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34176-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33651 I~ate: 04/17/09 THIS c~KTIFIES that the building ADDITIONS Location of Property: 605 FOUNDERS PATH (EOUSE NO.) (STREET)' Co%unty Tac( Map No. 473889 Section 64 Block 2 Subdivision Filed Map No. __ Lot No. -- SOUTHOLD Lot 37 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 2008 pursuant to which Building Permit No. 34176-Z dated SEPTEMBER 19, 2008 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, INCLUDING UNHEATED SUN PORCH AND FIREPLACE, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ARTHUR W RATHJE III & WF ( OWNER ) of the aforesaid building. SUFFOLK CODlqTY DEPART~NT OF H]~ALTH APPROVAL N/A ~.Rt-rKICAL CERTIFICATE NO. 4024300 03/06/09 PLUMBERS CERTIFICATION DA'r~u N/A /~o r~ed Signature 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 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. 2. A properly completed application and consent to inspect signed by the applicant. Ifa 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, 3. 4. 5. Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . Date. ~/~ ~/~ ~;~ (check one) Old or Pre-existing Building: DateofPermit. 9-I 5-c8 Street Hamlet New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~t~ Block o~ Lot 37 Filed Map. Lot: Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Appl4~ant~i~matur[ 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 ARTHUR RATHJE ARTHUR RATHJE 4 HARBOR VIEW RD 4 HARBOR VIEW RD SCITUATE MA 02066 SCITUATE, MA 02066 Located at 605 FOUNDERS PATH SOUTHOLD, NY 11971 Number: Certificate Number: 4024300 Application 4024300 Section: Block: Lot: Building Permit: 11601Z BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, family room,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 the6th Day of March, 2009. Name QTY Rate Rating Circuits Type Miscellaneous sun room as built 1982 Wiring And Devices Fixture I 0 Incandescent Outlet 1 0 Fixture Outlet 9 0 Gen, Purpose Receptacle 8 0 Gen, Purpose Switch 2 0 Gert, Purpose seal I 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. 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. 34176 Z Date SEPTEMBER 19, 2008 Permission is hereby granted to: ARTHUR W RATHJE III & ANO TRUS 4 HARBOR VIEW RD SCITUATE,MA 02066 for : CONSTRUCT ADDITION TO EXISTING ONE FAMILY DWELLING & ADD FIREPLACE THIS PERMIT REPLACES BP 11601. at premises located at 605 FOUNDERS PATH SOUTHOLD County Tax Map No. 473889 Section 064 Block 0002 Lot No. 037 pursuant to application dated SEPTEMBER 19, 2008 and approved by the Building Inspector to expire on MARCH 19, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........ .,,.~..~.~.~..~2,~/.d..,...~....~.: ............ : ,o ........ . . . .~ ~. q . d~. z~ ~ ¢. . . . ~ . . . . o~. ~. . . . .~,~. . ~ ......................... '"" at premise, located at ~'~.......~...~.-~..~__J~l~.~,.~.......~/~. ......................................... .............................................................................................. .~...~..~.¥,~./.~..m..:~.. ....... .~. . ~_.~. ,~.~.,~. . .. ~~. . . .~. . . d~. .~: ............... ~ ~.. .(:;~ ............ '. ........ County Tax Map No. 1000 Section ...~.~...~... ....... Block ....~.~.. ........Lot No. ~...5..~.. ......... pursuant to application doted .~.~J.~.....~ ......... , 19~......~, and approved by the Building Inspector. Rev. 6~30/80 1,4, 64.° 05' C,O" ~'' ZZXz ~. 64' 0500"W. MAP OF 5U~VSYED MILLICENT 50tJTl--I OL.~ LAI'4 D SALMON l~C.O A/ / / / / Guarc~'{'ecd +o +he H,.~rr~, Ti-l-!e. ~ivis~ot~ - ~h VA~4 TL.~'L& 50I.,~ TOWN ~OF SOUTHOLD ffROPERTY RECORD CARD FORMER ~WNER N S VILLAGE / W DISTRICT SUB. ACREAGE ../7,~ TYPE OF BUILDING LOT MISC. VL. LAND IMP. d'"~,~oE NEW Farm Tillable Tillable 2 Tillable. 3 Woodland Swampland B rushl~llit House Plot NORMAL Acre FARM COMM. I N D. CB. TOTAL DATE REMARKS ~ , --. ? ,~ 9-3 oO 4:~/,.z. /~ ~,'.-~ ~//d/"~',~~,o-n-~ BUILDING CONDITION ~ //hx/o~- ~r~r .~d ( _ B[kOW ABOV[ Value Per Acre Value xtension ! ~t. Walls ~ ~ ~ Interior Finish Porc~ Attic Porch Rooms ]st Floor ,r~zeway Patio ~ms 2nd Flor ).B. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [~]INSULATION- [ ] FRAMING / STRAPPING [ .-~INAL ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR ~'~ ~ FIELD INSPECTION. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION RER N. STATE ENERGY ~9DE FINAL COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, r.!.Y. 11971 TEL.: 765-1202 APPLICATION FOR BUILDING PERMIT Application No..K"'/~.O./. ...... Date /'~/~" °~.d-5 / ~°c '~ 19. INSTRUCTIONS a. Tbis application must be completely filled in by typewriter or in ink and submitted in triplicate to th~"Bui~ 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 stre or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part of this api cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc'.'aI of this application, the Building Inspector will issue a Building Permit to the applicaut. Such pen shall be kept on tlm premises available for inspection throughout the work. e. No buildiug shall be occupied or used in whole or in part for any purpose whatever until a Certificate of O¢cupar sb~l bare been granted by the Boilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ~ The applicant agree~; to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises,and in buildings for necessarT, inspections. ..~ ~ (Signature of appticfffit, t~(-'fiJme, ii' a corporation) ' (Mailing address of aPplicant) - State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Nmne of owner of premises . .{.7.K.-.>. :L~'/('~./.~...~....~.0:~--/'~'~,. ~/.D~. ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer. (Name and title of corporate officer) Builder's License No ..... .~..~.2F2.~"..,V7... ......... Plumber's License N~ ....... .;~.?;~,.¢'~ ........ Electrician's License No. ~.~lt...4q~4tt?Xd4~.~?.. Other Trade's License No ...................... . . b. Intended use and occupancy 1. Location of land on which proposed work will be done ................................................ · .oT.&. h%, ...... / ............... _b ................ House Number Street Hamlet County Tax blap No. iO00Section ~:~d"~-- Block . 0..¢~.. Lot ~.~..~.: Subdivision .~..)c{/¢:1q~4~'.~....~-%' ... FiledMap.o..~:~,~,~4(. ....... Lot ..~..: ....... (Name) 2. State existing use and occupancy of premises and intended use amt occupancy of proposed construction: a. Existing use and occupancy ....... /gq( ...~.'f'..5' ffd4'~ .~__.~ ' . .......................... o I./ ' ;. Nature ef ~ocl< (ct~ecl¢. ~h~¢h apglicable): New fi~ildiag .......... 'Aedltioo: ~ .... '.. ~{{e~ti:~ ......... Repair .............. Removal .............. Demolition .............. Other Work ...... ; ....... (Description) ..... ........... ,.. .................... ~ ~ (to be paid on filing ttfis application) ;.If d'.ve!liag, number of dwelling units./.*q~ .'r.~?f~e~er of dwelling Units on each floor: .............. If garage, number of cars ................................... 2 ................................... i. If business, commercial or mixed occupancy, spec~y fiature and extent of each type of use .................... ~. Dimensions of existing structures, if any: Front... ~d 5..: ..... Rear ...~O.~ ........ Depth .&q( .... ; .... Height ............... Number of Stories ... ~ ...................... ;... i ............... , ...... Dimensions of same structure witli alterations or additions: Front ..... Of~ ......... Rear.. ~O ............ Depth ........ ~ ~ ......... Hei~tt .... ~.~ ............... Number of Stories...Z ................. ~. Dimensions of entire new construction: Front .... ~& ........ Rear ... ~o ......... Depth .. ~2 ......... Height ............... Number of Stories .... ~. ........ : ..... . .......... ........................ }. Size of lot: Front ..... 5F~ ..... '.. ......... Rear ....... ~.: ........ :. Depth ; .XO7~-' ~ ............ ). Date 6r Purchase ............................. Name of Foyer Owner :.~'2~l~e~. ~ I~c,'~ ...... I. Zone or use district in which premises are situated... 2 .................... · .......... ~:' .........- ........ !. Does proposed construction violate any zoning law, ordinance or regulation: .... ~¢~ ...................... l. %~g lot be regrad~d ...... ~ ................... W~ll excess fill be r~moved fr~m premises: . Yes t. Nmne of Owner o f premises ~J~'~.~; j~ 0 ~.~. Address ~Name of Architect . .~.< .~'q'(~ ........... '.. Address ...... ... 2 ..... ;... 2 Phone No ............... ~of Contractor ..... ~W~ .............. Address .................. , Phone No ............... PLOT DIAGRAM - ~ Locate clearly and distinctly all or ildings, whether' existing or proposed, and. indicate all set-back dimensior[s fr property lines. Give street and block number or description according to deed, and show street names'and indicate Whet interior or corner lot. u,~ame oi ~ndnqdual signigg contrarao above named. /4 e is the .................. ~).~ ............................. (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 tkis ~xpplication; that all statements contained in tliis application are true to the best of his knowledge and belief; and that the Work will be performed in the manner set forth h~ the application filed therewith. ,Stvom to before me this ........ {. · · .'~. · .........day of... ~. · .~.. ........... 19 .~..~-- -- .... P,/otary Public, APPB©¥ED AS NOTIFY BUILDIh'G PEPART~ENT AT 765-1802 9 A~A Tq 4 PM FOR THE CODES N~T RESPONSfBLE FOR ~[~IGN OR ~ONSTRUCTION ERRORS.