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Home My WebLink About23348-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24271 Date APRIL 9, 1996 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property AVENUE B FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 6 Block 2 Lot 22.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1996 pursuant to which Building Permit No. 23348-Z dated APRIL 8, 1996 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 - PARTIAL ONE STORY & PARTIAL 2 STORY & OPEN PORCH "AS BUILT", CONSTRUCTION CONTAINS NO APPARENT DEFECTS AS CERTIFIED BY A N.Y. STATE LICENSED PROFESSIONAL ENGINEER. The certificate is issued to MARJORIE PEDLEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL LIC.#2990-P UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 3, 1996 PLUMBERS CERTIFICATION DATED N/A f \ rdin�g Inspect r 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 COMPLET10N OF THE WORK AUTHORIZED) NR 23348 Z Date....�"�............................................ 19.. Permission Is hereby grante o; , . . .... . .... ../� ...... ..... ... ............................... . ... ... .. ....,.. . to ........... -..fie.. . .. ....(! GIP�=�Y . G... . ...... .. . ... ...... ................... ........�� ........... . ... .. .. .. .... ......... .... . . . . ........ .... .......d:&........ -.../ .. ......�� ....... .. . .. , ..... . .... . ........ ................................................................................................................................... at premises located at....�:��?.... ..................... ........................!................1.5. ...;,rg County Tax Map No. 1000 Section ......... ............ Blocky.............. Lot No. .'. ........... pursuant to application dated .... ........................................ 19.Y ....... and approved by the Building Inspector. Fee$�.)U .../ .... `�... .... .. ......................... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT - TOWN HALL 765-1802 APR J APPLICATION FOR CERTIFICATE OF OCCUPANCY _ A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date March 27; 1996. New Construction. uilding. . . . . . . . . . . . . . . Location of Property. . . .(.no, k). . . . . . . . . . . . . . . . . . . .Avenue. B , , . . . .Fishers. Island . . House No. Street. . • Hamlet . • • • Onwer or Owners of Property. . :7, �� .. . . . �. . '??4j.51V , County Tax Map No 1000, Section. 006: 00 . . . . .Block. . ,02 . . . . . . . . , 022 . 003 19'7 Su beg ivision p .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . .N�:4 . . .Date Of Permit. . N/A .. Applicant. . . N/A . . Health Dept. Approval. . . .N�:�I.C?. . ./.�, . , .Underwriters Approval.N/A . . /W/!!,//J�� . . . . . Planning Board Approval. .N A . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X . . . . . . . Fee Submitted: $. . . .'�, , � . . . . . . Gy . . . . . . . . . . . . . ad37s' , ///yS/y/ C'3.Q,�. S�O$C,� APPLICANT Ep �� 7� . ,Stephen, L.. Ham III, MATTHEWS & HAM ATTORNEYS AND COUNSELLORS AT LAw 45 HAMPTON ROAD SOUTHAMPTON,MY,11968 516-283-2400 PHILIP B.MATTHEWS TET COPIER 516-287-1076 (1912-1992) STEPHEN L.HAM,III March 28, 1996 Mr. Thomas Fisher Building Department Town Hall 53095 Main Road P. O. Box 1179 Southold, NY 11971 Re: As' Built Dwelling at Avenue B Fishers Island Dear Tom: In connection with the issuance of a Certificate of Occupancy for the single-family dwelling owned by Marjorie Pedley and located at Avenue Do Fishers Island (SCTM No. 1000-6-2-22 .3) , I have enclosed the following: 1. Application for Building Permit. • r; 2. Application for Certificate of Occupancy. 3. Blank check to the Town of Southold to cover the fees for both .'applications. After the other documentation you believe to be necessary has been submitted to you, please issue a Certificate of Occupancy for the subject property" to Marjorie Pedley and give me a call when that has been done so that I may schedule the closing of the sale of the property. ' Also, please advise me of the amount you complete on my check. Thank you for your attention to this matter: Sincerely, Stephen L. Ham, III Enclosures 1 L �f AFIR 1 19p� _ I 03-27-1996 1�_:31AM FROM. TO 17651823 P.02 �"r 7.6d -- srJILS i=lSH.LFtS .ISLAND WATER. WORKS, CORPOFyAT10N FISHERS ISLANrk >: NEW YORK 06390 AREA CODE 516/788-7281 • i�fly;pt, - - ,� •:. . Z671 .4 I , ••:yYj• ToVn of Southold Ei $t3flt :ng Tep�rtmenE 10ishere -Island. N..If 06390 _ "C IF"v 01 � �_ ,�L� :•';;• Cehflemen: P1eaz�® accept this' letter as certification of W:zGer Sexvtce provided $y Fishers Island:"rater Works to eow �� ;:;, • the meter serviclr cOI)SiStS of supply thrc�u !1�pl Y F, � inch water ;>•;c.; line •from our •Jsland distribution system. Si.:,r;erel.y oUr , ;tip v s Robert T. _Wall. h;Superir tendent REW ew • _ ,. Y•• • , _ .•:;�;• �i�µ i ice! TOTAL P.02 04/08/96 13:16 CHANDLER PAU IER.'& .KING .4 516 ,765 182, 902 C :H A N C L E R a P _A L M �R $ K 1 N G �...: Arc hitocteure,Enl1inoarinq a sid.SurveyYn HIC HARD H.STROUSE, P.E., L.S. Charles G.Chandler(1878-1929) GQRDC)N C. HYDE, A:LA: Shepard S.Palmer(1884-1943), Benjamin H.Palmer(1923-1972) epard,B•Palmer Jr.(1939-1978) PdfcY Joe'King(1969.1989) April 8-, 1996 o�.SDv N Mr.. Thomas Fisher Town of Southold Building Department 53095 Main Road Southo:.1, NY 11971 RE: Residence at (no #) Avenue B, FJ.shers . Island, New York ,; SC'TM No. 1000-'006.00-02 00-022 .003 Dear Mr. Fisher: Please be advised that -I have inspected the referenced residence from a structural point of view. In my opinion, the residence is structurally sound and contains no apparent structural defects. My op .:a-ion is based on my own observations and also on '-he fact that the residence has - been standT..ng. in its current location for the -peist thirty years without ).awing sustained any apparent damage. from settling or from .the elements . Cgrdia..l do Richard H. .Strouse. RH S/md Stp�E Of NfIY yo9� or: $. 11 O 4�i a, 110 11hOADWAY NORWIGi 1,GONNECTICU'T 06360,4452 PHONE 203.889.3397 FAX 203-886 780I i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1o@0913 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date APRIL 09,.1996 Application No.on file 11421396/96 N 382600 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 RONALD PEDLEY, AIMI NUE3 B, FISHERS ISIT AND, N.Y. in the following location: ❑ Basement ® lst FL ® 2nd Fl. OUT .Section Block Lot was examined on APRIL 0 3,19gF and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT.FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER I X 2W 10 3W 3 0 3W 3.0 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W G. EQUIP. PER Ar OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: ENTIRE PREMISES-! SMOKE DETECTOR:-1 } `( Cb ID °i,1:( 'ENO VISUAL DEFECTS- "An electr:cal ------_ survey has teen made of the e.q)osed electrical equipment. in th(—:e premises indicated. " "No obvious �tnsat.1.sfactory condition was found. WALL ROBERT E. ,LIC.4`2�";55- GENERAL MANAGER ALPINE AVE V Per -e i, This certificate mu t.Fwc;pbe;alle edVigl'gnylmann,-Q�retd?n to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ' V,1 IE7t?TJ_INSPECTION -----REPORT--�=DATE __ __-__s=—===_________________COMMENTS====---___________ ro !I it x n •OUNDATI ON ( 1ST) n ii j — u •OUNDATION (2ND) �—ii ~ __=___-----=—_______ir----- ____=_— ;7e' —141 if / i .OUGH FRAME & , PLUMBING u c NSULATION PER N. Y. to STATE ENERGY CODE �� — ti n FINAL i ADDITIONAL COMMENTS: ro H '7 H I � z bN�j eo d*, FUHM NO. 1 3 SETS OF -PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . _ . - I BUILDING DEPARTMENT CIIECK . . . . . . _ _ _ . _ . . . . . . . - . ' TOWN HALL SEPTIC FORM _ _ _ . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NGTIF'f ; Examined. CALL . . . . . . . _ . . . . . . . . . . . .� . . . . . ., I . MAIL. T0 . Approved . . . . . . . . .. 19159 . Permit No.4�--A• . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 uildi nspcctor) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . :? INSTRUCTIONS •? a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ;i :ation. c. The work covered by this application may not be commenced before issuance of Building Permit. J d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall 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 hall 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 ;wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or I regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspec ions. l (Signature of applicant, or name, if a corporation) Stephen L. Ham, III 45 ,Hampton,Road, Soathampton: NY 11968 (Mailing address of applicant) ltate.whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . .agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . 1 lame of owner of premises . .Mar,j.orie, Ped.ley • . • . . • • (as on the tan roll or latest deed) f applicant is a corporation, signature of duly authorized officer. i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (no #) Avenue B Fishers Island House.Nu nber .Street . . . . . . . . .I-Iamlct . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section ,006..,00• , , , , , Block , , • .02: 00 Lot . .022 . 003 . . . . . . . . . . . . . . . . . . . . . . . . Subdivision . . . . Filed . . . . . . . . . .(Name.) . . . . . . . . . . . . . . . Map No. . . . . . . . .c. . . . . . Lot . . . . . . . . . . . . . . . { State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . , , Singly,—.family slv�ellang . . . ; , , , • • • , • • • • • . • • . • • . . • . . . . • . . • . . . • . . . b. Intended use and occupancy • .Single—family, dwelling . . . , . Repair i,1c). �,�„ . . . . . . . . . tinditwu . . . . . . . . . . Alteration . . . . . . . . . . Removal . , , , • , , Demolition . . . . . . . . . Other Work .AS BUILT 4.. Estimated Cost . . AS BUILT .'�S`f, � •6- (Description) .j . . 'Fee . . . . . . . . . . . . . . . . . . . . . . . . . (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 mix,ed occupancy, specify nature.and extent of each•type•of use . • . • . • . . • • • . . • • • 7. Dimensions of existing structures, if any: Front . .Depth . Height . . .. . . . . . . . . . Rear . . . . . . . . . . . . . . . . • • Number o f Stories . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front• • • • • • • • • • • • • • • • • • • • '• • ' Depth . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . • • • • • • • . Height . . . . . . . . . . . . Number of Stories . 8. Dimensions of entire new construction: Front . ' ' ' ' ' ' ' ' ' ' ' Rear . , Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . , . . . . . . . . . . . . . . . p . . . . . . . . 9. Size of lot: Front Rear ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 10. Date of Purchase . . . .,.•, . . . . ... . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . . . I.I. Zone or use district in which•premises are•situated , • • Name Of•Former Owner . . . . . . . . . . . . . . . . . . . . . . . . ... ,, ,, . 12, Does proposed construction violate any zoning law,•ordinance.or• , ; regulation • • • • • • • • 13, Will lot be reg 14, Name of Owner of premises raded . . . . . . . . . . . . . . . ... . . . , ,Will excess fill be .removed from premises: . • . .Yes • . No . . . . . . . . . . . . Name of Architect . . . . . . . . Address ' • • • • ' • • , • • • • • • Phone No. . . . . . . . . . . . . . . . . . . . . . .Address . Phone No. Name of Contractor . . Address „ • , 15. : Is this property within 300 feet of a� tidal wetland? • • • ' ' ' ' • • Phone No. . . . , *If yes, Yes.• . . . No. . . . . . . . . ... ,•i. Southold Town Trustees Permit may be required. ,• . 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. Application is for .existing structure AS BUILT f TATE OF NEW YORK 0UNTY OF .SiJFFOL . • • • . • • . S•S „ • • • • • • Stephen L. Ham, III • ' • • • • • • • • • • • • • • • • • . . . .:. . . . being duly sworn, deposes and says that lie is the applicant- (Name of individual signing contract) )ove named. l is the . . . •went . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) • • • • • • • • • • • ' ' ' ' said owner or owners, and is duly authorized to perform or:have' performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the . . )rk will be performed in the manner set forth in the application riledtherewith. . torn to before me this • . . . ?7t . . . . . . . .day of:. March. . . . . . . . . . 1996. •. 'tary P lie . . . S �L,F °tr tL • • . t+1�JA9 P!lv dJC,:i"02 mew Ytx6s QMSTsdln8aa"0&Catinty. Stephen �Ham�, •rY2' . . . . . . . . . . . . . . 'a' *11 . . . No.02VE49Sc'�°67 (Signature of applicant) Commission Expires July 13,rg4b I . �� overaeod qvE iR4 . i n°�se>+J JAN 171996 N5366.65 695 ` 4Q BLDG.U A NOTE-VOORD/NATE O/STAYCE,5'ARE-4A 4SURED FROM U.S. CQ4ST AND GEODETv SURREY iinn,an TRIAWUL AWN STAT'%ON_*QO CRE'SCENI'gIiENUE , , o h I CENTER L/NE /O'R/GNT OF WAY " ' SUFFOLK. COUNTY TAX MAP .REF- sepha.ibr� •ay Wells 9/Sr /000 SEC.6 BLOCK 2 LOT 22.3 / I I �? 6 Z / o I ►� W GUARANTEED rO.COMMONWEALTH LAND r1rL E A WRAWE OF N Fyr COMPANY and ROBERT L. HANSELL 8 PHYLL/S SHAKEY I % V- I ' s L /N ACCORDANCE w17H THE M/N/MUM STAN' co, Pp H.8T-_ D��40S FOR rlaE SURVEYS OF THE NEW YORK s7;4 ? / / I o I overhevd . c� �' ►�.. �,Y OZANvh r1nE ASSOC/AT/ON. 14 /004 , yQ RESIDENCE h t o N W � 1 0) o � • o a `` Shed 1 � SURVEY MAPShed PROPERTY TO SE CONVEYED Tl7 '1 : oo`r�k�n9 i Rom"RT L. HANSELL a PHYLL/S SHANLEY:HANSELL AVENUE B PJgs picket � (far,,,, FISHERS .�/SLA/UD, NEW.. YORK s�ckode 1�nce . . fence 1 \ �Sw/e- / -20 feet o /o .00.. 24915 �' 85, 5/' Q0 ' ��, /I0.23. DECEMBER.8, /995< 1047 Wr J S \ N/F M/CHAEL Mc CORM/GK E o% r —CHA.NDLEA. PALMER &A KINO' X. Architecture Engineering and Surveying' f10'WQADWAY NOR"CK CT 063M 203-W9-3397'FAX'203-W-7001 0 0-M PIC . . . . . . . . . . CLEAN--.Ct)T--. SQJCfe LhVet� Prr. . (Cc -r ce p w uTH E Y-r See, P44!16 Hfr*- —.2 FEB 2 Jzoco P_1__R_TF____Cov6a 400 2 4t.4w--- '5 - LATE F#q - 10_!O et- P 4/q f 7 C-(Z- M f 6 R Aq.1 S'AfCaM E_*_Ct49___OF, IT CqU6960 9Y AfLCY-AL A-09reS AND SLA-rL, A Pw( II