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Home My WebLink About11192-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z13322 Date April 3 1985 THIS CERTIFIES that the building ..... A..c .c.e.s.s. 9 ?.Z ................................ Location of Property 1420 Laurelwood Drive Laure 1 - h~'a/o~ ....................... 's't/e~i ....................... h~M County Tax Map No. 1000 Sechon .... ! .2.7. .... Block ...... .5 ........ Lot ........ 6. ........ Subdivision .L.a.u.v..e .~.w.q o..d..E.~. ~..a.~.e.s. ......... Filed Map No..5.5. 9. .5...Lot No .... 1,g. ........ conforms substantially to the Application for Building Permit heretofore filed in tiffs office dated ·...M.a.×. ~9 ............ 19 .8.1. pursuant to which Building Permit No ...... 1.1.9.2.z ........... dated ............. q u. .n.c. /[ 2. ....... 19.8.1., 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 ......... · ...~.q. I~ ¢.~.l,d...~p..a. g .c.e.s.s. 9 ry..b..u.5.1.d.% .ns.,..s..~p.r.a. gg..s, he..d ........................ The certificate is issued to ...... .~.QB. $~.T..~..B.~.~B..~3.h..L. 9.C.~.M..A. ~ ........................ (owner, I~ R~t~lT~ of the aforesaid building. Suffolk County Department of Health Approval 5//A N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector Building Inspector. Fee $ ........................ FORM NO. ~' BUILDING TOW~ ~ ~ ~r SOUTHOLD, 'N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON ~H,E PRE~IS [S,UNTIL ~ULL COMPLETION OF THE WORK AU'FH~RIZEb) ' 'Z Date i.... ...... ~......J....Y.., 19. .... , ~,' ~ Budding ~lnSPecfor FORM NO. 6 TOWN OF SOUTHOLD ~uJidlng Department Town Hall $outbold, N.Y. 11971 APP,-IC,~T,ON FOR CERTIFICATE OF OCCUPANCY instructions A. Th~s apohcat,on must be filled in typewriter OR ink, and submitted in dup)icate to the Building Inspec- tor with the followmg; for new buJidmgs or new use: 1. Final survey of property with accurate Iocatlon of all buildMgs, property lines, streets, and unusual natur,fl or tooograohic features ~- n,~ agprova~ of Heaith L3ep~. of water supoty and sewerage disposal--(S-9 form or equal). 3. Aporoval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a ceruflcate of Code compliance from the Architect or Engineer responsible for the building. 5. Submh Planmng 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 peoperty showing ail 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. DaTa of any housing code or safety inspect[on of buJdings or premises, or other pertinent informa- tion required to prepare a certificate. / Fees: 1, Certificate of occupancy SB.O0 2. Caruflcate of occupancy on pre-ex,strut dwelling or land use 3. Copy of certificate of occupancy SI.O0 $5.00 NewBuddmg............./ Old or Pre-existing Building(Z) ........ = /Vacant Land - Locat,on o f Property . .J.t.~'7,~ .... ..DL~.d'.I VO.O. ¢?~..',l~. ~'i ~'~. '1' ~ ¢' ~ ~ t ........... - .......... Hou~ iVo, Srree~ Ham/et Owner or Owners of Property .'~O~C~C~' ~ ~/A~-b~/~ Loo~Yy',~,~ .............. County Tax Mao No. 1000 Section . .i.~ ......... Block .... ~ ......... Lot ..... ~ .......... ......................... ..... r o. 5;5; fl ,o .... t ¢4 ....... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. ~ ,., Request for Temporary Certificate ..................... Final Certificate . / - Fee Submitted S ........................ Construcuon on above described budding and perrT~it-meets all app~cable~codes and regulations. FOUNDATION FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS 7Y, 9UT Temp~'ary Bracing- use scrop 17. ROOF CAP ASSLI~'~Hy ¥,i a~ ::,fi,~ B-,'n before insta~li:U qgles ::[m~q Roof P('cd~ Nail thc Cop, ~e,'h one sho.ld [)c ,'xp,>sed ,ut ~fine h~c~es (9"). /Cork i,om to F,'on t. A tHng,es ~/ ROOF CAP cut on tab :ONIOllC18 ONl~lrO~l$ ~10-1 (3OHI3W ~¥N~]I1V 'pein ~ ~8 x ,~ GOOMXq~ HOIH~XH OI ~ 'A~ NOI~I~D~ 'ON 'A~ :a~oN MOIZ~I~O~Q '0~ lin NI (]]13ddN$ ION ~l¥]a UM. OLV. peIq~3ua a~q3 aeooq V FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180'3 A~proved ....................... Disapproved a/c ...... '~.~% .................. ~,.. ..................................... /z .... (Building Insuector) APPLICATION FOR BUILDING PERMIT Application No.. INSTRUCTIONS a. This application must be completely filledqn by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apt' cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon aFproval of this apphcation, the Building Inspector will issue a Building Permit to the applicant. Such _p. ern shall be kept on the premises available for inspection throughout the work. x, e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate~_f Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of avplicant, or name, if a corporation) (Mailing address of applicant~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ ....... .................. , ............................................................. Name of owner of premises . ~.~. h..~.....qt....~?~..c.~.~..r-.¢~..../ve.C.7 ./~..v~...~. D. ............................. (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly anthorized officer. (Name and title of corporate officer) Builder's License No..../.?~' . ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... . .L~..../~. ................................... .. L ..... . Ce. /. . . .b. .rT, ..................... .L. /. . . .,h.' V. ............... House Number Street ' Hamlet County Tax Map No. 1000 Section . ,/.2.7 ............. Block .... ~ ........... Lot ..... /2. .......... Subdivzsion .... .-5...~. ~O7, .'7..~, .~. ~.(~(..~. ?....~.bt..'~..--~riled Map No... ~.~.?.?,5,7., 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 ................................................. ). 1. !. Nature of work (check which applicable): New Building ...... .~... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ ~ (Description) / (to be paid on filing this application) number of dwel~ng units AY'"zF' Number of dwelling units on each floor If dwelling . · · · If garage, number of cars ..... ~ ................................................................. i~m~iisn~!} i°°:~*~!!~!isY.~.n~I~::~i!:iii!~!i!i~! .~at.~.rl t~idl i~t!!ia!.fi!ai~ t!!i !fi~s~. . . . iI~. !P.t:: i i . !ii ..' ..... ' '...' ' Dimensions of same structure with alterations or additions: Front Rear . . Depth .. ................... ~..Height ...... [[~. i i .......... Number. of Stories .......... '/~" ' i .... Dimensions of.entire new constructxon: Front ...... Rear ............. Depth ............ Height .~. Number of Stories /. ........................... /..5~ ~ ' ~.' pth ~..g.~.~. Size of lot: Front ....... ~ ........... Rear.../. ............... De ................ Date of Purchase , Name of Former Owner Zone 9r use district in which premises are situated ...... s4r. ................ .~./ ........................... Does pr~)posed construction violate any zoning law, ordinance or regulation: ... :v.~). ......................... Will lot be regraded ......... ,.~.~. ............... Will excess fill be removed from premises: Yes No Name of Owner of premises .~../~../..~.q .~.r~..~.,~... Address ~:~..g_.t../~Z~...~.~./. .... Phone No. ~.~. :~.~.~,,,5. .... Name of Axchituct Address Phone No ......... Name of, Contractor ......... ~ ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly aJlibuildings, 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 corner lot. (l~ame of individual sig~l~g contract) bore named. being duly sworn, deposes and says tliat he is the applicant e is the ................. ~-'(C-°nt act° ' g~(*.C~f. · · · --.r...-r. ................................................... agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or liave performed tt~ sa. id work and to make and file this pplication; that all statements contained in this application are true to thh best of his k~owledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this ~ ........ ......... .... , rota~li~, ..g :.~..~..~-'~.. County s ......................... ........ ~o. ~141~5~o, Suffolk coul~- (Signature of applicant) Term Expires March S0, 1 ...~F~?~