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Home My WebLink About5709-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~l~l ....... Date ............ Doo-..~O ....... , 19.?~. THIS CERTIFIES that the building located at .Z/8.0~t.££~..8~; ......... Street Map No...~ ........ Block No .... U ..... Lot No...U ...~t,O~O$~O.. !~.][o ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~'®b .... ~0.., 19..~ pursuant to which Building Permit No.. dated ..... I~.b. · .¶.0 ........., 19.]/2., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .~l~..~Bs..b~tl.l~.~g. ~.l~t~ .$f.f.~,~..~.} ............................. The certificate is issued to ..-g~lm~¢l®~ .Z~pl~,.~$~..l.a~ ...... 0~m~' ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. 1~,I1, ............................. UNDERWRITERS CERTIFICATE No ...... ~Ol~lag ................................... HOUSE N UM B E R.. ~ ....... Street .... {~11'~1~'" '~1~- · '8'~ ............................... · 5 .. Building Inspector FOB~ NO. ~ TOWN 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) 5709 Z Permission is hereby granted to: · .aelmeMe~.....'l,q~.~e...:Jee ................... to ..... J~tt~ ..m..mtAl. t,.t~ ..m..m:LJt, S~ at premises located at '....JJJJ..JJ~[JJ;:JliJ..JJJt.....JJllllJtJlt ......... J.[~.....~ ............................. pursu~ntt' to applicetion doted ............................... ~.~. ......... ~. ...... , 19...~111~, ond opprov~l by the Building Inspector. FOB,M NO. 6 TOWN OF SOUTHOLD 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 triplicate 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 dispasal--(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 cT 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 . ,,, ! ,~ . /,~ ,~ o .; te ................. New Building .................... Old or Pre-existing Building~.[~,~....~....~..~.?....l~r~.. Vacant Land ............................ Location Of Property .../.. ................................................................................ 't ...... ~'-' ............................. Owner Or Owners Of Property ....... ~.~.~.l ..................... .~....~.(Z..I.~..C~......)....)...~. ....................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. .... /,"1-' ......... Permit No....~....Z.~...~:..'.Z.. Date Of Permit ..~./;..~.Z.......Applicant Health Dept. Approvol ............................................ Labor Dept. Approvol ................................................ Underwriters Approval ......... ..~.....~.,,~,..~./.~.. .............. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ....... .~..,.~ .............. Construction on above described building and P~71~ ~eets,j~l~ap~licoble~codes and regulations. Applicant .......... C/'~"t~'~ ~r::).~~ .................................... : ..... Sworn ~before me this ...:~..~... day of~......./i~...~f~Z- (stamp or seal) ~/~,,~/Z ~5' / Notary Pub_lie .......... .~~. County Notary Public, 5ta~e of New York No. 52-0344963 Suffolk County~ March 30, 19~.~ Commission Expires /- Approved ........................................ , Disapproved o/c ~ ....................................................................... ~ ..................... ................. .... - ........ ....... ................ . ......... APPLICATIOI'4 FOR BUILDING PERMIT INSTRUCTIONS Date February 10, 19 72 a. This applicatior~must be.completely filled in by typewri~ter or in ink and submitted in duplicate to the Building Inspector. 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 progress of 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. SCHNEIDERS EQUITIES, INC. (Signature of applicant, or name, if o corporation) 2~ Carlow St., Huntington, NY 117LI-3 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ownez' Name of owner of premises Sahne;Ld~.rs...~.qh~i.t.&~.a.~...I~Q~ ..................................... If applicant is a corporate, signature of duly authorized officer. ...... Secretary. ............ ........ I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ........................ Street and Number .O.~.~.~.~..I..N...G..S.?...R..~...~.?.. POST OFFICE C.U. TCHOGUE 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~.OST OFFTOE D~PART~ENT b. Intended use and occupancy POST OFFTO~ DEPA~TY,~NT 3. Nature of ~vork (check which applicable): New Building .................. Addition XX Alteration XX Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...........$..4...5..;..0.?.O..:..O..0. .......................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use p.9.~.$....Q~.~..;i,?~. 7. Dimensions of existing structures, if any: Front 43 ~ -6" Rear 43 ' -6" 82 ' -O" ............................................................ Depth .................... Height ....!..3..L.T.O..Y. ...... Number of Stories ........ .o.)~.e. .................................................................................................. 82'-0" 82'-0" Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth 87'-4" Height ........ ]..3...._..0. ........ Number of Stories one 8. Dimensions of entire new construction: Front 82'-0" Rear 82'-0" Depth .....8.~....~..4. ........ 1 3 ' -0" one Height .................... Number of Stories 9. Size of lot: Front .......... .1.-5..O..?..-..Q:!. Rear 1 )0' -0" Depth ,.,,,~.~.l....-..~,,.,.,~7. ft:ra~1e 10. Date of Purchase 1~.~/. & I~.7. O ............ ; ..................................... Name of Former Owner ...... ~.¢.b~...&...~.~,~f~.$.~..r. ................ 11. Zone or use district in which premises are situated ...~.m...s..i...n..~.s.~. .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. ~ao ......................................... 6 Hunt in 'ton . 13. Name of Owner of premises .S..c...h..n...e..i...d..e...r..s.....E..cl.u..i..~Sh,~dress .,2.......C...a..r...1..o...w...~,..t.., ............ Phg~ne No..2.~..1...-...2.~.~.~.. Name of Architect ..H...e..n...r.y.....S...c..h...w..e...i..b...e..r...t. ............. AddressS....C.-.r..e.-.s..t.....R.-.d.:..I.[.q.n...t..i...n.E~LtpFibne No...~.....~...-..2..F.?.? Schn~iders Equities. Inc. Name of Contractor q,-hz,a.r.~..e..s.....S..9..h...n..e..,i.d..9..r..:...~..e..CA'ddress .,2.6.....C...a..r...1.9...w....S..,t..:.H.z.b...t..i~F~lin~ZNo. '.2.~..1...~.2..'Z3.~.. PLOT DIAGRAM Locate cleorly ond distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give street and block number or description occording to deed, ond show street names ond indicate whether interior or comer lot. 'KC~ (~ /SD,t) ' STATE OF NEW(~O~,,71 tS SIS'D''o' G'R,~t,.t C-- ~z,'C'. \ ~ COUNTY OF ..~,~{4f~ ............. ~ · C b.~r ]/~/s Schneidez· ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ~.c..~.~.n..t.~.r..a.~.~.t.~.~..r.~.~g~9~.r.P..~.~.r..a.~.t~e.~.~.~.f.~ ........................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work end to make and file this application; that all statements contained in this application are true to the best of his knbwledge end belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ . ,~ n · q : ...... ........ ,,,.Ta % _ ,q") on. ......... ........ ............ : .................................. Notary Publi~~~... Count¥~F,l~~ (Signature of applicant) N(ffARY p1!81 lC, ~mie of Ne~ ?0i', ,.~CH/,iEISErZ EO UIT;£~ , INC. ~ ,~T~T - , '; . 3 I -'~-~*~7'$,~ ',:,'t J" ,:: '. .... 7-i :7: ¢~L A'v Soq tA L? rM k r NoT& 't - '!,Z I, ' ' 2 )FF~CE