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Home My WebLink About19198-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20879 Date JULY 21, 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 6 Block 5 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18~ 1990 pursuant to which Building Permit No. 19198-Z dated JULY 17, 1990 was issued, and conforms to all of the requirements of the applicable prouisions of the law. The occupancy for which this certificate is issued is ADDITION TO REAR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RICHARD BI{EINING (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-1B2~B1 - APRIL Bt 1991 PLUMBERS CERTIFICATION DATED JUNE 23~ 1992 - MARIO ZANGHETTI~ JR. Building In'specter Rev. I/Bi lvO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHO~.D, N. Y. BU~£DING PEg.~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Perm'ss'on's herein/granted to: ~ :~..~ .................. ..~.....~~..~-.~ ~.., ~..~,._..~. . ......... raises I ate '. ................ at pre ac dar ............... .......~,~.....~ .... _ ..-....~y~ ............................................................. ............................................. ~...~'__/'~//"- (~" ~( ............ ~_..,,..._ ............... ., ................................................... County Tax Mop No. I000 Section ..................... Block .................... Lot No .......... ~ ......... pursuant to application dated ...... .~ .......... /....~....., Jg..~.~...~., and approved by the Building Inspector. Rev. 6~30/80 FOI~M NO. S TO~ O~$O~THOLD Building Depo~tment Town Clerks Office Southold, N. ¥, 11971, APPLICATION FoR CERTIFICATE OF .OCCUPANCY Instructions ' ,,,,,,.day of~,, ...................................... . . ~ (st~rnp or seal) NotQ~ PUblic r ~ Nili~'Publi~ StGte of ~eW Yor~ ' '" . ~ , ' ~ Ouallfieain $:u/fotKCounty 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 and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board'of Fire.Underwriters. ' ' 4..Commercial buildings, Industrial buildings, Multiple Residences and'similar buildings and installations, a certificate of Code compliance from the Arqhitect or Engineer responsible for the building. '5. Submit Planning Board approval of completed isite pian requirements where applicable. B.For existing buildings (prior to April 1957), Non-conforming .uses, or buildings and "pre-eXlst[ng' land uses:' 1, Accurate survey of property showing all property lines,, streets, buildings and ;unusual "natural or topographic features. 2. Sworn statement of owner or previous owner as to use, o~cupancy and condition of buildings~ 3. Date of any housing code or safety inspectiol~ 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.ex~st'ng dwelling pr lahd use $5.00 3. Copy of certificate of occupancy $1.00 N W Additi~ ' g B ildi~ V e Building ................ on ................ Old or Pre-exishn u ng,... .......... ~ Ocanf Land ........... r,,i;Health Depf, ApprovoI .......... , ................................. Labor Dept. Approval r ' Approval ,.?..~..~,.~,J ............................. Planning ~o~rd Approval Zl Request For Temporary Certificate ........................................ Final Certificate ................ , .......... described budding an, d_.,perm~t meets all opl~hcabl,e codes end regulahons, ' ,;' : ,Cons'trut:tlon on above . . . r. · · TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECFOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~_ Owner ~,~ ~ ~ (please print) Plumber/77~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Swor~to befg~-e~me this Notary Public ,~J~- /'U'Apl~er s~signature) C unt-'o y: ~-" : ~illrY i~ub~ic Sm~e of New ~'~a ' No, 4806SSg Term Exptrel ~3~/~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ] OOC),~,!~ BUR~-AU OF ELECTRICITY ~- BS JOHN STREET, NEW YORK. NEW YORK 10035 THIS CERTIFIES THAT only the electrical equipment ~ ~sc~ibed be~w and introduced by t~ applicant ~m~d on the obove application number iR the prorates of in the following locatlon~ ~ Basemeng ~ Ist FI. ~ 2nd 37, OIIT .~ectlon Bilk Lot n, asexaminedon ~P}~'[ [~ 0~ e ].~9~ at~ou~tdto~elnco,npfinnceu, lth~herequlrements~fthlsBoard. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWIICHES FLUORESCENT OTHER DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME C~.OCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEEl SERVICE DISCONNECT R V ! C OTHER APPARATUS: S E NO OF Hi-LEG AWG OF HI,LEG NO OF NEUTRALS A,W G OF NEUTRAL 06 GENERAL MANAGER V This certificate must not be o)tered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT~ BE ALTERED IN ANY MANNER. FOUNDATION FOUNDATION ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE (lst) (2nd) FINAL ADDITIONA'L COMMENTS: F'EI£ ToWN OF SOU~'tOLD __ :,\N '-'OP;K 063,'.~0 516. 788-700! @ ? F'03 FORM NO· 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapprovec'l a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ................. NOTIFY CALL ..................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ~ ~.~' . a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered by th/s 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 shall 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 aoy purpose whatever until a Certificate of Occupancy shall 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 Building 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed inspectors on premises and in building for necessary inspections. (Signature o£ applicant, or r~me, ifa coi'l~o'r~:ic~n) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........................................... ~as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name a~itle of corporate offi~r) Plumber's License No ................... Other Trade's License No c~o~' ~ I. Location of land on which proposed work will be done ...... ttouse Number Street, Hamlet County TaxMapNo. 1000Scction ....... ~ ...... : Block ...~... ......... Lot...~. ............. Subdivision ..................................... Eiled Map No. ~. : .......... Lot (N e) .............. ~. State existing usc and occupancy of premises and intended t~se and occu0ancy of proposed construction: a. Existing use and occupancy ....... b. Intended use and occupancy ..... [3. Nature of work (check whichI applicable): New'Building ' Repair R~moval ........ Addition .......... Alteration ......... ............................ Demolition Other Work 14 Estimate'd Cost ese on , · ..... Fee ... i5 If d (to be paid on filing this application · welling, number of dwelliog units ..... N · ) [ If g .......... umber of dwelling units on each floor ....... ~ araee, number of cars .. ,,:,; .,:'. ................. .., .... usiness, commercial or'm occupancy, spccily nature and extent of each e of use .. ' ........ i7. Dimensions of existing structures, if any: FrOnt ....... typ .................. He ,,t~t. : ........ Rear .............. Depth = · .,,,~.~,.{ .... : ....Number of Stories... · ............... · ' " .......... : ..................... D:mens:ons e s ruCture iwlth alterations or a Front ~ i ........ ~' ' ' Depth ................ , tl ight ............. Rear $ D' ' . , .. e ....... N .............. f ~y ~tru F .............. umber of Stories ....... · lmenslonso entire ne con ct on rent ..... " · ......... H igl '' ".md cst pth ''' .. , ,~,,~,.~, ~ .............. Rear ............ De e it .... "..' ...... mber o ories ........... ; ................. 9 Si fl F .... ' zee et: rent ......... i ' ' R .......... ' ............ 10 fp .......... ear ........... ......... pth ...... Dateo urchase .. .. · De .............. ...... ? ................. ame of Former Owner ............................ 11. Zone or use district in which .ptremises are situated ...................................... I ~. Does proposed construction violate any zoning law, ordinance or re ulat~ 13 Will lot be reeraded ' g 'on: ....... ' ....... i"~''' 4 ' ~ .......... .... Will excess fill be removed from premises: ........... I . Name of Owner of premises ., .............. Address Yes No [ Name of Architect ~ ................... Phone No. I N ......... i ................ Address ......... ontractor ........ ~ .................. Address ... i~ amc of C ...................... Phone No ................ .Is this property loc ..... ated within~O0 feet of.if a ti wetland? *YES... " ' '' i yes, Southold Toon Trustees Permit may be required .... ] PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed and in pr~operty lines. Give street and block number or descri,,tio ...... -,..-,,. , ~ ' . i dicate all set-back dimensions from inierior or corner lot. ~- - -~,au,,o to ueea, ann snow street names and indicate whether STATE OF NE%~O2-K, . COUNTY O~....)-~t ~-/,-OklZ--, ~.~ ~ (Name of~dividual signit'~g contract) ...... being duly sworn, deposes ~d says that he is tile applicant abo~e named· lie i~ the ~ ' corporat; o~fi~e; elc) (Contractor agent .......................... )f s~id owner or owners, ~d is dulyiaut mrized to pe.rform or have performed the said work and to m~e and file this ~Ppli~cation; that ail statements conta'ped in this application are true to the best of his knowledge and belief; and that the yor~ w~l be perfo~ed in the m~ner ~et forth n the application fi ed th few' ,worn to befor~e this ~ , e ~th. · .... ......... ;Ota~ Pub ... ~ ' ~ ...... County Nol~q Pu~llo Slate of New Yo~k ...... . ? .... ~UIII~ii 1~ SutfolR County ] ~ (S:gnature of applic~t)