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Home My WebLink About15502-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bumldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19198 Date JULY 9r 1990 THIS CERTIFIES that the building. Location of Property CENTRAL AVENUE House No. County Tax Map No. 1000 Section 10 Subdivision ALTERATION & ADDITION FISHERS ISLANDr N.Y. Street Hamlet Block i Lot 8.1 Fzled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 10r 1986 pursuant to which Building Permit No. 15502-Z dated NOVE!MBER 17, 1986 was issued, and conforms to all of the requirements of the applmcable provisions of the law. The occupancy for which this certzficate zs issued is REPLACE WINDOWS & ADD ON TO EXISTING DORMER ON GAS STATION. The certifmcate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED GOOSE ISLAND CORP. N-136559 - JUNE 19~ 1990 Building Inspector Rev. 1/81 · '0~[ NO. ~ TOWN OF $OUTHOLD 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~ 15502, Z Perrmss~on ~s hereby granted to' ~.x...~..~ ........................ -...~.~ ~ ,o. ....... ~Ttd ........ ~".2'- '~ --2'""Y~" ...... ,~,,.: ............ ;.......... _ .~_. at premises Ioceted at .....~.....~ ..... ~~....~ . County Tax Map No 1000 Sect,on . (~...~.... Block ....... .(~.k ....... Lot No .... .~....~. ....... pursuant to opphcation dated ...j~.~..L~....../...~.. ..... , 19..'~, and opproved by the Budding Inspector, Fee $/...~.....' .~'"---- Rev. 6/30/80 Form No. 6 TOWN OF SOUTROLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY mo 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 ali 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 Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercmal building, industrial building, multiple residences and smmzlar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the bumlding. 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 mn writing to the applicant. C. Fees i. Certificate of Occupancy - New dwetlzng $25.00, Addmtmons to dwelling $25.00, Alterations to dwelling $25.00, Swmmmzng pool $25.00, Accessory buzldmng $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 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . ~ Date .... ~../~ .~./..~.~ ................ House No. Street Hamlet Onwer or Owners of Property...~.~./~...~f ........... County Tax Map No i000, Section..~.~.~ ~ ' ' ~~Block...~...l ........ Lot...~.,.]]~].' .... ' .. Subdivision .................................... Filed Map ............ Lot ...................... Permit No./..~.~.~.~.~.~Date Of Permzt.~.~f~.mpplicant~.~.~.~ .~...~ Health Dept. Approval .......................... Underwriters Approval.~.lJ.~S.~..~- ....... Planning Board Approval._~.~.~./5~..~..~... Request for: .Temp°rary Certificate ........... Final Certicate .... OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Nature of work (check which applicable) New Bufldmg . Addition . . e''/ Alteration ~epasr ve . . , Removal ..... Demolition .~/ .... Other Work ..... e"lcT-e-~ 12o.~ lYat~c,K_ ~ ~cr'n'lov,~ ~,~.,'X..C ,,4~t~a,'x/1 ~¢[~t.~ ~- c-~lsr~5 9ojat0~/.r (Description) Estimated Cost ~ ............ Fee .................. " (to be paid on filing this application) If dwelling, number of dwelling units.. /V.A ..... Number of dwelling units on each floor ....... If garage, number of cars ...... /Y/I ....................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use .... (l~t ...... Dimensions of existing structures, if any Front q_,y.t ~ao~, Rear t'/-veT~,x~OrtP/e Depth Height -- Number of Stories ! .. · Dmaenslons of sa,e structure w~th alterations or additions Front ~5"' ~. o,'o)~ ' Rear' .~'7.~ s~.. Depth ~ ' /~ot00R' .. Height ..... .-:-- .... Number of Stones t ...... Dimensions of entire new construction Front . 4(./( Rear g~/~ ..... Depth ~/~4' . . Height . Number of Stones . . J ...................... Slzeoflot Front ~3'O,<1~ · Rear..':J(-.q,.%t . . Depth . ].~Of. 6~_ft-~.P. ii '. DateofPurchase . 1210.C-F~ lSc--~ 1cl8(., NameofFormerOwnert~0,t~0/~u~lF~/t,q~¢L,~./~nlff Zone or use district m which premises are situated ..................... Does proposed construction violate any zoning law, ordinance or regulation ~/0. i. . . Will lot be regraded .. /V~ .... Will excess fill be removed from premises. ' Name of Owner of prem~ses~94~'~- ,~.(,0.eq). ~_.O~... Address t~ q~/. F[~.td,l-gs -~.~. Phone No.~7/.~.'7ll117'],~. ..~T''/ 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 dnnenslons from ~perty hnes Give street and block number or description accordmg to deed, and show street names and indicate whether snot or corner lot. 4,TE OF NEVj~ YOgI~, ~NTY OF .~-~ o ~1...1~. S S : 4~ff~. ~ ~. ~ ...... bmng duly sworn, deposes ~d says that he ~s the apphcant (Name of ~nd~v~dual s~gmng contract) ,ye named is the ~ O~W~ ~e~ ........ (Contractor, agent, co.orate officer, etc ) s~d owner or owners, ~d ~s duly auto. ed to perfom or have perfo~ed the smd work and to m~e ~d file ~s ,hcatmn, that all statements contmned m th~s apphcat~on are true to the best ofh~s knowledge and behef, and that ~e rk will be perfomed in the m~ner set for~ m the apphcatlon filed therewith. om to before me this ..... ~.. ~'~ .day of /Oo ~,.t ~ t~ e'g, 19 fi'. tary Public, .... g. o/~'.~../... 1g: ........ County 'FOP~ NO. I ' TOWN OF SOUTHOLD BUI LDI NI~DEPA~TM ENT' ~ TOWN HAL'L ' ~ $OUTHOLD, N.Y. 11971 TEL.: 765-1803 ~. NOV I 0 Received ........... ,19. Disapproved a/c (Budding Inspector) APPLICATION FOR BUILDING PERMIT Date .. ~ /qa~. ....... 19c~ INSTRUCTIONS a. Ttus apphcatlon must be completely filled in by typewriter or ~n ink and submitted to the Bufldmg Inspector, wltl sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stre or areas, and glvmg a detmled descnphon of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by tkis application may not be commenced before issuance of Building Permit d. Upon approval of this application, the Bmldmg Inspector will issued a Building Permit to the apphcant Such pen shall be kept on the premises available for mspechon throughout the work e. No budding shall be occupied or 1;~ed in whole or in.part for any purpose whatever until a Certificate of Occupm shall have been granted by the Bmlding [~tol; ~ ~, ~(~e _ APPLICATION IS HEREBY ~ t[~, ~Ae~tment for the msuance of a Braiding Pem,t pu~uant to Buil~ng Zone Ordm~ce of ~ ~f~ ~olk County, New York, ~d other apphcable ~ws, Ord~ce~ Regulahons, for the const~-f.~gs~ ~ns or alteratmns, or for remov~ or demoh~on, as here~n descfib The apphcant agrees C~Z~~~ e ~es, or~' dmances, building code, housing code, and reg~at~ons, ~d admit authorized mspe~ ~~: ~or necessaw inspections .X~X~TM ~' (Signature of apphcant, or name, ifa corporation) ~~ ~ (Mailing address of apphcant) State whether apphcant m owne~lessee, agent, ~ch~tect, enDneer, gener~ contractor, electncmn, plumber or build Nameofownerofprem~ses ~--~OO~.~:. ~.$(,ta~'.¢ .~_~tZ.p: . (as on the tax roll If applicant is a corpo;gbon, signature of duly authorized officer (Name and tdle of corporate officer) Builder's License No Plumber's L~cense No ....... Electrician's License No Other Trade's License No ....... Locatmn of land on which proposed work will be done House Number Street County Tax Map No 1000 Section Hamlet (22)1 CD ... Block .. l...Cx_~. ...... Lot. ~,OOi .. 2 Subdivision ... Filed Map No .. . Lot (Name) State emsbng use and occupancy of premises and mtended use and occupancy of proposed construchon a. Exlshng use and occupancy '~cr-F/~, f-~;~ ~.t,sY~'L.;.'-_'~a.~L, Od,-- ,~-,4T(orq. "t: ~/~0tr~ (~tjtg~. ~.' b Intended use and occupancy ...--gev ......... l