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33186-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33739 ~te: 05/27/09 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1640 IOkURELWOOD DR (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 127 Block 5 Subdivision Filed ~p No. __ Lot No. __ LAUREL Lot 4 ( HAMLET ) conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 2007 pursuant to which Building Permit No. 33186-Z dated JUNE 28, 2007 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 ALTERATION TO SECOND FLOOR DORMER & BALCONY TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. Ge certificate is issued to JOHN A & SUSAN DROSKOSKI (OWNER) of the aforesaid building. SuFFOI~K CO~ DEPAR~I~T OF }~EALTH ~PPROVAL N/A ~t-r~IC3%L C~ERTIFICATH NO. 4025790 05/19/09 PL~3MBE~S C~TIFIC2%TION ~T~D N/A Rev. 1/~1 MAY 272009 BLI)G. DEPL TOWN OF SOUTHOt9 Form No. 6 TOVFN OF SOUTHOLD BUILDING DEPARTMENT' TOWN HALL 765-1802 ATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: 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 Tater supply and sewerage-disposal (S-9 form). 3. Approval o f electrical installation from Board o f Fire Underwriters. 4. Sworn statement from plumber certi~g that the solder used in system contains less than 2/I 0 of I ~A lead. 5. Commercial building, indusfxial building, multiple reaid~nces 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 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, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00 Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Location of Property: 1~0 /- f~ c~{~ I~ *.,. ~ 'hO House No. Street Owner or Owners of Property: ~'-i) ~' A-M ~ Suffolk County Tax Map No 1000, Section j,~ ?' Block Subdivision Permit No. ~3/f~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~- b-, 6 0 ~'/~7J ~'~ Date of Permit. ~/~f-0 7 Date. ~5-' ~-"/- / (check one) Filed Map. Applicant: Underwriters Approval: L,a,~ 124 Hamlet Finai Certificate: Lot Lot: L'"~""~' (check one Applicant 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. 33186 Z Date JUNE 28, 2007 Permission is hereby granted to: JOHN A & WF DROSKOSKI 1640 LAURELW00D DR LAUREL,NY 11948 for : CONSTRUCT A DECK ADDITION,ALTERATION TO SECOND FLOOR DORMER & BALCONY AS BUILT.THIS PERMIT REPLACES BP # 19946 at premises located at 1640 LAURELW00D DR LAUREL County Tax Map No. 473889 Section 127 Block 0005 Lot No. 004 pursuant to application dated JUNE 26, 2007 and approved by the Building Inspector to expire on DECEMBER 28, 2008. Fee $ 253.60 ORIGINAL Rev. 5/8/02 l~~' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CO)APLETION OF THE WORK AUTHORIZED) Ne- 1994~ Z Pen~ission is hereby grant.ed to)~ ~.~ , /. ., /"~7~ .................................................. ~ .......... ~ .......... .:~ ........................ ./..~~ ~ ~ ../..~~..~.~,., .............................. ,. .... at premises located at ..Z~...~......Z~.~.~.F. ................................................. County Tax Mop No. 1000 Section ....... .Z.~......7.... Block ........ ~ ...... Lot No....,~.... ............... pursuant to application dated ..~ ........................................... 19..~../.., and approved by the Building Inspector. / DU~ msl~cror Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 g/Permit ...... Approved.· · .~./.~ ........ 19 No. Disapproved a/c ..................................... INSTRUCTIONS BOAED OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK ....... ? ............ SEPTIC FORH .............. CALL . .' ................ - 91991 . . ....... , 19 .q. [ Date · 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. 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 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 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, yuilding code, housing code,/~nd regulations, and to admit auth°fized inspect°rs °n premises and in building f°r necessary i~ns'L ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises , .~.0.¢..~...t..~.g&~'.~'....'~ I~'.Q~((/-~...~...~.'. .................................... (as on the t~ roll or latest deed) If applicant is a corporation, signature o f duly authorized officer. " (Name and title of corporate officer) · Builder's License No. C~..~D:C.rT. ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done....f.~. ¢ .,-....~w:,.-:.: . .,~,'~.. y.~?....sM..L: ................ · .......... ........... ................ House Number Street Hamlet County Tax Map No. 1000 Section ...I)~.~ ............ Block . .~.. ............. Lot..~. ............... Subdivision ./..gl.q .~..09..~0d.'...~..~..~,5. ............. Filed Map No...,~..~.~. ....... Lot..d.~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ~ ~o,e o ~ b. Intended use and occupancy ... 1"~--.'.~ .~..'M%.. ~ .................................................. 3. Nature of work (check which applicable): New Budding .......... Addition .......... Alteration .~Y~ ....... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost (to be paid on filing this application) 5. If dwelling, number of dwelling units..~.. ~9 ....... Number of dwelling units on each floor..~.~..~] .... · If garage, number of cars ...... Z... . ......... ' .... 6. If business, commercial or mixed occupancy, specify nature a/nd extent of each tlipe of use ..................... 7. Dimensions of existing structures if any' Front ~ &~. .. Rear .~,.~. .......... Depth .. ~ ,.ff.. ....... Dimensions of same structure with alterations or additions: Front ...~.~ t . . Depth Z,b~. He' ~ it ............ Rear· .(*9/ ........... 8. tJ~menmons o~ ennre new construction. Front b~. R~- I-l~ ~o' ,, ~, '-~ '~ .......... Size of lot: Front ... AO%--.. v ........... Rear .... /~.~. ........... Depth . g .2..~ Zone or use district in which premises are situated., t~.~ :.~.~.q-. ['.~ .................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . .4/.0. '. ..... 13. ,W, ill lot ~be~regrade~d ....... f .,.~?. ·. ~,. · . ;_..: .... Will excess, fill b.e re,mo, ved from premises: Yes No Name of Architect ........................... Address Name of Contractor g e~ ]-~'. Address ................... Phone No. .............. Phone No ................. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No..~ .... ·If yes, Southold Town Trustees Permit may be required. · -. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or descriptioh according to deed, and show street nines and indicate whether interior or comer lot. . ~ ~]o. STATE OF NEW YORK, COUNTY OF .... ...g¢,4.~.~.o.~..~... S.S ...... ,x~-.o.~.,q...~.~;~.~.o~..% [. ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .~. 9<,<..~.,e~.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. Sworn to before me this ........................ day of../~...~.~. ............. , 19 .]/. qotary Public ....... ~,,~ o,-~ County ~ No. 52-,~6010~, .... · ....................... Otmli~ed in Sutf01k C~u~ty (Signature of applicant) BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 , CERTIFIES THAT Upon the application of upon premises owned by DANA P. FOX JOHN DROSKOSKI 2810 WESTPHALIA ROAD 1640 LAURELWOOD DR MA~I'ITUCK, NY 11952, LAUREL, NY 11948 Located at 1640 LAURELWOOD DR LAUREL, NY 11948 Application Number: 4025790 Certificate Number: 4025790 Section: 127 Block: 0005 Lot: 004 Building Permit:. BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Second Floor, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 19th Day of MaY. Z009. Name QTY Rate Rating Circuits Twe FA Alarm and emergency equipment 1 0 0 CarMon/Smoke Sensor Appliances and Accessories Exhaust Fan I 0 F.H.P Hydro Massage Tub (Therapeutic) 1 0 Miscellaneous 2nd floor renovation-as built FA Wiring And Devices FA Dimmer 3 0 120v FA Fixture 13 0 Incandescent~ FA Outlet 13 0 Fixture Outlet 18 0 Gen, Purpose~-FA Receptacle 1 0 GFCI Receptacle 11 0 Gen, Purpose FA Switch 11 0 Gert, Purpose FA FA FA seal FA FA Continued on Next Page I of 2 FA This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by DANA P. FOX 2810 WESTPHALIA ROAD MATTITUCK, NY 11952, JOHN DROSKOSKI 1640 LAURELWOOD DR LAUREL, NY 11948 Located at 1640 LAURELWOOD DR LAUREL, NY 11948 Application Number: 4025790 Certificate Number: 4025790 Section: 127 Block: 0005 Lot: 004 Building Permit:. BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Second Floor, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on thel9th Day of ]May, 2009. Name q)TY Rate Rating Circuits T~ An as built visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in conformance with the applicable reference standard for the estimated period of construodon of the premises wiring system. 2 of 2 seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEh~:~.ATION REMARKS: DATE (1st) FOUNDATION (2nd) FOUNDATION 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS This is your receipt. Please print this page and keep it for your records, ht~p://nybfirorg/cgi-bin/formail.pl This is your receipt. Please print this page and keep it for your records. Below is what you submitted to applications~,nybfu.org on Wednesday, March 25, 2009 at 18:20:54 returnpage: http://nybfu.org/electricalbureau.htm Last Name: droskoski First name: john Street 1:1640 laurelwood drive, City: laurel, County: suffolk, State: ny, Zip: 11948, Home Phone: 2988699 Section: 127 Block: 0005 Lot: 004 Building Department Name: southold Owner Last Name: droskoski Owner First Name: john Contact Phone: 6312988699 checkbox: Residential cheekbox3: Renovation/additional checkboxS: 2nd Floor Additional Information: a electrical inspection was never obtained for a second floor addition Date Rough Inspection Requested: 3/30/09 1 of 2 3/25/2009 6:21 PM This is yot~ receipt. Please prim this page and keep it for yota- records, htlp://nybfu.org/cgi-bin/formail.pl Date Final Inspection Requested: 3/30/09 checkboxl8: A Portion of the Premises Electrical System Applicants ID Numbr: 001272 Customer Business Telephone Number: 6312985349 Name of Applicant: dana fox Street Address: 2810 westphalia road City or Post Office: mattituck ny Zip Code: 11952 Telephone: 6312985349 License No.: 525e Submit: Submit VI.92 © 1995 - 2002 Matt Wright A Free Product of 2 of 2 3/25/2009 6:21 PM TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST.' SUB. LOT /~' ~ 4 FORMER OWNER N E ACR. I~oo Zgoo 7~oo J, rlll~l~ , FRONTAGE ON WATER ~1o~ FRONTAGE ON ROAD / ~ ~ / ~-, DEPTH ~, ~ / ~ ~ P~ BULKH~D r~l ~ M. B A ql Extension Extemion Pok:h ~- × $/ gorch BreezeWay COLOR TRIM Foundation /~ Bosom.hr Ext. Walls Fire Place Roof I .~ I~n'' nterior Finish ' . Heat Rooms 1st Floor Roams 2nd Floor Driveway DR. ~R. FIN. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD June 21, 1991 John & Susan Droskoski Box 395 - 1640 Laurelwood Drive Laurel, New York Re: Premises 1640 Laurelwood Drive, Laurel, N.Y. Suff. Co. Tax Map #1000-127-5-4 Dear Mr. & Mrs. Droskoski: Enclosed please find Building Permit for the above premises. Kindly contact this office to set up an appointment for the Building Inspector to do a final inspection so that we may issue the Certificate of Occupancy. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWlq BUILDING DEPT. VRW:gar Vincent R. Ordinance Wieczorek, Inspector encl. INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 22, 1991 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Mr. & Mrs. John Droskoski 1640 Laurelwood Drive Laurel, N.Y. 11948 SUFFOLK COUNTY TAX MAP #1000-127-05-04 RE: NOTICE OF VIOLATION Dear Mr. & Mrs. Droskoski: You recently received a Notice of Violation. To date you have not responded/complied to that notice. If you do not remedy this situation immediately, you will have to appear in Court to answer criminal charges for violating the Southold Town Code. Please contact the Building Department of the Town of Southold at 765-1802 upon receipt of this letter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczorek Ordinance Inspector VRW:gar INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD ORDER TO REMEDY VIOLATION SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Date: March 20, 1991 TO: MR. & MRS. JOHN DROSKOSKI 1640 LAURELWOOD DRIVE LAUREL, NEW YORK 11948 PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance - CHAP. 100 Other Applicable Laws, Ordinances or Regulations at premises hereinafter described in that A DORMER AND DECK HAS BEEN ADDED WITHOUT OBTAINING A BUILDING PERMIT. In violation of ARTICLE XXVIII, CHAP. 100-281 YOU ARE THEREFORE DIRECTED AND ORDERED T~D comply with the law and remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at:1640 LAURELWOOD DRIVE, LAUREL, COUlqrY OF SUFFOLK, NEW YORK, SUFFOLK CO~ TAX MAP #1000-127-05-04 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. WIECZOREK~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or outhcYrized agent of,o~ner) ....... t~..~..u,..~ ~..~..~..I~.:..~Z:.....Z.I..~..~..~ .............. (address of owner or authorized agent of owner) PL'F.A$1:-rAKE NOT1L-~ there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .... ~......~..q..~....~.'x..~..~;.....~...~..~`.....~..~....C..~..~.....~....~...~......~.~t.~ (state character of violation) .~. b g ~ ~ ~..L.Z..!!..~.~..~.. o..~-r.~..:.~ ! ~ .+.,. ~..tu...(.~.~.. ~ ~ t?~...~ t-r in violotion of .~T~ct-t~ XXk/fftt d~flrt~ (State section or parograt~ of applicable klw, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned TMMEDI'ATELY The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at ...................................................... t ............................. z of Suffolk, New York. I~ailure to remedy the conditions aforesaid and to comply with the epplicable provisions of law may constitute an offense punishable by fine or imprisonment or both. ORDINANCE INSPECTOR o uJ 0 . I - .:':5 i'" j ~ TM .... ~'~ '~ u I | .-., ,./,, _ ~ ..-:7,:q., ' ..... II ~ 1 / APINIOJ~ED AS NOTED ~ec: ~BY: 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE ~. Ro.~.- .RAM,NG...u,,.,.G OCCUPANCY OR 3, INSULATION ,.,,NAL co.sT, uc.,o.M.sT USE IS UNLAWFUL BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET T.E REOU,REME.TS O. T.E ..Y. "~fiTHOuT CERTIFICATE STATE CONSTRUCTION & ENERGY co. Es., .o..Es.o.,.,. FO. n~ OCCUPANCY DESIGN OR CONSTRUCTION ERRORS ~'