HomeMy WebLinkAbout18888-z
d Yi
FORM NO. 4
'DOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20872 Date JULY 21, 1992
THIS CERTIFIES that the building ADDITION
Location of Property PRIVATE RD. EAST END FISHERS ISLAND, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 8 Block 1 Lot 6.5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5, 1990 pursuant to which
Building Permit No. 18888-Z dated MARCH 16 1990
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy far which this certificate is
issued is 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to PETER BRINCKERHOFF
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-236659 - MAY 28, 1992
PLUMBERS CERTIFICATION DATED JUNE 23 1992 - MARLO ZANGHETTI JR.
Building Inspector
Rev. 1/81
rosai xo. s
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)
No 18 8 8 8 Z Date ..°Y.I~.,~a.,~I........../.,~ 19..9..6
Permission is hereby granted to:
......,~..cr~.~~........
. . . .
ro .............o~... .........~~?~~Gti..~~.,;,... ...C~j.
...rr.4F.............
at premises locoted at
...............................................1:...~:lo~'~/.
. .
.....................................................~......y.......o~ 3 ~e
County Tax Map No. 1000 Section yBl-ock Lot No....ll.,~....~'.~
pursuant to apps(cation dated ....l..t~.T'd........e:7 19..y~ and approved by the
Building Inspector.
Fee $..~.~71..s~
Building Inspector
Rev. 6/30/80
1~•t NO. 6 g ~ . f,
TOWN///OF SOUTHOLD ~ ~ ,
F ,
Building Department ~ )
Town Clerks Offieo ,
Southold, N. Y. 11971 k
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instruefions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector 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.
7. 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
installations, 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 sfiatement 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 in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ~0.~.~..'3.~.9.~
New Building Addition Old or Pre-existing Building ....Y.......... Vocont Land
Location Of Property ..~/.~..~`..7....C.!v.9~.A....F/.~ ~:1 C ~ 5.... Z.S L.!;1..!'U.~i....!1?.~
Owner Or Owners Of Property .PG7..C...r.'~.....~~.r n1C.~~i.~.Pi.~.`?..F.F
Subdivision ...................................................Q..........LOt No. Block No.....~....... House No.............
Permit No. ~.~A.A.a...... Date Of Permit3l..(~4.~g9 Applicant ZdS..,CoN,T..~,~,c%.~ru,~,,,2',rv.c .
Health Dept. Approval ............................................Labor Dept. Approval
Underwriters Approval ~,~lR.~?.:s.`>' ........................Planning Board Approval
Request For Temporary Certificate Final Certificate
Fee Submitted $ o a
Construction on above described building and perm't eets all plicabl code and re ulations.
9
Applicant .:...:.'.~~~~...P~,CS,r%Eft1T
Sworn t~q before me~th7s
day of . ~;l!.`6 ~ - (stamp or seoq
J~
ot_p--~ -i'I~(®FN~s F~NkR~v JR.
Notary Public Cou ty lJ?~y
N~i`sryRubllt Stato of New York
- No. 4806559
o X71 - '~akYiftlealn5ut(olkGounty
(r3~~.e.. ~t-13q ~ ~ _ ~ _<t'erm Expires 12/9119L.~-
~ .
CO `.20$72 ~
ua ~
• TEL. 765-1802
~pS~FF~~CO TOWN OF SOUTHOILD
OFFICP, OF BUILDING INSPECTOR
P.O. BOX 728 ~,g I
~ TOWN HALL f
'eO,y,~~ ~ SUUTHOLD, N.Y. 11971 : ;i~,~.
''~~ll ~ r
,
z~
C E R T I F I C A T I O N
Date_ ~p1a3 f 9 ~
Building Permit No.f~
Owner~ETER DRWc1SL-!~hoFF~
(please print)
Plumber~o Zr9nJgh~7ri cT17T
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ Lead.
plumb r' ignat
Swor~to befo~c^me this
~Y day of ~...~UAIL.
19 ! Z ~7
Notary Public
Notary Public, ~IGGo~~ Cou~i:y~ - . ~ ;
rv, ~ '
' _ ~b®MAS F. B6HERTY ,7R,
P.ItlfAiY Publie Slate of New York
- No. 4806559 '
„ ~ QVeil/lep In Sut}olk County
Urm Expires 12gIii0Q~
;;:;:tt~tENI~ "
~t:.7f ~ ~~lln
Ut14pTI0tt ~ tlst) `
1
)US1DhTI0;7 (2nd) ~ _ "l
o
{
OUGH FRAhfE & I
1
.PLUMBING ~ 4:,:
c,~
• ~R~
ti
m
i.
27SULATIOPI PER N. Y• ~ A~~
STATE EtfERGY I '
CODE I~ .
~~1~
r
~
~ ~
~ ~ -
FzaAL
. ) m
x
pDDITIOtIpL COMMEIITS:
. _
. x~
•n
cn
m
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~r~a~5 ~
1.~34349h416 811R£Al3 OF £LEGTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date 29 r'i ~S~ Application No. on file ~Lf gyr~~~g~~S~ ~ ~-f~{,'i JTJ
THIS CERTIFIES THAT
only the electrical equipment os described 6ebty and introduced 6y the applicant Horned on the ohove application number in the premiaea of
?EP~R Rltlh7CC(~f?f1pFPr 1.A",T F'ND PR7Vb.x'Ei SFC:TtCl~t A'LSHI;RS3 IGLltHfl, N,t`,
in the foLlowinq Lacationg ? Basement ® 1st F'l.®2nd Fl. ~?~?'P Section Blcek Lot
uas examined on II~Y 1 ~ r 1. y 3 ~ and fourzd w be in cornplianre with the requirements of this Board.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHEF{ AMi K W. AMT K.W. AMT K.W pMi. K W AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULT40UTLET DIMMERS III
SYSTEMS
AMT. K. W. OIL M. P. GAS H P. AMT. NO. A. W. G AMT. AMP AMT. AMPS. TRANS. pMT H P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NG. OF 5 E R Y 1 C E
AMT. AMP TYPE METER L tW L A 3W ~ 9 3W 3,e' 4w NO. OF CC. COND A W G NO. OF HFLEG A. G NO. OF NEUYRAlS p. W' G'
EQUIP. PER .e' OF CC.COND. OF MI-LEG OF NEUTRAL
OTHER APPARATUS:
Fs,~,c. ttoot~ ~>°n~r~~s:;~-z,o x,w.,2w~.~a ~,~r,rl-.~~ ~~,w,
xomGRRi-g I~.r.,~_'i,, Il.r,~
FR~1T~;Gnlltlttll~~11.17 L".YR, 2~iN,?,~6 GS;Ct, L@N
P,LkI[;. WAY'I+1St }iFlY4TFF."tt:l-:~_5 K.GT„
U.P. C,I'I-~
S~(4KE P.L;TliC'POtt.'~2
Z & u C01irRfl. TNC, 1',?f.~RZ~,_.Py
P.4. 6p.X Zld7
FC:,F(FIRS I4f+Akf~r NT'r (~Li~9(~ GENERAL MANAGER
{ q ~ Y
Per L A
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 B ILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
' ~ ~ ~ 8VAR1) UN'' H8AL 1l!
~ s~TS or nLnrls ~.d.....
FORMNO:1 SURVEY
TOWN OFSOUTHOLD GRECK
' BUILDING DEPARTMENT SEPTIC FORM
• ~ tOWN HALL NoT>;FY
^ SOUTHOLD, N.Y. 11071 'CALL
~j TEL.: 765-1$02 MAIL T0: ~ '
Examined .'/!`rA.YJ•h . !'/,.7.., 19 yF~ QQQ
Approved .~,~il..lC..., 19~PerntitNo..~p.{%,P~~ ° t':'=~~}
` t
Disapproved a/c 1 S ~ ` '
,;~t MRK~- ~t990
(B... .
e~ t ;a~
{ ~st.Uwre,.~
uilding Inspector) TpWly Ctt
APPLICATION FOR BUILDING'P~RMIT
Date 19
INSTRUCTIONS '
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee accordingto schedule.
b. Plot plan showing location of lot and of buildings'on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
e. T'he 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
shall 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
shall have been grsnted by the Building Inspector.
APPLICATION IS FIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant tb the
Building Zone Ordinance of the Town of Southold, -Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, 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.
- - ~ ~ (Sigri9ture ofapplicxnY, (~fr name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, 9rchitect,, enginCer, general contractor, electrician, plumber or builder.
a o the tax
Name of owner of premises • • roll . .
hh or latest deed)
If applicaSn~~is,"~~a/corporation, signature of duly auJt~ho//rpized officer.
(Nam .nd title of corporate facer)
ALL CONTR CTOR'S MUST BE SUFFOLK COUNTY LICENSED,
Builder's Lice;tse No. .../~~~nZ .
Plwnber's License No. ....c5.-~~~-. .
Electrician's License No. ~~7.:. ~ '
Other Trade's License No. dc3~''~~....:. '
1. Location of Land on which proposed' w/o~rk willybe done . , , • . , .
House Number , ...~ut~.... SJ!s~~..c~`!~dra.-'t~Lr: <1!v~l~.. Hs~.r'c~9%~',
County Tax Map No. 1000 Section Block . . Lot , . , . , . .
~io.~
Subdivision . . Filed iblap No. Lot , .
(Name)
2. State existing use and occupancy of premises and intended use, and occupancy bf proposed construction:
~a. Existing use and occupancy , ' . .
- b. Intended usr and occupancy ....:-r^?~F?°!9.'~! . .
~Ni ; , , ~ ~ ~ / _
~ ~ ~ rg . ~ A . P
3. Nature of wort (check which a lal i dditldri e.:k' Alteration
pp icable): New Buddir
Repair Remov `~1!er'n7~~,itton - ~;y , , Other 1Vork , .
~ a ~ ~ ~ j' (Description)
4. Estimated Cdst 7~~~ :.lJ.z7 . : Fee ~ , .
Number of dwellitto be paid pn filing this application)
5. If dwellin number of dwelling units n units on each', floor • . .
If garage, nutnber'of cars . , , g ,
6. If business, commercial or mixed occupancy, specify naEure and oxtent of each type of use . . . : . . • . .
7. Dim~nsiohs oCexisting structures,',if any: Front Rear , , Depth , .
Height Number of Storied, "
Dimensions'of samg,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 I' . ...........Name of Former Owner .
l 1. Zone or use district in which prerraises 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 i . ..........Address ,Phone No, ,
Name of Architect .................Address . , . , ......'.........Phone No..:.:..'.....,... .
Name of Contractor , . .............Address , .Phone No..........
l5. Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit: may be re99u~ired.
• PLOT DIAGKAM
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 Ipk. I
- . -
t~ ~ ~ ~ ~ ,
STATE OF NEW YORK, ~ S.S
COliNTY OF / n dui s
n deposes and sa s that ,lica ,
........iGik~C~~....r'~yg . bei g y~ wor Y he is the app nt
(Name o divrdual st mng contract) '
j above named. - , I- ~ ' ' y~~7+tc~vL~'
(Contractor, agent, corporate offices, etc.)
of said owner or owners, and is duly., authorized td perform or have performed'the said work and to make and file this
application; thaS a1F statements contained in this application are true tb.the best of his knowledge and belief; and that the
work will lie performed in the manner',set forth iti the application Gled therewith.
Sworn to before me this ,
. t~ .day of 1 /~<~^w~~`:. 19 /
Notary Public, P~!~-:...~.'. • • County r
n
HELEN K DE YOE ~ ' ' r (Signature of appl'cair)t)
+ NOTARY PUBLIC, State of Npw Yorll` ~ ~ ~,s, ,1~ ,
'r E ~ ' ~ ~ No. 47078'/A', Suffolk County i ~ ~;i '
,n ~1 ' Torm Ezpires March 30,1 ~ ~ ~
a,
'
.. .. _ ,.._:.z.. - - :- .: . _ . i - "."�.-r',3 '�.._ ,�,'n;, wm.,p•wn .., ' „ '1 :r
:e+w_!
V Y \
r
r I
2e4 pWnIN6 � I \
4 , bhG541J 0.6 '0.PdYY4 W/Nv OYIh � I.
I
!ro /_� • I I I - — ;`.;� ti err
� a 'y' _- \ ` �\ �\ h� / �`•_ � -sY b0Gl7.
� r �
Fcrwn aT ,lu. TO l✓MT,1H II
49^ Y r 1
I
I �. tRU"ryv °mn°
/ ,Pz,syco`+& \ TRacrco wome
`yp09
44$5bt\0.L
1 � PpESbUth4 TR'FaTY� VAaPin vE cA�.� 1, -
{
� �� • - i _ _ ,_ CU R Y,� c
i USE IS�N�-p'W1CPTE /
R� \
_ -' 56cTlniJ 'E�sy-Km..'r `}I'-----___--_--- --- t------- - -----_ --- -- � —j�—E � laurrlGL FPIr_Ln � k_Mfr,5. 5/a8AL1.LLNAth�u. NOloN. a�4°: I•v" _ F—wn
— -----
0000
� f .r .S
--- -- _ Yin.
`•r+ui'
li N Jn GFA ( 5 NI7�cN T.GLT e--
- t7v.nwINC,.
.r _.
u
PA.a �..'`
G 4V
1.
a •
4 r
Q_t
( r t
� a 6
• -
' � F � � � � � � � � � �--L'�J'- - � _ - � _ •� Y r•n?�� 11
' - •lit �, � - - i � .e o �' '! i , 1!"V'�Jrh' �
t Y
1r�4
Y' 1
�[I��� �� itt f � �� �� t � � .i , -�' -,.._•� . -'S ' \ '/ '. �p�p �,f n,,x �{Xw'rt�
I �! � / " /�' 1. � �- _ e^ ,� $ � E9- � i� , IQ. „n"•• 4 ;�- 4a;��
A " L ✓ . - N �� v. t �� A,S � ' nPCu- V7
T ,
oV
ti
e� t
A
3 �i r. •e'."1'.
u � i
I I
-
w / he � n•�';� � r �.�e'-'r !,.
0�
1
V
�p , k !
r � 1�' �r •wl.n`�rc
i 4
J�
1
S
gg
w
Ak.�.
3� r•
{
N" a rv�
i
- t .
1
IM
I'
F
I:
J' J
f I
o.
:
"
x
•
-, ,-n.�:.. � , - :. .'pi , . . . i ', • .' as r � rr 1/N : i .. 1 '.J 4 IM r�
,,: a• ,fie i
l !
.Ea •
L
r / #
7 1 �
4�
1 rt
n a
}
� a
x
i� r
rt r- r •att'
r�: � • � , , , , � � . , ': . �, -", ' �.. ��- �: ��, .� .
t,y
a ' 4
rffi
r.
R i
� u , U
ra
{ ! ny
a 4
-,a^ rt ' .-� :, -F � . )l: ° ). '��. ,: 1 . ' • W I' -5 '4'y f',
yy�
y. 1 . � rrvrr .. J . '• , ♦ r it a i y - ri . i �'-- i i i_ ...- _l
rw
b��
,, e. m .. - . a .. �' . . , ' ,-)�. ?;a>, � , a � : .. '< - .; ., � �'• ,: � . - ,,. .: 1 ' '� .� .. . .: ., ��'�� .'I yl 'r p ,,.r' ,F ''t7 r ,��Py,J�
� ( l { f .,t, :n"S•: i til �'li f" ,,,
a�
a
k I yI-d.
1 h'
fi' lig
t
-
.1 AlYP:
=Y {
1 '
T a,�
i
v-
X
e !
"y
•a•
1 .
k
,
1 :M. , . � y •'I ,, , ;.y �. 1 :� � 1. - , X"� ., • o, i.„1, :,+ • �i�z:�
A �W v.
h •t ,�
_
! .'�., y •�,%' _ A r ,+,�: �i ' ,. 1 1i 2 `K_ ' 1 -k r r,wtk i,�#'y,;qj
1
- 1, -1 Vit.. 1 •, 6 _ '�3 ” 1 r ' .✓ nom'
�, "`"^+.-✓r'- _ l � ' 1 �JI(j. 'r .+s d• - �9' �,v: rL7 '- , ;,;x.: i
��' ✓ � � lY n
i
_ AG'� all,
i7' �t.,. Ito �„ �'i ` o• !� l _ is 3r : _ ,�
{ `,✓ ,,4 f„
�, OCCUPANCY OR
_ i -;• . USE IS UNLAWFUL �- ��j • � � , // � � __� 1 �,�,,
WITHOUT CERTIFICATE
OF OCCUPANCY awl
v f - l
.r ,'.. � ?t...'EK ts✓;,1> }pykh*drJ ']641v. " .r't r '�
If copper tubing is used - m . „ ,, c .. •,,n .- r-e.a. : v r< - • -- \� `� ,+ "NE '
- r water pdshall be — _ w
rr
ng
® tem: ng
oftypesKorLonly
UNDERWRITERS CERTIFICATE
v
REQUIRED
r
..f � '•.� > � � i , ', 11 � 'f� . . - � ._ .,�' .__ .. -__ .- -. .. :_.. -__- -___ - _ _ _ - '�iYl, r� ewn�t,;L�. '
;.. , DENCF fo -
L r�. ton.
R•ESI
A ,. John H. Mac FadARCHITECTT � I� � i��T x
AI .M A,fI,�C Euahman _ -._.___� +
r•z wl •! yen, �•. — u : rw
�� sa� �r,J ' .I�Si��Cl.� � i )/ , ("� 'TTY .1tl - �P�n^ -Ptl:,:.l.t• , ,•s ,.''' -
a ol. . .x.
- a7k
. . .S^ 1.` + '•.r .,,r.. w. -n. U 5
th tree �-
5P '-'..�_ ,'u ,�L++ .{'� •4,k., t* )�� °G; t k�. i, L ':6 �S } N p �/ A � It•
^N.W'.r5�. ` - � f,ro,ypN"� .,� } ,�, '-� „x .. '" .Xid fpE:)i. ••.} ���,t�. ,+ b� )J) N , o���� S�'���� �; .. �'•e, g'� ' . ., � �. . . , , .' ., '. , . �,
-
I.rx. :rM1 r,L'^,<x�'a.i'•..x '+..*, 1.941Ht{x �:a�m,9mAG 6x7iEwx5 �',..a', i,...,-U� ' :,
..a1�.A�.rta:�Jv'w .tiwa { w?iL.+sbwr:L�r7li1" b�� '�.T��. r4itMa".�� ,P a.r '_J�ryb�lti..�r df E ' � x i � y
! We' -SdbY'� ''W,dlt'k .rt. L,i.e,..w.ke.a. wi.:�}s '"., '!.•._..,..� ..r_t�i„u'3... # '.:q .. „, .. . . uhf µ.../L, .