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Home My WebLink About13100-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z12780 Date Sept. 17 ................. · ................................ 19 86 THIS CERTIFIES that the building .... F. 993 ........................ Location of Property 1620 King S'treet , Orient House No. Street .... Hamlet County Tax Map No. 1000 Section . .2.6. ........ Block ..... 2. ......... Lot 6 0 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated A~ril 24 1984 pursuant to which Building Permit No. 13100Z dated ~4a y..7 ...................... 19 8.~., 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 .......... .... Z,ng~o~Lr~. ~.w.%r0r~ j_D.g, p p.o. 1.. I 3.6..X...3.2 ................................... The certificate is issued to Burke E Libur t roYn'o; j ..... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. #N6482 1 1 & #N648093. Rev, 1/81 Building Inspector TOWN OF Sou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..._~- ............ .;; ................ .~ ...................... ~ ...... .~..;,~.~...~ .................................................... .... .......... ~o ...~~.~ ......... ~.~.z~...~.~'~rs~....:.~..~ ........ ~ ......... ........................................................................................................................... premises ,~ated at ...J..:/~... ~;;~...~~ ...... Z~;~ .... County Tax Map No. 1000 Section ...... ..~.,...'~....~.. ..... Block ...... ~ ...........Lot No .......~....~. .......... pursuant to application dated ........ ~. ; ................. , 19 ,, and approved by the Building Inspector. Rev. 6/30/B0 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~a~,l~;ct; 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 electrical 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. §. 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O, $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building . .~.~..~. .... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... . .~.~... · ~.~ ......... I~.. House No. ~ ~Street __ Hamlet Owner or Owners of Property .~).~.~...~'.,..~'~.~-......,.........~.~'~' County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ......................... Filed Map No ........... Lot No .............. Permit No. ~.~.0.0. Date of Permit .................................. Health Dept, Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ,, .~ ............... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~ ............ Fee Submitted $ ...... ~.~.9..:~...~.~ S~S,-~ ~ Construction on above described build~d p~rmit ~ets~l~ble codes and regulations. Applicant ~. 7/..~ .............................. 1000708 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN .STREET, NEW YORK, NEW YORK 10038 Oa~ June :t~,19o~ ~.Uca~ionNo. onyi~ 273294-84 only the electrlcal equipment ~ described bel~ and ~nt~dueed by the applicant named on the able a~l~c~t~on number in the peemlses o~ Burke Liburt ~ King St. O~ieac,~.~. in the following ~catlon;. ~ ~ ~jL~ent ~ Is, FI. ~ 2nd Fl. Section Block Lot OUTLETS DRYERS FLUORESCENT FUTURE APPLIANCE FEEDERI UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R NO OF CC'CONDI~/0At W.G. PER ~ OF CC COND A. W, G, NO OF NEUTRALS A W.G. OF HI-LEG OF NEUTRAL · ~ 2/0 Sal Prato, EI~c. Wiggins Lane Greenport,N.Yo 11944 lic. 1049E GENERAl. MANAGER Per This certificate must not be oJtered in any manner~ return to the office of the Board if ~.correct. Inspectors may be identified by their credentials. ~lT. 30 MANNER. ].000344 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of in the following location; [] Basement wase~.mi,,edo. Jua~ 11, 198~ [] 2nd FI. Outside Section Block and found to be itt compliance with the requirements of this Board. Lot FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS SWITCHES - FLUORESCENT 1 DRYERS S R V I C E PER ,~' OF ~C~/C(~ND. NO, OF HI-LEG, O~A Hi~A~'LEG~ NO OF NEUTRALS OTHER APPARATUS: i-G.F.C.I. .(_~__l~_n~'.._t~o~l)_ 'l~is c~tificate oDvers compliance at the d~te of inspection only. Because of urlu~u~l environments it is advise~ole to have ~i~lt~at test and/or repairs mad(,· by a quallflc~i person. AW, G, OF NEUTRAL Phil Gordon 12 Dean St~t Port Jeffersen Station~ .Y. 11776 .~~,~,~m,~ay,~This certificate must not be altered in any manner; return to the office of the Board f incorrect. Inspectors may be identified by t~el~ctedenhaJs.thel "~1 ~ ~F?R?,U!LDII~G DEPARTMENT. THIS COPY OF CERTIF CATE NIUST NO~:BE ALTEREb N ANY lUla~m~:. I=J l' IELD ~OU:IDATION (lst) P'OUNDATI(}U 2. ( 2nd ) BOUGU FRAME & PLUMBING COHHENTS ~[ISU[,ATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 xam ned.. ..... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF soUTHOLD , ~Appli~a£~on-Nrr: .- ................ Date . .~/'. ?.~/8. q-. ........ , 19... INSTRUCTIONS 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 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 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 inspectors on premises and in building for necessaryt~nspections//f · ..... d/ (Signature of applicant, or name, if a corporation) . ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... ..................................................... Name of owner of premises .... 5} .ll.r.k.o.. ,L,:L.b.q~..t ........................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No ..... 61 ................... Plumber's License No ..... N/~... .............. Electrician's License No ..... 2klO1E ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 1¢20 King Orient House Number Street Hamlet County Tax Map No. 1000 Section ..... 026 .......... Block .. ~. .............. Lot....0-.0. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy 0fproposed construction: a. Existing use and occupancy .... one..£alnS.].3r. r.o.s:~de~Qe ......................................... b. Intended use and occupancy ... 16x32 .... irl~r.o, tll2d. ~.Wirg~nX3qg. p.o.q~ ............................. 3. ature oLwork (check Which applicable) New Building Addition .......... Alteration .......... Rep~r~ ~ .............. RemOval ........ Demolition ............. Other Work .±nga?.aund..Dool 5{ { ~v A t ~ .: (Description) 4. Est~m edCost..e6..O00..O0,.=... ............... Fee ......... .. ", : '.: - , o be paid on filing this application $.If dwelilng; nt~mber'of dwellifig untts ............... Number of dwelling units on each floor ................ I~' garage, number of cars ..... , ................................................................... 6.If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 ...... Rear Depth · Dvmenslons ofexastmg structures if any: Front ............................................ 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 Depth I-[eight ............... Number of Stories ........................................................ ..... " pth 9. Size oflot: Front 6.1.'. .., ........... Rear ...61: ............... De ...................... 10. Date of Purchase ........... . ................. Name of Former Owner ............................. 11. Zone or use district in which pr6mises are situated ..................................................... 12. Does proposed construction viollate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded .... y.e.~ .i.:. · ._' ~: · · -: ....... Will exceeds ~/il b,e removed from premises:-..-~#~8 No 14. Name of Owner of premises .~..~.~.~.e..~..a.p.u.~...~ ..... Address . ??.~.e.n?. ......... Phone No 3 Name of Architect ......... ~ .....~ ............ Address Rb'6 ' k~r' 'POih~i .... Phone No. -.__-__~"2t,~: '~1~o .... Name of Contractor .S.¥.~.m..K..~.n.g..~..O.O..L.S. ....... Address ............... Phone No ................ 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ,, 'S S COUNTY OF .... ~$~)~.}:~JlC.. ~ : ' ............ · ~.~.~ ~...~ ............. being duly sworn, deposes and says that he is the applicant (II~ne of individual sign{ng contract) above named. He is the ......................... ~ ..................................................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application; that all statements contoined 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 Notary Public, . ................ i.,,,~.c( .~.~..0 ~.~.. \ Oualifi~,d in .SuIlo¢~ ¢?{~[V ...County //~ //~ (Signature of applicant) J 50 5 COURSES 8 x 8x 16" CONCRETE BLOCK SWIM-KING POOLS, INC. ROUTE ,2JA ~OCKY POINT, NEW YQRK