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Home My WebLink About8084-zTOWN OF $OUTHOLD BU~.r~ING DEPARTM~'T Town Clerk's Of[ice Southold, N. Y. Certificate Of Occupency No. Z78%~ ...... Date ............ Aug.. g~ .......,19.~2. THIS CERTIFIES that the bugdlng located at . .Iiarbo~. Lene .............Street Map No. r~c .........Block No. xx ........ Lot No...xx .... Cutohogue .............. conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ............ Ju$.y. · .1.7, 19. ?~ pursuant to which Building Permit No..~0[~.l+Z. dated ...........Jul. y.. ~8.-, 19~;., was issued, and conforms to all of the requir~ ments of the applicable provisions of the law. The occupancy for which ibis certificate is issued is . P.~ivat6 · s~.i~ini..peo.1..with, t~enee. & .acoess~ys ................. The certificate is issued to .~ohert. ldhite ..... t~ner .............................. (owner, lessee or te~t) of the aforesaid building. Suffolk County Department of Health Approval N ,~., ............................... UNDERWRITERS CERTIFICATE No.. N~31~976 ..... Auli. · ~... 197.~ ............... HOUSE NUMBER ..... a.200 .... Street .... Harbor. Lane... X~utchogu~ .......... ....... ..... Building Inspector TOWN OF SOUTHOI.D 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) Ne 8084 Z Permission is hereby gronted to: Sk~r~u~..,.~LD..i~.oo2[s...i~c.....A~.C..!{ah~.~...~fhi t~ ................. ~.~...~:~ ........ ~h~g~. ................... inst~ll rlvate ~i~m~ng ~oo~ ~i~h ~e ~ ac~as~r~ ~ p~em~ses ~oc~ed a~ ......... ~'!.~.Q~.,.~.~Q~. ........................................................................................ Cutc~o~u~ ~ .v ~rsGe~t fo eppUcef~o~ 8ere8 .............................j~ ....... ~.~....., ~9~.~..., ~8 epprove~ ~ tbs s~Sm9 ~.s~ec~o~. N0~ N9~d ~de~riters certificate for C/0 Fee $.!.~.:.0..0.. ........... " BUIM)IN~ DEP.4~,;I;I~IT ~ ~ ' TOW~ ci.ielc's OFFICB ~ (~ SOUTHOLD, N.Y. ' ,~ Exom, ~ ~ ' No. · ........ .............. : //,, / ,,..h ......... .................. ' ' ' .......... Disal:)p .r~ o~ ........................... ~' AFPLIGATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Bui,lding~J~. Inspector, with 3 sets of pla~ accurate plat plan to scale. Fee according to schedule. b. PI0t plan showing Iocatioh'df [of 8n'd~of buildings on premises,~t~l~tionsl~iPto Odjoining premises or public streets areas, end giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. -7i.3 c. The work covered by th s :applicat er~ may not be corn, mence~d before ssuance of Bud ng Perm t d. Upon approval of this appJicotioR,:.the Building Ins!~t..or.~il! issue a Bui!dJng Permit to the applicant. Such permit shall be kept on the premises available for inspection th'r~ugho~t" the WOrk. . e. No building shall be occupied or used Jn whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~i. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone 0Minance of the Town of Southald, Suffolk CoUnty, New_York, and other applicable Laws, Ordinances or Regulations, faf the construction of buildings, additions br alterations, or Tar removal or demolition, as herein described. The applicant agrees to comply with all applicable Jaws, ording~es, building code, housing code, and regulations, and to admit authorized inspectors on premises and in bulldlngs for ~ecessary inspection~ ;SEIlqY DIP POOT~, l'gC. {Signature of applicant, or name, if o corporation) 250 Cox Lane, Cuteho~e, New York (Address of applicant) State wt~ether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder Name of owner of premises ..................... ..~..o...b..e....~;.....J~...$..t.e. .................................................................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ Geo~aje Ahler8, ~reeident (Name and title of corporate officer) Builder's License No ........ ..2..T...T...H..[ .............................. Plumber's License No ................................................. Bectrlcian's License No ............................................... ............................................. Other Trade's License No . Location of land on which proposed work will be done. Map No.: ..................................... '... 'Lot J~o ........................ Street and Number .................JJ&lc~.~z'...J. an~.....Cu.t, oh~[~e[,...~.[....~,. ...... .~.i~ ................... [ ........................... Municipality ~iatef~:iliff uUjj fnndd fccuUl: al~f~yy .?~ljint ended use ....... an.........~l....._. ~..occupa......~..~i.~.r...o~.~.~..~...o~.it.m.~i..m.~:. ......... ; ..... b. Intended use and occupancy ......................... ./.~/(.~.~2-----~..~..../d;~..../(,/~ ....... ~...~...~../ ........... i. ................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .~w:l.n:Ln~..~.<~o.Z .................... (Description) $ 5,000 [ 4. Estimated Cost ............................................................ Fee ..~.. .................................................................................... (to be paid on filing this application) 5. If dwelling, number of*dwelling units ............................ Number of dwelling units on each floor ............................ If goro§e, 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 ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front .....2..0..0........YT.....a~.....':.. ........................... Rear ...2..0...0.....'~....../~......~. ................ Depth .....2..0...0....~.......'~:.....':. .... 10.' Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ......................................................... : ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded . ........................... Will excess fill be removed fr~[~or~S~:e~e) Yes ( ) No 14. Name of Owner of premises ...~.o:.b...e.~..t.,...V~...J:...t..e.. ................... Address ..(~&~eE,~,~. ........ Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No. ...................... George Ahlers, Pres. 250 Cox Lane Nome of Contractor ........... ~':['.~"!D~.*~"'P'6'6:Z'~'"'~'w6';: Address .(~u.l:e~og~.i.~. Phone No ..................... PLOT DIAGRAM 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 YORK.. ~ c S COUNTY OF ('..~__&l~l.~,._ ~aT./~,, , ,.bein, g duly sworn deposes ond soys that he is the applican, ................... .,. :'. .. (Name of ~nd~vldual s~gnmg contracw ' above named. bulder He is the .................................................................... (Contractor, agent, corporate officer, etc.) of sold owner or owners, and is duly authorized to perform or have performed the said work and to make and file th s app cation; that oll statements contained in this application are true to the best of his knowl~cl,~ and belief; and thor the work will be performed in the manner set forth in the application fileq~erew, ith. Sworn to before me .......... Z. day of Notary Public, .............Coun(-y .............. ................................. ~15,_ .~'~~ ~ _ ~ .,~,~..~. ( . ~igpoture of appli~ NOTARY PUI~LIC, St~t* of New Y~r~ No. 52-~52202J~ /Or" THE NEW YORK BOARD OF' FIRE ",~lte, Har~zr Lane, Main Rd., Cut~og~, L.I. July~,°~ 197> andfo,,,,dtohelne,,mp~i~e~irAt~qui~t~fflA~:: I 20 11779