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HomeMy WebLinkAbout18700-z 4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-2.0523 Date FEBRUARY 6, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property EAST END ROAD FISHERS ISLAND N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 5 Block 2 Lot 7.10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12~ 1989 pursuant to which Building Permit No. 18700-Z dated DECEMBER 20, 1989 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 ONE FAMILY DWELLING WITH ATTACHED DECK AS APPLIED FOR. The certificate is issued to BROWN BROTHERS TRUST CO. AS TRUSTEES (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-119-FEB. 5 1992 UNDERWRITERS CERTIFICATE N0. N-214625 - NOVEMBER 26, 1991 PLUMBERS CERTIFICATION DATED JAN. 17, 1992 - MARIO ZANGHETTI Building Inspector Rev. 1/81 ' .r _ Fosas 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 O 1~! ~ ~ Z Date ..1..°~..;~~ 19. Permission is hereby g nted to• " `~~.t-aL I~B~I'L ~Z~ ,G2zc//~~,,,/~li~C. % %~GZ~GG~~+f ~ p~ . ~~y~//~~JjJ....~ll~y~~.../s~......./.~........./.~...X/.~...... f ..4e~.~~........... .1 ct premises located at .....4.r~r~*•• • ......,n/.~+QG.~~ .......1"IYC.O."7Kti. y~........................................................... County Tox Map No. 1000 Section ............J Lot No...........! d Block 7.1...... pursuant to application dated ......~>~y- 19.7, and approved by the Building Inspecto`r~c~+~~ Fee $..`~..~-3,.~"/ ....9 .PrG. Buil 1 for Rev. 6/30/80 i ,~1 i. ' ' FORM Np. 6 ~ i TowN of souTHOLD ~ ~ ,Jd~[~ 2 i ~ ~ ~ I, Building Department Town Hall . ~ ~ ~ ' Southold, N.Y. 1197,1 , ~ . 765 - 1802 ~ ~ a,. APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~ ~ j A. This application must be filled in typewriter OR ink, and submitted ~s...~ to the Building Inspec- for with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property tines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-l5-9 form or equap. 3.'Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- ~ lion's, 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 I 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- lion required to prepare a certificate. C. Fees: Ad Ltions $25.00 POOLS $,25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling 25. Accessory 10.00 Business $50.00 II, 2. Certificate of occupancy on - g welling $ 50.00 I 3. Co of certificate of occu anc $ S ,years $ 10:00 ' ~ 4.Uacant Land C.O. p $ 20.005 00, over O 5. Updated C.O. S 50.00 Date ?.~~J~~/.~ N Construction , , , . OId or Pre-existing Building Vacant Land j ~,6 ~/~~~I) ///J ,--)J ~ location of Property ~~>'...Y'?L":... ~~1©FK.......:.~S:fevs ...r:S/c1:rF(~y.. ~:~y...... l House Na. Srreet Hamlet Owner or Owners of Property ...~~~/.?7.er'/:. ~:~`7.. . County Tax Map No. 1000 Section o-~.. Block ,Lot... ~ Subdivision .........:.Filed Map No. ......:...Lot,No. ~ J / Permit No. /.b".7./~~... Date of Permit ~/'://'~.~~y:Applicant . ;?,~C?rKS . ~j~/t~ /"Cep`:~~'...... . Health Dept. Approval ~~~'~~.':"1.~.~. .Labor, Dept. Approval Underwriters Approval /:1.~1~..6..~~.`.J~.-.:.....,...PlanningBoardApproval I Request for Temporary Certificate .......'.......,.......Final Certificate ~ . Fee Submitted $ P?Ft ~:r-:..,. . ' g. and permit m II app~lic%,a~ble codes and regulations. Construction bn above describApplicant , , r"~~~rxl~d eels a•'~~~:'v:"• . Rev. to-1eJe -.y~~ uL,nC, ~ ' 6~~c, y3aa3 f- ~ ' ' Co ~~os~3 - _ _ T _ ~ _ _ _ THE NEW YQRK dtiAf#fl Qf FIRE UNDERWI~1"r'IzRS PAGE ' 1.000656 ~ ea .wwn aT w rbNR, rtvolelc boas NOYEMBEH 26,:199'1. .fp'ltcetionNo.onfieRu~26590/90 N 2]46?.5 Twla GERTIRI6S TFIAT only the e6ebieel egttipwReat w dreerihsd hders coil WrgJrad 6y the eflrlinwt wanted en the chose eptikeMen nuwtM to tM pnndrw 4{? MARTRN YAN HENGEL, EAgS~T ~Ft,NRD, PRIVATE SECTION, FISHERS ISLAND, N.Y. in the folhneinR'°"'k89'~Mr3~ek 19;.L741 ~ ext F. ~ End fl. OUT Section alod~ Loa east exsmined en "UY end found to 6e In irontp/aaeee with the reggiromentR of this Buetd. w%lilY ApJlf fW17CINf S O UINAUfT OYilif'IS INCANelK7M nUbMIQM AMi. K. W. . AMr. R. W. AMT. kM. A*IC~ R. W. AMT. NJ. 56 8 41 53 1 1 7.1,1 3.5 3 F omrc nlwha MwoRS wtu+r'w.rwNat t~esc iwectociu YN[filU7/K ~i DUAAMIK AMr. i. w. al N. r. oAS N. r. AMr. No. A w. a. ,wr. AAq. AAIr. AAJS. T AMi. N. r. W !R AMr. wAm 1 30 fRVli7 olloonlNtT eto.or s t e v 1 t t AMT. AMY. 1Yrt ~ t / tW 111W 7 / TY AV N0. q .COND. W. NO.Or 1141!6 A W NO.O/ NRUIRALS a t 1 200 CB 1 X ] 2/0 1 2%0 oiMa ~wwaiw: - ELEC. ROOM HEATERS :6-1.5 K.W. M09'ORS:i-0.75 H.P. ELEC. DATER HEATER5::1-4.5 K_N. G. F.C..I:-8 Z & S CONTRS. T.NC,. LIC.{1824E P.O. BOX 202 FISHERS ISLAND, NY, 06390 11 Pa - . ~ u oas~fw~'. t _ . ,v ~ _ THE NEW YORK BOARD OF FIRE UNDERWRITERS ' 3000651> I~. BUREAU OF ELECTRICITY ~ ~ BS JOHN STREET. NEW YORK, NEW YORK 10038 ,7GNr 2i!;34GS 65R"J.OAkG/R9 nO1 ',~r Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described 6ebw and introduced by the applicant Homed on the oboes application number in the premises of NAART'EN VAN HENGFi~, PRT,VATh' RA;;"I"tOty - ~A4'C EINO; F"(sHF;RS T.2+LHItl11, N.Y, in the ollowin loco ' ant OiiT f R 4Wtt~, .iQ I~a ? tat FI. ? Ynd FI. Sertian Black Lot woe a:amined on JUIY andfound to 6e in compliance rcith the reyairementa of this Board. RXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST NS OUTLETS ECBTACIES SWITCHES INCANDESCFNr FIUORFSCENi OTHER AMr. K. W. AMi. K. W. AMi. K.W. AMi. K. W. AMr. M. P. IRIf UL DRYERS RIRNACE MOTORS WTURE A/FUANCE FEEDERS SFEGALRK'?T TIME CLOCKS ~Ll UNIT HEATERS. MULTI.OUTLET pIMMERS AMi. K, w. al R. P. oAS R. P. AMi. No. A. w. c. AMi. AMP. Aar. AMPS. TRANS. AMr. N. r. SYSTEMS unr. warns NO.OF FEET SERVICE DISCONNKT NO.OF S- E ~ R V 1 C E AMi. AMP, rYPE ELF 1ATW 1 B7W' 3A~W' 3AAW NO'~ER eCONU. OF CC. CONa NI-LEG ~'N'~ NO. Of NEV1RAlS OF NEVTN~I 3. 300 CP. i X 'I 4 3 4 E OTHER A/NIRATUS: TF;IfP.SF:RVICfi FOR RRAC CONSTR ONt.',"-; G.r.C,T;-3 a (%Y7~J, UN?,Y) 'CYI~i s i_s Ixrt a ~ Certificate. This i~ a Hi_i ~fqr, Serpires Retzt~inw.~d Only. TF' ~c S CONTkS. TNC. I~li;.(i~+7,$F; G~~~~ / P.O. HOX 2U1. ~ x'ISHP;RS r"S3~ANG, NY; hFi340 Gp~u i7 Per {Y 1. t1_~-1 This ceAificttN must trot be altered in any manner; roturn to the office of the Board if incorrect. Inspectors may be idaMified by their credentials. - COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. r - - ' TEL. 765-1802 O`~VFF~U(CpG TOWN OF SOUTIIOLD Z ~ j~ y~c, OFFICE OF BUILDING INSPEC'T'OR ~ ~ P.O. BOX 728 s°n ~ g TOWN HALL ~0~01 SOUTHOLD, N.Y. 1 1971 , , ~ Z ~ • ' ~ ' ~ I..=..~ C E R T I F I C A T I O N ' ~ Date / / ~ I Building Permit No. ~t~2t Owner ~ Av4 r~~~°L ~ vt 6~~ut cae'_ ~ ' (please print) Plumber r vI~F~~O ~`~~b (please prin ) I certify that the solder used in the water supply system contains less than 2/10 of to lead. STATE OF NEW YORK) (plum r' signature) COUNTY OF SUFFOLK) Sworn to before me this 17th day of _ January ~ ~ + 19 9 L G~et/Gr No .ary Public Notary Public, Suffolk County MARY B.PANKIEWICZ NIIfhRY PUBLIC, STATE tlF NEW YURH Ntl. 52.826795tl - SUFFDU( WUNTY t;l)MfdISSION EXPIRES v,3o~42_ INSPECTORS Victor Lessard o~gQFFO~kc Principal Building Inspector p Curtis Horton Gyac SCOTT L. HARRIS, Supervisor Senior Building Inspector y x Southold Town Hall v- T Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ 9 p! Southold, New York 11971 Building Inspector ~~l ~ ~a Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD January 28, 1992 Mr. Charles Brigham Board of Health Dept. Riverhead County Center Room #N204 (North Wing) Riverhead, New York 11901 Re: VAN HENGEL PREMISES - FISHERS ISLAND Suff. Co. Tax Map #1000-5-2-7.10 H.S. Ref. No. 89-SO-119 Dear Charlie: Please expedite this application for a final board of health approval as soon as possible. If there are any problems, please contact me at once. Please send final approvals to this office. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Curtis W. Horton, Senior Building Inspector CWH:gar encls. _ m o I . ~ II a o 'OUIIDATI01! (1st1 ~I ~ I u _ y 'OUIJDATI0IJ (2nd) - - - `o 30UGH FRAME & I `v .PLUMBING 1\ H 3 . ~ ~ IIJSULATIOfI PER N. Y. I ~ ~ a ~ STATE ENERGY CODE j 1 r m 4. a FIIIAL ( ~~e • ~ I o ADDITIOPIAL COMMEYITS: x3 • l H . ~ 1 O . ~ tt~__ - ) ~ ^J p ``VVVV ~ \ b a . ~ JAMES V. $IGH eERtrARCHITECTS O~ e~~ft m e BOSTON, MASSACHUSETTS 02108 QuV~uW~ u LIQL~ (617) 451-5740 ~ 1 - PTTENTION _ - L r0T/(~/~'I _~J1~~n `~'?/1--~ NEV/,t/,P-/_ta -~~p w>JV ~ f? ~ ,ng ~ WE ARE SENDING YOU ~ g~ > ~ttached ? U~der separate cover"v't'd „ D the following items: ? Shop drawings riots ~ ~ ? Plans ? Samples ? Specifications ? Copy of letter ? Change order ? COPIES DATE NO. DESCRIPTION Wi~~ THESE ARE TRANSMITTED as checked below: ? For approval ? Approved as submitted ? Resubmit copies for approval ? For your use ? Approved as noted ? Submitcopies for distribution > ? As requested ? Returned for corrections ? Return corrected prints ? For review and comment ? ? FOR BIDS DUE 19 ? PRINTS RETURNED AFTER LOAN TO US REMARKS (.V'e~ G~ewt ~ ~~s~~k a~~~~ corn ro L YV"~- . , V~'~ SIGNED: ~~~J'r-C .~~R.~-~ PPGGUn11G2 ses Inu, GmWn,Mm GII)1 1/ enclosures are no[ ae noted, kindly notliy us at once. Jame Volney IZi~ht~r nn _";~E ~i a r c h i t e c t s i n c ~ ~ff~.~w~.~.,.e.. ~ ~ :3LilU ~i€:PY. ,,,.,?~6'~V?J :dF soLrrr~t5t.p Building Inspector Town of Southhold Building Department Town Hall Southhold, N.Y. 11971 Dear Building Inspector: Enclosed please find the necessary information for obtaining a building permit for a new house in the Town of Southhold. I have attached: three sets of plans, a blank check made out to the Town of Southhold and a completed application for the building permit. If any other information is needed I would greatly appreciate hearing from you at your earliest convenience. Thank you for your cooperation. Very truly yours, Brooke rivas Jac o h D, A I V c r t Cr a i g 0. G i b s o n ~ James V. Rig h ter ~ Lawrence "f. Th o r n 58 Winter Street Boston Massachusetts 0210 ~ telephone 617 • 451 • 5740 FORM N0. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined ~~~°?'D......., 19~. / Received.......... , 19... Approved ~a/!'`a....., 19~~. Permit Nd.~ 7a ~ _ •~~JC~[C~ Disapproved a/c . . ' iii i ~i~ I~ t ~ ~ . fit..... 4~ - addi nspector BLDG DEPT TOWN vF 50UTHOL0 APPLlC TION OR BUILDiNi~ PERMIT ~ Date .12, 5;>:.Pr~M>}~iz„ 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 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 vihich is part of this appli- cat{on. ' c~ The work covered by this application may not be commenced before issuance of Building Permit, d.; Upon approval of this application, the Building [nspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throug?iout 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 Department for the issuance of a Building Pe~~9nrit ursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable`'t~~Or$i ces or Regulations, for the construction of bulldings, additions or alterations, or for removal or demolition, as harem 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. JA WI ES, ,VOe,n.ti y, , Klt,Hr•ElZ ; IIrV_Lli I1EC'fS 1 W[. (Signature of applicant, or name, if a corporation) 56,WINTert ST. 8o5ToN.: MA 02108,,,,, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .gacH 1•r~cT Name of owner of premises J:'t.~'.~, Mt25 MAA127EN VAN, NE:nvEL (as on the tax roll or latest deed) , If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ .`?.b . . Plumber's License No. „55!~;?,,,,,,,,,,,,,, L•lectrician's License No. .~24: E . Other Trade's License No . . . 1. Location of land on which proposed work wilt be done. EAST E'N D ROAD h 15HER5 151-AND : N ;Y. I-louse Number • Street , ..Hamlet County 'fax 61ap No. 1000 Section ~pr~.~........... Block 2........... Lot ...7! ~0......... I DGO Nil. AU(~. Iq8! Subdivision !~P... . . Filed Map No, te,~Y, ..M;~?I','!9$;~Lot ~:HILlWA1Ztl °,2 LOTS (Name) 2. State existing use and occupancy of premises and intended use and occupancy rrt~,~z5(ip;eii~cohstrucoon: a. Existing use and occupancy...N;Ar„.„,,,,,,,,,,,,,,,,,,,,„ b. Intended use and occupancy St NGLE • •FA?~gtbY VAGATloN ".~s~. ~ r.... . i 3. Nature of work (check which alplicable): New Uuilding ...X.... , Additign Alteration , . Repair Removal Demolition ..............Other 1York . (Descriptiion) 4. EstimatcdCost X50ro0~o..........' ..............,Fee (to ba paid on filing this application) 5. !f dwelling, number of dweilingunlts p ra.~:...... Nmnbet of dwelling units on each floor ...N:?'......... . If garage, number of cazs . , , , , , , , , , 6. !f business, commercial or mixed occupancy, specify naturo and extent of each type of use ..N.' . 7, Dimensions of existing structures, if any: Front ~ :!l......... Rear . N.:t1'......... Depth . ,Nrll:........ . Height N :A.'...... , Number of Stories N:~ , Dimensions of scone structure w}th alterations or additions: Front ..N: , Rear !Y:/.l, , . Depth ..Height ...1~'f)" Number of Stories /Y:A.'. . 8. Dimensto t~r const~trctlon: Front ~7: , Rear z24. Y'r.•..... Depth . ~l'F.t'T:...... Height . 2t'a, .~T. . Nun'ber of Stories - ...TNf,4, . . 9. Size of lot: Front Q~..~T'; Rear ~.•..'..'~.T.......... llepth r7. ~ ~s ...~L:........ . 10. Date of Purchase . , G`f,77 . . Name of Former Owner ;~~>~o . 11. Zooe or use district iu wisich pr~rnises are sitriatcd ..'t~,~5) DE~ITIq 1,,•,A,bte)t~11L;1',U},el!k~, , , , , , , , , , , , , , , , , , , 12: Does proposed constructiatt violate any zoning law, ordinance or regulation:. NP . . 13. Will lot be regraded ..Na.. Will exc ss fl# be renJov~ f m prernises: Yes o 14: Narne of Owner of premiseslMtZf1NK5 [t'~AAt°.rEw.unN NE~b~ct'ress .r~9~iS`~T4W~:`.N~:~~ Phone No. `1.IA'.(o31: Narue of Architect i!4R'.J!1t'?'rl?5. RI6HTEl2 • , , , , Address`30!"I~NTEK.'~T•,$osTprltN,~hona No. ~n17,•.'1~(•.~7~•A.. . Name of Contractor ?,+,5, CoNTRr~c r~trUb; , , , , , , , , ,Address F~NF'~' i5~':R.. n:~... Phone No.~16.~7.2t~i .76r~.Z . . PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing~or proposed, and, indicate all sat-back dhnensions from property lines. Cive street and block'numbet or description according to deed, and show street names and htdicate whether interior or corner lot.! ~ ~ ' S~a~ ~7'T"~EIJ I~ , I ' I I I ~ I • i ~l? GCQ~6LCI1~ , i S`CA'f8 0 F i S.S COUNTY 0~~~/~• • • • 1 yLL,~S, 1~. t `?1 being duly Nume of~ ividual sigi1+ r~~ ~ ~ ~ ~ ~ • ~ • sworn, deposes and says that lte is the applicant ( ring contract) ~ ' above named. Ilcisthe,... (Contractor, agent, corporate officer, etcJ ~~f said owner or owners, and is dyly authorized to perform or have performed the said work and to make and fie this rppiication; that all statements contained In this application are true to the best of his kltowledge and bollef; and that ttta work will be performed in the mmuter set forth in the application fled therewith. sworn to beforo mg rule . _ ; ~ : j, ' ~ , ",'~1~,~~--'' County r+ Notary Public fw~:^^c~ r .I~A?N FARREN • ~ r~trrlmisskrn >rttpif~9 . . . . . • (Signature of applicant) , .ys,.:,,. ' ~ •