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Home My WebLink About16213-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificafe Of Occupancy No. Z16339 Date October 28, 1987 THIS CERTIFIES [ttat the building ...A. 1. t..e .r.a.t.i. ,o.n .................................. Location of Property ...... 2.3. 2. .5 .... C..1 .e.a.r.v..i .e.w..A..v .e.. ............... .S .o.u.t.h..o .1.d ......... House No. Street Hamlet County Tax Map No. 1000 Section 070 .Block l 0 .... Lot 24 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..3.u.1. y.. ,6 .... ! 9. {~.7 ..... pursuant to which Building Permit No. 16213 Z dated .JV]-Y.. ! .2 ,..1.9. .8.7 ............ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ..~.c.r.~en in existing porch only. The certificate is issued to c. FRED & FLORENCE M. SCHOENBAECHLER (owner, I'~ ]~Kf~X X of the aforesakt building. Suffolk County Department of Health Approval ...... .I,I/.A. ................................ N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A / ~dilding Inspector Rev. 1/81 1~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 1 ~ 213 Z Date .......... ./. .................... , Permission is hereby granted to: ~. ~'~. .~.~.~.~..~...~....~....~..: ......... ~ ....... ~.....~.,.....LL.q..~.I....~... ,o .~~... .,~...~..~...*~.....~..~..~.X.~.~ '-'- ~,,.~ ~ ~ ~,_,' 2,~,Xo~"-"b, ~" ' . at premises located at ..~.,.~.~...~...: .................................................... County Tax Map No. 1000 Section ..... ..C~...,~.....~. ....... Block ....... ~....~.. ....... Lot No.....,.'~..~. ............ pursuant to application dated ..... ..~..~.....~. ......................, 19.~...~..., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor 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 disposal-(S-9 form or equal). 3.Approva~ of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, 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 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 informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory,,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5 .UpdaLed C.O. $ 50.00 Date . .~z.~ .;..~.~.?/.~. ~?. ....... NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...Z:..~..~.. ~.. ............. House No. Street Flamlet Ow.er or Owners of Property I. C ........ County Tax Map No. 1000 Section ...... ~..~.~ .... Block ..... ./.O'. ....... Lot .... '~ .~/ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /, .~..~./..~.. Date of Permit . .7?/.~.~.~ZApplicant . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 UNDATIO~ (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION ?ER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY..~.- --. TOWN OFSOUTHOLD CHECK [~-.' [: -- BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved Disapproved a/c .................................. /~ (Buililing Inspector) · APPLICATION FOR BUILDING PERMIT .!~., 19a. 7. .t.+..., 19~7. Permit No..l.g..~J..S..~. NOTIFY CALL ................ MAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throqghout the work. . e. No building shall be occupied or used in whole or in part fox' any purpose whatever u~til a Certificate of Occupan% 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 Zon6 Ordinance of the Town of Southold, Suffolk County, New york, and other applicable Laws, Ordinances o~ Regulations, for the construction of buildings, additions or alterations, or for.ramoval or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for necessary in~s...... ~ ~~~ .... (Signat6r cant, or name, if a corporation) " ~, ~g.~..C/¢a~. v.~ ~. ~ ~, ~,. J..o.~.2Z (Mailin~,i"° address of applicant) State whether applicant i~lessee, agent, architect, .engineer, general contractor, electrician, plumber or builder., Name of owner of premises · .~./0..~.//~./-.~.. HA~.~.e · ./~, .~.(~. ~,,~J~z:g .e. ~'.h./e ,/~. ............. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S I~UST BE~HFFOLK COUNTY LICENSED Builder's License No ..... ...5'.1~/..~ .............. Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done~ ................................................. d e. .............. .C. l e ) e. w :. . A. .,. , ........ ........................ House Nmnber Street Hamlet County Tax Map No. I000 Section ...... ./~..~ ......... Block ...... ./.q ......... Lot...~.~. ............ ' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premis}s and intended use and occupancy of proposed construction: a. Existing use and occul~ancy .... t~.o...z/'z'.. ~$1~.e,~.C.~ ............. . ................................. b. Intended use and occupancy ............................... ...... ................................. Nature of work (check which applic~.ble): New Building ' Addition .......... Alteration . . Repa/r .............. Removal ............. Demolition .... ,,~ ........ Other Work .............. ~ ,~r z . (Description) (to b'e paid on filing this application) If dwelling, number of dwelling unit ............... Number of dwelling units on each floor ............... If garage, number of cars ....... , ............................................ - If business, commercial or mixedocgupancy, specify nature and extent of each type of use ..I..~..iiiii'ii[iiii'.'~' . Dimensions of existing structures, ifiany: Front ............... Rear .............. Depth ............... Height ............... Number ,of Stories ........................................................ Dhnensions of same structure with ailterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... I. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height Number iof Stories ). Sizeoflot: Front .............. i ........ Rear ...................... Depth ...................... ) Date of Purchase I Name of Former Owner I. Zone or use district in which premises are situated ..................................................... I. Does proposed construction violate Ony zoning law, ordinance or regulation: ................................ L Will lot be regraded ............ i ................ Will excess fill be removed from premises: Yes No [ Name of Owner of premises ' Address Phone No Name of Architect ............. [ .............. Address ................... Phone No ................ Name of Contractor ............ , .............. Address .... : .............. Phone No ................ 5. Is this property located witl~in 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. i PLOT DIAGRAM Locate clearly and distinctly a/1 buildings, whether existing or proposed, and. indicate all set-back dimensions from operty lines. Give street and block nuniber or description according to deed, and show street names and indicate whether tefior or corner lot. 'ATE OF NEW YORK, . )UNTY OF ................. S.S ........................... ' ly th th ppli .... , ................. being du sworn, deposes and says at he is e a cant (Name of individual signing ~ontract) ore named. .~ is the.' ' (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly au'thorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the )rk will be performed in the manner seti forth in the application filed therewith.' ~orn to before me this ............... '~' ..... day °f' ' 'i' · '~ ......... , 19.q~.~ ll_ .~l~g'at~e~ oV~f New yofk (Signature of applicant) nT~l ~rk ~Q~unly~o