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Home My WebLink About23146-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-24061 Date DECEMBER 6, 1995 THIS CERTIFIES that the building Location of Property 3365 DELMAR DRIVE House No. County Tax Map No. 1000 Section 125 Subdivision ADDITION LAUREL, NEW YORK Street Hamlet Block 4 Lot 6 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15, 1995 ~ursuant to which Building Permit No. 23146-Z dated NOVEMBER 30, 1995 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to JOHN C. & BARBARA E. HARRISON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 / ~uil~ing ~nspector FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. N~o 23146 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: , ,.~,....../~.~.~ .......................................... .... £~.~...~.~....~ ................................................... ,4~ c/v/, ../../...¢/¢//...:....., ............... ';:; ~ _ ,o...~:~.~..';;Z;;;~'.'.'.'.'.'.'.'.';Z~..';.'.;.'.';;;~;;...,..,.~ ........... ~ ........... ~.~..~.. ...~.~.....~..~.~. ............ ...~....../,...:. .............................................................................................. ~','~',~,i~i';~i~'~i .......... ~..~. .......... ~~ ...... ...2..~ ........................................ CountyTax Map No. 1000 Section .../~'~" ......... Block .,...~...~.... ............ Lot No ...... ..~..~, ............... Building Inspector, Fee,......Z~. ..... //' Building Inspector Rev. 6/30/80 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 inspector with the following: 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. 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 a 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 i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential ¥5.00, Commercial $15.00 Date... New Construction ........... Old Or Pre-existing Building...: ............. Location of Property ........ ~ ................................... House No. Street Ha~et Onwer or O=ers of Property...~..~:..~.~.~...'~.~ ................. County T= Map No 1000, Section .... ~.~.~....Block ...... .~ ....... Lot..~ .................. Subdivision. ~Z/*~ .~- · ~-~.~.-- Filed Map. ~fg .... Lot. ~.~ ................ Permit No ................ Date Of Pe~it ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ................... .... · Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ...... $o$ .... ................... l lmght ................. : . , Number of S or es .~ ......... l)mmnsmns of entire new constmctmn: Front ..... ~ gm. .... : Rear . . . ].~ ........ Dcpth. . . J.7-.. ......... lleight ............... Number o£ Stories ......................................................... 9. Size orlot: l:ront i.';~...' ' .~:?:' : ................... Rear .... ~. Depth 10. Date of Purchase ............................. Name of Former Owner ............................. I I. Zone or use district in which premises are situated ..... (~,.~-.'2.>, 1 2. Does proposed constructiou violate aoy zoning law, ordinance or regulation: ..... .~..~. ....... 13. Will t6t be regraded ..... '.~. ~.. ................ ~. Will excess fill be removed from premises: Yes 14. Name of Owner of premises . ,~.~.~... k'sg~v,,~ddress .~...(~t::."~Phone No. '7-.q..~. 7. Name of Architect ....... 1>4Ot.,4.~....~ ......... Address ................... Phone No ....... Nmne of Contractor . ,.3..-.~,p.o .~. ......... Address ................. Phone No..2.q& .;"~.' ~i',~(I~'. [5.' Is this property within 300 feet of a tidal wetland? *Yes ........ No.. ~f~. *'If yes, Southold Town Trustees Permit may be required. PLOT DIAG ILadM Locate clearly and distinctly all buildings, whether existing or proposed, m~d. indicate all set-back dbnensions from property lines. Give street and block number o,r description ai::eording ,to deed, and show street names and indicate whether interior or corner lot. I'A TE 0 t-' NEW' Y 0 R K, OUNTY OF .. 5..~.~..~.~.~./.<'- .... S.S ......... ~.. ~: . .~.~.P ~ ............ being duly sworn, deposes and says that he is tile applicant (Name or individual signing contract) isthe .'.. O W ~ (Contractor, agent, corporate officc~, etc.) said owner or owners, and is duly nu0~m'ized to perfmm or have perfm'med the said work nnd lo make nnd file Otis plic:Hion; Ihat all stalcmcnts contained in this application are true to the best of his knowledge and belief; and that al: will be performed in the manner set forth in the application filed thmcwith. .om Io before me this ...... ......... or.. .... qa~v Public,~ q ~Fo ~l~ County 'll~l,l,~ LII.~PEI:'flDIJ RI~['OII'[' I]A'I'[z. Is'r) 'OI. JHD/V£' 10I,I (2HI)) R)II(;II I"R^HE & PI,IJHB I HfiHI.ATIO~'I PI~.R lq. ¥, CODE FINAL KIH) I.'t' tOt~fi, l, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN IIALL SOUTIIOLD, N.Y, 11971 TEL.: 765.1802 l£xamined . . . .... ., 19, ermit No ...... Disal~l}loved. a/c .............. . (B{~d~8 Inspector) APPLICATION FOR BUILDING'PEHMIT BOARD OF IIEAI. TII ........ 3 SETS OF PLA~IS ........ SURV£Y ................. CIIE C N' SEPTIC ['0 lIH ............ ,, ...... 1NSTRU~'rIONS a. This application must be contpletely fi led in by typewriter or ill ink and submitted to the Buikling Inspector, with sets of p aris, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location o~ lot and of buildings on preniises, relationship to adjoining premises or public st}eel' or,are~ls, and giving a detailed descri~>tlon of layout of property mu~t be drawn on the diagram which is part of this appH cation. . , c. The work cove~ed by this a ~ ~,1 cahon may not be commenced before ~ssuance of Building Permit. . , ~ ?. Upon approv,d of this applicahon the Braiding Inspector willigst er ~ Budding Permit to the applicant. Such permil snan be kept on lhe premises avallabl~ for hlspection lhroughot~t the wink. e. No building shall be occupied or used in whole erin part for any purpose whatever until a Certificate orOccupanc~ shall have been granted by the Buildifig Inspector. APPLICATION IS tlEREIIY MAbE to the Building Department for the issuance of a Buiklhlg Permit pursuant to thc Buildiug Zone Oidinauce of tile Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances J)~gulati~.n.s, for th~ construction ?rlbuildings, additions or alterat'ons, or for removal or de~nolition, as mrein described. ne aplmcant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations and admit authmized inspectors on pre)m~es and in building for necessar~ions. ~ ~ . [o~ture of applicant, or uame, if a corporation) (Maili~ g address of applicant) t State whether applicant is owner, leissee, agent, architect, engineer, generaJ contractor, electrician, plumber or builder. (as on the tax roll or latest deed) APPROV AS NOTEO H' appHcan~ Js a corl)on~LJon, sj~natureJoF duly aufllorlzcd ' (Name and lille of corporafe officer) NOTIFY BUILDING DEPARTMENT AT i 76B-1802 g AM TO 4 PM FOR THE Builder's License No .... j ...... I '' ' 4. FINAL - CONSTRUCTION MUST OlherTrade's License No. .[. ALL CONSTRUCTION SHALL MEET I THE REOUI'REMENTS OF THE N.Y, Location oF hind on which proposc~l work will be done .......... STATE CONSTRUCTION & ENERGY .......... ~b'~E~'. * 'NOT' 'RESPOUSIBL~* * FOR' ................ , , , ...... COUSr UCT OU I louse Nmnber I Street llamlet C<mnW'fax MapNo. lO00Secllon~., .' .......... Block ............. ',,. Lot ................ ~lflle exislhlg ~lfle alld occul)allcy o~ prellliSes alld illtCllded usg alld ocgupallCy o~ proposed colislrtlcl~oll; a. Existing use and occupallcy .... , , , ....................... 3. Nature ofwotk (check which apPlicable): New Building .......... Addition '...~..... Alteration .......... Repair .............. Removal .............. Demolition .... : ......... Other Wo~k ............... 4. Estimaled Cost ....... ~ .................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commer?at or mixed occupancy, specify nature and extent of each type of ese 7. Dimensions ofexistmg stmctures, ifany: Front .... 6~ ....... Rear ...~ ....... 't3~l}t'l;:: :~ 3~:::. sion~ of shine st,~,ctore with alterations or additio,,s: Front ...... ~ ~.' ....... Rear .... ~./. ....... I .... '...~ .......... lleight ........ ' .. . : Number o[ Stories ..... ~ ....... 8. Dimensionsofe ire e~vco~strtcto~'Fro~t [~ Rear 1~ De~t~ IT~ lleight Number of Stories 9. Size of lot: Front ..... i~ ........ '. Rear ......... ~. ~ ......... Depth ...... [~'. ........... 10. Date of Purchase ............................. Name of Former Owner ............................. I 1. Zone or use district in which premises are situated ..... ~.~., .......................................... 12. Does proposed construcfionviolateanyzo I g aw, ordinance or ~egulation: .... ~ .................... 13. Will Iht be ~egraded ..... ~ ................ ~ . Will excess fill be removed flora premises: Yes 14. Name of Owner of premises . A~.~..~~ddress .~...~l'hone No. ~h~7.~ Name of Architect ....... MOM~...~ ......... Address ................... Phone No ....... ~ .¢.. Name orContractor & ......... Address ............... Phone tS. Is this property within 300 feet of a tidal wetland7 ~,Yes ........ No..~ .... *I[ yes, Southold Town Trustees Permit may be required. PLOT DIAGI~ Locate clearly and distinctly fll buildings, whether existing or proposed, m~d. indicate all set-back dbnensions fr6m properly ~nes. Give street and block number el description accord~g to deed, and show street hanes dud indicate whetlier interior or corner lot. ' (Name of individual signing contract) :is the . .' ........ .O..~d...~...~'~..t~. ..................................................... ' .............. (Contractor, ageut, corporate officer, etc.) said owner or owtlets, and is dtfly autliorlzcd to perfollll or Itavc performed the said work and lo Illllkl? tllll. I file this plic:llion; that all statements contained in this application are true to the best of his knowledge and belief; and that the nk will be performed in lite manner set forth in the application filed therewith. .'orll to heroic t~te this ,,, ...... ...... '...0,,y ,Inly Public ....... ~.q..~..F?..t.:./.~.. ............... County N°larlt P~. 49~N~Y~ Oua~llr~ Suffolk Courtly (Signature of al, plic,~ntl