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Home My WebLink About10522-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector To~n Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22294 Date APRIL 28~ 1993 THIS CERTIFIES that the building Location of Property RESERVOIR ROAD House No. County Tax Map No. 1000 Section 9 Subdivision ADDITION FISHERS ISLAND~ N.Y. Street H~mlet Block 8 Lot 3.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 1979 ..... pursuant to which Building Permit No. 10522-Z dated DECEMBER 17, 1979 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 DECK ADDITION TO DWELLING "B" AS APPLIED FOR The certificate is issued to ROUNSEVELLE SCP~UM (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. l/S1 Building ~nspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZe:D) N°. 10522 Z Date e~"~.q:,~.../...~./~..~,~ ....... /"7" ......]9'~'"~'" Permission is hereby granted to.:~- ..... .,~.z...~..,...z~.~ .... ..:..-~.o/~.~....~.o..,o~ .................. ,.~. .~z.:.~£...~.: to 7 "--- .~.~~....~~:~/zc.~u.~.... ~.~ ........ ~ ...... at premises located at ...... ~ ..................................... .......................................................................... ~z~p.. ~z .... ~~.. z~o Building Inspector. Fee ................. Building Inspector 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 m ~.......~a 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 p~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 New Dwelling. $2~).00, Accessory ,$ J0.00 Bus'ness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3, Copv of certifJcate of occupancy $ 5.00~ over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... A.p.r.i.l.../f.,..1..9~.3 ...... NewCons t~,uc tion X. O{d or Pre-existing Building Vacant Land Reservoir Road Fishers Island Location of Property .............................................................. House No, Street Ham/et Rounsevelle Schaum Owner or Owners of Property ........................................................ ... . County Tax Map No. 1000 Section . .0.09.0.0.. Block .0.8.. 00.. /,~t 003. 003 Minor Subdivision Plan of Subdivision ~obert W. Brooks .... Filed Map No ..... Lot No. 2 Permit No. ........ ~. 0,5.2 2 Date o f Permit/~/~,~//,.'~.~App ,Jcant ....... l~...~, ~ .... /- Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .................. .. ... . Planning Board Approval .. .J.u.l.~z .,2.8,...198~... ... .. Request for Temporary Certificate ..................... Final Certificate ...... .X ................ Fee Submitted $ 25.00 Construction on above described building and permit meets all applicable codes and regulations. App cant .~;~ :: ,:~; ;~. ............... Rounsevel le Schaum INSPECTORS Victor Lessard Princtpal Building Inspector Curtis Horton Senior Bmlding Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Five Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 30, 1993 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Re: Premises at Reservoir Road, Fishers Island, N.Y. Suff. Co. Tax Map %1000-9-8-3.3 To Whom It May Concern: Please be advised that the building department has no jurisdiction on the existing deck of dwelling "B" on the above noted premises. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. CWH:gar Curtis W. Horton, Sr. Building Inspector FIELD ~NSPECTION COMMENTS FOUNDATION (lsd) FOUNDATION 2. ROUGHFRAME & PLUMBING (2ha) INSULATION PER N.Y. STATE ENERGY CO E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 76§-1603 xam,ned . ..... , l;;. ? _ ^pplic,,tionNo. ....... L. ., Perm, No / Disapproveda c ...... ....... 57 ...... // ' .... . APPLICATION FOR BUILDING PERMIT Date .A/..°v.". .8., ............ 197.~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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. ¢. 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 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) .. q.o..~m..~..,~. ,. 5:~..t~.....ct....~.m ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~ne.,z Name of owner of premises f~oDe_.~ 1~o ~.~,oott~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate offf.cer) Builder's License No.../VZ~../.(f~.~.'~..t'~X Plumber's License No. Electrician's License No./Y/cl. ................... Other Trade's License No. fl./fi. ............... 1. Location of land on which proposed work will be done..A/.~...c.?..afrO...o.~..~.e.p..e~..v~.~t...~.o~....a~.. ![J.'..~...~..~.o..a~. . . £,i.,~ 1,~:~ ~'.Y. House Number Street Hamlet County Tax Map No. 1000 Section ~ ............... Block ..... 08 . ....... ..... Lot .00.~. ................ Subdivision .~.e~..~..u~.v.e~....o?~....~. ................... Filed Map No ............... Lo.t ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of propos~&i constrEction:/~ a. Existing use and occupancy ......................... b. Intended use and occupancy . .J~.~. ~~ .......................... ':.' ..... ' .......... 3. Nature of work (check which applicable): New Building .......... Addition...X .... ... Alteration ....)~ ..... Repair .............. Rem~vai ............. Demolition .............. Other Work ............... I (Description) 4 ti t ~.~. .....O?...i. Fe ~.f,~ 190 Es ma ed Cost. s000, .... e 0 ............................ i (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits .~. ........... Number of dwelling units on each floor..ff./.// ............ If garage, number of cars .. 8/d .................................................................. 6. If business, commercial or mixe~ occupancy, spec¢'~/nature and extent of egch type of use . ~.]fl ................. 7. Dimensions of existing structures, if any: Front..q.k ........... Rear . .~.P ........... Depth . .P~ ............ Height ............... Num:ber of Stories . .2. ..................................................... ' Dimensions of same structure with alterations or additions: Front . p4n~ .............. Rear ,$6ttt~ .............. Depth...~ ................ i.. Height...S...o4~,. ................ Number of Stories..S..a(/X~. ................. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height I ............... Numlber of Stories ........................................................ Size of lot: Front ........... ~ ........... Rear ...................... Depth .................... Date of Purchase fl.o.v.,../~7~..i .................. Name of Former Owner ...~...S....~.olv'~i ........... Zone or use district.in which prdmises are situated ..................................................... Does proposed ~onst~dction violate any zoning law, ordinance or regulation: .~.0 ............................ Will lot be regraded .Y.e~ ...... I ................... Will excess fill be removed from premises: .Yes ('-No] Name of Owner of premises~/~{~b~./~,~g?ebe4 ....... Address ..P~/.~ng,..Cqr9~,... Phone No, .//~.-~,~7. .... Name of Architect ..... .O.o~ng..! ................. Address ................... Phone No ................ Name of Contractor ........ .S..o~e. .............. Address ................... Phone No ................ 10. 11. 12. 13. 14. Locate clearly,and distinctly all property lines. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from aumber or description according to deed, and show street names and indicate whether , C /V. STATE OF t~ll~, iS.S COUNTY OF ................. .............. ]~o. bp4~../P~, b,~d~ ................... being duly sworn, depose, s and says that he is the applicant (Name of individual signing contract) above'named. ,' He is the 0t0ne~ ~ ~ ......... ., ....... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contMned 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 .... ~,. ......... ' .7.~/~ .......... day o~../~e.c .................. 19 79. x,\N tary Public, . .ff.,op., ............... ., 'Coun~ty ' ~MY~~]~~/~/x~ , ~ .... x~' '~' ' ' ' '~' ' ' ' '~' '(Signature of ......... applicant) MY COMMtSSIONIEXPIRE$ APRIL 1, 1982 i ~*~l'~ ~1, N ~'6 ~13'O0"'W ' ' I ' 0 ' ' k%. r ' a : J'": ~¢' ' f '::--: J' ~ I,NG IN"' ECTICNS:' :~': ': ' ' , , ' ¢~ ,, ~ ;" ~: :': ,:' ,?' ]BE ~Q~LETE FOR 7,0, ~' ~'t p, -ee6': :* F' ,~' r ;~I:TRE:REQURCMENTS CCTHE N.zY