HomeMy WebLinkAbout39616-Z / OS� F 40 4,,,s, Town of Southold 10/27/2015
toiTh P.O.Box 1179
Vt53095 Main Rd
o4A, of-
��ycs 1 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37863 Date: 10/27/2015
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Property: 630 Oriole Dr, Southold
' SCTM#: 473889 Sec/Block/Lot: 55.-6-15.8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/23/2015 pursuant to which Building Permit No. 39616 dated 3/26/2015
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 AN EXISTING ONE FAMILY DWELLING FOR AN ACCESSORY APARTMENT AS
APPLIED FOR
The certificate is issued to Cowley,Joseph&Jordon Cowley,Patricia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-15-0009 06-30-2015
ELECTRICAL CERTIFICATE NO. 39616 08-13-2015
PLUMBERS CERTIFICATION DATED 07-22-2015 Walter Masczewski
Aut edfgn..4atu
"" TOWN OF SOUTHOLD
; BUILDING DEPARTMENT
•
y _?, TOWN CLERK'S OFFICE
o 4po/ SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 39616 Date: 3/26/2015
Permission is hereby granted to:
Cowley, Joseph & Jordon Cowley, Patricia
630 Oriole Dr
Southold, NY 11971
To: Alterations to an existing single family dwelling (to create an accessory apartment) as
applied for per SCHD approval.
At premises located at:
630 Oriole Dr
SCTM # 473889
Sec/Block/Lot# 55.-6-15.8
Pursuant to application dated 3/23/2015 and approved by the Building Inspector.
To expire on 9/24/2016.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $528.80
CO -ALTERATION TO DWELLING $50.00
Tot:1: $578.80
-Buil•ing Inspector
Form No.6
TOWN OF SOUTHOLD
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:
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 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.
B. 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 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.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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
Date. Oj )31 1,0l�
New Construction: Old or Pre-existing Building: (check one) l `
Location of Property: (,3 0 0%.b\4, v Cco J\�r.�\ 1
House No. Street Hamlet
Owner or Owners of Property: ��MC rrN.•Cows�i k JOSS � ����- Ye_
Suffolk County Tax Map No 1000, Section O 5 S+ O Block a 1,20 0 Lot 01 S. 0 D 0
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
pplicant Signatu;
/,,, iii�„...
Town Hall Annex alig ill; Telephone(631)765-1802
54375 Main Road ; N % Fax(631)765-9502
P.O.Box 1179 ; G Q �` roger.richertRtown.southold.ny.us
Southold,NY 11971-0959
- COUNT I i*.i"
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Cowley
Address: 630 Oriole Drive City: Southold St: New York Zip: 11971
Building Permit#: 39616 Section: 55 Block: 6 Lot: 15.8
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: "AS BUILT" DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 16 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures 3 Smoke Detectors 3
Main Panel NC Condenser Single Recpt 2 Recessed Fixtures 7 CO Detectors 1
Sub Panel NC Blower Range Recpt GAS Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures - Time Clocks
Disconnect Switches 13 Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - ELECTRICAL SURVEY- NO VISUAL DEFECTS
1-Exhaust Fan
Notes:
Inspector Signature: Date: August 13, 2015
— fr.--------C .615" ---;
Electrical 81 Compliance Form.xls
07/14/2015 10:29 6317656641 SOUTHOLD. TRUSTEES PAGE 02/02
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Town Hall Annex �� �` Telephone(631)765-1802
54375 Main Road ; Fax(631)765-9502
P.O.Bax 1179 +� +�
Southold,NY 11971-0959
o`4,°OU ,0"
BUZLDTNG DEPARTMENT
TOWN OF SOUTkTOLD
CERTIFICATION -
Date: 772,-2_
Building Permit No. 31 (,
Owner: pAh l Ci A � aZ)SE-PA Cow L&1 6.30 C IAO U L_G: �.
(Pl c print) / 5 o;THt)L.D, t--1-1
Plumber:
(Please print)
J certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
l leiF
urnl y rs Signature)
n nd
Sworn to before we this d+oi
day of J u l y , 20 1
.Jt 1. , lA . Le Alr
- I
•
Notary Public,S( 11< County
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YON(
NO.O1DW8308900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE O,2
„,,iii...,_'-_
1��h��OE SO1/4„,-
�? z*7
_o�yc UNiV,N�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION -
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[- ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE q( 31” INSPECTOR rives
1
KL
J�
so
u-4,-;
(/T�oloi
- ,�,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION .
[ ] FOUNDATION 1ST [ ] ROU PLUMBING •
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
57—%—rP6d*L
DATE 0 INSPECTOR
pESOlit
f'•
(Th \
t
----itoun0
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION '
, FOUNDATION 1ST [ ] RO H PLUMBING
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
C.<0
f
DATE
0,0 INSPECTOR
•
FIELD E SPEC0 N REPORT DATACO11,13,E,NTS
4)ro
FOUNDATION(1ST) • • .. . .
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FOUNDA.TIOIV'(2ND) '. . - . . . • .. �. •1- to
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PLUMBING • • . .
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STATE ENEXt0Y CODE , . • . . • . • . ,_ . ,
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TOWN OF SOUTHOLD BUILDING PERMIT-APPLICATION CHECKLIST
BUILDING DEPARTMENT - Do you have or need`the following,before applying?
TOWN HALL Board of Health '
SOUTHOLD,NY 11971 .ri,, 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502` ".' - Survey
SoutholdTown.NorthFork.net PERMIT NO. -Go ( ([ Check
Septic Form
N.Y.S.D.E.C.
Trustees
0lOH1f10S JO NM01 C.O.Application
1430 9018 Flood Permit
Examined ; ,20 Single&Separate
Storm-Water Assessment Form
-(3 ("Er
SUR £ t HVW 1I Contact:
Approved - e ,20 . 11111.0 Mail to: (1-'4%2, : ', E511'+'
Disapproved a/c l ' J
Phone: �) OW I
Expiration g � ,20
Building I h spector
APPLICATION FOR BUILDING PERMIT
Date C7S1G 2,(31
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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.
APPLICATION IS HEREBY MADE 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 of buildings,additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspecti
./ 1114%,
(Si.nature o r applicant or name,if a corpork0 on)
6/0 Co 30 • - l o Le D . S J +c)u ) IBJ
(Mailing address of applicant) 0-9.1 )
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises aO Selo t4 COW Leri c PA-TIR I C(A JOADAt.J'-COWL
(As on the,tax roll,or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer) - -
Builders License No.
Plumbers License No.
Electricians License No. •
Other Trade's License No. ' ' ' • f '
1'. Location of land on which proposed work will be done: •
ro&D 0+2,A0 1'J s0UTt40t—D fl q7
House Number Street Hamlet •
!-TCS- Ci .-�'rr-•z:. Ai:`i
County Tax Map No. 1000 Section (� 5.0!Q( JD z `�`Q`� 7,r. ''
tj ,,,_:Block' (o ,Q�)<' Lot 015, l7 b �
F",4Q;);4 g. •`;U i L-O rr-'.�i"1I.i/n
iClc t;l;::'I'v^i`_3
Subdivision 5(/L Ntf3 f2 14/6tfPof it AlaiDila Filed Map No. 8?/! Lot .5-
St/Cr/to-7J
stc 1to-N 7zvo .3/'9/96
( >)State existing use and occupancy of pren2ises nandp intended use and occupancy of proposed construction: .
a. Existing use and-occupancy st-S.c lrfr►1 CN..'1L.. dK,c-c
b. Intended use and occupancy /4.7;44:1*-I Lk) a A i‘i A1661 s5u'tJ Ai)AwIAa4
CAddi3. ' ature of work(check which applicable):New Building
tion Alteration
Repair Removal Demolition Other Work
(Description)
4./Estimated Cost Fee
(To be paid on filing this application)
0If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars Mft3 j 3 MI
6, ,, 6,- ,,-\ If`busines's;:commercial or mixed occupancy, specify nature and extent of each type of use. Ai /4
c-7.,/Dimen§ions,of existing structures, if any: Front Rear - Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8 Dimensions of entire new construction: Front Rear Depth
- Height Number of Stories
1Size of lot: Front Rear Depth
10. Date of Purchase. Name of Former Owner ,
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO<
'
(13,)Will lot-be fe-graded? YES NO< Will excess fill be removed from premises?YES NO ~
14.Names of Owner ofremises Address Phone No. -
Name of Architect 1)6 n / rz;Art. Address//1'w ir' l>li-Ivck Phone No `
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 thi's 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.
18. Are there any covenants and restrictions with respect to this property? * YES NO
' -* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS: .
COUNTY OF )
J 's t c " ' \i, ' ` " being duly sworn, deposes and says that(s)he is the applicant
C,
(Name of individual signing cont ct)above named,
(S)He is the
(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 this c
3 411 day of Nlarth 20 1 J -. , . : -
I, :, -,,
if, �.
TRACEY L.D ' ` °�'
Notary PublicNOTARY PUBLIC,STATE OF NEW YORK Signature of •pplicant
} ' - - 'NO.01 DW6306900
QUALIFIED IN SUFFOLK CO N
COMMISSION EXPIRES JUNE 38 'Ca_
/ 0-,c)5" +=-. ST(0)RMWA\T]ER
Scott A. Russell
SUPERVISOR MANAGEMENT
4
SOUTHOLD TOWN HALL-P.O.Box 1179 vvv
53095 Main Road-SOUTHOLD,NEW YORK 11971 11+ •
vvvv
� Town of So u th o l d
. dt !Yt ,
.......l 'its*f#
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑� A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑Eg B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑El C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
. ❑E' D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
1:1 121 E. Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map-of-any watercour--se.---- - -
❑L . F. Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
in-kind replacement of impervious surfaces.
* If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project.
* If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLICANT- (Property Owner,Design 'rofessional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date
_ District
NAME. ,l. \ it, 55 Co 15. 8` 3-13-15
MaltSection Block Lot
cSs�awr<i •` .��:x-x DEPARTMENT LSE ONLY 'x`F
Contact Information (.4t ^ : O fr I
FOR BUILDING au-L.4(A
dephmc Nmnbrr) dd
Reviewed By:
Date 3 _13 : 15
Property Address / LocationIof Construction Work: —
Co'J v V r 0 6 Q ���. Approved for processing Building Permit
l Stormwater Management Control Plan Not Required
SOO 6 ld 0 119 7 f D Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review)
FORM # SMCP-TOS MAY 2014
\?)3. DO\93
N
Town Hall Annex • - Telephone(631)765-1802
54375 Main Road � � ��� {631)765-995o2. �(r�
P.O.Box 1179 roger.richerttown.southotd.ny.us
Southold,NY 11971-0959 Of.
4% ,I
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yCOU(�T'ts�
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BUILDING DEPARTMENT i
TOWN OF SOUTHOLD LSU JUL 2 2 20 L ;
APPLICATION FOR ELECTRICAL INSPECTION,
REQUESTED BY: l-- r,-
0 W�J�� Date: --------_
Company Name: -
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: FA-IR i cl A se-p C di es Li?'-1
*Address: ( 3 a c>R i o L E DR— Soot-i+t ) 1q71
*Cross Street: Li s A- D 2•
*Phone No.: ((_3 I ) g v --U7 si
Permit No.: 396,/
Tax-Map District: 1000 Section: SS Block: 6, Lot: 15
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES'P NO Rough In canal
)
*Do you need a Temp Certificate: YES ! NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
'New Service: Re-connect Underground Number of Meters Change of Service Overhead
4dditional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
,01,o�QSUf Ft1�K4oG
Town Hall Annex �'1. .. - -' ' -G L Telephone(631-1802
54375 Main Road ! o ' ? Fax(631)734-9502
P.0. Box 1179 %
Southold, NY 11971-0959 ; -
t
y o� II
BUILDING DEPARTMENT
NOTICE OF. UTILIZATION OF TRUSS TYPE CONSTRUCTION, PRE-ENGINEERED
• WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION •
• Date: 01- \11)1).- - .
•
� . , of ��
Owner: �aS� Co-v.MAAyA(6.,,-.+, cAA,n
Location of Property: Cj _'_ (''J� - b c'• J L , .SO4►4 k` 1\cn-\ • ,.
Please take notice that the (check applicable line):
New residential structure 4,,.. • •
Addition to existing residential structure - . .
Rehabilitation to.an existing residential structure ;,
to be constructed or performed at the subject property reference above will Utilize
(check applicable line):
' Truss type construction(TT) • •' • • _
• ?� Pre-engineered wood construction (PW) . -
1 ->K Timber construction (TC) - -.
in the following location(s) (check applicable line):
• -x Floor framing, including'girders and bdams (F)
• ,
Roof framing (R)'r . . _ •_ .. -
Floor and roof framing (FR) _ .
Signature: .. NA -
1 ;'i'
Name (person subm i g this form): 5 -
Capacity(check applicable line): . - - _ ,
Owner , _
Owner representative
TrussResRegl5.docx Effective 1/1/2015
6" DIAMETER
REFLECTIVE RED • ROMAN ALPHANUMERIC
:- `PANTONE - DESIGNATION OF`CONSTRUCTION
•
(PMS)#187 _ ••;t, ' •-, - " TYPE BASED;ON SECTION 602 OF
THE BUILDING CODE OF NEW
YORK STATE
2 MIN• ` -•REFLECTIVE
WHITE ,
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..
1/2" STROKE '
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_ _ ...___ .-_.-----____--_______...- ..- -.'-DESIGN-KrION-FOR-STRUCT--U-I AL^ - __. .. ..---....--•----_:_.__._ ___._._�
_ .. C.OMPONENT_S.JHAT ARE OF :. • .. , .- 1
.
TRUSS CONSTRUCTION
"F" FLOOR FRAMING, INCLUDING
GIRDERS AND BEAMS; •- • " • -
"R" ROOF FRAMING -
"FR" FLOOR AND ROOF FRAMING . - •
11 TRUSS IDEI f1FIC�ATIC I.SIC I
- ,- COII/PLIAN CE 1MTH 19 IJICCRR PART126,54 e . , ; •. .
ror1O&'LE
. 1:
• ,i i =
CODES DIVISION ,
--, I
E AIV�'LE TRUSS IDENTIFICATION SIGN DATE:03/08/2005
•
r` � • =• NEW YORK STATE DEPARTMENT OF STATE
.. - , -I{ 7 , DIVISION OF CODE ENFORCEMENT
." ,',;"•• AND ADMINISTRATION
• ;DEPAmmENT:LTf,"S'(ATE.,
14, , :.., ✓ "4 _, r is, •rti.,.. ,Ffo ,.'r^,"•vF. Y, _ .r:......,e :4.K4•...-+•say?:w .a.^.!.*...s} rsr y.+ •Y9.:A.*"Y..1.44.4*. .
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11-oc;CD - 65-L - s.(g TOWN OF SOUTHOLD PROPERTY RECORD CARD u
OWNER STREET 63-.0- _ VILLAGE T DIST. SUB' LOT 5 .
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ACR. REMARKS /� L.) X
cii/6/177 --RP � C?/cZ `d-e-C>r):7; ohe &' YY?a // Jw/c -`'$cV. non,
t //y� y// I / //}// / TYPE OF BLD. p/ '/ /� Ul
1 of t- i i61. , Jl /1 LI OrI Cov (ey� 0 / 13 q3 `� 1 -sit-,0 6
PROP. CLASS TT ✓
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LAND IMP TOTAL DATE /09/4- 2e4oR 3 /ad - corn /eJe o2r=d tooR., 0 42.bWell; ,,elc .-
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FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND /61)C
BULKHEAD HOUSE/LOT °-150 CL ?-_
' I TOTAL _gis:‘,. .-:,/2.6
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Eaten i n i� 2-3..1,
� 1 Basement WL Floors Kit.
.. !.`� ��X.��3 '"" � a� lJ•_ SLAB
Extension Ext. Walls `2,u4c.4.1,L Interior Finish L.R.
_ v
Extension - Fire Place cl Heat D.R.
-Patio-AJ SPO-i- 2- Woodstove BR.
Porch Dormer Fin. B.
Deck Attic
Breezeway Rooms 1st Floor
Garage -2 x g, &05 Driveway /�tvA -6� Rooms 2nd Floor
O.B._
Pool ""-- \ �fRR-0 --rtt .� '4Y -t=P2:RI , 0•1451�. r-m'915 ---
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Town Hall Annex �I �O : Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
bie
Southold,NY 11971-0959 `. .
'yCOUM`(,*1 '
•
October 22, 2015
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Joseph Cowley
630 Oriole Dr
Southold, NY 11971
TO WHOM IT MAY CONCERN:
The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
A fee of$50.00.
t/ Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept.
Final Storm Water Runoff Approval from Town Engineer
BUILDING PERMIT — 39616= Accessory Apartment
SURVEY OF PROPERTY
N AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000-55-6-15.8
! SCALE: 1'=40'
DECEMBER 15, 2014
JANUARY 14, 2015 (REVISIONS)
.. JANUARY 21, 2015 (revisions)
N/O/F
GEORGE BROWN m..I,.. T C:::.1 r.Fi-°:t 1 E-.77.7;',.77.7:7,:,77! _. ._.., .::cr73
DWELLING :..._ _.r.:. ... , ... . '
0FE E4N Gc ssvv� -Q Y
. � n __
\ SED 2 7 26I
HSE. Z +�F x e::.",'_1r..._...:.. . .�1..._:-.;.:,-.:.:w': (D.�
WELL IN BASEMENT $ + + R6• ILS',7 ate.e 1 S� -17 ,`7....;E:E.� E..1; @ 7-77.0;,:71
K `+ 8 LOT (
K -N cps
•• +� F DWELLING .
o Wv •\% (PUBLIC WATER)
FE.
U �5 \,47'N
Z
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Y
N/O/F R•
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F
= F. 4.4'N r,u.
ANGELINA 8c VICTOR PEREZ �A° F �\ "t.a.µ ?,,�rR w..!1c17 •,�;�.. --.1'�-,, n
'PF .;/'s.. .. .1.�... . J ..l i,a,.o;r Ems, ll'.R.�].r1;
W w tis \ ccrn'�2 n.'.`,;x:r� is -}r'_ :i ice,_iii:.. ! i;e 1i
DWELLING cJ cc x� : :�« 4• :: '�%'�:- :a g_,..:k.�...
LOT ` ��F W, ,
W
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0.5'S -
F4 FE
23� 2.4'N
3� EXISTING SEPTIC
, •o •oq% TO BE REMOVED
4ISS / O
9• ` +h°F • .` 120 / ?Bl ,• s� TEST HOU
2�`4 n ` \f�R°R STKDE. '17 .1 e ? EL 21
O F,y o G �ev ��p)p �P�
iv R7j'C7Ni. 1�. N-• E'�. c' 7. A y1P'��.
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DWELLING �_! vi/
ry gSAy ��p Q cy --o!
TEST HOLE DATA (PUBLIC WATER) .10. .0-. It:, ' ' m
McDONALD GEOSCIENCE F Q044,6544' O 00 /
11/05/14 s 24 OR1 `� `' F /%•h0• /
EL 21.8 '
:: :
RK ::: :L
LOT• 11 I' oR•Le�gr co/6, HYDRANT•,/
4' REBARAO / '
DWELLING Fro.,
F�
PALE BROWN FINE SAND SP (PUBLIC WATER) 2O� ACCESSORY BUILDING - 822 SO.FT.
•
USE
Op BOX 1 STHFOLO R -1558 SO.FT. .
- 1500 SO.FT.
7' Zi
40 / UNFINISHED BASEMENT - 1500 SO.FT.
PALE BROWN FINE TO l��
COARSE SAND SW i 2
SUBDIVISION — "HIGHPOINT MEADOWS, SECTION ONE" :— ------ _
SUFFOLK COUNTY FILE MAP No. 8910. cO
NOTE: NO WATER ENCOUNTERED �O• 1
�_ dry�-,
o5 t
ELEVATIONS REFERENCED TO NAVD88 A p I \/ �_
ALL WELLS WITHIN 150' OF PROPERTY NOTED ON SURVEY LIS '4 wr '''�'
WELLS AND CESSPOOLS SHOWN 1 d::. :^" c� -::" so,..;'`�
THE LOCATION OF PUBLIC WATER, ,
HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA ' A,%.
OBTAINED FROM OTHERS THEREFORE THE LOCATIONS ARE NOT GUARANTEED VokT- '4.A. < r ^ s' . `i':: : -1::
[1] 1,500 GALLON PRECAST SEPTIC TANK ` N,''
• ,�-- « , ,. 1; i
ELEVATIONS TOPOGRAPHIC AMAPS AND ACTUAL FF ELD OBSERVATIONS
IVE EASTERN PROPOSED SEPTIC
8' DIA., 5' LIQUID $ y �!"�'C If
2 BR. APARTMENT `'
[2] LEACHING POOLS 8' DIA. x j�' DEEP r,- '.� ,, ' �•" � -„�.-.„-�-' ,. r-
LOT NUMBERS REFER TO "SUBDIVISION MAP OF HIGHPOINT MEADOWS, 4 BR. MAIN HOUSE e� ,)14 i' .r ,_�
SECTION TWO” FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE 6 BR. TOTAL BACKFILL WITH 3 SAND (SW) COLLAR, , ���,, •
4,y
- ,;-,r i 1 o• ��
3' ABOVE GROUND WATER `J'-, � f k0 ;?'�+ `S
ON MARCH 19, 1990 AS FILE Na 8911. }� `4 ” >2 ,;C^X.Y c''.�� N.Y.S. LIC. NO. 49618
ta,g� lC_i o Healthrvices 5�1D\` RECON/C EYORS, P.C.
ANY ALTERATION OR ADD/TION TO THIS SURVEY IS A VIOLATION SANITARY SYSTEM DESIGN BY. y �tfi0'nG�0.!1 ; ala =° (631) 765-5020 FAX (631) 765-1797
OF SEC770N 72090F THE NEW YORK STATE EDUCATION LAW. JOSEPH FISCHE771, PE. P.O. BOX 909
HEREON AS PER SECTION 7209—SUBDIDSION E ALL CERTIFICATIONS IF 1725 HOBART RD. AREA - 32,689 SQ. FT. 1230 TRAVELER STREET
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SOUTHOLD, NY. 11971 99-11,2
SAID MAP OR COPIES BEAR IMPRESSED SEAL OF THE SURVEYOR 631-765-2954 SOUTHOLD, N. Y. 11971
WHOSE SIGNATURE APPEARS HEREON.
SURVEY OF PROPERTY
N rr---',- -7 7 (1 '1f71:7:77----: r, i,
AT SOUTHOLD
i OCT 2 7 20 15 L, TOWN OF SOUTHOLD
.
..., ;,\(„. .
SUFFOLK COUNTY, N. Y.
ri n r; ,F I 1000-55-6-158
SCALE: 1'=40'
DECEMBER 15, 2014
f JANUARY 14, 2015 (REVISIONS)
MAY 21, 2015 (SANITARY AS BUILT)
N/0/F
GEORGE BROWN
SCDHS REF O R10-15-0009
DWELLING
FE. FE.
• 0.3.E4•N
+\
'e \+ '"F
HSE. \+ticF
HELL IN BASEMENT .--
ASQI NT11. it \ s
+ ` `10• L 0 T (6
_)
DWELLING ----
osw \
-��-/j., \ (PUBLIC WATER) r 9~.11- tC U`. Ctr��'ART1"�ht'F 'f N�A!:THScRViCES
\ FE.
Z \4.7N APri+OWst.OF CCONS1RUC1ED WORKS FOR
� I. 'k�;4"GLEF:�t�4,1LV RESIDENCE AND
Y
J ! V.
Z Q
N O F it
Es 4.4'N n Q� �� 3 0 201" �. . .FCS 14 ) V - J s 00 0 P
ANGELINA & VICTOR PEREZ ; _ ,���ti �� »F��
W , W s \ TM TmA.c1i5r.Qsa and water supply faciiNUos at t'iis Iocafon have been
O ' K
DWELLING N \ Inspect d:and/or cort:;:od by this D. pc:rt;Hent or ot"+ ap^ncies and found to
M o L 0 T lb -h.\
��F�F4 bs seisfactoty FOR
TyTAL ' °, y1 OF—6- BEDROOMS.
+\+ Walter J. Hilbert,P.E., lies
wELL ••
o \+ ice of Wastewater Management
, 9 • \+\+ ��� _
F
0 5'S.s \
FE
24'N li,
♦
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sss. 1 f1F� STKDE. a' �. ♦` '�e. , 4'1' .e",\N‘N TEST HOLE
40ti� FF*4's' FE. CI .•y / ���lV • .;•e EL 41.5'
TEST HOLE DATA DWELLING qSp ,
McDONALD GEOSCIENCE (PUBLIC WATER) ,� 0)q0 ti
11/05/14 os`.� , tier ; .!P t / 0., `
s F•P' � O
EL. 41.5' ORS ..,,,.:62,?
`� /
DARK BROWN LOAM DL . ~ '`e
so
249 39, I Fig. .444' / .
47
PALE BROWN SILT ML Aspyq<T sa _ 3',�4 /
LOT 1 °R' c`Re /
��'9Y HYDRANT �I V
4'
PALE BROWN FlNE SAND SP DWELLING REB p. /
(PUBLIC WATER) EL 20.9 4
7' .
,� • Limn, '1"v
SC'DXS 810-15-0009 �00• BOX / o'O
PALE BROWN FINE TO A B 14)
COARSE SAND SW ST 38, 17.5 v�"�') /
LPI 33. 40.
/
LP2 45 28. SUBDIVISION - "HIGHPOINT MEADOWS, SECTION ONE" -- ---
17' SUFFOLK COUNTY FILE MAP No. 8910. �� "p 4
NOTE NO WATER ENCOUNTERED \,�`' CSS 0 E�
C:,:m�
SUFF. CO. Hyp� PVLF_ 3
THE LOCATION OF PUBLIC WATER, WELLS AND CESSPOOLS SHOWNLISA DRIVE �� Q` �E:'"�� � �I "
HEREON ARE FROM f7ELD OBSERVATIONS AND OR FROM DATA w 1.
OBTAINED FROM OTHERS. THEREFORE THELOCAT/ONS ARE NOT GUARANTEED r�; E• 7;-." f
c3 �1� . ` `c=�\
ELEVATIONS ARE BASED ON THE FIVE EASTERN TOWNS ter,
[1] 1 500 GALLON PRECAST SEPTIC TANK .. ,1'`., rekl ',
TOPOGRPHIC MAPS AND ACUTUAL FIELD OBSERVATIONS PROPOSED SEPTIC 8' D/A., 5' LIQUID 1. ; T_.
2 BR. APARTMENT *= =l`
LOT NUMBERS REFER TO "SUBDIVISION MAP OF HIGHPOINT MEADOWS, 4 BR. MAIN HOUSE [2] LEACHING POOLS 8' DIA. x 12' DEEP < -•1:c:•a„.�-5 •'
SECTION 71Nt7" FILED IN THE SUFFOLK COUNTY CLERK'S OFT/CE 6 BR. TOTAL BACKFILL W7H 3' SAND (SW) COLLAR, � .4e, •b
ON MARCH 19, 1990 AS ALE N0. 8911. 3' ABOVE GROUND WATER ',LID-,`r • 1 _ • . Y.S. LIC. NO. 49616
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A V/OLATTON SANITARY SYSTEM BY: �ECON/C S i ORS, P.C.
Iv
OF SECTION 72090E THE NEW YORK STATE EDUCATION LAW. SYSTEM
DESIGN (b31) 765- •20 FAX P.C. 765-1797-
HEREON
AS PER SECTION 7209-SUBDIVISION 2. ALL CER71R7CA7/0NS JOSEPH ,
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1725 HOBART RD. P.O. BOX 909
,
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF 7HE SURVEYOR SOUTHOLD, NY. 11971 AREA = 32 689 SO. FT. 1230 TRAVELER STREET
WHOSE SIGNATURE APPEARS HEREON. 631-765-2954 SOUTHOLD, N.Y. 11971 99-112
APPPOVED AS NOTED cc:: -.' -.L.,: ',..-,...:7!-I :....LL coDEs OF OCCUPANCY OR
NEW
DATE AS',Iff_. B.P.4:75.c. ' ,.&"7-- .
RECU:FIED l'' 'T .c..u, &-e-A, F USE IS UNLAWFUL P
. 10
FEE:"- , -1-‘.. .?6)-PY:,„...f ‘ _
SO= iL.iNz.-LA--- WITHOUT CERTIFICATE 4
NOTIFY BUILDING DEPP.RTMENT AT
...2_, • ,,
FOR THE SOU BOARD BOARD OF OCCUPANCY
__ ._ _ • .
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED ...... S '..e----77.77:7773-E-1 ES
I ,..
, F•-, .. 0 . ,-- .-. , .. FOR POURED CONCRETE
, ,.... 4. -- C.)
2. ROUGH - FRAMING & PLUMBING
PLUMBER CLR TIFICAVON
. ; 3. INSULATION
I 1 4. FINAL- CONSTRUCTION MUST
1 i BE COMPLETE FOR C.O. t---------------
ALL CONSTRUCTION SHALL MEET THE
,
REQUIRF4MENTS OF THE CODES OF NEW
YORK ,STATE. NOT RESPONSIBLE FOR ,, '
, I DESIGN IOR CONSTRUCTION ERRORS.
.•
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. &WATER LINES NEED
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