HomeMy WebLinkAbout15432-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEFARTF~ENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22278
Date APRIL 26, 1993
THIS CERTIFIES that the building.
Location of Property EAST END ROAD
House No.
ADDITIONS
FISHER ISLAND~ N.Y.
Street Hamlet
12
County Tax Map No. 1000 Sectio~ 1 Block 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21, 1986 pursuant to which
Building Permit No. 15432-Z dated OCTOBER 28~ 1986
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 ADDITIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to PETER STRIFE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEAL~ APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N-055645 - JANUARY 30~ 1989
APRIL 13~ 1993 - A.JOHN GADA
Rev. 1/81
FORM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDinG PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
15432 Z
Permission is hereby granted to:
...a:....G....~.~ ....... ..g.~.,....~... ............
otprem,ses,ocoted' ~,..~..' .;.'~ ....... ~. ....... ~A~......~ ..................
..... /..C,. .... .~.~......, ........................ ~46,*.~, ..........................................................................................
County Tax Map No. 1000 Section ....... ..C~.....i ......... Block ...... ...1~...~ .... Lot No ..... 1...';/. ..............
pursuant to application dated .... m.~....LI ................. , 19..~....~, ond approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF
OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
<_~.~. i/.~...'~..~.LQ...
.~.
Location of Proper~7 ..... ~ ...... ..~-l~. .........
HOUSE NO. STREET --HAMLE~
..~ ~< ~. '' ~ .
o~ o~ o~ of e~o~w..,~,. . ..... -..=~/.~/.~ ...............
cou~w ~ ~p ~o. ~000 s~=~io~ ../... ~o=k ..-~... Lo~ .../~..
Subdivision ....................... Filed Map ........ Lot ..........
Permit No. ~'~'/,~.Z.~ate of PermitV.~.~.Ot.4~.C*pp,i=a,,~ .fl..~,.: ..........
Health Dept. Approval .................. Underwriters Approva .........
~.i.~ ~o~ App~ov~t ... ~. ~ ........
Request for Temporary Certificate ....... Final Certificate ................
Fee Submitted: $.~ .......... ~-
APPLICANT . .
rev. 10/14/88
'OU~4DATION (1st)
'OUNDATION ( 2nd )
~OUGH FRAME
FLUMBING
ZNSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
I,~'~, ~ ~ BUREAU o~ ELECTR,C,T~
~-- 85 JOHN STREET. NEW YORK, NEW YORK 10038
Date ,{ANIiARY ~(} ]~9 ~pplicationNo. onfile ~Aq~0~/~ ~ 0~g~
THIS CE~IFIE$ THAT
[] 2nd F/. ()fit &¥tion Block
ond found to be in compliance u'ith the r~q. irement# o~ this
Jot
RXTUIll RXTURRS RANGES
OVENS I~H WASHERS EXHAUST FANS
OIMMRII$
OTHER APPARATUS:
C
NO. OF HI-LEG
I,i('.~,:N~,; Nth ~q~ K
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ident;fied
P'~entials.
COPY FOR EUILDItlG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AHY MANNER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
C E R T I F I~C A T I'O N'
Date April 13, ~993
Building Permit No.
Owner Dr. Peter FI. Strife
Plumber A.
(please print)
O0hn Gada General
(please print)
Contracting, Inc.
I certify that the solder used
contains less than 2/10 of l%'lead.
in the water
supply system
Sworn
19
to before me this
day of
(plumber's signature)
License No. 452-P
Notary Public
Notary Public, County
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
8OUTHOLD, N.Y. 11971
TEL.: 765-180:3
Examined .O.~....a-gM~....~-..~.., 19 8.~.
Approved .O.~....a~.....~-.~.., 19~.~. Permit No..I.~.~.~
"' Ogr
Received ........... ,19...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
IN STRUCTION S
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application nmy not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work,
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector·
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary i.t~pection
~ (Signature of applicant, or name, if a corporation)
(Mailing address of applicant) '
State wh0tqt~r applicant is owzI'~, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
/!
!
/ '
....... ..... ............ .................................... :. :.:-,-..
Name of owner of premises .... .'¢).14.-, .... /. ¢ JA.~... ,~. L .~..~.'. ............................................
(as on the tax roll or latest deed)
If applicantJs, a corporation, signature of duly authorized officer.
..............
/ (Name and title of corporate officer)
Builder's License No .... ~..~./. ,~...~..~. .........
Plumber's License No .... 4.~..~. ,'7...P ...........
Electrician's License No....~.?.~..':.{'C ..........
Other Trade's License No..../..~.t/.'7.. J~ ~ ......
1. Location of land on which prol2oaed work will be done ..................................................
......... Hamlet
House Number Street
· County. Tax Map No. 1000 Section ....... / .......... Block ....... ~ ..... '... Lot .... ./..r~.. ..........
Subdivision .................................... '. Filed Map No ............... Lot '
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy ....................................................................
3. Nature of work (check which applicable): New Building ~ Addition..~. ....... Alteration . ~ ......
Repair .............. Removal .............. Demolition ............. Other Work ...............
4. Estimated Cost... ,, ........................ Fee .....
~ rte be pa~d on fihng th~s apphcat~on)
5. If dwelimg, number of dwelling units ............... Number of dwelling units on each floor ................
If garage number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear ....... i ...... Depth ...............
Height ............... Number of Stories ............. ; .............. i ...........................
Dimensions of same structure with alterations or additions: Front ............ i .... Rear ............
Depth ...................... Height .......... ~, ........... Number of Stories ......................
8. Dimensions of e tire new construction' Front ~.5' Rear ~ ~' Der !
Height .... ~.~. ......... Number of Stories ..... ( ...................... i .....................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ............. . ................ lya~e of Former Owner . ~ ...........................
11. Zone or use district in which premises are situated ...... .~.c.~??.~. ~.~.~.~ ......... i ...........................
12. Does proposed construction violate any zoning law ordinance or regulation: .... './~..~ ........................
13. Will lot be regraded ..... c~' 'Ar'°' ' ~kt; ;~.~; ......... Will exc~.e ? fill b~removed from premises: ,~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
!
STATE OF NE_W Y ORJ / S S ' '
COUNTY OF. ~q-~5~(~.. t..~-. .... '
..... tt~.,, .~O~4_M ~ ~'. ~ .................... being duly sworn, deposes and says that he is the applicant
(Name of indNidual signing contract)
Heab°ve named.is ~e~" ~ ~ ~C~0~ . ,:
(Contractor, agent, corporate officer, etc.)
of said owner or owne~, ~d is duly authorized to perform or have perfomed the s¢id work and to m~e and file this
application;that fll statements contained ~ this application are true to the best of his] knowledge and belief; and that the
~ork will be perfo~ed ih the m~ner set forth in the application filed therewith.
Sworn to be~o~e this ~
....... /~f~ .......... day of...~(~'~ C.~ ...... , 19 ~ :
.............. County ~
....