The URL can be used to link to this page

Home My WebLink About13147-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...~ J~ .2.8~.9. ........ Date ................. Q.c.tp.b.e..r...1,7.., 198..4. THIS CERTIFIES that the building . .A.d.d..i.t.i.q .n ..................................... Location of Property//3tJs~ h/o: ' . .W~J~.t.l,e.r., ~.v.~, Fi sher. s .I.s.. .... .............. Street ................. Hamlet County Tax Map No. 1000 Section . .0J-2 ....... Block . .Q~[ ........... Lot . .Q .1.2 ............ Subdivision ..... }{ ......................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated A.p .r.i.1. 24 , 19.8.4. pursuant to which Building Permit No. 13147Z dated .............. iyI.ay... ¢.1 ......19 .8.4., 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 Existinq Building Howard Knust The certificate is issued to .E. qc. ~9.s.J:.a. .~.~qa. .~. .S. qc. ~-.a.~Y. gf. .C.~. :. .C. gn. 9?. ~ . ~.~9~. . (owner, lessee or tenant) of the aforesaid building. N[a Suffolk County Department of Health Approval ......................................... UNDERWRITERS CERTIFICATE NO ................. N. [.A. ............................. Building Inspector Rev, 1/81 ]FOBlt[ NO. g~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13147' Z Permission is hereby granted to: ....... : .......... ~...~ ........................... ~ ;.~)'~:::.~.....~ p. ................................................... ....~.~. ~;~.~i~..~L ...~. ~.. ~ c~q- ,o ..~.~~....~....~.~......~~...~.~.....~.~ ...... ~. .................... ~~...~..~...~.:~....~ ....... ~ ............. ~.~ ............................................................................. at premises I~ated at ............. ~;~:W...~}~ .......... ~:~-~...~2~:~.~ ....... ~.LS~ .... County Tax Map No. 1000 Section ...... ~..!..;..~..... Block i Lot No. ), ~ ' '~ ~ L '. ................... , ., pursuant to application dated ... ~.~L~/.(...,~*,..~ 19~..L. and approved by the Building Inspector. Fee $....,Q ............. Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF $OUTHOLD Building Department Town Hall ~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-J~=flut~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 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.Oo $ 5.00 Date ... Jg.: .t.~.-.~ ............ New Building .. Vi/.. ........ Old or Pre~existing Building .......... ,.. Vacant Land ....... Location of Property ..................... .t,.J~...~..~.¢~..-~. ~'Ep~ ~'~'~- ~.'[ ~ Owner or Owners of Property ~.'..d-. '.~..~.'~..~.~.~.~.;..~..~ .~-..C?..~.~. .o...~..(~ .~..~.~.~:~. County Tax Map No. 1000 Section ...~.~...'~. ...... Block ...d?. \ Lot (~'~ Subdivision ............................. ~.~..Filed Map No ........... Lot No .............. Perm t No. I..'~.1.~?..~.. Date of Permit~.~.l,.~.Applicant .~..O..~.~.' .~?.(~..~.. '~-~'..L~.,.~p.~. ......... 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 anc[.oermit meets all applicable codes and reg~ations. ~.O ~= ~ -'~-?o'c[c~ Applicant . .~..-~. ,.~IZ.~.~ .......... ,~. ~[.,~/~/~,..~ .............. Rev. 10-10-78 ~ ,--z._ SMBJECT, -' D~TE:~ I3,P. (. ~ S"f'A-f b (,¢N:?J RUCT!'ON i ,i COD~. -L SUBJECT: SUBJECT: (203) 527-7001 or 635-65~9 To Whom It May Concern, This is to certify that Mr. Howard E. Enust, residing in Waterford, Connecticut, has been authorized to represent the Ecclesiastical Society of the Connecticut Congregational Fellowship for the purpose of signiug applications for New York State and County permits to improve the facilities at the Congre- gational Fellowship House, and to operate the facility as a temporary residence and as a children's Summer camp. Authorization was voted by the Executive Committee of the Connecticut Congregational Fellowship, acting as Trustees for the Ecclesiastical Society, on 12 April 1984. Respectfully Submit~ted, /~. Wi~iam J. Clark, ~ecutive Se~reta~ April 12, 1984 cc: File Moderator/President Fellowship and Society Rev. Earl W. Ostberg CONGREGATIONAL RANGER Fishers Island FELLO%~BNIp HOUSE Full FELLOk~HIP GATH~INGS are held in ~Y and OCTOBF~ OFFICE HOURS: Wednesday, 10 to 2 o'clock and by appointment 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y, 11971 TEL.: 765-1802 Examined...~/~ .~ .., · ~. - Approved . .~...cSV.&..~.~., 19~-.~. Permit No..[.~'<[.,. J:'l.~.t?. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 24 April 19 84 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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. 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 issued h Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occunied or_used in whole or Ln part for any pnrpese whatever until a Certificate cf 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 building for necessary inspections. Ecclesiastical Socieng¥. pl. gh~. ¢onn~;[c~. ¢ongrega~£onal. Fellowship (Signature of applicant, or name, if a corporation) Fishers Island Committee · P~Oo. Box. 206,. Waterford,Ct. 06385 ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ........ OWNER ................................................................................... Name of owner of premises .E .c g .l .e .s .i .a .s .t .i .c .a .1. .S 9 .c .i .e .t y . 9.f. .C 9 .n .np .c .t .i .c p -t . .C P.ng.r-eg.a.tipp.aJ- F~%lp!a~h;ip ........... (as on the tax roll or latest deed) If appl~ant is a~corporation, sig.galmwe of duly authorized officer. . I_,'AtV~.~2~..: Chairman, Fishers Island Committee (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other ~rade's License No ...................... 1. Location of land on which proposed work witl be done..C9.ng.r.eg.a.t.ipp.a.1..F.e.l.19.w.s.h.ip..ttg.u.s.e .................. .......................... .................. .......... i ..... House Number Street Hamlet County Tax Map No. 1000 Section ...... .~..[ .~-~ ..... Block ........ X ........ Lot .... .~. '.~.. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ....r.e.t.r.e.a.t..h.o.u.s.e..aja. d..s.u~m.e.r..c.arap ..................................... b. Intended use and occupancy ...r.~t.r.e.a.t..h.o.u.s.e..a.n.d..s.u.r~e.r..cAmp....~.~ ......... : ................ property lines. Give street and bloc~ interior or corner lot. SEE ATTACHMENT 3. Nature of work (check whtch apphcable): New Buil&ng .......... Ad&tmn .......... Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work K~-X:X~X~(~ ....... Extend rear porch to eliminate emergency exit congestion (Desc~ption) 4. Est~ated Cost.. $I~00 ..... : .......................... Fee ~a~. ~iy~r. ~. r~l~g~o~. ~v~.. 5. If dwelling, number of dwelling: units . · ~ ............ Number of dwelling units on each floor P9~. ~PP~.. If garage, number of cars . no~. appl~eabZe ......................................................... 6. If business, commercial or mixed occupancy, spec~y nature and extent of each type of use .. na~. appli~abZa ..... 7. D~ensions of existing structures, if any: Front .... 30 ......... Rear .. 30 .......... Depth . 7~ ............ Height D~ensions of same structure With alterations or additions: Front .... 30 ........... Rear... 30 ............. Depth 82 ~ HeiSt 35 Number of Stories 2 8. Dimensions of entire new const:mction: F~ont ............... Rear ............... Depth ............... Height Number of Stories 9. Size of lot: Front .......... ~ ............ Re~ ...................... Depth ...................... 10. Date of Purchase ...... ~ 97 ff ................... Name of Fo~er Owner .... Gads ..................... 11. Zone or use district in which p~emises are situated F~ber~. ~aB~ Ft gr~ght Section 12. Does proposed construction vidlate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i ........... uo ....... Will excess fill be removed from premises: Yes No 14. N~e of Owner of premise~cc~e~g~. ~99~ddress ~P. ~P~. ~ ......... Phone No. ~P~:. ~77.. N~e of Architect ' Address ~a~erford C~ Phone No N~e of Contractor ........ ~ .................. Address ................... Phone No ................ PLOT DIAG~M Locate cle~ly ~d dist~ctly ~I bufld~gs, whether existing or proposed, and, indicate ~1 set-back d~ensions from number or description accord~g to deed, ~d show street names and indicate whether STATE OF NEW YORK, COUNTY OF .......... S.S ............................ ' .................... being duly sworn, deposes and says that he is the applicant .'~'(Name of individual sigmng contract) above named. SEE ATTACHMENTS He is the .................... , ................................................................... (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 contained 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 Notary Public ............ , ............... County (Signature of applicant)