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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23129 Date AUGUST 1, 1994
THIS CERTIFIES that the building ACCESSORY
Location of Property 325 ORIOLE DRIVE SOUTHOLD, NY
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 6 Lot 15.27
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 17, 1994 pursuant to which
Building Permit No. 22103-Z dated JUNE 3, 1994
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 AN ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to MARK & JOANNE SOLO
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N321351 JULY 25, 1994
PLUMBERS CERTIFICATION DATED N/A
L~
>66ilding Inspector
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)
Date 19.. F.
j NO 22103 Z
Permission Is hereby gra d to: /
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to `U!C ? -'w / CCr SfO. C PF1f~~i
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at premises located at 11*45 .............i~~/C~ r~/../
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County Tax Map No. 1000 Section 7........ Block 0.(0 Lot No, r`
pursuant to application dated .............:~~.1. 19.... and approved by the
l Building Inspector.
Fee 'G
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Building Inspector
i
Rev. 6/30/80
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TOWN OF SOUTHOLD C~
BUILDING DEPARTMENT IL[ S _ l l
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building I~
inspector with the following: for new building or new use;
1. Final survey of property with accurate location of all buildings, property lines,
J,~l(
streets, and unusual natural or topographic features. IV
Z. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). IV
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 17 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 - $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
:ew Construction........... Old Or Pre-existing Building
.ocation of Property ...3''15.......0/?/6"/-t DR% . . L... 5C L} 7
House No. Street Hamlet
171 n.. P
l~i 0 c... t ~ I_ O
rower or Owners- of Property . . . . .A,J__
ounty Tax Map No 1000, Section.... y.......Block................Lot......s:~
y
ubdivi;ion. ....................Filed Clap............ Lot..... t.i.c . . .1 jL~
v .......Date Of Permit Applicant. ~R/~. A/ NC. SO~p
ermi[ :lo.........
e31th Dept. Approval ..........................Underwriters Approval.........................
lanning Board Approval
equest for: Temporary Certificate........... Final Certicate...........
ee Submitted: $
c^ 4`d ao0
APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000121 BUREAU OF ELECTRICITY
88 JOHN STREET. NEW YORK. NEW YORK 10038 t
Date JULY 25,1994 Application No. onfile 06165594/94 N '21351 g
THIS CERTIFIES THAT k
only the electrical equipment as described balmo and introduced by the applicant named on the abode application number in the premises of
MARK SOLO, 325 ORIOLE DRIVE, SOUTHOLD, N.Y.
in thefollowinplocation. ? Basement ? let Fl. ? Ynd FL GAR/OUT Section Block Lot
RCas eramined on JULY 18 .1994 and found to be in compliance with the National Electrical Code. "
K
R
XTURES RANGES COOKING DICKf OVENS DISHWASHERS EXHAUST FANSOUTLETS ~KM
MXTUlE r2T
NCANDESCENT FLUORESCENT OTHER NAT. K.W. AMT. K.wAMT. K.W. .WT K.W. 3 3
DRYERS RIRNACE MOTORS PUTUM APPLIANCE MERGERS SMCIAL IMCFT TIME CLOCKS RELL UNIT HRATERS MULTI-OUTLET DIMMERS .
AMT. K. W. OIL H. P GAS H. P. NAT. NO. A. W.G. MIT. AMP. AMT. "Fs. TRANS. AMT. N_ P. S AMT. WAi15
NO. OF OF FEET
SRRVM DISCONNECT NO.OF S E R V I C E
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AMT. MP. TYPE 1 / m 1 X rw j3 X rW S / AW NO. F C . ONa. Of CC. COND. OF HI-LEG OF H .AG .W OF NEUTRALS OF EUTtAI
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OTHER M?ARATUS:
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PAUL R. BURN LIC.#3897
P.O.BO% 1061
SOUTHOLD, NY, 11971-0932 G&JUM MANAGER
11
Per s
This certificate "W not be ahered 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 MUST NOT BE ALTERED IN ANY MANNER.
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Town Hall, 53095 Main Road C41 = Fax (516) 765-1823
P. O. Box 1179 .F Telephone (516) 765-1802
Southold, New York 11971 ,f. 0!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
~ July 19, 1994
Robert Bohn Contracting
P.O. Box 55
Peconic, NY 11958
Re: Mark & Joanne Solo
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)
xx No Underwriters Certificate on file.
The check is (outdated/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 # 22103-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
M-180 p ~
BUILDING DEPT.
NSPECTION
[ T-IFOUNDATION 1ST [ ] ROUGH PLBG.
[FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: gz4i?~a /z
-y
DATE INSPECTO
'A_'L'u~
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FOUNDATION
(1st) I~ 9 q a
FOUNDATION
(2nd) ry.
2.'
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INSULATION PER N. Y.
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STATE ENERGY II c~
CODE
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FINAL
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ADDITIONAL COM9IENTS: s
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or
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Lot 31 Lot 30 T
SURVEY FOR
Q D_B.M. COMPANY TUC irI9z
oT= a°o LOT NO.24(`NIGhPOINT NEACOWS•SECT0N TWO'" Dfr- Ic 99991 '
- AT SOUTNOLD =••e NOV. zr; ryw%
ACC
TOWN OF SOUTNOLO 9c •.E 1'. •p .
SUFFOLK COUNTY. NEW YORK, "C 91-1031
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APPROVED AS NOMD
DATE B.P.# 11 /0
FEEX~-0':
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
- 2. ROUGH - FRAMING & PLUMBING
3. 4NSULATION
4. FINA} °';CONST8UCT10N MUST
ALL
r
Co rx QTY D 14° -(rK St-AgJ ? THE REQbWl M ENTS-:OF*oNY
STATE CONSTRUCTION & ENERGY
CODES. NOT " RESPONSRTLE FOR
DfmraN OR CONSTRUCTION ERRORS
dy . _ VVV
W-W
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BOARD OF HEALTH
FORM NO.I ? SETS OF PLANS
TOWN OFSOUTHOLD }~URVEY
BUILDING DEPARTMENT ~ItECI: . .
TOWN HALL SEPTIC FORK _ .
SOUTHOLD, N.Y. 11971
TEL.: 765-11302 t:0'cIFY~
CALL / 1
Examined ...../~y~ 19p MAIL TO:
Approved 61(~...... , 19/.Permit
Disapproved a/c
~
( il I g Inspector)
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
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, ordinances, building code, housi ode, and regulations, and to
admit authorized inspectors on premises and in building for necessarynspectiorl'O
(Signature of licant, or name, if a corporation)
y t~
~~.x.. ..P::..........l...or t
(Mailing address of applicant)
State awhether Qapplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
T ACTW Ct
Name of owner of premises ll. Jl...... T.o p
(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. ...l.`.!~..- r").T
Plumber's License No .
Electrician's License No .
Other Trade's License No . .
1. Location of land on which proposed work will be done .
S Qlo( C~..... TE(Dc~..................
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot 27
Subdivision Filed Ma No. Lot
(Name)
1 State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy !J~ ~ ~u 4 /.G
b. Intended use and occupancy S. 17-1 :'.c y- ,
I
.3. Nature of work (check which applicable): New Building . rv...... Addition • • • • • • • Alteration
Repair Removal Demolition Other Work .
(Description)
or+
4. Estimated Cost...7111 Fee......................................
(to be paid on filing this application)
5. If dwelling, number of dwellin units Number of dwelling units on each floor
If garage, number of cars ..7. 40tt .
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 ofStories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number f Stories y..... .
8. Dimensions o eptire new construction: Front Rear Depth Z l
Height flu byr of Stories /
9. Size of lot: Front 7Z : Rear v.L.' 2Y.......... Depth 7 a............ .
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 within 300 feet of a tidal wetland? *Yes........ No..V
*If yes, 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.
EKfsTiri~ I
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6~/,Uz , l~,LI r
STATE OF NEW RIK S.S
~ L~j"U 1 C) ~t
COUNTY OF..
• , , , , , . Sf~S0~1 C; A.-d..°.`l being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the . C .-Y T-0& .
J M1
(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.
wom to before me this
(yj~
l.. '.`...day of 14
Y.
Jotary PubliL County
CLAIRE L GLEW ".....~J w~ z'.... .
Noel" Public, State of Now York . of alicant)
No.4879508 (Signature pp
Gu8lMW In
Co"M%lelon Expiree December 8,8, 19