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Home My WebLink About12426-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No z16812 Date August 18, 19 86 deck addition THIS CERTIFIES that the building ' 1525 g.ldrich Lane Laurel, N.Y. ' Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 125 , .Block 02 ..... Lot 00. 1 . 11 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June !.0 -.83p 12626Z .' 19 ursuant to which Building Permit No. dated J..u.l.y.. ! .5., ................... 19..8.3, 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 existing dwelling. 7.. The certificate is issued to . Terry & Laura Woodhull {owner, Iff~e~ ~tt ~ffe~ x of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 FOBM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL' $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ',AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12~26 Z Permission is hereby granted to: ......... ...-F~:~...~....~ ~.~..~.)..~-~.~.. ........ ............. ............................. ............. /~.,~..,..~..cT.~.o.~......~..~.,. .... ........... ~. .................... ~.~.......~..~-~..~......~.~.~..~..~../..o.o.....~ .................. '...5. ......... County Tax Map No, 1000 Section ..... {~...~ ......... Block .....,O,.,,.~-r,. ........ Lot No..~.(.,..L( .... pursuant to application dated ....... ~..(J..Jwl.'~-. ........ L~--) .................. , 19.~.',4 and approved by the Building Inspector. Building ~! ~nspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOU3'HOLD Building Department Town Hall , Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~a~ to the Building Inspec- tor 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 end sewerage disposal-IS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings 3nd installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings '(prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p;roperty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 ~.. ,~..Z~..~..~..~, 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ............. New C on s 1; r h c t i on Old or Pre-existing Building Vacant Land Location of Property , ./. House No, Street Ham/et Owner or Owners of Property . ./-~-~/'4z~,~.~f-+-J~/,~./~<... ~4~.c/O,J),,/~.~ ¢~..~-¢ ...................... County Tax Map No. 1000 Section ...J~.. ...... Block ,..~ ~ ....... Lot. ~)O/e./. ( ...... Subdivision ......................... / ._../ .... Filed Map No ......... Lot No .............. II Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certific~,e ..................... Final Certificate .... .Jd~...., ............ '-' Fee Submitted $ .... ~ ............ Construction on above described building and _d,~.~e~lT~_pl>~.b c~s and regulations. .~. 10-10.Ta Applicant ....~¢.~ ..... ~.~ ........................ FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qOD FINAL DATE COMMENTS ADDITIONAL COMMENTS: J ~ fili~ Fro,ciS · TEST HOLE ~oe$ott · supply have bee~ and found gtneerlnli SURVEY FOR TERRY WOODHU/I B /AURA WOODHULL AT LAUREl TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK dULY 28, 1981 NOV. 12, 1980 AUG. 26, 1980 DEC II, 1979 DATE: DEC, 5, 197'.9 SCALE: /" '~ /00' GUARANTEED TO: CHIC~Z;O TITLE INSUBANCE CO. HIV£HHEAD SAVINGS BANK FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined Approved .... i ..?Pe=it .a. 6.Z Disapproved aflc ............. Z ............ t~ ....... .................... [7 ............... .~d. ~. ~t or) APPLICATION FOR BUILDING PERMIT Application No...I .~..~.~. ~ ....... Date...':.-~.A/~ ..... 19.Z~ INSTRUCTIONS a. Tins application 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 streets 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 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 grm~ted 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 constnmtion 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. , / (Signat~of applicant, or name, if a corporation) ... 0 . 7 .,w Z:. t To ctc. /. ,. .X/. .......... (Mailing address of applicanl0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... TT.o-~)/..4r .Ld4~R~q.. ¢a2O. oO.Ot{ag.. ¢ ...................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... 'v~. .~'(. . .~r-T'. . ............. Plumber's ~icense No ...... ./ ............... Electrician s,License No.../ ................. Other Trade s License No. / ................... 1. Location of land on which proposed work will be done .................................................. /b~'5- ./'k.t~ o r~ ~r~I.+. ~.~u..- .... .t.~.C,~,.L=~.- . House Number Street Hamlet County Tax Map No. I000 Section ... [..~<..~.~. ........ Block .. bdivision ................ (iq'a~) ................ Filed Map No ............... Lot ............... //State existing use and occupancy premises use occupancy proposed of and intended and of construction: 7 a. Existing use and occupancy .... i.q:.O//O.t¢7 .... .~..~.~...Tf.~..~...t. ..(~....~..~. d.~.'. .......................... b. Intended use and occupancy ...... ~.~...~df~..'...~..~:..~..~..~.....~7.~~. .t ................. Locate clearly and distinctly a/Ii property lines. Give street and block interior or corner lot. 3. Nature of work (check which applicable): New Building .......... Addition .... 't ..... Alteration .......... Repair .............. RemOVal .............. Demolition .............. Other Work.. 0~"C,/~ ...... : '"~ (Description) 4. Estimated Cost...~.£ ~O.1D,..: ......................... Fee..~.. ~..-~.. ~.~'. ........................ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front...¥~ ......... Rear .... ~.~' ....... Depth. ,3~' ........... Height ............... Numlber of Stories . . l ~,~-, ............................................... Dimensions of same structure with alterations or additions: Front ....~.~ ........... Rear . .~. ............. Depth ....... ~.'~. .......... i.. Height ...................... Number of Stories... I..~/~- ............... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front .... :..~O~.! ........... Rear .... .,~D..~ .............. Depth .. 2~.rO~ ................ 10. Date of Purchase . .~l,./f~2 .................... ' Name of Former Owner . .~.Rd~,qc taoR.£1~t.)(. ............ 1 1. Zone or use district in which premises are situated.... 8~-'~1P~Tt,,'~.. ..................................... 12. Does proposed construction violgte any zoning law, ordinance or regulation: ...~.O. .......................... 13. Will lot be regraded .. ~O....I ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .T~.~....t,q. qo.l, t~.14, c~_. Address Z~o~: '~t).~'. m/~r-~ ~'rw~Phone No. ,~ ~c. ~2~t.J. ..... Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ......... i ............. ;... Address ................... Phone No ................ PLOT DIAGRAM buildings, whether existing or proposed, and, indicate ali set-back dimensions from description according to deed, and show street names and indicate whether STATE OF NEW YO/~K, -- 'S S COUNTY OF . .~.. S.S · ' ~ (Nam_.fc 'ndividual signing contract) .......... above named. being duly sworn, deposes and says that he is the applicant He is the ~ · (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 this i ......... /~i .- .... day oi ..... .~ ~..4.-~... ;, ......19 .~'.'~....~__.~ Notary~Public, ......... ~ ..,~ .... :. · .--~-~ .q1 .~ounty ~ i ~ ~-812~, Suffolk u0u~ 1~ [~ M~r~ 30, 19,.~