HomeMy WebLinkAbout27851-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28341 Date: 04/16/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: PENINSULA RD FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 10 Block 11 Lot 5.8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 5, 2001 pursuant to which
Building Permit No. 27851-Z dated OCTOBER 31, 2001
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 ACCESSORY CARPORT AS APPLIED FOR "AS BUILT" .
The certificate is issued to L.F.BOKER & SUSANNA S. DOYLE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1040775 03/21/02
PLUMBERS CERTIFICATION DATED N/A
c
s
ho zed Signature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 27851 Z Date OCTOBER 31, 2001
Permission is hereby granted to:
CORPORATION COVE
BRIDGE LA
SAGOPONACK,NY 11962
for
CONSTRUCTION OF AN "AS BUILT" ACCESSORY CAR PORT AS APPLIED FOR
at premises located at PENINSULA RD FISHERS ISLAND
County Tax Map No. 473889 Section 010 Block 0011 Lot No. 005 . 008
pursuant to application dated JUNE 5, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized S ature
ORIGINAL
Rev. 2/19/98
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 I% lead.
5. Commercial building,industrial building, multiple residences and similar buildings and installations, a certifica
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 Occupanc3
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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00
Date. April 11, 2002
New Construction X ACCY Old or Pre-existing Building: (check one)
ARPORT
Location of Property. PENINSULA RD. FISHERS ISLAND, N.Y.
House No. Street Hamlet
Owner or Owners of Property: L'-.F:BORER & 'SUSANNA S. DOYLE
Suffolk County Tax Map No 1000, Section 10 Block 11 Lot 5.8
Subdivision_ Filed Map. Lot:
Permit No. 22851—Z Date of Permit. f10/30/01 Applicant: covE CORPORATION
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: XX (check one)
Fee Submitted: $ 25.00
Applicant Signature
-- --- -
0 ----
c � y/
Do you have or need the following,before applying
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: 765-1802 ���/y Survey
�
PERMIT NO. (Z� Check
Septic Form
N.Y.S.D.E.C.
Examined X/ 20 1'�9/ Trustees
Contact:
Approved i 20 f Mail to:
Disapproved a/c
Phone:
Building Irlspzoi&F
APPLICATION FOR BUILDING PERMIT
Date , 20
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 waterways.
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 issue a Building Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupan
is issued 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 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
ENGINEER
Name of owner of premises L. F. Boke.r Doyle'.- & 9ttsana S. Doyle
(as on the tax roll or latest deed) -
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
T
E1vCtiiCiuiiS L.iGCi1Se LtiV.
Other Trade's License No.
1. Location of land on which proposed work will be'done:
Peninsula Road, Fishers Island
House Number Street Hamlet
County Tax Map No. 1000 Section_ 10 Block 11 Lot 5 . 8
Subdivision N/A Filed Map No. Lot
(Name) .
i
?. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .. Residence.
b. Intended use and occupancy Residence
�. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work request for c.o.
1. Estimated Cost N/A Fee (Description)
(to be paid on filing this application)
If dwelling, number of dwelling units 1 Number of dwelling units on each floor 1
If garage, number of cars carport for one car
If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front__66 ' -6" Rear 43 ' -4 Depth 371 -01,
Height 131 -611 Number of Stories 1 Y
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
Size of lot: Front-2 7 4 ft Rear 340 ft Depth 380"
0. Date of Purchase Jan 2001 Name of Former Owner Erard Matthiessen
1. Zone or use district in which premises are situated R80
2. Does proposed construction violate any zoning law, ordinance or regulation: No
3. Will lot be re-graded No Will excess fill be removed from premises: YES
L.F. Boker C/o Steve Ham, III, Es
4. Names of Owner of remisesDo le 4• - M t t ews & Ham
p Y Address 4 5 Hampton Road Pho.e No fo 3-�
Name-of Architect Address Southampton, NYPhone No
Name of Contractor Address Phone No.
5. Is this property within 100 feet of a tidal wetland? *YES X NO
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
TATE OF NEW YORK)
SS:
'OUNTY OF )
(Name of individual signing contract) above named,being duly sworn, deposes and says that(s)he is the applicant
�)I-le is the
(Contractor, Agent, Corporate Officer, etc.)
f said owner or owners, and is duly authorized to per forr.: or have performed the said work and to:Hake and rile this appiication;
iat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
-rformed in the manner set forth in the application filed therewith.
�vom to oefore me this
day of 20
Notary Public Signature of Applicant
INNER H R80R � , ,
Of
10' EASEMENT FOR GR� N 1083 47
o INGREES & EGRESS v - - -----
BY FOOT ONLY & E 1238.39
RIGHTS FOR A PRIVATE _
DOCK OR MOORING
N
(LIBER 8455/PAGE 126)
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72'29' 8, E -' M.5
38'5' °25 W (END )
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F.I.E.C.
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♦;F.I.E.C. MAY 4, 1998
#334W METER
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7�� 4 ya BIT. DRIVE CARPORT �JJCCC `O
9f � 4.2'--{x SUBJECT TO RIGHTS FOR
\\\ �-p 0 I \ EXISTING DRIVE TO PROPERTY OF `� v
P \ 10' EASEMENT FOR ��. POLE + v GEORGE CAREY MATTHIESSENI. � ' NOTES
(END.) INGREE & EGRESS P� oc I o (LIBER 8510/PAGE 119)
BY FOOT ONLY 126) 'C1� w\
' (DECK / o I 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE
(LIBER 8455/PAGE
. \ INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE
' PURPOSED AGREED TO BETWEEN THE CLIENT AND [HE SURVEYOR
/ HOUSE , \F EXCEEDS THE SCOPE OF THE ENGAGEMENT
' F.F. EL.=28 93 m\ o )
2 ) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY
PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND
#345W. SURVEYOR, TO AIDER AN ITEM IN ANY WAY
/ 5W
3 ) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYORS
' Nod m /ryoi SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE
SETBACK LINE PRODUCT OF THE LAND SURVEYOR
Ie ARALLEL TO \ �ARCEL LINE
p'4 0, 1 STREET LINE v 4.) COORDINATE DISTANCES ARE MEASURED FROM US COAST AND
� ^n \ GFODEIC SURVEY TRIANGULATION SIAUON 'PROS"
5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP
' I / \ , 1000, SECTION 10, BLOCK 11, 1 O 5 8
F. 7 W 1 6 ) TOTAL AREA - 2 32t ACRES
SEPTIC
eI I AREA (FND. S 820600 ,.'. N
I.P. 13000' 7 1 BASE FOR LEVELS - N G V U, 1929
(END.) S 82.06'00" W o.m.
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t 1
gI ' F.I.E.C.
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234 74
\ ' N/F (FND.) N 82'0000 E 111
\ o \ DAVID G. HANES �1 Z
\ O \ I 30' EASEMENT FOR INGRESS 1 C
�3D' & EGRESS BY VEHICLE OR FISHERS ISLAND\ DEVELOPMENT CORP.OTHERWISE (LIBER 8455/PAGE 126)
1p ' I O 1 SURVEY MAP
PROPERTY TO BE CONVEYED TO
L. F. BOKER DOYLE
\ & SUSANNA S . DOYLE
\I ,.
IT 40 20 0 40
'o _ A CPENINSULA ROAD
OR/ GRAPHIC scmL IN I I
�NFISHERS ISLAND, NEW YORK
A
` ` L�� n \% REVISIONS = AW CHANDLER. PALMER do KING
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.� : A. DATE DESCRIPTION m14ML
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02110101 ADDITIONS r 110 BROADWAY
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no eaonownv uaaww. cr osoeo eno-aes-ns> FAX ees-eee-'rani
09/27/01 REVISIONS
10 MY KeEAND BELIEF, THIS MAP IS SUBSTANTIALLY CORRECI
AS NG TE�/ DATE. JANUARY 13 2001
i S. #49521 DATE SCALE: 1 " = 40'
SHEET i OF 1
MATTHIESSEN_TO_DOYLE-PENINSULA_ROAD DWG\JJM
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REV151ON5
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QA B.R 6'�� OCCUPANCY OR
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USE IS UNLALdFUL
NO WILDING DEPA TMENT AT WIT1.100T CERT;FIC�_ T
FOLLOWING INSPECTIONS:M FOR THE OI" OCCUPANCY
I. FOUNDATIOW - TWO REQUIRED l7
FOR POURED CONCRETE 2
2 ROUGH - FRAMING A PLUMBING
I INSULATION ~
4. FINAL - CONSTTIUCRTII N' MUST' Y
SE COMPL'ETEFCR QO. 'r x
ALL CONST,RUCTNRIVSHALL TMS TT
THE REOUIREMENTStP TH `- T' ` ^
STATE CONSTRUCTION A E
CODES. NOT RESPONSI I, o
DESIGN OR CONSTRUOT1l5IWL� o
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LLI
FLOOR ELAN Z
1/4" = 1'-0"
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NORTH ELEVATION UJUT ELEVATION
1/4" - I'-O" 1/4" = 1'_0"
SOUTH ELEVATION SIMILAR, OPPOSITE HAND
DATE. MARGH 8, 2001
5GALE: 1/4" = 1'-0"
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