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Home My WebLink About21795-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27903 Date: 08/30/01 THIS CERTIFIES that the building ADDITION Location of Property: MONTAUK AVE FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 10 Block 8 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15, 1993 pursuant to which Building Permit No. 21795-Z dated NOVEMBER 22, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT E WALL & EG (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 08/27/0 1 PLUMBERS CERTIFICATION DATED N/A / //hor' ed Signature Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, KY. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 21795 Z Dare.././ 19.,9.!.. Permission Is hereby a t to: .9' ......../...J.......................................... to 6 X1....0. 9%t . p ra. ? ¦ 1.......G~'~% La.0........ .......:g at premises located at......h..Ge~~ `......G(f/C .......Q . County Tax Map No. 1000 Section ~Lq Block .............0........... Lot No............ 1 :3........ pursuant to application dated .l. r 19.2;7....... and approved by the Building Inspector. Fee $..J /....d . 10 uliding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. C. 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1 ~0Commercial $15.00 Date 1 New Construction.... Old Or Pre-existing Building.!!..... Location of Property House No.~J n Street Hamlet Onwer or Owners of Property.. /CQAGAr/.. Lr....,.[[ County Tax Map No 1000, Section..0/0...... Block. . lef.'.fr Lot.*/Z!.F Subdivision .............h .Filed Map...........f..~Lot...................... Permit No.=r. 79..../-..Date Of Permit.. IIAOX...Applicant. Health Dept. Approval ...........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.. h Fee Submitted: f~oMMa"l~O~ ...Y...!Y.w QS1 ~v S~. APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1000913 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date SEPTEMBER 24,2001 Application No. on file 1' / Al N 569771 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ROBERT E. WALL, 11 ALPINE AVENUE, FISHERS IST.AlM, N1 in the following location; ? Basement ® lst Fl. ? 2nd Ft. OUT Section Block Lot was examined on AUGUST 27 , 2001 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCE FIWRESCENi OTHER AMT. K.W. AMT. N.W. AMT. K.W. AMT. K.W. AMT. M.I. 6 8 12 6 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC-PT. TIME CLOCKS BELL UNIT HEATERS M SYSTEMS T DIMMERS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N.P. NO. OF FEET AMT. WA77S SERVICE DISCONNECT NO. OF S E R V I C E METER NO. OF CC COND. A. W. a. F W. G. A. W. G. AMI. AMP. TYPE EQUIP. L R MIT R SW J R SW S 0 eW ppR 0 OF CC. COND. NO. OF NI-UG 4 W G. NO. W HEUFRAM OF NEUTRAL HI-UG OTHER APPARATUS: G.F.C.I:-1 WALL ROBERT E. LTC. f245 -1 LdwF.. L L 11 ALPINE AVE FISHERS ISLAND, NY, 06390-0595 GENERAL MANAGER 11 Eper This cemneate must not be altered In any manner;, return to the office of the Board It Incorrect. Inmectors may be Identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 1cLD II:S: E la JJDA: E COMMENTS p~ FOUNDATION (1st) c FOUNDATION (2nd) 2. z 0 ROUGH FRAME & .PLUMBING 3. m INSULATION PER N. Y. m STATE ENERGY CODE r 4. 1 af/JAD/ CAA-1041 C/7 FINAL I ADDITIONAL COMMENTS: M a H O Z i m ^o H E _ BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS • • TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OT I FY Examined 19~ CALL MAIL TO: c Approved . • Y 1?. Permit No.~ 7/S Disapproved'a/c (13Gildin nspector) APPLICATION FOR BUILDING PERMIT / Date ..+<?~'dGl 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 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 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 applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryinspec ions (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. :5 rlew~`~ C~.......*.. ,.,.q Name of owner of premises O.? ~Es?/ C2 ~i~~E / . (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 . Plumber's License No . Electrician's License No. Other Trade's License No . 1. Location of land on which proposed work will be done. . - 4 4, ~`~G~......... . House Number Street Hamlet County Tax Map No. 1000 Section Block . c~ Lot Subdivision . (Na e) Filed Map No. ' . Lot 2. State existing use and occupancy of premises and intended use and occu` ancy of proposed construction: a. Existing use and occupancy 4 • , b. Intended use and occupancy P, ~ 2,'! ~/q,~~ , • Y'rt# t A 3. Nature of work (check which applicable): New Building . Addition . ~ Repair Removal . • • • • • • • ion w . • • • • • • • • • • • Demolition Other Work ork ' , , , , pro (Description) 4. Estimated Cost . 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 t 7. Dimensions of existing structures, if any: Front ...-*:5......... Rear --ype of use • . . . . • Height ...A/ Depth . 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 . Height Rear Depth . Number of Stories . • Size of lot: Front Rear...................... Depth 10. Date of Purchase '••••••••••••••••••••••••....NameofFormerOwner 11. 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 No 14. Name of Owner of premises Address Phone No............... . Name of Architect Address . Phone No. Name of Contractor . . Address • • . . • • ' ' - Yes Phone No . 15. Is this property within 300 feet of a tidal wetland? * " " " . *If yes, Southold Town Trustees Permit may be required. " No..° 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. AT tali r T!,) ,A, "OtiSTR?JCT.IO)U y, N!"OS T F:F CO N6PLETF ,°,LL rONSTRUCTI()hl SHALL MEET DiF c`3EQUIPER/ ENTS OF THE I' 'Y, ~7ATE CONSTRUCTION 8: ENIERGY MIDES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NE YO S.S COU Y OF., ' l y Q!1r ' ' ' ' . . ••'gWg • • . • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si nin contract above named. 3e isthe. (Contractor, agent, corporate officer, etc.) )f 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 vork Will be performed in the manner set forth in the application filed therewith. ;wom to before me this l.'CW' .......day of 19..1.3 Iotary Public, , , , , Coun EILEEN G. WALL ~ NOTARY PUBLIC, NEW YORK STATE NO. I QUALIFIED IN SUFFOLK COUNTY TERM EXPIRES OCTOBER 31, 19 94- (Signature of applicant) I d.~-oU~Lb re IE I'rt c C,- r5' za' G ,~~yi~X+ C3 sJ o44- r~rc ~,rrw°' ~ - . rvt - / / ~ 4 I I N z le / l 1 1 / / ~ JI I I is Cr) I II TT dqd L 1 I I24'oa.L-~ 1 v i \ \ 16 o 1 I `VI i II i I l rb4L a U S L oll 43o wf ~ I ~LV ~ / / / U / c s s3 ~ 4o w ~S4 I Zeazil / / / / / / I ~ ~I 1 41 t _ _ _ W.p / v 4.4.E i5. G ? y" ~ _ bpG'.,t ~t 71 Yr} ~t CIO I ';Q..'a'., , z v. t s _ /~~1~a~4IV _ IS 1 l~ rJ ct~'`e I ~L / t 3 4., a - . 5 '3$' 4y' 40 1V . • o"c° 45o / I ?.OG LI' I / / / / I I mT'I 1I IT"IT" I I 11' I I I l ~ I I I I Iv - - ~ 1 -1 -,7 - _ i 1 - J~_ I I II, ~ I ~ I I ~I I 'III I I ' I~ ~li I' I ' I ~I i I II II I li I I II ~rT I I I I I I I I I n w N EcK I I I I I I I I I I I 111,1 - I II v - OPEN 40 BE~ I+L ' I I ' i JI I I I I I WALL I I exIsnN F ELVST NE ~ I I o r - I II G I ~I I1~1 11 ~11 ~I_1~1J iJJ~J11L f~iY.'TO ALIIINI - INFILL~EXfENv FIELr~ L 2E(AINI(' WALL MTN I STONE FO[NEW YfKU,LTIJ -rOAUCrrN W NOII 1 ATN I - ~ I I II VININcirfwm LIVIN61 woM I (I ~ MASTEK BCnP.~aM ' II I II Aru 2 ~I I , -I h34fN 2 KCMbvE U15-`IKC~ INIKIOK- WALL ff j Phi,EI2I~VELrAfAYION III vg FA L L I III I II ~ I ~I ~EXI5T1NGA5PNALT - 'p 3Et?RDO 3Eprt~oM 15WUOM 2 b2IVE1.IAY` III _ I Nbf REMOVE ALL EX 15fItY I I OA9NEbl.~1LLS~ PoOES ~ WIIIJOOWS fl 5fEG5 , I UNDERWRITERS CERTIFICATE ADDITION TO: REQUIRED I I I WALL RESIDENCE I I FISHERS ISLAND EXISTINLrPLMFfcIZ - 99 s- NEn CLAP N i L `r NEW YORW, `I b T -ro Ex IsTIrY~ Roan OvE2NAN!r it I TO RE R£MaJEO REiN~riAU.E7 AS _ cal S nklfd mNi I SBT uN5TALLATIOM NOTE: AL NM: ALL 56U?WALLSARE 12 NEW caJSf2ucTloN PAN?Enix(pTZIM-TYPI[AL- 2k8 IL00r- VVI515La 8 I?T. 2x851LL-TYPICAL _ PROGRESS 'd NT y N ~ A 1 H I I Fi2~ DEC 14 1993 8" conk FoLlNnarioN tJALI--- y~-TTYPICAL .r 3o ti Ito Q''3° Y12°J li~_3u lkI2'y 9 3 ~I2nn 60 i I- 39 ' 1I I SEAL FLOOR Pl-AN rOP OF rOAPA-rION PEUL, TITLE FLOOK PLAN/5I11E rLA, DATE SHEET E JOE I7OKT SCALE DRAWN A - 1 CHECKED Of - ~t'l01 ig ADDITION TO: WALL RESIDENCE FISHERS ISLAND NEW YORK Ix a pili i ~ 'i Elcls'(~NGr d _ - - - - EXISTING LEJLINp NEI(gi4T 7. fT ICE - II I I DEC 14 1993 I ~ ~11 LL, SEAL I ~l 11 = m 'k [IL I EXISrIN(4 FIN15HEP Flksr FLtVz AWITION: FIINIOHEv PIF5M 91C N, - ELFV +11 -01, ~Q AVeI TI ON TOP OF WAIL ELEV: 0'_0" I - OF WIfJ~J W . '¢oF wlNvaN --I-r 'WELL Elf WELL III , r y TITLE ELEMf ION5 41160w~~ GLAD i"(1NLSLdO AdGIfION; 1oPOF SLAP - - - - .k_ _ _ ELEV:- W-1I II DATE SHEET JOB E SCALE DRAWN A - Z CHECKED OF l14