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HomeMy WebLinkAbout18000-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27790 Date: 07 06 O1 IBIS CSRTIFIES that the building ACCESSORY Location of Property: EAST END ROAD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 4 Block 7 Lot 3 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 1989 pursuant to which Building Permit No. 1800D-Z dated APRIL 10, 1989 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 ACCESSORY POOL HOUSE AS APPLIED FOR. The certificate is issued to EDWARD P MADDEN & ORS TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF REACTS APPROVAL N/A HLSCTRICAL CffitTIFICATS NO. N/A PLUMBHRS CHRTIFICATION DATBD N/A ~,u o zed Signature Rev. 1/81 808M N0. ~ 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) N 9 ~ l~ ~ Q ~ Z Date 19...~~..~ / Permission is hereby granted ty:Q~~, `~~D_~ .../../~'t;~ '=7`•2'X.? ...s'I...~.4~%i~....~,!!. rIV!! ~/"c ~ .,~~..........3...,~.~ ~ ta .......~~~r^ ct premises located at ........................................................~~..7.,P~i~...~G...~.1........P..:. 6.. ~:.1~................................ County Tox Map No. T000 Section~y........~~ Block/'.......~,~.......... Lot No.......~............ pursuant to applicotion dated ....L/..1..(~!lL. ..................~G/............, 19.~~and approved by the Building In~sp/ector. Fee $.,,S.-.P..~..~'.!f.~. .~.v ..................~..1.~......,~~~~~~ Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR 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-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ,B. Eor existing buildings {prior to April 9, 1957) non-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. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $SO.pO 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ........MaY..2,.2RQ~ New Construction....R Old Or Pre-existing Building Location of Property...~RO.~~) East End Road Fishers Island House No. Street Hamlet Onwer or Owners of Pro ert The Sanford Real Estate Trust P Y County Tax Map No 1000, Section... 004 OO,,,,glock..,07:00 Lot 003:000 Ma of Fishers Island Dev. Corp :,,Filed Ma A-421 .,,,Lot 15,-8 ,,p/o, 11:.15=9,&15 Subdivision... P . p....... Permit No. 18000, ,,,,,,,,,Date Of Permit. April,1989,,,,Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval. September,9z,1991,,,,, Request for: Temporary Certificate........... Final Certicate.....X..... Fee Submitted: $..?5„00 L _ _ , _ ~ ~ ~ ~ APPLICANT Stephen L. Ham, III, Esq ~ 01 _ FISHERS ISLAM WATER yr ~ ,'~,cr• PAGE 6317887fl11 ~ H6/H912681 19:31 _~~.~'F -1:. ° ~f~ ~ Q~Qz 7~Z~Z pI®C ~aj~ JUN t i ~ t ! BIJILDtNQ DtPT. _Fs y INSPECTION F-~-~ _ [ ) FOUNDATfON ls't ( ] ROUtiN PLaG. taOUNDATfON ZND [ ] INSULATfON Rl6MARKSs L.rv , ha~~~~'~ DATE INSPtax:roR l-~ ~,jlpGl~ r ~ _g _ _ _ _ ~ M y t FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 .TEL.: 765-1802 Examined .................19... Received...........,19.- ApprovedG~..~d 19U.~PermitNo..f~ ~Od z- Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....~./.~lp~s ~I..~~'.., 19 t~ 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 to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining gremises or public stye: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. 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 pern shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupam 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary ins ections: /J ~ _ Kim/ ..an... 4 , . C.:.... . (Signatur of applicant, ar name, if a corpcration) (mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builde Name of owner of premises . ~~~.ld-. ~~?.1+,~t,4 ~.VL[.iGi~.t.K......... . U (as on t tax roll or latest deed) If applicant is a corporation, signature of duly~aJu~thorized officer. (Nam nd title of co2rporate/officer) Builder's License No. ~ - H z Plumber's License No. . r Electrician's License No. Other Trade's License No . . 1. Location of land on which proposed work will be done. .a-C~F4Z. d~~-~ ~'~!~''!-"`+!"..~`:r`.?"`.°.~'Ha.`~, House Number ,'~//Street H~a/mlet ~r County Tax Map No. 1000 Section T........... Block / Lot . yAf ~.J.. . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of pr ices and intended u/s-e a_nd occupancy of proposed construction: a. Existing use and occupancy ~'~d'rG.tix~t~x).Jtitt.. 1~'7JGC./............r . b. Intended use and occupancy D" • • - . - . _ - 3. Nature of work (check which applicable): New Building ? Addition Alteration . Repair Removal , Demolition Other Work . (Description) 4. Estimated Cost Fee.... SA!.......................:... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......l........ Number of dwelling units on each floor . If gazage, number of cars . 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 Depth . Height ...............NumberofStories...................................................... Dimensions of same structure with alterations or additions: Front Rear . Depth Height ......................Number of Stories . 8. Dimensions of entire new construction: Front ...../..Fa....... Rear Tv......... Depth . Height D ......Number of Stories f . 9. Size of lot: Front Reaz Depth 10. Date of Purchase .............................Nanme of Former Owner . 11. Zone or use district in which premises are situated !(!i1-c~e~ . . 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~t7.~ . 13. Will lot be regraded . Will exc ss fill be removed from premises: Yes 14. Name of Owner of premises"C+4'~9y.D~.r~cr~. Address ~ta~.~<.«~ N~ Phone NoS/G:7,F,~~73.b~{. Name of Architect Address Phone No............. . Name of Contractor+'/~•~~~C4GC~Rrn,~...t.nhM:.g:inc•..Address .-tla~P.~.~~PhoneNoS7B-7.~f-7¢~,3, 15. Is this property located within 1.00 feet of a tidal wetland? * Yes No rl1R. * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frt property lines. Give street and block number or description according to deed, and show street names and indicate when interior or corner lot. STATE OF NEW YO SZ S.S COUNTY OF~ J...; II.~ ~ being duly sworn, deposes and says that he is the applic% (Name of individual signing contract) above namedy.~ He is the .!UC~u7~(,GtC~-~ . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file t application; that all statements contained in this application are true to the best of his knowledge and belief; and that 1 work will be performed in the manner set forth in the application filed therewith. Sworn to before me this t~- ~ ........day of `a.t. 1 Notary Public, ~~^~-~r..~~.°.':f'.~ Count r p , ElLEEN 6. WALL Noa.7 P No~ 52 9509165 ~w Yuk (Signature of applica i~~trYSS~~Ywdr ~30~N~©