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Home My WebLink About10162-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Ce~le Ot Occupancy 9658 . .A~,~...~ ~.'1. 1979 No .................. Date ...... ~ ................. THIS CERTIFIES tlmt the building ................................................ ................... ........ H~ No~ . ~t H~I~ Sub--on. ,SO~ .................. Ffl~ Map No .....g~t No ..... ~. ~ ..... confo~s subentry ~ ~ App5~tion for 9~ Pe~t ~tofo~ ~ed ~ ~ o~ ~t~ · . ~Z..40 ......... ,19 .~p~nt to w~ch ~ P~t ~o .... -1016~ .......... .t. .... ~T~! .~9 .............. ~9..~ =~, =, =o.~= to ~ o~ == ~===t, of ~ app~=~le p~= of the ~w. ~ ~u~ f~ w~=h ~ ~ifi~te ~ ~ b ......... ........... ~$~. ~e. ~. ~e~ ..................................... ~ ~.. ~.~, to ...~=.. ~ .~i~~ ..................... of ~ ~ b~g. ~o~ ~tY ~h~=t of H~ App~ .... 9~ ....... ~ .22r .1~ .... ~ER~ERS ~RTIFI~TE ~O .... ~Y.~O} ..................................... BuUding Inspector n,v 4~ FOB,M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT CC)~PLETION OF THE WORK AUTHORIZED) N.° 10162 ~ Z Date .......... ..~......--..../f./.. .................... '.. ...... , 1!~....~.. ........ ~..~.....~.~ ............ : ........ purSUant to application dated ....... ~......~..~.. ............. , 1':'.~.'.'.~.., and"approv~ by the Building Inspector. Buffding Inspector FORM NO. 6 TO~/N 0~: ~OUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLiCATiON FOR CERTiF~CATE OF OCCUPANCY instructions A ] his apphcabon must be filled m typewriter OR ink, and submitted in duplicate to the Buflc'ng m~oec- Lot with [he fr~llow;nrj; for new bLnldmgs or new use' 1. Fmat survey of property w~th accurate location of aH buildings, p~operty lines, streets, ar, d u~uscal nc, tu ral or topographic ~eatu res, 2Final approval o~ He~,lth Dept. of water supply and sewerage dtsposa!--(S-9 form or equal). 3.A[)~},ovel of elect~ca~ *qst,d',a~*un {fern Board o~ Fire Underwrl[ers. 4, Cornr~e*cla~ budd;qg% Industrial buddings, Multiple Residences and simiiar buildings apd msta~'a hof~, a cnrhf,cate of Cods comohance f¢om the Ar¢'hitect or Engineer responsible for ~ , 5.:;[,pm~[ CH~nn,n¢ rh~ard app:ow¢ o¢ ~:ocqp~etcd silo p'dU requirements where applicable. R For exmtm~j buddmns tpr,or ~o April 1957~, Non coqfo~mmg uses, or buildings and "pr~ 1 Accur¢~te su~vuy (/ peop(~,ty showing al', property hnes, streets, buddings and unusual ne,u~,~t or 2 Sworl~ staterf,cpt of o.~ner or prewous owner as to dSO, occupancy and condition of buildings 3 L)a~¢ of any housing code o~ safety insp¢('tlor] of bt~lidcngs or premises, or o~her pertin(,r,t ~,;for~ld- C, Fees: 1. Ce~t~fleate of occupancy $5.00 2. Cert~flc4te of occupancy on pre-existing dwelhn9 or lend use 3 Cony of certifwatr' of occ~q)']ncy $1.00 $5.00 °ate .......... New Buhdin,j .... )~. ....... Old oc Premxlstit~g Building ............ Vacant Land ........... Location of Property . . . ~'~./£~, "" f'~' tlou~e No Street Hamlet Owner or Ownersof Property . ,O;~es ' ~ ......................... County Tax Map No. 1000 Section . 0'/0 .......... Block . ~.~ .......... Lot. Permit No. ~,0.:]_62Z Date of Permit Health Dept, Approwll . 0:'~.2. =7~q .............. Labor Dept. Approval ..................... Underwriters Approval. ~/Z.?/~.)'...~'. ,~.z/.2./.O.~, ~ ,Planning Board Approval ...................... Request Jot "i ~,n,porary Cert ~cate ................... Final Ce.'tlflcata ............... Fee Submitted ~ ~.,~-.O ....................... Construction on above described budding and permit ~sall applicable,~co%e~nd/regulations. "'~ RK BOARD OF FIRE UNDERWRITERS Li,. i"[ : , ..: BUREAU OF ELECTRICITY - 'i~ '85 JOHN 5TREE"~, NEW YORK, NEW YORK 10038 . ~me~' G~apnf'C~ltte~- Hd.', ae~Wa.v, ;;ou~hold, N .Y. Augus,~, 23.. 197,9 .,,./o.,,,~ ,,, ~,.., ,.,,,,,~,~,,,,,.., ,,.,., · A~b~s f~,.~-oEc~s OVENS - oi~ Wxgh~s/ Der cto~ Memorandum from.... BUILDING INSPECTOR'S OFF~CE TOWN OF ~OUTHOLD Tow~ HALL, ~U~OLD, N. Y. 11971 FOu~ NO. TOWN OF BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Examined ........... ~/~.~...~ ............ , 197'9. Applicotian No./o.~,.~'~ .............. Approved ..........~,~.........?) ............ , 197~... Permit ,o...~...y..~.,.~...:~.. Disapproved a/c ............................................................................................ ........................................... = ........ '--7'~' ............................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................................................ , 19 ............ April 10, 79 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 lot and of buildings on premises, relationship to adjoining premises or public streets or 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 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. O~J~ujj~ll~)~'ce~ze~e, ~ ~orporatian) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant ', ~o~orate, sig~o~ ~e~'~ ~ .................. ......... Builder's Lic~se No ..................................................... I Plumber's License No ................................................. Electrician's License No. ~'P ~ Oth rTr d ' L e. No. /OaO - 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ........................................................................... ~ .......................................... .~5. .............. 2. StQte existing use and occupancy of premises and intended use and occupancy of pr~osed construction: a. ExisitJng use and ~cupancy ......................................... ~ ................................................................... ~e ~cA ~ Z~/vo ............ ,nt ndedu,e nd u nc ....... ........... 3. Nature of v~or~,'(cJ~eck which applicable): New Building' ......~ ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ 8 ................. Number of dwelling units on each floor '"~"F'""~ ............ If garage, number of cars .........2 .................................................................................................................................. 6. If business, commercial or mixed occupancy, specify 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 ...... ~O..&~;~ ................ Rear ....~..~,~ ......... Depth ....-~..£t,~ ...... Height ....~..._.~.i.. Number of Stories ...... .~ ......................................................................................................... 9. Size of lot: Front .... ~.80~?' ..................................... Rear ...t~.~.,1.,~ ......................... Depth ..... 1.~.,~ ............. 10. Date of Purchase .!~1%i~..].~"~1'~ .............................. Name of Former Owner ........................................................ 11. Zone or u~e district in which premises are situated ........ & .......................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~ ............................................ 13. Will lot be regraded ....~'j~ ................. Will excess fill be removed from premises: ( ) Yes (~ No 14. Name of owner of premises ... ~jl~..(~ll~l,.%e~%l. ........... Add r e ss ~JII~...~I~IP h~ Name of Architect .~l)~O.~l..~.~j~,~ .......................... AddressJJ~%ll. J~JJ .... ~W~...jj.~j..,Phone~-'"%'T~"~ ~'_"~ No ....................... Name of Contractor Oil~ip~e...Al~.l~.el~j.t...~A,J,.~..~.e%¥..~l~l~ress ~~.~ehone No...~I'.~-.~1~O- 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. See a~hed. STATE OF NEW YORK, COUNTY OF ................................' .................. . ..~Ol~.~...~..~%"~ ....... : ..................................... being duly sworn, deposes and says that he is the applicam (Name of indiwdual signing contract0 above named. He is the ......... .(~l~l.l~l~t,~Z'. .............................................................................................................................................. (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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perfor~ in the manner set forth in the application filed therewith. Sworn tx~befpr~ me this / Notary Public, ...~..~ ............... County ...... =................~. ............................................................. ~ I ~ ~,J (Signature of applicant) pAMELA I SCHINELLER Memorandum from .... Memorandum from.... BUILDING INSPECTOR'S OFFICE · o~ o~ ~o~o~ TOWN HALL, SOUTHOLD, N. Y. 11 765-1802 B. UILDING INSPECTOR'S OFFICE TOWN HALL, SOUTHOLD, N. Y. 11971 / /7 /? / / / / // l ALBERT A. SACCO AND GORDON K, AHLERS ' A~CHJT~CTS & J~N(~iN~J~RS ' ~'' ./ APPROVED AS NOTED ,/1, FEE=~ NOTIFY BUILDING DEPARTMENT AT 765-2660 gAM to 4PM FOR. RECIUIR. ED INSPECTIONS~ 1. BEFORE BACKFILLING FOUNDS* TiON OR START FRAMING 2. FRAMING INSPECTIO~ 3. BEFORE COVERING P[['~S OF ANY. KIND 4. FINAL WHEN JOB COMPLETED _ ~,, NOT RESPONSIELE FOR DESIGN OR CONSTRUCTION ERRORS ,5. ALL CONSTRUCTION MUST MEEr REQUIREMENTS OF N.Y. STATE CODE AND TOWN NOUSING CODE & ZONING ALBERT A. SACCO AND GORDON K. AHL~iF.~",,-i, FI · ~\ ~ " by an Architect or Licensed Profes- $1En**ureonTyDood for inltialuseof ~,,wa. ~.v: ~n*~ 4~,~ MA~N RO*D SOUTH6LD, N. ~o'~,, ~:~ tY ~Z/D ff~ ~/d~5~ '~'L;/./~,~,r~/.] Section 7209, Su~ivision 2,. wsisna to or l*-use of dra*in~s with- ~ N.Y. State Education Law. or Eng;neer's ~proval ~T~. : ~' mppm.'. ~?~ ~:~. ~. ~ ~ ' voids Seal and Si,,ature 0, same. IERT A. SACCO AND GORDON K. AHLE ~~~ ~ ' ,,Aiter3ti~n of this D<~cument except Arc hitec' and ~n~inee,'s S8,3t a,'~l r.~,~,~x/,e~r~: ~. . ~ -~ ~ r~ ~ids Seal and Sigaa~re on ~me. ~ ' .O~ NEV,, ' ' . ' . I ! ~ I~~,i A 1/,-*,.., ,1~-~.~-.,~,1.~-' ~'~p~ IAIt,ratien of thm Document except I __..--I /~~X I //~°u':'::~+~ I ~ ~' / / , '" /' ~y an Architect er Licensed Pr~es- A.~~RDONK. AHL ~ ~ , '& ~ , , ~l~al Engineer, is illegpl". I drawing. / ARCH L , H.Y 11 ~ ~ ~ LBERT A. SACCO ^ND GORDON K, AHLE '~ ?' "Alteration of this Document except by an Architect or L~censed Profes- sional Engineer, is illegal". Section 7209, Subdivision 2~ N.Y. State Education Law, Architect and Eogioeer's Seat and Signature only good [or imtiaI use of visions to or re,~se of drawings with- out Nchitect or ~n~ine~r's ~prova~ voids ~al and S~Rnature off same.. ~.LBERT A. SACCO ^No, GORDON K. AHLEI~ AItCHWECTS & ENGINEERS 655 M~'qN ROAD SOUTHOLD, N.Y. "A!teration of this Document except by an Architect or Licensed,P_rofe~- Section 7209 Su~ivision N. Y. ,State Education ~we ~ .,~ Architect anti Engineer's Seal and Signature o,nly ,good for in,rial use,of drawing. ~fianges, alteratte,~ ,d~' r~ visions to ~r re-use ~ dra~vings with. out Architect or Engineer's Approval voi~ Seal ~nd S~gnatnre on same