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HomeMy WebLinkAbout10971-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ..... Z.1.0.508 ...... Date ........ May. 2b.~ ................. 1981 · THIS CERTIFIES that the building ................................................ Location of Property ... J .4.5...g.d~e.r~ .e.r,.e..~. y.e.n.u.e...( .P.v. House No. Street Hamlet County Tax Map No. 1000 Section ... 1 2B. ..... Block ...... .0.6 ...... Lot ...... .0.17 ....... Subdivision...Igdg~.Ine~'e..P. al'k ............. Filed Map No. 7.42 ..... Lot No....P./O. 2..& · 3'mc]., conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... No.v. ernbez~. .12., 19 g0 pursuant to which Building Permit No ....... 1097.1..Z ....... dated .. No.v. ember.. 17 ............. 19 8.(t, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... A ~ ~ ;L.t.~, o~..t.q. D~.e.11 ~.~g ................................................... The ~ertificate is issued to ..... fi~'.~;hu~'..L o · a~d; [4a~.~,~yn..S · · ~t~, ~;~..Jr o ............ towner~.le.~e.e.or..t.en~an_t~. - of the aforesaid building. Suffolk County Department of Health Approval N/R UNDERWRITERS CERTIFICATE NO ..... 1~5 2 0.0.Q 0 ..................................... Building Inspector Rev 4/79 FO]~i~ NO, ~ TOWN OF~ $O~TH0t ' BUILDING D~p~RTJ~] ~ Town HALL SOUTHOLO, N~ Y. HS~S UNTIL F~ULL (THIS PERMIT MUST BE KEPT ON THE P~EA COMPLETION OF THE WORK AuTHoRIZED) N? ~L0971 Z Permission is hereby granted to: ...... ...... .~ .~. ,~.~ 4~.C2~..~. ~......~(!Z. ...... ~..~..z~.~.....~z~., ...... ~-~:.,.~ C~Jn~ Tqx Map No. 1000 Section ....~.~ ...... BI~E i~...~.ad.....;,~;Lot~o ...... ~'"7' ....... pursuant to application dated .~..~ ...... Z..~..:....4~..,~j ...... : 19~, and approved by the Fee Rev.~ 6130/80 ~spect6r FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hal~ 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: 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 $5.00 Date...~¢%.gO,.~981 ......... New Building ............. Old or Pre-existing Building . .z ......... Vacant Land ............. Location of Property . .1~+.~..Edge~ere. Avenue,. La~'el,,..New, .York ..................... House No, Street Hamlet Owner or Owners of Property Art;11~'. T.~..arid. ~ar.~ 1.~rz. S....$mi.%~ ~. J~ .................... County Tax Map No. 1000 Section . .128 .......... Block . 0~ ........... Lot, E~.? ........... Subdivision,..~..~,~,e.~.e..~.e..1~.a..r~ ............... Filed Map No. 7/+2 .Lot No. Par~c°£ Z°~c 2 ......... All' 'df' lb'~ ' j Permit No.. 3.0971. ·. Date of Permit ...ll,12~-,A©plicant. George..Ahle~.s. Buil4er.,.. In~.. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ~5-11-81 .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ...~. ................... Fee Submitted $~: .0,0. ........................ Construction on above described building and~,ermit meets all Applicant , ~. ~ Rev. 10-10-78 George Ahlers, Pres. and regulations. Inc. FIELD INSPECT~I~N~ .... FOUNDATION C~ElVIENTS -~ FOUNDATION 2. ROUGH FRAME& PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CO E FINAL ADDITIONAL q0MMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ' BUREAU OF ELECTRICITy ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the electrical ~quipment ~s~ibed belo~ and introduced b~ t~ applicant ~amed o~ ~he ~b~e application nu~nber in the premises of was exan~inedon ~y l~, ~]. and found to be ln co.tpt~nce ~ith the re~ulre,nents of thls Board. FIXTURE OUTLETS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDE$CENT F{UORESCENT 15 14 ll DRYERS TIMECLOCKS MULTI-OUTLET SYSTEMS NO. OF FEET DISCONNECT E R V I C NO, OF CC COND A.W.G. NO OF HI-LEG A. W, G NO OF NEUTRALS A W G pER ,0' OF CC COND OF HI-LEG OF NEUTRAL i 1/o I t/o OTHER APPARATUS: glee. Roc~ Heatea?s~2-1.5, g ~ ~tector~ John F~ Wmmrka, Ix% lbS0 Wasl-~rg'Con Ave[me ~oh~,ia, N. Y. 11716 L~c: g627 This certificate must not be altered in any manner; return to the office of the Board if i 1i Inspecto may be identified b COPY THiS COPY OF ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 E amined ..... Approved . APPLICATION FOR BUILDING PERMIT Application No.../..gf'.7/L ....... Date 11-12-80 ., 19. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sots of plans,,accurate pl0t plan to scale. Foe 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 of property must be drawn on tho diagram which is part of this appli- cation. c. Tho 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 1S HEREBY MADE to tho 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 promises and in buildings for necessary inspections. ........ George. Ahlers. Builder,. Inc ....... (Signature of applicant, or name, if a corporation) ....... 855. Eugen~.s .Rd.,..Cut,hogue.,..N,Y.... · (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General .C. q .19 .t ~.~q $ 9~. ...................................... Name of owner of premises ....Ar.t. hA1F..I~,, .a;Qd.. M.~r&lyn..S ,. S~lith,..Jr, ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..]~ ...................... Plumber's License No..797 .................... Electrician's License No.. 627. ................. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. //~.Dr. .............. Edg.eraer~re~e~enue,. I~urel,..N.Y,..i~i};n.l~; ...... ~>~-- .... ~-. HouseNu be . ~ /~-- O~ --~/~ ~ .... part of lot2)h ' / ~ all of lot 3 ./ ....... ............... ..... V ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .dwelling .......................................................... b. Intended use and occupancy .......... d..w.e.l. 1..i.n. ff.. :.~..-..~/.. ~.~]..-~.~W~.. ,~. ~.'.~ .//~... 3. Nature of work (check which applicable): New Building .......... Addition ...X. ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... : (Description) 4 Estimat d C $973.6 O0 Fee $15 O0 ' · e ost ...... o ,. ................................. . .. .................. i (to be paid on filing this application) 5. If dwelling, number of dwelling units .. 1.. Number of dwelling units on each floor. If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front.. 2.9 ! ./*? ....... Rear ,..19.'A': ..... Depth . ~. 7.'5q ........ Height .~. ~ ............ Number of Stories .. 1..!011,15..a~;~;f.~ ....................................... Dimensions of saroe structure witt~ alterations or additions: Front .39 ! ./4!7 ........... Rear , 29 ! ./4? ........... Depth..'...~.7. '..6!' ........... i Height . .20 ! .............. Number of Stories 2. , . .... 8. Dimensidns of entire new construdtion: Front ............... ~j' Rear ............... 20' Depth ......... 16' Height .. 2C~ t ......... Number of Stories .. 2 ..................................................... P. Size of lot: Front ....70.' .....I .......... Rear... 7(5.99: ............ Depth..1.29.' ..... i ........... 10. Date of Purchase 9./1.6/67 ................... Name of Former Owner ..... E .. .Michael ........... 11. Zone or use district in which premises are situated ...... ~, ............................................. 12. Does proposed con§truction violate any zoning law, ordinance or regulation: .. riO. ........................... 13. Will lot be regraded ..... .n.q.. i .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .A ~ L'.' .$m£th ....... Address . New .~ar~aan~. ~2orl~h.°ne No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .Geo,..Ah~er.s .Bldr.,. Irm .4ddress . Cut;¢hog.ue, · Ig,.¥, Phone No..7~4-501.0 ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, anti, indicate all set-back dimensions from property linep. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~] STATE OF NEW~RK i;- - 70 ' (Name of ~dual sig~ing contract) above named· He is the ' Con.t.r. aot.o~ ~ (Coniractor~ agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and ,to make and file this application; that all statements contained/n this application are true to the best of his knowledge and belief; and that the work w~l be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ Notmy Pu lac, .............. ,. . oun [IOT/~RY PUI~ C, State of New YorI~ (Signature of applicant) ~0. 1~2-812§850, Suffolk 0oun~ ~ Term Expires March 30,