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Home My WebLink About15649-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Braiding Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z]6426 I, Date November 19, 1987 THIS CERTIFIES that the buridmg . A.c.c.e.s.s.q r y ............................. Locatmn of Propert~ .... .3.51.7.0...CT.~....Ry....t/48 ..... S. 0..U.T.N0. L. D ............ House No Street Hamlet County Tax Map No~ 1000 Sechon . 0.6. .9 ...... Block 04 ....... Lot 1 . 2 Subd,wmon ................ Fried Map No .... Lot No ............ conforms substantially to the Application for Buridlng Permit heretofore fried in tins office dated .. J.an. 2.9., J 9 &7 pursuant to winch Building Permit No.. [ 5. .6.4.9. Z. .......... dated .J, ,ap..,. 2. .9 .,, ,1..9 .8 .7 ............ was msued, and conforms to all of the reqmrements of the applicable prowmons of the law The occupancy for wtuch tins certificate is issued is ..... Ar~.accessor.y..ga.z.e.b.o~. as. .a~op. lie.d f. or.. ..................... Thecertfficate~s~ssuedto., KEVIN KNOBLOCH (owner, t~.~i~Kl~fl[a,~ ~I X X of the aforesmd bmlchng. Suffolk County Department of Health Approval .... N./.A ..................... UNDERWRITERS CERTIFICATE NO, N /A PLUMBERS CERTIFICATION DATED: N/A Bmlding Inspector n~ 1181 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N~ $5649 Z Permission Js hereby granted to: ..... ~.~ ...... J..Y.~~ .......... ..... a..~.L.~..~. ............... ~.-... ~.~ ................. .... ~..~....~.........~.:..~.:.... L~.~..7.1. .... ,o ..... ........................... o, ,,e,,,,s ,~o,ed o, ...,~..~..:..Z.~......~....~. ........ ~ ........... County Tax Map No 1000 Sect,on .... ~ ..L~,....~ .... Block ...... ..q~...~ ....... Lot No .....l.:.?..: ..... pursuant to applicotion dated ......~..~......'~,.,/... Building Inspector. Fee $.~.:.~ ' ·., 19...~...~., and approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru apphcat~on mulst be filled in typewmter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following, for new buildings or new use. 1. Fma[ survey of property with accurate location of all buildings, property lines, streets, and unuSual natural or topographic features. 2.Final approval of IHealth Dept of water supply and sewerage disposal-(S-9 form or equal). 3Approval of electrical installation from Board of F~re Underwriters. 4 Commercial buddings, Industmal buddings, Multiple Residences and similar buildings and installa- tions, a cert~ficat~ of Code compliance from the Architect or Engineer responsible for the building. 5.Submit PIanmng Board approval of completed site plan requirements where applicable. For existing bulldin, gs (prior to Apml 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey 6f p~operty showing all property lines, streets, buildings and unusual natural or topograph lc features. 2.Sworn statement 6f owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any hous!ng code or safety inspection of buddings or premmes, or other pertinent reforma- tion required to prepare e certiftcate. C. Fees' Additions $25.00 1. Certificate of occupancy New Dwellzng $25,00, Accessory ,$10.00 Business $50.00 2. Cerhflcate of occupancy on pre-exist~ng dwelhng $ 50.00 3. Cop¥ of cert~ficate of occupancy $ 5.00, over 5 years $10.00 , 4.Vacant Land C,O. $ 20.00 5.Updated C.O, $ 50.00 Date ......................... NewConstructmon ...... Old or Pre-ex~stmg Budding ........... Vacant Land ............. Location of Property . 35170. B~¢..~o, ~¢¢PB%;¢. ~ ............................... House No. Street Hamlet Owner or Owners of Property I~:~in. ~,. Tim. K~ob£ocb, ..................................... County Tax Map No. 1000 Section .... ~9 ......... Block .. ,0.4 ........... Lot ...[...2. ........ Subd~wmon ...................... Fded Map No .......... Lot No .............. Permit No. 15A4~9 ..... Date of Permit . .1,-.2.9.-.8.7..Apphcant ?.e?.i.~. ?.nob¥ch Health Dept. Approval ....................... Labor Dept. Approval ....................... Underwriters Approval ........................ P[anmng Board Approval .................. Request for Temporary Certificate Final Certificate , . Fee Submitted $ ....................... Construction on above descmbed budding and permit meets all apphcable codes and regulations Apphcant ~$t~' ~ OUNDAT!ON (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING NSULATION ?ER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Carousel spacious and beautiful, th~s G~, ~,ebo ~11 accommodate large groups comfortably Ponderosa the ultimate ~n elegance, this large luxurious Gazebo adds charm and grace to any surrounding TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN ItALL SOUTtIOLD, N.Y. 11971 TEL. 765-1802 ¢,',,.r To]Whom This May Concern, I We are unable to complete your Certificate of Occupancy because .of the following reasons. /Z/ An application for Certificate of Occupancy is not on f~le. /ZL No Underwriters Certificate on file. /_~ The check is(o~not on file.)~/O ~ ~ /~/ No Health Dept. Approval on file. /Z/ No final inspectlon has bcen mado. Please contact our office on this matter. Thank you for your cooperation. -Building Permit ~ / ~ ~ ~ Z ~~_~ Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Examined ~0.44~.c~ ~-~ Approved .~ C~ Disapproved a/c BOARD OF HEALTH 3 SETS OF PLANS~ FORM NO I SURVEY TOWN OF SOUTHOLD CHECK =~ /7 ~ BUILDING DEPARTMENT SEPTIC FORM ~//~ TOWN HALL 8OUTHOLD, N,Y. 11971 TEL 765-1803 ,19~7 19~q , Penmt No CALL MAIL TO: ~ (Bmld~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .............. 19 .. a Tiffs application must be completely filled m by typewriter or in ink and submitted to the Buddmg Inspector, with 3 sets of plans, accurate plot plan to ~cale Fee accordzng to schedule b. Plot plan showmg location of lot and of buddings on premises, relationship to adjomlng premises or pubhc streets or areas, and giving a detmled description of layout of property must be drawn on the dmgmm which is part of this apph- canon, i c. The work covered by this apphcahon may not be commenced before ~ssuance of Bufldmg Permit d. Upon approval of this apphFatlon, the Building Inspector will ~ssued a Building Permit to the applicant Such permit shall be kept on the premises available for mspecnon throughout the work. e. No building shall be occupied or used m 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 Buildmg Department for the issuance of a Bmldmg Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulahons, for the construcnon 6f braidings, addlnons or alterations, or for removal or demohtlon, as herein described. The applicant agrees to comply with ali apphcable laws, ordinances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and m building for necessary inspections. (S~gnature of applicant, or name, if a corporation) (Mailing address of apphcant) State whether apphcant m essee, agent, architect, en~neer, general contractor, electrician, plumber or bmlder. Name of owner of premmes g.~-~-l. ~'~, [~]OC~ ............. (as on the tax roll or latest deed) If applicant is a corporation, s~gnature of duly authorized officer (Name a~td title of corporate officer) Builder'] License No ~x..' ' Plumber s ~lcense No. - 'x~,...x - 1. Location of land on whmh proposed work will be done 51.7 0 ..... q House Number Street 4.9.Block ....e.5' Fried Map No County Tax Map No 1000 Section Subdivision . (Name) 2 Hamlet .... Lot .... State ex]sting use and occupancy of premises and ~ntended use anti, occupancy of proposed construction a Exlstmg use and occupancy . [2[La~0t¢.D l~O¢tnMl .............. b. Intended use and occupancy 5 ) ......................... d~m~DD,e atlon (Description 4. / ' tto be paid on fihng this apphcatlon) EstlmatedCost .......... ~.~.(~ ............ Fee . ..~ ......................... Sn If dwelling, number of dwelling/, units .... ~. .. Number of dwelling units on each floor ........... If garage, number of cars [ 6 If business, commercial or[~ m~xed occupancy, specify nature and extent of each type of use 7. Dimensions of exmtmg structures, if any. Front ........ Rear .......... Depth ........ Height ' Number of Stones ............................ Dnnenmons of same struct.ure with alterations or addltlons Front ........... Rear .......... Depth ....... I ..... Height ......... Number of Stones ............... '~ 8. Danensions of entire new ~onstructton: Front .............. Rear ............... Depth Height ....... Number of Stones 9. Size of lot Front ............ Rear .............. Depth ................ 10 Date of Purchase ' ' I ........ Name of Former Owner I 1 Zone or use d:stnct In which premises are situated ................................. 12. Does proposed construction wolate any zoning law, ordinance or regulation ........................ 13. Will lot be regraded . .. I ................. Will excess fill be removed from premises' Yes 14. Name of Owner ofprem~sbs ............. Address ............... Phone No.. Name of Architect I Address Plxone No. Name of Contractor ... L ............... Address ............ Phone No .......... 15. Is thzs property located__ within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Tows Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and dlstmctly all buddings, whether existing or proposed, and, ~ndlcate all set-back dnmenslons fr property hnes Give street and block number or descnptlon according to deed, and show street names and re&cate whet interior or corner lot ~ STATE OF NEW YORK, S S COUNTY OF ..... (Name of individual signing contract) above named being duly sworn, deposes and says that he is the apphc He is the ................................... (Contractor, agent, corporate officer, otc ) of smd owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and file apphcat:on, that all statemer~ts contmned m thru application am true to the best of his knowledge and behef, and that work will be performed in the manner set forth m the application filed therewith. Sworn to before me thru ............... day o~f .~.~4~ ........... , 19~.7. #0Y~ ~u~J~, ~ ~ ~ ....... ~ ........... ~,4~7~ ~ A (Signature of apphc~