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Home My WebLink About18773-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21082 Date OCTOBER 14~ 1992 THIS CERTIFIES that the building. Location of Property PRIVATE RD. House No. County Tax Map No. 1000 Section subdivision ADDITION (THE PARK) FISHERS ISLAND~ N.Y. Street Hamlet 3 Block 5 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26z 1990 pursuant to which Building Permit No. 18773-Z dated FEBRUARY 5~ 1990 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to PETER COOK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-158427 - OCTOBER 3i~ I990 OCTOBER 13~ 1992-F.I. PLUMBING & HEATING Building inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLDo N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 18773 Z Permission is hereby granted to: ..¢..=...~~...~.~.., ~..~.~.-~,~-, ...................... ............................. .~....~.....~/.....~..,.....~..~. ............................... pursuant to application dated p ............. o~.~. ................. 19,..~.~, and approved by the Building Inspector. Building In.~ector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPART~XENT TOWN EALL SOUT~OLD, NEW ¥0[[K 765 -- 1802 11971 " APPLICATION FOR NEW CONSTRUCTION ....... OLD OR PRE-EXISTINC CERTIFICATE OF OCCUPANCY BUILDINa ...... VACANT LAND RaquesE for Temporary CucciflcaCe ....... Final Car~ificaEe re,.,. 10/14/88 TO~FN OP SOUTIIOLD BIJILD~N~ DEPARTI~ENT TOh~l I1ALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: i. 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). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less' than 2/10 of lZ lead. 5. Commercial buildings, industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect 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: l. Accurate survey of property showing all property lines, streets, buildings amd unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by n title company which shall show single and separate owaersbip of the entire lot prior to April 9, 1957. · If a Certificate of Occupancy 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 required to prepare a certificate. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of ,the entire l~t prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in ~riting to the applicant. FEES: !. CERTIFICATE OF OCCUPANCY -- New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition 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 - $I0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy --$15.00 Res{dential Commercial I0/14/88 .=OUNDATIO:~ (1st) FOUNDATIO:~ (2nd) ~OUGH FRAME & .?LUMBING 3. iNSULATION PER N. STATE ENERGY CODE FI;;AL ADDITION~'L COMMEI;TS: TOWN OF SOUTIqOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION [please print) [please prln~) I certify that the solder used in the water supply system contains less than 2/1~0 of 1% lead. .~ (plumber's signature) Sworn to before me this da , of ,. ~ County · EILEEN G. WALL t,iOTA~ PUBLIO, N;gEWJ1085RK ~T*TE NO. 01WA9~ QUALIFIED IN SUFFOLK COUNTY~ TERM EXPIRE~ OCTOBER 31, 19~ ~ Notary Public BOARD OF [~EALTg ...... 3 SETSv~O~F PLANS . TOW~ OF SOUTHOLD CHECK TOWN HALL SOUTHOLD, N.Y, 11971 CA~ TEL.: 765-1802 Examined ...... Disapprovcdu[c .......................... . .. . .. ..... (Building Inspector) APPLICATION FOF~ BUILDING PERMIT INSTRUCTIONS a. TbJs application must be completely filled in by typewriter erin ink and submitted to the Building I~'spect~r, with sets of plans, accurate plot plan to scale. Fee according to schedule. - cb. Plot plan showing location of lot and of buildings on premises, rdationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th/s app cation. , ~. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e. No buildin$ shall be occupied or used in whol~ or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Dep~rtment for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southoid. Suffolk County, New York. and other applicable Laws, Ordinances c Regt/lations. for the construction of buildings, additions or alterations, or for removal, or demolition, as hereL~ describe, Th,' applicant a~rees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and (Si=nature~f applicant, ~,r name, if a corporation). (biaiiin~ address of applicant) ~7~/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (as on the tax roll or latest deed) e~.~. (plicant is a corporatior~ signature of duly authorized officer. (Name ~thd title of corporate officer) ' ALL CO;~TRACTOR'S MU.~T IlK SUFFOL~ COUNTY LICENSED Electrician's License No..~. t~..~. ............ 1. Location of land on which proposed work will be done · · . .. fi;use Num ;e/ ..................................... ' Street Hamlet Subdivis}on Filed Map No · Lot ~. (Name) 2.State eXmm,*. ' ' = use and occupancy of premises and intended usc and occupancy of proposed construction: / b. ntended useand occupanc .................................. . .. . 3. Nature of work (check which applicable): New Building .... ' .... Addition ....,,..--~4' Adteration ..~. .. . Rep ai~' Remove! Demolition Other Work (Description E dC ~ F ...., ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number otdwelling units on each floor ........ ~ .... If garage, number of c~ ........................................... 6. If bus~ne~s, commercial or mixed occupancy, specify nature and extent of each iy~e of use .. D~ensions of same structure with alterations or additions: Front ... [~ .......... Rear . .~ ...... 8. D~ensions of eqtire new construction: Front ... ~ .... , ..... Rear ... d ~ ........ Depth ~ ........ Height .... [.~. ....... Number of Stories ..... g ................................................ ~. si= ot~o~: ~o,t ... ~z~ ............. ~= .... d~Z .............. v~pt~ .~.~.~ ......... 0. ~=~ otr~h~ .... ~ ........................ ~ or ro~Own~ ~ ~~. 1. Zone or use district ~n which premises are s~tuated.. ~~ ................................. 2. Does proposed construction violate any zonh~g law. ordinance or regulation: . .~.' 3. W~I lot be regraded . · ~: ....... Will exc~.hll b~ removed from premises:. ~ N 4. ~ ~Ow~= o~.~=~,~ ~ ~ ~ ~ ~ ~ ~ . Aaa~ ~~d.~. w,o~ ~ :zee :.~/.7~. N~e of Architect ....... ~ .................... Kddreas ................. Phone No N~ e of Contractor ~3~,.~~~. _~.. Address Z~.~Z ~. Phone N~7~: 5. %s chi~ property l~caced within 300 f2et of a rids% w~tland? *Yes ..... No ~..:~ · If yes, Southold To~ Trustees Pe~it may be required. " PLOT DIAG~M Locate cle~Iy ~d distinctly ~1 bulldogs, whether existing or proposed, and, indicate ~1 set-back d~ensions fron rope~y ~nes. G~ve street ~d bloc~ number or description aeeor~g m deed, ~fl show s~reet n~es and indicate wheth~ actor or comer lot. (Same o~individual si=nin~ contract) ~aid owner or owners, ~d is duly authorized to perfo~ or have peffo~ed the said work and to m~e and file ~ ~lication: that all statements ~ontained ~ this application are true to the best othis knowledg~ and belief; and that th~ ~rk will be perfo~ed in the m~ner set forth in the apglication filed therewith. 'om to before me this ...................... ~ay of .............. ~ ...... · o County .-~ (Signature of applicantl