The URL can be used to link to this page

Home My WebLink About15396-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z17483 Date November 2, 1988 THIS CERTIFIES that the building A d d i t i o n & A 1 t e r a t i o n s Location of Property 4425 Peconic Bay Boulevard Laurel House No. Street Ham/er County Tax Map No. I000 Section ..... ] .2.8 ....Block ....... .3 ....... Lot 17 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 7, 1986 15396Z ..................... pursuant to which Building Permit No ...................... dated............................Oct°bet 9, 1986 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 & 'alterations to an existing one family dwelling. Tile certificate is issued to .. BRENT R. & COLLEEN BOOKMILLER ................... ........... .......... of the aforesaid building. Suffolk County Department of Health Approval ........... N/A ................... UNDERWRITERS CERTIFICATE NO. N 00388 1 PLUMBERS CERTIFICATION DATED: 12/12/88-MASTER PLUMBING Building Inspector Rev. 1/81 FOBM NO. 0 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15396 Z Permission is hereby granted~ t~ , C~ ~ n .... Y..~,~.....~.~...~.~ ................ at prem,,, ,o~o,ed ot ...~.~.~...:~:..~...~.'"~"~""C~' '"~' .................... County Tax Mop No. 1000 Section ..... /....".~....~, ...... Block ...... ~.~. ........... Lot No ....... ]....~. ............ pursuant to application dated .... 0......~...~......'~. ................. , 19.~..~.., and approved by the Building Inspector, Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted a=~ 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 natu rat or topographic featu res. 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 completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ ]00.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date 10/1.5/8.8 NewC°nstruction... ... Old or Pre-existing Building X. ....... Vacant Land ...... 4425 Peconic Bay B.lvd, ........ .1: ............. Location of Property ........... ' Laure New Yo£k House No. Street Ham/et Bcent R. & Colleen Bookmillec Owner or Owners of Property ............................................................ County Tax Map No. 1000Section .. 128 Block 3 Lot. 17 Subdivision ................................. Filed Map No ........... Lot No .............. 10/9/86 .... Brent .R & Colleen Bookmiller Permit No,.......,..15396 Date of Permit .......... ~pp~can~ ...... Health Dept. Approval Pre;-.exis,t. in.$ Labor Dept. Approval N/A Underwriters Approval Yes (,?.o??. a..t~.a.c.h..e.d) g B App N/A ......... Plannin oard roval ...................... Request for Temporary Certificate ~ .................... Final Certificate . · Fee Submitted $ .... .0.0 Construction on above described building and permit meets all applicable codes and regulations. C'0'~ '~-~-~ ~ Applicant .. .......... %~. ............................ ......... Rev. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 119?l CERTIFICATION TEL. 76~-1802 Date Building Permit No. /~3 ~ Owner ~OO~f,'h ~ []e/'~- ]~PF¢~Jr~ C~ i/~e ~ (please print) Plumber ~{pl~~ ~.Z.~'. ~ pr±nt)~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ Notary Public ERWRITERS examined on and found to be in compliance ~rlth the require~nent~ of th~ ~ ~7~mscEN1 RXTUIES RANGIS COOKING DICKS OVINS DiSH WASHIRS EXHAUST FANS I~i ~C~U~TLITj..**T~ AC~J~ 7;~LGS 'I FLUORESCENT ~ ~/~T. K.W. AMT, K,W. ~)AT. K.W. MT. K.W. A*MT. H.P. / DRYERS FURNACE MOTORS I iqJTUll AI~UANCE I~IIS MT. K.W. CX H. ,. 7 ;' P'' ,~v~T. ~'O. A.W.O. S~T&LReC',~va,P1 T~I~T*CLOCK~ 1T1~4S. ~ J~.~M~l~r~ ~~ (;.F.C.I :- 1 G & S CONTRACTOR BOX 215 $OUTHOLD, NY, llgql This c~if~at~ must not I~ ~1~:1 ilt p), m~n~er~ return to the o~ice o~ the Board if incorrect. Inspectors may b~ i~k~ by thor COPY F TOWN OF SOUTIIOLD OPI:ICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTHOI,D. N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. //V~ An_ application. .for Certificate of Occupancy /__~,/:Io Underwritcrs Certificate on file. /_~2/ Tho check .£s(~/not on file.) /_-/ No Ilealth Dept. Approval on file. /_--/ No final inspection has been made. Please contact: our office on this matter. Thank you for your cooperation. Buildinq Permit tl ~_ ~__ ~_ ~ :,_ Z Building Dept. *** No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April lt19~4 7GS-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING FINAL REMARKS: 765-1802 ,~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUOH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL ,REMARKS: DATE /~-'//~/c2~:~/ INSPECTOR ,,~ / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~/FRAM!NG [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [.~SULATION [ ] FRAMING [ ] FINAL REMARKS: ~,~/~'~ ~*~-'~.-~., / DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL 765-].1102 BUILDING DEPT. INSPECTION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING FINAL FOU~DATION % ~(lst) FOUNDATION ( 2nd ) ROUGH FRAME & _ INSULATION PER N. Y. STATE ENERGY CODE/ FINAL ADDITIONAL COMMENTS'. ":N~E:i: UONU~ENT YOUNG & YOUNG ~/~.OFN~m. ALDI~N W. YOUNG DONALD GILDERSLEEVE 8~ ALIC AT LAUREL JSECU,RiFY rmrLEa GUARANFY CO. , ~wN oF SOUTHOLD _ _ ,..~ SUFFOLK CO., N.Y. ~: ,":~o' I~=:~ ~.,o~, I"°. ~{-~o~''~ MONUMENT J / . 'Oox~. m J i REVISION~ YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERItE~ SURVEY FOR: DONALD GILDERSLEEVE I AT GUAItAN~ [£D TO: ~ LAU RE L ISECU.RITY TtTL~E g, GUARANTY CO. t THE:~%~FH F'OR~K BANK ~,. TRUST CO. TOWN OF SOUTHOLD } [OU~TY ABSTRACt, INC. ~ SUFFOLK CO., N.Y. J ~/~-~'/F- ~F~¢*~'~ SCALE: i,,=4O, [DATE~MAY INO ,'2 ]~ .... 4, I97R I ' 76-20~ FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N,Y, 11971 TEL: 765-1803 Approved .O..e~..~-~· ..~ .... 19~.~. Permit No./.'~-..~..~..~...~c~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,1 9 .... a. This application must be completely filled in by Wpewriter 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 througCtout 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, 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 re~ulations, and to admit authorized inspectors on premises and in building for necessary~~ ~. (Signature of applicant, or name, if a _corporation) tmai±lng State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 LicenseNo ......................... Electrician's License No ....................... Other Trade's License No .................... .. · ~.,/' 1. Location ofland on which proposed work will be done. . .C..... ...................... .... .... ..................... House Number Street Hamlef County Tax Map No. 1000 Section .i~. ............ Block .3 ............... Lot./.r]. .............. 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 ....... .'~./~..~..~ .]m.']...g.~..~..I.. e~..~..~ ............................. b. Intended use and occupancy l ~''~ ' 'g~· ' -[ ¢ & est ~.. ~ ~ ~ ~ 3. Nature of work (check which applicable): New Building .......... Addition .... Alteration liti ~ Oth ~k Repair .............. Removal .............. Demo on ........... ... er We ............... .~. g~.~.~).~. :i (Description) 4 Estimated Cost Fee (to be paid on filing this application) 5. If dwelling, number of dwelling~nits . .~.¢~- ....... Number of dwelling units on each floor .......... If garage, number of cars .../~/.~ ............................. 6. If business, commercial or mixed occupancy, spec~y nature and extent of each ty~e of use .. ~.f~ 7. Dimensions of existing structures, if any: Front ............... Rear .. ~... Depth ............... Height . ~ .~.( ......... Number of Stories .... ~.~ ~ ................ /; . ~ .................. & ......... D~ensions of s~me~ structure with alterations' or add~tmns:' ' Front . .~ .... ~ ..... Rear . ~ ........... Dep~ ~ Hei t ' Num · O ~ " ~ ............ bet of :Stones ....... .q ............. 8. D~menslonsofent~renewconstructmn:Front ~ ~ Rear ~ ~ ~ n~,fh /.R Height ..I.~ ...... Number of Stones O0~..~.~j ..... ~' ' 9. Sizeoflot Front /.~0~ Rear ~0~ ~ . ' ...... ~;;~" :~'2 ............. 1 I. Zone or use district in which premises are situated ~ ./~a ~ f~ 12. Does proposed constructmn wolate any zomng law, ordznanceor~gulahon: ..~.Q .......................... 13. Will lot be regraded ..~.0. h...,... ,,. .... ~...: ..... Will excess fill be~removed from premises: _ Yes 14. N~e of Owner of premises ~.~.,ll~. ~&. Addressq.~,~:~O~ ~l%¢qr~hone No.~&~.. N~e of Architect ~.~gO ~..~ltr~ Address ~0.~ ~, ~m~ ~'X' Phone No ~ ~ '¢ ~ 3 22-Z Nme of Contracto~O ~O. ~0. ~ 0o~.} ...... Address ............... : .... Phone No .... .. ......... 15. Is this property located within 1,00 feet of a tidal wetland? ~ 7es ..... No ..~. · If yes, Southold To~m Trustees Permit may be required. PLOT DIAG~M Locat~ clearly and d~stmctly ~1 buildings, whether ex;sting or proposed, and. md~¢at~ M1 set-ba~k d~ns~ons from prop~y ~nes. Giw street and block number or description a~cordMg ~o d~ed, ~d sho~ str~t n~s and indiCat~ whether interior or Corner lot. , STATE OF NEW~(ORK .... , S S C~Y OF....~.. ~.t"'Lr>.... ' .... ~..~..~.".~ff :'....~..: .~..~. f'..C~..~..~ ......... being d~ly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~_P~ He is the ........ ' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authonzed- to perform or have perfomed the s~id work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of hi~ knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. his Sworn to before~~~ / ~ Notar~ ~bife, S~ York ~.~. ~ q ~~ ......... . ~o, ~,~ ~ ' ' ~ ' ---'~. ' ."' , - .... Qu~I~':'~S~I~ . ~ (S~gnature of apphc~t) OCCUPANCy WITHOUT CE OF OCCUPAN ~JP~OVED AS NOT~ iL ::1 ,I 'o~r ' "0i "~ ' -Go~don K. Able,s, ?. E. "Alterotlon of this Documenl !except by,~ :Licensed, .~ncd; 'E~gl~e~, Is' Illegal". ~. Y. State Education Law ji T 1 .%¸ -/ (, O.t!fioe O! 6to~on 1~, Ahlers, P. '"Alteration-of t~lJ except by a Uce~ed' Profes- sional Engineer, Is Illegal". Section 7209, Subdivision N. Y. Slate Education Law