HomeMy WebLinkAbout28201-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30964 Date: 06/07/05
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: PVT RD OFF E END RD FISHERS ISLAND
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 4 Block 5 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 18, 2002 pursuant to which
Building Permit No_ 28201-Z dated MARCH 21, 2002
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 AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to JAMES W B BENKARD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1102043 05/24/05
PLUMBERS CERTIFICATION DATED 02/10/04 MARIO ZANGHETTI
th ized Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL t 1 20
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This applic=ation 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 Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .41 j .1 c\. . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . .
Location of Property. . .� FAQ . . . , MS1..(.(QQ, , , , ,
House No. Street 1 Hamlet
Onwer or Owners of Property. :r�. f1 rr!?.$. . . :. s� : . .C�4t�.tS.AP��4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . . .Block. . Q . . . . . . .Lot. . . . . . . . . . . . . . . . . .
4-13 9 3I
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
,
Permit No. . . .�A tL . � 3` o �d.5Sruc-
. . . . .Date Of Permit. . . ail . . . � . . .ApplicanC. . . . . . . . . . . . . . Pt. G. 1� . . . . .
Health Dept. Approval.. . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . .
Fee Submitted: . . . . . . . . . . . . . . . . . . T!
APPLICANT _
c.o Z- 304y
1p� 9-�°/
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [A- NAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
C7 • ,� ��.v .® .
DATE o2 /O ' INSPECTOR
50 �tnrn����rsrs�nrn�� s�n�s rP r frJ�rJ rJcPrJ�r1rJ�rJ�rJ r J�rJ ar�rl?J�rJPL3jrJr pL3F�r.rar..rPL3F pLprrPpr o
ru
5 BY THIS CERTIFICATE OF COMPLIANCE THE S
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY c5
5 40 FULTON STREET — NEW YORK, NY 10038 5
5 CERTIFIES THAT 5
5 Upon the application of upon premises owned by
5 Z & S CONTR. INC. JAMES W.B. BENKARD S
C55 P.O. BOX 202 OFF EAST END ROAD e5
FISHERS ISLAND, NY 06390, FISHERS ISLAND, NY 06390 5
5 Located at OFF EAST END ROAD FISHERS ISLAND, NY 06390 c5
5 Application Number: 1102043 Certificate Number: 1102043 f5
5 Section: Block: Lot: Building Permit: BDC: NS11 �5+
Described as a Residential occupancy, wherein the premises electrical system consisting of 5
5 electrical devices and wiring, described below, located in/on the premises at: 5
First Floor,kitchen reno,
55
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 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
5
authority having jurisdiction, and found to be in compliance therewith on the Day of 1 24th May, ..005.
5 Name OTY Rate Rating Circuit Toe
5 Appliances and Accessories
5 5 Oven l 0 5 KW 5
Exhaust Fan l 0 F.H.P.
5 Dish Washer l 0 1.2 KW 5
5 5 Wiring and Devices 5
Outlet 6 0 Fixture
5 5 Fixture 6 0 Incandescent 5
Outlet 21 0 General Purpose
5 Receptacle 14 0 General Purpose
5 Switch I2 0 General Purpose 5
5 5 Dimmers 5 0 5
Paddle Fan 1 0
5 Receptacle l 0 GFC1
5 5
seal
5 5
5 I of I S
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
TEL. 765-1802
�pS��F��COG TOWN OF SOUTHOLD
t OFFICE OF BUILDING INSPECTOR
;= P.O. BOX 728
TOWN
LL
SOUTHOLD NAY .. 11971
1 �
C E R T I F I C A T I O N
Date I//,?ZO
Building Permit No. 11
Owner S� rr��.S VJYl► �S�q R d
(please print)
Plumber (yl y-1 t� I o Zdq rL) (S QI II I
(please print)
I certify that the solder used in the water supply system
contains fess than 2/10 of l% .lead.
plumbe s s ' nature)
Sworn to before me this
�0 day of �en
' 6 Notary Public
Notary Public, N&dCnd A County
Z & S CONTRACTING, INC.
BOX 202 • FISHERS ISLAND. NEW YORK 06390
Phone: (631) 788-7857
Fax: (631) 788-5600
fg 7
June 1, 20051 3M
� L; i
Dear Connie,
I am enclosing necessary paper work for
The Benkard CO on Fishers.
Also enclosing new check, could you please
Send old one back with the CO
Thanks
a,
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. 28201 Z Date MARCH 21, 2002
Permission is hereby granted to :
JAMES W B BENKARD
1192 PARK AVE
NEW YORK,NY 10028
for
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED
at premises located at PVT RD OFF E END RD FISHERS ISLAND
County Tax Map No. 473889 Section 004 Block 0005 Lot No. 001
pursuant to application dated MARCH 18 , 2002 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET 4VILLAGE DIST. SUB. LOQ'
,FORMER OV1/�IER N r t-JAI ACR
_ S A W TYPE OF BUILDING
9 Le e �t Ta ✓!e * 2 � �i4.� IE
RES, % SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
r C1
oo 2-17 D 5qL io ik�7 c �, � at L 177G
2 2
2-6 j vo 'p% -G / LT-w. 3. ac=41KOPd4w
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value i
Acre
Tillable 1
Tillable 2
Tillable 3
Noodland
iwompland FRONTAGE ON WATER
3rushland FRONTAGE ON ROAD
-louse Plot DEPTH
BULKHEAD
foul ^ DOCK
-- COLOR X ; ,
z1 x 3
a � I
- - - TRIM -d
I
1� 7 7 7
- Y z Qnc -
M. Bldg. 1 Foundation BathDinette e
Extension I" Basement Floors K.
i
Extension 9 Ext. Walls Interior Finish LR.
W6OZ
Extension /H x ' / 9 i -
x ,� , M w.� Fire Place 3 Heat -.- ; , CR.
J 32xi9 = Gn8 /5 47 - r– —
6/ Type Roof Rooms 1st Floor BR.
Porch Recreation Room Rooms 2nd Floor _ FIN B.
Porch Dormer
Breezeway y
Garage '�2 - ?> 7 Y '� ,� y a d
Patio -
O. B.
Total77-777
9s ✓
`�i �
iv ..i� vi .��,�.auVa,ai 17 V1LLr1VU rr+lV.r11111rL LLl,nl IV-N l-=-r,
F
BL-ffiDING DEP-ARTIVIEIV'C Do you have or need the follow ng,beicre appl}
TOV�N H A f L Board ofHeatth
SOUTHOLD, NY 11971 3 sets of BaldingPl=-,
TEL: 765-180: . Sarvey
PERMIT NO. 0.D8 20 -7, Check
Septic Fo=
N.Y.S.DMC.
3 S Trustees
FYaminrII L( 20
=PPr ted_ S 20 Z Mail to:
Disappro-rcd .
Phone:
j 1 Bading
' J APPLICATION FOR BUILDING PERMIT
Date Mg(e�i 15-
INSTRUCTIONS
5INSTRUCTIONS
application MUST be compla dy filled in by typewriter or in ink and sabmitied to the Building Inspector:rith
set, of plain, accurate plot plan to scale.Fee according to schedule.
b. F'1:i plan showing location of lox and of buildings on pretmsm,relationship to adjoining premises or public streets c
areas, and waterways.
c. The work covered by this applicadon may not be ca ja�.before issuance of Building Permit.
d. Upon approval of this applicatiom,the Bw7diag hapector.wM issue a Building Permit to the applicant. Such a perm
shall be kept on the premises available for inspection ttuoughout the work.
e. Ni building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certiucate of Oc�upa
is issued b.:the Building Inspector.
—PPLICAMON IS HEREBY MADE to the Building Department for tho issuaace of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other spplicabkLaws, Ordinances or
Rag,tion_. for the construction of buildings,additions,or akarations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws,ordinoas,building code;housing code,and regulations, and to admit
authorized inspectors on premises and n bmldmg for noomarymapections.
(Sigoeaae of applieaat or name,if a corporation)
K�hti„ Des,'`�
14S W+af Ytin &4. NY. NY /000/
212-1.5ti' (bfdi k g address of apph=t)
State whether applicant is owner,lessee;agett, ard*Ac4 engineer,general coutaactor, electrician,plumber or builder
Name of o,,,ner of premises S°tYVuE S w'. Q . Qgvt 1 fr�te�
(as on the.tax roll or lam deed)
If applicant is a corporation, signature of duly and ioxized officer
(Name and title of corporate officer)
Builders License No. 1�Y;L,4 _ 1
PhmibersLicense No. ssy P
Ele,cmeians License No. 4 7 g ri —
Other Trade's License No. )
1. Location of land on which proposed work will be done: r i 5�YS TS(4N Gt
House Number Street 13amlet
4 38 S
Count,, Tax Map No. 100000 Section Block Lot
Subdivision Hied Map No. tt�jtitt=
(Name)
2. State existing use and.oecapatcy ofpremases and iatuxud use and occupancy of proposed construction:
a. Existing use and occupancy Rcs telnKee - si w Jk/
b. Intended use and occapancy (ass i e(c n cG ci (a a u,' ., _
Nature ,,f work.(check which applicable):New Building Addition 1/ -titer.. .-,nA%
Repair Removal Demolition Other Work —_
iDes�ription i
Estimated Cost Fee --
(to be paid on filing this appli:anon
_. if dwelling, number of dwelling units I Number of dwelling units on each tloor_j_
If garage, number of cars
If business. commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures,if aay:Front . I l0 - O Rear 110 o Depth
Height Number of Stories 2
Dimensions of same structure with akerations or additions: Front 1101- o Rea r
115 `- 3" , u
Depth '3 '- 6U Haight Z - 2 Number of Stories 2-
Dimensions
Dimen;ions of entire new construction: Front 11 rt Rear l2 6 Depth 2 S
Height 1$ �-o" Number of Stories 1
a. size of lot: Front Rear Depth
J,_). Date of Purchase - Name of Former Owner
1 I. ?one or use district in'which premises are situated
I_' Does proposed construction violate any zoning lazy,ordinance or regulation Al e)
1.. `t'i11 lot be re graded N D Will excess fill be removed.from
premises:
GES '?O
11- Names of owner ofpvemises Tawtrs R"L(Ao Adams I I Pe.Ik lLe. NY phone No. Z7--ti2� 42Hrj
Name ef=schitc cr �_pddtxes l?o D�,� a St At YNVPhone\10 21Z-GSo-103 2
Name of Contractor Z# g 6& e},w Addy F' Phone No.
15 Is this property within 100 feet of a tidal`l wwetland7—*YES p (/
• IF YES, SOUTHOM TOWN TRUSTEES PERMITS MAYBE UIIZED
16. Provide sur•ey, to scale, with accurate foundation plan and distances to property lines.
1 If elevation at aaypoint on property is at 10 feet or below,must provide
topog<aphical data on sun-z-:
ST--\-TE OF NE 'YORK)
SS:
COTTNTYOF )
�ct�e
Name o:nidi idnat being�S sw=4 deposes and says that(s)he is the apoli inr
819=8 coIIhact)above ffimed
S)xe i; the A e`er '1-
(Co�'a�.Agent, Corporate Officer,etc.) —Of said„rner rr owners, and is dilly auffiotiaed to perfotni or have
that 11 _.,atemeatc co:rtaiaed m this P the said work and to make and file tht s application:
erB-rtned m the application are true to the best of his knowledge and belief, and that the«orh he
P ;nater set forth in the application filed therewith
SR'om I., bQ)kre me this
—w •-n
� N.,tarq c Gam/ •-t
SignattaeofAMhegt -- --
NOTARY PUMIC,YSM Y1 djh yo*
UM Owdkd h X1CMft
4
'ommieeion Expires_ � .
BUILDING PERMIT EXAMINER CHECK LIST
DATE ISSUED: /_/02
DATE REVIEWED: /ji/02
APPLICANT: DATSUBMITTED: /fig /02
SCTM# DISTRICT: 1,000, SECTION: '� , BLOCK: ,f , LOT:
STREET ADDRESS:� PIS. CITY: �,__ SUBDIVISION: vo
PROJECT DESCRIPTION: 2 Pr•d
ESTIMATED PROJECT COST: .?npCHITE T/ENGINEER: FAST TRACK? A-)�o
SINGLE & SEPARATE CERTIFICATION-REQUIRED? MD NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83;
ZONING DISTRICT: Q-/2o CONFORMING? 1X0
REQ. LOT SIZE:/2vfeOo ACT. LOT SIZE: /// s-111 REQ. LOT COV. e? l ACT. LOT COV. `J
REQ. FRONT 6o PROP. FRONT ✓ REQ SIDE �p yam ACT. SIDE ✓
REQ. REAR 4S PROP. REAR w-
WATER FRONT? /1/0 DESCRIPTION:
PANEL #: 3 FLOOD ZONE: X- —
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTHT: YES or g(BED#): DTE:—/—/ PERMIT#:R10-
TOWN SEPTIC RECEIPT: Y oru
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or
SOUTHOLD TOWN TRUSTEES: YES o
TOWN ZONING BOARD APPROVAL: YES o
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES o O
NYS ENERGY: YES ORoy.
H
EGRESS (18 min.? 4 sq-Total) VENT(SQ. FT. x 4%) + LIGHT (SQ. FT. x 8%) ^J1/j,
BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- ,
HAVE PRE CO'S : Y O BP -Z/C/o Z- ,
NOTES:
FEE STRUCTURE: FOUNDATION: 30o SF
FIRSTFLOOR: I;bo SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: $So SF FEE FEE FEE
1. ( �' SF)- ( SF)= SFX $ =$ +$ +$ = $ ira
2. ( SF)- (_ SF)= SFX$ =$ +$ +$ =$
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W F _j Z N
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REMOVE PANTRY APPIANCES, CABINETS
COUNTERTOPS,AND FLOOR AND WALL
FINISHES
REMOVE EX'G WALL FOR NEW WINDOWS W
PROVIDE SHORING AND SUPPORT AS pz
REQ'D UNTIL LINTEL INSTALLED-SEE S101 .FINN
I
REMOVE EX'G WINDOWS, FRAMES AND
SASHES&SAVE FOR REUSE-PROVIDE
L _L� 0J I I I j I PROTECTION FROM WEATHER e�
II I II
UP DN F — --REMOVE EX'G DOOR&JAMB-SAVE FOR
\� II REUSE
F- \ w
I —�—REMOVE EX'G WALL- PROVIDE SHORING w)
I I I AND SUPPORT AS REQ'D UNTIL LINTEL IS pm
F - --- - �_� I I I INSTALLED-SEES101 �y
I II
eftJ�� i REMOVE KITCHEN APPIANCES, CABINETS
� �_ COUNTERTOPS, AND FLOOR AND WALL
` FINISHES
REMOVE EX'G WINDOW,JAMB I '� I I --- �4
&TRIM AND SAVE FOR REDS M - ,-) \ / —REMOVE EX'G WINDOWS, FRAMES AND ISI •�
III �, `\1p�p '—REMOVE
&SAVE FOR REUSE- PROVIDE [�
�\ PROTECTION FROM WEATHER [�
REMOVE EX'G WALL-PROVIDE SHORING
II III I
7A
\� \ AND SUPPORT AS REQ'D UNTIL LINTEL IS
may\ INSTALLED- SEE S101
\-----RELOCATE PROPANE NO ISSUE DME
01
II
_4p
-----REMOVE GARBAGE CAN STORAGE
ENCLOSURE oz
03
REMOVE EX'G FENCE
\ -REMOVE ENTIRE EX'G EATING AREA
AS SHOWN INCLUDING ANY
FOUNDATIONS AS REQ'D FOR _
INSTALLATION OF NEW
REMOVE EX'G WOOD PORCH&FOOTING FOUNDATIONS AND FEB. 25
FRAMING-PROVIDE PROTECTION 2002
REMOVE EX'G DOORS&JAMB-SAE. FROM WEATHER
REUSE
�P
O
'u
f
O�
' ND. 019 " -�
DEMO LEGEND gTFOF �'
O DEMOLITION PLAN WALLS TO BE DEMOLITION
DEMOLISHED PLAN
D- 100
m
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