HomeMy WebLinkAbout22725-z 4'o�oS�fFOtKcoG Town of Southold 4/26/2023
P.O.Box 1179
C4
sm* 'Iow
53095 Min Rd
�oovtyf' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 24004 Date: 11/2/1995
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 120 OLD MAIN RD LAUREL
SCTM#: 473889 Sec/Block/Lot: 126.-2-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/12/1995 pursuant to which Building Permit No. 22725 dated 5/3/1995
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:
porch addition to existing one family dwellin ags applied for.
4/26/2023 Corrected for tax map number only.
The certificate is issued to Ilgin, Sukru
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
uth ri d ignature
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24004
Date NOVEMBER 2, 1995
THIS CERTIFIES that the buildin~
Location of Propert~ 120 OLD MAIN ROAD
House No. Street
County Tax Map No. 1000 Section 26 Block 2
Subdivision Filed Map No.
ADDITION
LAUREL, NEW YORK
Lot
Hamlet
2
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 1995 pursuant to which
Building Permit No. 22725-Z dated MAY 3, 1995
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 PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
RICHARD E. & EILKEN E. ODDON
N/a
N/A
N/A
Rev. 1/81
FORM NO.3
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED]
22725 'Z
at premises located at......~.~ ............................................................
Coun~/TaxMapNo. 1000 Section ....... ..'~.......~.. ........ Block ~" LotNo. '~
pursuant to opplicatlon dotoc~.~., ........................................... 19..~.~....~..., end oppro¥od B¥1he
Building Inspector,
Rev. 6/30/80
OF SOUTIIO LD
765-[802
APPLICATION FOR CERTI~ICATg OF OCCUPA~ICY
This applicstion must be filled in by typewriter OR ink and submitted to the building
inspector with the following' for new buitdi.g or new use:
Final survey of property ~ith accurate location of all buildings, property lines,
2 Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
] Approval of electrical installation [rom Board of Fir~ Underwriters.
Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial b~ilding, industrial building, multiple residences and similar buildings
and imstaiiations, a certificate.of Code Compliancs 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, ~957) non-conforming uses, or buildings and
"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 appiication and a consent to inspect signed by the appl~cant.
If a Certificate of Occupancy is denied, the Building inspector shall state the
reasons therefor in ~riting to tl~e applicant.
l. Certificate of Occupa.cy - Ne~ d~elling $25,00, Additions to d~etling $25,00,
Alterations to d~etling $25.00~ S~imming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-sxistin~ Buildilm - $[00.00
3. Copy of Certificate of Occupancy - $20.00
Updated Certificate of Occupancy - $50.00
5. Iemporary Certificate of Occupancy - Residential $15.00, Commercial $[5.O0
~le~ Construction ........... Old Or ~re-existing Bu£1ding,.....b~... .........
;ocatio. o~ Proper~y.../.~Z~. ~../~..~,~/K~. ~'~ .~.~ .....................
~ouse No, Street liamle t
,o ooo, ...... .......... ....
,ien[Lh DepL, ApprovnJ. .......................... Uiirler~¢r!ccr$ Apl)royal ...........
'~nnn.Lng Board Approval ..................
~-quest for' Tempornry CeF~i[icnte ........ Fin;Ii
~ee Submitted ' $. , ~f~.,,.~'~ ............
CerticoLe ...........
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 20, 1995
Mr. & Mrs. Richard Oddon
2455 Westphalia Road
Mattituck, NY 11952
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 # 22725-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1 BO2
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 20, 1995
Mr. & Mrs. Richard Oddon
120 Old Main Road
Laurel, NY 11948
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 % 22725-Z
Please contact our office on this matter.
cooperation.
Thank you for
$OUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
ROUGH PLBG.
1 I.S~UL~T,O.
DATE /~//7/~*--~ INSPECTOR ,~'~ -*~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] F/~ATIoN2ND [ ] INSULATION
[t~/'~ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
·
REMAR~K~S. ~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ~/FFOUNDATION 1ST [
[ ~FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
] ROUGH PLBG.
] INSULATION
] FINAL
DATE
INSPECTOR
FOU~DATION { 1st)
FOUNDATION (2nd)
ROUGH FRAME &
~.FLUMBING
INSULATION ?ER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
/ TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .......... , 19
Disapproved. a/c '
...............................
· (BuiFdino In~ector)
BOARD OF HEALTH .........
3 SETS O.F PLANS ...... ....
SURVEY ..................
CIIECK ...................
SEPTIC F 0 RI'I .............
APPLICATION FOR BUILDING PERMIT ~'~'~ '~' TM o. :"=-u'~I ~
Date ................... 19...
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 premises or public sti'eets
or areas, and giving a detailed description of layout of property muir be drawn on the diagram which is part of this appli-
cation.
e. 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 purpo%e ~vhatever 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 South6ld, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of bu/ldings, 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 regula~ons, and to
........
--' . / ' (Signature of applicant, or name, if a corp~ation)
(Mail/'ng address of applicant) '-~,~
(/.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... ........... , ...............................................................
Name of owner of premises , ,~, ~. ,~, ,Z~r,~, .~.. ~A..~. (/.~..~.....~.',..~ ,~..d¢~,..'G) .....................
(as on the tax roll or latest deed
If applicant is a corporation, signature of duly authori;~ed officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No ....... ' ..................
Electrician's License No... .................... ·
Other Trade s License N6.. ~.~.,¢x .~. ~,,fJ~/ .......
Couhty Tax Map No. l'000Section ../~ Block ~ ' Lot ~
Subdivision ........ . ................... ......... '. Filed Map No ............... Lot ...............
(Name)
State existing use and occupaBcy of premises and intended use and occupancy of proposed construction:
'
a. Existing Use and occupancy ~.. .....
......................................... .
b. Intended use and occupancy &(~' ~.~.~..~.~ .~.. ¢~.~ 7 .~....~..,~. ?. ~..~. ............... . ...........
· 3 Nature of work (check which app[icable) NeW Building '" Addition '
........... .......... Alteration .... ; ....
Repair .... Removal Demolition ' Other Work ,,~//
4 Estimated Cost /..t ~ . (Description)
................................ · Fee ....... ! ....................
. (t~ be. paid on filing this application)
5. If dwelling, number of dwelling units ,../. .......... ., Number of dwelhngiumts on each floor... ..........
If garage, number of cars ........ I ............... ' ................. ! ...........................
6.' If business, co,mmercial or mixed occupancy, specify nature and extent of each} type of use .................
7. Dimensions of existing struct'ures, if any' Front ,;1..~, ?. . . . Rear .A.!{:' ."+-. . . . De~th ,.~.O ~ :1. ' '
H.eight .. .............. Number of Stories .. ~ ...... . ' ' ' ' ...... ~' ' ..........
. ~D~menmons .o_f shme structure with alterations or additions Front' '~ ~ ~ ~-' 'i ......... ,~ .....~'d j .7 ...........
~Jepth .9-P. z~. . . . n'~h, .... '~ ............. Rear.. #.,..~. .....
..... ' ........... ~,' ...................... '. · Number of Stories ~ . . .'. 2 .........
o. J-Jlmenslons olentire new construction. Front . . · : Rear I '- -- ' '
l-l~h~ .... ' . " '. ....... . .............. ~epm ......
----* .................. r~umeer or Stones .......
9. Size oflot: Front ~ a,~.'~ . '*, ..... ,';','"~,;, ..... "! .................... ': ..........
· ,, ..... G.?,' 2, 'Z~'.: .............Rear .... t~ ~, .,.~.¥..;. ,.. ......Depth
· ..... ' . · ..................... ,,~-~m~,ormertJwner
x ~. ~one or use mstnct in which premises are situaied ./~?~'o&~,w,;.,/' i ' ' ' ~ ~" .... ~: .......
12. Does proposed construction violate any zomng law ordinance or regulation: /~..~ .... i.
13. Will 16t be regraded ~ O.; .................. Will excess fill be rem6ved from premises: Yeps~..~T....~'
14. Name of Owner of premises ./~4~T. q.*%.~.~..O...fl.ti~Address .~tF.-,4-..~..., .p.~,a..t,,}, B4.. Phone No. ~.. ?.a%. .,,
Nam~ of Architect ..................... Address .. m,~. r~: ' ·
· ..... .... Phone No .................
Name of Contractor .... .. Address [ Phone No ......
15. I.s this property within 300 feet of a tidal wetland? *Yes...l ..... No..~.... ....
· If yes, Southold Town Trustees Permit may be required.I
.. PLOT DIAGRAM
Locate clearly and distinctly all buildings, Whether existing or proposed, andi 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. '
ST. akTE OF NEkWS'D!~/~ // . --"----.,
cou ¥,OF s.s -
...... .
~ ........ being duly sworn, dep~ose~ ~s t~t&~s the applicant
(Name of individual signing contract)
above named. .
He is the .~ '
(Contractor, agent, corporate officer, etc0
of said owner or owners, ~d is duly authorized to perfo~ or have perfomed the Said work and to m~e ~d file this
application; that all statements contained ~ this'application are true to the best ofhls knowledge and belief; and that the
work will be perfomed in the m~ner set forth ~ the application filed therewith. '
Sworn to before me ~is ....
........ .' '~~day~~l..~, 19.~
CLAIRE t. GrEW ' ~ ~ .. ,
~o. 4U/~U3 ~/ ....
~miuton Elpires ~cem~r [ I~ i
Ol, O ~
o
AREA= I1,010 sq. fl.
1000 - 128- 02 O2
$oale, 1'~ 30'
July 6, 1992
N,Y,$. LIC. NO. 49~18
P.C.
Prepared In a~eordenee with the mlnlmum
~,tontlord$ for lille surveys as esfebll~ed
~y the L.I.A.L.S, ond ~proved OflE odopte~
/bt su~ u~ ~y ~e New York St~le fien~
UNDERWRITERS CER'flFICRTE
REQUIRED
FI~o id'r'..', t:L~vz~Ti oH
'ti[