HomeMy WebLinkAbout32574-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32234
Date: 03/08/07
THIS CERTIFIES that the building ADDITION
Location of Property: PRIVATE RD FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 7 Block 4 Lot 9
Subdivision Filed Map NO. __ LOt No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 21, 2006 pursuant to which
Building Permit NO. 32574-Z dated DECEMBER 21, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DOROTHY M CORBIERE
(OWNER)
of the aforesaid building.
SUFFOLK COUNT~ DEPARTMENT OF H]L%LTH APPROVi~L
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~u
N/A
3016413 12/26/06
01/12/07 GLENN GELLO
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. 32574 Z Date DECEMBER 21, 2006
Permission is hereby granted to:
for :
ADDITION.
DOROTHY M CORBIERE
198 NEWTON STREET
WESTON,MA 02193
THIS PERMIT REPLACES BP 15373.
at premises located at
County Tax Map No. 473889 Section 007
pursuant to application dated DECEMBER
Building Inspector to expire on JUlqE
Fee $ 150.00
PRIVATE RD FISHERS ISLAND
Block 0004 Lot No. 009
21, 2006 and approved by the
21, 2008 .
~---~0ri~ed~=~ re
ORIGINAL
Rev. 5/8/02
I~OB~ NO. It
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)
15373 Z
Permission is hereby granted to:
,
.~...~...~.. ............... ., .......................... ,4, ~. ~
at premises located at ......................................................................................................................
~ursuont to ~pplication dated ............. , 19.~..~, and approved by the
~luil~ Inspector.
~...~..~
Fee $.~...~...~ .........
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
APPLICATION FOR CERTIFICATE OF
DATE ...... 2/27/90 ...........
NEW CONSTRUCTION ..... OLD OR PRE-EXISTING STRUCTURE.X...VACANT LAND ......
Location of Property...Private Dr.off East End Ave ........ Fishers Island
HOUSE NO. STREET HAMLET
Owner or Owners of Property...Adrian Corbiere ...........................
County Tax Map No. 1000 Section..7 .... Block...4..Lot...9 .....
Subdivision ................... Filed Map .......... Lot ............
Permit No..15373Z ....... Date of Permit..10/7/86...Applicant A.J. Gada ....
Health Dept. Approval ................ Underwiters Approval .................
Planning Board Approval .......................
Request for Temporary Certificate ........ Final Certificate ..... X ..........
Fee Submitted .... $25.00 ............
Applicant. A. John Gada General Contracting, Inc .....
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.:
765-1803
. -] t._l
., 19 7~.L, Received ........... ,19...
., 19~. Permit No./.~,~.~.~..~..~ ~
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date....?./A ~: ........ 197..~
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 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 wk01e 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 Buil,~ing 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.
· .A.,..J.o.h..n..G.a.d..a..G.e.n. ~.u.a.l. Cp.r~ ~.c.~.iog.,..I~C-
(Signature of applicant, or name, if a corporation)
Drawer B
· 'Fi~'bers' ~,~n~,~ ' NY' '0o6 39,~ ...............
uviamng address ox appncant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .. A~iaa..B,. a.nd. Do.r. othy..B,. C.or. Die.me ................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
Builder's License No .... .3.fi ...................
Plumber's License No. 46.2-,P ..................
Electrician's License No..Z9 6 =g ................
Other Trade's License No..2@1. /-II .............
I. Location of land on which proposed work will be done .... Dark..Area.,..Eishers. X.slanc% ................
House Number Street Hamlet
County Tax Map No. I000 Section ........ 7 ........ Block ...~$ ............. Lot.
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 ..... Resi.dencm ......................................................
b. Intended use and occupancy .... ResS..denc~ ......................................................
3. Nature of work (check which applicable): New Building .......... Addition .... ~ ..... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
(Description)
4. Estimated Cost... ~.7.0 t 000 ;.{30 ....................... Fee.~' ~.~,~.. ~.. '...
· (to be paid on filing this application)
5. If dwelling, number of dwelling units ......... t ...... Number of dwelling units on each floor ................
If garage, 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.. 2.4 .......... Rear . .3.6 .......... Depth .. ~ .4 ...........
Height ............... Number of Stories ...... 2 .................................................
Dimensions of same structure with alterations or additions: Front 3 @: d~". ......... Rear .... 40 .' 4.". ........
Depth .24.' .................. Height . .25 ! ................. Number of Stories .... .2 .................
8. Dimensions of entire new construction: Front J-...4. Rear ...4. '..4y. ....... Depth .2.4. .' ...........
Height 25.' ............ Number of Stories ...... 2. .................................................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
1 1. Zone or use district in which premises are situated .... re~i. denl:.i, al ....................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ... tm ..........................
13. Will lot be regraded . .No ........................ Will excess fill be removed from premises: Yes x No
14. Name of Owner of premises~,,13,..Corbi~re ..... Address ?J.~her~..I ~ J.~.rlc].. Phone No. 7.~{3:-.7.~5.4 ......
Name of Architect ........................... Address ................... Phone No ................
Name of Contractor .~.. ~'.qho. g.a.c~ ........... Address .F.i.s.h..e .r.s..I..s.l.a.n.d... Phone No. 7..8.87.7.2.3..1 ......
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEWcYO.R~K,
COUNTY OF. ~.t¢ c.~.~.,-.~._~f: , ..... S.S
........ .,).C.q.~!...(~..~.~..,~....3..*... .............. being duly sworn, deposes and says that he is the applicant
(Nam%ol~,individual signing contract)
above named. ~
He is the ..... L..t).~.i7~..4 ~?/-. [~. .....................................................................
(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 file 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
........ zJ:. . ,,.:. x. r.._. ...... ,
Notary Public, ..i'. ( .t~.~..~?'?. ~?; .~ ~./~.. ....... County
· ' 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 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. F~rexistingbui~dings(~ri~rt~Apri~9~~957)n~n-c~nf~rming~ses~~rbui~dingsand"pre-existing~landuses:
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 masons 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. 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
Date. 12-13-06
New Construction: x
Location of Property:
Old or Pre-existing Building:
(check one)
Fishers Island
House No. Street
Adrian and Dorothy Corbiere
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 007
Subdivision
Permit No.
Date or'Permit. 10-7-87
Health Dept. Approval:
Planning Board Approval:
Block 4 Lot
Filed Map. Lot:
.Applicant: unknown
Underwriters Approval:
Hamlet
9 ~
Request for: Temporary Certificate
Fee Submitted: $ 25.00
Final Certificate: x (check one)
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
DOROTHY CORBIERE DOROTHY CORBIERE
198 NEWTON ST 198 NEVVTON ST
WESTERN, NY 02493 WESTERN, MA 02493
Located at EASTEND RD FISHERS ISLAND, NY 06390
Application Number: 3016413 Certificate Number: 3016413
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, Second Floor, Outside,
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 jurisdiction, and found to be in compliance therewith on the 26th Day of December, 2006.
Name QTY Rate Rating Circuit Type
Miscellaneous
as built 1999
Wiring and Devices
Outlet 11 0 Fixture
Fixture 8 0 Incandescent
Fixture 3 0 Flourescent
Outlet 20 0 General Purpose
Receptacle 11 0 General Purpose
Switch 6 0 General Purpose
Receptacle 2 0 GFCI
An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to
be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
seal
1 of 1
This certificate may not be altered m 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
$OUTtlOLD, N.?. 11971
C E R T I F I C A-T I 0 N
TEL. 765-i 802
Building Per~it NO. '~'-~ ~x~t'~ ~Z.
· (please print)
(please print)
Date
i certify that the solder used in the water supply sYstem
contains l~ss than 2/10 of 1% .lead. .
.(plumber's signature)
Sworn to before me this
~day of ~~ ,.
· Notary. Public ,~/~ County
,Yf NO ~a~y Publi~
ROXANNE SRAULDING
NOTARY PUB'LIC, sTATE OF NEW YORK
· No t]ISP§I ~3942
.I (~UA[ {I Ilil) iN SUI[101, K COUN I'Y !
ATTORNEYS AND COUNSELORS AT LAW
38 NUGENT STREET
January19,2007
Mr. Gary Fish
Town of Southold Building Depadment
P.O. Box1179
Southold, NY 11971
Re: Building Permit No. 32574 Z;
Dorothy Corbiere; SCTM No. 1000-7-4-9
Dear Gary:
In connection with closing out of the referenced open permit, I have enclosed
an original executed architect's certification by Evelyn Cole Smith and an original solder
certification by plumber Glenn Gello.
Please give me a call to let me know what further steps must be taken,
documents provided or payments made, if any, before you can issue a Cedificate of
Occupancy for the addition at the referenced property.
Sincerely,
Stephen L. Ham, III
Enclosures
CME Architecture, Inc.
Woodstock, CT 06281
(860) 928-7848 FAX (860) 928-7846
January2,2007
Gary Fish
Town of Southold
Building Department
Town Hall
53095 Main Street
P.O. Box 1179
Soutitold, NY 11971
Re: Corbiere Residence
Private Road
Fishers Island, NY 11971
Dear Mr. Fish,
Please be advised that to the best of my understanding and knowledge, work related to
the construction of an addition at the above referenced residence (County Tax map no.
473889, Section 007, Block 0004, Lot No. 009) has been completed in accordance with
the applicable codes of the State of New York.
~vel~n-~al'~ Smi'th~, ' ' - a ) Date
NY architectural license nm~r 029794
The foregoing instrument was signed and acknowledged
Before me this ,o~4~ day of ~ t2/YLIACX~-/ 20 0 ~.
Notary publi~ j
State of Connecticut [~ItNCY
M~rA~Y
My comm:ssion expiresMYcO~Iss~°N EXPIRES
Toll Free 1-888-291-3227 Afl Equal Opportunity Employer www.cmeengineering.com
03/05/2007 13:22 ~AX 631 788 7798 FISHERS ISLAND UTILITY
TOWN OF SOUTHOLD BUILDING DEPT.
765- t 802
INSPECTION
~002
FOUNDATION 1ST [ ] ROUGH PLBG,
FOUNDATION ~ND [ ] INSULATION
FRAMING / STRAPPING [ ,~'~NAL
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
DATE
03-05-2007 13:22 SOUTHOLD BUILDIN$ DEPT 1~317659502 PAGE2
TOWN OF SOUTHOLD BUILDING DEPT.
765-t 802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [~/]~INAL~/~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
DATE
/ //
INSPECTOR~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS~JLATION
[ ] FRAMING/STRAPPING [ ,~FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
CME CME Architecture, Inc.
Woodstock, CT 06281
(860) 928-7848 FAX (860) 928-7846
January 2, 2007
Gary Fish
Town of Southold
Building Department
Town Hall
53095 Main Street
P.O. Box 1179
Southold, NY 11971
Re: Corbiere Residence
Private Road
Fishers Island, NY 11971
Dear Mr. Fish,
Please be advised that to the best of my understanding and knowledge, work related to
the construction of an addition at the above referenced residence (County Tax map no.
473889, Section 007, Block 0004, Lot No. 009) has been completed in accordance with
the applicable codes of the State of New York.
~velyn ~ole SmiYr~, ~
NY architectural license numb/er 029794
The foregoing instrument was signed and acknowledged
Before me this day of
Notary public
Date
20
State of Connecticut
My commission expires
Toll Free 1-888-291-3227 An Equal Opportunity Employer www.cmeengineering.com
CME Architecture,'Inc.
Woodstock, CT 06281
(860) 928-7848 FAX (860) 928-7846
December 13, 2006
u :u I 8
Building Department
Town of Southold
53095 Route 25
P.O. Box 1179
Southold, NY 11971
Re: Corbiere Residence, Fishers Island
To Whom It May Concern,
Please find attached the Application for Certificate of Occupancy and associated fee of
$25.00 for the Corbiere Residence addition, District 1000, Section 007, Block 4, Lot 9
and 10.
In addition to this application we are submitting payment of $150 for renewal of building
permit # 15373 issued on 10-7-87.
Please notify me, as agent of the owner, if you require additional information and to
inform me that the Certificate of Occupancy has been issued.
Thank you for your attention to this matter.
Cc: Dorothy Corbiere
Encl.
Toll Free 1-888-291-3227 An Equal Opportunity Employer www.cmeengineering.com
TOWN
OF SOUTHOLD
PROPERTY
RECORD CARD'
OWNER
FOR~.ER/ OWNER
STREET
RES. Z./o SEZS.
L~ND IMP.
TOTAL
VILLAGE
I FARM COMM.
DATE REMARKS
AC~L~
TYPE OF BUILDING
SUB. LOT
CB. MICS. Mkt. Value
! ! I
r-L I
Tillable FRONTAGE ON WATER
Woodland ,.. .., ~ & _ ,. FRONTAGE ON ROAD
Meadowland
House Plot
Total
DEPTH
BU LKH EAD
COLOR
TRIM
M. Bldg.
Extension
Extension
Extension
Foundation Both
Porch Basement Floors
Porch ~t. Walls Interior Finish
Breezeway :ire Place Heat
Garage
rype Roof
~,ooms 1st Floor
inette
DR.
BR.
Patio ~,ecreation Room ~,Ooms 2nd Floor FIN. B
O.B. )ormer Driveway
Total
/~-*~~7 ~ /~? TOWN_ _ OF SOUTHOLD PROPERTY RECORD CARD //
DWNE~, STREET VILLAGE DIST. SUB. LOT
W ~ ~PE OF BUILDING
ES. S~S. ~L. ~/f FARM COMM. CB. MISC. Mkt. Value
~ND IMP. TOTAL DATE REMARKS
' ~/
AGE BUILDING CONDITION
N~ NORMAL BELOW ABOVE
FARM Acre V~lue Per Veiue
Ac re
'illoble 1
'ill,hie 2
illoble 3
w~mplond FRONTAGE ON WATER
r~_s~lend , FRONTAGE ON ROAD
louse Plot DEPTH
~ULKH~D
'o~ DOCK
M. Bldg.
Extension
E t ~g~_~
xtens[on
Extension
Porch
Porch
Breezeway
Garage
Patio
TotaJ
24,,,2/4
(ZOLOR
~tion
Basement
~xt. Walls
Fire Place
Type Roof
Recreation Roorr
Dormer
Driveway
Bath
Floors
Interior Finish
Heat
Rooms Ist Floor
Rooms 2nd Floor
Dinette
LR.
i DR-
BR.
FiN. B.