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Home My WebLink About21971-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTF~NT Office of the Building Inspector Town Hall Southold, N,Y. ~ERTIFICATE OF OCCUPANCY No Z-23453 Date JANUARY 19, 1995 THIS CERTIFIES that the buildin~ Location of Property. House No. Street County Tax Map No. 1000 Section 6 Block 5 Subdivision Filed Map No. ACCESSORY MANSION HOUSE DRIVE FISHERS ISLAND NY Hamlet Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DE~ER 9, 1993 pursuant to which Building Permit No. 21971-Z dated MARCH 29, 1994 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 AN ACCESSORY SHED IN THE REAR YARD AS APPLIED FOR. The certificate is issued to WILLIAM DURYEA of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H/A H/a H/A Rev. 1/81 F~RM TO~ OF SOUTHOLD B~ILDING DEPARTMENT TOWN HAM. SO~THOLD, N.Y. N£ BUILDING PERMIT ITHIS PERMIT MUST BE KEPT ON Tile PREMISES UNTIL FULL COMPLE~ON OF THE WOrK AUTHO~EEDI Date..~. 7 ............................................. 1 9 .~, .~'~., 21971 Z ' Permission Is hereby granted to: / J /-~ ~ :::~~~........(/~...,. ................................. ............................................ ....... .............. ...~/v.:~ ...... ...1~.~ ....................... ~.,... ............................................... ':. ...................... CounIy Tax Map No. 1000 Section ............ ~ ......... Block .......... ~ ......... Lot No. ..~'.~.. ................... pursuant to application dated ........~f..~.. ~. ........................................ 19...~....-~... ...... and approved by the Building Inspector. / / 8uildil~g Inspeotor Rev, 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 1OWN 0~: ~UTMOLD 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. 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. ,5. 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. Certlficate 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 Building - $100.00 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 19, 1994 ew Construction .... ~ ..... Old Or P xi ti g B ilding ~cation Of P~o ~r~ Mansion house drive, 'Fishers Is.N.Y. House No. Street Hamlet Jsmes M: Duryea ~wer or Owners of Property ........... ,unty Tax Map No 1000, Section .... .6 10 ......... Block.. 5 ,bdivision ............................... .....Filed Map............Lot ...................... Per .~ 3/29/94 rmit ~o...~%.~ ..... Date Of m~ ................ alth Dept. Approval.. ........ - -.......... ....Underwriters Approval ......................... Onning Board Approval ................. . quest for: Temporary Certificate ...... Final Certicate · FOUNDATION ( ls t) FOUUDATIO~; 2. (2nd) ROUGH FRAME & PLUMBING I~;SULATION PER N. Y. STATE ENERGY CODE FI:~AL ' II ADDITIO~L COM~tENTS: DEC 3 199~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF ItEALTII ......... SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FOR;I .............. NOTI PY; CALL ................... HAIL TO: ~,__~ , ,:_.. TEL.: 765-1803 Disapproved a/c ..................................... Z24 ............................... ........ : . ............. '~PPLICATIO~ FO~ BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 *of pi:ms, accurate plot plan to scale. Fee according to schedule. rb. Pot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part'of this appli- cation, c. Tile work covered by this application may not be cbmmeneed before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~,egulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. l-he applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to .dmit aul horized inspectors on premises and in ~uilding for necessary inspections. / / ./. -.. '.- · Z~-s a,,,..~...y (Signature of applicant, or name, if a corporation) ..... (Mailing address of applicant) gtate wi'ether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, jignature of duly authorized officer. (Nan~and title of corporate officer) Other'~rade's License No .... .~. ~-..'9~. ....... llouse Number Street Hamlet Corn,fy Tax Map No. 1000 Section ..... ~ Block .S . .. 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 .......... 3. Nat.re of work (cheek which applicable): New Budding .......... Addition ..... .-- .~--~'~: AJte~tion.. ......,.. ~. · Repair Removal ....... Demolition ......... O~..~r Wo~k~) ~(. (~escription) 4. Estimated Cost .... :.~'P .......................... Fee ...................................... (to be paid on filing this application) 5. Ir dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, comtnercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, 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 nexv construction: Front ............... Rear ............... Depth ............... · Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth .. ..................... 10. Date of Purchase ............................. Name of Former Owner ............ ' ................. I I. Zone or use district in which premises are situated ..................................................... 1 2. 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 ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *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. AP RO'I D AS NOTED 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNOATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMRING 3 INSULATION 4 FINAk CONSTR(ICTiON MUST ~E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET TI=E REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY (',DOES, NOT RESPONSIBLE FOR F~FSIGN OR CONSTRUCTION ERRORS FATE OF NEW YORK, S.S 9U,',FrY OF. '..L~A?' .......... . ' ........... './/~/4,~/~-..~....~'~..0'"'J,l/~. ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) eve named.' (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have perforn~cd the said svork and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the (Signature