HomeMy WebLinkAbout21260-z
„r • FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22406 Date JUNE 21, 1993
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 3 Block 1 Lot 9.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 27, 1993 pursuant to which
Building Permit No. 21260-Z dated MARCH 5 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 DINING ROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to JEREMIAH M. BOGERT
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - JUNE 3 1993
PLUMBERS CERTIFICATION DATED N/A
J
Building Ins ector
Rev. 1/B1
VOPM NO. f
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)
N2N9 2126OZ Date njj...... j . . 199
Permission is hereby granted to: ~i
~°~.r~..f~....-a .
fo ..........Q~...!N%....f/ ........1~~.
1~,:< r... ..,(J
at premises located at .......(..k~
I......~:.~ ~ . ....azzac
County Tax Map No. 1000 Section ....`,1 Block ......1............... Lot No...
. .
pursuant to application dated
......lZ.:'.. 7 19ff, and approved by the
Building Inspector. ~
Fee 7..,r..a.l/.
Building Inspector
Rev. 6/30/80
FOnM NO. 6 _
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 =1802
APPLICATION FOR CERTIFICATE 0,
Instructions
A. This application must be filled in typewriter OR ink, and submi ~widing Inspec-
tor with the following; for new buildings or new use: '
1. Final survey of property with accurate location of all buildii perty lines, streets, and unusual
natural or topographic features.'
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses; or buildings and "pre-existing",
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS ,$25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over. 5 year., $ 10.00
4.Vacant Land C.U. $ 20.00
5.Updated C.O. $ 50.00 Date May, AO„ 1994...
NewConstruction
...fit.. Old or Pre-existing Building Vacant Land '
Location of Property Ea.St . Eno .ROaa C Fishers is. A ..Y . . . . .
House No. Street Ham/et
Owner or Owners of Property ,Jeremiah M. Bogert .
County Tax Map No. 1000 Section .....3......... Block Lot 9:.1
Subdivision ..........Filed Map No. ........:.Lot No. .
Permit No. , 212602 Date of Permit . , 3/5 193 applicant .
Health Dept. Approval ...Labor Dept. Approval , .
Underwriters Approval ........'...Planning Board Approval ' .
Request for Temporary Certificate .......Final Certificate ....fit................. .
Fee Submitted $.,25;
Construction on above described building and permit m ets al/&S icable c es an regulations.
Applicant
Fin. 10-10-78 President, Contracting Inc.'
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FOUNDATION (1st)
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FOUNDATION (2nd) _ cr
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LOUGH FRAME &
.PLUMBING I
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INSULATION PER N. Y.
STATE ENERGY
CODE ? T ~Y
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. FINAL
ADDITIONAL COMMENTS: x
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BOARD OF HEALTH
FORM N0.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY .
BUILDING DEPARTMENT CHECK
JAN TOWN HALL SEPTIC F0RN
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t.OT I FY ;
CALL
Examined ............119 MAIL TO:
Approved A!/L.. 19f~PennitNo.Al.dom.(/7.49
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 7........, 19y3
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
x 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.
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
Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
flte applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
idmit authorized inspectors on premises and in building for necessary inspections.
4.:5:....... ~kj~
(Signature of applicant, ot°name, if a corporation)
n
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
ean~..4~4
Name of owner of premises ~eten~Jgli rT
(as on the tax roll or latest deed)
If applicant is a cor oration, signature of duly authorized officer.
(Na and title of corpora eeoff
Builder's License No. . /.3 o~y°2 , , • •
Plumber's License No. :~~'y-
Electrician's License No. • , , • , •
Other Trade's License No. 4/?.
Location of land on which proposed work will be done. [ W
]louse Number Street / Hamlet
County Tax Map No. 1000 Section ....3............ Block Lot qA /
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 S~n~e...T9.":
b. Intended use and occupancy ~!H c'
3. Re air Mature . of work (check which applicable): New Building Addition 1/ Alteration
P Removal Demolition Other Work
(Description)
4. Estimated Cost f/ ( . . • • • Fee ....7.f o
(to be paid on filing this application)
5. If dwelling, number of dwelling 4nits , , . , , , , , , • , Number of dwelling units on each floor .
If garage, number of cars .
G• If business, commercial or mixes( occupancy, specify nature and extent of each type of use .
Dimensions of existing structures, if any: Front Rear .
Height Number of Stories Depth h .
Dimensions of same structure with alterations or additions: Front
Depth........... Rear.................
- . Height Number of Stories .
8. Dimensions of entire new const ction: Front . . . . . . . . . . . . . •
Height Rear Depth
. Num~
.er of Stories .
9. Size of lot: Front Rear
10. Date of Purchase . Depth .
••••••••••••.....Name ofFormer Owner
I I . Zone or use district in which pre %nises are situated
1_. Does , , , , , , , , , , , , , • , • •
proposed construction viol
dte 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 , . , , , . . . .
Name of Architect Address Phone No............... .
• . . . . . . . . ..Address ...................Phone No. .
Name of Contractor . . . . . . ..Address . • ....Phone No. "
within 3
15. Is this property Yes....... No.. x.....
If Yes, Southold T00 own feet
Trustees a Permit wetland?
be and? ~required.
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
PATE OF NEW YORK,
OUNTY OF . S.S/
' • • • • • • • • • • , being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
,ove named.
ae ~iydy;GtcDbi~ .
is the
(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 application are true to the best of his knowledge and belief; and that the
)rk will be performed in the manner setlforth injhe application filed therewith.
orn to befforre rj this
00 . L-
.day o 19 `3
tary Pubfl
-County
.V
Tq®MAIy DOH0ty J",
• • . • •
Notary Pulsllc State of New.Vqrk
NoA806559
ounimpo in Sultotk cou'ntyii • • • • • • •
(Signature of applicant)
regIPJSit9fG
TOM tixpi
JAMES VOLNEY RIGHTER ARCHITECTS I
58 WINTER STREET 4
XBOSTON, MA. 02108
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t WT ouT E P- FT I-
N As wEaESCAWi AmtxA•ID
L0 NEa.I wojur, kM. E>cTErJSIO~I.
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R EADV6 OLD
Wino" QSAVE.. -
i
Iu6EaT : SALr*e-%6W M
W'TF- GLAD.
- OCCUPANCY OR
APPROVED AS NOTED POSITION KeuiE OLD C-W IVS
TO 5'~'
A&".D 3 B.P.~~ USE IS UNLAWFUL
FE ' BY: WITHOUT CERTIFICATE
NOTI Y BUILDING DEPARTMENT AT OF OCCUPANCY
765-1802 9 AM TO 4 PM FOR THE coNTIUVChp~LL
FOLLOWING INSPECTIONS: pr--TAILS ulcJ:
1. FOUNDATION - TWO REQUIRED INTIMOP- w4r'iusor, m`nL O ML WA
PvcM
FOR POURED CONCRETE F3 }iV I,,y RM.
2. ROUGH - FRAMING & PLUMBING R~"~DVE mOQ A c
3. INSULATION TAB eEpal~ p
4 FINAL - CONSTRUCTION MUST F->us'TI; LWC of EXT.
BE COMPLETE FOR C.O. waLL of HK.FtT ARFA.
ALL CONSTRUCTION SHALL MEET 5uPFo2T WALL A+awE vrHFAN IU CLq.
THE REQUIREMENTS OF THE N.Y. - - - - - - - - - - - -
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR NE~.1 pIUIL>CI
DESIGN OR CONSTA+_INAhlf4 Fd"K
oAVL PI-Y.. SdIU
61, sTi; Aoa
NEVI SHELV6s
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JAMES VOLNEY RICHTER ARCHITECTS
53 WINtER STREET
BOSTON, MA. 02108
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' _ - - \ JAMES VOLNEY RIGHTER ARCHITECTS
- 5~ WINTER STREET
- R BOSTON, MA. 02108
if copper tubing is used
for water distributing
w j o system; Piping shall be
o _ I Of types K or L onl
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_ S/a X 4 C O R N E R>3 D. UNDERWRITERS CERTIFICATE
\ I°= M TRED REQUIRED
ire trrt ~~g INCREASE TRIM
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JAMES VOLNEY RIGHTER ARCHITECTS
58 WINTER STREET
BOSTON, MA. 02108
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
ISr'ti OF OCCUPANCY`
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58 WINTER STREET
BOS'T'ON, MA. 02108
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JAMES VOLNEY RIGHTER ARCHITECTS
58 W IN i ER STREET
BOSTON, MA. 02108
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53 WIN-:ER STREET
BOSTON, MA. 02108
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