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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Z--24093
THIS CERTIFIES that the buildin~
Date DECEMBER 22, 1995
ADDITION
Location of Property 1275 LAURELWOOD DRIVE
House No. Street
County Tax Map No. 1000 Section 127 Block 5
Subdivision Filed Map No.
LAUREL, NEW YORK
Hamlet
Lot 8
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 30, 1979 ~ursuant to which
Building Permit No. 10501-Z dated DECEMBER 4, 1979
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 SOLAR--HEATED GREENHOUSE ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to BARBARA KELLING
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N-287397 - AUGUST 24, 1993
N/A
/ //~i l~ing Inspector
Rev. 1/81
FOI~M NO. 2
TOWN OF SOUTHOLD
BUILDllqG DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, Iq. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISI:S UNTIL FULL
COMPLETION OF THE WORK AUTt-IORIZED)
N? 105O1 Z
Permission is hereby granted to:
/
. .~.... ~>c ~.~./~....~... ~.~. -~-x2z.~.~ ..............................................
by
Building Inspector.
Fee Sf~. ................
FIELD INSPECT-ION COMMENTS
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N.Y.
STATE ENERGY
COpE
4.
FINAL
ADDITIONAL COMMENTS:
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
December 14,
1995
Ms. Barbara Kelling
1275 Laurelwood Drive
Laurel, NY 11948
Re: Building Permit 910501-Z & 21547-Z
Premises: 1275 Laurelwood Drive, Laurel
Suff. Co. Tax Map ~1000-127-5-8
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
BY:
BU!Lr)!NG DFPARTMENT AT
7654832 9 AM TO 4 PM FOR THE
ONS.
], FOUNDAF!ON - TWO REQUIRED
2. ROUGH - FRAFA!NG & PLIJM~IN~
' --3,-fN~Jthff~ .................
........ ~ N MU~T
..... ~-Cc~
ALL COI,'?TR~'C'rh~N SNAI,L
STATE CONg'TRUCTION &
CODES
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION
FRAMING
REMARKS:,
[ ] ROUGH PLBG.
2ND [ ] INSULATION
[ ~AL
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined ' . ..... ,1
Approved..~..~g..%..~-'.. ...... 197~. Penmt No./(~.~. ,~.--.O...// ~-
APPLICATION FOR BUILDING PERMIT
Application No. /O'-~O /
Date A/b ~/ ,~=0 1977
INSTRUCTIONS
a. This application must be completely filled in by typewritex 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 the diagram which is part of this appli-
cation.
c. The work covered by this applicatmn 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 inspectmn 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, buil, d_39&code~ housing code, and regulations, and to
admit authorized in sp ectors on premises and in buildings for necessar~?/~on~ //~/~.~ .
..... ....
"-~l~mna~ure of applicant~ or hague, if~ a coffpora )
........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......................... . .................... , ........................................
Name of owner of premise, .~~.-'5-~.'v...~'~.".~.. .....................................
(a~ on the tax/oll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No...~ ..............
Plumber's License No .........................
Electrician's License No..~ ...........
Other Trade's License No .....
House Number ' Street ............... Hamlet .......... -- ...........
County Tax Map No. 1000 Sect, on . [ 7_.- .....
Subdivision..~/r..o~..r~../~:~d .~-A::~q'.~ ~./~..~J. i i i i ..... Block .~..~Y.. ~.. .... Lot...~..67.~.. .........
Filed Map No....~.--.~..~?. ..... Lot.. ~.../'..~.. · . ·
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constructi°n:
a. Existing use and occupancy . . .
.....:,~..;,,/~/¢ ~~ ~,,,~ 21~;/-"7~,4(4~.~//?.~....dd%._: ...t.
b. Intended use and occupancy ....~ ..~-... ..... ,-, .....~: ...... ./-, ..........................
/
3. Nature of work (check which applicable): New Building .......... Addition...~..."~ Alteration
Repair'. ............. RemoVal .............. Demolition ..... / ........ Other Work ...............
~ . i ..~ ~-- (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 .... .~. .........
If garage number of cars ~ ..................................................................
6, If business, commercial or mixedr occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structure,,if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure wi~h alterations or additions: Front ................. Rear ..................
Depth .................... ,~. Height ............ ! .......... Numbte/r/of Stories ............. ./ ........
8. Dimensions of entire new construction: Front ..... /. q ....... Rear .../.~.'. ......... Depth ../$ .........
Height ............... Number of Stories ........................................................
9. ' · / ,,J~f. AL '
Szze of lot. Front ...................... Rear ...................... Depth ...... ~ ...............
10. Date orVurchase ...... /./¢~.~.~.~. .............. Name of~Fonyaer Owner .~.3~v...~.,.. ~.~.o~*4'~e~. ......
11. Zone or use dzstnct zn whzch p~emzses are sztuated ...... ,~'.~.,cg~'~4.. z~. ~/ .............................
12. Does proposed construction viol~te any zoning law, ordinance or regulation: ..... ~. O. ........... ~ ......
13. Wall lotl be regraded ....... ~ ........ ~, ....... Wall excess fill be removed from premzse: QYes~) No
14. Name of Owner of premises .~.~q4'~?'.~. ~nn../J~/'~.q. Address· ~//~.~.~.~x~s,.~.g..~...rS.. Phone
Name of Architect ~.~3ff~.g~ e,.t.c~ ./~...~ff~.~/f..~. 5'. ! Address .~./'3qr.-~/. ,~'.v. e~ ,~f. . Phone Sc~. './~-~.-. ~ ~.'~. ?..
· '- " .... 5.,~ .....
Name of Contractor ~4~'.~.e.rd.c/.(.. ~)~/.¢.~... Address .,(~ .~4,[..w.~.~.,./.J?~.. Phone No...o~. f....,5~..z .....
PLOT DIAGRAM
Locate qleariy and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from
property lin~s. Give street and block 9umber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW ~ ....
COUNTY OF .~./~.~.
......
. (Name of individual signing contract)
above named.
t .at7 ..... being duly sworn, deposes and says that he is the applicant
~3te is the .................... &'i .fa,/. A/.~. ............................................... ; .........
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this
application; that all statements contoin6d in this application are true to the best of hisknowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
' .~O.~t dayof ~.~ ~'.e~. ',e~.~.,19
No, ubli , .......... ' : .... County n . ..
NOTARY PUBLIC, ~t~te of New York