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Home My WebLink About15954-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date December 23, 1987 THIS CERTIFIES that the building CONSTRUCT DECK ADDITION Locatlon of Property 2225 Delmar Dr~ve Laurel, New York H~tts'o'glo ........ '~'t/*~i ............... H~rnle~ County Tax Map No 1000 Section 127 Block 4. ....... Lot . . .5 .......... Subd,vimon .......... · Fried Map No ..... Lot No ..... conforms substantmlly to rite Application for Bmlding Permit heretofore filed in this office dated April 2 I, 1987 pursuant to winch Bmldmg Permit No 1595/* g dated . .Ma.y. l: 19.8.7. . , was ~ssued, and conforms to all of the reqmrements of the apphcable prov~mons of the law The occupancy for winch tins certfficate ~s msued ~s .. .pECK A. DDITION T.O E. XIS. T, IN.G. 0N.E..F..A~.I.L,Y DWELLING AS APPLIED FOR The certtficate ~s tssued to GREGORY & SHARON DOROSKI towner,~ ......... of the aforesaid bmldmg Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO, .. N/A . . · N/A ...................... PLUMBERS CERTIFICATION DATED: Rev, 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT fi.HiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~ ~5954 Z Permission is hereby granted to: .~.,~....,~.~..~.~....~~ ......'~..o..~._~.L'1. .................................................. .. ~ ~.. I/~;~ ,o..C,,:~~....~:.~.~4~ ...... ~..~,~...~...~...~... ...... ..................... at premises located at ............ ;.'J~ ..... ~._~~.~r~ ...... ~_J.~ ............ ...~ ................. County Tax Map No 1000 Section . I ~,-/ Block cD ~ Lot No. (~ ~ pursuant to application dated ...~......~.\ ..................... , 19.~..~.., and approved by the Budding Inspectar. Fee $..-,~-..:.....d. .... Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor w~th the following; for new buddings 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 of Health Dept of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrmal installat~on from Board of Fire Underwriters. 4. Commercml buildings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5,Submit Planning Board approval of completed rote plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent mforma- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory ,$]0.00 Buszness $50.00 2, Certificate of occupancy on pre-exmting dwelhng $ 50. O0 3 Copy of cert~flcate of occupancy $ 5.00, over 5 years $10o00 4.Vacant Land C.O. $ 20.00 ~ -~--'-~ 5.Updated C.O. $ 50.00 Date. '~ Newconstruction ..... Old or Pre-ex~st~ng Budding ........... Vacant Land ............. o0atlonofPrope ..................... ......... ( ............. House No. Street tCarnlet Owner or Ow,ers of,roper ............................ County Tax Map No. 1000 Section .............. Block .............. Lot ................ Subd~wmon ............................. F~led Map No .......... Lot No. Health Dept. Approval ........................ Labor Dept Approval ...................... Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate .................. Final Certificate ...................... Fee Submitted $ .......................... Construction on above described building and permit meets all apphcabJe codes and regulations Apphcant ............. Rev 10 10-78 OUNDATION ls t) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL ?S: ~N 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~ REMARKS: DATE INSP£CTOR~ 765-1802 SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FIN/AL REMARKS: DATE INSPECTOR~ Disapproved a/c (Bml~Ihg Inspector) BOARD OF HEALTH .. 3 SETS O~..PLANS ....... TOWN OF SOUTHOLD CHECK - BUILDING DEPARTMENT SEPTIC ,FORM .... ~ ...- gOUTHOkD, ~.Y Tfik.: 7~5-~B0~ CALL '" TOWN OF SOU~OLD APPLICATION FOR BUILDING PERMIT , / INSTRUCTIONS a Ttus application must be completely filled m by typewnter or in ink and submitted to the Budding Inspector, wi sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buildmgs on premmes, relationship to adjommg premises or pubhc sir or areas, and givmg a detmled description of layout of property must be drawn on the diagram which is part of this a! cation. c. The work covered by ttus application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Building Inspector will issued a Buildmg Penmt to the apphcant Such pe, shall be kept on the premises available for mspectlon throughout the work. e No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa ~shaI1 have been granted by the Braiding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldlng Permit pursuant to 'Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto descnl The applicant agrees to comply with all apphcable laws, ordinances, bu,ldmg code, housing code, and regulations, an, admit authorized inspectors on premises and m building for necessary ips~ectlons (Slgniffure_df'apphcant,.or name, if a corporation) (Mailing address of apphca~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electnclan, plumber or built Name of owner of premises .... ~,-.--~..'- ................... (as on the tax roll or latest deed) If apphcant ~s a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) co. AC O 'S SH aLt L CZ.SZ Bmlder'sLmenseNo.~ ~/Q~-7 Plumber's License No Electrician's License No Other Trade's License No ... Location of land on which proposed work will be done House Number Street Hamlet~ County Tax Map No lO00Section Block .. Lot Subdivision ... Filed Map No, .. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of prqposed construction b Intended use and occupancy · -. ~.~ .'.. . ~ ~ ..... 3. Nature of work (check which applicable) New Budding ..... Add~tmn v,- Alteration Repanr Removal , . Demolition .... Other Work ..... e~ ,'(~------~) (Descnphon) 4 Est~matedCost .................... r/ Fee ........................... ' (to be prod on filing this apphcatmn) / 5. Ifdwelhng, numberofdwelltna~ ~ .~..~ ~ ._.~ ~umts / Number of dwe~ng umts on each floor' ' If garage, number of ca~ . ~~*~.f~ ~ ............. ~ ..... ''''"'" 6. If business, commercxal or m~xed occupancy, spec~y nature and extent of each type of use .. ~ ...... ~.. . 7,,~Dimenmonsofexlstmgstmctures, ffany Front..~z ~ ..... Rear ~ ....... Depth ~.~. / ... --~lght ......... Number of Stones ~ ........................ ~~ ~'~~ensm~ ~ture w~th alterations or addltlons Front ....... Rear ........ ~" Depth .......... He~t .......... N~ Stones ...... , t . ) .... 8. D~menmons of entire new constmchon Front . . ~ . . . Rear ~~ .. . Depth ~ ..... Height ......... Number of Stones ............................ 9 Size of lot Front ........... Rear ........ Depth ........ 10. Date of Purchase ~/~/.~ ....... Same of Fo~er Owner ~/.~~ 1 I. Zone or use dmtnct m %h~ch premises are mtuated 12 Does proposed constructmn wolate any zoning law, or~ia~c;'or regulatxon 13 Wflllotberegraded .. ~_f.~ ........... Wdtexcessfillberemovedfrompr~m,ses: Yes 14 N~e of Owner ofpremme; ~re~~ ~s~c~ Address ~D / Nme of Architect . . . . . Address ~-- .. . .Phone No .~ ..... N~e of Contractor ....... ~ ..... Address . ~ ........ Pho .. 7 ........ 15. Is thzs property located within 300 feet of a tidal wetland? *Yes ..... ~... *If yes, Southold To~ Trustees Permi¢ maybe requzred. PLOW~IAG~M Locate clearly ~d d~shnctly MI buddings, whether exmhng or proposed, and ~nd~cate ~1 set-back d~enmons fro~ pmpe~ hnes. G~ve s~reet and block number or descmptton according to deed, ~d show street nines and red,cate whethc STATE OF NEW YORK, S S COUNTY OF ..... (Name of lnd~wdual s~gmng contract) above named · being duly sworn, deposes and says that he is the apphca He is the .... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authomzed to perform or have performed the said work and to make and file tl apphcatmn, that all statements contained m this apphcatmn are true to the best oflus knowledge and belief, and that tl work will be performed ~n the manner set forth m the apphcatmn filed therewith Sworn to before me this ..... yof . Notary Pubhc ...... ~,... . County (S~gnature of apphcm Lot juS[?H NOTE m .' MONUMENT SMBO/VIS/ON MAP ~'/L~'O ~N THE 0~1~ JUN6 22,/970 ~S ~P NO 5485 YOUNG & YOUNG ,~U~.VEY i OR S PA ENTERPRISES, INC LOT I~, "LAUREL COUNTRY ESTATES , ~ r L A UREL tOwN or 50UTHOLD SUFFOLK CO, N Y