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Home My WebLink About39785-Z Town of Southold 10/21/2015 P.O.Box 1179 1(453095 Main Rd oy�Q Southold,New York 11971 . . ..� CERTIFICATE OF OCCUPANCY No: 37849 Date: 10/21/2015 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: Fox Ave,Fishers Island SCTM#: 473889 Sec/Block/Lot: 9.-1-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/19/2015 pursuant to which Building Permit No. 39785 dated 5/19/2015 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 Gorham Barbara M Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED L :ure I '�, , 1 gsuff01 eo,, TOWN OF SOUTHOLD o BUILDING DEPARTMENT yamfoL ?fl TOWN CLERK'S OFFICE ,�o ,�' SOUTHOLD, NY j4,9l * ,pay' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39785 Date: 5/19/2015 Permission is hereby granted to: Gorham Barbara M Trust Attn: Frank Megale CPA 9 Alden Ave Valley Stream, NY 115801001 To: Construct an addition to existing single family dwelling as applied for: Replaces BP#16844 At premises located at: Fox Ave, Fishers Island SCTM # 473889 Sec/Block/Lot# 9.-1-26 Pursuant to application dated 5/19/2015 and approved by the Building Inspector. To expire on 11/17/2016. Fees: PERMIT RE‘ _ • AL $75.00 To ial: �� A\0 $75.00 �� V e� �b Cru-lure renewal i5 t 5.00 / Building Inspector FORM 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 16844 Z Date ..O .,P..1 , 19.50 Permission is hereby granted to: 5J /aiLAie(de V*ffdA.22 s;i0V4tert-e-e4-H L w,,,,, , A 21104,1d. w,7, . to ziertericaet-a4/ gef// ze-P.i ØI4 ,4-eiye ro-*÷- � . .eei '& I . 7,244 ct premises located at . .. s�c.,e.. NAigt,ft) W0'711 County Tax, Map No. 1000 Section 9 Block / -Lot No. O pursuant to application dated 1/ /7 , 19e 2., and approved by the Building Inspector. Fee $ ' ------- lie Bu' din Inspector Rev. 6/30/80 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.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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. di) Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 V Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Qe.r ek" k cg J2,'(('-'J p t" <4- * I(At1 q Date.e. New Construction: / Old or Pre-existing Building: V (check one) Location of Property: /&'n"' L0 L-er 5'11,8te IAJA xJ T h51i.er 5 rSh,,....) House No. Street Hamlet p Owner or Owners of Property: O ""--- Suffolk County Tax Map No 1000,Section Block \ Lot '-LP Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Tem orary Certificate Final Certificate: V (check one) Fee Submitted: $ c DO lb) 1L--, g fi_ Ti u [F, , ,,, ( °'(1.1 Appl'ic Signature 111 k MAY 18 20 5 I i.J', SA-14,,..) e.J AS At3-e-k 1- rk3,r ; nt _ SAM FITZGERALD C TPC 15 E.PUTNAM AVENUE,#234,GREENWICH,CT06830 P:860.287.38081 F:631.788.71921 sam@sfapc.net 25 September 2015 i U OCT 1 2015 l�.,�, Mr. Gary Fish Ill), Building Inspector i 10„4' Town of Southold _ i Town Hall Annex Building 54375 Route 25, P.O. Box 1179 Southold, NY 11971 , RE: BP# 39785 — one-story addition to existing frame residence Gorham Residence 162 Lower Shingle Hill Road Fishers Island, NY 06390 SCTM#1000-9-1-26 Dear Mr. Fish, I have inspected the construction at the above-referenced property. I certify that all construction conforms to all applicable building codes. In addition, I have inspected the electrical wiring included in the scope of work for this building permit. I certify that all of the visible electrical wiring appears to be installed properly according to NEC code standards. There are no GFCI receptacles required for this work. Smoke and carbon monoxides detectors are not required for this scope of addition. Please feel free to contact me with any questions you may have. Sincerely, SAM FITZGERALD ARCHITECT, PC 1/4.),S4 Samuel W. Fitzg-iald, AIA NYS License 029399 FIELD Il`YSPE oN REPORT EDAT u i CONIlM3FTS, • . .. , 1-Cr • FOUNDATION(1ST) . i.! . ' q��q !... ,, - , , \. . L 1 i . 2 , FOUNDATION(2ND) • H . . • -0 g ROUGHFR tNO& ,• . H PLUMBING , . • • . , . -Tt- . .'. i CI\ $ D'''''H INSULATION PES.N,Y. • (7) STATE E1g11.0Y COD _. , _ . . ' • r • . . r ., - `�1J ��'•��y� . .. .1 ,. • d'• �.!! .. - . • • • • i -. . •• . ,• •• . • ;y -•_..„,,,i ADDITIb `4 -4 / 3Ti., 1 .Ts I r_. "Pi •De or d fie ' .F� !Cc , ,7 4 r._) a . A . , ,..i_ri:,.. 1 , i q 'k, 1, -_. 4 61.1 tio, ---„Nf.9 , r 101 I g-I 2- : a C-1) ,* Cr.-'"1:N\-S---19 .t'A. C*E4V\- 1 C:"\-d •Z4311c-1,. C • •t .. ,. .. j.. .� _ • . r , . • • •• , • • S'''''''0 • ti • .. I 1•• .. , • • • ' . ...• • ` , . .. _. • , • • • • • • •. .,, .. .. Y t r /. ... . . V 1' .,! r'.. , ;-i ;BOARD OF HEALTH . y,.3 SETS OF PLANS FORM NO. 1 . ; .SURVEY �• ' ,,. : � TOWN OF SOUTHOLD \: CHECK BUILDING DEPARTMENT ,.SEPTIC FORM • TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TALL TEL.: 765-1802 MAIL TO : Examined , 19�U c�. Approved . -V , 19 a8Permit No/9411/fi . Disapprove a/c yfy2.4 e=514;ri. (Buildi nspector) APPLICATION FOR BUILDING PERMIT Date .* , 191 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 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 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, ordinance's, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins•-► dor s. e / (Signature of applicant, or name, if a corporation) «^g;; g `+".` 'r '�bd, ,'x.5.14 .0 -/ L/ Z. M931.1.6.?i.,. . rf!.'[7./v. . (Mailing address of applicant) State whether applicant is ower, lssee, agent, architect, engineer, general contractor, electrician, plumber or builder. a-,,,e/ a., 7',/--4E-4,,,,,,-- Name of owner of premises . . .elk . . . .�"4f/V (as on the tax roll or latest deed) If appy nt •s . corporation, signature of my auth • ed officer. (Na title f corporate officer) ALL CONTRACTOR' S MUST SUF QLK COUNTY'YnLICENSED Builder's License No. ,A. �L� % Plumber's License No. Electrician's License No. Other Trade's License No. ar 1. Location of land on which proposed work will be done. . 1/ id - "---6X aar-lAr--e__ --7454;.,(4,, /7e41.6,1 House Number Street Hamlet County Tax Map No. 1000 Section I Block / Lot .US Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and ccupancy of proposed construction: :.- a. Existing use and occupancy . . . i/e . . Ae . .<�,ie--a,e. . .. . . . . . . . . . . . / b. Intended use and occupancy c,--291,..4,,,,,;'4-- fa--d-i(i.t)/ 3. Nature of work (check which applicable): New Building Addition . V Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Po Fee . . ,4 (to be paid on filing this application) 5. If dwelling,number of dwelling units 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories --S. Dimensions of entire new construction: Front / z- Rear 7 '2-- Depth / 0 Height Number of Stories I 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 No 14. Name of Owner of premises Address Phone No. Name of Architect Address 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 PermitPmay beDIrequired. 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. APPECV:.0 AS N r*TED REQUIRED DATE: /0 B.P. # b FEE: c r 7 BY : Aar NOTIFY B ILDING DEPART' NT At 765-1802 9 AM TO 4 PM OR THE • FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE CrIMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE RECUIREMENTS OF THE N. Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. STATE OF NEW YORK, S.S COUNTY OF being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He 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 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 day of 0-t)— , 19e,7 Notary Public, . . . . . .2-e "�"`' County Ar yam " NOTARY PUBLIC State New York No.4701878,Sr elkl;ount7 (Signature of applicant) Term Expires March 30,1