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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southo1d, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33084 Date: 06/10/08
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 1425
(HOUSE NO.)
County Tax Map No. 473889 Section 127
LAURELWOOD DR
(STREET)
Block 5
LAUREL
(HAMLET)
Lot 9
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in tbis office dated
MARCH 25, 2008 pursuant to which
Building Permit No. 33768-Z
dated
MARCH 25, 2008
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 MINOR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING.
The certificate is issued to JAY P & JOANNE SLOTKIN
(OWNER)
of the aforesaid building.
SUFFOLK cotJlIITY DEPARTMEHT OF HEALTH APPROVAL
N/A
N/A
ELECTRICAL CERTIFICATE lifO.
N/A
PLUMBERS CERTIFICATION DATED
~ri~
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
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 Department with the following:
A. For new building or new use:
I. 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 I % 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.
B. 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 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
I. 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 - $.25
4. . Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Ow JO~!6'if
I
(check one)
Date.
Old or Pre-existing Building:
./
New Construction:
~d
Locationofproperty: !4-J.t) l 'M1t..f~ lw
House No. Street
Owner or Owners ofproperty: :t p. S~~ <\. fVI"JOl4vtL b Lv / I - Sl.cl~
Suffolk County Tax Map No 1000, ection \ 11 Block 000,1)
Hamlet
Lot
DOC)
Subdivision Filed Map.
----Permit No. 33'7C,g--:; DateOfpermll.#--, Applicant:
Health Dept. Approval: Underwriters Approval:
Lot:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
v'
(check one)
Fee Submitted: $ .25:. () 0
QO ~ 33of(-f
16<:.- 7YVY0
{tt~/ ~
pplicant Signature
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.
Date MARCH
33768 Z
permission is hereby granted to:
JAY P SLOTKIN
1125 LAURELWOOD DRIVE
LAUREL,NY 11948
for :
25, 2008
ALTERATIONS TO AN EXISTING DWELLING.REPLACES EXPIRED BP # 30022
at premises located at
1425 LAURELWOOD DR
LAUREL
County Tax Map No. 473889 Section 127
pursuant to application dated MARCH
Block 0005
Lot No. 009
25, 2008 and approved by the
Building Inspector to expire on SEPTEMBER 25 2009.
Fee $
200.00
ORIGINAL
Rev. 5/8/02
I
'zed'Signature
'--
---~
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.
30022 Z
Date JANUARY
21, 2004
Permission is hereby granted to:
JAY P SLOTKIN
LAUREL,NY 11948
for :
INTERIOR ALTERATIONS AND ARBOR ADDITION TO AN EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR
at premises located at
1425 LAURELWOOD DR
LAUREL
County Tax Map No. 473889 Section 127
Block 0005
Lot No. 009
pursuant to application dated JANUARY
21, 2004 and approved by the
Building Inspector to expire on JULY
Fee $
150.00
21, 2005.
'\
/
uth rized
ature
ORIGINAL
Rev. 5/8/02
3 37~ l :z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
N~
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f ,r :J.-~() Y
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRucnON
DATE
[ ] ROUGH PLBG.
[ ] INSULATION
pi FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
-
d-
INSPECTOR
~~
3370 f 7-
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
~t(
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING rU FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
REMARKS: ?~ ~ ~ ~
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FIELD INSPECTION REPORT DATE
COMMENTS
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INSULATION PER N. Y.
STATE ENERGY CODE
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ADDITIONAL COMMENTS
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Slotkin Residence
1/13/04
New or replacement Doors & windows as per plans
All proposed windows and doors to be Andersen 400 Series, double glazed, high
performance, low E with U value of .34 or better
Ix Frenchwood Slider 6068
Ix French wood Slider 8068
2x Pair of French wood outswing doors 8068
4x CWI4 casement windows ,( 2 with egress hardware as noted)
(
Jay P. Slotkin
M. Joanne Davis-Slotkin
1425 Laurelwood Dr.
Laurel, NY 11948
631 298-1802
March 19, 2008
Building Department
Town of Southold
53095 Main Road
P.O. Box 1179
Southold, NY 11971
To Whom It May Concern:
i
\\
,
if
I
Re: Alteration/Arbor Addition
SCTM #127.-5-9
Building Permit # 30022
/
/ '
I \
/
,
\
Upon receiving your correspondence dated February 26, 2008 I called and
reported that the alteration and arbor addition were not performed. I
,eported that I had previously reported this to your office when I was making
another inquiry. I explained that we have only replaced an existing glass door
as a result of a rock being thrown by a lawn mower and replaced the existing
deck on our home.
Under protest I am paying this fee, as I feel that I obtained a building permit,
thinking that I would make alterations to our home and wanting to follow town
law. After obtaining the permit I realizing that we could not afford the
alterations. I find it unjust that I am now being asked to pay the fee again and
will also be charged for a new C.O. that will not differ from my existing C.O.
I can be reached by cell 374-4211 if your inspector needs my presence during
the inspection. "
"
Regretfully,
M. J nne Davis-Slotkin
:1
-\
-j-\.-...------
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 5th, 2006
ro-
Oi}
fQO
JayP. Slotkin
1425 Laurelwood Drive
Laurel, N.Y. 11948
RE: 1425 Laurelwood
SCTM # 127 0005 009
Dear Mr. Slotkin,
Please be advised that your Building Permit # 30022 issued Jan. 21st, 2004 has expired.
According to the Code ofthe Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of$150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
.
Fax (631) 765-9502
Telephone (631) 765-1802
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
September 25th, 2007
2ND NOTICE
Jay P. Slotkin
1425 Laurelwood Drive
Laurel, N.Y. 11948
RE: 1425 Laurelwood (Alteration/Arbor Addition)
S.C.T.M. # 127.-5-9
Dear Mr. Slotkin,
Please be advised that your Building Permit # 30022 issued January 21 't, 2004 has
expired. According to the Code of the Town of South old, a Certificate of Occupancy
must be issued prior to use of the structure.
To renew your Building Permit, please submit a fee of $200.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Pax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
FINAL NOTICE
February 26th 2008
Jay P. & Joanne D. Slotkin
1425 Laurelwood Drive
Laurel, N Y. 11948
RE: 1425 Laurelwood (Alteration/Arbor Addition)
S.C.T.M. # 127.-5-9
Dear Mr. & Mrs. Slotkin,
Please be advised that your Building Permit # 30022 issued January 21", 2004 has
expired. According to the Code of the Town of South old, a Certificate of Occupancy must
be issued prior to use of the structure.
To renew your Building Permit, please submit afee of$200.00; at that time we can
schedule an inspection by one of our Building Inspector's.
lfyou have any questions, please call us at 631-765-1802.
RespectfUlly,
SOUTHOLD TOWN BUILDING DEPT.
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Breezeway , . tJY- 10'" 0 130 (' eJqi/ N:C Fire Place I Heat BL DR.
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Garage 211 .1'/2. 'i - 57~-Jl. S/,~ /'? .5 6 'lf' ;r ype Roof 'r:;b!..-t Rooms 1st Floor SR.
~ , /9)... , Llc; Recreation Room RoomS 2nd Floor
0,1) e c /,:.. / ~ .Y it. ~ L.\~ TO FIN. B
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O. 8. C'r~ e';"'A'(Js..~ / 0 x. 1'1-: '-2'<> .,5'0 ?<J I Dormer Driveway
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TOWN OF SOUTHOLD I
BUILDING .QEPARTMEN~
TOWN HAlL I"
. .
SOUTHOLD, NY 11971 \
TEL: (631) 765-1802
FAX: (631) 765-9502
PERMIT NO.
'50":;;1...~'~
BUILDING PERMIT APPLICATION CHECKLISj
Do you have or need the following, before applying
Board of Health
3 sets ofBuilding Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
~ <;IJm 'f mILRf/AJ <'IL
7Z gb&vf &tturn
Phone: Jf 77 - tj '7 S '()..J
Examined
Approved
lid
I /.:2/
,
4-
,20
,20r
Disapproved ale
,./
20 ~
'-
r
Expiration-"-
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APPLICATION FOR BUILDING PERMIT
Date~ /3,
,2004
-.'---.../
INSTRUCTIONS
a. This 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. Pee 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 waterways.
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 issue a Building Permit to the applicant. Such a permit
shaH be kept on the premises available for inspection throughout the work.
e. No building shaH be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new pemllt shall be required.
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 inspections.
(Si of applicant or name, if a corporation)
dO", ~g~~~infftrf
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Q1Vnr
Name of owner of premises ]JR.. ~ MR5 0A~ P. S(ofkt'n
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
i +~5 LA-!JR.el wood. DnLi6
House Number Street
L ti..u;V &i
Hamlet
County Tax Map No. 1000 Section i .;11
Subdivision lt4u-d wooJ ~'Srtt.hs
(Name)
,
Block 105" . " .
Filed MlipNo:' 551:J
,Lot 09
; ,"I ..
. Lot
1/
2. State existing use and occupancy ofpremi~es and in,tlmded use and occupancy of proposed constrUet~on:
a. Existing use and occupancy $w\~ U) ~ J... i ~ e n ~ '
b. Intended use and occupancy ~ j.f- ~ .~ R..e- iul01 CL.-
3. Nature of work (check which applicable): New Building
Repair Ii Removal flA<j wmthuDemolition
Addition At: ~R.S Alteration //J'(ac 10 R.-
Other Work
(Description)
4. Estimated Cost
(To be paid on filing this application)
5. If dwelling, number of dwelling units ~Number of dwelling units on each floor
If garage, number of cars
100,000
Fee
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
,
7. Dimensions of existing structures, if any: Front 15!:
Height I&'( t" Number of Stories ft;;!::ti'
Rear g(, 't.
I'/~
Depth
,)b 't:.
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
'If I
I 0
Rear
IOq.";'"
Depth '2 q 0 C (lu-eJv )
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated /.. -
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ./
13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES _ NO -/
'1L<;;-/l/A..
+17 - q 7~d...J
Address
Address
Address
~a..UKI;t Phone No.
hVPPK'l~~hone No
, Phone No.
14. Names of Owner of premises :31otk..'n
NameofArchitect~e-vt BY'own
Name of Contractor
IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO -/
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet ofa tidal wetland? * YES_ NOL
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK.)
SS:
COUNTY OF $u..ffDIL)
~~ +!.. /Y)().-iffi ~ being duly sworn, deposes and says that (s)he is the applicant
(Name 0 individual signing contract) above named,
~sthe fkt~r
. (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 true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
200./-
JOYCE A. STEVENS
NOTARY PUBLIC, STATE OF NEW YORK
NO. 4875122
OUAlIFIEO IN SUFFOLK COUNTY
COMMISSION EXPIRES NOVEMBER 3, 20i&