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Home My WebLink About34303-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34718 Rte: 11/30/10 THIS C~KTIFIES that the building SCREENED PORCH Location of Prc~erty: MADELINE AVE (HOUSE NO.) (STREET) Cotmt¥ Tax ~p No. 473889 Section 6 Block 7 subdivision Filed Map No. __ Lot NO. FISHERS ISLI%ND Lot 12 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 18, 2008 pursuant to which Building Permit No. 34303-Z dated NOVEMBER 18, 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 SCREENED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LOUISE BURNHAM PACKARD & ORS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPART~4~NT OF H]~ALTH APPROVAL EI~L-£KICAL C~KTIFICATE NO. ~L~E~S CERTIFICATION DA'£~U ~/a N/A Rev. 1/81 t ~/u t ~/i z e d'~"l gna t u r e FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34303 Z Date NOVEMBER 18, 2008 Permission is hereby granted to: LOUISE BURNHAM PACKARD 26 DEXTER RD LEXINGTON,MA 02420 for : CONSTRUCTION OF A PORCH ADDITION AS APPLIED FOR. THIS PERMIT REPLACES 31838. at premises located at MADELINE AVE FISHERS ISLAND County Tax Map No. 473889 Section 006 Block 0007 Lot No. 012 pursuant to application dated NOVEMBER 18, 2008 and approved by the Building Inspector to expire on MA__Y 18__, 201__0~/ Fees 150.00 AuqTh-6~zed Signature ORIGINAL Rev. 5/8/02 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. ~3q~38 Z Date MARCH 10, 2006 Permission is hereby granted to: LOUISE BURNHAM PACKARD 26 DEXTER RD LEXINGTON,MA 02420 for : CONSTRUCTION OF A PORCH ADDITION AS APPLIED FOR. THIS PERMIT REPLACES #10244Z & 28645Z. at premises located at County Tax Map No. 473889 Section 006 pursuant to application dated MARCH MADELINE AVE FISHERS ISLAND Block 0007 Lot No. 012 10, 2006 and approved by the Building Inspector to expire on SEPTEMBER 10, 2007. Fee S 180.00 ~~//~ Au~qo ~'z~Siq~.ture Rev. 5/8/02 ORIGINAL FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS PERMIT NO. BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) -~6~4~5 Z ~0~ Date AUGUST 12, 2002 Permission is hereby granted to: STEPHEN T & ORS BURNFLAM ARLINGTON,MA 02174 for : CONSTRUCTION OF A PORCH ADDITION AS APPLIED FOR. THIS PERMIT REPLACES PERMIT f~ ~b~ at premises located at County Tax Map No. 473889 Section 006 pursuant to application dated AUGUST Building Inspector to expire on FEBRUARY MADELINE AVE FISHERS ISLAND Block 0007 Lot No. 012 12, 2002 and approved by the 12, 2004. Fee $ 150.00 Rev. 5/8/02 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICAI'E OF OCCUPANCY This application must be filled in by typewriter or ink aad submitted to the Building Department with the A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusu: 3. 4. 5 topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certil}/ing that the solder used in system contains less than 2/10 of 1% lead. Commercial bnilding, i~dustria! build;ng mn!fip!e residences and similar buildings and installations, a r'ertifi~-ate of Code Compliance from architect or engineer responsible for the building. 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 applicalion 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 - Ne¢~ dweiiing $25.00. Additiol~s to dwelling $25.00, Alterations to dwelling $25.00, Sx~imming pool $25.00, Accessory buildiag $25.00, Additions !o accessory building $25.00, Bus nesses $500t ~ 2. Certificate ofOccupanc5 on Pre-existing BuiJding - $100.00 3. Copy of Certit~cate of Occupancy - $.25 4. Updated Certificate ct Occupancy - ac0.)0 5. Temporary Certificate of Occupancy - Residemial Si 5.00, Commercial $15.00 Ney, Construction: Old or Pre-existing Building: ~ (check one) Location of Property: l~e[,'...4.~r~,,~ Owner or Owners of Prope=y: ox4¢ Suffolk County Tax Map No 1000, Section Block Lot Subdivision ~ {3~-'~ ~ Filed Map. Lot: Permit No. ~ Date of Permit.. .... Applicant:_~e~Ok&,~ _~_5~_~_._t~_ ............ .~teaith Dept. Approval: ....... ~ lr~derwriters Approvah 1 lalniet Planning Board Approval: Reques! fbr: Temporary, Certificate .... Fih~[ Cci'tificate: (check one) COMMENTS ~IET,D INSPECTION REPORT ] DATE I FOUNDATION (1ST) FOUNDATION (2ND) ROUGH F~G & PLU~G ~S~ATION PER N. Y. STATE ENERGY CODE E~amised ................. , 19 .... approved .... ......... ]9 .... Disa~pxoved a/c .................................. BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORN ................... NOTIFY: ....................... INSTRUCTIONS a. This application n~st be coupletely filled in by L~riter or in ink and submitted to the I~:ilding Inspector wi 3 sets of plans, accurate plot plan to .scale. Fee according to schedule. b. Plot plan shc~ring location of lot and of buildings on premises, relationship to adjoining pr~xlses or public streets or areas, and giving a detailed description of la, ut of property uust be drmm on the diagram ~aich is parC of this application. c. The ~x~rk covered by this application [~ay ant be ccmmnced before issuance of Building Penuit. d. ~ approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such pamit shall be kept ee the premises available for inspection throngh~t the ~ork. e. No building shall be occupied or used in Tdcole or in part for m~y parpose ;~l-.ata~er tmtil a Certificate of Oceepan~ shall have been granted by [he Building I[mpector. APPLICATIC~I IS ~l Ked~ to the Building Deparcn~nt for the isanance of a Building Pemit poreoa~t to the Building Zeee Ordinanee of the Toan of S~thold, Suffolk Connty, Ne~ York, and other '~plicable La~, Ordinates or Regulatia~s, for the cop~t~uctian of buildings, additiorts or alterations, or for x~al or demolition, am herein described. The applicant agrees to cemply ~ith all appli,cable l~s~, ordine~ees, building cede, housing code, pj~isee and in buildi f S in tions. , ~.~igna~mr.e_ of..applic~.t, .or nam. if a corporation) (14aillng ~ress of applicant) State ~netber applic~t is o~er, lessee, agent, architect, engineer, geseral contractor, electrician, plmt~r or builder pr~nises (as an the tax mi1 or latest deed) .,' If applicant is a corporation, signature of duly authorized officer. (Nam and title of on~porate officer) Builders License No .......................... Ph~bers License No ........ ~ ................ Electricians License No. ....... ............. . Other Trade's License No ..................... 1. I~cation of land on ~ihida proposed vonk will be done .............................................................. ................................... ............................. .............. ttouse Ii ~e.r Street ,, Hmflet County TaxHap NO. I~(I) Section ..... O.6...~. ..... Block ...... .~..~. ..... Lot ..~.O. 1.~ ....... Subdivision ...................................... Filed ~ NO ................ l~t ..... ., ......... 2. State existing use and oconpam~ of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................... Repair ............ Removal ............. Demolition ............ Other klork ·" iDescription) (to be paid on filing this application) If d~elling, r~ber of d~elling onits . I lxlunt~r of d~elling mits on each Floor If garage, nanber of cars ........... !~. ........................ If lamlnass, ocmnerclal or miami occupancy, wpaeify nature mad extent of ead~ type of use ..... 7..' .............. Dimensions of existing structures, if any: Front ...... 2~ .* ...... Rear ....~ .......... DePth .. ~.d..t. ........ Ileight ~ ~ N~ber of Stories . ...~.. Dimensions of sam structure with alterations or additions: Front ..... ~.~. ...... Rear . Depth . ~ ~..* .... '. lteight .............. JO ........... Ixla~ber of Stories ..... .~ ........ Dimensions of entire ee~ construction: Front .... ............I g ~Rear ..... ~.~....... Depth .....~.~. ...... Deight .......... I[.*. .......... lxlmt~er of gtories ..... I ............... Size of lot: Front .................... Rear .................... I~epth .................... of ...... of ........... Zone or use district in ~ich pre~iee~ ere situatnd ..f.~..~.;.~...~....~. ............................................. Dees proposed construction violate any zoning 1~, ordln~ee or regulatlon: ...rl..O .................. }/ill lot be regraded ........ ~ ......... }/ill mmess fill be removed fron pr~iees: ~-~3 1~ - ~ of Ardntect .................................... /kldress ............................. Phone lxto ............... lqame of Controctor ................................... Nldress ............................... Phone No ............... Is this propert7 within 300 feet of a tidal ~etland? · ~ES .......... N0 . .X ..... PLOT DIAGKAN locate clearly and distinctly all buildings, ~t~ether existing or proposed, and indicate ail set-back dimensions propart7 lines. Gi~ street and block nuaber or description according to deed, and ;ho~ street nan, s and ~ticate ~aether interior or ~o~r lot. (~ of i~ivi~l si~ing cmtrsct) (~t ctor, ~nt, cor~rate o[[~car, o[ ~id ~r or ~rs, ~ is ~ty ~thori~ tu ~rfom or h~ ~rfo~ fl~ ~id ~ ~ tu m~ ~ file this a~llcation; ~at ali stat~nts cmta[~ in ~is n~llcation are t~ tu ~ ~st of his ~1~ ~ ~lieF~ a~ ~m to ~[ore m MA~ · PAN~ ~ (si~m~ of Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 · Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 24, 2000 Mr. Charles VanVoorhis 628 Pleasant Street Suite 322 New Bedford, MA 02740 RE: LOUIS BURNHAM PACKARD Madeline Ave.,. Fishers Island SCTM#6-7'12 Dear Mr. VanVoorhis: 'The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 23, 2000: RESOLVED, that the Southold Town Board of Trustees grant the request for a Waiver to LOUISE BURNHAM PACKARD for the addition of a 18'X 18' sunroom and a 18' wraparound deck. This approval does not constitute approvals from any other agency. If you have any questions, please call our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms (Respondent) i /~; ~New York State epartment of Envlr~)nmental Conservation Order' On .Consent/Stipu~lation · NeW York Stat~ Env~ronmenta~ 'C(~nservation Law Number ,-m - --' , Of '~)~ '.",: ~U. ' (Street and Number) · .~.'~:- I -? [~ , hereby pay to the Depa~ent (Ndme of Town, Village, City and Sta~e) of Environmental Conservat on of the State of Ne~~ York th~., sum of ].-~ (~. dollars .ea~l_~ ~t ~~h e~conditiovvx~nr~q~ ed~A ' ' to-and made a pa~ hereof/by re.on of my act consisting of (zn~-c~-r~J ~he same being a viol~a~tion of S~c~ion '~" ":O ~) / of the State of New Ybrk's ~; Envi~o~mefi'tal Con ation ~aW and/or Section I -N ' (~ ~ ~ of'the State Of New York's Rule~ and Reghlations, ~ff~NYCRR, said act committed in , '~ fi ~ ~1 (nameofto~n,~ge, city) County of ~.?~.)~0~~J , ~ , ~.L ~. , State of New York on ~ , In so stipulating, I waive ~y right to a hear~g ~ this matter. : ~ . ,. ..... ? Respondent's Signature* ~ Res~ndent's ~tle If ~poration) .... :T", .39"' Dated: -s "" ~'~ ~ocation: ~ ~ ~ '- [ -~ ~ > ~ ., NY [month day (name of town, village, city) * NOTE: If consent order/stipulation is against a corporation, the respondent must he"an'official, ~ authorized, co.orate representative. /' ' ' "' This or~ti~ulation,;~] ~has b%el)/~/~J:e'v~w~¢d by: ~ '~.,--~~ .... .... ' ~ame and Title of DLE 6fficial ~ WHEREAs: · ~ ~ ~ '. {'~ , ..... ' ~ , having violated SectiOn ~ ~ ~ ! of the State of New york's (ResPondent) ~? ~, Environmental Conservation Law and/or Sectior~"7~(~'W-~ of the State of New York's Rules and Regulations, 6 NYCRR, at the time and in the manner stated above, and having waived the right to a hearing on the violation(s) and having offered to pay the sum of ./:~'~, "~ dollars by reason 6f said violation, and after due consideration having been had thereon it appearing that this order will be advantageous to the State, now therefore, IT IS HEREBY ORDERED, pursuant to the provisions of the Environmental Conservation Law, that the offered sum ~hall be paid to the Department of Envirdnm~efotal'~on~ervation as- a Penalty for the violation described above and Respondent shall comply with ...the'tt.r:m's., of the attached Schedule A by reason of such violation, .. Signed,. '~:' Reeional Director, for the Commissioner (name of town, village, city) , NY TOWN OF $OUTHOLD P~OPERTY R~:CORD CARD OWNER STREET VILLAGE DISTRICT SUB. LOT FOYER OWNER N E ACREAGE ~:' M~/L RES. ~'I6 s~s. v,. LAND IMP. TOTAL , DATE REMARKS AGE ND/f NORMAL BUILDING CONDITION BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland House Plot Total FRONTAGE ON WATER FRONTAGE ON ROAD DOCK Foundation Extension "*;~ ,~_ _= ~/~/_~ Basement Extension ~' ~ /f' i ~ ~c ¥~ Ext. Walls /'~ ( , Extension ......... Fire Place ~.~_~ Porch Breezeway Garage jFloors Interior Finish Heat Roof Type t.~'.~ ,9/¥ Porch j Rooms ~st Floor . Patio I Rooms 2nd Floor Driveway '. Dormer UNDERWRITERS C£RI'IFI~T~ s~ N/F P)I~ATE C(:~4E klARINE N/F ~LILEO VALE~N) ~HOE W. P~KARD~LOUISE BURNHAM ~HAAi~ARD, Eld T, I)URNHAII4. C~EJ,.IA B.' BUR , nRST ~OTA/~"il~ mN~RANC~ CO~,~P~Y ~ NEtN YORK AND ~ ~ ~ 151~$--0772 N/F ALFRED R. GREBE, JR. hi 86"44.'40' E EXISTINO AREA= 2.26i ACRES DE~K HOUSE 152 N/F PATRIC~ DOWNEY 87'~6'00" W 72.80' 40 20 o 40 GRAPHIC SCALE IN FEET RE~SIONS DATE DESCRIPTION DA'~Ei AUGUST 11, lggg SHEET 1 OF 1 COORDINAIE DISTANCES ARE MEASURED FROM U.S. COAST & OEODE~C SURVEY TRIANGULA'DON STA'DON 'PROS" 2.) TAX REFERENCE: DIS~ICT 1000, SECTION 006, BLOCK 7, LOT 12 PLAN OF PROPERTY PREPARED FOR RALPH ~ AND ROSAUE ROOKS RSHEES ISLAND, NEW YORK , MAY 1966 CHANDLER & PALMER SCALE: 1'-40' SURVEY MAP - PREPARED FOR GEORGE W. PACKARD, LOUISE BURNHAM PACKARD~ STEPHEN T. BURNHAM, CORNELIA B. BURNHAM ',k~AD.E~ NE; AVENUE FISHERS, :ISLAND, N[~V ,YORK PIRATE COVE MARINE N/F MIOHAEL LAUGHLIN MERESTONE N/F ALFRED R. GREBE, dr. N 86'44'40" E 242.60' AREA= 2.26± ACRES W.F 0 N/F PATRICIA DOWNEY 87'36'00' W Pipe N ¢313.05 W 626.27 EXISTING DRIVE 152 IRON PIPE~ POLe# 1519 NOTES: COORDINAllE DISTANCES ARE MEASURED FROM U.S. COAST & GEODETIC SURVEY TRIANGULATION STAllON "PROS" 2.) TAX REFERENCE: DISTRICT 1000, SECTION 006, BLOCK 7, LOT 12 MAP REFERENCE: PLAN OF PROPERTY PREPARED FOR RALPH E. AND ROSALIE ROOKS FISHERS ISLAND, NEW YORK , MAY 1966 CHANDLER & PALMER SCALE: 1"=40' GRAPHIC SCALE IN FEET SURVEY MAP PREPARED FOR GEORGE W. PACKARD, LOUISE BURNHAM PACKARD, STEPHEN T. BURNHAM, CORNELIA B. BURNHAM MADELrNE AVENUE FISHERS ISLAND, NEW YORK REVISIONS DATE DESCRIPTION 3/17/00 ADDED WETLANDS DATE: AUGUST 11, 1999 SCALE: 1" = 40' SHEET 1 OF 1 C LIVIN~ I;~DO P1 ~TCH~N FII:~T FLOOP. I~LAN ~GAL~ 1/4:' = 1' - O" t;~::~ EN T CONdiTION 16" O.G. r ~,ECOND FLOOR t::LAN ~ ~" O.C. 2(3 yI2. A~I::'~'~LT ~HIN~L,E~ lz~' F:t,,¥'VVD. ~HEATHIN~ W/'W'D, ~HIN~L~ ~IDIN~ CONG. ~F::CTION THF<OUGH 9Cl:;i~N I:~I:~H P-.EN OVATION..G ADDITION tothe BURNHAM~ACKARD HOUSE MAIDELINE AVENUE FISH~ ISLAND, NE%V YOP. K EXISTING FLOOP-. PLANS DURLAND & .VAN VOORHIS ARCHITECTS AI~CHI'FECTURE DI~iGN PLANNING EXG 1