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Home My WebLink About15562-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~%RTMENT Office of the Building Inspector Town Hal~ Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20429 Date DECEMBER 24, 1991 THIS CERTIFIES that the building I~cation of Property WILDERNESS POINT, House No. County Tax Map No. 1000 Section 12 Subdivision ALTERATION FISHERS ISLAND~ N.Y. Street Hamlet Block 2 Lot 6.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER l0w 1986 pursuant to which Building Permit No. I5562-Z dated DECEMBER 9, 1986 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 ~DDITION TO EXISTING GARAGE AND GUEST APARTMBlqT The certificate is issued to of the aforesaid building. JAMES BAILEY (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-025772 - NOVEMBER 26~ 1991 PLUMBERS CERTIFICATION DAgIED DEC. 16~ 1991 - JAMES MARSHALL Building ~n~p6ctor ~ Rev. 1/81 FOF~ 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) N9 i5562, Z ..~.,. ~,z .~ ~ 3. ~ ~ . .. ~;;:tl /rn/~ ......................................... ................... County Tax Map No. 1000 Section ..... /...~ ...... Bilk ...... ~ ........ Lot No....~.'...~.. Building Inspector. Fee $..~..'~..~.. ,.. ~...~/ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application'must be filler iD 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 Fire Underwriters. . 4. Sworn statement from plumber certifying that the solder used in system contaims ' ~ less than 2/10 of I% lead. ~ 5. Commercial building, indus, trial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from*architect or engineer responsible for the building. ,: 6. Submit Planning Board Approval of completed site plan requirements. : B. For existing buildings (prior to April 9, 1957) non-conforming use~, or buildings and ~ "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building amd 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 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 * Date ....... .~..~. i.. ~..~ ................. Old 'id' New Construction ........... Or Pre-existing Buz lng ................. Location of Property .................... . ..... .. House No. Street Hamlet County Tax Map No I000, Section. /7_ .~..~.. ............. Block ................ Lot ..... : ........... Subdivision .................................... Filed Map ............ Lot ...................... Permit No Z~'-~'/~ Z -~' ~ ~ Permit [ ~/~//~ ~ .~~..~.~~ ............... uat= Of ................ Applicant.. Realth Dept. Approval .......................... Underwriters Approval .................... Planning Board Approval *~'" Request for: Temporary Certificate ......... Final Certicate...:.~.. .... * .... * ........... : ....... TOV/N O~ SOLvr~OLD OFFICE OF BUILDING IN$?ECTOK P.O. BOX ~28 TOWN HA~ SO.HOLD, N.Y. 11971 TILL. 7~$-180:2 CERTIFICATION Date December 16, 1991 Building Permit No._, Owner James.. Bailey (please Plum~er James Marshall (please I curtify that the solder used in the water supply system contains less than 2/10 of 1%'lead. ~. James Marshall was the licensed c0ntr~ctor who supervised all plumbing work during the construction of the Bailey residence. James ipassed away in November 1989 and is therefore unable to sign this Icertificate. SWorn to before mo this ' clay o£ '~j?.~c.e_.,,~J-~<_' ,. THE NEW YORK BOARD OF FIRE UNDERWRITERS '~Am', ~ BUREAU OF ELECTRICITY T-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 NOVF,~E}~ 26,1q~1 07,16~4~1/91 ~ ~t~ Application No. on fll~ THIS CE~IFIES THAT ~y t~ e~t~d qu~mnt ~ ~ ~ 0~ i~t~ by t~ ~t MM off t~ a~ ~t~ numar in t~ p~m~s o~ ~s examin~ ~ and found to be in core.lance with the r~ui~menls of this ~rd. FIXTURE RXTUIIES IANGES OVENS DISH WASHE~J EXHAUST FANS D~YEIIS FURNACE MOTORS FUTUII AII~UANC~ I~I~MIS TIMAC~)CKS UNITNIATII$ M~M. TI-O~TLIT WilRS SYSTIMS OF cc. COND. 4)~IIRAL MAHAGII~ 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. COPY FOR BUILDING DEPARTMB~T. THIS COPY OF CERTIFICATE/lUST HOT :BE ALTERED IH ANY MANNER. ELD I~S~)ECTION UNDATION__ (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE 'FINAL ADDITIONAL COMMENTS'. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined..~.,. ( 19..'~ Approved ...... ,19* Pe mit Z- Disapproved a/c ,: .................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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 building for nece~'o~~~.~. ~/ . ~...,~ (Signature of applicant, or name, if a corporation) ......... .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor,~electrician, plumber or builder. Name of .owner of premises ................................................... // C(as on the tax roll or latest deed) oratio~ s. ig~na~f o f duly authorized officer. d/title of corporate officer) ' Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................... .... ......... House Number Street Hamlet County Tax Map No. lO00 Section ../.~ .......... Block .... ~ .......... Lot. ~..~. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ./~:Z~. ~ d~ .~/'/~.~..~...(. ~.~.~ .... J/2 , ' "' 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .' ...... Repair ....g~.. ....... RemOval .............. Demolition .............. Other Work ............... 4. Lst~mated Cost ..... ~. ....................... Fee . t ......................... i (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ..... /. ........ Number of dwelling units on each floor. ~.., ,. .......... lfgarage numberofcars ~ "'· , 6. If business, ommercmlorm~xedoccupancy speeffy nature and e>~tent of each t,vp. eofuse .. . ... ~ 7. I)~mens~onsofex~st~ngstructures,~fany Front .... ,..~.F~.. .... Rear .~..~.' ....... Denth .'~..~.. e~ght .. e¢.~t-. ........ Number of Stones . .7~.. ................................................... Dimensions of same structure w:ith alterations or additions: Front . .,~.. '~.-.-.-.-.-.-.-.-.~...z~. .... .-Rear .................. Depth ................... ~.. Height ...................... Number of Stories ...................... 8 Dimensions of entire new construction: Front Rear Depth He Nu er of Sro es .:~. ...... ~.. ,. .... ~ ........ 9. Size of lot: Front .......... 2 ...... Reai~ ' Depth ...................... 10. Date of Purchase .......... , .................. Name of Former Owner ............................. I I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ ! ......... ; .......... Will excess fillbe removed from premises: Yes ~ 13. Name °f Owner °f Pr!~.e..~'~/~' ' ' Adaress<~/'-~' -~'~' ' Ph°ne N° ................ 14. Name of Architect ..~~~?~F. ;... Address ~ .~z .~~. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all.i buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street mad block !number or description according to deed, and show street names and indicate whether interior or corner lot. FOLLOWING INSPEC'rlob~[4: FOrt POU~EO CONC~IF ~. IN~)Ut.ATIOr-~ STATE OF NEWA"O,R.K,__,, . ~ ~ COI.fl-I'JTY OF ~ :~s.~ (N{~m~'of individual signing contract) .. above named. He is the ' 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 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 ................ / ...... day 0T:. · .(~.'~ ...... ,19~.~.. ~' / (Signature of applicant) No, 4674306 Suffo k County cO Commission Expires, July 31o 19~[.~ / J~ A, I L F_... 'Y S~: hER USED IN WATER SU; ',% Y SYSTEM;CANNOT EX:'£ED 2/10 of I% LEAD. $Tt.dDIo - pl'~t-~F--.g~ t6L,.A, kJF)- PIP-ST PLUMBER C£RTIFICA rlO~ ON LE,4D COIVI'EAff EEFO~ Ci~'RI'IFICA I'E OF OCCUP~It~ -t OCCUPANCY USE IS WITHOUT 5,NJLF_Y - 5TLJpIo - FIsH~ 6TL~ DI o - .H ol~T H t 5 LA t~ i')- F--L~VAT 1 oH 5 E C-.TI OM P~ BAI L F-Y' - 5TUf'>I o ,-. JAr, ma yoLna¥ mc.~'t~ n~C~UTEC'T$ ~ .PJ 3~, I