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Home My WebLink About16805-zFORM NO. 4 ToWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22367 Date MAY 28, 1993 THIS CERTIFIES that the building ADDITION Location of Property 5400 PECONIC BAY BLVD. LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 128 Block 2 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21~ 1984 pursuant to which Building Permit No. 16805-Z dated MARCH 14, 1988 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 UNDER-PINNING ON HOUSE & KITCHEN ADDITION TO EXISTING oNE FAMILY DWELLING The certificate is issued to RUSSELL IRELANDe JR. & WIFE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-650146 - JUNE 29, 1984 / /uildlng inspector Rev. 1/81 l"O'n.M' NO. ii TO~N OF $OUTHOLD 8UItDING D£PARTMI:NT TOWN HALL SOUTI'iOLD, N. Y, BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE, WORK AUTHORIZED) N-o16805 Z Permission is hereby granted to: .................................................... .~ ' ~. ~ .~ - . / / 73 ~-.- ., at premises located at ~..~...~.1~...... ,.~..~~......~..~....,.'~...~. .............................. County Tax Map No. 1000 Section ...... ./..~....~.. ...... Block .......... ~ ...... Lot No. / ~:~ pursuant to application dated ///'fi/°~ 19 ......... and approved by the BuiJdlng Inspector. Rev. 6/30/80 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13177 Z County Tax Mop No. 1000 Section ..... L..~......~. ........ Block ....... ~ ..........Lot No ....... )...~ ......... Building Inspector. Fee $ ........................ and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~PLICATION FOR CERTIFICATE OF OCCUPANCY ~his 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. 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 '!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 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. C.' Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging 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 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 - Date ....... ~.~ · .'.~ .................... New Construction ..... ...~.. Old Or~.Pre-existing Building...~.~ !,.....~..~ Location of Property..-....,-.. ......................... ~ouse No. Hamlet Onwer or Owners of Property ..... ~.~$~-~.I ...... --~--~J~-~.~- .................................. County Tax Map No I000, Section.../..~.~ ...Block. ~ ...Lot. Q I .~. Subdivision .................................... Filed Map ............ Lot ...................... Permit No. ~~.~ .Date Of Permit'S. ~{-~.Applicant .......................... ~ o Heaith Dept. Approval ........ ~ ............ Underwriters Appr val~...~.~.~..Z.~.i' i Planning Board Approval ..... / Request for: Temporary Certificate ........... Final Certicate ....... Fee Submitted: $...~. '..~. ~. · · APPLICANT TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTHOLD, N.Y. ! 1971 TEL. 765-18O2 Thxs [r~ to advtse you that the job under building permit no. 13177Z issued to Russei Ireland oa _~31__~ .... for Alteration is completed a final inspection has ( ) has not ( x )"been done. and ;n order to complete thie file, it is necessary that ;, (;ertificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with n check for $10.00 payable to tile Town of Southold. Please indicate to Whom the Certificate of Occ~pancy is to be mai~ed~ and arrange with tills office for an inspection date Occupancy or n~e in nnlawful without a Certificate of Occnpancy. Plea.e, help us to clear up th[s matter so that legal act{on does not have to be taken. Thank you for your prompt attention. Vary truly~, Victor Lessard Executive Administrator VI,: ga r encl . VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O~ Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 14, 1988 Mr. Russell H. Ireland, Jr. P.O. Box 231 East Norwich, New York ]1732 Re: Building Permit #16805 Z Dear Mr. Ireland: Enclosed is your permit replacement for permit #13~77Z and a C.O. application form for permit #11016Z. Please make corrections listed in January 6, 1988 inspection and call for a final inspection. Return C.O. application with a check for $25.00 so that we can finalize these permits. Very truly yours, $OUTHOLD TOWN BUILDING DEFT. TF:gar encls. Thomas Fisher, Building Inspector TIELD l,l.i~ ECTION FOUUDAT i'Otl ( 2nd ) BOU~II FXAME & PLUMBING ~IISIJ[,A'TION PER ~J. Yo STATE ENERGY C,ODE FINAL ADDITIONAl, COHMENTS: VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box I 179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 6, 1988 Mr. Russell H. P.O. Box 231 East Norwich, New York Re: Dear Mr. Ireland: Ireland, Jr. 11732 Building Permit #13177 Z Pursuant to our conversation of today, your building permit expired on November 30, 1985. Since the work is not yet completed, please fill out the enclosed building permit application and submit it to this office with a check in the amount of $50.00. I am also returning your check #17~6 in the amount of $10.00 for the Certificate of Occupancy. When the work is completed and has passed the final inspection, please submit a new check to us in the amount of $25.00 for the Certificate of Occupancy. Thank you. SOUTHOLD TOWN BUILDING DEPT. GF:gar Gary Fish Building Inspector 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION FRAMING REMARKS: 2ND [ ?SULATION [//] FINAL FORM NO. TOWN OF 8OUTHOLD BUILDING DEPARTMENT TOWN FIALL SOUTFIOLD, N.Y. 11971 , . TEL.: 765-1802 Examined Approved Uis~ppm~e~ ~/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date..0.'-/.~.[.I ............ 19 ~.~] INSTRUCTIONS a. This application must b~ completely filled in by typewriter or in ink and submitted in triplicate 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 Iuspector will issue 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 Occupai~cy 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. - to°de' and regulations, and to admit authorized inspectors on premises and in buildings for necessary~ns. /) r~ r'~ J -~ (Signature of applicant, or name, if a c~rporatio ) ''?:~'"'~'~": ............... '~ /t /O (Mailing address of applican ) I 7 ' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... (~. q~o ~.~?. ................................................................................. Name of owner of premises ....~..~.~.e./.[.../J.... ~..~.~..LO~. ~... '.~.e,... ........................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Na/ne and title of corporate officer) 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 .................................. ~/.;~X' ' ,;,L, ........ ......................... .... .... .......... ....... ........ House Number . St reef(/ Hamlet ' C~>hnty Tax Map No. 1000 Section .. [.ag..qO ......... Block .... ~..~.q .o ........ Lot...o.. ! .z. ?p.o. ....... Subdivision Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~. ~.~ b. Intended use and occupancy ,.......~am~c~. ......../~¢s~'.~........ .............................. 3. Nature of work (check which applicable): New Building .......... Addition .~).e,.q~ .... Alteration ~ ...... Repair .. ~ ......... RemoVal .............. Demolition .............. Other Work ............... 4. Estimated Cost . · [~ .qq.o...i ............... . ............. / ~ (to be paid on filing this application) 5.If dwelling, number of dwelling umts ............... Number of dwelling units on each floor ................ If garage, number of cars ..... ; .................................................................. 6. If business, commercial or mixedi occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structureS, if any: Front..~....~/ ......... Rear . ,q.~..I. .... Depth · ~5/ ........... Height · Aa:..........Number, of Stories. . qo.o. ................................................. ~. Dimensions of same structure wi~h alterations or additions: Front .Sa~.~-~.......... Rear . .~o.?~...4. ' t~" · ' Depth. ~,~-~-~ ............. i.. Height . .,Ct,/ ................. Number of Stories.. -Kau~-~ ............ ' pth 8. Dimensions of entire new construction:. Front ............... Rear ............... De .............. Height Number of Stories ·. g " ;?4 ~ ' ~ Rear .5' 3.) ............... Depth .q~ ~ .. ............ 9. Size of lot: Front . ./.~ .................... " ' 10.' Date of Purchase . O.~-~10+~. (/.~.../.0.Eo. ........ Name of Former Owner . .0.r.q .l°c~. · 7; .~o.,et/pf. .......... 11. Zone or use district in which pr~mises are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................... 13. Will lot be regraded .. ~.~ .... ................... Will excess fill be removed from premises: Yes '(~ Name of Architect .......... ! ................. Address ................... Phone No ................ ' Address Phone No Name of Contractor I ................................... PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dnnens~o s from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si ning contract) above named. He is the .......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is c~uly authorized to perform or have performed the said work and to make and ~e this application; that all statements coptained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manlner set forth in the application filed therewith. Sworn to before me this ir term ,k 7L $ Ill,copper tubing is used water distributing %'ys.em; piping shall be types K or L only_ A7 3 AS NOTED rEE,~,,~". ~ BY' b' (~. L , NO~II~LD~iXIG DEPARTMENT ^T 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPFCTIQNS: ~. FOUNDATION TWO REQUIRED FOR Pr'II~r-D CONCRETE 2, ROUC'-I - FRAMING & PLUMBING r- '1