The URL can be used to link to this page

Home My WebLink About8564-zFOB. M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N, Y. Certi icnte Occupnncy No. Z?~01+ Date Pcb 2 .., 19.77 THIS CERTIFIES that the building located at .0~e~. t~.ll, .l,a~e ......... Street ~ores Map No. ~DD.~n... Block No ........... Lot No, 1~ .... G~eenDo~t...N,Y, ....... conforms substantially to the Application for B~lding Pear heretofore filed in this office dated ........... ~1...~6, 19F~. pursuant to which Building Femit No. dated .......... . ............ ~ay ~ , 19 ~., was issued, and conforms to all of the req~re- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . ~Y~. ~. f~l~Y. ~,W~, ]~ln~ ...................................... The certificate is issued to . W]~2.1a~a .&. C~.~el~e. S~h~o~de~ .... .q~mer. s ......... (owner, lessee or ten,t) of the aforesaid building. Suffolk County Departmem of Health Approval . .. ~?..~.. ~.. ~U. ~.~ .~!~.~.. UNDERWRITERS CERTIFICATE No... ~an.. 2~... ]~ ..... ~$i28 ........... HOUSE NUMBER ... ~2.~ ....... Street...free,hill .Lea ....... fi~npor.~ .... Building Inspector FOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C:LERK'S OFFIC:E SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE5 UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 856 Z Date .................... .J'~L)t ....... .~ .................. , 19..~.6.. Permission is hereby granted to: C. ~;....~.~w~l~....&/~-..~aa..&..Car~l.Lne Schroe~et' ..................... ~r~;.anpo~2 ..................................... to ~.n~ 1~.. ;~c~f....~ne...£~;~ ~,1~:...~.~ i J .~g ...................................................................................... at premises located at .....L...o..t.....~...2.~. ............ ~..a:.~..~.?.-..Z'..~..:.S~.O..~S.~ ......................................................... ............................................. G~:een..Etll../,ana ..................... ~r~e~7.or.t .................................... pursuant to application dated .......................... 2~D/L....2~ ............ , 19~.~..., and approved by the Building Inspector. Fee $.2~.-5~ ........... Building lnsl~tor [ TOWN OF SOUTHOLD , Building Department Town Clerks Office $outhold, 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 13uilding 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 disp6sal--(S-9 form or equal). 3. Approval of dectrica[ 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. 13. For existing buildings (prior to April 1957), Non-conforming uses, or buildings 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, ,occupancy and condition 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: 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 $1.00 Rte ...~.~.. ~::. ~Z...~ :....~ ~.~ ~ ....... New Bqilding ................ Addition ................ Old or Pre-existing 13uilding ................ Vacant Land .............. Location Of Property '[,o¢, ~ 1.~5 G~'een ~-~J. tl. ~%~e, E~s¢~n ~ho~es~ Owner Or ~ners Of Properly ...~:.~.].~.~?L.~...~A~9.~.$fl. fl...~!~9.~}L?.~ ................................................. Subdivision ~.~S.~TI..~t~gZ.~.~,..~.,....~. ............ Lot No..1~.~.... BlCk No ............. House No ............. Permit No..~.~.~..~..... Date Of Permit J~-Z..~.,.Z~.Applicant .9. r...~[,....~.~.~ ..................................... Health Dept. Approval .~.~.~.~ ........................... ~bor ~t. Approval ................................................ Underwriters Approval ~Z~.~.~Z..~..~.~.~ ........ Planning B~rd Approval ........................................ Request For Tempara~ Ce~ificate ........................................ Fin~ Certificate ..... ~ .............................. Fee Submitted $ 5,00 Construction on ~bove described building and permit meets all applicable C~es and regulations. z ......... Sworn to before me this ~ ~ ~ o, ....... 7 o, THE NEW YORiK BOARD OF FIRE UNDERWRITERS 1 BUREAU OI~ ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 CERTIFIES THAT W.L. Schroeher, 525 Green Hill Lane, Oreenport, L.I. the follo,vir,g &,cation; ~ Ba,~ement ~._] 1s~ Fl. ,~.,,,~.~,,,,,i,,,.,~,,. Januar7 l?, 1977 FIXTURES F LUOT{E~CENT Elec. Room Heaters: 2-2.5kw,3-2.0kw., 1-G.F.I. 1-Smoke Detector t-~.Skw HOt Water Heater i 2/o 1-1.75kw,l-l.5kw¢2-1.0kw,2-.65kw.! W.L. Schroeher 1G2bson Blvd. Valley Stream, N.Y. 11581 D This certificate must not be altered in any manneo return to the office of the Board if incorrect. Inspectors may be identified by ti TOWN CLERK'S OFFICE ~'~'$ ~ ,'~ ~' ~ o K ~ ~ Dote lpril 2~ 10g0 19 ............ I~STRH~IO~$ ~. This opplicotion mu~t be completely {ill~ in by ~pewriter o~ in i~k ~nd su'bmi~*d in triplic~t~ to th~ BuildlnO Inspector, with 3 ~t* o{ plonk, accumto plot plan to m~l~. F~ ~ccordinfl to schedule. b. Plot plan s~win~ Iocotion of lot ond o{ buildin~ on premises, relotionship to ~djoininfl premi~s or public streets o~ ore,s, ~nd ~ivin~ o detoiled description of la,out ofprop*r~ must be dr~wn on the dio~r~m which is Pa~ o{ this opplic~tion. c. Tho work covered by this ~pplication m~y not b~ commenced before issuance o{ Buildin~ ~rmit. d. ~pon ~pprov~l ~f this opplicati~, th~ Buildino Inspector will i~sue ~ Buildin~ Permit ~o th~ opplic~nt. Such permi~ sholl be kept on tho pr~misos ~v~ilobl~ for inspection throughout the work. e. ~o buildino sholl be occupied or u~od in whole or in Part for ony pu~ose wh~tover until ~ C~i{ic~t~ o{ ~cup~ncy sholl h~v~ bo~n ~ront~d by th~ Buildin~ In~poctor. A~PUCATIO~ IS H[R[~Y ~D[ to tho Buildin~ D~partment {or tho issuance of o Buildino ~rmit pu~uant to tho Buildino Zono Ordin*nce o{ the Town o{ Southo~, Suffolk County, ~ow York, ond other opplicobl~ [aw~, Ordin~nce~ or Rooul*tions, {or tho construction o{ buildino~, od~itions or oltorotions, or {or mmovol or demolition, a~ her~in described. Tho opplic~nt oOr~os to compl~ with ~11 ~palicoble I~w~, ordinonces, buildino c~, hou~ino c~, ~ r~Oul~tion~, ~nd ~o odmit ~uthorized in~poctors on premi~e~ ~nd in buildin~ {or n~es~ inactions. (~pplicant, or ~me, if a corporation) (Address of oppllc~nt) [(a ~ State whether ~pplic~nt is owner, lessee, ~gent, ~rchitect, engineer, general contractor, electrician, plumber or builder. Builder ~me o~ owme~ o~ p~em~ses Willi~m & Cmrollne Schroeher If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ...u..~!.~..~..o.,,,~,. ............................. Electrician's License No.U'..~..~...n..°....~.. ............................. Other Trade's License No. ~..~..]?..o...,~.,. ............................. 523a 125 Location of land on which pro~,osed work will be done. Map No.: ........... ;~ ........................... Lot No ......................... Street and Number ...G..~..e..e.~,,~.~.~.~..../d~..~...e. ....................................................... ~.e.,e..z).~..o...~.~ ..................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy T'Jtll].c]in~. ~].o% b. Intended use and occupancy ...~.e...s.~.d....e.~..~.~..~.,..c]..~.e.~.~.~.n,.E .............................................................................. 3. Nature of work (check which applicable): New Building..................XX~ Addition .......... ...... .. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... ~40-~.45,000 ~ / ...~...._~.. (Description) 4. Estimated Cost ......................................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .....o..~...e. ................. 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 ............................ 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 ....~.e. .......................... Rear ....~..t .................. Depth 25' Height ]-5' Number of Stories o~ze ~ . .... 9. Size of lot: Front 1:~0' Rear 1~0' Depth 130t i0. Date of Purchase ...]:..~....~...e..~..~......,,[..9.~ ....................... Name of Former Owner .....~..~...a.~.~....,S.,.~,~.~...m. .......................... ] ]. Zone or use district in which premises are situated ~.es~,d_enti~]. ]2, Does proposed construction violate any zoning Iow, ordinance or regulation: .~...o. ........................................ ]3:1 Will lot be regrodedl .,~..e.,.s. ................... Will excess fill be removed from premises: ( ) Yes (Z) No 14. Name of Owner of prem ses~l'm Schroeher Address ~all.ey. st[e...e~. Phone No 872 6384 Name of Architect ....... .1[.m....{~.c...h..~..o..e..[3...e.~ ............... Address ...~..~...].~..e~....S.~[.e..?.~. Phone No...8..7...2....6..~..~... Name of Contractor C, ~o Po~e].l P~o'h ............................................................ Address ..?..,~.e.e..~..?..o...~.~..~....~...~ e No. 477 0995 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 ATTACHED COllIES OF PLOT DIAGRAM BY R~ VAN TUTL P.oC. STATE OF NE'W YORK, [S S COUNTY OF ................................ ~' ' ...... ~..~ ............... .~ ........................... being duly sworn, deposes and soys that he is the applicant (Nome of ~lll~lllllll~li~rocf) above named. He is the ....... ~;.~.1] .................. ( r~l~ll~'~J~i~l~rporate 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 forth in the application filed therewith. Sworn to before me this ................ ~'2~" day of ............................ ~,~ .......... , 19 ...... Notary Pd~l~, ........................................ .~.~...~..~.._eau nty No. 52-8125850. Suffolk County ~erm Expires M~rch :z,~O__v O~ 1976 Tho SewaEo d~sPOSal and wato~ SUDDi~r Cseilits. es for ~his location ~vo boe~ Ohief of General L ,~,'F~.QVED AS NO1ED t'2 EL~wxw~od ,, cL~.mT 'e.'l-'c~. 2~ t& ~T~L I L.4 ~ L~ FILL. l ~'oO~E-LL 4" p.o. U' I '/'~ L,*~. M~. c~ W. Pov~kt_