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Home My WebLink About9650-zFORM NO. 4 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT Office of the Buildin~ InspeCtor Town Hall Southold, N.Y. Certifi.cate Of Occupancy No- · Z1381.9 Date Sept. 4 THIS CERTIFIES that the buildh~g .. A....d d i..~ i....o n .................................... LocationofProperty ..2.~.7~. Bayshore Road Greenport Hou~ No. ~ree~ ~ ...... Hamlet Co ty Tax Map No 1000 Sectio 5.~ ' ,BI ck 4 Lot un · n .. . o ........ 14 Subdivision.?.e. qg.n.i.c Bay Estates Ffled Map No. 1).24. .LotNo. 37 & P/0 36 conforms sub~lantially to the Application for Build/rig Permit heretofore fried in this offic~ dated .... M. Rr. clx. ,lQ ....... ,19 7.8. pursuant to which Building Permit No. 9.6.5. 0..Z~ ............... dated .M a r ~ ~a..~ 0 .................. 19.7.8., was issued, and conforms to all of the requirements of the applicable provisions of the hw. The occupancy for which this certificate/s issued is ......... .... A44. PA~Q. p?.i,y~.t.e, one family dwelling. The certificate is issued to PATRICK AND GERTRUDE FULLAN ...........................to.,er, ................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ................... .N./..A. ...................... . . . . . Buildin~ Inspector 1/81 TOWH OF SOU'I~JOLD BUILDING DEPARTMllI~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. llUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL I~UI.L COMPLETION OF THE WORK AUTHORIZED) 9650 Z Permission is hereby granted to: ....... .~.~.z...~:.L~ .......-- -:~:..~,...?~- pu~ant to amli~ti~ d~ ......................... ~.~.~ .......~.~..., 19~..., a~ ~pr~ ~ the Building In~ector. Building Impector FORM NO. 6 TOWN OF SOUTHOLD 0 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: 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-0 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 1057), 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: I. 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 [~te ~ ~.~, ~[.. ~,~.~....~.~.. ~,~. ............... New Building ................ Addmon ........ :'~ ...... Old or Pre-existing Budding . ~.~?.~ ~. Vacant Land .............. 2 ~ B~ s~ re ~ Location Of Property .. ~.7.~. ~y. ~.~. ; .oad~ reel~ rt New .G ........ 1;79. ~ ............ ~9. r.~; ................................ Owner Or Owners Of Property Pa'L~.ck aud (]er'-tr~de Fu!lan Subdivision l)eco~J c B~qy t;:;%a-bes Lot No .~. ...... Bilk No. House ~ 2't75 Permit No ...... J).(~.0 .....Date Of Permit ~/,~0~SApolicant GDar~n A~],e,~ Health Dept. Approval ............................................ Labor ~t. Approval Unde~riters Approval .............................................. Planning B~rd Approval ........................................ Request For Tempora~ Ce~ificate ........................................ Fin~ Ce~ificate .......................................... Fee Submitted $~.r..~ ........................ Construction on above described building and permit meets all applicable codes and regulations. .(~;~..0.[.!~(~!;; ~-T~.~ ~.]~.~ ~UTT 'n~$~ .,'r~TC Applicant . ~ .... ~ ............ ~:,.~ .~,~.~ ................................... Sworn tobeforemethis ~¢ ~ ................ day of ............................................ (stamp or seal) Nota~ Public .................................... Coun~ FORM NO. 6 TOWN OF $OUTHOLD Bu ilding 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 i ~ to the Building Inspec- tor 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 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacan% Land C.O. $5.00 $15.00 Date ..... ,~.~?, ,~, ..... ] New Building ............. ?l_~d - g B ......................... or Pre existin uilding ~/' Vacant Land Location of Property ................................. ~, ~ ............................... House No. /~ /, Street ~ Hamlet Owner or Owners of Property .../..~.~..~/~.(? ............................ ~ ./?.'~'. ................ County Tax Map No. 1000 Section .... :.~,.-~. .......Block ..... .~. ........ Lot ')~/' ~ubdiv' ' . ................................ Filed Map No ........... Lot No .............. Permit No .... ?'.~.. Date of,ermit ?.~.'~./.f~ ,A,,licant...Z~..~.~....~.#/.~.~.{,.. ?./.~Q..~../? Health Dept. Approval ........................ Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above describedA buildinglican and~,~, ~permit meets/~L~?2£all applicable.~,??? ~"'~'c~es and//,~/~regulati°ns' pp t ...... ~ ......................... .......... FOR~I/ i~10. 1 TOWN OF SOUTHOLD ~' BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am .ed ................. .............................. ................ ,,a xv .. .................................... Disapproved a/c ......... ~]~.._~;. ............. ~ C,~ (Building Inspector) APPLICATION FOR BUILDING PERMIT D~ March 39, 1978 INSTRUCTIONS a. This application must be completely filled in by typewriter oK in in.k 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 lot end of buildings on premises,'relationship to ~djoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagr.am which is part of this application. c. The work covered by this application may not be commenced before~ is, su,ance of Bu, ilding Permit. d. Upon approval of this application, the Building Insp?edtor will issu~ a Bciilding Permit to the applicant. Such permit shall be kept on the premises available for inspection throughouJ the work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until o 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, INC. (Signature of applicant, or name, if a corporation) 250 Cox Lane, Cutchogue, New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. general contractor Name of owner of premises ....?..~.t.~.~Q~...$.~'l..ql...G.~..r..t;.:~k,t.~..~.~,~,~'~, ............................................................................... If applicant is a, corporate, signo2uxe of duly authorizecLofficer. ~ ~tH ~eorge Ahlers, President ~;~ ~ George Ahlers, Builder, Inca .................. i~Z on~ii~i'~' of corporat'~"'"'"'""'"~"~i~:'~'~i ......... Builder's License No .............~.,.]:. .................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ~.3....~...5.~.B..a...y..s...h..~...r..e.~..R~...a~d.~t.~.~..r~?..e.~1~.~~ ................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .......... ..d..,ff'...e..1..1...i...ng .................................................................................................. b. Intended use and occupancy ...~.~.~fig~....~]~.~...~i,~..l~tB~],Jdl~ ................................................................. 3. Nature of work (check which applicable): New Building. ................. Addition, .. ................. Alteration ...... ~ ........ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ....~..~QI~.0.,.0.0. .............. ................... Fee .......................................................................................... (to be paid on filing this application) 5. ff dwelling, number of dwelling units ..,~...X'D.O~ ......... Number of dwelling units 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. Dimensions of existing structures, if any: Front ......~..6..~ ................. Rear ..~..t~. ......................... Depth ..~.6..! ........... Height ............. 18! .....Number of Stories ....o...~..e. ...................................................................................................... Dimensions of same structure with alterations or additions: Front ..... ~.6.! ........................ Rear ..21~.! .................... Depth .............. 3.~.~. ........... Height ....~:~l.~t.g~l~r...Number of Stories ..1. ............................. 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .......~ ............ Number of Stories ...... ~, ............................................................................................................ 9. Si,ze of lot: Front ........................................................ Rear .......................................... Depth ............................... 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: ...[l&l ................................................ 13. Will lot be regroded ....... SO. ............... Will excess fill be removecL, f/jf~,~&~ snorP&emisCs:Ce)tt~°~'zIps ( ) No 14. Name of Owner of premises .~e~..%~l[f~!..~..~.~,.%,l~.~l,.~.~ ........ Address .a['a~lEl~or.~e...N~ Phone No. ~..~.7?......~..~... Name of Architect¢ ................................................. Address ................................ Phone No ....................... Name of Contractor ~l'eox't~.e ~l. eZ's.~ Bulldlllr~ Address ................................ 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,--¥.OR,~,~ ,~. COUNTY OF [~:~.~./.~. ...... .f ' ............. ............ ~.,.../3. J.~-.£..~,......, ................ being duly sworn, deposes and says that he is the applicam (Name o{ individual ~ignibg contr~f) ' above named. He is the ........................................ .~3~.~...~.(J(....C.~..~..~..e../~.. .................................................................................................. (Contractor, agent, corpor?te officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this clpp]Jcation; that oil statements containe~[.'in this application are trqe ~to the best of his knowledge and belief; and thor the work will be performed in the manner set forth Jn the application filed therewith· Sworn to before me this ....~ ....... day of ................ ......... ......... ........ ................................................................. · -' - --b~hh - ~ ".:.~ .. '- '-- ' bATE:~~ APPROVED AS, N~ED ~ ' [~ ~ BY: FEE: ?.oTJFY ~UILD!I'!G DE?'6"RTMENT AT 7§5-~60 9:,~ to 4PM FOR ~EQUIR- ~b I~ Sp:CIIC,~: 1. BEFORE BACKFILLING FoUNDA' TION 0~- S~T FD ...... 2. F'~f'',~t:~ ...... p'rZS OF ~NY ~ EII~IL ~/; ~N ~O~ COMPLETED NOT RESPONSIBLE EOR DESIGN OR coNSTRUCTION ERRORS 5. ALL coNSTRUC1[ON ~uST ~EET