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Home My WebLink About20796-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21162 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 95 APPLE COURT SOUTHOLD, NEV YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot 18 Subdivision SOUTHOLD VILLAS Filed Map No. 9737 Lot No. 7 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 20796-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-44-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. PENDING - NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992- ARTHUR MALAUSSENA, JR. ,C."f al_ 1 ing Inspector Rev. 1/81 FORK NO. 2 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) NN? 2079 6 Z Date ............ ,!.. ....I...................... 19.3. Permission is hereby granted to: ..................................................... .. ... . . . '............ to ... . ...... ...... ....Qj..r;m,.j...... .. . .... ..............................................................................................................................................v............ atpremises located at .......................................... ....... . ... ................. ...... ................................................................................................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section .....0.15;....... Block .......9 ........ Lot No. ............. -L— pursuant to application dated ..... .. ............................... 193.... and approved by the Building Inspector. Fee $ V...0 . .. ..................................... . iu .1,g �0r Rev. 6/30/80 f - 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 aad 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. . . . . . .95 .APPLE.COURT .SOUTHOLD, .NEW.YORR. . . . . , . . House No. Street . . • Hamlet Onwer or Owners of Property. . . . . . , , , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PECONICPROPERTIESMANAGEMENT INC County Tax Map No, 1000, Section. . .69. . . . . . . . .Block. . .3. . . . . . . . . . . .Lot. . .18. . . .. . . . . . . . . . . . . Subdivision. .M(O.SOUTHOLD,VILLAS, , , , , , , , , , , , , , ,Filed Map. . 9737 . . . . .Lot. . . . . . . . . . . . . . . . . . . . . Permit No. . ?07.96.Z. . . . . . . .Date Of Permit. .iny 9,, 199?„Applicant. ,DONALD.BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . ... . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Fin Certicate. . . . . . . . . . . Fee Submitted: $. . . .25.00 , , , , , , , , , . . . . . . . . . . . . . . . . . . . .!. . . APPLICANT. 4 - THE NEW YORK BOARD OF FIRE UNDERWRITERS 10©OaA7 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEMBER 25,1992 Application No.onfile 787050,92192 tI 258436 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 N - HAEG-SOUT(IOLD VILLAS, ?S APPLE COURT, J01347 , SOUTIIOLD , N.Y. 3 �� Basement 0 1st Ft. � 2nd Ft. OUT Section Block Lot in the following location;was examined on NO VE RB E R 19 r 1992 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. I K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS - AMT. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP TYPE METER 1,•4W 1 f.3W 3 0 3W 3,0'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A•W G• EQUIP. PER A' OF CC.COND. OF HIAEG OF NEUTRAL 1 200 CB 1 x l 2/0 1 2/n = OTHER APPARATUS: G.F C..1. -2 SMOKE DETLICTORt-1 a A SPUDS ELECTRIC SE'RVICE LIC,0192E c� ?75 3RD.ST. BOX 156 GENERAL MANAGER ST. JAMES, NY, 11780 11 Per 4A� 1 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. k a COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TEL. 765-1802 TO N OF SOUTHOLD - OFFICE OF BUILDING INSPECTOR o '" t }.r P.O. BOX 1179 0' -%z - TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date Building Permit No. Q �2tj Owne r' (please print) P1urraer /Q'7�eje, - (please print) I 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 19�. ° Notary Public !rotary Public, County MARYANNE E. DOWLING (Votary Public, State of New York No. 5000030 Qualified in Suffolk County Commission Expires August 3, 199 _ ao791� �. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION pQ FRAMING [ ] FINAL REMARKS: DATE Wn INSPECTOR ao79to � 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T ( ] ROUGH PLBG. [ 7 FOUNDATION 2ND INSULATION [ ] FRAMING ] FINAL REMARKS: DATE 1 s91 � � INSPECTOR � L a.o7 91 � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE �� l °I q �- INSPECTOR Y 6 L_ c:_� U:It4LNT: . - 7� m 0 _ H ?OUNDATION ( 1st ) 1 'OUNDATLOtd (2nd ) ;OUCH FRAME & •PLUMBING off - N 3 . � H m :11SULATION PER N. Y. I n . y STATE ENERGY II CODErn I ? H FINAL iFl ADDITIONAL COMMENTS : i X d.* wktkh- try fol BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . _ _ _ _ . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ _ . . . . . . . . . . TOWN HALL SEPTIC FORK _ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY /� (�Ocl� q CALL . . . . . . . . . . . . . . . . . . . Examined . . . , ,9 , , 19 !.� PIAIL TO : Approved . . 4'. . .� . ., 19 Q l Permit No.c�-o? lD. . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT ;t DateP. . . .a. . . . . ., 199 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 neces inspections (Signature of applicant, or n-me, if a corporation) (Mailing address of appliVant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . .� . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . J Name of ow r of premises . � . . . . . . . . . . . . . . . . . . . . . . . ... (as on tPfe tax roll or latest deed) If ap lic a or o tion, gnature of duly authorized officer. . . .'. . . . . . .0. v:� . . . e and title of corporate officer) uil er's License No. . . . . . . ./. . . .//. . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . Electrician's License No. . . 9 . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . .. . . . . . . ... 1. Location of land on which proposed work will be done. . . L-t- � . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I-Iouse Number �jStreet Hamlet County Tax Map No. 1000 Section . . . . . . . . . Block . . . . . .0! . . . . . . . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . �� . . . . . . . . . . Filed Map No. 1. �� .!, , , . . Lot . . 17. . . . . . . . . (blame) 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 . Z. / . , 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 . . . . . . . . . . . . . . . . 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 . Depth . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . .Phone No. . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland?' .' „ . . No. .-/If. . . . . . . *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 YgRl COUNTY OF . . . . \?tol�. , . . S.S • • • • • .baA Z. 16 V4N. .. ... . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) pp leant above named. He is the . . . . . . . . . . . . . . . . . . . . . . . . . V. on . . . . . . . . . .actor., agent, corporate officer, 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 t manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . .�` '. . da f. . . . . 19 .�Z Sv��1 Notary Public, . . . . _ . . County •�-• S ROBERT 1.SC4TT,1 NOTARY PUBLIC,Sta N.Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No..47250$9,Suffo ugty, (Signature of applicant) Term Expires May 3 .19 • r 1�52• 4 • � 3sr� PGa� FF Lq O 4'vy� z , � a L 6' A. x� ry go i p uC n�• AC 447- itary syst+errr I ® to Placed under .W. �iriv ti AREA= 10,093 sq.ft. �`� SURVEY OF SINGLE FAMILY DWELLING LOT 7 RM . 3 Y F DAT. 1 QF N "AMP OF SOUTHOLD VILLAS" FILED MAP NO. Prepared In accordance with. the minimum A T SOUTHOLD standards for title surveys as established by the L.I.A.L.S. and -approved and adopted TOWN OF SOUTHOLD for such use by Title Assocla on: r The New York Stale Land SUFFOLK COUNTY N. Y. ll The water supply and sewage disposal 1000 — 70 — 01— P/O 06 systems for thls residence will conform SCale: 1"= 30 to the standards of The Suffolk County De a men! of Health Services. March 11, 1992 �-� &d e locations of wells and, cesspools shown hereon are from field observations and or from data obtained from others. -AND SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES :�'' "� FOR APPROVAL OF CONSTRUCTION ONLY 1 r G N.Y.S. LIC. NO. 49618 puca DAT(A S. REF. N0. MAY .D,q f992 , P .'_M 0. S EYORS, P.C. �14 20 09 APPROVED N"��jy ER• a� SO LD, N.Y. 11971 �10ES ' s ,l1RQ .523 S- GP�� P q� •D; �19- s 35- o' V Q 3• � 14 �Q o W a :0- Ve LAW, AREA= 10,093 sq.ft. �I V CERTIFIED TO: SURVEY OF THE LONG ISLAND SAVINGS BANK LOT PECONIC PROPERTIES MANAGEMENT CORP. "MAP OF SOUTHOLD VILLAS" FILEDJUNE 25, 1992 MAP/O. 9237 Prepared In accordance with the minimum A T SOUTHOLD standards for title surveys as established by the L.1.A.L.S and approved and adopted TOWN OF SOUTHOLD Tllle Association. . for such use by The New York Stale Laid SUFFOLiC COUi�ITY N. Y., . The water supply and sewage disposal 1000 — 70 — 01— P/0 06 systems for this and will conform " to the standards of The Suffolk County SCe�I�. ' = 30 Department of Health Services. Mc7/'Ch 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. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES (r 4 €n l 0 , FOR APPROVAL OF CONSTRUCTION ONLY aAR_ � 11 Y.S. L1G NO. 49618 DATE MS. REF. NO. P ~N� SU ES, S, P.C. (51 4.9 P. O. APPROVED MAINSOUTHOLD, N.Y. 11971 g l - G-10 (7 ) U I i UL 1 HE-A!TH SERMES 10 V y �p�; ',v�fer supo!y facilities for this l")J7a`iu:P 1:1,VC ,i,!s ria-ient and/or 10 LC bz- SaiiS(31--"LOj-y. GP ��O AV 3s . �'� 4)') O '� L11&19. Ce. z IV66' C, A, O 3• � la,93 114 CV Q4 • ZAN AREA= 10,093 sq.ft SUR VEY OF CERTIFIED TO, THE LONG ISLAND SAVINGS BANK L O T 7 PE-CONIC PROPERTIES MANAGEMENT CORP "MAP OF SOUTHOLD VILLAS" P (). sa-V 11y3 11�3s' FLEDjUNE 25, 1992 MAP No. 9237 Prepared In accordance with the minimum A T SOUTHOLD - standards for title surveys as established by the L.I.A.L.S. and 9pproved and adopted TOWN OF SOUTHOLD for such use by The New York State Land SUFFOLK COUNTY N. Y.Title Association. Y 1000 - 70 - 01- PIO 06 The water supply and sewage disposal systems for this residence will conform Scale: 1'"= 30 to the standards of The Suffolk County 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. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY S. L IC. NO. 49618 92S044 8 DATE HS. REF. NO. NOV 1992 P `6 I C SURVEYOR P.C. (51�6-Y X7N6, - 5020 P. JAT MA Iff POA D",4 S.C. DEPT. OF APPROVED HEALTH SERVICES SOUTHC,f� s 11971 -7 - G-1 0 (7 )