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Home My WebLink About11212-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Nos Z-26464 Date: 05/19/99 THIS CERTIFIES that the building ADDITION Location of Property: 1665 ~-LBO DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 3 Lot 18 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in thie office dated JUNE 3, 1981 pursuant to which Building Permit No. 11212-z dated JUNE 26, 1981 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 ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KEITH & CECELIA A.-ROEERTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A ~ il~ i~ector Rev. 1/81 11212 Z P~i'~i~$ion i~ hereby grant~l to: SOuTHOLD, N..¥. (THIS PERMIT MUST BE KEPT ON COMPLETION OF T~E WORK:AUTHORIZE~) ~ate $:.UNTIL F~ULL 4 ...... : ............................ : ............~:"~'~ ...... ; i at: p~emisei located at ....;/.[~/~...~.....~.~...~.J..~..;;~- ~ ....... ~.~/~..~..C.~,....~..;.~..,.. ..... ..'. ......... ~ ............................. ~ .................................. ~:.: ....... L.~....~...., ........... i Co6r~ty Ta~ Map No. 1000 Section p~s~ant to application .dated ... r ~' B~ilding Ifispector. i i and ~pproved by the Rev. ~6/30/80 - ~ : ~ ~ TOWN OF SOUTHOLD TOWN HALL APPLICATION ~R CERTIFICATE OF OCCUP~CY ThiM application must be filled in by typewriter OR ink and submitted to the buildi~ inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property line~ streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2fl0 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildJ and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings Vpre-existing" land uses: 1. Accurate survey of property showing all pmoperty lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicar If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fe~ ~%~ \~%~cate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, ~ ~, ""Al~B~ons to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ; ~,. ? '"' _~d2~ to accessory building $25,00, Businesses $50,00. ~\~ /)~' ~ ~,C~rt~ic~te of Occupancy on Pre-existin~ Buildin~ - $100.00 \'?'~ ~ ~3~ 'Co~M~f C~rtificate of Occupancy - _ "i,,~\ .~,.~[~rary'~a~ Certificate of Occupancy - Residential $15.00, Commercial $15.00 \ !~ Date ..... ~/.~/..f/. ..................... '~/New Construction .... ~ ...... Old Or Pre existing Building ............ House No. Street Hamlet Onwer or O~mers o~ property ............... ' ............................................... Oounty 1000, Seotlon..¥.'8..c, ....... ......... .......... Subdivision . Filed Map Lot . Permit .............. w~ //~7~.~... Date Of Permit .......... ...... Applicant ........................ Health Dept Approval Underwriters Approval · - Planning Board Approval ....... Request for: Temporary Certificate .......... Final Certicate ........... Fee Submitted: APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS 100i]4[~ BUREAU OF ELECTRICffY ~ ES JOHN STREET, NE;iN YORK, NEW YORK 10038 Oat~ Application No. THIS CE~IFIES THAT ~y t~ e~t~ ~u~mnt ~ ~cd~ ~ a~ int~ by t~ ~t Mm~ on the a~ ~t~ au m~r in t~ p~m~ of [.,T~.. , ,, ~ in t~ followin~ hwation; ~ ~ement ~ Ist FI. ~ 2nd ~. ;Jilt .~tlon Bilk ~t ~ examin~ on ~E . ~,~ ~ 17 , J 9 ~ and found to be in compliance with the requlre,~ents qf this ~rd. NXTUR~ FIXTURES PANGRS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS I~EDERS TIME CLO~KS UNIT HE&?I~S MULTI-O4JTI-mT DIMMERS SYSTEMS PhC PIP OF CC. CONO. H.I;L,/t~¥ it. biOL,I,BORN & SONS I~er This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~MHHER. Town Hall, 53095 Main Road P, O, Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-18,02 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 27, 1995 ~r. Keith Roberts 1665 Albo Drive Laurel, NY 11948 Re: Deck Addition ***** SECOND NOTICE ***** To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ax An application for Certificate of Occupancy is not on file. (Enclosed) ** No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 11212-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN, OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 }:AX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 7, 1990 Mr. & Mrs. Keith Roberts 1665 Albo Drive - P.O. Box 364 Laurel, N.Y. 11948 Re: Building Permit ~17125-Z (Pool) Building Permit %11212-Z (DECK ADD.) SUFF. CO TAX MAP %1000-126-3-18 Dear Mr. & Mrs. Roberts: Enclosed is Certificate of Occupancy ~Z-19274 for your inground swimming pool and fence. Certificate of Occupancy #Z-19261 for the deck around the pool was mailed to you yesterday August 6, 1990. In order for us to issue the Certificate of Occupancy for the deck addition to the house (BP #11212-Z), please fill out the enclosed application and return it to this office with your check in the amount of $25.00. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. GJF:gar encl. Gary J. Fish, Building Inspector FOUNDATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~DE FINAL ADDITIONAL COMMENTS: APPRO'~ED NOTED B.P. FEE:__ BY: NOTIFY 'BUlLiNG D'~AP. ThAEN-T AT ,. 765-1802 9 AM TQ 4 PM FOR THE FOLLO\'VING ~NSPECTtONS: l. FOUNDATION - TWO REQUIRED FO','?. pOuRED cONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU'J~, ,..,N 4. FINAL - CONSTRUCTION MUST BE C~!?---TE FOR C.O. ALL CONSTRUCTION SHALL MEET! T~E R'SOU~;~MENTS OF THE N. Y, STAT; CON-.TRUCTION & ENERGY coOES. NOT RESPONSIBLE FOP, L'~_5%GN OR cONSTRUCTION ERRORS., FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1B02 (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ,/./. ~.t/. ~ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 pnblic streets ~r areas, and giving a det0Jled descriptiou of Iayou~ of property must be drawn on the diagram which is part of this appli- :etlon. c. The work covered by this application may not be commenced before issuance of Building Pe.rmit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit ;hall be kept on the premises available for inspection throughout tile work; e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ~hall 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 ~uilding 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 regulations, and to ~dmit attthorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ././. ? ......... (Mailing address of applicant) :~tate whether applicant is owner, lessee, agent, 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 anu tide of corporate o~fic~ Builder's License No ........... ."7 ..............C~'~'Jz'~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ................./.~. ~. Block .... '...~. ~ ......... Lot .... O. ............. ~ $ "" Filed Map No .'77. Lot Subdivision ................................................................. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ~AJ~L~ ./..~,W~. te4. .(Zl,O~ b Intended use aRd occupancy ~'~,¢.r~..~'. ~ ~: c~ c~; Od---th 3. Nature of work (check which apt~licable): New Building .......... Addition Repair RemoVal ' Demolition I- Estimated Cost . .oc~. Fee ......... ~ ~,79~ A~teration -~. ,~..~./~. ........ ~ (Description) (to be paid on filing this application) i. If dwelling, number of dwelling ~nits..... ~........ Number of dwelling units on each floor.. . ..~ ....... .. If garage, number of cars : ~ 3. If business, commercial or mixed~occupancy, specify nature and extent of each type of use ....... .'7- ......... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ........... Height ............... Number of Stories .................................................... Dimensions of same structure wi~h alterations or additions: Front ................. Rear .............. Depth ' Height Number of Stories L Dimensions of entire new constrOction: Front ............... Rear ............... Depth ............ Height ............... Number of Stories ..................................................... ~ Size of lot: Front ~ Rear Depth ) Date of Purchase i Name of Former Owner [ Zone or use ...... · dxstncten which premises are s~tuated .................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ........ hJ.~. .................... L Will lot be regraded ......... i...4).q~_~ ........... Will excess fill be removed from premises: Yes No L Name of Owner of premises ~.~..tiT'O ./~...~*.~.~...~.~.~... Address ./.~.~'ff. ~/-~O..g.&°.~.~.. Phone No.. ~.,~qo.%q.~..~.7.... Name of Architect ' .~. Address '-- Phone No Name of Contractor ......... ~...~ ............. Address ....... '.~ ...........Phone No .... '.~ ...... ,.. PLOT DIAGRAM' Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate .all set-back dimensions from :operty lines. Give street and block number or description according to deed, and show street names and indicate whether terior or comer lot. 'FATE OF ~E~&~O~RK, -- OUNTY .... "7, S (Name of individual signinl~ contract) oove named. (Contractor, agent , corporate officer , etc. ) f said owher or ownem, ~d is duly authored to perform or have performed the said work and to m~e and file ~is pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; ~d that the' ~ork will be perfo~ed in the manner set forth in the application filed therewith. worn to before me this / ~-~2~85~ Surfak C~ (Si~ature of applicant) All Well & Cesspool l:;~'erm~t:~n Obtained ~:rom Phys~ccl Evidence cr D]~ecEon of 3wrier or P~c;~e~f. L::~n of Same Guaranteed cnly Whon /¥; MAP OF PROPERTY / DONALD J. TA~., L$. RICHARD WIL#ELM Mm