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Home My WebLink About14235-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16534 Date December 23, 1987 THIS CERTIFIES that the building . .A.C.C.E.S.S.O.R.Y..S.W.I..MI~.I.N..G..P.O.O.L.: .F.E.N.C.E..&..3. '.0..D.e.c.k. ..... Lo ..... 2225 Delmar Drive Mattituck, New York cation oI rroperty ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 127 .Block 4 .Lot 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August I, 1985 pursuant to which Building Permit No. 14235 Z dated . .S.e.p.t.e.m.b.e.r..5.,.. ?.8.5. .......... 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 ......... .A.C.C.E.S.S. ORY SWIMMING POOL, FENCE & 3'0 DECK AS APPLIED FOR The certificate is issued to GREGORY & SHARON DOROSKI ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ........ .N[.A ............................... UNDERWRITERS CERTIFICATE NO. N705642 PLUNBERS CERTIFICATION DATED: N/A Rev. 1/81 TO~'N OF $OUTHOLD BUILDING DEFAi~TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 14235 Z County T~3x Mop No. 1000 Sectio~....I.....-,~, ....... Block ....... g.,,~ ....... Lot No ......................... pursuant to application dated ...~ .............................. , ...... . pp y Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 TOWN OF ~OUTI:IOLO APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building inspec- tor with the following; for new buildings or new use: 1, Final survey of propertv 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. 4o Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a c~rtificate 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 topographic 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: Additions $25.00 POOLS $25.00 1. Certificate of pccupancy New Dwelling $25,00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10,00 4.vaoant ndo.o. 2o.oo 5.U~dated C.O. $ 50.00 Date New C on ~ t [~ u c t J on ...... Old or Pre-existing Bu ilding ............ Vac[nt Land ............. ocat,on of Property.. Subdivision ~ . ................ Filed Map No .... Lot No .............. Permit No ........... Date of Permit ..... cant .................................. Health Dept. Approval ................ ' ........ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approvat ...................... , Bequest for Temporary Certificate ............... Final Certificate ................... Fee Submitted $..0~'0~.,.~...~. ................. Construction on above described building and permit meets all apglicable codes and regulations. Applicant ~.~.-.~..~..~.. ~/~' Rev, IO.lO-7e THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000719 BUREAU OF ELECTRICITY ~ 8S *.JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the e~ctrical eq~ip~nent ~ ~scrtbed be~ ~nd introduced by t~ appllca~t ~d o~ tim a~ appllc~tion ~umber b~ the premises of Dr, G~ogo~y ~o~ 2225 De:~ Dr~ve, ~el~ ~Y in ~he followlng location; ~ Basement ~ 1st Fl, ~ 2nd Fl. Ou~eide Section Block Lot was examined on a~d found to be in compliance with the requireo~ents of this Board. 1 1 2 I DRYERS F~RNACE MOTORS FUTURE APPLIANCE F~EDER~ SPECIAL REC'PT ~ gO / C~ack, ~ 11725 Lio~1610~ This certificate must not ~ o(tered in any manner; return to the office of the Board if incorrect. Inspectors may be identifie~by'~r credentials. ~ ~; COPY FOR I~U I.DING DEPARTMENT. THI~ COPy OF CER'!'I~I~I(~,~E .M~JB,"r,~OT~[~E,~[,TEJ~ED r N ANY MANNER FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING F~~INAL OCCUPANCY OR USE,IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY \, \* FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved~ . · ~ ...... 19~..~. Permit No. ! .~..~.~..~.'~..~. Disapproved a/c : .......... ................................ ...... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. . 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 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 ;hall 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 ren)oval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building co~e, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspe~/;~ ~( .~..-~~ ...~.,. ~. ............. : ......... ~ .............. (Mailing address of apphc~ant) State whether applicant is owner, lessee~, architect, engineer, general contractor, electrician, plumber or builder. ................................ Name of owner of premises ..... or latest deed) If applicant is a corporation, signature of duly authorized officer. I (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No .... ./~..~..'.~.'../. ........ Other Trade's License No...~.~. ........... ~.- 1. Location of land on which proposed work ~will be done. ~ ................. ~ ....... /~ ..................... ...... ......... .......... ......... House Number Street Hamlet · '- /47 ................... Cohnty Tax Map No. 1000 Section .. i ......... Block .................. Lot 5~ . .~~.. dO~ ...~.'~: [?~- ~7..~_jFiled Map No. 5.~...~..~.. [ ~.. Subdivision . (~.ame).~ ..... Lot ........... 2. State existing use ~rld occupancy of~in~ use and °ccupancy of proposed construction: a. Existing use and occupancy .......... .~ ....~~ ........................................ b. Intended use and occupancy ~.~ .... . .~' · · · -~.~..~ .................. 3. Nature'of Work (check whlcl~ ~tnhcable): New Building .......... Addltton .......... Alteratl°nt 't ' '~' ~' ' Re~air . Removal ..... Demolition Other .Work ~ ' ' ':,~'~'~ ]'.' ' ........ ~ "- '-(Description) ........... : (to be p ' ' g P hr 5 If dwelling, number of dwelling ~nits ............. Number of dwelling units on eac oor ................ If garage number of c~s ' ~ ............................. 6 If business commerci~ or mixed occupancy specify nature and extent of each type of use ..................... of existing stmctur{ if any Font Rea ' Depth 7. D~ensions s, : r .. .............. r .............................. Height ............... Number of Stores '. .................... ................................... D~ensions of same structure with alterations or additions: Front ..... : ............ Rear .................. I)ep~ .................... I.. HeiSt ....................... Number of Stories ..................... 8. Dimensions of entire new const~ction: Front ............... Rear ~ .............. Depth .............. ight ' ' '~ ' pth ......... tie ......... Nu er of Stories ................. ~ ..... --- ....... .............. 10. Date of Purchase ..... Name of Fo~eriOwner ...................... 11. Zone or use district in which pr~mises are situated ................. ,. .................................. 12. l)oes proposed construction violate any zoning law, ordinance or regulation: .............. . .......~ ...... wm ~+ ~ ..... ~a~a , ~, o i . . Will excess fill be removed from ~rem~ses: ~s~ No 14, Nme of Owner of premises ~ . ~t. ~. ~Q~ ~ .... Addres~/~..% ........ Phone No.. ~ ......... Nme of ~chitect '~'/L' ' ' ' ~ ................. Address ....... ~ ........... Phone No ................ ~. ~m .... Address~ ~ / ........... Phone ................... Nme of Contractor~. .~?~ ' ' '7~ ~ ~?~'- PLOT DIAG~ Locate. ele~ly ~d distinctly fl~ bu~d~gs, whe~er existing or proposed, ~d. indieat~ fll s~t-baek d~ensions from prope~y ~nes. Give street ~d bloe~ number or dese~ption aeeord~g to deed, and show street n~es and ~dieat~ wh~th~r ~tefior or eorne~ lot. I ' ' (Name 6f individual/si above named. .S :n'c'o't;ic't3.......... being duly uorn, deposes and says that he is the applicant He is the !" '' 'e't~ ............................ ' (Contracto~or3ora'te 'offiCer ) 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 b. os~Lo~his knowledge and belief; and that the work will be performed in the mantlet set forth in the applica/tion filed there,~t~5 ) Swornfie~foreme this22~i D / ..... .... , .... , //: JUD TH T~ TERRY ~ .. Netaqt Publi=, Stete of New York Ne. ii2-0344963[$uffolk County~,o (Signature of applicant)