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Home My WebLink About11418-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10758 Date Novsmbe~ 2 1981 THIS CERTIFIES that the building ................................................ Oriental Avenue, Fishers Island, New York Location of Property ,. .............................................................. house No. 9 St{q~t 7 Hamlet County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 2 ~1 11418Z ..................... ,19... pursuant to which Building Permit No ...................... October 81 dated ............................ 19..., 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 ......... Inground Pool and Fence The certificate is issued to Margaret Bogert (°wnerx ~'xo'X ~x of the aforesaid building. Suffolk County Department of Health Approval N / R ' UNDERWRITERS CERTIFICATE NO. N 52119 9 Building Inspector Rev. 1/81 N9 11418 z BUILDING ' DIEP~R~I'MENT TOWN HALL' SOUT.'O:iDi N~ V. BUILDING I~ERMI'I~ (THIS PERMIT MUST BE KEPT ON tHE PRE/~IS~S UNTIL ULL COMPLY'ION OF THE WORK AUTHORIZED) Da,e ~.,... ...................... ~ ....... ~,~ .......... , Peffnission is hereby granted to: ...,:~./~ ....... ,~!.9.}'::i.{/.~..r.~7.!5...Z..:L.,..:~:ES./:.-.. 0'7 BuilOIng I~spector. Rev 6/30Z80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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: 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 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...... ~..~..~...I ~[ ('~/ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... O-~l IF_ IU 'T~ ~__ ~ V'~ (~(~/-I ~F)~.5 _~'L~r~//_~ House No. Street Hamlet Owner or Owners of Property /~ ~'/-~ ~/~ ~T~ F--7- --~'~) County Tax Map No. 1000 Section ......... .~. .... Block ....... /...;~, ... Lot .... 7 .......... Subdivision ................................. Filed Map No ........... Lot No .............. IIHI Z- e r .................................. Permit No ........... Dat of Pe mit .~,~,'~...~/..Applicant ~' ~ '~ ('O~JT~/~C1~'('~- ~,~-/¢~'-- 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. 1000656 THE NEW YORK BOARD OF FIRE UNDERWRITERS II~ BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Cate Mm¥ 26, 1981 099151 - 80 THIS CERTIFIES THAT only the electrlc. I equipment as described below and introduced by the applicant ~med on ~he ab~ application number i~ the premises of ~. ~ce ~ger~ 0r~t:al A~,~ F~ ~d~ N.y, ~,, tt,./ollo~.g to~t~o.; ~ ~.~.~.t ~ l~t ri. ~ ~.d ri. ~e - ~ s.ctio. ~1o~ rot ~.~ .......a o. ~y 19, 1981 and found to be ia compliance with the requirements of this Board, FIXTURE OUTLETS 1 DRYERS RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS 2 I SYSTEMS NO. OF FEET E R V I C NO OF CC, COND NO. OF HI-LEG A W.G. OF HI-LEG NO. OF NEUTRAl OTHER APPARATUS: M~toc/a~ i-1 I~p~ 1-3/4 Hp Par~lboard/a: 1-.§ cir, 100 g~ps~ 2-G~F,I, Bre~rs ~ of ~1 ~r~ it ~ a~le ~ ~ ~t test ~d/or ~ by a q~d perso[~ A~t~- J. Wal~h - P~rtz~r Z Fisl~rs Isling]d, N.Y. 06390 A. WG OF NEUTRAL OENEiAL 1! Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. FOKM NO. 1 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined (~'~ 19...~.... Approved iiiiiiiiii'.iiiiiii'.iii'.i'.i~'.~.',ii 19._~... Permit No..............(//~1// ......... ~'..._.~ iso.pro ed ...................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date.... ,,~ .................................................. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 application. 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 progress of 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. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ....................................................... ............................................................... .... Name of owner of premises ..k~,....L....~,...~...~..fi.L~...S..~r....!.~..a..:¥.e....~..L......~. ............ ~.. ...... ~..~ ................... .........~.... plicant is a corporq~'e, signature of duly authorized officer. (Name and title of corporate officer) , 1. Location of land on which proposed work will be done. Map No.: ........................................Lot No.: ........................ Street and Number ........................................................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy (x~ ~ ~ ' r.~, ~ ~ , ~ c, b. Intended use and occupancy . .~.~..~.~.~Z..'..t.~.~ ............................ ~.. . ~ .............................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Othe~Work (Describe) .................. 4. Est mated Cost ./~ ~ ff ~; ?...? ..................................... Fee ............ /.5Z ..................................................................... (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 cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ 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 .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......r~...~ ................................................. 13. Name of Owner of premises .~.....' ........ % ....................... Address .................................... '..~.... Phone ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW, YORK, . ~ COUKJTY OF ...-~,-~.~ ..... ~'~'~' - ............................ u;".'";:'O'.-'"~'".' ............................................. being duly sworn, deposes and soys that he is the applicam (Name of indiw~ual signing application) (Contracto~ 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 contained Jn 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 ......... ........... ;x'da of ............................... , · ....... :~;;'~'~ ............................ ($~natur~of applicant) \ IO~ ~blie, State of New Yor~ No~ 52-0028880 Te~ expires Mo~ch 30. 19~.~