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Home My WebLink About14173-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15560 April 1, 1987 No .................. Date ................................. ACCESSORY GAZEBO THIS CERTIFIES that the building ................................................ 1420 King Street Orient, New York Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section .... 0.2..6 ..... Block . 02 .Lot 040 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated &uly 17, 1985 14173z ........................ pursuant to which Building Permit No ...................... July 30, 1985 dated ............................. 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 ACCESSORY GAZEBO BURKE & FRANCES LIBURT The certificate is issued to ..................... fo.v~n.o),~.~[a~~. .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO .... N/A N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev, 1/81 ~o~ No. ~ TOWN OF $OIJTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 14173 Z Permission Is hereby granted to: ....... .~../~c.~.....~....~.~.~.~.~ ............ ....... ~.~..z..~......~.~.....~ ....................... ........ .... ,o ......... ~,.,.~.~..~.~.~,.......~..~..~..~.=.,....... .................................................... at premlses located ot ... ~. County Tax Map No. 1000 Section ....~..Z..~. ..... Block .,...~,~, ........Lot NO. ~-,~, ........ pursuant to application dated ........................................................ , 19 ........ , and approved by the Building Inspector. 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 featu res. 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 pz'operty 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50. O0 Date ..... .~/.~.~/.~.~. ............ NewConstruction...~.'.. Old or Pre-existing Building ............ Vacant Land ............. Location of Property..House/.~.~.O.No. ~'~'~'J"~'~/"'' Owner or Owners of Property County Tax Map No. 1000 Section ..... ~. '.~. ..... Block .... .~. ......... Lot.. ,(~,0. .......... Subdivision ............................. L~]ledMap_No .......... LotNo ............... Permit No. .......... Date of Permit. .,,.,...Applicant ............................. . ,,,, Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....~. .................. Fee Submitted $/~,' .......................... Construction on above described building and permit meets all applicable codes and regulations. A I cant Rev, 10-10-78 EOMMENTS FOUNDATION (1st) FOUNDATION t~OUGH FRAME & PLUMBING (2nd) FINAl' ADDITIONAL COMMENTS: DATE: FEE:~ NOTI 765-1 FOLL 1, FC FC 2. gC 3. IN 4. ALL THE STAT CODE WEXFORD ,PP,~OVED AS NOTED _ ~...~___.BY: ~ Y BUILDING DEPARTMENT AT 102 D AM TO 4 PM FOR THE IWING INSPECTIONS: JNr~ATION .- TWO REQUIRED ( POURED CONCRETE JGH - FRAMING & PLUMBING ;ULATION Al. - CON'STRUCTION MUST COMPLETE FOR C. O. ]ONSTRUCTION SHALE MEET ~EQUIREMENTS OF THE N.Y. CONSTRUCTION & ENERGY ~. NOT RESPONSIBLE FOB Size l~.M-feet point to point tte~ght F/f teen feet. two inches. See floor plan No. 2. OCCU?,~NCY OR LiE IS U[~L,~:UL OF OCCUPANCY 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [/J~INAL DATE ~F/,7 'NSPECTOR-~''~/~, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ..... pproved// '( , .............. .... (/ ...... ........ ...... .............. (Building Inspector) BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,1 9 · · · APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets 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 ar 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 tins 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 ~hail 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 ~ Certificate of Occupancy ~hail have been granted by the Building Inspector. i 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. 'he applicant agrees to comply with ali applicable laws, ordinances, building code,~hou~ing code,~and r~gajations, and to dmit authorized inspectors on premises and in building for necessary inspection~,~ ............. ~..~...~.. ,.. ~Jt, .~/, ...... (Signature of applicant, or name, if a corporat~bn) ~ .~.q...Q. (Mailing address of applicant) ~tate whether applicant is owner~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder s License No...'y~...~..~-~:~,I~.?-~.` .~.~,~ ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... Location of land on which proposed work will be done ................. ~: .............. ' ::. ........o.. ' Street Hamlet House Number County Tax Map No. I000 Section ...~.~.~..~..-- ........ Block .... .~...~. ......... 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 ..... I...~.~L&{ '?i ..... '~'~"' ';5~ "~' .%43. f'~'~' ' .( .~..'0--A~,~ ........ b. Intended use and occupancy .... .=~..~'. '. :4..~..-'rT~... ' ' ' ' .......................... N o r (check which applicable): New Building ~ddition .......... Alteration .......... --Re~ .... ~ ....Removal .............. Demolition .............. Other Work .............. Estimated Cost . ~.~ ?~..~.. ...... Fee (to be paid on filing this application) ' ~ 5:'"'If'd~ve~lfi~ er o'f d g numb wellin units ............. Number of d' yelling units on each floor ................ If garage number of cars ~ 6. If business, commercial or mixbd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rea .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. ....... Deptb':::::::::::::: Depth .................. i'" Height ..................... : b rof tories. Dimensions of entire new construction Front ...... ~O ........ Rear ........... Height . . . [~../. ........ Number of Stories ...................................................... Size Of lot: Front ......... ~ . ~ .......... Rear ..................... Depth ...................... Date of Purchase ........ ' .......... Name of Fonn~ ~ Owner .... ._ Zone or use district.in which p?emises are situated .................................................... Does proposed construction viglate any zoning law ordinance or regull :ion: Will lot be regraded ...... ~ 1 ~ :.' .... ~ ............ Will excess fill be removed from premises'. ~ Yes No 14. Name of Owner of premises ~2~,D(.. ?~...~.kk?.~4"... Address .................. Phone No. ~...74...~. ..... Name of Architect h'~,'~i~2d ~ Phone No ............... Address ................................... Name of Contractor .~-r,.'z~.x .'~,... ~ ........ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos ,~d, and. indicate all set-back dimensions from property lines. Give street and bloc number or description according to dee and show street names and indicate whether interior or corner lot. - 8. 12. 13. oF STA'rE s s ............................ i~ .......... ........... being duly (Name of individual si ' ;h~ng contract) above named. ~He is the ..................... k ............... ~ ........ ~ . (Contractor, agent, corporate~o of said owner or owners, and is drily authorized to perform or have perfo: application; that all statements conialned in this application are true to the work will be performed in the man~er set forth in the application filed ther~ Sworn to before me this ............. , .............. Notary Public, /~f.f..eft..: .~:. ~ ........... County ,orn, deposes and says that he is the applicant 'ricer, etc.) med the said work and to make and file this best of his knowledge and belief; and that the lith. (Signature of a~plicant)