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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-23028 Date JUNE 6, 1994
THIS CERTIFIES that the building ADDITION
Location of Property STERLING STREET FISHERS ISLAND
House No. Street Hamlet
County Tax Map No. 1000 Section 10 Block 9 Lot -3 & 1.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 10, 1993 pursuant to which
Building Permit No. 21742-Z dated OCTOBER 28, 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 TO CONSTRUCT AN ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to HARRIS B. PARSONS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N313691 MAY 12, 1994
PLUMBERS CERTIFICATION DATED MARIO ZANGHETTI JR. MAY 24, 1994
Building Inspector
Rev. 1/81
r
FORM NO.3
r
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)
Dale.. ~LC.f.:.. 199-,
N® 21742 Z
Permission Is hereby granted to:
I~........®J.
I tar,*O1G7o.'64,0.i........ d.,.... ,1 .aSi..... 04a.....
r~r .:.......................................U......
k
f ...........I I...........
( at premises located at.... J..f~*f
.......'v4.. I
County Tax Map No. 1000 Section ...'./...O Block ......1................., Lot No. .......1..!,. 3
pursuant to application dated ..e-,! r a 19Y5 and approved by the
Building Inspector.
a?7.7J
Fees.
't
t
( ing Inspector
Rev. 6/30/80 /
I
Form No. 6 2 p---,
TOWN OF SOUTHOLD NJ L5 r
BUILDING DEPARTMENT
TOWN HALL
765-1802
LD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. o£ 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.
3. 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.
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 . 5/13:94
ew Construction........ Old Or Pre-existing Building.,?{
pcation of Property.....".........•..Sterling St. Fishers Island,N.Y. .0.63961 a. M ,
1Douse .
No. Street Hamlet
~ f.n
ewer or Owners of Pro ert Harris B1 Parsons & Wife
P Y
Lot...... >unty Tax Map No 1000, Section..19..........Block..?..... 3 & 1.3 ?
ibdivision ....................................Filed Map......... .Lot............ .
rmit No.....217........Date Of Permit..1Q(2 V 93 Applicant. Z&S Contracting Ind.
alth Dept. Approval ..........................Underwriters Approval.........................
anning Board Approval
quest for: Temporary Certificate........... Final Certicate.. X.,,,; „
e Submitted: $.2`~~Q~
PjC~ ~79LlD President
•
W*~ 23a2$ LICANT
TEL. 765-1802
p~~FFULk~OG TOWN.OF SOUTHOLD j
o y~
.y ..c OFFICE OF BUILDING INSPECTOR'
r P.O. BOX 728
to ; I
u' TOWN HALL' SOUTHOLD, N.Y. 11971 MAY 2.6 z.
1
BIDG. DEPT.
TOWN OF SOUTHOID
C E R T I F'I C A T I O N
Date May 24, 1994
' I
I
Building Permit No. 21742
i
Owner Harris B. Parsons & Wife
(please print)
Plumber Mario Zanghetti Jr.
(please print)
I certify that the solder used ,in 'the water supply system
contains less than 2/10 of 1% lead.
(pl e s signature)
Sworn to before me this
e-)`7r day of ~ / -
191Y Notes {
ota'~z,'Public
Notary Public, sf - County
TH®MAa_ 'D~ONPwT-YJR.
kotiry-AUblie State of New York
No, 49Q6S69
Quetlttecda 6utialk County
- Term Expires 12/3-i
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
F BUREAU OF ELECTRICITY
I 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date MAY 12,1994 Application No. on fife 52307293/93 N 313691
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in thepremiaas of
dT
MR. HARRIS B. PARSONS, FISHERS ISLAND, FISHERS ISLAND, N.Y.
SPtion Block Lot
inehefollowinglocationl- T Basement 11st FL ~ 2nd Fl. OUT
sees examined on RK 10 F 1994 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTgClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER "I. N W. AMT. K W. AMT. KW. AMT K.W AMT. H P
26 20 7.9 20 6 2 F
I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS UNITHEATERS MULTI-OUTLET DIMMERS
BELL SYSTEMS
AMT. K. W OIL H, P GAS H. P. AMT. NO. A. W. G AMT. AMP. AMT. AMPS TRANS. AMT. H. P NO. OF FEET AMT. WATTS
3 600
SERVICE DISCONNECT NO.OF S E R V 1 C E
METER N0. OF CC COND A, W G. A. W. G. A W G.
AMi. AMP TYPE EGUIP 1,e 2W 1 q 3W 3 0 3W 3,e AW PER % OF CC. COND NO OF HI-LEG OF HI-LEG NO.OF NEVi0.Al5 OF NEUTRAL
0714ER APPARATUS:
20 AML' NOTONE IRONING CENTER-1
15 AMP TOWEL WARMER-1
ELEC. ROOM HEATERSt1-1.5 K.W,,1-2.0 K.W.
MOTORSi1-F H.P.
G.F.C.I.-6
SMOKE DETECTOR:-°1
e!~
Z & S CONTRS. INC. 1RZC.#924-E
P.0, BOX 202
FISHERS ISLAND, NY, 06390 GENERAL MANAGER
11.
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.
Airlyflimm
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
-IcLD I;:LUN 11DATE J1 COKM€Nrs
FOUNDATION (1st)
FOUNDATION (2nd)
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2.
ROUGH FRAME
PLUMBING
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3, m -3 ~K
x
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INSULATION PER N. Y. m
STATE ENERGY
CODE
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4.
FINAL 7Y~
ADDITIONAL COMMENTS: m
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741
BOARD OF 11EALTti
FORM NO. 1
- 3 SETS OF PLANS
{1.'" 1M TOWN OF SOl1THOLD SURVEY
BUILDING DEPARTMENT CIICCK . .
TOWN HALL SEPTIC F0 RN
t SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOTIFY; 7 ~
Exanlin 19°-.. CALL 4....
/ HA IL T0:
Approved ~r11, .a.~7~ ~G- . .
19 Permit No.,;: f"
Disapproved a/c
(Buifding his ector)
APPLICATION FOR BUILDING PERMIT qq~~ q
Date , 191.-~.
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 avallable for inspection throughout the work.
e. No building shalt 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
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
rite 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.
_ Z .S . ....P....~p~N./.... G .
(Signature of applicant, or name, if a corporation)
o. r3ox aoa.. /Q P ~u1V o~ a9d
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..G(µ 4WC7zK
\ame of owner of premises . !r!!.'...Ar,-7,s pyem-s
(as on the tax roll or latest deed)
:r applica t is a co oration, signature of duly authorized officer.
(iv a and title of co*rpo ``ae officer)
Builder's License No. ..C 1TLLl!a 1
Plumber's License No. ~S F.-?tom
Electrician's License No. ..&CI-; E
Other Trade's License No.
Location of land on which proposed work will be done . '
.....................5.~~ Sr.......... Fl* ~~4-v .
(louse Number Street Hamlet
County Tax Map No. 1000 Section lt~......... Block
Subdivision Filed Nlap No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy'of proposed construction:
a. Existing use and occupancy ~7Jr~...7)Ki~ti/ .
Y44 lr/~~~ . .
b. Intended use and occupancy S!h~ .
~tature (check Rein icable): New Building /
t t Addition , Alteration y .
3. 1\tre of work (check which n avlRl . • • • • . • . • • • • . • Demolition Other Work
4. Estimated Cost .SV &D (Description)
Fee ~ T ..)G
(to be paid on filing this application)
S. If dwelling, number g un 'its . . . . . . . Number of dwelling units on each floor
If garage, numberr of carsweilin
C. If business, commercial or mixed gccupancy, specify nature and extent of each type of use . .
7. Dimensions of existing structures, if any: Front , , , , , , , , , , ,Rear , . Depth Number of Stories epth . .
Depth unansions oons o f . , same structure wtthl alterations or additions: Front • • •
Rear
8, Dimensions of entire new Height . . . . . . . . . Number of Stories • , , , , , , , , , , . , .
construction: Front . Rear Depth
Height Number of Stories .
Depth epth
9. Size of lot: Front
0. Date of Purchase . .
I, Zone or use district in which remises • ' ' ' ' ' ' • Name of Fanner Owner
~ P are situated Does .
proposed any zoning law, ordinance or regulation: . . . .
3. Will lot be regraded
premises • • • • • • • • • • , Will excess fill be removed from premises: Yes No
f .
4. Name e of of Owner o of Architect , violate, Address . Phone No.
Name of Contractor . . • . . . . • • . • . . • • ' ' ' • ' • Address Phone No. t~
. Address . Pho
~ . Is this No.
Property within 300 feet of a tidal wetland? *Yes •,,No
*If yes Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all setback dimensions from
roperty lines. Give street and block nui' ber or description according to deed, and show street names and indicate whether
rterior or corner lot,
III
I
•
I
i ,
I
ATE OF NEW YORK,
)UNTY OF . S.S
IllOmwS• • • , • • I
' • ' • ' • ' • • says that lie is the applicant
. • . • being duiY sworn deposes and says that lie is the applicant
(Name of individual signing contract)
)ve named.' i
is the ..............(Jugetr~ ;A4tv4cttw
(Contractor, agent, corporate officer, etc.)
:aid owner or owners, and is duly autlorized to perform or have performed the said work and to make and file this
lication; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
k will be performed in the manner set forth in the application filed therewith.
im to before T this
/Q /
y f Pt srt 19
ary Publi r .
TNIBMd9 E 06LIERfy JR,''
NeN+Y fiubiie Sims of New York + •
N9.480111550 (Signature of applicant)
GWttllea In 6ut1o1k County
Term Expires 1213119gt•
i
N /F F %ARTHUR
NIF HANNAH S. LADD GREENLEA,
LINE BEARING D15TANCE N 19'20'00E
I.P. N 44'22'00"E \ I N 50'12'00'W 75.37'. 20454 4p, c4 2 N 01'16'00"W 51.30'
206.54' \ \ 3 N 3I'53'OOE 14 91 •G 7~ <~3
1 5 G5111'00E 75.00' j C q~C<~
5 5 OS°01;91°W G7.3Z' LIS
\ \ N 9r . N 4 S 17'04'00'W 3650' AB- 55,80' A4, 7 5 57'26'00'E 75.00'
Eq Os N 8 5 25.01' S'W 78.51'
' € 9' 90: a0 , •g0 `a0• p S 5 25'01' IS'W 17.00' 17 m
k+ A P W 10 N03'06°400W 11134' 4/8 r II N G7°31'00'E 3.31' y Al 51*3560 - frnvwr M+NMJ
a F$ 12 Nall 06'30'E 44.00' ~O h^ v ~~'L3 Izo.98'~
A F q. 13 N 74' 07'25'E 44.07' v`p /2 r s, p s
4 N 45'31'i01E 1721' `4 v '9 ( 7$ 15 N 19' 50' 10' E 55.00' 117,90' N
a y0/o 14 N 11-08'61'W G 5, 00' J f ^ ti 78' 00'36 MITC
1~ A N Al ~f5• 15 N 49,43'31'E 0038' 08l.~cc o a/ y1~ f 1I J V
A c+ q4. OJ. J8 S O.
2 S ~ C• u J ,
Oj a~P /aL 7898 1 Ay1F1 :1J
BOUNDARY MAP V
Z L a SCALE I'-100'
N
09.3
J \ q'. 2r sp,E i 1 F'Y`I, I.i~ P J' li .,Alm I• n1 •4i
,CC, c s l
N 49' OH. IN WALL 50'10"E
.c Y~ G 55. 80- LOCATION MAP a
SCALE' I"=G00'
9 \
S f1,
VR PROP09ED LAND TO BECOME
PART OF LOT
NOTES
\/y^~ AREA O,G% AC. 1. OWNERS HARRIS B. f ELSIE V. PARSONS
G3 CHAPIN ROAD DARRINGTON, RHODE ISLAND,
It 0. \N
IN ROCK ~ E. LOTS ARE LOCATED IN THE TOWN OF SOUTH'OLD, COUNTY OF SUFFOLK, STATE OF NEW YORK,DISTAtICT I
1. P. 1000, SEC. 10, DLOCK S, LOTS L3 03-
'S. UTILITIES ARE EXISTING. SITE 15 SERVICED BY
(POLE °217 , \ p1' 15~E PR Op D.H. N E 44.00 <07' (OSFO y EXISTING MUNICIPAL WATER i EXISTING ON SITE
I / IN ROC ,~E T SEWAGE SYSTEMS.
Og • ~ - PROPERTY IS LOCATED IN x,ONE R- AD;
/ GUY q loo O 9. COORDINATE 1715TANCES ARE MEA50@EP' FROM U:S., Y17
0 '3B3j'F P COAST AND GEODETIC. SURVEY TRIANG.UI.ATION
A m l 6 Ek 15TIING STATION. "PROSY'.
m m 1 f~14.91' LOT LINE ~~~N~1035'Op"E LEGEND z
~ _SE'cTION 10, BLOCK 9, LOT 1.3 o
P~ t \ .Dm 00,t, / LP IRON PIPE
O6 ~P i / t a ti W'o/ \ D.H. IN WALL MON. MONUMENT
p~ tip T N \ $hg 9~ \ Nw AC. ACRE 1911
al G 1< D A O 0 S.F SOLARE FEET
sm'` SECTION 10, DOCK 0, 1.0 T 3 ~w > oV D. H, DRILL HOLE
.0 .v
N Z m
OP J P~ . / ~°N. GNP / r^ON c
~~NE R ~ Oa. p0~~
G ° r. POLE LINE OCT - 6.1993
A--;,-RIGHT of WAY
P 5 TOWN OF ;;GU CACIL'i tJLL ULD,,,,_~,~ . "EI
~S7 9836"w P~~DF NEW YC 532 0 5A OaPPO H. ST90G
,`Ck WATER LINE U~0 H ST9OG~1-
RIGHT OF WAY D. H, Q ° x` m
G IN ROCK O• `y
~ ~ orvn~nsaesn i nT i ides nub*t:,~
i I w
O . o
oN
N
ro H1 1 'a1
N ~ pdE ~ '(a~e~ Se'so / Ph~K N G 20 Ph~K~N Sir (GRAPHIC SCALE IN FEEI C SCALE IN FEET IL IVw~I
Q'
I ew ~
c /N ~ 6 /N Is 2.99
$I< / I V 17 ( 172~G REVISED L07 AREAS
1\ PI MIS l$J.AND, NEWS "?001~%K
LINE BEARING DISTANCE N POLE w933 TAX MAP • EXISTING PROPOSED / - SECTION /O16L0Ck 914oT 3 .251A AC, .31 VAC. REVISIONS i EVISIONS OW ANOLiSR. Is.B:4,.M~CR O FCI'NGI
1 N 31'53'00"E 14.91 S
2 5 25101115"W 17.00 m gA xy1 SECTION 0, DILOCK 9, LOT 1.3 I.G5 AC. 1.59 AC. DATE DESCRIPi DESCRIPTION; Ar0hltecte, Engineers an?pd~~ Surveyors
3 N 67'34'00"E -3.34 1 O 5 26 0~"+g L/ 110 BROADWAY NOR'MCI, CT 090 F02-lBB-.lv./ FAX 200 4p 7801
l fl ~ i
1T .00 N G /
Rod /
j/ DATE`. NOVEMBER 15, VEMBER 15, 1991
SCALE: 1" = 20' 20'
3
,1 .3904 SHEET 1 OF 1 OF 1'
1
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