Loading...
HomeMy WebLinkAbout18747-zr FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23443 Date JANUARY 4, 1995 THIS CERTIFIES that the building ADDITIONS Location of Property CENTRAL AVElIOE FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 10 Block 1 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANOARY 16, 1990 pursuant to which Building Permit No. 18747-8 dated JANOARY 23, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued ie DECK & GARAGE ADDITION TO E%ISTING ONE FAMILY DNSLLING AS APPLIED FOR. The certificate is issued to RICHARD I. BDWARD3 (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ~~~~' _' ld ng I pector Rev: 1/81 ! . . 'A rosat 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) N~ ~ 8 ~ 4 ~ Z DateG~%/.~...~7............P..S..~.l ...................... 19..~~J Permission is hereby gwnted to: , ..~..~.~~~:. ..., ... ............... _ , ~ e ~ to ...~..r.~.r.~cckxi. at premises located at ~...f~ i%f...'i~.lY.`.... .....:..:. t...~~,~......".-......... County Tox Map No. 1000 Section .....~~......... Block ..~~..../...........pLot No....r.~....b........... pursuant to application dated ..c%'/~~... ,........r. ~ ................ 19..1.. and approved by the Building Inspector. Fee' $.. ~~.,..r~..~~... ................ .............. Building Inspector Rev. 6/30/80 r • ~ M ~. sosat: 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 16 0 4 8 Z DataG~~~.~,......1.~.~ ................... 19.x:.'7 Permission is hereby granted to: ~.~~/ ~ d to ...............Q.~.. of premise__sDDlo__cated at ...~`7.lr.XL,1,~x,~...~...c..~..t„r,~r.,~rt/,;,..,.0~!i'y../„/„! ,,,, ,a , ...... !'~/'1!t .. ... . County Tax Map No. 1000 Section ....~.~.......... Block ........6............ Lot No.......t ................. pursuant to application doted ......G!~~a.~ .............~f........., 19..~~and approved by the Building Inspector. Fee $..V...(l..p.~.l.. ~~ Rev. 6/30/80 . ~. ..L~l..t.....~~........ Building Inspector ~ild'ng I spectorI spector Rev. 1/81 ~S (j,,..,~( (, '( Form No. 6 "~ - ~ .~_~__ TOWN OF SOUTHOLD ' I` BUILDING DEPARTMENT TOWN HALL C)i; ( J ~i ~q~~ 765-1802 ~~.~.~`' t~; 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. of 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. 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. 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 ..©L.'ld~cz;,:..!:~~. l.f.`~.y. New Construction........... Old Or Pre-existing Building ................. Location of Pro ert ~'~~ Tf4 ~~:....~ V j ., . , , „ / ;i.5,h.gY~, .. ;.L S ~ Zn~.. P Y ......... ........... House No. Street Hamlet Onwer or Owners of Property.... ~:' ~~': a::r. ~:..~'.~ .. ~= ~: !~!a'Y`~ S . .. . ... . .... . . . . . . . . . .. ............... County Tax Map No 1000, Section......~~......B1ock.....~.~........Lot....D ~ .... .. .... Subdivision.CC.~~ ............................//.....//.Filed Map............Lot..../1..................`` .................. Permit No.~.ti~.?~~Z.~...Date Of Permit~{:°~.~F~O:.....Applicant.~~~':~~:Y`~ ~' ~~`/Ja'Yas Health Dept. Approval ..........................Underwriters Approval......................... Pl~nning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate... ~... o~ ~ Fee Submitted: $.q~.-S,c : .................... y .. Ja ~~~..1; ..~:~~r..~ ..:.......... . ~"p'~'~ $9 ~ ~ APPLICANT eo~d3`~ ~~ _ 7~~ - -zo ~o ~ 4. /~~~~~ 765-1802 BUILDING DEPT, INSPECTION [ ]FOUNDATION i5T [ }ROUGH PLBG. (] FOUNDATION 2ND [)INSULATION [ ]FRAMING [)FINAL REMARKS: tJG~ % ~ Cam, ,-- ~~ DATE ~ ~ INSPECTOR , Y .=~ FORIVf NO. 1° TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examine/~.. ~/'(~. /• ..., 19 !•d / /,/ \PProved .. pS.~..., 19(~dPermit No..l~.~.~/.~~ C/~.. DisapProveda/c ..................................... BOARD OF~HEALTH ............ 3 SETS OF PLANS ............ SllRVEY ..................... CHECK ...................... SEPTIC FORhf ................ NOTIFY CALL ..................... MAIL T0: ........................... .... ~.... ..~i.'. ~~,~~m--- (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date . .... L . ~...., 15 y~ a. Tltis 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 according to 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. 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 shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whale or in part for any purpose whatever until a Certificate of Occupancy shall 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 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 appiicab~e 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 corporarton) .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ., ... ~ ~ F,. Name of owner of premises' :.t:~~`~4.~-a:~x ~.~ . ~,'•, : ~ ~~"•"•~ ~"~ • • • . .q~-, M,.: .4 ... (as on the tax roll or latest deed) If applicant is a corpq~atiap, s}$~~,tu~~a af.duly~.authotized officer. ........ . t..~RF Ct....,.':'. ... ..~ i. w`s~t.. (Name and title o> gozporate officers .r Builder's License No. ...~F=•.~. ~. • • •G •'• ~'• Plumber's License No. ...... '~:-•'•:•'~ ~ • • • • ;,- , ~ .:... ..,it........... Electrician's License No. ~~~ ""` ..." . Other Trade's License No. .. i .:~~` • • ~'•'• 1. Location of land on which proposed work will be done. G.e~:YY.I ~.....~~' ~:Yt'•.+~•-~.~:~':~:~ .'~~ House Number Street; ,~- ---i~iamit,t-•- County Tax Map No. 1000 Section .... ~ ®r•~ ~• 1 • • • • • BI'ock .... O.l........... Lot .... ~ ~........... . Subdivision ..................................... Filed klap No. .............. Lot .............. . (Name) ~. State existin use and occu anc of remises and intended nSC and OCCFI a g p• y p p ncy of proposed construction: a. Existing use and occupancy ... /'~JS ~ ~ .................................. ..: ~; ..:,.................. . b. Intended use and occupancy ...C?•~:Y ~C~~.1' ........................ '.. -: ":.., . '....... i .... . . ~N~.y-~ ~~ (~ep~ac~ ~ ~tL,y~d~Ya~., ~z~rs'~a~'7' nf~ . ~Go1l~ c~a-1 ~~ ~~e~~S? ~~ r ~R 3. Ret air of work (check whiRc'~pplicable): New Building .....~..... Addition ... , ...... Alteration ......... . p moval .............. Demolition ...... , ....... Other 1Vork .~~?ra~.e.. , . . 1 ~' -~} (Description) 4. EstimatcdCost ..4'Y\.l~4X.'..~.1?Qp .................. Fee ...~.r.Gsy.~.~........................... Qo 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 .:'T.~el u ........... . ............ . ...................................... . 6. If business, commercial or mixed occupancy, specify naturepnd extent of each type of use ........... .r .. •a,• 7. Dimensions of existing structuYcs, if any: Front . , , L.~ d ... , .. Rear ..?~G1, , ....... De th ..vZ-,~• , ;~, . , , , P Hcioltt Number of Stories ...~ l?-• . ........ . ...................................... . Dimensions of same structure with alterations or additions: Front ............ . .... Rear ................ , . Depth .................. ~ ... lIeight ....... .....,.........Number of~Stories ......... .,, ...... . • .... 8. Dimensions of entire new construction: Front ..... c~ a....... Rear ....7•.~+..... , . , llepth .. ,~,~...... , , , Height .......... Nujnbe~ of Stories . 6C1,~ . ,~, , . , , , , , 9. Size of lot: Front ... ~.~~~..ar. ~........ , • Rcar .. , ~ .4C.~L! ~, ...... Depth '34'x"? r.9 ? . . . .... .. 10. Date of Purchase ......... J .......... . ........Name of Former Owner ~Sls~v. S..~h»•~. V. ,7+:jrTl~I, ,C,a 1 1. Zone or use district in ~vhiclt premises are situated . .... . .............................................. . 12. Does proposed construction viplate 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............... . ame o Contractor ...... P P ..y .....j .................. Address ...................Phone No......... . IS.Is this ro ert loc#tted within g00 feet of a tidal wetland? *YES....NO.X.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate alt set-back dimensions from property Bnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. I - -~` ~'t,:`~•:: Nr°~ `~ 1± ~ ~ L = , A F. ~ ...~ i. ' y ~, 6 ,' _' ; `.:,. A._.„M.~,~" `yet ~`~ P" N ~~ ~~ •N~ ~,, ~OUS ~' i ~; ~, ~, l i ~, jl, I~ I n ,. -~_; . ~~1= , ~~ ~1: ~, ,.~ ;,~ STATE OF NEW YORK, S.S COUNTY OF ................ . (Name of individual signing contract) above named. He is the ..................... .... of said owner or owners, and is duly authorized to pe~rf application; that all statements conta~pcd in this applicgti work will be performed in the manner!,set forth in the appl Sworn to before me this Notary Public, ....... ~`!~-e.?%'^:. ~ •'• • •n: "•l/d~; • , lror~rrr Puaitc~s~ o ry~ew rorw xo. arma~a, Suffolk Ceu Tam Expires Morsh 30,17 I i . I Ga-tra~~ ~ s I~ _ _ _~-~ APPROVED AS NOTE~~ -7/~ FEE: ,.:51~ ~..~ R1F -.~~ NOTIFY BI11LDtNG DEPARTMENT AT 765-18Q2 9 AM TO 4 PM FOR THE FOLLOWING INSPECT{ONS: 1. FOUNDATION TWO REQUIRED' FOR POURED CONCRETE 2. RQUGH -FRAMING & PLUMBING 3. INSULATION b. FINAL - CONSTRUCTION MUST BE CAMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ... beingq~Tlg s@O-}~jNtt¢.s~~~ygtylte is the applicant CODES. NOT RESPQNSP ALE FAR O1:SIGN OR CQNSTRUCTiAN ERRQRS (Contractor, agent, corporate officer, etc.) ~ • orm or )rave performed the said work and to make and file this on are true to the best of his knowledge and belief; and that the ication Glcd thcrcwittt. ...., 19 /~.~ County (Signature of applicant) FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ExaminedC/~ . ~.~ .., 19 ~. / / ~~// Approved .. ~d...., 198.~ermit No. ~ (7 <9.:(.. zf~. Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK ••-•---••- SEPTIC FORM .............: NOTIFY CALL MAIL ................ T0: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .-~~~/~..5........, 19g~ 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 according to 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. 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 shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to 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. .............................................. (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. Ot-c/AI erL .......................f,.J~........................................................................ Name of owner of premises .!<<"cl'~~9/ird, , , S,, , , ,~,~<-<7/~ R.~S .................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (N~me and title of corporate officer) ` , ALL CONTRACTOR'S MUST ~}E/~ UFFOLK COUNTY LI 9~ Builder's License No. ..w~'.24?~ • .............. ~ -` ~;• d Plumber's License No . .... . ................... flt i y°~.m ~ ~ .+_. .. ~ CJ'9V Electrician's License No . ..................... . Other Trade's License No. ' ..................... ' i~ I . Location of land an which proposed work will be done. C~u (~hlc 2, , , 6 /, , , C2e 5 ~.,/ j /~<~~~ ........ House Number Street Hamlet 0 , /D , / -.~......... Block ...~.. (?. n n ~ n`~y ~..... . County Tax Map No. 1000 Section ....... ......... Lot .. . Subdivision ..................................... Filed Map No. .............. Lot............... (Name) 2. State existing use and occupancy of/premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...!~'.Of/2 .. ................................... ... ................. , b. Intended use and occupancy . ~.~2:~9.6=. • • . P'. • • G'~~~~if•< • .... L~i~!L;/!.~!1%~!~Y//.. • .......... . 3. Nature of work (check whiRem~plicable): New BuIlding .....~..... Addition .......... Alteration ...... . Repur ....... ;oval ..... . ........ Demolition ..............Other Work GA'?~9 ~. °'`.~ec/~ (Description) ~,o 6 ooC~ ...................Fee. ..~.1 ~G~~.. 4. Estimated Cost ..~~.. Pp . ` (to be paid on filing this application) 5. If dwelling, number of dwellin ',units ............... Number of dwelling units on each floor ............... . g If garage, number of cars ..T~*-14 ........................................................ . ....... . 6. If business, commercial or mixed occupancy, specify ~ ure and extent of each type of use ,........ ... ~~.... . ... P Height ......... , g.... Nums, if any: Front .-. y......... '...Rear ... ,O ........ De th ..~.5. ~ ...... . Dimensions o exishn struc ur ber of Stories .. ~~~ ........:.......................:...... . ........... . Dimensions of same structure with alterations or additions: Front ................. Rear ................. . Depth . , ......... .... ~... Height ................. . .... Numbe of Stories ............ , ........ . ~ Hemh>Ysions of entire new c Nurp ction: Front ...a.4 ......... Rear ..~ ~ ....... Depth ~. ~.......... . g ber of Stories .. O.~/e .... . ....................... .... ............. . S'7' ~ , 3Q,7., y .......... . ........~~ .. Rear ..~.~i, S. ~/............. Depth .~.. ~ ......... . 10. Date oflParchaset 193. ' ...................Name of Former Owner ~`,S(ie,G~, 7~/.~~;~J,U,i,,/; 7~; ,w,,, 11. Zone or use district in which premises are situated ...............................................:.... . 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~!4i ........................... . 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. I"s this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit may be required. PLO"I' DIAGKAM Locate clearly and distinctly alb 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. ,24' i ~'~ ', GA2~+5 e . R t~ tW~ ~ . „ di ~ ~ (L~p~~jJ ~', A~,E Kl ~Al r11 ~ ~~ ~ 3 ~~ ~ ~~ LY '~ ~ ~~ ~ 1 tai 4~7 ~F ~.~ ~ + '~:.~. i ~a ,,y ix f; `f- ~ ~ '1 ~ ~ MY STATE OF NEW YORK, S.S COUNTY OF ................. ........................ '..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .....................'............................,........................,........,..... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this (j, ............ ~.U .........day o>`' . , ~4[C~~'N-~-//.~~..........., 19 ~/ Notary Public, ... ~ . ~1 ,..N..~.V.~-... County NELEN K. ~No A~07878,S~4NoIkfC~nYak (Signature of applicant) Term Expires March 30,1 ~P~ i~~4~ N3eos.r/ 8CA6L/OTT/ w/~e e.oe N N379I. O,! I W/3B 9,ft` D.M. + NI,-o fp' NOTE 3 O'E -~ { ~ -~_ _ C oord/nob Oi•IOnces Are ,T~' I 96.Sf' ~ M.o.w•d from U.8 Coos1• /O' 8•ooM/e Sway Tn nn9u/aNOn N I,!°fS SO'E O/ R/tAl OI WIY 99.86' SIOJ/on "Prot" For Ul///!7 (/no• CONTOUR LINES /NO/GATE EX/ST/NB ORAOES ll..~~ SUFfOLK CIX/NTY TAX NAP REFERENCE JV /Q70//O//// " SL~ Q TEST HOLE DATA 9//3/85 ~ O"-8" TOpsa/ ~ B"-30 ~~ sandy subsoil b °mF AREA= 0.99rAcres 30"- /20" fig sond L~ b ar G~ W ~ ~'~ i ly nr~ 0 ^,~d , oe ~ e . ~\ '4 c tl ~ 0 y^^' 1 ~ 3 ~.Y aca @S' i~g Y ~'Yp/,~~,lglfpf(/RT}~ a /~kQ ~ O ~"~ p^eeg ~~~/ I V I i ~ SYNMC~ /G9 ._ _S/6 ~~~~/ ~ A ~ ~LDY... PV ~~ c ~ BBB 3j7 ~ A° , f i r ~ ~`~'~ ~ ~-t~UT CERTI~~CA ~ E m9r~ . ~ ~ ~v; , i/ l ~ ~~~ ~~~~JRA,~CY l=- nob ~, , s,~;% 0 ,, BENCH MARK p S/ T E PL A N Orl// Aob a 'V ~~l prgoorly corner ~ rv E/.°oJ/on /e. e•' ~~In'wJ ,~,' N.ao7./o PROPOSED RESIDENCE NBVD re% ~' w/2f 9./I O p, MADE FOR R/CHARD EDWAROS .ba' FISHERS /BLAND NEW YORK y0 mon S79°30'30 W SCALE /"= 40{I. ~ptE°~ rJEwYO CENTRAL AVENUE CHANOCER,VALMER B K/NG c' Ppo H. STH 9'F NORWICH. CONN o~ ..~ oN AUG. 30. /985 :. ¢ m / ~~~ ~' Aral *rNS~ f," ~. ,• n. e Aa0/ravs /o/t/as