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Home My WebLink About8787-z~O~M NO. · TOWN OF SOUTHOLD BU1AI~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No. Z ?'..~..~.~.... Date .............. .]~...~....I..to...., 107b.... THIS CERTIFIES that the building located at SZ 5 ffUO~ ~4 ~'S I~'OA b Street Map No ............. Block No ........... Lot No..~...Of...~.,?..~.. ?..t~....D.{ .~! .~.t.o..~... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... O.q~.a...~!, 19.?.b. pursuant to which Building Permit No.~..7.~..~..~/ dated ............ A. ~'..f-r....9.., 19.7.~.., 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 . ~ .Pl~L~.~.'r.k"... ~.~..~.~..~j.k¥...~..tq .~..~.L~ ~..47. .......................... The certificate is issued to . ~0!g .~..~....~... ~.a..t-..~...S.T. ~. D..~. ( N..&. .................. of the aforesaid building. Suffolk County Department of Health Approval l~.C~..7¢. ~.7..~..-....~,;.~..0.-. !q..~. ...... UNDERWRITERS CERTIFICATE No ...... ~..~..N1).i ?. ~ ........ ?.~,?.~...~..~ i.~ .~.V.~... HOUSE NUMBER ~ ~ ~ Street ~ {3 f_,- ~ ~4 ~ -~ '~r e ~ ~ CO'rC~o6-t/~ Building Inspector I~OBM NO. ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8787 Z Permission is hereby granted to: Geo. Ahlers ~/C Gordon &- Dale Stubbings .............. .~.~.o.~.e. ............................................ at premises located at .....~...~...~..e..~...e.....~,.o,.~.~ ............................................................................................. ..................................................... .c..u...t~,o.~..e. ...................................................................................... pursuant to application dated .~1~ c) 19 ?~, and approved by the Building In~c~ctor. TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink,, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation fram Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building .... ~ ......... Addition ................ Old or Pre-existing Building ...! ............ Vacant Lond .............. Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Health Dept. Approval ...,~...~,(~..~,~.~. ..................... Labor Dept. Approval ................................................ Underwriters Approval .... ~~' ..................... Planning Board ApplraVal ........................................ F Request For Temporary Certificate ........................................ inaJ Certifi~:ate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicablle codes and regulations. Applicant ................................................. Swam to before me this ~ ~"~:~ ................ day of ............................................ Notary Public .................................... County (stamp or seal) 7~c~ TltE NEW YORK BOARD OF FIRE UNDERWRITERS ,~'I ~- 13.'l¢ EIUI~EAU OF [.ELECTrtlCI';Y ~,~j 85 JOHN o,,"'De¢,~mber~ 21, 1~76 ~ordon StubLD~g~, ~u'ene rM., ,,,a~.h ~oad ~ ~eebes~ 300' s/o ~4ain ,_ omok~ Detector Gustav bartra, 227 l';ast ~rea~water Mattituc~ , L.I. ll)r~ Lie. 1529~ Per_ D INSTRUCTIONS ~'~ a. This application muSt be completely filled in by typewriter .in ink and submitted in triplicate to the Building ~ Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiseS or public streets o~ ~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of 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. 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. ^PPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tho ~'~z Building Zone Ordinance of the Town of Southold,. Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, addihons or alterations, or for removal or. demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to 0~ admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) 250 Cox Lane ....... ~.u.~.~h~e.,...N.e.w...Yprk ....119 5~ ........................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ b~ld~r. ............................................................................................................. ~ ........................................... Name of owner of premises ..... ~orJ:].o~...,~.-~d ..D,!~.e...~t:lJ~.l:li~.~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. ...................................................................................... Deorge .~/ers, Pre.~ident (Name and title of corporate officer) · , · l Budders L,cense No ........... ~'J"""',~,_. j__ ................................. /~c.~,u/ ~-.S*'D-/V~' Plumber's License No ........... .~....';T;~....~.. .............. Electrician's License No ....... ~ ............................ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .................. .~/.....~: ...... Lot No. V Street and Number ...................... .~.~.~...~;...~.Q~,~s...~.u.t.9~--O~°'iJ.~,...N-e.~...~o~. ........................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~c ~ b. Intended use and occupancy .....(;],W.~.~.~,JJ[X~ ........................................................................................................ 3. Nature of work (check which applicable): New Building.. ...... ~ ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... -/~ (Description) 4. Estimated Cost ...~.~..~..,..0...0..0..:..0..0. ................................. Fee ~ ~ ' ,~'r.~ ~, ~ (to be paid on filing this application) t §. If dwelling, number of dwelling units ...............~, ........... Number of dwelling units on each floor .~ ........................... f If garage, number o c~rs ...................... ~g~,f~ ................................................................ : ............................................ 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 ....Z+.~.~.~..t.! ...................... Rear ........ ..~..]:..f..~.~t. ........ Depth 26' Height .................... Number of Stories ...........~. ...................................................................................................... 9. Size of lot: Front ...................... 3.00. .......................... Rear ........... l~,,R.,t ...................... Depth ...,~]_0. ..................... 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...................~, ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............... ..,'3.0~ ................................... 13. Will lot be regraded . ........................... Will excess fill be removed fr°m premises: ( ) Yes (x) No 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor .~f~D.~.~.~.:.~13~;~.~,..$.~j,~,.~r,. Addre ~ 2~.~ Cox La. .~.~.~....5..0...]:..0... ......... ss .............................. Phone No. Inc .' PLOT DIAGRAM Cutch°°~te Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~,P~I~,~.I~. (Name of i~ividual signing c~troc~ above nom~. He is the (Contractor, agent, co~rote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contain~ in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed ther~ith. Swam to before me this ELIZAB~fl ANN NEVILLE NOTARY PUBLIC, State of New York TIT£E NO 07-79720 O0 3.0 TEST HO£E LOAM GRA VEL SAND ORA VEL REVISIONS 'AUG.$1, SEPT I$t 19 7e THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OSSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RE$IDENC WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTM OF HEALTH SERVICES APF>LICANT _ ADDRESS TEL __ 0 YOUNG & YOUNG 400 OS~*RANDER AVENUE, RIVERHE,AD, NEW YORK ALDEN W YOUNG HOWARD W, YOUNG SURVEY FOR: ~ GORDON STUBBINGS 8 DALE STUBBINGS GUARANTEED TO" AT CUTCHOGU£ AMERICAN T/iZE INSURANCE CO TOWN OF SOUTHOI D SOUTttOLD SAVINGS BANK SUFFOLK Cp., N.Y. "~./,¢_./,2/',~_,~¢/z:~.¢,~.~ TIDE NO. 07-79720 TEST HOLE O0 LOAM GRA VEL 20 SAND GRA MO ....... THE LOCATION OF WELLS ~ND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDEN WILL CONFORM TON~I~.TAND~O~.~ THE SU~OLK COUNTY DEPART' OF .~TH SgRWC~_ ~ ~c~E.AHLERS ~o~flon ~e APPLICA N T* ~m~ ~~ ~$ .~ ~ ~ ~ ADDRESS ~e.q~__ ~m ~ ....... ~u,~ ____ CUTCHOGUIr, N. Y. 1193~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Fo/~APPROVAL OF CONSTRUCTION ONLY APPROVED _ REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUN SURVEY FOR:' GORDON STUBBINGS ~ DALE STUBBINGS AT CUTCHOGUE tOWN Of RIVERHEAD SUFFOILK CO., N.Y. SCALE / '~__50[i' APPROVED AS NOTED Ofiice Of Gordon ~ ~3e~10 P. E. , I i lZ ~] Oftie~ Of , n K. Ahlom,