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Home My WebLink About7941-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N, Y. Certificate Of Occupency No.Z.~...5~.. ...... Date ........... J..U~......~.0..., 19 THIS CERTIFIES that the building located at .~. ~-'i..~.~..h....]~..~...~..15... Street Map No. ~ ........ Block No...~. ....... Lot No, ~ ....NS..~.~.~..~t...e~....N.,.~.: ....... conforms substantially to the Application for Building Permit heretofore filed in this pffice dated ....... ~.l~.r.~.~.. 3..., 197~.., 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 .1~..~.?.&.~.~. ? f..a~.~..~...d.v~..ll~g...w~..~h ........................................ The certificate is issued tol~t.~.b.~.a....H..a~.. ..........0~.. ~. ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N. :~.~. ............................ UNDERWRITERS CERTIFICATE No...~.f.M..~./..~..~. ............................... HOUSE NUMBER...~..~..~. ...... Street....~a..]~..~..~...0..I~.. ~ ..................... FOR¢~ NO. 2 TOWN OF SOUTHOLD 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) No. 7941 Z Permission is hereby granted to: Gao.,Ahler. s..Pa~il~er...Inc ....A/O.....]~les & Barbra Ha~t ............... q~,~cho~:~.e.....~..,.~:. ........................ to .. ~LLi~i..a~..~i.~lO~ .. oA~...~.~:~.t~ir~g... ~.e ll i~g ............................................................ ......... (&l~Ovea..~y'..,l~d,,,..Apl~Als..&.Cc,. PX..Com~.) .................................................... at premises located at ..... .~..Y~......R~...~.f~....~.;~.~.~i{L..]~.~....(.~..e.,~..~,). ................................................. .................................................. I~a~t ituzk.....It,~,. ......................................................................... pursuant to application dated ........................~1~.~.4,~ ....... .3 ........... ]9...~.~, and approved by the Building Inspector. Fee $....1.~.e.~ ......... FO]~I NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Sou~hold, N. Y. 11971 APPLICATION FGR CERTIFICATE OF OCCUPANCY Instructions A. This opphcation must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the follow~ng; for new buddings or new use: 1. F~nol survey of property with accurate location of all buildings, property lines, streets, aha unusual natural or topographic features. 2 Final approval of Health Dept of water supply and sewerage d~sposal--(S-9 form or equal) 3. Approval of electrical ~nstallatlon from Board of Fire Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Residences and s~mdar buddings and installations, a cerhficote of Code comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. B. For ex~stmg buildings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-ex~st~ng" land uses: Accurate survey of property showing oil 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 hous.ng code or safety respect:on of buildings or premises, or other pertinent in- formation required to prepare a certificate C. Fees: 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 .............. New Building ................ Addition ................ Old or Pre-existing Building .......:c ...... Vacant Land .............. Location Of Property ..................~.4~.~..5.~.~.~..~..a..~.~..~.~g~.e.~9~.]:.a.~.~.~9~.a..c1.~'~..~..a.~?~..~.~i.~~t~ .................... Owner Or Owners Of Property ..... ~.al'.ha.~.a...~ .... JJ.~.t, ............................................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No...4..5..3...0.. Permit No ..Z.Z~.6 ......... Date Of Permit .4~.3/.Z.5.....Applicant ..g.e.Q.z'.ge...,~.JJll.e.~'.,s.,...]~.l~.~,,l,.rl.e,~.,...]~.g. Health Dept. Approval ...... .~....i...~...i ........................ Labor Dept. Approval ................ ..~....:..../~.. .................. Underwriters Approval .....~...~....~...~...f.../~......(?. ................ Planning Board Approval ....... .~....~./..~... .................. Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ .................................... Construction on above described building and permit meets all app, lieable codes and regulations. Appl' ~cant ............ '~'~ ....... ~~ ..................................................... George A~Jlers, Builder, Inco Sworn to before me ........ of ........ (,tamp Irlod UallV '~ '3 Z bJ Z 0 :' £' Allen 12' TOWN OF SOUTHOLD . . - ~ / .~ ............ .............. ...... ........ ...... . .... ..................... ~.~.~.:..:.:~ .............. ~ ...... :..: .................... / ~ . ~ -- ~o , ~ (Building Inspector)[ ' ' ' ~ ¢/ ~' , ~} / ate ......................... ~ ............. , 19.....~ o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Budd Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. , ' - b. Plot plan showing location of lot and of buildings on premises; 'Felaflb'~'~h~j) ~o: bdjoining premises or public street-~ areas, and giving a detaded description of layout ofproperty must be drawn on the diagram which is part of this applicati · 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 w,ll issue a B6ddmg Permit to lhe'applicant. Such per shall be kept on the premises available for inspection throughout the wo~k. "' e. No building shall be occupied or used in whole or in parc for any pu'rpose v~h'6tever until a Certificate of Occupa, shall have been granted by the Building Inspector .... · .. ~' APPLICATION IS 'HEREBY MADE tc~ the Budding Department for the issuance of a Building Permit pursuant to Budding Zone Ordinance of the Towr~ of Southold, Suffolk Coun'ty, New York, and other applicable Laws, Ordinance- Regulations, for the construction of buildings, additions or aJterations, or for removal or demolition, as herein descnl: The applicant agrees to comply w~th all applicable laws, ordinanceb, building code, housing code, and regulations, admit authorized ir~spectors on premises and in buildings .for necessary, jnsp,e, ctio0s.. , ...... ,' . .. ' ' ,:.... _ (Signa~t'ure of applicant, or name, if a corporation) ....... ,' " ...., ' 250 Cox L~e,. ' '. ,, '' ,,, ' "' ' ' ' ' ' (Address of applicant) State whether applicant is owner, lessee, bgent, archite~t, engineer, ger~eral contract~)r, electrician, plumber or bud, l~u! lde. ' , '" ..... Name of owner of prem,ses .... ~T~ ~...~.~.~...!.J./¥:..~:.~..~..~..~......J~..!.J.t~. ~.......!.J../g...J~.. ................................................. if applicant4~/s a corporate, signature of duly authorized officer. ....... ': -~h~r~;;~"~ ,;1'~ '~¥'c'~';p~'ra~e officer) Builder's License No. i?0 itl ' . Plumber's License No. . Electricians License No .............. ' ............................ Other Trade's License No ........ '.....L.' .............................. ' ' ,~, ~', ' ', ,. ¢~,~L Lt o'Xk Locotion of lond on which proposed work will be done M~pNo --~ -'-~'t ~'- ....... o N ................ St:eet and Number .~$..v.~f,e.. ~.~.~* .o~ ..V.e.~.,...~.~.~.~.*..u..e.~.,..~..e.~- '"" .~o.v.~ ..' ............................ Municipality State existing use and occupancy of premises and in',ended u,s~e and occupancy of proposed construction: a. Exisiting use and occupancy ...... .~..?..e.~..~..t..~.(j.' ....... ,~ ...................... ' ............... ................................. occu o c, ..... ....... ..................................................... b. Intended §. Nature ~)~ w~rk [check wh,ch ak,.,icable). New Building .................. Adc on ..: ......)~..[ .... Al~eratioh ...:.x ...... Repair ................. Removal ................ Demohhor ............... Other Work ............................................ 4 Estimated Cost ..... $~..0¥~0g~.0-0 ......................... Fee /'~ ~ O~ (Descrip~:ion) (to be paid on filing th~s applicahon) 5 If dwelling, number of dwelhng units ......................... Number of dwelhng umts on each floor ........................ If garage, number of cars ............................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......................... 7. D~mensions of existing structures, if any' Front...2.6: ............... Rear ....... 2.f3: .................. Depth ...30'...7..:,.. Height ......... 115., ........ Number of Stories ..... ].'~ ............................................................................... Dimensions of same structure w~th alterahons or additions: Front .......... 58:. .............. Rear ... 2~: ...... Depth 30t .7". .......... Height .25t . Number of Stories ........ 2,} .............. 8 D,mensions of ent,re new construchon: Front ....... ].2., ............... Rear ........ 3.2.~ ............ Depth .. 2Q' ........... He,ght .... 22.: ......Number of Stories .... 2 ............ ~. ......................................................................... 9 S,ze of lot Front 3.14 .f~e.t ....................... Rear .. -~03,.$.1 ~.ge.~; ....... Depth .. 10 Date of Purchase ...................................... Name of Former Owner 11. Zone or use dmtr,ct in which prem,ses are s,tuated ...... .~ ............................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation: ......................................... 13 Wdl lot be regraded .. 'g~.s .......... Wdl excess fill be removed f£ojm~remises: (.) Yes (~) No 2;.~ fCro~by l(oad 14 F,'ame of Owner of prem,ses ..B. arhaza ~B...H~r.~; ............ Addre_.sgB. unt..~.m.[~.+..~n.,.~....YPhone No .................... Name of Architect ................... Addressff~)...C.~.~...E}{.ff~ ....Phone No .................... I'Jame of Contractor -C.e~r.~e Al~.leZ's B,~ 3.~e~..~.~¢~A, ddre_.s~'C.ui:.eh~.~.e~,~...Y.. Phone No...7.3.4.-.50.3.: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and red,cate all set-back du'nensions fro property lines G~ve street and block number or descr,ption according to deed, and show street names and ind,co whether interior or corner lot. STATE OF NEW YORK. ~ COUNTY OF ~UF~OLI< ......... _ S S ................. G~O~C{~.J~KL~..RS ............................ being duly sworn, deposes and says'th<~t he ~s the apphcc (Name of individual signing con{racO above named. He is the ........................................... .C.9..n...C.E.a...e.t. 9..r.: ........................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d s~ork and to make and f this application; that all statements contained in this apphcahon are true to the best of his knowledge and belief; a thor the work wdl be performed ~n the manner set forth ,n the application filed therew,th. Sworn to before me this ..... l&t .......... day of · . ADr~.a ............... , 19 Nota~,~ Public, . ........ iSuf.f~o.l.k .......................... County NOTARY PUBLIC, S~ of New Yor~ Suffolk Oounfy . ~No. 52-4~J Commission Exp)res March 30, 19~ (S,g. hature of applicant) E. Alien 0 -~ ,,' S. 8° 44' J. Kelly FORUM NO. 1 TOWN OF SOUTHOLD /, BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved i[[[[[[~'~[[[[[[[[[i[[[[, 19~:.[. Permit No. ~2...~.....~...L.~..-~.. ..... , ....... ~'~ ................. ......................... ............................... AFFLI~ATION FOR I~UIL~IN~ F£RMI? INSTRUCTIONS o This application must be completely trolled mn by typewriter or in ink and submmtted in triplicate to the Buildin: Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedu, le. b. Plot plan showing location of lot ohd of buildings on prem~s~-,' '~etat~bn'sh~p td bdibining premises or public streets o areas, and giving a detailed descripbon of layout ofproperty must be drawn on the d~agram which ~s part of th~s application c The work covered by th~s application may not be commenced before ,ssuance of Building Permit. d~ Upon approval of this application, the Building Insp~ctorwdl issue a Budd,ng Permit to the applicant Such permi shall be kept on the premises available for inspection throughout the wo~k. e. No budding shall be occupied or used m whole or in part for any purpose v~hatever until a Certmficate of Occuponm. 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 thc Bu,ld,ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply w~th oil applicable lows, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in buildings for necessary inspections. _- (SignOre of applicant, or name, if o corporation) .................................. (Address of applicant) State whether opphcant is owner, lessee, agent, orchite~zt, engineer, general contractor, electrician, plumber or builder Name of owner of premises ....~1'~...J~...J~.~.~.....~.~....l~....~...~.. ~...~ ...................................................... If OppI'con~ a. corporo,~s~s?FfZ[e.,,of d~y authorized officer. (Nar~ and t,tle of corporate ofhcer) Builder's License No. t?0 HI Plumber's License No ................................................. Electrician's License No ............................................. Location of land on which proposed work wdl be done. Map No . . . Lot No..'.~.. ............. Street and Number ...P..~..I.Y..~..~.~.....~...~.II.II...~.....°..f.....~..~.~.*....I~..~.~.$~.~I~.~*...~.~.~....~...e.~.k. ............................................ Municipality State existing use and occupancy of premises and in~.ended u.s~e and gccuponcy of proposed construction: o Ex,siting use and occupancy ..... ..~....~...~...~.~.I.~J ............ // ........................................................................ b. Intended use and occupancy / 3 Nature of work (check which ~Lllll~icable) New Build,ng ...... Adll~lSn ..... ~ ... Alteration .. x Repair .................. Removal ................. Demohhor ............... Other Work ............................................... (DescriptiOn) Ir _..-- O O ~ 4 Estimated Cost ..... $~0¥00~r~ ...................... Fee ..L.~........:... ........................................................ ~ ........... (to be pa,d on fihng this apphcahon) 5 If dwelling, number of dwelling umts .................. Number of dwelhng umts on each floor .............. If garage, number of ca~ ........................ 6 If business, commercial or m~xed occupancy, spec,~ nature and extent of each ~pe of use ....................... 7 Dimensions of ex~stmg structures, if any Front .... ~6.' ............... Rear ....... ~6Y. ..................Depth ...3Qy....~.v... Height ........ .~6.~ .........Number of Stones ........ &J ......................................................................................... D~mensions of same structure wnh alterahons or addn~ons. Front ............ ~. ............. Rear ..... 2~ .......... Depth ..... 3O.t....Tn~ ........... Height ............ 25.~ ........ Number of Stones ......... 2J ............... 8 D~mens~ons of enhre new construchon Front .......... ~2.~ .............. Rear ........~2t ............ Depth .. 2~' ..... Height ...... 2~ ...... Number of Stories ...... 2 ................................................................................. 9 S~ze of lot Front ...&.~4.. ~ ........................ Rear...~0~..~ .~m~t ........... Depth .... ~9.2,.~2...~.m~ 10. Date of Purchase ..................................................... Name of Former Owner ..................................................... ] 1 Zone or use d~stnct ,n whmh premises are s~tuated ........ ~ .............................................................. 12 Does proposed construchon v~olate any Tatung law, ord,nance or regulahon ...................................................... 13 Wdl lot be regraded ....... .Y~m ........... WHI excess fill be removed f~remises: (_) Yes (x) No ~ ~ro~by ~o~d ~ N~e o~ Owae~ ~ ~em~ses ...~rha~.~..B....~a~.k ........... A~dr~ti~g2~,.~...Y~h~e ~o ..................... ~e of A~ .............................. A~ess 2.~...~.~..~.~ .... ~o~e ~ ..................... ~[OT ~A6~ STATE OF NEW YORK. [ c COUNTY OF ..~.~EFOL~ ........... f ~ S ........................... .G~ORGF..J~HL~S ......................... being duly sworn, deposes and says that he ~s the opphca~ (Name of ~ndw~dual signing contracf) above named He is the ................................................ ~..~.~..'f.~.~...q.'f...o.~ ................................................................................... (Contractor, agent, corporate off,car, eta of sa~d owner or owners, end ~s duly authorized to perform or have performed the sa~d work and to make and f~ th~s applicahon; that all statements conto~ned ~n thru apphcahon are true to the best of his knowledge and behef, at tk, ar the work w~ll be performed m the manner set forth ~n the apphcahon filed therewith Sworn to before me th,s ....... .......... ........ ............... ............................ Nota~ Pubhc, . ....... ~.uf.~oJLk .......................... County ................... (Signature of applicant) NOTARY PUBLIC, Ste."e of New Yo~'k Suf'~olk Cou~fy - iNo. 5L4521450 Cemrniss.:on Expires March 30, F~E: BY i,lOijF¥ BLJILD[NG DEPARTMENT BEFORE J /-CJ., I Li,-.G FCUNDA-