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Home My WebLink About20982-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21185 Date NOVEMBER 30, 1992 THIS CERTIFIES that the building Location of Property House No. County Tax Map No. 1000 Section 9 ACCESSORY GARAGE EQUESTRIAN AVENUE FISHERS ISLAND Street Hamlet Block 4 Lot 14.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 23, 1992 pursuant to which Building Permit No. 20982-Z dated SEPTEMBER 25~ 1992 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 REBUILD AN EXISTING ONE-CAR ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ELLF~N D. HARVEY Rev. 1/81 FO~.M NO. e, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDSHG PEI~,IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WO~.I~. AUTHOP, IZED} pumuont to opplicotion dot~:l ................ , 19.____nd,~.,.~.~ ~Jp~rovegt ~V the Building Inspector. Building Inspector Rev. 6/30/80 ~ FORM NO. S TOWH OF~OUTHOLD Building Deportment Town Clerks office Southold, N, Y. 11971 .PPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions if~rtypewrffer ,This application must be filled OR ink, and submitted in DU, PLICATE to the Building Ihspector with the following; new buildings or new use: '1, I Final survey of property with accurate location of ~all buildings, property lines, streets, and * unusual natural or topographic features. r 2,, Final approval of Health Dept. of water supply and sewerage dispasal~(S~9 form or equal). ~3.' Approval of electrical Installation from Board of Fire Underwriters. ' ' before me thls '4, Commercial buildings, Industrial buildings, Multiple Residences and .smla~ buildin.g.s and ~ ~. Installations, a certlfloate of Code compliance from 'the Architect or Engineer responsible for ' the building. * * ' " '5~ Submit Planning Board approval of completed site plop requirements Where applicable. For existing buildings (prior to April t957r), Non*cohformlng,Uses, or buildings and "pre-existing" land uses: 1,'Accurate survey of property showing all property lines, streets, buildings and unusual 'natural or *topographlc features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3..Date of any housing code or safety Inspection of buildings or premises, or other pertinent In- ',' formation required to prepare a certificate. , , .: l. Certificate of occupancy $5.00 9. Certificate of occupancy on pre-existing dwelling' or Jand use $5.00 3. Copy of certificate of occupancy $1.00 .... ~ ' Oct 30, 1992 Ildln~ × ' ................ Addition ................ Old or Pre-existing Building ............. ., Vacant Land ,.,,..,....,, EcTuestrian ave, Fishers ~,§~,~.~.~./.~.~..y,, , ~Lo~otlon Of Property ............................................................... · , . Or Owners Of Property ........................................................... ...... 14.2 4 sion ,,, .........,., .......................................... , ...... Lot No ....... ..,,. Block No, .,.,,,,.. House · .,., ermlt No. 20982z Date Of Permit , / .,Appllcantr . ~'~ ~D'r~'r'~D'~t~'*g'"'In'c""'""'""'" ApproVal ............................................ Labor Dept. Approval . ,.,,,.,--,,,..-,,,. ...... ,,,---,.-,.,." ' :U d ..... ? " ..................... '""'"'"'"'" e~wrlters Approval , ............................................. Planning Board Appr vol '' For Temporary Certificate ........................................ Final Certificate ...... .~.,.., .................... $ 25.00 , ,. ,," d.~p~:~,f at,ans. ,, on above described building an meets ali, appllcc~e codes and regul Applicant ............ 1,', ....... ~,~', ,e. ~,~, ~,.e, ~,t~,,,,,, ,,,.,., .. Publf¢ .................................... County ' r(st~p O~r seol) · ? :',, OUNDA~ION (1st) 'OUNDATIO~I (2nd) :OUGH FRAME & -PLUMBING ~NSULATIO~! PER N. Y. STATE EHERGY CODE FI~IAL ! / ADDITIO~IAL COMME~ITS: FORM NO. 1 TOWN OF SOUTHOLD "BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ , 19... Disapproved a/c ..................................... BOARD OF HEALTll ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. ~.0~ L F? ~ CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .................. I a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 >r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this applicatio.n may not be cbmmenced 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 Towfi of Southotd, 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. ['lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. , " (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the t,'rx roll or latest deed) il' applicant is a corporation, signatnre of duly authorized officer. ... ...... (Nanf~ff and title of corporate officer) Builder's License No .... /3 ~o2z/,';l //-.~ . ? ' ' CY.- Plumber s License No ........................ · "' · Elcctrlclan s Lmense No .................. ... Ot] er Trade s L cense No ...................... Location of land on which proposed work will be done. ~' ' ' llouse Number Street Hamlet County Tax Map No. ,000 Section .... ¢ ............ Block ..//. .............. Lo t../(...'.'.~.* c~2-' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. '.,isting use and occupancy .... b. Intended use and occupancy . 3. Nature of work (check which applicable): New Building .......... Addition Repair ... X ......... Removal .............. Demolition .......... Alteration .......... ~ ! · · .j~/ ........ Other Work ............... 4. Estimated Cost . .~.~..D,F_..~O ,i~ . ~ (Description) · 1 .......... Fee ' . (to be paid on filing this application) 5. If dwelling, number of dwelling hnits .... Number of dwelling units on each floor ..... lfg ~ ........... · · . · arage, number of cars ..... i ........................ ' ....... 6. If business, commercial or mixe occupancy, spec nature and extent of each type of use ......: ~. ;,.,~ ........ tm ~ 7. Dimensions of existing s cture ,if any: Front i ......... , ....*Rear .............. De th .... · ' Height ............... Number o f Stories ..... P ............ Dimensions of same structure w alterations or additions: Front D pth ' ] R e ............ . Hight ................ ear .................. 8 Di sio" [ ....... e ' · Number of Stories ...................... nti onstru tio F . . men nso e re newc c n: ront ............. Rear ............... De ....... Hight N mb fStorie · · pth 9. Size of lot: Front ....... ! .. . ' ........ ' ................................ Rea ' .......... D pth I0 Date of Purchase '..I · ·. r .... ;... ........... ~ ................. Name of Former Owner · 11. Zone or use ' ' · .................. d~stnct in which premises are situated.. 12. Does proposed construction relate any zoning law, .............................. 13. Will lot be regraded ordinance or regulation: ..... ~ ............................ ........................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ........ Name of Architect .......... Address ................... Phone No ................ ...................... 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 T6wn 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 nhmber or description according to deed, and show street names and indicate whether interior or coruer lot. FATE OF NEW YORK, S Si OUNTY OF · ............. q~' ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .ore named. ' · is the e, . ' (Contractor agent corporate officer etc ) said owner or owners and is duly authorized to perform or have performed the said work and to make and file this )licat/on; that all statements containe,~ ~,, ~h~o .. -. ........ appucat on are true to the best of his knowledge and belief; and that the ,rk will be performed in the manner setl forth in the application flied therewith. 'om to before me this ............... dayof ' ....... 19 ~..o2.~ '7/ .................. , ...... N~Publlo, r N0.4674~, 8~k ~U~ r~./ , // ...................... ~mm~lon ~dulyal, 1~ . ~ (Signature of abplicant)