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Home My WebLink About9829-zTOWN 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) N? 9829 Z Date J'U].~. 12 19 78 Permission is hereby granted to: ......... ......... ..a./.c......~.o.~.h~...~Le.~....&....~.c.Z.....~tie~ to .....bu. ll~t..a..i~.~.v.a.~,e..One..Fa~:L.l~..J~et]..~.~ ................................................................... at premises located at ..................... ]S85...Sh:Lpa.~Or'J..v.e ................................................................... ......................................................... ,.~eu.t.h~l d.,.. ~e~...Ye~l~ ............................................................ ......... ..F.~,I .~.d....~....~... ~.~.~.~...,... ~ ..#... !0. ...................................................................................... pursuant to application dated ............ Jl)'l~'.....~ ........................... , 1~.~,.., and approved by the Building Inspector, 1000-079-]-8 Building Inspector 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 OP, 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 Undenvriters. 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 in- 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 New Building ..... .~.. ........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ShiD's Drive, Southold, New York Owner Or Owners Of Property ...~.~.~...o..t;;.b.~.....a.D..~..~.~3..c.y...~.~k.e. TX ......................................................... Bayview ~,~oods Estates .... 10 Subdivis;on ................................................................ -or mo ............. Block NO ............. House No ............. Permit No. 9829 Date Of Permit~.../..]:..2.../..~..~......Applicant George Ahlers,Builder. Znc. Health Dept. Approval ...... .7...~.L.~.../.../..~.~... ................ Labor Dept. Approval ................................................ N406325 Underwriters Approval ...............: .............................. Planning Bo~rd Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .............. Sworn to before me this ~~ ................ day of ............................................ (stam~ or ~ol) Nota~ Public .................................... Coun~ TOWN OF' -C:IOUTHO/D rlFFIE~E OF IBUILDINB INSPE:E:TrlR TOWN CLERK'Ei OFFICE SOUTHOLD, N. Y. '119'71 TEL. FO~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...........~Y......')2 .......... , 19...~.~. Approved ........... J~.y. ....... .12, ....... , 19...~.~. Permit No ............. .?..8..2.~ ............ Disapproved o/c ............................. ~:'-- ...::: :.~','~ .~.....~. - ... ---- .~ ...... (Building Inspector) AFF'LICATION FOR BUILDING PERMIT Application No ........... 9J~2, 9. ............ 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. Plot plan showing location of Iot 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 Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept an 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 a~terations, 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, INCo (Signature of (3pplicont, or name, if a corporation) 250 Cox Lane .G~1~¢ h~g.u ~.,... ~ ~. _Y.q~k .._ .119~ .................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. General c .o.~,¢...z2.~p...¢..e.~ ....... Name of owner of premises ............. ?...J;..m...°..~.~.~....~.~...~...!~.~..~-?.~...!~..z.$..]:.e...~. ........................ · .................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ George Ablers, ?reslden¢ (Name and title of corporate officer) Builder's License No ......... ~ ....................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... ........................................ Lot No. ~..0. ................... 1. Location of land on which proposed work will be done. Mop No.: ~0 Street and Number ............. ~ZP...~...~.~.~ ............................................................. ~O~,:t.'~ZOZbd- ............................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............ ~O~e .......................................................................................................... b. Intended use and occupancy ....... .,cl:,.~,,.e..]:,l,.~,~,./~ .............................................. i ...................................................... 3. Nature of work (check which applicable): New Building, ..¥. .............. Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... (Description) 4. Estimated Cost ..~.39.,..O.O.Q.,.Q.0 ............................... Fee ...........~....~.i..~..,...~..~ ..................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .(~ ....................... Number of dwelling units on e?ch floor ...... .~ .................... If garage, number of cars ..................... ~Q~,f~ .............................................................................................................. 6. If business, commercial or mixed occupancy, specify nature end 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 ................................ ......... 3.~. ...................... Rear ..-~ .....................Depth ..3.0.! ................ 8. Dimensions of entire new construction: Front t Height ..... ~,o! .........Number of Stories .......... ~.a .................................................................................................... 9. Size of lot: Front ................... ],~O .............................. Rear ......................... ~,],0 .......... Depth ..~,(~..~^9..ZJ' ............... 10. Date of Purchase ...~..~¥....];~..7..8.. .................................. Name of Former Owner ,,~.~,O,...¥~. ..................................... 11. Zone or use district in which premises are situated ....................... ./~ ........................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: no 13. Will lot be regraded ...~...O. ..................... Will excess fill be removed from premises: ( ) Yes (x) No . ~ . Timothy and Nancy Mulle~ New Suf£olk Ave. 14. Name at uwner or premises .................................................... ~ddress .Ne~..,~u~._t;.e.~.k ..... Phone No ....................... Name of Architect .............................................................. Address ................................Phone No ....................... Cox Lane -- Name of Contractor ..~..e...°..r.i~..e......-~...]-...e.~.B..~.....~.~.J:.l..~.e...~. ...... Address ......................... ~' ne o. CJu~c~ogue, ~ew r~ort~ ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oH 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. see attached survey STATE OF NEW YORK, lc c COUNTY OF ................................ ....................... g.~..o.~.~.e....?....~..~...e..~...B. ......................................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the builder (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 and fife this application; that all stetements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the aj~plicotion filed therewith. ......... ..... day Notary Public, ......~,4~,,~-,I~,,~1'~....~..~. County ................... ....................................................... / &' ) ,,~ //q (Si~j~l~ture of applicant) t 7/,.'.,//4 . ;7 ' V) ,fA