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Home My WebLink About14811-zFORM NO. ¢ TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-16241 October 2, 1987 No .................. Date ................................ · ADDITION THIS CERTIFIES that the building ................................................ 6015 Peconic Bay Blvd. Laurel, N.Y. Location of Property ............................................................... House No. Street Ham/er 128 01 01 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 23, 1986 pursuant to which Building Permit No. 14811 Z dated Ap r i 1 26, I 986 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to R. COLL INS ..................... ?o¥o'e;, T&.vC; x .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ........... N8105 I 7 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEar'IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTEtORIZED) 14811 Z ~o,e ........ .~ ...................... , ~9.2...C Permission is hereby granted to: .... ........... ~.~~....~.:.~..:....:.../...~..~.-.....~ ~ . ,o ..~.~...,.~....~~....~...~~....~...~..~~.~. ........... ..~.~~-....~....y~...?....; ............ ~.~.....~ ....... ~ ........... ~ .................. ot premises [~ated at ...~.~.].~ ........ ~..~.~...~.~..~.~..~...~.~ ...................... ~~ . . CounW Tax Map No. 1000 Section ...... ~...~.~ ........ Bilk ....... Building Inspector. and approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Sou:hold, N.Y. 11971 765 ~ 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in wpewriter OR ink, and submitted m ~ 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 Flanning Board approval of completed site plan requirements where applicable. Bo For existing buildings '(prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn stat0ment 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 informs- :ion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 New C on s t r~ c t i o n ...... Old or Pre-existing Building $15.00 Date.. ~/~.~3.~./,~. ~ ............. ..... Vacant Land ............. Owner or Owners of Property ........................................... County Tax Map No. 1000 Section . ./.9~ ~. ........ Block ... ~./, ........ Lot .... O. {' ......... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. /,~.~,//..~--.. Date of Permit ~.~'.~./?/~.Appl,cant .~..'.~..~.~./;-..~.~...'~. ,,/.~/~..'~./~,. Health Dept. Approval ...... /~/~: ............. Labor Dept. Approval ........................ Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. ^ p,icant. i . ........ Rev. 10-10-78 ~oo~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CE~IFIES THAT ~icha~ Coll~,ns~ Pccon~c Bay :Bo~vard, Laurel, in thefollowlnglocatlon; [] Basement ~ Ist FI. [] 2nd Fl. Section Block Lot wasexaminedon }'~0.~ ~], ]~C)~7 andfourtdtobeirlcompliance~'iththerequirementsofthlsBoard, FIXTURE FIXTURES RANGES :OOKING DECKS OVENS OUTLETS SWITCHES FLUORESCENT DISH WASHERS EXHAUST FANS MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS= E R V I NO. OF CC, COND PER AWG OF CC, CONO C E Jody Pumi] lo Pat Lane ~,~ag tiguck, N.Y. 11952 Lie. 2300E MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU~ST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 To whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. /Z/ No Underwriters Certlf~cat on file. /~ The check is(outdated/not on file.) ~~ /Z/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this Thank you for your cooperation. Building Permit # _~/ ~ _~ _~ ~_ Z Building Dept. matter. No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, 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. /Z/ An application for Certificate of Occupancy is not on file. /~No Underwriters Certificate on file. /~The check is(outdated/~e.)~.O~ /Z/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # / ~/ ~ ,_~ t ,, Z ~>~.~,~_ Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 76S-1~02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [,~~INAL REMARKS: DATE ~:'/~Z/0'~ iNSPECTOR ~'~- BUREAU OF ELECTRICITy ES JOHN STREET. NEW YORK, NEW YORK 1003B THIS CERTIFIES THAT ~n the follow,n~ l,wat~on; ~ ~e~nt ~ Ist FI. ~ 2nd ~]. .~tio. BIlk ~ examtn~ on and found ,o be in compliance with the requirement, of RXTURE EPTACLES SWITCHES RXTURES ~ RANGES, CO~I(ING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ~.v,a ~o..~= ~,.~1 !7' ,~ ~7 T""'~';~'''w'- .,'"~'~'~*' ICE 'his (effificafe must ~f ~ olter~ in ~ny manner; return to the ~ .Fffi Bmmm DEPART~T. THIS CO~ FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: "': · ;FORM NO. 1 '- ,', TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined ' ' ~ (¢ .... , 1'9 .~.~, Approved ~ ~°~9..,19~.b. Per~itNo./.~.~.]!.~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF [JOUTNOLD Received ........... ,19... 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 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. /6// ..x~z~r~, ..... ::7.. ......... (Signature of applicanf, or name, if a corporation) Y.. .... .... (mailin~ ~dress of tapplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ../..~. '. ................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. · ~. -~(N a~J::le5~ }~e:~ .... Builder's License No ...... /~. ................. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ~ · · .,r: .C' "~'~- ( 'c'. · '/'-~' '~' ~'~· · '/''~' ~ '~;/?'' ........ House Number Street Hamlet County *~x ~p So. ~000 Seotio~ ........ ~. ~g ...... ~o~k ......... t ........ ~ot .... ! .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy ~f proposed construction: a. Existing use and occupancy .... M ............. C ................................................ b. Intended use and occupancy ... ~X ' 3. Nature of work (check which applicable): New Building .......... Addition ... ~ Alteration ... Repair Removal Demolition ' Other Work ~, .~/~ (Description) 4. Estimated Cost ............. /. .°.........,..........°°'~° Fee... ...... i ............................. [to be paid on fihng th~s apphcatlon) 5. If dwelling, number of dwelling units .............. Number of dwelling ufiits on each floor ...... ~ ......... If garage number of cars 6. If business, commercial or mixed occupancy, specify natur~ and extent of each t,Y,P,e of use ..................... 7. Dimensions of existing structures if any: Front ...~.t~. Rear 52, ~' n~nth ~ ~- / Height .../.~. ......... Number of Stories .... f. .... ii". ...... Dimensions of same structure with alterations or additions: Front ~ Q~' ', ....... ~}~' ' '"}' ~" ........ "' Depth ....... tf. ct(. ........... Height ..... /.57. .............. Number Of Stories .... ,,C. ................ 8. Dimensions of entire new construction: Front ............... Rear ....... ~ ........ Depth ............... Height ............... Number of Stories .................. ~ ........ 9 Si of lot F /. O o. R .x~.o..o. ................ ~' ........... · ze : rent .................. ear .................. Depth ...~...3-20..: ............ 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..... ~.'... ........................ . .................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...i ............................ 13. Will lot be regmded ...... ~._.O.. '~ ....... '.;, ......Will excess-fill be removed fr~am premises: Yes 14. NameofOwnerofpremises /~,! {..,o~,~./~t,~ Address ~.~o/~',,~- Id, t/' nh ,, Name of Architect ..... . ...................... Address .............. ..... Phone No ................ 15 p perry zocatea wlth~n1,00 feet of a tidal wetland? t Yes ..... No ..... * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ihdicate 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 corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ..... /.~.0..~...,(~.../9...~ff....~.:....,~..%../..~.~ .~., ............ being duly sworn, depjoses and says that he is the applicant (Name of individual signing contract) above named· He is the ' ' (Contractor, agent, corporate officer, etci) of said owner or owners, and is duly authorized to perform or have performed the isaid work and to make and file this application; that all statements contained in this application are true to the best of Ms 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 Notary Public,...~<.... ~..~...~..~/...r_/~..' County · "~ J k OCCUPANCY OR USE IS UN~WFUL WITHOUT CERTIFICATE OF OCCUPANCY FEE:. ~'-~' ,BY: NOTIFY SUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOLI~DAT1ON 'iWO i~EQUIRED FOR POUEEO CONCRET~ 2 ROUGH FRAMING & PLUMBING 3. INSUI.A TIO~'I 4., FINAL ~CD*~?;TRUCTION MUST BE COMPLE-FE FOR C.Or ALL CON~TRgCTION SHALL MEET THE REQUI~EME["ITS OF THE N~Y STATE ~ONSTRUC'~ION & ENERGY CODES, NOT RESPONSIBLE FOR r~ESIGN OR CONSTRUCT!Or~ ERSORS,