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HomeMy WebLinkAbout13603-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13849 Date September 12 1985 THIS CERTIFIES that the building n e w d w e 11 in g. 695 Albo Dr, Laurel Location of Property House No. Street ~ Hamlet County Tax Map No. 1000 Section 126 .Block 2 ..... Lot 12 Subdivision .... × .Filed Map No. .X...Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated July 18 86 to which Building Permit No ........... ?. ? .0.2.Z ...................... 19... pursuant ..... dated ..... November 30 84 ....................... 19 .... 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 ......... New one-family dwelling. MARK The certificate is issued to ..................... [o~n.o.r,{ey~.~if~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .. q 4 -S O- ~ 0 UNDERWRITERS CERTIFICATE NO... N6 9 8 0 0 7 Building Inspector Rev, 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13603 Z Permission is hereby granted to: .... ~..~~~.~..~~ .... .~ ~~__ ........... . ,o ........ ~~:~.~......~_.~~:~.~..~......~ZZ~' - ........... ,.~... County Tax Map No. 1000 Section l~.. .......... Block ..~.~.. ........... Lot No.~../..~... ........... pursuont tO appllcotion da,~ ....... (~l~ ............................ ~ , ,9.Z~ond app~v~ by ,~e Building Inspector. ~ Bulldln~ I~tor Rev. 6130180 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted ~11~ 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. Su bm it Plann lng Board approval of comp leted site p lan 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, occupancv 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date . ...,~0~19B~ ..s~t ................ New Building ...... ×.......OIdorPre-existingBuilding ... ...... . .. Vacant Land .. ........ . .. Albo Dr. Laurel Location of Property ................................................................... House No. Street Ham/et La Rosa/jMark & Lorraine Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 126 Block 02 012 .............................. Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. .~ 3 6 0.3~. Date of Permit Applicant Permit No ..................................................... 14-SO-10 Health Dept. Approval ........................ Labor Dept. Approval ........................ N698007 Underwriters Approval · · . Planning Board Approval ............. Request for Temporary Certificate ..................... Final Certificate .. . × FeeSubm tted 2.00. Construc.tion on above described building and permi~ts all applicable codes and regulations. . .... ~Z6, ~'~"~0, AppI'~?t ,~'~/~''r~' ' ....................................... Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 CERTIFICATION Date AUG. ~3 1985 Building Permit No. Owner MARK & LORRAINE LAROSA Plumber (please print) GEORGE BERRY (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead, (plumber'S signature) Sworn to before me this Notary Public, __C°unty MAR~< T. NOTARY PUBLIC, State of New York No. 4695650 Quali{led m ,St~io~k ~uoty Commission Exp}.es March 30. Notary Pubic FIELD /~'NS ?E~ T ION = _ FOUNDATION ( PLUMBING STATE ENERGY ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000174 SUREAU OF ELECTRICITy ~ ]~ 85 JOHN STREET, NEW YORK, NEW YORK?OO3~ ,,o,~ ~,ane ~,~ ~.,.,,~..o.,~o.o~.~ ~40/~sN 698007 THIS CERTiFiES THAT only the electrical equipment as described be/~ end i~troduced by t~ applicant named on ghe aboFe application n~mber in the premises of Mark ~arosa~ Albo Dr., off Bray Ave., ~aurel, was examination J~ 20 ~ ~985 and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS 18 FIXTURES ~ECEPTACLES SWITCHES NCANDESCENT FLUORESCENT 30 24 1~ EURNACE MOTORS VAFO~ RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS TIME CLOCKS UNiT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R OT~ER A~ARATUS: Mo%ors- 1-F H.P. G.F.C.I.- 1 Smoke Detectors- 2 AW.G, CC COND NO, OF OF NEUTRAL 1 Eeoo Elec%ric o p ( 325 Willow Point Rd. 1 ~ GENER~ MANGER This certificate must not be altered in any manner; retura Jo the office of the Board if incorrect, inspectors may b~ifi~/r c~qials. PERMIT iSSUED TO NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT I PEI~MIT NO. 10-84-0329 UNDER THE ENVIRONMENTAL CONSERVATION LAW [ ARTICLE 15, (Protection of Water) [] ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) I I ARTICLE 36, (Construction in Flood Hazard Areas) Mark LaRosa ADDRESSOFPERMITTEE P.O. Box 431 Southold, NY 11971 LOCATION OF PROJECT (Section of stream, tidal wetland, dam, building) On ~orton Creek north side of Albo dirve, 96± 1.f. west of "G.I. Lane" Laurel, NY. DESCRIPTION OF PROJECT ~onstruct a one family dwelling a minimum of 51 linear feet from the landward edge of fresh- water wetlands on Horton Creek. Septic system is to be installed a minimum of 100' from the freshwater wetlands edge in accordance with plan on survey by R. VanTuyl dated 8/3/83 with revised dates of 12/15/83, 1/16/84 and 4/23/84. These plans are to be on site while work is --in progress. COMMUNITY NAME (City, Town, Village) Laurel J TOWN Southold COUNIY J FIA COMMUNITY NO~ J DAM NO. PER~IT EXPIRATION DAN Suffolk J J December 31, 1986 GENERAL 1. The permittee shall file in the office of the appmpriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has sc- cepted expressly, by the' execution of the application, the full legal respon- sibility for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the proiect described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from the said project. 4. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plain or deep holes that may have a tendency to cause injury to navigable channels or to the banks of the waterway. 5. Any material to be deposited or dumped under this permit, either i, the waterway or on shore above high-water mark, shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material into the waterway. 6. There shall be' on unreasonable interference with navigation by the work herein authorized. ~. That if future operations by the State of New York require an alteration in'the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cau. se. unreasonable obstruction to the free navigation of said waters or flood ,flows .o~ eed~nger the health, safety or welfare of the people of the State, or loss or destruction of the natural resources of the State, the owner may be ordered by the Depart- ment to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall eot be completed, the owners shall, without expense tothe State, and lo such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to Its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. CONDITIONS 8. That the State of New York shall in no case be liable for any damage or injury to the strucldre or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navlgalion, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shall be installed and maintained by and at the expense of the owner. 10. All work carried out under this permit shall be performed in accoro dance with established engineering practice and in a workmanlike manner. 11. Jf Rranted under Articles 24 or 25, the Department reserves the right 1o reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as may he found to be just and equitable, if upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed~ the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former Condition. No claim shall be made against the State of New Yo~k on ~ccount of any such removal or alteration. 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the impairment of any rights, title or interest in reai or personal property held or vested in a person not a party to the permit. 13. The permittee is responsible for obtaining any other permits, ap- provals, lands, easements and rights-of-way which may be required for this project. 14. If granted under Article 36, this permit is granted solely on the basis of the requirements of AtUcle 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards - Building Permits) and in no way signifies that the project will be free from flooding. 15. By acceptance of this permit the permittee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse side. 95-~O-4 (SEE REVERSE SIDE) SPECIAL CONDITIONS 16. A row of hay bales islto be placed and secu=ed by stakes between the construction site and a 30' wide bdffer area extending along the landward side of the "Freshwater Wetlands per DEC" on said plan. 17. There is to be no disturbance of the natural vegetation in this buffer area, whether by filling, excavating, grading or clearcutttng. Plantings of native species may be made to augment the existing vegetation. SPECIAL CONDITIONS A THROUGH J ATTACHED. ~RMiTISSUEDATE June 13, 1984 USACE ! Daniel J. Larkin ~ .~%~ ~V~LDG. 40, ~L~NY @ STONY BROOK, NY 1179 Approved .~~.~.... ., 1 .4~.<'Permit No ........ BUILDING DEPARTMENT ~ TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 .~.(..~ Received..7. ... ,19.~.' Disapproved a/c .......... ~- ............ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 [~remises 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 application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWN ER MARK & LORRAINE LAROSA Name of owner of premises .......................................................................... (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...~a. ..../f--c... ~. Electrician's License No. ~' [/ * Other Trade's License No ...................... 1. Location of land on which proposed work will b'e done .................................................. .... 69.5 .................... Albo. g~.ive .................... L~Ut~L ........................... House Number Street Hamlet County Tax Map No. 1000 Section . .¢.2.6. ............ Block . .2 ............... Lot...12 ........... ' .... Subdivision. ' ......... Filed Map No ............... Lot ............... (Name) 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~ ~ .... ~-A'g.~,~..,~I~ · ..... ..................... 3. Nature of work (check which applicable): New Building ...X..' ..... Addition .......... Alteration ......... Repair .............. Rempval .............. Demolition ............. Other Work .............. 4. Estimated Cost . *" (to be paid on filing this application) 5. If dwollmg, number of dwelling, units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i ................................................................... 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dzrnens~ons of same structure with alterations or add~tmns: Front ................. Rear ................. Depth I Height Number of Stories .................... 8. Dimensions of entire new constrUction:, Front ............... Rear ............... Depth ............. Height ............... Number of Stories ...................................................... Size o[lot: Front .......... ! ........... Rear ...................... Depth .................... Date of Purchase ......... · ! .................. Name of Former Owner ......................... '.. Zon or use d~stnct in whm remlses are situated Does proposed construction vic!ate any zoning law, ordinance or regulation: ............................... Will lot be regraded ........ ; · ... · .' .............. Will excess fill be removed from premises: Yes No Name of Architect ......... 4 ................. Address ................... Phone No ............... Name of Contractor ........ i ................. Address ................... Phone No ............... 10. 11. 12~ 13. t4. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. 'S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sigr lng contract) above named. He is the ..................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly. authorized to perform or have performed the said work and to make and file this application;, that all statements contained in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the mannelr set forth in the application filed therewith. Sworn to before me this .............. (..~ .... day oi. · .~.., .......... 19.~t Note .fy P~gblic ...... ~.. ~,. ~.J~.a'.~/d'~:. County ~'/ ~ NO!,~.~[~}.~C., s.t¢,?l?,~ York ..... ~,¢~.~..~,~'.~ ............ (Signature Ie¢m 8 0 ~0 ,/ /2~ ,~' 96.0 j ~' ~4~ 5o W. Ioo.o~t~¢_~ ~ou~,'~ ~i~)~ ALBO -~S~ 3- 1985' ,. ~.:~.~/~d:~O ~ aewaSe dls~o~al and ~%er 9~pl~ b MAP OF PROPERTY SLIRVEYED FOR '* t_.._OE? $1TUATS LAUP. EL TOWN OF 50UTI4OLD,N.¥. SCALE ' E1 =MONUMENT - facilities for th!s Zo~at~ton h~Ve , G~I,iPOR~ ~ NELV YORK"