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HomeMy WebLinkAbout19617-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219772 Date MARCH 5, 1991 THIS CERTIFIES that the building ALTERATION Location of Property 755 ORIOLE DRIVE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 06 Lot 15.6 Subdivision HIGHPOINT MEADOWS Filed Map No. Lot No. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 3, 1991 pursuant to which Building Permit No. 196172 dated JAN. 4, 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 ALTERATION TO BASEMENT OF EXISTING ONE FAMILY DWELLING. The certificate is issued to DBM CO. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N174691 FEB. 19, 1991 PLUMBERS CERTIFICATION DATED K ~ K PLUMBING MARCH 5, 1991 Building Inspector Rev. 1/81 roses xa s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN71L FULL COMPLETION OF THE WORK AUTHORIZED) N~ 1 9617 Z Date I9~,~ Permission is hereby pronted to; ~ ~ .......................1............... . r...:....~./.~.t..y`~ at premises located at ....G~~~~7......~~....~.~ County Tox Mop No. 1000 Section .....~.'r~.J`~.I...... Block .........~........Q. Lot No..........<.ti,?..:.:6. pursuant to opplicatlon dated .........~~i~~~ 19,1 and opproved by Me Building Inspector. D Fee i••~~ s Buil Inspect r Rev. 6/30/80 Form No. 6 ~a_, TOWN OF SOUTIlOLD ~ - BUILDING DC•PAR'CMENT TOWN }TALL ~ 2 5 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY:... ...._._._r:.. This application must be filled in by typewriter OR ink and submitted to the building inspector with t1[e 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 Healtl[ Dept, of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation Erom 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, c[ certificate of Code Compliance Erom architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. i. For existing buildings (prior Co 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. IE a Certificate of Occupancy is denied, tl[e Building Inspector shall state the reasons the reEor 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 - $L00.00 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 $15.00 Date ,FebhuWc~.22: 1991 eta Construction........... Old Or Pre-existing Building...X......... .ocatimn cE Property...755_Uni.o.2e.Dru.ve :..............................Sotvtho.~d............... house No. Street Hamlet ~ncuer or Owners of Property...D.13.M.~4 15.6 ' :oumCy Tax Map No 1000, Section. SS. ..........Block.....b..........Lot ~ubdivision.Nti91i17o(,17;t hleadoGU? ..................Piled Pfap............Lot..4................... 'ermit No...19617Z,,,,. „ nate Of. Permit..1~~4/91....._,Appllcant.D,$,hl Co. Icalth Uept. Approva1.,90,-SU.26 ,Underwriters Approva1,N174691. ']arming Board Approval ~.e quest for: Temporary Certificate........... Final Certicate... X....... ce Submitted: 25. 00 . • di J, ~l+Kf ~~FQ~ TEL. 765-1802 x , 04!5 C~~~ TOWN OF SOYJTHOb,D ~ ~ /4~ ~ ~ ~ OFFICE OF BUILDIPIG INSPECTOR {~~np,~' ~ u°, ~ ~ P.O. BOX 728 ~ ~ _ L1 ~l ~ a , v~ ~ • ° i z TOWN HALL ij~Ol SOUTHULD, N.Y. 11971 ~ w ~ ~ , Bt.oC u~~r:..r., =.x TOWfV f3P ^~{)2J7h`C?E,t),, z C E R T I F I C A T I O N , Date 2j~,~_ Building Permit No.1 (please pr~ilnt4' Plumber ~~.1 n ` ~ _ z-- i (Pl se print) ~ G,G~"~~~/-~ I certify that the solder used in the water supply system contains less than 2/10 of l~ lead. r (plumber's signature) Sworn to before me this day of ~.,,,.l~ 19 T~, Vf-Q ~ Notary Public ftotary Public. County , t HELEN K DE YDE NDTARY PUBLiC, State of New Yady ? No. 9707878, Suttalk County ' 'Y Term Expires March 30,19..-3 , t`,< i ny ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS OAK,::. ' i "Q~`" EIUREAU OR ELECTRICITY (e r EIS JOHN STREET. NEW YORK, NEW YORK 1003Ei ~ ~ ~ ~ 9 ~ Date -3BRC:.R`_' _9,_99: .Ipplicatian .Vo. on fi4 i~..$~i >.%3' i7 _'"53- I TH13 CERTIRIE3 THAT onfy rka daeerieal squipwRSwt w dsserfksd hslw and iwtKOdreed by eM applieawt nuwRSd on tha chow appAeatiow nuu+wbsr in the pwasisw of / \ ~ JB:". CC.. ~R_CL~ JR=^= 3 1G SCL'?-C[:?. r- in NvJolloReinR locution: L Bawwssnt ~ Ist Fl. v 2nd fT. .Seerion Block Lot nw ersmined uw ,'SBRURIR.: __,.99. • and found to be in compliance with the meainmenrs of this Boaral. IIIOUN A06I SYIHOIES ! RXTURlS RAfYOEt COOKR160RCIIS i OVBiS DEp1 WASHERS EXHAUST fANS ' i ~E XM[TIIe6tZIO rlY0R0CaT arwin .wT. ~ K. W. bR. K. W. 4Mt. R.W_ ~wT. I R. W 41r. 1 M. r. s I I a I 0 3 2. ~ - ~ J DETERS IIIR?eACE MOTORS IUAtllf MFlIMrC'E ~ srquerrrl riwaoats ~ Iltrr twATrts wRn-OUnR ~ OMAMEfS o Mu H ~J Wsr. ~ R. w. as ~ w. r. r.Rt k r Krr. rla ; ~ w. Kc j rrr. ur. ,u.r. I Arri i TRANL ; uKr. j w r. NO.Of1iT I w.r. , wsm a ~ I ~O I SERV10 OISCOIMI[CT HQ O/ I S ~ E R V I C ~ E I Wr. ~ •Ilr. rna ~;1/TWI1Jlw~]/TV 10/Kw!M.af cc COMO. ~w c. r+D. Of wuc ! ~'WG 'w.flwHrtRUS K.wa rlRa a cc tpo. a nub d IKN14t o,HS AffMATUL i i SAGE & LaDEPL'ti27 ^IC. L~C.~363=E - ~.o.Bex 1768 SCli?BCLD, IQY, ii97_ OfE~AiMA11M! Per M' ~ Tfas earrifitala cowl nor ba allarad in arty Immw; raMn ro tfla ofBn d rhs Eeard if incorner. troPKMrs mey 6a idwtifiad by tfsr asdrnials. i r'1ELD iGSP CTiUH ~~UAiE ~ i;OMMENT° ~ .b m 1.' ~ 3 H FOUNDATION (1st) c ti FOUNDATION (2nd) _ ~ 2 . 7 ow P,OUGH FRAME & PLUMBING H 3. ~ ra I1ISULATION PER N. Y. ~ y STATE ENERGY CODE x A r a . z - y _ F I id A L p o z ADDITIONAL COMMENTS: x c~ x \ H ro~ y ~ H O (~y z /`iJ 1 x r~ • A • r H . - ~ d m -a H 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. ] FO DATION 2ND INSULATION [ FRAMING / [ ]FINAL REMARKS: C ti. DATE ~ INSPECTOR ti~ . , BOARD OF HEALTH FORMNO.1 1 SETS OF PLANS SURVEY TOWN OF SOUTHOLD Gt1ECK . BUILDING DEPARTMENT SEPTIC FORD! , _ TOWN HALL • SOUTHQLD,. t~LY_ 11271 NO•'F i FY ; TEL.:7G5•1II02 CALL Examincd~.•ll~.. .........,1991 MAIL T0: Approved ..~~`2':........, 19,~,f Permit No. /,7,~ . Disapproved a/c . r , ~OH1noS Buitdi Spector) •1da~JOIEjMOd APPLICATION R BUILDING PERMIT ~s~l ~ ~ NbY' Date . IS . ~n n INSTRUCTIONS a. This app r pletely filled in by typewriter or in ink and submitted to the Building Inspcao:, . sets of plans, accurate plot plan o cale. Fee sccording to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pui~::c cu or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pan o: t:::.:.: . 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. Suci: ; 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 uhtil a Certificate of O:cu;;:. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department far the issuance of a Building Permit purs::an; ;c Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ord:a~ncc.. - Regulations, for the construction of buIIdings, additions or alterations, or for removal or demoli 'on, as herein ucsc-r, The applicant agrees to comply with all applicable laws, ordinances, bu' ing code, housing ,and regulauo::., ~r:.: ; admit authorized inspectors on premises and in building for necessary in ctions. tgnature of applican or name, if ~ rporauo;~; (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or buil Name of owner of premises LJ :3 :M; , • . as on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized officer. • (Atame and title of corporate officer) Builder's License Nu_ , , , , , , , , _ , , , , , Plumber's License No . . Electrician's License No . Outer Trade's License No . ' 1. Location of land on which proposed work will be done; ' ............75.x. ...Q~ipG.~ 7~GI. (louse Number Street. ~ ~ ~ ~ ~ " " " '~O ~ L/,~ 7 ' • • . • • • . Hamlet County Tax i\LLt//ap No/.// 1000 Section ~.S , Block , , , , , , , , , , , , , Lot"~'s~„ /b' ~j - Subdivision 1 T f.~.z7. J.N, / , , , /'~Lc, {~~D cc/$ Filed !\fap No. • . • . . (Name) Lot Stag existing use and occupancy of premises and intended use and occupaucY of proposed construction: A. );xisting use and occupancy..N~N~,,,,, , , , , , , , , , B. Intended use and occupancy.. ©!U4`.... I:A:~7,! ~ y ~ {I (J'EJ~~-~,~~'~~' ' • _ • . • • • . 3, Nature of work (check which applicable Repair New Quilling Tennis Court , , , , • . Removal , ' • Addition • • • • • • . Demolition , • Uteration 4• Estimated Accessory Building....... "",..Swi;rttain^ - Cost , 000 ~ Pool. , • ..Fence .Other Work:, .Fee ~i~~~ 'tee 5. If - • . dtvcilin^, • • IC^ s nutnbcr of dtvclling units , , , , • (ta he paid on Cling this • ' ' ~ ' dara;e, number of cars Number of div • aPglication~ 6• IC business, commercial or mixed occupanc • ~ • ~ ' ' ' ' ' • • e.lli"g units on each floor. , ' 7• Dintcnsions of existing structures, if an Y, specif • ~ • ~ ' ' ' ' ' • • • • • ~ ~ • ' ' ' ' • • Hci~ltt Y natttrc and extent of each type of use . Y: Front Dimensions of sa • ' ' ' Number of Stories , Rcar me structure with alterations ~ • • ~ ' " " Depth , , , Depth or additions: Front • . . Dimensio Itcight Nu •Rcar ns of entire new constntction: Front , • , . , Hct=ltt ntbcr of Stories 9. Size oC let: Fion[ , • • " • • Number of Stones , ~ ~ ~ ~ " " • • Rear ,Depth . • • ~ • • • • ` • • 10. Date ofParchase • 1I. Zone or use district inwtticlt rc iscs•."•.,•Rcar„••,_•...•,._.•.•-.' • .Name of Former Owner • Depth _ _ t 2. Does proposed construction vio! tc an are situated , , • ~ • ' • ' 13, Will tot b; regraded Yzoninglaw,ordinanccorre~..•~•••~~~• l4. Name of Otvner oC rem'..... ' , gulation : . . P tses , j~„ N , 1Vi11 excess Cll be removed from prethises: • • . ~ • ~ ' ' ' • • • • Name ofArchitcct '~•-~0~---...Address~4 A„~ Name of •~~....?7,~(i' _ Ycs....Ne. Contractor , • • ' ' ' ' - • • • .Address , , , ~A'• Pltone No,t( ,7!7~ ~ ~ ~ . 15_Is Ghis proper[ ~ .Address PhoneNo.........,,„. *If Yes, SoutftolY located i+ithin•300 feet of a tidal wetland?n=ygs_':':ND!;::•.. d Town Trustees permit may be required. Locate clean PI-OTDIAGRAM property lines. Geve s reet and blo ~1 buildings, whether existin interior or corner lot. number or desctiption accoratnoProposed, and, Indicate al( set-back d' to deed, and show street names tmensions from _ and indicate whether ~ t ~ ~ i 7 4ctlF/) 77Lrr.c/ S dJ d r, K: t; Ai A iC A PM FOR THv ,...-':"J+;dil kh1S''cCTt^htS: t)il;v:~.1TtL10.+ Tu'VV REQUIRED +=C~.: Ft)l1REi? t:ONGRETE 2 RC'i`.)C,,iy - FRAt~.9iNG & PLUMBING ;3. iP3SliLATf()ts t F'I".EAL ~ c:ONSTRUCTtON MUST BE GONPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY COtSES. NQ7 RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF \EtV O COUNT]' OF ,~y~, S.S ..ctti (N`amc of individual signing contract) above named. ' ' ' • • • • being duty sworn, deposes and sa s Y that he is the aPPlican; He is tltc , , ~1~............ of said owner or owners, and is duly , bCnt. corporate officer, etc.) aPPtication: [hat all statements contained[ in rizcd [o perform • • . • , • • ' • • . ~ • ~ • • • • w°rk ivd] be Pcrforntcd in the manner set forthltin qtc a or have performed the said work and to . • Sworn [o bciorc me this PPlication arc true to the best oChis knowled m~`e and PPlication filed therewith. g° and belief; and Clc Ihi 3 / ihatthc ~~day ~la~w R`otan' Public, . ~'l~~!' _ ( ~ •Sv`~.e`9 .q. i; - zr- County C~ AOBERIL (Si;na[ure oC aPPlican[ jo ~~t~J r~ L ~ Q ~ ,n ~ X ` ~ p ~ ~ \ V I i _ ~ ~ ~ I 'rl y i~ r v 10 8 - ~o-a~ ~ ~ I ~ w ~ 3 ~ ~ a cil - ` ~ ~ ~ , ~ ~ ~ I ~ ~I~ ~ c ~ O Jr I ~ V ~ .A ~ P~~ ! i ~ ~J ~ ~ ~ a I ~ Ij , ~ ` ~ s I~ 1 _ 1 ~J I I l"1 ~ r1 ' ~ I~ ~~`IV j r ~ ~ ~'iT~"-~~'~" r o C°:,osc-~ n c3 1 v .o o N ~ - , - i ~ ~ ° ~ N x i < ~ ~ i i~ ~ N ~ ~ ~ .ta ~ ~ ~ ' ~x~~~ m ~ (;A - c ~s i ~ I d ~Q $ ~.~.,.:a ~ ! lit - ~ _ ~ ~a ; c . - ~ ~ -~az N ~ ~ u z ~ ~ ~ rvro+Nll ID rp d 1~~~ ~ ~ h2 G rn Z P cp I ° 6 i M ~ G "w R"4~ ~ 1 0 ~ ~ ~ ~ ~ J ~ W N0 3X t mU`.`t. i~. ~.Y...,,a~Y..~~..._,`.'___.,.~.~.._..~. )C^wMtk'[te'L. ~ ____.A,