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Home My WebLink About4850-zFORM NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificnte OI Occupnncy THIS CERTIFIES that the building located at -g~t~. Qu®el~ -S~; ............. Street Map No. ~ ........ Block No... ~ ..... Lot No. ~ ...fl~'lenl0Ol~t.. ~l.e.][e ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ,T~l~]r.. ~10 .., 1970 · pursuant to which Building Permit No. dated .......... J~7''' .$0., 19 70., 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 . ~ivate. o~ .family ~lwelling ................................... ... The certificate is issued to .. Antone .J.. Malhaa~lskas ........ 0wn~ .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Heaith Approval - ]~eRe .............................. Building Inspeeto~ FOB, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4850 Z Permission is hereby granted to: at premises located at ... ~ ~./..~..~...&../..'.~ ....... .~,~.~..~.'. ............................. ................................................................................ ~-..~.£.~..~.....~..d ~.~.Z ........................................ pursuan¢ to application dated ....................... ,/...~ ....... .~./...~.~..~..~. ........... , 19.,~.-~..~ and approved by the Building Inspector. ,:ee $ ...... ~. ................ Building Inspector BUILDING DEPARTMENT TOWN C:LERK'S OFFICE SOUTHOLD, N: Y. om,n ......... .../. 0 - · · ............. ,~-~...., 19 ........ pp d ............/... ., 19., ..... Permit No ............................. Disapproved a/c .......... (.~.. - ~ ......... ~ ........................................... APPLICATION FOR BUILDING PERMrT ~ Date ..................... ~.. ........... , ....................... , 19.~... ........ INSTRUCTIONS a, This application must be completely filled In by typewriter or in ink und submitted in duplicate to the Building~ Inspector. b. Plo. t .pi.an sha. w?g I.oc.ation. of lot .a.nd of buildings on premises, relationship to adjoining pram eel or public streets or areas, aha giving a ama.aa aescr~ptlon o? layout or property must be drawn on the diagram which is part of ~hle 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 nspector w Issue a Building Perm t 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 I~reuant to the Building Zone Ordinance of the Town of Southald, Suffolk County, New York, and other applicable Law~, Ordinances or Regulations, for the construction of buildings, additions or a terations or for remova or demollflo~ ae here n described. The applicant agrees to comply with all appl cable laws, ordinances, bul ding code, housing c[~le~-ahd regulations, ...,(Address of appllcanfl State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premlees t~9~, -t'~tvE ~'. /'v/~/./,~/~e ,$ ,~'~ £ .~. If applicant Is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on which proposed work will be done. Map No.: .....J~. .............................. Lot No.: ....................... Street and Number ~~~ 2. State existing u~ and occu~ncy of promises and intended use and occupancy of pmp~ constmcti~: a. ~lsting uae and ~cup~cy ~.~ ~.~.~ .~~ b. Intend~ uae and ~cupanc, . ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition )~ Alteration ......~.. ......... Repair ............ ~.~.. Removal .................. Demolition ....... ..'.'.'.~.. ...... Other Work (Describe) ........................................ 4. Estimated Cost~.....~..~..~:....~.. .......................................... Fee .......................................................................................... (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each flor ....~..~.: .................. If garage, number of cars ~ - . ........ 6. If business, commercial or mixed ~cupancy, speci~ nature and extent of each ~pe of use 7. Dimensions of exisHng s~ructures, if any: Front ..........~ ................ Rear ...... ~..~.'.~. ................. Depth Height ...... ~.~ ........... Number of Stori~ ........ .~ ..................................................................................................... Dimensions of same structure with olter~tiens or additions: Front ......... ;..'[~..,.; .............. Rear ............................ Depth .....~.~.~..~ .............. Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~..~ ........................... Rear ............................ D~th ........................ Height .................... Number of Stories ..................................................................................................................... . ~: Front .. '/~ / ' Z 3~/~~ ~e~ ~ 9. S~ze ~lot: ......................... Rear .................................... Depth........... ....... ........~9'~[ ...... ~; 10. Date 0f Purchase ~-~ ~. ~9~ ~ ~/~ ~, ......................... , ................................ ome of Fo~er ~ner ........................................................ ] 1. Zone or use district in which premises are situated ........ : ............................................................................................ 12. · D~s proposed construction violate any zoning law, ordinance or regu at on? ~;. .~ ................................ 13. Nome of ~ner of premises .......................: ........ ~dress ~ .~ ................. Phone No . u~, ~ % ~. y. ~ ..................... Name of Architect ......... ~ ............................................ A~ress ............................................ P~ne No ..................... Name of Contractor .....~.~....~.~.~.~.~.~A~ress //~ ~W~ ~ e. .~ .................. ~ ......................... P~ne No .................... PLOT DIAG~M L~ote clearly and di~inctly all buildings, Whethe~existing or pr~ed, a~ indicate all ~t~k dimensions from p~pe~ lines. Give street and bilk number or description according to de~, and sh~ street namK and indicate whether interior or corner Jot. ~o R~ H i STATE OF N~O.~j~JI, y~Y, COUNtCr, - .......... ,., . ........... ........ ~~....beJng duly sworn, deposes and says that he is the applicant (Name of indi ~,(],~(al sJgning,(:Jpplication) above named. He is the ................................... ~ ...... i...; ........................ ~[ ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make end 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 inthe manner set forth in the application filed therewith. Sworn to befOre me this / - f ....................... ~y, of ,~"~'/'"'"~x)'"-'~'~-,;j 19..2...... CoundjT ....... ........................ ELIZ H ANN M¥iLLE / / ~o. 52.8]25550 Suffoi,- ^ --'" ' lerm EXpires Ma~ch 3~ ~._~