HomeMy WebLinkAboutZ-24688 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE E%ISTIRG
CERTIFICATE OF OCCOPARCY
No Z-24688 Date OCTOBER 16, 1996
THIS CERTIFIES that the building ORS FAIiILY DWELLIRG
Location of Property MIDDLE FARlIS OFF EAST EED RD. FISHERS ISLARD, RY
House No. Street Hamlet
County Tax Map No. 1000 Section 8 Block 1 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-24688 dated OCTOBER 16, 1996
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 OBE FA!lILY DiPffi,LIRG
The certificate ie issued to FIBBERS IBLARD RBBTALS IECORPORATSD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R/A
UNDERWRITERS CERTIFICATE NO. PERDIRG - OCTOBER 4, 1996
PLUMBERS CERTIFICATION DATED R/A
*PLEASE SEE ATTACHED IRSPECTIOR REPORT.
it ng Inspector
Rev. 1/81
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I1011!i 1110 CUUI! 111!il'1!C I I UII Ill'.I'OICI'
I.uCn'I'1UII: MIDDLE FARMS OFF BAST END RD. FISHERS ISLAND, N.Y.
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Anne ut' ounl!It (n) FISHERS ISLAND RENTALS
SELF
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- _ 1000-08 01-02 .
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:iuulu:u. 17r nl l~ui '.'r: STEPHEN L HAM, III, ATTY on rh : AIIG. 26, 1996
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Iu.UnItKH: DNDERWRITERS SDRVEY CERTIFICATE WAS REQDIRED.
11161'1.1:'(1 I) IIY - Ilnl'I? UI III!il'I~.CI'IUII SEPT 20, 1996
GARY J A BERT WALL I'Itlli !i'I'nlt'I' 1:25 PM I!IIII 1:40 PM
- Form No. 6 S;'-~ f~
TOtdN OF SOUTIIOLD ,
BUILDING DEPARTMENT 2 6
TOWN HALL
765-1802 ~ -
APPLICATION FOR CERTIFICATE OF.000UPANCY
This application must be filled in by typewriter OP, 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 Der t. 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.
S. 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.
3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"prc-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 $15.00, Commercial $15.00
Date ..August.2.~.+..1~~6
::ew Construction........... Old Or Pre-existing Building.. X
[.ocation of Property.. ~}?o,~),,,,,,,,,,,,,,,,,,,,,F~~.st„End, Fj,oad,,,,,,,, Fishers.Island..
House No. Street Hamlet
Unwur or Owners of Property..FISHERS, ISLAND RENTALS,,INCORPORATED
County Tax Map No 1000, Section.. 008,.,00 , , , ,glock. ,01: OO , , „Lot. , ,002..:000. _ .
Fishers Island Development
Subdivision.~oZ:R9~~.tion ......................Filed Map.A421,,,,,,Lot.,,?1:5.,_...,_,.„:„
Pcrmlt No.. N~A..........Date Of Permit...: NJ
A........Applicant. Stephen L: Ham.. III
ltealch Dept. Approval... N /A ...................Underwriters Approval.Nl A.
Planning Board Approval. N/A.........
-;tequest for: Temporary Certificate......... ~ Final Certicate... X~ -
_
Fee Submitted: $.~,~0.00 -
'~e ~ ~~y~ . APPLICANT