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Home My WebLink AboutZ-23569FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PP~E EXISTING CERTIFICATE OF OCuUmANCY No Z-23569 Date MARCH 28, 1995 THIS CERTIFIES that the building Location of Property PRIVATE ROAD OFF EAST END ND. House No. Street County Tax Map No. 1000 Section 3 Block 3 Subdivision Filed Map No. ONE FAMILY DWELLING FISHERS ISLAND, NY Lot Lot No. Hamlet conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23569 dated MARCH 28, 1995 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 SEASONAL DWELLING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P?.~;%SE SEE ATTAC~ED INSPECTION REPORT. RICHARD E. & M. T.T.~,T.YN THATCHER N/A N/A N/A J ~ldfn~ -I~spector Rev. 1/81 LOCATION: Private Road off East End Rd. (number & street) SUBDIVISION MAP NO. NA~E OF ONNER (~) Richard &Llewellyn Thatcher BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT Fishers Island, N.Y. (municipality) LOT(s) OCCUPANCY ONE FAMILY DI/ELLING (SEASONAL) OILIER (type) (o~raer-tenant) ADMIYrED BY: BILL FAULKNER ACCOMPANIED BY: SAME KEY AVAILABLE SUFF.CO. TAX MAP NO. ]000-3-3-6 SOURCE OF REQUEST: OI4NERS HATE: FEB. 17, 1995 DI4ELLING: TYPE OF CONSTRUCTION FOUNDATION TOTAL ROOMS: BATHROOM (s) PORCH TYPE BREEZEWAY DOMESTIC HOTI4ATER TYPE HEAT NONE OTItER: CF~4~NT BLOCK & BRICK IST FLR. OPEN FRAME ~ STORIES I ~ EXITS CELLAR 40I _+ CRAWL SPACE 601 _+ ? 2ND FLR. 3RD FLR. TOILET ROOM (s) UTILITY ROOM CELLAR BECK, TYPE PATIO FLAGSTONE FIREPLACE I GARAGE TYPE HEATER ELECTRIC AIRCONDITIONING WARM AIR HOTI~ATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWli~MING POOL OTIiER: STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: C~APTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. -? DATE OF INSPECTION HARCH 3, 1995 TIME START /0 ' ~E) END //~/~ · !! , EB i ' 1995 BLDG. DEPL TOWN OF SOUTHOLD Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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-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 1% 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. 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 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . ~.~.~~. ~. ~..I.~.q.~ .......... New Construction ........... Old Or Pre-existing Building .... ~. ........... Location of Proper ty.~. ~V.~.~. . ]~. ~.~.. ~.~..~: .~ .~..~*~.~a. g~.~~.~..C.~g~, ..... House No. ~~ ~,,Street ~~ Ha~et 0nwer 0w ers County T~ ~p ~o 1000, Section ..... .~ ....... Block ..... ,~ ......... Lot ....... ~ ............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Fina~.Cert_icate. ........... Fee Submitted: $...~.~.O.:..~. .................. CONSENT TO INSPECTION ~/~ ,~, 7-'~$"7'"~---~'~ , the undersigned. Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town F~S~5 ~~ , which is sho,~ and designated on the Suffolk County tax map as District 1000, Section ~ , Block ~ , Lot~ That the undersigned (hms) (have) filed, or caused to be filed, an applica- tion in the Southold To~ Building Inspector's O~fice for the follow~g: 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. (print name) (signature) (print name) N07~ - COORDINATE D/STANCES ARK MEA$~V~D Ft~4~ U S COASTAND OEODETIO SURVEY TRIANDU£ATION STATION ~ CHOGO~OUNT ~" ,./ BOUNDARY MAP THA TCHE~ PROPERTY BL OGK 19 FISHERS ISLAND~ NEW YORK $~ALE' I "=40 ft. CHANDLE~ PALMER ~ KIN~ Norwioh~ Gonn. dULY ~2,