HomeMy WebLinkAbout36713-Z S�FFD4 Town of Southold Annex 4/16/2012
�4� C�fiy P.O.Box 1179
a, 54375 Main Road
oy Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35547 Date: 4/16/2012
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 575 Wells Rd, Laurel,
SCTM#: 473889 Sec/Block/Lot: 126.-8-20.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/9/2011 pursuant to which Building Permit No. 36713 dated 9/26/2011
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:
"as built" sunroom addition to an existing one family dwelling as applied for.
The certificate is issued to Harkoff,Dorian&Harkoff, Dennis
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36713 4/11/12
PLUMBERS CERTIFICATION DATED
000,
Auth ed Signature
FT'r `a TOWN OF SOUTHOLD
�SUFFo1,�coG
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
"oy • � + SOUTHOLD, NY
o
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#: 36713 Date: 9/26/2011
Permission is hereby granted,to:
Harkoff, Dorian & Harkoff, Dennis
PO BOX 1269
Mattituck, NY 11952
To: As-Built construction of a sunroom addition as applied for
At premises located at:
575 Wells Rd, Laurel
SCTM # 473889
Sec/Block/Lot# 126.-8-20.1
Pursuant to application dated 9/9/2011 and approved by the Building Inspector.
To expire on ,- 3/27/2013.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $576.80
CO -ADDITION TO DWELLING $50.00
Total: $626.80
.Building Inspector
Form 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:
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 Compliaiice'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:
L' 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool $50.00, Accessory building$50.00, Additions to accessory building$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 $1 5.00, Commercial $15.00
Date.
New Construction:_ v/ Old or Pre-existing Building: (check one)
Location of Property:
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section /ZG, Block Lot Z O
Subdivision Filed Map. Lot:
Permit No. lv �.3 Date of Permit. CJ Zi!� - f l Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (che e)
Fee Submitted: $ "7�
Applicant ignature
�O��pF SOUryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-95.02
P.O.Box 1179 Q roger.richert(d-)town.southold.ny.us
Southold,NY 11971-0959
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 X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage IX
INVENTORY
Service 1 ph Heat Duplec Recpt 25 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures 2 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 12 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt 1-30 Emergency Fixture Time Clocks
Disconnect Switches 16 Twist Lock Exit Fixtures TVSS El
Other Equipment: as built survey of sun room and detached garage, 2 paddle fans
Notes:
Inspector Signature: Date: April 11 2012
61-Cert Electrical Compliance Form.xls
�O��,OF SOUry�lo
co
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLOG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING (�] FINAL
[ ] FIREPLACE A CHIMNEY j ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: a�
3
DATE INSPECTOR
' r
FIELD INSPECTION REPORT DATE COMMENTS W
4�
FOUNDATION(1ST) �1
--- -------------- -------------
FOUNDATION(M) y
z
ROUGH FRA1VDNq&
PLUMBING
INSULATION PER N.Y. H
STATE ENERGY CODE
' y
FINAL
ADDITIONAL COMMENTS
m
IN z
I� IlurDa I"TOWN OF SOUTHOLD L� IS U BUILDING PERMIT APPLICATION CHECKLIS'
BUILDING DEPARTMEN Do you have or need the following,before applying
TOWN HALL Board of Health
` SOUTHOLD, NY 11971 SEP - 8 201 4 sets of Building Plans
j TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 BLDG.DEPT. Survey
Southold!Town.NorthFork.net 12VT TOLD �� 7J Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined 20 Single& Separate '
Storm-Water Assessment Form
Contact:
Approved ; ,r20 l' Mail to:
Disapproved a/c
Phone:
Expiration Ir?,20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date , 20_L
INSTRUCTIONS
j a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
i 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 part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. 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
i
authorized inspectors on premises and in building for necessary inspections.
I
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
i
I -
Name of owner of premises
(As 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 prop sed work will be done:
�t�s1�5 0A 1 U r--.I
House Number Street Hamlet
i County Tax Map No. 1000 Section /2( —Block p Lot
Subdivision Filed Map No. Lot
I
2. State existing use and occupancy of premises and intended use and occu ancy of proposed construction: "
a. Existing use and occupancy
b. Intended use and occupancy 3 1=P, - - I
3.' Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition . Other Work V-1- bun Rc=m
EI) J 7 (Description)
4. Estimated Cost Fee +„! 1,6
( be paid on filing this applicati6n)
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 /4 Rear. /qi ' Depth //,9 '
Height Number of Stories /
Dimensions of same structure with alterations or additions: Front Rear --
Depth Height — Number of Stories
i
8. Dimensions of entire new construction: Front. Rear — Depth
Height Number of Stories
i
9. 'Size of lot: Front ,601 Rear 202. Ad Depth 110.Z9'- 143',g3'
10. Date of Purchase 1%3- lgbl Name of Former Owner 0-F
11. Zone or use district in which premises are situated e-j0
i
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO >< Will excess fill be removed from premises? Yi S NO
14. Names of Owner of premises Address Phone No.
Name of Architect 5 e No 6aI -Z -64o z_
Name of Contractor Address Phone No.
As �.,tlk�hiy -
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO,X
* IF YES, SOUTHOLD TOWN TRUSTEES &D.F.-C. PERMITS MAY BE REQUIRED'.
b. Is this property within 300 feet of a tidal wetland? * YES NOS
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES NOS_
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OFS
benip-S 0ju-jZ D-F(- being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the t
(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 application filed therewith. THOMAS J•UHUNGER
Notary PubOo,Stet'of New York
No.01UH4733066
Sworn to before me this QuaIRM in Suf6k County
3 IJ day of A-'Jq J S T_ 201, ( Commission ExpiresFeb.26,20ffffr
�oA
Notary Public Signatur of Appl;.
I
t
Town of Southold:
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT i. w SSMENT FORM
° PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
JJ AW STORM-WATER,GRADING, AN
DRAINAGE D EROSION CONTROL PLAN
Ulstrfc� on eioTc- -Cot-- CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORKASSESSMENT Yes No
a. What is the Total Area of the Project Parcels?
(Include Total Area of all Parcels located within I Will this Project Retain All Stoml-Water Run-Off
the Scope of work for Proposed Construction) Z •$D S,(^ Generated by a Two(21 Inch Rainfall on Site?
b. What 19 the Total Area of Land Clearin (S.F.IAC�') (ihis.item will incluude all run-off treated by site
9 clearing and/or construdton activities as well as all — D
and/or Ground Disturbance for the proposed D Site Improvements and the permanent creation of
construction activil)R (3F/Acres) impervious surfaces.)
•.
PROVIDE BRIEF PROJECT Dncitr ITON (wovrar Ams w Pages es Necoaal 2 Does the Site Plan and/or Survey Show All Proposed
Drainage Structures Indicating Size&Location?This
Item-shall include all Proposed Grade Changes and •
]� D Slopes Controlling Surface Water Flow.
l�-� 3 Does the Site Plan and/or Survey describe the erosion
and sediment control practices that will be used to — I
control site erosion and storm water discharges. This
item must be maintained throughout the Entire
Construction Period.
4 Will thl$Project Require any Land Filling,Grading or �
Excavation.where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards
of Material within-any Parcel?
rj Will this Application Require Land Disturbing Activities
Encompassing an Area in Excess of Five Thousand y
(5,000 S.F.)Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site? is this Project within the Trustees jurisdiction
General DEC swPPP Requirements: or within One Hundred(100')feet of a Welland or- >�
Submission of a SWPPP Is required for all Construction activities involving Sol Beach?
disturbances of one 11)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes
are part of a i common plan that will ultimately disturb one more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to
- E]
including Construction activities involving sot disturbances of less
Than one(1)acre where One Hundred 100'the DEC has determined that a SPDES permit is required for storm.water discharges. ( ).Of Horizontal Distance? �•
(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will'Dnveways,Parking Areas or other Impervious
for Storm Water Discharges from Construction activity-Permit No.GP•0.10=001.) Surfaces be Sloped to Direct Stoml-1Nater Run-Off-
submitted .1.The SWPPP shall be prepared poor to the submittal nt the The t401 shag be into and/or in the direction of a Town right-of-way?
'submitted to the Department poor to the comm m enceent of construction
uction actindly.
2.The SWPPP shag describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material,
required,post-construction storm water management practices that VAI be used and/or Removal of Vegetation.and/or the Construction of any i
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliancewith the term and conditions of this permit.In addition,the SWPPPshafi Area?frhbnemwlpNortnuuaou,.lraanatlondn
identi►y.potential sources of pollution which may reasonably be expected to affect the rivewayApron&)
quality of storm water discharges. . NOTE: If Any Answer to-Questions,orie through Nine is Answered with a Check Mark
3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000•SF.31 Acre in area, f
component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage 3 Erosion Control Plan is Required by the Toxin of I
that fs knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit �
(NOTE A Check Mark(,I)andkr Aewer for each Question is Required for a Compete Appkation)
STATE OF NEW YORK,
COUNTY OF
Tbat I....................
duly sworn, p and h h
says that he/she is the applicant for Pernlit,
(Name of kirl�ividual atgnir�g Doaimenij�•••••..•••........being d deposes i
And that he/she is the .....................................
(Omer,Contractor.Agent.Corporate Officer,ela •.•.•...•.........•.........••.........•...........•..........
I
i
Owner and/or representative of the 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 i
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
...........................................day of............................................ 20
NotaryPublic: ..................... ..................................................
(Signalure of Applicant)
FORM - 06110
TOWN OF S. OUTHOLD PROPERTY RECORD LAW .
OWNER STREET VILLAGE DIST. SUB. LOT
.�
FORMER OWNER I � ACR. 1f
3/�
- - S W T� �l TYPE OF BUILDING
�+ �} _ _ ,
kES SEAS. VL. FARM COJ�+ ++t. C8. MIC Mkt. Value ,
LAI�IE� IMF. TOTAL DATE REMARKS
SA-
. ..
c 0-0
.fat. f
a c j 20 Q 7 6 0 ;/ 3 3 i 177 � � ���- t �� � 50
t A 3 # a
50o zz�v z7a o / ���3� 5 3 a
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Va[ue Per Value
Acre,
TilSnhie FRONTAGE ON VJAT£R
Woodland FRONTAGE ON ROAD
I
Meodowland DEPTH '
House v. BULKHEAD
DOCK
TotcP— I
VII� O OUTHOLD PROPERTY RECORD CARD
.
)yVi�fER 'STREET VILLAGE DIST. SUB. LOT
Le
=ORMER OWNER
qrr►, - E ACR.*/
. S :w TYPE OF BUILDING
'Jv
e-
SEAS. FARM C ytM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS �0 ! /t)� f rJi'f .► *a d �( �
ZQ, a +� 11 `T
TAQ
.moo 006
a� � .-� Ia:. :
AGd �! $t- CO DI Z l t p.- C&&iGr s62
EvY'
j :NORMAL BELOW ME
FA Acre Value.Ire r7 'Value
. O O Acre, p.. a 10
Tillable 1 00 R9V I Ko o 1/1/6 1 0
Tillat�6 i �� O Q
—Tillable 3 — - �
1+�oodland f1i ,' r L a At r' > -t 3 a --
Swampland FRONTAGE Ott WATER
Brushl and FROKTAGE ON-ROAD /AD X A 41
House Plot DEPTH
BULKHEAD
DOCK
Total
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
�ycDUN1Y,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
April 9, 2012
Dennis Harkoff
PO Box 1269
Mattituck, NY 11952
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (contact your electrician)
A fee 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 : 36713 — "As Built" Sunroom
r
d
IF
STATE OF NEW YORK, COUNTY OF SUFFOLK, ss.
Dennis C. Harkoff,being duly sworn, says:
1. I am the owner of 575 Wells Road, Laurel,NY 11948 as a joint tenant with the
right of survivorship with my sister, Dorian J. Harkoff. I reside at 1605 Pt. Pleasant
Road,Mattituck,NY 11952.
2. This affidavit is submitted in support of an application for the issuance of a
Certificate of Occupancy for a sunroom attached and added to the premises in 1971 (See
copy of Building Permit No. 5442 Z, dated August 4, 1971 granted to the owner, my
mother,Doris Harkoff, attached hereto as Exhibit"A"). A Certificate of Occupancy was
issued to the owner, my mother,Doris Harkoff on June 1, 1976 (See copy of Certificate
of Occupancy No. Z7062, attached hereto as Exhibit`B").
3. The subject premises were built in 1962 (See copy of Building Permit No.
1829 Z, dated July 19, 1962, granted to the owner,my mother, Doris Harkoff, attached
hereto as Exhibit"C"). A Certificate of Occupancy for the premises was issued to the
owner,my mother,Doris Harkoff on November 4, 1963 (See copy of Certificate of
Occupancy No. Z1753, attached hereto as Exhibit"D").
4. Finally, the Property Record Card on file with the Town of Southold reflects
that the premises were owned by my mother, Doris Harkoff from its initial construction
in 1962 and at the time the sunroom was added to the premises in 1971 (See copy of
Town of Southold Property Record Card No. 1000-126-8-19, attached hereto as Exhibit
"E"
Qennis . Hark
off
Subscpandrn to before meon Se011
Notary Public
My co ssion expires on
Paul J Renner
NOlery Public, State of New York
No.02RE6205080
Qualified in-Suffolk%ounty
nO
Commission Expires May04_JJ
o
OTO
Exhibit"A"
FORM NO,2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISE( UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
�44Z Date ............................�:::�u ..........., 19,.1
�_ Z
,
Permission is hereby granted to: •. Halkaff
........ a��1C: .: ;•............. .. ......................................
g ...........?•.qw'-'r,Pvw)............................................
T>LL ,��;,.i::��'�..X.�l.sh�.fn"'iR'�:..��K���i�.�r�i..�s...�S���i..�.�r�r.YsS•.�%4�rF.sK�.�� J�.............. ...................
to ..
............................................................ ........................................ .........................................I................
�,..�:'.t�rf�• ..:...........I...I.,.................. . ..................
at premises located at ......401 ,
...................................... ........................... X2i . ...�+i•rdi•s....... ........................................................
................ ..... ...............
...................................
1'l�i .... 19..`�: .., and approved by the
pursuarvt to application dated ......... ..................., .... ,
Building Inspector.
Fee $.. .,Q11............
r
Building Inspector
t
0
Exhibit`B"
�F 08M NO. 4
TOWN OF 80U 0 D
BUILDING DEPATM NT
Town Clerk's Oice�:
5outhola, N. Y. +:
Certificate Of 0=4 ancy
No. ?a62. . . . . . Date . . . . . . .}. . . . e .t. . . ., 19. .76
THIS CERTIFIES that the building located at ;# ; . . . • • � •. • . • • . • • • . . • . . Street
Map No. .=M • • . . . . . Block No. . . . .Lot No,; ,
IA jj�
conforms substantially to the Application for Building ,ermit heretofore filed in this office
dated . . . . . . . . . . . . .A-,9: *9• 19. 94 pursuant to w ich Building Permit No. .
dated . . . . . . . . . . . AUg. • • • .4• •� 19. 71, was issued, �nd conforms to all of the require-
ments of the applicable provisions of the law. The ocibupancy fdr which this certificate is
issued is . -Private- i ing -P00 . .w�.?i:Mt, . . . . . . . . . . . . . . . . . . . . . . . . .
m
The certificate is issued to . . pGIS. larl�Ott• • • . . . . :k . . . . . . . . . : . . . .
>owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . * • • • • • • • • • • • • • • • • • • • •
UNDERWRITERS CERTIFICATE No. . . • 20.1 ��. . . . . . . . . . . . . . . . .
HOUSE NUMBER . . . . . . .1+75. . . . Street . . . flat. . . . . . . .. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . : . . . . . . . . . . . . . . .. .. . . .. . . . . . . . . . . . . . . . . . .
Building inspector
1{'
3. ,
Exhibit"C"
FORM PTO. R
TOWN OF soOrH60
WILDING'DAPARTMENT ;
TOWN CLEP.WS. OFFICE
SG,W°t•H6LD,'N. Y. a
' BUILDING OERMIT
(THIS PERMIT,MUST BE'KEP`E�O I THE Pf�f=MI' E' LJNit= FULL,, ,
COMPLETION OF THE WORK AUTH1 "17-EDS- _ „[
N9 1829 Z
Doted
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Permission is hereby grgnted to:
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Exhibit"D"
FORM NO. 4 -
TOWN'OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERIC'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
N ......z..a;7a ....... Date .............................�QtY......4t�x'... 19.. 63
THIS CERTIFIES that the building located at ..s-..LaAr. l...••••..•••••..•• Street
MapNo. ......**............ Block No. .......AM.......... Lot No. ........129rr:11.30.................... ......................
conforms substantially to the Application.for Building,.,Permit heretofore filed in this office dated
................I................,; uly..,� 9.............. 19.. ..62 pursuant to which Building Permit No. . ..�8 1
dated ....................... AI-Sr.-IQ................ 19...3p,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 ........
........................................... `��.,ii'�,l F� ,4T-ram,... " :+l +Y,1 ? t SL.X.............. ....... ..............................
The certificate is issued to ........j ROX... ............. .......... .....I.......................
(owner, lessee ortenant)
of the aforesaid building.
�8uilding Inspector
Exhibit"E"
Iv /vj
TOWN OF SOUTHOLD PROPERTY RECORD CARD
8 0 0-- -./Q4 .8
DIST. SUB. LOT
STREET VILLAGE
OWNER
z C.
FORMER OWNER N E ACR.
D,
S W TYPE OF BUILDING
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RES. y /0 SEAS. !VL. �FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS 7 'el
7
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NEVI NORMAL BELOW-----------------
ABOVE
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FA*A Acre Acre
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Tillable 2
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
k e,
Brushland FRONTAGE ON ROAD J,
House Plot DEPTH
BULKHEAD
Tota-1 DOCK
MOMEME MEMO
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SITE D
SCTM # 1000-126-08-19&20
ADDRESS 525 Wells Road
Laurel, NY
�O OWNER: Dennis Harkoff
�• / h. o0
SITE: 25,421.80 SQ. FT. = 0.548 ACRES
(A ZONING: R-40 O
o �
o
rn SURVEYOR: NATHAN CORWIN LJ.I
1586 MAIN ROAD Z
JAMESPORT, NY 11947
LICENSE # 50467
DATED: DEC. 15, 2004
N/0/F
REALTECH, INC.
V�
W�
N 880 18'50" E 143.93'
FOUND g
CONC. MON.
NOFITH ELEVAT10"Immx CHAIN LIN FEN E CE FENCE N •' _
0.8'S• 0.1'E 2.3'S. OA V
SCALE: 1/4" = V -0" Z
� � �• �,�.o :,!• LOT AREA DATA
N MOo ► S.C. TAX No. 11,869.95 sq. ft.
'n 1000-126-08-19 0.273 cc.
S.C. TAX No. 13,551.85 sq. ft.
V x � IP S.C. TAX No. 1000-126-08-20 1000-126-08-20 0.311 cc.p TOTAL 25,421.80 sq. ft.
�z � '•: ' 0.584 cc.
I � -
So
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O WOOD LAMP �� UVERH�
STEPS
BELGIAN BLOCK CURB .
r
i '76.0'' a •i :� C •
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WOOD DECK y f.APHALT QRIVEWAY ram_ . ' o, •• J
a •
rn
c p I `a' :' :• {GJtig •` !dam
10
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4 x 4 GATE tv i 127.11 WOOD
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S 88'18 5 W
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N 8'1 ,50 FENCE 1.4'S.
8 127.11' a
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S.C. TAX No. 1000 J126-08-19 Q'
c M
• o K
�^ r 8.4• 33.3' g no WATER METER p W "'� w : ?i K
N IST. PERGOLA Z cZi ' �'• .' -
k DECK TO BE ► - • ~ a
REMOVED c = W• N c
9.1' it ;' •= ► a N C9
m ON ROOM rn <^ •: c� o? �O •' !
WES
T ELEVA- 1 ION Q 6.4' v#vim v •` • , ! ' r ' r sf'•��n F
s 0 a°,Y'
SCALE: 1d4" = V -0" N _ •� T : _ Fq ► `' R J /' '!'J�-
�/ ONCE t*1 ' .Go�G $ ~T ;. ; ,' d. j I'P�L A YAY i�""$i. ,..
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O FENCE E :. a•-r r 0ENCE 0.3'S J I '1
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„ STOCKADE FENCE
D�A�FT8 •��I!'•l�iB 110.219 " � '- ---'l-lt-=i-
VT r b'S 8
P, ROJ E�CT,
.NO:° 8'50" WN/D1F 57
./JOSEPH J. FINORA, JR.
L--J L--J
�\
FOR Tt iE DRAWN BY:
F 7FL0u�1;"j -'E("!r N',,
+ r :AJNDATI(.,, `iJIFC,D
EXISTING
FOR POUR')Cl)rqi;;� - CHECKED BY:
SUNROOM 2. ROUGH-FRAMING, P:U'."5...;
STRAPPING, ELECTRICAL & CAUi.KIP;S DATE: AUGUST 22, 2011
3. INSULATION
4. FINAL•CONSTRUCTION& `:.EC_J RICAL
' MUST BE COMPLETE FOR C SCALE:
EXISTING '
ALL CONSTRUCTION SHALL MEET THE AS NOTED
DEN SCALE: 1 vv - 20v'Ovv { REQYORUIREMENTS OF THE CODES OP WF,V SHEET TITLE:
EXISTING STATE. NOT RESPONSI6LE FOR
BATHROOM DESIGN OR CONSTRUCTION ERRORS.
\ L--J
ELECTRICAL
~ SITE PLAN
INSPECTION REQUIRE17
EXISTING
LIVING ROOM
SHEET NO.:
Rix I
SOUm"10H ELEVA110—N "P"ART1 A L BUILDIfti'mmG FLOOmrm%'&
SCALE: 1/4" = V -0"
L A N S U N "Rok 0 U" M
SCALE: 1/4" = V -0"