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Home My WebLink AboutZ-21049 - FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-21049 Date SEPTEMBER 29, 1992 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property FOX AVENUE FISHERS ISLAND, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 9 Block 1 Lot Z 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-21049 dated SEPTEMBER 29, 1992 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 ONE FAMILY DWELLING * The certificate is issued to HENRY L. KING (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. f ' Building Inspector Rev. 1/81 ~ TO:~~( Oc ~C'JT:iOLD, t1. Y. ECli I::G CC~.°. Iii:~?~CTIOtI iZ G;~T Location FO% AVENUE FIBBERS ISLAND, N.Y. ~nt:.:.ocr ~ ::~ree~) l~•iu:,~cipallcy) Subdivision ~ia~ CIo. Lot(s) N2.ze of Oerner(~) HENRY L. RING • R-1 OWNER Occupancy type) o~:rner-cen~nz) Ad.:fitted by: Acconpanicd by: Key available BAGLEY RIBD Suffolk Co. Ta:: PTo. 1000-9-1-2 Source of request STEPHEN L. HAMM III Dates SEPT. 11, 1992 D'.:'?LLING: Type of construction WOOD FRAMED =`stories Foundation STONE Ce11ar PARTIAL Cra*.~rl space REST Total roons, 1st. F1 7 2nd. Fl 10 3rd. F1 Bathroo:~(s) 3 Toilet roon(s) 1 Porch, type OPEN Deck, type ~ Patio, type_ Breeze:•ray Garags Utility roon • Type Heat OIL FIRED ~'rlarm Air ~ Hot:r",,.r Fireplace(s) 2 No. E:cits 4 Aircor_ditienirg Dc-festic hot~:rater YES T-,rpe hezzer PROPANE GAS Other SMOKE DETECTORS -ARE ON EACH FLOOR ACC=SSO~Y S'?'arJC^'JRL'S : NONE Gzra^~e type consi. Storage, type corst. o , Sari.: ~i no pool Guest, type const. Other V?OL.4TIOidS: ,CIIAPTER 45--N.Y. STATE UNIPOItrf FIILL•' PKIiVENTION d~ ISUILDING CODE - Lnr,ation DAscrintion IArt.I Sec. NO VIOLATIONS WERE FOUND. I i I I I I _ _ I I Re:~ar_;s: Iri3?eCted by: ROBERT L DatC Of Iri~p, SEPT. 21, 1992 ,rya ~/~~~,,,Z~ Tine start end • 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-O 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 Panning Board Approval of cos~ple~ed site plan requirements. For existing buildings (prior to Aril 9,__1757) non-conforming uses, or buildings and "pre-existing" land uses: 1. •Accurate surv_eX.___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. 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 5~2~@41~~.r:.~Qr. 19~? Iew Construction........... Old Or Pre-existing Building.......X......... '.ocation of Property:......~Q, ~ . . . .......F:Q?l. ~~~nu~........ , , Fishers ,Island, . - , , . House No. Street Hamlet ~nwer or Owners of Property..... Henr~t,L: Kind 'ounty Tax Map No 1000, Section..... 9.......Block..... 1. .........Lot.....? ubdivision ...........................:........Filed Map............Lot...................... ermit No ................Date Of Permit................Applicant....... f~ealth Dept, Approval ..........................Underwriters Approval....... lanning Board Approval equest for; Temporary Certificate........... Final Certicate... ee Submitted: ~ ~ ~ ~'~-<'~~g~- ~ APPLICANT... co::sr:::T TO IiV~PECCION HENRY L KING thrt unclc~r~i~ncd, Us•ncrts) Namct;;) do(es) hereby state: That the undersigned (is) (arc) the ovmcr(s) of the prcmiscrs is the To::-n of Southold located at No # Fox Avenue, Fishers Island, New York :which is sho::n and desirn~ted on the SuC'olti County tax map as District 100, Secticu 9 Block 1 Lot 2 , That the undersigned (has) (leave) filed, or caused to be filed, an applica- tion in the Southcld Town Luilding Insnector's Office for the follovrir.g: "Pre-Certificate of Occupancy" That the ur.dersi~ned doles} hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including an~r and all buildings located thereon, to conduct such inspections as they :~tay deem necessary with respect to the zforesaid application, including inspections to determine that said premises comp?,r r•ith all of the la::•s-, ordina^ces, :saes • ar.d re ulations of the To:vn cf Southold. The undersigned, in consenting to such inspections, do(es) so «zth the '-:no:vledge and understanding; that any info: oration obtained in the. cor:duct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the la:vs, ordinances, rules or regulations of the To:vn of Southold. Dated: September /Q 1992 • (sibnaturc) • , HENRY L. KING (print name) (si~naturc) (print name)