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Home My WebLink About10324-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No...~gfl.Q ......... Date .... ~¢IC,[~ .~ .................... , 19. [~.0 THIS CERTIFIES that the building ................................................ Location of Property ...'I.7..~.Q. Laur~lwood Drive .[:e..1J.x??.~..,..I~.~2~, ..... House No. ' ..................... 'fft/o~o{' ......... Ham/et County Tax Map No. 1000 Section ....1~.~.. ..... Block ....... ~ ....... Lot ....... ~ ......... Subdivision J~O~ICe. lWO0.~ .~:$g.a~;(~ ......... Filed Map No. ~595 .... Lot No .... 16 ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ,-]'U3~lr. .~.0 ........ , 19 .'/.gpursuant to which Building Permit No ........ .'I .0.}7../4.Z ....... dated .. ,~'.~.Z.y.. c-. ,. ................. 19.7..9, 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 ......... ............................ Qv.~..}?. e .m.&l.y.r.~.~.~:l. ~., .~.~g ............................ The certificate is issued to ........ Dox'o't;1.l~r and. d'oh~ gc, ocozzq of the aforesaid building. Suffolk County Department of Health Approval ...~.-~.0.-:T.~ .... ~[~/.~0 .... ~..~,.. ¥;[.i.~:g.. UNDERWRITERS CERTIFICATE NO ........... l~I..~.6.8.60.0 .............................. Building Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10324 Z Permission is hereby granted to:~- '7" .,~ ~ ....... .~.~f~W....d.,.:...l.~.~ ~.~ .... ..... ~~~.~:.~...,.,.~ ....... ~o ....~.~z~ ...... ~....~7..~zZ~7 .................................. pursuant to application dated .......... _,,,, ,~,,~,,~,,,,~.,,,,~..,,,~,. .............. , 19..LZand approved by the Building Inspector. . Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Bo This application must be filled in typewriter OR ink, and submitted in duplicate 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 Residences 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,~'..'~. ~b.~.q...~. ~ .~( ~. ¢../.~ .~.~.~.~...~.. ,~?. ~. ?. ~.. , .~..47.~.~..~; .~. ~ ./'. ~,. ~., House No. Street Hamlet Owner or Owners of Property . ~..~..- . ·. · County Tax Map No. 1000 Section ...//...~....~i .... Block .... .~ ....... Lot .............. Subdivision.. . . . ,J. ..... · . -. ~,...~.FiledMapNo. .Lot No. Permit No.~... ?..~? ~/.~5~ate of Permit ~. T.~..~.~.?,~Applicant ...~.~..~..~. · .~. · .-~.'..~-:~'.%~.- or o Health Dept, Approval ........................ Lab Dept, Appr val ........................ Underwriters Approval /~/?'~d.. oc~d~ ~ o Planning Board Approval ..... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...%~... ~ ..................... Construction on above described building and permit meets alt applicable codes and regulations. .......... Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 Memorandum from.. · . BUILDiNG INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 g-i I,y A I el NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .....F. e..~_ .~..U..~...~y.....~. ........................ 19....8..0.. (owner or authorized agent of owner) (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violahon of. Zoning Ordinance Chapt. 100 .... Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter descr,bed in that ..... .~..~...~..$..~.~...i..n......~..~..e...~.l...i..~.~..~.~.o..~...~. ......................... (state character of violation) in violotion of ..... gh~,g.~.....JDO. ....... J.g.O=.J./.f.~...A.-..(..1.) ..................................................................... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ......... .~.J.~. ................................................... day of ...... ~...e..~.~g~.~;~. ............................. , 19.....8..0. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 'F7 0 Lauz'elwood Dr. ~ L~u~"el. N,Y-Countv ...... ~. .................................................. ..................... of Suffolk, New York, Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT, TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 E×amined,, ........ 19 '7 Approved . . ........ 19:?e=it No. '- / Disapproved,~ ...... --'...-~ .......... ~,'¢ .... ~/ ............ ::' ............ ,. . Z / . APPLICATION FOR BUILDING PERMIT Application No/~f.&'9.~. .~..~ ....... Date. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w~th 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 th~s application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Buil&ng 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, 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, ho,~,~ng code, and regulations, and to admit authorized ~nspectors on premises and in buildings for necefl~ry inspections~'~l ,,-F b,/(b,'-~' , ~, /r~/ (SibF4tature offapplicant, or name, if a corpor t'o ) (Mailing address of applicant) //~/ State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises. ~/~.....~.. ~ ~ .~..~...~. :~../. · ..~.~ .o..~, .~..,~...~...~. .................... (as on t14e 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....~...?..~..?. ~. · · .~.~. .... Plumber's License No ..... ~...~../.../.;~. ........ Electrician's License No ...................... /'~ g ~ lc/ ~5~q~ ~ ~ e ~ Other Trade's License No ...................... Location of land on which proposed work will be done ................................................. .... l 7..S..o... L.~... ~.e... ~ .~.~..~...~.,.'p..¢ ........ Z ,~..,., .~ .~.Z. House Number Street Hamlet County Tax Map No. 1000 Section ... i ~-~7 Block --~ Lot.. ~3 Subaiv,sion Zff~.qR~../.~. ~ ~..~.. ~.~ .~. 7~.e ~' ...... Filed Map No. 5'~ ? "'%"- Lot. lb (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~//z] C/J ~ '7~ Z O 7t~ b. Intended use and occupancy /..~. r~.; .... .~././/~. Z'..~..//:~.. ~./....~..~..(~..~... ......... 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost . . ~? O i0 ....................... F .................................. (to be paid on filing this application) 5. If dwelling, number of dwelhng Umts ............. Number of dwelling umts on each floor ................ If garage, number of cars . . ................................................................... 6. If busbiess, commercial or mixed 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 with alterations or additions: Front ................. Rear .................. Depth .................... ,.. Height ...................... Number of Stories ............. , ......... 8. Dimensions of elltire new construction: Front ..... ~7..~ ....... Rear .. ~.~ .......... Depth . Height... ~.l~ .......... Number of Stones ... O. ,6/.g .............................. 10. Date of Purchase . ~ ............................ Nan~,e of Forme.r Owner .............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . ./~. ~. ........... 13. Will lot be regraded ...... ~.~.~ ................. Will exc~ess ,f!ll be remoKed from premises: ..... 14. Name of Owner of premises .~o~ t:~'¢~.C~2a... Address ~./]flf. ~°~a/, ~'t_o~y.. Phone No. i .... ~' .~./~' ~'' Name of Architect ............................ Address ............ ~.~/. Phone No. mOT mAORAta Locate clearly and distinctly ill:buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block 9umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~YOI~K,i / Z~ , COUNTY OF. ~. ~,t..J'~.~:/../~.. ~ . ...."'~" ~ .,~..O'.D et~.'../~....--/~" .~.,..~, ~.e.~'~ ~ 2 being duly sworn, deposes ~a says that he is the applicant ' (Na~e of individual sign~g contract) aboven~ed.~ ' ~4~' ' He is the ..... ~ .~. [.. ' ........... ' "' ' ' (Contractor, agent, corporate' officer~ etc.)' ' "'~ ' '; ............ "" ......... of said owner or owners, ~d is dul'y author~ed to perform or have perfo~ed the said work and to m~e and file this application;, that all statements contained ~ this application are true to the~best of his knowledge and belief; and that the work will be performed in the m~n{r set forth ~ the application filed therewith. Sworn to before me this " ' ....... ~. ~ ....... day o~ ........... r~rm Exnires March ~, 19~ v ~' c~ forr~erlY Of now Ho THE LOCATION OFWELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR TH~S RESIDENCE WiLL CONFORM TO THE STANDARDS OF THE SUFFOLI( COUNT"/ [)F_PAR'T~Et'IT OF ~KI_'T~ SERVICES APPLICANT -- ADDRESS - TEL bot 16 woOD$1DE LANE ~0t, \ ~. ~. ~ SUBDIVISION MAP FILED IN TH~ ~FICE OF THE CLEBK OFSUFF6 MAY lY, 19Yl AS FI~E ~ OF THE CLERK OFSUFFOLK COUNTY ON MA Y Ir, 1971 AS FILE NO. 5595 NEAREST wArER MAIN-' 5MILES 2T GUARANTEED TO' L ,~UNEL FIR ST AMER/C~N TI TL £/NSUfeANC£ TOWN Of COMPANY OFN Y $ 0 U THOL D UNION SAVINGS BAIVK OF PA ~HOGUE oo~ 0r ¢r0'" THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIE~LO OSSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH APPLICAN T - ADDRESS ............. TEL SUFFOLK COUNTY DEPARTMFNT OF HEALTH SERVICF~$' FOR APPROVAL OF CONSTRUCTION ONLY DATE .... HS REF. NO. APPROVBD Lot 15 ~ co~J~Es O,P THIS NO TE : I -- MONUMENT SUBDIVISION MAP RL~D IN ?~IE OFFICE OF THE CLERK OFSUFFOL/( COUNTY ON MA Y 17, 1971 AS FILE NO. ~595 WATER MAIN .= .~, MILES ' :- YOUNG & YOUNG 400 OSTRANDEE AVENUE, RIVERHEAD, NEW YORK HOWARD W. YOUNG FOR: SCOCOZZO 8 DOROTHY SCOCOZZO tVO. 16., 'LAURELWOoD ESTATES" GUARANTEED TO: I ~'HOL D · ,StJF~FOLK'CO., N.Y. 79- ,t44