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HomeMy WebLinkAbout29115-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29586 Date: 07/23/03 THIS CERTIFIES that the building FIRE REPAIR Location of Property: 1840 DELMAR DR LAUREL (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 127 Block 4 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 8, 2003 pursuant to which Building Permit No. 29115-Z dated JANUARY 17, 2003 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 FIRE REPAIR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LAWRENCE & DEBORAH CONNER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1101681 05/23/03 PLUMBERS CERTIFICATION DATED N/A I X'� Au orized Signature Rev. 1/81 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. 29115 Z Date JANUARY 17 , 2003 Permission is hereby granted to : LAWRENCE & DEBORAH CONNER 1840 DELMAR DR LAUREL,NY 11948 for FIRE REPAIR ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1840 DELMAR DR LAUREL County Tax Map No. 473889 Section 127 Block 0004 Lot No. 019 pursuant to application dated JANUARY 8 , 2003 and approved by the Building Inspector to expire on JULY 17, 2004 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN�Y, JUL 2 1 This application must be filled in by typewriter or ink and submitted to the Building Dep�rtmdnt-with the following: r ' A. For new building or new use: L.,. .? 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 prnperty 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$25.00, Additions to dwelling $25.00, Alterations to dwelling$25.00, Swirmning 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 Date. New Construction: Old or Pre-existing Building: V111 (check one) Location of Property: 1840 2)etmar- be- LNUto,E /VL-W House No. Street Hamlet Owner or Owners of Property: Lo-wrente ? d.4 bora �6n/12r Suffolk County Tax Map No 1000, Section O Block fi L( -CC Lot © (� .0 O Subdivision Filed Map. Lot: Permit No. 4!1 ( I _Date of Permit._ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ lac� �Q C � �3 So Applicant Signature D cPrJ�rJ�rJ�rlorJcPcP�PrJrJ�rJ�rJ@PrJ�r�rJ�rJ�rJ�rJ@PcPrJ�rJ�rJ�rJ�r�rJ�r�rJ�rJ�rJ�rJ�r�rJr PrJ�r��PrJ�rJ�rJ�rJrJ�rJ�rJ�rJrJ�rJrJ@PrJ��P rJcPr�rJrJ�rJ�cPr� o 5 BY THIS CERTIFICATE OF COMPLIANCE THE '`�l� ` � 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 55 BUREAU OF ELECTRICITY 55 5 40 FULTON STREET - NEW YORK, NY 10038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 ANDREW ZIMLINGHAUS LAWRENCE&DEBORAH CONNER 5 5 103 SOUTHERN BLVD 1840 DELMAR DR 5 C5 E.PATCHOGUE,NY 11772 LAUREL, NY 11948 5 Located at 1840 DELMAR DR LAUREL, NY 11948 5 Application Number: 1101681 Certificate Number: 1101681 5 5 Section: Block: Lot: Building Permit: BDC: NS11 fry Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5�5 First Floor,Outside, 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 rj found to be in compliance therewith on the 23rd Day of May, 2003. 5 5 Name OTY Rate Rating CircuitType 5 Alarm and Emergency Equipment 5 5 Sensor 2 0 Smoke 5 SWiring and Devices 5 Receptacle 6 0 General Purpose 5 Switch 1 0 General Purpose 5 5 Paddle Fan 1 0 C5 5 Receptacle 1 0 GFCI Ij 5 5 Service 5 1 Phase 3W Service Rating 100 Amperes 5 Service Disconnect: 1 100 cb 5 Meters: 1 5 5 5 5 seat 5 5 l 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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L N UFVSYOR LAND M.Y.S.L.C.N0.13R1p u '� _A• SURVEY FOR: crD`' S DOUGLAS G.HAVILAND & NANCY M.HAVIL -- 7D _ LOT NO.47,"LAUREL COUNTRYESTATES" m b 'T LAURGUARANTEED TO: EL THETIT-LE GUARANTEE CO. \ 0 4 1w - \ - SOIITHDLD SAVINGS BANK , °23 48 1 TOWN Dv SOUTHOLD LOf A , s - SUFFOLK CO N Y y BY \ ' SCALE` 1" = 40 DATE:JULY B, 19[°7(6 ND M-559 Applicant/ Date. Owners Name: Reviewed: Architect/ Date Engineer: Submitted: 03 SCTM N: District U00 Section131ock: Lot: 1� Project Y y-�-tom--C Subdivision Location: ��J Z /L c � Name: Sin&Ie & separate Required certification: (Yes/No) Req- rr 11 I(eq. � Y,oning DislriCC Ilei size rev' Actual: ,fid�J I JW average o l'rupuscJL-- dal Req, Re }/ Req [I'roni Tos Yard 7 Proped: f (S idc Yard Proposed: w� 1 (Rear Yard ,L I'ropose'de Project Description: �t QA i YTc AGENC=ERMITS Permit REZUIRED FOR REVIEW Il A, NO YES Number Suffolk County Health Dept. New York State D. E. C. ✓ _ Town Trustees Town Zoning Board approval: _ Town Planning Board approval: Flood Plane Elevation 77? Flood Zone: _ Notes: M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE Oj INSPECTOR (" 765-1802 BUILOIIVO-DEP . INSPECTION [ ] FOUNDATION IST [ ] ROUG [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] �RH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR ass-lW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] �INSION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: cc DATE �� INSPECTOR ; FIELD INSPECTION REPORT DATE COMMENTS SZ J �y77 � S FOUNDATION(1ST) ------------------------------------- FOUNDATION(2ND) 7777 " z � —o C<N ' ROUGH FRAMING& PLUMBING / deem. �1 > r r INSULATION PER N.Y. 3 STATE ENERGY CODE 0 _ s ® C-0 1\ FINAL ADDITIONAL COMMENTS Z Z i J o } x ty 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 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. 6'9// ga Check Septic Form N.Y.S.D.E.C. Trustees Examined 1 J ,200 `5 Contact: Approvefl l / 7 ,20_O „iN ' 8 j Mail to: Disap;proved a/c L _ .., Phone: 9d- Expiration 17 . 20 O C Building Inspector APPLICATION FOR BUILDING PERMIT Date 1-- 7 2003 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 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 inspectio: i 'tore of applicant or name,if a corporation) (Mailing addfess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder C:cx-y,-.tics E;e� 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) fi4 S <02.a•may Builders License No. -1--77S4>vsJA 46im9 CSC Plumbers License No. Pa 3jtX 114 Electricians License No. SA--1rV1Ls' AA/ 1iZ�� Other Trade's License No. --Fe 72-- 22-72- 1. -7v1. Location of land on which proposed work will be done: Llrc-4C, Zyzt I House Number Street Hamlet County Tax Map No. 1000 Section Z2-2 Block Lot 12 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 ,2ES b. Intended use and occupancy ,mss/n& UGC iu I t/1 m-e r < 2 n r r t r 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units l Number of dwelling units on 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 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 9. Size 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 ,X 13. Will lot be re-graded? YES_NO .f Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address 1'R4n .ZD6c,/nAP__Phone No. s � Name of-°— A6a5e 3cu�TS�'„un„Alddress/7SSSr _ ��,;2� Phone No Z�?Ss IRSS Name of Contractor C'Rnic, ,UAAS Address eo 93ou� 9l4 Phone No. ?, 7 77 $AYllaoWrAXI 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ZS * 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. IT If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YO S: COUNTY OF 11 �To � COd 2t�OV being duly swom, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, We is the ;t� „u,ya-g, (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. Swo before me thi5� a of l 2 otary Public LYNN ttp00 PUBI.Ic,State of N®W gnature of Applicant No, , 6x,020832 Qualified MOO" fl 70 Term SCOPE OF WORK: REMOVE AND REPLACE GYPSUM BOARD ON WALLS AND CEILING IN FIRE DAMAGED BEDROOM AND ADJACENT CENTRAL HALL. REMOVE AND REPLACE WATER DAMAGED FLOORING IN FIRE DAMAGED BEDROOM AND IN ADJACENT HALL AND LIVING ROOM. i NEW WINDOWS REMOVE AND REPLACE WINDOWS IN FIRE DAMAGED BEDROOM 4 SQUARE FOOT CLEAR OPENING. - REMOVE AND REPLACE FIRE DAMAGED PARTITION WALL STUD IN FIRE DAMAGED NEW SHEETROCK BEDROOM. ON WALLS AND REMOVE AND REPLACE FIRE DAMAGED ELECTRICAL WIRING IN FIRE DAMAGED _ CEILING BEDROOM. - REMOVE AND REPLACE INTERIOR DOORS IN FIRE DAMAGED BEDROOM AND IN / BEDROOM ADJACENT CENTRAL HALL. NEW FLOORING - REMOVE AND REPLACE FIBERGLASS INSULATION IN WALLS AND CEILING IN FIRE BATH DAMAGED BEDROOM AND IN ALL ATTIC AREAS.ATTIC INSULATION R-30 CL. NEW DOOR - REPAIR HOLE IN ROOF OVER FIRE DAMAGED BEDROOM AND CRACKED RAFTER CAUSED I I BY FIRE FIGHTERS. Ce -` REMOVE AND REPLACE ALL WALL COVERINGS AND PLUMBING FIXTURES IN ADJACENT HALL BATHROOM. � - CLEAN AND PAINT INTERIOR WALL AND CEILING SURFACES THROUGHOUT THE BUILDING. NEW 2' HALL CL. SHEETROCK ON CEILING - IN-HAtt I L F__ PROVIDE ANTI-SCALD ANO/OR THERMAL SHOCK PREVENTING DEVICES AS TO PART. 902.6(K) i H-Y. STATE BUILDING CODE. BEDROOM BEDROOM Au. � : ,,uo wGASTE if car;: , & v,, ., HNESNEED our Y.: +"� TES„hv: taxi ORE COVERING r' - ' oii .. , UNDERVdid4h ' C;iIu IGRIL PL ` -17RT/F/CATf0A! Iwilh�D TENT,F EF0i?!- CE. . F OCCiJP,,L ii C:y cD IN 1411iT r CL TEM C.,,3!VIVO T 110 0/ 1 d) LL A P OVEDASNOTED �i r-1�.). DA . r 00 3 B.P./P 7/;Z—� FEE J 5-0' BY: NOTIFY BUILDING DEPARTMENT AT PROVIDE OPENINGS FOR 765-1802 9 AM TO 4 PM FOR THE EMERGENCY ESCAPE AS FOLLOWING INSPECT!`MS: REQUIRED BY PART. 714 OF 1. FOR POUREID CONCF,Z:, F OUIRED N.Y. ST4TE BUILDING CODE, 2 ROUGH - FRAMING & PLUMBING 3 INSULATION ♦ FINAL - CONSTRUCTION MUST PROVIDE SMOKE-DETECTING BE COMPLETE FOR C.O. ALARM DEVICESALL CONSTRUCTION SHALL MEET AS 7U PART. 721.1 OCCUPANCY OR THE REOUI6'EMENTS OF THE N.Y. USE IS UNLA°NH L STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR FRONT WALL OF BUILDING, N.Y.S BUILDING CODE. 'NITHOUT CERT lFi DESIGN OR CONSTRUCTION ERRORS 444 OF OCCUPANCY OF avW YO. Plans are prepared by Condon Engineering,P.0 It is a violation of the SAF 1 do -P,y . New York State Education Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Professional Engineer,Architect,or Land Surveyor,to alter any item in any way.If 1I an item bearing the seal of an Engineer,Architect,or Land Surveyor is .5 W altered,the altering Engineer,Architect,or Land Surveyor shall affix to 2 - the item his/her seal and the notation"Altered by"followed by his/her -i Ego @" ' signature and the date of such alterations,and a specific descd no the alteration. PRuFES5101`P�'� CONNER RESIDENCE Scale: 112"- 1'-0" Condon Engineering, P.C. 1840 DELMAR DRIVE Drawn by:JJC 1755 Sigsbee Road LAUREL, NEW YORK Mattituck, New York 11952 V S 1 I Date: 11412003 (631) 298-1986 FLOOR PLAN DRAWING1