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Home My WebLink About22587-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z-23514 CERTIFICATE OF OCCUPANCY Date FEBRUARy 28, 1995 THIS CERTIFIES that the building Location of Property PETERS WAY House No. County Tax Map No. 1000 Section 6 Subdivision WALSH PARK NEW DWELLING FIS~W-~ I-qr.aND, N.Y. Street Block 2 Filed Map No. Lot H~let 3.5 Lot No. 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT~/4BER 29, 1995 pursuant to which Building Permit No. 22587-Z dated FEBRUARy 24, 1995 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 OWE FAMILY DW~r.LTNG AS APPLIED FOR.. The certificate is issued to WALSH PARK BENEVOr~NT CORPORATION (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RlO-94-0117-FEB. 17, 1995 UNDERWRITERS CERTIFICATE NO. PENDING -- JANUARy 27, 1995 PLUMBERS CERTIFICATION DATED JAN. 30, 1995 - Z&S CONTRACTING - ~Bui~ing 'I ns~6~r Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAU. $OUTHOLD, N.Y. N_O BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ..... ~/...~...,.~...' ....................................... 19 22587 Z ........... Permission Is hexeb~graj:ltecJ¢4o: ~ . County Tax Map No. 1000 Section ......... ~. ............ Block ......~ ................LotNo. ~"-~' Building Inspector. 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. 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 Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1~.00/ Commercial $15.00 Date New Construction..~.. ...... O~ Pre-exi~Zing Building...~ ....... Location of Property .~.... ~./.~.~..~...~..~.~ ..~~..~. ~. ~ House No. ~ / Street ..................... Hamlet Onwer or Owners of I~L~. ~ ~.~¥.~..~.~.~...~, Property..~.~ ................... County Tax Map No 1000, S~ijp.~' ....... Block. ~-' ............... Lot.. Subdivision ........................... Filed Map ............ Lot Permit No..~..-~.~-.~..~.Date Of Permit. ~.~.~.~.7...Applicant ...................... Health Dept. Approval...~-- ~--~ Unde · ~ ~/~--C~P ....... ................... rwriters Approvai Planning Board Approval ...... ~ ............. Request for: Temporary Certificate ~- ~ ....... ~ ' ....... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Buildi~ng Permit No. _~ · (plea~ print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Swo.r~ to befo~ me this ~0 ~day of J~M~A~d~ 19 ~1~ ' / ~lumbe~ s ~g~ature ) ~ Notary Public ~'-- County Notary Public grate of New York No. 480~559 Term Expires Z & S CONTRACTING, INC. BOX 202. e FISHERS ISLAND. NEW YORK 063g0 0,II 77 Uaste I~ater Flanage~snt Suf'~folk County Health Services, CoUnty Center Tc ~hom it may concern. U® at Z&S Contracting on' Fishers Islsn?~N.y., ,have t,ta~slled the septic sy~[em at the~AL~. ~.~ ~ p~ape~ty aooerdlng to 'all'Suffolk Ce.usry' Cedes. Prs"J. dentT. '. Z&'S Con~rac~lng Inc. 'I',IS/rZ FISHERS ISLAND WATER WORKS CORPORATION FISHERS ISLAND NEW YORK 06390 AREA CODE 616/788-725t 0/17 Da r ed 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 _~~.~_?~..~~ ~~ The water service coesists of supply through a / inch water line from our Island distribution system. l{EW/ew Sincerely ¥obrs, Robert E. Wall Superintenden~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;2 Examined.../..~/~.. ~ ...... ,19~.~.'~ Approved. · . ~'~..5~. ~ ...... 1' .c~.. Permit No..~...~..~..-7.~. ?~' .............. a. Tlfis application must be completely fi~ed N by Wpewfiter or in ink and Submitted to th~ Build~g Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ show~g location of lot and of bullrings on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led description of layout of prope~y must be drawn on the diagram which is pan of this app~- cation. c. The work covered by tNs application may not be commenced before issuance of Bufld~g Pe~it. d. Upon approval of ~is application, the Building Inspector will issued a BufldNg Pe~it to the app~cant. Such pe~it sh~ be kept on the premises available for ~spection throughout the work. e. No bu~dNg shall be occupied or meal in whole or N p~t for any purpose whatever untta Ce~ificat= of Occup~cy shall have been granted by ~e Bulldog Inspector. ~PLICATION IS HEREBY M~E to ~e BuildNg Depmment for the Nsu~ce of a B~lding Pe~it pumuant to the Building Zone Ordnance of the Town of Southold, Suffolk Count, New York, ~d other app~cabla ~ws, Ord~ces or Regulations, for the construction of bufld~gs, addi~ons or alterations, or for removal or demoli~on, as here~ desc~bed. The app~cant agrees to comply with a~ app~cable laws, ordinanc build' - admit authohzed ~s ectom o - ' .... a ~_ ~ ...... :~'. mg , ho code, and reg~ations ~d t P n ~rem,s ...... ~, uunumg ,or necess~ msp,ction~ ~ , o ture of appl~nme, if a corporation) . (Ma~g add=ss of appli~;) .... ......... ~ ·. ~ ............................ ~ ~ ~' ' - ~ (as on the tax roll or latest deed) ................ I i ...... ~i~~° f d ul~th(riz~o filter. - ........~ uue oi ~ate officer) · Builder's License No. Plumber's License No. Electrician's License No .... ~ ................. Other Trade's License No. ,. ........ ....... ...... ..... .... ............. ..... house Number " ...... ~;r~; ....................... ~ ...... ' ..... ~ ........... / Hamlet .' ................. ' ......... ' ' (Name) ............ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................... ~' ...~ b' Intended use and occupancy ~ /~ BOARD OF HEALTtt 3 SETS OF PL,i~,L.q ......... SURVEY .................. ClIECK .' .................. SEPTIC F 0 Ri'! ............. t:OTl py ~ CALL ................... HA I L TO: 3. Nature of work (check which applicable): New Budding Repa/r .............. Removal .......... Addition Alteration . ,.~,.,Td .............. Demolition . · ............. Other Work 4. Estimated Cost ....... /.~..~. ..... (~._ t_~Description) 5. If dwelling, number of dwelling units '(};'b'e';~?d~r~ filing this application) .... · If garage, number of cars ............... Number of dwelling units on each floor ....... 6. If business, commercial or mixed occupanc . s ecff D~menmons ot exmtin- struc · _ Y' p y nature and extent of each t ...... Heivh o t. ures, If any: Front ..... Ype of use ................. · Dimensi .... r~_ . ''5 ocr of stories ............... ' ........... ueptn .............. -,,,~ ,,, ~ame structure with alterations or additions: Front D.epth .. ..................... Height ................. Rear ......... 8. Dm~enmons of entire new construct' ~ ...................... Number of Stories ......... ' ........ · mn: front ............. Rear De th 9. SHi;Iff~[ 1:,~ '*k ........... Number of Stories ..... ' .............. p ......... ' ..... 10. ut vront ..... . ..... Rear ...................... Depth ............ Date of Purchase ..................... me f Former Owner ' ' ' 11. Zone or use district in which premises are situated .~,.?~.1 .t~.....~?.~.,.. ............................... 12. ~,.o,,es. P.r.oposed construction vi.o_late any zoning law, ordinance or regulation- K! 0 -.- 13. wm mt t>e regraded ....... .t~..9 ................. Will exc ss fill b~ge oved from premises Y~s' '" 14. Name of Owner of re, cruises ~AL%~ ~'~t~.-- Ad Name of Arc ...................... dress ~,tC~ ~M?~rb ' hnect '(~V~t. X/'t re", V, ....... ~ - NameofContract~-2a'2 r'~ '~ .... 22_ ......... Address .~l.~.~3r.~/~', ~ ,,~ .' ........... I ............ " ~-- · · · one No .... · If yes, Southold Town Trustees Permit may be r~qui~g~[ ..... No.....~y.. ~'' .--. PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. STATE OF NEk~YORK, . ' . cou y .3. ct _ I S.S . (Name of individual signing co~k~c't ........... being duly sworu, deposes ~d says that he is the applicant ) ~bove named. (Contractor, gent, corporate Officer, etc.) f said owner or owners, ~d is duly authorized to perfom or have perfomed the'said work and to m~e ~d file this ~plication; that all statements contained ~ this applicatim~ are truz to the best of his ~owledge and belief; and that the 'ork will be perfo~ed in the manner set forth ~ the application filed therewith. worn to before me this ............ ......... : ................ County EIL.,~N ~ALL NOT~ ~L~E~~ATE Cou