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HomeMy WebLinkAbout30879-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30711 Date: 01/21/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 2250 DELMAR DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 127 Block 4 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 3, 2005 pursuant to which Building Permit No. 30879-Z dated JANUARY 5, 2005 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 ACCESSORY 12 X 24 ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD APPLIED FOR. The certificate is issued to TODD ERIC GORDON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A f Authorized Signature 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. 30879 Z Date JANUARY 5, 2005 Permission is hereby granted to: ANNE O'DONOHOE PO BOX 219 MATTITUCK,NY 11952 for : CONSTRUCTION OF A 12 X 24 S.F. SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 2250 DELMAR DR LAUREL County Tax Map No. 473889 Section 127 Block 0004 Lot No. 023 pursuant to application dated JANUARY 3, 2005 and approved by the Building Inspector to expire on JULY 5, 2006. Fee $ 75.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 'gym 19 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 Department with the following: A. 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. 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 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 - $.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: (check one) Location of Property: Z Z S-0 A Lc, u ,-e House No. Street Hamlet Owner or Owners of Property: _ 60 11 Suffolk Suffolk County Tax Map No 1000, Section ! Z Block DO n y Lot O e-3 Subdivision Filed Map. Lot: Permit No. .3 D Date of Permit. Applicant: 1—v Jd 6o 40 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature ca3Q?►1 /,000 - i 7 _ _ TOWN OF SOUTHOLD PROPERTY RECORD CARD 9 OWNER STREET 22-150 VILLAGE DIST.1 SUB. /' LOT-*.c�� � fir a. N �i--� ✓e d. v -e v � FORMER OWNER N E ACR. 4. S W TYPE OF BUILDING RES. SEAS. VL. .. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 1�1� /� �p �e l l�o 6 b �� Ta 00 U� 3 211V 73 c�0, .1' /�, i� H J@T T11 / o Q 0, j AQ ii i eI 2 v 0 J tv �j O 0 2'� 8 Ir L y' o� �,., �3 0 s,,e� A:c O l o o -) Doh v 2 - 3(X3 'a/c /4.00 C°�rafr. AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH V j House Plot BULKHEAD DOCK Total « . x'2a\y. «. K, f , 30 o � ` � 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING FINAL [ ]FIREPLACE & CHIMNEY[ ]FIRE SAFETY INSPECTION REMARKS: �Z DATE /������ INSPECTOR FIELD INSPECTION REPORTDATE COMMENTS FOUNDATION (1ST) ----------�`- ------------------- Lo O� � H —_ FOUNDATION (2ND) C -- z ROUGH FRAMING & PLUMBING 0 H d H = INSULATION PER N. Y. STATE ENERGY CODE H — FINAL Q ADDITIONAL COMMENTS U Z a0 �z m H �O Z x H d b _J A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined f 20J Approved o , 20 PERMIT NO. �? -� BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health —4 sets of Building Plans_ Planning Board approval purvey Check 'I �-,> ,<)O Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Disapproved a/c C, Phone: Expiration , 20_&_ 571:1dirIg In APPLICATION FOR BUILDING PERMIT JAN 3 Date tie c-,3 / , 20� INSTRUCTIONS a. This application MIDST be,cgmplet ly filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, tza`e"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 inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premisesl o d� Gorden 0 L.✓ t ,- (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 3 2 IDL- H 1. Location of land on which proposed work will be done: 27-9-0 Oe- lN+ar` dam, f..c.vr4 House Number Street Hamlet ia38 jm County Tax Map No. 1000 Section I z �, ao Bloom � -Lot o z3, 00 Subdivision fli��w Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .a. Existing use and occupancy 02esJ��n�e_ b. Intended use and occupancy 4/00Z shev, 3. Nature of work (check which applicable): New Building +� Addition Alteration_ Repair Removal Demolition Other Work 4. Estimated Cost— %©®• d0 Fee (Description) (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor jS1 If garage, number of cars 24 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front L S/ Rear 2 y Depth /2 Height 0` S' Number of Stories 1 9. 'Size of lot: Front f 2 V161 Rear l Z Y, yr Depth 10. Date of Purchase i/ l/z 10 5/ Name of Former Owner 4,1,1 c L9 , /J igaa 4 © C 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO,,N' 13. Will lot be re -graded? YES NO 3C Will excess fill be removed from premises? YES NO 14. Names of Owner of premises '(,o J1 64rdmi Address_ZF-0 Phone No. Name of Architect Address Phone No Name of Contractor /it,�, Fo,k wov t OeLOe1 Address AvA Lg. �dt yQ' Phone No. 6 -3?06 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO �s * 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. 17. If elevation4t any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF s-Ao/k ) ©cC 60 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing cAtract) above named, (S)He is the byle4/— (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 thi any �of/ 200 Notary Publ' GEST IYANk Nd" 1 SW Signature of Applicant ,40��E: N•11�23 , N �0t Tia 3'4��IvV S• 2 got 44 n �REET J�SEPN NOTE: ar = MONUMENT SUBDIVISION MAP FILED /N THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON JUNE 22, /970 AS MAP N0.5486. REVISIONS YOUNG & YOUNG MAY/, /972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ✓UNE /9,1972 ALDEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR LAND SURVEYOR, N.Y.S. LIC. NO, 12845 N.Y.S. LIC. NO. 45883 SURVEY FOR: S. P. A. ENTERPRISES, INC. LO.T ..NO. 43, "LAUREL COUNTRY �S P� -O AT LAUREL SECUA1rY RIVE A A TOWN OF SOUTHOLD SUFFOLK CO., N.Y. BY SCALE: 40' DATE MAR. 27, 197 CO. APPROVED AS NOTE DATE: B.P. # FEE: > BY:� NOTIFY BUILDING DEPARTM-^'-r 765-1802 8 AM TO 4 PM r FOLLOWING INSPECT' 1. FOUNDATION - 7- ; ED FOR POURE^ 2. ROUGH - F �i,4BING 3. INSUI. nY 4. F11' 'JN MUST F;c _j C.O. ALL ONS :fur ?".UN SHALL MEET THE REQi;iRE " _,,IaTS OF THE CODES OF NEW YCK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY COMPLY V "'TH ALL CODES OF NEW YO"' ATE & TOWN CODES AS REQI; I AND CONDITIONS OF ;THOLr' TOWN ZSA -CwN °LANNING BOARD I7H01LD TOWN TRUSTEES S. DEC ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OLE CODES OF NEW YORK STA FLOOD ZONE COMPLY WITH CHAPTER "46" FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS a ti3 BUREAU OF ELECTRICITY A 0 ULTON STREET — NEW YORK, NY 10038 3� CERTIFIES THAT 3a the application of upon premises owned by R.J. CORAZZINI ELECTRIC 320 RICHMOND LANE PECONIC, NY 11958, Located at 2250 DELMAR DR LAUREL, NY 11948 Application Number: 2058197 Section: Block: Lot: TODD GORDON 2250 DEMAR DR LAUREL, NY 11948 Certificate Number: Building Permit: 2058197 BDC: ns11 Described as a Reside tial occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: service only, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 14th Day of June, 2005. Name Service 1 Phase 3W Service Rating 200 Amperes Service Disconnect: Meters: 1 QTY Rate Ratine Circuit Type 1 200 1 of 1 cb seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.