HomeMy WebLinkAbout23365-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31329 Date: 12/13/05
THIS CERTIFIES that the building ADDITION
Location of Property: 2300 ALDRICH LA LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 125 Block 1 Lot 2 .22
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 3, 1996 pursuant to which
Building Permit No. 23365-Z dated APRIL 11, 1996
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 ONE STORY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ROBERT & NANCY SHAW
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-408643 01/05/97
PLUMBERS CERTIFICATION DATED 04/04/98 ROBERT SHAW
Au
lAilghd Si nature
Rev. 1/81
Pd .��x yes
• Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT q y�
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building 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 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 buildings 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 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 application and consent to inspect signed by the applicant. 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 Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 /L
Date. /� —L —06—
New Construction: Old or Pre-existing Building: A(check one)
Location of Property: �.G9pMMW
House No. / Street / 7 Hamlet
Owner or Owners of Property: 666 /
Suffolk County Tax Map No 1000, Section/02 Block U Lot
Subdivision Filed Map. Lot:
Permit No. o?3:3(a Jam' Z Date of Permit. ���1/q(^pplicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary
-yCertificate Final Certificate:_ X (check one)
Fee Submitted: $ �S
Applicant Si tune
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE
r 1135107 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Date JANUARY 15,1997 Application No.on file 12626196/96 N 408643
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of,
ROBERT & NANCY SHAW 2300 ALDRICH LANE, LAUREL, N.Y.
in the following location; �j Basement [i ht Fl. ❑ 8nd Fl. OUT Section Block 01 Lot 13
alas examined on JANUARY 10,1997 and found to be in compliance with the National Electrical Code.
RXTMt EClPTACLES SWITCNK FIXTURES COOKING DICKS OVENS DI W RUST FANS
INCANDESCENT H110RlSClNT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. AMT. H.P.
10 18 15 10 1 F
DRYERS RJRNACK MOTORS PUTUN APPLIANCE MONS SPECIAL REC'PT TIAQ LOCKS E!LL UNIT MATERS ARIL ERS
AMT. K.W. OIL H.P. GAS M.P. AMT. NO. A.W.G. AMT. AM►. AMT. AMPS. TRANS. AMT. H:`►. ..,MMT. WATTS
SERVICE WSCONNtCT NO.Oi S E R I c E
AMT.
Amp. TYP! mom
1/2W 1,I 3W 3./3W 30 4W NO.F &CONDI. W: NO.OF WI•LEG ��W. NO. NEUTRALS OF W.NEURAL
OTHER APPARATUS:
i
PADDLE FANS-4
MOTORS.4-F H.P.
G.F.C.I:-2
SMOKE DETECTOR:-3
JAMES MURRAY LIC.#3653
P.O.BOX 305
LAUREL, NY, 11.948 0 DOM MANAM
11
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT, BE ALTERED IN ANY MANNER.
y,�o�og�FfOL�-�oGy
A
Town Hall, 53095 Main Road Y CO = Fax (516)765-1823
P. O. Box 1179 ` - Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N Q
DATE: L,
Building Pe it No.
Owner: J
(please print)
Plumber:
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 18 lead.
�°R" �TOA"� Sa (P umbers Signature)
9afa4.`. 4 OLcy.
d
4F832323 &-w4484&
Sworn to before me this
day of 19
Notary Public, County
//� ASAI
OF SO�T�o�
N p•
�n coum,
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]"!N CATION
[ ]
FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE �/ ty �� INSPECTOR
1 1141.1) RVII(MI DA I I.; Cut IIIIAl 1!;
--------- ---------------
FOUNDATI011 RID)
------ -------- ---------- - ------------------t
ROIJCII FRANC
PLUMBING
----------------------- ------------------ -------------- ---------- -----------
11)SULATION PER U. Y . II
------- -----
SIAIIF ENERGY
I;ONIi
---------------- ------- -----------------------7----------Z--------06----
A--z
----------
F IIIA I.
of
------------ ---- -------
Al)l)l'IIOIIAI, COUNIOICS:
---------------------------------------------- --------------------------------------------
- ------------
M-1802
BUILDING DEPT.
NSPECTION
[ F NDATION IST [ ] ROUGH PLBG.
T [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: _
DATE WO INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ wl FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE Iq 6 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ UGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE161j-p 19r, INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] R PLBG.
FOUNDATION 2ND INSULATION
[ l [
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: -
`7'Ea a
DATE �� INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FO DATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: .l� _
DATE ZO INSPECTOR
;23 36 J-]�-
M-lW2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLB
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
ice- � 6 -------
DATE �j� INSPECTO
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)
//.......................... �i
Date......................./ 19...........
NP 23365 Z
Permission Is hereby granted to:
�/�- 1........ 4 '�
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.../ 'er.. ....;s"...........................................
�, !��1 ...... ........//. 9,�,P........................
to ....�-"?+"'"Ir.��Gf .clf..-.............e............J!tir......0 ... ...../�P,�./.rZ.�l-✓..........�.........,......
�� '�..... �✓.r.. <c✓l
..........ch✓ ......./` ....... .�
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— ... ................
12�f.........�� '1� �t............ Ott .f....................... ................................................................
...................................................................................................................................................
........................................................ ...
...............cfQ��/� J�✓............. .................................I....I.................—...
at premises located at...........fT..✓.�.....././...` ! f '
�^^ .4................. ....................................................
County Tax Map No. 1000 Section .....�Qt41........... Block........41...//.......... Lot No. .... .:. . .........
pursuant to application dated ............... /.,J................................, 19....,�$0.., and approved by The
Building Inspector.
Fee S•• .f!!./..-...........
.............. .1 ! a...........................
I......
ilding Inspector
Rev. 6/30/80
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET . VILLAGE DIST.1 SUB. LOT 1
FORMER OWNER Cabne( 4u> N E ACR.
S W TYPE OF BUILDING)
f t —1 . /--al
RES. ' SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
4, :21 r
5 Yp44 0 • `>+ei 1<r
0133- 410'10 3- 410'10 AI -CC rre * v 6haiv 41, ,
oh e) (z g�� 4E -�q �) ice. I s/ — CDnS ne ' 1 c�v�el - 000 ,
t, o 6,<60 gyoo 5 � 1/ co
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD loo
Meadowland DEPTH
House Plot BULKHEAD
Total
BOARD OF HEALTH
VOUH no. 1 — 3 GETS OF PLANS . . . .
r" TOWN OF SOIITHOLD s SURVEY ♦ . . . . . . . . . . .
' BUILDING HRPARTHRHT ,� CHECK . . . . . . . . . . . . . . . . . . . . . . . .
APr - 3 ; t `3 '101411 NALL SEPTIC FOAM . . . . . . . . . . . . . . . . . . .
S(111'IHDIM, N.Y. 11971
; ; DEPT. TEL: 765- 1802 NOTA RY.*
j CALL
Iix;aiuned......'//... 9.p7,/.� p1 / MAIL 7'0: . . . . . . . . . . . . . . . . . . . .
Approved.......7.6/L:...., 19.t IF. Permit mi. .0016.31..... .......................... .... .... . .
Disally"Wed o/c .................... .............. ................... ... ........ .. ....
......... .... .......................... ......... ... ...
(Rusin u iremecfo .'•...
APPLICATION FOR BUILDING PERMIT
Date . . . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
A. 'Thin nppl lentiau oust be cuydetely fillers in by 1-llmurbte_r or in init taxi nulndttel to die Building Innlreclor with
3 rein of pinna, Accurate plot pinn to scale. Vee according In nchrrdale.
b. Plot plan donning location of lot: and of buildings our premises, relationship to adjoining premises or public
nlreels or nrenn, And giving a retailed rescriptAcia of Inyo nt of property oust Ire drmai or (.Ire dingrem which in part of
, thin nppdbcntlor.
c. 'tile work covered by thin application may on. Ire casrenxted before iaaanwe of Bollding Pennit.
d. Upon npprrovnl of thin Application, the Bsilding Inspector will issue a Banding Permit In the applicant, lkmh
permit shall pre kept on the premises available for iwinpectior thiorginnut the work.
e. wr boilding shall be occlopied or used in whole or in part for any purpose whatever until a certificate of
Occwpasmy similhave been grunted by lire Belding Inspector.
APPLICAFI(N 13 IIEIIIiItY MADE to the Building Depnrtaent for (lie inmuax.e of a Building Permit polimant to tine
Ikiildlog Zane Orditarwe of the 'Ibwn of Southold, Soffodk Coaly, Nei York, rind other nppiicable Laws, Ordinances win
Regulations, for Ile caatnx-tion ofhaildings, okditioa or Alterations, or for runoval or demolition, ria herein
dencildxd. 'Ile applicant ngrees to comply with nll Applicable laws, ordiomx:en, Ixllding cod, Imxahmg cock, mxl
regulntbons, and to rubdL anrtlnrized Immpeclorn au prrmminen not in poi ldinI for CP.flnAry bnpect.loo.
.............. .. . ...
(Signature of apprlknot, or nine, if. n corpointion)
11 (
(Mailing address of: Applicant)
!,'(;lie opener Applicant is nae lessee, ngent., ar(hil:ect, engineer, gererril con:rnctor, electrician, plrnier or builder.
........ ....... ...................... ... ........ . .... ...... :......... ....... .... ............................... .. . .... ..
Nine of ager of premises .. ..
(nn Oil the tam roll Or- intent 17(ted)
If nppdicunt in it corpxrratior, signature of duly mr(horized officer,
.. .... ............... .... ...... ...... ....... . ......... ...
(one and Cilie of cotporal.e officer) l
Builders License Cir. ....... `c..
Pludern Licenne No. ...... ..
......... ........
Electricians License No. .,V�!�.. uJ� Q c9gy cooC. �m
011ier Trunk's Licenne lir. ....................
I. Incatiom of lad on whuirlr proposed work will. Ire done......... ... ........ . ........................ .................
X300 efi..1r�� �C�u/ .. ................................
... ............
House Boier Street �j J hamlet
County 'tax Wap Mr. IOCO Section .....� CZv. .... Rlrxtk . .....O!,... .. dol: .. .....45
.ex ilxlivbsirxm .. .`^-..!--I.. 4.1o..`.�.��..... . Filed Wnp Iir. �0..��l J�.C?.(.... Int ..1J.........
2. Stole existing one and ocagrao:y of pprrpedineir uol intentleed use and owcuprarxy of proposed coatnmctiun:
a. Existing use anxl awoularx:y ..... . ... ......... ..... ....?. .. . ......... ...........
h. intended wine mod occupancy .... 1..`lxgn.. /. An AP / ....... ......
I.......
I. I!ihnU of wlk (cln:ck %All(71 algd Icublle); Ika I0 Id'Ing . . . . . .. .. . N1,11t ion . . . . . Al Ierol ion . . ... .. .. .
I11011' ....... . .. . . Itr]INVr1I .......... ... Ileerll Il.ion . .. . . . . . . . .. Mller Unit
. . .. . . ..... . .. . ........ . . . . . ... .. .
(01ea:r 1pftoll)
/e. Est Inuded Guo .. . ./J)r.KKY.. . .. . .. . fee . . ...... . . .... . . .. . .. . . .. .. . . •
On be field on f11 Ing 1111e 111,V1 ico(.lost)
'i. If d.n!ll hill, unller of rAiell lug all Ia . ..... .. ... . Mier of Met I loll anila 1x1 each flrxlr . . . . . . ... ...... .
1F llunyle, otelser of care . . ...... . . . .... . . .. .. . ... . .. . . . . .. . .. .
6. If ixalneen, calmarcinl or mixed ocrulunx:y, sllecif'y nalt n! mal enleut of eoth lylie of tine. .. . . . . . .. . . .. . . . . ....
2. Dinensirom of exist lug Arockoren, If any: FrnoL. . . . . . . . .. ... . . . Iteur .. . . . . .. . . .. . . . Depth . . . . . .. . . . . . .....
Ikeigllf ... ... . . . ...... ..... ..... Reiser of Slorlen . . . . .. . . . . . . ... . . . . . . .
OinMawlalm of erne sl nxaure with utteruLiona or lddlilons: 1'rout . .. . . . . . .. . . . .. Item ... .. .... .... . .
Ik!plh .... .. .............. Ikeigllt . . . . . . .... . . ... .. .. . Muller of Hlorir.n . . . . ... . .. . . . . .
H. Ilimenlllrxa of wAllee Hate; tram"l Ma.ia1; Front. . . . . . . .. . Mar .. . . . . . . . . . . .. . Ikgllh .. ./. . .
Ikeiglil. .. .. . ......... .... 1#mlxer of tilorieu ... . .If
9. Sire of loL; [honit ... ....... . ... . . . ... Rear .. . .. .. .... . . . . . .. . . Depth . . . . .. . .. .. .... ... . .
Ill. Ikde of 1111clmae . ......... ... ... .... . tlnne of fouler tkater .. . . . .. ... . . ... . . .. .. ... ... ... .. .. ......
11. 7ooe or use dito rict In tAlIch preuisee ire situated . ... . . . ... . . .... ... . . ... . .. . .. . . .... . ... . . ... .... . . . . .. .. . ..
12. IkWa 111'01siumll CaWL"MAIa1 violate erg uxliug line„onldornce or rewdul.!nil: . . . . . . . .... .. .... .. .....
I7. NI11 lot lie regraded ........ . . .... Will excess fill lie relived fr'nn plenlnee; Yli:i (Tow
M. Mien of lkan!r of prenlses « pp-tema Ik . .�
'
Rue of .. ...... .. ...
Arcllitecr .. ...... .. ..... ... . . . .. .. .. .. . ... . Mklrean .. .. . . . .. . . . . . ... . .... ........ Mora Nn. . . . ... . . ... .. .
Niue of QM1tractor .........-5n.1... ..... .... . . ... . Mill one . . ...... ........ . ..Moon Us.
11. Is [hie prolxu ly wilhht AX) feel: of a tidal txflalxdl a Y1:9 N0 .. . ... ....
All yvs, 'XAIIIKXI) 'film 'Ilultillum ivimrf my IXi ltpp I1um.
1'1.01* II IACIIAH
llical.e clearly and distinctly all buildings, Jualber exlaLlug or proposed, and halicrlte till end:-back diuenalunu
f'tul looilnuty lines. Give street text block rnul Mer or description uccoreling to deed, axd shite+ atreeL neren end llxlicrllis
%Airther inlnrior or corner lot:. I�p �1
�l ...._.._.______ .___. ..
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IXXIIIIY IX'• �.[.!.lr! .4 .�. . . 11 ��
. . ... . . . ^ /� .�. LI�_______._..--.Ixtiug duly Immo, 11LIXemu mini Hoye that he ho lbs nppl Icmul.
/.IV/. .. . . .... ..... . . .
(Ilene til' individual. signing colicktic,
above olumd, J )
ileiit; Ilse . . . . . .. . . . . . . . . . ... ... . )�`.-^.! nj . l. . . . . . . . . . .. .. .. . .. . .. .. .. . ... . . . . ..... . ... . .............. . .
( ind.ructor, ragout, coilnu ate officer, etc.)
of nnid 1A'oel or uaMiro, and In duly uuthurlzed In jerloim or bravo pal loused Ih1! uudd tank and to nuke and lido (hill
npplicut ion; Ilul till ntnleseeuLu cunfaiiml in thin npplirotiun one Iala Lo the heat of hill knowledge. and Ix!lief; mnl
1hul. the mok will be 1lerfoneed lit Iho unuaer net. linlh in [he uppl icution filed Iheicallb.
:kaon In IroAwa u a [his
Aof ..... . ✓t. .l. l9
. . ...
tkd illy IN11d . . . . . .. ....... ... ..
/ Giil;uatlne 1�icuu ) �✓ '."'•L�""
Notary uti ILII c, State oIRE L. f New York
79505
Qualifi d!In Suffolk County <
Commission Expires December 8,18 `
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SURVEY FOR
ROBERT SHAW a NANCY SHAW NOV 15, 1989
LOT 13 LAUREL ESTATES EAST, SECT. I" AUG. 15,1988
AT LAUREL DATE JULY 25,1988
TOWN OF SOUTHOLD SCALE I "=50'
SUFFOLK COUNTY, NEW YORK No. 88-0887
*UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED T0:
SURVEY G A VIOLATION OF SECTION 7209 OF THE - FIRST AME , SURANCE
NEW YORK STATE EDUCATION LAW
PA
*COPIES OF THIS SURVEY NOT KARNS THE LAND ROBESSS R O
SURVEVOR'S INK(D TEAL O EMBOSSED SEAL SHALL
NOT GE CONSIDERED TO ME A VALID TRUE COPY
,GUARANTEES INDICATED HEREON SMALL RUM ONLY TO NAN Y i0 t
THE PERSON PON WHOM THE SURVEY IS PREPARED SO S S
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND a HIS BEHALF TO THE TITLE COMPANY,GOVERN-
NEAREST WATER GAIN_MLI *SOURCE OF WATER, Pwl*TE -�PUBLIC_ MENTAL AGENCY AND LENDINS INSTITUTION LISTED
M SURF CO. TAX MAP DIET 1000 SECTION 126 BLOCK 01 LpT 2,22 HEREON,AND TO THE ASSISNEES OF THE LENDING
*THERE ARE MD DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
M TME WATER SUPPLY AMD SEWAGE DISPOSAL SYSTEM FOR THISRRIDEMCE OWNERS
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES
Of HEALTH SERVICES. TOEKISTIMS STRUCTURES ARE FOR ASPECIFIC 4.
' m-
APPLICANT- PROPERTYPURPSEALINESRORROT FO TTHEESTABLISH ERECTION USED TOEOF FENCES ALE* S4LIO
ADDRESS
TEL. YOUNG a YOUNG �RHT o"�w,ORE
NOTE) n=STAKE ■ = MONUMENT
ALDEN W.YOUNG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y_S.LICENSE NO.12845
SUFFOLK COUNTY ON APRIL 4 , 1985 AS FILE NO.7870
HOWARD W.YOUNG, LAND SURVEYOR
*1HELOCATXHMOFWMLIWI,SEPTICTAMH(BTTGCEOPOOLSW)SNOWM MEREON N.Y.S.LICENSE N0.45893
ARE PROM FIELD O WATIONS MID ON DATA OBTAINED FROM OTHERS
BRANDIS & SONS INC. 1046