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HomeMy WebLinkAbout29974-ZFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPA2{TMENT office of the Building Inspecsor Tovrn Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30081 Date: 03/15~ 04 THIS CERTIFIES that the building ADDITION Location of Property: MANSION HOUSE DR HOUSE NO.) (STREET) County Tax Map No. 473889 Section 6 Block 5 Subdivision Filed Map No. Lot 8 Lot No. FISHERS ISLAAVD ( PL~MLET i conforms substantially 5o the Application for Building Permit heretofore filed in this office dated DECEMBER 24, 2003 pursuant to which Building Permit No. 29974-Z dated DECEMBER 24, 2003 was issued, and conforms to all of the requirements of the applicable provismons of the law. The occupancy for which this certificate ms issued is CHIMNEy ADDITION "AS BUILT" TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CERTIFICATION OF EVELYN COLE SMITH, AIA BATED 3/8 2004. The certificate is issued to WALLACE CALNEY of the aforesaid building. OWNER) SUFFOLK COLTNTY DEPARTMENT OF ~KEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A A~h0 ri z~ed 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) P~T [N0. 29974 Z Date DECEMBER 24, 2003 Permission is hereby granted ~o: WALLJ~CE & WF CALNEY 742 PLACIDO WAY NE ST PETERSBURG FL, 31704 for : 'AS BUILT" CHIN~EY AS APPLIED FOR. ADDITIONAL CERTIFICATION WILL BE REQUIRED at premises located at FLANSION HOUSE DR FISHERS ISLAND County Tax Map No. 473889 Section 006 Block '0005 Lot No. 008 pursuant to application dated DECEMBER 24, 2003 and approved by the Building Inspector to expire on JUNE Fee $ 300.00 24, 2005. ?/ ~ Aut h~ri ze~i Signature Rev~ 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILOING WPA Ta'mNT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE This application must be filled ia by typewriter or ink and submitted to the Building Department with'the following: A. For new building or new use: I. Final survey ofproperty 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 iff electrical installation from Board of Fire Underwriters. 4. S~:°m~ ~m~fe~. ~,:e~ f~om pkumb~, certi!rying that the solder used in system contains less than 2/10 of 1% Iead. 5. G0mm~clal b~d]ng, iadustria!.b~_g, multiple residences and similar buildings and installations, a certificate of CoCre Compliance from architec[ or eng/neer responsible for the building. 6. Submit Plan~ring. Board Approval of eompleted site plan requrrements. For existing bnfldi~s (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sarvey of property showing ali property lines, streets, building and unusual natural or topograpkic features. 2. A proger)y co~¢pleted application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is den~ed; the Building I~spector shall state the reasons therefor in writing to the applicant. C~_~jCertificate. ~.e~ of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00 Swimmh~g 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 - $25.00 4. Updated'Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Location of Property: /44 ~'~o D /z~or~ House No. Street Owner or Owners of Property: _ ~/~c Suffolk County Tax Map No 1000, Section Subdivision Date of Permit.__ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ (check one~ Hamlet Block Lot ~:~ Filed Map. 17~/g~/~ Applicant: lf~T~[t~ Underwriters Approval: Lot: Final Certificate: (check one) ~t signature CME Assoc. Engineering, Land Surveying, & Architecture, PLLC. March 8, 2004 formerly Chandler. Palmer & King 110 Broadway Norwich, CT 06360 (860) 889-3397 FAX (860) 886-7801 ~gLj.'TH © LD _ Mr. Gary Fish, Permit Examii~ Building Department Town of Southold P.O. Box 1179 Southold, New York 11971-0959 Re: lite Gaillard/Calney Residence, Fishers Island, NY To Whom It May Concern: This letter is to advise you that we have reviewed the chimney modifications a~ the above referenced site and find that the chimney has been modified as per our earlier recommendations for code compliance. Modifications included extension of the chimney by approximately 5 feet so that it is at least 2 feet higher than any structure within 10 feet, and repointing of the existing chimney. If you have further questions regarding this issue, please contact me at (860) 928-7848. Evelyn Cole Smith, AIA Toll Free (888) 291-3227 An Equal Opportunity Employer www.cmeengineering.com APPLICANT: ~.~., (.~5~,.,,~ SCTM# DISTRICT: 1,000, SECTION: DATE REVIEWED: 1o~ _/~/03 DATE SUBMITTED: 12/~/03 BLOCK: 5 , LOT: 55 SUBDIVISION: ~ la ADDRESS: t~ka&~;~o~ 44~¢ h~t~ CITY: ZONING DISTRICT: -- CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE BP -Z / C/0 Z- ,.INFO CO: Y ORN _/'BP &_x~;.Oo4=Z/C/0Z- o¢~-~ o lNFO / BP -Z / C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUI1LED ~* NOTES: - LOTS 4O.000SF -100-24. Lot recognition.(CRF2ATED before Ju~qe 30. 1985~, UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming ax any time after 7/1/8 REQ. LOT SIZE: ~ .P~EQ. FI~ONT . 3g'-. ~Q. REAR 5~ ACT. LOT SIZE: ~cg'r REQ. LOT COV. gl~O~ · PI(OP. FRO.~TJi_ REQ SIDE ~/z~ PROP. REXR REQ. I~IGET ACT, LOT COV~ ACT) SIDE ~ PROP. HEIGHT PROJECT DESCRIPTION: ¢?5 ESTIMATED PROJECT COST: WATER FRONT? ~(~ DESCRIPTION: ---- PANEL # FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or~J~> (BED ~): DTE: TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: ~-~c ~/1/~5 Y-ES or~ DTE: SOUTHOLD TOWN TRUSTEES: YES off~ DTE: TOwN ZONING BOARD APPROVAL: YES or~) DTE: TOWN PLAN. BOARD APPROVAL: YES or ~) DTE: TOWN HISTORICAL PRE (SPLIA): YES or~ PERMIT #: PERMIT 7: PERMIT s: PERMIT #: PERMIT #: NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: 1.( SF)-( SF)= SFX $ 2.( SF)-( SF)= SFX $_ 3.( SF)-( SF)= SFX $ SF SF SF SF SF =$ INIT OTHER TOTAL FEE FEE FEE · $ +$ = $ +$ . +$__ = $ +$ +$ = $ FINAL TOTAL: $ 01/07/04 ~/~ED 10;02 FAX 20~ 22~ I]4',~ F ITHLEPHO~g H~&LTH~T ~oo8 P~]ra~r &.~h~ De~mb~' 5, 2003 R~: ,The~ll~rd/Ca~eyRe.Sidel~ce, Fishers lsla~Zd, lqY To Whom It May Concern: showing modificstior~ to 11~¢ existing chimney at thc, above the' chimney s'amcture into compliance.with the New York Modifim~/6ns '.include eXtension of the Ci~imrley by approximately 5' feet $o flmtit 'is at.Ieast 2 feet higher than may s~ucmm within 10 feet. The existing conCrete:block singloflu¢ chimney w~ll be exterrdCd by adding 8" x 8" x 16" triple core lightweight block, lined with nominal 8" x 8" clay fine t~l¢. If you have further qacstidus regarding this issue, please contaC[ mc at ~860) 928-784g. Sincercly~ Brad Cheney, P.E. Toll Free (8~6) 291-32.27 An Equ~i Opportunro/' EmPloyer TOWN Ow SOUTHOI,Dj ~B~0ILDINO PERMIT APPLICATIO~JiC;k~CKLIST BIJILDIN~ DEPART~I~ENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTItOLD, NY 11971 3 sets of Building Plans TEL: (.631) 765-1802 Planning Board approval FAX: (631) 765-95112 Survey_ nortlrfork, net/Southold/ PERMIT NO. C~q~L~ Check Septic Form N.¥.S.D.E.C. //~ Trustees t~" ~ ,20 '~ Contact: De-"T-~& Examined ^pprovea ,20 2, Ma to: Disapproved aJc //' BuUd g/I AiPPLICATION FOR BUILDING PERMIT ~.~ '"-: ......... d ~ Date ~r~er~r~ t ~ ,2003 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 adjoin'rog premises o[ 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 permil 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 puipose what se ever until the Building Inspector issues a Certificate of Occupancy. f. Every building perm/t shall expire//the work authorized has not commenced within 12 months after the date of ~ssuance or has not been completed within 18 months from st/ch daze. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit sholl be required. 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 constmctioa of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees m comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorize'd inspectors on premises and in building for necessary'inspections. ,Signature pp or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (A~ 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. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamle~ County Tax Map No. 1000 Section Subdivision (Name) Block ~ Filed Map No. Lot Lot State existing use and occUPancy of premises and intended use and occupancy of propos~Co~strucd~on: a. Existing use. ~d occupancy ~¢~ ~,~,~y /~ b. Intended Use and occupancy ~f~;~,c ~,L~/ /~/- Nature of work (check which applicable): New Building Repair RemOval Demolition Estimated Cost ~'J~ ~ ~,¥,',Ft Id{r ~)~t,l(.) Fee If dwelling, number .of dwelling .units If garage,, n umber of cars 7. tJimensions o~ existing ~if any: Front Height ' ' ':Number of Stories Addition Alteration OtherWork ~Joo~ l)~c-[r_ (Description') (To be paid on filing this application) Number of dwelling units on each floor / t If business, commercial or mixe0 o~cupancy, specify nature and extent of each type of use. g ~ Rear 3fo Depth Dimensions of same ~tructure with alterations or additions: Front Depth . Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size oflot: Front IZ'/' ' Rear //o Rear Depth £ Depth / O~ 10. Date of Purchase [ ~]£5' Name of Former Owner 11. Zone or use district in which premises are situated ¢ ~ ~o 12. Does proposed construction violate any zonhag law, ordinance or regulation? YES //NO 13. Will lot be re-graded? YES NO V/Will excess frlt be removed ~om premises? YES __ NO Addr~ss~qZ {~:~o u~y ~ Phone No. Ad&ess~,~o~¢ ~P~ne No Address Phone No. 14. Names of Owner of premises Name of Architecl Name of Contractor t5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__NO __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE,J~QUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E,C. PERMITS MAY BE REQUIRED. 16. 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 dam on surv.ey. ;TATE OF NEW YORK) SS: ;OLFNTY OF ) ,~.C T'~ ~-~/clL.b..4'~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, ~)He is the (Contractor, Agent, Corporate Officer, etc.) fsaid owner or qwg_~rs, ._a~dj~ d,uly au~h~t~d ~0 peffqrm or flare performed the said'work and [o make and ~le ¢i~ application; ~t ali statements cofitained in,is appii~on ~ true to the-best ~h~-~-fflb~d-ge and belief; an~Lhat ttfe-woH~ ~'ilI be ' erformed in the manner set forth in the application filed'therewith: ~wom~o before me this~ ~ ] (~ 7tX day of C~/~ ~ 20 0 -~ Signature of Applicant NC).~VA='-"I~ A.RNPIIHO O~dO~d A3NqV3 3O¥1"IVM/O~V-I-IlVO ~313d SNOILYbl3i-I¥ A~NRIHO ~J