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Home My WebLink About16370-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16141 Date September 8, 1987 THIS CERTIFIES that the building A C C E S S 0 RY $ H E D Location of Property ...1. Y..8.1.5..S..o.u.n.d.y.t.e.w..A.y.e.n.u.e. .......... S. outhold, New York House No. Street Hamlet County Tax Map No. 1000 Section .... 0. 5. .1 ..... Block 0 I . .Lot 0 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 2I, 1987 pursuant to which Building Permit No. 16370 z dated.......,....August ...... 22, ...1987 ........ wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ACCESSORY SHED The certificate is issued to z. MICAH & GAYLE KAPLAN ..................... x x ................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................................................. PLIIMBIgRS CI~RTIFICATIObl DATED: Rev. 1/81 Building Inspector TO'~'N OF $O~THOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. n~ 16J70 BUILDING CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CO~PL~rION OF T.E WORK ^UT. OR~ZEm Z [~ote .~. ."-~..,~.~.., ....................... ~ ~' , ,~.7. Permission is hereby granted to: , _ t..v.~:..~'....~..u..~..~,~.L ............ ~~....~.:...'4.,.....tz.t..zt ........ _,--~ cou., ~o~ ~o~,o. ,0o0 ~,~.?_~..,. ........ .,o~, ..... ~..! .......... ~o,,o.....~..;.-.. .......... pursuont tO oppllcation dated .~.4&~,~..,.,..~,..J ............ , 19..~..,"~., ond approved by the Building Inspector. 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 ~ ~ 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 e~ectrical 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, $25.00, 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 5oUpdated C.O. $ 50.00 Date ..~;~...~[;...~? '~ ..... NewCons tr'uc %ion ...... Old or Pre-existing Building ............ Vacant [_and ............. House No. Street Hamlet County Tax Map No. 1000 Section .... .~..[ ........ Block ............... [ r.~ Lot...'...'~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No; .......... Date of Permit .......... A pp licant . ~).(~.1.~.. ¢/~X.(~l ~L4~Ct .' ........ Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $-. J O .(~ 0 ' Construction on above described building and permit meets all applicable codes and regulations. ADplicant . ........................ Rev. 10-10-78 FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ODE COMMENTS ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION DATE 'FORM NO. 1 · TOWN OF SOUTHOLD CHECK ~ BUILDING DEPARTMENT SEPTIC TOWN HALL SOUTHOLD, N,Y, 11971 NOTIFY m.~. TEL.: 765-1802 CALL MAIL Exa . A?'.., 19 . 7. Appro~ .~...~. .aT'..~.., 19~. .~. Permit No. I.~. .~. ?..O..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ......... , FORM ............. : TOWN OF Sou'rHOLD Date .~4J~_~':. oq-/ 19~'.~. 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 throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc~ shall have b~en 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 Tbwn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to. admit authorized inspectozs on premises and in building for necessary inspections· (Signature of applicant, or name, if a corporation) o D. . . . · 'L~ U~t~] ~aili~g address of applicant) ''' Stale wh~[her- a~plican[ is~owneL lessee, agent, ~chi[ec[, engineer, general con,fac[or, clcc[rician, plumber or builder. ......... · If applicant is a co~oration, signature of duly authorized officer. (Name and title of co,orate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... lumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location ofland on which proposed work will be done. ..j~. .(.~...~. c~ .r~ ' ............. · ./.q...ZI ....................Y./¢ .CO ......................................... House Number Street Hamlet County Tax Map No. 1000 Section . . ~ ~ ............. Block ...t ............... Lot..~ ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: - a. Existing use and occupancy . . . :.~.J .fl_.~ ................................................ Intended use and occupancy ' '- .. ,,..., 3. Nature of work (check which applicable): Ne~ Building ition .......... Alteration .......... Repair .............. Rem~oval .............. Demoliffon .............. Other Work ............. ~ I .~.0. 0. '."'. (Descrip. tion) 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 .... i ........................... . . .. ...... ~ .... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of'u'~[ '"' ~'; ..... ' ..... 7. Dimenmons of existing structures, if any Front . Rear .. ' 'DenSel). . Height ..... Number of Stories ....... '...~ .'..' ..........~ ............... ..' Dimensions of same structure w~th alteratmns or additions: Front ................. Rear .................. .epth .. .......% ~... ~., ......I . . Height' .... · · · .,~ ............. Number of Stories ......... .q..'~'" i ........ ~3,menmons of~tire new construction: Front...~ ~O Re:r ./....~-~,,:... Depth ........... Height .... O ......... Number of Stories ............ ; .... i ...... . ....... 9. Sizeoflot Front .~ .[ ,...,."Rear:...... '' ~r ' J. ~ ''' ' ~ ...... Deoth ......... 10. Date of Purchase ~ .(/tc44~,..e-x ! .~-! J.q'b.") ........ Name of Former Owner ..... 11. Zone Or use &strict ~n wh'.ct/rJprem~ses are mtuated .......................................... 12. Does proposed construction V~a;~ any zoning law, ordinance or regulation: ...t~. O..'7 .............. 13. Will lot be regraded ...... /.V .~/ ................. Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises ..: .................. Address ................... Phone No ................ Name of Architect ~ Address . Phone No. Name of Contractor ..... ................. Address ............ ' ,[ ......Phone No. 15. Is this property locatediwithin 300 feet of a tidal wetland? Yes ..... No .~"~. .......... · If ygs, $outhold Town TrUstees Permit maybe required. I PLO-T DIAGRAM Locate clearly and distinctly alJ buildings, whether existing or proposed, an& indicate all set-back dkaensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CER'flRCATE OF OCCUPANCY NOTIFY ~ ~ '~' ' STATE OF NEWYORK, COU~Y OF. ........ d,]y sworu, and s ys ,ppli ant (Name of individual '" sigqmg contract) above named, l He is the .. ................... ................................................................ (Contractor, agent, corporate officer, etc.) of said or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this owner application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~n~r set forth, in the application filed therewith Sworn to before m~ this j ' ....... Notary Public, ..~ ..~..~..~. ~~ ......... ~ ......... County ~ (Signatu~ of applicant) Notaw Publlo, S~te of N~YoA~ No, 4822563, Suffolk Coun~ ~ Term Expires December 31, 19,