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Home My WebLink About21645-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-27136 Date: 06/13/00 THIS CERTIFIES that the building ADDITION Location of Property: WEST ST. (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 4 Lot 8.2 Filed Map No. -- Lot No. Subdivision FISHERS ISLAND conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 30, 1993 pursuant to which Building Permit No. 21645-Z dated SEPTEMBER 7, 1993 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 DECK ADDITION TO EXISTING RETAIL STORE AS APPLIED FOR. The certificate is issued to FISHERS ISLAND ASSOC (OWNER) of the aforeeaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO,3 TOWN OF $OUTHOLD BUILDING DEPARTMEN1 TOWN HALL SOUTHOLD, N.Y. NO_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date.....¢..//.:2 ................................................ 2~L645 Z CounlyTaxMapNo. 1000 Seotion ........ ~ ............ Block.....~... ................ Lot No. .~.¢.,.~ ............ pursuant to application dated..~..-,-~2.,......,, ...................................... 1 g...~ ....... and approved bythe Rev. 6130/80 DATE 22 MILL STREET ALBANY, NY 12001 JOB Brookway-$~nlth Company I'110#()o Al(~llli#()l~lr#l (~l*OilI) ,%'l,rvi/iR' (It'¢,al, lw N/i/'thtu~st Archit, octs sinl'O 1890 MARK SACKERSON ARCRITECTURAL REPRESENTATIVE 800-225-7912 FAX (24 hours) 800-242-4533 OIl/cos and Exhlbll Ares' 7~ OLD BROADWAY NORTH HAVEN, CT 06473 ENTRY DOOR SYSTEM ~ndersen "Rain Sensitized" Wood and Steel ~utomatic Closln~ Hinged French Patio Doors ROO~ WINDOWS DATE 22 MiLL STREET ALilANY~ NY 12001 Brockway-Smith Company I:lro~oo Arohlteolur#10~roup ,q¢l,vln~f (h'..l,~u, Nm'l, lm~i~ Ar(,hl~t~l~ ~1.o~ 1890 MARK SACKERSON AnCHIT~OTURAL .EPRES~NTATIVE 800-225-7912 FAX {24 hours) 800-242-4533 JOB : Hinged French Patio Doors :: Ec,.ot~-- Dei~ ~: ENTRY DOOR SYSTEM Andersen "Rain Sensitized" Wood and Steel Automatic Closing ROOF WINDOWS Form No. 6 Ao BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC This application must be filled in by typewriter OR ink and s inspector with the following: for new building or new use: 1. BLDg,, 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 buildint 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. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings an( Upre-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. C. 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 qccupancy on Pre-existing Buildina - $100.00 3. Copy of Certificate of Occupancy - , .2fv¢ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....~...~. [ · -~. n 9..~). · .................. New Construction ........... Old Or Pre-existing Building...~. ........... of Property Location · · · House No. Street Hamlet Onwer or Owners of Property..f -lo q- County Tax Mmp No 1000, Section .............. ~ c ............................ Subdivision .. .. Filed Map Lot........... ....... . · Permit No.~. .............. e rermzt /-/o Health Dept. Approval .... z..%..'~.. ............... Underwriters Approval ....................... Planning Board Approval.../..~...~. ............... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: S 007 SO APPLICANT CERTIF CATE OF DETERMiNATiON The following Information la required to aealat the building Inepeclor In delermlnlng It a alle plan la required. AI~ P LIi~AMT HOME ADDRE88 LANDOWNER ADDREaa , . RILLIAN BLOETHE BOX 446 ~ILLIAH ~. BLO~U~ FISHERS ISI~ ASSOCIATES 516-- ~H~N~ ~ 788-7133 FISEgRS ISLAND, N.Y. 788-7133 PHONE ~ : LOCATION OF SITE [~'EST, STREET Hamlet FISHERS ISL~II} Tax Map ,,~ .... 9 8eot. Zoning Dlflfrl~t Preaent, Uae(a) Propoaed Uae(a) lib 100 Chapter ., C2 RETAIL STORE SANE ~ITH DRY STORAGE 4 8.2 BLOCK LOT -' Artlc~le 100-90 la there a alta plan available? Yea ., No XX 130n't know Office Area Relall Area Indualrlal Area 81orege Area Parking Gpacea Board of Heallh Other For Offlcal Uae Only Comments FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 IEL.: 765-1802 BOARD OF HEALYH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH CALL t t L\PPLIC/kTIOi'd FOR BUILD~NG PZFdvi:F TO: 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 wdrk. 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 al/ applicable laws, ordinances, build/rig code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corpo~ration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~//",~.~dt2fFf.. ~....'l~.d~z~d~df~, ...................................... (as on the tax roll or latest deed) If al~pli,*aht.is~ cqrporation, signatuLe of dgly au~orized officer. .... (Name and title of corporate officer) Builder's License No.~...-q~.~..~.~ Plumber's License No ......................... Electrician's License No Other Trade's License No I. Location of land on which proposed work will be'done ................................................ ...: ......................... . .... .............. ............ House Number Street Handet County Tax Map No. I000 Section ......... ~. ....... Block d Lot &~ 6't Subdivision .................. ,,,~ ^,' ................... Filed Mn...ar No ............. ;. -L .~.,~ ....... ,, ..... 2. State existing use and occupancy of premises and intended use and occupancy of proposed cbnitruction~. Existing use and occupancy ~; ~ntended use and occupancy -(. ~ .~. ~..~...f ~.~.~ 3. Naiure of work (check which applicable): New Building .......... Addition .......... Alteration ....... .. Repair .............. Remlovai .............. Demolition .............. Other Work.. 4~C./~.. ...... - ~, o ~ ~o (Description) 4. Estimated Cost . . .q~. 4> .... "~" · ........................ Fee ./~.~ ............................. (to be.paid on filing this application) 5. If dwelling, number of dwelbng units ...~.. . Number of dweltin~ units on oneh fl~ If garage number of cars I ~fJ~/~ ' ........................... 6. I bus~ness, commercml or m~xed occupancy, spemfy n~ure and extent of each type of use ..................... 7. ~i?~}~sions o~ng stm~[urCs, if any: Front... ~ ........ Rear .. ~ ........ Depth .... ~ .... e~s.~ ...... ~oa ~ ...... ~un)ber of Stories .... ~..~/~ ........ ' ' D~ensions of~¢me st~[ure with alterations or additions. Front "~3J.'.......... 26 ,' ....... ~pth .. .... ;~...~/~, .... ~.. ~e~t ...... ~.. ......... Number of Stories...~. ......... ~; ..... 8. ~nstons ~}~}re new const~ctmn: Front.. ~..~ ....... Rear ...~ ........ Depth .... ]~ . ' me,gat .... W0~ ....... Number of Stories .~ . . ' ...... 9. Size of lot: Front ~ Rear ' ~ ................. i ' / ....... ~ i~ ............ Dat~ ~ - '"'M~'~ '~:.";~ .......................... ~n ......~7~ ............ 10.. e m~mre~ase ... ~'"~r [~X ........... ~me ofFonn, er Owner /:.~. ~/~ . 1 ~. z~one ~r n~e ~qs~rk~' 'n wh2-~, 7' i " ....... m,, ~,, . ~,~/~d., ' ' ' ....... I2. Does ~roposed construction~v~2;are any zoning law, ordinance or regulation: ..... ~ ..................... 13. Will lot be regraded ' ~ ~i · Will excess fill be rem ~ ~ , ' " ~; ;~9 q ........................ ', ove~ ~,om premises: res 14. wT~[ o premise~//d~m.~dgt& Address .~a-~.F~¢.. Phone No. , · ~rcmrecr .. ¢~ ./g~(g~ '~ .... ~..., ......Address .................... Phone No ........ ~e of Contractor .~. ~ff~.. Address . .~ ...... Phone No .......... ' ' 15. Is th&s properfiy wtth~n 300 feet of a tidal wetland? eYes ........ No ......... eYi yes, Southold ~own Trustees Permit may be required. · .. PLOT DIAGR~. Locate cleaHy ~d distinctly ~I ]build~gs, whether existing or proposed, ~d. indicate ~1 ~et-back d~ensions from property ~nes. Give street ~d block number or description accord~g to deed, and show street nines and indicate wh~ther interior or corner lot. AP~tRO,,VED AS NOTED ~ 7854802 9 AM ~ 4 PM FOR THE FOLLOWING iNSPECTIONS: t. FOUNDATION '~0 REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUM~ING 3. ~NSULATION 4, FINAL CONSTRUCTION MUST BE COMPLEYE FOR C.C. ALL CONf~TRUCTION SHALL MEET TIRE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION g' ENEI~GY COD[:G. NOT RESPONSIBLE FOR PFS~GP¢ OR CONS'rRUCTION ERRORS STATE' OF NEW;2g'OP~K,, , t. S ° COUN'rY OF. ~. ...~. ~.'.~...._/.-.~ ....... .. being duly sworn, deposes and says that tie is the applicant (Name of individual signing contract) above named. I-Ie is the ........................... ' (Contractor agent .................. ') ............................ ~ ' , , corporate officer, etc. vf said owner or owners, and is duly ~uthorized 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: ~ork will be performed in the manner sdt forth in the application filed therewith. ;worn to before me this xlotary Public ~ ~ ~k) lt,C~_ ~. '. C~ · NOTARY PUBL C, NEW YORK STATE NO, 01WA95091851 ...... . QUALIFIED IN SUFFOLK COUNTY,,.., ' TERM EXPIRES OCTOBER 31, 19'"~ ~ (Signature ofap, plicant)(~}'~