The URL can be used to link to this page

Home My WebLink About18874-z ,r FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19978 Date JUNE 13, 1991 THIS CERTIFIES that the building ADDITION Location o£ Property PENINSULA ROAD FISHERS ISLAND N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 10 Block 3 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 1990 pursuant to which Building Permit No. 28874-Z dated MARCH 15, 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 DORMER ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ROBERT K. WHITE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-182379 - APRIL 8 1991 PLUMBERS CERTIFICATION DATED JUNE 7, 1991 - MARIO ZANGHETTI Buildi~ ctor Rev. 1/81 rosx xa s 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) x.8874 p~~ / q N ° Z Date ....1..!L.~!ll .............~E....~.........., 19.,1...1' Permission is hereby granted to: ~d~ to ..............P.1.........l1 ..~~.......a.~........................ . ........a..r..~ OJ~/~ at premises I at ........~,l~Ld..... .................................................~.,~,/....~,1~.y.....0....~....~..~~................................ County Tax Map No. 1000 Section .........~Q....... Block ......~...........gqLot No......,y pursuant to application dated 19...l..~~, and approved by the Building Inspector. Fee 5...~~.pQ.. . ~.i'1~1<u.Y.(rL.......~~'1....t..... Building Inspector Rev. 6/30/80 Form No. 6 ' ' ~ TOSJN OF SOUTIIOLD • • ; BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OGCUP~INCY 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-Q form). 3. Approval of electrical installation Erom Board of Fire Underwriters. k. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building, mulCiple residences and similar buildings and installations, a certificate of Code Compliance from archi'_ect or engineer responsible for the building. 6. SubmiE Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9> 1457) uon-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing 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. i If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations Co 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 - Residenti//al $15.00, Commercial $15.00 Date ~,1~1f.~.~ ew Construction.. {`^.-f'''~... Old Or Pre-existing Building.. ocation of Property..{~~P'~"'t~` ~.p":~ ................(.!SJK':1...~s.~4^':!................. House Nom. / 'Street Hamlet ewer or Owners of Property..t G o ~r~ /~l Cn~f~f{- aunty Tax Map No 1000, Section......./.G.'....Block....~~........Lot.....;1 ~bdivision...ff.~~...//JJ .........................Filed /Map............Lot...................... :rmit No...~G.~l.~~..Date Of Permit....S~~l-~.y.~l4~Applicant :alth Dept. Approval ..........................Underwriters Approval. ~~.S.................... anning Board Approval quest for: Temporary Certificate........... Final Certicate.. SubmiCted: $-..°1rr-J0 .~'.::.::'f^.: f ~ ('r) ~ fGG7S~ _ APPLICANT ' ' TEL. 765-.1802 O~pFF~L,~CpG TO\VN OF SOUTIIOLD ~ y~ OFFICE OF BUILDING INSPECTOR o rn P.O. BOX 728 cn yc TOWN HALL "'p ca? Y SOUTHOLD, N.Y. 1 1971 -yQl ,~~0 ~ , C E R T I F I C A T I O'N ' ~ Date Building P;e~r/mit)l No.~ 1 / Owner ~p6er/'` ' (please pr~.nt))J d~~~ , Plumber l~;va .~~rf.(EN/ _ , (please pri t) I certify that the solder used in the water supply system contains Tess than 2110 of l~ lead. ' , r~~ (plumb 's signature) Sworn to before me this day of~i•^~-e--- 19~. Notary Public Notary Public,_s''~~ County ~ Et4ECN a. wwt.,c. ~Ss~'t"~T7f'ti-"~ . NiM~/ Public. Sf&~ o/ Nov ~~w,. ° No. 52-95Q9t85 Qualifin~f in Suttofk Couwy asa c..K.-+~.~ so. ~ 9 Z ' Coos . _ r a m a ?OUIID:,TI0:7 (1st) I _ ~ ~ y 4 ~ c ?OUIIDATIO:I (2nd) I m 2. ~ , o .'.OUGA FRAI~fE & .PLUMBING ~ - ~ 3. ~ - ~ T_IISULATIOII P°F-R II. Y. ~ ' STATE EPIERGY ' CODE ` - ro ~ i1 4. T- FINAL ' o ~ ADDITIOPSAL CO?^."fEtSTS: m • - x - .ti. - H 9 ' H • H O m 7 - r - ~ . - c rt R : r_ ~.r".~".... ~ ~ ~ ~„~,~n~ 0 D A ~ N ~ cT ~tt~;ti C~ ~v We m0 rmZNO ~~~W~1 ~ ~ ~ 'Ci" cnR1 C'~C)DCC zLr~aW~, „`.gyp ~cn OOr ~s 5OO'~~~ 7d ~~~~~OZ ~ ~ N..~ f~~t9qf Z 9 ~i zGl C~'~ p b.. ~ ~ Z W Q° ~ x C G ~ \ ~ ~ 9 m N ~ ~ M ~ ~ ~ N i 'I I' r._ . ro 'I RE`s I ?~rJ o 4~__ ! \ 1 c 9.~'~ ~Cy~~~~ ~ ~ ~ bC~~~~ ~9.~~ ~ ~ ~.S ' om ~ ' ~ ccn i Q n m ~ ~ G. ~ ~ ~ ~ ~ a o C ~ ~ ia'-o`' ~ o ~ ~ O o o~mC n~~~ ~~~o ~ ~C~ j c=~ r.. ;i r+'t THE NEW YORK BOARD OF FIRE UNDERWRITERS PACT 1 1000656 BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK, NEW YORK~1003B Hate APRIL 08,1991 gpplicationNo.onfile 6763A090/90 N 182379 TH13 CEFlTIFIESt THAT only the alectrkwl equipment r dncribed below ru.d Introduced by the applbent warned on the aboq teppNw[ion number in the premLer of ROBERT K. WHITE, PENESULA. REST END, FISHERS ISLAND, N.Y. in thefolbwinA location; ? Basement ? IAt FI. ®Ynd Fl. SMtion Block Lut war eramirted on APRIL Oa , 1991 and found to be in compliance with the rvyufrementr of thu Buord. ~ - RXTURE RXT NOB COOKING necXS OVBK OKN WASNNS EXHAUST FANS OUTIETS ACIB fWITCIN3 nCANDESCEM FIUdENlNT OTHER AMT. R. W. AMT. K.W. AMt. R.W. AMT. R. W. AMT. M. r. - a to s i 1 F - ?a DRYER RR2NAC! MOTOR IUTYM AFFt1ANC! IREOERf fNOAI EK'FT TIhY CIOCKS apt IMNT MMTRRS tNAT40UT1ET DIMMlB AMt. K. W, dl M. r. OAS X. r. AMT. NO. A.W.O. AMT. AAV. AMT. AMrr. TRANS. AMT. N. r. tl ~ I~pi AMT. WATR 'r.1. e_ T SMVK7! DISCONNECT ttO.Ot S E R V 1 C E _ z 2 AMT. AMV. T1TE :1 tw 1 / Tv ] / ]W IW tq. Di a. ca+[I. A.~ . a. wo. a N~{Ea NO. PE NEUTRAIi a eUniAl .i C onaK AnAKATUS: C.F.C.. T:-1 i? - ~ - 's -,/e ? Z & S CONTRS. INC. LIC.~924_g L P.O. BOX 202 FT5NSRS ISLAND, NY, 06390 OYIRAIMANAOM ~ 11 ';Y Per Thh nrtificaM mutt cwt be oherad in any manner; Mum to the ofRa of fM Enorfl if inaore~cf. Inepecbrs may ba identified by their crodsMiab. r COPY FOR BUILDING DEPARTN16fT. TNLS COPY OF EFR'TiPiGTE 7: IgT SE /4t7ER~ IN ANY MAINER. z. liVAKU Ur' Hte\L+tt 1 SETS OC PLANS FORM N0. 1. SURVEY TOWN OF SOUTHOLD CHECK .,BUILDING DEPARTMENT SEPTIC FORhf TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 MAIL T0: Examined .................19... r Approved 19 ~Perntit No... ~ DisapprovedaJc , i MAR - 91990 (Building htspector) APPLICATION FOR BUILDING PERMIT Date ......~s~....., 199G INSTRUCTIONS ~ a. This application must be completely filled in by. typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according td schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. c. The work covered by this application may not be commenced before issuance of $uilding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such penni 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 any purpose whatever until a Certificate of Occupanc ~ shall have,been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o ~ Regulations, for the construction of buildings, additions or alterations,, or for removal or demolition, as herein describer The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t• p p g ry ~ pections. admit authorized ins ectors on remises and in buildin for necessa ms (Signature of applicant, or n9[fne, if a corporation) (Mailing address of applicant) f%'~ State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builde Name of owner of Premises ........~'"~'lzPi'.~ . (as on t}te tax roll or latest deed) If applicant_is a corpora ion, signature o duly authorized officer. (Name title of corporate offic r~~GZl+i?df4'~ ALL CONTRA TORS MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ....,l.J'„7.~,102 ...hf..~.... . Plumber's License No. ...:~~y.-/~......... . Electrician's License No. ~~.y.: • Other Trade's License No. a7t7'.~..: Z..... . 1. Location of land on which proposed work will be done. ~ ~ , • . k[otise Number 1 nStreet ianilet i County Tax Map No. 1000 Section .....Ll-: Block Lot . Subdivision . Filed itiiap No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction; . "MKS ' 9' ' ' I/~'iaZt . a. Existing use and occupancy " b. Intended use and occupancy -~r~4, _ - . ...a~ '~':vjj'~ . . . k 3. Nature of wot I (check which a licable New Buildin ~ Additi PP g i% • • on Alteration . Repair Removal pembtition Other Work . 4. Estimated Cost c ~ . . Fee ~~d d0 (to 6e paid on 61ing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars 6. If business, commercial or mixed occupancy, specify nahtte and gxtent of each type of use . 7. Dimensions of existing structures, if any: Front Rear Depth . Height Number of Stories . Dimensions oit~;structure with alterations or additions: Front . Rear . Depth ......................Height ...................:..Number of Stories . 8. Dimensions of entire new construction: Front . Rear Depth . Height Number of Stories . 9. Size of lot: Front Rear Depth . 10. Date of Purchase .............................Name of F'onner Owner : 1 I. gone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded ............................Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ....................Address ...................Phone No.............:. . Name of Archrtect .......................:.:.Address ...................Phone No............... . Name of Contractor .........................:Address .:..:..............Phone No............... . 15. Is this property located within 300 feet of a Cgidal~ wetland? *Yes No *If yes, Southold Town Trustees PermitPL~ DIAG1ZAMed. Locate clearly ar;d distinctly all buildings, whetter existing or proposed, and, indicate all set-back dimensions from property tines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. , l/ ~v t.4~ . - ' i I STATE OF NEW YORK, S.5 COliNTY OF , ,f~i~ry.J~.'<....... -•~~r~$w being duly sworn, deposes and says that he is the applicant (Name c: indivi al signing contractl i above named. v Heisthe ..........................~?GttGtd~(.,.GR~1~?~-~......................... (Contractor, agent, corporate officer, etc.) of said owner.or ovaners, and is duly authorized to perform or have performed the said work and to make and file this 4 application; that all statements contained in this application are true to the best of his knowledge and belief; and that ttte 1 work will be,performed in the manner set forth in the application filed therewith. Sworn to before me this i i•~~Votary Public, 1.1:... County /~iJf~yp/J~ HE EN K Of VDE , . Y~~`~~~ . ~ . m ..'/r7•F"F~~7r.~" • . NOT.gRY rIR~C ~h eut'~~~York ~ • • • • :.:.y rJ; r ~ . ..k County :r ~ - 3'~ 1 : ~ tHIG L.aLn va N.~iW. Srf, i9~ (Signature Of ap~ C~bti _ . '