HomeMy WebLinkAbout27920-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29050 Date: 11/02/02
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 105 THOMPSON BLVD. GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 35 Block 1 Lot 25
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 15, 2001 pursuant to which
Building Permit No. 27920-Z dated NOVEMBER 19, 2001
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 SINGLE FAMILY DWELLING (UNIT #105) WITH ATTACHED TWO CAR GARAGE
AND COVERED FRONT PORCH AS APPLIED FOR.
~"ne certificate is issued to PECONIC LANDING AT SOUTHOLD, INC.
(OWNER)
of the aforesaid building.
SUFFOLK COD1FrY DEPi%RTMENT OF HEALTH APPROVAL C10-97-11
ELE~-£KICAL CERTIFICATE NO.
PLI~WBERS CERTIFIC3%TION DA'£~ 05/17/02
05/28/02
1038604 07/15/02
HARTCORN PLUMB. & HEATING
Rev. 1/81
FORM NO. 3
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)
PEPd~IT NO. 27920 Z Date NOVEMBER 19, 2001
Permission is hereby granted to:
PECONIC LANDING AT SOUTHOLD, I
PO BOX 430
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED 2 CAR
GARAGE AMD COVERED FRONT PORCH AS APPLIED FOR (UNIT 105 FULL)
at premises located at
County Tax Map No. 473889 Section 035
pursuant to application dated NOVEMBER
Building Inspector to ex~ire on MAY
105 THOMPSON BLVD.
GREENPORT
Block 0001 Lot No. 025
15, 2001 and approved by the
19, 2003.
Fee $ 1,156.80
f A~~u t h c r~i z/~ i~ure
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FoR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department 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, indnstrial building, .multiple residences and similar buildings and iustallatious, a certificate
of Code Compliance fi.om architect or engineer respousible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
Bo
For e~isting 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 cousent to inspect signed by the applicant. If a C~rtificate of Occupancy
is denied, the Building laspector shah state the reasons therefor in writing to the applicant.
Eees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $2S.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 Oecupancyon Pre-existing Building - $100.00
3. Photocopy of Certificate of 0ccupancy - $ 0.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction:
Location of Property: ~~
House No.
Owner or Owners of Property: %C..g'14 [ c_
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building:
- I Street t '
S -~' Block
Filed Map. __
/
(check one)
Hamlet
Lot 2,1~'
Lot:
Permit No. Date of Permit.
Health Dept. Approval: -'/' ~ ° LOo a
Planning Board Approval: [ ~. - ~'{ ~ 7_ o Oo
Request for: Temporary Certificate
Fee Submitted: $ ,¢-..~ '~'
Applicant:
Underwriters Approval:
Final Certificate:
(check one)
Applicant Signature
Dennis M. Wilhelm
Town Hall~ 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTI-IOLD
CERTIFICATION
Date:
Building Permit No.
Owner: P0.f.~0Q~L LlltI~/I 0
(pleas~ print)
Plumber: Hartcorn Plmg& Htg,
Inc
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this ~
day of ..fi~ ,20d~-
Notary Public, County
(Plumbers Signature)
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
Located at
E.F. MALONEY * PECONIC LANDING
P.O. BOX 6070 MAIN ROAD / ROUTE 25
MILLER PLACE, NY 11764, COTTAGE # 105
SOUTHHOLD, NY 11971
MAIN ROAD / ROUTE 25 COTTAGE # 105 SOUTHHOLD, NY ! 1971
Application Number: 1038604
Certificate Number: 1038604
Section: 35 Block: 1 Lot: 25 Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Attached Garage, Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 15th Day of Jab,, 2002.
Name QTY Rate Rating Cimuit Type
Additional Charges
modular house N.Y.State approval # 19-15
mfg Avis America serial # 687001
Appliances and Accessories
Air Conditioner i 0 48,000 BTU
Furnace 1 0 Gas
Wiring and Devices
Receptacle 1 0
Switch 1 0
Fixture 3 0
Service
1 Phase 3W Service Rating 200 Amperes
Service Disconnect: 1 200 cb
Meters: I
General Purpose
General Purpose
Incandescent
seal
i of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
FINAL INSPECTION REPORT
Sidncy B. Bowne & Son
Consulting Engineers
235 E. Jericho Tpke., Mineola, NY 11501
PECONIC LANDING
TOWN OF SOIJTItOLD
BUILDING PERMIT NO.:
COTTAGE NO.: /O5-'
In accordance with the Agreement between the Town of Southold and Sidney B. Bowne & Son,
LLP, Consulting Engineers, dated January 14, 2000, for professional engineering services
relating to the above project, we have completed the final inspection for the subject premises.
In addition, we have reviewed inspection reports and other relevant material for conformance to
the requirements of the Town Building Department for a Certificate of Occupancy.
Based on this review, we have no objection to the issuance of a Certificate of Occupancy for the
subject cottage.
By:
Dated:
Gino N. Aiello, P.E.
June 6, 2002
Mr. Michael J. Verity
Code Enforcement Officer
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, NY 11971-1179
PECONIC LANDING PROJECTS.
Re: Cottage #105 Code Certification.
Dear Mike:
In reference to the above mentioned project we, Barton & Associates, LLP (Architects of Record
for said project), hereby certify that to the best of our knowledge, information and believe that
Cottage #105 has been constructed in compliance with all applicable laws, codes and ordinances.
Very truly your;
BARTON & ASSOCIATES, LP
Frank P. Laughlin, RA
Senior Vice President
cc: Dennis M. Wilhelm, RLS
3ti Broszeit, E&F Walsh
Bob Ellis, O/N
INSPECTION TEST
GAS AND WATER SERVICE
Sidney B. Bowne & Son
Consulting Engineers
235 E. Jericho Tpke, Mineola, N.Y. 11501
PECONIC LANDING
TOWN OF SOUTHOLD
GAS WATER
Pressure Pressure
COTTAGE # DATE APPROVED BY
Test Test
5.0 PSI 50 PSI
REMARKS:
March 14, 2002
15. F. Walsh
Developers Peconic Landing
Village of Greenport
Utilities Department
Re: Peconic Landing Sewerage System
To Whom It May Concern:
The Village of Greenport is allowing Peconic Landing to deliver its sewerage to the
Village Sewerage System on a conditional basis until the pump facilities are complete and
certified, at which time the Village will accept total responsibility for the lift station and
related appuntages.
Presently units 1-45 are allowed to discharge into the Village's system.
The sewerage being delivered is acceptable to the Village sewerage system.
Respectfully,
William Swiskey
Utilities Foreman
WS/js
INSPECTION EEPOET DATE .: ~.. ,.-~ _CO141'tEHT S
~OU~H PRAHE &
· PLUHBING
I~u ~tTIOI~ PER
~?.ATE
CODE
-' A~DXTIOI~AL
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
PERMIT NO.
Exam/ned t~", /7 ,20 g>f/
^pprov d / 7
Disapproved afc
~mm~ %J r ~r. lvll I ~rrbl%~ i IL)IN
Do you have or need ~e follo~g, before applying
Board of Heal~
3 sets of Buil~g Plans
S~ey.
Check
Septic Fora
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
PPLICATION FOR BUILDING PERMIT
· . O ate
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. schedyle.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street~ or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Lnsp~ctor will issue a Building Permit ~:o the applicant. Such a permit
shall be kept on the premises available for inspection througho,.it the work.
e. No building shall be occupied or used in whole or ip'part for any purpose what-so-ever until a Certificate of Occupan
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building D. epartment 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, ho~.sing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections·
(Signature of applicant o~- name, if a corporation)
,(Marling a~dre-ss of applicant) -
State whether applicant is owner, lessee, agent, architect, engineer, general contractoi electrician, plumber or builder
Nameofownerofpremises (~/9~c'Oil[C. [QII~'/I/~
t (as on:the tax roll or latest deed
If apl~l~BJ~is a corpor%Con~ signature of duly authorized officer
X "'
!
/ (N'an~ ~ind title of corporate officer5 .
Builders License No.
?lumbers License No.
~lectficians License No.
DtherTrade'sLicenseNo.
Location of land on which p,[oposed work will be dori~.:
House Number Street
Hamlet
County Tax Map No. 1000
Subdivision
(Name)
Section
Block
Filed Map No.
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 tl {~,S]
-
3. Nature of work (check which applicable): New Building X Addition Alteration
Repair Removal Demolition Other Work
4. Estimated Cost ~ 700, 000. O0
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Rear
Depth Height. Number of Stories
5. Dimensions of entire new construction: Front ~-,~,t~.- Rear .Depth
Height 2(/ Number of Stories
Front ~/]~ Rear .Depth
).
Size
of lot:
-..L
10. Date of Purchase 3/J~ Name of Former Owner
[ 1. Zone or use district in which premises are situated
t2. Does proposed co.nstruction violate any zoning law, ordinance or regulation:
!3. Will lot be re-graded __Will excess fill be removed from premises: YES
.4. Names of Owner o f,p~mises~Address Or'/ ~t'/~
Name ofA.rchitect ~t~'/'t)/I k[.~.. . Address ~l ' Phone No~
Name of Contractor ~ t'tar[ [~ ll]~) Address' . p Phone No. [ ~31 )/-J~'7- ~t') ]
5. Is this property within 100 feet of a tidal wetland? *YES NO
· IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines. Ot'/ fr~f~._
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
;TATE OF NEW YORK)
SS:
:OUNTY O~¢f'rr'~//~ )
f, iV'/JTt~ ~ ~/~.~Z/O~-~/~'~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
$)He is the
(Contractor, Agent, Corporate Officer, etc.)
fsaid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
mt all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
erformed in the manner set forth in the application filed therewith.
worn to before me this
/ Signature of AppliCant r
iii
{ii
{i
,, I
CUS~ UNSOLD, cO~rAGE ~5
GENERAL NOTES
RECEIVED
OC! ~ ~ 2001