HomeMy WebLinkAbout23563-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25932 Date: 09/02/98
THIS CERTIFIES that the building ADDITION
Location of Property: 1290 ORIOLE DR SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 6 Lot 15.39
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 17, 1996 pursuant to which
Building Permit No. 23563-Z dated JULY 8, 1996
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to KEVIN & SUSAN METZ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
) I zr_�
Bgj. dig Inspector
Rev. 1/81 !/
WORM NO. f
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)
N° 23563 Z Date ....................... ........................ 192f..
Permission is hereby granted to:
! ..... ..............................................
........., .. . ........ ...................
to ... s1.7 ..... ....... E. ..... . ...11� .!/..y '`�......L .....! ' . lfilll� ✓ .........
.i
........ , �IIN rf....s�0�°�� ....i:� .........................
�90
......................
atpremises located at ...... .................... .4r ..... �. ...........................................................
.. � � ............................................................................
................................................................................................................................................................
County Tax Map No. 1000 Section ....55.......... Block ........�-�0..... Lot No. ..rs �
��Pupursuant to application dated ...........�Z. ......... .................., 19. . A and approved by the
Building Insector.
7J'7'v,
Fee $..... .................
/ uil ng Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT -
TOWN HALL
765-1802 # '
APPLICATION FOR CERTIFICATE OF OCCUP Ay
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 2110 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:
i. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
92. 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 - .?51',.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, (Commercial $15.00
Date . . . . . . . . . . . . Al(�f. . . . . . . . . . . . . . . . . . . . .
ew Construction. .. . ./ ... Old Or Pre-existing Building. . .. . . .. . . ..
ovation of Property... .lZ9v. .. .. .. . . '?:° .e .. . 2: . . ... .. . . . . .C� .r1�.�.-.j . . . . . . . .. . . . . . . . .
House No. Street Hamlet
ower or Owners of Property.. .^.4Y!�A O.S41'C . . .t�E T�. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ounty Tax Map No 1000, Section. . . .$S . . . . . ..Block. . . . . . . . . . . .. .Lot. pc?. t5 39
36
ubdivision. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .Filed Map. . . . . .Lot. . . . .. . .. . . . . . . . . . . . . .
ermit No. .Z 3 S 6%3. . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ealth Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
lanning Board Approval. . . .. . .. . . . . . . . . . . . .
equest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
i
'ee Submitted: $. . . . . . . . . . . . . . . . ..� 5• ... . . . .
��t•SSOSS APPLICANT
na 2, js93.2
1411O.W ±NSPECTION REPORT DATE COMMENTS
---- 3'--- ----------- -- LA
I
ti
Ir-------- ..- .-
FOUNDATION ( 1ST) II It
FOUNDATION (2ND)
II ii
I. II
n------- II 0
ROUGH FRAME 6
PLUMBING R------11---------------
11 jl
INSULATION PER N. Y. n li ra
STATE ENERGY
CODE I✓j-------��-------'------
n
Il II
II
-
17
FINAi. —_.--
'll"-'- -------
II
ADDITIONAL. COMMENTS:
ra
y
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76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS: G
DATE / INSPECTOR 'j
V, BOARD OF fP A .. . . ... . . ... . ..
v v POEM N0. I 3 SETS OF PLANS
NS
TOWN OF SOUTIIOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT
TOWNISAIA. SEPTIC FORM . . . . . . . . . . . . . . . . . . .
nspa0)(Yl SOTEL, 7 N.Y. 11971
�q,/'� TTL: 765-IR02 NOTIFY:
� S rCJ�r Ib.� CALI, .7�. .�.�-�.
Examined......�/`pp/�'...... 19.&p � 2 MAIL TO: . . . . . . . . . . . . . . . . . . . .
Aplmuved....7�0.......... 19,i.'o PermiL N0-1; 56P 2.... ....................................
Disapproveda/c .................................. ....................................
......................................................
(lhn/ 0
ull, ector)
APPLICATION FOR BUILDING PERMIT'
INSTRUCTTONS
a. 'Itis application mut be canpletely filled in by typewriter or in ink and snlmitted to the Building Inspector wit
3 sets of plans, accurate plot plan to scale. Pee according to schedule.
b. Plot plan slmwing location of lot and of Ixnildings on premises, relatiomship to adjoining premises or public
streets or areas, and giving a detailed description of layout of property "list be drawn on the diagram whictn is part of
this application.
c. The work covered by this application may not be c fenced before issuance of Building Permit.
d. upon approval of this application, tlne Building inspector will issue a Building Permit to the ap licant. Such
permit shall be kept on the premises available for inspection throxgtnout the work.
e. No Wilding sln.all lie occupied or used in whole or in part for any purpose uliatever until a Certificate of
Occupancy shall have been granted fry the Building Inspector.
AI'PXAT'ION IS IIRRREBY MAIC to the Building Department for the issuance of a Building Permit pursuant to tlne
Building Zane Ordinance of the Town of Soutlx)ld, Suffolk County, New York, and other applicable Taws, Ordinances or
Regulations, for Ilse construction of Imildings, additions or alterations, or for rarcrval or derrolition, as herein
described. The applicant agrees to cetgly with all applicable laws, ordinances, Ixiilding code, Ixxuirg code, and
regulations, arxl to ahuit auUnrized inspectors on premises ani in mild' for
necessary inspections.
(signature of apple or nam, if a corporation)
12q� (a2I(A b'u Vtl. !v
..... .. ............
(Mailing address of applicant)
State wlnellner applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pl nher orinilder
pw�I tL-
.................../..........................................................................................
H C—
Nave of owner of premises ..7�. t:....tt 5! '.:'..._ .1......................................................................................
(as on tlne tax roll or latest deed)
If applicant is a corporation, signature of duly anLlxrrized officer.
_ title f corporate ..icer.................... p �J���
(Nair and title of corporate officer) F�
r
U 1 1 7 19 1
Builders License No. .........................
Plminers License No. BLDG 0111
T- �SOtJItfOLD n
Electricians License No. ..................... ------_._...�
Other Trade's License No. .....................
1. location of land on w1iich proposed work will Ice done..............................................................
1-290 (D2tol� 1�ztv� _.. t??1�..~ x.. 09"71
................................... ..................................._...............
Ilouse No.rlter Street Itanlet
County Tax Map No. IWO Section ................ Block ....(:q
Subdivision .................. .................... Piled Map No. ............... Int O:..3C°.....
(Nine)
2. State existing use mrd occupancy of/ p uses and inteo 1 use and occupancy of proposed construction:
Ca. Existing use aril occupancy .... 1.. �17....��............JJ........y...... ��
b. intended use and occupancy .... ... � ).� .... b�?!l KNru4 ..... ...:.......S ..
}
1. Rit tit of work (drec:k %,Adds apps icabl e): Kk )krtldinfl .... .... .. &kliliau .✓....... Alt-er:Ilion . . . .. ... ..
Ifo:Iallr . .. ........ . Renmal ............. Void itioil ...... ...... 01her Wlxic
.. ............... ...... ...........
Jy��,, (Description)
`c! J 1?sl iurrt cid (bsl�V'..3.50c>......... ... . Fee ... .....
(to he rlaid om filial, this application)
5. If (h,ellinll, rxnier of (k+ellily; Uoits . .. .... Ihrdrer of rh+ llinf, trolls cm each floor .... . .... ,..
If garage, ooder of cars .. ....... ..... ...... ...... ... ... . ... .
fi. If lxlsilless, c(arterc.ial or lnixevl rx!colunu:y, srecify Millie aid extent- of each type of Ilse. ...... ... .. ..........
l
7. Diax:os ool; of exisLing slr,;Uaes, if airy: Frox1L. . .. ... ... ...... Hear .. ............. Ikapth . ..... ...........
Ileff)ll .. .. ..................... Mailer of Sl ori es . . .. ... ........... ... .
Dimoslrxls of same structure with all.eraLims or axklitions; Front . . .... ......... hear .. ... ........ ..
Ikeplh . ................... Ikci 0 I .. . ... ......_..... .. i♦.nln:r of stories ... .... ........
fi. Dinullsilxls of enLile oe$t cootillotA iou: FrxIL . . .......... .... Hear . . .. ... ........ Depth ... . .. ....... .
lleif)IL hkniler of Stories ... ....... ...........
9. Size of lot: Pitch .............. ...... Hear . .... ...... ......... lkptil ................... .
IO. Date of Aachase ................ ..... Haw of Foolur lMler ... ....... . ........................ .....
11. 7<xre or Use dist r lCt in wilidl praxises are slrtrat L�l ....... .............. ....... . ....... ............ ............ .
12. Does profuuscA COOSI rY:li(xl violate any z(xling Irma, ordinali:e or regolatloo: k'D............... .....
11. Will lot he regrtled ..rJ.q�/.. ............ Will excess fill lx: ro mveol Fran preitises: YES ii
18. Nal -s of (.)Amer of prrinises' ((!-!t $!r �...�' .... 7uklress tc.3:CSQ �� �}2• ' �. Pixxte IkI.�. (i
Nenia of Architect' ........... .......... ............. .. lukiress .. . ... ... . ... ........ ......... Mone a). .. . .. ... .
Name of Cord.ractor ..... ... ........................ ... /uklress .. ... .... ...................... kine fk). .........
15. is this prolx:rty within 3GO feet of a tidal wetlalxl'1 * YES . ......... N(l ..:-c��...
*11, YIiS, ". J11YHD '11AM 'ITiI)5111:.5 PLotiir my 111: mplin).
PLOT NfAGHAM
locate clearly and distinctly all Ixlildiogs, r•Alelher existing or prorxrsed, aixl irxlicate all set-back dialensions
flan prolmlty lines. Give street alxl block u.nirer or okascription according to deed) aixl sorra street routes a(xl ilxlicate
Idwliter interior or corner lot.
51'A'lli M' N3J YMK,
�C^ SS(N' .7�:...Ll�
.. ... ....... .....;nein); dnty atinnn, delxvxs :rxr says that he is lite applicaol.
(tl:ue oflllilul___Iv lthull signing; coni raciL .
ik: i:; tile ... ......... . .. ....��: !.( �f....... ... ......... .. . ...........................................
(QAILlacLor, ageoL, corlxlrate officer, etc.)
of avid (morn or (enuers, tax) is duly :mthurizeil to lKWfolnt nr IIMa Ixarforned the said "nk aaul to nndce alxl file thin
application; that. all st-Itownls conLaited io this al,plicaliou aro title to lite Ixml, of his knowledge aixl Ixili(!f; aixl
that, ibe tack will 1xx Ilerfo(ntvr in the Imnnler set filth in the applicalion filcnl ltretcwilh.
!)worm to twl'-f'fe pr 11119 ��yy
.t...... .day of ( •-!),It .19, . .4
Kolar 1111ic. ... .. .. .
CLAIRE L GLEW ....Q.tilr-+...�.:. .. . .. ........
Notary Public,State of Novy York (` iguatare of Appli(:ant)
No.48795(7&
Qualified In Suffolk County
Commission 6pires December 8,78 ;[
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_ ORIOLE DRIVE
-WATER MAIN S67o58RS O,00.
_-- R=809,071 �L=105.911 R=809.07 132 �S4• A
L:303.61
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m� S.T. �\ 3 In O ✓/�
oz
36.5' m
2 STORY 21_3
n �18.3
N FRAME HOUSE
B GARAGE n
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36.3' ID.3'
Lot 38
— ( --r - L 0 T 37
?
ED
70LO
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0 ml
`O Lot 36 f
z
Area = 20887 s.f. I in
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N.89 D 5411011 W. 12975'
now or formerly Carl & Anthony COdan & Another fs OWN � .
JUN 1719%
- =7,"ri!i'Pi-DC
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES SURVEY FOR
K
,- _ KEVIN METZ & SUSAN METZ SEPT 13 1991
SINGLE FAMILY DWELLING ONLY LOT NO. 36, 11HIGHPOINT MEADOWS ,SECTION TWO" MAY 7,'1991
DAMP 2 5 1991 H.S. REF. NO. Ya-LSi�=.�c3 JAN. 31 , 1991
AT SOUTHOLD DATE '. OCT. 26,1990
The sewage disposal and water supply facilities for this TOWN OF SOUTHOLD SCALE1"= 40'
focaGonhave been inspected bythis Departmentand/or
other ad-T u(pi to Isf SUFFOLK COUNTY, NEW YORK No 90 -0840
g
V' «WMUTHORIZED ALTERATION OR ACOITION TO THIS CERTIFIED TD: ..
Chief Q ufEau of Wa$tEwatEf Mana Ernest SURVEY 4 A VIOLATION OF SECTION 7209 Of THE KEVIN M OF V
$ NEW YORK STATE EDUCATION LAW $USA or EW
III COPIES OF THIS SURVEY NOT BEARING THE LAND y
SURVEYOR'S '"KEG SEAL OR EMBOSSED SEAL SHALL FIRS $U Irl A`G• CORP.
NOT BE CONSIDERED TO BE A VALID TRUE COPY
RGILARANTEES INDICATED HEREON SMALL RUN ONLY TO Q �O
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PCRSON FOR
WHOM rHE SURVEY IS PREPARED 2' G
AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- p
M NEAREST WATER RAIN—MI t *SOURCE OF WATER PRIMTE—PUBLIC,_ MENTAL AGENCY AND LENDING INSTITUTION LISTED
R $UFP CO. TAX MAP DIST 1000.SECTION 35_BLOCK _§__LOT 2/915.1 HEREON, AND TO THE ASSIGNEES OF THE LENDING *'
*THEM ARE NO DWELLIMSS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
M THE WATER SUPPLY AND SEWABE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS A1_
WILL CONFORM TO THE STANDARDS OF THE SU"OLK COUNTY DEPARTMENT *DISTAMCES SHOWN HEREON FROM P"ERrY LINES RE
OF HEALTH SERVICES TOEXISTING STRUCTURES AREFOR ASPECIFIC J 4
APPLICANT, PURPOSE ANO ARE NOT TO BE USED TO ESTABLISH
PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS
TEL 4W OSTRANDER YOUNG a YOUNG RHEAD, NEW YORK
NOTE 0=MONUMENT 8- STAKE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR YS LICENSE ALDEN WYOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR, 19,1990 AS FILE NO.8911.
12845
HOWARD W YOUNG, LAND SURVEYOR
m *THE LOCATIOMOP WELL(W),SEMC TANI(IST)BCESLOOLS(CP)SHOWN HEREON N Y S. LICENSE NO 45893
o ABC FROM FIELD OBKWATIp1S MIO OR DATA OBTAINED FROM OTHERS Z.B.
BRANDIS A SONS INC.
I -- ---- ---- -- --------------------
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OCCUPANCY OR
. - - USE IS UNLAWFUL
111
WITHOUT CERTIFICATE.
(- -sOF OCCUPANCY
1 �_-_- - ter; u- - i� u F Ems.-r-i. (T.v...., 1212..1 is��r•
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APPROVED AS NOTED
2yH ibnc cin 121 �- C+[w, 2vt� II �'Vdll� r�.L t[? ��.�L t�
" (-I DATE: A404—B.P.M
FEE:k BY: w"4
NOTIFY BUILDING OEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
QTS 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY'
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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