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Home My WebLink AboutZ-39609 g�FFp(,�c Town of Southold 4/18/2018 53095 Main Rd ' Southold,New York 11971 X44 ao� PRE EXISTING CERTIFICATE OF OCCUPANCY No: 39609 Date: 4/11/2018 THIS CERTIFIES that the structure(s)located at: 4000 Great Peconic Bay Blvd, Laurel SCTM#: 473889 See/Block/Lot: 128.-6-2 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 39609 dated 4/11/2018 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling with covered porch and accessory wood frame garage_* Notes:BP 30132 foundation COZ-31135; BP 32716 dormer and deck additions and alterations N bedrooms only) COZ-33180. The certificate is issued to Robert Kelsey&Elizabeth Corydon-Apicella (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 128.-6-2 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ho Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 4000 Great Peconic Bay Blvd, Laurel SUFF.CO.TAX MAP NO.: 128.-6-2 SUBDIVISION: NAME OF OWNER(S): Robert Kelsey&Elizabeth Corydon-Apicella OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Kelsey,Robert DATE: 4/11/2018 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: piers CELLAR: CRAWL SPACE: BATHROOM(S): 3 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: covered porch DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING: see elect cert TYPE HEAT: gas WARM AIR: HVAC HOT WATER: #BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 2/9/2018 TIME START: 9:33am END: 10:20am 6?/ -god �7p Form No.6 6a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 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 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 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, min o�icao 00,Accesso building$50.0�Addit�ionsto accessory building$50.00, Businesses$50.00. 2. Certificate ofncy on Pre-exiuilding 3. Copy o ert� ccupancy- 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: j (check one) Location of Property: 000 �r� c v d L.�•–V House No. Street Hamlet 1=LIZQ-been S , LLV+kL-r Owner or Owners of Property:EI'2C "k Catc,do�ri – _l1Cx.�Lesk, Nee- y . srY 0_0OUl b(2Tru6f LIS rzemgrc- Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $t ot4;[D Applicant Signature CONSENT TO INSPECTION (FLUO-W6 C_ Yj&ji- L-e&1V"—tk1djV, the undersigned, do(es) hereby state: wner(s)Names) That the undersigned (is) (are)the owner(s)of the premises in the Town of Southold, located at 4660110-1� I� 1 Q which is shown and designatefA on the Suffolk County Tax Map as District 1000, Section , Block ,Lot That the undersigned(has)(have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Ply—64"j.517614 L 0 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 may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (Signa re) Ei 12,a,6i h Corq&h- App c2(UA, (Print e) (Signature) (Print Name) pF S0�/dy®� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q Southold,NY 11971-0959 ® • �® roper.richert(,5-town.Southold.ny.us COU BUILDING DEPARTMENT TOWN OF SOUTHOLID CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION IssUed To: Kelsey Address: 4000 Great Peconic Bay Blvd. City,Laurel st: New York zip: 11948 Building Permit#: Pre-CO Section: 128 Block 6 Lot: 2 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 X Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures 6 HID,Fixtures Service 3 ph Hot Water ELEC GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures CO Detectors Sub Panel 1 A/C Blower 2 Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 2 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Notes: 2- A/C Units in House. Electric in Detached Garage, Including Over Head Electric Service with 1 Meter and 2 Disconnects, 1- 200A, 1-100A, Attached to Garage, Electric Hot Water, and Well Pump. Inspector Signature: Date: February 20, 2018 0-Cert Electrical Compliance Form As ______-________________�___ ' U ' � /�__' _ - ` ___-' I Z Prepared In accordance with the minimum q p standards for title surveys[as established by the L.I.A.L.S, and approved and adopted h for such use by The New York Stole Land API o Q Tll/e Association. A 41 'l F�,t 0P N , N C) 0 m `� Opti ;n �r ,o � 3 i l ' ' Ib O y3 T �3 4 r ° O Iz ? ` i•- A m \ C m 70 Z 0 F '70 0 -< 1 SURVEY OF M PROPERTY ° A T LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-128-06-02 Scale: 1"=40' F, Jan. 13,1993 - y s 7 god 5'F � tD Q one o _ y 9 ry \ I ` � 1 r�\•� `o /6o0 a o n� �\r��0�9 10 �T 0P h8 S�PtE°1 MFEW yon AREA = 1.091 Acres b�� to tie lines * � o �II Y. C N0. 496/8 P Q ECON! 6 .C- 15161. BOX 76 -B S 5 P O AIN ROAD SOUTHOLD, N.Y. 11971 93-122 SOF SOU,y Pre. C � rV � W � � � • �o TOWN OF SOUTHOLD BUILDING- DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMA KS: `� i --Y �bn ov 'G ns `ov✓ k aot A 4 DATE INSPECTOR OF SOUlyOlo w V G� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ]`' ELECTRICAL (FINAL) REMARKS: LAG I-e -6 tttC L DATE f' INSPECTOR r �'� pF SOU TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG.' [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] -FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: WN DATE. . INSPECTOR (TY � r L Y " � f L. 1 �s Wy t j : -,..•, — .' r � / }•�J 4`e Jarski, John From: Robert Kelsey <rdkelsey@comcast.net> Sent: Friday, February 16, 2018 6:17 PM To: Jarski,John Subject: Kelsey,4000 PBB John, Here is the pic of the relief valve extension as required for the water heater at 4000 Peconic Bay Blvd. Regards, Rob Kelsey 678-246-9992 rdkelsey@comcast.net Sent from my iPhone LOCATION: 4 ffV -tom Vb' (number & street) (municipality) SUBDIVISION: _- MAP-NO.: LOT(S): .. NAME OF OWNER(S)': OCCUPANCY: OV W (type) (owner-tenant)- ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFE. 'CO. TAX MAP'� 0. 1000- — SOURCE OF REQUEST: DATE: A DWELLING TYPE OFC NSTRUCTI'ON:084 f�"to� �.# STO !�. # EXITS: (Drip,` pa-(Jars, ; FOUNI�ATI N /rUIGC. /. jLI]WtMENT: 'CRAWL SPACE: # OF BEDROOMS: 1ST FLR: 2ND FLR:, _ 3RD FLA: �. BATHROOM(Sj: 3 TOILET ROOM(S): -d'. UTILITY ROOM: PORCH.TYPE: DECK, TYPE ' C-0 PAI BREEZEWAY:' FIREPLACE: Onv A GE: DOMESTIC HOTWATER: TYPE HEATER: RC 'ND TI KING: TYPE HEAT i WARM AIR: HO WATER: # OF KITCHENS:'_Q II FINISHED BASEMENT:- YES NO' OTHER: ACCESSORY STRUCTURES r• GARAGE; TYPE OF CONST.: 1i STORAGE, TYPE CONST.: SWIMMING POOL: GUEST,'TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FX PREVENTION &BUILDING CODE ' LOCATIO DESC PTIO ART. SEC. v Aft LWAAJJIr ' r REMARKS: INSPECTED BY: DATE OF INSPECTION; G6 �r TIME START: END: iw-w Lw-wPO4