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Home My WebLink About19722-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19994 Date JUNE 17~ 199% THIS CERTIFIES that the building. Location of Property FOX LANE House No. County Tax Map No. 1000 Section 12 Block 1 Subdivision Filed Map No. ALTERATION FISHERS ISLAND~ N.Y. Street Hamlet Lot Lot No. 5.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 29~ 1991 pursuant to which Building Permit No. 19722-Z dated MARCH 19~ 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 ALTERATION ON BATHROOM & LAUNDRY ROOM ON EXISTING BUILDING The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED FISHERS ISLAND DEVELOPMENT CORP. PENDING - 6/12/91 N/a Building ~n~pector Rev. 1/81 It'OR,H ~0. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tax Map No. 1000 Section pursuant to application dated ....... ~ ............ .'.~....~'........., !9.~...~/, and approved by the Building Inspector. Building In.~ector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - ]802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE - .~£ 1.~.~.. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BNILDING.~...VACANT LAND Loeatlo~ of Property ............ ~ ~Z-./~.~C ~.~. HOUSE NO. STREET HAMLET Owner or Owners of Property.. ~ ~r~. ~. 1~.~ .~l~~.Ccrf.,.. Cou~ ~= u~ ~o. ~0o0 Se~io~ .~J.~ ~o~ -.Z... ~o~' .9~./. .... Subdivision ....................... Filed Map ........ Loc .......... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate .. Fe~ Submitted: $...-i-~,OO .......... · .. Final Certificate APPLICANT. ~?. .~~ .... rev. 10/14/88 FOR~ NO. 6 TOWN OF SOU~OLD BUILDING DEPART~NT TO~ f[ALL 765- 1802 APPLICATION FO~ CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be ifiled in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: J. Final survey of property with accurate location of all buildings, property lines, streets, and unusual n~tural er topographic features. 2. Final approval of Heal'th Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electricali installation from Board of Fire Underwriters. 4. Sworn statement from p~umber certifying that solder used in system contains less than 2/10 of I% lead. 5. Commercial buildings, Lndustrial buildings, multiple residences and similar.' buildings amd installa:ions, a certificate of code compliance from the Architect or Engineer responsibl, for the building. 6. Submit Planning Board '~pproval of completed site plan requirements. For existing buildings (P~'ior to April 9, 19570 non-conforming uses, or buildings amd "pre-existing" land u:es: 1. Accurate survey of pro:,erty showing all property lines, streets, buildings aud unusual natural or topographic features. 2. A properly completed a~plication, a consent to inspect signed hy the applicant and a certified abstract of title issued by a title company which shall show single and separate OWnership of the entire lot prior to April 9, 1957. · If a Certificate of Ocdupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information ~equired to prepare a certificate. For Vacant Laud'Certificate of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstradt of title issued by a title company showing single aud separate ownership of (he entire 10t prior to April 9, ]957 shall also accompany the application. If a[Certificate of Occupancy is denied, the Building Inspector shall state the reason~ therefor in writing to the applicant. FEES: ]. CERTIFICATE OF UCC ANC¥ - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addltlon to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of OccUpancy on pre-existing dwelling - $100.00. 3. Copy of Certificate; of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate! of Occupancy - $50.00 6. Temporary Certifies:re of Occupancy - $25.00 Residential $50.00 Commercial 10/14/88 ?OU~;DATIO:! (1st) FOUr, DA T I0:4 ( 2nd ) COMME~;TS: ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI~;AL ADDITIO};A'L DEPARTMENT OF HEALTH SERVICES COUNTY OF SUFFOLK PATRICK G, HALPIN SUFFOLK COUNTY EXECUTIVE DAVID HARRIS, M.D,. NLP,H. February 2, 1990 Mr. Kurt Wiersch Box 628 Fisher's Island, New York 06390 To Whom It May Concern: This office has no objection to the installation of two single or double-load laundry washing machines at a commercial building located at Fox and Crescent Avenue, Fisher's Island, New York. It is our understanding that the effluent from the machines will be discharged to an existing subsurface disposal system. GJW:JHN ,' TOWN OF SOUTtIOLD Examined ................. 19... ^pp,oved . . . l lg lPe ,t .1. FORM NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CIIECK ...................... SEPTIC FORM ................ CALL ..................... MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Iimp~t~xr, with sets a£ prams, ac.~'urate plot pla~} to sc:>te. Fee according to schedule. b. Plot pl~ showing location of lot and of build~gs on premises, relationship to adjoining premises or pubic street~ or areas, and given a det~led description of layout of property must be drawn on the diagram which is pan of t~s app~- ca~on. c. The work covered by t~s application may not be commenced before issuance of BuQding Pc~it. d. Upon approval of this application, the Building Inspector will issued a Buildimg Pe~it to the appHc~t. Such pe~it shall be kept on the premises available for ~spccfion throu~out the work. e. No build~g shall bc occupied or used in whole or in part for agy purpose whatever until a Ce~iflcate of Occup~cy shall have been granted by ~e Bulldog Inspector. APPLICATION IS HEREBY MADE to the Build~g Depmmcnt f~r the iss~ncc of a B~lding Pc~it pumu;nt to th~ Building Zone Ordinance of ~ To~ of Southold, Suffolk County, New York, ~d other applicable Mws, Ord~ces or Regulations, for the eonst~ction of buQd~gs, additions or alterations, or for removal or demolition, as hcre~ described. The applicant agrees to comply with all applicable laws, ordinances, burden code, house; code, and regulations, and to admit authorized ~specto~ on premises and ~ bulldog for neccssa~~~ .- ' . '-'="-~-' ~--[-~ .... . .' . ~,t ~[ailing address of appHc~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .............. (asont e xr t e ) If applicant is a corporation, signature of duly authorized officer. .............................. ;fflcer) (Name and title of corporate Builder's License No. .................. Plumber's License No ............. ....~ Electncmn s Ltcense No ....................... Other Trade's License No 1. Location of land on which proposed work will be done; tlouse Number Street Hamlet / ount Ta. ,'lap 1000 S ct,nn lock Lot L Subdivision ..................................... Eilcd Map No ............... Lot ............... (Name) ~ Slate exist' o · of rem ses and intended use and occupanc o d on t uction -' · ln~ use and occupancy P yofprop se c s r . ,. ..... ....................... ~. ~,~d,d ~ ~d o,~y...]aan~r~... ~... ~...~Em~ ............... [ W: 3. Nature of work (c~.~k which =ppH~Ic): N~w u 1~ ., ....... A~iti~n .... · t~ n ~ ~ ;aid on filing this a~lication~ 5 Ifdwelling numberofdwellingun'ts Nomber of dwelling units on each floor If garaee hum her of cars 6. If business, commercial or mixedioccupancy, specify nature and extent of each type of uso .................... . 8. Dimensions of entir~ new construction Front ............... Rear ............... Depth ............. 10. Date of Purchase ........... ~ ................. Name of Foyer Ow?~ ........................... Zone or use dmtnct m whtch premmes are sttuated .... :. ~ e~.~.C¢.~.~ / ..... ./ .............. [[[[..~.. · 12. Does proposed construction vio~ any zoning law, ordinanc~ or regulation: ..... ~ ............... 13. wm ~ot be regraded ........ ~.O ............ ~.. ~. Will excess fill be removed from pr~mis~~-2 · ~N~ N~ of Architect .......... [ ................. Address ................... Phone No. ~.; ;~ ..... N~e of Contractor ......... [ ........ ~ ........ Addr~ ................... Phone No .......... ~ .... · If yes, Southold Tow~ Trustees Permit may be required. PLOT DIAG~M buHd~gs, whether existing or proposed, ~d. indicat~ ~l set-ba~k d~nsions from tumber or description accord~g to d~d, ~d show stre~ n~s and ~dicat~ Locate clearly and distinctly all l property lines. Give street and block interior or comer lot. 51o 1c I /o'/- .U STATE OF NEW YORK, S.S COUNTY OF ...S.u..f.fg!-k. ....... Gregory C. Thibodean .............................................. being drily s~vorn, deposes and says that he is the applicant (Name of individual s~gnmg contract) above named. IJre is the lessee i ' ' I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dt~ly authorized to pe,rform or have performed the said work and to make and file this application; that all statements conlained, ~ in this application are true to the best of his knowledge and belief; and that the work will be perforated in the mannler set forth in the application filed therewith. Sworn to before me this j 4th d df February 19 91 Notary Pubhc ....... /./c?..~ .....,~ ............ County O MARY B. PAN~IOZ ' ~0. 52-820~a0 - sllFflla I~ON~ · o o iNSERT PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WAFER SUPPLY SYSTEM cANNOT EXCEED 2/10 of 1% LEAD. If copper tubing is used for water distributing system; piping shall be . of types K or L only. UNDERWRITERS CERTIFICATE REQUIRED