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Home My WebLink About31830-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold. N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31514 Date: 04/04/06 THIS CERTIFIES that the building ALTERATION/ALTERATION Location of Property: OFF MANSION HOUSE DR FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 8, 2006 pursuant to which Building Permit No. 31830-Z dated MARCH 8, 2006 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 KITCHEN AND STORAGE ADDITION/ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JENNIFER MILLER & OTHERS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 H 027696 03/20/92 N/A Si Form No. 6 TOWN OF SOUTHOLD 17 r Yn BUILDING DEPARTMENT vui dil U TOWN HALL 765-1802 1 APPILICATION 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 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. A properly completed application and 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 � opy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New New Construction: Location of Property: No. Date. 3 - 2 - Old or Pre-existing Building: �_ (check one) �_ MMM Street SLi 1 k&to ), Hamlet Owner or Owners of Property:y e ti n a✓ �� ti J �( tr ( cr G />� f a✓ QQ Suffolk County Tax Map No 1000, Section_ Block Lot U Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for; Temporary Certificai.c va Fee Submitted: $ -2-4 �eC_69g/7 Filed Map. _ Applicant:_ Underwriters Approval: Lot: Final Certificate: (check one) Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. 1.1816"341 !]14:43-l" (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31830 Z Date MARCH 8, 2006 Permission is hereby granted to: JENNIFER MILLER L90 MAIN ST WATERTOWN,CT 06795 for : KITCHEN AND STORAGE. THIS PERMIT REPLACES BP 17 at premises located at OFF MANSION HOUSE DR FISHERS ISLAND County Tax Map No. 473889 Section 009 Block 0001 Lot No. 008 pursuant to application dated MARCH 8, 2006 and approved by the Building Inspector to expire on SEPTEMBER 8, 2007. Fee $ 150.00 4 � Authorized Signature ORIGINAL Rev. 5/8/02 POEM NO. 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) No 17 6 y 9 Z Date ....�lc........1..(............... 19...8.6 .., Permission is hereby granted to: ....................... k .................. `_ �j...................:�/1 ..................... to .............. /!.?%1......�i ........./.. ...:.....%. atpremises located at.................................................................................... .......................... ....r�.............................................. ....... County Tax Map No. 1000 Section ............ ......... Block ........ I........... pursuant to application dated..ev'40. ............. Building Inspector. Fee Rev. 6/30/80 ........................................ Lot No. ..... G .............. 1951, and approved by the ��,.....:... ., Building Inspector l HE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 28 BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 re MARCH 20,1992 Application No. on file 68636590/90 H 027696 RTIFIES THAT electrical equipment w described below and introduced by the applicant named on the above application number in thepremises of [DWIGHTHILLER, MILLER, PRIVATE RD., FISHER ISLAND, N.Y. lowing location. ❑ Bwement ® Ist Ff. ❑ 2nd Fl• OUT .Section Block Lot ined on MARCH 17,1992 andfound to be in conipliarrre with the requirentents of this Board. KE►TACLES RXTURES COOKING DECKS OVENS DISH SWI7CNE5 WASHERS EXHAUST FANS INCANDESCENT FLuce S Ni OTNEH AMT. K. W. AMI. K. W. AMI. K.W AMi. K. W.1 A 1 1.2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SP9CIALREC'PTj TIME CLOCKS I BELL TRANS. UNIT HEATERS MULTI -OUTLET SYSTEMS NO. Of FEET DIMMERS AMr.K.W. at H. P. GAS H.I. AML NO. A.W.G. MM1L /JAr. r T' AMPS. T. H.r. AMT. WAITS 1 30 SERVICE DISCONNECT NO -OF I S E R V t C E AML. AMP. TYPE METER EQUIP. I R ]W 1 $ 3W J $ ]W J $ AW NO. Of CG COND. A. W G NO. Of HbIFG A W. G' NO. OF NEUTRA S A. W. G. IER! OF CC.COHD. OF HI EO OF NEUTRAL OTHER APPARATUS: G.F.C.I:-1 SMOKE DETECTORt-1 DWIGHT MILLER P.O.BOX 628 FISHER ISLAND, NY, 06390 GENERAL MANAGER �v 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 03/22/2006 10:31 FAX 691 788 7798 g3o Z �(i je 00 � FPic,l-?HOT . TOWN OF: SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: IV -� ®Ae d- ® 0 Of DATE ®�' INSPECTOR ��'f 2002 - Y� yti• dam• . •.� �� 0 A Y i N'ai b�i i TOWN OF SOUTHOLD PROPERTY RECORD CARD ; OWNER STREET VILLAGE DIST. SUB. LOT L Q C� �% o• (_ FORMER OWNER N E ACR. ^ W TYPE OF BUILDING zt- RES. SEAS. �/� VL. (FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS / 2- l b J� 6 Sona oar°" /vr� .- 300 J -4-(-)e)5 ! 154 -44 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushlond FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total DOCK FORM NO. 1 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: ,,72265-1802 Examined ................. 19 ... v Approved D,GE..` ....... 19�„//. Pcrmit No. J..716../..�7Z Disapproved a/c ..................................... ................................. (Building Inspector) BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: APPLICATION FOR BUILDING PERMIT Date ...��. - �... ....... 15 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street - 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 Buildin, 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, bind r:g code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecti s. (Signature c) 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. Gi?suL�L ............................................................................ Name of owner of premises (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. 4.......... .... .. yt/ Plumber's Licence Nc. ........................ Electrician's License No. .. ....... Other Trade's License No . ..................... 1. Location of land on which proposed work will c done. ......... 1—S,S /f fiS is iJ iv.j} ...........�.... ............................. House Number Street ` Hamlet County Tax Map No. 1000 Section ......... Block ..6..i. . ' ..... Lot.. e�,.............. Subdivision ..................................... Filed Map No.. .......... Lot ............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......L b. Intended use and occupancy .... L� C �t �� "YS OZ R (9 ............................ 3. Nature of work (check which applicable): New Building ..... *..... Addition ....Y.. • • • Alteration .'i! .... . Repair .............. Removal .............. Demolition .............. Other Work ............. (Description) f 4. Estimated Cost ... �l_l� o u c. c .................. Fee ...,,5.-0.., � �............... . (to be paid on filing this application) 5. If dwelling, number of dwelling; units .... %.......... Number of dwelling units on each floor ................ Ifgarage, number of cars ............ ........................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number ofStories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number ofStories ............................................ ........... 9. Size of lot: Front ...................... Rear...................... Depth ..................... 10. Date of Purchase ............................. Name of Former Owner ........................... . 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 N 14. Name of Owner of premises )i� ? G �T `.'' `2A ')Address ............ Phone No ............... Name of Architect Du!�(t? 2: `Z1 ��..:..... Address'OAI.. ��....... Phone No ............... Name of Contractor .......................... Address ................... Phone No............ 15.Is this property located within 300 feet of a tidal wetland? *YES .... NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set -back dimensions frorr property Lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF l.; �r.,a� • OR" COUNTY OF . Y.loindividual .. .. "'S ....� � ............ (Name signing contract) above named. He is the . being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Erle this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner,set forth in the application filed therewith. Sworn to before me this I I .............. F.�....... day ..... ,........ ,19� Notary Public, ........... _- ,` ` ...... County �. EILtS^" C Notary Public, Sle!o �t 4-W York (Signature of applicant) No, oJ p ouali!i.6 i, Sudo"3�cou9!yr ( O Term Exolres .Y1�s��, 0 11, • 3 1 64: ----- qai {�1�i.4vr p(ant3 }f{fi, �aIIoN� L" III V, I. 9 0 PLUMBER CERTIFICATION FORE ON LEAD CONTE UPANCY CERTIFICATE of ar SODER USED NWATER SUP>'LY SYSTEM CANNOT l EXCEED 2/10 41% UAD, I 42- !i I� �f li copper tubing is used for water distributing. system: Piping shall be �l of typos K er L onl 3/ X30 APPROVEDAS NOTEDpay DATES: B.P. N� /l�J��/2[1�/'Z FEE. BY: Lam"' ' L7" NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1._ FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE, FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY OR • USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 4xl.AIJ,a,Ns �3s clrdn4aN �,iRtf.: rin*�ioav-� , eaurJ�Pr(aGuj 44'SI� , f i 1� 4A d1 rG'RAM.�-i' NMR. V✓t.�oS -_. _ ._.—___�_ �I2.a GM,d "{o tknrYi�r?�'ril, — 1 I Ilenb"c•�v .1owa .lii6 I I I �.t j.ice" G q �`GiLlrw� 0` D XUu� �M+c-C w Y NG r{ U ,..0 w/ R -0,, ` 6.6df x,3 I, T 2b �y°�owt �w.�eve � n �v�'4>•..� v�e.«o-vti�e N g 'bu HN,, e� f r1 � 9 (I aN� rfAy Ittu } 2" OR v$IS 12�LAVVFUL 'ITHOUT CERTIFICATE OF OCCUPANCY N I '�i`j*` ,-. d'1n GC LULLV STtK it 'fu��(>•- �Onap Evc¢Y nP+E=Jl+,ul ID✓n �.OY+Jnnn -�� ( --� LAM -J,� �4Ca.W,.� HAnww a q�'q.grLnnwq x Ind I� •mw.a. 61 a•.Itn v4Y Iinur. 410.] HmobKeA Co11uun� block CAntllevvreA wall u N/l, a: 111 (0 61.1, u: d,lh .1 1mM..1—h--, :, gmele9 the N, c rclnlmie eM Len for H b;u lbm, 6 Il 11 n 110. 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