The URL can be used to link to this page

Home My WebLink About10444-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Bouthold, N.Y. ~ERTIFICATN OF OCCUPANCY No Z-24517 Date JULY 25, 1996 THIS CERTIFIES that the buildin~ Location of Propert~ CLAy POINT ROAD Rouse No. County Tax Map NO. 1000 Section 3 Subdivision ADDITION FISHERS ISLAND, N.Y. Street Hamlet Block 1 Lot 6 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SETPEMBER 27, 1979 ~ursuant to which Building Permit No. 10444-Z dated OCTOBER 16, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to OLIVER J. ANDERSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A PENDING - JULY 23, 1996 Rev. 1/81 ~*~- ~'-"~' ~ ~ r~ ~'%! Form No. 6 k § 1998 i TOWN BALZ APPLICATION FOR CERTIFICATE OF_OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installationg, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 yea~s - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 July 23, 1996 Date ....................... . . )Jew Construction ..... .X.... .. Old Or Pre-existing Building ................. Location of Property...(n..O ~.) ....,~z.Cla Point Road Fishers Island House No. Street Hamlet ~nwur or Owners of Property Oliver J. Anderson 'on 003 O0 ~ounty Tax Map No i000, Sect~ ....... · ....... Block... 01.00 . 006.000 iubdivisi°n ................................... - Filed Map ............ Lot ...................... 10444 1979 )erml~ No ................ Date Of Permit ............. -. · Applicant ............................. N/A pending {oalth Dept. Approval ......................... · Underwriters Approval ......................... qanning Board Approval ........................ f C tific Fi 1 rtl .~." ' lequest or: Temporary er ate ........... na Ce cate .. ....... i- 'ce Submitted: .. 0 : .siC, . ~/~ATTLIEW$ ~ HAM ATTORNEYSAND~0UNSBLLORSATLAW SOUTHAMPTON, N Y 11908 July 23, 1996 Mr. Thomas Fisher Building Department Town of Southold 53095 Main Road P. O. Box 1179 Southold, NY 11971 Re: Anderson1 Certificate of Occupancy Dear Tom: I have enclosed an Application for Certificate of Occupancy, together with a check ~n the amount of $25.00, relating to the issuance of a CO for the additions and alterations to the Anderson residence on Fishers Island. I have left a message for Mr. Richert to get in touch with you concerning the pending Underwriter's Approval Since our closing is scheduled for Monday, July 29, I would very much appreciate It if you would issue the CO by Friday and fax a copy to me at 287-1076 Thank you for your cooperation regarding this matter Sincerely, Stephen L. Ham, III Enclosures TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Date...Sept. 24, 1991... NEW CONSTRUCTION ..... OLD OR PRE-EXISTING BUILDING. o X..VACANT LAND ..... Location of Property ........ Private Drive ............................ Owner or Owners of Property ..... O. J. Anderson ....................... County Tax Map No. 1000 Section .... 3... Block ...25... Lot .... 6 ...... Subdivision ..................... Filed Map .......... Lot ............ Permit No.10444Z ....... Date of Permit ........ Applicant.A. John Gada Health Dept. Approval ................ Underwriter Approval ........... Planning Board Approval ................. Request for Temporary Certificate ........... Final Certificate...X... Fee Submitted: $...25.00 ......... Applicant Ao John Gada General Contracting, Inc.. o Ao FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be fil~ed in Wpewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buddings 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. 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 requ ired to prepare a certificate. Fees: 1, Certificate of occupancv $5.00 / 2. Certificate of occupancy on pre-existing dwelling / 3. Copy of certificate of occupancy $1,00 landuse--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date.. ~] ../.~7../.~. ............. New Building ............. Old or Pre-existin_Q~LBuilding .. ~. ........ Vacant Land ............. Location of ?roperty ~'~ ['~ d"~h ' d ~-."~ .."'~4~ (t.~ ~/~.~ . Hou~ No. ~ ~Street ~ Hamlet Owner or Owners of Property ~ ~ ~ . ,~, /~0 ~ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed, Map NX¥ ..... ~-ot No .............. Permit No.,/.~?..q.q. '..-~.. Date of Permit /.??..?.. ./4ppncan[. 7T.~ .. ....... t ..................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board'Approval .................... Request for Temporary Certificate ..................... Final Certificate ................ Fee Submitted $... t ....................... Construction on above described building and permit2~ll applicable codes and regulations. ^pp,,cant . . . ....... Rev 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY tnstructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. 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- dons, 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. 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 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling / 3. Copy of certificate of occupancy $1.00 landuse--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date... ,~.//.;2'/~..~.... ........... New Building ........ .~.;.. Old or~P, re-e~i~g Building ,~.~.. ,, ..... ~.~catnt Land ............. Location oT Yroper[y ........................... ~ ...................................... Houm No. , Street ~ Hamlet Owner or Owners of Property . . 0 . ,. ~ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No..~ ~ .... ./2~t No ..... ~ ....... PermitNo ........... Date of Permit //.,..~,.. Annli~nf L~/~ f~--~/~t-~J~-'~(~ ¢} ................. ..................... 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. Applicant..~-.~...~ ..................... Rev. 10-10-78 FOB. M TOWN OF SOUTHOL,D BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined .................. ...... prov d .................... I :27 Pe m,t .... Drsaj)~roved o/c ........... ...........L.....~ .................... {Bui dino nspector) INSTRUCTIONS a. Thts application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building ,Inspector, with 3 sate of plans, accurateplot plan to scale. Fee accor,cling~to sc, hecJule. b Plot plan showing Iochtion of lot and of buildings on premises, relationship t9 adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. r -c. · The'work covered by,thi~ application may not be commenced heroine 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 Soutbold, 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 hereto 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. A. JOHN GADA GENERAL CONTRACTING, INC. (Signature of applicant, or name, if a corporation) Fishers Island, New York 06390 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor O.J. Ander s~n.. Name of owner of premises ............................... ~ .............................................................................................................. If applicant ts a corpo,~te, signature of duly authorized officer. ................... ................. (NarrP~ and title of corporate officer) Burlder's License No. 281 - HZ J,~-~, -~ [000 ~ 'j~-/- Plumber's License No. 462 - ~ 296 - E Electrician's License No ............................................. 2 Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No .... .~..~..o..~..~.,...2...~.,...~ ............ Lot No ........... .~. ........... Street and Number ............. ~.QJJ~ .......................................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy'~f prop6sbd construction: a Exisiting use and occupancy ....... ~.~;I,.¢1,~.~. ................................................................................................. Residence w~th add/.tion and alterations b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which[ applicable): New Building.. ................. Addition ....... X ........ Alteration ................ Repair .................. RemovalI .................. Demolition .................... Other Work ................................................... (Description) 4. Estimated Cost ...... ~.$.~..O..~...O.,..0.Q .............................. Fee ..... $1.5.,Q0 ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dweIling units on each floor ............................ If garage, number of cars .......................................................................................................................................... 6, [f business, commercial or ,m~xed occupancy, specify nature and extent of each type of use ............................ 7. Dim:ens ons of existing structqres, if any: Front ......~,~.~ ................ Rear ........ ;...~..2..~. ............... Depth ........ .~..0 ....... Height .......................16e Number of Stories .......... ~ .................................................................................................... [ 52' 52' Dimensions of some structure with alterottons or additions: Front .................................... Rear ............................ ~ 2 Depth .......... ~.(}. ................. Height .......... 2.&! ........... Number of Stones ................................ 8 Dimensions of entire new construcbon: Front ........... ~.~..J~ ................ Rear ......... '~.&.~.6. t~. ....... Depth ........ &SJ. ....... I-le~ght .................... Numbe~ of Stories ..................................................................................................................... , 398.37 9. Size of lot: Front Z38~98~ ..... Rear .............. 20Q .................... Depth lr0? Date of' Pu~rchdse(~,:;. ........ ~..'..~.~.~. ............................... Name of Former Owner ...... ~.~...~.t...F.r...~.~.~..h.. ............. 11. Zonb or use district in which ipremises are s~tuated ............. JJ~si~el~aI .......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ .~.~.. .......................................... 13. Will lot be regraded ............~.?.~ .......... Will excess fill be removed from premises: (X) Yes ( ) No 14. Name of Owner of premises ....~..O..t.~........2~.~.~..l~.~.l~ ............... Address .~,'1 sJ'~r~.,Z~ ..... Phone No..~..8..~...~7..~g.. ~ NON~. .................................... Address Phone No. Name of Architect ..............t .............................................................. Name of Contractor iA. JOHN GA~ Address FJ.~her~ 'rs. Phone No..~..~..~_-..~.2..~.. PLOT DIAGRAM Locate clearly and distinctly a I buildings, whether existing or proposed, and indicate all set-back dimensions from property lines G~ve street and block number or descr pt on accord ng to deed, and show street names and indicate whether interior or corner Io~ STATE OF NE~¢~I;~I~.~, COUNTY OF .............................. .......... :;.~.%.~.~..~.~...~.~:~...::'::.'.:~. ..................... being duly sworn, deposes and says that he is the applicam above He ~s the Contractor , (Contractor agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform of'%~ve~ pe'Rormed the said work and to make and file this applicationh tba~-a. II ,s~gteme~t~o~i~gd t i~,¢this-a~p.li~tiRa~'a~6t~ue to the best of his knowledge and belief; and thor the work wiff~J~erfo~med in th~ ~an~er set foER'iE the a~phcStion filed therewith. Sworn to before me this , . ' ..... ~J.~.... day of ..... ~.~:~ ............. , 19.~. ~ /7 . ................. ......... co.. .................. ....... ...... .................. ~ ~ (~L p~ ~'~ZC ~gnature of applicant) MA~Y B. P/kNKIEWICZ NOTARY PUBLIC, STATE OF NO. b2-8267950 - SUFFOLK COUN~ OO~ISSION EXPIRES M~R~H