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HomeMy WebLinkAbout25871-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27366 Date: 10/24/00 THIS CERTIFIES that the building ADDITION & ALTERATIONS Location of Property: PVT RD OFF E END RD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 3 Block 6 Lot 2 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24, 1999 pursuant to which Building Permit No. 25871-Z dated JULY 14, 1999 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 KITCHEN ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HIRAM UPSON, III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-535244 08/31/00 PLUMBERS CERTIFICATION DATED 06/20/00 A. JOHN GADA, JR. thor' ed Sic'nature 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. 25871 Z Date JULY 14, 1999 Permission is hereby granted to: HIRAM UPSON III TRUSTEE 275 STANWICH RD GREENWICH,CT 06830 for CONSTRUCTION OF KITCHEN ADDITION & ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at PVT RD OFF E END RD FISHERS ISLAND County Tax Map No. 473889 Section 003 Block 0006 Lot No. 002 pursuant to application dated MAY 24 1999 and approved by the Building Inspector. Fee $ 75 .00 Authorized Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD , NEW YORK 11971 765 - 1802 APPLICATION FOR CF.RTLFICATE OF OCCUPANCY DATE $5MI • . . NEW CONSTRUCTION . . . . . . .OLD OIL FRIT-EXISTING BUILDING.,l�. .V . - VACANT LAND. . . . . . . . Location of Property . . . i7S. . . y�T_CIMiC. . . . . . . . . . . . . . . . ..7-. : . . . . . . . . . . . . . . --- UOU-SE NO. ( STREET - - - - DALSLET Owner or Owners of Property. . . `:'1.1.F ' . . . .O�-�. . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No . 1000 Section . . . . . . Block . . . . . . . Lot . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . Filed Map . . . . . . . .Lot . . . . . . . . . . r Permit No .ZJr�II F.. . . Date of Permit *01 ?':01.Appticant 6 Health Dept . Approval Underwriters Approval . . . . . . . . . . Planning Board Approval Request for Temporary Certificate . . . . . . . Final Certificate . . . . Fee Submitted : $ . • • • _ _ • _ - „ . _ . . . A1'PLICAN'1. .. Gtd MA,✓A. . . .B.A rev. 10/ 14/88 ly Town Hall,53095 Main Road :z_-z y Fax (516) 765-1823 P. O. Box 1179 j • r.v Telephone(5 16) 765-1802 Southold, New York 11971 �� a0? OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: �CJ Building Permit No. 2 S8'7 1 -,7, Owner: HIR-b-'" :5C:> I (please ',print) Plumber: AJol4ty 034hA JR (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Si' gnatur Sworn to before me this day, ;ofQ?fJ Notary Public) � "/ County SSCCL A 571-v6 BD e i u , DESIGN GROUP ° 7v� n '' TRANSMITTAL SHEET TO: FROM: COMPANY: Q DATE: 1c�ur� oss w�c Ip- I1 - DO PHONE: FAK C cv3> 7 l0 5 — ISoZ RE: TOTAL PAGES (including cover sheet): URGENT _ FOR REVIEW _ PLEASE COMMENT _ FOR APPROVAL NOTES/COMMENTS: �v1 CIOS2CY 'c�� '. Cl ack �'o� x' ? oc7 AgPGca r� �Or C"v;'wJ-.fCA occ-"?" _-�vwl� ..�d,,� BOX 447 FISHERS ISLAND,NY 06390 PHONE: 631.788.7919 FAX 631.788.7192 P - fl0,1RD OF H D . . . . .. . . . HEALTH . FORM 3 SETS OF PLANS Wy 7 A I. TOWN OF SOUTHOLD SURVEY . . . . . . _ . . . . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC, FOR.I t BLGu. DEPT. " T OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 766.1802 t:oTIFY Examined . . • CALL . . . . . _ _ . . . . . . . • 19 . DIAIL TO : � � Approved . . . . �r. I . . . . . . .. 10. Permit No.d JZ�, . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . I (Building Inspector) , APPLICATION FOR BUILDING PERMIT r��} Date . � . . . . . . . . . ., 19,9 ,/ 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'.propertr 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 necessa ins ections. ' (Signature of applicant, or name, if a corporation) (Mailing address of applicant) Stat ejhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises .M.�•. .f7/,l!Ct•??�, , , , , • QL . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If app ' t is orporation signature of duly authorized officer. ( m, and eitl;o f corporaptezofficer) Builder's License No, - Plumber's License No. . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ® fl�o l� House Number Street Hamlet County Tax Map No. 1000 Section • . . . . , . . . . . . , Block . . G!. . . . .'. . . . . . . . . Lot . . .�. . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No., -. ..... . . .,. . . . . . . Lot . . . . . . . . . . . . . . .(Name) 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 . , . t; . . . . . . . . . . . . . . . . . . . . i 3. Nature of workcheck which cable): New BuildingDemolition A� ition . . . . . . . . . . aeration Repair moval . . . . . . . Re ' Other ork 4. Estimated Cost . .$ / 75 (Description) � .�� . . . . . . . . . . . . . . . . . . . . . . Fee . . . .. �. . »Pws «i`il>ng this application) 5. If dwelling, number of dwellin� g$ units . . . . . , , , , , . :. , , , Number of dwelling units on each floor , , , , , , , , If garage, number of cars 6. If business, commercial or mixed occupancy, ncy, Spec if nature and extent of each type of use I)l�',', , 7, Dimensions of existin s[ ctu> if an Front . . . .�', . 77�uu e� M 1 , i u Height * . . . . . . . . Rear .� '. . . . . . . . . . Depth ./.(P. . . . . . . . . . . . u�nberofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . , , , with alterations or addition : Front .�8 � ' �C� 3 ' r�fckx� . . . . . . . . . . . Rear ./. . . . . . . . . . . . . . . . Heme Height . . . . . . . . . ... . . . . . . . . . . . Numb of Stories . . . . . . . . . . . Dimensions o same structure ruction: Front .l,b? lr ', , , , , , , Rear . ' ." . . . Depth .5_ 3. . . . . . . . . t 1. • • • • • • mber of Stories . . . . . . . . . . . . . . 8. 9. Slze of lot: Front tmensionsofenhrenew cNUl. . 1 . • , . • ' • . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . • • • • • . • • • • • • • • • • . . . ... . . . Name of Former Owner 11. Zone or use district in whichremises are situated . . . . . . . . . P 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13, Will lot be regraded Will excess fill be removed from premises: Yes No 14. Name of Ov:ner of premises/� F/yYGcrn, > ( ?�o�, . .Address Address 3??5, 5' i wet, •W 6+ ne T No.?®,3, Name of Architect 12G4f.�u oS P ' f s, 4 `Qi S 'Phone No. ,1a Q h Name of Contractor OP.k4". Nvxq ;!.1?4 Address PuX.K`17, i7S)10 r (SJR l�C Phone Nos/6.� 71? 15. Is this ro ert within 1300 -feet of a tidal. wetland. *Yes e as r . • . . . . . . No. . . . . . . . . I yes, Southold iTown Trustees Permit may be required. PLOT DIAGRAM Locate cleat'.y and distinctly alj buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block'Inumber or description according to deed, and show street names and indicate whether interior or corner lot. I!I , STATEIF EW OUNT OF . wL' SIS �` g n contract) being duly sworn, deposes and says that he is the applicant ( . . .. .individual si nm hove name f le is the . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corpora.te officer, etc.) . . . . . . . . . ' ' ' ' ' ' ' ' ' ' ' f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this k wd11 bl be performed in the marine that all statements contained in this forapplication are true to the best of his knowledge and belief;and that the worn r to befor rspt forth in the application filed therewith. otary lic, . . . . . .\. . . . County THOMAN K, w4"TV JM, Notary PUblle State of New York Na.4a06559 • . . . . ' . . . . ' . Qualified In Suffolk County , , ' ' ' ' ' ' ' Term Expires 12i31SO (Signature o applicant) —N — 91F � J-X J.OAIEI AAMd sEc.xn 1x 2.0: \ SOUND O 0.6A R ISIJ�O 0 m a O 5.2 Y 6 4.IAItl E C0 ss f.BA ]•t � ].9A 4• .r O N I,IO�n, ... MA 1H� -�. . 2 12 6.OAId T J.AA l.iA t 4 2.tA y Fj 2341d } I1y " F139 MA Adptc) l0 Fdi PAfICEL O4 to SE05- 10.001 I� Y6 6 8 4 1a 2.84 Iiiii ry6W 10A 4.9A r 2 1R \B) 19AW REA —rr-�'T.:"• 9 MA 6 r NO' 1.2 4.1 OF R0. I J. 2.JAl<I 2dA1E1 � 26.2Atc1 1.64 C J O 6.0I0 9 1 R LBAId A 3.3A(c) \ x "Middle Farms PoM F1OR46 sE�E EL 8.84 FOR PARCEL N0. 'SEG NO. MATE SEE SEC,N0.008-01-OOJ I 6048211 R pp `1 NRT( LRE m yd0 C `O Py 9 rQ� SECTION NO N ,mX� SOUTHOLD - COUNTY OF SUFFOLK E ` er °° _ 41irx mxumE. %u. vnov[n�"sr NOTICE © 003 ,rE aAmw6 as*" yX11TFNAX6 M,FAAiWLOLLE OR Real Property Tax Service Agency r 110 �i YALME Ri County Center RlverheodlN Y 11901 M wx w1 %,vflxn WYPoBeteN a AxY FE6JM1 rc IRE LOGO PROPERTY MM ,41FR fiLFi011160.WfY tA%WP R%M[BIIfO 4 ,�, Y P m1 ryp- g51eC11O P6UJ[ Or,F 6M1tEX FEW"IC OF THE 56µE X FEElr 1 ,A51[,M[R OEµpREp[fl1Y 145 SffNY•E AfifNLY. CgNFR2M W4L AUPR,19%[ L i 1 F i P I i FISHERS ilf 3.11� ED.80���� 2.IA 2..0�Ac 2.OA JAA '�20.,O A 1 W'. 6 x 0 LBAIp L6AId ♦ O S.BMCI 5.1 24A A 3.S 2dAltl 3 2.1 R.6A O8 9.1 c. UAWl.1Alc1 3.IAIc1 / 6.3 A c244 UAW 10 2TAIn1 It ♦ 1.01 2 n LOAW US � m � 9 ♦ 3.6 72AIN /.200G N 2.5A 3.2.311G 0 ` ti © 3.11 W 5.2AId 0.�1c1 32 LiM.) i0W PARCEL N0. IAA O E SEC.0.000-01 LINE u MATCH LIME r J EEET SEF lMl.oOB p11M1 _ I. MgW„Y w M LM 4M.kM Lel IM �� —_ YM PrbA1 lM f � 41w Wahl LN � x SpYl1 fF^�.TIA,' "L— walw.lamnlww. 12SI �,x„ O iM_ E mww Mw —z Z u1xglMl ux --•-- x.wxaMMLM —XBB-- Iwr_ C Nb.411M hN gMYm m (yaY LM Ufl MM 1M —�A I6Aa11YlY[11M— A P._ N hkI IM IM MNIM > — ImIM1Y g11lkl lM�' O y!Yaly, 2J M1.a rw Ywf2.l Algl or 12.1A tmYl.e 12.1 Alcl rey 1M M[MrY11M Ufsoa 18( Arg, 7/2-- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL REMARKS: DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1075012 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK,,NY;10038, . Date AUGUST -11,20M Application No. on"file x.9513799{99..- N 535244 THIS CERTIFIES d4HXU-,s:1--s'+4 only the electrical equipment as described below and.inhoduced by the applicant named on the,above application number is in the premises of HIRAM UPSON, gEDAR RIDGE ROAD, FISHERS Isum, NY , in the following location ; ❑Basement ® Ist Fl. ❑ 2nd Fl. Section Block Lot was examined on, AUGUST 25,2060 and found to be in compliance with 'the National Electrical Gode., FIXTURERECEPTACLES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SWITCHES OUTLETS INCANDESCE FWORESCENi I OTHER I AMT. I K.W. I AMT. K.W. I AMT. I K.W. I AMT. I K.W. AMT. N.P. 7 7 7 7 1 1 1 1 1 1 1 1 1 3.6 1 1 1.2 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS I BELL IUNIT HEATERS I MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. I X.P. 1 NO.O yEET AMT. WATn 2 - �. 2 600 SERVICE DISCONNECT NO.OF S E R 'V,- - I C F. METER NO.OF CC GOND. A.W.G. A.W.G. A.W.O. AMT. AMP. TYPE EQUIP. 1 e RW T 0 JW J 0 JW J 6 IW PER 0 Oi CC.COND. N0.OF HI-LEG OF NIdEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS; G.F.C.IL-2 ED REMODELING AND RESTOR. LIC.#296-E PO EONS 477 FISHERS ISLAND, NY, 06390 GENERAL MANAGE 1 Per This certificate must not be altered In any manner;return to the office of the Board If Incorrect,"Inspectors may be Identified by their d nflals. - COPY FOR t3UILOWG -D FM NT.-THI5 COPY 0 ' CERTIFICATE MU5T,-NOT EE,-ltLTfREL) IN ANY MANNER. " - t SAWN DY x PN'�Ov�D 6Y / x F�Z Q g eo N V a X � L EEGFf 1 Ff A l C-1- 'pR���17 3 4'JZ1�2` ONE bToe�( AtDI'{'10N PORCN PORGN *� U j. ,MsnNu Houma M POPCH xl� 3 O � z E R PAif 5GALr it : 2d n WN6 # BUILDING PERMIT REVIEW CHECK LIST Applicant/ p �( Date Owners Name: i �d� f t�X q 41 Reviewed: Architect/ Date Engineer: Submitted: SCTM#: District: 1,000 Section: .3 Block: G Lot: 12 Project Subdivision Location: (�Sj &51'vD oAot'Itptr,2,TAL-41 Name: Single&separate Req ' d certification: Yes No Req. Zoning District: [Lot size: Actual: [Lot coverage Proposed: 1 Req. (5"1 " -t-6 n3 Req.V' U C[Front Yard Proposed: I [Side Yard ?--e44t)q oposed: 1 [Rear(Yard Pc40oose 1 Project Description: ����e&��i9N/5 '�b �1C15ri G Pock,,,6 AGENCY PERMITS Permit REQUIRED FOR REVIEW .A NO YES Numbe Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Notes: M1110f=