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Home My WebLink About20529-zFOR~ NO. 4 TO~N OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. CERTIFICATE OF OCCUPANCY No Z-20895 Date JULY 28, 1992 THIS CERTIFIES that the buildin~ Location of Property EAST END ROAD House No. County Tax Map No. 1000 Section 1 Subdivision ALTERATION FISHERS ISLAND~ N.Y. Street Hamlet Block 2 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1992 pursuant to which Building Permit No. 20529-Z dated APRIL 9~ 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 ALTERATION & REPAIR TO MAIN HOUSE AS APPLIED FOR. The certificate is issued to WILLIAM L. HANLEY JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-240374 - JUNE 25~ 1992 PLUMBERS CERTIFICATION DATED JULY 22, 1992- RICHARD AHMA Building Inspector Rev. 1/81 TO~VN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tax Mop No. lO00 Section ........... / .......... Block ........ ~-~ .......Lot No ......,,,~,,, ............ the Building Inspector. Fee $..~...~..s~..,~'....~,.. Building Inspector Re~ 6/30/80 Form No. 6 TOWN OF SOUTIIOLD .,' BUILDING DEPARTMENT 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. 5. 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. 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 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 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 Date July 22., 1992 :;ew Construction ........... Old Or Pre-existing Building.. X no # East End Road Fishers Island Location of Property .......................................................................... House No. Street Hamlet Lee Henley )l~wer or Owners of Property .............................................................. . . . . :ounty Tax Map No 1000, Section..! .......... Block ..... ~. .......... Lot ...... ~ ............... F, I. Development Corp. .1. i-B ;ubdivision ........................... Filed Map ......... Lot. 1~o Robert. N~ An ' ~holl%e, ~ ES~. ~crml~ No..............20529Z ..Date Of Permit · · · ·.. · · .....April 7, .7.~.%ppl icant..~.s..a.~.e.~l.~. .I. 9.r..~.e.? . .~.a.~. i..e .y. Dept. Approval ...... ~/.k. ................ Underwriters Approval....Y.e.s. N .~...~.~...~. !ealth '!anaing Board Approval · equest for: Temporary Certificate. Final Certicate. . ,. ........ Ant~o~L~CA~Ii (0 ~0~ Robert N, lne, ~sq,, agenl~ Lee Hanley TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Date July 22, ~992 Building Permit No. 20529Z Owner Mr. Lee Hanley Plumber {please print) Richard Ahman (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 22nd day of July ,. 19 92 Notary Public, Suffolk County (plumber' s signature) THE NEW YORK BOARD OF FIRE UNDERWRITERS 3. 1 ~3~0~,;] BUREAU OF ELECTRICITY ~--- 85 JOHN 5TREIET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only t~ electrical equipment ~ ~ri~ balm and i~t~uced by t~ applicant ~med on theatre application number in the prem~es of in thefotlowing location; [] Basement [] /st Ft. ~ 2nd FI. O~t~! Section Block wasexaminedon J ~ ~'I ~ ~ 6, :1_992. and foand to be ln co. plla.cewDhtherequlre.tentsoftalsBoard. Lot FIXTURE OUTLETS SWITCHES DRYERS FIXTURES RANGES COOKING ORCKS OVENS DISH WASHERS EXHAUST FANS FLOOJ~ESCENT SYSTEMS E R V I C NO OF CC. COHO ~. V/ C~ NO. OF Hi-LEG A, W G. NO OF NEUTRALS A, W G* P~R ~ OF CC COND. OF HI-LEG OF NEUTRAL l OTHER APPARATUS: GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the ~oard if i~correct, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERT FICA~E MU~,N~T BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'~,~ :~ ]. ~, 3~0~ ~ BUREAU OF ELECTRICITY ~- B5 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~'~l]~l~ ~,i~l~ ApplicatlonNo. on.fiJe 7'~3~9692/92 g 24~374 THIS CERTIFIES THAT o~y the e~ctrical ~uipment ~ ~scribed b~low a~d (~t~uced by the ap~Jcant ~med on the a~ve application nu tuber in the prorates of in thc fotlowlng tocatlon; [] Ba~sement ~ Ist FI. ~ 2nd FI. 0~I' Section Block tt~ts examined on ~ ~ ~ ~] 1 (~ t l. 9 9 ~ and found to be in compliance with the requiretnents q[ this Board. Lot $1XTURE OUTLETS DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OTHER &PPARATUS~ E R V I C .o. %,%co,o. [ A* W O, NO OF HI-I~G A W, G A, W, G OF CC, CONO -- OF HI-LEG OF NEUTRAL R GENERAL MANAGER Per~ ,'*./// This certificate must not be altered in any manner; return to the office of the ~oord if incorrect. Inspectors may be identified by their credentials. , COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERT FICA~E MUS~T NQT BE ALTERED IN ANY MAHNER. FOUNDATION (1st) ?OUMD~TION ROUGH FRAME & .PLUMBING (2nd) [~SULATION FER N. Y. STATE EHERGY CODE FI:IAL ADDITIOMA'L COMME~TS: BLDG. DEPT. ,, TOW~ OF SOUTHOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. '11971 TEL.: 765-1803 Examined..~. ?!.{';r..~.....7 .... 19 Disapproved a/c ..................................... .................................. (Building APPLICATION FOR BUILDING PERMIT BOARD OF HEAL ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. CALL ................... MAIL 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 work. 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 all applicable laws, ordinances, building code, hous~¢, ~d regulations, and to admit authorized inspectors on premises and in building for necessary~xi??'e,~ttgW~,.,~,,~~ -~~ .. ~c. (~.~.c..~..~ .~. 2.~.~ ~ .~. ~... -- (Signature of applicant, or name, if a corporate)n) V 5.-. XK. (Mailing address of applicant) /_)~; Z.~ O State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................................... Name of owner of premises ....~././.~U.. ~.~/:...~: .~Tq~./.~..~'. ~.~. ............................................. (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..'i?.'q4:'.~.~.~<~-~7~:'~ ............ Plumber's License No. '~>.'.er~-. · .~...~. ~.~.} Electrician s License No..~ ........ ~;~-~ ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .,Vn . . ........ r--& . . .z? ................ . e,: ................ House Number Street Hamlet County Tax Map No. 1000 Section ..... .~. ........... Block ....... ~ ......... Lot ..... ..~. ........... Snbdivision..,~.' .~-.: .- .~.~..~'.~.~F/~?~/~57~r$ '~. · .~7.0. ·/0. ',~'.: .... Filed Map No ..... -.~ ......... Lot . .?.~/-.~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .F..~. '.e.~5'.,~-~ .%7~.,~...TT:.-~A~.~ ................... ............................ b. Intended use and occupancy .. '.,.,~.~.~ g-'Z>&'-dL/7'-Z5.~2_ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....~.. ..... Repair .... )~5. ....... RemOva1 .............. Demolition .............. ,Other Work ............. ~ I .... ~~ll[~[ ~l~ ripti ) I ~' sc on 4. Estimated Cost... · ...... Fee ........... f. · [c~..4 ........... ~ · · .~ .... (to be p~id o~.t~sappli~a~ion) ~ 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units~'~h ~flfbr ................ . If garage, number of c~s ..... ~ ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing stmctureg if any Front Rear Depth Height Num~er of Stories .......................................... D~ensions of same structure w{~ alterations or additions: Front ................. Rear .................. Depth i HeiSt Number of Stories 8. Dimensions of entire new const~ction: Front Rear Depth Height ............... Number of Sto~es ........................................................ 9. Size of lot: Front ........... ~ ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... ~ ......... . ......... Name of Fomer Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. 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 Nme of Owner of premises ' Address Phone No Name of Architect i Address ......... Phone No ................ N~e of Contractor ........ · ] .......... ..... ..Address .... .............. · PhoneNo ................ 15. Is this property within 3:00, feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold T~own Trustees Permit may be required. PLOT DIAG~ Locate clearly and distinctly ~1 [build~gs, whether existing or proposed, ~d~ indicate ~l set-back d~ensions from property ~nes. Give street ~d block jumber or description accord~g to deed, and show street n~es and indicate whether inte~or or corner lot. STATE OF NEW YORK, COUNTY OF · .~-~. -..~..~...C~.. ..... S!.S ...~.3~. ~ g~rx../l.~. L' ~..2:' .r~.~.~.~..,~..~. .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ........................................................................ (Contractor, agent, corporate officer, etc.) 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. Sworn to before me this ................... day of .............. , Notary Public, . ....... ><..~. 'cl:~'~..I.~ .......... 'County · ' , .... ....... ~¥ PUeU0, 8Ial~ ~ flEW tuRK (Signature of applicant) i'l(I 52-82679~0 -- tlUFI~U( .COgflrl