The URL can be used to link to this page

Home My WebLink About20759-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20892 Date JULY 28, 1992 THIS CERTIFIES that the building Location of Property FOX LANE House No. County Tax Map No. 1000 Section 12 Subdivision ALTERATION FISHERS ISLAND, N.Y. Street Hamlet Block 1 Lot 5.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18~ 1992 pursuant to which Building Permit No. 20759-Z dated JUNE 24~ 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 GABLE ROOF OVER AN EXISTING FLAT ROOF & NECESSARY REPAIRS TO BUILDING $98 AS APPLIED FOR. The certificate is issued to F.I.D. CO. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -B~ilding InSpectOr~~ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N°-N.° 2075~Z Dot~~.....~...~ ................. , i~...~d.,, .... ~..d.:...~~../..~ , ..... /..,.~....~...~.~.~. ..~....~.,,.: .............. ...... ./....~..~/.,...~..,....~.. ./ ~ ~ _ ......... ot p~. ~s?, ~tod .~ ............... ~.....~ ....~ ............... ~ ...................... ..................... ......................................... ...................................... .~ .~ ....................................................... ............................. .~:...~ ~ ........ ~ :... Coun~ T~x Map No. 1000 Section ....K.~ ........ Bilk ......... L ........... Lot ~ ..... ~-C...L. ...... Buildln~ Inspector. Fee $.....L~.....~Z......~, ~ Building Inspector Rev. 6~30~80 , i~OI~IK NO. S TOWN OF;$OUTHOLD Building Deportment Town Clerks office '- Southold, H. Y. 11971 APPLICATIOH FOR GERTIFIG~TE OF 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: 1, Final survey of property with accurate location of,all buildings/ property lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept. of water supply rand sewerage disposals(S-9 form or equal). :" 3. Approval of electrical installation from Board of Fire Underwriters/ :''" '' 4,'Commer.cial buildings, Industrial buildings, Multiple Residences and .similm: buildin,g.s and ;, Installatmns, a certificate of Code compliance from the Architect or Engineer responsible for >rthe building. ' L ' "~;, Submit Planning Board approval of completed site plan requirements' where ,applicable. B, For existing buildings (prior to April 1957), Non-canto;ming .uses, or buildings and "pre-existing' land uses: ' ' 1."Accurate survey of property showing all property lines, streets, buildings and unusual <natural . or topographic features, r. 2. Sworn statement of owner or previous owner as t~o use, occupancy and condition of buildings. I 3.Date of any housing code Or safety inspection of buildings or premises, or other pertinent in-', . ~, formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling' ?r land use $.5.00 3. Copy of certificate of occupancy $1.00 <~ . , ' . Date.' ,.,,,,. ............ ~ . , .....,..... Bui,ldin ................ Add ban ................ Old or Pre-existing Building ............. ~;, Vacant Land, .........,. tion Of Property ...... ~ .......... ~,., ...... ~.,, . l ..... Owne~ Or Owners Of Property ...... : ................... .~?.~.,~.,(,,..,.,.....~,C~.,~,. · :,$ubdivislon , .......... ,, ....... , ............................... J.,.'~..,...Lot No ....... [.,. ,, Block House No,,,..,,,,~ ~' 2- Perm t .~..~.,~/..?.~, Appl cant A~..~.....~.~...'~..T.~:~ R.T/.L~.~, ,~.,~,.R',',,:..,,., Pe,r<m? No.'~,...~..~,.~ ........ Dote Of ,, ,,, , , , , ,,,, Underwriters ApprovaJ .................................... Planning Board Appr.oval : .) ~ Request For Temporary Cerhfmate ........................................ Final Certlfloate ..... .v, ...... , ........................... ~ee, ,Submitted $ ...~. ,.~ ............ , .............. QtJon9 onstruCtlon on above described budd,ng and parrot meet~ all c~.oilc.a e codes, end regul Applicant ...... · , before me ,thts~ ' =' ~;3"i , '~( , ,~,/~ I~/Public Slate of No. 4eOOSSe Ousllfleo in Suttolk County T~m Jxpirel FOUNDATION {1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING II~SULATION PER N. STATE ENERGY CODE FI;~AL ADDITIONAL COMMENTS: JLIN g Igg2 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examilied ............... '., 19 ... 19 , r,n,t No... 7. f" Disapproved a/c ..................................... BOARD OF HEALTlt ......... 3 SETS OF PLAt;S .......... SURVEY ................... CIIECK CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... ¢.~.' ......... 19 .~.~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ,ets of ptans accurate plot 151an 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. ¢. Thc work covered by this application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit &all 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 ,ball 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 3uilding 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. file 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 lnspections. ......... .... .......... (S gnature of applicant, or n/frae, 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 /LT, sw/e,~.~ ff~/a~ Jx, ,~,,e./.~.~?. p/ 4~.. '' (as on the t~ roll or latest deed) If applicant is a corporation, signature of duly author!zed officer. (Name a~ title of corpm:ate offic~er) Builder's License No .................. Plumber's License No ......................... Electrician's License No .................... ... Other Trade's License No ...................... Location of land on which propoyed work will be done..-. ..................................... · ......... Number Street Hamlet ' ' ' ' County Tax Map No. 1000 Section ..... /..a~ ........ Block .... ~ ...... ' Lot .... ,~.*../ ...... ..-. Subdivision ..................................... Filed Mg~No> '}~cJ"-, Lot (Name) ............... State ex/sting use and occupancy of premises and intended use and o~uiSancy of proposed construction: Existing use and occupancy ......................... ................. .......... ~-' ....... a. b- Intended use and occupancy . . . .~..~.)Ze. ..... ./.dO~.,~,, ............. 3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration ..... Repa/r .............. Remo?al .............. Demolition .............. Other Work ............... 4. Estimated Cost. a~'O, . . j. ~ .7.7* &~.. (Description) [ (to be paid on filing this application) 5. If dwelhno, number of dwelhng units ............... Number of dwelling units on each floor · If garage, number of cars ...... I... ' ............... 6 If business co,mmercial or mixed joccupancy specify nature and extent of each type of use 7 Dimensions of existing structuresi if any: Frgnt .... ' ............. ',, ................... Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. D pth .... · :.. ........... Hetgh Number of Stories ...................... 8. Dmlenslons olennre new construction: Front ............... Rear ............... De th .. ' Height .... ........... Num bet of Stories , , P ' ........... 9. Size of lot: Front .... ]. ~' ' ear;. ' .................................... I0. · ................ R ' .' '' . .... Depth.. ..................... Date of Purchase ... ~ ..... ;~ ....... . .... ri ....Name of Former Owner ................ 11. Zone or use district in hich pre ises are situate ............. Does proposed construction viola? 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 .... i! ............... Address ................... Phone No ................ Name of Architect ........... ~ ............... Address ................... Phone No ................ Name of Contractor ........ 15. Is this property within '3'010' 'f;'e't .......... Address ............. Phone No .. of a tidal wetland? *Yes ...... '-'- No..~ : · If yes, Southold To~n 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 n 'mber or interior or coruer lot. t~ description according to deed, and show street names and indicate whether TATE OF NEW YORK, OUNTY OF S.S ................ ? ....... being duly sworn, deposes and says that he is the applicant (Name of individual signin ~ontract) ......... ~ove named. e is the ......................... , ....................................................... (Contractor, agent, corporate officer etc ) ' snid owner o'r owners, and is duly a~thorized to perform or have performed the said work and to make and file this plication; that all statements containe in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the manner set' forth in the'a, pplication filed therewith. .'om to before.,!!~ this ...... ,tary Pub c, ./~../.'(.C~...~....~/..../Q~.. ,~ · o/ ................ Notllry Public State of New Y~'J~ .......... . No, 4806559 ' ' .......... Qu~llflea in ~tutfolk County ' 'g of applicant)