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24066-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25446 Date: 12/22/97 THIS CERTIFIES that the building ADDITION Location of Property: 45 APPLE CT SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 69 Block 3 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 9, 1997 pursuant to which Building Permit No. 24066-Z dated APRIL 22, 1997 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN J JAKLEVIC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buil ng Tnspe6l r Rev. 1/81 FORM NO. $ 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) Nd 24066 z z 19 Date ..............!./.... ......................... .., ... Permission is hereby granted to: ..................... �fS.......... °P.. .......C&reeU....................... �:..... ....�� �............... ......................................................................../....................................................................................... ................................................................................ ................................................................................. atpremises located at.............4.6......!//!lt:.���....... /fl........................................................ County Tax Map No. 1000 Section ..../p.-X.......... Block /.......03....... Loot No. ..Z.�........... pursuant to application dated .....✓1� -/ ....... 19�/..., and approved by the Building Inspector. Fee $.....���. ........... .... /)Uil� ..�?'`��l ............................ g Inspector Rev. 6/30/80 m Form No. 6 O V TOWN OF SOUTHOLD BUILDING DEPARTMENT DEC 7 TOWN HALL 765-1802 J" 1! i BLDG.DEPT. a 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 17 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 - .25,�, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . .��./1. Old Or Pre-existing Building. . .. . . . . . [�. . . ALocation of Property. . . . .7. . . . r?I.?. . CLtCPU . . . . . . . . . . . . . . . . . . . .�'JL.{.+t.Vjd . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . J.4.n. n. . .J•. . Qklevlc�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .1.(�. Iqq. . . . . . .Block. . . i'�. . . . . . . . . . .Lot. . ` ./ . . . . . . . . . . . . . . . . Subdivision. . . . . . . ../.,,....�.yy. . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . .ff.Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . :; ky c&.'-.Date Of Permit. . .. 1.�.Z.tr'a.�. . .Applicant. .J.©hr'1 .1 .�, R. le ic:. . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . .. . . .. . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . .. . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . .. . . .. . ... . . . c S3?9 C 0`Z,2 5 LP q�, icANT o��gUFFO(,��QG Town Hall, 53095 Main Road 5 • Fax(516)765-1823 9 ��Q� �� Telephone(516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 12, 1997 John J. Jaklevic 45 Apple Court Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 24066-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I II:I,II III;i I'li l;l Illll II I:t'illl r 'Wlllln'I'toll ^n..�.nn»ww n n»wv nf�rm.Frtn n»n. 11110.11 rnn)uR K JR r1.w n I rIa ----------- .n rtmnmm.art a,nnmm_ I --__ N -••�_—_—•_ Il:illl.n'I'IIIII I'E1l 11 , RTA'I'M Klll;.1111Y 1;1)111! »nm» ;sm �i I.i I: I IIAI. m»»mnm, ADI)II MIAl.»n.,n»m........,.m» T collln:IrI'll t ..._,,.m..m..n»n..»n__ »..m» » c -------- m_»nnn_m»n»n»n. !;� r y Izi • o `D r. U- G M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ i/f/FINAL [ ] FIREPLACE A CHIIMNEY REMARKS: DATE ( / INSPECTOR �2W 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: DATE INSPECTOR BOARD OF HEALTH . . . . . . . . . . . . . . . (� Polut NO. -ISETS OF PLANS � (i v � � SETS TOWN UP SOII'I'1OLD SIINVKY . . . . . . . . . . . . . . . . . . . . . . . . SBUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . l of ��� ,L.. APR -: S WT 'TOWN NALI. SEPTIC FORM SOII'1'IIULD, N.Y. 11911 4 i 'flit.: 765- 1602•x• NO'1'1,PY: '- TQWNOF50u;"rlOLla �j CALI. . . . . . . pp p� HAIL TO: . . . . . . . . . . . . . . . . . . . . Approved......�IL AII_ 19 7 Tenant bio. y�((/ �� .............. .............. ............ . . . ... .... Disapproved it/(! ....................... .. ... ... ... ......................... ... . ... . ... .............................;.................... ... ... ... . .. ... .N !••.. . (Buil n Ioe as Or APPLICA'I'IoN P( It BUILDING PERMIT bate. . 03`. . . . . . . . 19 INSTRUCTIONS it. '11118 1111AIcatien auat be ccsgdelely filled in by typewrites or !n ink and mhrnitted to the Building linpector wi J seta of: plans, accurate plot plan to scale. Fee according to rrherlule. h. Plot plan showing location of lot and of Inildtngs on pranisen, relationship to adjoining premises or public orweeLn or areas, and giving a detailed description of: IayouL of property rust he drawl on lite dlagrnn wltidl is batt of this application. c. 'the lark clrvered by this application rrry not be comrax:ed before issuance of. Building Pernik. d. Upon apprrval of Olin application, the Building Inspector will issue a Building Permit to the applicant. Such perm!1. shall he kept, cn the premises available for inspection thrrwtglwnnt Ute work. e. No Inllding altall le occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy alall have been granted by the Building Inspector. APPLICA'I'lCN IS HEREBY 11ADKK to the Building Deparinent for [lie issuance of a Building permit prcminut to Cite lluildb% Zein Ordinance of: Use Tum of SouOK)ld, Suffolk CiAnnty, Naw Yolk, nod other applicable Inds, Ordinances or Regulation, for tie construction of Ixrildingn, aklttiam or allerationa, or for renaval or (lenolition, an herein t described. The applicant agrees to comply with all appillenble lawn, ordinances, Inlldiog cele, INAalllg code, and regulations, mol to ainit aulltorized inspectors on p onises ax) in building f r lie a ry inslectionn. r � . (Signntu oNn nl Boast, or norm, if of rorlxxnt ion) ..IJ...00%NOT— �.. (ani I ini" address of spill k;anl) Slide whether upplicant is owner, lessee, agent , architect., engineer, general contractor, electrician, phsier or Ixiildei ....................................()w7Yal. .. ........• ...... ... ..................................:................. Pusan of•.cwsner of: prcanlnei -.SOI-1N 3 ..�A,I;zEV1(✓ .............. ............. ..... ... ............. ............ ... ............... (an at the Lax roll or latest, decd) If applicant In a corporation, siNiatune of duly nuthorized officer. ............................................. ... ......... (Norm mill LiLle of corporate officer) Builders License No. ......................... finders License No. ......................... Electricians License No. ..................... other Trope's License No. ........ ............ I. Icx:aliat Of: land at whnich proposed wink will he dote......................................................... ..... ..s.-.. .... .... .. .... so ... ©> ...::.N:`1:..:.11 1. :. ............... .. House Noviter Stree t LQ� . Ilrmyalet Canty lax lisp pNo. I(10 DSSection .....t7dl•I•....... Illalc ... .......... Lot ...i.r/.......... fnlxlivialot ..S. .U:.h.01d...1/ll)-C6.... .... ... Piled will tMr. .. ..... ........ lot .........:..... (Name) : 2. HInLe exinthpl use rad licaqui;y of proainen and !mended uno and occupax:y of. proposed coud:ructloll: n. Exist!ng use and occupancy .....V!m:`f.. .S?C.wC41... . . ... ....... ..... ....................... ..... b. hn cadet use and occupaw:yYfG� .............................. . ... ...... . .... ................................ 'I. I:alito of wok (t11Lt:l( IAli(.h 11 1l llalblL Ikar Ikll ldiu Nldll dull f III )l 1l ... .. . . . . . 1 .. ... . .. . Allln fll bon . . . . . . . . . . Mimi l l .. ........ ,. Ilulrmo l lk}Irll(t,llNl ... .. .. . .. O PC 11 VMS 1 ILIILInY,ICd Gall: . ..1.......�...... ... ... . ... fou ' •(111 Ia: ,,,Id on f ' r 5v(� , i{ Jl, I! p 1 it lop title appl ll:a( loll) ' :i. If IAx:lllo molar of (6alllo noila . . . .N/. . . Ilnllur ill' IAAflllo oUliju on each floor . ../1/i', .. . .. . . Il• Ilnnytu, lumber of earn ..... ... . . .. . .. .. .. . . . . .. . . . . . . . . . . . . . li 6. If luullnuuu, anuwrplul or luland occ, lwlicy, ulalaify lini�nst! olid catiloc of 41101 lylxl of title. .. .. . .. . .... . . . 7. ❑6lwmll(mill of uxlulanp ul'rlu:lornu, If any; Vlonl . . . . . 81 I ��11 q 11(:110 IC .... .... .. ............... 1111bar of tact It:n . . . .(L. I' . ... . .. .. .. . . ! .�® Ohlwuui(alu o f alllw alnN:rure W1111 at lot at loin fir Iu1dl1ioon: l'1 o01. .. . Nt IWur ..."?F!` . !��(� IklpHl ... ..1,✓ /3Ik11100: . .. . . . ./.11 41,... . . .. 1#nL(:r of iitur'lLa /,)114... . . 1 Il. 111011 it loam pf Lit IL l rlf anal cone l Itis I 11 a l l I,k im n' .. ...o�,�.. .. . , lkur .. . .. .. ... . Witt It . .. �.. ... . . Iwittllt ........Wyk...c1 .'1. ...... IA rd a:r of 1lcor lou 0. pine of locl Vl1. 'ool: ..... -1,(.`J..I. . . . . Ituur IT CITA X --3 33. j. e.C12n1� ... .. . ...�°�i,/:�110.0..... IJlmr: nl` Itonlrfr la,lu:r 111. L4a1e or Imes IU111Ck' to VIA pu}nluUM Ulu uiloulMI . . . . 5' ?Ot& ... ....... .. .. . .. . . ..... ... . . .. . . ... . . .. 12. Ik,na l,rolalted coitutnwdon Violate fioy a}IlOp IIM, ordlnmu:u 0r t'upnluCtvu�' . .. .' ,Q... . .. .. .. . .... 13. 11111 101: Ito rapiluk:d ...,../Lj.Q... / n l prt}ulnuul Ih. (� YI3t1 IJ:.Iwa of Wiser of prlauleau jiflf L.LXI.�C/h . tVAllpau y`•�.. / ..11},I „J(](f} In.�lilolal 1k1.70:3fDllb.. II L'Ie:nlla fill la: IUIUVnII I'I I}ll Mon of Arclrltect: •.........:....... ... ...... .. ...... . &kilnet ... . ..... .�. ... . .. ... ... . .... . 1110aw IJ(l. .. . .. . . . . . tbaliL of In Hilo I1rnlN:rCy Nlth(a 30(1 feet (If 11 r,llltll 1xf1.1111N1'1••A Yid`':uu.... .. ... . 1... ,, . ... . I... . .I1WHie lit. . . . .. .. .. AIV us, 8(lillll(M1) -1(Am 'lluufllfim luoll'1' HAY 1u? Italifil1Ui1). I'LO•I' 1)1'AGRAH localL clearly moil dial:loua'ly fill lalildirylu, }Alulhur aalfillop or prolalsed" mol imllento all net-back dluwnalonu film lllllla:lt'y lilefl. 01Vu "Cied : "nil Illoek hamlet or Ilaucrip( loll acc(llllillp to feed, AM filllM fil'ruet IIIYIwn Until ifallvalo 1d11:11ur lulurior or ronu:r lot, II J GIA'11; IXI lY�1J YIXu(, I' (MillY W 3. SAK��✓'(C- • . . .. ... . . . .lxaop dilly u%Ann, drlai'nun olid nays Illnl: Ila in IhL opplicunl (W,wrf of ioillvldonl allylloil coalrncl') I,lalVn IIUIraI, ' IA: 1!t lilt: ... . ... ... . ... ... .. . .. .... . .. . . . .. . .. .. ... .. . .. . ... . . . .. .l ... ....I . .. .. . .... . ... ... .. .. .(l:oul:nti;lof, npuul', ror1}Iralo of 11Iro:l , ul III' Ilaid tAntor or (Mllorn, anti In dilly alallor iwed all 1N:1'lll1lll ill' havo liol'it1111Y$I Ilei amid mak mal to iwU IuW Hill thin opiA ical.loll; Ilan, all nullwamu cmanhed In thin 1"dicalhm we Ina: ul the tient: of hill lommiPallia mol leliufi mal Ihnl: Ulu Milk Will Ie lN:rl"(alntd to Ilia nulnoer ael: forth ill Ihu upplicutioo filull thermAul. 16n)Ia to lu:fora an thin . . . ..../,. ...... ....dpy of .. . ,. I'l.. /.�.. „ • l E M.WILKINSIl •uol ) (iib w l n u ,l it N,p�ary Publlo,SIM of New York No.X1852,248,Suffolk Conu . %nti 1pkOs June 12,1 7 Q RVS UOYT OF SE SFFLK CrT SII:SLE FAMILY DY+ELLhf3 ` S Q 3 H S.ftE(.Fi0 ?, fwr this The,wage 6sn0-af and v:a;er eau Deienmentend%r IocaLOn tea•,='cean�asoectun:y is^s p other agencies anti Lound x?Gc�,.itt�taatyy,J;° Q Chief81 Byreeu of 4VasiGwater Management u1 tt r L40'447- BS S22SF O �O VAC4N7. zs� 933 J C a • 1V O � ryyM '�Y \ \ ` �O O' � Z53 / 3J p^��• p' 'SNI h/ 53p ✓gSM��E �qN /1 o pp' R�23 21' E . .`: .,.�.,.,,(;Y.�.r.�„,�. .�=1._ _ "•:;fid 4 �iee.°....a...x.w...ti AUG 3 11993 AREA = 10,768 sq. ft TOWN OF, i y () 0 CERT/PIED TO, SURVEY OF THE LONG ISLAND SAVINGS BANK LOT 6 PECONIC PROPERTIES MANAGEMENT CORP. raa&e-F //Y3C l in5�1-�• // �,�5— "MAP OF SOUTHOLD VILLAS" FILEDJUNE 25, 1992 MAP NO. 9237 Prepared !f accordance s a me minimum lisped AT SOUTHOLD standards for lI11e surveys as established bythe L.AA.L.S. and approved and adopted TOWN OF SOUTHOLD for such use by The New York State Land SUFFOLK COUNTY, N. Y. Title Association. The water supply and sewage disposal 1000- oe� systems for this residence will Count Scale: _e: I"= —4q30r to !ha standards of The Suffolk County Deportment o/ Health Services. Match 11, 1992 JUL Y 15, 1992(foundation) The locations of wells and cesspools shown hereon are from field Oct. 23,192(final) observations and or from data obtained from others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ' ' FOR APPROVAL OF CONSTRUCTION ONLY PCII 92 SO 43 NOV 13 1942 i� l E.S. LIC. NO. 49618 DATE HS. REF. NO. PECONIC SURVEYORS, P.C. 15/6J-.785 - 5020 S.C.DEPT.OF P. 0,; QX 909,`j MA/N'RO tO:�" APPROVED HEALTH SERVICES ��, SOUTHOC6;�4.�. 11971 7-7 V, ---rr,f.,,�, - I -, ,�I'll—-1, , � " �, I� I , ., I I -V, ,i, : �i_1 ,, I 1: �� V I � , I I . I � - . , ; ir -, � ,, I , t , . - -I, 4 _t,, . .. I - , I, , -I . 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