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gUiFOt,t�; _ Town of Southold Annex 9/24/2014 P.O. Box 1179 C 54375 Main Road ,s l"ate • -t ` Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37174 Date: 9/24/2014 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 4170 Great Peconic Bay Blvd, Laurel, SCTM #: 473889 Sec/Block/Lot: 128.4-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/17/2014 pursuant to which Building Permit No. 39192 dated 9/17/2014 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: solarium addition to existing one family dwelling as applied for. The certificate is issued to Chisholm, Joseph&Chisholm, Joan (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39192 9/24/2014 PLUMBERS CERTIFICATION DATED Auth r' d Sig ature Foc, ' ,. TOWN OF SOUTHOLD BUILDING DEPARTMENT . Q TOWN CLERK'S OFFICE s . SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 39192 Date: 9/17/2014 Permission is hereby granted to: Chisholm, Joseph & Chisholm, Joan PO BOX 305 Mattituck, NY 11952 To: construct a solarium addition to existing one family dwelling as applied for. Replaces 16975. At premises located at: 4170 Great Peconic Bay Blvd, Laurel SCTM # 473889 Sec/Block/Lot# 128.-4-26 Pursuant to application dated _9/17/2014 and approved by the Building Inspector. To expire on 3/18/2016. Fees: PERMIT RENEWAL $25.00 CO -ALTERATION TO DWELLING $50.00 Total: $75.00 Building Inspector FORM NO. 2 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) cJCt �� 2 16975 Z Dote ... ................................... 19.....�� Permission is hereby granted to: r ... . ..y......................�.... .........�. ...... . ....... ..... �.......... . to `.4L.... . .�.. ...... ............... .... I.... ......... .:0:.:....... .......� .. ...... ............................ at premises located at 7 .z2 ................................................I ...... ................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ......It-5 ...Ll..... Block ........... Lot No. :�R- 4(...... pursuant to application dated .............0;2 ......................, 19.`.. and approved by the Building Inspector. ' Fee $.. ..�. .. :.J/ .�:" ./.... ... ...... :....................... .ding Inspector Rev. 6/30/80 -s-1�_ - �fc3 — q q1 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: 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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 Dail / New Construction: Cid or Pre-existingBuilding: (c one) Location of Proper MW, House No reet Hamlet Owner or Owners of Propert-j,j Suffolk County Tax Map No 100 , Sectio Block Lot Subdivision Filed Map. Lot: Permit No.3 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ *Applicantignature i.; .+Fr Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.sox 1179 = _ roger.riche rt(D-town.southoId.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Chisholm Address: 4170 Great Peconic Bay Blvd City: Laurel St: NY Zip: 11948 Building Permit#: 39192 Section: 128 Block: 4 Lot: 26 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 4 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches F1 Twist Lock F1 Exit Fixtures TVSS Other Equipment: Sun Room-----As Built-----Electrical Survey-----No Visual defects----- Notes: Inspector Si nature: Da te: Sept 24 2014 9 81-Cert Electrical Compliance Form.xls 7ico"' 70-1802 suaoiNc DE". INSPECTION 1/1 FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ 7 FINAL REMARKS: DATE v I � �V INSPECTOR /(019 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J INSU TION [ ] FRAMING [ FINAL [ =� tq CE & CHIMNEY REQ c, DATE INSPECTOR r lr�4g so u TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION IST ROUGH UMBING FOUNDATION 2ND IN LATION INAL FRAMING / STRAPPING R= FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION CAULKING REMARKS: c,z2jj LY - z DATE _ �/)'�/4 - INSPECTOR Z/1 ho��OF SOpl�olo OOUNn,� TOWN OF SOUTHOLD BUILDING DEPT. v� 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE f INSPECTOR OUNDATION ( 1 ' UNDATI0N \ 0 ( 2nd ) TOUGH FRAME & PLUMBING t� rillH [T] =iISULATION PER N . Y. • STATE ENERGY CODE ' ` H FINAL ( (\ - O , ADDITIONAL COMMENTS : x H a , y H O a ' r H 0 m H BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY TOWN OFSOUTHOLD CHECK . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . _ . . _ TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY - �7. - • . • - TEL.: 765-1802 CALL - Examined . . . . . . . . .. 19 t �. MAIL T0 :` �► gg �s Approved . . . . . . . . . . . .. 19�C?Permit No. �6 . . . . . . . �` , Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...n._ d . . . . . . . . . . . . . . . . . err, '-TTOWN OF szoiNOLO Z_i�/�,g spector APPLICATION FOR BUILDING PERMIT Date . S% �: . . . . . . . .. 19 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 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 inspections. (Signature of applicant, or name, if a corporation) . . . x . . . . . J-?:�� 's��..�c f�., . . .�.. . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. r. � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises d (as on the tax roll or latest deed) If applicant is a corporati , signature of dully authorized officer. (Name and title of corporafe officer) ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . ./W. ;?/. . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. ,/�/- CC��/`^�C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . l . . Block . .�J.�. . . . . . . . . . . Lot . .�-. . . . . . . . . . . . . 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 . . . . /"W . . . . . .��.� /4 f.!4!.e - ./. .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . .(-12`(. . GGZz'! /A 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . .�� '�. . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . .. . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . Rear . . . . . . . . Depth ... . . . . . . . Height . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ea Dimensions of same structure with alterations or additions: Front �d��/.3�G.��>Cl3:lr".yak �a r . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . 8. Dimensions of entire new construction: Front .G. . . . . . . . . Rear ✓3. .G. . . . . . . . . . Depth .i>'. . . . . . . Height ,. . . . . Number of Stories . . ./. . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . Rear . . 1�:2?: . r. . . . . . . . . . . Depth ��.,� . . . . . . . . . . . 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: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . .H. . . . . . . . . . . . . . . . ... .. . . . Will excess f9i be removed from premises: Yes v No 14. Name of Owner of premises (hmv!� -tOltc yUr Ulli(7 Address 1#X" �',<<t�4 /<<!° �f��?Q. Phone No.?`X. `j/Y�' . . . . . . Name of Architect . Lr� 't Sr?�4'. . . . . . . . . AddressJ?0_/,e/ A0J"'K. . Phone No. 9: T'p. . . . . . . Name of Contractor .�l4�s'��. 7��,Zi?Z�� !X.'c . . . Address � : r5..rP1'?�� s�'�? . Phone No. rf.2.? .�{.4.y 7. . . . . 15. 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 clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. ;TATE OF NEW YORK, S.S 'OUNTY OF . . . . . . . . . . • • • • • . . �� �- ��!�l� Tz. • • • • . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. ie is the . fz7�!i` ' /5<?o�i;'�j2 S. . .��t/ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the fork will be performed in the manner set forth in the application filed therewith. .worn to before me this . . . . . . . . . . . .� . . . . . . . .day of. . .`�, . . . . . . . . . . 19 �8 iotary Public, . ��. . . ?'� .-. . jj�: vim-. . . . . . County ata NEIEN K.QE VOE (Signature of applicant) NOTARY PUBLIC,State of New York No.4707878,Suffolk Couot�r Term Expires March 30,19. ?A%%u"c§S gteAlprpfO!pgM aft Egy1eVmgatat ervation Room 219 , Stony Brook , NY 11794 C Aad- b - fed- 'k-, Re: 06d`3 P-LP.I7f i. "604 '64V.'&- 'SC or Ar/0VO-/af y-.26 Henry G. Williams Dear A review has been made of your proposal to: /tO�hVZtt�, ac..�. , "t47U,& 6 AMO. r)I a4t BI`7 Aw cu W..A� YEA" �I�9/�� �a� uy.� 3/-73/ff. Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the parcel v/ project is : Greater than 300 ' from inventoried tidal wetlands . Landward of a substantial man-made structure greater than 100 ' in length which was constructed prior to 9/20/77 . Landward of the 10 ' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10 ' in elevation above mean sea level . Listed in Part 661 . 5 of 6NYCRR (Tidal Wetlands Land Use Regulations) as a use not requiring a permit or notification letter of approval . Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law) . Please be advised, however , that no construction, sedimentation or disturbance of any kind may take place seaward of the 10 ' contour or topographic crest without a permit . It i-s your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10 ' contour or topographic crest and the project ( i .e. a 15 ' to 20 ' wide construction area) or erection of a temporary fence, barrier , or hay bale berm. Please note that any additional work , or modification to the project as described, may require authorization by this. Department . Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other 4 agencies . KM Very truly yours, Depfity Regional Permit Administrator �9 i SO�ryD� � o Town Hall Annex Telephone(631)765-1802 54375 Main Road ,,aaxx(631)765-g5�2 P.O.Box 1179 G, Q roger.rictlert golNn soufho fQ! nV us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOM APPLICATION FOR ELECTRICAL INSPECTION ' REQUESTED BY: Date: Company Name: Name: License No.: I . Address: Phone No.: - JOBSITE (NF%ATION: ' tes required in€ormation) * t Name: «�*Address: *Cross Street: �" I *Phone No.: Gf Permit No.: j V If Z, Tax Map District: 4000 Section:��� Block: Lot: ' *BRIEF DESCRIPTION OF WORK (Please Print Clearly) i i (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES ! NO Temp Information(if needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION i c 82-Request forinspec600 Form 711XX i INSPECTORS (516) 765-1802 VICTOR LESSARD,Principal �� SCOTT L.HARRIS,Supervisor CURTIS HORTON,Senior Southold Town Hall VINCENT R.WIECZOREK,Ordinance P.O.Box 1179,53095 Main Road ROBERT FISHER,Assistant Fire N Southold,New York 11971 Building Inspectors .+ Fax(516)765-1823 �,' ?� Telephone(516)765-1800 THOMAS FISHER - GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 30, 1990 Creighton Bros. , Inc. P.O. Box 79 Jamesport, N.Y. 11947 RE: Building Permit #16830-Z (Renov. ) #16975-Z (Add. ) Premises: 4170 Peconic Bay Blvd. , Laurel, N.Y. Suff.Co. Tax Map #1000-128-4-26 (Chas. McAllister) Dear Mr. Creighton: During a review of our files, it was noted that the above building permits have expired and a Certificates of Occupancy have never been issued. According to the Code of the Town of Southold Article XXVIII 100-281 and 100-284 a building permit is needed for any construction of additions, accessory structures, alterations or new dwellings, and it is unlawful to occupy or use said structureuntil the Certificates of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Victor Lessard, Principal Building Inspector VL:gar cc to: Chas. & Alice McAllister 1*00 No !i 0-Y CY OROCCUPAN USE IS uNLAWFUL CERTIEICAT WITHOUT _ _ 0OCCUPANCY� APPROVED AS NOTED f M �,'� s.p# / 97.5" - _ DATE: _�L�C . FEE: f NOT Y UIL G DE FOR AT a. 4 PM FOR THE 765-'t 802 9 AM TO t FOLLOWING INSPECTIONS: x TWiO REQUIRED v :ELEVAT 1. FOUNDATION - � ELECT i I=+�~ FOR POURED CONCRETE" C t'Dip #yIBINQ r ! R 2. ROUGH - FRAC-*- ( cm-T C'Asi x- HAS D S. INSULATION 4. FINAL - CONSTRUCTION MUST 5_ Y BE COMPLETE FOR C.O. k;L ALL CONSTRUCTION SKAIJL mea THE REQUIREMENTS•i STATE CONSTRUCTtC?N 8� + CODES. NOT RES PONtlftt� AOR } n DESIGN OR CONSTRUCTION ERRORS /Jy 1. p � `-- � rc } FsraMm w s n \1 s� M toJ 2 CO 11C f OU4 VA /11�L Z S4 *4-f 16" ,6\W 4 Hei W I Kw0W S,,4 E4c_14 OL F.. * y � r � t Y • ,h ' - 1;1t(- �•. : ' ,_ ��" �' 4z; �, "�'. 4�!.tie. ; � ;���'� 4 �:Mtt'3#Cb'b i. -TW5 150L.tirziam wiLL Ac 4iI V'E. A LIvE LoL9 or 42 psF, A wI.Hp Uwe v r>f- Z,7 PS &Mp w I LL 0 AIrE 2-. ALL cu� iz Ll.c-not. -To �. -sQ u,6 rtz, F L.0 MF3. A!5 � N - o JO's No. o � - � T9TF OF �� 0 SHORTS 0-0-m—, t,FEt.s A=fs7t.li►e,rzn LF r/r1. ► i - �AWIMORIlE64LIERATIOI4 OR oAvow,)& x U THIS SURVEY 15 A VIOLATION OF ! ',ECTION 7209 OF THE NEW YORK STAT{ � ,. 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