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HomeMy WebLinkAbout20795-Z . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21161 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 720 JASMINE. LA & 45 APPLE COURT SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1.000 Section 69 Block 3 Lot 17 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. 20795-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 & SECOND FLOOR AS APPLIED FOR. The certificate is issued to PECONIC PROPERTIES' MANAGEMENT INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-43-NOV. 1.7, 1992 UNDERWRITERS CERTIFICATE 'NO. N-258439 NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992-ART'HUR MALANSSENA JR. ui ding Inspector Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT T014N 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. . . . . . . . . . . . . . . . . 1 31 . JASMINI; LAME & 45 APPLE CT. SOUTHOLD, NEW YORK Location of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No.. Street Hamlet Onwer or Owners of Property.. . . . . . . . . . ,PECONI. .PROPERTIES.MANAGEMENT.INC: . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section— f l . . . . . . .Block. . : . . . . . . . . . . .Lot. . . . .. . . .7. . . , , , , , , , , Subdivision. . . M)0 SOUTHOLD VILLAS „Filed Map. . . 9737. . . . .Lot. . . . . . . . . . . . . . , , . . . . , Permit No. . .M97 M. . , , ,Date Of Permit. •JULY.97. 1992. .Applicant. ,DONALD,BR4CKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . .. . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . ... . . . . . . . . . . . Request for: Temporary Certificate. .: . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $„ •,-00. . . . . . . . . . . . . . . . . . . . .�(�) . . . . . . .. . . . . . .. .. . . . . . . . (a__t APPLICANT CO-2- FORK NO. 9 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) NW? 2079 5 Z Date ........... ................. 193 Permission is hereby granted to: a�................................................ . �� � ... ... ... .wmqjw. ...V....�..g... ........ Y.to A.....Q........D... ..... 0 4............ . JA.. ... ... . ...... .. . ...... .... ................................................................................................................................................................ at premises located at ........w. .... ...................�.�.Q. ......................................................................................................................................................#.. ................................................................................................................................................................. 0 County Tax Map No. 1000 Section .... ........ Block ......0.1........ Lot No. ...1z...)... ............ pursuant to application dated .......1. Ik& ....;) ......................... 19.1-1-1 and approved by the Building Inspector. Fee LL C1 iding Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1.000837 BUREAU OF ELECTRICITY F 85 JOHN STREET; NEW"YOF iK;'�i4EW YORK,10038 Date NOVEMBDR 25,199 ? Application No.on file 78705392192 N 258439 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 JA.KLFVIL SOUTHOLD VILLAS, 45 APPLE COURT, JOM , SOUTHOLD, N.Y. in thefollowinglocation; ® Basement 9 Ist Ft. ® 2nd Fl. OUT Section Block Lot was examined on MOVE RB E r 1 9 ,19 9 2 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS u OUTLETS INCANDESCENT1.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 15 35 20 15 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMT, K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEETAMT. WATTS 1 2 12 2 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER 1,,PW 1.6 3W 3 03W 3 X 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER AY OF CC.COND. OF HI-LEG OF NEUTRAL 1 100 CB 1 x 1 a 1 4 OTHER APPARATUS: C.r.C.It -3 SROKH DETECTORt-1 pf SPUDS ELECTRIC SERVICE LIC.4192 F 175 3RD.ST, BOX 166 GENERAL MANAGER a ST. JA140S, IVY, 11780 Per t 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-FORMILDING DEPARTMENT. TH S COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF S TEL. 765-18®2 p OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN-HALL Jr SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date /� 9� Building Permit No._, © � ,57 Owner _ l !C_ 0 e - es AINUClr e W-C-a, I N e (plea e/ rint) Plumber/ter' ZL (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% . lead. (plumber's signature) S.Wgjpn to before me this day of 19e--) Notary Public Notary public, Sk�°�k_County MARYANNE E.DOWUNG Notary Public,State of,New York No. 5000030 Qualified in Suffolk County Commission Expires August 3, 199A 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [>(j ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: b'- DATE INSPECTOR Y � L ao 9s� 76s-iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE `l a8 i. INSPECTOR �L i a o1 °I S �. 70-1802 BUILDING DEM. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [x] FINAL REMARKS: DATE " °� W INSPECTOR I:.:_�:i :- IMLNTS FOUNDATION 'OUtdDATIOld Zl- ( 2nd ) Ev '-• 9 i + Q ;OUCH FRAME & •PLUMBING H :NSULATION PER N. Y. I _ . y -3 oc II v STATE ENERGY CODE I , N FINAL ' b ADDITIONAL COMMENTS - as .0 ` H I17 � r _ r � a f BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . _ . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY : �6 5—_ 6Q7l 1 . . . CALL . _ . . . . . . . Examined . . 19 a MAIL TO : Approved . ..I Arjl. I . . ., 197 Z , . Permit No. 0 7 9 L . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Q Date . . . . ., 19 f�" 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 a inn n . . . . . . . c . "i (Signature of applicant, or n e, if a corporation) (Mailing add es s of appl�cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of ner remises 1! -�� (as on2ex roll or latest deed) If p i f a�'` o 'ora on, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . ame and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . .� �. . . . . . . . . . Electrician's License No. . : l M .,�E . . . . . . . . . . . . Other Trade's License No. .. r 0 1. Location of land on which proposed work will be done. . . . . . . . . . . . . A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I-louse Number Street Hamlet County Tax Map No. 1.000 Section . . . . �� . . . . . . . . Block . . . . . ©!. . . . . . . . . . Lot . . . .� . . . . . . . . . . . . . Subdivision . . tiJ- lU/-�/. (-MAV . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . b. Intended use and occupancy . 4 . . . . . . . . . . . . . . . . . . . . . . . . . 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) S. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . Rear . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . ... ... . Number of Stories . . . . . . . . . . . . . .I.. . . . . . . 8. Dimensions of entire new construction: Front. . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . .Phgrle No. . . . 15. Is this property within 300 feet of a tidal wetland? *yes. , . .. No j� *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 Y RK, COUNTY OF . .SvAk�k� . . . . . . /S/.S • • • • •j.� •-N 44 4 • �,-ULAa A C-A/• • • . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . kiractor*, a ent corporate officer, g p , etc.) 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 Athis . . . . . . . . . . . y . �.v��'. . ., 19 Q Z Notary Public, . . County ERT I.SCUTT,1 . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC,State�of N.Y . No.4725089,Suffolk County (Signature of applicant) Terrn Expires May 31,19U N PLEA. :isTnot to be �anita u deg d veway area. IlaCed I `A� 42131 t ES�2SF O . ' ,. • P�o� P�Zcy ra � hs Q V o ti oa e�Z � � 3S" ch'O��' 0 s0Q �v •�h0 0 P/ 30; N.�5.43i0 - O syst�� Q ✓q Z st&/Ate ARE = 10,768.sq.. ft - SINGLE FAMILY DWELLING ONLY SUR VEY OF 3 YEARS FROM DATE OFAPPROVAL - . LOT 6 %MAP OF SOUTHOLD VILLAS" FILED MAP NO. ; Prepared In accordance with the minimum A T SOUTHOLD standards for title surveys as established TOWN OF SOUTHOLD by the L.I.A.L.S and approved and adopted for such use by The New York S/ate Land SUFFOLK COUNTY, MY Title Association. 1000 — 70 — 01— P/O 06 The water supply and sewage disposal systems for this residence will conform SCale: 1" •- 30" to the slandards of The Suffolk Counly D Imenl of Health Services. March 11, 1992 UTPeilocations of wells and cesspools shown hereon are from field observations and or from data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY r� r` AAA ` ' :� - N.Y.S. LIC. NO. 49618 JUi� 02il� Y 2� 4 DATE H3'. REF. No. P�CO NlG3' S 0YORS, P.C. C. DA P 09 IDEAL)'N S�cR' oF `� '�`� CPT APPROVED '�i��� SOtJfiT-1 D� N.Y. i1971 sss. 4Nr . szzs� } 1'4C4NT cop �� p�► � r 25.0 3S. Q A: •�. CAI. r _ C, Shp• 0Q y �r - s�.o- �!v D(0 c � Q ✓qs Q' ,/0 00 00, YVAF - 3 -ZA,4 ` P / f P AREA = 10,768 sq. ft. L SUR VEY OF CERTIFIED TOf THE LONG. ISLAND SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. LOT 6'- "MAP OF SOUTHOLD VILLAS" FILEDJUNE 25, 1992MAP NO.,9237 Prepared In accordance with the minimum A T SOUTHOLD standards for tl/le surveys as eslvb/lshed by the L.GA.L.S and. approved and adopted TOWN OF SOUTHOLD for such use by The New York State Land Title Association. SUFFOLK COUNTY, MY.' The water supply and sewage disposal 1000 — 70 —.O1— PLO 08.. systems for lhls residence wit/ conform , to the standards of The Suffolk County Scale �:��= ' 30 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- other's. SUFFOLK COUNTY DEPARTMENT OF HEALTH .SERVICES FOR APPROVAL OF CONSTRUCTION ONLY �a N.Y.S. L/C. NO. 49618` DATE• HS, REF. NO. • o, 65 - APPROVED FI � SO , N.Y. 11971 8-7 - G-1 0 ( (o , ` � � {J-7 /_-l /\ / L- \