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Home My WebLink About20791-Z V FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z.-21155 Date NOVEMBER 18, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 365 JASMINE LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. R0791-Z dated JULY 9, 1992 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 (FIRST FLOOR ONLY) The certificate is issued to PECONIC PROPERTIES MANAGEMENT, INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-39 - NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-256227 - NOVEMBER 9, 1992 PLUMBERS CERTIFICATION DATED .00T. 8, 1992 - ARTHUR MALANSSENA, JR. Building Inspector Rev. 1/81 FORK NO. D 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) N 9400 2079 1 Z Date .........I ......................... Permission is hereby granted to: C_ x.....1.)Az............................................... ... .. ....... .4-06_ - .....0...4........ to . ......Q6..... ..... . . D.... ... .. ........ ...... !ttp; ................................................................................. ....... ........ ... .......eal at premises located at ....3.(? ....... . ...... ......... ........ �jcLrlu. ..... . ........ .. .................. .............. ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ..... ........ Block ......(:).k......... Lot No. .....q.. .......... pursuant to application dated ........... I's,......D..._..................I 19. — and approved by the Building Inspector. . .. 1L Fee $ I-) ,.....b-D ..... .... ...... ..... . ...............1�............ BCutlngg Inspector Rev. 6/30/80 y Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 '--'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 a 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 - $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 . , , ,November.18: .1992. . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . S„ . . .JASMINE . LANE. . . . . . . . . . . . . . . . .SOUTHOLD, .NEW.YORK. . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . .PECONIC.PROPERTIES.MANAGEMENT.INC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .?9. . . . . . . . . .Block. . . . l. . . . . . . . . . .Lot. %3 . . . . . . . . . . . . . . . . . OUTHOL Subdivision. . M/0 . . . . . . .. . . . . . . . . . . . . . . . . . . .Filed Map. .973. . . . . . .Lot. . .oil. . . . . . . . . . . . . . . . . Permit No.-7 0 7.1 Le. . . . :Date Of Permit. Applicant. .DONALD,BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . .. . . . . . . . . . . . Request for: Temporary Certificate. ... . . . . . . . .XFinCerticate. . . . . . . . . . . 25 Fee Submitted: $. . . 20.00. . . . . . . . . . . . . . . . . . . . . �,y._5/2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Co'a ��.S.5 APPLICANT ,s. THE NEW YORK BOARD OF FIRE UNDERWRITERS PA(,E 1 1000037 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date BOVEMBE R 09,1992 Application No.on file 7 Ta1 199?./`�? 11 256227 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 €'All L & JOAN Z1aN11S[;1:, 365 JASMINE LANE , JO? 2) , SOUTHOLD, N.Y. in the following location; ® Basement % 1st Ff. F 2nd FY. OU T Section Block Lot was examined on N O VEa MB E R 0 2 ,19 a 2 and found to be in compliance with the requirements of this Board. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. K.W. I AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 13 '6 18 13 1 1,2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 1 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE EOVIP 1-0 2W 1,B 3W 3,0'3W 3,0'4W NO.OPER%COND. OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 200 C33 1 x 1 2/0 OTHER APPARATUS: i;,F,C.T.c • 2 SMOKE DETECTOR t -1 SPUDS ELECTRIC SERVICE 175 3RD.ST. BOA 166 GENERAL MANAGER ST. JJfMES, NY , 11740 11. 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. b ALTERED IN ANY MANNER. TEL. 765-1802 TOWN OF SOUTHOlLD O OFFICE OF BUILDING INSPECTOR - n, P.O. BOX 1179 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date Building Permit Owner (please print) P1urrber liftAlWe (please print) 2 certify that the solder used in the water supply system contains less than 2/10 of lo • lead. (plumber 's signature) Sworn to before me this . day of z 19 Q--) . � Notary Public tlotary Public, County MARYANNE E. DOWLING Notary Public, State of New York No. 5000030 Qualified in Suffolk County C-Omraission Expires august 3, 1994- ao ,79l � 765-i802 BUILDING DEFT. INSPECTION LX FOUNDATION 15T [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ 7 FRAMING [ ] FINAL REMARKS: 1 sr � w�+%n� 4 DATE 9. 2- INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. pQ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ J FINAL REMARKS: �-k 64 *r-a DATE 7 ao Z INSPECTOR G L � 0791 � 76s-ssoz BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ J INSULATION [xJ FRAMING [ ] FINAL REMARKS: �',t�.u..`,� WE DATE Z- INSPECTOR G� L 70-ieo2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST D�j ROUGH PLBG. [ ) FOUNDATION 2ND [Dq INSULATION [ J FRAMING [ J FINAL REMARKS: 94 DATE �I �I q L INSPECTOR ao79l T, ors-tso2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE " �, q'- INSPECTOR ZZIN Dn:E 3 FOUNDATION 'OUNDATION ( 2•na ) 7 Acwj (1� ;OUCH FRAME & � .PLUMBING 3 ii cn . y e ^c m =NSULATIOIN PER N . Y. I "� • • y STATE ENERGY II CODE I t m H FINAL ,p ADDITIONAL COMMENTS : ac Jo P N • _ H 1 !tA O BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS .OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . _ _ _ . . . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . TOWN HALL SEPTIC. FOR.. . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.. 765-1802 NDTIFY ; .�� 0 .7,// CALL / . Examined . . , . , 19 �- MA I L T 0 . Approved �- A-tfll . . . . . . ., 19h. Permit No 07 9/ . . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . ��. . . . . . .. 1990 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 bd 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 nece inspectio/�s� (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. &�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of n r o pr ices . . �i1 . . rtr?�-;�--... . . . . . . . . . . . . . . . . . . . . . (as on the x roll or latest deed) If ap i a a o atio , si re of dul a orized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X a e and title of corporate officer) B ilder's License No. . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . .� �. . .�: . . . . . . Electrician's License No. . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . ... 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . �it`i� . .�%�� 1`;`i. . . I-louse Number Street Hamlet County Tax Map No. 1000 Section . . . �. . . . . . Block . . .0. . . . . . . . . . . . Lot . . .4�! . . . . . . . . . . . Subdivision .: � k✓. .x.�. . . . . . . . . Filed Map No. �. ,/. , . . . Lot . . . .c2 . . . . . . (Name) 2. State existing use and occupancy of premises and.intended use and occupancy of proposed construction: a. Existing use and occupancy . . . .dd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . b. Intended use and occupancy . . 1. . . . . . . .' C� ? {° , , , , , (/ 3. Nature of work (check which applicable): New Building . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . ... . . . . . . . . Other Work . . . . . . . . . . . . . . . ' n) 4. Estimated Cost .!d.�.�.d��'d . . . . . . . . . . . . . . . . . . . . . . . Fee . . .7.7:. . . . . . . . . . . . . . . . .(Desc riptio riptio . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage,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 . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . ... . . . Number of Stories . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . Rear . . . . . . . . . . . . . Depth• . . . . . . . . . . . . Height . . : . . . . . . . . Number of Stories . . . . . . . . . 9. Size of lot: Front . . . .. . . . . . . . . . . . . . . 10. Date of Purchase . . Rear . . . . . . : . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . .Will excess fill be removed from premises: .Yes . . No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . Name of Contractor Address . . . . . . . . . . . . .Phoy No. 15. Is this property within 300 feet of a tidal wetland? eyes, 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 property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YQR1 S.S COUNTY OF . . . .SS. 5 � . /V • • • • • • • • • • • � • • • • • • • • • /u • • . • . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . . . . . . . . . . . . . . . . . . . . _ tractor, a ent, corporate officer, etc.).• • . . . . . . . . . . . . . . . . . . . . . . . . g P of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . .(. . . . . . . . .day o vLY. . .. 19 .. Notaryc'u \Public, . . . bounty R08ERT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . k�472 PUBLIC ,R. (Signature of applicant) of Ity, Term fx 'Suffolk Ca Qrres Mey 31.I9 _ N - P.oP �✓/M o , ✓A S+M�/Vj LANE E. �rl o f 43 L+ L� e(20 6',S�sJ., oPe n ) 61 22 R=321.46' L=119.72' L= 51.96' La77.g3' La4/.89',sw el?2 s .. P�aP Or �y��S,Op• L Septic :G pp pp lip system �� R•32/. h�i i 44, 44 N � Cb R•25 Prof, � L•`;9 27, V CONSERVA'l/O - I 3 6' N c., /0' r*w0 EASEME O Q vJ � Nr N Q o o Z TO 0p, `.1 N 20"W nj N N/p/F FL D e�WE `IS R H/LL BU 264'70, zo _ VACANT /LD/NG CARP AREA = 45,004 sq. ft. FSanitZarFy .E,�`SE �� toy System is notnder driveway area. SURVEY OF SINGLE F Y IELLNG 014LY LOT 2 EXPIRES � YEAM FROM DATE GFAMROvAL %MAP OF SOUTHOLD VILLAS" FILED MAP NO, Prepared In accordance with the minimum A T SOUTHOLL? standards for title surveys as established by the L.1.A.L.S. and approved and adopted TO WN OF SOU THOLO for such use by The New York State Land N. Y. Title Association. SUFFOLK COUNTY The water supply and sewage disposal 1000 - 70 — 01— P®O 06 systems for ihls residence will conform to the standards of The Suffolk County Scale. 'ii i = 40 Dli6p Iment of Health Services. MalCh 11, 1992 The locations of wells and cesspools shown hereon are from field observations and or from data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES rRI�s 1,.� iiy FOR APPROVAL OF CONSTRUCTION ONLY . � a N.Y.S. LIC. NO. 49618 DATAN 02 W HS. REF. NO. PJJAY 28 1992 � PE�CONIG= S , WYORS, P.C. r /�Q .765 Z50 0 D9 y S.C. DEPT. OF APPROVED HULLI'Iii ERVICES SO( Tf7r9LD N.Y. 11971 J P�oP �✓/M SA- 01AWeLANE L el zo F 6S.�5, �n o t oPQ,, ) el zz R-36g 79, R=321.46' L=119.72' L= 51.96' La41.89' el Z2 y, 235. w i7j°OO100-1 p 00 a 4 I C 4q t-- --- �2 .00, Y` (p I fNu COnc� N / V CONS ERVq T/O/V W iosJ 35.0 ° cl r,� '-`gSEMENT �Q "J • 70.00, e( 2i JV N N N1011C F�Ow ER H/LL 264 70• V'4CANT e/�o � BU/LD/NG CORP �Nd AREA = 45,004 s . ft CERTIFIED TO, .7 UR VEY OF THE LONG ISLAND SAVINGS BANK LOT L^ PECONIC PROPERTIES MANAGEMENT CORP. "MAP OF SOUTHOLD VILLAS" FILED JUNE 25, 1992MAP W. 9237 Prepared In accordance with the m/nimum A T SOUTHOLD standards for title surveys as estobllshed by the L.I.A.L.S and approved and adopted TOWN OF SOUTHOLD for such use by The New York stole Land T11/e Association. SUFFOLK COUNTY, MYThe water supply and sewage disposal WOO — 70 — 01— PIO OB systems for 1hls residence will conform to the standards of The Suffolk County SCale: i� = 40 Department of Health Services. March 11, 1992 JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are from field observations and or from data obtained from others. A_AND S SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY 0 S. LIC. NO. 49618 DATE HS. REF. N0. P C S° i/EY k? , P.C. P. O. p APPROVED MA/N SOUTHOLD, N.Y. 11971 8-7- (o-70 (2) S-UFF01.K COU'l",ITY DEENURZT: OF H-EA!-'i H KL VIIIH flLY UVVELL!,,ir. 0., 3/DATE If. . 1"LE117 The sewage disr)osal and t,ater sLiprlly facilities for this to ca-boil hate "De 3rl ;I.-Is pected 1.mient a ild/or H b other agc, nru oi ,,e W, Chief of &lraau of V%fastewater 1',olanagement • 00 S4 A 1 15. , �k, . LANE 65 R=321.46' L= 51.96' L=41 9' .00, *00,00-M, 4 -'96' CIV I 3' �yti o � 4.� N 00 4-39 A;Z LU $0 CONSER VA rION W Cl 15, C—.0 E-A SEAIEN r /� O Q X 1(0 o h O —� o 70.00, (0 N. N A(101F Fj 0 WER HIZ L BUIL AF VACANT CORP AREA = 45,004 sq. ft. CERTIFIED TO# SUR VEY OF THE LONG ISLAND SA VINGS BANK PECONIC PROPERTIES MANAPTMENT CORP. LOT 2 11X3 `yy ll93-5, "MAP OF SOUTHOLD VILLAS" FLED JUNE 25, 1992MAP W. 9237 Prepared In accordance with the minlmum A T SOUTHOLD standards for title surveys as established by the L.I.A.L.S. and approved and adopted TOWN OF SOU THOL D for such use by The Now York State Land TI/le Association. SUFFOLK COUNT Y N. Y I The water supply and sewage disposal 1000 - 70 - 01- PIO 06 systems for this residence will conform to the standards of The Suffolk County SCale: 1" = 4 0 Department of Health Services. March 11, 1992 JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are from field Oct 24,1992 (final) observations and or from data obtained from others. U, SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY LIC. NO. 49618 92SO39 C1 DATE NO. Is 'EY P.C. —HS. REF. PE Z'�1011Z'44�, V� Ito (51 .5020 P. O. . 4 MA IN APPROVED -SOU FHO 11971 -7 - G-7 0