HomeMy WebLinkAbout15948-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No .z 174.04 ......
Date N..ovember 13, 1987
THIS CERTIFIES that the braiding . Alterat ~on & renovat zon
710 West Shore Drive Southold
Locatmn of Property House 'No .............. St/eet .................
County Tax Map No 1000 Sectzon 080 . .Block 01 .Lot
Subd~wmon.
·. .Filed Map No ...... Lot No ..........
conforms substantially to the Apphcat~on for Bmld~ng Permit heretofore filed ~n tlus office dated
.... .A.p.r. i .1 2.3.,. ,1.987 pursuant to wluch Budding Permit No .1.5. 9. .48 Z
dated· .Ap.r£1 2.8., .1.98.7.. .. was~ssued, and conforms to all of the requirements
of the apphcable prowmons of the law The occupancy for Much thru cerhficate ~s issued ~s
Alteration & renovation
The certificate ~s ~ssued to R 0 B E R T
of the aforesmd budding.
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE NO ...
of existing one family dwellzng.
& DOLORES SCHISSEL
(owner, ~¢~K~[,a~
Pending II/2/87
PLUMBERS CERTIFICATION DATED:
Henry J. Smith 11/10/87
itdmg lnspec[or
Rev 1/81
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)
15948
Z
Permission is hereby granted to:
...... ~...~.~. ...................... ~......~ ..............
...~.~...~....~.:.~.:....cc~..~,J.... ,. _
:::::::::::::::::::::::::::::::::::::::::::::::::
pursuont to opplication doted ..~~.....:~....~. ................ , 19.~..'7.., and opproved by the
Building Inspector.
Fee $..~..,..~...:.....~
Building Inspector
Rev. 6/30/80
FORM NO. 6 ~[?~ ~ ~J ~[ ~
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUP
Instructions
This apphcatlon must be filled in typewmter OR ~nk, and submitted m ~ to the Building Inspec-
tor w~th the following; for new buildings or new use:
1, Final survey of property with accurate location of all buddings, property lines, streets, and unusual
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage dlsposal-(S-9 form or equal).
3 Approval of electrical installatmn from Board of Fire Underwriters.
4. Commermal buddings, Industmal buddings, MulUple Remdences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responmble for the building.
5. Submit Planmng Board approval of completed rote plan requirements where applicable.
For existing buildings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buddings and unusual natural or
topograph m featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condmon of buddings.
3. Date of any housing code or safety inspection of buddings or premmes, or other pertinent ,nforma-
t~on required to prepare a certificate.
C. Fees'
1 Certificate of occupancy New Dwelling $25.00, Accessory ,$ ]0.00 Business $50.00
2, Certffmate of-occupancy on pre-existing dwelhng $ 50.00
3, Copy of certlflcate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date .f.\]0.~...JQ;,.~°c'./ .....
NewConst~uc%lon. , .v~... Old or Pre-existing Building ............ Vacant land .............
Locat,on of Property ...~.J .0......~..'~j.. ~..~..h..o.r%~.. J~f. I.g~-~ ...............................
Hou,~e No Street Ham/et
Owner or Owners of Property ...... ~ ..... .cr_..~.. ! .....................
County Tax Ma~p No. 1000 Sect.on ....0...05fO ....... Block ...0../ ......... Lot .... O.V..~. ......
Subdivision/r'/~l[[.~ ~).r.~..~..~.CJC-eM' ............ F,led Map No .~.~/ ..... LOt No....c~../T.CJ ....
Perm,t No. /~..~ ~/~..~.. Date of Permit. ?/.~.~/.F.,~.Apphcant..'~.0 ./)n../3C..~'~,hO J'. ./~. C.~.,.l~/.~.r~...-~..~
Health Dept. Approval ..... ..... ~'. .......... Labor Dept. Approval ........................
Underwriters Approval ....................... Planning Board Approval ......................
Request for Temporary Certificate .................. Final Certificate. . ......~'". ..............
Fee Submitted 8..
Rev 10 10 78
d.D. z/4
OUNDATION (1st)
0UNDATION ( 2nd )
OUGH FRAME /
FLUMBIN~//
NSULATION PER N. Y.
STATE ENERGY
CODE
FI];AL/
ADDITIO?)AL CO,~MENTS·
PETER T. PODLAS, A.I.A.
Arohitect
71 SHINNECOCK AVENUE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] I/NSULATION
/
FRAMING [~'] FINAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ]/~,NSULATION
FRAMING [v/~ I=II]FINAL
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 15T [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[~FRAMING [ ] FINAL
REMARKS:
DATE
INSPECTOR~
765-'1802
~'~ ~ BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1001071
BUREAU OF ELECTRICITY
~ 0 '~O'Vl~l.h~r ~7~ ~LOJSY$ JOHN STREET. NEW YORK. NEW
,,.,, ,,,.,.-..o. ~,~ o.;.,. N 843552
THIS CERTIFIES THAT
Dr Robert Schiseel. West Shore Drive. l~ydon Shores, Southold, N.Y
m thefollowlnghwat,on, [] B~,ement ~ Ist FI [] 2nd FI %ctmn Block ~t
~s examined on O~ob~ 2~ ~98~ and found to be tn cotnphan¢ e utth the r~ q.trements of thts B~rd
~, ~ RXTU~E F ~ RXTURES T RANGES ~ ov~msH ~5HERS I EXHAUST FANS
~otors: 1-1hp
Ton A/C Unit
t",C. I. 1-smoke Detectors
G 4, $ Elect:r~.c
Box 215
Southold, N.Y 11971
Per .~ ~L.~
This cerhflcate must not be altered in any manner, return to the offsce of the Board ~f mcorred Inspectors may be {denttf{ed by their
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
xamlned ~ .9...~ .,
4~prove~....~. ~ , 19'~-1
t~approved a/c
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
EOUTHOLD, N,Y, 11971
TEL.: 765-1802
Penmt No./
TOWN 0{' .. ~,HOLD
Recel. ved ........... ,19
APPLICATION FOR BUILDING PERMIT
Date /-)pr' ~2 a, , 19~
INSTRUCTIONS
a Ttus application must be completely filled in by typewriter or m znk and submitted to the Building Inspector, with
ts of plans, accurate plot plan to scale Fee according to schedule.
b Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or public street
areas, and gwmg a deified descnphon of layout of property must be drawn on the dmgmm whmh is pa~ of th~s appl
tion
c The work covered by t~s apphcahon may not be commenced before ~ssuance of Building Permit.
d Upon approval of this apphcatton, the Bufldmg Inspector wdl ~ssued a Building Pe~t to the apphcant. Such perm~
,all be kept on the premises available for inspection throughout the work.
e No bufl&ng shall be occupied or used in whole or in part for any purpose whatever until a Cemficate of Occup~c
~alI have been granted by the Braiding Inspector
APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Braiding Permit pumuant to th
.uld~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ordm~ces o
egulatmns, for the constmcbon of buildings, add~tmns or alterahons, or for removal or demohaon, as herein described
ae apphcant agrees to comply w~th ag apphcable taws, ordinances, building code, housing code, and regulations, and t~
lm~t authorized ~spectom on premises and m building for necessa~pections
(S~gnature of apphcant, or name, ff a corporation)
........ t akiifi ' aaa A ' apb11 &AAH' - .....
late whether apphcant ~s owner, lessee, agent, arctutect, engineer, general contractor, electr~cmn, p]mnber orbuilder
....... btu/4 ....
alne of owner ofprenllseS Robert & Dolores Sch~ssel
(as on the tax roll or late~t deed)
apphcant ls.a corporation, s~gnature of duly authorized officer
(Name and htle of corporate officer)
Buflder'sLmenseNo. /~/~' ~
Plumber's License No. ~ ~~
Electrlman's L~cense No. ~ ~ ....
Other Trade's License No . .
Location of land on which proposed work will be done
'7]0 West Shor.e .Dr.zye. , Sputho.ld~ .N..Y... .
lIouse Num her Street
County 'Fax Map No 1000 Section -olr'r' d ~
Subdivision .Reydon..Shores
(Name)
}tamlet
Block 01 . Lot.
Fried Map No Co ~ ] Lot
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy Iii story reszdence
b. Intended use and occupancy 1~ s.tp;cy re.szd.enc.e (4 ]7'-~ ~a_ ~ O/0 .....
3. Nature of work (check which applicable) New Building ..
Repair ... Removal .......... Demolition
4 Estimated Cost $50,000.
1
If dwelling, number of dwelling units . ..
If garage, number of cars ................
Addition .. Alteration .,,~ .....
....... Other Work ...........
~, ~ (Description)
Fee ..........
(to be paid on filing this application)
Number of dwelling units on each floor .......
6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............
7 D~mensions of existing structures, if any. Front. ~25.Q , . Rear Z8..Q Depth .35..0
Height 28:0 .... Number of Stones .1-~
Dunenslons of same structure with alterations or addlhons Front
Depth 50.0 .... Height . 28.0.
Dunensions of entire new construction' Front..
Height ...
9 Size of lot Front i9~0 Number of Stones
..... Rear.. ~.6
0 Date of Purchase 19.74 ...... Name of Former Owner
1
2
3
4
25. q ..... Rear .2,8.. 0
Number of Stones.. 1% .
Rear .... Depth
· 'i I .........
Collins
Zone or use district in which premises are situated ... Residential A .....
Does proposed construction wolate any zoning law, ordinance or regulatmn .no ....
Will lot be regraded . ao ............ Wall excess fill be removed from premises Yes Nc
Addres~ .~s~p~ ~ ...... Phone No 581-1165
Name of Owner of prem~ses g. Sch~-ssel 4 t:. M r s La.
Name of Architect .~Pet.er T. Podolas Address E. qu, o~u.e . . jehone No '7~-'5.'~['i'i '.
Nan~eofContractor .,JOhD /~e't~/~..~' .... Address?SR~f~O-/cc~T0~/~ ~honeNo 7.(o3%/.5Y2.'~...
5. Is this property located withfnl00 feet of a tidal wetland? * Yesx .... No .....
· If yes, Southold Tox~a Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buddings, whether ex~sting or proposed, and~indlcate all set-back dimensions fron-
,roperty lines Give street and block number or description according to deed, and show street names and indicate whethe~
atenor or comer lot.
TATE OF NEW YORK,
OUNTY OF SUF. FOL. K. .. S S
(Name of individual s~gnmg contract)
~ove named
bcmg duly sworn, deposes and says that lie m the apphcai
e is the .......
(Contractor, agent, corporate officer, etc )
f smd owner or owners, and m duly authorized to perform or have performed the said work and to make and file th
~phcation, that all statements contmned m this apphcat~on are true to the best of his knowledge and belief, and that
ork wdl be performed in the manner set forth m the apphcahon filed therewith
dom to before me this
...... ~.5 ...day or.. ,'52p/d//~ ..... 19~7
otary Public, . ....
· , .~uff~k County
Term I~,r~ D~ember 31, 1~
,~ ¢.~. F~/../q County
(Signature of apphca~
~t×/
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