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HomeMy WebLinkAbout20797-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town .Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22026 Date DECEMBER 14, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 155 APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 6.9 Block 3. Lot 19 Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 8- conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 2.0797-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 (1ST & 2ND FLOORS) WITH- ATTACHED DECK. The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-45- NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258834 - DECEMBER 2, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALAUSSENA JR. ox ilding Inspector Rev. 1/81 FORM 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) N PTO 20797 Z Date ........1-4.......... ..... ....................., I9.9..Z- Permission is hereby granted to: .�. ...?c. ..�........ .................................................. to ............. .. .... . ...... ...1 !\A... . . .' ... ... ..�. ...... ......... ....... . . .... ...... .............................................................................................................................................. .. . ..................... .. at premises located at�,��S..1342� �-��,..........�.. .... .. ..... .... . ..................... ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ...... 1.©...... Block .....R.A....... Lot No. ...Q.. ............ pursuant to application dated .......... ..:)........................... 19Q L.-, and approved by the Building Inspector. Fee ..... ..ding Inspector......................... Rev. 6/30/80 zM_n\\rJ��f• .Y"- ; � Form No. 6 • 'I TOWN OF SOUTHOLD ; s 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. . .��� . .�. ,�t. . . . . . . . . . . . . . . . . . . . . . .SOUTHOLD: .NEW.YORK. . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . .PECONIC.PROPERTIES.14ANAGFNENT.INC: . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . qq County Tax Map No 1000, Section. . . _M. . . . . . .Block. . . .,3. . . . . . . . . .Lot. . . . 1 . . . . . . . . . . . . . . . . . Subdivision. .MIMOUTHOLD,VILLAS , , , , , , . . . „ „Filed Map. . 9737 . . . . .Lot. . . . . . . . . . . . . . . . . . . . Permit Nod L a . .Date Of Permit. Applicant. .DONALD.BRACREN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . F a Certicate. . . . . . . . . . . Fee Submitted: $, , , ,25.00 . . . . . . . . . . . . . . . . . . . f�� . . . . '. . . . .�... . . . . . . . . . . • ?. . . . . . . . . . . . . . . . . co APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000a37 BUREAU OF ELECTRICITY F_ 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date DECEMBER 02,1992 Application No.onfile 78705592192 A) 258834 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 JENKINS SOUTHOLD VILLAS, 55 APPLE COURT, dOR48, SOUTHOLD, .N.Y. _ in thefollowing location; ® Basement 11 Ist Ft. ® 2nd Fl. OUT `.Section Block Lot Y was examined on NO VERBE R 2 5 ,19 9 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 1: OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 18 16 19 18 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL. UNIT HEATERS MULTI-OUTLET DIMMERS MS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT., AMPS. TRANS. AMT. H.P. N SYSTE O.OF FEET AMT. WATTS 3 F 2 _ 2 §� SERVICE DISCONNECT NO.OF S E R V I C E , METER NO. CC.COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP 1�9'2W 1,B 3W 3,�3W 3,0"4W PER% OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 200 CB 1 1: 1 2(0 1. 2/0 OTHER APPARATUS: _c SMOKE DZT;CTOR c ^2 n SPUDS ELECTRIC SERVICE LIL, '192E 175 3RD.ST, BOX 166 GENERAL MANAGER ST. JAMES , NY, 11780 Per i 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. RTMENT. THIS __RTIFICATF: MUST NOT BE ALTERED IN ANY MANNER. .v C\ F TEL. 765-1802 TOWN OF SOUTHO]LD OFFICE OF BUILDING INSPECTOR 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 No. p Owner (please print) P 1 usb e r (please print) I certify that the solder used in the water supply sys-tern contains less than 2/10 of 1% * lead. (plumber 's signature) Sworn to before me this ' -*day of . 19 otary Public Notary Public, a County . MARYANNE E. DOWLING Notary Public, State of New Yoh o Qualified in Suffolk County Commission Expires August 3, 199 . ao 797Z 765-SS02 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: A -to i� DATE 6 9 .)- INSPECTOR Y �sL 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE INSPECTOR V� lc'LD i,:s. LNrS *A-Al _ I J ?OUIJDATION ( 3 s t ) ' 'OUNDATIOII ( 2nd ) U' TOUGH FRAME •PLUMBING W 3 . �v y m --IISULATIOPI PER N . Y. I • • y STATE ENERGY II CODE IF ' FINAL I ADDITIONAL COMMENTS : v W x H • O ��re , 4 S,��n� ® [v. J a BOARD OF HEALTH . . . . . .. FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CtIECK . . . . . . _ . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.. 76571802 NOTIFY ; GC��. CALL . . . . . . . Examined . . 19 q Z- MAIL T O : Approved . . /. . �. . . 197.)- Permit No.c'Z 7 � . . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 .1.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 nec sa inspectio s�.� (Signature of applicant, or ame, if a corporation) (Mailing a ressof aplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . .' Ag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1:011, / Name of er o remisesez-&_za�. .6v$J . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . (as on th tax roll or latest deed) If pl' is a or orat' n, signature of duly a. thorized officer. 0 ( ame and title of corporate officer) Builder's License No. . . . . . . . . . .... .J Plumber's License No. . . . . :P J./ . . . . . . . . . Electrician's License No. . .1 q ,E. . . . . . . . . . . . . Other Trade's License No. .. I. Location of land on which proposed work will be done. :CrCx �. . . � it .l�C . . . . . . . . . . . .1�1J `'. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet / County Tax Map No. 1000 Section . . d . . . . . . . . . Block . . . . . . ��1, . . . . . . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . Filed Map No. J. �3./. . . . . 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 . . .�. . . . . . . . . L.Y�Lr . . . . . . . . . . ... . . .. ... . . . . . . . . . . . . . . 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 extentof 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 . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . .PhQn_e No. . . 15. Is this property within 300 feet of a tidal wetland? • *yeS• 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 YgRI ,� COUNTY OF . . . . . u • , . LS.S7 . • • • • • I-✓� •L-�• W��•����•. . ... • • • • • • . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . : . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, 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 the manner set forth in the application filed therewith. Sworn to before me this . . . .� :. . . . . .day . . . �v�Y. . . . . . . 199. . . , Notary Public, . . . . . . . � . ...�. County ROBERT I.SC09't, IR. . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC,State of KY. (Signature of applicant) No.4725089,Suffolk Coto Term Expires May 31,19 _--- not to be s is .020o X, � sanitary n�e� �riv�way area. u a \�ti P Oo ,e Q s � 60 `SO- •ash,� .�s. ,� , h , . o F�O ff r0 0 0 11� OV O ti� ti cho JASM/NE �I-NO� . �,qNE :_ �- rAA1Y:DLtI OF W REA 10,151 sq ft.. .o SURVEY OF LOT 8 "MAP OF SOUTHOLD VifLLAS" FLED MAP Prepared in accordance with the minimum slvndards,for TUIe surveys ds �establlshed A T SOUTHOL by.the L.1.A.L.S and ap�proved. and adopted TOWN OF SDUTHOLD� for such use by The New :York Stale Land Title Association. SUFFOLK COUNTY, N.Y The water supply and sewage dlsposa! 1000.- 7Q -01—;P/O 08 systems for ihls residence, w111 conform ��, , to /lie slandards --of The Suffolk County : SCale .1 . 30 YTI lmenl of Health Services. M C�'1 1�, 199 locations o/ wells and cesspools shown hereon are from' 1le/d ` observallons and or-from data oblalned from "others. � �a - d > , SUFFOLK COUNTY OEPARTMENT OF HEALTHr �`� ��� `� ° -SERVICES FOR APPROVAL OF CONSTRUCTION'ONLY N.Y.S. LIC. NO. 49618 DATE_ WS. REF. N0. 01 ,�9� E 11I1 '/ y ORS P.C. C. APPROVED. LAI 1197/ 17-FTC /RI n00 A A0 so x, J Al y _ 60 e`�V �� V I 1� (0 Fes_ A ,,0 o b e —6 y0 'o-�,00 9 L V �0 s G 00 `� �2 0, Q,• al O `V op ZC; Q . <,�.3Spp, • JA SMINE LANE AREA = 10, 153 sq.ft. SURVEY OF CERTIFIED Tor LOT 8 THE LONG ISLAND.SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. "MAP OF SOUTHOLD VILLAS" FILEDJUNE 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 approved and adopted TOWN OF SOUTHOLD for such use by The New York Stale Land SUFFOLK COUNTY N. Y. Title Association. r The water supply and sewage disposal 1000 — 70 — 01— P/0 08 systems for this residence will conform to the standards of The Suffolk County Scale: 1it r 30 Department of Health Services. Mcvch 11r 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. aI_A$V SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES9 o FOR APPROVAL OF CONSTRUCTION ONLY N.Y.S. LIC, NO. 49618 DATE_ MS. REF. NO. P CONl` sL�YORS, P.C. ;7a�t�6J�765 5 p;20 09 1lVI El,, APPROVED S L N.Y. 11971 87-670 (8)