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Home My WebLink About3408-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. I 281i-2 Date Sept 13 ' . ,19.61 THIS CERTIFIES that the: building located at SIB Cleaniew ,lTe . Street Map Nlai1'Tlew P~~ck No. , Lot No. 2l- Southold, liS......... conforms substantially to the Application for Building Permit heretofore filE'd in this office dated Karch . 2lt , 19 67 pursuant to which Building Permit No. 3'+08 Z dated Karch ,~ ' ,1967 ,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. t.amll\r- .dweJ.l1nc.. ..... ..,... ................... . The certificate is issued to Barold .Mella.a . . , Owner, . . . . . . . . . . . , . . . . . . . . . . . " ,.. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Sept, 12 f .19.67. . by . R... .'1111& ~~t...................... Building Inspecto FORM NO. :& TOWN OF sOUTHOLD BUIL~ING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ! , BUILDING PERMIT 1 , , <THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ~ I ! I COMPLETION OF THE WORK AUTHORIZED) ,c t " / .- I I N'! 3408' Z Dote ..........,...............~......a......, 191""... Permission is hereby granted to: ......~~~~..~~f.............,.,..................,..,..,.. ..........ao.utibo14.........,..............................,.,...,.:. ...................................................................................................................... to .1Q11..........t.-11r...dIr.l11n&,. ,...,.,.......,........,.............,................................,......... ...... ..................................... .............. .......~.................. .... ... .... ....... ............. ....... ................~.......... ...... oa .... ...... ._. ....... at premises located at .....1o"....a....l'~",.,.....,...,.....,............,....................................... " ...."...,..............a..a"'.1........ft.....1f.11.l.ow...P.oft<l..~ .........8011.*14 .....,..,.....:.............. ~ '^ _.,r< ......... ................... .~.............................................. ............... .. .............. ............................. ........ ........... ....... .... ..... .... ....... pursuant to application doted ......,.....~........:.............,........., 1.'...., and approved by the " Building Inspector. 'v Fee $...1Q.ot........ , . ~ -'~ '-. .. -: :.... '" ..,...........~"~.....~..,.............:. : ;::" . EtuTfdirig Inspector ) < ~ " I S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH SEP i 2 1967 Date Bldg. Permit No. o 9"d J> Z- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at '~ah~/1M~ ~ ~~a/#'c.?/ (l J ~..a4~../';'.v fh-U'. (Give deed location) / / ~,(;;f-~~ have been inspected by this department and found to be satisfactory. K ~A- Q, ?! ~'7 , , ,...v....-Cv Distriot Engineer District Engineer' FORM NO.1 V 0/\;1 ~ 1'1- 01(/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ...~.~...ft.t........., 19~.f SOUTH OLD, N. Y. Applicatian No. .}.~.~..C,...... Approved ....,....,............~................., 19...~.~..Permit No. 3.~..~.t.~...... .......................................................................................................................... Ii~ .,............. ....,...........~t~~}.........................,......, APPLICATION FOR BUILDING PERMIT March 24 67 Date ...............................,.......................,...., 19.......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing locotion of lot and of buddings on premises, relationship to adjOining premises or public streets c areas, and giVing a detailed description of layout of propertymust be drawn on the diagram which is part of this applicotior 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. Suc permit shall be kept on the premises available for inspectIOn throughout the progress of the work, e No building sholl be occupied or used in whole or In part for any purpose whatever until a Certificate of Occupanc 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 th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of bUildings, additions or alterations, or for removal or demolition, as herein describec The applicant agrees to comply With all applicable laws, ordinances, building code and regulations. Harold Nellas .................................................................................................. (Signature of applicant, or name, if a corporation) Tuckers La Southold ..,...........",....,.............."........,.,.,...,..,...,......,....................,...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, owner - builder ,........................,....,....,...........,...........,...........,..,.....~..,......,...........,............,..,..,........,...,.,..............................,......................,. Nome of owner of premises ..Jj:f'l..:r.Rld...J:1~llas............... ..............................,........................,.....................................,.., If applicant is a corp~rate, signature of duly authorized officer. ...................................................................................................... (Name and title of corporate officer) 1. L t' f I d h' h d k'lI b d M N' Fair view Pk L N 21 oca Ion 0 an on w IC propose wor WI e one. ap 0 ..,......,..............,.............'..... ot 0: ...............,.. Street and Number . .9J~.9J:::v:~ ~;i.. !'AXr:;,.,..,...,.... ..~.?~ ~~? ~,~.....,.........,..............................,.,........ ..............,......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy.. ...... .Y?cJ;J.:n.,t...l<;l.P..i;J.........,.........................,.,.....,......................'...................,...., b Intended use and occupancy .... .........oJJ.e...famil~-...dw.a;l..l;i;ng.....................,............................................. 3, Nature of work (check which applicable). New Building ....~..... Addition .....,............ Alteration ................ Repair ....,............... Removal...........,........ Demolition........,........... Other Work (Descnbe) ..,.............,........,.......... 4 16 000 PIN 10 Estl mated Cost ,.,......,.,.1....,......,..,.,......,..,....,.,.,.......... Fee ......, ,..,...............,........,..........,.......,..,......,..........,...,..'..,.. (to be paid on filing this application) 5 If dwelling, number of dwelling units .,...9p.~........,..,....Number of dwelling units on each floor ,......................... If garage, number of cars ....tW.Q,...........................................................,...........,............................,..,...................... 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 Stones ....................,.................................................................,........,........,.,.. DimenSions of same structure with alterations or additions Front ..............,..,.............. Rear ..,..,..,..................... Depth .............................. Height ..,........,.......,.......,..Number of Stones ..................................,..... 8. Dimensions of entire new construction. Front ,......,..7.!i............ Rear .......7.4........,....... Depth ,......2.Y:.............. Height ...........,.............,.. Number of Stories ...QJ1~.................. 9. Size of lot. Front ....,16.Q.............,.. Rear ........l60............. Depth ......J..25................... 10, Date of Purchase ..................:L9.9.7..,.........,......,.........Name of Former Owner ....,......,................,......................... 11 Zone or use district In which premises are situated........!!A.!!...dist.............,..,................................,.................. 12 Does proposed construction violate any zoning law, ordinance or regulation? ...,.......,...no......................,....,.... 13, Name of Owner of premises ...Ji.a~9~d...M.e.lla.s.....Address .........southol.d................ Phone No. .................. Name of Architect ....................,.................................Address ...... ,..........,..,...................... Phone No, .................. Name of Contractor ....Same....,...........,..,...................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 numbers or deSCription accordrng to deed, and show street names and indlcat whether rnterior or corner lot. , I C" 'I '{ ( ~ ~ - l./o/=7" /.f . of -7' o!I _ ~ ~ t ~ I c~ ~ I . , I~ , ..3s .. ~ ,- e . , t\ 'j C k t:: ~ \'" V \ t.. t'. ~6'0Wr~F O~E~R~?~~l)s;.........J S.S ............................,ljg.r.Rlct..J1sl1as................,..,......,..........beIng duly sworn, deposes and says that he IS the applica, (Name of IIldividual signrng application) above named. He is the ..,...... ........Qw.:n~.r...)?1J.:iJ,Q..e.~.., .... ,..,.... .... ...,... .........,....... .... ........ ........................................... ,." (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 and fi thiS application; that all statements contained In thiS application are true to the best of his knowledge and belie and that the work Will be performed in the manner set forth rn the application filed therewith. Sworn to before me this ~ .....,.............?~... day of .............,....,March............., 196.7... Lf-- ~ . k1:Y.1 : U J.e . t- ~ ," ......., ,~..............~.......................... Notary Public, ,.. .Ld....~;....(J.~.:1.......(..,.... ''7tt':.~ " 1l!Cflt~ CC,__, \ " (Signature of applicant) 1 '( pur) \::. S.<l .-: l, i _ MOlAr,52 32'~120 :,~,,',,< l .k C, N~t>rm- Ex~~re5 I\tarc'n 3'), 19 I