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Home My WebLink About11829-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..z..x3.q3.9 ......... Date ......... ~.9¥.e..~..e.r ......2.9 ........19.8.4. ' THIS CERTIFIES that the building ....... ~ .e.w..D.~..e ~.].j:.n. c~ ........................... S./.$ FOX Ave. Fishers Island Location of Property ............................................................ House No, Street Ham/et County Tax Map No. 1000 Section .... 0.0..6 ..... Block ... 06 .Lot 001 Subdivision .......... .X. ................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .G.u.1X ..... 2.9. ....., 19..8.2pursuant to which Building Permit No ....... .t.1.8..2 ~g ........ dated .......... ~..u.17.....2.9 ........ 19..8.2, 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 ......... Private One Fami,1X Dwelling The certificate is issued to ........... D..O.Y.E.N. t SERGE, J. Jr. [owner, le,~ee.~t'-ten.a~t} of the aforesaid building. Suffolk County Department of Health Approval ..... ?_ .2,--.S.O. 7.7.6. ........................... UNDERWRITERS CERTIFICATE NO ..... N6 2 3 9 8 8 Building Inspector Rev. 1/81 No. 11829 z peri:nissio~ is hereby grantedto: sOuTHO~D,' N~~ Y. (THIS PE~IT MUST BE KEPT oN~ COMPL~ION OF THE WO~K AUTHORiZeD) [0 at premises located ..:...~ ......... ,~ ...................... ~ ............................ y...~..? '~? ,.,,.,:....~ !,at NO.:C~,(~..~,. .......... c~uhty T~x Map No. 1000 ,Section ...~..~.;~, po~uant application dated ..~...~.~.~...,~:.~..{.., ~0 ;'~:'~, I and approv~ by the B?il~lng I~spector. FORM NO. 6 TOWN OF SOUTI'IOLD Building Department Town ,~jouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink. and submitte~eto 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. Commerc a bud ngs. ndustrial buildings. Multiple Residences a.nd similar buildings and installa- tions a certificate of Code compliance from the Architect or Engineer responsible fodthe building. 5. Submit Planning Board approval of completed site plan requirements where applicable, i! 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. Copv of certificate of occupancy $1.00 use--Pre-Existing C,O. $15.00 Vacant land C.O. $ 5.00 New Building ..... ~ ... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. ~ -'"" '.; ................... House No, Street Ham/er Owner or Owners of Property . [ff',~:( .-~. ~, .~....~ .~.'.~.. ,O/~, .~Z~.. ~..~,.~...: ........................ County Tax Map No. 1000 Section ............... Block ...~. .......... Lot .~....%7;-... f .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No././. Z .~ .~,'~ Date of Permit~U~. ~ (~.~/f~ %' Health Dept. Approval /.~ .............. Labor Dept. oval ........................ Unde~riters Approval ....... Planning Board pproval ...................... ~oquo~ for Temporarg Cortificato ..................... Final ¢~ificato ................. Foe Submitted $ f~ .................. Con,ruction on above described building and perm~eets all applicable ~es and regulations. ~pohcant ................. 10oo12o THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ NOV~e~ ~ 109'~85 JOHN STREET NEW YORK, NEW ~QRK 10038' THIS CERTIFIES THAT only the electrical equipment ~ described belo~ and ~t~duced by t~ applicator ~am~d on the able application number i~ the premises of Se~ ~ye~'~, ~sion ~e Dr,, Fi. shes Isled, in the following location; [] Basement ~ 1st FI. wasex.,ni,,edo~ Fk~vember 8 , 1983 FIXTURE FIXTURES OUTLETS FLUORESCENT 33 8 DRYERS FURNACE MOTORS ~ 2nd FI. 0~$i(~ Section Block Lot and found to be in coml~lia~ce with the requirements of this Board. RANGES OVENS EXHAUST FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Motozs ~1-~. 4-15amp, G.F.C.I. 2~S~oke Detectors gd~,~rds Elect, Co. P~ O. ~ox 511 Fishers Isled, N.Y., 06390 This must [?e altered in an S E NO, O~E,%~O,~ ie office R V I A.W Gt NO. OF HI-LEG OF CC, COND. 2/0 C A. W.G. NO, OF NEUTRALS A. W G. OF HM. EG OF NEUTRAL 2/0 LIC~1297 may be identified by their credentials. MANNER. FIELD INSpECtiON COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING {~nd) INSULATION PER N. STATE ENERGY C,pDE FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ for pe~it to construct..~. County Tax Map No. 1000 Section .............. Block .............. Lot .............. Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds .~., ~,~/, ~.,...-... ~:c~.. ~..~.,..C~.....~....~,,. ~ ./,.~ ?~.~.. ~.~..,~:./..~.~...?~.~. :/.: ~. ~.,~,.rz'.-~.. .... ... ............. ~, ...... t,' ' ~Building Inspector RV 1/80 N. V~ 1991.~Z 1-% TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19 .> APPLICATION FOR BUILDIiNQ PERMIT : INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted :iu-J,d-t41~ 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 b~ 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 issue 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 descr/bed. 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 buildings for necessary inspections. __ ~ ¢ ..../ ..... /..: ...~- .'-t/..'r*7 ................ . .... /(Signature ofF. atCplicant, or llame, if a corporation) (Mailing address of applicant) State whether applicant is ow?__w~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde: _ "neofownerof-remises ~'~' ,,-T- .~.°.~'.~.../d,~ ~ lXlal Y .......... )" ......... Z ............... ............................ (as on the tax mil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No...~...[.~..~7 .-. ~ .......... Other Trade's License No. c~ ,'~ Location of land on which proposed work wilt be done. (Name) b. Intended 3. ' Lci~eck ' ' . htg~0/~#l}.~iag Addi[x4- ....... Removal Demolition 4. Estimated Cost .... ~ ....... 1 ......................... Fee ....................... ' (to be paid on filing this application) , ¢ 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ..... . If garage, number of ears ..... i ..................................................... , ............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... ; ................ 7. Dimensions of existing stmcture~, if any: Front ............... Rear .............. Depth ............... Height Num'ber of Stories Dimensions of same structure w~th alterations or additions: Front ................. Rear .................. Depth. ................... ~.. ' ' He~t ....................... Number of Storms ...................... a. Dimensions of entire new const~ction: Front. ~.~. Rear ............... Depth Height ............... ~u~ber of Stories ....... '~, .............................. - ................... 29. Size oflot: Front .... ~. ~ ..... ' ..... Rear J~.,.~.~ ............. Depth ~..~¢...... . 10. Date of Purchase .~u.~8~d~/]~ ........... Name of Fomer Owner 4~_~ ~.~*~.~ .... 1 I. Zone 6r use district in which pr{raises are situated..~g/~e~A ~.. ~,. ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .~ ........................... ~13. Will lot be regraded ....... ~ ................ Will excess fill be removed from premises: Yes 14. Nme 9f Owner ofpremises ~. ~'~qff~.~. Address ~.J..~*(~... Phone N~/~ 7g~: ~]. ~Name of Architect ............. ~ .............. Address ................... Phone No ................ ~Nme of Contractor ...... . . .-, ........... Address ................. Phone No ............... PLOT DIAG~ Locate clearly ~d distinctly ~1~ buildMgs, whether existing or proposed, and. indicate ~1 set-back d~ensions from property 5nes. Give street ~d block mmber or description according to deed, and show street nmos and indicate whothor interior or corner lot. STATE OF NE~YO~K, 'S ..... · .' .........'...' ....~. ~ ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ' above named. He is the (Contractor, agent, corporate officer, etc.) of said owger or owners, ~d is du}y author~ed to perform or have perfo~ed the said work and to m~e ~d file this application ~ that all statements cont~ained ~ this application are true to the best of his knowledge and belief; and that the work will be perfom'ed in the m~ncr set forth in the application filed therewith. Sworn to before me this ' ........ ~3. .. ' ..... dayof ............... ,19 ~ . ..: ........ County' No. 52-0028880 · · ~Qlffied~ in gu~olk ~o~ ~ Texm expires March 30, X9 ~ s, NO'r,~rO .? I t LIWl~J~ -s'-4' s'-4' ~d' CEDIIB klnDRk OEDOR HOMES REPORT NO. APPROVAL NO. 73117-73 ICBO SEE REPORT NO. 1949 & 2779 "THIS DRAWING IS CONSIDER- ED PROPRIETARY, IT IS NOT TO BE REPRODUCED, NOR IS THE INFORMATION THEREON TO BE USED TO PRODUCE PRODUCTS, UNLESS WRI'Ci'EN CONSENT IS FIRST OBTAINED FROM LINDAL CEDAR HOMES." SERIES J klflDRk GEDIIR HOMES REPORT NO. APPROVAL NO, 73117-73 ICBO SEE REPOR~ NO, 1949 & 277g "THfS DRAWING IR CONSIDER- ED PROPRIETARY. IT I$ NOTTO SE REPRODUCED, NOR IS THE NFORMATIDN THEREON TO EIE' USED TO PRODUCE PRODUCTS, DATE PAGE ~ of blflDRb CEDIIR HOll REPORT NO. APPROVAL NO. 73117-73 69-31 ICBO SEE REPORT NO, 1949 & 3779 "THIS DRAWING IS COHSIDER- ED PROPRIETARY, IT IS NOT TO RE REPRODUCED, NOR IS THE INFORMATION THEREON TO BE USED TO PRODUCE PRODUCTS, UNLESS WRITrEN CONSENT IS FIRST OBTAINED FROM LINDAL CEDAR HOMES." SERIES SCAL£ I/,~": I' o" DATE DRN, CKD. APPD. PAGE DRAW NO, ORDER NO. klm]Ak "THIS DRAWING IG CONBIDER- ED PROPRIETARY. IT lB NOT TO BE REPRODUCED, NOR IS THE NFORMATION THEREON TO BE USEDTO PRODUCE PRODUCTS, UHLEGS WRI3TEN CONSENT I$ 'IRST OBTAINED FROM LINDAL CEDAR HOMES," blnDRb r. EDRR HOmESN REPORT NO. APPROVAL NO. 73117-73 66-31 ICBO SEE REPORT NO. 1949 & 2779 "THIS DRAWING IS CONSIDER- ED PROPRIETARY. IT IS NOTTO BE REPRODUCED, NOR IS THE INFORMATION TNEREONTO BE USEDTO PRODUCE PRODUCTS, UNLESS WRITTEN CONSENT IS FIRST ORTAINED FROM MNDAL CEDAR HOMES," ~ERiE$ MODEL ir iI, 1- UU~AE :,,,, ',,,~ ...... ; .... '~ ' ;~,' ,~ ,',, ~ %~1, ~" , , , , ,,', , I , ~,, , ~, , , , , , ,. ,, ~: , ,. r ) ,! WALL. hi.1 BE iNKOflMA110fl THFRE~IITO l[ UNLm mrrrEN ~ ~ FIRST OBl'RlNtCl ,T- _ ,,,'C---'---- i REPORT NO, APPROVAL NO. , iI · FO~ N, W, 159 I, N. ~-w(,,2. ~ W. ZO?8.1~- I I FOX 1 I /~ //// xx ,, ~,~o~,~-.=~ / ~-__ ~URED Y~QH U~ COAST FIS-NE~ W. ~.~?'7. $3 N. 44e,,2. o~, w. ZO,Te. I'1- N. W, 1991.3Z