HomeMy WebLinkAbout20127-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20386 Date NOVEMBER 29, 1991
THIS CERTIFIES that the building NEW DWELLING
Location of Property 630 ORIOLE DRIVE SOUTHOLD NEW YORK
House No. Street Hamlet
County 'Pax Map No. 1000 Section 55 Block 6 Lot 15.8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 4, 1991 pursuant to which
Building Permit No. 20127-Z dated SEPTEMBER 6, 1991
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 ACCESSORY GARAGE.
The certificate is issued to DBM CO.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-70 - NOV. 6, 1991
UNDERWRITERS CERTIFICATE N0. PENDING - NOV. 25 1991
PLUMBERS CERTIFICATION DATED OCT. 3, 1991 - K&K PLUMBING & HEATING
r .
uilding Inspector
Rev. 1/81
roses xo. s
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)
No 2 012 7 z Date ....4~.....,~..~~..:~.......~......., 19.`?..!
' Permission is hereby grouted to:
'L3 M Cq ,
y ~3......~'1.....~..~...~.-e-~'........
d:~:....~:.!~..... i.i q ~ ,
to .~..w:R:
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at premises located of ~.~D.....~.`.~.
r.4.~.t..~.....:...a?..2
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County Tax Map No. 1000 Section _Blockt~.,...~~:P.......... Lot No...~.~.:..4..........
' pursuant to application doted .....~5?.^..^^:`.'`.~'i:~,......J..........., 199...., and approved by the
Building Ins`pelctor. VVV
Fee 5..3~ :
.~(S..C..I,....,
Bw ing Inspector
Rev. 6/30/80
cL7R~ a~~~ Form No. 6
~~~`Z~• ~ TOWN OF SOUTf10LD
7 .~_OILK, D ~ BUILDING DEPARTMENT
mot/ _'177] TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCllPANCY
' 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 11nes,
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 yr engineer
responsible for the building.
r 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, 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.
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 S years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
~~yy Date ~I
:cw Construction...1\...... Old Or Pre-existing Building..
~.S'a ~ nfa ~ i~
.ocation cf Property.... ~ b............(~ !:~.1.Q.~:,c.....7 2
House No. Street Hamlet
)nwer or Owners of Property......~~.~...~ ~
_ ~ Q
;ounty Tax Map No 1000, Section...4~?.:? ......Block ...........Lot..~:S.~. ~
subdivision.. :'.//.Piled Map.........,.,Lot .
'ermit No. ~ U.~.a ~ -..Date Of Permit...~.'~?:.~~,...Applicant.,~.~.M.Cd.'
Iealth llept, Approval.. ~.-,S O -.~O ,,,....,,,Underwriters Approval...
'lanning Board Approval
request for: Temporary Certificate........... Final CerticaCe...~......
'ee Submitt~eyd: $,.~;~,:OU,
Q~ • l~i~~,~ . . . . . .
APPLICANT
Co ~.ao38
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JK
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TEL. 7G5.1802 ~ j
0~0.,, Oy
TOWN' Or SOYJTIIQd~D _
~ • .4 ~ ~ 1 F
a ; t OFFICE OF BUILbitlG INSPECTOR K,°~'
r L°n ~ ' rn P.O. BOX 728 I
~+0 CA z T01VN HALL +xr'~.'
k ; //,~O! ~ ~~O~c SOUTHULD, N.Y. 11971 _ ~F
• ~ Ffyj~
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C E I2 T I F I CAT I O N - ~
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Date `
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Building Permit No. ~ Q ~ Z
Owner '~'P)'t'(~ C c~c p ` '~F
(please pr'nt) 4`~~"
1,` t
6~i
(pleas p int) ~O
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I certify that the solder ua3ed in the water supply system
ti r
~Stcontnins less than 2/10 of l;} lead.
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t~,,
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+ 4
't
~ (plumber's signature)
Swor to hcfor: me this
day of oZ.) O t) ~ '
19~ ~ ° /'~~~i,~,c~~ Jk-~.
Notary P lic ~,i
+
potary Public, County SC+SANNE 1. PfRRICONF
NOTARY PU6LIC, State of New York
- ~ IJo. 48627')9
' Qualified in Suffolk County
- Commission Expires Jan. 7.0, S9 ~ 3
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MELD I;:S1'EC:iO;J ~~UA;E ~ OOMMLNT° yl
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FOUiJDAT20N (1st)
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FOUNDATIOtJ (2nd) _ - m
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ROUGH FRAME &
PLUMBING
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ItJSULATI0P7 PER N. Y.
STATE ENERGY
CODE
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
DATE l INSPECTOR
/
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
(]FOUNDATION 2ND [ ] INSU N
[ ]FRAMING [ INAL
REMARKS: ~ S
DATE 11 ~Y INSPECTOR
~~1
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ROUGH PLBG.
[ ]FOUNDATION 2ND ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
4-,.~'- D
' <
DATE ~ ,I' INSPECT
765-1802
BUILDING DEPT.
INSPECTI N
[ ]FOUNDATION 1ST [ ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~~~u.~.~P
DATE INSPECTOR /
765-1802
BUILDING DEPT.
1 NSPECTION
[~UNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
_ _
YG~~~_
TE / ~ Z INSPECTO r
~
rc~-iso2
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: -
DATE lO ~ INSPECTO
Fairweather • Brown
Architects • Designers f~
~~c ~
Box 521, 122 Front Street Garden jc., t°~
Greenport, New York 11944 ~ '~',w(/ ~ „f~~
(516) 477-9752
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''~zat?~4~~.'`~,Q .l
September 2t4, 1991
Mr. Tom Fisher, Building Inspector
Southold Town Building Dept.
Southold Town Hall
Southold, N.Y. 11971
Re: D.B.M. Co. House
Lot 5 Highpoint Meadows
Suffolk City Tax Map No. 1000-55-6-15.8
Dear Mr. Fisher:
This is to advise you that structurally, we find it
acceptable that the rear foundation wall be constructed
with one pier rather than the two piers shown on our drawing.
Please call if you require further information or
clarification.
Thank you.
Sincerely,
Robert Brown, A.I.A.
Fairweather-Brown/Architects & Designers
•
E10.1F0 OF HE.\LI'Fi
' ~....r~ FORMN0.1 3 SETS OF PL,l77S U'•;~.~•~
C TOWN OF SOUTHOLD SURVEY _ ~ _
SEP ' Q 19g~ { BUILDING DEPARTMENT CIICCI: _ . /L~ Y... _ .
,~j ~ TOWN HALL SEPTIC FORA
SOUTHOLD, N.Y. 11971 pp~~ '
; TOt~'~~~is~',~:. ~fF~~t~t~r7 TEL..765-1II02 ,:OTIF'f: ,,A\w~~. `~77 a2dd3
"xamincd 19. CALL ....dJ .
f ~ MALL T0:
•PProved~~~• lo•, 19nI Pernrit No.c~ D ~c1~ .
'isapprovcd a/c _ _ .
(Bur mg Inspector)
APPLICATION FOR BUILDING PER~AIT
Date . , 19
INSTRUCTIONS
a. T}ils application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, rclationsltip to adjoining premises or public streets
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ion.
c. The work covered by this application may not be commenced before issuance of Buildin; Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
dl be kept on the premises available for inspection throughout the work.
e. A'o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
11 have been granted by the Building Inspector.
APPLICATION IS HEREBY MAbE to the Building Department for the issuance of a Building Permit pursuant to the
'!ding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
:ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
applicant agrees, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
nit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Mai]ing address of applicant) 179 wy
to whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......4. u?./J,e.Y
ne of owner of premises D Q, F'1 , , •Co .
(as on the tart roll or latest deed)
~plicant is a corporation, signahire of duly authorized officer. •
(Name and title of corporate officer)
Buildcr's.Liccnse No. ,
Plumber's License No. ..~3 5 ( p~ ,F 1,~
Electrician's License No. .S!}C~r~ tAt~~yy,~,~~
Other Trade's License No. .
.ocation of land on which proposed work will be done . .
.........1°.3~.. ~/:I o t..L. 7R.
louse Number ~~,U,T'i-FO ~ ~
Street
Ilamlct
ounty Tax Afap No. 1000 Section ,
~ 5........ Block
Lot ~5.~. ~ .
~bdivision../-~~~({~oi.u7- J''/,c;4i~,OwS,,,,,PilcdMaPNo.
(N.mc) Lot...............
ate existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy
Intended use and occupancy !~~?^~..../~tJ.JS t
. . t
3. Nature of work (check which apl}licable): New Building Addition Alteration
Repair Removal . •',~r...
Demolition .Other 1Vork , , , , i
4. Estimated Cos (D'esfiript~d~i,
5. If dwelling, number of dwelling (to be pard on filing this application)
If garage, number of cars ° ullnits , . , , , , • , , , Number of dwelling units on each floor , ,
6. If business, commercial or mixed ,occupancy, specify nature and extent of each type of use ~ ~ ~ ~ ~ ~ ~ • ~ ~ •
g
if any: Front [tear .
Her•ht
Numb Depth...............
D!imcnstons of same stnutureuwrt,l'er of Stories .
h alterations or additions: Front ~ ~ ~ • ~ ~ ' ' ' ' ' ' ' ' ' ' ' '
Rear...............:?.
pct
8. Drmcnsions of entire new constru Height . . . . . . . . Number of Stories ;
Height Gtion: Front . . . . . . . . . Rcar ...............Depth .
~rofStories......
9. Sizcoflot:Front ..~gumb
Rear ......1.~ ~ Depth 3 00..... .
0. Date of Purchase
"""'T•••••••••••••••.NamcofFofinerOwncr ,
1. Zottc of use district in which prcnt /
2. Does proposed construction violat~sany zoning law, ordinance or re•~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ' ~ ' ' ' ' ' ' ' '
3, 1Vi11 lot be regraded °ulation : .
Name of Owner of premises ..~r~,i N, „C' ~ ~ ' ' ' ' ' • • Will excess till be removed from premises: ,lGe+ No
R...i .......Addicss`,(.~13 Fj.t/,~.•5T,...PhoneNo..!'I?,');Z~%Z3
Name of Architect (j4,r,Rwc rrFER- Qr2gW,v ,Address , F'Ra7.~-r 5 t CyRfh' '
Nance of Contractor ' ' • • ~ • • • • • • Phone No.. y ~ 7: /cS?
i. Is this PrYes,tSouthold Tao feet of a tidaldwetland? ~ ~ ~ ~ • • • Pttone No.
p y Yes.
*If n Trustees Permit may be required. • " ' No..t/,,,,,
~ PLOT DIAGRAM ,
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
roperty lines. Give street and block nu{nber or description according to deed, and show street names and indicate whether
tterior or corner lot.
i
~ .
i
~TEOPNE~VYO K,'
JNTYOP~~.,,,,, S.S II
' ' ' .q~, "'"'~.'sll'A•`' L being duly sworn, deposes and says that he is the applicant
(N; n~of individual si nin cq
;c named. g g ntract) .
t the ~Q~~y~w
(Contractor, agent, corporate officer, etc.) ~ •
ud owner or owners, and is duly autliorizcd to perform or )cave perforntcd the said work and to make and file this
capon; that all statements contained ~n this application arc true to the best of his knowledge and belief; and that the
will be performed in the manner set fgrttt in the application filed therewith.
n to before me this
.........day of ....Jx.~,"__'l!~."~~. 19 9l
"Y Public, County
• L i
. NOTARY PUCe((~E 'I .
No. 4882799 w York i, ~ (Signature o .
Qualified In Suffolk County ~ f appllCant)
Camrnlsalon Fxptres Jan, 20, r9 H Z '~I
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Subdivision - °F@ighpoi€~t fVfeodows, ~
Section One" ~a , ~
Suffo9k County RiBe fVo. 899®. , o®
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AT SOUTHOLD scA~E 1 so
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' NOTES'®=R90NS;MENT !
APaC LA(~D SURVEYOR N. Y.S. ESCE4~SE N6 S2S4~
SU'~D9V ISSON MAP FcLEC tNTF1E OFFICE OF Tti ECLEReC OF ~ k
SUFFOLK COUNTY ON MAR. i9, lS90 AS FdLE NO. $9SE. 940~PARD w. YCt;?~G, LBaND SCERVEY'CR
. N.Y. S. LICENSE S~0.45~95 - za.
~ gTHC~ LcxArs~,~.s.(wS, ~9TYG BmeascQ4YB®cE Qa.s6~1 ea &~sa
T4E8,ID TP8RV9 OW E39RR 0®Y~O~®~ OTR8ER3
I~ c BRAPoOd4 S SONS PNC. ~ ,
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Mary Wheeler
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Robert Goldsmith w
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Subdivision -'1lighpoiM Meadows, ~
Section One" a" p~
Suffolk County File No. 8910. ~ N9' o°
N0.
Q.,
LISA DRIVE
SURVEY fOR
D.B.M. COMPANY
LOT N0.5, "HIGHPOINT MEADO WS,SECTION TWO' SEPT 18, 1991
AT SOUTHOLD DATE. JULY 22,1991
TOWN OF SOUTHOLD scALE~ I"=so'
SUFFOLK COUNTY, NEW YORK NO 91-0644
w wYprNORIECp uru{nox on AOOInoN ro rxn
TVRVCr Y A VI0.AtIOM W ]L CLION >]0] Or IX( ,
NEw vORN ]i1fC CWCRLION LxM
w corlES ar mis suxvfr Nor KARWG rN[ LAND 4P,IE DF NFk-
TVRVE10R3 IMNEO SUL OR EMt OS5E0 ]E.LL SNRLL
Mpl ]C CUM]IpC K010 tf A Y1LIp rRUE COVY O
MGUARIM}[E] IMpIUT[0 X[R[ON SHALL RUN MLY Tp ~,yLO Kr a
HEALTH DEPARTMENT -OAT4 FOR APPgOL4L TO Cp15TRUCi TME rtRSON con wxoY rxE spPVn n RRERUfp E°-
Axp a xls KxALr ro TM( TlrlE CCMPANY~ OOVGN- ZOO ~QG
N NGLP[]T wPIG YAIM~NI Y NSOURC( CI WATER MIMTE _PUN.,(.- NEMiAL A6f MCY .LMO Lf M01NB INSTIIV>ION LISi[D
NYIr<O TAP YAI LWi~O-P],![Ci1pM _OIL NDCP ~_LpT 158 NEIIECN, INO TO ME IT]IOxECS Or fMf LCx01N0
N iMLP( AK IO M'(LLIW/ WITMIM 100 rECY Of TYL PPOY[Pir IMS LIrUTICN OUARAMTC[S APE 1qt tpANS[CRA LL[
OTN[P iNAN TNOfE SMOwM XGLOM TO AOOITIpNAI INSTITVTIp1E OP SVl3[OVENT
N TXL wAT[P ]UMLY RMp ][wAK MVOCAL SY/T{Y rCP TMl/ POIpLMG( OYMEPS
WILL CLwfOPM l0 THE 1TAMPLPO/ Or iN{ SUr[OLK COUMi1 OOLPTM(NT Y OI SrANt(] SNOwM M[PLON EPOY IRMER>Y UM[l
OI NULTN tLMICt/ 10 [RISTIM] [LRVC iUR[l APL rOR A SI[CIrIC M1O
IUPPOS[ AMO APL MOT TO !E US{0 TO {ILNUSN C,x Q
AIwLILANT~ IPOPLPiY LINE] OR rOP LNC LRECTION (I r[M<[S 'y
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AOpILK
nL YOUNG & YOUNG R,
VER~IEpo"new voRKE
NOTES ~ ~ =MONUMENT D =STAKE ALDEN W YOUNG, PROFESSIONAL ENGINEER
SUeO1V ISION MAP FILED IN THE OFFICE OF THE CLERK OF 4N0 LAND SURVEYOR N YS UCENSE NO 12843
SUFFOLK COUNTY ON MAfl.19, 1990 AS FILE Na. 8911.
HOWARD W YOUNG, LANG SURVEYOR
, a •M LOGTI0101 PR2LIWI,KPT10 iAIMl/TI~C[/WOL/(fY1 N10wN MGtON N.YS UCENSE NO ISB93
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SUBDIViS10N MAP FELED iAt T1iE OFFICE OF THE CLERK OF AND LA;~D SURVEYC~ N.YS.LICE~SE Pl0.128~5
SUFFOLt~. CDUN7~! ON MAR.33, 1990 AS FILE NO. 89!(. ~
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