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Home My WebLink About11573-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall southold, N.Y. UPDATED CERTIFICATE OF OCuumANC~ NO Z-26296 Date FEBRUARY 23, 1999 THIS CERTIFIES that the buildin~ DWELLING Location of Propert~ MADELINEA~ENUE FIEBRRS ISLAND House No. street Hamlet County Tax Map No. 1000 Section 6 Block 8 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 9~ 1981 pursuant to which Building Permit No. 11573-Z dated FEBRUARY 22, 1982 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 OWE FAMILY DWELLINC WITH ATTA~HED DECK ASAPPLIED FOR * The certificate is issued to RICHARD C. & BARBARA A. EDWARDS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 11-BO--120- APRIL 8, 1982 UNDERWRITERS CERTIFICATE NO. N-576571 - SEPTEMBER 17, 1982 PLUMBERS CERTIFICATION DATED N/A * THIS UPDATES CO Z-19241 DATED JULY 25, 1990 Rev. 1/81 TOWN ;OF SOUTHOL~) BUILDING DEpARTM~N~ TowNHALL i: SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRE~ISI COMPLETION OF THE WORK AUTHORIZED} 11573 Z ..... ,......?.:...~. ...... : ....... .~.....;...~... · at premises located at County! Tax Map No. 1000 Section ....... pu~s~ant tb application dated ........................... 19L~ ~nd approved by tho rl~ecto¢ Rev. 6/30,/80 FORM NO. 4 TO~N OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19241 Date JULY 25~ 1990 THIS CERTIFIES that the building. ONE FAMILY DWELLING Location of Property. MADELINE A~E FISHERS ISLAND House No. Street Hamlet County T~xMap No. 1000 Section 006 Block 00S Lot 03.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 9~ 1981 pursuant to which Building Permit No. 11573Z dated FEB. 22~ 1982 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 (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED BARBARA & RICHARD C. EDWARDS 11-SO-120 APRIL 8~ 1982 N576571 SEPT. 17~ 1982 NOT REQUIRED Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, T E M F 0 R A R ¥ Certificate Of Occupancy No. Z.1,092.1--T- .... Date ............ Ma¥c.h .23 ............ 19.8..2 THIS CERTIFIES that the building ................................................ Location of Property ................... M a d~e.1 in e..Aw e nme ....... ¥ ;[.s.h ~ r.s..]~ u .1.a.n.d... House No. Street Hamlet County Tax Map No. 1000 Section . .006 ....... Block . . .0~ .......... Lot ~.a.r .t..qt.. 99.3.... Minor Minor Sub. Subdivision F...I ,. l~tilt.t,y. ................ 4;ited-M~tF No. ~31 ..... Lot No..1 .,..Sec.~.~.qn. 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. Nx~v ember · 9 ....... , 19.81 pursuant to which Building Permit No.. ] .15.7.3. Z ............ · dated ..... Eebru.a~.y. 2.2 .......... 19 ,El2, 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 ......... -. e, .pr:[.v.a~e. ~ne,.'famil~r..dsel.linE ............................................ The certificate is issued to . .. d.o. llI)..~....&.. ~.n.ge. ~.a. ,c.:..P.e.n.d..1.e.t.o.n. ..................... (owner,_J~;see.er-te~)e~t) of the aforesaid building. Suffolk County Department of Health Approval ......... pl~dSr~g. ........................ UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector TOWN OF SOUTEOLD BUILDING DEPART}lENT TOWN HALL SOUTROLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Health DATE ................. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Loeatlon of Prop~rtr ............ /~Z,,W~ 4~ HOUSE NO. STREET ............. HAMLET S~bdivislon ....................... Filed Map ........ Lot .......... Planning Board Approval Request for Temporary Certificate ....... Final Fee Submitted: $ .~. ~. ~ ~..~ ........ Certificate APPLICAN . ~ BLDG, DEPT. TOWN OF SOUTHOLD FORHNO. 6 TOWN OF SOUTHOLD gUILDING DEPARTMENT TOI~/fIALL 765 - 1802 APPLICATION FOR CE~TIPICATE OF OCCUPANCY INSTRUCTIONS 'Thz-~ application must be filed in typewriter OR ink and submitted to the Building Iuspeqtor with the following; for new buildings or new use: I. Piqal survey of properly with accurate location of all buildings, property lines, Streets, and unusual natural or topographic features. 2. Final approval of Ueal~h. Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of eleetricall znstallation from Board of Fire Underwriters. 4.. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of 11 lead. ! $,. Commercial buzldzngs, ~ndustrlal buildings, multiple residences and similar borUildings and installations, a certificate of code compliance from the Architect Engineer responsibl~ for the building. 6.. Submit Planning Board ~pproval of completed site plan requirements. For existing buildlugs (P~ior to April 9, 1957] non-conforming uses, or buildings arid "pre-existing" land uses: I., Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the pplzcant and: a certified abstradt of title issued by a tltle~t company which shall shoM single and separate ownership of the entire l~t prior to April 9, 1957. If ~ Certificate of OcCupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ~'~ ~, 3. Date of any housing code or safety inspection ~ bulldzngs or premises, or other pertinent information required to prepare a certificate. For Vacant Land Certificate of Occupancy: i. An application for vacant land Certificate of Occupancy shall be submitted, andI a certified abstract of title issued by a title company showing single and separate ownership of ~he entire 10t prior to April 9, 1957 shall also accompany the application. If a iCertmf~cate of Occupancy ia denied, the Building Inspector shall state the reasons therefor in writing to the applicant. FEES: I. CERTIFICATE OF OCCUPANCY - l~ew Dwelling $25.00, Additions to Dwelling $2§.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to AccessOry buildings, $25.00 - Businesses $50.00. 2. i Certlficate of OccUpancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy ~ $5.00 - over $ years - ~. Vacant Land Certifi'cate of Occupancy - $20.00 5. I Updated Certmfxcat~ of Occupancy- $50.00 6. Temporary Certzf~cate of Occupancy - $25.00 Residential [ ,'i, $50.00 Commercial Form No. 6 TOWN OF SOUTI~LD 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, end 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 installation~, 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, ~dditions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Busines§es $50.00. 2. 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 ebruary 7.99 Date ................................... "' Old ti ildi X · ,ew Construction ........... Or Pre-exis ng Bu ng ................. Location of Property................(n°f/) . Madeline Avenue.~. Fishers Island House No. Street Hamlet Dn Owners of ~roperty Ed ard d Barb a A Edwa ds~ wet or - · Richard C. w s an ar . r Uoue~y Tax Map No 1000, Section..PPP:99 ...... Block. q~%qq ........ not 003.001 ~ubdivision Filed Map Lot Permi~ No Date Of Permit Applicant {ealth Dept Approval Underwriters Approval ~- ' 'lanning Board Approval ........................ '' ~equest for: Temporary Certificate ..... Final X ...... Certicate ......... ATTORNEYS AND 00UNSELORS AT LAW 45 HAMPTON ROAD SOUTH~PTON, NEW YOgK 11968 February 9, 1999 Mr. Edward Forrester Town of Southold Building Department P.O. Box 1179 Southold, NY 11971 Premises at (no//) Madeline Avenue, Fishers Island, New York CSCTM No. 1000-6-8~3AJ Dear Ed: I have enclosed a photocopy of a reduced survey of premises that a client of mine has contracted to purchase later this month along with a copy of Certificate of Occupancy No. Z 19241. I would appreciate it if you or someone in your office would confirm to me that any structures shown on the enclosed survey that would require a building permit are covered by the permit referred to in the enclosed Certificate and are therefore covered by that Certificate. (A separate application for a pre-CO for the garage is being submitted on behalf of the current owner and, in connection with that application, I sent an original print of the enclosed survey to Georgia last week.) In case an application for an updated Certificate of Occupancy is required in connection with this inquiry, I have enclosed a completed application form and a check to the Town in the amount of the $50.00 fee. Thank you for your attention to this matter. Sincerely, Stephen L. Ham, III Enclosures N/E,,W YORK BOARD OFFIRE UNDERWrR1TERS BUREAU OF ELECTRICITY 85 JOHN STREE'~,<NEw yORK, NEW YOP.K 10058 17, 1982 ..~.,,¢,~,,io.~'o.o,,fi,¢. 167988-82 ' ~y the a~plicant namedon theabove, appllcatio~ ~u~nber in th~pr~n~ses~f ~end~e~, ~1 Ave., Flsher~' ' ~B~emen~ ~lst~. ~ 2nd Fl. ~age~tsi~ 2 a~dfou~dto be in co~llance with ~he req~ire~rtts p~r ~, 198 ,25 26 FUTURE APPLIANCE FEEDERS .TIME CLOCK~ ~Y~TEM~ NO.'OF FEET A, W* G. NO, OF NEUTRAL5 2-15amp GFI Rec. 'N,;Y." ' 0639Oj' ; .. Lzc!~ 438-E manner;, ret~rrf'tb,the off~ce, of the Board ff ,n~orrec~, Jnspecfors-~may ;be JUL'~' 4 1990 FOUNDATION (1st FOUNDATION (2nd 2. ROUGH FRAME & INSULATION PLUMBING PER N. STATE ENERGY G~ODE FINAL )ATE COMMENTS B~ILDING DEPARTHENT FEE SCHEDULE AMENDMENTS EFFECTIVE 2/25/8~ SINGLE FAMILY D~ELLING 1) Ne~ d~ellin§s & additions & alterations, decks~ ~o exis~ina dwellings-.$~O. 00 plus . 15¢ for each Sq. Ft. of floor area in excess of 850 Sq. Ft. 2) Accessory buildings, additions, fences, stoves and alterations to existing accessory buildings-S25.00 plus . 15¢ for each Sq. Ft. of floor area in excess of 500 Sq. Ft. FARM BUILDINGS Farm buildings and additions and alterations buildings: $50.00 for each building. to existing farm HULTIPLE 2) Hotel, motel, multiple dwellings and business, all other buildings: ]) New buildings and additionsand alterations to existing buildings: $100.00 plus .20¢ for each Sq. Ft. of floor area in excess of ~000 Sq. Ft. Accessory buildings and additions and alterations to existing accessory buildings: $25.00 plus .]5¢ for each Sq. Ft. of floor area in excess of 500 Sq. Ft. industrial and FOUNDATION Foundations constructed under existing buildings $75.00 POOL & FENCE $150.00 DEMOLITION Demolition and/or removal and/or relocation of any building: $10.00 minimum and .05¢ for each Sq. Ft. in excess of 300 Sq. Ft. of floor area SIGNS All signs, except signs permitted by § 100-3]C(9)(a), shall be $1.00 for each Sq. Ft. of sign area, with a minimum fee of $25.00. CERTIFICATE OF OCCUPANCY ]) Business buildings and/or business uses and additions and alterations thereto-$50.O0 2) New dwellings and additions and alterations thereto-S25.00 3) Accessory buildings and additions and alterations thereto-S25.00 4) Pre-existing dwellings-$lO0.O0 5)' Vacant land-S20.00 6) Updated-$50.O0 7) Copy $5.00 Over 5 years $10.00 8) Temporary: Residential $25.00 Commercial $50.00 Cellars, decks, be included in FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date .......... To ...¢.i.4.(.L).~....~-... PLEASE TAKE NOTICE that your application dated .................. Q ~i~. ~ 19 ~.. for pemit--to-constmct ........... . ................................................ at Looation of Property: .... ~ou~ tVO. Steer Hamlet County Tax ~ap ~o. ] 000 ~ectio~ .............. ~ioc[ .............. lot .............. Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds . . . .N. 0. ..... ~?.~j .~.q ~././fi..~.~ ...... .o.!;:..~x.!4.,l~... ~L~-~-I~i'q~ B0f~'>. T~ S~ '~v' ................. .l ......................................'t9..4~... ~ .a Building Inspector RV 1/80 76S.1802 REMARKS: '0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B02 .~..~ ~-~ ~-~' Examined ......... .zy~.., 19 ... Approved ........ .~-./?7.*T., 19 .~.i PerZ~-~lit No..r.( .J~..? ?...T Application No. ( t' 5 -[ ~ Disapproved a/c ..... ~'~_L .......................... ......................... ':': (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .Il:.%- £'1 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedu, le. 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 issue 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 buildings for necessa~)insp~ctions. ~. ~ (/(Signature of applicant, or name, if a corporation) ........... (Mapfing address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....O..~...l~.. ~..... ~. . .~.. ~..'~-..~.~ ................. (as on the tax roll 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. ~'0lo~., ~.,~.. ~ 1~'~1~. OL~,'~IC~ ~ ~ ~,~ , Electrician's License No. ~..%.~ .?,..~7 ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ .................... ..... .................. House Number Street Hamlet' ~ /~7 .County Tax Map No. 1000 Section ...~P.~ ........... ~lock .x.~ .............. Lot~ Subdivision. ~L ,r,..~.V, .& "~'~'a~)~, ................ F~No. ~. ~ .4 ........ Lot $~6~v~' 2. State exisfing 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 whmh apphcable): New Building ..... Addition .......... Alteration .......... Repair .............. Removal ............. Demolition .............. Other Work ............... 4.. Estimated cost .... ~? ....... !~ ~ ................... Fee ....... .'T. 2". - . ................. , (to be paid on filing this application) 5. If dwelling, 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 type of use ..................... 7.,' Dimensj~.qs of existing structures, if any: Front ............... Rear .............. Depth ............... /--Hei~'i~rft ............... NumCer of Stories ........................................................ . ,,,,Dimensions of/n~"*h same structure with alterations or additions: Front ................. Rear / Depth ..................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new constrgction: Front .. ~ .2..r ........ Rear . ..~..1-..*. . Depth 10. Date of Purchase .......... ~. g.~' .( .............. Name of Former Owner . ~. t,L. ~4 J.:. :,..r'/~=~ ......... 11. Zone or use district in which premises are situated...~:,~,-.,../.../r~~ ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~). 13. Will lot be regraded . .'t~...7~,~._' .~ ............ Will exce,,ss fill be relgoved from premises: Ye.s, ~'~No~ Name of Architect .b~'wtc~,,~. ~,o.,~-~.,q ..... Address ~rZ.~t~'Ae.r~;4,t~,~,'.tF. Phone Nod~7~.7~#.: PLOT DIAGRAM Locate clearly and distinctly all bulldmgs, whether existing or proposed, an& 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 cbrner lot. STATE OF iNEW YORK, COUNTY OF .... .... jS.S .......... .~j.¢c..,~.. ~..,..~. ~--~.~. ¢.~...~-~..~. .......... being duly sworn, deposes and says that he is the applicant (Name of individual sign.'ing contract) above named. He is the ..... ~.u.. ~..~. ~ ~ ..... (Contractor, agent, corporate officer, etc.) of said owoer or owners, and is dui: authorized to perform or have performed the said work and to make and file this application; that all statements cent tined in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the manne, r set forth in the application filed therewith. Sworn to before me this 2net d?y of Decemb.er 19 81 Notary Public, . .~ , . Suf.f.olk. .... County N~TARy PU~LI~. ~TATE'0F NEW YORI~ (Signature Of applicant) ~ N0. 5gqt~8~0~- sur~0t~ cou~ GRID NORTH CENTRAL AVENUE .J .! ',(