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Home My WebLink About1392-ZFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~RTIFI~ OF OCCUP~ No Z-25443 Date DECEMBER 19, 1997 THIS CERTIFIES that the building Location of Property. 2105 BAYSHORE RO~D House No. County Tax Map No. 1000 Section 53 Subdivision DWELLING GREENPORT, N.Y. Street Hamlet Block 4 Lot 13 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 1961 pursuant to which Building Permit No. Z-1392 dated MAY 9, 1961 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 ONE FAMILY DWELLING WITH ATTACHED DEC~ * The certificate is issued to JANE SCHUHACHER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL DECEMBER 1, 1961-R. VILLA UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A *THIS UPDATES CERTIFICATE OF O~cumANCY %~-1186 DATED DEC. 2, 19~1. / Build~ Inspectof4 Rev. 1/81 ~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1392, z Date ........................ ~r.....~ ................... Permission is hereby granted to: Raker & l~.ek.e.i, ssen.....A~C...R..Sehu~aehe~ .............. .......... D~tho-16 .................................................. to ...:~.~l. t4..me~..ene..~.e~i.ty...d,~el.l..~l ................................................................................... at premises located at ~Ot..~t. ....................... Peeon~.~'"Day'"E~'l;&l;e~' .......................................... ............ Eel,,~,t~.-~l.~6.... e~ ............ ~,..~i~o~,e...Read ...............~eel~t,.t v'"N-'Z, ................ pursuant to application dated ........................... M~"'9 ......................... lO~,j...., and approved by' the Building InsPector Fee ~l. 0.,.01~ ............. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building Ioceted at .~.~'.~.......~.~k~...~.~q~..~...~,.O.~,.c[ .................... Street Peconic Bay Estates Mop No ....................... Block No ...... ~ ....... Lot No..35......~3..6. ......... ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................... ~[.~.~..,..~. .................... , 19~...]-..... pursuant to which Building Permit No. dated ..................... ,[v~.....c~ ............... , 1~;~..., was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is .......... ........... .................................................................................... This certificate is issued to ...]EJ.Q,~,a,13,d.....J~C]~I, ZI~tc~Le~' .................... O~33.e~ ...................................... (owner, lessee or tenant) of the aforesaid building. H.D.Approval Dec l, 196l by R.Villa ......... Bui Iding 'i~'~ ';~'~'~ '1 ................ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY mo This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, .~lterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existin~ Buildin~ - $100.00 Copy of Certificate of Occupancy Updated Certificate of Occupancy q.pg.ooD Temporary Certificate of Occupancy - R~esidential $15.00, Commercial $15.00 Date ...~..~.~...~...~ .~...~.. Onwer or O ers of ............................. ooo, ..... ....... .... ............. . . ~Co~l C , -._ . ..... ~o~ ...................... Subdivision ................. .~...~...~..~.Fiied Map.. Health Dept. Approval .................. . .... .. iUnderwriters Approval... ................... ... Planning Board Approval ........................ Fina/C/~ Request for: Temporary Certificate ........... Fee Submitted: $ ............................. +'% FOKM biO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ ]9 ........ Permit No ............................... Disapproved o/c ........I"~ ......... Application No...../...~..~...~.. ......... APPL.C^T,O. FO..U'LD,NG PERM,T Date ~:~.6~ ..~..~ 19~/ INSTRUCTIONS a. This opplication must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plon showing location of lot ond of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detoiled description of layout of property must be drawn on the diagrom which is part of this location. c. The work coYered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or Jn 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 o 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Signature of opplicant~ or name, if a corporation) (Address of applicant) State whether applicant is owner,~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. -r-i--- ~ Nome of owner of p ~m ~....~..~..~ ...................... ~..~.., ................................................................................................... If applicant is a corporate,~signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ~.~...~.....~...~..;.~. ~.~/ VZ) ~...~.....~..~.~...o,~ /._~, Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ....................................................................... - .............................................................. use /. b. Intended and occupancy .............................~....~... ...... ~ ....................................................................... $. Nature of work (check which applicable): New Building.......~T............Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ............../.......~. .................................... Fee .....~..~..~ ................................................................... (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, commerciol or mixed occupancy, speci~ nature and extent of each type of u~ .............................. 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 .......~.~I.~.~ Depth ~ ' Height .....~..~...~. .......... Number of Stories ..... ~ ............. .....~. 9. Size of lot: Front ..... ~.~ ........... Rear .....~ ................ ~pth .~.~.~...~.~.~..~ 10. Date of Purchase .................... ~. ................... Name of Fbrmer ~ner ~L..~..~.~.~..~ .............. 11. Zone or use district in which premises are situated ............ ~/~~.~ ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~.~ ....................................... 13. Name of Owner of premises.~...~.'...~...~.~l;..[~Address ~lZ.~.~.~.e.~ ...... .~(~.Phone Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor~...~.~/~~dress ....~.~..~.~....~Pho~ NO.4~.~;.~.~.~.~ 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. k STATE OF NEW.~..OJ~ _ ) S S COUNTY OF ..~..,.4 - ' ~..~ .......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named He is the ~~ ................. (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 rnc~/~ ~tB(~l~h in the application filed therewith. Sworn to be.~e me this ...,_.., Nota~/ Public. State of New York .~- . ,. .,~,~/~. / No. 52-G344..9.~3, .~J_ l~lk County t~ ............ .~.. ....... aav ot .............. .'.~..~.~.~ a~[,~.30, zgu~ (Signature of applicant)