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Home My WebLink About21385-zFORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22312 Date MAY 11{ 1993 THIS CERTIFIES that the buildin~ Location of Property 4050 DELMAR DRIVE House No. County Tax Map No. 1000 Section 125 Subdivision ADDITION Street Block 4 Filed Map No. LAUREL ~ N.Y. Hamlet Lot 20 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 27~ 1993 pursuant to which Building Permit No. 21385-Z dated APRIL 30, 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 12' x 12' DECK ADDITION TO EXISTING ONE FAMILY DWR3J,ING TO CODE AS BUILT. The certificate is issued to ELIZABETH CONWELL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i~ing Inspector Rev. 1/81 lvO~ NO. II TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N.° ~1385 Z Permission is hereby granted ............ .~.~,~...~.....~ .,~...~~.....?~.~. .... · . ........ ,o ..~~.......~.....~./~,~..~.~...,...../~....~~...~ ~.....~..~.~.....~.~..~.~.. ~. ,~.... '~.......~....~./.... ........................ at premises Iocate~'d at ........~..~...~...--..~....,..~.~-~'.~-..i..~~ ............................................. County Tox Mop No. 1000 Section ..../~....~....~.... ..... Block .......... ...~.... ..... Lot No ....... ~ ......... pursuant to application doted ..... ..~.,~,~... .................................... , 19..~,., and approved by the Building Inspector. Fee $....~...~.~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL 765-1802 APPLICATION FOR CERTIFICATE 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: ~ 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 2½10 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 Approgal of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and ~"pre-existing" land uses: · tl, 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, Swimming 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 - $5.00 over 5 years - $10.00 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 ................. Location of Property .......................... House No. Street Hamlet Onwer or Owners of Property ............. ~ .................................................... County Tax Map No 1000, Section . ~a~ ~ , ~ ~ ~.~. ........... . .DZOCK ............ ....Lot ....... . ... ..... s ' ' ' ubdzv].szon ................................... Plled Map ............ Lot ...................... c~l-~;~'~"-~ .... ~ ...... cant .......... Appli ................... ~ealth Dept Approval Underwriters Approval Planning Board Approval .......... % ........... lequest for: Temporary Certificate ........... Final Certicate ........... ~ee Submitted: $~-'~-7~'~ ¢ I LS / ... ................. ' c.' APPliCAnT - THE NEW YORK BOARD OF FIRE UNDERWRITERS .u.=^u 40 FULTON STREET, NEW YORK, NY 10038 . -- NOVEmbER (39,1999 193i2999/99 H ~6622~ Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant n~med on the above applicaHon number ~ in the premises of PHILLIPS, 4~54 D~ DRI~, ~.~ELUCK, ~ in the following locaHon' ~ Basement ~ 1st Fl. ~ 2nd FI. G~/OuT Section Block ~t NO~3ER ~2,1999 wa~ examined on and found to be in compliance with the Nat~ona~ Electrical Code.. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS RECEPI'ACLE$ FLUORESCENT OTHER DRYERS SYSTEMS HO. OF FEE! E R ' OF HI-LEG AWG, OF NEUTRAL *HO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condiLion was found. JOHN F. DE REEDER P. O. BOX 1322 14ATITTUCK, BPi, 11952 Per 11GENERAL MANAGER 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 (JERTIFICATE MUST, NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAG Z 40 FULTON STREET, NEW YORI~, NY 10038 ~ DECE}~R O6,1999 19312999/99 H ~66224 Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant namqd ~o~ the above application number is in the premises of PHILLTFS, 4050 DEL~HLR DRIVE, LAUREL, NY in the following location; ~] Basement [] 1st FI. [] 2nd Fl. GAR/OU~ Section Block not was examined on lqOXfP3].~BI]~. ~)2,1999 and found to be in compliance with the Naiional Electrical Code.. FIXTURES RANGES COOKING DECKS OVENS DiSH WASHERS EXHAUST FANS FIXTURE RECEPTACLES SWITCHES OUI'LETS FLUORESCENT OTHER DRYERS SYSIEMS NO. OF FEET OTHER APPARATUS: *NO VISUAL DE~CTS: "An electrical survey has been made o~ the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. C E AW.G AWG, OF CC. COND OF NEUTf~AL A W, G, NO, OF NEUTRALS Og HI-LEG JOHN F. DE REEDE~ P. O. BOX 1322 MATITTUCK, NY, 11952 This certificate must not be altered in any manne~; (efum ~o the office of the Boa~d if incorrect, tnspectors may be i~entmed by their credentials. COPY FOR BUILDING DEP, ARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~OUGH FRAHE & .PLUMBING ~SULATION PER N. STATE ENERGY CODE II FI;;AL ADDITIONA'L COMMENTS APR 2 7 1993 FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . . ....... , 19 ~ ' ' Approved ..., 19¢ SPermit No. Disapproved a/c ..................................... . ~Bui~Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ........ 3 SETS OF PLANS ........ SURVEY ................. CIIECK ....... Date .~..~../7.~.~../f7 ...... , 197.~. INSTRUCTIONS a.' This apl~lication 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 sti'eet~ 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 ghall 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. ' ,, ~ -, . (Signature of applicant, or name, if a corporation) " x/o, o b,e.., (Mailing address of applicant) State whethe/applicant is owner, lessee, agent, architect, engineer, generai ·contractor, electrician, plumber or builder. Name of.owner of premises a z~ t. t_ - (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriied officer.' (Name and iitle of corporate officer) ; Budder s Dcense No ....... Plumber's License No ............... . .......... Electrician's License No ....................... Other Trade's License No ...................... 1. LocatiQn of land on wliich proposed work will be done ....... 5'./.~.~.~. ~.~. ~?.~5..~... ' /a~7~ [Z ~ gCC... ' - - --D~L~'D~,~ La ~s~ 0 ' 0 House Number Street Hamlet Couhty Tax Map No. 1000 Section ...].4~ ........ '. Block .... .~ ' .. Lot .... ~..~.' ..... Subdivision ......................... '. Filed Map No. Lot .. ~ ~ (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy ~/~f/~ F~m/~g ~E$/~6~cK' ~ ~ , b. Intended use and occupancy ....... ~ ........ ~1~1~ ~ /'~'X I~" ~-~( * .~ ~o~r . L .3. Nature of work (check whlchlapplicable)' New Building .. ~ -- - ' ~ ' Repair .............. RemovaI ' . ,, .~: .... aaamon ... ,/.~/ .... Alteration .... ,... '4. Estimated Cost i.. i f.~ ~..~., .~ 'i ........" ... ,~. ~:/cy~,,,~_~,~ (Description) · . ' 'i · ..r ofdwalbn, un,tsoneach oor. .... · t~garage, number of cars ..., ..... /f//~ ............. : ......................... , .... ,... 6. If business, commercial or mi~ed occu/pancy, specify nature and extent of each t e ' ', 7. ,Dfi.men. smns ot ex~sting structu,~es, if any: Front ......... rt,,~ yp of use .,~... ~////~i ,,,,,,~ ..... r~e~gh[ ............... Nulmber of Stories .. 2. ' -' '. · ·., ........... tJepth ............... Dimensions ofshme structure Mth alterations or additions: Front ................. Rear .......... Depth .... ~ .............. i... Height ..... ' ...... ".~ ..... ;.,NumberofStories '' ~ 8. Dimensions of entire new conslruction: Front.. / '~/ ~ ' ............... Number of Stories " . ' -'- ..... t .... 9. Size o£1ot. Fro~t ....... ~ ' ' Rear ....... ~ ~ ......... 10. Date of Purchase ...; ....... Depth .......... i .......... '. · · Name of Former Owner I 1 Zone or use district in which premises are situaie(i ' '" 12 Does proposed construction violate any zoni ' ' ' ' ' · n~ law ordinance or regulation: ' ~ 13 Willl6t be regraded ..... '~ ........ ' .......... ; · Will fill b f p . [ ........ excess e removed from premises: Yes No 14. Name of Owner o rem~ses .................... Addres PhoneNo ......... Name of Architect .... ! . s ..; ...... , .......... ,... . .... ; ................. Address ..... Phone No. Name of Contractor ..... ~ .............. · ......... '.; .... Add . .... , ................. tess ............ ~ ...... Phone No ....... 15. Is this property within i300 feet .of a tidal wetland? *Yes ........ No .... · If yes,'Southold ,Town Trustees Permit may be required. ' .... i ' PLOT DIAGRAM Locate clearly and distinctly al1 buildings, Whether existing or proposed, and, indicate all set-back dimensions from property tines. Give street and blocklnumber or description according to deed, and show street names and indicate whetl~er interior or corner lot. ' ~.. ;T^TZ OF NrW ¥O Z. :OU Y OF .... sis (Namb of individual signin~ contract) bore named· . . .NOTIP¥ BUiLDIN'~DEPA~'~'I~T ~ 765~1802 9 AM ~ 4 PM FOR THE ' FOLLOWING iNSPECTIONS: 1. FOUNDATION ~0 REQUIRED FOR POURBD CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSU~TION 4. FINAL CONSTRUCTION MUST 8E COMPLETE FOR C,O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF 'THE N.~ STATE CONSTRUCTION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ! ·. · being duly sworn, depose~ and says that he is the applicant is the ' ' ' ",,J (Contract or agent .......... ~ ........................... porate officer etc said owner or owners, and is duly fmthonzcd to perform o~ have performed the said work and to make and file this ~plication; that all statements contain'ed in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner s~t forth in the application filed therewith, ' .yom to before me this ' . ', ~ ' ' (Signature of applicant) . THE LOCATrO~' (51':' 'F;Er. SE · ~HOWN HEREIN ARE PROM'FIELD OBSERVATIONS ANDIOB,~BO~tl DATA 03TAII~ED NOTE': ~ = ~ONUMENT ~' HUED/Y/S/ON MAP FILED IN THE OFFICE' OF THE G£ERK QF ~UFFOL~ COUNTY ON dUNE 22~ 1970 AS FILE~ 548~. REVISIONS MAR. 14~ 1974 YOUNG & YOUNG LAND SURVEYOR. N.Y.S. LIC. NO, 12~4S ~ LOT NO. ~0," LAUR[L COUNTRY EST/ TOWN OF ' SOUTHOLD SAVINGS BANK SOUTHOLD s~: I" = 4d' J~: NOV. t5,~973