The URL can be used to link to this page

Home My WebLink About14023-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20275 Date OCTOBER 16~ 1991 THIS CERTIFIES that the buildin~ Location of Property BRICKYARD ROAD House No. County Tax Map No. 1000 Section 10 Subdivision NEW DWELLING FISHERS ISLAND~ N.y. Street Hamlet Block 5 Lot 2.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15~ 1985 pursuant to which Building Permit No. 14023-Z dated JUNE 7e 1985 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 ATTACHED DECKS The certificate is issued to SUZANNA VON DER SCHULENBURG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-S0-266 - OCT. UNDERWRITERS CERTIFICATE NO. PENDING-OCTOBER 15, 1991 PLUMBERS CERTIFICATION DATED SEPT. 16, 1991 - JAMES MARSHALL 15~ 1991 Rev. 1/81 ' Buildin~ -Inspector~ FORM NO. B TOWN OF SOUTHOLD I~UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 14023'Z Permission is hereby granted to: ...~~....~....~....~~ ~'."!~'Z ........ ~'i-_'/-')..'_' .~.~_Z._~ . ............. pursuant to application dated ............ ~.~'~ ......... /....~...-~....., 19...~.....,~nd approved by the Building Inspectar. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ' APPLICATI6~ 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 conta~,~ ~ less than 2/10 of 1% lead. .~ 5. Commercial building, indus.trial 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, B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-exzsting" land uses: 1. Accurate survey of property showing all property lines, streets, building amd 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 dweili~g"$25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, SwimmingLpool $25.00, Accessory building $25.00, Additions to accessory building $25~00. Businesses $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 .. · Date ... ~ ............... New Construction .... ~.-... Old Or Pre-exi~ting Building. ' .......... House No. ~treet ~ .... ~"'' Hamlet Onwer or Owners of Property ....... ..~.~...~..~.. ~ ~..~ County ~ax Map No 1000 Section ~ ^,, 3'''~ ...... _'''''z~'~J~.'-' ..... i'' Subdivision .................................... Filed Map ............ Lot ~ Permit No.. · ..... Date Of Permit ................ Applicant.. . ............... ~ealth Dept. Approval .......................... Underwriters · Approval ,, Planning Board ......................... Approval Request 'for: . Temporary Certificate ........... Final Certicate. Fee Submitted: $. ~c~,~O · TOWN OF SOUTHOTI) ' OFFICE OF BUILDING INSPECTOI~ P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 7~$-1802 CERTIFICATION Building Permit No. 14023Z Ow~e=.Suzanna Von Der Schulenburg (please prln:~7 ' James Marshall (please prln=; Date Sept. 16, 1991 I certify that the solder used in the water supply system contains less than 2/10 of 1%'lead. .. James Marshall was the licensed contractor who supervised all plumbing work during the construction of the Von Der Schulenburg residence. James passed away in November 1989 and is therefore unable to sign this certificate. Sworn to ~befOre me this _/~ ~ da:, o~ ~ · ,. Oener. al Manger Bouton Services ·No=ary Publi ~A*E:: October 10, 1991 INVOII~I~,' ' '985 · 'Bagley Reid ; Fishers Island; NY 06390 ProfesSional Services ~2 Prints of~Von Der Schu]~enberg:Fed~eral'E~p~e:~si~ to Towh'of Southold Bu~ldin~ TOTAL DuE: FIELD INS[~ECTION COMMENTS FOUNDATION {1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT ' PERMIT NO. 10-84-1338 UNDER THE ENVIRONMENTAL CONgERVATiON LAW [] ARTICLE 15, (Protection of Water) [] ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) [] ARTICLE 36, (Construction iu Fleo~ Hazard Areas) PER~dlT ISSUED TO Ms. Susanna Yon Der Schulenburg ADDRESS OF PERMI~EE 144 Library Place, Princeton, New Jersey 08540 LOCATION OF PROJECT (Section of stream, tidal wetland, dam, huitding) Fisher's Island DESCRIPTION OF PROJECT Construct a one-family house, swimming pool and garage a minimum of 75 ft. landward of tidal wetlands and a sanitary system a minimum of 100 ft. from tidal wetlands. COMMUNITY NAME (City, Town, Villag~ Fisher's Island COUNTY Suffolk 1. The permittee shall file in the office of the appropriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Enviroemental Conservation who may order the work suspended if the public interest so requires. 3. AS a condition of the issuance of this permit, the applicant has ac- cepted expressly, fly the execution of the application, the full legal respon- sibility for all damages~ direct or indirect, of whatever nature, and by whom- ever suffered~ arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from the said project. 4. Any material dredged in the prosecution of the work herein permitted shah be removed evenly, without leaving large refuse pites~ ridges across the bed of the waterway or flood plain or deep holes that may have a tendency to cause injury to navigable channels or to the banks of the waterway. 5. Any material to be deposited or dumped under this permit, either in the waterway or on shore above high-water mark, shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so ixescribed thereon, w}tb{n or behind a good and substantial bulkhead or bulkheads, such as w~l{ prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. That if future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or Jr, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flow'.or endanger the health, safety or welfare of the people of the State, or loss or destruction of the natura} resources of the State, the owner may be ordered by the Depart- ment to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure, fill, excavation~ or other modification of the watercourse hereby authorized shall not be completed, the owners shall~ without expense to the State~ and to soch extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. J TOWN Southold FIA COMMUNITY NO. OA~t NO, --~,,,~ ~ ~-- F~EeR~IT~ E~X~P,~R~ATIq?SD~ATE 1987 GENERAL CONDITIONS 8. That the State of Nev~ York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future o~erations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the disp{ay of lights and signals on any work hereby authorized is not otherwise provided for by law~ such lights and signals as may be pre- scribed by the United States Coast Guard shah be installed and maintained by and at the expense of the owner. 10. All work carried out under this permit shall be performed in accor- dance with established engineering practice and in a workmanlike manner. 11. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as may be found to be just and equitable. If upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 12. This permit shall not be construed as conveying to the applicant any ~ right to trespass upon the lands or interfere w~th the riparian rights of others to perform the permittnd work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 13. The permRtee is responsible for obtaining any other permits, ap- provals, lands, easements and rights-of-way which may be required for this project. 14. If granted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part g00 of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards - Bail(ting Permits) and in no way signifies that the project will be free fr6m flooding. 15. By acceptance of this permit the permittee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse side. RS.lO.,4 (9/?S) (SEE REVERSE SIDE) SPECIAL CONDITIONS continuation . .I. 16. Ail devel¢ ~ment shall conform to the Revised Site Plan "A-i", by David Acheson, dated January 14th, 1984. PERMIT ISSUE DATE I February 13th, 1985 Alte hate PERM[TAD,~INISTRATOR ~- ~ ~ [ADDRESS Bldg. 40, SUN"f-Room 219 Davi~ DeRidder/A~.~/~ ~ Stony Brook, New York 11794 Michael E Doyle, AIA 506 East 84th Streeu New ~brk, New York 10028 212-535~7006 Michael E Do le, AIA 506 East 84th Street, New York, New York 10028 ~L~ ~Y~Z ~,7 ....... S~F_.t.)____ .T~-k--Va~l- ~-0'~'R'i~. or ~' BTUH - _ ...... ~Uf = .0~ ~ Down __ '4" ,~,,) .... [. 2{D.._~ Total BT~ Gain WaZ :ermor Wall :al Glazinc .~). ..................... ~al D~p_.o_r._s. _.(.,iLo. _ _U..n..h..e_ .a. _t.9.d _ ~rs (Over Ambient Conditions !o__r_s (Over Un~_h_e_a.t_.e.d__$~..a_~.e~ (From (Grade & sm' t (Top of Slab With Heat (To Bott. & In No Heat Horizon ~es: Heating Range: Cooling Range} Outside Inside Air: 70 ! Outside Air:d/A I '] Inside Air: ~[~, ~CHITECT OR P.E. S~L TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 January 9, 1985 Dave Ackinson % Ulrich & Franzer Assoc. 228 E. 45th St. Now York, N.Y. 10017 Dear Mr. Ackinson: Flease find enclosed a copy of the Plan Review Comments for Von Der Schulenburg~ Fishers Island as requested per our conversation today. Yours truly~ CH:hd e~C. Curtis Horton Building Inspector ATTORNEYS ~D C0~SEL~RS AT LAW SOUTH~0N, N.Y. 11968 5i6 - 283 - 2400 September 26, 1991 Mr. Curtis Horton Building Department Town of Southold Main Road Southold, NY 11971 Re: Certificate of Occupancy for Suzanna yon der Schulenberq Dear Mr. Horton: At your request, I have enclosed four additional prints of the property of Suzanna yon der Schulenberg for which we are seeking a Certificate of Occupancy. Please advise me additional information or can be issued. if you would like me to furnish any documentation before the Certificate Sincerely, Stephen L. Ham, III SLH: j a Enclosures FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined~e'~...7.., 19 ~. ,,,~-- Approve~(... 7 .... 19 ~'.~.-~rm~t No. /. q.~..~.~,~- Disapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. Bouton Services, Inc. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Susanna yon der Schulenburg Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, sign~t~e 9 f,~ly auJ[;h~ized of~cer. ,~ (Name and title of corporate offi~er)~// Builder's License No. 120 Plumber's License No. 1.9.5.8.. P. .................. Electrician's License No. 1297 E Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. Brickyard Road, Fishers Island House Number Street Hamlet County Tax Map No. 1000 Section .... : .... [.~. .... Block ...... .~.. ........ Lot ..... c~..~.~.~. ...... Subdivision. SNYS 473889 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 ..................................................................... Single fam. ily dwelling b. Intended use and occupancy ................................................................... property lines. Give street and block interior or corner lot. 3. Nature of work (check which applicable): New Building ... X ...... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition ............. Other Work ............... · ~ ~ ,, (Description) $250,000.60 Fee (. 2. 4. Estimated Cost ............. i .......... ................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling hnits...· ...........1 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire newconstruction:' ' Front ............... 56 Rear ............... 56 Depth . .4~ ............ Height .. 29 [ .......... Number of Stories .... 2 ................................................... 9. Size of lot: Front 180. I Rear .190. Depth .300. 10. r)ate of Purchase ........... ~ .................. Name of Former Owner ............................. 11. Zone or use ...... . .... district m which premises are situated ...................................... 12. Does proposed construction vioiate any zoning law ordinance or regulation: .. N. 9 ....................... 13. Will lot be regraded . '. 00 ..... i ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises V.o?...de..~. S..c.b~. ] .e.~ .b~.g. Address .................. Phone No ............... - Name of Architect , .......................... Address ................... Phone No ................ Name of Contractor ..... i Address ................... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NE~Y.Q~Y-9,,4' "S S CZT.r .'~: -/~. · .~4~'C.J'[f-A~.~ . being duly sworn, deposes and says that he is the applicant above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application l 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 the manner set forth in the application filed therewith. Sworn to before me this .q ! 457U I z ?~ ~ 7~ GUARANTEED TO ' THOMAS ~ BOCKNER TICOR TITLE GUARANTEE ~-N ACCORDANCE ~ITH ~TANDARD5 FOR TITLE ASSOCIATION. TITLE ~IZ~I-050~ SURVEYS OF LAND TITLE NOTES: I) COORDINATE DISTANCES ARE MEASURED FRO~I U,$ COAST AND GEODETIC 5UR',/Ey TRIANGULATIOH STATION ~) LOT TO BE CONVEYED ]5 PORTION OF ~DRD~R BLOCK $~ LOT ~ PLAN OF PROPERTY To Bc CONVEYED BY S UT-ANNA ~ON DER SCHULENBERG To Tuon^s W FISHERS ~ SLAND SCALE I''= 40 CHANDLER, PALnER ( KIN~ NORW,CH, JULY 13,1331 CONN. / I?_ --lc) I -- !o0 tdoT~-3 ' L : CATE