HomeMy WebLinkAbout35778-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
4/19/2012
No: 35551
Date: 4/19/2012
THIS CERTIFIES thatthe building
Location of Property:
SCTM#: 473889
Subdivision:
ADDITION/ALTERATION
575 Wells Rd, Laurel,
Sec/Block/Lot: 126.-8-20.1
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
Lot No.
filed in this officed dated
8/13/2010 pursuant to which Building Permit No. 35778 dated 8/13/2010
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:
nonhabitable second floor addition to an existing accessory garage/storage building.
The certificate is issued to
Harkoff, Dorian & Harkoff, Dennis
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
35778 4/11/12
Autl~rized Signature
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. 35778 Z Date AUGUST 13, 2010
Permission is hereby granted to:
DENNIS HARKOFF
P.O. BOX 1269
MATTITUCK,NY 11952
for :
CONSTRUCT SECOND FLOOR ADDITION TO ACCESSORY GARAGE & STOP, AGE
BLDG. FOR SAME USE.REPLACES EXPIRED BP # 13356
at premises located at
County Tax Map No. 473889 Section 126
pursuant to application dated AUGUST
Building Inspector to expire on FEBRUARY
575 WELLS RD LAUREL
Block 0008 Lot No. 020
13, 2010 and approved by the
13, 2012.
Fee $ 100.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TO~VN OF souTHOLD
BUILDIHG DEI~ARTMEHT
TO~'~ HALL
souTHOLD, N. Y.
BUILDIHG FE~J~IT
(THIS pERMIT MUST BE KEPT ON THE pREMISES uNTIL FULL
coMpLETIO~ OF THE WORK AUTHORIZED)
,,o .....~..~F~~ ....... /~ ....... , ,9..~
~6 Z
.......... Buil01ng
o.,. ~,/30/80
Fo~m No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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: I. Final survey of property with accurate location &all buildings, property lines, streets, and Ulmsual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical iustallation from Board of Fire Underwriters.
4. Sworn statement from plumber certifyi ~g that tile solder used m system contains less than 2/10 of I% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliauce from architect or engineer responsible for the §uildiug.
6. Submit Plalming 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:
I. Accurate survey of property sbowiug all property lines, streets, building and unusual natural or topographic
£eatures.
2. A properly completed application and consent to inspect signed by the apphcant. Ifa Certificate of Occupancy is
denied, the Building [nspecto~ shall state tile masons therefor in writing to the applicant.
C. Fees I. Certificate of Occupancy New dwelliug $50.00, Additions to dwelling $50.00. AJterations to dwelling $50.00,
Swimmiug pool $50.00, Accessory buildiug $50.00, Additions to accessory buildiug $50.00, 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 $[ 5.00
Date.
New Construction: Old or Pre-existi!!g Building:
t.,ocation of Property: l_ ).OJLt s,
House No. S~t
(check oue)
Hamlet
Suffolk CountyTax Map No 1000, Section
Su[division
Health Dept. Approval:
Planning Board Approval:
Date Of Permit.
Filed Map. Lot:
. Applicam:
Underwriters Approval:
Request/'or: Te~nporary Certificate
Fee Submitted: $
_ Final Certificate: (check one)
' Applicant Signature'
Bo
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
,~outhold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitte~to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of cqmpleted site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
I. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owne~ as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwe ng / land
3. Copy of certificate of occupancy $1.00
use--Fre-Existing C.O. $15.00
Vacant land C.O. $ 5.00
Date ...... .~,~...~..~.. ........
New Building ............. Old or Pre-existing Building ............ Vacant Land ... ~ ....
Location of Property . ~,~"~ .. ~,Lr,~,L. ~,, ~ ~.
..............................
House No. Street Hamlet
Owner or Owners of Property ...... [~. ~..~. J.~ ...... t ~.~A['-/'.~. .~.O. ~. ~-. ......................
County Tax Map No. 1000 Section .../'..,~ .~,,~. ..... Block ...... ~.. ...... Lot .... ,¢~-..~? .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board' Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Subm,,ted $.. .........
C(~nstruct[ort~n above described building and, Rermit meets all app! regulations.
~; O -2- / ~ ~ App cant , ~,¢,~ .............................
Rev. 10-10-78
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, NY 11971 0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
ro.qer, richertC,,town southo d ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Dennis Harkoff
Address: 525 Wells Rd City: Mattituck St: NY Zip: 11952
Building Permit#: 35778-36713 Section: 125 Block: 8 Lot: 20
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures ~ 21 Smoke Detectors
Recessed Fixtures~ CO Detectors
Fluorescent Fixture ~ Pumps
Emergency Fixtures~ Time Clocks
Exit Fixtures [~J TVSS
as built survey of sun room and detached garage, 2 paddle fans
Notes:
Inspector Signature: ~.~~
Date: April 11 2012
81-Cert Electrical Compliance Form.xls
TOWN OF SOUTHOLD BUILDING DEPT.
765-t 802
INSPECTION
[ ] FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
~FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE 3- ~--~ INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS', -
DATE
INSPECTOR ~-'~-.~~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING/STRAPPING ~FINAL /~/~
[ ] FIREPLACE&CHIMNEY [ ] FIRESArE:,flNSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] fiRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE
FIELD INSPE~T'IO~ ' COMMENTS
FOUNDATION
(1st)
FOUNDATION (2nd)
2 o
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
ODE
FINAL
ADDITIONAL COMMENTS:
'FORM NO. 1
.TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~ .. $OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .~./~... :.,1 /.~,~..~
Approved ./..v.~. ., 1~.. m~eermit No .........
Disapproved a/c ....... i . .~'~....~_~_...___~ ........... ~. .....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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 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
shali 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 applicable laws, ordinances, building code, housing code, and regulatigns, and to
admit authorized inspectors On premises and in building for necessary inspectipns. ~, _ ,~ f J
· ' · ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................ ~. W. LY r:.,'.~ .....................................................
Name of owner of premises . .~..~..~.[. ~. ..... ~./.~t. ]?. [~..O..ff.~ ~ ..........................................
(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 ..........................
Plumber's License No .........................
Electrician's License No ...... ~. ~-~..v~?. .......
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..... /?./.'/~. /. ¥.~--' /. /.' .~.~/. 9. ]~ .........................
· ..................... .2 .... ..........................................
House Number Street Hamlet
County Tax Map No. 1000 Section .. ~..~.~. ~. ........ Block. ..... ~. .......... Lot .... ~. .............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... ]~ ~ [.~. ~ ~r~.~. 6..~. ...... ~.p.(. (~ .... ~..~.~.~. ~. ~.~..e~. .........
b. Intendeduseand occupancy....... ~-.~'~g ,~. to.-. ~ ..... ~gie 3 :,... $:/..~. ~. ,~ .d~..~..
~ ~',~ &~ :;;~' i .......
3. Nature of work (check which applicable): New Building ..... ' .... ,. Addition .......... Alteration ...~....~...
Repair .............. Removal .............. Demolition .............. Other Work ...............
· . ~ (Description)
4. Estimated Cost ....... ~.O...~. 9..,. ~ Fee .. ./.., . ! .'~. .........................
.... ~" (to be paid on filing this application)
5. If dwelling, number of dwelling units ..... r~rx-.:; '.: ~.. Number of dwelling units on each floor ................
If garage, number of cars ....... ~. ...............................................................
6. If business, commercial or mixed occupancy, specify na~ture ~a~d extent of each ttype of, u?e ........... ~ ....;~...
7. Dimensions of~ejxisting structu~res, if any: Front..~.O....~.~ .... Rear . .3 P....~. .... Depth . .ff...ff../.q ......
Height .../.~. ......... Number of Stories ...... .~/:F?. ..., .....................
Dunens~ons of same stru,cture w~th alterations or additions Front ,~ 0 ~.. Rear ~.. o
Depth .. ,X/?(..../.4~ .......... Height ...... /..~. Number of Stories ..... ~../4cC..~ ........
8. Dimensions of,entre new construction: Front ...5..o. ~...~. ~ '.: Rear .. ~ O. :...~. ~ i.. Depth . ~..,4'..:/.~..~: ...
Height .... ,~'~. ........ Number of Stories ...... 5;;~/.~. .............
'z ' ..................... p . ................
9. S~ eof lot: Front ...... /.~.O. ........... Rear /.~,~ r ' De tl~ .......~v' ..............
10. Date of Purchase ............................. Name of Former Owner .............................
1 1. Zone or use district in which premises are situated ....... .~. 4'7-~ ........................................
12. Does proposed construction violate any zoning law, ordinance or regulation: . .P/. 19. ........................
13. Will lot be regraded ........ ~ {5 ............. ~ ,-,. Will excess f'fll be removed from premises: Yes
14. Name of Owner of premises tO. Ctlg. I ~ /-/~/?~.O/.zt/~Address ...~/.c.~Eb. ~../~l) .... Phone No.,~. f'. ?..~./.~.t~....
Name of Architect ............ ; .............. Address ................... Phone No ................
Name of Contractor ........ ~.&-.A-...~. .......... Address ................... Phone No ................
PLOT DIAGRAM
Locate clearly and distinctly all 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 coruer lot.
STATE OFNEW _c~K,~ ~ ~ SS
COUNTY ·
........ ~ - :~~.~~~ .......... being duly sworn, deposes md says that he is the applicant
named(N ' .
above
He is the ............. ~~ .............................................................
(~ctor, agent, corporate officer, etc.)
of said owner or ownem, ~d is duly authored to perfom or have perfomed the said wo{k and to m~e ~d file ~is
apphcation; that ri statements cont~ed ~ this application are true to the best of his ~owledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed ~erewith.
Sworn to before me this
~ '~2~2~~ ~//' ~ (S~atu~ of apphc~ )
FORM NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ~/ 19~.....~...
Approved ................. ~..~. ....... ~.~.. ........ , 19../.~.. Permit No....~.~.....~.....~Z......?.. ......
Disapproved a/c .~~~
INSTRUCTIONS
Application No. c~' 0 ~_~ ~
o. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Budding
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 ofproperty must be drawn on the diagram which is port of this application.
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 issue 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.
p
A PLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Bud ng 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 applicable laws, ordinances, building code, housing code, and regulations, and to~
admit authorized inspectors on premises and in buildings for necessary inspections.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...............................
Name of owner of prem ses ~ ..~x... ~~ ......................... ~'~Z~';~" ""~' ~-' '~'~' ~"~Z'"" '~'~ i'i':'~ ......
Bu der's kcense No .......... ~ ...............
Plumber's License No .................................................
Electrician's License No .............................................
Other Trode's License No ...............................................
1. Location of land on which proposed work will be done. Map No.: ................... ~ ............... Lot ~...
Street and Number ........ I~..~-/;.~..S;....~....~ .......... I.~...O ........... ~L...~..~.~....L.~...O.....~....~. ................. ../../..,~..~%~.....~:r... ............
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ................................................................................................................................
b. Intended use and occupancy ........... ~.....~/....~......6.?~?LJ~-.'~.. ..............................................................................
3. Noture of work (check which applicable): New Building'. ................. Addition .................. Alteration ................
Repair .................. Removol .................. DemoHtior ..................... Other Work ................................................ .
(Description)
4. Estimoted Cost / ~.~.OO - ~ CY Fee ~, b ~ .....
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................
cars ~ /'
If garage, number of ................... ~-.. .................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe of use ............................
7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height ............................ Number of Stories .................. ; .............
8. Dimensions of entire new construction: Front ...~...~ ...................... Rear ...... ~..~ ................ Depth ...~.~ ...........
Height .....Z~ ......... Number of Stories ..............~.~ ........................
9. Size of lot: Front ...............~.~...~ ........................... Rear ........ ~..~ ......................... Depth ..~....~...~.~.~...
10. Date of Purchase ........................................................ Name of Former ~ner ........................................................
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ............. ~.~ ...................................
13. Will lot be regraded .....~. ............. Will excess fill be removed from premises: ( ) Yes (~ No
14. Name of ~ner of premises .~....Z~.~/~ Addre~ ..~....~ ..... Phon~ No.~.~.:..~.(..~
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor ..............~/.~./~ .......................... A~ress ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from
prope~y lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW_Y~,__ ~ S S
COUNTY ,OF ....~...~.~.~..O...~..~.....: ....... f ·
........................... C~I~.].~..I~I~'.i~I~ .................................. being duly sworn, deposes and says that he is the applicant '
(Name of individual signing contraclO
above named.
He is the ................................. O',./rl.~.~" ............. . ...................
(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 statements 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 applicaffon filed therewith.
Sworn to before me this
....... .?...b~.. .......... day of ...... ..0~....~..O...~.?~. .................... -., 197~...
k
Notary Public, . ................. l~.~1~.~.~J .................. County ')1'" i ............................
ELIZABETH ANN NEVILL~
I~OTAt~Y PUBLIC, State of New York
No. 52-8125850, Suffolk Cou..flJ~
Tm'm Expires March~ 30, 19_~,
TOWN
OWNER
FORMER OWNER
OF SOUTHOLD
VL.
TOTAL
FARM
DATE
/7°
3/3/177
¢1/~1~
BUILDING CONDITION
BELOW ABOVE
value Per
Acre
Value
PROPERTY RECORD CARD
VILLAGE
DIST. SUB. LOT
//
REMARKS
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK
CO 'M~. 'CB.
~s.~&.~ s~s.
LANi~i c~ IMP.
Zoo
~ /
AGE
N~ NOeL
FA~ Acre
Tillable
W~l~nd
Meadow~d
Hou~ B~
Tot~ ~
E
TYPE OF BUILD!NG
Tram
-~ldg,
Extension
Extension
Extension
Porch
Breezewoy
patio
O.B.
Total
Foundc
~Bosen
~tion ~3th Dinette I
Floors K.
'ails InteriOr Finish LR.
~eot DR.
Lace
BR.
Loof Rooms Ist Floor
~tion Room Rooms 2nd~Floor FIN. B
Driveway
Fire I
Ret;ca
L 'Bldg.
Extension
Extension
Extension
COLOR
j Dineth
M. Bldg.
Extension
Extension
Extension
TOWN OF SOUTHOLD
OFFICF, OF BUILDING INSPECTOR
P.O, BOX 728
TOWN IIALL
SOUT}IOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. 13356Z issued to Doris Harkoff
on .... ~q/1~[8~4__ for Addition ia completed and
;~ final inspection has ( ) has not ( x ) been done.
An Underwriters Certificate is needed
in ordc, r to complete this file, it is necessary that
;i Certificate of Occupancy be issued. Please fit1 out the
enclosed form, return same to tile above office with a check
for $25.00payablc to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy ia to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupnnc¥. Please help u, to clear up this matter so that
legal action does eot have to be taken.
Thank you for yo,r prompt attention.
Very truly y~,
Victor Lesserd
Executive Administrator
VI,: ga r
encl .
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold. NY 11971-0959
Telephone (631 ) 765-1802
Fax (63 I) 765-9502
April 13, 2012
BUILDING DEPARTMENT
TOWN OF 8OUTI-IOLD
Dennis Harkoff
PO Box 1269
Mattituck, NY 11952
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
v//Application for Certificate of Occupancy. (Enclosed)
__ Electrical Underwriters Certificate. (contact your electrician)
Afee of $50.00.
Final Health Department Approval,
__ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
Trustees Certificate of Compliance. (Town Trustees # 765-1892)
Final Planning Board Approval. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT: 35778 - Addition
SURVEY OF PR()I~ERTY
,?ITUA TED A T
LAUREL
TOWN Of SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-126-08-19
10130-126-08-20
SCALE 1"=20'
DECEMBER 15, 2004
S.C. TAX No.
1000-126-08-19
S.C. TAX No.
1000- 1 26-08--20
TOTAL
DATA
~ 1,869.95 sq.
0,273
13,551.85 sq. ft.
0,311 ac.
25,421.80 sq. ft. i
0.584 ac.
Jo~
Land Surveyor
A. Ingegno
PHONE (631)727-2090 · :~ ,.
Ld
Z
S 01"41'10" E
! O0 00'
60,0'
C,
X
2 STORY
FRAME HOUSE
'100.07%
37.7'
200.00'
Y
209'
10~
TO~fN oF ~u~
207-.B0'
coNSTANc~
II-'I-TI II II
t lllll _Il
IIIllllll
~-' rl'l rlt '~{J. ~r[l :~tfZ