HomeMy WebLinkAbout22701-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23855
Date SEPTEMBER 7, 1995
THIS CERTIFIES that the building ALTERATION
Location of Property C~ESCE[TT A~-ENUE
House No.
County Tax Map No. 1000 Section 6 Block 2
Subdivision Filed Map No.
FISHERS ISLANDw N.Y.
Street Hamlet
Lot 21.1
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 11, 1995 pursuant to which
Building Permit No. 22701-Z dated APRIL 26, 1995
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 ALTEBATION TO EXISTING RETAIL STORE & OFFICE WITH CO~4ON
TENANCY AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
SCOTT N. DAVIDSON
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - AUGUST 29, 1995
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FOi~M NO.3
TOWN OF SOUTHOLO
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
22701 Z
Permission Is hereby granted to:
............ '"i'
....... ............
Courtly Tax Map No, 1000 Section .......... ~ ........... Block ........... ~ .........Lot No ..... ...~'...~.¢...Z ........
pursuant to application dated .........~..//./.. .....................................
Building Inspector.
19. ~ ,~,., and approved by the
,/ ¢5/ Bull~ting Inspector
Rev. 6/30/80
Post-It'* brand fax transmittal memo 7671 I # of pages
$OUTHOLD
HAL~
t- Final aofv~y o~ pco~erty wi~h aacurace location of all buiJ, din~,
Approval o~ electrical instal.[afloat from So~rd of Fi~e Underwriters.
5. Co,~ercial buildipg, industrial b~ilding, mul~iple r~idences
re~pon~ibl~ ~o: ~h~ buildi~tg,
For existing buii~ing~ (D~io¢ ¢o April 9, 1957) ncn-conformir~: u-~es, or bqildi~gg
l, Accur~t~ purvey of property showing .~1 prope(~y ~ines, ~re~s, building
uuusual natural Or ~opographic ~ea~ure~,
Certificate o~ Occupancy - Ne~ dwe£iing $25.O0, Additions to dw¢.l, li.~ ~25,00,
Ai~era~ion,~ ~o dwellin~ $25.0Q~ S~lmmi.g po~t $25,00, Accessory buil,]i~ $25.00,
Addi~ions ~o ~cce~sory buildi~ $25,00. [h.)~ir~es~e~
2. C~rtific~ of Occupancy on Pre-existi~]z Buildinot - ~]OO O0
3, dopy of Certifica~e of Occt~pan,:y - $20.00
.acior~ of Proper~y ....................... ~ ,, . Y ...........
,~ivisior, .................................... Filed NMi> ............ Doa ......................
.................... ¥.~,.
,m~ing 8o¢~rd Approv~l
Scott Davidson
875 Saybrook Rd.
Haddam, Ct. 06438
(203) 345-4330~/,
April 1~, 1995
Thomas J. Fisher
St, Building Inspector
Town Hall, 53095 Main Rd.
P,O. Box 1179
Southold, N.Y. 11971
Re: Tax Map # 1000-6-2-21.1
40 Fishers Island, N.Y.
Dear Mr. Fisher:
Thank you for meeting with Kevtn Barnes and myself on
Fishers Island yesterday.
As you know our immediate concern is to obtain temporary
or permanent certificate of occupancy for the two stores in
order to close a real estate mortgage, and open the store
for the season.
Enclosed please find the application for a building permit
and a check that you requested. The location of a new exit
door ( at least 3' wide ) is indicated for the West
storefront on the existing floor plan.
We look forward to your investigation as to any further
requirements the town may have. Your prompt attention to
this request is appreciated.
Sincerely,
Scott N. ~avidson
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 19, 1995
Mr. Scott Davidson
875 Saybrook Road
Haddan, Ct. 06438
Re: Premises @ Crescent Ave., Fishers Island, NY
Suff. Co. Tax Map #100076-2-21.1
Dear Mr. Davidson:
Your building was posted with this Order to Remedy
Violations on June 13, 1995. These violations are serious
enough to require immediate attention.
Very truly yours,
SOUTHOLD TOWN BUILDIJ~ DEPT.
Thomas J. Fisher,
Sr. Building Inspector
TJF:gar
THE NEW YORK BOARD OF FIRE UNDERWRITERS
ELECTRICAL DEPARTMENT
A.J. REED, GENERAL MANAGER
RFSPOND
85 John Street
NEW YORK, NY 10038
(212) 227-3700
I~J 41 State Street IEi 570 Delaware Avenue I Ii) 217 Lake Avenue : J 202 Arterial Road
ALBANY, NY 12207 I BUFFALO, NY 14202 ! ROCHESTER, N'( 14608 SYRACUSE, NY 13206
(518) 463-2122 (716) 884-1155 (716) 254-0141 (315) 463-8552
THIS IS A REPORT OF (SEE BO X CHECKED HEREUNDER) ,~"- --/D
[] INSPECTION C. ~] EL,ECTR!CAL SURVEY
,,/r q,.,,,.._;
PERMIT NO.: ~
AJ'~ON-INSPECTION: We have received your application for an mspection of the electrical installation made by you at the
premises named herein but we have been unable to make the inspection for the following reason:
_] Floor location and name of tenant not furnished ~ Premises locked, no entry possible.
~ Floor location of building not furnished L~ Other.
Inspector's Signature Date_
Please provide th(; necessary information or suggest arrangements for our access to the premises on the green form
attached and return it to this office.
Applicant's Signature
Date
B, OD
INSPECTION OR ELECTRICAL SURVEY: We have attended at the premises named herein to inspect the electrical
installation and regret that we can not issue a certificate of compliance for the reason(s) listed hereunder;
Concealed work not exposed sufficiently
for inspection.
Installation not completed sufficiently
for inspection.
E~ Additional electrical work found for which no application
for inspection has been received.
[]'Electrical installation does not comply with National
Electrical Code for reasons listed hereunder.
(see reverse side for explanation of coding)
KEY TO FORM: Code number printed under BLACK column listed below combined with code number printed under RED column listed below
indicates condition. EXAMPLE: ~LACK RED = Service Conductor not of proper capacity.
76 45 ~
BLACK
RE[) FLOOR
BLACK I RED
~ -
FLOOR
BLACK [RED I FLOOR
BLACK I RED
FLOOR
Inspector's signature.
NOTICE TO APPLICANT: Please sign. date and return green copy of this
form to request re-inspection when modifications have been made.
APPLICANT'S SIGNATURE DATE
NOT:E: IF THIS IS A REPORT OF ELECTRICAL SURVEY, A NEW APPLICATION MUST BE MADE FOR RE-INSPECTION.
,, BUILDING DEPT.
Examined ·/~ )."~ ..........
Approved k//~ .......... ,
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1B02
19¢LPermitNo..~...~. ....
BOARD OF HEALTH ............
3 'SETS OF PLANS ............
SURVEY .....................
CHECK ......................
SEPTIC FORM ................
NOTIFY
CALL .....................
MAlL TO:
Disapproved a/c .....................................
tBuildin,, InspSC'tor)
APPLICATION FOR BUILDING PERMIT ./ ~..'~.
Date ........... 1
INSTRUCTIONS
a. Tiffs application mugt be completely filled in by typewriter erin ink and submitted to the Building Inspector, with 3'
sets of plans, accurate plot ~lan 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 ttfis 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 af~y 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, build~ng code, housing code, and regulations, and to
admit autt~orized inspectors on premises and in building for necessary ip~,a~rti~_~ _-
·
· w " (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..o7'~.... ~.... ~..~.~'./.~. ~--5-..d. '.*q .........................................
(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 ..........................
Plumber's License No .........................
Electrlcmn s L~cense No .......................
Other Trade's License No ......................
I. Location of land on which proposed work will be done. '
........ .......... _T ........ ....... 5:'..,. ...................................
House Number Street. Hamlet
County Tax lVlap No. I000 Section .~..~..~..a...~..d~. .... Block ~. 2.-- ~ d~.O. Lot ~. ~/:r~.O~.Q/ ..
Eiled Map No.
Subdivision ...... (Name) ........... .,. -' ' ' '~ .... ' '
2. State existing use and occupancy of premises and intended use and occupancy of proposed constrti~tibni
a. Existing use and occupancy .. · · - · . .... ~
b. Intended use and occupancy ''
3. Nature fwork (check which apphcable) New Bui ding · . Additio Alteration
oval .............. Demo it on ...................
.......... Other Work ...........
...... , .................. Fee .....
[ (to be paid on filing this application)
5. If dwelling, nu nber of dwellmlg units ............... Number of dwelling units on each floor ................
If garage, number of cars ... i ......................................
6. If business, commercial or mixed occupancy, specify nature and extent of each, typic of use . i i ........
7. Dimensions of existing structui'es, if any: Front t'/~ ~ ~, ~/~ ' ....... :.~ · '/ .......
~D~me. nsmns of s.~am~e s,,tructure w~th alteranons or additions: Front //~. ~,,~.- ~J,.~' ...........
· 8. ons oxent~re new cons~ructmn: Front .............. Rear ............... Depth . . '. ' ' ' '
Height ............... Nuinber of Stories ...... . ........ ' ' i ........
9. Size of lot Front ~
10. Date of Purchase ~ ,2.-2..., t',~ ~' }; .... '-' ........... D e pj.~ .............. ./.. .
~ ~. t, one or use aistrict in wnicn premises are situated z ~ ,, ~ ' z b ' · · v ....
12. Does proposed constructmn v~Olate any zoning law, ordinance or re ulatmn .... . i. '.. ' .
13. Will lot be regraded ....~,t.O · g ' : .... ~' ......... ..... "
14. ~ame~f~wner~fr~remi~e~`-~..~/~¢.~.~)~2~.~]~..~.`.~W~d~e~ss~ber~em~vedf~n/premises:t~' Yes
IS.Is this property located wlthin~lOO feet of a tidal wetland.* *YES .... NO~.~.~'
tlf yes, Southold Towh 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.
S TA TEO F -~-v,~v-~;~ ~,
couN ,,¥
..... ~ r ............... bem dulv
u~ame o~ naiv aua~ s gni!~g contract) g . sworn, deposes and says that he is the applicant
above named.
lie is the ......
I (Contractor ...................................
agent corporate officer ftc ) .............
i .
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 contailned in this application are ~rue to the best of his knowledge and belief; and that the
Work will be perforn~ed in the mannerlset forth in the application qled therewith.
. County '~-', ~k~-,~ ~
(Signature of applic,,