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Home My WebLink About9557-zFO~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sou~old, N. Y. Certificnte Of Occupnncy No. Z.8997 ...... Date . .~ April.. · 28 ............ , 19. ?.8 THIS CERTIFIES that the building located at . .'16.~. S. terllllg. R.o.e~d ..... Street Map No..1179. ...... Block No ........... Lot No.. Part. Let..~5.0 ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .0c~,ober~ 25 ........ , 19.7.7. pursuant to which Building Permit No...9557Z dated . .November. 18 ........ , 19.77., 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 ..... ~PRIVATE. 0N~. F~'~ILY. D~rELLIN,~ .................................. The certificate is issued to .... P~....Geo,.ge. Schut.eder ............................ (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ...Ap?.i.~...~.,...~9~8... UNDERWRITERS CERTIFICATE No ..... N~.8.~.2.~0. ............................... HOUSE NUMBER ...1.640 ....... Street ...... ~..~.e~.~.~..rig .R.o..ad. .................... ............................................ gU .~.c~og~.e. ~..N, .Y..~ .................. Building Inspector NOTE -TWO NON-HABITABLE ROOMS ON SECOND FLOOR ........ pERMIT REQUIRED TO FINISH AND USE BUILDING D 'TOWN CLERI~ ~:~lq:~E SOUTHOLD, t~l~ YJ BUiLDiNG p£RMIT ~ (THIS PERMIT MUST BE KEPT ON THE RREM'ISES UNTIL FULL COMPLETION OF THE woRK AUTHORIZED) N? 9557 Z Permission is hereby granted to: at premises located at ...p.O..~,]:o.t,.../j ,~(~'"'~}g.'~g~'"~T~'"'~'0.1~ ........................ .............................................. · %1; ~.r..~.i.n~...Read: ...... ~u~eh~e ...................................................... pursuant to application dated ........................... ~C'~"'"Y.~ ........... , 19.,~r/.., and approved by the Building Inspector. Fee $.~,.~.,,GO ........... TOWN OF $OUTHOLD , Building Department Town Clerics Office 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 Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dlsp0sal--(S-g 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, o certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit PlannJng Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1057), 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 in- formation required to prepare a certificate. C. Fees: 1. Cerfifloate of occupancy $5.00 2. Certificote of occuponcy on pre-existing dwelling or Iond use $5.00 3. Copy of certificate of ocCUl~ncy $1.00 New B~ilding ....~... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Property ....-~.'~..~, .' .~ .~- · "~.q ....~.,~(~l.~..~ ............. .~.'.'.~...~...~ .~...(~ .Q..'.~. -~,, ................ Location Of Owner Or Owners Of Property ....~.~,....~.~;~'~.~q.~.~..,.~,~.....,t~.'[..~'..~.~,~.~.e'\ Subdivision ......... ~ ..................................... ~"¢ ....... ~...Lot No ............. Block No ............. House No ............. Permit No.....~..?.~.~ .?...~. Dote Of Permit ..~..~.~../...././...~..~..Applicant .................................................................. Health Dept. Approval ...~../.~.h~'/[ ......................................./7 '~/ 7~'~) ~/~¢1 nhn, Dept. Approval ................................................ Underwriters Approval ..............~. .............................. rqonmng Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and. p~nit~meets o_lJiclp)jrJt~e c°de~s~ond regulations. Applicon~~....~........~....~. '~. '/2r~~ ........... Sworn to before me this ................ day of ............................................ Notary Public .................................. County , : ,I ,,~ [ NEW YO OF FIRE UNDERWRITERS ~ ' ' - ' :' :';" '",-'* I - ' :~! J q i, i ' ' 85 JOHN STREET, NEW YORK; NEW YOR~' ;10038 only the el~t~cal eqmpment ~ descmbed belo~ and int~duc~ b ,, ..... , g~orge, Schne der/~ter n~ Rd p t l..20~ -19~8 ,,:,,:~, ~ f undto~ei~gon~plia~t~etvtththerequ,re,nentsofthtsBoar~ 27 ,, ,:14 :18 ...... ' ':1 :: - 3 , , '1953 ?[' ;: "" 'L~-'' '[Calver+on,' N.y. ',i ~. This cert[ficote must not ~e ~Itere~ in on~ monner; refurn to ~e office of t~ ~oar~ if incorrect. Inspectors moy be identified BUILDING DEPARTMENT ~ ; -~'~/~'?;~'/'" ~- -J~ Town ~,,c's omc, ;_~ ~..~:~. _~, Sou'moLD, N.Y. ~/-'"'~-----? '*'~'y - .............. .......... ....................................................................................... : ........ ~, .................... ~' ~.~~. ........................... m:ir~r~"i~;;i ................... 7~ ~~ APPLI~TI~ FOR BUILDING PE~IT/~~~~~ l~......~ ..... ....... , iNtRUSIONS o. ~is opp{icoti~ mu~ be completely fi{{~ {n by ~ewriter o~ in i~k o~ s~mi~ in trip{icote {n~tor, with 3 ~ o~ p~s, occu~te p{~ p{on ~ ~o{e. F~ o~o~ing to s~u{e. b. Plot p{on s~owing {~ot{on o~ lot ond of bui{di~s ~ premises, re{otionship to ~jo n no prem ~s or pub{ c stree~ o, or~s, gild giv{~ o detoi{~ d~cription o~ {~o~ ofpr~e~ must be d~wn on the d{og~m which is ~, of t~is opp{icot{~. c. The work c~ered by this o~{icot}on moy n~ be commenc~ before {ssuonce o~ Building Permit. d. Upon o~o{ of ~is oppl{c~ion, ~e Building {ns~tor wi{{ issue o Bu}{ding Permit to the o~{icont. Such permit s~o{{ be kept ~ the premiss ~i{oble ~r {nsp~ti~ through~t the ~rk. e. No building sho{{ be ~cup}~ or u~d in whole or in po, for ony pu~ose wh~er until o ~e,ificote s~o{{ ~ove been g~nt~ ~ t~e Building {nsp~tor. APPLr~T{ON {S ~EREBY ~DE to t~e Building Depo,ment for the }~uonce of o Bu {ding Permit pu~uont to Building Z~e O~{nonce of the T~n of ~utBo{d, Suffolk Count, New York, ond ~her oppl{coble ~ws, O~inonces or Reou{ot{ons, for the const~ion of bu{{d{ngs, odd{tions or o{~eroti~s, or for ~movo{ or demol{ti~, os he,in dear{bed. ~e opp{{cont ogrees to comply with Gl{ opp{icoble {~, ordinonces, bui{di~ c~e, h~si~ c~e, o~ ~u{oti~s, odmit outhoriz~ in~o~ on p~mi~s ~ {~ bu{{dJ~s ~ n~e~o~ {~tions. (Sionotu~ of opp{{cont, or ~me, {~ o coast{on) ....... · (Addm~ of applicant) State whether applicant is ~er, les~e, agent, amhit~t, engineer, general contractor, el~trician, plumber or builder. .......................................................... ~.~.~~ ................................................................................................ Name of owner of premises ............ .~.~ ~.~ ~......~ ~..~.~.~.~.~ ............................................. If applica~is a co~orate, signature of duly authorized officer. ~ [ ~ .... (Name and title of co~orote officer) ~,X ~ 7-$0 Electrician's License No .... ~.....~.~~.. ............................................... _ 1. L~otion of ,an~ on which pr~o~d work will be done. Map No.: .~~.~ Lot No Street and Number .... ~.~.~....~ ................... .~.~.~'~'.~ ............ ~.[[[[[[[[[[[[.[[[[[[[[[[[ Munici~li~ 2.State existing use and ~cu~ncy of premises and intended use and ~cu~ncy of p~d construction: ~, ~,~,n. ~.a~ ~.~.~ ...~..~.~.~.~...~.~.~ ........................... ~ '~ ........ 'T"- '" ~ ...................................... b. Intend~ use and ~cu~ncy ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ..... ~.... Addition .................. Alteration Repair .................. Removal .................. Dentolition ............... :.... Other Work ................................................ . .... · (Description) 4. "stimated Cost ......... ................................................................... (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 ............................ 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 ....,.-~.~..! ............. Depth ..1~..~ ............. , Height ....~...~. ....... Number of .Stories ...................... : ............... ;. ........ ~ ......................................... :'z': ....... '~ ............. 9. Size of lot: Front ............ .~ ............................... Rear ........ ~k..~...~ ......................... Depth ...... L..~..~..~.: .......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~.....C;~ ......................................... 13. Will lot be regraded ....~..~ ............ Will excess.fill be removed from premises: ( ~ ( ) No .~ .~..~.~ ~ld ress 14. Name of Owner of premises .....~-.~ ................................ Phone No ....................... Name of Architect .............................................................. Address .; .............................. Phone No. ...................... Name of Contractor ....Ir'.~,.~'..\...~.'.~...~.~...i..~...k.~...¥...~..~,~Address ................................ Phor~ No ....................... 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. · n / STATE OF NENV YORK, [ c ¢ COUNTY OF ................................ ' ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracl0 above named. /.~ ~..~. He is the ...... ...~W....~C4~...t~'~...~ ........................................................................................................................................ (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 thor the work will be performed in the manner set forth in the appl'tc~'tlon filed therewith. methis ,h . , ', ........... ~¥.~m-:... day of ...... ~c...-:x~...-r.-r..¥.....,,,¢. ............... , 19.f2 ~01, ~ ~ ,~,~,.-~J"~ Notary Publ~, .....~ .......... ~ ............................... County-.__~-,,~......~..-~.;;..:.~ ..........~.~..'......~¢,..v-:..~....--...~:::~',---~ ~j//,~ j/., [ } t~ignature'of 6pplicant) Iem Expires Ma~[Fh,;30 BUFF. C:O. HK. AI.TH DEF'I'. Alq'IIOVAI- H. $. NO. ~ (v,,e~,~) ; ~ 'Vo ar: t.e~¥ ff4o ,~r~ OCT 71977 ,.,.,,,,,.,,,., ?- %0 ~ La:d' I~'. TI'lit WATI[.q gUPPI.Y AND 0t~:)~L Sy~r'~ll4~ FOR ~IS ROI- ~AND~ ~ SUF~ CO. The sewag~ disposal and ~ter supply Chief of General En¢ineeri~ ·~ . '?,P, GUAR~E~ I~CATED ~o=mCK v~ TuY~ P. c. ,J L