HomeMy WebLinkAbout45581-Z ,f;�SUffOLK
�o�o coGy Town of Southold 12/18/2021
P.O.Box 1179
2-1 53095 Main Rd
y�l `iao�jf'` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42632 Date: 12/18/2021
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1270 Bray Ave.,Laurel
SCTM#: 473889 Sec/Block/Lot: 126.-7-30
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/6/1972 pursuant to which Building Permit No. 45581 dated 12/18/2020
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:
porch addition to single family dwelling as applied for.
The certificate is issued to Ricketts,Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED C\ C-\
Prizedature
�oS�FFoi TOWN OF SOUTHOLD
moo ay BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
�. SOUTHOLD, NY
�fyS
y oma.u
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 45581 Date: 12/18/2020
Permission is hereby granted to:
Ricketts, Mary
40-11 196th St
Flushing, NY 11358
To: Addition to single family dwelling as applied for.
Replaces BP# 6167
At premises located at:
1270 Bray Ave., Laurel
SCTM #473889
Sec/Block/Lot# 126.-7-30
Pursuant to application dated 12/18/2020 and approved by the Building Inspector.
To expire on 6/19/2022.
Fees:
PERMIT RENEWAL $67.50
Total: $67.50
Building Inspector
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N:. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N96167 Z Date ...............................6?... .7......., 197�
Permission is hereby granted to:
....! .....� r 1'.6.M�.y3y-Al...................................
.......... `
................................................................................
to ........��.Z.0. .......T L........0.i..e. .fl)-fa.T.+..L-Y...... ................................
............................................... ..... ................................................... ..............................,.............
at premises located at
....f.��. �.v..... "A.�. ... .� ......... ........5.....`. ......................
.............................. . .............. . .......................... .. . ,. .��....................................................
pursuant to application dated ................................. ..... 197..., and approved by the
Building Inspector.
Fee $ ................
... .... ...............................
Building Inspector
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION .
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING /STRAPPING [ FINAL�"4% Flyer
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ 1] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
( ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
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Nov bloem rm4) 9& w -
�-� Nvorspa(dP �� 1 �v:
Conk'. 10 _
DATE. ! INSPECTOR MLJI
X I OF SO(/l�o�
TOWN OF SOUTHOLD BUILDING DEPT.
coum, 765-1802
INSPECTION . ,.
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ULATION/C ULKING
[ ] FRAMING /STRAPPING [ FINAL "Cw
[ ] FIREPLACE-& CHIMNEY [ ] FIRE SAFETY IN PECTION
[ ] FIRE RESISTANT,CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE _10214 INSPECTOR
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FORM NO. 1 j
TOWN OF SOUTHOLD 17-17-3
BUILDING DEPARTMENT 2Ct
TOWN CLERK'S OFFICE&
SOUTHOLD, N. Y. vn
Examined ...................................... .. ( ... (/ Application No. ................................
Approved ......................................... 19........ Pemit No. . ..................... C '�Zr
Disapproveda/c ...........................................................................................PC t'-
........................................................................................................................
........................................................................................................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT L
Date ................................................. 19�........
INSTRUCTIONS 3
ith3a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 streets or areas, and
giving a detailed description of layout of property must be drawn on diagram which is part of this application.
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 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, Suffokk 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 buildings for necessary inspections.
(Signa re of plicant,or name, if a corporation)
..... ... �� ..........
(Address of applicant)
State whether}applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....................G 7&.1..! !?c tn!2
................................. ..............................................................................................................
Name of owner of premises .....�Jd�.&71. ........�......��.........S.....................................................................................
If applicant is a corporate, signature of duly authorized officer.
...................................................................................................
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: ....... ./.. Lot No. .....�j....... .......................
Street and Number 5
Municipality
2. State existing use and occupancy of pmises and intended use and occup�of na. Existing use and occupancy ..........p'yl.l. } .g....................
b. Intended use and occupancy .... i��N.1�f... ... ..........`. ...... ...... /Leel 4.it..LU.d.... . .... ...�.r�: .
7
1 `
3. Nature of work (check which applicable): New Building ....................... Addition ........1' ....... Alteration... ::._.�
Repair ......................... Removal ......................... Demolition ........................ Other Work ....................................
(Description)
4. Estimated Cost ............................................... Fee ................ ..............................................................................
.(to be paid on filing this application)
5. If dwelling, number of dwelling units ......./....... Number of dwelling units on each floor .........................................
Ifgarage, 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 ...J'K........... Rear
....J..:................ Depth
Height .../..y................................................ Number of Stories ........../.................................................................
of same structure with alterations or additions: Front �L Rear _22-
'Dimensions
. .......................... .........................................
.
Depth ........Y.................................. Height ........./..`.�.......................... Number of Stories ....... ................................
8. Dimensions of entire new construction: Front ......2. ............ Rear ........................... Depth ..... 2 .
Height ........ 'y ........................ Number of Stories
........../............................................................................
9. Size of lot: Front s'0..................... Rear , ......................... Depth .........
Height .................................................... Number of Stories ......................................................................................
10. Date of Purchase ..................................... Name of Former Owner .............................................................................
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: .............................................................
13. Will lot be regraded ........ ...... ..• Will excess fill/be removed from premises: [51'Yes [ ] No
14. Name of Owner of premises ..... „2 6f,f4!. ,AL,—.(eJA7
Address (PUne No.
Nameof Architect .................................................................................. ..................................................�...............
(Address) (Phone No.
Name of Contractor ... / .. .. . ...............
.eAA....A/e/ K'VA.rZ............... 9�
;Address (Phone No.)
PLOT DIAGRAM
Locto clearly and distinctly all buildings,whether existing or proposed, and indicate all set-back dimensions from
property lints. Give street and block number or description according to deed, and show street names and indicate wheth-
er inte for or corner lot.
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STATE OF NEW YO ` ) SS
COUNTY OF .. .u .4?\K..........................)
.............. ...���c................... being duly sworn, deposes and says that he is the applicant above named.
(Nt�me of individual signinontractJ
Heis the .......................�Un @15_NA '...._................................................................................................................................................
(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 al
statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne
set forth in.the application filed therewith. TERRI LEE ELAK
NpTARY PUBLIC, State of New
1�`,'�� No. 52.6168295 �
day of ... .... .... filed irt•Suffolk1�Q rf�. ..
m 'ssion Expires a�Cl�3 4�9 ty
Notary Public, . ...................... ....................... County � .... .. .. ......: .11!l'1..........................
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