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Home My WebLink About9725-zFORM NO. ~ TOW~ OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office South&d, N. Y. Certificate Of Occupancy No..Z9.~8.6 ..... Date . SeFtember,. · 1 ............ , 19 c/L~. THIS CERTIFIES that the building located at .1850.9~;h. S.'cr. eet .......... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore flied in this office dated .. ~q~'.. ~ ............ , 1~.. p~suant to which Building Pemit No. ~$.. dated .. ~...1.~ ............ , 19. ~, was issued, ~d conforms to ~1 of the requ~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~Y~.~ .P~..~.~. ~ ................................ The certificate is issued to Dr~ Bern~d K~rsch ( owner, of the aforesaid building. S~olk County Department of Health Approval .... ~'~ ....................... UNDERWRITERS CERTIFICATE No ..... ~. ............................... HOUSE NUMBER 1850 Street Ninth S~ree~ . ............................................... X orl~ ............. B~lding Inspector TOWN OF SOUTHOLD BUILDIHG DEPAR'rMEHT 'TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9725 Z PermiSsion is hereby granted to: ...~/.,< ...... ~%,....~[~.~.~.~.~. ...... !~.!.~.~c. to · . ......... 2 .................................................................. ."~ ........................... I1~ 50- 9'~A ~-~eT at premises located at ............................................................................................................................ pursuant to application dated ~A ~' Y 19Z.~. and approved by the Building Inspector. Building Inspector FOKM NO. $ TOWN OF $OUTHOLD , 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: I. 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 os to use, occupancy and condition of buildings. 3. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in* formation required to prepare o 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 Land .............. Location Of Property -~ ,0 ,.].~ ~,~... v. ~- u. ,~?~r)o.cb, J.:e~ Yo~lf ~ner Or ~ners Of Prope~y .......... ~.~.:...~[~.~J~:~...~J;~[~2~. ................................................................. Subdivision ................................................................ Lot No ............. Bilk No~.~![]~..,.:.~ House No...~,~0. Permit No. ~ ~;-" Date Of Permit -~--//7~ Ann ~nn~ G¢,O~('e .~h~ez .~, ~u_~].~; .... ~1<,, Health Oept. Approvol ..... ~.~},~.~4.~} ...................... Lobor ~t. Approwl ................................................ ~nde~H~ers Approw~ .............................................. P ~nn nfl B~rd Approval ...... ; ................................. Request For Temporary Certificate ........................................ Finc~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this Applicant ;.~;'../j.,..;~;v~_~/,~.. ................ day of ............................................ (stamp or seal) Notary Public .................................... County ~i'-/ TO~N OF SOUTHOLD [~FFII~E rIF PlUiL~iN~ INS;~I~TPlR TnwN FI. LERK'S rIFFII~E S~UTHI]LD, N. Y. 1~19'71 TEL, l~.,oke D~ctor __. Lic.t529E \ y "1 227g, B~eakwa~r Rd. Mattituck,N.Y. 11952 FOB~I~ NO. 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN CLERK'S OFFICE ' SOUTHOLD, N. Y. Examined /'~ 19.. Application No. Approved., ~ r'? 7...~Perm,t .............................. ~7.~ ................................... ,,9 ........ 'No. Disapproved ' ~..:..: ....................... i .............. : ............... :. ......... a ~ c ~h~T.'~:~ .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................. ................. , ..... INSTRUCTIONS a. Thi~ application ~ust be completely filled in by typewriter or: in ink and submitted in triplicate to the Building Inspector, with 3 ~ets ,of plans, c~cd'rate plot plan to scale. Fee according to schedul6~ b. Plot plan shqwing location of lot and of build rigs on pram sas, relationship to ad oin ng pram ses or public streets o~ areas, and givin~ a d~taded description of layout ofproperty must be drawn on the Wagram which is part of this application. c. The work.cove[ed 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 shale.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, In¢~ (Signature of applicant, or name, if a corporation) 250 Cox L~ue .... ,... .............................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder: General Contractor · . Dr. and Mrs, Bernard Kirsch Name of owner or premises .................................................................................................................................................... If applicant~i~ a corporate, sig~al;ure of duly authorized officer. (Nam~,jand title of corporate officer) Builder's License No .................. ~...~. .............................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ...................... ~ ................. Lot No ......................... Street and Number ..D&s.t~.~..t..~.0.O~).,...~t~.Q~,QD...~.~.~..~]4~Ck..~L,.,.~..f~'.¢.f~ ....................................... .23, Suffolk County Tax MaD Municipality 2. State existing use andP~Jc'~TPpt~'cq/~o'~!~r~is~t~'hci~t~e~'us~rc~'~ncy of proposed construction: a. Exisiting use and occupancy none b. Intended use and occupancy ....,....~..~...e,.]:.l..~.~.~ ...................................................................................................... 3. Nature of work (check which applicable): New Building........~ ......... Addition .................. Alteration ...... ,......,.., Repair .................. Removal .................. Demolition .................... Other Work .................................................... ([~scriptim~) 4. Estimated Cost ..~.~..0.,..~..0..0..,.0..O. .................................. Fee .......................................................................................... (to be paid on filing this application) 5. Ii.dwelling,, number of dwellina units .....?. ..................... Number of dwelling units on each floor ..~....O.~....~..~...~..s.~.. ~J. OOZ') u, o~- secor~d ~'].oc~z~ If garage, number of cars ............. ~. ................................................................................................ 6. If business, commercial or mixed occupancy, specif,, 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 ..-~. ..................... Depth2-,./'f. ................... Height ...2...2..".....+./..-.. Number of Stories ....... ~, .................................................................................................. , ......... 9. Size of lot: Front ...... ..]:.0...2.....~.~.0. ................................... Rear ...;],.Q~..).~O. ........................ Depth ...~,5 ...................... 10. ~ Date of Purchase ..r. ................................................... Name of Former Owner ..U~..~..~..°....w~.. ..................................... 11. Zone or use district in which premises are situated ...... ~. ............................................................................................ 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ..... ~..O. .............................................. 13. Will lot be regroded ....~.O..~: ........ .~ ....... Will ex.cess fill be removed from p_remises: ( ) Yes (x) No ur, J~ernard Klrscn £2~7..Park .~e. 14. NameofOwnerofpremises .................................................... Address ,L'~....~.~a...~X... IIl~l~e l~ ., ................ Name of Architect ...............l~...o..rl...e. ...................................... Address ................................ Pho~ Ne ...................... Name of Contractor .~...e..o...r.~.e.....A...h..1...e..r...s.~....B..u...i..1...d:.e.?.. ...... 2~5OI2ox Lane Address C.[L~,~d~tee..4'~ 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 i~llc~te whether interior or corner lot. see attached sheets STATE OF NEW YORK, ~ ~ c COUNTY OF ................................ [ '~"~ George Ahlers h, nn duly sworn, deposes and says theft he is the applicanl (Name of individual 'signing ~odtrac~ r C~eao~o~ ,, .' He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work a~ to ~ke a~ file this applicatioh; that all statements contained in this application.are frae fo the best of his k~Jedge and bileS; and tha~ the work will be perfo[med in the manner set foffh in the application filed therewith. Sworn to~fore me this / jill ........ ..... ....................... , - ......... - .............. ~u~ icj ..... ~d~ ................... '2: ' 4'oo @ I 15:7' / atO/V J£,'Az~.-: //4')/:0' out A~hitect or E,gioer't ~il 12' ~b N, 1~ ~ ' DATE:- NOTIFY BUILD~N~ DEPARTMENT AT /~ Z ~ ,' ~ '~ /~ ~" ~ to 4p~ ;oe ~E~Um- ED INSPECTIONS: ~ 1. BEFORE BACKFILLING FOUNDA- ~ ( TION OR START FRAMING 5. ALL CONSTRUCTION MUST MEET UIREMENTS N.Y. STATE CODE ALBERT A. SACCO ~ GORDON K. AHLE~ HOUSING CODE & ZONING ARCHITE~S & ENGINEERS ~'~ MAiN ROAD SO,HOLD, N.Y. 119~ - · V ~ ...... ' $7_'%0/( "Altma{iorl ~r this [~cu~mlt by an ArchiteO c,r t ;-om,~ Profes. sional Engin~r, is il~egai". ; ~-:lion 7209: [uMivisio~ visions to or re-use of dray/mBs w~th- out Architect or [n~ine~rls Approval voids Seal and ~i[n~ture on same. ZO:O' 4C~c ~oO',B'z)A T/O/V //=OO T//VG. PZ,4A/ :cA~:- : ~ b/to" ALBERT A. 655 MAIN SACCO Am) GORDON K. AHLERS ARCHITECTS & ENG!NEERS ROAD 5OUTHOLD, N. Y. 11971 ~ i=-I~.ON T ~c,,4 t b.'/~. "-- /: o" I I ~'Allera~to~ of this Docur~nt except by aln Architect or Licensk"d P. rofes~ ~onal Engineer, is illegal". ~v Sectlo~ 7209, Subdivision 24 N, Y. State Education Law. .u'. S~nadure only goOd for if~itial uss ¢ drawing Changes, alterations or re vis,nS to or re-use of drawings wi~ out Architect or Engineer's ~prevat voids Seai ~d Signature on sams, I I 'ALBERT A. SACCO A.D GORDON K, AHLERS ARCHITECTS & ENGINEERS $4655 MAEf, I I~OAD $O.UTHOLD, N, Y. t1971 L~-FTJ~IDE ~-L E-V~ TIO N ALBERT A. SACCO A.D GORDON K. AHLERS ARCHITECTS & ENGINEERS ~4655 ~t~. ROAD SOUTHOLD, ti. Y. 119TI "Alteration of this Document e~c~ by an Architect or Licensed ProfeS- sional EnEineer, is illegal". Section 7209, SubdJvlsJon 2,: N.Y. State Education Law. · Architect and Engiooer's S~al and Signature only good for initiet use of drawing. Changes, alterations or visions to or re-use of drawiogs with- out Architect or Engineer's Approval voids Seal and Signature on same. ~ D.A. YbNT ~' IlWrULAT~- "A~teratton of this Document except by a~ Architect or Licensed Profes- ston~l EnFjneer, is Secbun 72~3. Subdivision 2, N Y, State Educabou Law, ~lrawing. Ch~mges, alarm[ions or Te, vision~ t00r T~ ~f ~r~win~s with, out ~c~tect o[ En~neer's Approval voids ~al ALBERT A, S.~,CC~~'~D GORDON K. AHLERS ARCHITECTS & ,~NGINEERS 54655 MAIN ROAD $OUTHOLD, N, Y, 11971