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Home My WebLink About11016-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22366 Date MAY 28~ 1993 ALTERATION & ADDITION THIS CERTIFIES that the building Location of Propert~ 5400 PECONIC BAY BLVD. LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 128 Block 2 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 11, 1980 ~pursuant to which Building Permit No. l1016-Z dated JANUARY 14, 1981 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 4'x8' DECK ADDITION & ALTF~RATION TO EXISTING ONE FAMILY DWELLING The certificate is issued to RUSSELL IRELAND, J~. & WIFE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-650146 - JUNE 29, 1984 /$~ildi~g Inspe Rev. 1/81 vow. oF so~.aL~ i T0~N HALL. SOUTH'OLD, N.; YL BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH.EiPRE IS~ UNTIL F~LL COMPLETION OF THEWORK AUTHORIZED) 11016 Z Perr~isston is hereby granted to: · ......... /.~.~ ~?/./.....~./.... ..... ................. ...... ~o ..~.C~..~..~.~..~....~,,~ ...~4~-~. ~ ~..~.~...~.!, ~-~',4 ~...~.~*,~....~.. ...~.~<-~.....~4/~G ......... ; ....... ...... ~; ........~....~ ................ ~ ....................................... Coufi~ T~x ~op No. 1000 Section ........... . Block ~ .......... ~°t No ............. p~rs~ont to ,pplicohon dated ........... ;~....., 19. ; ~nd opproved by the Building Inspector. : · Rev.;6/30/80 : :-: , FORM NO. 6 TOWN OF $OUTI'IOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUP/~ Instructions This application must bo filled in typewriter OR ink, and submitted ~, aaa.mrna to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-{$-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 completed site plan requirements where applicable. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p,4operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner 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. C. Fees: New Dwelling. S25.00, 'Acce.,.~ory :$10.00 Bu~ines:~ $50.00 1. Certificate 9f occupancy 2. Certificate of occupancy on pro-existing dwelling $ 50.0 0 3. Copy of certlficate 0'f occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land c.g. $ 20.00 c..o. $ o.oo Oate .............. /6. Altcrat~.on $25.00 NewCOna tr'uc t;ion ...... Old or Pre-existin§ Building ............ Vacant Land ............. Location of Property .................... '..~&o;~/.%... [ ."~...~/...T~..L.v .~. ....... ; ...... .~..~.. House No. Street( Hamlet Owner or Owners of Property --l~7~se {' ( l"/ .~. v~ 2~.,,~-,,c~ ~'~,. . County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Flied Map No ........... Lot No .............. Permit No. Date of Permit .-., r,~ ;.,,..Applicant ~.' Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building a~lt meet~ appli~codes and regulations. n~v. 10.10.711 Form No. 6 TOkrN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 I% 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 a 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 i .../~Old Or Pre exist' D~ .~.~. ~ ..~/~i!...~. .................... Construction .... 1~I ~cation of Prop~r~y ..... ii... P .~?. ~.~.=~ J.~...~..~.. J..~[~. ii. i ...... ~i~.~l .......... House No. ~Street Hamlet Onwer or Owners of Property...~.k~.~.~.~. .... ..~.~.~..~ ................................. . .. County Tax Map No 1000, Section../..A~. ...... Block...~..~ ....... . Lot .............. ~../.?-'~ .... Subdivision ............................... ... .. Filed Map ............ Lot .................... .. Permit Xo../.g~.f.~..~.Date Of Perm~Z~.~./..ipplicant .~.O~.~[ .... ~ . Health Dept. Approval ...... ~ .......... .... Underwriters Approval~..~.~..~../.~.~. ......... Planning Board Approval ..... ~ ............ / Request for: Temporary Certificate ........... Final Certicate ...... ..~...... APPLICAN~/ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIdlTY f 0048/4 8S JOHN STREET, NEW YORK, NEw YORK 1OO3~ rate A~,~,lleatio,,,~'o.o,,,~ile 273493.a4 N 650146 THIS CERTIFIE~lt~T29' ~t~84 only the electrical equipment as described below and introduced by the applicant ~amed on the above application nu tuber in the premises of Russ Ireland, s/s Peconic Bay Blvdo Laurel, N.Y. was examined on Jane 25~ ;1984 .nd foand to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT E R *Fur:ufo Appliance Feeders: Hot water heater: V I C 1-3#8, 1 GFIo track lighgs~ room heaters: 3~2.0, 1-1.5, 4-1.25, 1-1.0, Richard Kleia£e ldt ~~ 114 Carleton Ave. Islip Tart, N.Y~ 11752 lie. 665E GI.:NSRAL MANAGJR/- This certificate must not be altered in any manner, return to the office of the ,oard if {nco~rec,. ,nspecto,s may be identified by their credeotj;Js. ~./cqpYjFO. B~ILO No DEPARTMEN~ TH. S COP~ O~ CER! F~C~%~u~T~q~ ~E~TE~ED ~,N ANY MANNER. COMMENTS FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 February 4, 1988 Mr. Russell H. Ireland, Jr. P.O. Box 231 East Norwich, New York 11732 Re: Building Permits #13177Z llOl6Z Dear Mr. Ireland: While examining your application for renewal of permit #13177Z I found that our files show an- other permit #11016Z for addition/alterations, this file doesn't show a final inspection. In arder to complete this file a fee of $50.00 is required to replace permit #110~6 because it has expired. An additional fee of $25.00 is required for a Certificate of Occupancy upon completion of work and a final inspection. Enclosed you will find an application blank. TF:hdv Enc. Yours truly, Building Inspector FORM[ NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ..... /~...~....~.... .................................................. ...... ~....n~.~..~..~./....~...~.......zz 73 ~. , PLEASE TAKE NOTICE that your application dated/~..C. ....... ./..(. .............................. , 19,,0~. for permit to construct~..~.~...~..~..../~...'.~.~,at the premises located at-~'..d'.~...~...~...~,.~v','~ Map .......,/. ~9, ,~., ................. Block ......... .,~,, .~.. .......................... Lot ....... . .~./..~, ............................. is returned herewith and disapproved on the follow;ng grounds .,~....~.~,~.~,.Z.¢~-.~......~.,~,.~..~.-~.~- ·~.~.~.~.~.~.....~..~.~....~.¥.z~..~....z.~.~.;~.~..~.~.....~.~..~.... ~.......~.~.~..,9..f../......~/-. ~r~..z~.~..~........~.~-c~. ~./. ~.....~.....~....~/.~. ~...~.~.... .~...~ ~.~. ~....~.~...:.c~..~.~..~? ~.~. ~.~....~...~.~,.~.~....cc/,~, ~, ,c~-~ ........................................................ Bu, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ;...< .... , ' ' ...... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ./.~../. ].] ........... , 19~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 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. 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, Snffolk 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 necessap, rTfllspections. (~ ,,~ ~ .... · ~.+.~....~.:o .... .&~...t..~.~...~...~.~.~ ~. ~,,.~. (Mailing address of applicant)~ ' ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .O..~.~.~ ................................................................................. Name of owner of premises . i~.'~/~. ~..LJ.:....~.:...~'.. t~-.~./~c/~4c~0... J.~x, ................................. (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 ~icense No. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 5.V. qo/'lV~o.~...'~ .l~c.~.. - ~ ~ o~ ......... /~L...: .... .~..~had. Hous. e,N't~mber r'e;i Hamlet County Tax Map No. 1000 Section . .. / ,2~ O.~. ..... Block ....0.,2.....0..0 ........ Lot...O. I?.: .O.o.O ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....~. ~.wx~.e~ ..... ~¢~.;.&v~cJL~ ..................................... 3. Nature of work (check which applicable): New Building ~. ......... Addition~d~'/'~t-- Alteration Repair ~ Removal D~molition Other Work · 4. Estimated Cost ...... ~i ......................... Fee . ~. .......................... : (to be paid on filing this application) 5. If dwe ~ng, number of dwelhng ~mts . .. ............. Number of dwelling units on each floor ................ If garage, number ofc~s ..... ~ .................................................... ............... 6. If business, commercial or mixed occup~cy, specify nature and extent of each type of use ..................... 7. Dimensions ?fexisting structure's, if any: Front..~,¢.* ....... Rear ~.,.q ........ Depth .3.? ' Height ~ j ........... Number of Stories . .'~O. .............................................. Dimensions of same structure with alterations or additions: Front .S~.~ .......... Rear .. ~ ......... Dep~ ,.. ~A ~ .......... . Height . ~.&~ ................ Number of Stories.. ~ ~ ............. 8. DimenSions of entire new constrUction: Front ............... Rear Depth ' Height ................ Number of Stories ............................................ I ........... 9. Size of:lot: Front . l~ ..... ~ ......... Rear .... ~,. B ............ Depth . ~. ~ t ~ ..... ~ .... 10. Date of Purchase ~.~.~ ..... ].~ ........ Name of Former Owner ~.~.¢~.~c4~I~'.... 11. Zone or use district in which pr6mises are situated ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~.~ ........................... 13. Will lot be regraded .. ~ ~.: .................... Will excess fill be removed fr~ premises: Yes 14. Nme of Owner of premises '.~ .d .~~ Address R~. ~.~ ......... ~hone No. ~..4 B~ Name 0f Architect .......... ................. Address ................... Phone No ................. Nme of Contractor ......... ................. Address ................... Phone No. ............... PLOT DIAGRAM Locate clearly and distinctly all; buildings, whether existing or proposed, and, indicate all set-back dknensions from property 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 YORK. -- ,. - i (Name of individual signing contract) above named. He is the ........... : .......... ! ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dui: authorized to perform or have performed the said work and to make and file this application ;! that all statements cont work will be performed in the manne Sworn to before me this HOI~ tined in this application are true to the best of his knowledge and belief; and that the r set forth in the application filed therewith. AMELIA P. HUHN RY PUBLIC, State of New York · ./1.. · ' No. 30-4641539 ' ~ ~,,~gnature of applicant) ualified ia Nassau County .0~ O0~r lesion Expires March 30, 19~.~