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Home My WebLink About22592-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23647 Date MAY 16, 1995 THIS CERTIFIES that the building ALTERATION Location of Propert~ ROW OFF MANSION HOUSE RD & FOX RD. FISMERS ISLAND House No. Street Hamlet County Tax Map No. 1000 Section 9 Block 1 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 6, 1995 pursuant to which Building Permit No. 22592-Z dated FEBRUARY 17, 1995 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is INSTALLATION OF NEW WINDOWS TO ~ODE AB APPLIED FOR. The certificate is issued to JOHN N. YERKES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 FODM NO.3 TOWN OF $OUTHOU) BUILDING DEPARTMENT *1OWN t4Nl $OUTHOLD, N,Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date, .~../.~. ............................. ' ................... 22592 Z / Permission is hereby granted t~: ~.....,~ .'...~ .................. . ~~..... / CountvTax Map No. 1000 Section ............... ~ ......Block ....... Z~ ............... Lot No ......... ../...~. ............. pursuant to application dated ~./~.. ............ 19.~...-'~' .................................. and approved bythe Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD BUILDIN.~ DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 FOR CERTIFICATE OF OCCUPANCY APPLICATION DATE.'.~..o. .. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING. ..VACANT LAND ........ ..... ,.~ ~ ......... ~.~ .... HOUSE NO. STREET HAMLET o.~ o~ o.~. o~ ~o..~..~.~...~..~.~, ........... , .......... Subdivision ....................... Piled Hap ........ Loc .......... ~.~.,, ,o.Z~&~.~=. o~ ,.~.,, ~:/LU~2.,,~,=~.= ................... Health Dept. Approval .................. UnderwriCer~ Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Cer'tifica£e ..u~. ............. rev. ~0/~4/88 FOUNDATION (lst) FOUNDATION 2. (2nd) ROUGH FRAME & tPLUMBING' INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD /t BUILDING DEPARTMENT ' TOWN HALL ' SOUTHOLD, N,Y. 11971 l~ammed ............ A~provedl ....... /'~.. .,. 19 m D~approved a .............. FEB ] 0 t995 BLDG. DEPT. ,ow. OF soumom Application No ................ Plumber's License No ......................... S~ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde N~ of owner of preimses ...... ~ ..................................................... (as on the tax roll or latest deed) lf~applic~s a corpomtioh, si~na~u~ of duly author~ed officer. . Electrician's License No ........................ Other Trade's License No ..................... '. 1.! Location of land on which proposed work will be done....F./.,~,~.~ .~..$....~.----'.,-~../..A~../LJ..d/...'~..? ........... House Number Street Hamlet County Tax Map No. '000 Section ..... -- ~ .......... Block .... ( ............. Lot...(.~ .......... Subdivision ...................................... Filed Map No,-'Q.% .:..~ ......... Lot .............. amc - <~ '.- 2.~ ~tat~ ~xisting us~ and occupancy of pmmis~s and intended us~ and occ~p.a~ey~of propos~,d constmctmn: a. ~xisting us~ aad Occupanc~ ...................................... ·: ..... ' .... . .... , a z ',' b, ~t~nd~d u~ and oooupanoy ................................................................. PROVIDE OPEP, INGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. (Buildirv~msp¢c tor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS . . "a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi~ In~pector, with 3 sets of plans, accurate plo,t plan to scale. Fee according to schedule. ' b. Plot plan showing location of iot and of buildings ou premises, relationship to adjoining premises or public stree or: area~, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app ca~tion. I c. Tho work covered by this application may )tot be commenced before issuance of Building Permit. I d. Upon approval of this application, the Building Inspector will issue a Building Penuit to the applicant. Such pern: sh~ll bo kept on the premises available for inspection throughout the work. o. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupam sligll have been granted by the Building lnspeetorl I APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to ti B~tflding Zone Ordinance of tile Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances R~gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe TI~.e applicant agrees to comply with all applicable laws, ordinances, building'code, housing code, and regulations, and at[mit authorized inspectors on premises and in buildings for necessary inspections. Nature of work (check which al~ ~licable): New Building Addition Alterationescripti./.~. n) Repa}~r .............. Rem¢ ,val ..... , ........ Demolition .............. Other Work ............... lDO ' (to ba paid on filkng this application) i /. Num. ber of dwelling units on each floor 5'. If dwelling, number of dwelling lnits ............................. If garage, number of cars ....................................................................... If business commercial or mixed occupancy specify nature and extent of each type of use .... ,~,~.* Rear ,~.4'' Depth -~'.~.' 7 ~ Dimensions of ex~stmg structurgs if any' Front He/~ht " Number of Stories Dimensions of same structure with alterations or additions: Front .~..,~. ~. Depth ' Number of Stories 8 ' ' ' R.~7. : Depth . Dimensions of entire new construction: Front ...................................... , H~ht ............... N,~ bar of Stories ........... ii i; .................................. 9.] Size of lot: Front ........... ~ ........... Rear ..... ' ................. Depth .................... 10.I Data of Purchase .: .................. , ......... Name of Former Owner ........................... 11. Zone or use district m wh. ich pti misei aie situated...'.;..". ............. [ ............................. Il.} Does proposed construchon viol ~te any zoning law, ordinance or retulation: ..... ~ ...................... 13.1 Will lot be resraded ....... .~. 14.' Name of Owne. r of premises . Name of Architect ........ ,~. ........ ~ ......Address ................... Phone No ................ Name of Con ractor ~.~. t . . .l... '~...., ..... f ./~T~JAddress ..~...~.. X .... 7;...;~ Phone No. J~. .... ~?~.. ? .... PLOT DIAGRAM Locate clearly and distinctly all ]buildings, whether existing or proposed, and, ihdicate all' set-back din?.ensions from pert,/lines. Give street and block Qumber or description according to deed, and show street names and indicate whether ~ ;riot or corner lot. ~,epZ~ce EMERGENCY. ESCApE AS REOUIRED BY PART. 7~4 0F COt.INTV ~ k_~ Q A~/-- ~.~' , ..... · . · ~ ..... .~...~.-,~..; ~ .... ~ .............. veto8 amy swornt aeposos ~a says that ho is the appiic~t ~ (N~in~ividual si~g contract) ~ ~, ~ .... Y.. ~.~~ ~.. of ~d ~wner or owno~, ~d is dulyjau~o~ed to perform or have porfo~od the said work and to m~e ~d ~o ~is ap~ca~on; ~at ~ s~toman~ centred ~ this application am true to tho best of his ~owlodgo ~d be~of; ~d that ~e we ' .... ~k wffi bo porfo~ed m ~o m~ner !et forth m the appHcatwn filed therewith. Swbmtobof~o~ ', ~ ~ .. .... ..... . . .......................... ~rm ~Xp~re~ 12~o ~