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Home My WebLink About25645-zFORM NO. 4 TOWN OF ~OUTNOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26827 Date: 12/13/99 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 4250 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 128 Block 4 Lot 23 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11, 1999 pursuant to which Building Permit No. 25645-Z dated MARCH 24, 1999 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 ADDITIONS AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT A POTDEVIN & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N 507562 11/22/99 N/A Building 'Inspect~ - 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. 25645 Z Date MARCH 24 99 Permission is hereby granted to: ROBERT A & WF POTDEVIN 208 BEECHWOOD RD RIDGEWOOD~NJ 07450 for : CONSTRUCTION OF ADDITIONS AND ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 128 pursuant to application dated MARCH Building Inspector. 4250 GREAT PECONIC BAY BLVD LAUREL Block 0004 Lot No. 023 11 99 and approved by the Fee $ 75.00 ORIGINAL Rev. 2/19/98 lOgl OF SoIIrHOLD 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 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 1% lead. 5. Coumercial 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~pre-existing" land uses: I. 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. · 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~mtng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildlnm - $i00.00 3. Copy of Certificate of Occupancy - = .~5~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy'- Residential $15.00, Commercial $15.00 ~. Date .... ~l. -~..~ ~ ......................... ~ Const~uction ....... Old Or pr~e_~existing,Buildi~tg_ ........ ~'J''l ] { ~ation of Property... i../~g.~.O-.-- ~ -~-~q i~5.~ ~ .... ~ ..... '~.~ ~ ......... ~ ~'' House NO. Street ~ W~mlet t~er or Omers of · ,o ,0o0, ..... ...... .... ........... ,=it ~o..~h.~ ..... Date Of PemiC..~/a~l*~.~ .... Applicant ............ Unde~iters Approval · · ~lth ~ept Approval ......... .arming Board Approval...7~. ................... V squest for: Temporary Certificate ........... Final Certicate ........ ..~. Submitted: $ ............................ THE NEW YORK' BOARD OF FIRE: U:ND,ERWRITERS 1 1135107 'BUREAU OF ELECTRIqlT,¥, ¥,,: 40 FULTON STREET, NEW ~ NO~ER 22,1999 ' 186~5~99~99~ ' N 5~7562 Date Application No. on file THIS OERIIFIE$ THAT .... only the ~lec~cal equipment as described be~w and introduced by the~ applicant named. , : "On the abo~e, ~ ~ ,, u~p~a~on, ~ number =s in the premises of ROBERT PO~EVI~, 4250 PEC0~IC BAY BL~., PO~ ~ 63, ~EL,~ in th* following lotion; ~ Base,*ut ~ 1st Fl. ~ 2~ Fl. OUT '~ ~ ~ ~e~aon B~ck ~t~ was examtn¢a on and found to DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A' W. G. SERVICE DISCONNECT NO. OF - S- - RANGES iPECIALREC'Fi'. UNIT:HEATERS MULTI-OUTLET SYSTEMS , NO. OF FEET EXHAUST FANS DIMMERS P.0.BOX 305 , LAUREL, NY, 11948 Per llGENERAL MA~ER~ This c®dlRcofe must not be altered In ,,ny manner; return to the office of the So,rd if incorrect. In~pecfo['s moy be Identified by thek cre entiols. COPY FOR BUILDING DEPARTMENT( THIS COPY (DF CERTIFICATE MU~'NOT,~'SEiAET~R~ED IN ANY MANNER. JOINS PANEL 0481 ZONE X ~ONE AE COASTAL BASE FLOOD ELEVATIONS AFW~L¥ ONLY LANOWA, RD Ol: 0.0 NG ZONE AE (EL ZONE AE GREAT PECON OAKWOOD ZONE X Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (516) 765-1823 Telephone (516) 765-1802 November 15, 1999 Fred Milner 985 White Eagle Dr. Laurel, NY 11948 RE: Potdevin, 4250 Gt. Peconic Bay Blvd., Laurel. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. 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 # 25645-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROU~.BG. [ ] IN~a'LATION [ ~NAL ] FIREPLACE & CHIMNEY INSP~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ,] RO~PLBG. [ ] FOUNDATION 2ND [/_,~*INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP~AC~C.HIMNEY REMARKS. ~ DATE ~~,~/~.. INSPECT~ 765-1802 BUILDING DEPT. /INSPECTION [/_~ FOUNDATION~ND [ ] INSULATION [ ] FRAMING [ ]FINAL INSPECT~~ 765-1802 BUILDING DEPT. INSPECTION F~JDATION 1ST [ ] ROUGH PLBG. ~:)UNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REPORT ' DATE UNOATION UNDATION ISULATION PER N. Y. STATE ENERGY CODE FINAL Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18~2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD March 5, 1999 Donald G. Feller, Architect 11725 Main Road Mattituck, NY 11952 RE: ROBERT POTDEVIN Dear Mr. Feiler, The Southold Town Board of Trustees reviewed the survey dated and received in our office on March 5, 1999 and determined that the construction of an addition to house and a roof over stoop, t~o be out of the Trustee Wetland jurisdiction, under Chapter 97, of',,%~he Town Code. Howevef~,,,,~,a~y activity within 75' of the Wetland line would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept. FORHNO. I TOWN OF SOUTHOLD BUILDING DEPARTHENT TONN HALl, SOUTHOLD, N.Y. ]]97] TEl.: 765-1802 HOARD'OF HEAL fl ....." .- 3.,SET$ OF PLANS ......... ' ...... Su~v~x'~.q ........ CHECK '..~ ................... · -- SEPTIC FORH · NOTIFY~ CALL I'~IL TO:. .~ · · · · Date ................ ,19 .... a. 'mis application mint be ec~letely filled in by type~iter or in ink and aikuitted to tim Buildiag InsFector witl 3 sets of plans, accurate plot plan to scale. Fee according to ~hedule. b. Plot plan shemiag location of lot and of Imilditkgs on premises, relationshlp, tO adjoining pr~aiaee or public streets or areas, ~ gzwng a detailed deaerlption of layout of propert~ mint be drtr~n o~ the diagcam ~hich is part of tlus apphcat ion. ' ,, ¢. lhe ~ork co~ered ~y tld$ applleatlon ,~y not be eoa~aenced before isstmnce of Dailding Permit. ~,. Upon appro~a! of this apDlieation, the Building Zes~eetor wilt issue a Building Permit to the applicant. Such pemit sl~ll be.kept on the premises a~aitable for iospaction thrcughcut the e.' NO building shall be oncopled or ased in ~ahole or in part for any purpose ~hate~er t~tll a 6ertifleate of O~copancy shall ha~e heon granted by tim Building Inspector. AP~ICM'ION IS It~I~BY ~ to the Building Ilepartn~nt for the xssonnee of. a Buald~,.n~g Penmt pursuant to the l~ilding Zone Ordinance of the To~n of Southold, .Suffolk County, ~ York, and othe?'applleable La~s, Ordinances'or Regulations, for the etmatruetion of buildings, additions or alterations, or for ~ma!'o? d~olition, as herein described. The applicant agrees to oanply with all applicable la~a, ordlnasees, building code, housing code, and regulations, and to nd~it authorized inspectors on premises and in beltl'lfi~a8 for.neces~ ~Slmetions. ................ (Siguature of app"~mant, or naacp, if a corporation) (Hailing a&tress of applicant) State ~t~tber applicant is o~mer, lessee, agent, architect, engineer, general cdntractor, electrician, plmber or builder. t - ............................. lao~~.....~.....P...O.T..Q...~.. :~ '...., . ..... :' ........... ~ of ~onr of premises .......................................... ] ..... (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly autl~rized officer. (Nam and title of corporate officer) Builders License No ......................... . Pluabers License No ........ Electriciarm License No. Ottmr Traders License No ......... ]. I~eation of land on ~hich ~ark will be done .... ' ........................... ' ....................... ............ ' .... ] ......... Wotme Nk~ber Street Hanlet County Tax flap No. lO00 ~action ..... L~....~.-- .....Elock .... -C~---~. ....... Lot .'..,~;~.. ..... ~bdivi i~ ~ Ell ed Hap No Lot .......... .. · 2. State existing use and occupancy of premises and intended use and oecopaney of proposed construction:' ~~ ~-~m, ~.~ .... .0.~'~..~.'.... ............... a, ~xistiag ~m and, occupancy ..................... · .~,~ ~..~...~.. ....'. b. lnteeded tm and oecupan~y ..' ................ 3. P;lture o[ ~ork (cl~k ~hldl applicable): '~ ~dlding .... ...... ~iti~ .l~...... Alteration .......... l~ir ~a!~ ~ · ~ ~ ~ l~liti~ Other ~ ~,/,~ :~ ~ ~rip~i~) , ';, · (to ~ ~id ~ fili~ this I~i~,t.. ..... .~.[ .... :.:: .... :~ ~d~r gf Stories : .... ~ .............. r ,. ~pth ...t~.r.~. ........ m~r ..... t~ ....... ~r o~ SCorie~ .....~ ......... 10. ~te o~ h~rdm~ ~ ~ o[ Fomr ~r ....... , .......................... ~ · I I, ~ or u~ ~i~iict t. ~d~ pr~ a~ ~i~t~ .............................................................. 13. ~i1l lot ~ ~...~..,,...,....,....~ O,'~' ~ill ~ss fill I~ ~ fw~ I~i~s: i5. Is /his p~r~ ~iu ~ [~t~ o[ a rial i~tl~ * ~ .......... ~ .......... ; i PLOT DIAGRAH l~ate clearly ~ dlstl~tly al! ~lldl~s, ~mflmr ~iscing or pro~, ~ i~icate all ~t-I~k dtmnsions ~ ~rty lima. ~ st~r,i~ ~l~k ~r or ~scripti~ ~co~ing ro ~, a~ ~ s~r~r, ~s ~1 i~icace ~Im~lmr in'~erior or co~r lot.' ,,, OCt ~[IY (~ ........... (~e o[ it~ivi&ml sinai.8 c~tract) ~ (~Cractor, ~ent, coT~rate o[[icer~ etc.) o[ said (~mr or ~rs, a~ is d01y ~chori~ to ~rrom or h~ I~r~om~ a~e ~id ~ aid to m~ a~ [lie this al~)l, icati~l thai: ail statmntfl'c~ta[~ in this a~l.,icaCi~} are t~ to file ~8E o[ his h~l~ sift .l~l, ie[i a~xl that the ~r~ will I~ ~r[on~l 'ih"tl;e major ~t forO~'in O~e a~ticati~ fil~ tt~ith. 9~orn LO be[ore ma this ROtary IA~blic NO,