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Home My WebLink About16830-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33876 Date: 08/05/09 THIS CERTIFIES that the building RENOVATION Location of Property: 4170 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 128 Block 4 Lot 26 subdivision Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit NO. 16830-Z dated MARCH 17, 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 RENOVATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH G & JOAN R CHISHOLM ( OWNER ) of the aforesaid building. SuM~OI=K COIJNTY DEPARTMENT OF I{EALTH APPRO~i~L ~.RcJrKICAL CERTIFICATE NO. PLU~ERS CERTIFICATION DA'£~U3 N/A 3958-H 07/29/09 N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('rills PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9168~0 Z 19.~,.~:) Dete '1 Permission is hereby granted to: ...'~..x.....'l...c) ....................................................... County rox Map No. 1000 Section ..... /....~...~. ........ Block ....... ,(~..,~, ...... Lot No....,'~,.,.~. ............. Building Inspector. Fee $ ..................... and approved by the Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF O This application must be filled in by typewriter or ink and submitted to the Bu 3 2009 :CV A C¥ BLDG. DEPT. A. 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. 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 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- $.25 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: (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section /~ ~/ Block ¢ Subdivision . / ! Filed Map('h .~ Lot: ~, ,~7 · PermitNo. /3~r30 Dateofeermit.[3//7/~:v~:~ Applicant:~~ Health Dept. Approval: ,'-'-'- Underwritem Apprdval: [ , .... Planning Board Approval: Request for: Temporary Cert~c.~t~ Fee Submitted: $ (~$, ~' Final Certifica~ (c~ ~/ Applicant Signature Nassau Suffolk Electrical Inspections,Inc. P.O. Box 549, Aquebogue, New York 4. 11931 Tel: 631-591-3097 Fax: 631-591-3098 Application: 3958-H Date: 7/29/09 Issued to: Chigolm Address: 4170 Peconic Bay BIvd Introduced By: Village: Laurel License#: N/A H/O Residential [] Commercial The following was examined and approved up to the above date and found to be in compliance with the NEC: Attic I't Floor [] 2"~ Floor 3rd Floor Garage Conversion Basement Hot Tub Addition [] Detached Garage Pool Switches Receptacle Fixtures GF.L Microwave Hood Smoke Detectors 4 I Fans Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Carbon Monoxide Furnace Oil Gas Heat Zones Whirlpool Exit Signs II Final Insp. Meter Amps Phase Motors II 7/29/09 Other Equipment: Sun Room Permit: Section: 128 Block: 4 Lot: 26 This certificate must not be altered in any manner 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/FRAMING ~ r ] FINAL REMARKS: 4 DA,, ~t/l~[l~;t INSPECTOR ~//.~ 765-1~02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]/~)UGH PLBG. / FOUNDATION 2ND [//] INSULATION FRAMING [ ] FINAL DATE FOUNDATION { 1st) FOUNDATION (2nd) 2. ROUGH FRAME~// .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 '~ S I,UI' ,q SURVEY .......... CHECK '~ ......... SEPTIC FORM ............. NOTIFY CAUL .-1~t2:.~.~.1 '. .... TEL.: 765-1803 MAIL TO: Examined. ~/~-~..I.I ..... , 19~.~.. , , ..................................... [[ o,."lllll ......................................... . iLI I '~ ' '//~' ' '"-4~ fl BLDG. DEPT. .'~..;-~ ~..CO:~'....~ ........ TOW. o~ ~O~T~OLD (Building Inspector) APPLICATION FOR BUILDING PERMIT Date /1 ///4 (~.,~ 19 . . .J:~' 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. 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 properW :must be drawn on the diagram which is part of this appli- cati6n. 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, bull.ding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections, ev~tx./ .... d~,~//~,e,,~ ~ ........ ~ .......... (Signature of applicant, or name, if a corporation) .... :¢. :~. 7.?. ~.~..w..X./~. ~.q..z .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ..~....~..C...~....~... ........................... : ....................................... ;~'~ o~ 2;~er of prem~mes .0~. ~. c,~ ~--,~,C ~ ~ '~' · ''' ' · '~' ' · '~' '~'~ ................... (as on the tax roll or latest deed) If applicant is a corpora~4on, signature of duly authorized officer. .... ............... (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... .'//. ?.o. ..... .~..~.~; .,.7.~.../~ .z.4 ................ ,,~ ................. ~ ............. House Number Street Hamlet County Tax Map No. 1000 Section .... ]. '.~..?~. ........ Block ... (-2...~. .......... Lot... 2 ~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occnpancy of proposed construction: a. Existing use and occupancy....~..)..'~. · /~.- -Q~. · 9.~ ..................................... F-..F.d~, va V Io~l ~AST ~VATI~H 8UMM~,~q¥ ~ TOTAL THIiRMA~ I~M'IN~ · A. .1. NET gaLl~ C. GI.~Zt,III Dt, Ft,O~S Insul&t~ ~,~Vi lut Feet Feet. Feet. Sq.' Ft. PLlrcent~ F. ~OUTH fACING ~LA~IN6 ~outh Gle~slTotll Glass ' 61. Arie/G~o~s Ikl1 Area ~ Abb I 4T~l~