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Home My WebLink About20650-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21032 Date SEPTEMBER 18, 1992 THIS CERTIFIES that the building ADDITION Location of Property WEST END FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 10 Block 3 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 1992 pursuant to which Building Permit No. 20650-Z dated MAY 26 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 DORMER & BATHROOM ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to SCUDDER H. SINCLAIR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-036391 - SEPT. 28, 1988 PLUMBERS CERTIFICATION DATED SEPT. 1, 1992-MARIG ZANGHETTI LQdel~IlsG vv Buildin Inspe Rev. 1/81 FORK NO. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NN! 20650 Z Date ....~.n............ ~.6 19.g:.-'L... Permission is hereby granted to: / - _ zl~ I~..~/,.....o to ............dui at premises located at ~C....1 - County Tax Map No. 1000 Section I.~.J. Block ~ Lot No....... pursuant to application dated ...............?...../..Lal............... 19.J.%and approved by the If* Building Inspector. Fee %/.~J Building Inspector Rev. 6/30/80 trial No. 6 TOWN OF'30UTHOLb Building Department EP - 3 r',~It';1 Town Clerks Office Southold, N, Y. 11971 its.. APPLICATION FOR CERTIFICATE OF OCCUPANCY""" Instructions A. this application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: Final survey of property with accurate location of • all buildings, property lines, streets, and P r( 1 unusual natural or topographic features. !j;y 21 Final approval of Health Dept, of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters.' 'fl'{#ir•' 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and "1'';`,' ` • Installations, a certificate of Code compliance from the Architect or Engineer responsible for Ir ~1~ the building. 5, Submit Planning Board approval of completed site plan requirements Where applicable. B, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: M s+' 1 Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. `t ` 2, Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. S., Date of any housing code or safety inspection of buildings or premises, or other pertinent.in- I formation required to prepare a certificate. 1 Rl lCi C, Fees! 1 a q- 1, Certificate of occupancy $5.00 2Certificate of occupancy on pre-existing dwelling or land use $5.00 Copy of certificate of occupancy $1.00 d h , j, I Date ......",.........w1,., L MI l' New Building . Addition Old or Pre-existing Building Vacant Land ` 1111' Lotafinn Of Property ....................'Ili lo~ . MkyAT +•Cwril Or Owners Of Property UH,".u,...:u.,u.uuu. If i „1+ it 5ubdivlsion . :.:.....,..~..°...,.,.,....Lot No. Block No..,:3. 1"it House No Ill t +f .l 9 r permit Date Of Permit Z-,.,Applicant, •~r I.. 5 1 ~ ...........................................Cabot. Dept. Approval .,......,,..,...4... Health beet Approval ` ' Underwriters Approval (Y0,3,63..71 .............Planning Board' Approval ,,,....,...,,...,.I equest or Temporary Certificate Final 'Certificate ~1~ 1 l 'J t dn trunb Non on above described building and permit meets all applicable codes, and regulations. $1 Applicant .41wihil i ' tit efore me is~~ ~r ~i tL,{ 1 - - ~ b{'Mw ''.(,1`yh P or soap st&h1 ( l day of 01;11& ssai:afv JR. {j ~ t.,; Nola Public Count No Puats New York No.45 { No. d6o855 9 n ~o Ouakfl6tl Suffolk County r„ lY Term Expires 12131rwi TEL. 765.1802 o~'FbLA~~O TOWN OF SOUTHOLD . . OFFICE OF BUILDING INSPLCTOR', P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y: 11971 l~ SEP - ,3 C E R'T I F I C A,T I'O N. ' ~ti.. Bui:,d ing.)Permit ' No -12LL ,?6 - owners 1 hl' St r J'cL6{ p~ (please print), (pleasej,,pr nt) certify that the solder used in the water supply system :i conta(.ns less than 2/10 of 18 lead. . (plum rt, signature)' SwoY.r.~ o befor me this r r day ofd(&ladi yr / i a 199 Notary Public „ Not<fry Pub11County THOMAA,f:~eaA~ N,etery Public State of New York ' No.4806559 ouetffletf in Suffolk County Teem Expires IZ3119t. - i THE NEW YORK BOARD OF FIRE UNDERWRITERS{" ` ~ono55 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 gi{?']HMii ~:k ~t8: `t N.K 5>t: Ytv ij;.l; ry ~}}e;;ca ; Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of y u ;INCLAIR, PRIVATK ROAR F't HPIR 1'hAN1 iS~Y. in the following locat' a t, ist Fl. En 2nd Fl. Section B/och Lot was examined on and found to be in compliance with the requirements of this Board. FXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHMEt EXHAUST FANS ~T~S EPTACLES SWITCHES INCANDESCENT-FLUORESCENT v AMi. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. M. P. td R p DRYERS FURNACE MOTORS PUTURE APNIANCE FINDERS SPECAL REC'PT TIME CLOCKS ElLL UNIT NEATEK MULTI.OUTINT DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P. SYSTEMS AMT. WATTS NO. OF RET o FIB+, SERVICE DISCONNECT NO. OF S E R V I C E Mr. AMP. TFFE METER 1 X 3W 1 ,e 3W 3 N 3W 3 X AW NO. OF CC. COND. A W G. NO. OF X4LFG A. W. G NO. OF NEUTRALS A. W. G. EOW?. PER A' OF CC. COND. OF M-IEG OF NEUTRAL OTHER APPARATUS: M'O'1'CtkS:1_-P H_P. F'nNH;r,fihARt15:1-1.? ~'"I.R. 1.2'; G.F l".t•-1 - r & S f'S'S. 114C, u7 tiNY:R 19t.AND I>.O. BOX 2021 OBIYAL N1:W YORK NY. 16i4o 1'11?IA0lR Per This aAifitgle must not be aMered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ON FE MINAMIG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED IN ANY MANNER. I~JF: UXILNI.^. FOUNDATION 1(1st) I c FOUNDATION (2nd) m 2. z 0 ROUGH FRAME & PLUMBING H` c~J 3. x m m INSULATION PER N. Y. „ STATE ENERGY CODE m~ 4 ' H FINAL ADDITIONAL COMMENTS: m x . x0 m } m I H BO,1FD OF HEALTH FORM No.1 3 SETS OF PLANS ` TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CIICCI 8 9? MAY TOWN HALL SEPTIC F0Rrt SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r:DT I F't ; CALL Examined 19.... MAIL TO: Approved 6.. 6.., 14~.ermit No.A.Q 6. Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 ~i INSTRUCTIONS 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 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 `tall lie 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 'tall 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 ;uilding 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. he 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. ?v~S l~nY 9c dl . (Signature of applicant, name, if a corporation) Zl..!I..... (Mailing address of applicant) state whether applicant is owner,, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ?z!vl V`itiuc li~2_ lame of owner of premises !2......... . (as on the talc roll or latest deed) f applicaanttiis a corpo ation, signa~t~ure of duly authorized officer. (Nam d title of corporate officer) Builder's License No. ! "i Plumber's License No. J`?5 Electrician's License No. Other Trade's License No. d:3d" /~1Z Location of land on which proposed work will be done. 4 ! ~t4? s/7enS .Gs d./ y 1-louse Number Street Hamlet County Tax Map No. 1000 Section . Bldck~ Lot :4~1............ 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 ........iu b. Intended use and occupancy , , , , , , , , , , , , , , . 3. Nature of work (check which applicable): New Building • Addition Alteration Repair . Remo Val Demolition Other Work . ~~~rr (Description) 4. Estimated Cost G1'J~ O~ Fee . S040.0 , . (to be paid on filing this application) 5. If dwelling, number of dwelling nits Number of dwelling units on each floor If garage number of cars s.r 6. If business, commercial or mixed' occupancy, specify nature and extent of each type of use . Dimensions of existing structures, if any: Front . Rear Depth . Height Number of Stories , . . Dimensions of with alterations or additions: Front . Rear p Depth l .Height Number of Stories . $ Dimensions of entire new constr Suction: Front Rear , Depth Height . • . umber of Stories . . . . . . . 9. Size of lot: Front ; ; Rear Depth 10. Date of Purchase ' ' ' ' ' ' ' • ' • ' • • • .........p Name of Former Owner 1. Does Zone or use proposed in construction which premises are situated P..... . 12. ,te any zoning law, ordinance or regulation: 13. Will lot be re.raded I . • • • , • • , , , • . • • , • • Will excess fill be removed from premises: Yes No 14, Name of Owner of premises . . . . . Address Phone No............... , Name of Architect , ,j Address Phone No.......... , ame o Contractor 15. Is this r~ ert within 3 Address Phone No................ * pop Y If es, Southold 3 0 feet of a tidal wetland? *Yes........ No.. QTrustees 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. i I,I STATE OF NEW YORK, S $ 'OUNTY OF . ' • . • • • • • • • • • • • • {'Omsis-• • • • 5 ~ • , being duly sworn, deposes and says that he is the applicant (Name of individual signing' contract) bove named. le is the . (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this iplication; 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 sett forth in the application filed therewith. .vom to before me this . A of 19 9 Z-_ otary Public, . County Ni Yy G. G. VJA4.1, Ww V Noe, St f. of Now Vvrl. • (Signature of applicant) Qualified in Suffolk Countyq ...9.2..- (M Wires ~ 30, 19 O ~ I 1 ~ yyI~ I -n O0. T;p M pp c ONm~ n 'm Z>G h c vONg-4' ~ Q. O ~ Z ro 2 rn o 3 t~ o m Hnl ZI OONel -z 10pN W Z*' C(\ t~ i ~N 20-40 m°o co 50Z ~ 0 zScz"y 'U !9roD p, ZZONOC~ r' 0 rn x Q° ~ ~ tag ~rn z m~ z 0 0 m C "D ; 3 W m3 m 1Zm a z m 2 Ow < D 1 -Ni L7 O m -1 Q U N ` -i a N 1/0 no, Itgl' Zl O m m a m~ p ® E T A aw I • W ' ~ R'