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Home My WebLink About8866-zFORM NO. 4 TOWN OF SOUTHOLD BUII,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy THIS CERTIFIES that the building located at .La .l~.e..lVp. od' . .D.I'. ......... Street Map No..La.lkr..e.~L.w.o..od. Block No ...... Lot No, .?~ .... ~,&.l~. .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~e.p.t . .17, 19 7.6. pursuant to which Building Permit No...8.8.6.6.Z.. dated ....... ./t.e.l~ .t;...1.7..., 19.7.6.., was issued, and conforms to ~11 of the req~:ire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P..~.~.~.a.~..e..?~.e., .fa/m~'l?..d..~..1.1 .~.~. ................................. The certificate is issued to H.u.~. &...J~..e.~.t...F.O.X. ..... .0]~..e..r.s ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval J~e..1..~...1.9..77...~.~. B; .V.~.~.. UNOERWRITERS CEaT~FICATE No.. N.32003~. .J.~...1.O...1.9.7.7 .............. HOUSE NUMBER ....~, ... Street . .L..a.u?.e.1w..o.od...D.~ ....... L.a...u~e..l. .......... " F~B~lilding Inspeetd~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEP,~RTMENT TOWN CLERK'S OFFICE SOUTHOLD, N,. Y. BUILDING PERJV~iT (.THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 8866 Z Permission is hereb~ gn3n~ed to: ~ra~.e.,e..~....~,.o.,.a..e....~.o.~.?..~....I.~.?........A~...C....~.~.~.....~..~e t[e fox .................. .q~.t..e.~.o.~...e. ....................... ::' .............. to BU£1a ne~ one t~.~.Z...7...~.~?...Z..Z..L~....g' ................................................................................. ct premises located at ..... .~...O.~...,~..~.....~.,.a.-.'q~.-..e-.~-.,~.9-O-.-~.---~.-~.~-, .......... : ............... ~ ................................. puFsuant to ~b,pplication kiate~ ................... z,,'2 :/ .~.e.]~.t,.....~.l..~,~; iz~ ..... Z~.[.;.~,. 1(~ .., and opP;ove(~ .e< .,~ Building Inspector. Fee ................. FOBM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage dlsposal-~(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible far the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 3. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1.00 New Building .....Y..9.~ ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~.~/...~./..~.~.~.~.z.~..e..l..v..~.-.~.D.~..e.~.~..];~.~/~.~.~.e.~..~-!~~. Owner Or Owners Of Property ...... ~.~..~!~....~...:......a~..~...~.~..,,e.~,~..e...~.......~.,o...~. ............................................... Subdivision ..... ~..~..~.,,z'.~,]r.~.°...°,.~....~..%..~.,.~..e.~ ................ Lot No.....2..2. ..... Block No ............. House No...9.{~.~.., Permit No....~.~...~... Date Of Permit ...i~./..1..?./..~.~.Applicant ....... .~..:...~..:.~.:,..~.o.~... ................................ Health Dept. Approvol ....... ~/.~./..7...7. .................... Labor Dept. Approval ........ ,~,T,,/.: ................................. ,/:L0/77 m · . ....................................... Underwriters Approval ..'. ............................................. annmg Board Approval Request For Temporary Certificate ........................................ Finctl Certificate .......................................... Fee Submitted $ ..~.:..0..0. ......................... Construction on above described building anb/permit/ meets all applica~ble codes and regulations. Applicant ........ L.; ........ ~ ............ .~.' ...................................................................... Sworn to before me(~ ......... [ ..... day of ..~...C~...Z?... (stamp or seal)~) :-~f )::~r__ ,~... ' THE NEW YORK BOARD OF FIRE UNDERWRITERS t~l~ -- - ~l,,, ~URIEAU OF ELECTRICfT"Y _ ,,~ I - "'"'"'" eS JOHN STREET. NEW YORK, NEW YORK 10038 [I~~""J,.-u~,, -,, ---- .,,,,,..,.,..,o...f,,. oo....., k, 320034 ~ances Rose Homes,lne., e/slde Lau~elwooa D~., 110' s/o Hea~he~ ~ . La ~e L . o '~2 -~ * .... ,,, ~,,.,,,....~...~, ~ ~....~ ~ ~, _, ~.. ~. .~.~ .t '. ......... '""~0" Janu~ 6, 1977 ,~ *Futu,-e appliance feeder/s: 1-3~8, 1-2~12, 1-2~1~ ! G.F.I. 1 Smoke Detector 350 Lake Ave., fh,s ceHd,~ ate must not be oJter~ in any manner, return ~ the off,ce of t~ ~ar(J i{ recorded Ins~dors Iq)EM NO. 1 TOWN OF SOUTHOLD ~/~/7(- BUILDING DEPARTMENT TOW. _ ~UTHOLD, N. Y. .......... .......... .......................................... ~mpproved o/c .................................................. ................................................................................ ........................... .................. ~P~U~TIO~ ~OR 8~l~l~ ~g~MIT .............. ........... , INSTRUCTIONS a. This application must be completely fdled m by typewmter or m ink and submitted in triplicate to the Buildin 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, relationsh,p to adjoining premises or public streets c areas, and giving a detmled description of layout of property must be drawn on the d~agram which is part of this applicatior c The work covered by this apphcation may not be commenced before issuance of Budding Permit. d. Upan approval of this application, the Budding Inspector wdl issue a Building Permit to the apphcant Such perm shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additions or alteratior~s;'~ for removal or demolihon, as hereto describe~ The apphcant agrees to comply w~th all apphcable laws, ordinanceS, buiJding code, housing code, and regulations, and t admit authorized inspectors on premises and in, buildings for neceSsary/inspections. (Address of applicant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde ........................... .l~.l~r ................................ Name of owner of premises ..... .I-lllgh...'~,,...~,~...alr~l..~l~et,~.e.g.,~...~O~ ............................................................ if apphcant ~s a corporate, signature of duly authorized officer. _ (Name and ,title of corporate officer) Ben le-,'~o~a, ~'res. Builder's License No ..................................................... Plumber's License No ........ ~-J~D,..~ ............................ Eleclncian's License No .... :D,O.~...~. ............................ Other Trade's License No ............................................... T.auz'elwoocl. Location of land on which proposed work wdl be done. Map No ...~.~....~.$..1~:.~.$.. Lot No ..... ..~..~. ............ Street and Number ...~./.~..~...I~u~.e~w~c1~.~.~..3"1:~:...a/..~..~e~.~.?1~e.~...~.e~*..~ Municipality State existing use and occupancy of premises and in~,ended use and occupancy of proposed construction' a Exisiting use and occupancy .................................................................................................................... b. Intended use and occupancy .......... Oz]l.~...l~lJ~tl~...]~l~.~l.1~ ...................................................................... 3 Nature of work (check which apphcable). New Budding .... ,~ ........ Addition ...............Alteration Repair .................. Removal .............. Demolmor .............. Other Work .................... 4 Estirnated Cost ~.. ?( ..... .~. 1-~..., .Q.Q.O., .................................... Fee ............................................................................. (to be paid on filing this application) 5 If dwelling, number of dwelhng umts .......... ,1~ .............. Number of dwelhng umts on each floor ......................... If garage, number of cars ...........1 ................................................................................................................. 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7 Dimenmons of ex~stmg structures, ~f any' Front ..........................Rear ................................ Depth .................. Height ....................... Number of Stories ........................................................................................................ D~mens~ons of same structure with alterations or addJhons Front .................................... Rear ........................ Deplh ................................ Height ........................ Number of Stones ............................... 8 D~mensions of entire new construct,on: Front ......... ~..~. .................. Rear ...~....~.. ................ Depth ....~'&.'~. ........ Hmght .................... Number of Stories .............. ],. ............................................................................................... 9 S~ze of lot. Front ................. 140.! ........................... Rear .......... ]:.4.O.t .................... Depth ...... 3.90! ................ 10 Date of Purchase .................................................. Name of Former Owner ........................................................ 11. Zone or use distnct in which premises are s~tuated ................................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulahon: ........ ~[O- ......................................... 13 Wdl lot be regraded ....... .~.,, ........ Will excess fill be removed from premises: ( ) Yes ( X) No F an li 14 Name of Owner of premises .]~..~,,...&..~Z;l~:~t,e...G,...O/~dress ..'~.O~g]~.,...~.. ~ne No..L~...~-~-~(~ Name of Architect ......................................... Address ................................ Phone No ....................... Name of Contractor .3~/;~.e$. l~:lS~ ..Hom~s ~ 3*.ne,. AddressI2.O~..gg~0..~..~:[~.tn.. ~i:lone No..~',.~.-~.66~.2.: PLOT DIAGRAM Cut~hogue~ NY Locate clearly and distinctly all buildings, whether existing or proposed, and indmate all set-bock dlmenslons frorr property hnes Gwe street and block number or descnphon according to deed, and show street names and indmatc whether interior or corner lot See Filed Plans STATE OF NEW ~(~1~,O]a~' ~¢ S COUNTY OF ...... I~ ~.~- · ~:~O~ ........................................................................................ being duly sworn, deposes and says that he is the apphcan (Name of indiwdual signing contracO above named He ~s the ...................................................................................................................................................................... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and this apphcahon; that all statements contmned m th~s apphcation ar~e to the best of his knowledge and behef; that the work will be performed ~n the manner set fo~h in the apphc~o~ filed therewith Sworn to~ me th,s Bept~r 76 / / ........................ of ............. Su,,o .... . Nota~ Public, ..~ ........................................ m ....Coun~ ....... ~.Z..~..~.:.I.T.~.~...~.~ ............................. K*~ .'~ X~' ~, , . ~. ~ ~ ~ (Signature of ~p~cont) ELIZABETH ANN NEVILLE NOTARY pIJB[/C, State of Ne~rk No 52 8125850, Suffol~ d~ Term EKptres March 30, ~ THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENC WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTM OF HEALTH SERVICES APPLICANT,_ ADDRE'TSS . TEL __ SUFFOLE COUNTY HEALTH DEPARTmeNT The sewage disposal and wat~r supply facilities fo~. this location have been inspected by thi~ department ~d fo~d to be sa~isfacto~~ ~,. · C~ief of General ~gi.e~ VOGu p, reO ¥ vOu''' = i~e~.100'* F~es' I00'* IVO · --MONUMENT = STAKE IVEARE$1' WATEt? MAIN- 4 MILES REVISIONS MAY 13,1977 YOUNG & YOUNG 400 OSTRANDER AVENUE, RWERHEAD, NEW YORK ALDEN W YOUNG HOWARD W. YOUNG SURVEY FOR: Ft?ANCES ROSE HOMES, INC. LOT N0.22, "LAURELWOOD ESTATES," . LAUREL TOWN OF SOU THOL D SUFFOLK CO, h, Y SCALE I GU,~'RANTEED TO' SEPT. 15,1976 76-751 JOB #203 Bu~ Id er: ~anc¢~ Rose Homes, Inc. P.O. Box 992, Main Road Cutchogue~ N.Y. 11935 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RE$1DENC> WILL CONFORM TO THE STANDARDS OF THE BUFFOLK COUNTY DEPARTM[ OF HEALTH SERVICES APP/IP.A Hugh T. a d Annette G. Fox ...... NT: ...... ~ .......... ADDRESS 46 F~ankltn Ave, __TEL,....?~_.4,. -- ,~y,~-%V_g'o~-;' ;~ ?7 --6662 SUFFOLK COUN1Y DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY ~es' I00 v0¢Opt gl i~ot vOGu 6~oo i~' '*vOGu 6FORE. · :MONUMENT N£ARESF WATEt~ MAIN - 4 MI~£S ceS. I00'* . .EVlS,ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG / HOWARD W. YOUr SURVEY FOR: FRANCES t~OSE HOMES,/NC LOT N0.22, 'LAUREAWOOD ESTATES," A~ LAUREL GUARANTEED TO TOWN OF SOUTHOLD SUFFOLK CO., N.Y.DATE BYI ~~ ~ ~CA~.E: /,, ~0' I s~Pr/$,/9~a i~°' = 76 -751 o ~ T __1L l~ 3.15~E D " 3 i I [, -' I I ,1 . T.~. FGU~ 0 f M ~ I-'L' ........................ i ' -. T '¥ 't