HomeMy WebLinkAbout19949-z FORM NO. 4
TOWN OF SOUTHOLII
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20891 Date JULY 28, 1992
THIS CERTIFIES that the building STRUCTURE
Location of Property RIGHT OF WAY OFF WHISTLER AVE. FISHERS ISLAND NY
House No. Street Hamlet
County Tax Map No. 1000 Section 12 Block 1 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 14, 1991 pursuant to which
Building Permit No. 19949-Z dated JONE 18, 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 WASTE TRANSFER & RECYCLING STATION
The certificate is issued to TOWN OF SOUTHOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAI, C10-91-009-JUNE 29, 1992
UNDERWRITERS CERTIFICATE N0. N-219010, N-219011 & N-240218 - 6/24/92
PLUMBERS CERTIFICATION DATED JULY 22, 1992 - ROBERT E. WALL
Building nspecto
Rev. 1/81
l08M N0. f
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)
Permission is hereby grant to:
~u~~
.~~.........~G....3....~~.:...rf...
to .......1 ...............2~.. A :A~kiq.r,E',~L.lf~..~X.l.
of premises l~~oc//oted at ..G~~~~~......~.~.....
.........~.r.... G~22R~
~~jj..
County Tox Map No. 1000 Section ~.t!..a5,,...... Block .......d Lot No....?...,Cl..........
pursuant to application doted . ...........I..y........, 19..l..~, and approved by tt,e
Building Inspector.
Fee 5....~Y(..
l.~rf!'.~',r~.
Building Inspector
Rev. 6/30/80
TOWN OF SOUTIIOLD
• BUILDING DEPARTPIENT
TOWN HALL ~ 7 j~;;;e;
c ,
SOUTHOLD, NEW YORK 11971 a{.~'~;,p
765 - 1802 ~ ?sr t
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE : z.Z.. ~ .
NEW CONSTRUCTION ..X....OLD OR PRE-E%ISTING BUILDING.../...VAC/ANT LAND........
Location of Property.....p~.~ (~{?~IS~~F!? ~~/`L.'_. ~~`/~/1S' 1S~/g~v/a
HOUSE N0. STREET RAREFY -
Owner or Owners of Property... o Sp V~tiO~CJ
County Tax Map No. ]000 Section .c7l~. Block Lot ..Ig....
Subdivision Filed Mpap ........Lot......./.
Permit No.~.(~.(.9~'..Date of Permit ~~J.~..Applicant~s~~'~'~:;`:bG'~;~".G~s~'~f~~
~5 d Gj ' Qi~~
Health Dept. Approval .f€5(i^.~.cl:.l~':~~(Underwriters Approval./€•.5.........
Planning Board Approval's///~?~
Request for Temporary~Certificate Final C~/e~rti~fica~tjJe
Fee Submitted: $...J.Y...~........... ~~""'~~~~1~=---
APPLICANTi~t":"::::~A~~"'~
rev. 10/14/88
cot ao$g1 ,.,.::..;>,~;~:iRf~~
TEL. 765-1802
~oSVFFUL!(CpG TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
o z P.O. BOX 728
yc TOWN HALL `,~~`y`('`
~0~0~ ~ SOUTHOLD,N.Y.11971 s,~,
~l ~ (i .
C E R T I F I C A T I O N
Date ~
Buildin~~g--°° Permit No.1~~?1~/
Owner i3~( ~.2,~ ~-5'~i,1,/ d/°~% //S~~ r~~~_
(p/le~agse print)
Plumber ~/e/~ ~ %l/..q~/i _
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
~~G2~~~/
(plumber's signature)
Sworn to before me this
~3 f''~'day of ~~.52-ice \ ~ W n,(
Notary Public
Notary Public, v County ,
tj'~jSCN O. YM/\11.
QMfsy PabRt, Stau of Nwa ~
No. 52-9509165
Qualified is Sulfolk CoaNY
aura Ltvsax iior ID, 14~
V-
~ _ T _ _ .
THE NEW YORK BOARD OF FIRE UNDERWRITERS aria<»°;
i'~'`Srlr~~' BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10036.
- I~Taid15?L,RY 61"i,!992 1~%fl23Rg~./[)! h1 ,7,~9t1'I;1
' Date Applica[ion No. on file
THIS CERTIFIES THAT
only the electrical equipment ae described below and introduced 6y the app(icont Homed on the above opplicotion number in the premises of
,•"tS?iT+tkS i3ilAl~f) 4ti1R8A(~f:, PV2TV?1`Pr, ttf)„ F'~~¢l'r.',ftS 'Eai,1llV17, C:1.Y.
in thefollotvinq Creation' ? Ba. ement ? Lct Fl. ? 2nd FT. f117 ~ Section Block Lot
wos examined ort and found to 6e in cmuplianre with the requirements q(this Board.
FI%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS D{SH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FIUORESCENi OTHEfl AMi K W~, AMi N.W AMi. KW qMi K W AMi H.P
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ggLL UNIT HEATERS MULTI.OUTLET DIMMERS
L SYSTEMS
AMT K. W. OIL H. P. GAS H P AMT NO A. W G. PMi AMP. AMi AMPS. TRANS. AM7 H P NO. Of FEET AMi. WA[LS
SERVICE DISCONNECT NO.OF S E R V 1 C E
'F AMi AMP, TYPE MET£R I ~ 4W I,a 3W 3.0' RW 3 $ dW NO. OF CC COND A W. G. NO. Of HI-LEG A. W NO. Of NEUTRALS A. W G'
EQUIP, PER B Of CG COND Of HbiEG OF NEUTRAL
. 1 Ctt) l:R 1 X i t~ ~ i
OTHER APPARATUS:
'rk,MP.SN~RV.r'oit Iit,7)i:,~'UttP,Ctl`at;~`°'a
t) l~eC..l;-1
WAI,Sff S:ERVT.fi@; {',(.t'.'~~1~-~~'
>fivm~r~ux avH,.
FTSRFAS 7~JItlN11; IVi', t1FS~"d t1 ~ 6ENERAI MANAGER
?1 /
Per
j 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.
Eli COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE; UNDERWRITERS `~`i{;a: '
.',}ail BUREAU OF ELEGTRICITY
44 ~~r{, y tt 1 85 JOHN STREET. NEW YORK, NYE?WRp YORK/10038 ~ n1
~ ~ Ji9ltli~llY 1111. 1~1~ IGI IPl;"1 ~i.1+ II IV fni~l{ill
Date Application No. on file
THfS CERTIFIES THAT
only the electrical equipment os d¢acribed 6eloty acrd introduced by the applicant named on the above opptfcation number in the premises of
i'i;AS:fiS '[SI,f1'niCt (;APC~t~GF, fN-fYf~'S'f; ii)., 1~3~SH]=`.RS Y-~I,htVf), N.P.
n G/d1T
in thefollouing loentfoni, Bpsgme t ~ Lst FL ? 2ad F'l. Section Blork Lot
11 x!C M:1$!3 F;,Y ; , , l ~ } t.
uas examined on artd found to 6e in cmnpliance with the requirentenro of [his Boord.
- FI%TURE ECEPTACLES SWITCHES F{XTURE$ RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT RUORESCENT OTHER AMi K W. AMi. K.W AMi. KW AMi K.W pMi. M P.
H +t 4 > 7 <i
DRYERS FURNACE MOTORS PUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTIAUTLET DIMMERS
AMi. K. W. Dll H. P GAS H. P N.1i NO. A W G AMi AMP PMT. AMPS. TRANS. AMi H p SYSTEMS AMi. WAliS
j ~ NO.Of FEET
` SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND A. W G. A, w G. A. W G.
AMi. AMP TYPE EQUIP. I%~ I'P 3W 3$JW 3,e4W PERa OF CC.COND NO. OF HbLFG OF RI-LEG NO. OF NEU1RAl5 OF NEUTRAL
t bi)t; ("4} ~ k f X10 { 1fi;
OTHER APPARA7U5:
3
_ ~k;Y.bRt2S° i ~ E's CtAtiP:i•Yi:AP'C 9't7 R'11;9i?~,i~N4"}'
7
Gig17Rr: atf?!`x;l"fC1R,..,1
*(:tt'Yr N,: 'Pit i:, 'i s rl jla't. 'r i a7 , C'+rl i' a
L`OIp (4ii_f{-+ t't~p"f; T;ll r~H 4. L~.
W7t[~SF! ;tGFV'I:Cf; f,:tC . {{it:;ti-F;
` inOYu'Tili)R AB1R L/~~~~~
p~'iHb;RS 'f ,Rll.~l'd'f), MY, O6 `f'J fJ GENERAL•MANAOER
.S
Per
This certificate must not be altered in any manner; refurn to the office of the Board if incorrect. Inspectors may be identified by Their credentials.
,f COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATEMUST NOT BE ALTERED IN ANY MANNER.
" ~v:wMENTC ~ ~
t . ~ m'`~
?OUJJDATIO`! (1st) `j~
V
?OUIJDATIO;J (2nd) _
0
.'.OUGH FRAhfE &
~PLUMSING
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I;JSULATIOPI PER N. Y. ~ ~
STATE EPIERCY
CODE
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New York State Department of Environmental Conservation _
Building 40-SUNY, Stony Brook, New York 11790-2356
(516) 751-7900 Ext. 251 ~f~~~~~~_~~'~~_~'~j~~~`~~`-s.`~
Fax - ( 516 ) 751-3839 p(~
~`;'z~ JUN f 7 f93!
z
}',ta Thomas C. Jorling
, Commissioner
3une 12, 1991
Curtis Horton - Building Inspector
Southold Town Hall
Southold Building Department
53095 Main Road
Southold, NY 11971
Re: Fisher's Island Garbage District Transfer
Station
Dear Mr. Horton:
I have conducted a field inspection of the above
project on May 20, 1991. The proposed project site is
beyond the jurisdiction of Part 661 Tidal Wetland Land
Use Regulations.
Very truly yours,
Cam. ~-~.,.;Q~.
Charles T. Hamilton
Regional Manager - Region T
Marine Habitat Protection
CTH:kW
,
BOARD OF HEA'Y.TIi ~y, . , ,
FORMN0.1 3 SETS OF PL.lYS ..,Y,,,,,,,
TOWN OF SOUTHOLD SURVEY . .
BUILDING DEPARTMENT c11ECJ: . .
TOWN HALL SEPTIC FORr1 .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:oTIFY;
Examined :f 19~f..~ CALL .
p~ ~/q r1AIL TO:
APProve~/~iGr~y~Q....~C/..,19%`PermitNo..~.•1..~.%• / Z ~
Disapproved a/c
(Building Inspcctor)
APPLICATION FOR.BUILDING t'FFiJ4ii'I'
Date 19 ~f
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
rr 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
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
wilding 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.
'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and re lotions, and to
dmit authorized inspectors on premises and in building for necessary i~~^^pectio
~ss.))
(Signature of applicant, or name, if a corporation)
6`~s~(V~~sl~~,n~H~d~~ ~d.~>~~sr., as~irrc?-
rdl~>sis l ~Gs+ .C1~4~/,1(Mailing address of applicant)
Mate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. ........6cunl~,~2
Jame of owner of premises ~,~~.~.`,z',~:~.~Sl~4k/D..~~,4i?K/~~L,,f¢r(~Jl/C~FUS~,.U/,5~/c'7 q~D~~
~SSS ,Ci9triL! h.'..~ /''~'(rGL:1 /~lJY/ZlG7~ (as on the tai "roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
..%~aGulttrc d „ ~¢A/G',fic~...('Gll~,~{2~/,~a../J
(Name and title of corporate officer)
Builder's License No. ~ ~ ~,/./,l~ , , , , , ,
Plumber's License No. ,
Electrician's License No. N
Other Trade's License No. .
Location of land on which proposed work will be.done. Tti s!r£ ! 5 tW f (-ti' ~79ce~,i~ Sod~~im~D
Cov,.,-r;
;i.,o~'„S~,F~aLdc,~-fix, yysrav, l,oQo,3~~tiq.v,oi2 ~l,~clf,l, DoT.,/~..........
House Number Street Hamlet
County Tax Map No. 1000 Section a.l.r~ I31ock I.. , Lot .
Subdivision F;iled'iYiap'No.~ Lot .
(Name)
State existing use and occupancy of premises and intended use anc,~ occupan~y,of prpposed.construction:
a. Existing use and occupancy /.(e:~0, , , ,
b. Intended use and occupancy .~~57~~(gitJ.~~~~-197~Y:~,~/~F{~(J~.- ~ ~`~q7"`«!(J':
`A, w'~ . .
','.6z . r_xy, ~ 4`.., .,,:.:i^f k zLnu. «a$-d, ~ ~ . ~ "+L. "rJ:ttC.•v?/ ~fra'a~~`.ht~.'.e3L.x:.ea^..umwiK: ~ SNm"~°"`~o:
i
r
3. Aapure of work (check which a plicable): New Building Addition { Alteration
Re au•`......
. Remo pp
• • • • • • • pval ~ Dem lition Other Work .
LGYvsT"•~iraoe3t'ks°,~ ~aa/d ~sc&le~i~uC~ ~so~u,a~, (Description)
4. Estimated Cost l."m,Q.•.4'fJ.4.•.O.d Fee .
g g g ~ (to be paid on filing this application)
5. If dwellin number of dwelling u
'nits Number of dwelling units on each floor .
If araenumberofcars ,
6. If business, commercial or mixed•,occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures if any: Front Rear , • , . , . , Dc th .
Height . . . . . • Number of Stories . • ~ • ~ • • p ' ' '
Dimensions of same structure wit~r alterations or additions: Front ,
Depth........... Rear
• • • • • • ....j. Height Number of Stories .
8. Dimensions of entire new constru'iction: Front ~ • • • ~ • ~ • • • ~ • •
Rear . ,Depth
Height Number of Stories , .
9. Size of lot: Front Rear .......Depth .
10. Date of Purchase
••••I'•••••............NameofFonnerOwner
1 1, ,7,nne, or use district in :vhich prcmises are situated k°..y00.. .
12. Does proposed construction violate any zoning law, ordinance or regulation: . s//..q . . . .
]3. Will lot be regraded ...~~'S. I• • , , , , , , , , , , , , , , , ,Will excess fill be removed from premises: Yes No
14. Name of Owner ofpremises .~y.~,~, p~~,¢~; ,Address . , ~ is
Name of ArchitectG'hKN.PI~'k. ~~/Ft,PlK ~ iN, , • • • • • • • Phone No.~r.. 7.~h.'7.~~s: ~ .
O k fir:. Address.f~o/?,LBrq , .~;q-; _ , ,phone No.'24~ ~$`~t.•~3`j7
Name of Contractor Ct! , , , , , , • • , .Address Phone No...... .
15. Is this
* property within 30,0 feet of a tidal wetland? eyes,,,,,,,, No..-K-.
If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. ~
~~f'.G.eS~ Sz^F, ~17-f'c~r.l~t.f~~ if/0..~
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'TATE OF NE1+~-Y~I2 ~1[ S.S I
'OttUffNTY OF .
f'fot~,-~D ~h•~!-i~ Gc~e~S • • g•I'• • • • • • • • • being duly sworn, deposes and says that he is the applicant
Name of individual si nin Contract)
hove named. nn ~'n/~ 11~• /
C..l~V`"f~G 9~~'~".e, cJ 1'r`l '~-~-I~ a r IYR ~...rr L..... ~ ~ dG-~ ~s c,$c a
'e is the i sh R7 s atio ~A -t- l F ~'r 5'7'/LI e T
(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
plication; that all statemenfs contained in this application are true to the best of his knowledge and belief; and that the
ork will be performed in the manner setforth in the application-filed therewith.
Horn to before me this
3 ~.1 ........d~ay~of . ;x,19
otary Pub~G~ G~.~~'~'d~.a.e~-;.~'i~'~ tau Fi~t.Y~., C un
• o ty
(Signature of appUcant)
J ~ fN k~
z. . ~ _r ..,a~~., , ~~,:rt~bv`,r.~c,,„r.t.,.... . , « a } ~ I . ,,...~:we.,.~.o.~z&~.kuaax'~a'~su:f:~[~tY~.'~~-" e