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FORM NO. 4
TOWN OF SOUTHOLD
.BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20416 Date DECEMBER 18, 1991
THIS CERTIFIES that the building ADDITION
Lccation of Property 2625 PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 128 Block 5 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 5, 1991 pursuant to which
Building Permit No. 20020-Z dated JULY 17, 1991
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 AND
AS PER ZBA APPEAL #4036.
The certificate is issued to ELLEN M. BRAUNSTEIN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. PENDING - DEC. 3 1991
PLUMBERS CERTIFICATION DATED N{A
Building Inspector
Rev. 1/81
!ORM N0. f
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~ ~~VZ® Z Date i9.~.
Permission is hereb,~y
°nt to:
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to 4 ss17r...~!?~~.....~ r. ..fa7~.~??~.. f~...Y...
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at premises lasted ot .:~,lcr..eZ..~.../.~~~'~~~.!~Y..
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County Tax Map No. 1000 Section ....~~'?i..Cl........ Block Lot No.
......y~............
i pursuant to application doted ....~~..~w'?~ 19../....., and opproved by the
f Building Inspector.
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Rev.6/30/80
Form No. 6
TO[JN OF SOUT[IOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
BLDG. DE
OP SO APPLICATION FOR CERTIFICATE OP OCCUPANCY
This application must be filled in by typewriter OP, ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property caith 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 17 lead.
S. 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.
3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-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 Co 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.
C. 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4, Updated Certificate of Occupancy - $50.00
S. Temporary Certificate of Occupancy - Residential $1//5.00, Commeercial $15.00
L/ Date .......la~
::cw Construction.... O/-ld Or Pre-exisy~ting Building., y~
Location of Property...~X~~(.J ............./,"~CCJ/(~/C ~~~.....~GVl~J....... ~:/?.~C?2~7.-..
House No. ~r Strej-et Hamlet
Onwcr or Owners of Property.......~"Z..~~~....~:1,:...U.n-~C~;$/, 1./~
County Tax Map No 1000, Section.....~~.~...Block... ~.........Lot
Subdivision ....................................Fi/led M:tp............Lot......................
Permit No..~~J~.Q,.,,.Date Of Permit...?~/~/, 9/, ~._,/LC/L~~'~,Sf~itCl'.. ,
.Applicant. -~?~c~
itealttt Dept. Approval ..........................Underwriters Approval.....................
Pl:nuting Board Approval .
^e9~~est for: Temporary Certificate........... Final Certicate.....
:'ce Submitted: //f//j~,
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INSPECTORS
Victor Lessard ~;j;a'fl~;~~
Principal Building Inspector 1,~~\1~~' ~~,y ~
Curtis Horton ~x=' SCOTT L. HARRIS, Supervisor
Senior Building Inspector 3~-~i ' ~ "~~'t'
Thomas Fisher, ~ 1aP Southold Town Hall
v ~ ~ ~ ' P.O. Box 1179, 53095 Main Road
Building Inspector ~
Gary Fish ~ i Southold, New York 11971
Building Inspector dp =~;a ~Sy" Fax (516) 765-1823
Vincent R. Wieczorek '``~'"r-~°~'1 Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
DECEMBER' 13, 1991
A. REILLY h SONS, INC. ,
P. 0. BO% 98
MATTITU IC, NY 11952
RE: ELLEN M. BRAUNSTEIN
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)
No Underwriters Certificate on file.
The check is (outdated/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 # 20020-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
CC: ELLEN M. BRAUNSTEIN
ciELD iI:SPEC;iUN ~~UATE ~ OOMMENTS
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FORM NO. a
' T05VN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTIIOLD, N.Y.
NOTICE OF DISAPPROVAL
s Date ....~P./ 19 9~
To .~U.<~-s?-~E~~di~X~.-1~G..~G.,6-~j .tj'yf. .t~,~~~rr,~~'.......
. 9~' . .
PLEASE TAKE NOTICE that your application dated•!....~~'../, ; , , , , , , , , , , , 19 .
for permit to ~~xi~~!-~. ~.e j~X!'t3j:. ~~~Z!`~4~r~s.~........... at
Location of Property ~.lP. a`~, S~J,'. ~ G
House No. Street Ham/e~
County Tax Map No. 1000 Section ,/,off ~ , ,Block , , , , . , , ,Lot .
Subdivision Filed Map No . Lot No. '
is returned herewith and disapproved on the following grounds .Cs~~Y„ Gf~~~!~. .
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uil ng Inspector "
RV 1/g0
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APPEALS BOARD MEMBERS 3'n~~,~ ~ SCOTT L. HARRIS
.~~;~'e'~ ~ Supervisor
Gerard P. Goehringer, Chairman ~ ; ~~,a~i
Charles Grigonis, Jr. ~ ~ Town Hall, 53095 Main Road
Serge Doyen, Jr. ~ ~ ~ a;~e: r; ; ~ P.O. Box 1179
James Dinizio, Jr. 'i '".a ' ~ ~ Southold, New York 11971
Robert A. Villa `~'~2 a;~"~'~y' Fax (51~ 765-1823
Telephone (516) 765-1809 Telephone (516) 765-1800
r~xzzcu''"
BOARD OF APPEALS
TOWN O~' SOUTHOLD Q
July 17, 1991 i1Jl , T
BLDG. DEPT.
TOWN OF SOUTHOLD
Mr. Norman Reilly, Jr.
A. Reilly & Sons, Inc.
P.O. Box 98
Mattituck, NY 11952
Re: Appl. No. 4036 - Variance for Braunstein
Dear Mr. Reilly:
Transmitted for your records is a copy of the determination
rendered by the Board of Appeals concerning the above
application.
Please be sure to return to the Building Department and any
other agency for permits or other approvals which are
appropriate for this project. A copy of this decision has
simultaneously herewith been transmitted to the Building
Department for its file and update.
Very truly yours,
Linda Kowalski
Enclosure
Copy of Decision to:
Southold Town Building Department
J~
APPEALS BOARD MEMBERS "~~:a SCOTT L. HARRIS
~ Supervisor
Gerard P. Goehringer, Chairman ~
>,yy
Charles Grigonis, Jr. ; ~ ~ -~'~j
Ser a Do en, Jr. Town Hall, 53095 Main Road
8 Y ~ P.O. Box 1179
James Dinizio, Jr. ? ' -:°W~ # • Southold, New York 11971
Rober[ A. Villa ~~d'' r;~ Fax (516) 765-1823
Telephone (516) 765-1809 4rar1,~~,. Telephone (516) 765-1800
BOARD OF APPEALS 1,.~~~-~ f; r ~r/
TOWN Ox' SOUTHOLD ~ t~', ~L,~ ~ l~/
ACTION OF THE BOARD OF APPEALS ~U~ J(JL + 7
Appeal No. 4036: U BLDG.DEP7:
70WN OF SOII7HOLD'
Application for ELLEN BRAUNSTEIN. Variance to a onin
Ordinance, Article ILIA, Section 100-30.A3 to construct
addition to dwelling with reduced rear yard setback on this
corner lot. Lot area is nonconforming in this R-40 Zone
District. Location of Property: Corner of Wendy Drive and
Peconic Bay Boulevard, Laurel, NY; County Tax Map Parcel No.
1000-128-5-7. Also referred to as Lot "A" on the Map of
Rollingwood Estates.
WHEREAS, a public hearing was held on July 12, 1991 and at
said hearing all those who desired to be heard were heard and
their testimony recorded; and
WHEREAS, the Board has carefully considered all testimony
and documentation submitted concerning this application; and
WHEREAS, the Board Members have personally viewed and are
familiar with the premises in question, its present zoning, and
the surrounding areas; and
WHEREAS, the Board made the following findings of fact:
1. This is an appeal of the June 6, 1991 Notice of
Disapproval from the Building Inspector for a proposed 15' x 15'
addition to existing dwelling with a reduced rear yard setback
to 28 feet (shown on the sketch submitted with this
application).
2. The premises in question is a corner lot with frontage
of approximately 98 feet along Wendy Drive and approximately 120
feet along Peconic Bay Boulevard, Laurel.
3. The subject premises consists of a total nonconforming
lot area of 14,375+- sq. ft. and is shown on the Minor
Subdivision Map of Rollingwoods Estates as Lot A.
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765-1802
BUILDING DEPT.
INSPECTION
' [ ]FOUNDATION i5T [ ] ROUGH PLBG.
]FOUNDATION 2ND [ ] I UI.ATION
[ ]FRAMING FINAL
I REMARKS:
1
INSPECTOR
DATE ~ j ~ ~
~r, . r _ : ~ , _
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FO NDATION 2ND [ ]INSULATION
[ FRAMING [ ]FINAL
E REM RKS:
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DATE INSPECTOR r~~~
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] R GH PLBG.
FOUNDATION 2ND [ INSULATION
[ ]FRAMING [ ]FINAL
,4 REMARKS: ~~Cid~_
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DATE ~ INSPECTOR
~ r. ,,u_~_ . z ~ _ - ,
765-1802
BUILDING DEPT.
INSPECTION
'E FOUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
~ [ ]FRAMING [ ]FINAL
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I REMARKS:
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( DATE J"`~ INSPECTOR ~G~
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"'"'"'rva~~r \`~J 7'1"((°``°"" BOARD OF HEALTH
~'I"~,I".~c~~~~a\V/_ I 3 SETS OF PLANS
,p~...~., !I FORM NO. 1 SURVEY .
JUN - 51991 TOWN OF SOUTHOLD CHECK .
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
~.~~E)~t~P°t.~` SOUTHOLD,N.Y.11971 NOTIFY
n-.•n. p~ J
_.,.-~:ttc,!b~ s TEL.:765-7802 ~..o~i./(rr- l~~•a.
p CALL
Examined .Spry?.:`:........~.., 19 MAIL T0: ,
Approved 19~Pennit No.
Disapproved a/c ..~j 6 , , ,~'t~~ , , , , ,
(Build' g Insp . or) . .
APPLICATION FOR BUILDING PERMIT
Date ...`~~/V..........., 15
INSTRUCTIONS
a. Tltis 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 i[nJspections.
(Signature of applicant, or name, if a corporation)
..C'.-.~.. ~x..~... !~I~9c~.~!Y
(Mailing address of app]icant)
State whether app/li~cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............(j.~~~6-~C.....CJ~.7.~~...n............................................
Name of owner of premises ~.?L~~!... ~ .......adze~r~s.~7.C1/ .
(as on the tax roll or latest deed)
If appli n 's a corporation, si tur f duly authorized officer.
(Name and title of corpor o ficer)
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. '
.
House Number Street, Hamlet
County Tax Map No. 1000 Section ,/.o'Z.$~.......... Block , , , , , , , , , , Lot
Subdivision Filed Map No. Lot...............
(Name)
State existing use and occupancy of premises an//~~d intended use and occupancy of proposed construction:
a. Existing use and occupancy ............/.4~j1~~1!T
b. Intended use and occupancy C ~~~.y,~l,?t!i-!f~ '~~'~44~i~^A"•'t`~~r~4~oq
. ,
Na[ure of work check whit
Re air , , , ( ~ aPPhcable): New BuildinS , , , , , , , , Addition Aiteratian .
P R moval . . Demolition Other SVork .
I.
+'t~l {Description)
4. Estimated Cost ....../!!j 0.~ : U~ Fee .
(to be paid on filing this application)
^ ng units . Number of dwelling units on each floor , , , , , ,
If ara_e, number of cars
fdtvellin~ number ofdwelli
6. If business, commercial or mdxed occupancy, specify nature and extent of each,4y a of use , , , , , , , , , , , , ,
5 s Numb if any: Front , . 5.'.7........ Rear ~ De th . ,
Hci~ it
1
ip ens~ans o ewsGn struct, with alterations or additions: Front '
Dimensions of same structurebres er of Stories , , , , , , , , , , , , p o'~rv. ' ' ' ' ' ' ' '
Dc, th... Rear............
• . IIeight . . . . . . ,Number of Stories . ~ •
8. Dimensions of entire new construction: Front . Rear . .Depth ~ • •
Height Number of Stories • • .
9. Size of lot: Front ~a~:.......... - Rcar , De th .
10. Date of Purchase p
••••••.••..,.NameofFormerOwner
1 I. Zone or use district in which iolate an are situated .
p p premises
y zoning law, ordinance or regulation : . .
13. Will lot be re,raded , ,
Narri /t • • ........Will excess fill be removed from premises: Yes Nc
14. Name of Owner,of premises VI',
.~H.rr,~7,'ir?v, ,Address . L~a~tl'.G~L. , , , , , , ,Phone No. .
e of Architect .I, _ , , , , , • • . • , • , , , , ,Address . .Phone No. .
Name of Contractor . ~ ,Address ,Phone No. .
IS.Is this property located within 300 feet of a tidal wetland? *YES....NO.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly all bui]dings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whett~et
interior or corner lot.
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STATE OF NE1V YORK, „
COUNTY OF ......5.!~¢, ("z~'-LC 'i S.S
• ~
• • ~ • 3~/~ ' ~ ~ ~ ' ' ' ' SiLL • being duly sworn, deposes and says that }te is the applicant
(Name of individual sip ~in~ntract)
above named. ~
He is the......(,p?~Q,/~/fc~Q;/~•••,••
(Contractor, agent, corporate officer, etc.) • ~ • • • • • ' ' ' ' ' '
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are ~truc to the best of his knowledge and belief; and that the
work will be perforned in the manne'!F set forth in the application filed thercwit}t.
Sworn to before me this
......day ofl. • 19 .
it ~~~~~J••`
Notary Public, , , , h`=!, , ;e!1;`;`;
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; County
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Na2?.16;Buffogt (Signature fapplicant)
Term EHplras June 12, • •
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