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Home My WebLink About17678-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18805 Date FEBRUARY 16~ 1990 THIS CERTIFIES that the building Location of Property WEST ~R House No. County Tax Map No. 1000 Section 10 S~bbdlvislon ADDITION FISHERS ISLAND Block 11 Filed Map No. Street Hamlet Lot 5.8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 30r 1988 pursuant to which Building Permit No. 17678-Z dated DECEMBER 12, 1988 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 BEDR00MADDITION TO EXISTING ONE FAMILY DWELLING The certIficate is issued to COVE CORPORATION (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVP~L N/A UNDERWRITERS CERTIFICATE NO. N-104999 - NOVEMBER 29r 1989 PLUMBERS CERTIFICATION DATED 1/15/90-ROBERT E. WALL .... Bul ldlng ' i~p'ec~or ' ~ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tax Map No 1000 Section.... / ~.. #__ Budding Inspector. 19.~'.~, ~nd approved by the Building Inspector Rev 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcatlon must be filled ~n typewriter OR ink, and submitted t~ to the Building Inspec- tor w~th the following; for new buddings or new use' 1. Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographic featu res. 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 Underw.ters. 4. Commercial buddings, Industrial buddings, Multiple Remdences and similar buddings and installa- tions, a certlhcate of Code compliance from the Architect or Engineer responmble for the building 5. Submit Planmng Board approval of completed s~te plan requirements where apphcable. B. For ex~stmg buildings (prior to Aprd 1957}, Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of property showing all property hnes, streets, buildings and unusual natural or topograph lc features. 2Sworn statement of owner or prewous owner as to use, occupancy and condition of buddings. 3Date of any housing code or safety inspection of buddings or premmes, or other pertinent mforma- tlon required to prepare a certtficate. C. Fees Additions $25.00 POOLS $25.00 ALTERATION $25.00 1 Cert~hcate of occupancy New Dwelling $25.00, Accessory $]0.00 Business $50.00 2. Cert~hcate of occupancy on pre-ex~stmg dwelhng $ 50 00 3 Copy of cert~ficate of occupancy $ 5.00, over 5 years $20.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ......................... NewCons truct~on ..... Old or Pre-ex~st~ng Budding ........... Vacant Land ............. Locat,on of Property. ....................................... . .........~..~..~..~.~.. ... . House No. Street /~arnlet Owner or Owners of Property .. ~O..q.~...C~O?.~i~:...~__ .4~r. ;. ~ ~..~.%.~.'~..~7:;.~....~..~9....~.~.o...... County Tax Map No. 1000Section ..j.O. ........ Block ..././. ......... Lot ..... ~, ......... Subdivision .................... Fded Map No ......... Lot No .............. Perm,t No.[.--/.~?...~... Date of Perm,t Health Dept Approval ...................... Labor Dept Approval ....................... Underwr'ter' Approval N/~..f.f. f~. ......... P'anmn§ Board ApDrovs, ....... Request for Temporary Certlf,cate ................... F'nal Certtficate.:: ~ :::. . Fee Subm,tted $. ........... Construction on above described budding and permit meets all apphcable codes and regulations. Apphcant . ..(~..~..~ ...... ~..%~. ~ .......... Rev 10-10 78 FOUNDATION FOUNDATION 2. ROUGH FRAME & 3. INSULATION (1st) (2nd) PLUMBING FERN. Y. STATE ENERGY CODE FINAL ADDITIO~AL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS _009[~ BUREAU OF ELECTRICITY 85 JOHN STREET NEW YORK. NEW YORK 10038 Da~e NOVEMSER 29~*L989 ~pphr~,onl~o o. fde 6096~89/89 N ~0~999 THIS CE~IFIES THAT ERARD A. ~ATH[ESSEN, PRIVATE RD., FISHERS [SLAND~ m thoJoltowmg tocatmon, [] B~sement ~:as~xam~nedon NOVE~tBER 1/', 1989 fiXTURES 6 7 DRYERS DIMMERS WIRING ASSOCIATEO WITH NEW AOOITION-I ELEC. ROOM HEATERS.I-1.25 K W.,1-1.5 K W. ELEC. WATER HEATERS:.i-/..5 K.W. ¢ E WALL ROBERT E. ALPINE AVE FISHERS ISLAND, L]C.~2~55 E NY, 06590 I ~AGER 11 I'hts certificate must not be altered in any manner, return to the office of the Board If incorrect Inspectors may be identified by their credenf TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-t802 CERTIFICATION Date Bul!ding Permit No. Owner ~ ~- /'/2~/~-/~L/ (please print) P lumber .~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Swo~to before-me this ~9 ~0 . Notary Publ~c,~~ (plumber's signature) ' g/ Notary Public County ?NOMad. F, Examlned jr~ ~..~ FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y. 11971 TEL.. 765-1802 , 19~PemntNo / 7.~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: Disapproved a/c .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a Tlus application must be completely filled m by typewriter or In Ink and submitted to the Buddmg Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing locatmn of lot and of buildings on premises, relationship to adjoining premises or pubbc strec 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 ttus application may not be commenced before issuance of Buzldmg Permit. d. Upon approval of this application, the Building Inspector will issued a Bmldmg Permit to the applicant. Such peru shall be kept on the premises ava/fable for inspection throughout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever untd a Cernficate of Occupan, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Buildmg Department for the issuance of a Bmldmg Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto describe The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary lns20ections dl~ignature of apphcant, or name, if a cot{5oratlon) (Mmhng address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrlclan, plumber or build. ........ ............ , .................................. Name of owner of premises ~-/ff.......~'~.~,~.~ -/~. ~'-'~./~, .... (as on the tax roll or latest deed) If applicant Is a corporation, signature of duly authorized otficer , iNai~i anti 'title of c~>~p;rate ~ffil/c"~e~ '* ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's LicenseNo . ,~..~-)..~t'[~ .-- ,/7*'2' Humber's License No .......... Electrician's License No ............ Other Trade's License No ......... Location of land on which proposed work will be done " /~tA'7"7~'~ / ~'.~.~..~., °¢- . '<. ... House Number Street Hamlet Co tyT pNo ..14. ..mock ..Il .... Lot Subdivision '(Nai~e) ...... Filed Map, No ........ Lot 2_ State existing use and occupancy of premises and/~.,- .'~ ~/~//~lntended use~ and occnpar~cy of proposed c~nstruction a Existing use and occupancy . ". tZ'm.~ Z~...~r-~--~.. ~.~... ~-,-: ~-~.~ ...... ,· .... .... ,, b. Intended use and occupancy ................................................... 3. Nature of work (check which applicable) New Building Repmr . Removal ..... 4 Estimated Cost "~'~-- O.~o .... 5. Ifdwelhng, numberofdwelhngunlts. .. ~ If garage, number of cars ....... Addition .t~... Alteration Demolition ....... Other Work ....... (Descnpllon) ..... Fee ..... · .......... ~' (to be prod on filing this application) ·. Number of dwelling units on each floor ..... 6. If business, commercial or mixed occupancy, specify nature and extent of eac~ t_yp~e of use .... 7 Dimensions of existing structures, if any Front -.~f .O . .. Rear .~'.~...' ... Depth ... Height ......... Number of Stones . :./. . Danenslons of same structure with alterations or addmons Front .~.r Rear /;[~. . Depth ........ Height ......... z .... Number of Stones .. ~ ~ Rear ~,~ .. Depth ........ 8. Dimensions of entire new construction Front ./ Hmght ... Number of Stones .............. 9. Slzeoflot. Front ....... Rear.. . Depth .............. I0. Date of Purchase ............ Name of Former Owner ..................... 1 1. Zone or use district in which premises are situated. . -.'.'.'.'.'.'.'.'.'~,~/~""~ ./~-'~.~ ...................... 1 2. Does proposed construction vmlate any zoning law, ordinance or regulatlon ............... 13. Will lot be regraded ..... ~ .~..~ ........ Wall excess_.f, tll ~ removed from premises Yes 14 Name of Owner of premises ,~.'4. ,,~ .,~r?.~{.~..~/~ . Address 2r"~'.-:~.'' .... Phone No Name of Architect Address Phone No .. . Name of Contractor ~.~/.~. i .~7:~..,~. i ' .~.' "~':/~'t'~i'ess .~.,,~" 15. Is thxs property located within 300 feet of a tzdal wetland? *Yes ..... No ~ .... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dtrnensions from property hnes. G~ve street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWK-YOR~a ~ L S S · ~,..~,~ r'~ . jlt~ j~'~2~t 9. ff.' . being duly sworn, deposes and says that lie is the apphcant (Name of ~n&v~dual signing contract) above named He m the (Contractor, 't ................................. 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 flus apphcatlon; that all statements contained m th~s application are true to the best oflus knowledge and belief; and that the work will be perform, ed ~n the manner set forth m the apphcat~on filed therewith. Sworn to before me this Notary Public ......... , County .... . .,,.. ~m~N ~ W~L~- (Signature of'~l~.51icant) Quah ~ed Term Expires