HomeMy WebLinkAbout28567-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29350 Date: 04/09/03
THIS CERTIFIES that the building ADDITIONS ALTERATIONS
Location of Property: OFF AVE B FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 6 Block 2 Lot 15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 15, 2002 pursuant to which
Building Permit No. 28567-Z dated JULY 16, 2002
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 & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to PIERCE RAFFERTY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1090589 04/03/03
PLUMBERS CERTIFICATION DATED 03/03/03 ROBERT E. WALL
f
la4
Au orized Signature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 28567 Z Date JULY 16, 2002
Permission is hereby granted to:
PIERCE RAFFERTY
496 NINTH ST #2
BROOKLYN,NY 11215
for
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES EXPIRED PERMIT # 13138Z
at premises located at OFF AVE B FISHERS ISLAND
County Tax Map No. 473889 Section 006 Block 0002 Lot No. 015
pursuant to application dated JULY 15, 2002 and approved by the
Building Inspector to expire on JANUARY 16, 2004 .
Fee $ 150 . 00
Au Kori d Signatu e
ORIGINAL
Rev. 5/8/02
NO= N0. S
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)
N° 13138 Z ..... 19. .
Date ............... .. .... ............. ..,
q.
Permission is hereby granted to-
.......
- -�
.. ......!�.. 1. �:�..........�C.J r, 1 ................
.... .4.:?4... . .. .. ...........................................
to .............. ..... ........° ....... .;.. :.. :.... .,.... ....... ...........................a.........
.. .`.:`. .... ...................��..j........ ........�, ... .. ...... ..................
atpremises facated at ..... ....... ............../.•..1............. !. .... . .................
................................................................................................................................................................
..................................................................................................................................................................
County Tax Map No. 1000 Section ... ..Q (P ... Block ..... ? ::....... Lot No. ......Q .......
....... .........
pursuant to application dated ...5....{..................I 19d., and approved by the
.......
Building Inspector.
Fee $ ..... ..........
�C C
... ......... Building Inspector
.........B . '....... ................
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD ��
BUILDING DEPARTMENT la 2 5 202
TOWN HALL
765-1802
1T140Ln
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-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 buildinf
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 an(
"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 Buildinc - $100.00
3. Copy of Certificate of Occupancy - -2. .
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ,September. . .. 2002
. . . . . . . . . . . . . . . . . . . .
New Construction. .. . . . . . . . . Old Or Pre-existing Building. . . . .X
Avenue Location of Property. , . . . . . . . . .Fishers Island
. . . . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
PierceRafferty
Onwer or Owners of Property. . . . , , , . , . . . . . . . . .
County Tax Map No 1000, Section. , 006. . . . . . . . .Block. . . . . . . . . . . . . . .Lot,015 . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . .
Permit No. . Date Date Of Permit,5/18/84. . . . . . . .Applicant.Ronald .Rudd . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . :. .. . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
X
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
25.00
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .. . . . . . .
Z . • . • •. . . . . . . . . • • • . • . . . . . .
3 G � APPLICANT
L� 9 ,35 0 Pierce Rafferty
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1065008 BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK. NEW YORK 10038
Date NOVEMBER 18,1994 Application No.on file 85598194/94 N 333940
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named an the above application number in the premises of
BERNARD RAFFERTY, EAST END ROAD, FISHERS ISLAND, N.Y.
in thefollotcinAlocation; ❑ Basement ❑ Ist Ft. ❑ 2nd Fl. OUT Section Block Lot
teas examined on NOVEMBER 15,1994 and found to be in compliance with the National Electrical Code.
FIXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RICIPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT.. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE SEEDERS SPECIAL RWFT TIME CLOCKS REu , UNIT HEATERS MULTI-OUTLET DIMMERS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. _-AMT. H.P. NO.OF RET AMT. WATTS
SERVKX DISCONNECT NO.dF S E R V I C E
AMT. AMP. TOPE
IQ T X YW 1 X 3W 3 X 3W 3 X 4W NO. CC.COND. A.W.G. No.OF HIAEG. A.W G• NO.OF NEUTRALS A.W.G.
PER 0 OF CC.COND. �F'H6LEG OF NEUTRAL
i
OTHER APPARATUS:
REPLACE DEFECTIVE tfETER SOCKET-1
f
FISHERS ISLAND ELEC.
DRAWER "E"
FISHP:RS ISLAND, NY, 06390 GDOM MANAGER
11
Per --'
This certificate nAW not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their-credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
03/03/2003 15:37 FAX 631 788 7798 FITEUPHONE IM 002
TEL 765-1802
FFotk�p Towle OF SOMMOLD
OFFICE OF BUILDING INSFyEMOR
P.O.BOX 728
TOWN HALL
SOUTHOLD,N.Y_ 11971
C E R T I F I C A T I O N
Date
Building Permit No.
f
Owner /cf
et
(please print)
Plumberlld6��/ .e. Axa`
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber's signature)
Sworn to before me this
_day of f
--iAf ax- 3 Nota31%W ` _ blJ
v�
Notary Public, County :� _ r
VERONICA H�
NOTARY PUOLlb.
STATE UP NEW YQF ...._..-�
NO. 01 HA6067785
QUALIFIED IN SUFFOLK
TERM EXPIREB.. ,���
r
loom-
M-1802
J
BUILDING DEPT.
P T
1 NS EC ION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ .1 FRAMING [ INAL
1-10
REMARKS: - '�•,,_, ^'
•'e. :ox. -y ,
DATE INSPECTOR
FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD,N.Y. 11971
TEL.:765.1802
Examined .. V� ... , 10 Received. . . . . . . . . . . .19. . .
Approved . .. ... U�^!� �.. , 193.1.Permit No .41 0
Disapproved a/c . .. ..v........ ...... .... .. . .. .. .. . .. . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT g p
Date
INSTRUCTIONS
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 may 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 co , ousm code,a lations,and to
admit authorized inspectors on premises and in building for necessary inspections,•
P ...........
(Sign re of applicant,or name,if a corporation)
�. 663 firljays I/ � /l/.!! 063�a
(Mailing address of applicant)
State whether applicant is owner, lessee agent, architect, engineer, general contractor, electrician, plumber or builder.
iae .... . .. ... .A *�*
Name of owner of premises . 4/d .'g."OK �./.` e` � l.` ...... ..... .... .. ..... . ......
(as on e taxroll or latest deed)
If applicant is a corporation,signature of duly authorized officer.
..... ............... ....... .. ... .... ..... .. ...
(Name and title of corporate officer)
Builder's License No. .. .... ..... ....... ... ....
Plumber's License No. .. . .. .. ... .... ..... . .. ..
Electrician's License No. ... .. .. .. .. . . .. ..... ..
Other Trade's License No. .......... .. .. .....
1. Location of land on which proposed work will be done. .. .... ... .. ... ...... ...
.... ... .. ... ... .. .. d�r��... . . .. ... .... .. .....�..�e�s.r,,��/��l :'..'..
House Number Street Hamlet
County Tax Map No. 1000 Section . . .. .... D6 .... .. Block ....(2.9 . .. ....... Lot.,
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 .. .112/.O-2nCv.L44 !"z a!,,�.. .!�eS!c�h�. ......... .... ... ...... .
b.Intended use and occupancy ..P? ..... .. ... ... ..........s'd �
3. Nature of work(check which applicable):New Building ........ .. Addition ...Y.•. •• Alteration ..�!. .....
Repair .............. Removal .. ...,. ....... Demolition .. .. .......... Other Work...............
(Description)
4. Estimated Cost ....... 0,0, IO•..��^... ............... Fee .. .... ..D.
(to be paid on filing this application)
i
S. If dwelling,number of dwelling knits .. ..../........ Number of dwelling units on each floor.. ..............
N/+ If garage,number of cars ....:........... .................... ... ........................ .........
/V/+6.
business, insecifynZturyand extr f each use. If
ensins of existuo tructurof any:Front Rear
.. 'Deth . ... .......
i
p 3/ o;
Height ......Number of Stories•... ... .........•• ••...•••,
Dimensions of same structure with alterations or additions: Front ...`+��'7.3. 1 1 1 1. Rear .'¢9'.:"•4'....,..•.
Depth .. +!.".4. ...........Height .. .... Number of Stories..t2-.................
g, Dimensions of entire new constt'uction: Front . ............ Rear .......... ..... Depth ..... ..........
Height .Nuniber of Stories . ....... .....•••
9. Size of lot: Front .... .... ... Rear.. ....1 a O.�.......... Depth ..7r ... . . . ..... .
10, Date of Purchase ...!P/z4/13:!x..............Name of Former Owner .�° �i .
11. 'Lone or use district in which promises are situated.. .......... .....1111: .............. ..... . ........
12. Does proposed construction violate any zoning law,ordinance or regulation: �?..... ........ .. .......
13. Will lot be regraded � �'-, ... ...Will ex ess fill be removed from premises: Yes No
14. Name of Owner of premises /�°Na.'. ..... ......Address 0:6`''���.3r�'..4r Phone No.f!}A
Name of Architect . .... .. ; ...11 1...1.... ..Address .... ...............Phone No. .1........... a :.s
Name of Contractor .,.... ..i..... .......... ..Address ...................Phone No. ...............
i
� PLOT DIAGRAM
Locate clearly and distinctly alb 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. Cbr (`
I
i
i
i
STATE OF NE}y YORK
COUNTY OF W., R �4., S.S
.., •. ,,,,, ••,, •,, ,,,, ., ,. being duly sworn,deposes and says that he is the applicant
1 (Name of individual sig ing contract)
above nambd.
Heis;the ............ ...... . ... ..... ...... .. ... ........ ...I...........
(Contractor,agent,corporate officer,etc.)
ef-o*.owner a&sweefs, and is dgly authorized to perform or have performed the said work and to make and file this
aliplipationj;that all statements contained in this application are true to the best of his knowledge and belief;and that the
work will be performed in themprajer set forth in the application filed therewith.
Sworn to befure•me this 19 1
.. ......... day qf..
., 19122
Notary Public, ....(X"A v ... County
Q.Qi>rt-
• 7(D/'J NNotoa,ry41ENA" Ife Qf Naw Yerk 1 1 1....
% � ,..
.........
.5695950 Qvoone County
(Signature of applicant)
Tent Eapiros March 30, 19 6
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of
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EAST ELGVATib1 Mi}nY FLOOK.iGM�
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.47-9 am ;10":D AS NOTED
17 Q+ D B.P.
F
FOYER- N BUILDING DEPARTMENT A_
7-6.4-4 1 02 9 AM TO 4 PM FOR TI,E
F7 F OWING IN&PECTIONS:
QQ UNrA I TWO REQUIRED
TH
BA R POURFFl CONCRETE
2 " L,'G;-! FRAMING & PLUMBING
or
I i 4 .
inN MUST
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-.'CTION SHALL- MEET
RF-'"Rf:kA=NTtS CF THE N.Y.
E'C,:)N'7 "
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12.00 AVENUE B POLE #160 '
N � �
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MONUMENT I I N Jg D3 1D W ,■II•, o a
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I I I MAP REFERENCES w 0
SHED 3 4� IRON PIPE
NALD & MARY ANN RODD; AVENUE > 3
IRON PIPE 1 .) PLAN OF PROPERTY FOR RO
MONUMENT I 88.00' B; FISHERS ISLAND, NEW YORK; CHANDLER, PALMER & KING; < 0 LL m Z
N 7'00'30"
/ J NORWICH, CONNECTICUT; DATE: 12/23/99; SCALE: 1 "=20' Q
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NOTES
/ / m
_ SEWER ea I �,pi� 1 ,) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE Q� � _
M.H. I m 5ti INDICATED HEREON, ANY EXTENSION OF THE USE BEYOND THE 0 w cn
EXISTING RESIDENCE II II p FENCE g% q�� 0�$ �F. PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR a 1+-
N 9a�o EXCEEDS THE SCOPE OF THE ENGAGEMENT.
ANNETTENIF
ZAB0H0NSKI r / n o ,¢tG 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY
m
I � PERSON, UNLESS ACTING UNDER THE DIRECTION OFA LICENSED
N I A y LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY,
J
3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND
SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL
\ — O` / ARE THE PRODUCT OF THE LAND SURVEYOR,
LOT AREA= 8926 SQ.FT.1
0.20ACRES �� -- MONUMENT
PICKET FENCE "\ — i 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S COAST AND NR
\, 1 I GEODETIC SURVEY TRIANGULATION STATION "PROS" Z a
OLD WIRE FENCE /
O
MONUMENT
'y W 103.91' N
\ 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX w
11i o
SHED I I� I 03 \I MAP 1000, SECTION 006, BLOCK 2, LOT 15. —
i >
POLE f I`12 �Iz 02 / CERTIFIED T0;
N/F I o \ // PIERCE RAFFERTY o
WALTER E. & KILLGOAR ROBERT N �I� Y COMMONWEALTH LAND TITLE INSURANCE COMPANY
/ 07 \ HALE IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS
06, \ I� ? �'I�°, OF THE NEW YORK STATE LAND TITLE ASSOCIATION. o
DETAIL TITLE # RH80014583 - z
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FIRST FLOOR I � FIRST FLOOR
`tea I I vwmL aIle xow
SNR MIM
I I I
I I I I I
j
N o
Z a
_ w
0
w
a
0
a
a
o p
v
a u
m
o p
O U = Z Y
LJ
El Y J W K 2
0. li p p U
DATE: 03/29/2002
SCALE: 3/16' = 110°
SHEET: 4 OF 5