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Home My WebLink About10830-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z]5556 Date March 31, 1987 THIS CERTIFIES that the buildh]g Inground pool Lo~ti__^Cp_o_^r.. 1425 LAURELWOOD DRIVE LAUREL House No. Street .... I~l~/e~ County Tax Map No. 1000 Section ...1.2.5. ...... Block 05 .Lot 009 Subdivision Laurelwood Estates .Filed Map No. 5595 ,LotNo. 11 conforms substantially to the Application for Building Permit heretofore Fried in this office dated Aug. 12, 1980 pursuant to which Building Permit No. 10830Z dated ...~.u. ~ :.. 1. 2. .,..Itl. 8..0 ........... 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 ......... ..... I~grg~.n. cl ~inlr0.i.ng pppl and fence. The certificate is issued to ROGER L. & IRENE .A. MUNZ ..................... /of, o'er, '/~ ~/,~4k X .................... of the aforesaid building. Suffolk County Department of Health Approval ......... .N./.A. ............................. UNDERWRITERS CERTIFICATE NO, N4 9848 7 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 10830 BUILDIHG ToWH HALL ; SOUTHOtD; Iq~ (THIS PER~IT MUST BE KEPT ON THE P~E~I~ES UNTIL COMPL~ION OF THE WORK AUTHOR ZED) ~ D~t, ..~ -'ULL ...... ....... .......... ..... ,/~z~..~/~..,,. .... .................................................................................Z~:Z~.,~-~.~. .... ~ .............. r-. '- ~, ....... ~,~/ ~...I~...'" ........... County ToxMapNo, 1000 Section ..../,..~......~... . Blocki, ' L No.,..O..~,.? .... ;...~ ~ . ...... ~ at · ...... ..~.~/; ....... /,.,~.~,.,.,, 19 ., and approved by the pursuant to application,dated ... Building Inspector. Z.~.-....-.. Fee $ ........ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICLTY 85 JOHN STREET, NEW YORK, NEW; YORK 10038 FIXTURE FIXTURES RANGES :OOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET OIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT S E R V I C OTHER AeeARATUs Panelboards: !-2cir. 60alo £-GFCI E (Sk~bz~ing ?ool) This cer~Lf~a~e cover~ compliance at ~ date of tns~ctiom~lyo ~ of raw. ual envir~mm~t~ it i~ advim~le tO hav~ frequ~,~t ~est and/or repairs ~ by a qualified per~c~. OF NEUTRAL 4 ~dscho 11725 Ltcol610 Th~s cerhhcate must not be altered in any manner; return to the ofhce of the Board copy FOR BUILDING DEPARTMENT. THiS COPY OF Inspectors may be identified by IN ANY FORM NO. 6 TOWN OF SOUTHOLD Bu ilding 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 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. B. 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 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 $15,0 0 3. Copy of certificate of occupancy $1.00 o.o. $5.oo / 5. Updated C.O. $15.00 Date ......... ~. ...... NewCons tpuction ...... Old or Pre-existing BuiJding ............ Vacant Land ............. ............. Location of Property , ./..L/. ~. ...... ~ ' House No. Street Ham/et Owner or Owners of Property ~..~?../.~,...~. :.. ?...' .~. ~..~... ,~. ?... ,~.~' .~/?.-. .............. County Tax Map No. I000 Section .... / 7~'~ Block ~.. Lot. ~ ~ .~..~.~Z:~,.. ,Lot No. b v o ............. ~ ..... Filed Map No .............. PermitNo. ?..~.~. ~..~.. Date of Permi, /~?.':fZ~.Applican, .~?....4.-7../~..~...¢'~---~;.. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $... '-~.T ...................... ---.. ~ l ,'/ ] /~ .,l l///'~ } .......... BUILDING DEPT. INSPECTION [ ] FOUNDATION ~IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~INAL F~ELD INSP~C~I~ FOUNI~ATION (1st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CO~E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examine~O.~.. {..~....., 1 .9~.. TEL.: 765-1803 .... Disapproved a/c ................................... ~~, (Building ~nspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./. ~. ~.. · .~.~. ........ a. This application must be completely filled in by typewriter 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 drown 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspectton 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 compiy with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ,0 ./,'/;.~ ~ .... ./.. ...... (Signatjlre of applicant, or namE, il/a corporation) · ' ' (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. ................................................................................. ofownerofpremise~O~E~b'" ....... ~ c~ ~'-~-~,~)~ ,/~ Name .t : ........................................................... / (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 ....................... Plumber's License No ......................... Electrician s License No. ,,~. ~ ~...~...~... ?.~,O ~'~-'-q~ '7~/dt5. ,~,~/~l~¢.,d-,a~/ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... /. .¢. C ........ z..b. .a;. d . . . : ............... .z. .,C. L .................... House Number Street Hamlet County Tax Map No. 1000 Section ..... /..~..~. ...... Block ...... .Or-.. ......... Lot .... .~ ............. Subdivision..~.~.~./.~.~../~.o..O~...J~.¢J.~./..C~.. ........... Filed Map No .... ~.~....~.' .~... Lot .... /.~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~.~ ............ ',, b. Intended use and occupancy '. ..... .~..~..~..~..... ~ ./.~,z'.~,,~¢. .~,/,LZ, z;2... ~,~ ./~'./~/,/~..-.?.. ~/-.,_ 3. I~ature ~of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost. : ....................... Fee ................................. (to be paid on filing this application) 5. If dwel!ing, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, 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 entire new construction: Front ............... Rear ............... Depth ............... Height . NumBer of Stories .................. 9. Size of lot: Front ....... /.q.O... .......... Rear ........ t5/.O. .......... Depth ...... .,~.?.-~.....~ ....... 10. Date of Purchase ... [.~.7..~... .................. Nature of Former Owner . g~..~.~..'.~J....O~t./.~.C.~t. ........ 11. Zone or use district in which premises are situated ....... 4/~. ........................... .v. ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~..C? ......... ~ 13. Will lot be regraded ............................ Will excess fill be removed from premises: yef~.~' 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect .......... I ................. Address ................... Phone No ................ Name of Contractor ......... : ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. : STATE OF NEW ¥6}R _K,,,...f-- r, o o COUNTY t ....... .... ..... · (NiXie of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ author/zed to perform or have performed the said work and to make and file this application; that all statements contOined 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. t40T A-RYz, C~t a,.te.o? ~. ?? Term Expires March 30, ¥ (Sign~e of applicant) SURVEY FOR ROGER ,9 IRENE/4. MUNZ .AT L ~ U REL TO¥/liV OF' SOUTHOLD SUFFOLK COU~TY~ N.Y. SCALE' I"' 50' JULY 9, 1976 OCT. 28~, DEC. ~ 19 76