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Home My WebLink About12544-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDSNG DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y, Certificate Of Occupancy Z14807 Dte August !5 t9 8.6. No ............ a ......... ~ Inground Swimming pool & fence THIS CERTIFIES that the building ' 2895 Aldrich Lane Laurel~ N.Y, Location of Property ~s~ Ho ......................................................... · Street Hamlet County Tax Map No. 1000 Section ....12.5. ..... Block ..... D2. ....... Lot...1.0.0.5. ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .J.u.Z. 7....5., .............. 19.8. 3. pursuant to which Building Permit No. ~. 2..5 .~.4.. Z. ............. d0a~g~lu .s .~..6. ,. ...................... 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 ......... Richard Miller The certificate is issued to ........................................................... (owner;q~r&~e~ ~i~rYe~t x x of the aforesaid building. Suffolk County Department of Health Approval N/6. N618684 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 ing Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ 1254~ Z Permission is hereby granted to: · .~.~...:.~.....~..~.~.~..~., ....... ~.~.~ ....... ...... ~.:..~....~:~ .......................................... .... ~.,~:.~..~ ...... ~..,....W..., .............. ~.. ...~'.~.~.t.....~ ~~..:..~., ..................................................... ,~. ...................... .~ .................................. at premises located at ....~....~..cj..~.........~..~...,~..~..~..~.., ...... ~./.~ ........ .~. ~, ................ County Tax Map No. 1000 Section ........................... approved by the Building Inspector. Building Inspector Rev. 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted mlaam~mma 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 and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Reside~nces and similar buildings and 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. Bo For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacan% Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date .... ~,t ,/,/.~ .'~, .............. New C OhS t ruc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~..~..~',.. House No. Street Hamlet Owner or Owners of Property .~../: .~..~.)~-~.. ¢~.../~./.~ ................................ CountyTax Map No. 1000Section .../.~..~..~...Z¢~...'~'Block .... ........... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ......... Date of Permit .......... cant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final 0ertificate ....................... Fee Submitted $ ............................. Construction on above described building and permit me~:~,all applicable codes and regulations. Applicant ~~ .......................... Rev, 10-10-7S co?. APPLICANT: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 DATE: July l~, 1986 Dear: While reviewing our files I find that your expired pool permit ~!~has never been finalized. Kindly return the enclosed application with a check for $5.00. Also, please call and arTange for a final inspection so that we may issue a Certificate of Occupancy on the above pool and complete this outstanding file. Yours Truly, Victor Lessard Executive Adminstrator OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY "IMMEDIATELY" ENCLOSE POOL TO CODE u.on c9~,~,.0.~ BEFORE 'WATER FIELD INSPECTION FOUNDATION (1 FOUNDATION ROUGH FRAME & PLUMBING DATE COMMENTS st) nd) z . mQ / ~ ~ ADDITIONAL COMMENTS: INSULATION PER N. STATE ENERGY CpDE 7~4802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PWG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL ~ SPECTO. ~~// 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] RouGH P'LBG. [ ] FOUNDATION 2ND [ ] INSULT ON [ ] FINAL ' [ ] FRAMING REMARKS; tooo663 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRJCdTY, ~ ll~ 85 JOHN STREET, NEW YORK, NE ,~v YORK 1003~ /,: i - THIS CERTIFIES THAT in the following location; ~ Basement ~ 1st FI. ~ 2nd FI. ~Si~ Section Block Lot w~ examined on S~t~er 29, 1983 and found to be in complia,~ce with the requirements of this Board. 1 1 2 1 DRYERS FURNACE MOTORS T!MECLocKs Nil HEATRRS MULTI-OUTLET SYSTEMS NO. OF FEET SERVICE DISCONNECT S E C E OTHER APPARATUS: NO, OF CC, COND. PER ~ OF HI-LEO NO, OF NEUTRALS 1-G.F. 1. (Swh-~ming Pool) %his certificate covers compliance at tt~ date of Because Of unusual environments it :Ls advisable to ~ ~eq~t ~ests ~/or repair~ AWG, Glenn R. Bradley tk)r~on Ave. - RFD Mattituv,.k, N.Y., 11952 This certificate n)ust not be altered in any manner; return to the ~NT. THIS. COpy OF of the Boal Lid:. #1227 GENERAL MANAGER Pe~ may be identified by their ' MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined..._.~.~..~'tr.~.~.'.~-..1'I~., 19~.~.".~ Approved...(~ .~:~..'~7...[0., 19~. -.~. Permit No.).&. .s~. 9.~ ..~.. Disapproved a/c ..................................... Application No.../.~.~.~.c./.~ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 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, 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 regulation~s, 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~architect, engineer, general contractor, electrician, plumber or builder. (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 LicenseNo .......................... Plumber's License No ......................... Electrician's License No .... /(.~.~..~./~ ....... Other rrade's License No ...... ~.~.. .......... 1. Location of land on which proposed work will be done .... . .~../....~.../..~. .... ~'~. ~). · .~. · .~...~.. ................................................................................. House Number Street Hamlet County Tax Map No. 1000 Section ..... [..'-~....~. ......Block ..... .(~.....~. ....... Lot...~..~. .{.~..O..0. ~7.. Subdivision .............. '~ .............. Lot.. (iq'a~) ................ Filed Map No. 5<' .x/( ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... i~.~..~../..Q/..~..]...~! C] ......................................... b. Intended use and occupancy .....~?...O.] .... ..~.....~..~..~ ................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ........... ~,~ Removal .............. Demolitio~ .. a Other Work ............... ~fi'~'lirq/'3 0~O°~ &' ~/,r'~' _ (Description) . 4. Estimated Cost , (, ,~r~. !.,k~,)~,,~. ............. Fee , , f,O, d. ~' , . : (to be paid on filing this application) 5. If dwelling, number of dwelling! units ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixe'd occupancy, specify nature and extent of each ~type of use ..................... ' 7. Dimensions of existing structures, if any: Front.. Rear ..... :.. Depth lteight ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front ....(~.'.~..,~... Rear ............... Depth ............... Height Number of Stories Size of lot: Front .......... ; ............ Rear ...................... Depth ...................... Date of Purchase ~ Name of Former Owner Zone or use district in which premises are situated ..................................................... Does proposed construction vioilate any zoning law, ordinance or regulation: ............................. Will lot be regraded ....... zo;.., .......... ; ........ Will excess fill be removed from premises: Yes Name of Owner of premises ~(~C~../~ /.~: ./t/~ .vT Address/ Jfl ,:.c .. hone No..~.q.~..%9. .... Name of Architect ......... I .... ^ ........... Address .... , ............. Phone No ................ Name of Contractor ~,~ j~o~q i0.~'g. ~1/.~ .~. ~. Address flq~-.~ M.~J-a ~ .. Phone No. '~..o/~..'7~F~..~..o.. 10. 11. 12. 13. 14. PLOT DIAGRAfi Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block!number or description according to deed, and show street names and indicate whether interior or corner lot. %/o/ STATE OF COUNTY,O.F above named, i .......... being duly sworn, deposes and says that he is the applicant Heis the i~ ~ ............ i ~'c'o;~oia'te 'o'fbicer, 'etc.') ....................... of said owner or owners, and is duly. au_t .o~_zed to perf~ 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 manne? set forth in the application filed therewith. Sworn to before me this ' .......... ..... dayoi .... ....... ;¢ ~¥ ~u~uo, s~t%of fl~ Y.~ / / (Signature of apvlicadt) ~. ~.llt~Ss~. Su(~0~ oeO!v,/ ,/ ~/' (Signature of applicCt) ~ ~g'lt~ I~l~'Ch 30, 19,.~~''' / $C,4LE I "--40' ~j~/, '3 formerly [ioVl Or Acres A reO ~ 4.059 or f°rm*rl( N.7~ ,67 TH[ LOCAJlON OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD APPLICANT:_ ADDRESS The s~ws~e disp°sal and water supply facilities fo;* ~his location have been InspeCted b~ %h~s dopar%mont and,~tt°und 'f he'Jr of-G~neral Engineer~ng NOtE: ' = MONUM~ WA~R ~RVICE = PRIVATE WELL fhord A. Miller F~EVISiONS DEC. ~$. 1976 APR. I, 19FF OCr. 5, 1977 ocr/2, 1977 j. cotolon° YOUNG & YOUNG 400 OSTRANDER AVENUE RWFRHEA~I~ SURVEY FOR: R/CHARD A . MILLER LAUREL TOWN Of SOUTHOLD ~* ~ / "=/00' t /VOM /5,/976 i 76-972