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Home My WebLink About27375-ZFORM NO. .~ TOWN OF SOUTHOLD BUILDING DEP2LRTMEN~f Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30955 Date: 05/31/05 T~IS CERTIFIES that the building ADDITION & ALTERATION Location of Property: OFF EAST END RD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 4 Block 5 Lot 19.13 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 6, 2000 pursuant to which Building Pez~it No. 27375-Z dated JUNE 11, 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PRUDENCE G.& RAYMOND B. G~LRY (OWNER) of the aforesaid building. &~3FFOI~[t~OI~YDEPAR~ OF ~L~{AP~{OVAL N/A ELRt-z~ICAL CERTIFICATE NO. 2048887 04/26/05 CERTIFICATION DAi'~3 02/10/04 MARLO ZANGHETTI /~hoJz e d S~nature Rev. 1/81 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 submi{ted 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. 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-existinK Buildinm - $I00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .............. New'Construction ........... Old Or Pre-existing Building ........ Location of Property .... .O. ~ ~...~.~. ~. ~.-~...~..~? .~.....~..L? ....... ~J.~. ~a$ .... ~ ~ ~.~..~- ~- ...... House No. Street Hamlet Onwer or Owners of Property. C~.o.~.~.rp.~..~.. ...~.[ .~.~....~{.f.g.~ ........................ . .. . . . County Tax Map No 1000, Section..~D..W ...... Block..O.qa~.. ...... Lot..~.J~-'.~.!--~. ......... Subdivision .................................... Filed Map ............ Lot ...................... Permit No..~f~ ~. ~.~. ...... Date Of Permit....~. l .I.~. !~.I .... Applicant..~.~. Health Dept. Approval. ........... . .. .. ~........Underwriters Approval ......................... Planning Board Approval ........................ Request for: ~emporary Certificate ........... Final Certicate.. ?. ....... Fee Submitted: $ .... .~.~.:.~.? ............... ~ ..~...~ .......................................... APFLICAMT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [~C DATE~~~Z 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. 27375 Z Date JUNE 11, 2001 Permission is hereby granted to: PRUDENCE GIBB GARY 840 PARK AVE NEW YORK,NY 10021 for : ALTERATIONS & ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 004 pursuant to application dated NOVEMBER Building Inspector. OFF EAST END RD FISHERS ISLAND Block 0005 Lot No. 019.013 6, 2000 and approved by the Fee $ 115.00 ORIGINAL Rev. 2/19/98 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by Z & S CONTR. INC. P.O. BOX 202 FISHERS ISLAND, NY 06390, RAYMOND B. GARY TOP OF TH WORLD EAST END FISHERS ISLAND, NY 06390 Located at TOP OF TH WORLD EAST END FISHERS ISLAND, NY 06390 Application Number: 2048887 Certificate Number: 2048887 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having iurisdiction, and found to be :~t~ompliance therYv~id~9~$the Day of Name QTY Rate Ratin~ Circuit Type Appliances and Accessories Exhaust Fan 1 0 F.H.P. DishWasher I 0 1.2 KW Wiring and Devices Outlet 17 0 Fixture Fixture 17 0 Incandescent Outlet 12 0 General Purpose Receptacle 6 0 Genera] Purpose Switch 6 0 General Purpose Dimmers 1 0 Receptacle 2 0 GFCI sea( 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR. P.O. BOX'728 .. TOWN HALL SOUTHOLD, N.Y. 11971 C E RTI F I CAT I O.N TEL. 765-1802 Date, Building Permit No. ~'~ (please print) Plumber C~ ~l~ ~3~ (please print) I ·certify that the solder used contains less than 2/10 of 1% .lead. in the water supply system · ( ~(p~r~s signature) Sworn to before me this /~ day of ~ ,. Notary PubI~'c J Notary 'Public, N~~ ·County STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) being duly sworn, deposes and says: That deponent is over the age. of 18 years and resides at That on the ~3~day of ~__, 2001 deponent architect/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- O0 ~-- ~- -'1~ Sworn to before me this ~:]D day of /~.~ ,2001. Notary Public~ N~ ~, S~ of N~ Y~ No. 31-4962171 mm~l~ ~p ~s F~ma~ ~ z, z~ cc: Applicant FORI4 NO. I TO~I OF SOUTDOLD BUILDING DEPARTNENT. TONN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 BOARD OF HEALTH ............... 3 SKT8 OF PLANS ............... SURVEY ........................ SEPTIC FOILM ................... DEC ........................... TRUSTEES ...................... NOTIFY: CALL ~LI.~. r.xJ. /~. T.4.U~.d. NAIL TO: .................... APPLICATION FOR BUILDING PERHIT INSTRUCTIONS Date .~.. a. This application mast be e~pletaly filled in by type~iter or in ink and aul~itted to the l~dldisg Inspector 3 sets of plans, accurate plot plau to scale. Fee according to schedule. b. Plot plau sl~ring location of lot aed of buildings on e,,~ises, relationship to adjoining pranises or pablic streets or areas, and giving a detailed description of layout of property must be dra~ on the diagrsm ~t~ich is part of this application. c. The turk on,red by this application rmy not be coramnced before isauanee of Building Perrait. d. ~on ,~up~ucal of this application, the Building Inspector ~*ill issue a Building Pemit to the applicant. Sud~ permit shall be kept on the v,,=aises available for inspection thmughont the turk. e. No building shall 1~ occupied or used in ~/nole or in part for auy ixtrpose *t~atever until a Certificate of Occupancy shall have been grmated by the Building Inspector. /RaPLICATIflq IS ~ ~ to the Building DepariJmnt for the ism of a Building Pemit pursuant to the Building Zone Ordinasce of the To~n of Sonthold, Suffolk Coonty, ~ York, and other applicable La~s, Ordinmaees or Regulations, for the eonstruction of buildings, additions or alterations, or for t~al or demolition, as herein described. Tas applicant agrees to eaaply with all applicable l~*s, ordlmmces, Imilding code. housing_ code, and regulati~on, and to atimlt authorized ionpeetors on premises and in building for seceslmry iqapections. (Signature of applicant, or name, if a corporation) ~ner, lessee,~-~architect, engineer, general camtraetor, electrician, pltmber or builder State Mlether applie~t is ..q~!k~..ot..~ ~....q~....a~.~.l..~. f.C?.~...¢~..~..~. ~ of ~= of ~s....[g~.ma..~..... ~=..6..~..~ .......................................................... (as on the tax roll or latest deed) If appllc~mt is a corporation, signature of duly authorized officer. (Nam and title of corporate officer) Plts~bers License RD .......................... glectrlciaus License No ...................... Other Tra~e's L~cense No ..................... ~ ~-dq' ..~...~...~... ~tion of a~ on ,t,i~ ~ ~o~ ,,m ~ ,~......:~-...; .................................... House Nmber Street Ik~fl.e t C~nty Tax 14ap No. 1000 Section . ..~...~...~ ...... Block ..... ~ ........ l~t .... t.~* ]..~.... Sulxlivision ...................................... Filed ~ No ................ Lot ............... (t~) 2. State existing use and oeonponey of premises and intended use and occupancy of proposed construction: a. ,~ds~ing ,~ ~a ec~-~ ...Cx~3.&.~.~M ......................................................... 12. 13. 15. aLure of ~rk (e~:k ~idl applicable): ~ I~filding .......... fidditi~ .... ~'.L ....alLerati~ ..~': ...... I~[r ............ ~al ............. l~liti~ ............ Otlmr ~ ................................. (~ripti~) -o .. ' Esti~mt~ ~st ..,~..~...~ .......... f~ .......................................... (to ~ ~id ~ ~ili~ this a~li~tim) I[ ~11i~, ~r o[ ~11i~ ,mits ..... ~ ..... ~r o[ ~lllng ~its ~ e~ H~r ................ If garde, ~r of ~rs ...................................... If I~[~ss, ~rclal or ~ ~, ~i~ ~ture ~ ~Cent of ead~ ~ of ~ ...................... Di~i~s of ~isti~ st~m~s, if ~: ~t.~.~.~.~ ...... ~ar ..l.q.~ ....... ~pth ...~./.~ ........ tki~t ~ ~-~ ~r of Stories .. O~z I~ ~ ~a~ ~c~l') O~i~ of ~ st~e ~th alterati~s or ~itions: ~t ..$.q~ ...... ~ar ..$~.~ ...... ~pth .... ~fi~: ....... ~i~t .... k6.~ ........ ~r of Stories ...~ ..... Oi~nsi~ of entire ~ ~st~ti~: ~t ..... ~ ....... ~ar ..~.?& ....... ~pth ...~..L~; .... ~ t ] I~i~t .. ~.. ~ ............... ~r of Stories ..................... Si~ of lot: l~t .................. ~ar .................... P~pth ................ 2~ a~ ~,~-x/~,? ~te of ~d~a~ ..................... ~ of Four ~r ........................................ ~ or ~ district in M~i~ pr~i~a a~ s~t~ .............................................................. ~s ~o~ ~t~ti~ violate ~ ~i~ 1~, o~i~e or r~lati~: ...~ ................ ~ill lot ~ ~r~ ..... ~ .......... gill ~ss fill ~ ~ ~ ~s: ~ ' ~ ~ .............................. ............. ~ of ~it~t .~'~[.~.~---- ' -- .............. ~ress .~.~r~.~7~. ~'.~Y.~.~. ~ ~. RtX: ........ ~ of C~tr~tor ................................... ~resa ............................... ~ ~ ............. Is fl~is p~ifiin ~ f~t of a ti~l~tl~? * ~ .......... ~ ...~ .... PLOT DIAGRAH £z~cate clearly and distinctly all buildings, ~t~etler existing or proposed, and indicate all set-I~c_k dimensions froo property lines. Give street and block rulber or description according to deed, and sho~ street nines -and indicate ~hether interior or corner lot. (h~ of individual signit~g contract) above n~ed, (C~tracCor, agent, cor~rate officer, etc.) ~om to be[ore n~ this ~1 ~__/~. ' (Signature of Applicant)