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Home My WebLink AboutZ-9855 �4�gUfrPQd,f�OG� Town of Southold 2/25/2020 53095 Main Rd a N Southold,New York 11971 2 o � PRE EXISTING CERTIFICATE OF OCCUPANCY No: 9855 Date: 1/29/1980 THIS CERTIFIES that the structure(s)located at: Off East End Rd, Fishers Island SCTM#: 473889 Sec/Block/Lot: 4.-5-19.5 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 9855 dated 1/29/1980 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: private one family dwelling and accessM garage. Corrected 2/25/2020 to add accessory garage only. The certificate is issued to McDonough EM 2012 Rev Trt (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. AuthchVed Signat re Form No.6 TOWN OF SOUTHOLD ,1 ' y" _t• '^_-j ;b" ' s -4 ` ,�.. BUILDING DEPARTMENT j c' TOWN HALL 765-1802 FEB 2 5 2020 - APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department wilfi'the following:` A. 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 I%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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool $50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: Z 3 jar U A`5 2 v o ff( S �'S Sf��il House No. Street Hamlet Owner or Owners of Property: �- /� �/ � / C,�v v rs i of 1- fa`vse 0 t 7-4. Suffolk County Tax Map No 1000, Section 0 U H . U Block a S• V a Lot 0 el. 9b''r Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:_� (check one) Fee Submitted: $ -50- 11,110 5 a Z a b Applicant Signature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ..... Z98.~.5 ....... Date .... J..~U.8~...~9 ................. 19 ..~. THIS CERTIFIES that the building ................................................ Location of Property i~. iva.~e. Road. ~.t, sh.~.a. II~llRt~t,..I~.Y. [4~[~s~ 'N'o~ ....... 'S'tle~{ ...... Hamlet County Tax Map No. 1000 Section .... ./4 .......Block ..... ~ ......... Lot .... 'l .~. ~1..1~[.. Subdivision ............................... Filed Map No ......... Lot No .............. requirements for a one family dwellin built prior to conforms substantially to the ' Certif~oate of Oooupancy Z9855 · . . gJp~il. 27 ........ , 19 .~7. pursuant to which ]~J~J~lJl~No ...................... dated ... J~Ua~Y..i~9 ............. 19 8.O., 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 ......... ......... ?': ......... Pri~tate..One. F. amil~..Dw?lling ........................... The certificate is issued to of the aforesaid building. .......... A.,. all. II.i .......................... (owner, tJ{~3~3~l~ Suffolk County Department of Health Approval ............ N/R .......................... UNDERWRITERS CERTIFICATE NO .................... 1{//~ .......................... Building Inspector Rev 4/79 No Inspection ,~.. = FOKM NO. $ TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, an6 unusual natural or topographic features. 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 installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. §. 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 property 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 in- formation required to prepare a certificate. New Building .... z.r. ............ Old or Pre-existing Building .............~. .............. Vacant Land -- Location Of Property ......... .,~..~..s..h..e..~..Z..s..]:.a..~...d..:....~..:....~..: ............................................................................... Owner Or Owners Of Property .....W...~.I:..t~,a...z~,....A........H...a.!:..I:~...[..[..[ ........................................................................... Subdivision Z.T ............................................................ Lot No...q.Z ....... Block No...T..'~ ...... House No.~.T ......... Permit No .....;.Z ............. Date Of Permit ..... 7.~. ........... Applicant .~.Z .............................................................. Health Dept. Approval ...T.Z ..................................... Labor Dept. Approval Underwriters Approval .... ~..Z ...................................... Planning Board Approval .... q.Z ................................. Request For Temporary Certificate -- Final Certificate ................ .~. ........................ Fee Submitted $ .... .5.:...0..0. ....................... Construction on above described building and permit meets all applicable c~des and~regulations. Ap.plican, ~7...~.~ ................. Sworn to before me this ~' ................ day of ....... ~.a.,.n..u..a.~..:..~.9..8...0. ......... (stamp or seal) Notary Public ............... . .S..u.f~.o.~.k. ....... County