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Home My WebLink About24415-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No—Z-25331 Date October 29, 1997 THIS CERTIFIES that the building ALTERATION Location of Property CENTRAL AVENUE FISHERS ISLAND House No. Street Hamlet County Tax Map No. 1000 Section 006 Block 04 Lot 04 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 3, 1997 pursuant to which Building Permit No. 24415Z dated October 20, 1997 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 ALTERATION AND RENOVATION TO EXISTING DWELLING AS APPLIED FOR The certificate is issued to ST. JOHN'S EPISCOPAL CHURCH (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H 057474- October 23, 1997 PLUMBERS CERTIFICATION DATED October 15, 1997 - Mario Zanghetti ui ding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. ` BUILQING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date.......QC.T.A.BER........20......................... 19....9.7.... 24415 x Permission is hereby granted to: .........HARALl0;.S............................................................. ..........P...A...S0...b41...................................................... .........F.I,SMFRS...ISL.AND,.,.N.Y...06240..................... to .......TO..ALTER...AND...RENQUAT.E..ELECTR.I.CAL...AND...P.LUMB.I.NG..SY.ST.EMS..IN..AM,.... ...........................................SX.ZST..I.Nra..S1MOLE...FAM.I.LY...DWELLINQ...AS...W..PLIED...FQf3..... .................................................................................................................................................................. .. .............. ....................... . .................................. . .......................................................................... .................................................................................................................................................................. at premises located at.................................r.ENTRAJ-..AVE.....................................F..1aHERS...I.SI„AND ....... . ..................................................................................................................................................... County Tax Map No. ......4.7.RRT... Section ....006........... Block ......OQ.Q.4....... Lot No. ..0.0.4.............. pursuant to application dated .....O.QT.QAER...........:3....................... 19.......4.7...., and approved by the Building Inspector. Fee S.......... 5...00... r � ................... . ... ..�"""l"'.......................... B ding Inspector Rev. 6/30/80 [ N TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 contains less than 2/10 of 1% lead. 5. Commercial building, industrial 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. 3. 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 in writing to the applicant. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25-v. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date . .September„1,7 , . 1997 . . . . . . . . . . . . . . . . . . New Construction. . . . . ./ . . . Old Or Pre-existing Building. . . .. . . . . . . . . . . . Location of Property. . . . . . . . .. . . . . . . . . . . . .Central. Avenue. . . . . . . . . .Fishers. Island. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . St... .John'.s. Episcopal . Church. . . . . . . . . . . . . . . . • . . . . • . , _ . . . . . County Tax Map No 1000, Section. ,00 6. . . . . . . , ,Block. .94. . . . . . . . . . . .Lot. . . , ,0 . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . .t . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .X. . . . . . . Fee Submitted: . . . . . . . . . . . . . c_� — •�5 331 . . . . . . �7... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • APPLICANT Steven M. Alden , Attorney-in-Fact 10/16/1997 12:27 516-788-5549 HAROLD 'S PAGE 02 �a�FFoc,��o Town Hall,53095 Main Road at Fax(518)765.1823 P. O. Box 1179O • ! Telephone(516)785-1802 Southold, New York 11971 v +�►of OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. Owner: v- 's Rs�y (pl ase print Plumber: MA?i0 Z M_ ". (please prim ) I certify that the solder used in the water supply System contains less than, 2/10 of 1% lead. /-e- 9446 umbe gnature) Sworn o before me,this p day of, d `L� 19 /7 Notary Public, - — ounty ' EILEEN 0. WALL NOTARY PUBLIC, NEW YORK STATE NO. OJWAOM185 QUALIFIED IN SUFFOLK COUNTY TERM EXPIRES OCTOBER 31, 10 9 e THE NEW YORK BOARD OF FIRE UNDERWRITERS - PAGE 1 506:8256 BUREAU-OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date OCTOBER. 2:3,1997 � Application No.on file 1.4827:1.97/97 H 057474 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ST. JOHNS PARISH, CENTRAL AVENUE, FISHERS ISLAND, NY in the following location; ® Basement ® Ing Fl. El 2nd Fl. OUT Section Blocl4 Lot 4 was examined on OCTOBER 20,19-97 and found to be in compliance with the National Electrical Code. FIXTURE' RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. I H.P. DRYERS FURNACE MOTORS FUTURE APPUA14CE FEEDERS SPECIAL REC►T TIME CLOCKS "LL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL M.P. GAS M.P. AMT.. NO. A.W.G. AMT. AMP. AMT. AM►S. TRANS. AMT.I M.P. NO OF FEET AMT. WATTS a SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP, TYPE METER 1�.2W 1 N 3W 3.I 3W 3 X 4W NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER I OF CC.COND. M AEG OF NEUTRAL OTHER APPARATUS: *NO VISUAL DEFECTS: "An eIect.rir_—a1 survey has beeil made= of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. HAROLD COOK-D/B/A HAROLDS II l� P. 0. BOX 661 FISHERS ISLAN, NY, 06390 GENERAL MANAGER 11 15 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 DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OF HEALTH . . . . . . . . . z FORM NO. 1 3 SETS OF PLANS . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . 3 1997 BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . . . . . -- TOWN HALL SEPTIC FOR:I _ . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 it DT I FY ; a� CALL Examined . . . . .� . . r cIA I L TO . 19 !. . . _ . . . . . . . . . . . . Approved . . ./.� . . . . IQ . Permit No. . 7`:� . . . . . . . . . . . . . . . . . . . Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . _ . . . . . . . . . . . . uil ng Inspector) APPLICATI FOR BUILDING PERMIT AWL-tcA nct l x-02 As 'T!)Ut VT— . . ., F ie 91g`r� 4cM_ AND Pt,U.Mt31W64 Date . . . . . . 191T 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 app4cable Laws, Ordinances or Re ulations, for the q dings, additions or alterations, or for remov 1 demol herein described. The, applicant agree %a a li ble laws, ordinances, building co o e and gulations, and to admit authorized inspects Muilding for necessary inspectio _ , �'��k`i � 0NNLVA (Sig .ure of applicant,or name if a corporation) t txT MA #vW41K IW,;0301 OWa .� (Mailing address of appli nt) Sfate whether ap AtIA 4s of architect, engineer, general contractor, electrician, plumber or builder. yf! UR�$1R Name of owner of premises L `r:.? RAfi13 (as on the tax roll or latest deed) If applicant is a corporation s gnalux q oriied officer. (Name and title of corporate officer) Builder's License No. Plumber's License No. Electrician's License No. .V N VQ\10W. Al , Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed P P �lbedone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . n �: . .v.�,. . . . . . . . . . . . .1. .N0 . . . . . . . . . ... House Number Street Hamlet County Tax Map No. 1000 Section U'Q(P40-0- . . . . . 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 b. Intended use and occupancy . . . . ..J(,l,M M. �. . . ESIDC . • ` u 3. Nature of work (check which applicable): New Building . Repair . . . . . . . . . . . . . . Removal . . . . � . . . . . . . . . . Addition- . . . . . . . . . . Alteration . . . . . . .�. . . . . . . . . .. Demolition . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . 4. Estimated Cost (Description) . . . . . . Fee . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . S. If dwelling (to be paid on filing this application) b,number of dwelling units . .. . . . . . . . . .. . Number of dwelling units on each floor.. . . . • If garage,number of cars . . . ; , , , , , , , , • 6. If business, commercial or mixedoccupancy, specify nature and extent of-each type • • • • • • • • • • ' 7, Dimensions of existingYP of use . . . . . . . . . . . . . structures,if any: Front . . . .. . . . . . . . . . . . Rear Depth . • Height • . Number of Stories . . . . . . . Dimensions of samestructure with alterations or additions: Front . . • . . . . • . . . • . . . . . ' ' ' ' ' ' ' ' ' ' ' ' Depth . . . . Height . . . . . . . . . , . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front ` • ' ' ' ' ' Number of Stories . . . . . . . . . . . : . . . . . . . . . . .Height . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . t . . . . . . . . Number of Stories Depth . . . . . . . . . . . . . . . 9. Size of lot: Fn"t . . . . . . . . . . . . . . ... . . .... . . Rear. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . 10. Date of Purchase ' ' ' ' ' ' ' . • • • ..• • • • . • • • Depth . . . . . . . . . . . 11. Zone or use district in which•premises•are si • • ' Name of Former Owner . . . . . . . . . . . . . , , , tuated 12. Does proposed construction violate any zoning law,,ordinance or•regulation: . • . . . . . . . . . . . . . 13. Will lot be regraded , . . . . . . . . . . . . Will excess fill be removed from premises: Yes• � • • • • • • • • . 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . . . . •. Address No Name of Architect ' . . • ' • • • • • • • • • • • . Phone No. . . . . . . . . . , Name of Contractor Address• • • . , ..Address . • • • • . Phone No. � � • • � ' ' ' ' ' ' ' • 15. • Is this property within 300 feet of a tidal wetland? • *• • • . . . . . • . Phone No. . . : . , , , • „ Yes.. . . . . . . . No. . . . . . . . . *If yes,- Southold Town Trustees Permit may- be required. . 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. PLUMBER CERTIFICATION NM AS WMD ON LEAD CONTENT BEFOREob CERTIFICATE OF OCCUPANCY D �� ILP ,....�: _ SOLDER USED/N WATER ' SUPPLY SYSTEM CANNOT• 1� •AM TO s PM 04 �R NT AT THE EXCEED 2110'0,F 1%LEAD. re0 JIGWIRED man IAIM M • �'WMBtNG 4► MNAL • CON!*R MUST M Cot IS UNDERWRITERS CERTIFICATE AL1' N SH MEET REQUIRED TW MENTS OF THE N.Y. COOK MY S ON BLE ENERGY DESM OA CONSTRUCTION ERRORS STATE OF NEW YO , COUNTY OF r / . ' ' ' ' • . •.. °t"D• •_di being duly sworn, deposes and says that he (Na ua i contract) Y is the applicant lbove named. ieis the . ... . . . . . . . . . . . . . . . . . ... ... . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) . . ' ' ' ' )f said owner or owners, and is duly, authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this'application are true to the best of his knowledge and belief;and that the cork will be performed in the manner set forth in the application filed therewith. :worn to before met is . . . . . . . . . . . . . . . .d of. . . 19. . ,� / -109otary Public; .. . . . . . . . . . . . . . . . . . CIty `` 6L. 'LS 8380100 S381dX3 WFj31 ( .\• ZNf100 X10jjfIS NI a31311Vf10 58L6056VML0 'ON . . . . . . . . • 31V1S )IIjOk MSN 'Oliend AHV10N Signature of applicant) 11VM '0 N33113 -