HomeMy WebLinkAbout24757-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26877
Date: 01/07/00
THIS CERTIFIES that the building
REPAIR ACCESSORIES
SOUTH/PEC
Location of Property: 1375 PECONIC LA
(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 MARCH 3, 1998 pursuant to which
Building Permit No. 24757-Z dated MARCH 9, 1998
was issued, and conforms to all of t~e requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is REPAIR ROOF ON EXISTING ACCESSORY BUILDING AND REPLACE ATTACHED SHED ON
AN EXISTING GARAGE AS ApPT.TRD 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
H 066699 12/29/99
N/A
ure
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
24757 Z Date MARCH 9 98
Permission
is hereby granted to:
JOHN WILLIAM NIERODZIK
PO BOX 363
PECONIC~NY 11958
for :
REPAIR ROOF ON EXISTING ACCESSORY BUILDING AS APPLIED FOR.
NOTE: REPAIR NOT TO EXCEED 50% OF FAIR MARKET VALUE UNLESS IT CONFOEMS TO 100-242
at premises located at 1375
County Tax Map No. 473889 Section 075
pursuant to application dated MARCH
Building Inspector.
PECONIC LA SOUTH/PEC
Block 0005 Lot No. 001
3 98 and approved by the
Fee $ 127.00
Building ~specto~
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF O~
This application must be filled in by typewriter OR uild
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lim
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 fort
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contain
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buil,
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
9pre-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 applic.
If a Certificate of Occupancy is denied, the Building Inspector shall state th~
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelli~$25.~0?j[
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buil'd~.0
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Qccupancy on Pre-existing Buildinm - $i00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate Of Occupancy - Residential $15.00, Commercial $15.00
Date .... L [~.~/. ~. ...................
New Construction ........... Old Or Pre-existing Building .................
Location of Property ...... ~ .................................... ~ ..... ~ ............
House No. Street Hamlet
Onwer or Owners of Property .............................................................
County Tax No 1000, Section.. ... .Block .... Lot ....
Subdivision Filed Map Lot ....
....
Permit No. .~ ..... Date Of Permit ........ ~pp~cann .... ? ................
Health Dept Approval .~./~. .........
...................... Underwriters Approval ..........
Planning Board Approval...~..~........ ........ . .
Request for: Temporary Certificate ........... Final Certicate....~.. .....
w- ..... T ...............
PO Box 709
Cu~hogue, NYl1935
December 14,1999
631 765-6861
Town of Southold Building Department
Town Hall
Southold, NY 11971
631 765-1802
Budding Permit #24757
1375 PeconicLane, Peconk, NYl1958
Tax Map #1000-075-0005-001
Please amend the above building permit to cover replacement
of existing shed. Attached is a construction plan drawing.
Sincerely,
Ray Blum
THE NEW YORK BOARD OF FIRE UNDERWRITERS P~l
8078234 BUREAU OF ELECTRICITY ,- :
40 FULTON STREET, NEW YORK; NY 10038 ~
V DECEMBER 29,1999 19593299/99 H e66699
THI~ CERTIFIES THAT , , ~'
only the elect~cal equipment as described be~w and in~oduced by the applicant nambd, on the~above 'applica~on number ~ in the premises of
BLUM, 1375 PECONIC ~, PECONIC, NY ,~
G~
2nd
Fl.
Section
B~ck
was examined on~ and found to be in compl~nce with the Na~onal Elec~ical Code..
FIGURE I,ECE~ACLESI SW TCHES I FIXTURES RANGES [coo~,.= =.c~.l ov~Ns IDISH WASHERS EXHAUST FANS
OUTLETS INCANDE~ENT FLUORESCEN~ OTHER ~MT. K,W. AMT, K,W. AMT. K.W. %MT. K.W. AMT. H.P.
1 1 I 1 . , _
AMT. ~,W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP, AM~ AMPS. TRANS.'J ~T~' J ~. NO. OF FEET
I I
/
SERV CE DISCONNECT to. OF] S E R ' V I C E
OTHER A~ARATU$:
P O BO X 151
PECONIC, NY, 11958 1GENERAL MANAGE, R
Per I ; ..... ~,
This certificate must not be altered in any manner; return to the office of the Board if incorrect.~ Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ML)ST NOT BE ALTERED IN ANY MANNER.
FIELD INSPECTION NEPORT - DATg : ~ COI~I~NTS
I
ADDITIONAL C01~IENTS:
./
BLDG.,,DEPT.
PO Box 709
Cu~hogue, NYl1935
December 14,1999
631 765-6861
Town of Southold Building Department
Town Hall
Southold, NY 11971
631 765-1802
Building Permit #24757
1375 Peconic Lane, Peconic, NY 11958
Tax Map #1000-075-0005-001
Please amend the above building permit to cover replacement
of existing shed. Attached is a construction plan drawing.
Sincerely,
Ray Blum
7G5.~1802
BUILDING DEPT.
.INSPECTION
[~FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO~NDATION2ND [ ]INSULATION
[ ~'~FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: /~,~ ~
DATE
I NSPECTO ~"R~~~'/
THE NEW YORK BOARD OF FIRE UNDERWRITERS PA~E1
8078234 BUREAU OF ELECTRICITY
~- 40 FULTON STREET, NEW YORK, NY 10038
THIS CERTIFIES THAT
only the elect~ca{ equipment as described ~.low and introduced by the applicant .amed o. the above applica.o, number is in the premises of
BL~,~ 1375 PECONIC ~, PECONIC, ~ ~ ' ~ r
. . DgC~gR 2e, 1999 anUfo~d t~ ~ COmpronce with the Na~onal ~t~tricat Code:
I I I
~OTHER APPARATUS:
RAY BLUM
P O BO X 151
FEE PAID
· AMOUNT
PLEASE REMIT BY CHECK OR MONEY
ORDERTOTHEORDEROFTHENEW
YORK EOARD OF FIRE UNDERWRITERS
AS CASH SENT BY MAIL WILLEE AT RISK
OF SENDER.
THIS IS YOUR StLL FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF CO~4P/IgNCE. THI~ BILL PAYABLE AT THE NEW YORK OFFICE, 40 FULTON STREET, NEW YORK, N.Y, 10038
Box 709 Main Road
Cutchogue, NY 11935
March 6, 1998
516 734-7361
Michael Verity
Town of Southold Building Department
Town Hall
Southold, NY 11971
1375 Peconic Lane, Peconic, NY
Tax Map #1000-075-0005-001
Current Owner: John Nierodzik
I am requesting.~uilding Permit to repair the existing 'out
building~/~m~.:~-The nature of work being:
1. "Sister" existing roof beams with like material
2. Replace damaged sheathing
3. Tar paper and re-shingle roof
4. "Sister" any damaged wall studs
5. Reside/replace any damaged wall siding with T-11 or
equivalent material
Sincerely,
y um (New Owner)
FORH NO. ]
TOWN OF SOUTIIOLD
BUll. DING DEPARTNENT
TOWN I1ALL
SOUTI101.D, N.Y. Jl971
TEl,: 765- 1B02
Di~apln-6ved a/c ....
BOARD OF IlEAL'H1 ...............
3 SETS OF PLANS ...............
SURVEY ........................
CIIECK .........................
SEPTIC FORH ...................
~OTIFY:
CALL ..................
HAIl. TO: ....................
(lldHding ln~,~eetor )
" . ~1~ ~ APPLICATION FOR BUII.DING PERHIT
i___=, ........ ' , ....
i B~DG. DEPT. / INSTRIICTIONS
a. ~ds ~lleati~ mst I~ c~letely fill~ in ~ ~.~iter or in ink a~ ~itt~ to the ~dldlng lns~tor ~ith
3 ~ts off plans~ aeo~ate plot plan to scale. Fee acco~li~ to sch~de.
b. Plot plan ~i~ l~atlm of lot nM of I~dldbgs m ~i~s, mlati~shlp to ~joln[ng ~i~s or ~bllc
at--ts or arena, mffi givi~ a ~btailal {br<rlptlm oF l~fl: of p~rl.y mint 1~ drmm m the dia~ ~HcJ~ 18 ~art of
this aris icatlm.
c. llm ~k e~ by fl~is ~lieati~ ~ ~)t Im c(~m~l lmfore ismmme of ~dldi~ Pemit.
d. U~ a~a[ of Ud$ n~lieati~, Ihe l~fildisB 'lns~ctor will [s~ a hdtdhg ~mit to the o~limnt. ~<h
~mlt ~mll ~ kept ~ tl~ ~i~a ~ailnlfle for ins~ctlm I:hr{a~a:t tim ~rk.
e. ~ Imildi~ ~mll ~ ~i~l or uml in ~ole or in [}art for a~ ~r~ ~mt~r tmtll a C~rtlficate of
~ ~all h~ I~ ~t~l ~ fl~ ~ildi~ Inserat.
~l~'r[~ IS I~l~ ~E to fl~ I~ildi~ ~¢artmnt for O~e ismm~e of a ~fildi~ Pemit p~r~nt to the
~ildi~ ~ ~im~e of tim ~ of ~tlmld, ~fffolk ~ty, ~ York, ~ DO,er a~lieable l~$, ~i~es or
~latlms, for tl~ ~$t~tim of ~ildi~s, akht~ms or alteratims, or f~ ~ ral or~tion, a~ t~in
re~latlms, md to ~it m~fl~rl*~ in~t~s m pr~s md m I~nld~
.... . ..............
(Si~re 9ff~ Le~t. or n~, ir a ~ra~)~
................
(~ili~ ~lmss of ~lie~t~
State *tlett~r al~lleaat is ?r~rf les.q~, agent, ~ddLe% ep~J, ~mral cmtractor~ electrician, pl~r ~ I~il<~r.
.......................... ......................................
(aS m tim t~ mil or latest d~)
If amlicant is a m~ratim, si~tnre of ~,ty ~tl~rlz~ offflcer.
~ ~ ~MENT AT
REQUIRED
l~ilders License No .......................... t
Plumbers License NO .......................... 4. FINAL ~ CONSVRU~TION 'MUST
Electrmmns L~cense No ...................... ALL CONSTRUCTION SHALL MEET
Other Trade's License No ..................... THE REQUIREMENTS OF 'i'HE N,Y,
STATE CONSTRUCTION & ENERGY
lx~c~tic~ of lmxt ~ ~hi~ch proposed work will be done ......
· Pecoat c Lm.2g,
ltouse ~r Strut
(~)
(Lo ~ fid (,I filing Lhi~ al~lJcarJ¢~)
aLe,:Lure lwith alteraticsia or l~klitionn: Front: ......... l~ar
.
i~ilO~r I KJdmr of 81'oriea ...... ~ .............. :
· }lr~ ef lot: Fr{~r ................... }~nr .................... IMpth ....................
I
I.
12. l~ma pre[~l c~mtnmLi~ v~o[aLe any ~dnfi 1~, erdit~me or regularly,: ........................
~n of C~rracter ......... ~ ......................... ~klress ............................... [~1oi~ ~ .............
PI.OT DIAGRAM
I~:ale clearly al~ dtatllmtl~ fill Indldit~s, d~ethe~ existing or pro~m~l, ar~l ilxlicare all set-l~k dlmnaions
fro. prol~rty lt~ea. Oi~ at~t hrgl bl~k nel~r er {~acriptit~ acce~ling to ~ed, taxi M~ $tree~ ~s mgl I~lieate
~d~ether lntet'ior or eonmr tot.~I
)
((~)IILI-iIC~Or~ ~l[~l)t:) (:orlx)rme ()fl:it:er, ele..)
(ff ~mi(I (~r or (~l~;, mM ia th:dy ntitiR)[ ize(I to ixtr.l'();u~ ()t have i~rl()in~,(I Iix( mhd ~)tk ulKI t() ll~l[{e iiixl f{Je (hi~;
alq)licntio,; that all. ntatoi~nl.a (()l)tah~N ii) t[l{$ applit:at:ion ~lt'e t ii~ Lo the I~m; ol: hi8
IJJJlJ III(T ~)Tk will J~ i~rl'ont~l in tlx~ II~llll~r Bat forth iu ilia iqqdieation filed tl~rc~ilh.
~l
~.,d~'CE¥ Ot=
SITUATE: F~ECONIC
TO~N OF= SOUTHOL~
DETAIL
GRAPHIC SCALE
0 ~00
t"= ~00'
200 300
55~ °24~0~,1,,,I
150.00~
FEE: -- 0'- _ BY: ~
NOTIFY BUILDING DEPA~E~ AT
765-1802 9 AM TO 4 PM FOR THE
FOLLO~NG INSPE~IONS:
1, FOUNDATION * ~0 REQUIRE~
FOR ~UREO CONCR='~ =
2. ROUGH - F~MING & ~UMBtNG
3~ INSU~ON
4. F~NA~ -CONSTRUCTtON MUST
BE COMPL~E FOR C~O~
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUe;ON ERRORS
OGCUPAI~CY OR
USE iS UNLAWFUL
WITHOUT CERIff~CAIE
OF OCCUPANCY