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HomeMy WebLinkAbout20411-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20682 Date APRIL 27, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 470 ORIOLE DRIVE SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 15.10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 28, 1992 pursuant to which Building Permit No. 20411-Z dated JANUARY 29, 1992 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 A3 APPLIED FOR. The certificate is issued to DBM CO. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-117-APRIL 20, 1992 UNDERWRITERS CERTIFICATE N0. PENDING - APRIL 27, 1992 PLUMBERS CERTIFICATION DATED APRIL 22, 1992 - K&K PLUMBING & HEATING Bu.ldin Inspector Rev. 1/81 soast xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N a 2 0 41 1 Z Date 1,~~,% 19.~.~- Permission is hereby granted to: ~ 1:;~ ~ r to .F~'tr?rC.....C~......~~..... ......C.~~i.......~~~~..' .4:. .r C~~a............... . . . . . . . . . . . . . .j . , . . , . ~A ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . of premises I«ated at ....::....1~.!`.~G .............................................Sl.s'~ County Tox Map No. 1000 Section ..4:~..~..~....... BI«k .........~?..........pp. Lot No......~~.'~'®.. pursuant to applieatlon dated ......../..~e2..~ 19(..s~, and approved by the Building Inspector. Fee S: ~ .l.~.~,iC Build Inspector Rev. 6/30/80 ~~qq~~{//~~ QQ F y~ V.,LC,o ~ Form No. 6 ~i~"^ G)~°" TOWN OF SOU1'FIOLD ~ - z Z z BUILDING DEPARTMENT TOWN FIALL 765-1802 APPLICATION POR CERTIFICATE OF OCCUPANCY .1. 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 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, ai certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 3. , 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, sheets, 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwe111ng $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 y.. a~.....j.Z :ew Construction...S~..... Old Or Pre-existing Building.. .ocation cf Property....:. ~ V O P I O ~ C= .~2~ SO U. T" }-1 O ~ Ll douse No. Street Hamlet )nwer or Owners of Property.... ~ ....L., U . ;ounty Tax Map No 1000, Section... ~ ~ ....Block....., 6 9S./D 11 ......,.Lot ;ubdivision.ti~C IC~,N,(~U~ ~T f"(Ef1l~OW S Filed Map.........,..Lot 'ermit No.aQ:~,~,~, ....Date Of Permit.. ~.L~`~~:~,Z...Applicant....~,~.~,.C?? Iealth De t. A roval..~.~,. ~ ~ P PP .....Underwriters Approval... . Tanning Board Approval request for: Temporary Certificate........... Final Certicate,,.?,,,, , 'ee Submitted: $..c~5.s~.v ~ ('o~ao6ga AP'PLI ' T / .-•-_.-..v....a...,»+YeiwiwA,revx.~...urn.~..w~^'~F:a2f'iaC"'9!'"'."";:"''«"egy'3".';..,_. _W._ ~ 8 f~. t.~, OS~F~(j(~.~0 TEL.7G5-1802 ' { 1 ~ Y ~ ~y TotvN or sq~o r~ioLn ~ t'4=n`??:t" ~ OFFICE OF UU?LDit•!C INSPECTOR ~ o ~ ' ~ p.0. DO!C 728 ~ '?~,,~`.P i Off' SOU7HOLD,N.Y.1197) ~ !!Oj ~ ono {•`~d.; r q(~ ~R ~ ~ ;}z ~ C E R T I F I C A T I O N _ `h~R:, ' 'x~, !~r'" ,F-z~., ; a. I 1 i Date ~-'2 Z ,n.~,. ,fv~~ , ;f. 8uildinq permit No. ~ D ~ ~ I Z. ~"~I r:, Owner 1~ /_3 M Co, 't}a Ip ease r ;~`t, p >.nt? r 4 ,1 lp ease pr'ntl ~ ~'::F;x r„ x ;tip ``j 1' '~~Ab i I cortify that the solder used in the water supply system ~nR:: contains less than 2/10 0€ 1~ lead. - w#;~.~~ .'r, (plumber's signature) Sworn to before me this ~ ~ --~.~Qday of ~ f~~ ' Notary p is 'y;t~ fiokary ~tubl,ic, p Caunt~ SWSANNE J. PERF2ICONF •v~ (VOTARY PUBLIC, Stele of Naw York No. 488299i,~ Qualified in Suffolk County "I CoixmiaHon Expires Jan. 20, 1993 : u C'° i ~ }ryi k w!d ~.o~~r r65.t802 BUILDING DEPT. 1 NSPECTI4N [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSU [ ]FRAMING [ INAL REMARKS: ~ ~ INSPECTOR DATE 2~~~( r 1 rss-~soz BUILDING DEPT. INSPECTION [ FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ DATE INSPECTOR ~~'6~ ~~i 765.1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [)FRAMING [ FINAL REMARKS: -c~-~-- t DATE L1~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL n REMARKS: ~-~ti''~-..(J~---~~:~ r ~ (~J ~ n/~'-4 DATE ~ ~3 ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST OUCH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ ~ ~ ~ ~ .,C. r DATE INSPECTO . ~~j rss-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL R/EM K~S: ~ ~~.e., 7 a DATE ~cP ~ INSPECTOR ° ~ ~G "6 ~~r/ 765-1802 BUILDING DEPT. INSPECTION [ ] FO NDATION i5T [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: g ~ ~ a l/ DATE / INSPECTOR ~lELD~i::SyE .1J:; ~~J„, l~ ::i:Mi4E.NTC 0 s . ~ I ~ ~ H 'OUI7DATION ~I flst) 'OUNDATIOf7 ( 2nd ) ~ ~ ~ Dr ©1 ~ ..y~'C ~ O :OUCH FRAi~fE & ti ~ ,2iy ~ o r~ PLUMBING .3~3 z- n :17SULATIOf! PER N, Y. °-3 STATE Ef7ERGY CODs I ' . LY ` ~ m H I i FI;7AL I ~.ry 0 ' I ADDITIOf1AL COMMEflTS: m x • x ro H a . H tii O f - ~ . m ~ Q ' ~ ~ . o. _ m R ~ THE NEW YORK BOARD OF FIRE UNDERWR{TERS ~ 12~bf~l-? BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date P{P1Y 01,9.192 ,4pplicationNo.onfile 76232092192 N %3r10~11 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 D6td Cp, '7 Otdl6L11 I)P,., 9~1U1'IfOLt1, Pf,Y, in thefallouing location: ~ Ba.9ement ~ lst F'!. ? 2nd Fl, jt~~~C ((YQ~ Sertian Bfcek Loll uas exmnined on !f fl ~l ~'f ~ + ~i' } ~ 2 and found to be in cornplianre with the reYiuirentents q~ this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT. K.W AMT. KW. Amt K W AMT. H P 22 2H 3`.i 9.6 1 2.7. 3 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W, Oil H. P GAS H. P. AMi NO A. W. G. AMT. AMP AMi AMPS TRANS. AMT. H P SYSTEMS AMT. WATTS NO. OF FEET 9. '1, - k 3 600 SERYICE DISCONNECT NO.OF 5 E R V I C E METER NO. OF CC. COND A W G. A. W. G. A W. G. AMT. AMP, TYPE EQUIP. 1 ]W 1 ~ 3W S,a 3W 3,e 4W PER 9 OF CC. COND. NO. Of Hi-LEG OF HbIEG NO. Of NEUTRALS OF NEUTRAL 1 100 01:3 1 % 1 ~ 1 2 OTHER APPARATUS: :lxalts n;rECmot;: - 1. G!~~-~ SAfffi & J.AI}k1I49tNN 7NC. T,Tt`.~3635•F; ' p. 0.60% 176!1 SOlf9ffI0I,I11 NY, 1.9,971. GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED IN ANY MANNER. a . 3- Nature of work (check which applicable): Netv Ouilding~X......... Addition Alteiation . Repair Removal Demolition ..............Swimming pool............ Tennis Court•......... Accessory Building......,,..Fence .......Other Work... 4. Estimated Cost Fee ¢o be paid on filing this application) 5. IC dwelling, nurnber of dwelling units Number of dwelling units on each floor If 3aragc, number of cars . 6. If busine4s, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions o(existittg structures, if any: Front . . Rcar , . , Depth . . ileig}tt Number of Stories . . Dimensions of same structure with alterations or additions: Front Rear . . Depth Ilcigttt ......................Number of Stories . 8, Dimensions of entire new constnuction: Front Rear Depth , . lici;ltt . Number of Stories . . 9. Size of lot: Front & ~ . Rcar Q ~ Depot .2 R 0 ~ t0, Date of Pucchase . .Name of Former Owner , 1 1. Zone or use district in which premises arc situated . . . . I2. Does proposed construction violate any zoning law, ordinance or regulation : . . 13. 1Vill tot be regraded , ,n~ ...Will excess fil be removed from premises: Ycs , No X. ' V,'8'~.'C~G:...... 443 h~a~.n S~. I4. Narne of Otvner of p miles ..Address Pltone No..4.7, 7.-2.22 3.... , . Name of Architect `~atinw~it~.h'eR ; BXacdVt:::: ,Address Fiidvt.a`; 5~.::Gicj~,~:.phone No. 477•- 975 2 , , • , , , Name of Contractor . .Address ..Phone No..... . . . . . . . 15.Is this property located within 300 feet of a tidal wetland? *YGS....t30xX.. *If yes, Southold Town Trustees Permit may he 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. STATE OF NE1V YO S.S COUNTY OF „ , Su~~o2h H A R~ = S R. A. E L , , . being duly sworn, deposes and says that hr, is the applicant (Name oC individual signing contract) about named. (Contractor, agent, corporate ofCiccr, etc.) oC said otvncr or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all staternents contained in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application Glcd therewith. Sworn to before me this Sf .........:............day of.. . ~:u~:~.., 19 Notary Public, County ~(~L~v SIDSANNE PERRI We . FP . -7VbTARY Pt1aLiC. State of New York (Sl~flaYnr~ Of a hCant) No. ,4882799 tloMlfled in Suffolk County COMF116aitlrl Exptrea Jon. 20, ,I9 ~ 9 I BOARD OF HEiALTH . ~ FORMNO.1 7 SETS O~PLANS , . SURVEY TOWN OFSOUTHOLD ciiECx ,~k,~Q~~-i 6U11_OING DEPARTMENT SEPTIC FORF1 TOWN HALL $OUTI{OLD, N. Y. 11971 NOTIFY; o~p J q TEL.:7G5~1$02 CALL N~7;a;?~3 Examined , IJ . ~L,~/~ b1AIL T0: Approved 19~..2Pennit No. d. G!,~?~~ • • . Disapproved a/c , 'i , . ~-'.a r~i.~ it i..~-~.~~~~a.:,~~ ~ . , , r ~f E ~ t . ~ . , ~ 1~ ~ _ , s I ~c.. e ~ ~ ~ ,J ( dding t ector) i, ~ 9 ' APPLICATION FOR BUILDING PERMIT ~"~i.~i~rf"~'-r ~ ~ ' s~~ . i ~.-f C;vdty.t'~;,:at;a~';'s-,tr[.s~s ~ i Data 7anucth.y 20 Iy 92 ~ INSTRUCTIONS a. Tlus application must be coYnpletely filled in by typewriter or in ink and submitted to the Building Inspector, with ~ sets of plans, accurate plot plan to sale. Fee according to schedule. b. Plot plan showing location Qf lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of Inyout of property must be drawn on the diagram which is part of this appli- cation. a The work coveted 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 l'etmit to the app8c;utt. Such petmit shah be kept on the premises availab,e 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 Buildr~tg Inspector. APPLICATION IS HEREBY M~DE 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 o~ buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildutg code, housin>; code, and regulations, and to admit authorized inspectors on premilses and in building for necessary insp tions. ( ignature of applicant, or name, if a oration) ,P,, U. Evx 2130, Gaeeny~ah~,.,N, y, 1194,4 (Mailing address of ap~licant) State whether applicant is owner, lessee, agent, architect, engineer ,general contractor, electricians; phunber or builder. aWYteK Name of owner of premises .....D IB M Co (as ort the tax roll or latest deed) ~ ~ ~ ~ ~ ~ ~ ' ' ' ' ' ' If a licant is a corporaUOn, si natured PP g iofdulyauthorizcdof(icer. (Name and title of corporaRl'e officer) ' I Builder's License No. Plumber's License No. . , 5 ~ R . (K & K ) Electrician's License No. , ' , , , , , , (Sag e ~ . Other Trade's License No. ~ 1. Location of land on which propose work will be dorc; Un.ia2e 17!e~,ve Sau.tha2d Flousc Number sl . Street • }lamlct • • • • • . County Tax Map No. 1000 Section I 55 , , , , ; Block d Lot.. 15. 10 Subdivision . Htighpo~,n,~ Mea~atu~, , P YIJ:u File) Alap No. l.ot . . State csis ~te) . ling use and occu Inc of rremises and intended use and occupancy of proposed constrttctiora: A• >ixisting use and occup%tncy ' B. 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Area = 31777 s.f. 4 ~ I i l ° m I I `ter ~ i ~ 92 i\~CD ~ 2 /2 / ~y? N~ HOPS\ON Z9~i 61 H Foy O u. 2j ~ ~ wRtEP YRtN 3ro~ ~ R'~ i .2`'•i ~ \0~~ e ~ aR l I SA ~RIV L- 4000 E R' SURVEY FOR D.B.M. COMPANY FEB. 18,1992 LOT N0.7, 11HIGHPOINT MEADOWS,SECTION TW011 JAN.31, 1992 D E C.I6 , 1991 AT SOUTHOLD DATE. OCT. 15,1990 TOWN OF SOUTHOLD scALE 1"=so SUFFOLK COUNTY, NEW YORK N0. 90-0799 N UIYUTMOIIR CO AaruAn oN 'oR ADDIno« m T«If CERTIFIED T0: sullv[r a • vloLUroN of f[CTIOM Tzof os r«E D.B.M. C NSF NpIy NEr YORK STATC fDUCATi ON LA• N COZIES OF THIS SURVEY NOT fEARwG TN[ LANG BRIDG T10 Ff BANK fUR VE YOM'S IMBED SEAL OR EMf OSSfD S[AL SN•LL TICO T ~IA(~rA C'.~ MOT f[ COMSIO[RED TO iE A VALID TRUE CORY N GU •RANT[[f INOIUT[D XUfOM SHALL RUM OfILY TO .a1 `O 'f T«E KRfON fOR rNOM THE SUMEr IS IRE?ARfO O HEALTH DEPARTMENT-04TA FOR APPRO\RL TO CONSTRUCT • r Z c AMD OM NIS fENALf TO THE TITLE CONIYIY, GOVf11M- r M[AR[fT rAT[R YAIr_YI.I MSOURCE a WT[R MIVTE _IVfLI[ _ MENIAL AGE MCY AMD LE NDIMi INSTITUTION LISTED 0 r fllf CO. TAf WR DIfT IOOO SCC TIOM 3S_ fLOCR Ji_ LOT IS.IO HEREON, AMD TO TNf Asf IfN E[f Of THE LENDING R TM[IR AR[ MD Or[LLOM• rITNIM 100 FEET Of TMf RROI[RTr INSTITUTION. GUARAMTf[f ARE NOT TRANSFERAfIE OTM[R TNAM TMOfE fMOrM MQEON. 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" e x ~ X262 'a. 9~y5 yo 1l~ ma yb° ~Z~ s 6~ '3`j 0 fl7^\ I I I moo) I I I _ W IA O` IW / I `I W =o 'b'SLLLI~=oa~d ~'~1 L }off ~s I~ 'fib, I 2 I ~ I I I __~I N M tll~-- - - * I ,£9'61 '3„0£,L6,88'N _ z o ~g }off ~ r Z91 ~ , i ~ ~ ~ ~ L815 oN ally ~}uno~ Hlo}}nS ~ w~ Il~laod ~><ooauua,~ }o doWII-uo(sinipgnS y ~ ~ ~r-~ i ~a . ~ rt' ` Ldp p _c~_~ _ ~ rte. ~ p TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT ~~tale ~L.~,O`d ~ (i ~n~ ea~Fo~vs ~c.Z ACR. .~Z~ REMARKS TYPE OF BLD. PROP. CLASS P ~~r r'f" 1~ e G nD ~ 11 LAND IMP. TOTAL DATE Zv0 ~ zDp ~23~t0 o~~ ~ _ e ~ pd 3 z O FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT 29 ~ hoo TOTAL ~ -1 OO M-, _ _ J TOWN CLERK TDWN DF SD1J1'H°LD 4 2 4 3 4 Suffolk County, New York Phone 516-765-1801 Southold, New Yprk 11971^ Date ~ - R ~ Ig r c~'~ I ECEIVED OF ~ ~ ~ C~ M ~ ~n ,~*tt .e, Dollars ~ For .J `~--Zi.2-/ 7'>- G c[ Judith T. T11er/ry, Town Clerk Cash ? Check ~ C 5 B j~~ ~ /'+C~~~~-~ ) ~ y 'i TOWN CLERK 4 3 2 41 TOWN OF SOUTHOLD >r~-1 Suffolk County, New York Phone 516-765-1801 Southold, New York 11971 ~1- ~ ~ T Date 19 RECE D OF .l/ 1-"' ~'1 Cam'-• ~ ~ O O rs~0 d o a For ~ ' ~~1 J dith T. Terry, Town Clerk Cash ? Check 3 ~-a-~ By U !.ems-~~c, a1.~3 X 36 /ooz ~ ~ ~ ~ /cz7 Ir~` y3. zs X 3 ~ X3'7 F