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Home My WebLink About15232-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Off]ce of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ... &1579~A... Date ....... ~.~6~ 1987 THIS CERTIFIES that the building , .. i.n.g.rgu, n.d p.qo. 3:...a.nd...f.e.nc.e .......... Locatmn of Property .935 ........... W.a.t.ery~.e.w p.r: ......... .Sou. t.h. 9.1.d' .... House No Street Hamlet County Tax Map No. 1000 Section .... 7~...Block ....... .7. . .Lot ..... ~.3 ........ Subdivlszon .... X. .............. Fried Map No. . .X....Lot No. X conforms substantially to the Application for Building Permit heretofore fried ;n this office dated August 18, 1986 pursuant to wMch Bmld~ng Permzt No 15232Z dated .... .Se, p.t..e~be.r 4, .197.6. was issued, and conforms to all of the reqmrements of the applicable provisions of the law The occupancy for which this certificate is issued is ..... · gu.n p.?oS. ......................... The certlhcate is ~ssued to of the aforesaid braiding. IRWIN & CEIL KAPLAN · '' (d~,ner,'~~ ............... SuffolkCounty DepartmentofHealthApproval ....... N~ .................. N778960 UNDERWRITERSCERTIFICATE NO ......................................... N/A PLUMBERS CERTIFICATION DATED: / Burid~ng Inspector Rev 1/81 FOR3~ NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEPO, M T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 15232 Z County Tax Map No 1000 Se(g~ .~"J ~ pursuont to c~pphcahon dated~f~ Building Inspector. ~ ~'~ ..... , 19~J~ ('~, end approved by tile Building Inspector Rev 6/30/80 COMMENTS FIELD INSPECTION 1. FOUNDATION { 1st} FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 76_5- [802 APPLICATION FOR CERTIFICATE OF O( Instructions A. Th~s application must be filled ~n typewriter OR ink, and submitted m~ to the Braiding Inspec- tor with the following; for new buddings or new use: 1. Final survey of property w~th accurate Iocatmn of all buildings, property lines, streets, and unusual natural or topographic features 2. Final approval of Health Dept of water supply and sewerage d~sposal-(S-9 form or equal). 3. Approval of electrical mstallatmn from Board of F~re Underwriters. 4. Commermal buddings, Industrial buildings, 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 s~te plan reqmrements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p:Coperty 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 reqmred to prepare a certificate. C. Fees: Addlt£ons $25.00 /1. Certlhcate of occupancy New Dwell[noo,$25.Q0, Accessory ,$10.00 BusLness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. ~30 , 3. Copy of certlficate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ...~.\[. ,l?.~ ~.~..~.~ ......... NewConstructlon .... OId or Pre-existing Building ............ Vacant Land ............. Hous~ No, Street Ham/et Owner or Owners of Property ..................................... County Tax Map No. 1000 Sect,on . .~ .~ .......... Block ... 7 .......... Lot...J.-~. .......... · Subdivision--~./~)./~. ..... I/~(~......... .... . . ..Flied Map No ........ Lot No ............ Permit No. 1.~.~ ~ .~..~. Date of Permit c~/.~/~...(°...Apphcant ~,. Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwrtters Approval '7 7~'~ ~ O .Planmng Board Approval Request for Temporary Certificate .............. Final Certificate ....................... Fee Subm,tted $ . ~, ,~,, .'~,~. 3.~,~ ......... Construction on above described budding and permit meets all apphcable codes and regulations. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: ROUGH PLBG. ZND [ ] INSULATION [~FINAL DATE 765-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] ROUGH PLBG. ['I FOUNDATION 2ND [ ] INSULATION []FRAMING 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~AL REMARKS: DATE INSPECTOR~~'~ UIIIIIIItllllIIIItlIIIIIIIIII~IIIIIIIII HI~IIItlIiIHtltlII~ttlIIIIIIIItltI~ Ir~Itllllltlltlllllllllllllllllllllll IIIit11111tliitl D~sapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTN1ENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.. 765-18013 .,19~h ., 195.I, Permit No )~.~..~.~,~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... , 1 9 INSTRUCTIONS a. Tlus apphcat~on must be completely filled m by typewriter or ~n ~nk and submitted to the Building Inspector, wi sets of plans, accurate plot plan to scale· Fee according to schedule. b. Plot plan showing locatmn of lot and of buildings on premises, relationship to adjoining premises or public sh or areas, and g~vmg a deta,led descnptmn of layout of property must be drawn on the diagram wh,ch ~s part of fins a cat~on. c. The work covered by tlus apphcatmn may not be commenced before issuance of Building Permit d. Upon approval of th~s apphcanon, the Bmldmg Inspector will issued a Budding Permit to the apphcant. Such pe shall be kept on the premises avadable for mspectmn throughout the work. e. No building shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of Occup. shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bmldm§ Dep~rtment for the ~ssuance of a Bmlding Permit pursuant tc Bml&ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinanc. Regulations, for the constructmn of buddings, additions or alteratmns, or for removal or dcmohtmn, as hereto desert The applicant agrees to comply w~th ali apphcable laws, ordinances, building code, housing code, and regulations, an admit authorized mspectors on premises and m bmldmg for necessary ~nspections .. ,,~'.. ,,'Z£/.~ ~. 't' .-,..3':.o.,~:s..,.., .._._._._._._._._.~.c., ...... (Signature of applicant, or name, ff a corporatmn) (Marling address of applicant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bml, ............ ,c ........ Name of owner of premises Z~l,O ! ~ f.-. . .~.-I~ J~.~ Mg,~/ .. (as on the tax roil or latest deed) If a~ation, signature of duly authorized officer Builder's L~cense No . ~-~.. ..... Plumber's License No ............. Electrician's L~cense No fi/,'/l>.O. Z4~,~.. .~.bT'7'~.t'~ Other Trade's Dcense No .... Locatlon ofland on wh~ch proposed work wfil be done. .~'C'g~)Z~'~.../~?:'.F~......~. ~.- .. House Number Street / Hamlet 7 .,.or 13 County Tax Map No 1000 Sectmn Block ... Subd~v~smn ~#~/,"//'rl/ .... Fried Map No Lot (Name) 2. State ex~st~ng use and occupancy of premtses and ~ntended use and occupancy of proposed construction a. Existing use and occupancy ................... b Intended use and occupancy .. Nature of work (check which applicable) New Budding .. Repmr ..... Removal .. Demolition Estimated Cost .... (~t~ ~:).- OxO .... Addition ....... Alteration .... ...... Other Work. ~)escnptlon ·. Fee " (to be paid on filing this application) 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, speckfy nature and extent of each type of use .. 7. Dimensions of existing structures, if any. Front .... Rear ........ Depth ........... Height ......... Number of Stones Dm~enmons of same structure with alterations or additions Front ............. Rear ............. Depth ........... Height ..... Number of Stones ................... 8. Dimensions of entire new construction Front ........... Rear ........... Depth ........... Height .......... Number of Stones ........................................... 9 Size of lot FrOnt ............ Rear ............ Depth ................. 10 Date of Purchase .............. Name of Former Owner ................. 11. Zone or use dmtnct in which premises are situated ........ ~'~k:~ZO~'4~i ~'/.,~. & .................... 12. Does proposed construction violate any zoning law, ordinance or regulation' . ................. ~ ..... regraded . . t~..O. ........... Will excess fill be removed from premises 13. Will lot be 14. Name of Owner of premises .. ~/~. ..... Address . .~.~7"/j4~l~t"22 ,~Z~.. Phone No . Name of Architect Address ............... Phone No ............ Name of Contractor . ~:~ ,i ~'~.~14~".~' '~.o'-~,,r. :~ Address /)/P~-f./. ,/"~l¢.,&~ Phone No.. 15. Is this property located wzthin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and dist~nctly all buildings, whether existing or proposed, and. indicate all set-back dtmenmons fro~ property hnes. Give street and block number or descnphon according to deed, and show street names and indicate whethe interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ....... ................... betng duly sworn, deposes and says that he is the apphcat (Name of lndiwdual signing contract) 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 th application; that all statements contained m this apphcat~on are true to the best of his knowledge and belief; and that t? work will be performed in the manner set forth m the application filed therewith. Sworn to before me this .~ ~" day of .... Notary Pubhc, ~ ~.'....~.l'..~.~'~.....ff. County I10~ 1~ISLIC, State of New lo~