HomeMy WebLinkAbout26366-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27241
Date: 08/10/00
THIS CERTIFIES that the building ADDITION
Location of Property: 1375 PECONIC LA pECONIC
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 75 Block 5 Lot 1
Subdivision Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 16, 2000 pursuant to which
Building Permit No. 26366-Z dated MARCH 1, 2000
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 AND REPAIRS TO AN EXISTING AGRICULTURAL STORAGE BUILDING AS
APPLIED FOR.
The certificate is issued to REYNOLD BLUM
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
~or ~'d S ~gnature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26366 Z
Date MARCH id 2000
Permission is hereby granted to:
REYNOLD BLUM
PO BOX 709
CUTCHOGUE~NY 11935
for :
CONSTRUCTION OF AN ADDITION AND REPAIRS TO AN EXISTING
AGRICULTURAL STORAGE BUILDING AS APPLIED FOR.
at premises located at 1375
County Tax Map No. 473889 Section 075
pursuant to application dated FEBRUARY
Building Inspector.
PECONIC LA
PECONIC
Block 0005 Lot No. 001
16, 2000 and approved by the
Fee $ 50.00
Authored Signature
Rev. 2/19/98
ORIGINAL
TOWN O'F 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 buildir
inspector with the following: for new building or new use:
1. Final survey of .property with accurate location of ali buildings, property linea
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 buildiqs, industrial building, multiple residences and similar buildi
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 a
Ppre-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 app
If a Certificate of Occupancy is denied, the Building Inspe~
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions t¢
Alterations to dwelling $25.00, Swimming pool $25.00, Access(
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate 'of Occupancy on Pre-existinK Buildin~ - $i00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........... Old Or Pre-existing Building .................
House No. Street Hamlet
Onwer or Owners of Property ...................................................
County Tax Map No 1000, Section....~?$' .Block ..... ~ Lot ../...
Subdivision .............................. · . . . . . Filed Map ....... .....Lot ...................
Permit No...~ f ..... Date Of Permit.. ~ ...... Applicant..~/..>'.~.?C~.... ~.~-~.~ ......
Health Dept. Approval ..... ~./~Z~. ................. Underwriters Approval ..................... .~..~.~.
Planning Board Approval....~../.~ .................
Request for: Temporary Certificate ........... Final Certicate ...........
! 5' ...... ................
L$~25 . 00,
~$25.00,
CONSULTING ~NGINEERS . PLANNERS
'1
7675 COX LANE , P.O. BOX 1033
C_UTCHOGUE, NY 11935
(516~ 734-7492
July 26 2000
Ray Blum
Penonic Bay Vineyards
Box 709 Main Road
Cutchogue NY 11935
Re:
Barn Extension Constr, uction
Peconic Lane
Peconic NY 11958
Ray:
Observation of barn extension roof construction,
2" x 6" roof rafters 16" o/c will support a live
load and dead load of 45 lbs. per square foot.
the
It was noted that the collar beams were attached to the
roof rafters with bolts which gives the structure
additional support.
Sincerely,
Warren A. Sambach Sr. P.E.
enc1.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN O1' SOUTHOLD
Fax (516) 765-1823
Telephone (516) 765-1802
July 27, 2000
Reymold Blum
P.O. Box 151
Peconic, NY 11958
RE: 1375 Peconic Lane,
Peconic.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
.(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 26366-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
~Iq~PECT ION REPORT
FOUNDATION
COMMENTS
DATE
FOUNDATION (2ND)
ROUC~ FRANE &
PLUI~ING
INSULATION PER N. Y.
STATE ENgRGY
CODE
FINAL
Ti
II
II
ii
fl
fl
ADDITIONAL C01~IENTS:
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 25535
Date: 02/10/98
THIS CERTIFIES that the building DWELLING
Location of Property 1375 PECONIC LA SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 075 Block 0005 Lot 001
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 25535 dated FEBRUARY 10, 1998
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 ONE FAMILY DWELLING WITH ACCESSORY STRUCTURES *
The certificate is issued to JOHN WILLIAM NIERODZIK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
~d'/ing i~/~ec~t or
Rev. 1/81
BUILDING DEPAR~T4ENT
TOWN OF SOUTEOLD
BOUSING CODE INSPECTION REPORT
LOCATION: 1375 PECONIC LA SOUTHOLD
SUBDIVISION: MAP NO.: -- LOT (S) --
N~4E OF OWNER (S) : JOHN WILLIAM NIERODZIK
OCCUPANCY: SINGLE FAMILY
ADMITTED BY: ~AN DROBNY
KEY AVAILABLE: SUFF, CO, TAX MAP NO.: 75~-5-1
SOURCE OF REQUEST: CAMINITI & GIBBONS. ATTYS
JOHN WILLIAM NIERODZIK
ACCOMPANIED BY: SAME
DWELLING:
TYPE OF CONSTRUCTION: WOOD FR~E
FOUNDATION: BLO~
TOTAL ROOMS: 1ST FLR.: 4
BATHROOM(S): 2.0
PORCH TYPE: *
BREEZEWAY:
DOMESTIC HO~ATER: YES
TYPE HEAT: OIL WARM AIR:
OTHER: *COVERED ENCLOSED PORCH UNHEATED.
2ND FLR.: ~
TOILET ROOM(S):
DECK TYPE:
FIREPLACE: ~O
TYPE HEATER: GAS
HOTWATER:
CELLAR: 1/2 CRAWL SPACE: 1/2
UTILITY ROOM(S): YES
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: WOOD FP~AME STORAGE, TYPE CONST.: ~OOD FRAME
SWIPING POOL: GUEST, TYPE CONST.:
OTEER~ BARNS (SEE BELOW)
VIOLATIONS
LQCATION
CHAPTER 45 N.Y. STATE UNIFOP~4 FIRE PREVENTION & BUILDING CODE
DEECRIPTION I
BUILDING # 1 - ROOF REPAIR NEEDED
BUILDING #2 - POOR CONDITION
BUILDING #3 - POOR CONDITION
BUILDING #4 - POOR CONDITION
BUILDING #5 - FAIR CONDITION
BUILDING #6 - FAIR CONDITION
CLEAN'UP REQUIRED: VEHICLES & MACHINERY)
REMARKS:
REINSPECTED ON 2/9/98
DATE ON INSPECTION: 01/16/98
TIME START: 10:25 AM END: 11:45 AM
765-1802
BUILDING DEPT.
NSPECTION
[ ~]/FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
INSPECTOR ~/~ '~/~/~
FORH NO.
TOI~I OF SOUTHOLD
BUILDING DEPARTI4ENT
TO~N HALL
SOUTHOLD, N.Y. 1197 I
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FOPaXi ...................
NOTIFY:
CALL ..................
PL~IL TO: ....................
Disapproved a/c .
l[-'~ [;) 11~', ~' ~' :, .... ~ . ~ ...... ~'x- ..........
f~ ~. ~. !"' ,2 ':-' ' ' ~ / (P~ailding Inep~ct~)
~': L, '; ~g t 6 ~ '"~ APPLICATION FOR BUILDING PE~[T
a. '~is a~llmtlm ~t ~ ~letely fill~ in ~ ~iter or in i~ ~ ~irr~ to ~ ~ildiag Ins~ctor
~ ~ta of pl~, ~ate plot pl~ m ~ale. ~ ac~i~ ro ~le.
b. PloC pl~ ~ lmtim of lot ~ of ~ildi~s m ~s, ~lation~ip to ~joini~ pr~s ar ~lic
struts or ~e~, ~ givi~ a ~il~ ~ripri~ of l~t of pm~ ~t ~ dr~ ~ ~e diem ~ich is ~rt of
this ~liatim.
c. ~ ~ ~ ~ ~is a~licatim ~ mt ~ ~ ~fore isle of ~ildi~ Pemit.
d. U~ ~al of ~is a~li~ti~, t~ ~ildi~ Im~cCor x~ll is~ a ~ildiag Pemir to the apptic~r.
~t all ~.~pt ~ ~ ~s ~il~le for i~ti~ ~mt ae x~rk.
e. ~ildi~ ~II ~ ~i~ in~leor inert for ~~at~er ~tll a~rtlficaCe of
~m~ ~all h~ ~n ~t~ ~ ~ ~ildi~ ~tor.
~I~I~ IS ~ ~ to t~ ~i]di~ ~nt for ~e isle o~ a ~ilding Pe~t ~rsmt to the
~ildi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yo~, ~ other a~li~le ~s, ~di~es or
~lati~, for ~ mt~tim of ~ildi~, ~iti~s or alterari~s, or for ~al or ~liti~, ~ ~rein
~ri~. ~ a~li~t ~s to ~ly ~ all ~li~le l~s, ordi~es, ~ildlng c~, ~i~ c~e,
.......................
(Si~e 6f a~llc~t, or ~, if a ~rati~)
State ~etl~r applicant is o~r, lessee, agent, architect, angineer,' general contractor, electrician, plmt~r or builder
d ...............................................................
(a ~ ~ t~ mi1 ar latest ~)
If ~licat is a ~rati~, siva of ~ly mt~ri~ officer.
(Na~e and title of corporate officer)
l~ilders License No ..........
Plumbers License No ........
Electricians Licenee NO .................
Other Trede's l~cemse NO .....................
I. ~ti~ of 1~ ~ ~i~ ~ ~rk ~ill h ................................................................
~f~ ~~ //?f~ ...............
~ ~r St~t
~ ~ ~ ~. ~ ~ti~ .... 3.~?.-- ...... ~ ~- ~t / ,
~ivisi~ ............. Fil~ ~p ~ ................
(~)
2. State ~sti~ ~ ~ ~ of ~i~s ~ int~ ~ ~ ~ of pro~ c~stmcti~:
a. ~sti~ ~ ~ ~ ..............................................................
b. ~t~ ~ ~ ~ ...........
3. I~ture o£ ~ork (cl~ck ~fich appllcahle): ge~ l~dlding .......... ~i~i~ ........ Alteration ..........
~ir ...... ~al ......... I~1 iti~ .......... Otl~r ~ ......
Esti~mtal ~s ~ ........ f~ ...........................
(to ~ ~id ~ filing this a~ticati~)
If ~lli~, asi~r of ~lli~ ~mlts ............ ~r of ~lling mits ~ ea~ ~r ................
I[ garage, ~r of car~ .....................................
If I~i~ss, ~rcial or ~ ~, ~ci~ ~ture ~ ~tent of ea~
Di~nsi~s of ~ stricture m(h alterag~s or ~i~ions: ~t~..~.
~pth .... Z~..~ .... ~l~t ..Z~ .............. ~r o~ Stories ..~ ..........
Di,~nsi~ o~ entire ~ : ' ~ / ~ ~ .... ~p~v.;.~.~.
l~i~t ...... Z~ .............. ~ ~r of Stories .... { ................
Si~ of lot: t~t ../ ........ ~ ........ ~ar .................... ~pth ....................
~te of ~rcha~ .. ~ of Four ~r
7~ or u~ district in ~id~ p~s a~ slat~
~s ~o~l c~C~ti~ violate any ~i~ 1~, o~i~e or r~lati~: .... ~.~ ..............
Will lot ~ r~ ~0 m
~ of Arddt~t ............. i .................... ~res~ ..................
~ of C~tr~tor ............ ~ ~ress
15. Is this p~rty ~ithin ~ ~ of a ti&l ~tl~? * ~ .......... ~ .........
i PLOT DIAGRA~
l~ate clearly ~ disti~ly ail ~ildi~s, ~r ~isti~ or ~, ~ i~i~te all ~t-~ d~si~s
~ pm~r~ li~s. Gi~ st~t ~lbl~k ~r or ~scripti~ ~co~i~ to ~, a~ ~ strut ~s ~1 i~icate
M~tl~r interior or co~r lot. i
· .. , ....................................... being duly s~om, deposes a~
(~ of i~[vld~l signing c~tract)
a~ ~,
lb is the ....... ' ............................................................................
..............
(C~tractor, agent, ~r~rate officer, etc.)
of ~id ~r or ~rs, a~l is duly athorlz~ to ~rfom or h~ ~rfo~ ~m ~id ~ m~ to ~ke ~ file this
a~l. icati~; timt all stat~nts c~t~i~ in this a~llcati~ a~ t~ to ~e ~st of his ~1~
that the ~rk will I~ ~rfom~l in tlm~ ~m~r ~t forO~ in ~e a~licati~ film ~a.
~m tp t~fore ~ this
No. 01BOa02093a
Oua,fled In Su~01k ~u~
Term ~plres Uarch 8,===2~ ~
SURVEY Ot~ Pi~,OPEt~TY
SITUATE.. Pt=CONIC
TOhlN Ol~ SOUTHOLO
SUFFOLK COUNTY, blt
PETAIL
~Ut~t~OLK, OOUNT'v TAX MAt='
I000 'tS ~ I
~t~¥NOLP DLUh4
GRAPHIC SCALE
JOHN C, EHLERS LAND SURVEYOR
6 EAST MAIN STREET
~°24~0"H lID.14'
N Y.S LIC
I..50.00'
LAND NOW Or&
NO 50202