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Home My WebLink About15688-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. THIS CERTIFIES that the building .. Certificate Of Occupancy Date . M.arch 18, .1987 A.~ ~ t.i o.n ~ ............... 1640 FIRST STREET NEW SUFFOLK Location of tkoperty/t3f,~b bio ...................... 'St/e3i .................... Iq~rn/ei County Tax Map No. 1000 Section . 1.1.7. ...... Block . . .qS. ........ Lot . 46.03. Subd~vision ........................... Fried Map No ........ Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 2D, 1987 . pursuant to which Bmlding Permit No. 15688z dated .... F..e .b....20,.......l 987 ... .... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate m issued ~s ......... .... p.e.c.~...aclAi, t.i.o, ns .t.o..e.x.~st.i.?g one famzly dwelling. LEON AND PAULINE KREMENTZ The certificate is issued to ................... i~wrie'r,~t~i~lJi~k~ ............... of the aforesaid building. Suffolk County Department of Health Approval ...... N/A. .................... UNDERWRITERS CERTIFICATE NO ............. N./.A. ...................... PLUMBERS CERTIFICATION DATED: N/A Budding Inspector FO~M' NO. D TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15688 Z Perrn~ssion is hereby gronted to: .... .~..~....~... ~...~..~.~.z..~ .....~..~.....~..~..'-L ................... .... ~.~...~.:~:.....u..~..~.~... ~ ...~ .................. ~ ................................................. ~~.. ............................................................ pu~uant to application dat~ .~~~... ~ ..... , 19~3., .nd appm,~ by t~e Budding Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANC¥~ 2 ~- -~ Instructions A. This application must be filled in typewriter OR ink, and submitted ~ II~ 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. Approval of electmcal ~nstallatmn from Board of Fire Underwriters. 4. Commercial buildings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code comphance 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 Aprd 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of pz"operty 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 ~nforma- lion required to prepare a certificate. C. Fees: 1. Certificate of occupancy ~ ~r~o~, Ob 2. Certificate of occupancy on pre-exist~ng dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ..t~,r,c,h, i.I.; . .. · . I9.87 ........... New Building X Old or Pre ng Building Vacant Land 1640 First St., New Suffolk, New York Location of Property House No. Street Ham/et LEON & PAl/LINE KREMENTZ Owner or Owners of Property ............................................ ....... ..... . .. . CounW Tax Map No. 1000 Section .. ,1,1,7 .......... Block ..... ,0,5 ........ Lot,. ?,4,6, ;0,0,3, ...... Subdiwsion ................................. Filed Map No ........... Lot No. Wickham, Wlckham & ~g~i~;'~6., Permit No. 1~. ~... Date of Permit 2/20/87 .Applicant a~tg{P~. ~9~.~{~n~z . Health Dept Approval ............... Labor Dept. Approval ..... Underwr[~rs Approval Planning Board Approval ............ Request for Temporary Ce~ificate Final Ce~ificate Fee Submitted $ ~5..~0 . . Construction on above desc?bed building and permif~eets all~plicabl~[~odes and regulations. , A Applicant ... x.. ~~ ................................. , By oaniel ~ Ross R~ 10-10-7S Attorneys for Applicants OUNDATIO.U {1st) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS' BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENI SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL ................ , MAIL TO: 7 Examined ~-~ .~..o, 19 Pe m,t No. Approved Dmapproved a/c ................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ...... , 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in mk and submitted to the Building Inspector, wit sets of plans, accurate plot plan ~o scale. Fee according to schedule b. Plot plan showmg locatmn of lot and of buddmgs on premises, relationship to adjoining premises or pubhc str; or areas, and glvmg a detaded description of layout of property must be drawn on the diagram which is part of this ap catxon. c. The work covered by flus application may not be commenced before issuance of Buildmg Permit. d Upon approval of this application, the Building Inspector will issued a Bufldmg Permit to the apphcant Such pet shall be kept on the premises avgdable for mspectlon throughout the work. e. No buddmg shall be occupied or used in whole or in part for any purpose whatever untd a Certificate of Occupa shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Buddmg Department for the issuance of a Bmlding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnance- Regulations, for the construction of buddmgs, additions or alterations, or for removal or demohtlon, as hereto descnb The applicant agrees to comply with all apphcable laws, ordinances, budd~gr'Oode, hou,%I3g code, and regulataons, anti admit authorized mspectom on premises and in bmldmg for necessalT lnspe~lr~ls (Mallmg'address of applfcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bml, Name of owner of premises -~-a-Co-x..O.4,& ~5)~ ~-~,~z~ .................... (as on the tax roll or l~est deed) If applicant is a corporation, mghature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ........... Plumber's License No ............. Electrician's License No .. Other Trade's License No .. Location ofland on which proposed work will be done House Number Street County Tax Map No 1000 Section l ['~ .. Subd~vmion ...... Filed Map No Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existtng use and occupancy..,f'~'~J~ ~--Y:-e~~ b Intended use and occupancy Y~af, r-~ .......... 3 Nature of work (checkwhlch applicable) New Budding Repmr . Removal .. 4 Estimated Cost ff~"~... ,. . Addition/~v~ Alteration ...... Demolition Other Work ~c~ ~6 (Description) ........... Fee . . .: ..................... " (to be prod on fihng th~s apphcat~on) 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 ex~stmg structures, If any Front Rear .......... Depth ......... Height .... Number of Stones ............................... Dnnensions of same structure with alterations or additions Front ........ Rear .......... Depth ........... Height ........ Number of Stones.. 8. Dnuenslons of entire new construction Front ~-7C!~ a4~..'~l~ar°P ~ ~ ---DePth' . Height ........ Number of Stories. 9. S~zeoflot. Front .~.O(.,.3~ ........ 10. Date of Purchase .................... Name of Former Owner .................... 11. Zone or use dzstnct in which premises are situated .......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation .......................... 13. Will lot be regraded ................. Will excess fill be removed frq[n premmes' Yes No 14 Name of Owner of premises ~ ~f..oaf~dress [6.q.q ~.~3~.,~,r .~.~...~.~on Name of Architect ...... v No e .......... Address ........... Phone No ............ Name of Contractor .............. Address ................ Phone No ........... i5. Zs th±s property locaeed~q±th2_n 300 feel: o£ a t±dal xqet]_and? ~Yes ~.... No ..... ~,Tf yes, Soul:hold Town Trustees Perm±r maybe requ2red. PLOT DI AG t/akM Locate clearly and dzstmctly ali bm!drags, whether existing or proposed, and ~ndlcate all set-back dn-nenslons from )roperty hnes Give street and block number or descnptlon according to deed, and show street names and indicate whether ntenor or corner lot. ;TATE OF NEW YORK, ;OUNTY OF..G'~FFtp£.I& .... S S .... ~.~ .~.,TF_-~ C-. ¢~5¢~ . . . ... being duly sworn, deposes and says that he ~s the applicant (Name of individual slgmng contract) bore named. (Contractor, agent, corporate officer, etc.) ff-~s~&c~:.'ner or ...._ n~r~. ~n~ i~ a~ulv -°.:::~-,rlzcd_ ~ ,-"'~r"'~' ........ er k~ and to make and file flus pphqat~, that ail statements contained m this application are true to the best of his knowledge and belief, and that the tork ~ performed m the manne? set forth m the apphcatmn flied therewith. worn to before me this ............ .~.~'.. .... day of...~.--~.., ............ ,19~ ,otaryPubhc, ~.~;~C. ~.~..&..~..a~.... County H~~ -~ ~ ~res ~a*ch ~0, 19~ (S~gnature of applicant)