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Home My WebLink AboutZ-16619FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16619 Date January 28, 1988 THIS CERTIFIES that the building . .T.w.q.f.a.m.i. 1. y..d?.e. 1.1. ~.n.g ........................... Location of Property Hedge Street Fishers Island, New York h ~ ~ s 'e 'd d ....................... 's't /e; i ....................... h ~r~ iei County Tax Map No. 1000 Section ... !.0 ....... Block 7 .Lot 19 Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a private one-family dwelling built prior to conforms substantially to the Al~!al/~,a4,~,~xfiatxll~tildi~ [hnnaitxh~n~t~l~fit~i~o~fi~lgnh~t~xxx Certificate of April 23, 1957 pursuant to hichl~[g~t~ll~l/qO ...................... ..................... W ' xy -tw OccupanCyz-16619 dated .... J.a.n.u.a.r.y.. 2.8. ,.. !9.8.8. ........ 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 ......... TWO FAMILY DWELLING & ACCESSORY SHED The certificate is issued toDOROTHY EDWARDS ..................... ?o;;,.'e;, ..................... of the aforesaid building. Suffolk County Department of Health Approval Iq/3. UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 BUILDING DEP;d{T[~ZENT T0%'~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location Subdivision Hedge Street [numoer & street) Fishers Map No. Island, N.Y. (Municipality) Lot(s). Name of Owner(s) DOROTHY EDWARDS Occupancy R-2 (type) A~mitted by: Key available R. Reed' (owner-tenant) Accompanied by: Suffolk Co, Tax No. ]0-7-~9 Source of request Stephen L. Ham iii' Date Jan. 5, ]988 D¥~LLIMG: Type of construction WOOD Foundation Stone Total rooms, let. F1 9 ~stories 2 Cellar ~ Crawl space ~ 2nd. F1 4 .3rd. F1 Bathroom(s) 2 Porch, typ~ Breezewa~ NONE Type Heat OIL Fireplace(s) NONE Domestic hotwater Other screened inDeck' type. Garage NONE Warm Air No. Exits 4 Toilet room(s) NONE Patio, type none Utility room Hotwater xx Airconditionin~ Tankless Hot Water Type heater ACCESSORY STRUCTURES: Garage, type const. NONE Swimming pool NONE Other Accessory Shed Storage, type const. Guest, type const. NONE· NONE VIOLATIONS: Location Housing Code, Chapter 45 N.Y. Stat~uiform~Fire Prevention & Buz±aln~ Coo$ Descriotion [Art. I Sec. Two Family House Accessory Shed Remarks: This is a_pre-existin~g~o family dwelling Inspected by: ~~.~.~ .~.?--Da. t e of Insp. ~/7/88 -Time start 10:32 end 11:05 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, 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 Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and 'similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling ~6~. ~0]0X $50.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date . .5.a.n..u.a.~....5 ~..~9.. 8..8 ....... New Building ............. Old or Pre-existing Building ....X.~. ...... Vacant Land ............. Location of Property ............ I~(~]gD..~i;r.e.e.t' ...... Fishers Island - House No. Street Ham/et Owner or Owners of Property ¢:. J~qb~.~.c[ .]~.~.~e..i.s.,..5.~: and Eaten .A...Bartels County Tax Map No. 1000 Section 10 Block 7 Lot. [.9 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ............ Fee Submitted $. ~.0...00 ...................... Construction on above described building and permit meets all applicable codes and regulations. Applicant · Stepher/ L. Ham, III ' Rev. 10-'10-78 * two- £amil¥ CONSENT TO INSPECTION C. RICHAR~ BARTELS, JR. and KAREN A. BARTELS, by their attorney, Stephen L. Ham,,III · the undersigned, Owner(s) Name(s) do(es) hereby state: the attorney for That the undersigned (is) ~ the owner(s) of the premises in the Town of Southold located at Hedge Street, West End, Fishers Island · which is shown and designated on the Suffolk County tax map as District 1000, Section 10 , Block 7 ., L, ot 19 ¥ That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy for pre-existing dwelling Ctwo-family dwelling) That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon· to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws· ordinances· rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: January 5, 1988 ~"~ig~natu/"r~) Stephen L. Ham, III (print name) (signature) (print name)