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20563-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24323 Date MAY 1, 1996 THIS CERTIFIES that the building ADDITION Location of Property 3790 PECONIC BAY BLVD. House No. Street County Tax Map No. 1000 Section 128 Block 6 Subdivision Filed Map No. LAUREL~ N.Y. Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1992 ~ursuant to which Building Permit No. 24323-Z dated APRIL 20, 1992 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 OPEN SCREEN PORCH ADDITION TO EXISTING OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to AUGUST D. & BARBARA KELSEY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 lvO~ NO. ,u 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) N-ON? 20553Z Date ............ ~ ............. , County Tax Map No. 1000 Section .... ~/...c~....~.. ........ Block ..... .~....~.. ....... Lot No......~.....~ ............. to application dated ....... "~ ~ ~.~.......~...~.. ................... , 19.~....ZC., and approved by the pursuant Building Inspector. BuiTding Inspector Rev. 6/30/80 ~: souTHO_LD_.-.~-J Form No. 6 TOWN OF SOUTHOLD BUILDIN0 DEPARTMENT TOWN HALL 765-t802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 fromBoard 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 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 Upre-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 applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - .25¢ 4. Updated Certificate of Occupancy - ~50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...................... Jew Construction...A'/.. Old O~ Pre-existing Buitding...A .............. ~ocation of Propa t ...... , .............. z ..................................... House No~ Street Hamlet )nwer or Owners of Property...~.~. .... ..~-.../-.~.~.:-.~. ................. ;ounty Tax Map No 1000, Sectiou[../~..~.. Block . Lot . ~ubdivision .................................... Filed Map ............ Lot ...................... .......... Date Of Permit ...... Applicant .................. :iealth Dept. Approval .......................... Underwriters Approval ........... . ............. 'lanning Board Approval ........................ ~equest for: Temporary Certificate ........... Final Certicate ........... ee Submitted:~L~,~', ~ ~ $ ' '?'~ '~"~ .................... ......................... ~ ~ ~~ ?OUNDA~ION (1st) ~OUNDATION (2nd) ~ Y {OUCH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 29, 1996 Mr. Augustus Kelsey P.O. Box 405 Peconic Bay Blvd. Mattituck, NY 11952 Re: Building Permit #20563-Z - (screen porch) Premises: 3790 Great Peconic Bay Blvd. surf. Co. Tax Map #1000-128-6-4 During a review of our building permit has expired, never been issued. files it was noted that the above and a Certificate of Occupancy has According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. ,/ ! i-r-l, t-- L 1 I ~i ~ , F~q (_FI L I -4 F-- 7© FO C~ . p~ New York State Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 Re: U A review has been made of your ~a_ ~7~'~u~/~~ K..~.,C.¢ xucc. ~.,'.." .' ",/ . . . Based on the information you have submitted the New York State Department of Environmental Conservation has determined that the parcel, ~-~pr o j ect is: Greater than 300' from inventoried tidal wetlands. ~ Landward of a substantial man-made structure ~)/~X~t~(~- greater than 100' in length which was construc/ted prior to Landward of the lC' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection, of a temporary fence, barrier, or hay bale berm. Please note that any additional work or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Administrator TRUSTEES Jo~m M. Bredemeyer, III, President Henry P. Smith, Vice President Albert I. Krupsld, Ir. John L. Bednoski, Ir. John B. Tuthill Telephone ($¥6) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Mnin Road P.O. Box 1179 Southold, New York 11971 March 27, 1992 Augustus D. Kelsey Peconic Bay Blvd. Laurel NY 11948 Re: SCTM% 1000-128-06-04 Dear Mr. Kelsey: The following action was taken by the Board of Trustees ag their regular meeting of March 26, 1992: Resolved that the Southold Town Board of Trustees Grant a waiver to construct a 10' X 35'3'' screened-in porch attached to front of house, as shown on application. If you have,any questions, please give us a call. Ve/7 ~ruly you__rs, John M. Bredemeyer, III President, Board of Trustees JMB/~jh 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSU...U~I, ATION [ ~I~AL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR I 6 1992 FORM NO. 1 '., i TOWN OF SOUTHOLD 'BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1~02 Examin, ...o~......, 19c]'..~___ Apl .~;q~. :., , 95~ .-M. Permit No. ~..O.~.~..~..~ (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 SETS OF~/3'~L.,NS .u~..''''''. SURVEY ~. ........... '''''' CHECK ................ , . . . HAIL TO: INSTRUCTIONS . a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. ~. The work covered by this application may not be cbmmenced before'issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available for inspection throughout the work. ~. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. · APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pen-nit pursuant to the ;uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in b~ilding for necessary inM~ctions. / ,. · ( f a amc, if a corporation) (Mailing address of applicant) :tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber Or builder} (as on the t.ax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. title of corporate officer Builder's License No. 0203 .~/.O.., j~.Z Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 0,9' T//~- a//~,~c,~'/¢ ~,,~ ~ /~. Location of land off which ~roposed work will be d'one, o.N .'?~ ~ .P~eo~,e ~ay e~ z//~ llouse Number Street Hamlet County Tax blap No. 1000 Section .................. Block ................. Lot .................. .. Snbdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy /X~dg~<x 4~ ' · nten e uscan occupancy .............................. . '~,4-',(.~. · '3. Nature of work (check which PPhcab e): New Building .......... Addition . .~.a~.c.a. ....Alteration ... Repair ........ ; ..... Rcmdvai ...... · ...... .~ . . . .. Demolition ....... Other Work ........ ?,, .t~..: I .... ': (Description) 4. Estimated Cost ....... ~ ........ Fee .~..'~. ' ~ (to be paid on filin~ this application) $ Ifdwelling numbcrofdwelling~nits .~. i ' · ' .......... Number of dwelling units on each floor If garage~,riumber of cars ' ' 7 ' $ ilany: Front ,.5.5.' ~ Rear ./4.._.6] ............... ~ ..... Height Number or Stories .... ,~. ' ' ' ';~ ' ............ Depth 3.5' · .Dimensions of same structure wiih alterations or additions: Front .~ ................................... Rear A7~6-' ~' ' Depth .~.41 ................. ................. ~. Height ........ Number of Stories ~;~ ...... \ ........ 8. Dimensions of entire new constniction. Frnnt ~A~' Rear ,-, Height ............ ) ....: ....' .... : ...: ;.D. ept .. ((4 .......... ............ Num bet of Stories ............................................ 9. Size of lot: Front .:../Oq'. ..... Rear .................... Depth ...3P~..~ ..... ~ .... I0. DateofPurchase ...&:4$.--.F.7.!' . Name ofFonner Owner 11. Zone or use district in which premises are situated ............. ,. .r. I2. Does proposed construction viol te any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ...... . Will excess fill be removed from premises: Yes 14. Name of Owner of~remises/q4~aJro.5 P/ff~z~- · · Address ~ ~a~- ..... ' .............. · ............... F.. Phone No..~,r Name of Architect ........... ! .......... Name of Contractor .~.oq..wL*./. .aavar..a; ./~.'~. .... Address .).2l~_/.o~.a/.vae 'z'max "Phone No ........... Is -' . · ', ...... ..~....Address .~.~.q~%7. a¢t.... :.. Phone No. 4.~?.X ././?.'1~. [5. tnzs property within 300 feet of a cxaax wetland? *Yes ........ - ~, .... ' *If yes, Southold T~wn Trustees mo ....... Permit may be requiredt ," ... i PLOT DIAGRAM i" ;. ' "" . Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frown property lines. Give street and block number or desc~iptioh according to deed, and show street names and indicate whether interior or comer lot. , FATE OF NEW YDP~, t. OF .... ..... S.S ['Marne of individual signing ~ontract) ove named· I .......... being duly sworn, deposes and says that he is the applicant I (Contractor ............. ' ..................................... , agent, corporate officer, etc.) said OWner or owners, and is duly ai, thorized to perform or have performed the said work and to make and file this all statements containqd in this application are true to the best of his knowledge and belief; and that the ,/~cat/on;that will be performed in the manner se't forth iu the application filed therewith. om to before mc this ; SURVEY FOR A UGUS TUS KEL SEY A T LA UREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 128- 06- 04 Scale.. I"--40' Feb. 20,1992 AREA = 38,468 sq. ft.