HomeMy WebLinkAbout31364-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 04/12/06
No: Z-31521
THIS CERTIFIES that the building
ADDITION
Location of Property: 1980 DELMAR
(HOUSE NO.)
COlmty Tax Map No. ~73889 Section 127
DR
(STREET)
Block 4
LAUREL
(HAMLET)
Lot 20
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
AUGUST 10, 2005 pursuant to which
Building Permit No. 31364-Z
dated
AUGUST 15, 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to THOMAS J & BARBARA J BALL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~~-
Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPUCATION 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:
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 form),
3, Approval of electrical instaHation from Board of Fire Underwriters,
4, Sworn statement from plumber certifying that the solder nsed in system contains less than 2/1 0 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:
I, 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
(J./ Certificate of Occupancy - New dwelling $25,00, A'iditions 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
~ 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. 7' ~'/CJ b
New Construction: pee k
Old or Pre-existing Building:
/)<j M(I-r- i) ~
Street
1~"MCi .L..for{~,..fi. j;" d
(check one)
L a (./,~.{
Hamlet
Location of Property: /<i'rf-V
House No,
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 17..1 t-J7'
Block /,.2 7
Lot 0'/'''''(
u2(/
Subdivision
Filed Map,
Lot:
Permit No, S /..1 (7'2..
Date of Permit.
_ Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval: _.
Request for:
Temporary Certificate
Final Certificate: __ (check one)
Fee Submitted: $
2:,-:
L~
Applicant Signature
rS-u:... (P9 ?57
CO.:t,.315JI
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.
31364 Z
Date AUGUST
15, 2005
permission is hereby granted to:
THOMAS J & BARBARA J BALL
1980 DELMAR DRIVE
LAUREL, NY 11948
for :
DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
at premises located at
1980 DELMAR DR
LAUREL
County Tax Map No. 473889 Section 127
Block 0004
Lot No. 020
pursuant to application dated AUGUST 10, 2005 and approved by the
Building Inspector to expire on FEBRUARY 15, 2007.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
~. - --....---_. - ----- ~.-
313'1.t Z
TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PlBG.
[ ] FOUNDATION 2ND [.] INSUlATIO~ n "-
[ ] FRAMING I STRAPPING [?{ FINAL ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS. ~
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DATE
INSPECTOR ~~
3/3GLfL
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
~FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE f-;1-oS
INSPECTOR ~~
3/3~Vt-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNPATION 1 ST [
[ ] F~';DATION 2ND [
[~RAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [
-
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
REMARKS:
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LAND IMP.
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TOWN OF SOUTH OLD PROPERTY RECORD CARD
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BUILDING CONDITION
BELOW
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Value
FRONTAGE ON WATER I
FRONTAGE ON ROAD
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Extensi~O> tlx II. / -/,,/ .)..€! 3io
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. Foundation p~ Both , , Dinette
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Porch Basement rv t. <- Floors 0 ~ 1< K.
Porch Ext. Walls <Vtlo[) j,4/y.Jc. Interior Finish I <tI {.[..1 i?o<. lJ..R.
Breezeway Fire Place WI> Heot /J ;:-." DR.
Garage 10 '-I ). 73 /'" (J :77 "'- Type Roof Rooms 1st Floor SR.
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Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Dormer Driveway
Total '1.57. Q
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CERTIFICATION OF
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,5-1802 8 AM
OLLOWING /NSP CTlONS: \
1. FOUNDATION - TWO REQU/RE!t '
FOR POURED ONCRETE .
2, ROUGH - FR NG & PLUMB/Nit i '-
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- i. FINAL - CONST UCTlON MUST ~ ! 0
BE COMPLETE OR C.O, '! '>
'ILL CONSTRUCT/ SHALL MEE1i'fjE
REQUIREMENTS 0 THE CODES Of!.N~
YORK STATE. NO RESPONSIBLE'~Ot:t-
DESIGN OR CONS RUCTION ERROR))~
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COMPLY WIT N CODES
NEW YORK STA E &(T
As REO IRE A - I " /
SO THOLDTO~ZBA G,rJ~ 'l. - 1",)0"
SO, .lJLeJ lOWN PlANNING BOAHU
SOrHOLD TOWN TRUSTEES ,....-0
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~ AlL CoNSTRUCTION SHAlL
MEET THE REQUIREMENTS OF THE
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USE IS UNLAWFUL
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I 400 OSTRANDER AVENUE. RIVEHHEAD, NEW YORK
i ALDEN W~ YOUNG HOWARD ...."" -rOUNC:
-I PROFESSIONAL EHGIHmR...AHD !-AND 9UHVl!iYO.~-
I '-"ND OURVO;YOR. N.V.... LIe. NO. r~ ".Y.G. we. ..O:...~
. SURVEY FOR:
~ WAlJER KOSIANOWSK/ 8 KATHERINE KOS/ANOWS'KI
, .
1 LOT NO 46 "LAUREL COUNTRY ESTATES"
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I GUARANTEED TO:
BlWOKHtlVEN SEHVICINrJ CO.'?/>.
FEl:JEHAt.. HOVSN6 AUM'Hf~J:VlTIO,
!LAIVrE1iS .ITLE fNSl/RANCl:' .,;ORP.
BY ~ - 1 ---
I SUFFOll{ CO., N.Y. ~?rL
L__,.~ i__---L:~~:c 1":_401 PATE. MAR/5,/912' NO.T2_Id'
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LAUREL
TOWN OF SOUTHOLD
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PERMIT NO.
3/'2,6 if 7!;-
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL .
SOUTHOLD, rJv 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
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\,a/~~.apPlic~ti6n MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of Pl,ans, aC\(l1pile plot plan to scale. Fee according to schedule.
b\flolJlfan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and W:l'terways.
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.
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APPLICATION FOR BUILDING PERMIT
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Date
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,20~
INSTRUCTIONS
/Ut
f1,~ /70 J- JJ,)?t:l NY /'/9 7/
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
o "'=-Vlev-
Name of owner of premises /!:.o""^~J d- I:fa.rSC!..-c, 180..//
(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.
~OV7 P
2;~20 r
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1. Location of land on which,.prolJOsed wor),:;, will be done: I
/9,f-c/ /Je( rl1Cl r Vv-, La (.J rc..
House Number Street
NY
Hamlet
County Tax Map No. 1000 Section /:2. 7 Block -7"
Subdivision L,c..v/'t:( G,V>1'7ry E~/FiledMapNo. :;-~I-r;
,
Lot ~ 0
Lot L/ c;
(Name)
2. State existing use and occupancy of premises and intended use and o~upancy of proposed cGnstruction:
a. Existing use and occupancy ,,_r;'nrlr ;:0''''7 /C:i...P'eh/-e . .,~__
b. Intended use and occupancy J) hJ' If' "'::c,,, '0 A'?/':/'e~ r-e __'~_"___
Qy Ne~ beet(
3. Nature of work (check which applicable): New Building~,_____Altcration
Repair RelaPvalk'/~,,",'/-( Demolition Other Work______~_____,
fJ~ 'N,"" (Description)
4. Estimated Cost
/ :2. eN
Fee
5. If dwelling, number of dwelling units /
If garage, number of cars t
-._._ _',_.______n__
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of usc.
7. Dimensions of existing structures, if any: Front
Height J f Number of Stories
7'rJ
2
Rear
'-7U
Depth
.,..( (,
;:?~..,~.rt' S',,/~ ,~",,-, /6 X "2
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Ado! DeeI(' /-<x'TU
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size oflot: Front
/j-J
Rear /' j''''
Depth
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10. Date of Purchase
9 '/J' vV
Name of Former Owner /"'~,/~ {' .I-~/7,...- I";/"Ch,,~ r<<::/
II. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO_I""
13. Will lot be re-graded? YES_NO~ Will excess fill be removed from premises? YES.__ NO_
. _/ p I tp..11' ;>",~ t;!y!.-
14. Names of Owner ofpremlses/"'..Mo/',jrJOr,lu.. Address ,J'u4'-.Jd 1'''7
Name of Architect Address
Name of Contractor -r;i..-c..r /il'c. (( Address
Phone No. lielr
Phone No
Phone No.
7br 7'JS--"f
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO _Y_
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE 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 elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATEOFNEWYORK)
SS:
COUNTY OF )
l!to ""'~ r 50-I! being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
OV-/t1€v
(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 know ledge and belief; and that the work will be
performed in the manner set forth in the application tiled therewith.
20.a:L:'
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Si ture of Applicant
SUSAN J. NAGY
Notary Pwpllc State of New York
No. 4896735
Qualffil1d In Suffolk Cownty
Commission Expires May 20M