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Home My WebLink About25694-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26757 Date: 10/27/99 THIS CERTIFIES that the building NEW DWELLING Location of Property: 240 LISA DR (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 55 Block 6 Subdivision Filed Map No. __ Lot No. 8OUTHOLD (HAMLET) Lot 15.4 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 22, 1999 pursuant to which Building Permit No. 25694-Z dated APRIL 28, 1999 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 TWO CAR GARAGE & FRONT PORCH AS APPLIED FOR. The certificate is issued to DBM CO. of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-97-0159 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 10/15/99 PENDING 10/25/99 10/20/99 K&K PLUMBING & HEATING FORM NO. 3 TOWN OF S0UTHOLD 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. 25694 Z Date APRIL 28~ 1999 Permission is hereby granted to: HERBERT R & ANO MANDEL PO BOX 2100 GREENPORT~NY 11944 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWRT,LING WITH ATTACHED TWO CAR GARAGE AND FRONT PORCH AS APPLIED FOR. at premises located at 240 LISA DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0006 Lot No. 015.004 pursuant to application dated MARCH 22 1999 and approved by the Building Inspector. Fee $ 648.40 ;Authorized/Signatu~ Rev. 2119/98 ORIGINAL BLDG. 'rQ\%~D 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 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. 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 - $5.00 over 5 years - $10.00 4.. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....... ¢ .... ~ ... New Construction....~ ..... Old Or Pre-existing Building .... Location of Property....~..?~. ............ .~T.(~..~..D~I~.iiiiiiiiiii.'.~.Q.~.~.~.~ ..... House No Street Hamlet Onwer or Owners of Property ...... ~ .............................................. County Tax Map No 1000, Section....~.~.. ..... Block ..... ~ ......... Lot .... /~.~. ........... Subdivision ......... Map ................... Permit No. . .Date Of Permit..~ ....... l.(...Applicant .................. Health Dept Approval . Underwriters Approval Planning Board Approval ........................ ~ Request for: Temporary Certificate .......... f Final Certicate ........... Fee Submitted: $ .......................... ~--~ ~ ~~ 5 /_,, ................. ~ RTi,F I C~T ION THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY ~-- 40 FULTON STREET, NEW YORK, NY 10038 Date OCTOBER 29,1999 ApplicaHon No. on file lS795q~9/99~ ~ g 50526S THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premise* of RONALD HORRIS, 250 LISA DRIVe, C/O ORIOLE, SOUTHOLD, NY in the following locaaon; [] Basement [] 1st Ft. [] 2nd Ft. GAR/ATTIC/OUT $~ction 55 Block6 Zot 15.4 was examined on OCTOBER 25,1999 and found to be in compliance with the Natiottal Electrical Code.. F XTURE ECEFT CLES SW T HES FIXTURES RANGES COOK NG DECKS OVENS D SH WASHERS ' EXHAUST FANS ~"PADDLE ~/~/~S F-5 G.F.C.I:-10 SMOKE DETECTOR: -8 BOX 215 SOU%~OLD, NY, 11.971 11GEN£~ALMANA6~N Per This cerllficate must not be altered In any manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT THiS COPY OF CERTIFICATE MUS~ NOT BE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (516) 765-1823 Telephone (516) 765-1802 October 25, 1999 DBM Co. P.O. Box 2100 Greenport, NY 11944 RE: 240 Lisa Drive, Southold, 1000-55-6-15.4. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) 4 xx No Underwriters Certificate on file. The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 25694-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. INSPECTION P~PORT OUNDATION (X ODNDATIO~ (21~) ~t DATE CO~I~rs OUGH FRAME & .NSULATION PER N. Y. STATE ENERGY CODE FINAL 765-1802 BUILDING DEPT. INSPECTION [ [ ] ROUGH PLBG. [ [ I INSUlaTION [ [~'~INAL [ ] FIREPLACE & CHIMNEY REMARKS: /~/~/~ ~ :~.~ ~ ~ ~ FOUNDATION IST FOUNDATION 2ND FRAMING DATE: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FRAMING [ ]FINAL [ ] FI/RE~CE & CHIMNEY BUILDING DEPT. INSPECTION F~JNDATION 1ST [ ] ROUGH PLBG. [ ]/OUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL FIREPLAC~EY REMARKS. t~~~ · I N S PECTO 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [,~'~ROUGH PLBG. FO~DATION 2ND [ ] INSULATION / ~[~4~RAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ '~ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~~~/~-~/~- 765-1802 BUILDING DEPT. INSPECTION ] F~NDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE.&-,CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~SULATION [ ] FRAMING [~ FINAL ~~[ ] FIREPLACI~&CHIMNEY> ~.~_ _ _ ,, I NS PECT~~/,~' ~qAR BLOC DEPT. TOWN OF FORH NO. TOI~N OF SOUTHOLD BUILDING DEPARTHENT T0I~8 HALL SOUTIIOLD, TEl,: 765- IS02 Oiseppr~ed a/c . , . ROARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CRECff ......................... SEPTIC FORH ................... .NOTIFY: CALL .... .q. NAIL TO: .................... (Daildlng InspeCtor) ~' APPLICATION FOR BUILDING PERHIT INSTRUCTIONS a. Ibis appiieatlon attst I~ completely filled in by typewriter or in ink a~ ~itt~ to ~e hlil. di~ I~ctor with 3 ~ts o~ pl~s, aerate plot pl~ to scale. Fee accordi~ to sch~l~. b. Plot pl~ ~ l~ti~ of lot ~ of ~ildi~s ~ ~s, ~lati~ship to ~joining ~s or ~blic st~ts or a~as, ~ givi~ a ~tail~ ~scriptim of l~t of ~r~ mst ~ dr~m this ~licati~. c. l~ wrk ~ ~ ~is ~llcati~ ~ ~t be c~ed ~fore isae of Mildi~ Pe~t. d. U~ a~at of ~is a~licaticu, the ~ildi~ Ins~ctor will is~ a ~ilai~ Pemit to the ~licant. ~d~ ~mlt Mmll ~ ~pt ~ t~ ~s ~ailable for in~cti~ th~t Om x~rk. e. ~ ~ildi~ ~mll ~ ~i~ or u~ in ~mle or in ~rt for ~ ~m ~mt~r mtll a ~rtifi~te ~ ~M1 bm ~ g~tM ~ t~ ~ildi~ In~ctor. ~I~ IS l~m~]i ~ to t~ Mildi~ ~r~nt for the isle of a ~ildi~ Pemit ~t to the ~ildi~ ~ ~i~e of ~ ~ of ~tlmld, ~]ffolk ~, ~* York, ~ other a~licable I~, ~i~es or ~latims, for t~ ~st~ti~ of ~ildi~s, ~iti~s or alteration, or for ~al or ~litlm, ~ri~. ~m ~llc~t a~a to c~ly with all a~llcable 1~, ~i~es, ~ildlng r~lati~s, ~ to ~t m~i~ in~tors ~ ~i~s m~ in ~ildi~ for ~cea~w in~ti~s. (Hailing address of applicant) State ~hetber applicant is ¢~mer, lessee,~ architect, engineer, general contractor, electrician, plt~ber or builder. ,~ of o~ of ~nes...O.-.g.. = ...~,. :.. ~ ...................................................................... (as an the tax roll or latest deed) If applicant is a corporation, signature of duly anthoriz~M officer. Buildors License No .......................... Fhm~ers License Ro ...................... .... Electricians Licen~ No ...................... Other Trnde's Licanae No ..................... 1. Location of laed on whirl] proposed ~x~rk will be done .............................................................. ........ ~.%? ................... ~sa ..%.~..%. . .~:~.~.' tl~ase lqtmber Street ltamle t Ccunty Tax Hap lqo. I000 Section ...... ..~.?. .... mock Lot a,~u,l,lon .. Lq.%%0.&~....%.~..,~.. 5 ...... ~ned mp No ................ ]~t .... ~ ........ (sam) 2. State existing use and occupancy of premiss and intended use anti octalpaocy of proposed eonstructlon: .. ; a. ~ist~ng u~ aaa oco~cy .......... ~..(L~ .... S ................ . ..................... ............... ............... I0. II. 12. 13. IZl. frc~u prope[Ly liras. Olw ,~treel: And hlo~k ~0hether interior or eonvar lot. garase, s~sd~r oE car~ ..~ ................................... Ixmitess, ~mrcial or m~ ~o~y, s~ci~y ~mture m.I extent of each tYl~ of u~ ...................... Bimnui~s o~ ~m ~tnm~ure~ltlt alterati~m or ~Mition~: Front ............... I~ar . .............. off Ardtitect .................................... ~glre88 .............................. ~m~m ~ ............ PI.OT I~:ate clearly m~ distimtl all Ixsildis~a, Mtetlmr existing or pro~, m~l hxlicace all aet-I~k di~mnaiona ~mtmr or t~aeripti~ acco~ing to ~, a~ ~ street ~ma a~l i~licate .Ix~hq~ ~July ~,~Jrn, delX).,m8 mM aaya tirol: lie i.,t Lhe allpi i(:mll. Ihe ~lpl)licntion; thnl. nil ~Lul~l~nl:. cc~ntni*xn in this nppl i(:ntioH lilo l l~ LO the I~sl: off his klx~t~lgo a[xl I~[iefj n[xl lhnl. the ~)rk ~i Il Im i~rfon~l ~ii illl~ ll~l[ll~r ~[ [orlh hi lite ~pp] toni:ion riled tl~r~it.h. (Silpml'ure of Appl __ o-.o..,,~..,,_ , Elizabeth Simcik ---~ .... ~--.~ , O~ LIU[ r, AY 1999' T, OW ;~ SOUTHOLD SU~Y FOR D.B.M. COMPANY H MAY 14, 1999 LOT NO. ~, "HIGHPOINT BEADOWS, SECTION ONE OC~ 16, 199~ ~T SOUTHOLD D~TE: DEC, 16~ 1~91 ~N ~SOUTHOLD SCALE: F'=50' SUFFOLK COUNTY, NEW ~RK NO. 9~- HO9 ~U~N~ES ~0 M~ON ~Lk RUN ~kY m HE~ DEP~RTMENT-DATA F~ APPRO~ TO C~STRUC T mE ~ ~ WMO~ ~M~ su~Y ~S " YouNG YOUNG ~ RIVER~AO~ NEW ~RK NOTE~ ·: MONUMENT SUBOiVISIOH MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W.~UNG, PROFESSIONAL ENGINEER SUFFOLK COUNTY ON MAR. 19,1990 AS FILE NO. 89i0. ANO ~AND SURVEYOR N Y.$. UCENSE NO 1~845 HOWARD W. YOU~G, LANe SURVEYOR. BRANDIS & SONS INC. I , L=62 6" r · / { ,, , SPLIT RAIL FENCE/~ ~ ~ '% . O~ ,~2~ or formerly ;, ~ SU~Y F~ D.B.M. COMPANY LOT NO. 2, "HIGHPOINT MEADOWS, SECTION ONE" oc~ tG, ~997 ~:~ ..... Co~.n,yt ~N ~ SOUTHOLD SCALE: ¢'= 50' ~OT ~ ~ i~7 ~ SUFFOLK COUNTY, NEW ~RK NO 91-1109 , ~ur~lzgo ~crms~r~o~ OS~OD~T,ON m mis CERTIFIED TO~ sunv[~n's ~.K[O S[*L OR [~aOSS~O S[~L S~LL TICOR TITLE GUARANTEE HE*';~.~,. DEPARTM~NT~ -DATA F~ APPRO~ TO C~S~RUC T ~E mR~ FOR WHOM THE SU~EY IS ~" ~ MAIN STRE~ ' ",, ..... .... NOTE: M = MONUMENT . SUBDIVISION MAP FILED IN THE OFFIOE OF THE CLERK OF ALDEN W~UN6, PROFESSIONAL ENGINE ,.'~, SUFFOLK COUNTY ON ~R. Ig, Ig90 AS FILE NO. 8910. &ND LnNO SURVEYOR N ~'~ HO~RD W. YOUNG~ LANO SURVEYOH : , :. . , '. - . ' , : " , .. . .- . :, .. :. ._, .'. .. , ',, . · ' Elizabeth Simcik ',, .~ ."'' ' ' : ' '-:. v ,; : ' now or-foX, r.." ' : ' , ~~ :.,..:..: . ,' ,.. ,: ::.-.., ~ ,.' ~. '," , , . ., ., , ,. :. -.~ '.. ,: .:,~ .' . . . " , " ."':.1' . ,' " ' ' '.. ' ' - ,., ~ ' .. '..' ' ~': '. 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