HomeMy WebLinkAbout17070-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217658 Date JANUARY 6, 1989
THIS CERTIFIES that the building ALTERATION
Location of Property 3855 BAYSHORE ROAD GREENPORT _
House No. Street Hamlet
County Tax Map No. 1000 Section 053 Biock 06 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 19, 1988 pursuant to which
Building Permit No. 217070 dated JUNE 7, 1988
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 RENOVATE EXISTFNG ONE FAMILY DWELLING.
The certificate is issued to GERHARD SCHREMMER
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ,
UNDERWRITERS CERTIFICATE N0. NJA
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
FOEM NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMEN4
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ ~17~7~ Z Date ......~,.(.~!?.:t-e:.....~ 19.y~
Permission is hereby granted to:
..1..~~...s...`~~
.rS-~:d..:-.....N.:.y......~ r..9.7.~
,~y . ,
`nt~na/'-~.'~~.!F
:!{?!`.&.!4.4:...,~~.7r:".~f{.... 41'.':~,4..~.A~+'!'k1.~.~1,I..... ~,.d..q..,... 4-.°.....~~
/ :....................................................................u/~...~..~..~.......r.~f...1..............................1...............................
at premises located at g.SS...~ °~.w'bX.bf?!`-r+...l~........,...~.~4.R,~.i~
..~....~.A~.~......sa..~~~ v~??.t-, .......................................................U..........................
County Tax Map No. 1000 Section Block ......5?.~t........ Lot No....~.~
pursuant to application dated ....a~ 14.~.~.., and approved by the
Building Inspector.
Fee
.A~'(-
g
Buildin Inspector
Rev. 6/30/80
~ ~ ~
TOWN OF SOUTHOLD
I~y BUILDING DEPARTMENT
gyp` „i~ TOWN AALL
Flt_L`G. i:5~~i". SOIITHOLD
70WNi)FSOiJi'MOLOw„w, ~ NEW YORR 11971
^ ^_M. 765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE ..A. .`Q . ~ .O ~ .
1
NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING.. X ..VACANT LAND.....
Location of Property..~.u.`~'.`~.'....~ c~Z~~..~~....
HOUSE N0. STREET HAMLET
Owner or Owners of Property. E~'~ ~,..~nC//~~~,,,,,,,,,,,,,,,,,,
County Tax Map No. 1000 Section Q~.~. Block .Q`P... Lot
Subdivision Filed Map ........Lot..........
Permit No. ..........Date of Permit .~~.LCI~.Applicant .~~~..i~.~...4.,K7.C.~
Health Dept. Approval Underwriters Approval..............
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: $
APPLICA T..
a6 yea
r~~~~ y
~G z/~~s~
rev. 10/14/88
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(~j~ UnxrHhorNod aMrratta+or oddhbn
~ to this survey fx a Wolafla+d
N & Ilion 7N%+ d tha NmnYork SWm
MAP OF P~QPE2TY ~""a"`""'
Coplaa dthh atmmy map not bnMnp
the knd saroeYOYo IMUM sent a
i SU2VEYE0 FOIE baevana~iiu®~or~bewrisktama
f duaranteae Indketed hxreon elwli run
• b 1r10 t1xr6M rnr VOFrOrn thB OUlvay
k Drehared, and on hic brhaH to the
Y.=_, B;N aanpenY. 9owmmontel e9xncy and
5 CCrA~,~i-1~'li2D tanr9rq Inethotlon Ilsted hereon end
to the aacigneec nr the Iendinp Imti• ~ N t
n drtion. Guarentoxx ue not tranxlnrnb(a
11111 A K S NA MVJMA tiL U~ «ad'd!`in^xi instltutinne nr ,ubsapUent
Towly ors SOUTHOL.D, nr.Y.
Nofd : ~,of tiur,~bersq,5.,F1oWr! ~dfdv C7uarrxrr-l -fa f~ia~tic Ab3fmc~;lr;
Varioub; trta~i~ Qf ./"~LOtIlC $b' okd fro #F,d: 5cw,~ko/d 5avirrq~ E.+ar,k,
,~~r!'e',6,"fi'r'/tel • in %Su~ol~ ~a~str~ exs survra~ed .lar4. ~l , 1?~86 .
K~rer.~%*•s o~f'~c~e ds . ~rra~~..n.~c d'~t~,~i -rrn~. ~*+c~r~ vgryr ?~r~rz,., ~?G.
p ts'~rrtp~r~»rerrt ~.lcrtrraerd ,~G~it~~t .'3d~w~' ,rsrc~•
FIELD INSPECTION 'ID ATE COMMENTS
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FOUNDATION (1st)
FOUNDATION (2nd) _ ~
2. b C.eJ'~-v r ~
ow
ROUGH FRAME & `
LLti .
PLUMBING
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3. ~
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INSULATION PER N. Y.
STATE ENERGY
CSODE a
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F I N L \ - ~
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ADDITIONAL COMMENTS: ~
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ l ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[~RAMING [ ]FINAL
r
REMARKS: ew n o litti
°II ~ ~r-~,~ ~RelXdt
.Oil ~ , .An. i ~sWDL~. `?a.
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DATE ~_~,~~~_INSPECTOR ~
~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ }ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [~NAL
REMARKS:
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DATE ~ INSPECTOR
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JOB NAME
SCHNORR CORPORA 101 SOS NO. PAGE oP~
56-OZ R1f084D~IRRr ~ 8 used CALCULATED BY DATE
WOODSI~fP1!y~igfl~tflb4t~ yER~FOEO BY DATE
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FORM 80017
~r2~a BOARD OF HEALTH
D -d 3 SETS OF PLANS ~ .
FORMN0.1 SURVEY .(J./c~............
YAY TOWN OF SOUTHOLD CHECK ...d 7 S . . . . . .
1l~~nn BUILDING DEPARTMENT SEPTIC FORM .•r""~.......... .
• TOWN HALL
BLD('.D'.~~~i SOUTHOLD,N.Y.11971 NOTIFY
Trna~~,~ (~:..."`?".L:~n~~ TEL.: 765.1802 CALL 5~ - S / ~ 3
MAIL T0:
Examined . 19 ~8 ~o C1'~' '
APProved 19~~. Permit No..~.~.d.~].a''3=
Disapproved a/c .
.1~.~" n'~' .
(Building Inspector)
,APPLICATION FOR BUILDING PERMIT _ ~i'
, Date 19~"
INSTRUCTIONS
a. This application must be completely f711ed 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 throughout the work.
e. No building shall be occupied or used in whole or in 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 fo •re • val or demo 'tion, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildin ,housing co e,,
an~ulations, and to
admit authorized inspectors on premises and in building for necessa ec
(Signature of"app scant, or name, if ya~corporarion)
c~.. d-~~~.. J\ 17 .
(Mani g a dress of applicant)
State whether applijant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ...........?U•1.~!z-~~ • • f~%u!?-y'<'?~~ .
(as on the tax roll or latest deed)
If ap nt ' corporpa~tio~, sigx~tpre of duly authorized officer.
(Nam and title of corporate officer
/
Builder's License No. ...7.'~f_J-'. ~ •
Plumber's License No. ~I•?~~R~~
Electrician's License No . .
Other Trade's License No . .
I. Location of land on which proposed work will be done . .
~~55...... ~~t,
Vials.t~:~.....i~`:o-a~ ; .
House Number Street Hamlet
n
County Tax Map No. 1000 Section • Block .....1.~ Lot
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and int nded u``se and occupancy of proposed construction:
a. Existing use and occupancy )...T~`~`°"~ .
c- -
b. Intended use and occupancy .
r.bi-,.w..u.
%bw{
Iq
3. Nature of work ch ' which a Addition r... Al `i_
plicable): New Building , teratibn .
p , pval . .
Re air Rem , . , Demolition ....~1 Othe~,,~'q c~ : '~3~ .
( P `~(tCp~ 3 +N,nroaa,~S ~~.~itG ~ •P,~~` )
~=yy (cr1 tao~
4. I'sstimated Cost Fee ~ .
g g (to be paid on fi]ing this appllIication)
5. If dwellin number of dwellin units . , Number of dwelling units on each floor , ....l .
If garage, number of cars . . .
7. Dimensions of ex' tin structure occupancy, specify na re and extent of each tape of use , ,
6, Iles htness c~ m~mercigl or Nue s, if any: Front ~ Rear A:....... Depth ~ .
berofStaries...,.../........,...~...~.".
Dimensions of same structure vvth alterations or additions: Front ....c~?"7'. Rear .
Depth i ..Height ......................Number of Stories .
8. Dimensions of entire new construction: Front , , , Rear . . Depth .
Ileight N~~JJrr) r f Stories .
9. Size of lot: Front (.`.t. 9.... , Rear C{ .ay..... , Depth ~ . . .
1 fil . gone or usecd strict in which prG • ' ' ' ' ' ' ' • • • Name of Former Owner .
12. Does ro osedconstructionvromisesaresituated...~,,,,,,,,,,,,,,,,,
.ate any zoning law, ordinance or regulation: 6 .
13. Will lot be re radedp ................Will excess fill be removed from premises: Yes No
g
14. Name of Owner of remises G~„r)>~,QO ,~:Hit~r'>!M~dress~~aS ~sW,r,~,Ci,.y?!phone No .
Name of Architect ~
t^,t,,,, , ; , , , , , , , ,Address , ,Phone No...1.-........ .
Name of Contractor . ~ a, BZ`.L , , ,
, T'k~ T ........Address . 1.`~, ~ . ~r9!k' Phone No...7, ~9 . ~ ~ : .
'i so~Trl~-D
PLOT DIAGRAM
Locate clearly and distinctly alli, buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block ~tumber or description according to deed, and show street names and indicate whether
interior or corner lot. 'i
~~tiI~C.C ~ ~ r of t1~nl S _ j_ti f 5- i~i-c t_ ~ r ~ ~/lC ~ ~J~~,
_ ~ ~
Ct}rati[G-t ~T'~4, ~-r'Y.T~t.,K~3 I
(/15. Is this property is located within 300 feet of a tidal wetland4 Yes..yl.//.. No.....
*If yes, South old Town Trustees Permit 'may be required.
STATI3 O W YORK,
CO1~PF ...~..S.S
~ (N e .of individual signs • ~ ~ ' ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant
ng contract)
above named.
He istlie
(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 that the
work will be performed in the manner, set forth in the application filed therewith.
Sworn to before me this
~.......day~o/f'../'.~,~?/L'~rJ..........., 19/f~
Notary Public, , , . , i~ ..zl :.K!~-.t!. , County
HELEN K. ¢E VOE '
NOTARY PUBIIC, Stpte of Hew York (Signature of applicant)
No. 4707878, S Nolk County
Term Eapires Maro~r 30,19.,
I