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Home My WebLink About4911-z FORi~ NO. 4 TOWN OF SOUTHOLD~ BUILDING DEPARTMENT Town Clerk's Office $ouihold, N. Y. Certificate Of Occupancy No.Zh. 5~.~ ....... Date ...... : .... F~b~a~J.. 23 ..-, 19..~ THIS CERTIFIES that the building located at . ~;~g. ~. Lt.]..ae ....... Street Map No. Nas.s,. Fa.~.~Block No ........... Lot No. t20 ..... Ctt~hog~e.. N.,][, ...... conforms substantially to the Application for Building Pekmit heretofore filed in this office dated ......... AUg...].9 ..... 19.70. pursuant to which Building Permit No..~9.~.~. dated ............. ~g.. ]9., 19. ~0, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pr±va~e' 'one' 'faml'l~f 'dw~lling ......... : ............................. The certificate is issued to ... Fre(i' ~ "ifher~a' ~e].it~ ' ' '0w~s .................. (oWner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval House ~ 325 ·. '~t~e.. '~-8 j' '~ 971' · b~y' R-,..¥ ...... .... ,.. :...j ........... Building Inspector( FOI~I NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERM, IT (THIS PERMIT MUST BE KEPT ON THE PREMISE COMPLETION OF THE WORK AUTHORIZED) N~? 4911 Z Dine ............. UNTIL FULL Permission is hereby gronted to: 1~,~ ~a~ S~ at premises located at 3~ot~ ~ :~ass~t Fa~tll ................................................................... ,f ................ ? ...................................... ...................................... ~.~¢.~ .~. ~ ...... L~~::........,....~..: ........ ~,..... ~t ~ , 19. ~, and approv~ by the pursuan¢ to application dated .................................................. ~..,~ ......... Building Inspector. Fee $ ........................ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y, Certificate Of Occupancy No. Zh;2{~? ..... Date ...... : ....... ~%~l~e...22 .... , 19.7,1. THIS CERTIFIES that the building located at .. ;i~/S .~e~].lz~ Roa~. Street Map No..~aS.~, .~a~ck No ........... Lot No.. ~... ~.~O~e...~.~ ....... conforms substantially to the Application ~or Building Permit heretofore filed in this office dated .......... A~g ..... 19 , 19..~ pursuant to which Building Permit No. dated ............. A~g..~.., 19.70., was issued, and conforms to all of the require- ments o~ the appl~cab]e provisions o~ the law. The occupancy ~or Which this certificate is ..... ~,..... The certificate is issued to . .F~ed..&. ~e ~ .. ~.~. ...... ~8 ............... (owner, lessee or tenant) of the aforesaid building. . .~ (. ~..~97~...W. ~,. ~lzz~... Suffolk County Department of Health Approval House # · ~ ' r' "c:' r:" ' ': "" ' ' ~? ?" ":l .............. Building Insp~tor S-9 $CHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF' HEALTH JUN! 8 to71 Peirmit No. ~q llZ TO WHOM IT MAY CONCERN: The sewage disposal facilitie,s for a structure located (Give deed location) have been inspected by Ibis department and found to be satisfactory. G~nief of Oeneral ~ngineering Services ¥ -- ,~ ~,- Z~r~ 'TOWN OF soUTHOLD ,~r,Z~lP- . ~ , / ~/- BUILDING DEPARTMENT ,/~</~ ~ ~' L ~ ~ ~' ~ {~ T~N CLERK S OFFICE ~ '~ ~ ~ · . · ~ .............., . . . ~ppli~Tion ~o ....... ~.. ................... ....................................................................... .... - 0" ~,I I,~, ~' APPLI~TION FOR BUILDING PE~I~ : ~ ~ ~. Thl~ ~ppfi~otion mu~t be ~l~l~ fill~ in ~ ~writ~r or in ink und ~ubmi~*~ in ~1~ I n~r. . . . b. ~1~ plon ~wi~ I~otion o{ lot ~ o{ budding, on ~r~m~, ml*tion~h}~ to odl~l~l~ ~m~ or c. ~ ~ c~ by this ~licati~ ~y not ~ commenced before i~ua~e of Bulldl~ Permit. d. Up~ ~r~al of this appllcati~, the Building Ins~ctor will I~ue a Bulldi~ Pe~it ~ ~e ap~lcant. S~h ~it ~all ~ kept m the premiss available for ins~ction t~mughout the p~reu of the work. e. No building s~ll ~ ~cupl~ or u~d in whole or in pa~ for any pu~e whate~r until a Ce~iflca~ of ~c~ncy shall h~ been gmnt~ by the Building In~r. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.aw~, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Fred Nelin (Signature cf applicant, or name, if a corperatlon) ........ .., ............................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ .u,ild.ez ..................................................................................................... Name of owner of premises .....~..~..q.~...~...~Bfl~.~l.~ ....... ~.lJA~ ........................................................................................... If applicant Is a corporate, signature of duly authorized officer. . . (Name and title 'of corporate officer) Nassau Farms 120 1. Location of land on which proposed work will be dane. Map No,: ........................................ Lot No.: ........................ Street and Number .... ~. ~..~....~.~.~ ~'~, ~.; ~.. ~;.. ~:I,~,~,C,..~ ............... C:gt ~a~Ize, ................................... ~- '~, 5 ~/ ~ ~' Municipality. 2. State existing use a.nd occupancy of premises and intended use and occupancy of pmpaeed con~h-uctlon: a. Existing use and occupancy ..... .9~O&~t~..~&~ ................................................................................................... b. Intended use and occupan:', . ....... IDD. e..,~nm;L~.~'...dle'~,~ ........................................................................... 3. Nature of walk (check which applicable): New Building ~.~.... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ....................................... 4. Estimated Cost ....... .1.~e.(~.._,+ ................................. Fee ....1.0a,0~) ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... t~ ................ 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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ~ .......................... Rear ........ ,~ ............... Depth .......... 2.~. ......... Height .................... Number of Stories .:~ ................................................................................................................ lot' Front 218 1 2 10. Date of Purchase .......... :...1.C)~t ................................. Nome of Former Owner ........................................................ ! 1. Zone or use district Jn which premises are situated 12. Does preposed construction ~olate any zoning law, ordinance or regulation? ............ ~ ........................................... 13. Name of Owner of premises .~z'.e~..~(,B~JL~ .............. Address ........ ~JZ.e]3.~l~.~ .............. Phone No ..................... Name of Architect ..: ................................................... Address ............................................ Phone No ..................... Name of Contractor ........ ~.~. ................................. Address ............................................ Phone No .................... PLOT DIAGRAM Loca.te clearly and distinctly all buildings, whether existing or prapaeed, and indicate all set-bock dimens ons from property lines. ~ive street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ...... ~a_~f'e3.~ ........ ~"~' ......................... ~'~eUl;1...JlJe~ ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .......... ~tl~e~ ..... b~.-l~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 end file this a. pplicat, ion; ,t.hat all. state.re, ants contained in .this application am true to the best of his knowledge and belief; and thaz the worx wi De performed in the manner set torth in the application filed therewith. Sworn to before me this Notary Public, ,~.Z.[ ..................... f~.,...lf.z,~-~/.. Coun~ (Signature of applicant) MARION A. REGENI - NOTARY PUBLIC, State of New Yr- ~J . J~o. 52-3233120 Suffolk Coun~ .Term Expires March 30, 19~