HomeMy WebLinkAbout28088-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28252 Date: 03/07/02
THIS CERTIFIES that the building DWELLING
Location of Property: PVT RD OFF E END RD FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 10 Block 6 Lot 10.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 15, 2002 pursuant to which
Building Permit No. 28088-Z dated FEBRUARY 15, 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 ONE FAMILY DWELLING WITH ATTACHED DECKS AS APPLIED FOR.
The certificate is issued to MICHAEL BLOW
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 9-SO-114 02/08/02
ELECTRICAL CERTIFICATE NO. N521263 05/26/81
PLUMBERS CERTIFICATION DATED 12/21/01 MARIO ZANGHETTI, JR.
//h/lzed Si nature
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. 28088 Z Date FEBRUARY 15, 2002
Permission is hereby granted to :
MICHAEL BLOW
546 NORTH STREET
GREENWICH, CT 06830
for
REPLACEMENT OF EXPIRED BUILDING PERMIT #10513Z FOR CONSTRUCTION OF
A SINGLE FAMILY DWELLING
at premises located at PVT RD OFF E END RD FISHERS ISLAND
County Tax Map No. 473889 Section 010 Block 0006 Lot No. 010 . 002
pursuant to application dated FEBRUARY 15, 2002 and approved by the
Building Inspector.
Fee $ 666 . 60
Authoriz Signature
COPY
Rev. 2/19/98
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 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 Building- $100.00
3. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00
ate. 2 2 2.00 Z
New Construction: Old or Pre-existing Building: (check one)
Location of Property: t S A e>15 t1L-,A bt NUA R-COD -l S146L5 lS LAN10
House No. Street Hamlet
Owner or Owners of Property: M 1C'.1- ACL, ;2>LOW
W
Suffolk County Tax Map No 1000, Section C) Block (P Lot (�• 2
Subdivision Filed Map. 46 Lot:
Permit No. Date of Permit. 140 Applicant: Lu b RAP ODA t SaE*17)
01
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted: $ 3�J •��
Applicant Signature
01 AX, G (
Cd Baas
Chris Norfleet LLC
29 Dorado Court
Wilton,CT 06897
January 6,2002
Town of Southold
Building Department
Town Hall
Southold,NY 11971
Re: Michael Blow Addition
Isabella Beach Road
Fishers Island,NY 06390
BP# 10513Z
Dear Sir or Madam:
It is my understanding that a Certificate of Occupancy is required for referenced property and that
Robert Wall recently made a walk through inspection.Listed below are the items to be addressed from that
inspection and the proposed solution:
1. Provide 3 copies of AS Built Survey.
SOLUTION: 3 copies of Topographic Plan of Block 43,Lot 4,Fishers Island,NY prepared by Chandler,
Palmer King dated 3/30/01 revised 4/6/01 are enclosed herewith.
2. Improve safety of deck seat(install a back).
SOLUTION:A seatback will be installed,immediately.
3. Install joist hangers under deck.
SOLUTION: Joist hangers will be installed under deck as required,immediately.
4. Repair cracked deck joists.
SOLUTION:Cracked deck joists will be doubled or replaced as required,immediately.
5. Double joisting under parallel partitions.
SOLUTION:Joist will be doubled under parallel partitions,immediately.
6. Provide certification by an N Y State Professional Engineer of the structural integrity of the
building.
SOLUTION: The undersigned,Christopher Norfleet NYS License#069946 do certify that the referenced
building and improvements are structurally sound.My most recent inspection took place September 14,
2001.
We have submitted plans for additional improvements to the referenced property. The property is used as a
summer residence. It is presently not occupied and it will not be occupied until June 2002,with your
approval. I would like to suggest that Temporary Certificate of Occupancy be issued presently,a permit be
issued for the additional improvements presently,and the Final Certificate of Occupancy be issued when
the additional improvements are completed and all applicable inspections are passed.
Yours
Chris fl,
cc:Michael BloF. im Allie Raridon Robert Wall
03/07/2002 09:54 6317887109 F I UTILITY CO PAGE 2WO
�6S-�SOZ
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ I ROUGH PLBG.
C ] FOUNDATION 2ND [ ] INSULATION
C ] FRAMING [ ] FINAL
REMARKS: z�7, �. Q• a ,
DATE INSPECTOR
TEL. 765-1802
pc��FGU[k�OG TOWN OF SOUTHOLD
�c OFFICE OF BUILDING INSPECTOR
P.O. BOX'728
v' TOWN HALL
11971SOUTHOLD,N.Y..
. , .
C E R T I F I C A-.T. I O :N
Date
Building Permit No, 1 05 13 Ci 9 k')
Owner 1v1 i s j, c L
(please print)
Plumber v,"n �ci
(please print)
I .certify that the solder used in the water supply system
contains less than 2/10 of 1% .lead.
(pl,u r ' s(-
signature-Sworn to before me this
�s—day of ,
Notary .Public
notary -Public, fi" Wrdpn County
Z & S CONTRACTING, INC.
BOX 202•FISHERS ISLAND, NEW YORK 06390
Tel: (631) 788-7857•Fax: (631) 788-5600
January 9,2002
To Whom It May Concern:
The water supply plumbing and sewage disposal system at the Michael Blow house,
permit#9S0-114 was installed as per building department code and is in proper working
order at this date.
Respectfully Submitted
M 'olttiJgher.
Zc acting Inc.
tvwiv ur ouUtriVLL liuiLVINUklhKMII AYk1UCA: 'ION CHECKLIS
BUILDING DEPARTMENT Do you have or need the following,before applying
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans 09 F 1 LSE
TEL: 765-1802 Survey DN IF IL6
PERMIT NO. 6? !Lb M� —27 Check A, 150
Septic Form
N.Y.S.D.E.C.
Trustees
Examined ,20 Contact:
Approved ,20 Mail to: ALLk L Rw
Disapproved a/c
Phone:
d63CIO
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date `l ZZ -zoo Z , 20D7,
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 waterways.
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 issue a Building Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupan
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, SuffolkCounty,New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings,additions,6'r"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.
(Signature of applicant or name,if a corporation)
(Mailing addr ss of applicant) (�(p'3Oi0
State whether applicant is owner, lessee, agent, architect,engineer, general contractor, electrician, plumber or builder
9, 1t-AT
Name of owner of premises I CJA 1keL ?ZLOW
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. ��J - 2-� 01�A1JO EM Ca6TT t -- beA Z'-S C oA r.
Plumbers License No 5 54 - P MARAO CANO(,7---T 1 — C)QSa z-*.5 GO 14T.
Electricians License No.A 0124
Other Trade's License No.
1. Location of land on which proposed work will be done:
1 SA►P��I.I.A pAc.K• �SSFEID rF lsl-15 t�l� \1p
House Number Street Hamlet
County Tax Map No. 1000 Section Block G Lot_ 16
Subdivision Filed Map No. .4b Lot
(Name)
Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. .Intended use and occupancy 1,1cf,
i. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
Description)
1. Estimated Cost Fee oo (PfR pwo4)
(to be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
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 any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
r
Dimensions of entire new construction: Front &' jt -?jt Rear 8t� Depth I -a a
Height 2l`- (Q'' Number of Stories Z
Size of lot: Front Zl O Rear I 4�O t Depth
0. Date of Purchase L el 15 h 30 Name of Former Owner F I OGO
1. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation:
3. Will lot be re-graded Io Will excess fill be removed from premises: YES NO
1`1 WAAAEA, SLO V4 54fo IJO Rx K ST.
4. Names of Owner of premises Address C� Wlic" CY Phone No(ZO-3)6(o9-2-71.44Name of Architect DAVID ALIS-rml Address E.0-BOX fol s*'W'Phone No(&S) 2 -403!
Name of Contractor 1,1- 5 Ga►1T12ACXIAka Address r-l" S ISL,M(b Phone No. Ce3i -"lS5'7
5. Is this property within 100 feet of a tidal wetland? *YES NOy
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
TATE OF NEW YORK)
SS:
'OUNTY OF )
kW G R QJWT� being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
3)He is the _ &CAS
(Contractor, Agent,Corporate Officer, etc.)
f said owner or owners, and is duly,authorized to perform or;have performed the said work and to make and file this application;
tat all statements contained in this application are true to the besi.of his knowledge and belief; and that the work will be
erformed in the manner set forth in.the'application filed therewith.
worcp a re
M1 it 20-6 Z
Notary Public Signature of Applicant
t ,
THOMAS F,DOHERTY JR.
Notary Public State of New York
No.4806559
Oualifiso in Sutfolk County
Term Expires 12/31/69:.
1000656 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
26, 1981 85 JOHN STREET, NEW YORK, Ngr7j?P1JC1038
Date May
0� Application No.on file L�"� 33 7 � N 521263
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
Michael Bloud, East End, Fishers Islmzd, N. Y.
X x x
in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
was examined on may 19, 1981 and found to be in compliance with the requirements iof this Board.
FIXTURE RECEPTACLES FIXTURES RANGES COOKING DECKS VENS ISH WASHERS EXHAUST FANS
LES SWITCHES
OUTLETS INCANDESCENT FLUORESCENT i YA R AMT. K.W. I AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
28 27 22 28 1 10.6 1" 1 1 1/20
DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL; UNIT HEATE MULTI-OUTLET DIMMERS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AA1T. AMP. AMT. AMPS. TRANS. SYSTEMS
T. H.'P. NO.OF FEET AMT. WATTS
3 600
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER Ar 2W Ar 3W 3 0 3W 3,9'IW [NO.OF CC COND. A.W.G. NO.OF HI-LEG A•W G• � NO.OF NEUTR A.W:G.
EQUIP. PER Ar OF CC.GOND. OF.HI-LEG 4 aF NEUTRAL`
1 150 CB 2 x I 1 1 2/0 1
OT%R APPARATS: '
Motors$Y-1/3, 1-1/20hpe
Pa>r aboaxWei l-22cir. 200aaW
2 Simko Detectors o
1-4.59W Water Hsater
1 GF1 Recpt. f
t
z & ,5 construction !
Fishers Island, N. Y. 06390
N
I ,
Per
This certifipote must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be iden4ed their c entials.
F
� INY MANNER.
A
iii COPY FOR BUILDING DEPARTMENT. THIS COPY.OF CERTIFICATE MUST NOT BE ALTERED y___• ti..
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LOCATION MAP
SCALE 1"=400'
6" CHE RY \ o 400 200 0 400
c I /
I /A0" CHERRY/' °� 10CHEIRRY
GRAPHIC SCALE IN FEET
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APPROXIMATE LOCATION �1 1 l w� ' MrywL I I I I N g BLOCK 43 LOT 3
UNDERGROUND UTILITIES
REFERENCE MAP
11 110" MAP / /�r ` , \ \ I I N 1 .) PLAN OF PROPERTY CONVEYED BY FISHERS ISLAND DEVELOPMENT
�1 � I 12"IMA LE / D I ,� CORP. TO MICHAEL BLOW, BLOCK 43 LOT 4, FISHERS ISLAND, NEW
\� \�0 '<%, CONN. NOVEMBER YORK, SCALE 1 30, 1978CHANDLER, PALMER & KING, NORWICH,
\`'� °`; Vwryp ,✓/ / NOTES
A19 DECK / EDGE OF MWN 1 .) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE
/ INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE
BENCHMARK SPIKE 1 / /"0p PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR
ELEVATION-34.62 \ N1j '+•1 ¢ _I)b EXCEEDS THE SCOPE OF THE ENGAGEMENT.
SEPTICSYSTEM \ 8" CHERRY ,�� 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY
LOCATION �— 6" CHERRY ° / PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED
Gt N" (PROVIDED BY8" CHERRY LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY.
BLOCK 43 LOT 6 HEALTH DEPT.)
8" OAK 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND
SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL
w. ARE THE PRODUCT OF THE LAND SURVEYOR.
4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND
GEODETIC SURVEY TRIANGULATION STATION NIN,
5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX
MAP 1000, SECTION 010, BLOCK 6, LOT 10.2.
APPROXIMATE
FRESHWATER--).
RESHWATER 6.) TOTAL AREA = 1 .88f ACRES.
WETLANDS
7.) BASE FOR LEVELS: NGVD 1929.
N
N�
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mut• O.
BLOCK 43 LOT 4
AREA = 1.881 ACRES
TOPOGRAPHIC PLAN
PREPARED FOR T�j�
MICHAEL BLOW
a`9• `2
A.
BLOCK 43 LOT 4
FISHERS ISLAND, NEW YORK
/ REVISIONS Im MW CHANDLER, PALMER do KING
DATE DESCRIPTION I AV
m _ Architecture, Engineering and Surveying
\ 04 06 01 REVISED r
110 BROADWAY NORWICH, Ci 06380 880-889-3397 FM 860-866-7801
S8000920,W 01/19/02 SEPTIC & UTILITIES LOC.
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gORMEgLY 20 10 0 zo
DATE: MARCH 30, 2001
GRAPHIC SCALE IN FEET SCALE: 1" = 20'
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