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Home My WebLink About9866-zTOWN OF SOUTHOLD BI~DI~G DEPARTM~T Town Cl~rk's Offlee $outhold, N. Y. Certificate Of Occul~ncy THIS CERTIFIES that the building located at ....e./.~..0..al~o.o.c] .~)~.. ....... ~ Map No ...... 9.0. .... Block No ...........Lot No ...........7.~ ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .....ff.~tly .... 20 ...... , 19..7.8 pursuant to which Building Permit No .... .98/56Z dated .....~ttly.. 26 ........ , 1~'.8.., was issued, and conforms to all of the require- ments of the applicable previsions of the law. The occupancy for which this certificate is ~sued is .............. .~..~×~.t..e...m..~..F..~_t..Zy...~...~..~..~. .......................... The certificate is issued to ............ .D..~..i.e.1..L.y..o.rl.s. ............................. (owner, tesm~xmmsS~x of the aforesaid building. Suffolk County Depa~-tment of Health Approval 8-.qo-/~ December 20, 1978 ................ tlob'e~'t' ~.' '¥1.1L~a' · UNDERWRITERS CERTIFICATE No ........ lP.~4.~l~ ............................ HOUSE NUMBER ........ .e/.s... Street ........... .0..a~. C.o.d..I)r., .................. .Soul;b.o.],d, N..¥, ..... .~./..~.j .......... Building ln~%-ter County Tax h'tanber 1000-090.-/+-22 FO]~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N~ ¥. BUILDIN~ PERMIT ([HIS PERMIY MOS~'B~ R~Pt dN THE P~EMISES UNT L FULL COMPLETION OF THE WORK'AUTHORIZED) N°. 9866 Z Date ........ Permission is hereby gronted Go: at premises located at pursuant to,,apphcahon dated ........ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conform~ing uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .D.e.o..e.m.b.e. zT...2.2.,...~.7.8. ..... New Building .... ~. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property . . .C(~¢~. ~.~q~. P.~r.R ......... q~.~wP.q~...Dr... ........ .So.u.~.bp.¥, ..... House No, Street Ham/et Owner or Owners of Property . . .~¢tT~J,e.~-. ~.... ~x. ~.],&..z.e..~.e..'~.~..~.., . .~y.q,~.s ..................... County Tax Map No. 1000 Section ...~.0 .......... Block ............... Lot...7.]: ........... Subdivision. C.e.c],&u7. ;B.e.&tCh. ~,aT~: ............. Map No..9.0 ........... Lot No ............... Permit No. 9~6.~. ..... Date of Permit 7/.2.~.~7~, .Applicant C-..~.0.~.¢4'.~...A.~.~.~.R.S.,...~.U.Z.~.~.~.,..Z..~.C... Health Dept. Approval . .t2/2.Q/.7~ ............. Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate .................... Final Certificate Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations, Rev. 10-10-7a Applicant G.E~.~.(~. AHT,ERS, BUILDER, INC. .... .... ...................... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~v~ BUREAU OF ELECTRICITY ~-- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Tills CERTIFIES THAT only the etectrlcal equipment ~s described belo~ and introduced by the applicant n~med on the ~dm~e ~pplie~tlon number in the premises of in the following location; [] Easement [] 1st FI. [] Znd Fl. Section Block Lot 7 tvasexarnlnedon [~t~ ~ ~ ~ ~ ri7[~ andfoundtobeincompllancewiththerequirementsofthisBoard. FIXTURE | I I FIXTURES RANGES ICOOKING O~K$ ] OVENS [DISH WA~,~r'~ EXHAUST FANS OUTLETS IECEPTACLE$ SWITCHES INCANDE~CENT DRYERS I FURNACE MOTORS I KITiJRE AI~LIAN~E I~D~. iSPEClALK-~'~T T,MEOOC~CS I B, LL IUN,THUTERS M~S~I"~ -- DIMMERS A~T. K.W. OIL H.P. GAS H.P. A~T. NO. A.W.O. ~*~t.j ~'~' A~4T. ~S. TRANS. ~,.P. NO. OF mT ' '~wAm SERVICE DISCONNECT J NO. Of Jon ~,tuar~' F|ec,, Corn. J MANA~ Huntl ~n~on, L,i 11~4S Ltc.ln~ F ~1~ This cedific~ must not ~ altered in any mannert return to the office of the ~ard if incormd. Insp~tors may ~ idefltJfi~ by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED .IN ANY MANNER. TOWN OF SOUTHOLD nFFIOE FIF BU[LDINr~ INSPEr. TOR TOWN P-LERK'S E}FFIr~E SFIIJTHnLD, N, Y, TEL, 76~-266~ FOP, M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... .............. ~PPLI~ATIO~ FOR BUILDING PERMIT Date July 20~ 19 78 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. PIot 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 Buildin~ InspeCtor will issue b 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 pursuant 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. GEORGE AHLERS, BUILDER, ING. (Signature of applicant, or nome, if a corporation) Lfmc .................................................................... (Address of applicant) Cutchogue, New York 11935 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General contractor · · Mr. a'ad Mrs. Daniel Lyons Nome of owner or premises ........... ' .......... ' ............. :.....: .................. , ........................................................................................ If applicant is a corporate, signature of duly authorized officer. George Ahlers, Builder, Into ....................................................................................... George Ahlers, President (Name and title of corporate officer) Budder s L,cense No ........ ?..~ .......... ~ .................. ..,~ ......... Plumber's License No ........... .~...~...~.....~..~ // E ectrician s icense No ..... ~....J;'~(,,,~ ................ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .................... .9.0. ............... Lot No. 7.,'L ................... Street and Number ....0.~f.~ff~.O.(t,...b;C.i.-vT.~.~..;:'~O~&~O~ ........................................................................................ Municipality 2. State existing use and occupancy of premises and inlended use and occupancy of proposed construction: a. Exisiting use and occupancy ~lo~le ~/~C~/~ ~ b, Intended use and occupancy ....................................... (..!.~.e..~..~.~.~..~ ...... ..(~.....~....~......f~.../~...~(.....~..'-'- -- ......................... / 3. Nature of work (check which applicable): New Building ..... ~ ..........Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~ 70 (Description) 00o.oo 4. Estimated Cost ,l...3., ..................................................................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~. .................... Number of dwe.lling units on each floor ~...~..rt..~....]: ........... If garage, number of cars ................ .~,..o.,~....e. ................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and exteflt 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 .................... ,~.t. ......... Rear ..2.'7.! .................... Depth ....3~..~ .............. Height....................23' Number of Stories ...]r....a...~.~....]:..,.'~. ............................................................................................. 9. Size of lot: Front .......................... 9.q.~. ....................... Rear ........cJ0.,.~.2.~. ............ : ....... Depth ..]-~.~...!. .................. 7/:1978 ........................................................ ]0. Date o{ Purchase ........................................................Name of Former Owner unkD. o1criq ] ]. Zone or use district in which premises are situated ............... ..A. ................................................................................... ]:2. Does proposed construction violate any zoning law, ordinance or regulation: ......... D.Q .......................................... 13. Will lot be regraded . ........ .~,..O. .............. Will excess fill be removed from pr_emises: ( ) Yes (x) No Daniel - 240-61 Depew Ave. · ~' OHS ]4, Name of Owner of premises ..................... ~. ............................ Address ]~oU~']:~.'s'b"o~ ........ Phon~ No ....................... Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor .Q...e..o..~g..e....A...~..~...e.~..~.,....:~..u~...~..e...z2~...~Dgkddress .C.,.o.,~....L.,a.,.n..e. ............. Phone No. ,~..~.~... PLOT DIAGRAM Cutchogue Locate clearly and distinctly ail 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 NDvV YORK, ~ ~ ¢ COUNTY OF ................................ ~'~ George Ahlers h, ~,~ duly sworn, deposes and says thor he is the applicant (Name of individual signing contract) above named. He is the Bui:1der (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 ~nd file this application; that aH statements conlained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the ~lication filed therewith. ' Sworp to b~e m~ this ~ ~ .... ...................... . ~oto~ ?ublic, ....~~ ...... Coun~ .............. ~.~-x~ ...................................................... ~ ~ ~'-~ ~ ' (~gnature of applicant) I ~TAMP T~H~E SU , C: . DEPT. OF H£ALT VI3 MENT OF' INTENT '°-' ., __,,.,,...,,.... DATE: ; : DI$1~)~AL 9YsTEM$ FOR THIS w~*c~f H.S. REF, NO,: 0", : EI'I'A,,DA~I~ OF SUFFOLK Co. DEPT. ' ~ 17' q: ' A~LICA~ ~'L./Z~-~'rN /~. ~'~ ~EC 2 0 1978 .. ~. ~. ~ ~0-~1 ~ ~v~. ~1.~'~) facilities for th~ ~', '"~ ~nspectod b~' thisc~'~a ..... ~,t' a~d found to bo satisfactom ~ ~.~ ~ --~:~ Chief of'~ne~al Engf~eerl~ 2 'L~'- /.6-~' n' / .... ~ ,- u '%:~~a'/~ · ~ - '~ ~ ' ~ / - Is m~Am, ~ND Or~ His mAU To mi