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Home My WebLink About20805-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21165 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 600 JASMINE LA.& 60 APPLE COURT, SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.8 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. 20805-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 & SECOND FLOOR) The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-52-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258427 - NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA, JR. • wwL ilding Inspector 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) NN? 2080 5 Z Date ...............1-4d�L,...... ................ 193A— Permission is hereby granted to: r, T- D 44.... ........ ...... .. ... . ................................................. z4--j-�- P.:4�... .... .... ........ to .................afff.LA. at Qf ....premises................located at...............................................................................*...... ....... ....................... ................ 0 ................. .......k. L.:... ................................................................................................................................................. ................ ................................................................................................................................................................. County Tax Map No. 1000 Section ....... ...... Block .......QJ........ Lot No. ........... pursuant to application dated ............. -.?......................... 19.?J--1 and approved by the Building Inspector. Fee $ ... ..... . ............. ..... . Qig...I.nspector......................... B uj Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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 arfd 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. . .. . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . : ,V, . . . .JASMINE . . . .LAN. & 60 APPLE CT.. .SOUTHOLD, .NEW.YORK. . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . . . . . . . . . .PECONIC.PROPERTIES.MANAGEMENT.INC. . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section.'.'._ - . .7.d. . .Block. , r . . . . . . . . .Lot. . . . . _ , .�o•,Q, , , , , , , Subdivision. . . M)n SOUTHOLD VILLAS . .Filed Map. . . 9737. . . . .Lot. . . ... . . � . . . . . . . . . . . . Permit No. . .?QM . . . . . . .Date Of Permit. .:nY.?,. 1???. .Applicant. ,DON49.BRACKEN. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . ... . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $ §.00. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT c�\\F��C, TEL. 765-1802 O TOWN OF SOUTHO]LD OFFICE OF BUILDING INSPECTOR o P.O. BOX 1179 TOWN HALL �1� ,,0� SOUTHOLD N.Y. 11971 C E R T I F I C A T I O N Date l� Building Permit Owner (pleas/e�print) Plumber , (pl ase print) 2 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 ' ' k mod a y of 19 � Notary Public flotary Public, & County MARYANNE E. DOWLING Notary Public, State of New York No. 5000030 Qualified in Suffolk County C-MMission Expires August 3, 199!�", r THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1. - 1.000837 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEMBER 25,1992 Application No.onfile 78590892/92 N ?.58427 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 RELTNSKI-SOUTEOLD-JOB 6,15 , 50 APPLE COURT, SOUTHOLD, PI,F. _ in thefollowing location; ® Basement ® 1st Ff. 0 2nd Fl. OUT .Section Block Lot was examined on N OVE RBO R 19 ,19 9 2 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 12 33 23 12 9. F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS 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 2 12 2 - [ b SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER EQUIP. 0 YW 1 0 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 H OF CC.COND. OF HI-LEG OF NEUTRAL 1 200 CB 1 x �. 2/0 :l 210 OTHER APPARATUS: W , SMOKE DETECTOR; -2 y - SPUDS ELECTRIC SERVICE LIC. 0192-E 175 3RD.ST. BOX 166 GENERAL j"MANAGER R ST. JAMES, NY, 11730 Per f _ 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 BUI DIN DE R ME . IS C Y 0 CE I I EMS NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING [FINAL REMARKS• DATE � � � 9 9 'L- INSPECTOR V � Z-- co 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST L3(] ROUGH PLBG. [ � FOUNDATION 2ND [A(] INSULATION [ ] FRAMING [ ] FINAL REMARKS: a k �Yo DATE �l � ' `1 �-- INSPECTOR � I-, M-1802 BUILDING DEPT. INSPECTION N FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: �sy c��►- ..� �k DATE -7 ► Z. INSPECTOR V _ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION (�q FRAMING [ ] FINAL REMARKS: DATE °� �- INSPECTOR T65-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ � FRAMING [ ] FINAL REMARKS• DATE INSPECTOR 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: •ycf o..u-YLcQ Q �r;,x• e DATE -7 l (D 9 Z INSPECTOR y L 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION Q�J FRAMING [ ] FINAL REMARKS: DATE � a� q i INSPECTOR � � Z- U;-felLNT_^, . 1 . I m N _ H OC7 ?OU11DATION 'OUNDATIOid ( 2nd ) nI • I z 0 6- ;OUCH FRAME & I fop •PLUMBING -� 3 . cny 91 INSULATION PER N . Y. 6�l STATE ENERGY CODE FINAL ADDITIONAL COMMENTS : m !Mv-�o , H -------------- rn O �� BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . _ . . . . . . . . . . . . . TOWN HALL SEPTIC FOR:I _ .. . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:a?<<FY . . . �. . CALL . . . . - - - - - • - . . . . . . . Examined . . q 19 q.>,_ MAIL TO .: Approved . . . .I� . .I. . ., 19?2. Permit No.a 13��0�.'�, . . . . . . _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Buil 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 a inspectio s. '. �. . . . . . . . . (Signature of applicant, or name, if a corporation) oa(Mailing�d ss of aPPlnt ) State whether applicant is owner; lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of o er of premises .�i`�: . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If ap li i a o ora on, signature of duly authorized officer. . . . . . . . . . . . ... .... . . . . . . ame and title of corporate officer) Builder's License No. . . . . . . . ./. . . . . . . . . . . . . . . . . Plumber's License No. . . . . D. . . . . . . . . . Electrician's License No. . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . ... 1. Location of land on which proposed work will be done. �.QJ. . . .A�a//w.. . . . . . . 11 . . . . . �0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I-louse Number Street Hamlet County Tax Map No. 1000 Section . . /. . . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . . .��. . . . . . . . . . . . . . . Subdivision . . 1 /•( . . . . . . . . . . . . Filed Map No. . . .�.J. ,�.�. . . . Lot /S. . . . . . . . . . . (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 . . :/ . . .!u'� �� !::" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building : . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . .. Demo ition . . . . ... . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. 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 natu•a and extent of each type of use• . . .;. . . . .... . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . ... : .�;: : . . : . , Rear . . . . . Depth Height . . . . . . . . . . . . . . . Number o.f 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 . . . . . . . . . . . . . . • ' . . . ..Phone . . . 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 YgRl COUNTY OF . . . . . .�. .. . . . S.S ��77 • • • • • d•' •��• • •=��`� Clv. • • • • . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . . . . . . . . . . . . . . . . . . . . . . . . ntractor, 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 . . . . . . . . . .4a4 . . . . . ay of. . . . ��4 . . . . . .. 19 .q 2— Notary Public, . . . • • County • • • • • • . . County ROBERT I.SCOTT,JR. NOTARY PUBLIC:State e'�lP.Y . . . . . . . . . . . . . No.47250R9,Suffo{n u��,,{{y (Signature of applicant) Term Expires Nlay 31,19 7 J� A. �It �h 91 S 6160 . 40T ,;o s 6 V �r� V A 4i �o B i h0 O hS 4 3 � Oj 0 6 • �S• q3,boy � - O„� 1 JqZ Z �60 1S, P �O Y AREA = 16,654 sq.ft. �,�9 \ LI fiAMILY I)wF-LUNG ON�.Y.. LNG f Ott A�°E Gf- jXPR SUR VEY OF a LOT 15 M "MAP OF SOUTHOLD VILLAS" Prepared /n accordance with the minimum FILED MAP NO 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 SUFFOLiC COUNT N. Y Tllle Association. 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: "' = 30 zrlmenl 01 Hea/lh ServJces Mach 11, 1992 The locations of wells and cesspools shown hereon are from field observations and or from data obtained from others. ' ANDq SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY ''ttp�iV p� N.Y.S. LIC. NO. 49618 DATE JU �'/2 Q S. REF. NO. l0k cS� ��, f9�� C F ORS, P.C. APPROVED — — — — `�� ' SO N.Y. 11971 87-670 - 15 N : 660 4(O " 6" `V v FZOP 41 a �C gam, 43•/0" K! I O JA'S4 NE16o.�5. a�cr ZA)vE AREA = 16,654 sq.ft. 1a1��g�. y , CERTIFIED TO; THE LONG ISLAND SAVINGS BANK SURVEY OF PECONIC PROPERTIES MANAGEMENT CORP. LOT 15 "MAP OF SOUTHOLD VILLAS" - FALEDJUNE 25, 1992MAP NO. 9237 Prepared in accordance with the minimum A T SOUTHOLD standards for title surveys as established T by the L.I.A.L.S and roved and adopted OWN OF SOUTHOLD' for such use by' The New York State Land FF Title Association. SU OLK COUNTY, N. Y. The wafer supply and sewage disposal 1000 - 70 — 01- P/O 06 systems for this residence will conform to the standards of The Suffolk County Scale. "= 30 Department of Health Services. Mal'Cf1 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. - AID , SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES �' `+ • �+ E � FOR APPROVAL OF CONSTRUCTION ONLY a �• Y.S. LIC NO. 4961,8 DATE- NS. REF. N0. PE,CONIC>_:x 5 V p�'tSRS, P.C. ( I 765 = 5Q . � APPROVED MTJOR . DJI Souliv ,v-13-1 Y. 11971 87-670 7 SUFFOLK CGUtI Y CEPARTfVfENT 4r HEPLTH SEftlrtCES SNIC-E FAU�4,;-Y D,YEl.L sz0 �, Y �o 5- Thr Sew ire t, } al �,-d, viator st!?Phr facilitic-S for thi.5 location have Ile.ni jr'S: pClnrj �)y this Ue.17?rtmeflt afid/or other ager;ci2� aizri 3J ita `tJ };a sL is actc7 y {� Chief of Bureau of WaSi,-water Variagernen't A` J� 0 G 1h s 660 �0)- z6.F \� Q ST p. r� ti Srj. - Zc�92't lezz o'I 4fo Ve iso,s. C), ZAMF AREA = 16,654 sq.ft. CERTIFIEDTHE LONG ISLAND SAVINGS BANK SUR I�EY OF P0. os PROPERTIES M13 MANAGEMENT�o T CORP. /193 1�— LOT 15 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 State Land SUFFOLK COUNTY Title Association. T Y N. Y The water supply and sewage disposal 1000 - 70 - 01- P/® 06 systems for this residence will conform i to the standards of The Suffolk County Scale 1io= 30 Department of Health Services. March 11. 1992 JUL Y 15, 1992 (foundation) The locations of wells and cesspools shown hereon are /tom field Oct 23,1992 (final) observations and or from data obtained from others. �a SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 81VFOR APPROVAL OF CONSTRUCTION ONLY E a ' / i' N.Y.S. LIC. NO. 49618 92 SO 52 DATE H5. REF. N0. Nab! 13 1992 `,PECONIC S VE"YORS, P.C. - (5161: 765 5020 ' S.C. DEPT. OF MAIN .ROAD" APPROVED HEALTH SERVICES ; SOUTHOLD, N.Y. 11971 87-670 - 13