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Home My WebLink About7159-zFO~M NO. 4 TOWN OF $OUTHOLD BUn.DING DEPARTMR~ Town Clerk's Office Southold, N. Y. Certificate Of Occupency No..Z..6.1+.8.9 ..... Date ............. l~ay. 29 ........ , 19..?~ THIS CERTIFIES that the build!,~g located at ...No~th. Bayvie~ .P, oed. · · Street Map No.. mr.x ....... Block No..xxx ..... Lot No. ------..~outhold...~,~:, ........ conforms substantially to the Application for Building Permit heretofore filed in *.h~s office dated ........... April .... ~, 19.. 7~pursuant to which Building Permit No... ?.~.~gz dated ............ Apl~il .... ~, 19..~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which th~ certificate is issued is . Pr. ivat~ .one..fataLly. d~llLng..w~th. ~n. addition .................. The certificate is issued to ... Cmorge .$ch~.oede~. ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . N..I~ q .............................. UNDERWRITERS CERTIFICATE No.. pending ................................... HOUSE NUMBER .... 77.0~ ..... Street .. Rorth .Bab~viaw. Road .................. Building Inspector / FOBM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN C:LERK'S OFFICE $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7159 Z Permission is hereby granted to: O'o~e~.. ~- oz~m3~....~.~...Ge~...ne_~.oe4e~. .............. -~oGt~m~4 ....................... ~ ...................... to ~¢ ..~'~..~L~l.~.~a.. ~z~..ez.t s.~iz~.. ~ve~L~l~ ................................................................ at premises located at .....~...*...~;~I~.;~1(..~..~J~1~....~..~.~,~11,~;~..~.~'. .......................................... .................................................. ~,z.t~o3,~ .......... N..~... ........................................................................ pursuant to application dated ........................~pFJ.~.. ....... ~ .......... , 19~..., and approved by the Building Inspector. Fee $.t.~..,...(~.. ............ Examined .... ~... Approved ................ !! ............. ~......, Disapproved a/c ........................................................................ __ ~ APPLICATION FOR BUILDING PERMIT Date ................ .~. ~..r. ~ .3:.......~. ............ ,19 ............ INSTRUCTIONS a. This oppllcotion must be completely filled in by typewriter o~ 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~r areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which Js part of this opplicatio[n. 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 port 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. .... ......... .................. icant, dr name, if o ;~'~oratior~i Q~6uthold N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Name of owner of premises George Schroeder If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Cornell Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........ ~ ........................... Lot No. zX Street and Number N/S north Ba .2~..iew Road & Brlsentine Dr Southold Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....d:.~...e..]:..1.~[ .......................................................................................................... b. Intended use and occupancy same with an addition 3. Nature of work (check which applicable): New Building .................. Addition ...~[:~ ....... Alteration .............. Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) .7 aa* .;E .. 1 ,00 4. Estimated Cost ............................................................ Fee ..................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... g~.e ........... Number of dwelling units on each floor ........................... If garage, number of cars ............................................................................................................................................. 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 ................................ 8. Dimensions of entire new construction: Front ............ ~. ..................... Rear .............6 ............. Depth ........ ?.6 ............ Height .................... Number of Stories ........ D.~ ...................................................................................................... g. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ "" di 1 1. Zone or use district in which premises ore situated ......a. .......... ~..~. ............................................................................... ]9. Does proposed construction violate any zoning Iow, ordinance or regulation: ..... ~JD .............................................. 13. Will lot be regraded . ...... ~ ................ Will excess fill be removed from premises: ( ) Yes ( ) No ] 4. Name of Owner of premises ...~{3...~]P,~3.r~.oc].e:~. ................. Address ......... ~D~{~.~..... Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....~T.....~.Qrna~l. ................................ Address ...... S.Q~t~3D~. ...... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-b~ck dimensions property lines. Give street and block number or description according to deed, and show street names and ind whether interior or corner lot. :rom cate STATE OF NEW YORK, t c ¢ COUNTY OF ...~:l,t.f~.011~ ............ f~'~ .................................. ~T.Qs.~..I~.(3Z'Iiel 1 .................................. being duly sworn, deposes and says that he is the applicam (Name of i~ividual signing contracf) above name. He is the ................................. .~. .............................................................................................................................. (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 performed in the manner set fo~h in the application filed therewith. Swam to before me this ................... ....... , Not~ Public,~~...:~~unW ~....~~.:....-~.:...-~-~A ........................... ~ ............ ~ / // (Signature of applicant) No,o~ JP~l'['c~ S't;~w York No. 52-0344963 SuffoJk Coug~ Commission Expires March 30~