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HomeMy WebLinkAbout16648-zFORM NO. 4 TOWN OF SOHTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17945 Date APRIL 13, 1989 THIS CERTIFIES that the buildin~ Location of Property 3765 WELLS AVENUE SOUTHOLD~ NEW YORK House No. Street County T~x Map No. 1000 Section 070 Block 04 Lot 03 Subdivision Filed Map No. Lot No. ONE FAMILY DWELLING Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 24, 1987 pursuant to which Building Permit No. 16648-Z dated NOVEMBER 24, 1987 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 WITH GARAGE & ATTACHED WOOD DECK The certificate is issued to ROBERT & JEAN FAIRLIE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-50-222-JAN. 19~ 1989 UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 13, 1989 PLUMBERS CERTIFICATION DATED 4/13/1989-GARDINERS BAY PLUM~ING & HEATING Building Inspector Rev. 1/81 FO~M NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ............................................... _.. at remis~eS~l~tedot/~'.'p ' . .'~..~..~ ...........~,~.~R....~., ......... ..~.~....~.... .......... County Tax Mop No. 1000 Section ..... .(~.~....~.. ...... Block ...... ..~..,.~. ........ Lot No.....~.....~.. ............ pursuant to application dated .... ..~...~..~.....~...~. .......... , 19.~..7., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPAN Instructions A. This application must be filled in Wpewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property I[nes, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- ~ tion required to prepare a certificate. . C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.O0, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of cbrtificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updatecl C.O. $ 50. O0 Date ...%Pr~.%. ~3.,..19~9. ...... New C o n s t r u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. ~ 7(5.5..'., ~l'.e.3~],~..~.~.~O~ta.,..$o~'c. hol~.,. ,~]Y .............. House No. Street Ham/er R.o.b.e. rt & J.ean Fairl. i.e Owner or Owners of Property ...................................................... Count,/Tax Map No. 1000 Section ...... .7.0. ...... Block .. Q.4 ........... Lot ..... q3 ......... Subdivision ................................. Filed Map No..8..57 ...... Lot No .............. Permit No. 16~.48Z. Date of Permit ll/24/B%nnii-=-tGardiner' s Bay .Qg~t~.~j;~¢.t.~.qg. Co HealthDept,.Approval........................87-50-222 LaborDept. Approval ....................... . Underwriters Approval . ,T, 9.mP.-. ................ Planning Board Approval .......... ' ..... Request for Temporary Certificate Final Certificate Fee Submitted $ .... .$.2.5,0.0 .................. Construction on above described building aF~e;~it rr~et,,~all applicable codes and regu{ations. Applicant .~.~..~ ......... Rev. 10-10-78 a 2os7 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date April 13, 1989 Building Permit No./~ · (please ~rint) ,(please prifvt ) ' '~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. 7' ure) /~(!lumber s signa~ "~ Sworn to before me this Notary Public, County Notary Public NECEN iL DE NOTARY PUBLIC, State of New York Ne. 4707879, Suffolk Countlto ! Term Expires N~e~ch 30, 19-....2-1 TOWN OF SOUTtlOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 March 31, 1989 TEL. 765-1802 Gardiners Bay Const. Co. Box 604 Shelter Island Heights, N.Y. 11965 Re: ROBERT & JEAN FAIRLIE To Whom This May Concern, We are unable r.o complete your Certificate of Occupancy because .of the following reasons. /_--//An application for Certificate of Occupancy is not on file. (ENCLOSED) /~ Iht check i:;~l~~not ou file.) $25.00 /~/ No Health Dept. Approval on file. /-_'/ No final inspection has been made. Pleaue contact our office on this matter. Thank you for your 'cooperation. Building Permit t! 1 6 6 4 8 Z Duildincx Dept. ***/]/ Ho Plumber ~older Certificate on file. ( all permits involving plumbing being .issued after April 1,1984 1. , ~ FOUNDATION FOUNDATION (2~) 2. ROUGH FRAME/' ,PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL COMMENT~: HENRY P. SMITH, President JOHN M. BREDEMEYER, Vlce-P~'es. PH1LLIP J. GOUBEAUD ,. "" ALBERT KRUPSKI, JR: ELLEN M. LARSEN BOARD OF TOWN TRUSTEES TOWN OF $OUTilOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 August 19, 1987 (516) 765-1892 Mr. Glenn E. Just Land Use Company North Country Road Box 361 Wading River, New York 11792 Re: Fairle, Wells Ave., Southold Dear Mr. Just= .... ' Please be advised that the Trustees h~[Ve visited the site of the Fairle property located on Wells Avenue, Southold on July 22, 1987 and have determined that in accordance with the-survey submitted and dated May 21, 1987 the Trustees have no jurisdiction in this matter, Please note that all construction material and fill must be kept out of the 75~ area,during construction. Should you have any questions 'or concerns, please do not hesitate to contact tiffs office. HPS :ip cc: file Bldg. Dept. Very truly yours, Henry P. Smith, President Board of Town Trustees e% )epi, lm ,E m lmT meotal [ elsen atlon ~Room~ 219, Stony Brook, NY 11794 .A re.vi~ew has bee,, ma~de of your proposal to: ~'~n~y,}~-~- Based on the information you have submitted, the New York State Department o~viron, mental Conservation has determined that the parcel .~._~. project is: Greater than 300' from inventoried tidal wetlands.. of a subs.tantial man-.made structure-- ~k)~}~/ ~-~4 Landward greater than 100' in length whlch was constructed prior to-9/20/77. Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Listed in Part 661.5 of 6NYCRR (Tidal Wetlands Land Use Regulations) as a use not requiring a permit or notification letter of approval. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Env£ronmental Conservation Law). Please be advised, however, thath, no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. It is your responsibility'to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic cre~t..and the project (i.e. a 15' to 20' wide construct%on area) or erection of a temporary fence, barrier, or hay bale berm. Please note that any additional work, or modification to the project as described,"may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve yOU of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, onal Permit Administrator 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND ~ ~ INS~LATION ~ FRAMING ~'~INAL BUILDING DePT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. // FOUNDATION 2ND [~/~NSULATION [ ] FRAMING REMARKS: FINAL DATE , INSPE R 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST ['~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ~FRAMING [ ] FINAL REMARKS: ~-, ,~/'~,~- · INSPECTOR~ ~ ~,~ ~ :'~ 765-11802 BUILDING DEPT. INSPECTION ]FOUNDATION 1ST [ ] ROUGH PLBG. [~J/FOUNDATION 2ND [ ] INSULATION ] FRAMING r. ] FINAL INSPECTOR ~ t.~, 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 15T ~ ]ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. ~ ,NS~,~ro~~ ,r.~FINAL REMARKS: DATE THE NEW YORK BOARD OF FIRE UNDERWRITERS 10(){~ ! !,I BUREAU OF ELECTRICITY 85 .JOHN STREET. NEW YORK. NEW YORK 10038 ~4ppllc. tionNo, onfite 54~59688/88 ~ 06'/866 THIS CE~IFIE$ THAT ~ t~4~exnmlnedon APR~J~ 04,1989 ~/Y.l,h$ AVt.:, SO l'f'flOh!). N. Y, ond /ound to be in compliance with the requirements of this Lot IqXTUel RXTURIS ILM~OiS PANS ~l~ OTHER SIRVIC~ DISCONNECT S E R V I C I MOTt:'RS: I. F FI.I:,. I,;.E.C.O. ~';1.~,; ,IR.lc (,ORP. !!5650 COdNTRY 8I). 48 PF, CON):C , NY, certiflcat~ mud not b~ alt~r~ in any manner; r~turn to the office of the Board if incorrect. , dmir credentiob. COl)'/. F(:X~ BUILr)IJ, K) DEPARTMEHT. THIS COI~( OF CERTIFICu~TE/vIUST HOT BE AI.~I~U~IH ~ M. I TEST HOLE 12.3' ~m Z d 516) 765 ~ O/BOX 909 algal N ROAD 'HOLD , N.Y. Hg?! , . ~., -LOT S. 16 ° 40'OOZE. 1 ;;m fai;n, ilia~wiTh the Standards for At3.groval a~d -.-,.~-~C4':'::'";-'~""t"Sh--: ,.*~ Oub--~,.*~ [o,~¢= -~','~G~_ ~[~'F~'~:~ ~u~.BAy~ ~T~ON ~. for Siqgle Family Residences ~d will abide by the P.O. BOX ~ ~6nditioP~ s~'for~h there~d ~ the permit t~ I~ND, N. Y. t~S construct. ~ {~16] 7~t~ 0 AREA = 15. 875,,SO,FT, . PLEASE,NOTE It is the'applicant's responsi.b, llit~Y to maintain ad'equate ?.anitary ols.ance i~tween att water, supply and sewage disposal facitittes. - .~UHVEY OF P/O LOT "PLAN OF LOTS OWNED BY GEORGE H. WELLS" Prepared in accordance with the minimu- standards far title ~urveyi as ettablishe~, the LI.A,L.S. and approved and for such use by The Ne~ York ~tate Land N. 16 W. P/O LOT 3 192.$2' ' FILED NOV. 28,1927 FILE NO. 859 ~..o,...~..~ ..... . _ 'AT SOUTH OLD ""=~'~.~d..co.,,~o.,o,~,o,,. TOWN OF SOUTHOLD ~ ~ ~ ~. ' SUFFOLK COUNTY, N: ~ ~WELC~,e ~ I000 - 70 04 - 03 ~ ~1 ~ SCALE I"= 40.'. ELEVATIONS ARE REFERENg~D ~: N,6.~ D 87 - 40t I TOWN OF ~OUT~OLD :1 , s 16°?O'O0"E , 204.56' ~I,l AREA= 15, 875 ~.r-~. -- _ - . .~ J~ ! .~ ............... I~/~' ~ ~ ~ ~~~ :~-~ ,, . PlO LOT 5 ~ ~?~' N, 16°40'Oo"w. P/O LOT ~ 192.32 FILED NOV. 28,1~27 FILE NO. 859 ~ '~T BOUTH OLD ~ * 10~ OF SOUTHOkD .~ SUFFOLK COUNTY, N.~ ,~~ ~000 70 - 0 4 03 OAKLAWN AVE- SCALE ~"= 40' MAY. 21, 1987 Jen.. 6~ i988(u.c.) TEST HOLE -Tj~CON iI.~.~.UiI~iiI'~s]~.~ENGINEERS , R C. MAIN ROAD~ SOUTHOLD ,N.Y. 11971 Prepared in accordance with the mini. standards for rifle sur~eys as the L I. A. L $. end af~roved and adopte._ far tach use by The New York State Land Tale A~seciationC. ELEVATIONS ARE REFERENCED 'TO N.G.M 87 401 TEST HOLE 12.3' LOT 4 17' P.O.'BOX 90[~ MAIN ROAD $OUTHOLD ~ N.Y. 11971 S. [6°40'00"E. ~t 172 00' U. C. k tt.O' __ BLDG. DEPT. TOWN OF $OUTHOLD AREA= 15, 875 SQ.FT. ~_ ~.r ¢ 0 SURVEY OF ............. P/O LOT ~<~ N. 16° 40'00" =- 0 AKL A'C/N AVE. 165 25' P/O LOT 3 192.32 ' "PLAN OF LOTS OWNED [DWELLING NO. 4966 8 ~/GINEERS ~ R C. Prepared in accordance with the m:~:~..~, ~h~ds far title sun, ey$ as establi;h~4, ~i I~ LLA, LS. and approved and adopte~ ~,t ~ use by The New York State Land ~ Aesaciation. FILED NOV. 28~1927 AT SOUTH OLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. I000 70 - 0 4 SCALE I"= 40' MAY.' 21, 19 87 Jan,. 6~ 1988(u.c.) B ¥ GEORGE H. WELLS" FILE NO. 859 O3 ELEVATIONS ARE REFERENCED TO. N.G.'~D 87 401 TEST HOLE 12.3' t7' tS; LIC. R ENGINEERS TOWN OF SOUTHOLD s. 16 4o oo E. 204.. 56 ~,,/J AREA = 15, 875 SO.FT. ~..X~_ IAI~ ' ~lJ ~ ~11 [~ ...... ~-~-'~ ' ~ ~IIE.~ ~ - ~X 1~ ~ ~ ~ II ~1~. o 0 ~ C DEPT. OF ...... ~__~N~ ,~,~ ~JJ~¢~0 .SURVEY OF . PlO LOT ~~ ~ ' ~ ~" ~ ~; "PLAN OF LOTS OWNED B Y GEORGE H. WELLS" ~?~ N. 16°40'OO"W. P/O LOT 3 192.32 ' FILED NOV. 28,1927 FILE NO. 859 _ 'AT SOUTH OLD ~ TOWN OF SOUTHOLD ~ SUFFOLK COUNTY, N. M / / I000 - 70 - 0 4 03 0 AKL A~N AVE. SCALEMAy. 21,1" =19 8740' ~ J~.. 6, 1988(u.c.) ~ ~ ~ ~ ~ ~CER~FIED ~ ' ... ~I~-~ F~Y gW~ ~ CHI~GO T~TLE INSURANCE COMPANY ~OV. 28, /g881F/NALJ '-" ~~ r~- ~" ~. ~~ PEGASUS ABSTRACT INC. NO. 49 6~ 8 ?e sewag~ d~s~ and ~a~r ~u~y ~ ~r ~ c~OCation have ~e)~ i~te6 by th~s Ds~nt ~10r ' prepa[ed ih accordance with the minimum , ~ ~ a~aUn~t~ ~{~. standards for title su~eys as ~tob~ ~,~,~>~-- ~, ~,;~ ~,~ the L.I.A.L.S. a~ opprov~ and adopteJ ~ ~ ~ ~ ~ ~ for such use by ~e New York S~te Land '" Zitie As~cialion. ELEVATIONS ARE REFERENCED TO: N.G,VD 87 - 40l '~pproved .~....ea~.~'%~.. ~..2.t[., 1977. Permit No.! .~..~..q..~. 3 9isapproved a/c ........................... ' ..... ./(~) (Building Inspector) APPLICATION FOR BUILDING PERMIT 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Received ........... ,19.., Date .~.~../.1.?/fi}? ........ , 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and'submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram ~hich is part of this appli- ation. c. The work covered by this application may not be commenced before issuance of Building l~rmit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to t.l'[,e applicant Such permit hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or {egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for neces~y~insp~tiff~s.~,t.~,~,,~ / ~ ~~ ~ (] (Signature of applicant, or name, if a corporation) 7. .gr.. (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... Gemaxal..Gongr~qgor ........................................................ %me of owner of pre,nises . .I¢Ol~.e.z:.t. &. ~tr~..~gSAF]i..L.e. ............................................... (as on the tax roll or latest deed) If applir4mLJ, s a corporation, sianature of duly authorized officer. Builder's License No ..... 3~5~ .................. Phunber's License No .... ~¢~3,(at? ............... Electrician's License No...E.8.~.6...E ............... Other Trade's License No ...................... I. Location ofiand on which proposed work willbedone .................................................. ~q~ ' Wells.Avenue ~outhold~ ~y .... }louse Number Street Hamlet County Tax Map No. 1000 Section .... 7..0 ............ Block . .Q/3 .............. Lot.. 9.3.. .............. Subdivision ..................................... Filed Map No ....... .8~.9 .... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' a. Existing use and occupancy Vacant land b. Intended nsc and occupancy ....... Q~9..f. am.$.~Y., f..z'.am...~..d, welIax..,ll~i~I, , ..,2L. ·., . .. 0. 1. 2. 3. 4. Nature of work (check which applicable): New Building .. X ...... Addition ...... ~... Alteration . · .~.[ ...... Repair ............ Removal .............. Demolition ............. ~. ~ O t h~[~o~ e.~ll~. ~, ,~.~ ~ .... Estimated Cost .... il}}.,.gPP q ................... ..........I ..... Lt .... If dwelling, number of dwelling units .. 1 ............ Nomber of dwelling units mi each floor ............... If garage, numbe~ ofca~ .... 1... L .............................................................. ~d ~y ) d type of If business, commercial or mix occupancy, spec na ure an extent of each use .................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............. ] {eight ............... Nuinber of Stories ...................................................... Dimensions of same structure ~ith alterations or additions: Front ................. Rear ................ D~pth ................... !... HeiSt ...................... Number of Stories .................... Dimensions of entire new cons{ructmn Front . .~'~ahefl..... Rear ............... Depth .............. Ileight ............... Nu~ber of Stories ........................................................ Size of lot: Front ' Rear Depth Date of Purchase . , ................ Name offerer Owner W Co~e~. & E~.iz~. ~. .... Zone or use district m which p~emises are situated .... i .......................... ALberts,on ......... Does proposed construction viglate any zoning law ordinance or re~lation: . .~0 ....................... Will lotbcregraded. . ~o.. .~... .. ... . .. . .. .. ... .' Will excess fill be removed from premises: Yes No Name of Owner of premisesR.~.&, J. Fairli.a .... Address63, Shadysi.de. A~.e ~hone No88.3-~44~ · · · ·. · Name of Architect ..:...$9a~ ................ Address ,~$,..~aahi~gto~. Phon~ No ................ N~e of Contractor S~4ia~ ~. Ba~. C9aat .. AddressS. hel~.a~. Is...~. ~X, · Phone No.7~9-~183. ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether lterior or corner lot. TATE OF NEW YORK, OUNTY OF ................ (Name of individual si /love named. ie is tile .................... f said owner or owners, and is d pplication; that all statements coy S.S being duly sworn, deposes and says that he is the applicant ning contract) (Contractor, agent, corporate officer, etc.) fly. auth, orize, d to perform or have performed the said work and to make and file this tamed m this application are true to the best of his knowledge and belief; and that the /ork will be performed in the mam'ter set forth in the application filed therewith. .worn to before me this .... ounty . m. 470787~ . . 1~.~' / ,~ ~ (Signature of applicant) 0.,4..'/o°~' _T.A. : 7o',~ ,¢_¢-¢',,4z/.,,u~ _it % 2., /¢ 4) PIPE INSULATION 7813.19 5 ) ~OWS - DOOBLS GLASS. 6) C~TRUCTION TO MEET N.Y.S. ENERGY CODE. 0.17 O. OE 0.5~ o. o 0. 0.~ O. O.C o.o/~ TO THE BEST OPMY ~2qOWLEDGE, BELIEF, AND PROFESSIONAL 3UDGEMENTTHESE PLANS ARE IN COMPLIANCE WITH THE CODE. T ~o *T OCCUPANCY OR -© CC;, l: ¥ .., oEL: ¥, rd} N ¢ 'N