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HomeMy WebLinkAbout8666-zFOII~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No~. ~S~.. ....... Date ...NO.~.~I~I]IO~ .~i~1, ........... , lg THIS CERTIFIES that the building located at . .~/8..~. ~.~.~. P~t~ ....... Street ~asau Map No.. XX ........ Block No... ~ ..... Lot No ................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . *Y~e. ~.. I~1~ ..... , 19.7~. pursuant to which Building Permit No. dated . ~.11~8.22, ............ , 19. ~.~., 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 .. P.~'i.V&~e. 0tlc.. Fa~$~y..~tS~;~g ....................................... The certificate is issued to .. ~.~ba~'l~ .Siegel. ....... ~. .......... ~ ................. (owner, ~) o~ the aforesaid building. Suffolk County Department o£ Health Approval I?~.V.~. ~..~.~. ~.~....R.o.b.~.~..A?..V..i.l.l~. UNDERWRITERS CERTIFICATE No...(.I~d.i.~g). ................................ HOUSE NUMBER . .3~3,~ ....... Street ...V.~..m.~.~.O.~...~.o,a.~. ~ ...... .................. Cutehog I~, ~. Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8666 Z Date Permission is hereby grunted to: ...~.~'. ...... ~/:(.!:.~..~.~...r....~.~!.!..~fL.~.~L...2~~- ....... ~Z~ ....... ~ ........ ~.!..C.~..~./-. ................... -~L/ 1.~ ~ ~v'~T~ ~1~' ff~l ~ ~L~E~LIN~ at premises located at ~/~ I~ ~..~.~ ~! ..... ~..~ ~ ~) ~ ~..~. ~ ~..0.~..~ [ pursuant to application dated .......................... ~.~,~.~. ...... ~.,~ ..... 19Z~.., and approved by the Building Inspector. Fee $,..!.~...~...~ .... Building Inspector TOWId OF $OUTIdOLD Building Department Town Clerks Office Southold, Id. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPAIdCY 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 lines, 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 from 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 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 Date Novembez~ 17~ 1975 X New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..V...a..n...~.~.~.n...~.~..a...d.~....~!.a..~}.~a.~`...P.~...~..n...~.~...`.C..u..~..~g~.~.?....~..~.~ .................. Owner Or Owners Of Property ....B.a.:13.]~.a~?.~,..~q.~.~fi.~], ................................................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No. 8655Z Date Of Permit .~./...3.~./..7..6.....Applicant GEORGE AHLERS, BUILDER, TNC. Hearth Dept. Approval ..~....S..0....!.]-..9. ....................... Labor Dept. Approvol ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ J:in~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ....C*~Q l~.~.. J~ILF~q. ,....~J.T. LD.I~Px ,... ~L'~I~ .................................... ~ Swomtobeforemethis '~/6~'.~c. ~/~~fb-''-'''~ ~j~J~ /.1 ................ day of ............................................ ,stamp or seal) ~'l /, ~ ~' Notaw Public .................................... Coun~ ~ ..; ~ //~ (Building Inspector) *PPLIC*TI' FOR BUILDI"G PE'IT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sate 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 oF areas, and giving a detailed description of layout ofprpperty must be drawn on the diagram which is p~rt 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursu,a, nt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions 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 admit authorized inspectors on premises and in, buildings for necessary inspections. (Signature of applicant, or name, if a corporation) :1' ~ ) COX Lane, Cutcho~:~ue, ew York 1193~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~z'. and .Nfs. N~n:Cred :~e-;al 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 ............................................... Location of land on which ~)~opse~ work. wjJl be done.. Map_Ho.: ...................................... ¢. Lot No., ......... ... ............. Street and Number ....... ~~y...~.~ ............................................................................................... M~I~Ii~ State existing use and ~cu~ncy of promises and intended use and ~cu~ncy of p~ c~t~ti~: am Exisiting use and occupancy .................................................................................................................................. dwellin~ b. Intended use and occupancy ............................ ;~ .................................................................................................. 10L 11. 12. 13. 14. 3. Nature of work (check which applicable): New Building........Z. .......... Addition .................. Alteration ......... Repair .................. Removal .................. Demolition .................... Other Work ....................... i .............................. ~ (Description) 4. Estimated Cost ...... [?...2. X..~.../~...".O..; ............................... Fee / ~ i~ , (to be paid on filing this aplMication) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floqr ............................ If garage, number of cars .................................................................... ; ......................................... i ............................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usb ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories .................................................................................. L .............................. Dimensions of same structure with alterations or additions: Front .................................... Rea~ ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front 79 t '79 30 .................................... Rear ............................ Depth ........................ Height 22' Number of Stories 2 Size of lot: Front ...... ; ...... ;,... ...................................... Rear .......... ~.~.¢,.,.I..,. .................. Depth .J ........ ~.O.g.~....~.. ........ Date of Purchase ........................................................ Nome of Former Owner ........................ Zone or use district in which premises ore situated Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ Will lot be regraded . ........................... Will excess fill be removed frgrn premise~! ( ) Yes 'v ~'~ 5~co~ [~:Loact Nameof,~ ..... · ....... :Ls. Barbara ~le: el ~,,,u~r -- ~,~,,,,~ ........................................ ~ ......... A~re~ g~eh~ev..~. P~ Name of Architect .............................................................. A~re~ ................................ Phon, Name of Contractor ueoz .. ,-.h,.~.. ~,, .I .... e. A~rne ~_.~. Coz L~e ................................................................... ~ ........................ v--" Ph~ PLO~ DIAG~M ~atcho~e~ ,~Y Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bo property lines. Give street and block number or description according to deed, and show street whether interior or corner lot. (x) No ~ No. ...................... :k dimensions from ~ames and indicate STATE OF NEW Y~R~/ ~ / ~ S S ; COUNTY OF ~....[ ' ................................................................................................. being duly sworn, deposes and says that ihe is the applicam (Name of individual signing contractO above named. He is the .................................................................................................................................................. ~ .............................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work andi to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to befo~'e me this . ~/' ~'..,~..~ ~. ~ ~ (S~gnature of apphcant) b~mm.ssion Expires March 30, iS/'~/ THE NEW YORK BOARD OF FiRE UNDERWRITERS ' N 318G03 ~,- Cu~ChOgU~, C,L,,,.,,' ~...~,,,,,~-.~"" December 27, ~976 ~RV CE DscoNNECT METER ' ' ~200 Panelboar~/s: 1-gci~- 125~PS' O.p.I. Smoke 1-10 amp. Comp~c~O~ Gustav Bartra, 227 East Breal.~;ater Rd., Mattituck, L.I. 11952 Lic. 1529E ' Ir't~. .5'1~- 764- ~{~~ ~. ~. ~.'~f~-'~ T~e sewage d~sposal and ,~t~r ~upp~Y f~olltties for this l ocs. tlon ~qve Deen ir spected by this department ~ %¢ be satisfactory. . ' Service~ St)Pr. CO 01[~1' ~ H[ALTH FOR APPROVAL OF ~U~N ONLY A~NOVED: GEOR~'AHLERS ~I~R lNG COX ~E CUTCH~, N~ Y. 11935 / 7 ~. ' lUFF'. GO. HIAI.TM DI~T. AF~v-~AL H. NO. ___.. C~m~ny GEORGE AHLERS BUlmER C~NO~UE, ~. Y~ 1/93~ ~oss 250 cox ¸.7 i - o 'Office Of ' exz:~:pt by a Licensed ~: , N, Y. State ,~duc,tlO~ LaW. ' : " Office O~ Gordou K. Abler., P.