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Home My WebLink About16771-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPkRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20106 Date JULy.25, 1991 THIS CERTIFIES that the building Location of Property PRIVATE ROAD House No. County Tax Map No. 1000 Section 4 Block 5 Subdivision Filed Map No. ADDITION & ALTERATION FISHERS ISLAND, N.Y. Street Hamlet Lot 19.5 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11, 1988 pursuant to which Building Permit No. 16771-Z dated MARCH 7, 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 SECOND STORY ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL ROTHFELD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEakLTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-090309 - SEPTEMBER 3~ 1989 PLUMBERS CERTIFICATION DATED N/A ' ~uilding Insp~ Rev. 1/81 FOw. M' NO. It TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_16771 Z County Tax Map No. 1000 Section ........... ~ ....... Block ............ '.~..... Lot No ........ pursuant to application dated/~::....~X/~ ......................... , ]9 ......... and approv~ by the Building Inspector. Rev. 6/30/80 TO~N OF SOUTROLD BUILDING DEPAKTHENT TONN DALL SOUTDOLD, NE~ YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY " E~ /~/~?~ DAT .......... ./ ...... NE$7 CONSTRUCTION ....... OLD OR PRE-EXISTING DUILDINC-~/----VACANT LAND Location of Property ....... ~ . . .: HOUSE NO. STREET HAMLET Owner or Owners of Property... . . county Ta~ ~ap No. ,000 Sention ...~.. ~loc~ . .~.. Lo~' Subdivision ....................... Filed Map ........ Lot .......... Health Dept. Approval ............... Underwriters rova~-~ ...... Z ..... ' ' - app Planning Board Approval ................ Rcquest for Temporary Certificate ..... Fee Submitted: $ Final Certificate ................ rev. 10/14/88 ¢o £ ~o log TOWN llALL APPLICATION FOR 0ERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must b~ filed in typewriter OR ink and snhmltted to the Buildlog Inspector with the roll,wi,g; for oew hnildlngs or new ~se: ~. Final survey of property with accurate locatlou of all buildings, ~roperty llaes, street~, and ueusuallnatnral or topographic features. 2. Final approval of De~lth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swor~ statement fromiplumber certifying ~hat solder used in system contains less' 5. Com~erclul buildings+ industrial buildings, multiple residences and s~milar. : buildings and instal%atlons, a certificate of code compliance from the Archltect or Engineer responsible for the building. 6. Submit Planning Boar4 Approval of completed site plan requirements. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" laudluses: I. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or tppographlc features. 2. A properly cempletediapplicatlou, a consent to inspect signed by the applicant and a certified abstract of title issued by n title company which shall show single and separate ownership of the entire lot prior to April 9, ]957. · If a Certificate of Qccupaucy is denied, the Building Inspector shall state tho reasons therefor in writing to the applicant. 3. Date of any housing ~ode or safety inspection of b~ildlngs or premises, or other pertinent information required to prepare a certificate. For Vacant Land Cert~flCate of Occupancy: ]. Am application for ~aeant laud Certificate of Occupancy shall-be submitted, and a certified abstlract of title issued by a title company showing single and separate ownership o:f ,the entire lbt prior to April 9, ]957 shall also accompany the appllcatiou. I~ a Certificate of Occupancy is denied, the Building Inspector shall state the reaslons therefor in writing to the applicant. FEES: I. CERTIFICATE OF dCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to D~elling $25.00, Swimming Pool, $25.00. Accessory building Addition to Accessory buildings, $25.00 - Businesses $50.00. Certificate of Occupancy om pre-existing dwelling - $100.00. Copy of Certifldate of Occupancy - $5.00 - over 5 years - $10.00 3. 4. 5. 6. Vacant Land Cer! Updated Certifi( Temporary Certi~ ificate of Occupancy - $20.00 ate of Occupancy - $50.00 icate of Occupancy -$15.00 Residential Commercial FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Memorandum from .... BUILDING INSPECTOR'S OFFICB TOWN OF SOUTHOLD PIALL, $OUTHOLO, N. Y. 11971 765-1802 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~-- ">~ ' ""'~:,I~,! '~.~.1;~,~ 03, :[989 62022189/89 Date ~pplication No, on file only the ~lectrical equipment ~ ~scdbed below and intmduc~ by t~ op~icant ~med on the o~ve application number in the in thefollowln~ loc~io~j ,~ ~sem~t ~ Is~ FL ~ 2nd Fl. Oi)~[' Section Bilk Lot ~s exa~nlned on attd found to be in co.tpliance u'ith th~ requlreme~ts of this Board. EIXTURE OUTLETS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST OTHER DRYERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V t C E OTHER APPARATUS: NO OF CC COND 3/O NO OF HI-LEG ^~A This certificate must not be altered in any manner; return to the o{fice of t~e %ord if incorrect. GENERAL MANAGER be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Examined 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ..-.~//~ .......... , 19~. Permit No../.~. 7.. 7.~..~T.. Disapproved a/c ..................................... (Bj,ffldin~l, fisp oct or) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... 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 shat[ 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~ulations, and to admit authorized inspectors on premises and in building for necessary ~slq~tions./-~ /") / ~ ... (~gnature of applicant, or name, if a corporation) ..... (Mailing address of applicant) State whe~ applicant is/~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .............................................................. Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ~:. 'and title of corporat, o'otficer)' Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet . County Tax Map No. 1000 Section ........ ./7/.. ....... Block '~-- ' Lot .~_ . .'. ' r(/"7, ~ Subdivision "Filed Map No ............... Lot ............... (Name) State existing use and occupancy (~/~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... K..~. i .~.~..~..~../-7 .................................................. b. Intended use and occupancy .. ~5'.):q.~.~7. .... /ff~...'7~>o.~,~. ,~ ..................... 3. Nature of work (check which applicable): New Building .. ' Addition .. . ..... Alteration Repair Removal Demolition ' Other Work , (Description) 4 Estimated Cost Fee * (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ............ ,. If garage number of cars ~ .~ .... 6. If business, commercial or mixed occupancy, sp.ecify natu~ and extent of each type of use ....... '~.~"."...~, .... 7. Dlmensmns of existing structures, if any: Front.. ~.~..~.. ....... Rear . . .~-~.tt~.. ...... Depth ...~...~.~' Height ............... Number of Stories ............. ~ ; .............. ~ ........................... Dimensions of same structure with alterations or additions: Front . r~ ......... : .... Rear .................. Depth ...................... Height ............. ~ .~. ~umber of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ i ...... Depth ............... Height Number of Stories , 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. cNa/ne of Former Owner . i ............ 11. Zone or use district in which premises are situated .... ~ .K'.~t. 2.~g.q~. ~ L,. , 12. Does proposed construction v, iplate any zoning law, ordinance or regal'at/on': 'iii 13. Will lot be regraded ...... ~,.O~ .................. Will e~.ess fill ~,:nemoved from premises: Yes 14. Nam e o f Owner o f pj;c.misea4,~. ,jg~ F~.~ ......... Addres~t~. ,2~.~.h. .... Phone No.'2.~.f 7.7.?..g~. ..... Name of Architect ~.?4r~,~g.,.. ,, ......... Address~ .~$?A~ .~ .~..'. .. Phone No.~./~V..4/~7.~...~...7.~iO. Name of Contractor ?.'..4oB. al.. ~.~.~.. · .~.'~Address ~.6~.O..~1 .&.u~. .... Phone No. ..... PLOT DIAGRAM Locate clearly 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 sho~ street names and indicate whether interior or corner lot. STATE OF NEV~YORK, "S COUblTYrO:F..,:~.q ~ .~,&l~... ....... .... .......................... (Name of individual signin~ntract) above named. ~ ~ ~ Hd is the ............................. , (Contractor, agent, corporate officer, etc.)~ of aid owner or owners, ~d is duly authorized to perform or have perfumed the shid work and to m~e and file this application; that all statements conta~ed ~ this application a~e true to the best ofh~s ~owledge and belief; and that the ~ork will be perfumed in the m~ner set ~orth in the application filed therewith. worn to befomme this 'ut a~ Pub~. ~:~ '. ~TG~ .... County THOMAS F. DOHER~ JR ~(Si~tfi~ of.a Nota~ Public State of New York ,~pplicant) Qualified In Suffolk County ~ ~,; ,,,, Term ~plres 12/31/88 being duly sworn, depo?es and says that he is the applicant