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Home My WebLink About19308-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27921 Date: 09/10 O1 THIS CERTIFIES that the building ADDITION Location of Property: FOX AVE FISHERS ISLAND (HOUSE N0.) (STREET) (HAMLET) County Tax Map No. 473889 Sectioa 9 Block 1 Lot 24 Swbdivisioa Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 1990 pursuant to which Building Permit No. 19308-Z dated AUGUST 7, 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 ADDITIONS IN ROOF FOR LIGHT & VENTILATION IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to K SERENA CARSON & ORS. (OWNER) of the aforesaid building. SUFPOL& COiTNTSC DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLDUBSRS CERTIFICATION DATED NIA l ut rized Signature Rev. 1/81 r 1~ ItQ ~ TOWMI OF SOUTMOLD WILDING DE?At7'M~lIT TOWN HALL fOUTHOLD, N. Y. WILDING ?LRMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) A ~ Z ......1 19.~~ N_ i 9308 Dat............ Permission Is Mr~y pwntd ....tC ~,,,..?1...., .0~6~'to ro ' ....~Iht}.. ...r.~. s r at promise loeoted at ..~.9AM.#~RG..iG.da..~~A~~~~y. ~Tf.................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .g. . . . . . . . . . . . . . . . . . . County Tox Mop No. 1000 Section Bkx:k Lot No.....gt"...~.... pursuant to appNcatbn doted ...........C/~~.~e7 j.....Y..'.1..... 19.~a6~., and approved by tM Butldlnp Inapsctor. Fee 5.~.~'~. Rw. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT , TOWN HALL ~ 765-1802 I ~ 1-- 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 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Complianoe from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For 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 - .25~p 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentia/l /$~15~.y00, Commercial $15.00 Date . gl.Z l/V ~ New Construction........... Old Or Pre-existin uild fling......... ~ . Location of Property ~Y............1..'7i!: ~~~~.l~.Jl. House No. M,,' Stre,,~et/ Hamlet Onwer or Owners of Property.S'~!~:.Gj~.~~~~~..`{'!...p~S County Tax Map No 1000, Section....(.........B1ock.....~..........Lot...Z ~ Subdivision ...Filed Map............Lot~... /1..... Permit No.~l..llt.~O..Date Of Permit.~?~~......Applicant.~..::..~'/.. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate...././'J.... Fee Submitted: z~ ~ ,G,~;^?~~ . ca ~ ~ 9a-i ~ 2 - 6 ~ IO6 APPLICANT I ~ ~ ~ ~ w$- ~ ~ C 1 ~~p~A~ ~ tt~?~ ~ - _ 'E r______----- 1 L~ {N! _ _ OCCUPANCY OR USE IS UNLANIFtx. , ~ Wti'HOlR CE1R'fIF~CAT!F OF OCCUPANCY ag' ~x51s`FW~ f~~~ UiFw, ~Zoo~ r. ~xS~ST IN G' 5t0~ U'~`~ , ` ~ Fp~ ~R o~J aS ~fl OoR rn E12 _ sx r G "~i ~ J` r~. ~ r ~~bU~g~ Q°i~ ~4 aQo~ I a ~f 6~r APPROVED AS NOTED C.ATE: 7~DB.P.ay a NOTIFY BUILDING DEPARTMENT AT ?65-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: FOUNDATION .TWO REQUIflED =0R POURED CONCRETE HUGH -FRAMING ry PLUMBING ~~ULATION SAL - CONSTRUCTION MUST COMPLETE FOR C.O. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS