HomeMy WebLinkAbout20277-z t " FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22189 Date MARCH 10, 1993
THIS CERTIFIES that the building ADDITION / ALTERATION
Location of Property HEDGE STREET FISHERS ISLAND, NY
House No. Street Hamlet
County Tax Map No. 1000 Section 10 Block 7 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21 1991 pursuant to which
Building Permit No. 20277-Z dated NOVEMBER 14 1991
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 ADDITION AND ALTERATION TO EXISTING ONE-FAMILY DWELLING. .
The certificate is issued to FRANCIS T. DOYEN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A
UNDERWRITERS CERTIFICATE NO. H 029960 JULY 20 1992
PLUMBERS CERTIFICATION DATED MARCH 9 1993
_ °Li/
Building Spector -
Rev. 1/81
lOEM NO ~
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)
N 2 2 7 7 Z Dote ...?.ktG`tre.~..~.......1...~ 19../..C
Permission is hereby granted to:
....r.~ ........~.>yj..~.. !'63 9 O
ta ............r~::.....~..I~.~.....,~~:~~..~.....
' at premises located at .................~lZ • . .....~'...0.
....G~~~~~~......M
.
County Tox Map No. 1000 Section .......~.U....... Block Lot No...1..~.,~..
RR
pursuant to application dated ....~...P":.....~ 19..®,f...,~and approved by the
Building Inspector.
Fee S•••'K ••Y THE NEW YORKBOAfjQOFFIRE UN~gqEppWRITERS
f./ZOa?1~~ NoJ1'~
WE ARE IN THE PROCESS OF ISSUING A
CERTIFICATE OF COMPLIANCE FOR THE
ELECTRICAL INSTALLATION AS COVERED
IN AN APPLICATION NOTED BELOW
r /
APPLICATION NO. G ~6 ~ J _7~~ f
LOCATION G•ysCd ~1 i BUllding IIISpeCtOf
INSPEC~ORDATE
IBD (REV 9/9
Rev. 6/30/80
Form No. G
TOFTN OF SOUTIIOLD , ,
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION POR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OF, 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 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certifica;:e of Code Compliance from archi~:ect 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 shocaing 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.
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
' / Dace /~.~„3„ _
ew Construction.....(,,,, Old Or Pre-existing Buildir./g .
ocation of Property
House No. Street•.••••............Hamlet
awer or Owners of Property..
aunty Tax Map No 1000, Section.... 1. D......B1ock... „
.........Lot..
~bdivision...
.,F/ilJJJe/Sd Map............Lot...............
~rmit No.pSi/,~,,~~~ate Of Permit./,~,L,~/,/cry/,Applicant....
•alth Dept. Approval ....................../.....Underwriters A
pproval.~ ~ Q,,,,•.,
arming Board Approval
quest for: Temporary Certificate........... final Certicate...~
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Torm'vKp~tes,t
207' APPLICANT _ - fl
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'.OUCH FRAME &
•PLUMBING
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IIlSULATIOH PER N. Y. I
STATE EPlERGY
CODs I~
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o~ol,~..,, o~ TO'4Y~N Or SOTtTTB[Ob,D
l•:::" ~ ' . ~ OFFICE OF BUILDII~IG INSPECTOR
u~ `fie. rn P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Date -I i ~ 7 ~1~ -
Building Permit No.o~Y~~'~
Owner
(please print)
Plumber FMS N~ 1S~/3~-!b a /~-tc~ ~ r_=r~ %/~r~
(please print) ~
~~~~zs~3r
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
lumber's nature)
Sgwozn to befor/e~~me this
/ /Q~- day of ~i'/A1C</
Notary Publi
' Notary I'u,61ic., _ County
Ti19M~i~ F. aal+e~~Y J~.
/ PIatNFY pukiiic State of Nate York
No„4eosssa
Ouailflop in Suffolk County ,
Terrh Expires 7213714
~ _ - -
THE NEW YORK BOARD OF FIRE UNDERWRITERS >~n~~; ~
~0~34f131 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date ~[1J,'f, 7@1r19~1'L Application No. un file 7B6~b792l92 j[ ~2~9~8
THIS CERTIFIES THAT ~~iRP4T5' H0. 2027%2
only the e(ec[rical equipment as described 6ebur and introduced 6y the applicant named on the above application number in the premises of
BRANCIS T. Dt1YEH, HEI)t;E :;i'Rk;F~'r F"f,'u"HHPS l:i):~RE~CIr H,Y.
in thefollowinq hrcations ® Basement ? /st F'f. ? 2nd F'l. ~~IT Sertinn.~{+~ Block? Lot ~
- u~os examined on >f H~aY 14 I 1 ~ 4r', arzd found to 6e in contp(ianre with the requirements of this Board.
FIXTURE ECEPTACtE$ $wITCHE$ FIXTURES RANGES COOKING DECK$ OVENS DISHWASHERS EXHAUST FAN$
OUTLETS INCANDESCENT FIUORESCENi OTHEn AMT K.W. AMi K.W AMi. KW AMi. K W. AMT, H P.
f; 9 b G
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS $PECIAI RECPT TIME CIOCN$ gEll UNIT HEATERS MUITI-OUTLET DIMMERS
AMi K. W Oll M. P. GAS H. P. AMT. NO A W. G. AMi AMP AMT, AMPS TRANS. AMi. H P SYSTEMS AMT. WATTS
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V 1 C E
METER _
AMi. AMP, TYPE EQUIP ~-e YW 1 $ 3W 3 9 3W 3,e' 4W NO OF CC COND. A. W. G NO. OF HLLEG A' W G. NOAF NEViRAlS A W G
PER 9 OF CC. COND OF MbLEG OF NEUTRAL
a. 2~~a r~~ i. x ~ ~ aie
OTHER APPARATUS:
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PR7~tdCT:J T. Dr1YFSH C~~~~
HEDGF, Sx.
FT~il1RR5 I9L. r HYr te~6390 6ENERAI MANAGER
Per '„I~ ~t~
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
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New York State Department of Environmental Conservation _
Building 40-SUNY, Stony Brook, New York 11790-2356
v
:,9~~-,(irj~_a,ii~~,;,
- Thomas C. Joding
Commissioner
APR 101992
a.l 14~,_
&..~_a?~"1V~.r`~~. April 8, 1992
CF,RTIFIED RETURN RSCEIPT
Mr. Curtis Horton
Foothold Building Department
Main Road
Southold, MY 11.971
Re: Permit # 20277
Dear Mr, Horton:
A violation has been found at. the nropert_.y of Francis T. Doyen,
In order to complete my investigation of this; I am requesting a
copy of Mr. Doyan's permit #20277 {dated 11/14/91) and all_ other
information concerning this site to he sent to my attention at the
above address.
Thank you for your r_.ooperation in this matter. If there are any
q~.iestions concerning this req~_test, please do not hesitate to
r_.nntact me a.t. 515-701-R46R or the ahave address,
hery ttri_zl~y yours,
Charles T, Hamilton
Regional Manager - Regi_nn 1
Marine Habitat Protection
CTH~j1Jp
r_.c; William Southard - Regional Flood Plan r_.nordinator
D ~~11 11~ ~ 60.1FD OF HE,~LI-II
Y \I FORM NO, 1 3 SETS OF PL,~:IS •
~s~• TOWN OFSOUTHOLD SUt:VE'I
cllr.c2:.....____
O4t 3 ~ BUILDING DEPARTMENT _ • ~
TOWN HALL SEPTIC FOR:I _ '
SOUTHOLD, N. Y. 11rJ71 ~ ~ •
t " ,ui-scwr~ TEL.:7G5-1~o2 ::oTIF'r;
zamincd 19 . CALL _ - _ .
/y~ / /J .~J fI~IL T0:
PPraved ././..~!'!l. f .~1.. , 19~J. Permit No.. P.t. OP.`Y./ ~iL.. . . .
isapprovcd a/c _ . k .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ....1
fl f 19~~.
INSTRUCTIONS
a. T}ils application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s 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
ireas,•, and giving a detai]ed description of layout of property must be drawn on the diagram which is part of this appli-
,on.
c• The work covered by this application may not be commenced before issuance of Building Permit.
d°QUpan approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
:.~be kept on the premises available for inspection throughout the work,
e. A'o building shalt be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
.1 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
.din; Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
ulations, for the construction of bu7dings, additions or alterations, or for removal or demolition, as herein described.
applicant agrees,,to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
:rt ai:•thorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name; if a corporation)
(i\tailing address of applicant)
c whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bui]der.
of owner ofprcmises • . 1 ,
(as on the roll or latest deed)
plicant is a corporation, signature of duly authorized officer. '
(Name and title of corporate officer)
Builder's I-icense No. -
Plumber's Liccnsc No. .
Electrician's License No.
Other Trade's License No. .
xation of land on which proposed work will be done. ,
.....~^.i
ruse Number .....................~f~~~... , ;.~-;SL~g„/~
Strcct
~ Hamlet
:only Tax ,~fap No. 1000 Section ..'#~J, J,p • . , , Block
Lot..
irdivision Filed ~I:tp No. .
(Name) Lot
to existing use and occupancy of prerises and intended use and occupancy of proposed construction:
ixisting use and occupancy ~t%S C ~.t=!'.~~:~....... , • '
mended use and occupancy ~~%~l~L~G,~
• PPI{ ~,.,.:w.~a
3, Nature of work (check which a o ~_?!yr~;
a • •
Repair cahlc): New Building Addition • • ..',u Other 14d,t k .t ' '
Remov~l Demolition ti .
i t ; ~ ~ ; .
4. EstimatedCosi.. ~~O p~,r `'(Description)
' Fee~,~~~G'
5, If dwelling, number of dwelling un is lto pail on C~~; this application)
• Number of dwelling unus on circhMt7oor... ,
If garage, number of cars , , • ,
G. If business,comrncrcialormixcdocc? anc
7, Dimensions of existing structures, if any: Fromecify~t~ ure ,ind ex[Rea ~l,~r,`~ SY~te oC use •D ,pth ,6Z.;! , , , , , . ,
Nuntbc
D ncnsion ~~samc struc,tur,, with of Stotics . .
' alterations or additions: Front • ~ • ~ • • • • " " • "
c. tt
Rear..................
g. Din~cnstons of entire new cNum~eCHcil;ht , , , , , , , , , , , , , , , Nurubcr of Stories , , , , , , , • , • . • • • . .
Hci~ttt ion: Front . . . . Rcar , . '
of Stories. '••••••••••••Depth
•
9. Size of lot: Front ...'el~d! , _ . . . .
0. Date of Purchase • Rear .....`'f,S Depth .../..~t;.. ,
1 • Zone or use district in which premi$cs arc situated , , , , N~,rCS ~rmer Owne ,
Does proposed construction violate any zoning ' ' • • • ' • • • • • • . • • • . •
N11 iot be regraded ~ law, ordinance or re•• , , Q • • • • • ~ :
„elation: e
' '~p ' ' ' ' • • • • • • ..Will excess fill be removed from premises: Yes No
-C. Name of Owner of premises ,~/Gig~,',ir,~s : q ~
Name of Architect , ~ Address/yf,~:2s, ~L~~ • • plrone No. S/,,(, ~88;~, 6('~"'
Nance of Contractor • , • , • • • . Address , , , , , , , , , , , , , ,Phone No.. .
''''Address
Is this property within 300' feet of a tidal cuetland?~ ~ ~ ~ ~ • • • Phone No,
•If yes, Southold Town Trustees Permit may be required,~~ " ' No,,, _
• PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fromi
-opcrty lines. Give street and block number or description according to deed and show street names and indicate whether
tenor or corner lot. }C ~l p r _a,, o ~1 ,
~ ~ ~ _
r ~2c~ p~'ii'T~ 6 G /=/Cs~tl c~ T-
C D rr'~ G~ ~ ..17o yEr/
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•tF'
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j ~D- ~ s ~ I 1 ~7 - I~~VJ f7E[-~c_
~ -+-H-+-a-' ~I
i l ~-~'7 ~LOp[2 a~ L I
TC OF NG~~tYY YORK}}~~ ~ - Sl La ~~~a' /s/~uJ G~{r~tu~ 1
'NTYOF.:'u~'p.IK...... S.S - rlbT T~ sc/+ut
-
~C,rlhhl~ _
(Name of individual signing contract) ~ ' ' ' bC1°g duly sworn; deposes and says that he is the applicant
'named. ~i
the w!~~ f'Z..... .
~I (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ' '
d owner or otvncrs, and is drily authgrizcd to pcrforrn or have perfonncd the said work and to make and Glc this
anon; that alt statcmcnts contained irk this application arc true to the best of his knowledge and belief; and that the
will be performed in the manner set fojth in the application Gled tltcrctvith.
i to before me this
• , o2I afi.......day of C~C~?algy., .
1 ~ 9/.
rebue, Sc.t Ilk.. '
~ ~cr.~ ~ county r
cawt,o ?/7 r
• MARY f3. PANKIEWIC~ • • • • ' ' ~?t~.. .
Nt)TARY PUBLIC, STATE OF NEW v0911 ~ ~I'
80. 52.8287960 - SUFflIIK COUwTV ' I, (Signature of applicant)
txr~tlalsswn EXPIRES H/ 3of .9 z. {
INSPECTORS ~~;~131'1'~4e{t,®n
(516) 765-1802 ~.,~y
y
VICTORLESSARD Princi al SCOTT L.HARRIS,Supervisor
P ~ t~ ~~a,'
CURTIS HORTON, Senior ~ r ~ Southold Town Hall
VINCENT R. WIECZOREK, Ordinance"". ~ P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire mss' ~ ` ~~K'~~ Southold, New York 11971
Building Inspectors '~~-r `i~' Fax (516) 765-1823
~~a~~ Telephone (516) 765-1800
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 21, 1992
Charles T. Hamilton
Regional Manager - Region 1
Marine Habitat Protection
NYS Dept, of Environmental Conservation
Building 40 - SUNY
Stony Brook, New York 11790-2356
Re: Building Permit X20277-Z Frances T. Doyan
Premises: Hedge Street, Fishers Island, N.Y.
Suff. Co. Tax Map #1000-10-7-17
'Dear Mr. Hamilton: ;
In reference to your letter dated April 8, 1992 regarding
the above premises, enclosed please find herewith copies of the
information that you requested.
If I can be of further assistance, please do not hesitate
to contact me at this office.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
~
Curtis Horton,
Senior Building Inspector
CH:gar
encls.
(Cert. Mail)