HomeMy WebLinkAboutZ-22968FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22968
THIS CERTIFIES that the buil
Date APRIL 27, 1994
ONE FAMILY DWELLING
Location of Property 7080 GT. PECONIC BAY BLVD. LAUREL, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block it Lot 7
Subdivision
Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 91 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22968 dated APRIL 27, 1994
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 DAVID & BRIGITTE PALMER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
u ilding Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 7080 GT. PECONIC BAY BLVD. LAUREL, N.Y.
number S street) municipality
SUBDIVISION MAP NO. LOT(s)
NAME OF OWNER (s) DAVID 6 BRIGITTE PALMER
OCCUPANCY SINGLE FAMILY OWNER
type owner -tenant)
ADMITTED BY: DAVID C. PALMER ACCOMPANIED BY: DAVID C. PALMER
KEY AVAILABLE SUFF.CO. TAX MAP NO. ]0 - - -
SOURCE OF REQUEST: DAVID C. & BRIGITTE PALMER DATE: DEC. 30, 1993
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME # STORIES 1-1/2# EXITS 2
FOUNDATION CONCRETE CELLAR FULL CRAWL SPACE
TOTAL ROOMS: PST FLR. 6 2ND FLR. 1 3RD FLR.
BATHROOM (s) 2 TOILET ROOM (s) UTILITY ROOM
PORCH TYPE DECK, TYPE FRONT WOOD PATIO
BREEZEWAY FIREPLACE 2 GARAGE
DOMESTIC HOTWATER XX TYPE HEATER LILCO GAS AIRCONDITIONING
TYPE HEAT OIL WARM AIR XX HOTWATER
OTHER: SHOWER STALL ATTACHED TO FRONT DECK, CLOSED FRONT ENTRYWAY
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. 2 CAR WOOD FRAME STORAGE, TYPE CONST.
SWIMMING POOL GUEST, TYPE CONST.
OTHER: ACCESSORY DECK IN REAR (WOOD)
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE
REMARKS. ORIGINAL FIREPLACE IN BAD CONDITION - DAMPER MISSING ON NEWER ONE.
INSPECTED BY _ DATE OF INSPECTION
TIME START 9:30
JAN. 11, 1994
AM END 10:00 AM
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SUFF'CQ. TAY MAP DATA` 100 �- 126,11- 7.
.MAP OF R20PE_RTY
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SUFF'CQ. TAY MAP DATA` 100 �- 126,11- 7.
.MAP OF R20PE_RTY
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Unaugho ed aebrweon Wadd we
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... bll tlA _.:,utba OJnII &vd
to be a W„Jd ww OODl
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LIC.LAtWO SURVE` O e2E!eNp0r2T NY
Form No. 6
e
j"•� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
.i.? TOWN HALL
R'
j(.! 4 765-1802
APPLICATION FOR. CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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
'.'pra-Px� Gr;,,g" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unus''- ual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupa�--ncy 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
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..... /9-./.51 . g�.....................
dew Construction........... Old Or Pre-existing Building
s.... )c ..;•-......•. ll ��,,�`,
ocation of Property .....................I.Ar �+1is�.A7�:.iJ�VO...........��s'to�r:. .....
House No. Street
,,,,gStreet HHamlet
wer or Owners of Property..�J..'. • • �:.... .'..... ..rte• • ... w. ....... • .. .
inty Tax Map No 1000, Section... .. v .....Block...../.i.. ...Lot .....................
division...../:f•
//I4 ..... ..................Filed Map ....�..i.....Lot ......................
mit No................Da�teeOf Permit ................ Applicant .............................
.th Dept. Approval.....!0 ................Underwriters Approval.../•"•''.I..................
ning Board Approval.. for ................
est for: Temporary Certificate........... Final Certicate...........
>ubmitted: $...........................
( �• N77i2�
-z_ say
APPLICANT
APR 27 '94 15:06
Itl6w
STATE OF
)ss:
COUNTY OF N -YeIM)
BRIGITTE PALMER, being duly sworn, deposes and says:
ONE: I am one of the owners of a property located at No# Peeonic Bay
BoWevard, Laurel, New York, and I purchased same with my husband on
August 2,1968. SCTM# 1000-126.00-11.00-007,000
P.2/2
TWO: At the time of said purchase, the property was improved by a one
family dweftg, detached garage and a detached deck on the South si&of
the property.
Sworn to before me this
dayof April, 1994.
Z;:Z�
1*IOTARY PUBLIC
GIOVANNI La®ARQERA
NOTARY PUBLIC Of NEW JERSEY
My Commission Expires SEPT h l 9
I
CONSENT
TO
INSPEC'T'ION
Pf('101z AG �j—i9C�w 4Q the undersigned,
Omicr(s) Name(s)
do(es) hereby state:
l.i
That the undersigned (is) (are) the owner(s) of the premises in the Tovm
of Southold located at AFn.&&Ar� Q Air 41
which is /shown and designated on the Suffolk
County tax map as District 1000, Section Block Lot f
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
J /lfi; J1,22- h < v o OCaiD&1-4 %a✓
e- L
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 as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
oaoov�;
Dated: vim. = 5-� ff✓�
C
(signature)
t77T- ?_4 L-AIA&C-
(print name)
c.
IMMAL M,
E NEW YORK BOARD OF FAE-0`4-WRITER?'PAGE 1
1175003 BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK. NEW YORK 10038
Date OCTOBER 06 ,1994 Application No. on file 85633594/94 N 329398
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
KEITH FRIEDLANDER, 7080 PECON�ItC BAY BLVD., LAUREL, N.Y.
in the following location; ® Basement IX lst FL ® 2nd Fl. GAR/OUB` Section Block Lot
was examined on OCTOBER 04 ,1994 and found to be in compliance with the National Electrical Code.
FIXTURE
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS WIC&INCANDESCENT[
TACLES
SWITCHES
FLUORESCENT
OTHER AMT.
K. W. AMT. K. W. AMT.
K.W. AMT.K. W. AMT.
H. P.
8
22
15
8
1 1.4
DRYERS
FURNACE MOTORS
FUTURE APMANCE FEEDERS
SPECIAL REC'PT
TIME CLOCKS
ULL UNIT
TRANS.
HEATERS
MULTI -OUTLET DIMMERS
NO.OF FEET SYSTEMS AMT. WATTS
AMT.
K. W.
OIL
H. P. GAS H. P.
AMT.
NO.
A. W. G.
AMT.
AMP.
AMT.
AMPS.
AMT.
H. P.
1
30
4
600
SERVICE DISCONNECT
NO. OF
S E R V I C E
AMT.
AMP. TYPE
MITIR IMP.
I p 2W
I ,? 3W 7 B 3W J,I 4W NO. OF CC. COND.
PER 0
A. W. G.
OF CC. GOND.
NO. OF HI -LEG
A. W. G.
OF HIAEG
NO. OF NEUTRALS
A. W. G.
OF NEUTRAL
OTHER APPARATUS:
HOTORSt3—F H.P.
PANELBOARDSt1— CIR. 100
G.F.C.It-9
Q. C. ELECTRIC INC. LIC.#3823E
P.O.BOX 518
LAUREL, NY, 11948 GfNEM MANAGER
11-
1.Per
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUDDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF SOUTHOLD
PROPERTY RECORD CARD
OWNER
STREET 6D
VILLAGE
DIST.
SUB. -._LOT
FORMER OWNER
N
r
E
ACR.
S
W
2).0 fA L M
TYPE OF BUILDING
ES. 2
SEAS.
VL.
FARX
COMM. CB. MISC. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
k - -
3 a
M1
- +,
Q
`
,
I
- - til
I
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable 1
Tillable 2
Tillable 3
Woodland
64,Lt- � If f 3 3 �i
Swampland
FRONTAGE ON WATER-
Brushland
FRONTAGE ON ROAD_a
15
House Plot
DEPTH
�--
-'
BULKHEAD
—/
Total
DOCK
WF
6,00
TOWN
OF SOUTHOLD PROPERTY
RECORD CARD y
OWNER
STREET
VILLAGE DIST.
SUB. LOT
-y , it � � •'�' � ,��
�%' 7
e G
�
FORMER OWNER °
N
E ACR.
S
WV TYPE OF BUILDING
.RES.
SEAS.
VL. �.
FARM
COMM. CB. MISC. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
FRONTAGE ON WATER
?j
Brushland
FRONTAGE ON ROAD
House Plot
DEPTH
?
BULKHEAD
Total
DOCK
BUILDING DEPARTMENT
TOWN OF SOUTIIOLD
HOUSING CODE INSPECTION ItEPORT
LOCATION:
number S street � ' municipality
SUBDIVISION MAP NO. LOT (s)
NAME OF OWNER.6f
OCCUPANCY, �l� r, �,E,
(type (owner -tenant)
ADMITTED BY:. j / �- � �� AC=IPANIED BY:
KEY AVAILABLE SFSUU.F. CO`. TA.K MAP NO.
SOUI.;;:; OF REQUEST: ,{��jj/c-l. 81�//� DATE•_TZ�,3d`I .3
DWELLING: ,, % ��
TYPE OF CONSTRUCTION DDGY � STORIES # EXITS
FOUNDATION CELLAR �Gy �� CRAWL SPACE
TOTAL ROOMS: IST FLR. 2ND FLR. ,C 3RD FLR. ---_
BATHROOM (s) Z-- TOILET ROOM (s) UTILITY ROOM
PORCH TYPE DECK, TYPE ;�Z-6,Cvf Lya�o�. PATIO, TYPE �--"
BREEZEWAY - FIREPLACE GARAGE --
DOMESTIC HOT[dATER A TYPE HEATERXX/, AIRCONDITIONING
TYPE HEAT WARM AIR HOTWATER
OTHER:
ACCESSORY STRUCTURES:
7 IV
GARAGE, TYPE OF CONST,�2( 0641�' STORAGE, TYPE CONST.
SWIEMING POOLA ,/, GUEST, . TYPE CONST. r----
OTHER:_ e- e- .S /ZC.r je e /10
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
REMARKS:
INSPECTED B14:
DATE ON INSPEECTION_
TIME START
ART. I SEC.
Le..)
TD