HomeMy WebLinkAbout25507-z FORM No. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26628 Date: 08/12/99
THIS CERTIFIES that the building ADDITION
Location of Property: 485 NORTH OAKWOOD DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
county Tax Map No. 473889 Section 127 Block 7 Lot 17.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 22, 1998 pursuant to which
Building Permit No. 25507-Z dated FEBRUARY 1, 1999
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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to LINDSAY SHADBOLT & ORS.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
/1%u'jdinj Inspe for
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25507 Z Date FEBRUARY 1 99
Permission is hereby granted to:
LINDSAY SHADBOLT & ORS.
120 KENNILWORTH ROAD
RIDGEWOOD,NJ 07450
for
CONSTRUCTION OF A 201X 20 ' DECK ADDITION (MAINTAIN 35 FT. REAR
YARD SETBACK. )
at premises located at 485 NORTH OAKWOOD DR LAUREL
County Tax Map No. 473889 Section 127 Block 0007 Lot No. 017 . 002
pursuant to application dated DECEMBER 22 98 and approved by the
Building Inspector.
Fee $ 75 .00
Authorik6d Sign re
ORIGINAL
Rev. 2/19/98
BUILDING DEPARTMENT
TOWN HALL
765-1802
PLICATION FOR CERTIFICATE OF OCCUPANCY
A. applicSm� filled in by typewriter OR ink and submitted to the buildit
i sp gFt@la ollowing: for new building or new use:
1. ,"*�i I ey of .property with accurate location of all buildings, property lines
s ets, 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 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildi
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 z
'.'pre-existing" land uses:
1. Accurate survey of property showing all property 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. Fees
1. Certificate of Occupancy New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15x..00, Commercial $15.00
Date 1 � . ! . . . . .. . . . . .
New Construction. .. . . . . . . . . Old Or Pre-existing Building` V
r
Location of Property. . .
House No. In pp �S'trrt Hamlet ��JJ
Onwer or Owners of Property.. .�l�Yl . I. J' . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . .��.il . . . . . .Block. . . . . . .7. . . . . . .Lot. .11Y. �� ^
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Rap. . . . . . . . . . . .Lot. . . . . . . . . .
. . . .
A^ 11 . . .
Permit No. .p'� �� .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . .' +• . •. . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . '//
Request for: Temporary CCe//rlI�t/ifficate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . �,.VQ . . . . . . . . . . . . . . . .
. . . . . . . . ... . . . . . . . . .
APPLICANT
' o��gUFF0�kC0 M.
Town Hall,53095 Main Road Fax(516)765-1823
P.O.Box 1179 O� • ��� +. �' lephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
N,-
July 1, 1999
Lindsay Shadbolt
120 Kenilworth Rd.
Ridgewood, New Jersey 07450
RE: 485 N. Oakwood Dr. , Laurel .
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX 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.
1
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 25507-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
o�OSpFFO(,�cO
o� Gyp
CA
Town Hall,53095 Main Road Fax(516)765-1823
P.O.Box 1179 Oy • Telephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 1, 1999
Lindsay Shadbolt
120 Kenilworth Rd.
Ridgewood, New Jersey 07450
RE: 485 N. Oakwood Dr. , Laurel .
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX 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 # 25507-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
I
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� °0°aq 7G 0 o RFD#1 • 1 Tuthills Lane PROPOSAL AND CONTRACT
D®AV 1�1 T �p�CT (516) 722-3245
Riverhead,New York 11901
R TTSME (516)324.3119
Buyer(s) To: Ey S* 1T _ Date 19'
/l�UJoo� i1/,.T'. p '7hRSo
Proposed The undersigned contractor proposes to furnish all materials and perform all labor necessary to complete the following:
Work n
sG�a01 Xao' �EfJI AS 7���.`ay
—,�// Sa�isiizu
C-72,1ti= To ��TlirFs�i2�� �is� 4..�,/ v
LE7XgEi2 �oAr27 '�4L>� io X/y w,{E /LYS�,y/2.
— ?.��u � � xa 57'y� ��� �.� � �1ns►L !fir-SAL
Price All of the above work to be completed in a substantial and workmanlike manner aiordiinnig to standard practices for
the sum of ���� /kltLf 4nD �x�f✓A � / — Dollars (
� so
Payments Payments to be made
The entire amount of contract to be paid within 7 days after completion.
Changes, Any change from the above specifications involving extra cost of material or labor will only be executed upon written
Extra orders for thein.There will be extra charges for changes.
Charges All agreements about changes must be made in writing.
THIS ESTIMATE IS FOR COMPLETING THE JOB AS DESCRIBED ABOVE.
IT IS BASED ON OUR EVALUATION AND DOES NOT INCLUDE MATERIAL ✓Y�� yf Z �""t t
PRICE INCREASES OR ADDITIONAL LABOR AND MATERIALS WHICH ontractor
MAY BE REQUIRED SHOULD UNFORESEEN PROBLEMS OR ADVERSE
WEATHER CONDITIONS ARISE AFTER THE WORK HAS STARTED. By
Acceptance TO THE CONTRACTOR:
You are hereby authorized to furnish all materials and labor required to complete the vork met ione in the above
proposal,for which I (We) agree to pay the amount mentioned in e opos i4 accordi o its t s.
ACCEPTED BYBUYER(s)on wi f 193B,4, Buyer
Buyer
�50s Z)7,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE _INSPECTOR S
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLAC & CHIMNEY
REARKS:
,z
DATE 0413 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMAR
6
DATE INSPECTOR 1�✓�
BUILDING PERMIT REVIEW CHECK LIST
Application Name:
Architect/Engineer:
SCTM #: District: 1.000 Section: �7 Block: Lot: 7 �-
Subdivision Name:
Req. Req. f
Zoning District:® [Lot size: 004, ()V Proposed: �`� •G,� [Lot coverage Azroposed: �J 7Q
Req. 2_ _ 1 Req. � Z Req. /
[Front Yard Proposed: [Side Yard q� Proposed: ] [Rear Yard 39' Proposed: ]
Project Description: ;20 X C)
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A/ NO YS Number
Suffolk County P Health Dept.
New York State D. E. C. /
Town Trustees /
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone:
0�2�_
3�
FIELD INSPECTION REPORT DATE COMMENTS y
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INSULATION PER N. Y. ii N t+i
STATE ENERGY
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FINAL I ~
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ADDITIONAL COMMENTS:
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BOARD OF HEALTH . . . . . . . . .. . . ...
FORM NO. 1 ,�3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD ,SURVEY - :. . . . . . I... . ..•.
BUII,tDING DEPARTMENT ,'CHECK .. .. .. .. . . . ... .
PO SIX 1l TOWN HALL SEPTIC FORM . .... . . . . . . . .. . . ...
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY
. ... .. .. . �3 ail
99 CALL ... .. .. . . . . . .
Examined.. .. .... '. , 19.71 / MAIL TO:. .. . . ... .. . .. .. . . . . .
Approved.. . /...., 19.!.! Permit No. .... l`.� ..........I........................
Disapproved a/c .................................. ...................................
(Building Inspec or)
ITj
4J w 4 APPLICATION FOR BUILDING PERMIT
CSS, Z�
Date.1.V .
INSTRUCTIONS
a, ,cation soar be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan slowing location of lot and of buildings on praxises, 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 application.
c. 1be Work covered by this application may not be connenced 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 inspection thrOug}out 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 11EREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zona 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, g1d % , buil ' code, boos' code, and
regulations, and to admit authorized inspectors on premises and in bunece i
1 ... ..
(Signature of licant, or ease, if a corporation)
(Mailing address of applicant 074&CS
State whether
applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildeu
Z,pane o ro premises .......Y J.> t � . � ............................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporateQQoffi er)Jj'�� uu TT
i Builders License No. ..C]]�.P.�.(........l J......
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1.°( Location of land on wbidu proposed work will be done..............................................................
.... .4- S:........... JET�t`f(n..C� to c� ... Q&..........('01fr t..........................
House Naber Street
County Tax Map No. 1000
p Section ....... Block . lot ... Fam1eC'�
Subdivision ,,4.4 t CI►1 r�. ( ..^. �..... Filed Map )o..... J2..... .2�........
2. State existing use-,4Q occupancy of premises aqd intqnded use and occupancy of proposed construction:
a. Existing use andoccupancy, .. Rf .. ...................................................
b. Intended use and occupancy ...J,� U� . .��LLLLtT.7.............................................
1. Nature of work (check wldch applkable): New Building .......... Addition .i . Alteration ..........
Repair ............ Removal ..... ....... Demolition ............ Other Work ..................................
(Description)
i. Estimated Cost .... 41� Q..'I...... fee ....... .757...............................
(to be paid on filing this application)
5. If duelling, number of dwelling units ............ lhoiner of dwelling units on each floor ................
Ifgarage, mober of care ..... .............................
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 sane structure with alterations or additions, Front ............... Rear ...............
Depth .................... Hsi* .................... Narber of Stories ...............
8. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
Height ........................ ;Rmber of Stories .....................
9. Size of lot: Frust ............ ....... Rear .................... Depth ....... ........'a,`... ::
10. Date of Purchase ...............''...... Name of Forner Owner ........................................
II. Zone or use district in which premises are situated ...............................................................
proposed to any zoning law, ordinance or regulation. ........................
12. Does construction viola
5
13. Will lot be regraded .................... Will excess fill be removed from premises: YES N0
14. Names of Owner of premises .....',I..................... Address .............................. Phone No. .....:.........
Name of Architect ..............i...................... Address .............................. Phone No. ..............
Name of Contractor ........... ...................... Address ...............................Phone No. ..............
15. Is this property within 300 feet of a tidal wetland? * YES .......... No ..........
*IF YES, S01HiDID 'TOWN TRDSIFB.S PIRAIIZ- MAY BE R mmm.
PLOT DIAGRAM
Iocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property linea. •Give street and block amber or description according to deed, and show street names and indicate
whether interior or corner lot.
SfAIF. Or NU YORK,
0 MIY U
.....................................Ii.....................being duly sworn, deposes and says Lhat he is the applicant
(Name of individual signing contract)I,
above owed,
Ile is Line ....... ......... .......
..... ......................
(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 atatements contained 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.
%worn to Wore me this
.......(.(f... .day ofp��19.��
ZONotary Public -6:7........ ... ....
CH G
y pubNa gmla of NOW York ngnature o A cant)
No.01WA8002710
t; f3ualMed in&iifolk
Govnq
Oomfiis"expkee Feb.17 2000 I't
SURVEY OF
LOT F
LAUREL
�/� (gyp po' - O L PARK
l(y�`� ( C 2pp FILE No. 212 FILED OCTOBER 5, 1925
/ - - N Na SITUATED AT
LAUREL
/ a N TOWN OF SOUTHOLD
1016 - - o, SUFFOLK COUNTY, NEW YOF
1�-1
e^`� �% �� S.C. TAX No. 1000-127-07-17
A. �L SCALE 1"=20'
/— Q JULY 29, 1996
\ / A
o L/ AREA = 0 367 15,994.62 sq. ft.
1�0 ;- 9
LOT 0
\ _
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- /— ,•+ C'
y —/ OW
N a� Zpp
U�AM
�: ` / S O SfANDAROS FptER/EYS AS 6i�a19iED
11p0FwssooAuffla_K; xEwivwc•'oirA• i,w
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^d o O sem'^' V Y� \9T qa OQ•>-
'� ��p � N.Y.S. Lie. No. 4�
o� a�`�F`a �F.%ys KY
0g � O�ZC Joseph A. Ingegnc
VFIC TO KM« OF Land Surveyor
G ✓Asf j. \ 5 rm9 a
AT 1NE xcw mIX STATE
I C l$F V M=ON + IS)
COF16 CF i115 SURJEI•YAP NOf 9Fpry11G
111E UWO SURYflM'S aIXED SFAL OR
\ S
CERTIFIED TO: 10 sFrt swaE NaT +m Ttle unrys — Subdivisions — Site wan: — Ca+uW�tan Lc
m WA vNlO 11111E COPT.
COMMONWEALTH LAND LE INSURANCE COMPANYCER1R1cOa aAgIGTEa HEREWI 4w RUN PHONE (516)727-2090 Fax (516)722
BNY MORTGAGE COMPANY, Inc. snrva'u. i a wwP m
RAYMOND C. FEENEY ' THE ensTo+a of RILMS ai wAr ^"�C01°""Y• '1K'�Q1f''011p OFFICES LOCATED AT U4UNs ADORE=
KATHLEEN M. FEENEY AND/oR EAs6NENrs DF RECORD. IF ro1pixc ° ra- oae unwn swmrc P.O. eo:;193
ANY, NOT SHOWN ARE NOT GUARANTEED. 111OaM.CEROFl mm Am Mal tRA1gEW&E Ayuebogm. New Yah 11931 R erh od.Ne.,YaM1 t