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Home My WebLink About8784-zNO. & TOWN OF $OUTHOLD BUrtDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificete Of Occupency No..Z799.1 ...... Date ................ }lo.v....7 ...., lg?~.. THIS CERTIFIES that the building located at . .E./.$. Bay. A~ ............. Street Map No. XX .......... Block No...X.X ...... Lot No. xx..East, ballon ..... I~.,.~, ..... conforms substantially to the Application for Building Permit heretofore fried in this office dated .............. J.~e. 29 lg .76. pursuant to which Building Permit No...~7.8.~.Z. dated ............ Ja~a~.. 29..., 1976.., 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 . .P~'~.a~.~..(ag.c.e.~.oI'~}. g.~r.~g.e ....... .(.~.pr0.v.e. cl. bY...!~1. A!~l~.et~,~) .... The certificate is issued to .D..o.r.l.s.. S.c.h...i)~..t.z..4..R.i.t..a..S.c..h~.!d..t ..................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ...N?.R.: ............................. UNDERWRITERS CERTIFICATE No..p.e~.d. ln.g ................................... HOUSE NUMBER ..... 13~ .... Street... ~ay. A'~e ..... E ,. }larlo~a .............. Building Inspec/~dr ~0~ 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) N? 8784 Z Date .............................. Augz~s.t ....... 6., 19....~.6 Permission is hereby granted to: .................. ~..A~ ...... ~s~..~&or~ .......... to. J:zzil~ .. r~ e~...t~x.i.va k..~ .. ~a ~a g~ ................. (.atyp ~ve4L · ~ ¥...Bd...A~p ea-~.s .)...~2.¢ ~.4~ ...... at premises located at ...J~/~..,l~aY.,.,a--~.e .............................................................................................. .................................................... ~a.~...M~±o~ ................................................................................. pursuant to application dated .........................~1~6~....~ ........... , 19..~., and approved by the Building ~ ' ~ Inspector, Fee $.....~..~.t..Q..O. ....... ..... ~.. .. :J.. , ~ r' ~i,d~g '~';r~;';Fo'~-' }r .......... FORI~ NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Imtructlonl A. This application must be filled in typewriter OR ink, and submitted ih 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, aha unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposalm(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and simdar 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), Nan-conforming uses, or Ibuildmgs 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, occupancyI and condihon of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: l. Certificate of occupancy .$5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $l.00 New Building..~../.~...A...~. Addition ................ Old or Pre-existing Building ..... [ ........ ;. Vacant Land .............. Locat,on Of Property Z.~.. ~.~. ~.,.~.,~ .~.~.'.~."~ ~..'.~...~.- ~..!...~.'. < y~ Y' ' X · . .................................................... .~..2:..~.~. ...... ~..._...~/..: .................. o,,., o, o, ......... ................. Subdivision ................................................................ Lot No ............. Block No ........ u... House No ........... ,-,,,o ..... ,,.., ...... ,,,, O, .... ...... , ....... : ........................................ Sworn to before me ..~. ........... aay or ..~..;.~'A:.~. ~ ...................... Nora .-Public ...~.~,~'~..~....; ..... County Health Dept. Approval ............................................ Labor Dept. ApprovalI ............................................... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinaJ Certificate .............. ~/~...~...~. ............. Fee Submitted $ ,.,~.,..:Z ...... Construction on above described building a,l~d permit /e~s al~oplicable! codes and regulations. Applicant .~~'.~....; ............. / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH CLERK'S OFFICE ~OUTHOLD, N. Y. ,~p ~ .... .,,-~/= ..... ~ ........ ~, ......... ~ ................................. ~ - ,~,/_ ~ , ,. pp,ovedo,c ......... .............. .......... / 7' ..... ....... ......................... / ~ u'~- ~" Date 6/29/ ~a 76 ,~ ~r'~ INSTRuCTIoNS ................................................ ' .............. o. This application must be completely filled in by typewriter or in ink and submitted in triplicate to ~e Building Inspector,-with 3 set~ of pkms, accurate plat 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 ofpraperty must be drawn on the diagram.which is part of this application. c. The work covered by this application may nat 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 Jn 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 cede, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. WILLIAMS CONTRACTING, INC. (Signature of applicant, or name, if a corporation) Seawood Di-ive, Southold, NY 11971 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. contractor Name of owner of premises Doris Schimalz and Rita Schmidl If applicant is a corporate, signature of duly authorized officer. (Name ond.,title 498°f c.;rporateHi :~¥/~//~c~>°ffi~er)/7 Builder's License mo .................... .~...~....~.:x~...~..~ .......... Plumber's License No ................................................. Electrician's License No ............................................. Other Trede's License No ............................................... ~ F Location of land on which proposed work will be done. Mop No.: ............................... Lot No ......................... Street and Number ............. .1..~.~.~..~...~.v~......E&st..ll~ap&on~....Ny......l.t. 9~ .............................................. Municipality State existing use and occupancy of premises and intended use and occupancy of profx~ed construction: o. Exisiting use and occupancy ....9..q.e.....~.~.2m..~.~...E~.cJ~D,~.~ ...................................................... ..~ .................. b. Intended use and occupancy ....................................... o...c~r..gal~ltge .................... 3. Nature of work (check whic New Bui!ding .~,~ .......... Agion .... ..~.. .......... Alteration .............. Repair .................. Removal .................. Demolitior ..................... Other Work ................................................... (Description) 4. Estimated Cost ............................... :;....... ...................... ee .~..~....~.~ .......................................................... (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 two 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: Fror~ .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of P~rchase ..................................................... .,1.~N~me of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated .~ ............................................ ..v. ........................ ~r.-4...-,w.~. ....... 12. Does proposed construction violate any,zo~in; ,ow, f~lrld~ o; r;toUmlati;;~ ~ ...... ~.~...~J.../.~..~ 13. Will lot be regraded ...~ ........... v¥i e cess ' ovd p is s: ( ) Yes ('X~ No 14. Name of Owner of premises/ r..D.g~.i.~...~.a..b.;.m...i..t..~....e..t...~.o. Address ..~. ,....]~[.a.~.~.9~,.....i~..)EPhone No..~..[Z.~.g.~..3..3. .... Nome of Architect ............ ., ........... .~ .................................. Addre~...~ ..... Phone No ....................... of Contractor .................... ....... ;-Phone .o ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram 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 NEWYORK_ ~ S S COUNTY OF .S.~..O.~ ............ f -- ........................................... ~.d...~...a,..~.g]...~.~....~F.:~.~,i,D,~:[~,~ .......... being duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. He is the ...................................................................... ~DnL~'.~O~'. ..................................................................................... (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 trJ4e to the best of his knowledge and belief; an~ tk, a~ the work will be performed in the manner set forth in the application filed therewith. Sworn ~:) before me this .......... .......... doy of .................................. Notary Public,. ................................................... ~ounty .... /--~,4[ .. · .~/~.. ~ ... · · .~..} ;..: · .v. · ...'~...~ ./~.~ .............................. L>ignature at applicant)