The URL can be used to link to this page

Home My WebLink About6488-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z~2314- ..... Date ............ June.. 28 ..... , 19.23 THIS CERTIFIES that the building located at .... 01d..~o~'e..BlYd..(Pv~.).. Street Map No... xx ....... Block No...XX ..... Lot No. xxX... ~o~ttholcl.. I{,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... April.. ] 8.., 19.73. pursuant to which Building Permit No. dated ........... %~?.~1... ].&., 19.7.3., 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.J. va.te..or~e..familY..dw.e, ilSng, v~lth, a, clcl~.ti.o.r~ ...................... The certificate is issued to .. Achille.s .&. ~rio~ .Stachtiaris ........ Owner.s ..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... l~.,tt, ........................... UNDERWRITERS CERTIFICATE No.. N.,~l~, ........................................... HOUSE NUMBER ............. Street ................................................. Bttildmg lnsl)cctor ~ FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 6488 Z l~ermission is hereby granted to: ............... ~.~-...~e~r.-~Tde-.l~.. ~a~l ............ ................. /)a~den../:~.~. .................................. to ...~u~.~a...$~..add~.*~en...o~..e~-q-ng.~a~et'l.~_:_n~ ..... (-~t~,a~.) .................................. at premises located at ~d....~/)~'e..~]:.¥~ ..... {.i:;~...1~.)~ .................................................................... ...................................... JDI~,...T~..Bea~.h~ ....... /~e~+,,h~:~ d. ....................................................... pursuant to application dated .................... &19F-~].' ......... '~ ......... , 19.~.~.., and approved by the Building Inspector. Fee $.-~-~.,4)O .......... Building l~stS~ctor ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. ~' ........................................ t( t 19 ........ Pemit No ..................................... Approved [ u~ lng Inspector) Application No. INSTRUCTIONS ~ a. This apphoat~on must be completely filled in by typewriter or in Ink and submitted in trlphcate to the Building Inspecto 3 sets of plans, accurate plot plan to scale Fee according to schedule b. Pict plan showing location of lot and of buddings on premmes, relatmnshlp to adlommg premmes or pubhc streets or are~ glwng a detailed de~cmpt~on of layout of property must be drawn on diagram whmh is part of this apphcat~on. ~_~ c. The work covered by th~s application may not be commenced before Issuance of Budding Permit. ~ d. Upon approval of this apphcat~on, the Build~ng Inspector will msue a Budding Permit to the applicant Such permit,shall be I~/ept the premises avadable for inspection throughout the work. e. No building shall be occupied or used m whole or in part for any purpose whatever until a Certihcate of Occupancy shall have b, granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Z, Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construct~o buildings, additions or alterattons, or for removal or demolmon, as herein described. The apphcant agrees to comply with all apphcable Ja ordinances, budding code, housing code, and regulations, and to admit authomzed ~nspectors on premises and ~n buddings for necessary ~nspectio ..... ~ar ~te~";(~f,l:v"t~'"~.tg'3.0 ................. tAooress CT app.cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull. Name of owner of premises ACHILLES & MARION STACHTIARIS If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... 1. LocaLion of land on which proposed work will be done. Map No ....................... ~ ................... Lot No ......... ~ ....... Street and Nu tuber ......... .(-~.....J=~, ~1~) ......... ..(~....~...~..~,. ...... .~....L: ~.~.t...: ............ .~.. ,~..~...~ff..%: .~. 5. ..... f~...cl...~...~ .0...~..J,~, .......... Muh-~Jpality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~.z:-~,a~..hau~e ...................................................................................... b. {ntended use and occupancy ........ ~.:E;J,.~.~J~:.~...~.~.~t~.{~ ...................................................................................... ,.~ ~, ~ L ~"t ~ 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .~.o..o..]......~..o...~..s...e. ........... (Description) 4. Estimated Cost ....... ~..~x00,.Q~) ..................... Fee ..(.~'"....~........ ........................................................................... {to be paid on fdmg th~s apphcation) 5. If dwelling, number of dwelling units .................Number of dwelling units on each floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ~.b.~,....~,8.L.. Rear ..~t;,....~.~.~. ...... Depth ...~.1;,....2,1~.~. ............. Heigh[ ...... ,~b.~,,....],,5.! .................................. Number of Stories ........ ozze .............................................................. Dimensions of same structure with alterations or additions: Front ...... ~0.! ............. Rear ...... .6.0.~. ............................ Depth ......... ..2..0..~. ............................. Height ......]...,5.~ .............................. Number of Stories ....o...~..e. .............................. 8. Dimensions of entire new construction: Front .... ~?,,.~. .............. Rear ..... .[.~..~. ................ Depth ....2..0..~. ....................... Height..................[5 ~ ..... .... ........ .......... .... Number of Stories .... .O. TI~. ................................... ~.(~y ................................ 9. Size of lot: Front ].20' Rear ..... [.0..6......7...~..~ ...................... Depth 10. Date of Purchase ....... ]~1~....~,c,).7..~. ........... Name of Former Owner ~A~-~a~(:1~[~?~:~a~a~e~]:~]:~a~ ............... 11. Zone or use district in which premises are situated .............. ~.e..s..:[....(:t..e.?.~.a...[. ............................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .~.O.. ............................................... 13. Will lot be regraded ................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ..... Ach~T~ll_es..&..Ma3c-lo~...$.y,,ac,13.1;~A];;[.~. - i~L~ N~....E.7. de ?..~..~..,..[~Q....a...d.. (Address) '"~'~;~L~'"(~.~'~; {~'~;~ 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 dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate whet er interior or corner lot. STATE OF NEW YORK, ) ~ COUNTY OF . .,,~.~,,~,' ~0~\~. .......... } ............................................................ being duly sworn, deposes and says that he ~s the apphcant above nam (Name of tndtvtdual signing contract) He ,s the .............. ~ ..~.'--~...~.~. ~-.~ ........................................................ : ................................................................. (Contractor, agent, corporate officer, etc. ) of smd owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and hie th~s apphcation; tha statements contained m th~s apphcat~on are true to the best of h~s knowledge and belref, and that the work wdl be performed m the ma( set forth ~n the apphcat~on hied therew,th .,. \ ......... day of % 3 ~ ~ I~Oll~Y pUBLIC State 5t ~ew Yo ....... ~mm~ss:on ~p.r ..... r ......~ ~ (Stgnature of applicant)