The URL can be used to link to this page

Home My WebLink About15803-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15589 Date April 6, 1987 THIS CERTIFIES that the building ..... Addition Location of Property 2485 DELMAR DRIVE LAUREL House No. Street Hamlet County Tax Map No. 1000 Section . .1.2.7 ........ Block 04 .... Lot 03 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 20, 1987 pursuant to which Building Permit No. 15803Z dated . .H.a.r.c.h..2.8~..1.9.87 .............. 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 an ~existing one family dwelling. WILLIAM AND MARY BERRY The certificate is issued to ..................... [o~n'e'r,'lrdl~'ti'~X'lO(~'~ ...................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A ~Building Inspector Rev. 1/81 TOWN OF $OU'THOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,. Y. BUILDING PERMIT (THIS PERMIT MUST Bt:: KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~ 15803' Z Permission is hereby granted to; ,. ~.~~...~.~..~ ..... ..~..~:e~ ........ ...~..~ ................................... -~, . .... ~~.~ .......... ~,~ .......... ~ _~ ~_~___~4~...-:.>..~.~.....~-...~-~.....~..: ............... ~,~ ........... : .................... at premises located at ..,~....~....~.,.,~....~....,~....~..~.,..c~.. ........ ~..,,.~ ................... County Tax Map No. 1000 Section ...../... ,~.-~. ......... Block ...... ..C~...~. ...... Lot No ..... .,~....~. ........... pursuant to application dated ..... ~.~...,~,.,...?~....?. ............... , 19.~..~.., and approved by the Building Inspector. F,,...~..:..~ 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 application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters, 4. Commercial buildings, Industrial buildings, 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 site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~'operty showing all property lines, streets, buildings and unusual natural or topograph ic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ ,50.0 0 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°ns tructi°n...'.~z.. O~d or Pre-existing Building ............ Vacant Land ............. Location of Property .................... , ................................. House No. Street Ham/et Owner or Owners of Property ~.~.~, ,~,ff~). ~.~..~.. ............................. County Tax Map No. 1000 Section . ./..; ......... Block ............. Lot .... 07. .......... Subdivision ....... ..... Filed Map No ..... t .... Lot No ............. Permit N o. ' .~9~'..~. · .~.~ Pate of Permit .......... Applicant..~...~.~,~.. ;~..,y~ ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Plannirig Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit me~et;F all applicable codes and regulations. 0 U ~ D A_.T I_~O N (1st) O__UNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ,/ ' form~dy or BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ............. : Examined..~.0-~l..~.~..., 197.-1. TOWN HALL NOTIFY 8OUTHOLD, N.Y. 11971 TEL.:765-1802 CALL MAlL TO: Approved ..~ .{>~.q~. ~.~.., ................................................ b (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 p!an to. scale. 'Fee according to schedule. b. Plot plan showing locatibn of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed' description of layout of property must be drawn on the diagram whioh is part of this appli- cation. ' c. The work cgvered 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. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 i.n ..~.t.~_A,~....~. , ¢/~.~.~.~ .... ........... (Mailing address of applicaflt) State whether applicant is 9wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................................................................ Name of owner of premises ............................................. (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) , ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of Iand on which proposed work will be done .... ~. (~..~../.r. 1..~...~.....?..¢.?ff.~... · ¢. w..'y.¢. .L/. .................................................. House Number ~ ~)r- Street L..~/~,Oll ~<-~ . ,/~ Hamlet o2- O~c ,.~,,~-/L ~,,~ County Tax Map No. 1000 Section .. J.. f.]..: ........ Block ...(¢.q. ........... Lot...'-,'~ ............... ' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ...~. V.tV...~.../~...~r./.<1. .................................................. b. Intended use and occupancy . .. ~ ~ I'd.. 157 3~.<-].<, ................................................ 3. Nature of work (check which applicable): New Building .... AdditJon~ . .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............. (Description) 4. Estimated Cost ,~ ~ O,..0~. ....................... Fee .,-,q 0/.~ ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units ion each floor ................ ,. If garage number of cars ' . - 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... ' ......... 7. Dimensions of existing structures, if any: Front ............... Rear ........ ~ ..... Depth ............... Ileight ............... Number of Stories ............................. ~ .......................... D/mensions 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 ' 9. Sizeoflot: Front ...................... Rear ...................... Dbpth ...................... 10. Date of Purchase ............................. Name of Former Owner .. ~ .......................... hp ! 1. Zone or use district in whic remises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess filJ be removed from premises: Yes No 14. Name of Owner of premises 0,!~ ~Jf J'~/~.'.~'.~..~. Address ~. ~P.~. ~.,'~.~./;~'~ .t~. Phone No..~. ~.~ .~.:~.~./~... Name of Architect ........................... Address ................ J.. Phone No ................ Name of Contractor .......................... Address .... : ...... ; .... ~.. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *YesI ..... No .~ ~l'f yes, Southold Town Trust:ecs Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indi ~roperty lines. Give street and block number or description according to deed, and show nterior or corner lot. :ate all set-back dimensions from ~treet names and indicate whether TATE OF NEW YORK, IOUNTY OF ........ S.S ................................................ being duly (Name of individual signing contract) bore named. ~b~Z), ~- . , . 7~, i~O~ ~. ~ 1"{~ ~. PM ~)B THE A~,,~ '~ '~- ~ ~ ~,~,: ' <~¢~ >;~A~.~ MEET ~e'r~ {;ONSTRL (;~f~ & ENERGY sworn, deposes and says that he is the applicant [e is the ..................................................... : (Contractor, agent, corporate officer, etc.) f said owner or owners, mid is duly authorized to perform or have perfonned the said work and to make and file this pplication; that all' statements contained in this applichtidn are"true to the best of his knowledge and belief; and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before m6 this · i ................. , .... day of ....... ,~~ ..... 19.. 7 'ota ,blic .. /. ,i N~..ARY~U StW Si natur a licant) . .0,~7.0787~ ~ul~,tnt~. o ~ ( g aru~app