HomeMy WebLinkAbout21167-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
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i
No Z-22407 Date JUNE 21, 1993
i
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property FOX AVENUE FISHERS ISLAND, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 9 Block 4 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 22, 1992 pursuant to which
Building Permit No. 21167-Z dated DECEMBER 29, 1992
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 & ALTERATION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to ROBERT & PARSONS
(owner)
of the aforesaid building. re
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
I} UNDERWRITERS CERTIFICATE NO. PENDING - JUNE 8 1993
1
.1 PLUMBERS CERTIFICATION DATED MAY 26. 1993-MARIO ZANGHETTI. JR.
J ~rw~
~nBuilding InspectoRev. 1/81
!l
FORK NO. A
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)
NN9 21167 Z Date 194.5;
Permission is hereby granted to: I
d..
3 57
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at premises located at .....lf
t. i~![r.1s....
County Tax Map No. 1000 Section ~In........... Block Lot No.......
pursuant to application dat 191Arand approved by the
Building Inspector.
!e
Fee 5..~4.iq.
wilding Inspector
Rev. 6130180
FORM NU. B ~
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 = 1802
APPLICATION FOR CERTIFICATE OF Ot
Instructions
A. This application must be filled in typewriter OR ink, and submitted .t to the Building Inspec-
tor with the following; for new buildings 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 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-
il tion required to prepare a certificate.
Additions $25.00' POOLS $25.00 ALTERATION $25.00
C 1e 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 years $10-00
I 9.vacant Land C.U. $ 20.00 SJ26,~93
5.Uodated C.O. $ 50.00 Date
NewConstruction„.,,,Old or Pre-existing Building ?t
Vacant Land
,
Location of Property , -Foac• Avenue,, Fishers Island,N.Y.............................
House No. Street Nam/et
Owner or Owners of Property . , , Robert. Parsons & Wife
County Tax Map No. 1000 Section ....9.. Block ..'4....... Lot
Subdivision ..........Filed Map No. ........:.Lot No.
Permit No. 211672 Date of Permit 12F29f92.Applicant . , Z&S Contracting Inc.
Health Dept. Approval ...Labor Dept. Approval
Underwriters Approval ......................"...Planning Board Approval
Request for Temporary Certificate .....................Final Certificate .5 .
Fee Submitted,$ 25,•.49
Construction on above described building and permit meets II appli le codes and regulations.
pplicant,,,,President,,, Applicant
Rav. 50-70.79 '
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Co z aa~lB 7
TEL. 765.1802.
r~E~(1Lkc
o TOWN,'OF SOUVOLD
OFFICE OF BUILDING INSPECTOR'
,P.O. BOX 728'
TOWN HAIL
SOUTHOLb, N.Y. 11971
C E R T Z F I C A.,T S`O N.
bate May 26 19
,
21167Z..
guilt ing.)Permit"No. OUE
? OWhOw Robert Parsons.& Wf. „
(please pr nt...
s
P~umlhAx Mario Zanghetti Jr.
(p eases pr nt)
i certify that the .solder used in 'the water supply system
"contains less than 2/10 of 1% lead."
plu er' sgnaturey'"
e
thisswo~ ~o before day of,
19 ~3 Notary Public V
Notary public, ounty
M '
1 TNOMAlf R. ae aaary arr
Nptpry 1?ubfye State of New YOKk' s~
No. 49q,6559 '
OHaUfiao Iq Suffo*'County
Urm txblras 12/31/9p~
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F1 O S.Z II®ATg it A4M t~"S 99
ac'
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FDDIIDATIDN (1st)
>OUNDATI077 (2nd) 0
o
`,LOUGH FRAME & I
-PLUMBING
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tI7SULATI0i7 PER N. Y.
STATE ENERGY
CODE
H
FINAL _
Pill
ADDITIONAL COMMENTS:
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71 ~K - 78s~7
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, BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY _ _ .
BUILDING DEPARTMENT CIIECK _ .
TOWN HALL SEPTIC FORK
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:OTIF11
q CALL
Examined J: 2 19 / MAIL T0: .
Approved .f. .'.fir 19~99"-Permit No. ~ //.6.. .
Disapproved a/c
,)o 15Z
uil ),Inspcctorr)
APPLICATION FOR BUILDING PERMIT
Date 19~-
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.
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.
flee 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 IS...GanS~i2,r~i,~J,....................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
6 Lt-~j9Y/IKb .
Name of owner of premises ~roh,.T ~ri'an5
(as on the tax roll or latest deed)
It 'applicant its a corporation, signature of duly authorized officer.
~//O,l?tl=~ ~ik1 f ,1~?dUy/1G,14'•p ~
(Na a and title of corporate officer)
Builder's License No. . . . //Z
Plumber's License No.
Electrician's License No.
Other Trade's License No. 093F-IqP
~JJ i/
Location of land on which proposed work will be done, ft/
.......l`~d'f
3louse Number Street Hamlet
County Tux Map No. 1000 Section f Block , , , , ,
LL ,e,I6t
Subdivision Filed Map No . pt
(Name)
State existing use and occupancy of premises and intended use and occupancy dfpraposed epmlruction:
a. Existing use and occupancy ~tv ~e.... y
3SAY°~ Y3 r~x uaw~t d "2AC,, .
a a
b. Intended use and occupancy ...:S`" f.. ° , , , , , , ,
3. Nature of work (check which applicable): New Building Additi9n • • • Alteration
Repair Removal Demolition Other work
(Description)
4. Estimated Cost ..~C:~'r%.C'~' Fee
(to be paid on filing 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
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height...................... Number of Stories......................
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of Lot: Front Rear...................... Depth
10. Date of Purchase Name of Former Owner
It. Zone or use district in which premises are situated
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 Owner of premises Address Phone No............... .
Name of Architect Address Phone No............... .
Name of Contractor Address Phone No............... .
L5. Is this property within 300 feet of a tidal wetland? *Yes........ No........
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAb1
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 comer lot.
OUN OF NEW O S•S
RUNTY OF
being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
ove named.
is the . ( °im..~ ~f ve lk
(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 set forth in the application filed therewith.
om to before me this
3-7-
u da~~y//of S?^ ! 19 tary Public, Coun
EILEEN O. WALL
NOTARY PUBLIC, NEW YORK STATE 1 7!' , !l,
NO. 01 WA9609185
(Signature of applicant)
TERM QUALIFIED OCTOBER ER 31, 104%
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1 CER-TIFICATE
OCCUPANCY
q201911 AS NOTEDq
DATE:'/ 9.P.N ~ / -Z 9
tt- FEE: NOTI B ILbING DEP~A-R~-T~M-E-N--T~-'AT'
7aR,-100 1 0 GM Tn 6 PRA PnR TNF •1~~;~.`-
FOLLOWING INSPECTIONS:
.1, FOUNDATION'- TWO REQUIRED
FOR POURED CONCRETE ~'SI
2 ROUGH : FRAMING &.PLUMBING-
3 INSULATION FINAL CONSTRUCTION MUST
[ BE COMPLETE FOR Q.O.
FALL CONS'i'RUCTION SHALL MEET'S
THE REQUIREMENTS OF THE N.Y. . STATE ~ CONSTRUCTION & ENERGY
~lRST', ,FLOOR EXISTINC+ coNt~lYVoh1`r"`. CODES. NOT RESPONSIBLE FOR
i/4n~~t on
/ DESIGN OR CONSTRUCTION ERf#ORS
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1 /12', ;^fghl 2' ~c 4` T4", sash r -2 10 1/4" x Y-1 f/2 r o nacessary.
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JEW ZK WALLS Up
OCCUPANCY OR
LL fED gnoM Pt-~YEnom - I1
2 u. O ] I USE IS UNLAWFUL
WITHOUT CERTIFICATE
O cl PoSr
OF OCCUPANCY
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for tubIn
FIRST Fi DOV- PLAIA soffte/paP P ng bit n9 d
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UNDfRWRIre of
REQ~R CERTIrICAre
ONLEADO. '7 CERFICAE OR O 90 ON ET/F/CAT/OA,
CVh-OF CCU gHCY
SOLDER USED ER bSCD /N WArcg
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EXCEED 2110 0
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5 M1091 2'D' x68 c#ip1e track tslscreans. 6-Ct{odd`4~ng~c~}lae door 1°{' x 4, p"
n ''J erg' r 31r6'sash WAD 1i4" ix 3.4'1/2' rp g 7 6f ? d51 "2'6' x ~8' GixYo£f co7n~r as rupcessaty
. =.2% y M A~1 2 0 x 6_4 eagh' (Pain of doops) r,r l ~,;~rc:'x~' T'Q" sash x 5 1 4/2 z4~ R r 1vL 3+"184` "2'-§'" x,6`-6, _
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ANCY OR
OCCUPANCY OR
USE IS UNL"FI UNLAWFUL
UT CERTIFICATE
LEI-1 WITHOUT CERTII
OF OCCUPANCY CUPANCY
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y X9'S GASES I ' w/ix . t'UVCS C[ILJWC.+'VUL~L.VVUr ASwE F~IJ, Fl0.. FA
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o JoiS ~TUµo JOISTS 616"OL- I- F
DECrivy \ 9+H PosT s c"`Wi.T SHEn~WA7F
7ArMe;D ~Q Ae~yE ~3
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2X 51E07Ep_5 5~4.c3 6oTiPM PJ+IL r
e2 F MEMBRAUE C \ r I ~ m I
,M1I 4X9 POST CuR
c" PUNP. FLASH1Uy `T='r eF ~~..FPU. tout. sLF tout. SLA STEP CONC. SLAB I ~ ~I a ac.
6 N 4H~Si ne n~ SLAtd o4! 4YkPE To SWITCH ti MJn EM.
y I C SOW 5~ n MA5T"- 8E- 8 MASTF F.-5EDROOM \1
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As P_DO EONS ril P REq. oN [sY FI-a...
T'f V EK
I SECTION TN2o[a4N ,lz" cs~x rtYwro. ~ RAI ~I u PAST
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µ 14 STUDS eiv° o.c. 12 ~ _ _I O n \ W
5 op-A4E SNED ~\\~iY_-I/
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PLUMBING N UD zM,.
- - m~E~AVe"s ~~NUD RdA. lA U.InRY
p.SPNp ASPµALT SNILY LFS to MATCH EXIST'4~ ALL PLUM9IINENEED K aNMTE~I.N GOVERINti G
518" t 98" Cvx FLYwto. \ wnNG gEKWA
~Lec._FlxTUrr E s
SKIS 2X12 R/,FTER5 @16"O.c. ~ .
9 ° FIR 9" FIBE04LAS BATTS 1. Lightolizr 1102/1105 recessed
1
2. - Lightblier 110211178SH
I 'I ' recessed shower light. OCCUPANCY OR
am 10 1 INI AWFUL
\V 3. Light-fan heater
I / 3 separates" switches
WITHOUT CERTIFICATE
pMypeoM F OCCUPANCY
C~~~~~~ srenPPwy Fan ducted to outside - 'h1'4`fP.eo. t .4. Lighta mounted on wall 'e~aDOh~ abQYC mirror
4 MIL POLY VAF. 34M.
5, Lights, mounted on wall,
I I ' 'Center 6'-ll"'. above fm. fir.
.6. Closet light, to code, =LODR- h-L.CC-TRkLAL PLA44
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