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HomeMy WebLinkAbout23348-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~uupANOY No Z-24271 Date APRIL 9~ 1996 THIS CERTIFIES that the buildin~ Location of Property A~ENUE B House No. County Tax Map No. 1000 Section 6 Block 2 Subdivision Filed Map No. ONE FAMILY DWELLING FISHER~ ISLAND, N.Y. Street Hamlet Lot 22.3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1996 pursuant to which Building Permit No. 23348-S dated APRIL 8, 1996 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 DNELLING - PARTIAL ONE STORY & PAMTIAL 2 STORY & OPEN PORCH "A~ BUILT", CONSTRUCTION CONTAINS NO AImPA~ENT DEFECTS A~ CERTIFIED BY A N.Y. STATE LICENSED PROFESSIONAL ENGINEER. The certificate is issued to of the aforesaid building. MARJORIE PEDLEY (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL LIC.$2990-P UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 3, 1996 PLUMBERS CERTIFICATION DATED N/A dig Insp~ct6r Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN ~ SOUTHOLD, N.Y. Ne 23348 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....~ ............................................ 19....?.~.. Permission to Counh/Tax Map No. 1000 Section ......... ~. ............ Block ....... ~ .............. Lot No..~...~.,.,..~.. ........... to application dated ......~..~..~.. ........................................ 19..~....~. ........ and approved by the pursuant /- Building Inspector. Fee ~.~.., .~.~ Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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, 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 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-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 I. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .M.~.r..c.h. ?.~. ~..1.9.9..6; ...................... ............. New Construction ........... ~ g. .X. . Location of Property .... ~..o. ~.). ................... .A.v.e.~.l?...B. .............. ~.. ~.~.h.e.r..s. House No. Street Hamlet Onwer or Owners of Property .................................................... County Tax Map No 1000, Section..0. q~.:p.0. ..... ....... ........... · .~. ~..~ ........... · .'w4%/.~. ..... ,F>l)d M~p ............ Lot.. Permit No..?../.A .......... Date Of Permit...N./..AL/.~./?.~....Applicant .... Health Dept. Approval ........ Underwriters Approval..N/.A. ........ Planning Board Approval...N/.A. .................. Request for: Temporary Certificate ........... Final Certicate...X. ....... Fee Submitted: $ ...... ................. ................. ~ ~' , ///~..,.f'//~/' (~,~,,~. ~:lO..~ ~' ' APPLICANT -- / CO~o~")] Stephen L. Ham, III STEPHEN L HAM, HAMPTON ROAD SOUTHAMPTON, N.¥.iI9¢8 March 28, 1996 Mr. Thomas Fisher Building Department Town Hall 53095 Main Road P. O. Box 1179 Southold, NY 11971 Re: As Built Dwelling at AveDue B, Fishers Island Dear Tom: ~ In connection with the issuance of a Certificate of Occupancy for the single-family dwelling owned by Marjorie Pedley and located at Avenue B, Fishers Island (SCTM No. 1000-6-2-22.3), I have enclosed the following: 1. Application for Building Permit. 2. Application for Certificate of Occupancy. 3. Blank check to the Town of Southold to cover the fees for both applications. After the other documentation you believe to be necessary has been submitted to you, please issue a Certificate of Occupancy for the subject property to Marjorie Pedley and give me a call when that has been done so that I may schedule the closing of the sale of the property. Also, please advise me of the amount you complete on my check. Thank you for your attention to this matter. Sincerely, Enclosures Stephen L. Ham, III 03-27-1996 10:31AM FROM TO .., FIsH. ERS ISLAND WATER WOR~[$ CORPORATION FISHERS ISLAN[~ NEW YORK 06390 AREA CODE 5161788-725l 1?6~1823 Po 0~ TO~t Of Sou~hold FiaharB .Island, N.Y. 06390 (~etl~lemen: Please accept thiS'letter as cer[~£[ca~on o~ ~acer Service provided " [i~e.£~om our 'Island dis[ribucion 5i:~cere'].y ~o~r$, Robert g. Wall Super £~enden~ '3':' 04/08/96 13:16 CHANDLER PALMER & KING '.~ 516 ?65 1823 Q02 GORDON C. HYDE, A.I A. ~'~ ~ n ~ ~enJ~min H. Palmer (1923-1972) ~, ~ '~,.~ ~ ~ ~ Percy Joe King (1959.1989) Aprzi o, ~~ Mr. Thomas Fisher Town of Southold Building Department 53095 Main Road Southok~, NY 11971 RE: R~idence at (no #) Avenue B, F~.shers Island, New York : $CTM, No. 1000-006;00-02.00-022.003 Dear Mr. Fisher: Please be advised that I have inspected the referenced residence from a structural point of view. In my opinion, the residence is structurally sound and contalins no apparent structural defects. My op2, aion is based on my own observations and also on ehe fact that the residence has been standing in its current location for the pa2t thirty years without having sustained any apparent damage from settling or from the elements. Cordie~l~/ Richard H. Strouse RHS/md THE NEW YORK BOARD OF FIRE UNDERWRITERS PA~E ~ 1~913 .UREAU OF m.=CTRIC,TY ~- 85 ,JOHN STREET, NEW YORK, NEW YORK ~0038 0.,~ ~RIL 09, ~996 ~...~.a.. ~o, ..f~ 11421396/96 ~ 3826~ THIS CERTIFIES THAT o~y t~ el~trieal equipment ~ ~eri~ be~w and int~uced by t~ ap~ican~ ~med on the a~ve application number in t~ p~m~es of RONALD PEDLEY, A~NU~ B, FISH~RS IS~, N.Y. in the fotlowlng locatlon~ ~ Basement ~ Ist Fl. ~ 2,,d ~. OUT Sec,ion Bilk Lot ~s examined on APRIL 03,1996 and fouhd to be in compliance with the NaMonal Electrical Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER DRYERS )THER APPARATUS: ENTIRE PREMISES- I SMOKE DETECTOR: - 1 ~NO VISUAL DEFECTS.' "An electr:ical survey has been made of the exposed electrical equipment, iii t~ie premises indicated.," "No obvious unsatisfactory condition was found. E R NO, 0 E COND' OF CC. COND. C E OF HI-LEO NO OF NEUTRALS A.W.G. OF NEUTRAL WALL ROBERT E. ~' LIC. #2~55LE ': eN~ht ~aoi~ This certificate m~sT.~J~J~l~affe,~'e~D~ny}~pnO~;~lJ~ to the office of the Board if incorrect. Inspectors may be ~i~nfified I COPY FOR BUILDING DEPARTMENT.' THIS COPY,OF CERTIFICATE MUST NOTBE ALI~ERED IN ANY MANNER. IE~D' INSPECTION REPORT DATE COMMENTS '0~ATION ( 2~ ) [ ....... ii ,z,, .... , ' STAr~ Cm~R~ II " CODE II II '~/II / /','I // ' ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Exmnincd . .) ....... , i. ' Approved .~./l/~.. .......... Permit No..-~...~'.~'..~"..~.,j~' Disapproved a/c ..................................... , · . APPLICATION FOR BUILDING PERMIT 3 SETS SURV£Y CIIECK SEPTIC OF PLANS FOR}I hO~ L PY CALL ~tAIL. TO: Date ................... 19... INSTRUCTIONS a. Tiffs 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 which is part of this appLi~ :ation. . c. The work covered by this application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to tile applicant. Such permit halt be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in p~rt 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 necessary inspe~ions. . I (Signature of applicant, or name, If a corporation) Stephen L. Ham, III .4§ Hemp. ton Road~ $outhara[~ton NY 11968 (Mailing address of applicant) ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .- ,lame of owner of premises Marjorie P.e. dlex (as on the t.at roll or latest deed) f 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 ...................... Lo ationofl d whi I p p dwo kwillb d ' C an on c I ro ose r e one ........... , ........................ (no #) Avenue B Fishers Island House Number Street llamlct County Tax Map No. 1000 Section .. 006.00 Block 02.00 Lot 022.00.3 Snbdivision Filed Map No ..................................... · ........ q ...... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: " a. Existing use and occupancy S.i.n.g~F~mi.l.y. ~%ell~g ' ' b Intended use and Single-family dwelling · occupancy .................................................................... -,~lc); l~c,, ..'. ........ .'~.d'.htloa .......... Alteration .......... Repair .............. Rembval D liti .A.S BUILT t, · ............ cmo on ............. Other Work, ~S. BUILT .ff.S.T ~2~'~ ~-e~O~ (Desc iption) 4.. Estimated Cost ......... t ......... . ........................................ i "' ! .) ! ~ :" "' (to be paid on filing this application) 5 If dwelling number of dwellingiunits Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy specify nature and 7 Dimensions of existing structurqs if any FrOnt ~ _ extent of each type of use ............... . ..... · ' Rear...".".':. Depth Height Nm~er o f S~ories ............... ''" ..... ' Dimensions of Same structure with ........................................... alterations or addihons Front Rear 8. Depth ' Height .................... "' Number of Stories Dimensions of entire new construction: Front Rear ' ' ......... i i~ · Depth Height Number of Stories ....... ~ ........... '?" .................... Size of lot Front I ...... ....... , ........... Rear .... Depth i Date of Purchase ' '~ ' "' ............ ........................ ' · · .'. Name o£ Former Owner Zone or use district in which premises situated ' i ............................. .10. 11. 12. Do ope d ti i l~t i gl dinah es pr se construc on v o e any Eon n aw, Or cc or regulation: ........................... 13 Will lot b graded 14' Name of e re ........... . ................... Will excess fill be removed from premises: Yes No · Owner of premises · · ~. ·. ............. Addr " · . ess ................... Phone No ...... .......... Nam f A hit ' ' e o rc ecl .......... i ......... Add ........ tess .. Pt N Name of Contractor .......................... Address .......... PI,,--,' M,-, . . ,, : Is this property within ,~ ~ u~ a ezra± wet~anu't *Yes ........ ~,~ ~ , . ' , [5.. *If yes, Southold Town Trustees Permit may be required. Locate clearly and distinctly all !buildings, whether existing or proposed, and. indicate all set-back dimensions from. property lines. Give street and ~bl .ock, number or descriptioh according to deed, and show street names and indicate whether: interior or corner lot. . TATE OF NEW YORK OUNTY OF .S.UFFOLI S.l Stephen I/.: .H.~.m.~. III (Name of individual signing: contract) rove named. b ' lg dly n, deposes and says tha~ he is tim applicant ell U swot ~ (Contractor,~ agent, corporate officer, etc.) 'said ow.ncr or owners, and is duly a)utl?orized to perform or.hav,e performed the said work and to m.ake and file this plication, that all statements containqd m this application are true to the best of his knowledge and bebef; and that tho )rk will be perfo~ed In' the m~ner se? forth in the application~filed therewith.. tom to before me tills ' .................. day of... ............. , . N ~66, 6~ ~Y 10~6~3 / / / /~verheod uNl#ie$ --i Otto I RK$1D~NGK i~5~ 51 N/F MIGHAF~ M~GoFtMtCK e~, al S~I~FOLK COUNTY TAX M~o ,~F. DIST. I000 S~'~. 6 BL. OI~K ~ LO~ ~.$ TO ~MMONW~ALTtt LAND IN ACCOtN~tNC~' WFFH TH~' MINIMUM OF ~'HK NKW YOttK II