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HomeMy WebLinkAbout18050-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18905 Date MARCH 19, 1990 THIS CERTIFIES that the building WATER FACILITY Location of Property EAST END AVENUE FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 03 Block 06 Lot 03.8 Subdivision Filed Map No. Lot No. conforms substantially to the Apphcatxon for Building Permit heretofore filed in this office dated APRIL 3, 1989 pursuant to which Building Permit No. 18050-Z dated APRIL 17, 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 WELL WATER TREATMENT BUILDING The certificate is issued to FISHERS ISLAND WATER WORKS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-117480 - MARCH 7, 1990 PLUMBERS CERTIFICATION DATED N/A J Building Inspector Rev. 1/81 >?oa~ xa s TOWN OF SOUTHOLD 6UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ° g ~ ~ d Z Date r. 7..............., 19.~~ Permission is hereby pmnted to: ~.oc..:~ ro ..~:!`^-4:s~-..0...~-~:?:..w:~.1~-a:~r~!:tom.,.A"-.......~..~....?.°~ . ...........................................................................n..~~..............n........................................................ at premises located of ao ~ ...~?l~ ~......F.-:!~3t.~.......... l:..i ~ . . County Tox Map No. 1000 Section Block .....Q.~........ Lot No ..o.~.'.~. pursuant to application dated 19~.~., and approved by the Building Inspector. Fee uildinp Inspector Rev 6/30/80 ' ; _ e - ' TOWN OF SOUTIIOLD BUILDING DCPARTHCNT TOWN HALL SOUTIIOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CCRTIFICATE OF OCCIIPANCY DATE . `.~~'3,i _ . . HEW CONSTRUCTION .1.....OLD OR F1tE-E%ISTING BUILDING......VACANT LAND...__... Location of Property. _ HOUSE NO. ST/~R,EET HAMLET Ovoer or Owners of Proper[y..h~N~~.::~1Q0'~_,w~TL4._~6t.(LS_,._____•_'.--,-_-- County Taz Map No. 1000 Section ~ 3.. Hloclc Lot ~3: _ Subdivision Filed Map ........Lo[........_. Ip Permit No. .~~~:~~?:_Date of Permit ~I1~~P9..Applicant'~~~!~,Ls(e~,.? ~~~__aerra BealLh Dep[. Approval ~t~..'S~.~~..'.._.... Underwriters Approval ~7 y/?(°_~1_"_=. Planning Board Approval Request for Temporary Certificate Final Certificate Fee Submitted: $_~j~.,~ //J,/ ~~k rev. I /[4/88 3yi~ C c ~1890~3 L ~ ~ • ' r t FORM NO. 6 TOWN OF SOUTIIOLD BIIILDING DEPARTMENT TOWN AALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to [he Building Inspector with Che 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 fea[ures_ 2. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval o£ electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used is system contains less than 2/10 of IZ 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. B. For eaisting buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent Co inspect signed by 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 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. C. For Vacant Land Certificate of Occupancy: 3. 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 Che entire lot prior to Aptil 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state Che reasons therefor in writing to the applicant. D_ FEES: I. 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 - $(00.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial co. 10/14/S8 >_~L~ Ii. S:_~':iuiJ pu~~;; i c~,~rMr;ur° - - m a H _ y FOUtJDATI0:1 (1st) ~a c OUNDATIOtd ( 2nd ) _ m~, • z 0 ?OUCH FRAME & PLUMBING ti _ H 3, a c~ n Ii1SULATIOft PER N. Y. - STATE EfJERGY CODE ~ 4, ~ H FIiJAL =i o ~ E F ADDITIOfIAL COMMEtJTS• ~ F f t m x v H b , • a H H Q ~ f I - r ~ - H i v m ^o H a l~ ~ ~ + ~ ? ~ t i ~ .rt-~ f ~ ~ ~ i r r' ~ ~ ~ ~ 6oca oq J ~ 1 ! ~ ~ N~~~ ~zg.t _ ~ 1 'ryn~ ~ I' r i ~j-3 21-2 2t .P ~ , 3t-4 31_5 rL.v ' - ~ ~c 'i~ ~ 21-4 t 31-3 - ~ ' 'r' i ~ , ~ 2{ - 5 t_au4~tm i ! i ~ / ~ / / ' a / ~ \ i i MIDDLE FARMS pdND ` , ~a' nau~ w .ar MitVCi ~ ~ ~ ~ r Noyes y',` ~ y f Subdvblan Corrs+rw! ~ 1986 ~ ,~,,,,,h, ,o ~ ~ ; ~,~,::•r cor3 ~ • y~,.y t F.ra+ ` o,,h~ . ''mil-, `~1--!Musown •22-`' t ` ~ !Y~ ~ ~ C,shmon Sabc~+6sim ~ ~ ' ~ L oI 2 1y92 Q-- - ~"~p}'"~ ~ .~T . _ THE NEW YORK BOARD OF FIRE UNDERWRITERS t'Ar;t ~ as U?OIJ')13 BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK. NEW YORK 10038 MAREai LYi~t'd911 APPUcationNo.onfile 6G4116R4/H9 N ij74NU ~ THIS CERTIFIES THAT only [he ekTCtrlcd pufpwsent m described 6skro and introduced by the opp/icent named on [he abase oppiiceefon number Jn the promlws of 't`;Itl'R 1',LAND WA(t:k WDPK:i, f°RCVAIi~. KO., 'rlSlfEh C'iALANU, N. Y. © 1st Fl. ? Ynd FI. .Section Blxk Lot in the following location; ? Basement 1i11 I was examined on (t;HRUARY t1h,1Y41j ondfound to be in compliance with the reyuirements of ehia Buord. flXTURE ACLlS SYY1T01ES flXTURES RANGES COOXINO DECKS OVENS DISN ASTERS iXNAUST FANS OUTLETS INCANOEECENi ~ PIUGIIESCENi OTHER AMT. t. W. AMT. K. W. AMT. K.W. AMT. t. W. AMT. H. P. ;5 ) F. DRYERS FURNACE MOTORS 191TURE AFFl1ANC! F90EK SNN:IAL Rlt'?T TIME tXOCXS Rill WRT NEAT[K MIILI40UTLET gkIMERS AMT. N. W, ql H. I. GAS H. P. AMT. NO. A. W. G. AMT. AMI. AMT. AMPA TRANS. AMT. M. P. ~ t1 ~T AMT. WAITS ¦ .t U ; SERVN7 DISCONNECT NO.OF 5 E R V I C E AMT. AMP. 11TE b~L11FR 1 p t\Y 1 F ]W ] R ]\4 ] / /W ~ER lCt~. W CC C ~ D.' NO.Or NI.IEG Oi W~IEO NO. p NEUTRAIS q ~NEVAAI 't X 2 2/fi T .III - O711ER AFMIIATUS: _ ttt' `.~'tAkllk.`.~~ 'i 111' Si'AN1'i~:HS-i 411KW 3t'W GPN-1 sa)I) AMP MACCNt'. 1"RAN'i rtil~.'3W[tcht...1 ! I LC. ftOGM Ffk'A'IiEliS:?-h.'~ R.W. _ I'ANtiI.H0AND1i:'ltk. CSM. 111(1, 1.1 1;1K. 611 t FttfiNSf URMtFt:7-'1,!, FVA WALL RI?tiLt2 i P . 1. [f., tt24!i'i A I. F'7. Nt AVF. t'LSHIF_42'i t'ILANI), NY, r)F,Syu OpiRAI HAAFIAOB t] ~t/ Per YY Thit certificate mwt not bs altered in any manner; rofurn ro the office of the Board if incorrect. rs .may be idMlified by 1Mir crodentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE Ml~{T NOT bE ALTERID Ri ~ r~ ~ ~ ~ - ANY MANIHR BOARD OF HEALTH 3 SETS OF PLANS FORM NO 1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL • vDUTHOLD, N Y 11971 NOTIFY , p TEL.. 765-1802 CALL Examined , 19~q\ MAIL T0: Approved 19~ I . Permit No~ 40~~ Disapproved arc ..~5~" (Bull ing Inspector) APPLICATION FOR BUILDING PERMIT Date ..~t'Rf,L. •3...., 19 INSTRUCTIONS a. Tlus application must be completely filled rn by typewriter or rn ink and submitted to the Budding 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, relatronslup to adlorning premrses or public street or areas, and giving a detazled description of layout of property must be drawn on the diagram which rs part of this apple canon. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the BuIldmg Inspector will issued a Building Permit to the applicant Such permr shall be kept on the premrses available for inspection throughout the work. e. No building shall be occupied or used rn whole or rn part for any purpose whatever until a Certificate of Occupanc• shall have been granted by the Burldmg Inspector APPLICATION IS HEREBY MADE to the Burldmg Department for the issuance of a Bmlding 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 described The applicant agrees to comply with all applicable laws, ordinances, 6urlding code, housing code, and regulations, and t~ admit authorized inspectors on premrses and in building for necessary inspections Fm's is/•~y~ .1a/?I~t~,P.~fJa,Qi.~rs.l'~4?, . ~(~na~re of applicant, or name, rf a corporanon) (Marling address of applicant) State whether applicant rs owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buAder O~UHe~.° . . . . Name of owner of premrses ~fb!C+~.S -~j/~'~ .~t.°YP~v~4~l1GYT t••re~~... . . . . . . (as on the tax roll or latest deed) If ap a t rs a~j orporatJr,~n, signature of duly authorized officer !'g'7 .fK/f srVi'r~'~,(~t~ri . Frw u1. (Name and title of corporate officer) Builder's License No Plumber's License No . . Electrician's License No . Other Trade's License No . 1. Location of land on wlrrch proposed work will be done r!~5~. ~ °Y ! l o!'~'O~ . . . House Number Street Hamlet / County Tax Map No 1000 Section . Qe.3 .Block P~?. Lot Q.Q.'~• S ~.2^v (.a. 'Ciri~'f i' /Eo~S ,r p /.'~/oG,C .30 Subdrvrsron • , . T • /Y~1-. Filed RIa No Lot.f~~ai.~Yi Fl('lr, (Name) .f~oL~d 2. State existing use and occupancy ofpr/emrsesand intended use and eccupancy of proposed construction; a. Existing use and occupancy 1,~// /~g~~r • • • ,•~•~F.~~.Q . . b. Intended use and occupancy l~e~/• •~0~~ • . 3. Nature of work (check which applicable) New Budding .Y.. Addition Alteration . Repazr .Removal . , Demolition Other 1Vork . . ~ (Descnphan)t 4. Estunated Cost ~f!f8 ~mO Fee'.f~'. o®. . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each t7oor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use : Wrt,! ^ 7. Dimensions of existing structures, if any Front Rear Depth . Height .Number of Stones...... . Dunensions of same structure with alterations or additions Front .Rear . Depth .................Height r ! Num er o ~ nes J ~ . . 8. Dimensions of e~9tyre new construction Front . ~r,?s Rear ,~+iF.u'~ 'lam ~ ....Depth . . . Height f$......... Number of Stones ~ ~ . 9. Size of lot Front . ~j?5.~ . Rear 3.:b..... Depth ...S, S`.~.... . . 10. Date of Purchase o~~~-~ . ...Name of Former Owner !v~^.'~- . 11. Zone or use district in which premises are situated ........-.r 12. Does proposed construction violate any zoning law, ordinance or regulation• 1`10 . . 13. Will lot be regraded ..No ..Will excess fill be removed from premises. Yes 14 Name of Owner of premises F. ~,.j~bY, .~o ~ ~ ....Address .FT,. Yf~~ rr . :3fr'°. Phone No.-~~~ :Z~~.'TZS,(, Name of Architect JA./'~1.~^?. ~,~'y~R.... ....Address .$.sSTP M.~' ....Phone NobtT-.~S/-: $.7'/t- Name of Contractor 1, ~A~~. r'YCS ..Address .F ~ : .Phone No.SIG : 7$.$ ~ 7.?~.1. 15.Is this property located within 300 feet of a tidal wetland? *YES....AO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing or proposed, and. indicate all set-back dimensions froze property lines. Give street and block number or descnption according to deed, and show street names and indicate whethe intenor or corner lot. ~ l~,~w ,~u~ BJr,~ E'.vsiC - h~ilieTFa.ed GT ~a3 - 527. z6 7? ~RRt.~ewt~s !.-7TlP'aliGd, ~/a .S'cP 7'1c, ~'l,.s m 5 STATE OF NEW YORK,e' S S COUNTY OF'" ~ . tGl~XlaPs~ Jr' , • ~~~~R being duly sworn, deposes and says that he is the apphcan (Name of individual signing contract) above named He is the 4dRP, ¢~~`G~,~/~iQ65~ dC,e,-~) _ . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file thi application, that all statements contained in this application are true to the best of his knowledge and belief; and that th work will be performed m the manner set forth m the application filed therewith. irILEEN o wnu_ Sworn to before me this p No1~y pubSrc, State of New Yuri /n",d( - Q ~ No 54.9509185 day of ~wL6d Sulfotk cow,rrg0 . , 19 Etrpras i~YrAN, 30, 19._. Notary Public, ~..i:".~ .Coin ignature of applicant