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HomeMy WebLinkAbout20798-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. •CERTIFICATE OF OCCUPANCY No Z-21163- Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 205 APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot 20 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. 20798-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-46-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258434 - NOVEMBER 25, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA, JR —Building 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) WN! 20798Z Date ............1..'t. . ......I................. Permission is hereby granted to- .. ........... . ... .... ... L ............................................... QICA ... .......... Cw"'*. ..............�.n...&to ... C4. ............... ..'��L .. ................. ...... ... at p...r.e.m...is..e..s. lo..c..a..t.e..d. at.... t ... ......................g.....f...t.tg....A...........&-. . ..."..t.. .. :.. ....... ..... . .................. ......................................................................o............................... ...... .................................. .................................................oo......o...............o...........................................o.....................o.......o—.......... County Tax Map No. 1000 Section .....0-7-11-St....... Block .....4.A.......... Lot No. ........... pursuant to application dated ........1. me. .....�.................. 1912L.—I and approved by the Building Inspector. Fee $...Aal-.V. .. QBagE ............. Inspector Rev. 6/30/80 Form No. 6 T014N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, 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 17 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. ,?05.APPLE.COURT. . . SOUTHOLD, NEW YORK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . .PECONIC.PROPERTIES.MANAGEMENT.INC: . . . . . . . . . . . . . . . . . . . . County Tax Map No 10'00, Section. . .6. . . . . . . . . .Block. . . .3. . . . . . . . . . .Lot. .?O . . . . . . . . . . . . . . . . . . Subdivision. .M(O.SOUTHOLD.VILLAS. . . . . . . . . . . . . . .Filed Map. . 9737 . . . . .Lot. . .? . . . . . . . . . . . . . . . . . . Permit No. . ?07M. . . . . . . .Date Of Permit. .4%Y.9P. 1???. .Applicant. .99NALD.BRACREN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . , . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . .25•0� , , , , , , , , , , , , , , , , , , , , nn 6u= ��.. �) Y �— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1{ APPLICANT e© <,::?_Cz THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGB I 6 1000837 BUREAU OF ELECTRICITY ik F " 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date NovoP•T n 25 ,1992 ApplicationNo.onfile '18705692/92 2.5843-! 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 SIPAPLES-SOUTI-lOLD VILLAS , 2.05 APPLE COURT, JOBa9 , SOUTHOLD, 1•I, Z, _ in thefollowing location; © Basement ® lst Ft. KI2nd Fl. OUT Section Block Lot uvs examined on fa o vuf }1 19 ,19 9 2 and found to be in conLpliance with the requirements of this Board. FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT_FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 10 26 !6 1@ 1 P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELI UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS 3j AMT. K.W. 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 1 2 12 2 - SERVICE DISCONNECT NO.OF S E R V I C E c AMT. AMP. TYPE METER 1�•2W 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 AY OF CC.COND. OF HIAEG OF NEUTRAL g 1 3.00 C B 1. x OTHER APPARATUS: C.F.C;..[ , SMOKE DETECTOR. -1 SPUDS LLECTR4C SERVICE LIC. 0192 t 175 3RD.JT. BOX 166 GENERAL MANAGER ST. JAMES, Fly' , 11790 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 BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TEL. 765-1802 o -v• �: �.� TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR �E.. ?. 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. Owner f�- (p'lease print) P 1 Urab e r� (Please rint) I certify that the solder used in the water supply system contains less than 2/10 of lo • le.ad. (plumber 's signature) Sworn to before me this ' day of (� 19 , tart' Public Notary Public, g 0k County . MARYANNE E. DOWLING Notary Public, State of New York No. 5000030 Qualified in Suffolk Countyy Commission Expires August 3, 199-i ao79 $ -� 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: D4 -y-, �ow.�XaXA� DATE � � �-- 9 �- INSPECTOR \ ao� Cl s � �� 76s-iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ J FOUNDATION 2ND INSULATION [ ] FRAMING ] FINAL REMARKS: o4 �o DATE INSPECTOR T 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: U� e •G DATE �� � 9 .. i INSPECTOR (� _ H � 'OUIIDATION ( 1st) _ 1 1 , 'OUNDATIOtd (2nd ) Q _ �' r�± `L 19 ;OUCH FRAME & � PLUMBING 3 . O T" y =IISULATIO?I PER N . Y. . H STATE ENERGY II CODE I ? --------------- }� FINAL ADDITIONAL COMMENTS : m — x LJ vri o'�__ o met' ..,,pper� • • ' ,. t°: RJtt�. H • � O BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . _ . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ _ _ . . . . . . . . . . . TOWN HALL SEPTIC F• ORrI _ _ . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDTIFY ; �� 6 rl� Examined . . . ,9, , ,� 10 CALL _ . . . . . . . .' . j a MAIL TO . Approved . . . . ."►. . . 19U Permit No. -9 9 �. . . ; . : . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . ......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3 . .. ,. �(Bui ding Inspector) APPLICATION FOR BUILDING PERMIT . DateP- - . �. . . . . . ., 19/� 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 necessa spections. (Signature of applicant, or name, if a corporation) ( A�adresAf Mailin applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of o er of prem . . ... . . . . . . . . . . heaxrollo(as on r latest deed)ises If a li *am�e rayon, signature of duly authorized officer. { title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . .� .�s1.J. . . . . . . . . . . Electrician's License No. . J .Ic . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . Q 1. Location of land on which proposed work will be done. . . t . . . . . . . . . . . � . �1/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I-louse Number Street Hamlet County Tax Map No. 1000 Section . . . . .�.7.&?. . . . . . . . . . Block . . . . . .0 f . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . Filed Map No. ./ 7.. ./. . . . . . 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 . .�.�1�./�. . . . . . . . . . . . . . . 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 . : . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . 15. Is this property within 300 feet of � ' ' '?: Phone . . . . . . . . . . . . . . . . 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 Y99, , . S.S COUNTY OF . . . .C . ... . . . /v .. • • • • • •t) /. . �. . . • • .. A��"! • • • • • . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is 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 . . . . .J ; . . . . ., 19QZ Notary Public, . . . . . . . . . . .. . . . . . . . County ROBERT I.SCOT1'.J . . . . . . . (Signature . .applicant) NOTARY PUBLIC,State fitof No.4725089,Suffolk Ccu Term Expires May 31,19. 3� e► 0 - *&o V0 a2 0� e\ so. "-� op 'o Fes• ��c e O �F. VP y ` y e� V • ems,-• 5 _ - •off. rj _ tih��h hoo, e� �t�� �CK :DO 'A . 1t`(01 �Z O . -1A 641/v LA%V�c Q' St ICLE FAM1LY'0WMLjNG ONLY ' CPfRES 3 YEARS FROM DATE OFAPPROVAL A A = 10,742 sq.'ft. SURVEY.OF ' LOT 11MAP-OF�SOU.T11= VIL Seo FLIED A+IAP,NO. - Prepared In accordance with the min/mum standards for title surveys. as .es/abilshed A T SOUTHOLD by the L.LA.L.S and approved=vnd adopted TO-WH :OF SOUTHOLD for such-use by The -New York Slate Land Title Associallon. UFFOLK COUNTY'N. Y. The water supply and sewage disposal PLEASE NOTE. : 1000 70 - 01- /O 06 systems for this residence will conform $anitafy SySt@i'11 is not tQ be �� � /o -the standards. of The Suffolk County placed udder driveWayarea. Scale: 1 , = 30 0 rfmant of Heath. Services./ March 1 r, 1992 he locations of wells and cesspools shown hereon are from field observations and or from data obtalned from others. � x_AND& ' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY. _f '� e ' •�M,;, �� "" f' AY.S. 11C. NO. 49618 EJUN 02 �01 ; ,7,�� DAT S. REF. N0. Q � N/C . YORS, P.C. 09 APPROVED H SC-pEaT 'SOU . OLD, A�Y. 119T1 Z�l ei - O V - •' 0 x0 v, �O o 02 �2 V0 e\ 60 el V / 2$� a o°o el `h Q aXI q • r Je I 00 s VV JqS Q . &fl VE Q , LAlVe Q' AREA = 10,742 sq.ft. THE LONG ISLAND SAVINGS BANK SURVEY OF PECONIC PROPERTIES MANAGEMENT.CORP. LOT 9 "MAP OF SOUTHOLD VifLLAS" Prepared In accordance with the minimum F/LEDJUNE 25, 1992 MAP NO. 9237IQ T�SOUTHOLD standards for !file surveys as established by the L.I.A.L.S and approved and adopted TOWN OF SOUTHOLD for such use by The Title Association. SUF New York State Land FOLK COUNTY N. Y. The water supply and sewage disposal 10010 — 70 — 01— P10 08 systems for lhls residence will 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 obtalned from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY m 0 Y.S. LIC. NO. 49618 DATE S. REF. NO. !Cy`'` DRV RS, P.C. P. �9 APPROVED MAI SOUTHOLD, N.Y. 11971 87--670 r9) 0 Ft.'l'T"Ai!I-N'r OF NFL.;_.H K F,�'rC ES 5 The 9(tv�ap- cS im �ihis IrJCF,4�10D [k;C w,,d/or oti-lor (7 @Iftief of raaul ot W,EstevlaLef r416nag- :ent ) --------- -VO vo LA 00 O � \10 + -10. co 01 0 C-3 1\0 CK py 4) ,,FV . < Q9 0 0. A f J A SA 0 fly V1c A)VA AREA = 10,742 sq.ft. CER TIFIED s THE LONGTO ISLAND SAVINGS BANK SURVEY OF PECONIC PROPERTIES MANAGEMENT CORP. LOT .9 "MAP OF SOUTHOLD VILLAS" Prepared In accordance with the m1n1mum FLEDjuNE 25, 1992 MAP NO. 9237 standards for fille surveys as established A T.SOUTHOLD by the L.I.A.L.S. and approved and adopted TOWN OF SOUTHOLD for such use by The Now York State Land Title Association. SUFFOLK COUNTY N. Y. F 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"= 30' Department of Health Services. March 11, 1992 JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are from field Oct 2,71992 (final)' observations and or trom data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY Y.S. LIC. NO. 49618 92S046 DATE —HS. REF. NO. 0MNIC URVEY01" P.C. NOV 13 1992 P.`,�,',O- BOX WR`�ZAD APPROVED &C. DEPT. OF SOL)" D11. 11971. HEALTH SERVICES 8767010)