Loading...
HomeMy WebLinkAbout18433-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18317 Date August 29, 1989 THIS CERTIFIES that the building ADDITION Location of Property 1705 LAURELWOOD DRIVE LAUREL N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 5 Lot 11 Subdivision Laurelwood Ests. Filed Map No. 5595 Lot No. 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26, 1989 pursuant to which Building Permit No. 18433-Z dated AUGUST 28, 1989 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. The certificate is issued to JOHN A. & MARGARET A. ROSE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~ B il~g ~I peetor Rev. 1/81 lO1B,DR N0. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN71L FULL COMPLETION OF THE WORK AUTHORIZED) N° ~$4~~ Z Date 19...~~ Permission is hereby granted to: G~2~r.,..~~....°~.~,.~tn...G~,~~~~.r~.....f~. ~a~.2 ....~..~d~',~ ta ............~~~?ti.'~..~.......:~....fC~(.~1..........o~:n.~l~...,~..~„1~.:y~a.. .,~~t.-.......r%~... , nt premises at ........................................1....7~5.......~..~r.~~.~~../~...1,,.~..~,.................... ..........................................~.~~-r .....°r..~~....~~~~....-:.................................................. County Tax Map No. 1000 Section Block Lot No.....1..~ pursuant to application doted .....1~~/~ 19.~~and approved by the Building Inspector. Fee • ~,.!G~ v~.l~....~~rl.......~~........YY~... Building inspector Rev. 6/30/80 TOWN OF 50UTIIOLD BUILDING DEPART2IENT TOWN HALL • SOUTHOLD, NEW YOF2K 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY d~ J~ p' NEW CONSTRUCTION .....OLD OR PRE-E%ISTZNG BUILDING......VACANT LAND.../.'.__. Location of Property.....~.~.~~..••„•.4_91/QL`00000d=•~~,_•._ L. ;4Uf2~L,. HOUSE NO. I l1 STREE/T(/~ HAMLET Owner or Owners of Property.. J~~~ _ /~G{~~~'T •.a~ ~a~~ County Tas Map No. 1000 Section Block 5 Lot/ e/ Subdivision..G!'4?J?44WO.Q~ „~fL.~--., F~filed Map ~~/.~,.Lot...~~. Permit No.1p.7•~~ZDate of Permit(/,'~r$~.AppliCan~~/'~ ....r~r~--,-c.~ Health Dept. Approval Underwriters Approval....-.~,..•..•_ Planning Board Approval Request for Temporary Certificate Final Certificate s ~~©a Pee Submitted: $...,Z APPLICANT.. Q.~~. 3ss~o y.~ CD ~.)Fi31~ rev• 10/14/88 li _ ~ FORM NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765 - 1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be',filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, aad unusual 4atural or topographic features. 2. Final approval of Hea th 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 solder used in system contains less than 2/10 of 1Z lead.; 5. Commercial buildings,~iindustrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsib)re for the building. 6. Submit Planning BoardApproval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of pr~perty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properlq completed application, a consent to inspect signed bq the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in whiting to the applicant. 3. Date of any housing cide or safety inspection of buildings or premises, or other pertinent informationrequired to prepare a certificato. C. For Vacant Land Certifica,~te of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of ~'ithe entire lot prior to April 9, 1957 shall also accompany the application. If a!, Certificate of Occupancy is denied, the Building Inspector shall state the reasonis therefor in writing to the applicant. D. FEES: I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwel~~ling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessbry buildings, $25.00 - Businesses $50.00. 2. Certificate of Occuupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 S. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial i rev.i 10/14/88 I i Wh~l l%`F:r.F~:~L T~"MAP Ow LAUG?~a~w:~'_ E5'C(aT'EE> ON FSI.Fit{W~'!•it~~ultf`F~I,iGCOlJS3TV''Lt.ti-.a~;~ t gFFIGE rte, MAP NO, 5595. _ ~ m ~ y~s`~cg5f~J4af I 290, O! ~ cv ~ c~ ~~,,e ~''<< ~ ~ ~k' p'z ~+s f ~ 1 2 ;H~ b ~ - ~ Q' f~ • ~ ~ SEpTiC TANK P 46Ji y__ ~ y f ~ ~ CE55PWL - ~~a ~ ` ~ 5~66'JC71IC~'l~is: ~ ?.8Z0~ iy 7- J, ~ 7 E ~ ~ _ _ ~ : i ~ v; vNA 1. ~ ~ - e ro H5~',U'~DOF~Hr"Fw oRx.~AL2AINT"E(_t7"TC}"fry~E.~~'CUC_I~Y 7'~".. f~"4'G(SAI~F',P:_ r ~J. ; ' D - f, ED~ipnnoN~'N' ta11C"~-'C.~ JAN_291973 U VCY MAF NOf •~iYXe"'°-. F ry ~ jq e OOPIES OF URVEYORS INI:[D SE~ONSRDFR~ Kf I ~t 4 ~1 ~ ~ ~A Y/..V. L',ITHE 1 ASD gtAL SNAIL NOT BE .V L. Ci~~ ! t , 1 V~fl, i4 ~e~~..-,-_.._..-~t.d'~.T I~~90L F. 4AtID YNUE COPY. y EAU. C1~N ~ . ' /'~h~ ~.,{r( YHF SUAVN q"' ~ f 4:1,~,~V} \~e t{;iF,l~IGU A1:~Ni[CS SNDICATED H~.RVOt10M S ~ Y 4°.~1.~.-..r ( ~.v... ~ 11 J!~ t1i PCR`'ON FOR 40 YHE A , ,:._Y,~ 4 ~fF 7 .6 s~C,P ~ ONLY i0 7 ON MIS BCHALF _~,...,._.e.,~..._...__ . 15 GRCFpRLD, AND OVEIWMENYAL y,GFNGY a tITLE COMPANY," HEAP.ONr AND 'I_ICWJ~T-~aw.~. {..ANA `it.yPV~~P C.~~[;. , 'r ~ 1NSSRUi1UN 1151 LCµDIFiG 1~ NSTN - . - ~ SOOTHE A551GNEES OS THE N~g„F(yAM~ 9{-'1~~~~d~~~._Y 1 . ~ :TUitON. GUArtPNiFF3 ~ ~Ok?"°'"- TO ADDlT10NAF' INSTOti1fOFJ~ u »,$a£';c?v''g?°4 ~`~.t'~S'c',''de~"f.53°n'~1?`;vE,}1 - ~..~ryfl,~ei~ ' ' # s"?u.,, ~eP~¢bn,r:;. '.Ca ~~l a'».?!VP.lel a i ~r- ~ ~ ~ l' "r i b~ ~q~ ~~r K ~ L ~2 n iS~ , '.~a, \N X ~ ~ IB i J I k / b\ ~ -d ~ ~ ~ ~ o ~ ~ ~ ~ ~ ~ a a ~ , ® ~ j~ ~ ~ I i ~ fi i' 9' ~l x ,z ,v ~ IBS x~s~ ~ ~ . a ~a~~ N X ~ ~ _C' ~ N ~ ~8 v ~ 0 i i ~ k ro C IX Zi ~ ~ ~ T~ ~ ~ ti ~ v u v N U w ,v ~ v ~ 4 a a ~ ~ ~ ~ ~ ~ a ~ _ 9~ w BOARD OF HEALTH FORMN0.1 3 SETS OF PL.1NS SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT S•PTIC FORM TOWN HALL ^ SOUTHOLD, N. Y. 1197 OT ~ TEL.: 765-1802 L Examined .~4 .~./r?/. 19lQ/..~ ~~~~GG p ~•q,_ Approved . .~i,7/.., 19~~ennit No.<.~~.'(..~?. ~ p ~ ~ 15 0 Ll L5 I~ DisapprovedL~i`c • • • AUG 2 $1969 U BLDG.i7EP'C TOWN OF SOU7fIOL0 (Building Inspector) rRFPLiCATION t=OR BI-1iLt~IIVCG PERMIT Date . , (J....~ ~ 15~j INSTRUCTIONS ' a. Tlus application must be completely filled in by typewriter or;n 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 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 applicati3e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signa[ur of pplicant, or name, if a corporatron) ' (Mailing address of applicant) • State whether applicant is caner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ~ ~"7 ~ G'9 T '7 ~DS L (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. ...~q2.,•~.;,,.,,,,,,,,, Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. ~ . ../..7~?~`:..... Gg~2EL to c?od ~ t~2~ L IlouseNumber Street. ~ -7 .••.~-••••Hamlet / County Tax Map No. 1000 Sectio/n Block , ~J, , • , , , , , • , , Lot ...1.~.......... , . Subdivision ...G. /a v/~,EC~CIOOd , ~S ~A,~.$ Filed Map No. .~r..s~~~ , L,ot (Name) State existing use and occupancy of premises and intended use and occupancy of pro osed construction: a. Existing use and occupancy . b, Intended use and occupancy •b~c ~ 3. Nature of work (check which' applicable): New IIuilding , , , , Addition Alteration , , . - Repair Rgmoval Demolition ,Other 1Votk . OO.O~o (Description) 4. Estimated Cost .,8 Fee~~~~v,,,,,,,,,.• (to be paid on filing this application) ' S. If dwelling, number of dtvelliitg units , , , , , , , Number of dwelling units on each floor . If garage, number of cars ..:......!U~!`~ 6. If business, commercial or mil ed occupancy, specify nature and extent of each type of use , ~ - 7. Dimensions of existing structytres, if any: Front . .Rear ~ ~ • • • ~ ' ' Height . Number of Stories . • Depth . Dimension$ of same structurcl, with alterations or additions: Front • • ~ ~ • ' ' ' ' ' ' • . Iieight . , , , , , , Rcar . • . Dcp~'fl! ¢E I~ , . Number of Stories . . 8. Dimensions of entire new con'Struction: Front . Rear . .Depth • ~ • Height . Number of Stories . 9. Size of lot: Front Rear .......................Depth ]0. Date of Purchase i• ,,,,NameofFormerOwner • . 1 1. Zone or use district in which tSremises are situated , _ , , _ , • , - • • • . • • 12. Does proposed construction yjol t any zoning law, ordinance or regulation: ~ • • • • ~ • . l3. 1Vi11 lot be regraded , , t~ ' • • • • • • • • • • • • , . , , 1Vi11 excess fill be removed from premises: Yes ~ 14. Name of Owner of premises . ~ , , , , , , , , , , , , , ,Address . Name of Architect '••••••••••••••••.PhoneNo,,,,,,,,,,,,,,, Name of Contractor ' .................Address ...................Phone No.............. , If es Southold To • Address ...................Phone No...i... IS.Is this property located with in 900 feet of a tidal wetland? *YL~S... NO.... * y = wn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al] buildings, whether existing or proposed, and indicate all set-back dimensions frc'ir property lines. Give street and block number or description according to deed, and show street names and indicate whethe: interior or corner ]ot. i rQ/t~7,~f+'rti' ~J~ 4 I III I li i STATE OF NE\V YORK, COUNTY OF I,S.S ~I.. ynJ (1\amc of individual si;n, ~OJ~' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the appllcan't • • • ~ig contract) above named. Hcisthe. ~~NEOL-~Ga,Ur-2~cTo.~ (Cohtr.~ctor, agent, corporate officer, etc.)........................... . of said owner or owners, and is dut~ authorized to perform or have performed the said work and to make and file this application; [hat all statements cont~tned 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 tht: application filed therewith. Sworn to before me this o2!Y~-lti... .day of ~ ..~G-?-2l-:. , 19~.~ Notary Public, , • • ~ • ~'i • County ~Ge~ t~ i~oMAlNe ~ J07ARY PUBLIC, Stste of New Yark' • ' • • • . No. 52.3334925 - Sutfolk CountyI (Signature of a hcant) Commisslon Expires Mey 31, 19.~~i PP