Loading...
HomeMy WebLinkAbout21497-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 8-23615 Date MAY 1, 1995 THIS CERTIFIES that the building ADDITION Location of Property 2485 DELMAR DRIVE LAUREL, NEW YORE House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 4 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1993 pursuant to which Building Permit No. 21497-8 dated JUNE 24, 1993 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 ADDITION & ALTERATION TO EXISTING DECK (UNHEATED ROOM) AS APPLIED FOR. The certificate is issued to WILLIAM & MARY BERRY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-043339 - NOVEMBER 11, 1194 PLUMBERS CERTIFICATION DATED N/A i Z-'C~ H ildin Inspector 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 WORKK N° 21497 Z AUTHORIZED) O Date......} ~G ..1...•• 19..r4~.. Permission Is hereby granted to: Y.1.T..... r f~~S......./~ ...?7,~............f~o..f3 ~z - V-.......... ! to..~....~ . mow...... Z....4 4/iA ..4. Z, ,4.ZJ . (2-2- at premises located at.... ..9~fnn.....Zp-tzjzj4ZA..... 2)/1.r 4;64e County Tax Map No. 1000 Section f .,~7.... Block .........T Lot No. pursuant to application dated .....~P-41 19.3„x....., and approved by the Building Inspector. y d'r/ Fee Building Inspector Rev. 6/30/80 Form 110. 6 - TOWN OF SOUTHOLD BUILDING DEPAP'INE:1T _ TOWN HALL Ar 5 1995 ' 765-1802 APPLICATION FOR CERTIFICA'111- OF OCCUPANCY A. 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: I. 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 Eorn). 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 buildin industrial building, multiple residences and similar buildings and installations ,1\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 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 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00. Alterations to dwelling $25.00,'S imming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. , 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00.1 .o}mmee1rcial $15.00 Date New Construction........... Old Or Pre- ,{¢-)'stin Building .......1~......... Location of Property.( ~J~..........1:1' W-kA'IT a /S•. .....Y.. House N~~o/.) JJ ff Street J Hamlet Onwer or Owners f Property..?11t1`!!,!J9A) „i. - A J.9. k.1.....~~ County Tax Map No 1000, Section... I....... Block ....`.r. )/.......Lot.....$ Subdivision.0................................. Filled Map............ Lot...................... Permit No..4),`,,,(,72,Date Of Permit..~i/ AppIic:int. j!. ~ Ilealth Dept. Approval ..........................Unnderwriters Approval... Planning Board Approval 'equest for: Temporary C/e~rtificate........... Final Certicate... 'ee Submitted: $ . cow G 1 a3 5 . r~ C6 a V ~ U G7 +.l U1 eir S ~ Q1 0° ~ b O la~+ 9D ~l ° S U3 kf. CDC =~O~OgpFFOCKcoGy~2 Town Hall, 53095 Main Road y Z Fax (516) 765-1823 P. O. Box 1179 W- _ Telephone (516) 765-1802 Southold, New York 11971 ,f. 0! poi ~ ~a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 21, 1995 Mr. William Berry 2485 Delmar Drive P.O. Box 82 Laurel, NY 11948 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21497-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I %'I LD !:;S.'; :iON COaYMENT° ~ FOUNDATION (1st) FOUNDATION (2nd) 2. 0 ROUGH FRAME & PLUMBING N~ y 3. z m m INSULATION PER N. Y. STATE ENERGY CODE w m 4. m H FINAL 4 ADDITIONA L COMMENTS: y AAA ' x H m~ ' x d m v y ln- l1; J G a Z Avlavv . M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL REMARKS:. a DATE C INSPECTOR P t ~ "1 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8048352 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEMBER 11 , 1994 Application No. on file 84759794/94 H 043339 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of WILLIAM & MARY BERRY, 2485 DELMAR DRIVE, POLE-LILC.O#22, LAUREL, N.Y. in thefollowinq location; ? Basement ® lst Fl. ? 2nd Fl. OUT Section Black Lot was examined on NOVEMBER 07 , 1994 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W AMT. K W. AMT. KW. MIT. K W. AMT. H P 2 8 3 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W G. AMT. AMP. AMT. AMPS. TRANS. AMT H. P SYSTEMS NO. OF FEET AMT. WATTS SERVICE DISCONNECT NO, Of S E R V I C E AMT. AMP. WIPE METER 1)r 2W 1,V3W 3.e 3W 3,e' IW NO. OF CC COND W. G. NO OF HI LEG A. W. C'' NO. OF NEUTRALS A. W. G. EQUIP. PER d Of C CC. COND. OF HI LEG OF NEUTRAL OTHER APPARATUS: i WILLIAM BERRY P 0 BOX 82 LAUREL, NY, 11948 GENERAL MANAGER 11 Per. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OF HEALTH U FORM NO.1 ~-3 SETS OF PLANS TOWN OF SOUTHOLD iSURVEY BUILDING DEPARTMENT --'CIIECI:..................... TOWN HALL SEPTIC FORT! _ . BLDG. DEPT SOUTHOLD,.N.Y. 11971 FSOUTHOL©TEL.: 765-1802 r,'O,TIPY CALL Examined 197„ HAIL-TO: Approved j„~ 1 . Permit No.-Pm?? . Disapproved a/c .....................................lulijlm5ans~ector APPLICATION FOR BUILDING PERMIT Date 19 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 stieets 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 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 inspections. - 3 . . (Signature of applican , or na e, if a cor oration) ~.yfs'S ...~.r^ 1M-AK.~.......... j~ D I3. ailinpLa eR,~pp~U-a ~ 0 .)?p State whether applicant is owner, lessee 'agent architect engineer, general contractor, electrician, plumber or builder. ~.vlt~ cl Name of owner of premises r..y -3. tF (as on the t roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (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. bk.* .y.~s-........Y~ c~L.. m .r~......b, -411M,1?45 House Number Street Hamlet County Tax Map No. 1000 Section ..)A7 Block ...0.uu A............ Lot.. 3 . Subdivision tI3Ua C000ie4 5T19?~5.... Filed Map No. Lot (Narde) , 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: - a. Existing use and occupancy ................................n..................................... . b. Intended use and occupancy ~1/....-D D04.i . , • •I:~~J¢ ,Gf. ° 3. Nature of work (check which applicable): New Building Addition . • Alteration Repair Removal Demolition , . . -•--f gp' ^^(Description) 4. Estimated Cost .Se Fee 7Y. (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, 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 OfStories Dimensions of same structure with alterations or additions: Front Rear Depth Height........ Nu ber Stories.......... . 8. Dimensions of entire new construction: Front T..... Rear Depth / .M........ . Hei-ht Number of Stories . 9. Size of lot: Front Rear ....~.r~............... Depth . 10. Date of Purchase ..~.4 f ` . /.g R.3r Name of Former Owner .-Y)ev. • HR 41 CF 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: lv~ 13. Will lot be regraded . . . . . . . . . . Will excess fill be removed from premises: Yes N.%Sl 14. Naive of Owner of premises 'yQ A , a :.13,t- J?Pv Address 6105-DF JVAR . OR. Phone No. 4 j~ : 4-5 6s . Name of Architect Address Phone No............... . Name of Contractor Address Phone No............... . 15. Is this property within 300 feet of a tidal wetland? *Yes........ No. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all setback dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWg pp!T7 RI({r L S.S COUNTY OF . 1~ . U`:..........? f Pq............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. I* is the Vti~ t 3......................................................... (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. Sworn to before me this - .....~....dayof.\~:.~.~lia. Ln 0......, 15,3 Votaryblic,_....... County J ELIZABETH NN NEVILLE Notary Public, tare of ;'-,w York ignature of applicant) No. 52-8125850, Suffolk Co Term Expires Oeto«er '7 i. , - i - 1100 f I - I I I I ~ I - - - - - - - ---1- II --I 11 I-- it - - - i- i I I- I -ERi ~ 1 F i UN ER RIT RS FICA E -I I I I RE UIR D i - - I 1 Al ?M A$N . 3 , I I E! . B.P. ri - - _.1 FEE. --gg -_i- I NOW, a ' PA AT 765-11102 B M P F R HE POt LO,y NDA I N P _ TI NO RE UI ED tOL 'FOP POIUR DC NCRE E 2-,'O GM-ll- A =C-&- A, C-&- LU .BI_G NlsljtAl L OP ST UC 10 M S7 - HF (OIV~PLEFE FOR --,0. ALL ,PLE E FOR .O. R OUTR CTI N SHALL M ET -THE - - - - - - - 4 7E CONST UUTS- OF -THE-11Y. - STA 1 EER '1L--_- CODES NOT RESPONSIBLE F R T - - -I - IDESIG ORCO S RU TIO E RO S III I iI I!I i~~ I II I I ~ ~I i - - - - r I