HomeMy WebLinkAbout27705-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29052
Date: 11/02/02
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 107 THOMPSON BLVD. GREENPORT
(HOUSE NO.) (STREET) (HA24LET)
County Tax Map No. 473889 Section 35 Block 1 Lot 25
Subdivision FiledMap No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 22, 2001 pursuant to which
Building Permit No. 27705-Z dated SEPTEMBER 17, 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 #107) WITH ATTACHED TWO CAR GARAGE AND
COVERED FRONT PORCH AS APPLIED FOR.
The certificate is issued to PECONIC LANDING AT SOUTHOLD, INC.
(OWNER)
of the aforesaid building.
SUFFOLK COI~l~f DEPARTIqENT OF }~F~%LT~t APPROVAL C10-97 11 05/28/02
ELEt-£KICAL CERTIFICATE NO. 1038723 07/15/02
PLU~BERS CERTIFICATION D~r~ 05/17/02 HA=RTCORN PLUMB.&HEATING
Authori~e~ Signatu~
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)
PERMIT NO. 27705 Z
Date SEPTEMBER 17, 2001
Permission is hereby granted to:
for :
LANDING AT PECONIC
PO BOX 430
SOUTHOLD,N~f 11971
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED 2 CAR
GARAGE & COVERED FRONT PORCH AS APPLIED FOR UNIT #107 CP~AWL
at premises located at 1205
County Tax. Map No. 473889 Section 035
pursuant to application dated AUGUST
Building Inspector.
MAIN RD GREENPORT
Block 0001 Lot No. 025
22, 2001 and approved by the
Fee $ 755.10
COPY
Rev. 2/19/98
Form No. 6
TOWN OF $OUTHOLD
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 Deparhnent with the following:
For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and nansual 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 Underwr/ters.
4. Sworn statement fi.om plumber certifying that the solder nsed 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 fi.om architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
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 C~rtificate of Occupancy
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
Co
1. Certificate of Occupancy - New dwelliag $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. Photocopy of Certificate of Occupancy - $ 0.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of. Property:
House No.
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Date.
Old or Pre-existing Building:
'
- I Street t '
~ ,~' Block
! !
(¢h~k one)
Hamlet
Lot
Filed Map.
Permit No. Date of Permit.
Health Dept. Approval: "~ '
Planning Board Approval: l ~.. -
Request for: Temporary Certificate
Fe~ Submitted: $ ,,~.~' '"~
Applicant:
Underwriters Approval:
Final Certificate:
c o 2q o
(check one)
Applieant 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 SOUTHOLD
CERTIFICATION
Date:
Building Permit No.
Owner: ~O.~L ~flllJ?tl 0
(pleasg l~fint)
Hartcorn Plmg & Htg,
Plumber:
(please prin0
Inc
/07
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 /~-~ , 20 ~
Notary Public, County
(Plumbers Signature)
VIRGINIA M. GOCIN~KI
Notmy Public State of NewYolk
No. 4873841
Qualified in Suffolk County
Tram expires October 20, ~>
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
E.F. MALONEY * PECONIC LANDING
P.O. BOX 6070 MAIN ROAD / ROUTE 25
MILLER PLACE, NY 11764, COTTAGE # 107
SOUTHHOLD, NY 11971
Located at MAIN ROAD / ROUTE 25 COTTAGE # 107 SOUTHHOLD,
NY
1
971
Application Number: 1038723 Certificate Number: 1038723
Section: 35 Block: 1 Lot: 25 Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting
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 therewith the 1#th of Jul),,2002.
compliance
on
Day
Name QTY Rate Ratine Circuit Type
Additional Charges
modular house N.Y.State approval # 19-14
mfg Avis America serial # 676201
Appliances and Accessories
Air Conditioner 1 0 42,000 BTU
Furnace 1 0 Gas
Wiring and Devices
1 0 General Purpose
Receptacle
Switch 1 0 General Purpose
Fixture 3 0 Incandescent
Service
1 Phase 3W Service Rating 200 Amperes
Service Disconnect: 1 200 cb
Meters: 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
Sidney B. Bowne & Son
Consulting Engineers
235 E. Jericho Tpke., Mineola, NY 11501
PECONIC LANDING
TOWN OF SOUTHOLD
BUILDING PERMIT NO.:
COTTAGE NO.: /D7
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//107 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 #107 bas been constructed in compliance with all applicable laws, codes and ordinances.
Very tndy your;
BARTON & ASSOCIATES, LP
Frank P. Laughlin, RA
Senior Vice President
cc: Dennis M. Wilhelm, RLS
Al Bwszeit, 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
107 ~///T'~ ~ ~, ,L'Z. ~ ~
REMARKS:
March 14, 2002
E. F. Walsh
Developers Peconic Landing
Village of Greenport
Utilities Deparlment
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 Iifx 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
)I]Ifl)ATION (IST)
)U[~I FRAI4E &
PLUI~ING
ISU~I'ION I~ER
STA~'E ENIgRGY
CODE
· ' AD1)ITIOI~L
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Exam/ned
Approved
Disapproved
7 ,20
PERMIT NO.
mo~z~'qu rm~x. tviii ,~"Jt'LIL, AI ION (2~CKL, IS.
Do you have or need the following, before applying
Board of Health
3 sets of Building Plans
Survey.
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
" Date ,20
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 oflot and of buildings on'~remises, relationship to adjoining premises or public streeti 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 Inspector will issue a Building Permit ~;o the applicant. Such a permit
shall be kept on the premises available for inspection throughotit 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, hoesing code, and regulations, and to admit
authorized inspectors On premises and in building for neeessar7 inspections;
(Signature of appli~nt or name, if a corporation)
~(Maiiing a~dre-ss of applica~)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
I
Nameofownerofpremises (D/9~trOtl,~ ~Otld[//O O'l"~[IT~f.l,i
I (as on:the tax roll or latest deed)
If apl~l~.an3 is a corpora~on~ signature of duly authorized officer
tr. ':.
] (Narr~ mad title ofcorporatgofficer~
Builders License No.
?lumbers License No.
Electricians License No.
Dther Trade's License No.
Location of land on which pA-oposed work will be doric:
/2O,5 2,_X "
House Number . Street
Hamlet
County Tax Map No, 1000 Section Q.~' Block [
Subdivision ' Filed Map No.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Addition Alteration
Other Work
a. Existing use and occupancy.,
b. Intended use and occupancy"r/~c~,Sj;0d(~
/
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost_~,~ 700: 0OO. t~O
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
~ear
.Depth
Dimensions of same structure with alterations or additions: Front
Rear
Depth Height.
~. Dimensions of entire new construction: Front
). Size of lot: Front A//t~ Rear
I 0. Date of Purchase
'7"
Number of Stories ~
Rear .Depth
Number of Stories , /
Depth __
Name of Former Owner
t 1. Zone or use district in which premises are situated
[2. Does proposed construction violate any zoning law, ordinance or regulation: /~/~)
~. 3. Will lot be re-graded /~5 __ Will excess fill be removed from premises: YES
Name of Architect ~t~l~/I l~%r,/~. , . Address. t! ' .Phone
Name of Contractor ~ tl~t~ 1¢ II.#~h Address t~ Phone No. (_ ¢~/) ~7~ /-/)fO /
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. ~)//
7. If elevation at any point on property is at I0 feet or below, must provide topographical data on survey.
;TATE OF NEW YORK)
SS:
;OU'NTY Ot~Ff~2/'/~, )
f~"/',qT~ ~ h.,/~-~'Z//,),~.5/¥~' being duly sworn, deposes and says that (s)he is ~e applicant
~ame of individual si~ing conWact) above named,
$)He is the
(Contractor, Agent, Corporate Officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
tat 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.
Signature of Applicant "