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HomeMy WebLinkAbout20803-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE 'OF OCCUPANCY No Z-21164 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 160 APPLE COURT SOUTHOLD, NEW YORK House No. . Street Hamlet County "Tax Map No. 1000 .Section 70 Block 1 Lot 6.7 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. 20803-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. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-51- NOV 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258431 - NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA, JR. ZJ U4- �-�Bfiilding Inspector Rev. 1/81 FORK NO. B 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) N2N920803 Z Date ...............I. .a.'L .....7................. Permission is hereby granted to: . ........................................................ .......1J.q . ..to ...Q47.1—.�. . ...a ..... . .....De.0......... ......... ........ ....................................................... ................. . ..................4.1. .. ............................. .......................... ....... . .... %-R...at premises located at ...L;5�.... ....................................................... ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ......Q-1�...... Block .......Q.A........ Lot No. ............ pursuant to application dated ..........1.uj .......................1 19.1y and approved by the Building Inspector. Fee c 1A ... ..... -i i0*r-"--*-*-*... u i dng Rev. 6/30/80 Form No. 6 T014N OF SOUTHOLD BUILDING DEPARTMENT T014N 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. . , 160,APPLE. COURT. , . . . .SOUTHOLD, .NEW.YORK. . . . . . . House No. Street. • Hamlet Onwer or Owners of Property. . . . . . . . . . . ,PECONIC.PROPERTIES.MANAGEMENT.INC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000, Section. . . 70. . . . . . . . .Block. . . !. . . . . . . . . . . .Lot. .6:�. . . . . . . . . . . . . . . . . Subdivision. .MlO.SOUTHOLD,VILLAS. . . . . . . . . . . . . . .Filed Map. . 9737. . . . . .Lot. . . 14. . . . . . . . . . . . . . . . . Permit No. . 20803Z , , , , , , ,Date Of Permit. Applicant. .DONALD.BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . :. . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $, , , 25•UO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1ic083 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEMBER 25,1992 Application No.on file 78706092192 V 258431 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 GEORGE BERRY, 155 APPLE COURT, JOB#14, SOUTHOLD, N.Y. in the following location; ® Basement ® lst Ff. ❑ 2nd Ft. OUT Section Block Lot was examined on C30VEC4iBER 19,19 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 OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT., K.W. AMT. I K.W. AMT. H.P. 10 25 15 10 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELI UNIT HEATERS MULTI OUTLET DIMMERS SYSTEMS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT: AMP. AMT. AMPS. TRANS. NO.OF FEET AMT. WATTS a 1 2 12 2 - SERVICE DISCONNECT NO.OF S E R V I C E - AMT AMP. TYPE METER �,YW 3W 3 0 3W 3,9'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. EQUIP. PER 0 OF CC.COND. ' OF HIAEG OF NEUTRAL 1 200 CB 1 X 1 210 1 2/0 OTHER APPARATUS: 5 SMOKE DE`L'ECTOR t-1 SPUDS ELECTRIC SERVICE LIC.4192 E s 175 3RD.ST. BOX 166 GENERAL MANAGER ST. JAMES, NY, 11780 11 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. FULA-�Oli TOWN OFg - TEL. 765-1802 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 �a Building Permit No._C O/1 1 3 Owner (please print) Plumber 1, ���please (,Z6-3 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 . Notary Public Notary Public, Sul AV County MARYANNE E.DOWLING Notary Public, State of Now York No. 5000030 Qualified in Suffolk County Commission Expires August 3, '19SLq l 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T � ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION � FRAMING [ ] FINAL REMARKS: DATE Ia' i 1- INSPECTOR r � L aogo3zi. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING ( ] FINAL REMARKS: DATE )e -7 9 z- INSPECTOR Y � L �08 , 765-1802 BUILDING DE". INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [X] FINAL REMARKS: DATE " 1 °1 �-- INSPECTOR P L. : U;-M LNT 1 . I oG FOUNDATION ( 3 S t ) I — W 'OUNDATI011 (2nd ) • a �1 ;OUCH 41ME P ING 3 . . l0 '1 N H m :NSULATION PER N . Y. I • . y STATE ENERGY II CODE 4-- FINAL I -� ADDITIONAL COMMENTS : m -7 In/9� 9, �--c� tn �✓J H 1 0 a � . I B0,1RO OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . • BUILDING DEPARTMENT C11ECK . . . . . . _ . _ . . . . . . . . . . . TOWN HALL SEPTIC F.ORN _ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r:DT t FY q CALL . . . . . . . . . .. . .. . . . . . . . Examined . . : . A4 , `; , 194: MAIL TO : n . . . . . . . . . . . . . Approved . . . . . . . ., 19?? Permit No. .Z�©$9.43.& . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 (Bui ing Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 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 nece Tqin.spect.io ns —" (Signature of applicant, or me, if a corporation) 6b. ./�y3. . �� �i�3 sue. (Mailing address of applicalft) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . ..�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of o er of emises ..�-C�C',62f(� . � . . . . . . . . c. . . . . .'. . . . . . . . . . . . . . . . . . (as on the tax ro 1 or latest deed) If pl' is c r ora 'on, signature of du" authorized officer. . . . . ��. . . . . . . . . . . . . . . . . . . . me and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . a.D. . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . .. 1. Location of land on which proposed work will be done. . . Z-. . . . . . x. , , �l/.� �. , , , , , , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number t be Street Hamlet County Tax Map No. 1000 Section . . , . . ./. ®. . . . . . . . . Block . . . . .d./ . . . . . . . . . . Lot . . . . . . . . . . . . . . Subdivision . . . . . !. n104.1. . . . . . . . . . . Filed Map No. .7.�3.7. . . . . 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 . . .�. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building .!` . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . ... . . . . . . . . Other Work . . . . . . . . . . . . . . . •• 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . .• (Description) . . . . . . . . . . . . . . . . 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 . . . . . . . Address . . . 15. Is this property within " ' n ' " " • • • • • • • • • • •Pho No. . . . . . . . . . . . . . . . p p y t in 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 descriptiodaccording to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y l S.S COUNTY OF . . . . . . . . .� . . . . . . . . . . . bf',. .A�, . . /s?AG./-(° N . . . . . . • . . . . . being duly sworn, deposes andr says that he is the applicant (Name of individual,signing contract) above named. He is the . . . . . . . . . . . . . . . . . . . E � �- C- ontractor, a � cor P g e-nt o ate office � etc.) rr . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 f. . . . . . . . .�v4�. . 19 Z ;7 Notary Public, - • • • • • • • �. . . . County RORI:RT f. . . . . . . . . NOTARY?MLICC t J� Y . . . . . . . . . . . . . . . . . . . . . . . NO.-4725089,'Suffolk Co u (Signature of applicant) Team Expim May 31,19 1 PLEASE NOTE Sanitary system is n©t to be pkxed under driveway area. 01 {GC el �a ^� 27•G' � _ L G °T0 13 000 • R=5 . • ;. R-25.00 -51.05 Z s 20,13pd E. Q' 1P , z3 qD O o �2hg2� ZOO- �V 3 1s LgN�c AREA = 12,804 sq.ft. -3 SmLE-i IlY DWILLI ONLY SURVEY OF EXPIRES YEMFWM DAT1E0FAFFft0VA LOT 14 "MAP OF SOUTHOLD VLLAS" FLED MAP NO. Prepared,in accordance with the minimum A T SOUTHOLD standards for NtJe surveys as established by the L.I.A.L.S and approved and adopted TOWN OF SOUTHOLD for such use by TheNew York Stale Land Y SUFFOLK COUNT N. Y. Title Association. , 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: 1ii i = 40 D rlment o/ Hea/lh S March 11, 1992 The locations of wells and cesspools shown hereon are from field : observations and or from data obtained from others. �/S' �S �.3�o a � ace• � �����r:. � �� L����s� SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES' FOR APPROVAL OF CONSTRUCTION ONLY � . , �, :� N.Y.S. LIC. NO. 49618 J�3�i o 219 `��s _S- A14Y ,28 DATE UN HS. REF. NO. f 9�� Ln Z'DIVI ' YORS, P.C. 0 DF.Pr N O9 APPROVED NLALTH SER*tgC j J SOOT .OLD, N.Y. 1197/ 87-670 - 14, k �a G nor 13 R-25'00, R r5p p5 0 3 20" 26zt �,�ya0 L-25.37 0 9s, v 19�' �/z3 Ci o " (0 QW O 540), do/9 �S e m • ✓qsM� • /VE Lq , NE AREA = 12,804 sq ft. CERTIFIED TO' THE LONG ISLAND SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. SUR VEY OF LOT 14 'MAP OF SOUTHOLD VKLAS" FKEDJUNE25, 1992 M.4p-NQ 9237 Prepared In accordance with the minimum A T SOUTHOLD standards for fitle surveys as established by the L.I.A.L.S and approved and adopted TOWN OF SOUTHOLD /or such use by The Now York Slate Land SUFFOLK COUNTY N. Y. Title Association. , The water supply and sewage disposal 1000 — 70 — Of— PIO 08 systems for this residence will conform Scale: 1��= 40 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 observations and or from data obtained from others. -AND SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICESY, FOR APPROVAL OF CONSTRUCTION ONLY ° � N.Y.S. L/C. NO. 49618 DATE Ws. REF. NO. *PEC; ORS, P.C. APPROVED S - ( ; N.Y. 11971 87--670 - 14, SLFFO!K CMU IITY DEPARTIMEW OF HEALM SERWES W �r"L 1' 0"'''ELLi ,S Y DATE --f S. F;E [ 0. _ �...5 The sewage G1SPo•ai wid 4V Mr i2,Cillt;°S ft)f 111iS loco';x) have b3�ri Othef E6fePCiCS app fOU to L,, S' ISIZt; Qi't Chief of MlianagGmeilt 01 k G� � G0 nor r3 R73 =50.00� R-25.00 L=51.05 �. s 0�0'30- 00 V <k1h° L=25.371 w� c� h .9 -- N 3s O V N 660 Q 1 O /1/E L 4, AREA = 12,804 sq.ft. CER TIF/ED TO, THE LONG ISLAND SAVINGS BANK PECONIC PROPERTIES MANAGEMENT CORP. SURVEY OF LOT 14 MAP OF SOUTHOLD VELAS" FXEDJUNE25, 1992 MAP NO. 9237 Prepared in accordance with the minimum A T SOUTHOLD standards for tille 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. , The water supply and sewage disposal 1000 — 70 — 01— PIO 06 systems for this residence will conform ii i to the standards of The Suffolk County Scale: 1 = 40 Department of Health Services. March 11, 1992 JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are from field Oct. 23,1992 (final) observations and or from data obtained from others. WIVSUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES pillH FOR APPROVAL OF CONSTRUCTION ONLY 92 $0 51 •' ��' �� N:�Y S L/C. NO. 49618 NOV 1 a 1992 DATE MS. REF. No. PECONIC URVEYORS, P.C. (5I'6)-'7,65 - 50201, Y. < S.C. DEPT. Of P. i APPROVED HEALTH SERVICES' MAIN TtRO�Qa �.�:., �> SOUTHOL�Q, I � 1197/ 87-670 - .14,