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HomeMy WebLinkAbout20799-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No K-22025 Date DECEMBER 14, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 235_ APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot 21_ Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 10 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 20799-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 FLOOR ONLY) 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-47 - NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258833 - DECEMBER 2, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALAUSSENA JR. Building Inspector Rev. 1/81 FORK NO. a 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) NNO 2 0 7 9 9 Z Date .............. ... ..... .................., Permission is hereby granted to: 4 ... .... Qom. .... ... . i✓ .o�c !.►................................................... ..... . .... max.... :.....1.!. - -i�........ to ... � '..g-:.... .�.. ..1:. ... ........ ........ .... ....q.f.9.ALJ... .................................................................................................... ..... .. ................ ofpremises located at .. , fir... ... ....... ....... .. .. ...... ... ....... ..........LP...... ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section .....Q 0....... Block ..... .�.......... Lot No. ...Q....O........... pursuant to application dated ........ .. .... ......................... 19.g.Amr and approved by the Building Inspector. Fee $...1`l. -1:..4 *— I�.0 a. .. ..................................... Bw ing Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT Lc •` TOWN HALL l - 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 1-'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. . . ,23.5. . . .Q� . . . . . . . . . . . . . . . . . . . . . SOUTHOLD: .NEW.YORR. . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . .NI. .PROPERTIES.MANAGEMENT.INC: . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . .0. . . . .Block. . . . ..3. . . . . . . . .Lot. . . �. . . . . . . . . . . . . . . . Subdivision. .*19.SOUTHOLD.VILLAS. . . . . . . . . . , „Filed Map. . 9737 . . . . .Lot. . !® . . . . . . . . . . . . . . . . . Permit No A.Q 7M.- � , , , .Date Of Permit. Applicant. ,DONALD.BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . .. .. . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . .25.0� . . . . . . . . . . . . . . . . . . . APPLICANT - TEL. 765-1802 TOWN OF SOriI�'IIO OLD '— OFFICE OF BUILDING INSPECTOR v, P.O.BOX 1179 O e?s • '' f '� TOWN HAIL r�ol �bQ� SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date A9 Building Permit No. D Owner (please print) P1urrber 4711v, (please print) I certify that the solder used in the water supply ,sys-1:em contains .less than 2/10 of 1% . lead. (plumber 's signature) Sworn to before me this ' day of 19 '; o Notary Public t10tary Public,_Stl, tpl k—County . MARYANNE E.00'NUNG Notary Pu�o'state of New York Quatif ieCun X n res iAugust 3,t198� commission P THE NEW YORK BOARD OF FIRE UNDERWRITERS ' '.ACE 1. 9.000337 BUREAU OF ELECTRICITY- 85 JOHN STREET, NEW YORK, NEW YORK 10038 it Date PECERBER 02,1992. Application No.on file 78705792192 11 258833 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 8SHONMENJARIN, 235 APPLE COURT, jOB #10 , SOUTHOLD, 11.Y. in thefollowing location; ® Basement ❑A lst Ft. ® 2nd Ft. OUT .Section Block Lot was examined on NO VE MBE R 2 5 t 19 9 2 and found to be in compliance with the requirentents q/this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 11 31 18 11 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 3 F 2 SERVICE DISCONNECT NO.OF S E R V 1 C E METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G. - AMT. AMP. TYPE EQUIP 1,0'2W 1,9 3W 3,0"3W 3,0"4W PER.0' OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 100 CB t X 1 4 1 4 OTHER APPARATUS: G.F.C.Icp2 SMOKE DETECTOR: --2 SPUDS ELECTRIC SERVICE LIC.# 192 E 175 3RD.S`P. BOX 166 GENERAL MANAGER ST. JAIIES, 11Y. . 11788 1.1 Per Y 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. z coE A ER D IN ANY MANNER. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION �(] FRAMING { ] FINAL REMARKS: � �o `da�,�,�Xo✓�' _ DATE � � s-- 9 y INSPECTOR S 76s-seox BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: d� rto Jai DATE INSPECTOR )4> L 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ) INSULATION [ ] FRAMING (J(J FINAL REMARKS: DATE INSPECTOR Y If�n it U:*1LUT� At FOUNDATION ( 1st ) c 'OUNDATI01'1 (2nd ) apl cn . cr /o o JL) ;OUCH F 1E & •PLU NG 3 . /0 T n 1 y =I7SULATION PER N . Y. y STATE ENERGY II CODE I ? FINAL I 1 ADDITIONAL COMMENTS : m J b H 1 � O i — a ►'� _ IT7 ; BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . ... . . . . TOWN HALL SEPTIC Forth _ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDT1FY �. _ �0,// CALL . . . . . . . . . Examined . . . 9 , 19 4� MA r L T 0 : e Approved . . . . . ., 197 Permit No. . . . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CfL MIS (Bui ding Is APPLICATION FOR BUILDING PERMIT pp Date . . .� . . . . ., 19 .90 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 (Signature of applicant, or nzHne, if a corporation) (Mailing addr s� scoff applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . .� .— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of ow of premises /���?� . .((J/�b� : . . . . . . . . . . . . . . . . . . . . (as on the t�or latest deed) If ap lic t ' a c rp r ion, nature of duly authorized officer. . . . . . . . . . . . . . . . . . . fit . ( a .e and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . Electrician's License No. . . 1. a . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . ... 1. Location of land on which proposed work will be done. . . A . .VZ . . .� W. . . . . . . . . .��.d .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-souse Number Street Hamlet a let County Tax Map No. 1000 Section . . . . . .70. . . . . . . . . Block . . . . . 01. . . . . . . . . . Lot . . . .6. . . . . . . . . . . . . . Subdivision . . . �.� . . . . . . . . . . . Filed Map No. . .�. 3 . . . . Lot �Q. . . . . . . . . \ (Name) . 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 . �. . . . . . ��. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . )s. . . . . . 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 . . . . . . . . . . . . . 6.. . . . 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 . . . . . . . . . . . . . . . Phone 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 YO S.S COUNTY.OF . . . . . � ...,. . . . . �. NA 4. /C,�G&' . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ontractor, 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 . . . . . . . . . .� of. . . . .`. .. . . . 19 Q Z Notary Public, . . . . . . . . . . . . . :-.:--County . . . . . . . . . . OBERT I.STT,JR. . . . . . . .0 F. . . NUTARY PUBLIC,State of SLY. (Signature of applicant) CO No.�725089,Suffolk Co��gqt�� Tenn Expires May 31.IR RUSSR`` M,gNN s. T . OqN 2 M 1670. ANN h zs. `00 �. coNS�R V-4 9000, T OT 18 .02 'O'V D�' Eq SEiy�NT 3\ e� or P ,o a rop Vol hsc m RN Lp 5' .o 29 AREA 13,073 sq.ft. 2'� =50.0 4', 00� L=32.9 - J dr 0 �o <,0s SINGLE FAMILY DWEL EXPIRES. ,3 Y q FRAM pLING pN.LY /,6��IeJq S/l ilj/ c AT'0'F APPROVAL Lq/V�c SUR VEY OF - 11Y,3 LOT 10 PLEASE NOTE MAP OF SOUTWLD 'V/LLAS Prepared In accordance with the minimum Sanitary sySte i i1 is not t0 b 6' D- MAP NO standards for title surveys as established placed under driveway area. A T SOUTHOLD by the L.I.A.L.S. and approved and adopted TOWN OF SOUTHOLD for such use by The New York Slate Land Y SUFFOLK COUNT N. Y. Title Association. , The water sup�ply and sewage disposal . -10.00 — 70 — 01— P/O OB systems for lhls residence will conform SCSI@� rai= 3O� to the standards of The Suffolk County tment fof�He h Service . March 11, 1992 .spools shown hereon are from field observations and or from data obtained from others. T1 ry 3 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY N.Y.S. LIC. NO. 49618 JUN 0210 DATE WS. REF. NO. EYORS, P.C. 020 ' 909 APPROVED7r.. MAIN ROAD ' /�c SOUTHOLD, N.Y. 11971 �� ► .I_v ► ,� 87-670 (10) fVip,� R M _ NN � ✓p q 'l19 s T2.g6�0"F Q4 9V h zs• 00 �. cpNS4-RV� 9000, T 18 .02 32- el 3ti _ .N, ` Lp T >r as Ol � TU _ 1, 19,7 h 10 `j Q� I .O I 29 AREA = 13,073 sq.f t. e'er R-50.00', 000 C 32•g4 �h0ih, el P.2s L J dr 0 1 � h 00 �v �o `V JASum L,4/V� cFJED Too THEI LONG ISLAND SAVINGS BANK SUR VEY OF PECONIC PROPERTIES MANAGEMENT CORP. . LOT 10 "MAP OF SOUTHOLD VILLAS" !n accordance with the minimum FLED JUNE 25, 1992MAP NO. 9237 Prepared A T SOUTHOLDstandards for Ntle surveys as established by the L.I.A.L.S and approved and adopted TO VVN OF SOUTHOLD for such use by The New York Slate Land Title Association. SUFFOLK COUNTY, N. Y The water supply and sewage disposal 1000 — 70 — 01" P®O 08' systems for this and will conform to the standards of The Suffolk County Scale 1"= 30� Department of Health Services. March 11, 1992 The locations of wells and cesspools shown hereon are from field JUL Y 15, 1992 (foundation) observations and or from data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY .N.Y.S L/C. NO. 49618 DATE_ Wg, REF. N0, n� ;CONI,C"'SURV0' RSy P.C. Bo)(- 90 APPROVED llRo�o SOL°J I�1�0Y. 11971 87--670 (10) NiO�F RU SSF<< Mq. N)V 4 ✓O h�' F 2s. V•4 o 90 00• s ,�, F \ zor 10 ti� O � .N i zOs � � T 0 0 0 � h� v — i5•a Iog 15 20•0' "'• to � h V, 1 'o I AREA = 13,073 sq.ft. R=50.00•• L=32.94 D v <aje;pO• Co . 0 W o� 0 SUFFOLK COU. 111TY DE?AKB,`1E.,W OF HEA11-M sEWC~`s V•O �A LY �°�I.I 'r��L.�.�..� ,p � � I � .� i'I.S. (Ci=. Isla. �. ����25 � The xviage disc; .:d d`?ij %`�r SW1 i� fcfiii iSS for tli:S location have u::'n ,, /t:iis 1 c-prfinent and/or 2� Q' other agenci s anqLfourlt; io i;t satisfawior,Y.� Chief of B reau of Wastewater Wnagement •/q SM/NE Lq/V�c CERT/FJED TO, SURVEY OF THE LONG ISLAND SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. //��� LOT 10 po- e� 11,13 6U2 Uj- 'MAP OF SOUTHOLD VILLAS" Prepared /n accordance wllh the minimum FA.ED JUNE 25, 1992MAP NO. 9237A T SOUTHOLD standards for Nl/e surveys as established by the L.I.A.L.S and approved and adopted TOWN OF SOUTHOLD for such use by The New York Land FF L k State Association. SU O K COUNTY, N. Y. The water supply and sewage disposal 1000 — 70 — 01— P/O 06 systems for this residence will conform i 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 : observations and or from data oblalned from others. Opto -1992,E{�fi0al) PI SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY p 7e .Y.S. LIC. NO. 49618 92 SO 47 DATE_ Hs. REF. NO. WV 3 PEC©L1Y1� `-SU FORS, P.C. � (5/6J�` P. 0. 09 APPROVED DEPT. OF MAIN_ ROAD SOUTHOLD, N.Y. 11971 URVICFN j. 87-670 00) rl n l I_ i f A1