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Home My WebLink About15813-zFO~RM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z- 17523 Date NOVEMBER 18~ 1988 THIS CERTIFIES that the buildin~ ALTERATION & ADDITION Location of Property 1420 KING STREET ORIENT., NEW YORK House No. Street Hamlet County Tax Map Mo. 100O Section 26 Block 2 Lot 40 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23~ i987 pursuant to which Building Permit No. 15813-Z dated MARCH 28~ 1987 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 ALTERATION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to FRANCES & BURKE LIEBERT (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 '~Bu~flding Inspector FOR~ lqO. ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 15813 Z Permission is hereby granted to: ~ ..~.~.~......~;......~ ................... ,o _ r~ ' · ~ . . I .... .]. ........ ~~...~ ....................................................................................... __ ~.. ~_ ; ....................... at premises located at ...L.~,....~....°..........~..~¥$~....~... ...... ..~..~'~ ............................ Cou.~ To× ~op No. 7000 Sec.o. .... ~.~...q ....... mock ...... ~..~. ....... Lot No ..... ~..O. ............. pursuant to application dated .............. ~ ~....~........~....~ ............, 19..~..-"7.., Building Inspector. Fee ' ~--~ ' ~ 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. 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.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. 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 POOLS $25 . 00 ALTERATION $25.O0 1. Certificate of occupancy New Dwetling~$25.Q0, Accessory I$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 5.Updated C.O. $ 50.00 Date ................... NewC°nstr'ucti°n ...... O]dorPr, e-existingBuilding .~.. Vacant Land "'/ ..... ...... Owner or Owners of Property ~.//]..~(~.. ~-~ .~... o~ County Tax Map No. 1000Section ..... ~,, ,(.....~, ..... Block. . ..........c~ .. Lot .(~..q Subdivision ................................. Filed Map No ........... Lot No ............. Permit No. ~, .~,~! ?.... Date of Permit .......... Applicant'~,~..,,, ,~,,,,, ,~..,.., ,~..~ Health Dept Approval Labor Dept Approval Underwriters Approval ............. Planning Board Approval / Request for Temporary Cer~:ificate'. ..................... Final Certificate ....................... Fee Submitted ~ Construction on above described building and permit meets all applicable co?s and regulations. Rev. 10-10-78 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. / fl_7/ An application for Certificate of Occupancy is r/et on fil~,. ~-~ /.~q 'Ibc cheek is(~not ou file.) /~-_/ Ilo !Iealth Dept. Approval on file. /]~/ Ilo final inspection has been made. PJcase contact: our office on this matter. Thank you for your cooperation.~ Buildinq Permit tt ; J ~___ ~_ ~ Z Building Dept. '~**/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-3.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST F ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [] FRAMING [~/~FINAL /('/0 REMARKS: ~ DATE "~'~ INSPECTOR' OUNDATION ( ls t) OUNDATION (2nd) 0UGH FRAME & PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE Fi'NAL/ · ADDITIONAL COMMENTS'. ~,', ~" I BOARD OF HEALTH /i '~ 'FORMNO I SURVEY 1987'i!!;,TOWN OF SOUTHOLD CHECK [ [ [~ ~"] ]- ~!,.~UILDINGDEPARTMENT SEPTIC FORM ............. ', ' ,' TOWN HALL ' NOTIFY - ,. :,~OUTHOLD, N.Y. 11971 TEL,: 765-1803 CA~L ................ Examined .~.o~. &~.., 19~. ?. Approved ~ . .o~...~....~..~.., 19~.7. Permit NO.]. .~.'~. ?./..~..~. Disapproved a/c ..................................... MAIL TO: ~' (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 necessary inspections. ..... ............ (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' . ......................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S HUST BE SUFROLK COUNTY LICENSED Builder s License No. l ff~.F~A~CZ_~...~.../~.. ~...~..). Ag,r_,c ~ , Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on wlfich proposed work will be done~ ................................................. · ' ' House Nulnber .................... I~1217n'1;t~ ................. County Tax Map No. I000 Section ....... ~..~. ....... Block ..... .~. ........... Lot....~..~. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended us.e and occupancy of proposed construction: a. Ex~st~ng use and occupancy ..... ~.~~¢..~..(.. ~..~ .................. b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building .... ' Addition ........ Alteration ...... Repair .............. Removal .............. Demolition ............ I. Other Work ............... (Description) 4 Esdinated Cost Fee ~' (to be p~id on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units bn each floor .............. If garage number of cars 6. If businesS, commercial or mixed occupancy, specify nature and extent of each typeiof use .................... 7. Dimensions of existing structures, if any: Front ............... Rear ........ i ..... Depth ............... 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 ~. ............. Height Nmnber of Stories 9. Size of lot: Front ...................... Rear ...................... Diepth ...................... 20. Date of Purchase ............................. Name of Former Owner .., ................... ' ....... t 1. Zone or use district in which premises are situated ..................................................... :[2. Does proposed construction violate any zoning law, ordinance or regulation: ..~..~. ~3. Will lot be regraded ...... ,~..,~..~.: ....~ ......... Will excess fill, be removed-from premises: Yes _.~, No 14. Name of Owner of premises~.?./?: ~ ....... Addr~s t.~l:0.]..~....$~.~ PhoncSo.~..~..%..'P~-~..Sff.... Name of Architect ................. Name of Contractor ~ i i~ ....... AddressAddress t~Tq-~ff....k'";i '.': '~ '~'~. ~ Phone'i"' Phone No.~25 :. ?.,.77.~..N° ....... , ......... 15. Is this property located within 300 feet of a tidal wetland? *Yesl ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from >roperty lines. Give street and block number or description according to deed, and show Street names and indicate whether nterior or corner lot. ~.TATE OF NEW YORK, ~OUNTY OF D.~. ~£.o~.g; ....... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) lbove named. te is the .............................................................. i .......................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and.file this ~pplication; that ?all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this iotary Public .... .~ ......... ~ . . .~/,...O~.. ...... County , NOTARY HELEN lC DE VOE (Signature of applicant) PUBLIC, State of New Ym'k . No. 4707878, Suffolk County~ ~ imm Expires Msrch 30, I~.-ZE. ~