HomeMy WebLinkAbout18628-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219026 Date MAY 7, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property PETERS WAY FISHERS ISLAND
House No. Street Hamlet
County Tax Map No. 1000 Section 006 Block OE?2 Lot 3.1
Subdivision WALSH PARK Filed Map No. Lot No. 10
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 9, 1989 pursuant to which
Building Permit No. 186282 dated NOVEMBER 1, 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 ONE FAMILY DWELLING
The certificate is issued to WALSH PARK BENEVOLENT CORP.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-22 APRIL 13, 1990
UNDERWRITERS CERTIFICATE NO. FENDING SLIP APRIL 17, 1990
PLUMBERS CERTIFICATION DATED Z & S CONTRACTING APRIL 18, 1990
SOUTH. TOWN HIGHWAY LETTER 4/13/90
FISHERS ISLAND WATER WORKS CORP. LETTER 4.11.90
~ ~
uilding Spector
Rev. 1/81
sosi~ xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. V.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N o 18 6 2 8 2 Date ..1,1,1 19..~./..~.
Permission is hereby Aron ed
at premises located at ~~~>,~~r........
..,~,,t.~...o~~..~~:~-~.................
County Tax Map No. 1000 Section Block Lot No..........
pursuant to application dated ...........1.,l.jl~ 19.~., and approved by the
Building Inspector.
Fee S.kIIGG~ /vit/.!/iC/,~~
O'L
/~~uild t r
Rev. 6/30/80
C~ i ,i ~~{~V WL{
T047N OF SOUTIIOLD
BUILDING DEPART?IENT
TOLdN HALL -
• SOUTIIOLD, NEU YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE~~~/~/ / /C~. .
NEH CONSTRUCTION ~~....Q~-~ pRE-E%ISTING BUILDING......VAtiC/ANT LAND........
/J r-~
Location of Property...... je'leLd . I„~~..
HOUSE NO. STREET HA//MEET
I ~ Wl
Ovner or Ovners of Property.~^~: a.~~~. , _A~~,..~N~'Uc'L~'~ _ _ ~ . _ _ . _ . • .
P~
County Taa Map No. 1000 Section ~
~ Block ~ _
f Lot
Subdivision!:':!8!SH_ //AQ~......_ .
Filed Map ........Lot. ~ Q,,,,,,
Permit No. ..........Date of Permit
~`~j ..........AppLicant
Health Dept. Approval ~t~
Underwriters Approval
Planning Board Approval
Request for Temporary Certificate
` Final Certificate
Fee Submitted:
APPLIC ~ i
Z'y~z~ _ `
~ ~ U
S~~~y
rev. 10/14/88
TEL. 7GS-1 &t)2
~~ca\1F~OC1~~~~~, Ti~'~N C3T` ~!'}IUT~[~d,L7
~!f`•~° c1~FIt^E OF UII.L~I,'~G i?v'SPECTOR
~ ~ P.~, f3nX 72$
~ ~ "c" Si'~UTIIc.iLll, N.Y. 11971
~~al e ~~D
D C%R
TT I P' Z C A 7' x O N
~~8~
BLDG. DEPT.
TOWN OF SOUTHOLD e ` p
Dates /Ls~[ /o l~
Euiidirg Perrni}
Owrer_ ~ ! / 13F.~,,. ~ Car's ~/D
(_p(lea~e print) ~ '
fi3lu~~e print)
I certi~y thn~ V~lder. used in L-he water supply .system
eontair,s Bess thin ;t/10 of 1$ lead.
~ ~
i
" ( ].umbe sirt~natuxe)
~ _
Noti~ry I'uL;aU
"IOt~,ry E~ubl_c, County
'PgAWAb 80NpATY Sli.
Maury Pubtfe St~to of New York
Ne. 40bt356ti
~tlMitflie in Sullclk County
Tarot Etpir~~ t L91 app
FISHERS ISLAND WATER WORKS CORPORATION
FISHERS ISLAND
NEW YORK 08390
AREA CODE 516/788-7251
Dated i~2r'~~4 ~L-'
Town of Southold
Building Department
Fishers Island, N.Y. 06390
Gentlemen:
Please accept this letter as certification of Water Service provided
by Fishers Island Water Works to y~J,f~/~(/~ ~~~'f~~<,
~ ~
The water service consists of supply through a ~ inch water
line from our Island distribution system.
Sincerely yours,
Robert E. Wall
Superintendent
REW/ew
Hiyl~way Deparirnent
Town of Southold
Peconic Lane
Peconic, N.Y. 1195f3
not MOND L JnCOE3S
Superinrendenl icl 7053140
734 52r1
April 13, 1990 ` ~ l I""`"
i~ ! i
r;i:~~ ~ 6 i~9G . ~
~ 1.1
'1l.CG.
C~~ri~ ~
Southold Town Board Members ~ r'"`:'' ~ ' ~ _
Southold Town Hall
Main Road
Southold, New York 11971
Re: Walsh Park - Fisher's Island ,
Dear Town Board Members:
On April 13th my Deputy inspected the road and
drainage structures in the above mentioned project
and reported to me both were constructed as specified.
Also present was Mr. Howard Hancock.
I concur and find the project acceptable.
Respec lly,
Raymo d L. Jacobs -
Supe intendant of Highways
cc:
Mr. Victor Lessard, Building Dept.
Mr. Dave Patterson
Mr. Thomas Dougherty
A ~
765-1802
BUILDING DEPT. G~(~,~~
INSPECTION
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
.
REMARKS:
r
y.~_
DATE INSPECTOR
t . II
_ ~ _ K
FOUiIDATIO:! (1St) - 'j
-
FOUJIDATIOII (2nd) ~
- m
2.
. I
o~
ROUGH FRkilE &
-PLUMBING o
N
3. -
IIISUL;.TI0I1 PER N. Y. y
STnTE EIIERGY I
CODE
4 , m~~
H
- I
FINAL
- I - ~
ADDITIOPJAL COi~?MEPlTS:
- -
• _ m
~~G•~
H
N
O
A~
H C
- m ? e~
_ y
BOARD OF HEALTH
` 3 SETS OF PLANS
FORM NO. 1 SURVEY .
TOWN OFSOUTHOLD CHECK _
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
,,pp TEL.: 765-1802 CALL
Examined ..~~~Z........, 19f/.y MAIL T0 .
Approved ...~~~y 1941. Permit No./0. V.~"4 . ~ h.`~ ~ j~' /2 p nn
Disapproved a/c
~ 15 U V'
nom, ~~r- VI 1'T,
uildin nspector) '~^LG t•
APPLICATION FOR BUILDING PERMIT _
Date :-1,~~,ud~• 15 !
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 premises or public streets
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 Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
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 Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectio
Cv A is ~-~~i ^
(Sigrtature oi' applicant, or name, if a corporatton)
PC3 ~ ~ lc~Y r,
- (Mailing address of applicant)
State whether applicant is/o~wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises CIJ~a ~5~-1 f p Qi~ ~j ~ u~ yr ~t N~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(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 landron which proposed work will be done. , ~/oe?N n~
~i /~,QPA
l,(~~ S'i G x~ ~ -HS,at'tt.! J~i ~4~ ~O2~.t~ t• ~ ..~1'~S C~N~ .
.......a................. _
House Number Street Hamlet • • • ~
County Tax Map No. 1000 Section 6 ~ 1 ~ v Block ~ ! O cJ OQ 3 , D ~
/ ,Q Lot. ~
Subdivision .4f/~~ • . ~E:Jr.~:....... Filed Map No. Lot . . .
(Name)
2. State existing use and occupancy of premises and intended ttse and occupancy of proposed constr..uction
a. Existing use and occupancy ..~~Jf'`r... ~d«"~. ~L.~• • • • • _ . • • •
b. Intended us ~^~~`T ~h~'214~LC~ •
e and occupancy l~uL,Ivc G6~:v.S%ox/
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