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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 Date: 04/17/09 THIS CERTIFIES that the building,ADDITIONS ,Location of Property: 605 FOUNDERS PATH SOUTHOLD (HOUSE NO. ) (STREET)' (HAMLET) County Tax Map No. 473889 Section 64 Block 2 Lot 37 Subdivision Filed Map No. Lot No. 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 i.s •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 COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 4024300 03/06/09 PLUMBERS CERTIFICATION DATED N/A. u or' ed Signature Rev: 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 5� 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$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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.0�0+ ,! p' Date. `Z '( 7 U D New Construction: ✓ Old or Pre-existing Building: (check one) Location of Property: (,0 d ,5- (�%11 f I ('s �do7 SQ In,Th o House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section S0 Block Lot 37 Subdivision , ha_a 2n,,)c Q p Filed Map. Lot: Permit No. fit-} 1'_�LP Date of Permit. O Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ App 'can ature rJ�rJ��urJ�rJrJ J�rJ��l-�ncnrJ��nrP�ncn�n�nrn nrJ2�rJ ,�rJ�rJ�rJ�i Pr�rJflJ�rJ�r�rJ�r�r�rJ�r�rJ�r�rJ�rJ�rJL n, :! arJ�rJr�rJ�rJ�r�rJ�rJ�rJ�rJ�r�rJ�rJ� 0 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 SS NEW YORK BOARD OF FIRE UNDERWRITERS 5 E RI 5 5 BUREAU OF EL CT CITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 ARTHUR RATHJE ARTHUR RATHJE 5 5 5 4 HARBOR VIEW RD 4 HARBOR VIEW RD CCj SCITUATE MA 02066 SCITUATE, MA 02066 5 5 Located at 605 FOUNDERS PATH SOUTHOLD NY 11971 C5 5 5 Application Number: 4024300 Certificate Number: 4024300 c Building Permit: BDC: c 5 Section: Block: Lot: g 11601Z ns11 c5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of c C5, electrical devices and wiring, described below, located in/on the premises at: S L� First Floor,family room,Outside, 5 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the6th Day of March, 2009. S Name 2 Rate RatinE Circuits Tvoe 5 Miscellaneous 5 sun room as built 1982 5 5 Wiring And Devices 5 Fixture 1 0 Incandescent 5 5 Outlet 1 0 Fixture Outlet 9 0 Gen,Purpose 5 5 Receptacle 8 0 Gen,Purpose �5 Switch 2 0 Gen,Purpose 5 5 5 5 S 5 5 5 5 5 5 S S Seas 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the Iocatidn indicated. 5 5 . o ����������������������L���������������������������������������� o 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 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH-OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1 Z Date ... :L. Y ��...... ..........., 19G1.� Permission is hereby granted to: r ..... .... . ...... ...... .. :.. i 7 CEr0.../.. n... ....... �.. /� C- ...✓c...�. .:............. ...7�5...C=->Z;.Z/. . ....Q/2C................... . .....<:...... >C:!`cf'..... ,� ••' Cam. ............................ c �1= � .. . ❑t premises located at ......................................... ................................................................................ .............. � �../. .:............ !.. ................�� -�... .......................... County Tax Map No. 1000 Section ... ....... Block .... Of.......... Lot No. .��� 7......... C pursuant to application dated .l l'CJ.. .... ...... ......... 19?4-1'and approved by the Building Inspector. Fee $.. l. .... ........... 4u4ildinginspector .............................. .... . �... ....... .. ,. .. \ Rev. 6/30/80 77 4 I{.77t.'4 rrY S�J �t yy q. x i q r. y u ( :r t z. y F7 _ ;� "s i :•yL,; lei �jY�+. rl. , . 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LOT E`.n L lr,.(J ``F « 6'-y P.`E FQR1v1ER OWNER N E ACREAGE W TYPE OF BUILDING Ilu / -°— REST SEAS. VL. FARM COMM. IND. CB. MISC.. I :, LAND IMP. TOTAL DATE REMARKS ., 40 a `raMGE c p BUILDING CONDITION- �" /� `� NEW' NORMAL BELOW ABOVE s . - Farm Acre Value Per Acre Value Tillable 1 Tillable . 2 Tillable, 3 Woodland Swampland Brushlan 1c House Plot 44 ■■■■E■ ■E■�■■■■■■■■■ ■■Emu ■ ■■■■■■■■■■■■ ■■■�■■■■ ■ ■■■■■■■■ME MIN■■l■■®■■■■■■■■■■■■■ ,. ■■■■�■M■■■■■■■■■■■■■■ r IF • ® • • • U . I OF SO//l�, coulm,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION - [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION _ REMARKS: ��. co DATE �� INSPECTOR ,,,"'L )��k FIELD INSPEC, ION JDATE COMMENTS FOUNDATION ( 1st.). x FOUNDATION ( 2nd ) 2- ROUGH FRAME & PLUMBING 3 . r•-3 INSULATION PER N . Y. STATE ENERGY _ CODE x r :kl FINAL . b ADDITIONAL COMMENTS : AV H 1 O x L=] • r i H x d H FORM NO. 1 • TOWN OF SOUTHOLD BUILDING DEPARTMENT TOVIIN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1302 j Examined . . , 19 S Application No.I1�J. . . . . . . Approved ., 19 — Permit No—.. Disapproved a/c . . . . . . . . . . .. . . . . . . . i (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . .-h; ,r ,/ I9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to th6*Bui•ld Inspector, witl: 3 sets of plans, accurate plot plan to scale. Fee according to schedule. '` 1 .c.. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stye or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apt cation. c. The work covered by this application may not be commenced before issuance of Building Permit. it d. Upon apprc-,al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen: shall be kept on the premises available for inspection throughout the work. e. No building sliall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. I� APPLICA-riON IS I-IL-RE13Y (MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of 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 agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessa �spec ions. (Signature of applip� name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, arc'iitect, engineer, general contractor, electrician, plumber or buildo . . . . . . . . . . . . .ara',.e2&. .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . ... . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . . . a�YIe—v. . . . . . . . . . Plumber's License ND. . . . . . . '?Z.�/�I . ... . . . . . . Electrician's License No.' .4j1, . l�z4r!�.vlavlzl. . Other Trade's License No. . . . . . . . . . . . . . . . . . .... . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . ./ �!/l/l� . 'YS. . ?�4�r . . . . . . . . . . . . . . . CAD z 7 . . . . . . . . . . . . . . . . . House Number Street / Hamlet County Tax Map No. 1000 Section . . . . . 10� . . . . . . Block . . . Y . . . . . . . . . Lot . Subdivision K .a,3 . . . Q 4Uylder.�. . . Y't�S . . . Filed Map No. ffb . . . . . . . . . Lot .�? . . . . . . . . - '� (Name) 2. State existing use and occupancy of premises and intended use/and occupancy of proposed construction: y . . . . . .�f'��Yl'It. !y. . . {.S�. l� � . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . a. Existing use and occupanc b. Intended use and occupancy . Nature of wock (cVieck. applicable)) New 6,4'ldiRs. . . . . . . . . . . Adc.itipr) . �: . . Al _r,,60A , Repair . . . . . . . . . . . . . . Rc;ziov l . . . . . . . . . . . . . . Deniol:tion . . . . . . . . . . . . . Other.V-6rk . . . . . . . . . . . . . . (Description) ` / -(to be paid on filing this application) If d:veiling, number of dwelling units . ,�.1° ?.`lt". `�� ucn -cr of dwelling units on each floor . . . . ... . . . . . . . . . If garage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. If business, coinmercial or mixed occupancy, specify nature and extent of each.type of use . . . . . : . . . . . . ... . . . . T. Dimensions of existing strictures, if any: Front . . . f,�Q .. . . . . . Rear . . .a0./. ... . . . . . Depth Height . . ..... . . . . . . . . . . Number of Stories . . . 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . Dimensions of same structure with alterations or additions: Front . . . . .3G. . . . . . . . Rear ... . . . . . .. . . . . Depth . . . . . . . . .Cz : . . . . . . . . . Height . . . . . . . . . ... . . . . Number of Stories . . .l. ... .... . . . . . . . . . . . . i. Dimensions of entire new construction: Front . . . .3�c . . . . . . . . Rear-. . . ,pia. . . . . . :. . Depth . . OA). . . Height . . . . . . . . . . . . . . . Number of Stories . . . .%� . ... . . . . . : . . . . _ . . . . . . . . . . . ). Size of lot: Front . . . . .S. ... . :. . . . . ... ... Rear . . . . . . . ,� Z� . :. . . ... . :. . Depth ,�.5.��.. . . ). Date of Purchase r . . . . ..�Name of Former Owner :.��!/�f«�t�.��t 1����n. 1. Zone or use district in which premises are situated . . . . . . . . . . . . : . . . . . . . . ... . . . . . . . . . . ?. Does proposed construction violate any zoning law, ordinance or regulation:. . %1��? . . .. . . . . . . , . . 3. Will lot be regraded ...2/. . . . . . . . . .. . Will excess fill be removed from premises: Yes c i O.W; lZ i t i,�; , c l-. Name of O�:n„r of premises /.�."�ft1. �:�. . Address S7r��. ]��wya.G��t. �fl�T1'. Phone No 7.�:�r-.3./. !/.5= ► Name of Architect . .1q✓ S . . . . . . . . . . . . .Address . . . . . . . . . . . Phone No. ., . . . . . Nam4of Contractor . . . . ..Wrn '-7... . . . . . . . . . . . . . Address . . . . .... . . . ... . . . . . . . ;:Phone No. . . . : . . .. . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dim-nsio s fr n Property lines. Give street and block number or description according to deed, and show street names and indic.ate.ti het e interior or corner lot. STATE OF N OR S.S C OUNTY OF . . .'.p._ • • . • • • • ���• • • •/� ` �13!i. . . . . . . being drily sworn, deposes and says that he is the applicant (Name of individual signi traah� Qbov named. 1,4 e is the . . . . . . . . . . . . . . . ... .�. .v?zU/ . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 L-zpplication; 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. . . f�(C . . . : . . . . ., 19 Notary Public, •Gr�tCa�I oz. .`. . . . . . . . '�. . . . . Cou ty �i.'N L. PILLIG Not PUNi.-, S:wte q Nlow.York No 41 731s't# Qualified in �e-bu, CciLrnty Commission Expjres ll�a.cl30,1g83' : ` ..F .. / c; „b...�-.fir,}..:, _ .�..—�...�........_,,..............Y,..�b.�..; _...,...�...�;..,..� _ ° 3 r6, h r N Atl- "'Y OR Vu, 'FUL AW Uv w il'JR "lf F 1 q �A '_Cz✓ . ATE P i L iV sA I f OF, OCCUPANCY r r � I 1J{.�.15LLIl.fke yT'^4 .. yj i F r ' ,o �p p [� ter^ .. t LET Ah l� a :' *, Z v ',. k t 6,a j IA C s� }y 1 'k \ • _„ - r.....t,.,e.,.�.a,.s».+... ,r.......»..a..s».r.-....a.+...,....m."+...-._. n...w.-.w—«w-r+,w_ ..w .,._..,..".....+++�+1. t a _t ri ,,�;A � t sue• .. .,,'1 6,c.f"7<�/-a.. �a i t • sib " � � -'s� d` > +f i3�'! '�� - � ' � � _�_........»., _ .,...:..�.A,........�a:.:,w....-..r+.«..a.<»�a.-v+�.-* ,-.»*....e _ .Y-.».ww.w^,.«....n.+.w,�.,...-A...,+w•x«....++�,....-•..+u, www a°.....,......oa:,�,...._,:,..«+n....._.�.. �. 1 z , w .. APPROVED AS NOTED z i z a \� DATE: ]9jiB.P. # _ �f FEPj NOTIFY BUILDING DEPARTMENT AT Y � PM FOR THE 765-1802 9 A,"A �'� �+ `. >£ FOLLOWING P"'c IITIONS: 1. FOUNDATION'! — T\A,10 REQUIRED r. r FOR POURFir) CONCRETE 2. ROUGH FRAM IINI; & PLUMBING „ I 3. INSl1LA ' 4. FINAL #_ MUST BE C :" R C. O. SHALL MEET � THE OF THE N. Y. a.. ........,.e,_ n..._�...... .-...#. � STATE CON'�12UCTION & ENERGY F—ODES. 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