HomeMy WebLinkAbout33032-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 07/02/07
No: Z-32443
THIS CERTIFIES that the building ADDITION/ALTERATIONS
Location of Property: 300 CEDAR
(HOUSE NO.)
County Tax Map No. 473889 Section 15
BIRCH RD
(STREET)
Block 8
ORIENT
(HAMLET)
Lot 25
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 10, 2007 pursuant to which
Building Permit No. 33032-Z
dated
MAY 15, 2007
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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MARY D DORMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
11/14/05
ELECTRICAL CERTIFICATE NO.
2078326
PLUMBERS CERTIFICATION DATED
03/24/06 RBT.VANETTEN PLUMBING
~J;t~_'""e
Rev. 1/81
J'
Form No.6
TOWN OF 80UTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
I. 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 (8-9 fonn).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Swom statement from plumber certifying that the solder used in system contains less than 2/1 0 of I % 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 ~n~pre-existing" land(us~s:,
I. Accurate survey of property showing all property lines, streets, building and unusuatnatural or topographic . I
k~=. . I
2. A properly completed application and consent to inspect signed by the applicant. If~ CertitiitJl!eofOGbli)1ancy is; I,
denied, the Building Inspector shall state the reasons therefor in writing to the appl,icant. , ! .J1
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 - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Location of Property:
SOo
D~~
Old or Pre-existing Building: frPo I nUN (check one)
elt'.l.t1
10 ,vr .u7
New Construction:
UiJtte
Street
MA)'t L( 'I>
Suffolk County Tax Map No 1000, Section 'i 7 ~ ~ &- '1
~b.
CJrtt 'z.N'-
House No.
Hamlet
1Ja'C-~
~'l(
Lot
Owner or Owners of Property:
~~
If"
Block
Subdivision
Filed Map.
Lot:
Permit No. 3~ () '71.. L
Date of Pennit.
Applicant: ~ 'I b - b uYe.VvIAr\J
Health Dept. Approval:
Plmming Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate: )C (check one)
\~~,-s;g~",,~
Fee Submitted: $
1$,or)
~u. l:;'~ '70
COWLf'-/-2
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)
PERMIT NO.
33032 Z
Date MAY
15, 2007
permission is hereby granted to:
MARY D DORMAN
306 WEST 19TH STREET
NEW YORK,NY 10011
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR. THIS PERMIT REPLACES BP # 30557
300 CEDAR BIRCH RD
ORIENT
at premises located at
County Tax Map No. 473889 Section 015
Block 0008
Lot No. 025
pursuant to application dated MAY 10, 2007 and approved by the
Building Inspector to expire on NOVEMBER 15, 2008.
Fee $
206.00
\
ORIGINAL
Rev. 5/8/02
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I Located at
~ Application Number:
i Section:
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~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
m herein, was conducted in accordance with the requirements of the applicable code andlor standard
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
~ authority having jurisdiction, and found to be in compliance therewith on the 14th Day of
~ November, 2005.
m Name OTY Rate Ratin. Circuit ~
~ Miscellaneous
~ kitchen-sun room
~ Appliances and Accessories
~ Dish Washer
~ Panels
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~ Dimmers
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~~~~I!I
BY THIS CERTIFICATE OF COMPLIANCE THE 3cS.s1 ;
NEW YORK BOARD OF FIRE UNDERWRITERS ~
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BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
JIM SAGE ELEC. INC.
P.O. BOX 38
GREEN PORT, NY 11944-0038,
MARY DORMAN
300 CEDAR BIRCH LANE
ORIENT, NY 11957
300 CEDAR BIRCH LANE ORIENT, NY 11957
2078326
Certificate Number:
2078326
Block:
Lot:
Building Permit:
BDC: ns11
Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located inion the premises at:
First Floor, Outside,
1 0
1.2
KW
60
11
Wiring and Devices
Outlet
Fixture
16 0
16 0
18 0
12 0
4 0
7 0
1 0
3 0
Fixture
Incandescent
General Purpose
General Purpose
General Purpose
Outlet
Receptacle
Switch
Paddle Fan
Receptacle
GFCI
seal
15/6"~\
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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Public Slate .
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Commission Explres ~uly 31, Q::j
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONS11lUCTlON
[ ] ROUGH PLBG.
[ ] I LATION
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
DATE
INSPECTO
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JUS- ~ 7-is-
765.1802
BUILDING DEPT.
INSPECTION
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[vrF"~UNDATION 1 ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
/
DATE 11J.V/ 0 Y
INSPECTOR
-
30 ':)s7 t--
765.1802
BUILDING DEPT.
INSPECTION
[ ] FO [ ] ROUGH PLBG.
[ OUNDATION 2ND [] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: I)
DATE 11:17
INSPECTOR
~
305'5"71=
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [~L
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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INSPECTOR
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TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PlBG.
[ ] FOUNDATION 2ND [] I~TION
[ ] FRAMING I STRAPPING [v1FINAl
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE
( V/ICj/t;{"
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INSPECTO
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. 06
'7
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] R~H PLBG.
[ ] FOUNDATION 2ND [ "'t'f'NSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ~~-~ ~~~- -~-
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INSPECTOR ~4
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ]..f6UNDATION 2ND [] INSULATION
vJ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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INSPECTOR
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FIELD INSPECTION REPORT DATE COMMENTS ' r
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TOWN OF SOUTHOLD
BUll l>INI]; DEPARTMENT
TO. HILL
SOUTHOLD, NY 11971 .
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southoldl
PERMIT NO.
~J~.:r..:z
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
Planning Board approval
Survey
Check
Septic F onn
N.Y.S.D.E.C.
Trustees
Contact:
Examined
Approved
Disapproved alc
z/tu
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{
20 L\
'-
,20~
Mail to:
Expiration
,20_
Phone:
.
;
~ - 9 '2l)Oa
,
. APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20_
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 waterways.
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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required. ,
APPLICA nON IS HEREBY MADE to the Building Depar,meIlt for the issuance of a Builqing Permit pursuant to the
Building Zone Ordinance ofthe Town of Southold, Suffolk County, New "<ork, and other ap . able Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for remov or olitl n as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, ho ing c an regulations, and to admit
authorized inspectors on premises and in building for necessary inspecti s.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ;tJ It R Y Do R.. IJ1 t::j /IJ
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
- .. '_
(Name and title of corporate officer)
, ~ J
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location ofland on which proposed work will be done: rllOlf
J.txJ:l:Jr:-.[) I')fJ !.vIS ClrrBJAIl (jJ~I!L(.J/.JFf- ;),)'1.&1 /lIIMJ RO
House Number Street Hamlet
0/2 /EIJT
County Tax Map No. 1000 Section
Subdivision
1'5'
Block ~
Filed Map No.
Lot c:J S-
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constructio!1!' 4
a. Existing use and occupancy 51 N 6/....E.. f'P.H. I L't lZEEb I O~ cE?
b. Intended use and occupancy
.sL!.Hi::
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition X
Other Work
Alteration
(Description)
4. Estimated Cost
So 1(700. f7b
Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units l?j.:1f: Number of dwelling units on each floor Ot-J€.
If garage, number of cars e;..)(\~T"1 '" 6-
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front ? e> L ~ Rear? 0 \.. 3
Height :l. ,1-0" Number of Stories [) IJ e
Dimensions of same structure with alterations or additions: Front I;~ I - '2,
Depth 4/i? \.-<:ill Height~ l-O" Number of Stories
8. Dimensions of entire new construction: Front \E> '-4-h Rear \ ~ "-4-
Height -----3 (p L. 0 1\ Number of Stories ,-
9. Size oflot: Front 1-"3 S ~O ~ Rear I "3-5'-0~
Depth ?-8 \.. '3
Rear r;ol'"3
Depth
Iq\..~1I
Depth
IS' c> '-0 t
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated
z...o~ - e
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X
13. Will lot be re-graded? YES_ NOX Will excess fill be removed from premises? YES_ NO_
14. Names of Owner of premises ~e.::t.JblZM AU Address Phone No. (p31- '5;;13 - \~&>
Name of Architect 'N ,Ill r- SA\lIL:lDAddress "1 ( ~ :1-3"'~nhone No ")-.1'--1J...1-")..Z'f8
Name of Contractor . Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO _
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO_
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
tv! ~ () 0 'l. '(VI 1\ W being duly sworn, deposes and says that (s )he is the applicant
~ndividual signing contract) above named,
(S)He is the
{) vv..P.-1L
(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.
Sworn to before me thij.1
C{vJ. day of UdZ20~
~?~
Notary Public
NICHOlAS P. VESSlO
Notary ""bIle. 5."", of Now York
No. 41-C2....24
Qualified In QuHI'lS County
Commluton ElCplr.. Lf - 30. . 06
e of Applicant
William F. Savino Architects
71 West 23rd Street Suite 1908
New York, N.Y. 10010
~ 330'~
May 8th, 2007
\ "",17
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Building Department
Town ofSouthhold
53095 Main Road
Southhold, NY 11971
Attn: Inspection Department
I
'-...-J
Re: Donnan Residence
Cedar Birch Lane
East Marion, NY 11971
Permit No # 30557
To Whom It May Concern:
I have inspected the above premises during the course of construction. I have
found the installation of the 120 mph wind resistant straps to be in accordance to the
approved construction documents and the New York State Building Code.
tlJJ:;~
WilliamF. Savino RA
RA# 012623
Tel: 212-727-2248
Fax: 212-727-8291
100,; -
OWNER
- Z r'
.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
.
.
VILLAGE
DIST.
SUB.
-
/0-'
LOT
)E.s~
S
17 f~
~J6
W
TYPE OF BUILDING
,,,0
COMM. CB.
I-
Mkt. Value
RES. ..2/0
LAND
IMP.
TOTAL
1100
1"- (J "
(
oil q 00 iCEV'
n o<c)
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER .
Woodland FRONT AGE ON ROAD 1"3S'" e. ,,~ /OR 0 .,
- ~
Meadowland DEPTH 5'0 '
House Plot BlJI:KHEAD
Totol DOCK
-
-
-- - ....
-
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I W"J,o,rw:: ye((o<p TRIM , -
,-
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f{qq "" >,.-..,
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M. Bldg. .J Bv';/'1 .. /1'I3f.. .":/..:;'0 :? (p 'JtI Ie- l,...;
G ..... L.-. ....' <j ,"...
l~e~i~ri ~l<.k.. 'l(e ~~ .2S~ ~ ... ..
-
Extension . ~. " 112'
-
Extens~
"J:l.t'fC~ CI<\ \ en~,' :?':I~ "- ~\o~ ,7';- Q2 Foundation ~ 8> Bath / Dinette
Porch 8l(?c,', \~C ( Basement rd/L Floors r.,~ K.
Porch Ext. Walls IWbtlJl <" "I" Interior Finish WhLt. ~~. LR.
~-~CL ' "
B reezewoy Fire Place I/~S Heat /.1""'- DR.
Garage .:to y... t ., ~ O/> I" 0 _? fJO Type Roof Rooms 1 st Floor BR.
,
Petie A.-M' ... ~ ~ Recreotion Room Rooms 2nd Floor FIN. B
~. I~ v .:II : 3J...L
O. B:-k>-.... ~~ (10 /% ~~':l Dormer , Driveway
-
Total I JI_ I _ ~O<~ '1o'Gl!! t ""'~y r"..." I"no.> 1:1.- ._+
.. 1..,.Il;_ A\ ..... u-,~" -
~ f!&) \J~ ..,~'\;., . V-,l., $~ .....,.
-,
(~, 411'20- trr C) "
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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)
PERMIT NO.
30557 Z
Date AUGUST
10, 2004
permission is hereby granted to:
MARY D DORMAN
306 WEST 19TH STREET
NEW YORK,NY 10011
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
300 CEDAR BIRCH RD
ORIENT
County Tax Map No. 473889 Section 015
Block 0008
Lot No. 025
pursuant to application dated AUGUST
9, 2004 and approved by the
Building Inspector to expire on FEBRUARY
Fee $
206.40
ORIGINAL
Rev. 5/8/02
2127278291
PAGE 02
05/08/2007 15:58
SAVINO ARCHITECTS
William F. Savino Architects
71 West 23"' Street Suite 1908
New York, N.Y. 10010
May 8th, 2007
Building Department
Town of Southhold
53095 Route 25
Southhold, NY 11971
Attn: Inspection Department
Re: Donnan Residence
Cedar Birch Lane
East Marion, NY 11971
Permit No # 30557
To Whom It May Concern:
I have inspected the above premises during the course of construction. I have
found the installation of the 120 mph wind resistant straps tobe in accordance to the
approved construction documents and the New York State Building Code.
William F. Savino RA
RA# 012623
.
Tel: 212-727-2248
Fu: 212-727-8291
05-08-2007 15:02 SOUTHOLD BUILDING DEPT 16317659502
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