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Home My WebLink About20800-Z FORM NO. 4 TOWN OF SOUTHOLD . BUILDING DEPARTMENT. Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No K-22024 Date DECEMBER 14, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 275 APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.4 Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 11, conforms substantially to the Application for Building Permit heretofore filed in this office dated July 2, 1992 pursuant to which Building Permit No. 2080G-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 ONLYp 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-48-NOV. 11, 1992 UNDERWRITERS CERTIFICATE NO. N-258832 - DECEMBER 2, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR LALAAUSSENA Jr. AuTl'ding Inspector q 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) NNO20800Z Date ..............1-4A�J ...... ................ 193.4.- Permission is hereby granted to: ...... OL96.1 11 .. ......... ................................................. to ... ..... ....................................................................................................................................... ..................... atpremises located at ... ...... ...... .... . ...... ............. ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ..... ........ Block ...!.N........... Lot No. Q9............... pursuant to application dated .........I. A., .. ......).................... and approved by the Building Inspector. Fee ...... .*fA,....... .. . ..... . .. ..... ......... ........................................... ...i......................................inag Inspector Rev. 6/30/80 Form No. 6 TOWN. OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 DEG I 9 1992 APPLICATION FOR.CERTIFICATE OF OCCUPANCYSx° ,�s3 .; 4 OF SOUTHOLD � 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. . . . . . . . . . . . . . . . . NEW Location of Property. . 15 . . . . :Q.2�. _ , , , , , , , , , , , , , , , , , , , SOUTHOLD, . . . . PORK. . . , . . . . House No. Street. Hamlet Onwer or Owners of Property. . . . . . . . . . , ,PECONIC.PROPERTIES.MANAGEMENT. . . . . . . . . . . . . . . . . . . . .INC.. . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . .. . . . . . .Block. . . I . . . . . . . . . . . .Lot. . . .�: . . . . . . . . . . . . . Subdivision. ,MlO.SOUTHOLD,VILLAS. . . . . . . . . . . . . . .Filed Map. . 9737 . . . . .Lot. . JJ . . . . . . . . . . . . . . . . . . Permit No.1-M g.-(16 ., , , . .Date Of Permit. .inT. 1???. .Applicant. .DONALD.BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . .. . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Fin Certicate. . . . . . . . . . . Fee Submitted: 00 $. . . .2 . .. . . . . . . . . . . . . . . . . . . . . / 5 �tr . . ..!� . . �.�:��. . . . . . . . . . . . . . . . . . . . . e as 0 2 APPLICANT i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1OOC�$37 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date DECEMBER 02,1992 Application No.onfile 7$705$92/9"'' N 25$$32 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 L RACORBER-•SOUTHOLD VILLAS , 275 APPLE COURT, J013011, SOUTHOLD, N.Y. , S in thefollowinglocation; ® Basement Rl 1st Ft. ❑1' 2nd Ft. OUT Section Block Lot was examined on NO V E;RB E R 2 5 ,1.9 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 OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 7 23 15 7 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. T. AMPS. TRANS. AMT. N.P. N SYSTEMS O.OF FEET AMT. WATTS w 2 2 - `w SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER 1,•4W 1.0 3W 3 0 3W 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 A' OF CC.COND. OF HIAEG OF NEUTRAL I 4 1 n. Q OTHER APPARATUS: SHOEiE DETECTOR: -l s SPUDS ELECTRIC SERVICE E �( 1.75 3HD.ST. BOX 166 z' GENERAL MANAGER ST. JADES, NY, 11.730 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 8E ALTERED IN ANY MANNER. TEL. 765-1802 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN HALL 71N.Y. , SOUTHOLD 119 . C E R T I F I C A T I O N Date Building Permit No. Owner (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% ' lead. (plumber 's signature) Sworn to before me this . day of 19 otary Public tlotary Public, county MARYANNE E. DOWLING Notary Public,State of New York No. 5000030 Qualified in Suffolk County Commission Expires August 3, 199-4 � 0800 � 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [Dj ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE � � � `I i- INSPECTOR V�� 76s-iso2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING ( ] FINAL REMARKS: DATE -1 L, INSPECTORS do *2Oo � T65-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE � � 9 2. INSPECTOR Y _ jJDA 70U11DATION t I ( 1s ) '0U14DATI01.1 (2nd ) 7 ti 10 i c o =0 FRAI.1 v` •P IVG IF 3 . /u cn --NSULATION PER N . Y. . ^3 STATE ENERGY II �jj CODE I , FINAL 0 ADDITIONAL COMMENTS : m 241 o -O a � ^pO� yN C4 v G 1 BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ _ . . ... . . . . . . . . TOWN HALL SEPTIC FORIN . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r:aTIFY ; CALL ./-�6�� Oy� 1 . . . . . Examined . . . . �, , 19 MAIL TO : Approved . . IM1.1 . . J. ., 19 9.�Permit No. .a�. . �. , . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . ., 19 .9 . ' 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 de olition, 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 inspections. � . ,1. . . . . . .• . . . . ..... .`ti� . . (Signature of applicant, or naff�e, if a corporation) (Mailing add' appliWant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Na41' is of premises .Q�l�7�uC��" . . . .��,4oll b"�!� . . . . . . . . ... . . . . . . . . . . (as or latest deed) If o oatio signature of duly authorized officer. . . . . . . . . . . . ..� . .me and title of corporate officer) Builders License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . .c .R �. . .P. . . . . . . . Electrician's License No. . . /. . . . . . . . . . . . . . . . . . Other Trade's License No. 1. Location of land on which proposed work will be done. . . . . . . . . . . . . `. . . ,!!��9. . . . w. . . . . . . . . . . e oy_ . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . Q. . . . . . . . . Block . . . . . d . . . . . . . . . Lot . . . .� . . . . . . . . . ... . . Subdivision .(: &_. �ila��: L'ti� . . . . . . . . . . . . . . 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 . . . .�. .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . 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 6 . . . . . . Address Ph No. • . ' 15. Is this property within 300 feet of a tidal wetland?-**. . . . ... . . . . . . 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. x . STATE-OF NEW Y RK COUNTY OF . . . � ,2,&X , , S.S • • • • •'-•-(� •� 64,�/v. • • • . . : . . . . . . . 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 o . �... . . . .y . . . . . . 19 . . . Notary• •P C��. �. s�1 Public, . . . . . . . . County a .ROBERT 1.SCOTI'; . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . NOTARY PUBLIC,Sta of N.Y. (Signature of applicant) No..725089,Suffolk Co��t#yy�� Term Expires May 31,197 N�Oy�. Russ cc ^� c 9g 01, ✓04* CF DNS 4'4 SFf,q Vq T/o soO`� �L1gNN \ MFAl N \ T 00, 15. \$6. h� A PLEASE NOTE e W s stem is not to b h ryh Sanitary Y area. placed under driveway CO / e(29CP .:, .. ��5 C``39�'3• .9 o• 5. Ie( 27.�t ASV P GO $ I �N v R-17-00' �- L.105J5' 3 NJ-1.50'E. P is J ' �t4y W E LANE �. JASMINE SINGLE FAMILY1lVELLi1Vt3N •: '. EXPIRES 3 YEARS FROM DATE rfJ o' y3 T OFA PRi VAL SUR VEY OF AREA = 15,000 sq. ft LOT 11 "MAP 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 The New York Slate Land SUFFOLK T1ae Association. COUNTY, N. Y. The water supply and sewage disposal - 1000 — 70 — 01— P/O 0� systems for this residence will conform to the standards of The Suffolk County Scale: "= 30 D rlmenl o/ Health Services. March 11, 1992 The locations o/ wells and cesspools shown hereon are from field observations and or from data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES l� F ' ,�' FOR APPROVAL OF CONSTRUCTION ONLY E'fk3 N.Y.S. L/C. NO. 49618 DAT 19 S. REF. N0. �d �� `� C ORS P.C. cep � APPROVED �CTI� Fj. OF SOUTHOLD,IV sfi?VI r HOLD, N.Y. 11971 87-670 /1 . Nip�F s sF�l e(3z 2'g6ro.F tijgNN — N —. 190 MFVT N �400, h v mil.Zgs ro ti a6 oro* o - L,i G� cort / �,,39 oo<z9 y3. Iet 2 ZGt I - P - 1 �N J CERTIFIED. TO, THE LONG ISLAND SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. W75§ �+ L4055' Nd4p6'50S P . 10:00' 3 "'.V oo SMINE.�,. SANE JA SURVEY OF AREA = 15,000 sq. ft. LOT ,11 "MAP OF SOUT.HOLD:.VILLAS FILED DUNE 25, 1992MAP NO. 9237 Prepared In accordance with the. minimum A T SOUTHOLD standards for title surveys as established by the L.l.A.L.S, and opproved and adopted TO1/VIV of SOU1'HOLD 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 06 systems for this residence w111 conform to the standards-of The Suffolk County Scale: rrr=' 3pr Department of Health Services. March Ill 1992 - JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are from field observallons and or from data obtained from others. �A_P�0 Sa SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY r r,on , ., N.Y.S. LIC. NO. 49618 DATE WS. REF. N0. 1V1 ORS, P.C. • 6 •`l65 �, [APPROVED �R SO , N.Y. 119.71 "` 877670 ll . kl NiO-AP g6ro F MgNN — � — t 9g 0 1 ✓O N S \ E" T Ts 00, h v s' �a6' � '3S �Jy SUFFOLK COUNTY DEPARTP IENIT OF !iE,,1,711 ScfWICES SINGLE Fa,",AIL Y D'y'dELAll Li �'y, Tho `lewaae disposal andt'13i2r +^I,/ f Cilii'ES for this h — location hale b?�n InS;)ECiPiI `i�ill! I-E1 3i ii�fC'nt anU�Or / 3� \� other agenci s an found to be satisfa::tory. ��r Chief of eau of Wastewater M "agement 1510 Qe JL P 00 o CERTIFIED TOt THE LONG ISLAND SA VINGS BANK PECONIC PROPERTIES MANAGEMENT CORP11f. r R-175.00' L�1O J5' 14.14-16'50'6. 10.00' LANE JASMINE SUR VEY OF AREA = 15,000 sq. ft. LOT „ "MAP OF SOUTHOLD VILLAS" FILED JUNE 25, 1992MAP NO. 9237 Prepared in accordance with the minimum A T SOUTHOLD standards for title.surveys as eslobllshed TOWN OF SOUTHOLD by the L.I.A.L.S. and approved and adopted for such use by The New York Stale Land. SUFFOLK COUNTY N. Y. Title Association. The water supply and sewage disposal 1000 - 70 - 01- 06 systems for this residence will conform , to the standards of The Suffolk County Stale: „ = 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. 2319.92_.(final) observations and or from data obtained from others. {';=+, SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES .;,,'•1 FOR APPROVAL OF CONSTRUCTION ONLYPIC 92 SO 48 S. L/C. NO. 49618 DATE NOV HS. REF. NO. PECONI:,6+ S. R,VEYORS, P.C. r (5161ti:. 6 � S.C. DEFT. Of APPROVED HEALTH SERVICES SOUTHOLD, N.Y. 11971 87-670 /l