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Home My WebLink About14459-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21026 Date SEPTEMBER 15, 1992 THIS CERTIFIES that the building. Location of Property BELL HILL AVENUE House No. County Tax Map No. 1000 Section 9 subdivision ADDITION FISBERS ISLAND, N.Y. Street Hamlet Block 3 Lot Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Building Permit No. i4459-Z NOVEMBER 6, 1985 dated pursuant to which DECEMBER 9, 1985 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 OUTSIDE 2ND STORY ENTRANCE ADDITION TO EXISTING STRUCTURE The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A HAY HARBOR CLUB, INC. Rev. 1/81 I~B,M NO. ~ T(YWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N9 14459 Z Permission is hereby granted'to: , / ............ i ...... i ......................... >5'5'~"~'2';'~;; ...... 7~"";;>~'"~:~?"~"~ '" at premises mcatea at ......... x~:..T~. .......... ,,.t.x~. ......... ~..~c,~ ....... /..~:.~e;., ...... ~<.x..:..~ ............ County Tax Map No. 1000 Section ........ ~ ......... Block ..... ~, ............ Lot No..../,, ................. pursuant to application dated ...... ..~....~ .......... ~ ......... , !0.~' .~and approved by the Building Inspector. Fee $.,/.. ~, .~...../.,d~,~_. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION -~D OR PRE-EXISTING BUILDING,~ACANT LAND ........ HOUS .................... Subdivision ....................... Piled Map ........ Lot .......... Dept Approval Underwriters Approval Health Planning Board Approval ................ Request for Temporary Certificate ....... Fee Submitted: $ .................. Final Certificate ................ APPLICANT .... .~. ..................... ~ , rev. 10/14/88 ¸ir TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEff YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING--~----VACANT LAND ........ Owner or Owners of Property. County Tax Map No. 1000 Section ...... Block ....... Lot ......... Subdivision ....................... Filed Map ........ Lot .......... ..... Permit No ...... Date of Permit .......... Applicant~.~ ................ Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: rev.'lO/14/88 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - [802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING.~..VACANT LAND ........ Location of Property ..... Owner or Owners of Pr operty..~.~.~.~..~.~.~,~. County Tax Map No. 1000 Section ...... Block ....... Lot ......... Subdivision ....................... Filed Map ........ Lot .......... Permit No ........... Date of Permit .......... Applican ....... .?.~.~--~ t .~-.~.~.~k- .......... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $.. ~..~.. ............ APPLICANT ........................ .Q~..~ rev. 10/14/88 F1ELD INSFECT%ON FOUNDATION (1st) COM~4ENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N· STATE ENERGY CODE FINAL ADDITIONA~L COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved. ~,.~...~. .... ,19~. Permit No./.~ .~..~.. ~. 7~ ~isapproved a/c ..................................... ............................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ......... 19... 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 necessary in~~ f~~ ~ ;~ } 3~j. (Signature of ap~d~ant, or' name, ifa corporation) ! State whether a33tClicant is owner, lessee, agent, architect, engineer, gene_~al ~c_ontractor~ electrician, plumber or builder. ":. ......................................................... Name ofowner ofpremises. ~./~:'[(. · .H.Pv..~. ·~.Q?.~ -(-.-~ ./'>. .u I~ .............. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. ~.. 0. ~ ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...... .~. ...... .~ ......... -~.../~. ............... County Tax Map No. 1000 Section . . '7 ............. Block .... .~. ............ Lot... I ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and oc,cupancy of proposed construction: a. Existing use and occupancy " q b. Intended use and occupancy .......... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration ...... Rep~,r ....... ;...~.. Remloval .............. Demolition .............. Other Work .......... . ..... '" ',~ -i- ~/ ~ (Description) 4. Estimated Cost ..... ~..~. ...................... Fee ..... .~r../. ~'/ //5 *" (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 an{ extent of each type of use ..................... 7. Dimensions of existing strnctur~s, 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 ............... Nuinber of Stories ........................................................ 9. Size of lot: Front .......... i ............ 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: ................................ 13. Will lot be regraded ........ : .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. .................. Address ................... Phone No ................ Name of Architect ......... i .................. 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 dknensions from property lines. Give street and block interior or corner lot. number or description according to deed, and show street names and indicate whether OCCUPANCY OR, I'!SE IS UNLAWFUL ? iTHOUT CERTIFICATE ' ,: /'PIIDAMPV STATE OF NEW YORK, COUNTY OF ............ ..... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named.~ ~ t~,/ //- ~ '"// i , (Contrac~tor, agent, corporate officer, etc.) of said owner or owners, and is du!y authori~'~o perform or have performed the said work and to make and file this application; that all statements confained 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 ~ i ,i~)~_~ 19 ?..5.~ ...................~....i~. day of ..................... , HKEN IL DE VQE I~. 470~, ,~dfetk ~a, (Signature of applicant) ?;. ii\! ,;2, jt.,ATIO N THE REQUIREf~ James Vo,lney R~ghter~,,:, A r c h i t e~ c t s' 58, Winter. Street. Boston · Massachusetts :,0~2!Op .. . ,, '¸1 t,157:40 ' ,%,