HomeMy WebLinkAbout21550-z
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24354 Date MAY 13, 1996
THIS CERTIFIES that the building ADDITION
Location of Property EAST END ROAD FISHERS ISLAND, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 4 Block 5 Lot 19.8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 7, 1993 pursuant to which
Building Permit No. 21550-Z dated JULY 22, 1993
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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RAYMOND B. GARY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
i
UNDERWRITERS CERTIFICATE NO. N-325261 - AUGUST 29, 1994
PLUMBERS CERTIFICATION DATED jan. 13, 1995-NMIO ZANGHETTI, JR.
8 ding Inspector
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)
Date l~....°1G . 19./...
N2 21550 Z
Permission Is hereby grante to;
moo.,....... .
.....a..6.. 350
6a `,0
at premises located at...Fr. ..~r'3!~....
V ...,........:C [4t9
County Tax Map No. 1000 Section.... -7 Block Lot No. ,....1 ?..'...p.......
pursuant to application dated ~i 19...~~ and approved by the
k Building Inspec
f
p Fee
i
E .
Building Inspector
Rev. 6/30/60
x
Form No. 6 M O 5nale
° CS 4C141L
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 = y"
APPLICATION FOR CERTIFICATE OF OCCUPACY ~
A. 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,
f 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.
~i. 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.
B. 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, 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 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
:ew Construction........... Old Or Pre-existing Building...
'.ocation of Property.. GIJS.!...Co),..~ °
House No. Street Hamlet
)nwer or Owners of Property. rr o nJ q'/
i t
:ounty Tax Map No 1000, Section Block. ...:5.......... Lot.... .1.g..............
;ubdivision ................................/....Filed Map............ Lot......................
'ermit Noa1~S5? Z Date Of Permit.. ~ja2~43 Applicant ..~O S C.ysiR , is w,l ,`YUC .
ealth Dept. Approval ..........................Underwriters Approval.: a5 a ,
lanning Board Approval
2quest for: Temporary Certificate........... Final Certicate...
'e Submitted:
71 ..n R CS I Jo yU
/;CAN I T
TEL. 765-1802
~pc~VFFOU(~0o TOWN OF SOUTHOLD `ter
OFFICE OF BUILDING INSPECTOR (i`\v
jjj c rn P.O. BOX 728
U3 TOWN HALL g1c~Q,iG
O O ~~~t SOUTHOLD, N.Y. 11971
TCV~~
C E R T I F I C A T I'O N
Date 95
Building Permit No.a1550
Owner 1 OS f r]')~,-u L G~7j-~4
(please print)
Plumber /,7rli;fo .,.gr\9~PT dom.
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
mrtF ' signature)
( u
Sworn to be o e me this
n~~ day of
19~ Notary Public
Notary Public-/04;CK- County
TNOMAI F. ®euERTY JR.
NelSgr PUblic State of New York
No. 6606559
Ousllllea in Sutfolk County
Term Expires i2'37,96
%OUIIDA'TIOV f 15t) `f y
~OUNDATIOU (2nd) _I rN
2. ll~~
o
goUGH FRAME & I Q
-PLUMBING II Y,
H
II rn
• II ~
rn
171SULATIO;t PER N. Y. C-1
! .•a
STATE ENERGY I)
CODE
FI;lAL ~ _
ADDITIONAL COMMENTS: xM
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000656 BUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 10038
Date AUGUST 29,1994 Application No, on file 81972093!93 N 32526:1
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
RAYMOND B. GARY, EAST END ROAD, PRIVATE SECTION, FISHERS ISLAND, N.Y.
in the following location; 23sement [N I st Fl. ? 2nd Fl. OUT Section Block Lot
toes examined on AUGUST ,1994 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES WCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K W AMT. KW. WT K W AMT. H.P.
f
9 13 6 9
DRYERS FURNACE MOTORS PUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEALERS MULTI.OUTLET DIMMERS
AMT. K. W. OR H. P. GAS H. P. AMT NO. A W. G. AMT AMP. AMT AMPS. TRANS. AMT H. P SYSTEMS AMT. WATiE
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R Y 1 C E
AML. AMP. TYPE METER 1 tW 10 SW D p' 3,e' AW NO. OF CC C ND A W. G. NO. OF ",.LEG A. W. G NO OF NEUTRALS A. W G.
EQUIP. P R b' OF CC. COND OF HbLEG OF NEUTRAL
i
~y OTHER APPARATUS:
G.E.C.It-1
i
i
E
t Z & S CONTRS. INC. LIC.#924-E
P.O. BOX 202
l FISHERS ISLAND, NY, 06390 GENERAL MANAGER
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 credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED, IN ANY MANNFEnI
HOARD OF HEALTIl
i pp FORM N0. 1
3 SETS OF PLANS
TOWN OFSOUTHOLD SURVEY
7? Q BUILDING DEPARTMENT CIIECR
TOWN HALL SEPTIC FORK _ . . . .
SLOG.DE . SOUTHOLD, N.Y. 11971
TOW OFSOUTHOLD TEL.: 765-1802 ttoT=Fy:
CALL
Examined 6 G , 14~3 HAIL TO:. . . . . . . . . . . . . . . .
Approved . /~.7?7 19P. Perini t No. go
Disapproved a/c - .
ild' nspector) ,
APPLICATION FOR BUILDING PERMIT 01~~- D
ate I95 ~
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 which is part of this appli-
:ation.
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
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.
r
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
2egulations, 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.
(Signature of applicant, or name, if a corporation)
i
:..I? x...°'oa ...r...~~ s lam/ .Y .
Y..
. (Mailing address of applicant)
State whether applicant is owner,, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
U`.'~`.^~ra'r..... 1"~' 4;74C774-1 . .
`ame of owner of premises ~54AX . .
(as on the tax roll or latest deed)
If applicant i a corporation, signature of duly authorized officer.
.
(Name title of corporate officer)
Builder's License No. F 3 ayO~~
Plumber's License No. Sy
Electrician's License No.
Other Trade's License No. -,72.3
Location of land on which proposed work will be /done. . , • ; , , • • , , , , , , , • , , , • . , .
iSd/ers LS~ o.. 31~D
House Number Street Hamlet
County Tax Map No. 1000 Section / Block ...:Lf Lot
Subdivision Filed Map No.
(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 ~~Y.e ?
3. Nature of work (check which applicable): New Building ,
Addition , . Y• Alteration
Repair Removal Demolition Other Work
7 (Description)
4. Estimated Cost GUL>: OQ . Fee ..J .
(to be paid on tiling 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
Heshtsions of existing stru Nuios umber any: Front Rear Depth
of Stories .
un ensi ons of same structure with
8. D pth n. of entire new const...~ ;alterations or additions: Front , , , . , , Rear .
p Heig eight
Number of Stories . .
ion: Front , . Rear Depth
Height , . , . , . , Number of Stories .
9. Size of lot: Front . Rear , Depth .
10. Date of Purchase . .Name of Former Owner
0. Zone or use district in which . .
promises are situated
11,,, 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 Owner of premises . . . . . . . Address Phone No.
Name of Architect ,,,,,,,,,,,,,,,,,,,,,•,•,,,Address Phone No.
Name of Contractor , Address . Phone No.
15. Is this property within 300 feet of a tidal wetland?
*If yes, Southold Town Trustees Permit may be required. No..
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, 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 corner lot.
I
FATE OF NEW YORK, S
OUNTY OF /
(Name of ind v.....sig ...l n'/off • ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
contract)
,ove named.
is the . (?'e??el ~sr.ocDcotr
(Contractor, agent corporate officer, etc.)
said owner or owners, and is duly Authorized to perform or have performed the said work and to make and file this
plication; that all statements contained in this annliririnn ~
eepejee*1 10
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BE COMPLETE FOR C.O.
p~ Z LOT S 3 ALL CONSTRUCTION SHALL MEET
DC N 1 1.73 t/ ~cRE-S Q A 'THE REQUIREMENTS OF THE N.Y.
r c.0 drill STATE CONSTRUCTION & ENERGY
nK a ••p CODES. NOT RESPONSIBLE FOR
N N DESIGN OR CONSTRUCTION ERRORS 1
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N o LOCATION MAP 100 600 300 0 600
r rw h 100 so o Ioo moma la
BLOCK la GRAPHIC SCALE IN FEET GRAPHIC SCALE IN FEET
Cr UOT a
\ 4~0 ~jLOGK I~ I~
\ \ LOT 6, 1. OWNER 1. OWNERS LOT 5 LOT 6
~ ~ ~ ~ 85 acees - 4cees (1000,004 BLK5, 014) (1000,004 81-K5 LOT15)
4 ~ y~ PPE RAYMOND B. GARY RAYMOND B. 6 PRUDENCE 6. GARY
840 PARK AVE. 840 PARK AVE.
NEW YORK, N.Y. NEW YORK, N.Y.
s N
2. LOTS A 2. LOTS ARE L~/OGATED IN THE TOWN OF SOUTHOLD, COUNTY
nF C-i IPT nF 411FPnI C c,ThTP nF HR,I Y/)RK MI ,TRI(-.T Innn
5'1-t= 43 1 p 1 SEGTIOI SECTION 004, BLOCK 5, LOTS 15 4 14.
5. UTILITIE 9 ~a MUNIGIF 5. UTILITIES ARE EXISTING. 51TE 15 SERVICED BY EXISTING
MUNICIPAL WATEF $ FXISTING ON 51TE SEWAGE SYSTEM' .
0
C 1 4. PROPEf 4. PROPERTY 15 LOCATED IN ZONE R-120.
s 14.Coo~ ~ L I < 6'~~ m E 2m~ ~ ,~Qa~/ NV~/
5. GOORD 5. COORDINATE DISTANCES ARE MEASURED FROM UNITED
STATES 5TATE5 COAST AND GEODETIC SURVEY TRIANGULATION
l?Id1UY epT N67-19ZO'E .L-- 143 l'I °Ha.vr STATI OI STATION "CHOGOMOUNT 2".
6. LOT AF 6. LOT AREAS:
140
P
3" III N o B BL< 6LOGK4LOT EX15TINO PROPOSED
E87-19 od W IZGI PIPi- PIN
a5 ea BLk BLK. 16, LOT 5 1.-75 AG. 1150 AG.
~ BLk BLK. 16, LOT 6 1.85 AC. I.GI AG.
G9e'E Z ~5 12 ~ OQ oa ~ ~
1 g x'12 ~,z yG
~D ClE BY S y} ~F Lauo T' ~J:
E 27H rte`' 1 TL,E F15H-E'.:~ Is~C-~D DEVELro~^1T p~y F t'jy[Q To FAYNOIJC> B G , PROPOSED LOT LINE CHANGE
PWL~r~Eu G?.2-Y L6IDGK Vv I( lbl((n~ 1 PREPARED FOR
-1 o Aga = :'7r G +i sr- Coe, i- ace~s> 1 ~LOGK I(a LOT#9
a tn~ BLOGL I(n Pfl H gL,.
~Z loi~10 _ F 15HER5 I!S
MRS ISLAND DEVELOPMENT CORPORATION,
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