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HomeMy WebLinkAbout37418-Z Town of Southold Anuex ~r '~FFOI,f 8/13/2013 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37418 Date: 8/13/2013 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 1400 Aldrich Ln, Laurel, SCTM 473889 Sec/Block/Lot: 125.-1-2.13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/19/2012 pursuant to which Building Permit No. 37418 dated 8/2/2012 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: addition to an existine one family dwelling as applied for. The certificate is issued to Gillmore, Francisco (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37418 8/7/13 PLUMBERS CERTIFICATION DATED 4/12/13 Pete Victoria o ~ Si ture ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE 'ffi SOUTHOLD, NY * .m~`n BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit 37418 Date: 8/2/2012 Permission is hereby granted to: Gillmore, Francisco _ 3165 Route 25 Laurel, NY 11948 To: Addition & Alterations to a Single Family Dwelling; Bedroom, Bath & Windows, as applied for. At premises located at: 1400 Aldrich Ln, Laurel SCTM # 473889 Sec/Block/Lot # 125.-1-2.13 Pursuant to application dated 6/19/2012. and approved by the Building Inspector. To expire on 2/1/2014. Fees: CO -ADDITION TO DWELLING $50.00 SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $387.20 Total: $437.20 Building Inspector Form No.6 ~ ~ r ~ I~ TOWN OF SOUTHOLD. ~Q . BUILDING DEPARTMENT "P'"" Qa l TOWN HALL C> 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 aew building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natttra} or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage~isposal (S-9 fotm). 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 2110 of 1 % lead. 5. Commeroial 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 Apri14, 1957) non-rnnforming 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 Buitding Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool X50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certifteafe of Occupancy on Pre-existing Buitding - $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 77 Date. ~ J ~ ~ Z New Construction: Old or Pre-existing Building: check oneJ - Location of Property: 1~D0 (J/~ 1 I-( ~A,U~ ~~p~ House No. f Street Hamlet Owner or Owners of Property: _ r /Q f3 /~D Gt I Sly C~ ~ I LG /Yt Q R b . Suffolk County Tax Map No 1000, Section /,~5~ Block / Lot ~ ~ 3 Subdivision ' L Filed Map. ~t Lot: Permit No. ~J ~ 7 ~ ~ Date of Permit. 8"~ - / Z Applicant: t- f7 /1 7J 0 Health Dept. Approval: Underwriters Approval: _ . Planning Board Approval: , / Request for: Temporary Certificate Final Certificate: ? ( eck on Fee Submitted: $ ~Q c Appli tt Sig e 'ogUFFO[K Town Hall Annex ~~r cQ~ Telephone (631) 765-1802 54375 Main Road ~ ? Fax (631) 765-9502 P.O. Box 1179 G • Southold, NY 11971-0959 'y~pl } ,~.a4~' roger richertantown.southold.nv.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Francisco Gillmore Address: 1400 Aldrich Lane City: Laurel St: NY Zip: 11948 Building Permit 37418 Section: 125 Block: 1 Lot: 2.13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: J,11/~l Electric License No: 4664-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pod New Renovation 2nd Floor Hat Tub Addition X Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 8 Ceiling Fixures HID Fixtures Service 3 ph Hot W ater GFCI Recpt 1 Wall Fixtures 1 Smdce Detectors 1 Main Panel A/C Condenser Single Recpt Recessed Fixtures 6 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency FiMUres Time Clocks Disconnect SwRches 5 Twist Lock Exit Fixtures TVSS other Equipment: 1-paddle fan, 1-exhaust fan, 1-electric base board heater (3 ft) Niles: Inspector Signature: ~p.L ~i=~~f' Date: Aug 7 2013 ElecMcal Certificate.xls n TEG. 765-1842 Q~~FFn(k~o TUNN Ol% SOUTIIOI.D Z ~~c OfPICE OF DUILnING INSPECTOR o ~ P.O. DOX 728 a ~ ~ SOUT IOLV NnY. i 197! ~01,~,~~~ D~~~~~1~~ ~~-9~ D C E R T I P I C n T I O N BLDG GEFT. TOWN GF SOU~AOLD .Date l jZ l~._ building Permit No. 3 owner t'rltnG~sCD G/~OPe (p eas`e` p=>.nt) Plumber Q~ y~(. C~ (please prim i certify that the solder used in the water supply system contains Iess titan 2/10 of 1B lead. (plumber's signature) S~:orn to before me this - --day of S~r(~-~/„ Notary Public Notary Public, ~"tv vC County ROBERTA MA2ZAFERRO NOTARY AUBLIC - S7ATE OF NEW YORK NO. O1MA6207376 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 15, 20 ~3 # ~OF SO(/jy~*c TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION F DATION 1ST [ ] ROUGN PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT COIISTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ r`-,U/~ DATE ~ INSPECTOR TOWN OF SOUTFIOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOU TION 1ST [ ]ROUGH PLBG. [ ] F NDATION 2ND [ ]INSULATION [ FRAMING /STRAPPING [ ]FINAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROU,G/H) [ ]ELECTRICAL (FINAL) REMARKS: O ~S-T L~ ~ ~1~~2~~i.J~~`-u DATE ` 3 INSPECTOR ~fi~.~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ } FOUN TION 1ST [ ]ROUGH PLBG. [ ] F NDATION 2ND [ ]INSULATION [ FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ l FIRE RESISTANT CONSTRUC710N [ ]FIRE RESISTANT' PENETRATION [ ]ELECTRICAL (ROUGH) [ ] E CTRICAL (FI REMARKS: S DATE / ` ~ ~ INSPECTOR 1 O~,AOf S0~/% TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION ~J ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ ~ , DATE ~ ~ INSPECTOR ~ o~~,OF 80f/T,y_ Q// ' f 'Y6~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC N [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ - .~-~1 z / ~ DATE ~ INSPECTOR 3 ~ T / X ~ ~o~MOF 80(/r,~o<o TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUG PLBG. [ ]FOUNDATION 2ND [ ] I CATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: DATE ~ ~ 3 INSPECTOR o~,~Of SOGIy~ ~ ~~C~ TOWN OF SOUTNOLD BUILDING DEPT. 765•i 802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE l INSPECTOR ' FID'S,D N ~nRT DATE COMMENTS v FOUNDATION (1ST) ~ ; oQ. a `1 r FOUNDATION (2ND) / o cc.~sJ' ,o o o L ~ ~y7 I~1 ROU6R FRgNIYnTG & , ~ , t~ PLUMBING , r--~ ~~~yy INSULATION PER N. Y. H STATE ENERGY CODE / , FINAL , ~a / ADDTTIONAL COMMENTS p P ..s ~ 9 3 ~ d, 1 L C' j O a 0 z D~ e n~ TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 2 .7 t„[ ~ p Survey www. northfork.net/Southold/ PERMIT NO. 7 fl` b Check Septic Form ~ i ~ ~ ' p/ 12 N.Y.S.D.E.C. I b a IS ~ Trustees Examined , 20 I Contact: Approved ~ ~ , 20 / ~ ~ N ~ g 1Q~ ~ Mail to: ~.Hiaf~p, ~i i TOWN OOF SOUTHOLD Phone: Z ~ IR~`~/ Expiration ~ , 20 r Building Inspector APPLICATION FOR BUILDING PERMIT Date ~-~Zj~" / , 201 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 azeas, and waterways. 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 a 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 par[ for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. £ Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. tore of applicant or name, if a corporation) i7s //95~- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~y~,u~~ Name of owner of premises ~-,t~ip,GN,~,,,?'~~i/GG,~Ia,P..F (t1s on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: l'~~ ~ l~2iGlJ 1~4.v,~' L~~LALL'G- House Number 'Street Hamlet County Tax Map No. 1000 Section /2 S Block O( Lot 2. ~3 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premise!s ~an~d intended use and occupancy of proposed construction: a. Existing use and occupancy /~J~F +LS~ b. Intended use and occupancy ~1.T~5.~/G&' 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor If garage, number of cars / 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if 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 /G ~9 Reaz 9 Depth /Z! /D ~ Height Number of Stories / 9. Size of lot: Front /G?'J ~ Rear /O6 ~ Depth ~,6c1~ ~ 10. Date of Purchase Name of Former O~wJner 11. Zone or use district in which premises are situated /«~~ra~,lltl, 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO x 13. Will lot be re-graded? YES_ N(yG WGill~ex~cespstf~ill be removed from premises? YES NO_ 14. Names of Owner of premises~~'y'~-'~ 7"-" ""~iddress~~0/Q Phone No. Name of ' --`~=--t FtY.~o~~~"or[.c,~TlatraatAddress~ s -458 Phone No Z9~-19~~ Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO~i * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFS~-F~. n n ~h ~ in l ~Mr; being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~ Y (Con t r, 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 application filed therewith. Sworn to before me this ~ 8' day of 20 12 ~ ~ ~ Notary Public -y_~.d` r of Applicant LYNDA M'1s9HM- NOTARY PUBLtC, State of New York NO.Ot 806020J32, Suffolk County Term Expires March 8, 20~- _ ~ _ ~ Town of Southold -Chapter 236 - Stormwater Management ~ ~ SWPPP -Storm Water Pollution Prevention Plam Assessme~rt Form GF.tyF.RAi. IIVFOItMATION: (All estsd Information is far a Com lete A ) •nuc~wr wuE: Ow.-rteee•oasrrr- o,.r oMacwo.r.....~o..-.o o¢S' a a [-(M! C ~ u E~w6 °1epi4'"d8~ ~ Gbt LA a>rfne'o~ao.dooomacionAc9~iq.llrovad8uaeideYlb Bait fl 9heduda.HLP..P~tasmDa~9epmxdca..t.mionA~i9 NrMdCa!-mrdhrCa~Yet Pr.ae ansereeMfarYnoYrraimdaarvPr: ___f_~1~~.C_~~IY!V__LSC_~LY~:''-?-- ------4~ -.b'~G'iScv'C~fQt~ I¢-ate '~_`lalift__ ~7T/ttN~~~7T lNw~ d Iti•Nir t M eniitls~ ~ Y~Ya~~w d ('a~b~ CaeYal hsMe _ ~x~.w.Frioe~ ~o_w,trc~s_?,72.G_Y_--- e-te.ta r_,~IrJC! e~_?_?I_ s"~~~,Nl!?c~ ~YL7~ O~ !!J-rte r~---------`----------'----- TawM..aru rarN..atlamotitrsrp 2 nworo~wbow,b.Mw Z~ `_a~$_~l_.eS?!!~!~!~'!VY__!v!7_<_L~~`____ nv.,...n aF-,.ter `--Nor .w_~~n9?~G!V~----------------- ~ rr-a __~Ti-• ~ YYBl thls Project Wsttabe llre ('for Man Aerea at MyOae Tyne Dmtnp tlra Propomd Development? Yos ~ "'r___________________________________________ er~rr.w~e.wwraer.uar j~ a. Does tha Apglanl haveaQrMed Yrpeitor On 1 BhttTo txorrdud tlw RePtlred w 7 m b. Dom Nel3IAIPPP Indinle Flow FraquardyMSae Wtew iMttesOe~derrdrVdreY/~MdMdreeirdarWrwes bupecYorre wi Oeera aMrorWM Parbd of TYm7 Yee ~ G Dom the SVMPPP Mequdey tlwNyNTampaay Q Q - erdlorPwrtwnpd8d91eheBrdonMemtem? Ym t1e d Dom the 9WPPP MewMey IdsnWy a Qompbb Q e. Dom the$WPPP~fndcete Ad611onaI3Aa Speotac Yam Noo amd ~er~e.errp4~.anl~ure.u-^• PwatlmetlrtVW be lxtRedbReteat Watart~yZ Ym NO f. rim uwAppBtairt subnalbdearmgebd Dwc WaBOe O Q rye.d ta~e.e wrre.brto tar.a..t r.r..aawi4Ar...w.e.ra or ktant and SWPPP Aeoeptenoe Form for Review ty the Town at Siouarotl 7 Ym No SPATE OF NFW YORK, CO^U7-NIT OF SS That 1, ~s..~Al'_!3]....~.S,c~ heiog duly ewom. s and aye tha[ hdshe;s the applioot f~ Peru, {tt.m. a wadesr.d+q t~j..___. And thatherbi6isthe ...._._...._..ttT.ntd" (o.e:, c"ni~ace.,~aeR OepersOie<,de) Owner arx(/or neptesenhtive of the Owner or Owners. and is duly atdhaiaed m perform ar have pe<fatmed the said work and m make and file this appfiation; that all stabrments conhemed in this appfiption are hue b the bat oihis kmwledae and betieF, and drat the work will be uerformed in the manner sa Earth in tlx applinfion filed herewith. Sworn toQbef~me dns 5.2........_. aay of _ , 20,.~ Notary Public:... .c BONNIE t dllpeorq EMIPPP Assenamemt FORMS 12 o ry ublic;State Of Newyork No. O]D06095328, Suffolk C my Term ExpiresJuly 7, 20~, ~o~~OE S!t(/r~~ Towu Einli Annex l~t ~ TdeRRp~~h~~one (631) 7651802 5 pSgMainRog ~e f0SlefrichertCCnIOVR11~O~.nV.US = Southold I~fY 11971-0959 ~ ~YII ~ •Y BLfIIDING DEPARTMENT TOWN OF SOUTHOILD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: /3 .Company Name: Name: License No.: 66 4 F Address: P©. o D ~ / / 3 ~ ~ Phone No.: ~6 oG.J 86 6 JOBSITE INFORMATION: (*Indicates required information) *Name: !'1^QnC(SGD Gi~~120%C `Address: !~{DO ~/dr~~C~1 ~c2~1e l l~-~78 `Cross Street: ,Q~C Z~ *Phone Na.: ~ ,Z QB ` 14,Z~ r,~ll 9.Z~ ' ~ Permit No.: Tax Map District: 1000 Sections 145- Biock Lot:_ "BRIEF DESCRIPTION OF WORK `(Please Print Clearly) ~e Q~YOOIY2 ~ QQ '1"00/Y1 ~ i~ (Please Circle AN That Apply) *Is job ready for inspection: YES / NO Rough In Final *bo~you need a Temp Certificate: YES i NO - Temp Information (If needed) `'SeNlce Size: 1 Phase 3Phase 100 150 200 300 350 400 Other `'New Sevice: Re-oonnecC Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION n~ ~ ~ ~ ~~5~ 82=Requestfw Inspection Form TOWN OF SOUTHOLD PRORERTY RECORD CARD I UJ~ s - i-~ 1~ ~~p i OWNER STREET VILLAGE DIST. SUB. LOT4 FORMER OWNE N E ACR. S fl nsrn a~-F ~igU,~J1~Q ~`Cr1~• A~~+"I'~~ S W TYPE OF BUILDING J ~ RES. Z I o SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. "TOTAL DATE REMARKS ~ l `'4 A 24 5 4 ~ f ~ ~o , (j.~ _ tJ to ~s v £'S 5 - ~ " A r ~ 7 k ~ 8 5v < i r. f; , / s zQ y< ~ 8 - L 0 r ~'li #an o ~2 - ~ o IS~~`' S2A0 (a-rAO 7~2z 9`?. 7 r3/9 -("3P~a~ol Con~f. One-~izm~ t~ .~i,~~Jl, ~45oo~~y p©o ~ ,~.OU 9q, ~ IIG oar- ~i• ~ l~T Ui ' S = %V C- ~~~o~~ goo i Zz a ~ -LII~ 'i,,, _ I In dJ~ ''/?~~o. 5o g o ~ - ( - ~ry-F ~v r ~ I I r>,t.Ure ~ u7~- H ~-z, r~ a4 ~v-sso~ Tillcble FRONTAGE ON WATER Woodlond FRONTAGE ON ROAD t O0 Meadowland DEPTH ,4 U ~ House Plot , 9 i $ ~(op~ BULKHEAD Total ' Cr'C.Q,.... 9 3~ - - k ti.rLQ 'hl i a ~Q4 N. Bldg , ~ x ,z ; i$9 Sze (5( Foundation Q ~ , Bath ~ ~z en i 18 Z = ~(Qg 55-° 257 Basement Pant ~l Floors :xtension F_xt. Walls v,Ny~ ~C interior. Finish S ~ ?xtCnsion Fire Place I Heat 'orch K 1g, ~~6 hp ~+f- Pool .Attic )eck 16Y ' ~Z,~ S` ~ ~3q Patio Rooms tst Floor ~ ~'p,,, ~ _„,K ~ i 3reezeway Driveway Rooms 2nd Floor J~~ 2 dR_ 3arage I~jX2.ta <$c> 375 p50 13. 5i45 :y . - 700 i ~aae~ On?SC 9~-9gOacC~%~~..e+.a. ~.,a 'L'NJ 5 ~2~: ~ e.P ~ 3~~/g BUILDING PERMIT EXAMINER CHECKLIST 'Date Submitted: ~ ~ Date Reviewed: ~_Q ~ Applicant: Jr~'~Y"r'~ ~•-d~'~-do--,~r~ Owner: -,4rehitecb'Engineer: ~ ~~~^-moo n Estimated Cost: ~ SCTM# 1000 - ~ °~'S ~ - ~.3 Subdivision: v""""im -"Z-on~ep: ~ ~ Conforming? Property Address: ~ a ~ ~ City: of-a-wt-e-~ Pre COs? Building Permits (Open/Expired): BP -Z / Go z- ,Info: BP -Z / Go z- ,Info: BP -Z / GO Z- ,Info BP -Z / C/0 Z- ,Info: BP -Z / GO Z- ,Info: Single & Separate Search Required? Y or~N)Deterrt?ination: SToRMW11.Y-~, RuN n,FF REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. do°To ACT: Lot Cov. REQ. Front ACT. Front REQ Side ACT. Side REQ. Reaz PROP. Rear REQ. Height. 35~ AC~~T~~.H~~eigttht RE6t, BOTH SIDES ACT Project D criptlon: G2~-cdr` o/- U/ ~ aa- Waterfront? Y or N If yes, water body: Panel# - Flood Zone: Bulkhead/Bluff Distance: 3 ADDITIONAL APPROVALS RE UIRED ALAN S SIGNED, SERLED o~4S+FR'dGY-CR SITE PI-AN af"C Saffolk County Health: Y o - If yes, *Bed#: *Date: *Permit#i Town Septic: Y• N - If no, certification required: Y or N Received: Y or N By: NYS DEC: e~t~osc vnns Y o~- Date: Permit or NJ Letter -Notes: Southold Trustees: Y o I~- Date: Permit or NJ Letter -Notes: Southold ZBA: Y o~i -Date: Permit -Notes: Southold Planning: Y o>~- Date: Permit -Notes: Town Landmark C of A: Y o~DTE: *NYS CODE C`omplianco (page 2): Y or N ~ CoNTRkCTgR t.tCEN ~_DISABJLITY_LIItBiLITy_w~~kMEN¢ CoMP~NS TIoN~~ Notes• ,~p_ ~ i -a Fee Structure: Calculation: /I// Foundation: - SF ~ b g X $ , T~ ~ $ 7 a-O First Floor: SF + Initial Fee: $ a'O O ~ O Second Floor: SF + Additional Fee $ Other: SF SF X $ , Total: p SF + Initial Fee: $ + Additional Fee ( $ C OF O FEES ~So•o0 AS BUILT FEE $ TOTAL:$ ~ 07~ 1 NEW YORK STATE CODE COMPLIANCE CHECIQ,IST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 20 ~ Wind Speed: 120MPH _ Selsmlc Design Category: B Weathering: Severe Frost Depth: 36" Termite: M-H Decay: S-M Design Temp: 11 Ice Shield Underlay: YES ~ Flood Haeards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: YIN LUMBER SPECIES AND GRADE: Y/N , WINDOW AND llOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N ~ LIGHT 8%: Y/N ~~ENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y(N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM:IY/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: ~/N ~RESCHEcK~ TOTAL COMPI,IENCE? Y/N (RETURN TO PAGE ONE) ho~~pF SOUlyolo Town Hall Annex Telephone (63 L) 765- LR02 54375 Main Road ~ ~ Fax (631) 765-9502 P.o. Box 1 l79 G, Q Southold, NY ] 1971-0959 ~ °~dCOU~ N~ BUILDING DEPARTMENT TOWN OF SOUTHOLD July 31, 2013 Francisco Gillmore 3165 Route 25 Laurel, NY 11948 Re: 1400 Aldrich Lane, Laurel TO WHOM IT MAY CONCERN: The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) ~I Underwriters Certificate. (contact your electrician) A fee of $50.00. Final Health Department Approval. ~ ~ , Plumbers Solder CertIflCBte. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (town Trustees # zss-tssz) Final Planning Board Approval. (Planning # ~s5-fs3s) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept BUILDING PERMIT: 37418 -Addition/Alterations