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Home My WebLink AboutZ-26156FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26156 Date: 12/10/98 THIS CERTIFIES that the building DWELLING Location of Property 4525 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 128 Block 0003 Lot 018 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26156 dated DECEMBER 10, 1998 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 ONE FAMILY DWELLING * The certificate is issued to CAROL GIBBON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. /--z e BuIlding Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING OD INSPECTION REPORT LOCATION: 45.5 GREAT ECONIC BAY BLVD A1RE SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): CAROL GIBBON OCCUPANCY: A-1 RESIDENTIAL CAROL GIBBON ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 128.-3-18 SOURCE OF REQUEST: GARY PLANNER OLSEN. ATTY - 11/17/98 DATE: 12/10/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: _2 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 2ND FLR.: �. 3RD FIR.: 0 BATHROOM(S): 110 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: XX OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION i ART, i i i i REMARKS: INSPECTED BY: / DATE ON INSPECTION: 11/24/98 GAO J /FI§g TIME START: 10:15 AM END: 10:30 AM PLDG. DETT. .. . FORM NO. G TOWN OF SOUTHOLD Building Dopartmont Town Hall Southold, N.Y. 11971 765 — 1002 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted w awnim w to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. h. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and Installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of cornploted site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25:00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $50.00 3. Copy of certificate of occupancy $'S * '00 , over 5 ' y e a r s $10.00 A.Vacant Land C.O. $'20.00November 12 1998 5. Updated C.O. $', 50.00 Date .. November 12, 1998 ....... r NewCons true tion, , , , , . Old or Pre-existing Building X .......... Vacant Land ............. Location of Property ... ......................... . Nouse No. Streit Handot Carol Gibbon Owner or Owners of Property ............................................................ . County Tax Map No. 1000 Section ..12 ........... Block .. 3............ Lot .. 18........... . Subdivision .................................Filed Map No. ..........Lot No. ............. Permit No. .......... Date of Permit ..........Applicant .................................. J. Health Dept. Approval ........................ Labor. Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................F' al ertificate ......... a ............ . 100.00 Fee Submitted $ ......... •................... . Construction on above described building and permit m I icable codes and regulations. Applicant ....... ,r ....................................... now. 10.10.78 GARY FLANNER OLSEN, ESQ. P.O. BOX 706 CUTCHOGUE, NY 11935 s s9es h 14k'• y -� % a yr o ,yo -0 .hod 7J 0� �ti % Q < IN P' v SURVEY FOR FRANCIS B. HOYT Q AL/CE D. HOYT LAUREL TOWN OF SOUTHOLD. SUFFOLK CO., N.Y. SCALE I = 40� GCOMMONWEALTH LAND T/TLE MAY 20, /970 INSURANCE CO. OF NEW YORK NOTE: /= MONUMENT AL DEN W. dp yNy((V��G �GYy///J PROFESS/O AL EN NEER ANO LAND SURVEYOR, N. Y.S. L /C. NO. /2845 RIVERHEAO N.Y. 0 3co u o � 14k'• y -� % a yr o ,yo -0 .hod 7J 0� �ti % Q < IN P' v SURVEY FOR FRANCIS B. HOYT Q AL/CE D. HOYT LAUREL TOWN OF SOUTHOLD. SUFFOLK CO., N.Y. SCALE I = 40� GCOMMONWEALTH LAND T/TLE MAY 20, /970 INSURANCE CO. OF NEW YORK NOTE: /= MONUMENT AL DEN W. dp yNy((V��G �GYy///J PROFESS/O AL EN NEER ANO LAND SURVEYOR, N. Y.S. L /C. NO. /2845 RIVERHEAO N.Y. CONSENT TO INSPECTION Carol Gibbon by Gary Flanner O1sen,,Esq. the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 4525 Peconic Bay Blvd., Laurel. NY which is shown and designated on the Suffolk County tax map as District 1000, Section 128 Block 3 Lot 18 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in -the Southold Town Building lnspecw. orrt�o r__ ♦hA fnilowinLy: One story frame house That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including -inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections maybe used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules orregu tions of thh/e Town of Southold. Dated: November 1._2, h�98 l (signature) BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: (ID -1 72,11(47' (number & street) .(municipality SUBDIVISION MAP N0. LOT (s) NAME OF OWNER OCCUPANCY (- tYPe _ ADMITTED BY: KEY AVAILABLE SOURCE OF REQUEST: owner -tenant ACCOMPANIED BY: SUFF . CO. TAX MAP NO. o i -O3 '�� + DATE: DWELLING: TYPE OF CONSTRUCTION �� # STORIES EXITS_ FOUNDATION C V CELLAR -�'"r� CRAWL SPACE TOTAL ROOMS: IST FLR. 2ND FLR. 3RD FLR. BATHROOM (s) TOILET ROOM (s) UTILITY ROOM PORCH TYPE DECK, TYPE PATIO, TYPE BREEZEWAY FIREPLACE GARAGE DOMESTIC HOTWATER FS TYPE HEATER AIRCONDITIONING TYPE HEAT WARM AIR HOTWATER OTHER: . ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL OTHER: STORAGE, TYPE CONST. , GUEST, TYPE CONST. ------------------------------------------------------ ---------------- VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION b BUILDING CODE. LOCATION I . DESCRIPTION I ART. I SEC. INSPECTED BY: DATE ON INSPECTION TIME START t ( ENC