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17203-z
~ K FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18224 Date JULY 28, 1989 THIS CERTIFIES that the building ADDITION TO ACCESSORY Location of Property 1420 LAURELWOOD DRIVE LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section I27 Block 5 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 1988 pursuant to which Building Permit No. 17263-Z dated JULY 11, 1988 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 INGROUND POOL & FENCE AS APPLIED FOR The certificate is issued to_ ROBERT & BARBARA LOCRMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FOEM NO. D TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CfHiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N fl ~ 17 2 ~ 3 Z Date ~,1./.r< 19C7~ Permission is hereb gr me to: ~ ~d. .~~...y~.,, .....1.1..g~d'.... to r ~a......,..fA.... ....~i~ ...~~~o ~~....~.......~~........,.,........~..~..,.~....~........'.7.~ ct premises located of ®........C..l:~~:~....A%~.~~~TT.P~{•......r~~. ...................................................~a,~,C.le Caunty Tax Map No. 1000 Section ........Co2//.7..... Block Dort No..........-~.~............ pursuant to application dated ...................f~..~~~..2?................, 19.~G1, and approved by the Building Inspector. Fee Bu' ng nspector Rev. 6/30/80 0 TOWN OF SOUTHOLD BUILDING DEPART2IBNT TOWN HALL SOUTHOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY -7/ r DATE. II .~Q/y . NEW CONSTRUCTION ~ ..OLD OR PRE-E%ISTING BUILDING......VACANT LAND.....__. Locacian of Property.~.`.Z~~..,,. L~-CRt-eLW(~ ~,r,...... ~--GLt_,2~~_ HOUSE NO. STREET ..HAMLET Ovaer or Owners of Property.~~~r.~a,~~.~~~~ ~~~I-~~_~. CounCy Taa Map No. 1000 Section .12~ Block Lot-...( S=R.... Subdivision Fi/led M/apq ........Lot...(~.p...._. Permit No. Q~~Zd-3Z Date of Permit .'P.~~~(7/~U.Applicant ~~4!;r~ ~~~~'~ICC If' ..--.77 ..1~ . IIealth Dept. Approval Underwriters Approval...d.',2~ 1~~„ PLanning Board Approval Request far Temporary Certificate Final Certificate Fee Submitted: $ APPLICANT ?~G~S U't/t~ : ~Ui~!i'~'~,~~J . rev. 10/14/88 mac, 37gy3. co ~ I~aa~{ L ' 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: ll. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. l.. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form). 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, ',industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect - or Engineer responsible for the building. b, Submit Planning Board~Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land µses: 1. Accurate survey of proilperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by 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 writing to the applicant. 3. Date of-any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: I. 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 the entire lot prior to April 9, 1957 shall also accompany the application. If a'iCertificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCCUPANCY - New Dwelling $25,00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificatg of Occupancy - $5.00 -over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $2Q.00 S. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial - ~I rev, 1(y/14/88 ~C:iU:7 U6TE ~ ~OhfMLNT° ~ c'icLD I::SP:. I j.' ~v ~ t . F ~ ~,pU~ ~ H ~Q~ H FOUtJDATION (1st) Co NM1 ~ FOUNDATIOtJ ( pad ) _ - ro~a~ b 2. z o P,OUGH FRAME & 5-~ .PLUMBING C~ Na 3 3. ~ ~ m IIJSULATIOPI PER N. Y, y 0 STATE ENERGY rJ CODE m a ~"1 ~t ~ y~ 4. r FIi1AL ~ A ~^1 ADDITIONAL COMMENTS: x°I~ ~ a . ~ ' x _ H ~ y . H\ H O~ O z M a~ • r\ H S b P7 b H ° - d ~ fi ~ ~ ~ -t~ ~ o ~ ~ ~ Q Cl a ,Y f - _ i f - . i - - - - - -t , . ~ ~ i -----t _ m_~°_ 1 !V t ~ W V V ~ ` ~ C ~ ~ ~ r ~ 1 y~y n t . C C` ;pzm . <,m - - I ; --j-- - ~ a r n'~~ - - ~ - t' ~ ~ - ~ - ~ ~ Z~ - - - - C.~~ ~ r"'; l " _ _ __-1.____._. _ tab's a/ ~ 1 4 - 1. 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Rar.2 . pG ~z~ ~ca Y~~~~L~~~'a1I~ Approved 19 40 Pcnni[ Nol ,..pp~~~~.rry~_. ~ Old. tU DisaPProved a/c ~ nAU17 ~7 0 f 5T'gt2T' ~IG FFFIII k3LCG.DEi'T. ~'3G MOWN VF SOUTiiOLD ' r '(Bu' g Inspector) APPLICATION FOR BUILDING PERMIT _ ~jl~lV12..3~...., 15~~'. Date INSTRUCTIONS a. Tltis 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 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 shell be kept on the premises available for inspection throughout the work. e. No building shalt 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. Tlie 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 inspectio~n~s.~ 1, (Signature of"applicant, or name, if a corporation) ~?:.3.QX Z L~u.l-ei N.:~. l t4~ . , ' (Mailing a dress of applicant) • State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ®cv I~C-~• Name of owner of premises ~~'rb~'r~ KrnC2rl (as on the [ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) if~Ap~~®fATGLY ,mVV1! G o• Builder's License No . ENCLOSE POOL TO CODE UPON COMPLETION Plumber's License No. BEFORE "WATER" Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . . ..I•~F2D, , (,-a.u,re(t;`?©.~L-.~ . ~ r;~ 41'e..,..~.~.~.re.l House Number Street Hamlet County Tax i\tap No. 1000 Suction ~o~..7.... Blpuk .....J'~• , , , , , , , , , - Lot .....~P p rt f............. Subdivision .....l.,Y~tV(~C(.- F.ilud t•lap No. • „Z 1~,, , , , , , Lot ...l.~ . ......Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~:es1 ~~Y'1`}'t,CC • • • • • • • • • • • ,`r~ b. Intended use and occupancy . - • ~~Si• ~en;E;l.a( ~(rh C{ e(' ..............I•- f_-_ _ 3. Ret air of work check whichmoval ' ' • P ' ( applicable): New Building , , , , Addition Alteration Re Demolition Other Work . 4. Estimated Cost r~©lJ, , , , , _ • , , , • (Description) Fee 5. If dwelling, number of dwellin (to be paid on filing this application) ig units . . . . . Number of dwellin units on each floor . f garage, num bcr of cars g 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. pimensions of existing stnictu~•es, if any: Front , • , ,Rcar ~ • • • • ' ~ ' ' ' ' ' Height Number of Stories . Depth . Dimensions oG ~r~e S41lucture with alterations or additions: Front • • • • • ~ ' ' ' ' ' ' ' Rcar.................. c.pth 8. Dimensions of entire new c Nu ~ Ilcight , , , , , , , , , , , , , , , , , Number of Stories . tntctton; Front • Rear . .Depth Hc,i~ht anberofStorics 9. Size of lot: Frbnt ..........I.....• Rear 10. Date of Purchase ~ Depth .........p .Name of Former Owner . 1 I. Zone or use district in which remises are situated . • ~~5 j~`,~~~-~ aj ' ' ' ' ' ' ' • • • • • • • • • • • 12. Does proposed construction violate any zoning law, ordinance or regulation: • ~ ~ • • ~ • ' ° „-S • • • • • • • • • • • • • • Nill excess fill be removed from premises: Yes No 14. Nameooof Archit ~P premises...',. 4~rK,~f'k , , , ,Address LF4-v11z~Li R1,.~~~, , , , ,Phone No. , Name of Contractor . ' ' ' ' ' ' ' ' • • Address ...................Phone No............~. . IS*]:s this property loco ~"""•••Address ...................PhoneNo......... ted with in~00 feet of a tidal wetland? *YES....NO. Cf yes, Southold Towjn Trustees Permit may be required. . PLOT DIAGRAM Locate clearly and distinctly al( buildings, whether existing or proposed, and. 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.lat,____ _ _ A i l~ ~ rID[aSC~ i I t~,~ , 5 ~ ..~.~w r,_ t r i COUNT OFE\V YpRK„~... S.S ~ 1JL~~Cg~~~~'S ,being duly sworn, deposes and says that he is the aPPlicant (Name of individual signii'ig contract) above named. i~ fie is the ; l~.~i. yC?/.tJ.........II..... (Contractor, agent, corporate officer, etc.) • ~ ' ' ' • ' ' of said owner or owners, and is dulylauthorized to perform or have performed the said work and to make and Gle this application; that all statements contaiped in this application arc 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. Swom to before me this ,.~.~.o.c.TE,,........dayof.!.~.t~~c.c_........ , 198. ~iotary Public/Y~ ~ix, gNI~~AEk~`.-~+ County (v/ NOTARY PUB41C, S~~Y~~aaattttte of New York - ~ Reeidmg m Suffolk County - L- No 62.5595900 • • • ~`~'r : • : • . ~ COOlmlwwn Fwxpms Apnf 30 ]9,`Co ' • ' ' • ' (Signature of applicant) I ~I ~ z H ow° c~o• WOw O q y 3u= Y fV ~ ~ u~q ~~h o a~u rca ~ 4 v R~ ~ yRyww ZYO ~ `~J ah C' i~ ~.G G • ~ ~.{O~ ~t141 W OZY - Om~ . Fi n 5, ~~-w11~0 ~aJ~ z xSi JN~ o ~ d ~ i ' ° t~ ~~q 4,xW~r. _ gins.: ~ ~ 1' ~ Oq0 ~OJw ~ w O lil,;•r..''J ~~`K~ ~ 1.. FPM--' u 8`00» ~ i5" za z~ ZW D Z n ~ ~ o < Q J t7 l i,z .--x '':;=i5 O O?r Va W U Q ti t; ~ i~ / J W y O ~WC 17 r~ ° O ~ a 0 y ~ ~ r~~ D O J O d' Q Q O ~ 11 1 Z m o W W Z O"o 04'"0 07:. WW ~l fit- Z W ask No•2 ~s_~~sza ooZ ~ oo ; < P MaP 3~ a J Q o N ' QUnty / ul v ire G z r- „ °'La 1 0~= SUf}oIK X39 0o w s a ~ a m gppgp~!Ep AS NOTED 950° ~ _ PATE 17 ~..B.Ptt`/,7/alb. 23~o v- q~v~`c_t~.^Ax O. FFE ~S?J~ _gv -Y• G'~iC.~ _ v' ~`'F ,8~,i°~"° O N()TIfY 6lIlt fJING OFPARTMENT AT q? ~,~e~/~ ~`~'Ee~~" ®®~~,~a~~~ ~'cv 7!,S 18;)2 9 AP.n TC? ~1 ~ ~V! FOR THE X61 N~~®~ ~~tl ~ FC)!!C}SnjiNCi INSPEf ~i f(i~V o ~ ~~~~ap~APa~ t FOUNDATION - TvvO REQUIRED ~a Ft7R POURED CONCRETE ~l pe~'• ~ 2 ROUGH FRAMING ~ PLUMBING D~~ ,°`q~~~, 3. INSULATION ~ a' 4 BE COMPLETE NSR C.C~ N MUST "o ~ ALL CONSTRUGTt SHAIA MEET THbREQU1REME OF Q>ElE N.Y. m~ 1 STAB CON$TRU A ENERGY CYO CODEES~, NOR R BLE FOR ~ ~ r y~ DESIGR,~R ON ERRORS ~ T r D ~ W ~ K'DD li ~ ~ ~ d ~ ` f ~ Y 7' ~Y ~ y V ~ ? .i w ~ o a~I. .o Y~ i ` 1 J/f f/ 'o o ss ~ ~ "o ~ I ~ ~ ~ ~ ~ .^I ul \t p~~1. 2 l I~2 0 oim V 1 o v R~~E z i380 ~ O Q ' ~ E~~pO N-23ooq 50 ~P~R •