-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certific8te Of Occupsncy No..~......Z.5.2.02 Date June 1~- 19 73 THIS CERTIFIES that the building located at .. ~[.n. 1..e.t..L..an..e .............. Street Map No..xx ........ Block No....x.~. ...... Lot No..~..~.....G.r.e.e..nP0.~t. .... N:.Y.· ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Ap.r.~l....g., 1~.2... pursuant to which Building Permit No. ~.7.89. Z.. dated ......... .A.p..r.i.1 .... ~..., 1972.., 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 Private one fami.ly, dwelling The certificate is issued to .J. oba .BSd.d.~lph ............ .0w~.e.r ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. UNDERWRITERS CERTIFICATE No... ~.:B.: .......................................... HOUSE NUMBER...2.6.5 ....... Street....X.n.2:.~.$..L.~.n.o. .................................. FO~.M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5789 Z Permission is hereby granted to: ~,~,~h..V.~_ ~.~,.... ~,~.. ~ohn...a ~.. ]~:t.~d,ul~. ................. ~h-e~np~rt. ........................................ to ...... ~.~t.~ ..~...a~t.,~. i ~2t:~...on...e:e~. ~ ~.:~ ..,~.~e.~.m~ ........................................................... ~t premises located at .......~/~..'[l~L~.~..~,~tl~ .................................................................................. ...................................................................... ~xm~l:'or~ .................................................................... pursuant to opplicotion doted .................... ~.;~.~ ......... .~ ........... , 19..~.., and approved by the Building Inspector. Fee $.. J.~[~,.QO. ......... I ~- Building Inspector / / TO?N, CLERK'S OFFICE SOUTHOLD, N. Y. Examined ' . ..... 19.?..?.. " Approved ........................................ , 19 ........ Pemit No .............. ^pplication No ..... .~...7....~..~. ............ Disapproved a/c ..... ~ .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS · Date ................................................ ,19 ....... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, withI 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plen showing location of lot snd of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is pertiof this application. 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 work. e. N~ building shall be occupied or used in whole or in pert 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 9ther 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 ell alaplicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Joseph Diaz (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................. ...................................................................... i .................................................... Name of owner of premises .... .Jeb_q...C~,...~&d,~.l~ ..................................................................................................... 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.: ........ ~ .......Lot No ........ ~ .............................. Street and Number ......... -T-:t~3,e;~..~a~e ....... ~-:,~ez~o~'.'c .......................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy oflproposed construction: a. Existing use and occupancy ............. .~,J~,§ ..................................................................................... b. Intended use and occupancy ................ sa~e..~.i.t,h..&~..~([~l,&~4.e~t ................................................................ Nature of work (check which applicable): New Building ....................... Addition ....a~T, lr~ ......... Alteret*on.....~l;~... Repair ......................... Removal ......................... Demolition ........................ Other Work ................................... (Description) - %..o.o.o., ................. - %oo ............................................................ 4. Estimated Cost .......... r. ............... Pea .................................... (to be paid on filing this application) 5. If, dwelling, number of dwelling units ....... .o..~..e..... Number of dwelling units on each floor ............. ........................... If garage, number of cars .............. ~,W~....,,~ ........ ,..,....L ............................................................................................ ,. 6. If business, commercial or mixed occupancy, ~paclty nature and extent of each type of usa .................................. 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ........................................................... Num~ bar of Stor!es. ............................................................................ Dimensions of same structure v~lth ~lteretlons Or additions: Front ................. ~ ........ Rear ......................................... / Depth ............................................. Height ........................................ ~ Number of Stories ........................................ 8. DimenMons of entire new construction: FrdmO ............... , ......... Rear .......... .~CX ............ Depth ......... 2,L~ ................... one ..................... Height ................................................. Number of Stories .................................................................... 9. Size of lot: Front ..3.~O ............................ Rear ............... .~30 .................... Depth ............. 10G ............................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ "A" dist 11. Zone or usa district in which premlm are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regul~n: ............................................................ 13. Will lot be regreded _J_e~,q ........................... Wlllaxcauflllberemovedfrompremi~es: [ ]Yes [ ]xNo 14. Name of Owner of premises ...... ~:,..~p~.: ....................... ~ ............................................................................ (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address~ (Phone No,} Name of Contractor J. Diaz Green ort .................................................................... {X~l'~')' (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all building% whether existing ~ prol~OllKI, and indioate all mt-beak d!m.e, ngien~ fr~m property lines. Give i~reet and block ntlmber or de~riptlon according to deed, and ~hew ~feat names and Indicate wheth- er interior or corner lot. See filed plan STATE OF NEWYORK, ) COUNTYOF .............~:..1~...~..3=~.. ..................... I '~ Joseph Diaz being duly sworn, depesas and says that he is the applicant above named. (Name of ~.dividual ~l~l.~ ~ontract) contractor He is the ............................................................................... ,..., ............................................................................................................................. ( Cbnn~mr, .p~en~, corporate ~J~car, eat.) of said owner or owners, and is duly authorized to perform er have performe~ the ~aid work and to make and file this application; 1flat all statements contained in this application are ~'ue to Sb~lba~.~q~i~l~ne~l~l.doe and belief; and that ~he work will be perfarmed in the maurer ~et forth in the application filed therewith. ~ ~tcry p~b~ic, store o~ lqmv No 5~,0344963 SuffOlk Counef~,~ · .~ . day of ..~.l;l]~A~i~ r~,i~t,~ ;~Oor,~.. '~:~ /~ ' ....................................................................... ,.oz.... ....... , , .-, , ............ ...................... -I /~90. 0