HomeMy WebLinkAbout23595-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27033 Date: 04/12/00
THIS CERTIFIES that the building ACCESSORY
Location of Property: 900 CALEB'S WAY GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 40 Block 5 Lot 1.45
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 29, 1994 pursuant to which
Building Permit No. 23595-Z dated JULY 19, 1996
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 AN INGROUND SWIMMING POOL FOR CONDO COMMUNITY AS APPLIED FOR & AS
PER ZBA #4243.
The certificate is issued to MOORES LANE HOLDING CORP.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL C10-96-007 10/12/94
ELECTRICAL CERTIFICATE NO. 13991 10/28/96
PLUMBERS CERTIFICATION DATED N/A
Authorized 91gnature
Rev. 1/81
FONK NO. s
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)
hT° 23595 Z Date .....�.�f....................................... 19
Permission is hereby granted to:
f� 'cd...4Q.,.. ... .. .. .. ...... ........ .....
.`.. °:. ...�/.. 3 ...............................
.. ...... .......... ....�,J..® ..:.... .i/. oOr
to . . . .. ...!�J . .... .,�ic!!3'? .,gin. .. . .....:�......
......, .......
.. .... ..�. .�........ . ..... .... . . , ..
Q ...../............. d
..... ............... .............. ... . ........
...
....... .............. ....... . ........ . .. . .. . .... ..�...... .......
��// -� ...../.............
County Tax Map No. 1000 Section ...'3'.Q........... Block ...................... Lot No. lry)
pursuant to application dated ../1 ., .............................., 19 , and approved by the
Building Inspector.
Fee S•slt �
d
NI .. .. . ...................
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 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 Buildiniz - $100.00
3. Copy of Certificate of Occupancy - .2. .
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00 Commercial $15.00
Date . . . . . . �7_. . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . ." . . . . . . . Old Or
Pre-existing Building
. . . .
�,9 � �
Q .. . . . . . . . . . . .Location of Property. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No.. Street Hamlett/ ,,/
Onwer or Owners of Property. . .aeo C'./:`!'& . . . . . '�. :j. . ::: . .`/- • • • -
. .
County Tax Map No 1000, Section. . . . . . .�. . . . .Block. . . .015. . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. .. .Date Of Permit. . . 4 f
Health Dept. Approval.4:l4 .-. F6 ��..t . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final t' te. . ." . . . . . .
//��
Ge--,
Fee Submitted: $. . . . . . . . . .a: 0. . . . . . . . . . . . . .
�9C•S 7 7 3I . . . . . . . .AP . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
�Q� a?033
ELECTRICAL INSPECTION SERVICE INC.
375 DUNTONAVENUE
EAST PATCHOGUE,NEW YORK 11772
(516)286-6642
13991
DATE: 10128196 APPLICATIONNo.ONFILE
VILLAGE: GREENPORT TOWN' SOUTHOLD
ADDRESS. 900 CA LER.S'WA Y
ISSUED TO: MOORS LAND DEVELOPMENT CORP.
INTRODUCED BY. K. V. ELECTRIC INC. LIC No: 3389-E
was examined on 10-28-96 and found to be in compliance with the National Electrical Code
LOCATION- Base.. I st XX 2nd 3rd Attic
Det.Garage Hot Tub Pool XX
SWITCHES RECEPTACLES FLYTURES HEATERS FANS G.F.L AIR.COND.
DISHWASHER DRYER CLOTHES WASH. GAR.DISP. RANGE OVEN SMOKEDETECTOR
FURNACE OIL GAS CIR. MOTORS BELL TRAM. SERVICE DISCONNECT
METER AMPS PHASE
1 200 UG
OTHER
EQUIPMENT
OUTSIDE, CLUB HOUSE
WIRED TO 680 CODE
1-220V TWIST LOCK
1-20AMP TIME CLOCK
1-IHP MOTOR
1-200AMP PANEL
6fu(GO S. SURDI
PRESIDENT
BUILDING PERMIT No. This certificate must not be altered in any manna
Inspectors may be identified by their credentials
BLUE ORIGINAL YELLOW COPY PINK COPY OFFICE
COUNTY OF SUFFOLK
141994
ROBERT J. GAFFNEY
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P.H.
COMMISSIONER
October 12 , 1994
Mr. John D. Roseberry, R.A.
Hawkins Webb Jaeger Assoc. , P.C.
200 East Broadway
Port Jefferson, N.Y. 11777
SUBJECT: APPROVAL OF PLANS TO CONSTRUCT/RENOVATE A SWIMMING POOL
AT PHEASANT RUN AT GREENPORT (TOWN OF SOUTHOLD)
Dear Mr. Roseberry:
This office has reviewed the plans you recently submitted for the
above referenced facility and finds them in conformance with
Chapter I, State Sanitary Code, Subpart 6-1, for Swimming
Pools.
Enclosed are copies of each of the following:
1. "Certificate of approval of plans for the construction or
renovation of a swimming pool (s) . 11
2 . Approved plan sheets .
3 . Approved engineering form 134R.
After construction has progressed to the point that the piping
has been completed in accordance with the approved pians, an in-
spection by this office must be done before backfilling can
begin. This inspection can be arranged by calling me at tel . :
(516) 854-2544 .
V,, truly yours,
Richard Markel, P. .
Environmental Engineering Bureau
Enclosures
cc . Building Dept. Town of Southold
(w/certificate of approval)
15 HORSEBLOCK PLACE
(51 6)854-25
■ FARMINGVILLE, NEW YORK 11738-1220 ■ FAX#854-2505
COUNTY OF -SUFFOLK
N
4 1994
ROBERT J. GAFFNEY
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P.H.
COMMISSIONER
CERTIFICATE OF APPROVAL OF PLANS FOR THE CONSTRUCTION
OR RENOVATION OF A SWIMMING POOL(S)
Application having been duly made to the Suffolk County
Department of Health Services, as provided under Chapter I, Part
6, of the New York State Sanitary Code, approval is hereby
granted for the construction of the swimming pool , located at
PHEASANT RUN AT GREENPORT, N.Y. , subject to the following condi-
tions :
I. That the proposed artificial swimming pool (s) and treat-
ment equipment shown on the plans and specifications
approved this day shall be fully constructed and in-
stalled in complete conformity with such plans and
specifications or approved amendments thereto, within 18
months .
II. That the engineer of record shall inform the Department
48 hours in advance for the purposes of making a joint,
as built, pipe inspection.
III. That the engineer of record shall inform the Department
48 hours in advance for the purposes of making a joint,
final inspection to ascertain conformance to the approved
plans . Two final inspections are included. Additional
inspections are $ 100 . 00 each.
IV. That the owner or operator will not open the swimming
pool (s) until a certificate of compliance has been
received.
V. That the swimming pool (s) shall be operated at all times
to conform with the requirements of Part 6 and the
criteria for operation of a swimming pool and to the
satisfaction of the permit issuing officer.
VI. That whenever required by the Permit-Issuing Official,
modifications, additions or more adequate equipment as
needed for the operation of the pool (s) in accordance
with the provisions of the State Sanitary Code shall be
installed, and plans for such modifications, additions or
more adequate equipment shall first be submitted to and
receive approval of the Permit-Issuing Official .
VII. That a certificate of construction compliance shall be
submitted to the Permit-Issuing Official . This certifi-
cate shall be prepared and signed by a professional
engineer or architect, licensed to practice in New York
State. The certificate shall include a statement that the
pool (s) and appurtenances have been onstructed in ac-
cordance with approved plans and fic io s .
19
Richard arkel, P.E.
(51 6)854-25
15 HORSEBLOCK PLACE ■ FARMINGVILLE. NEW YORK 1 1 738-1 220 ■ FAX#854-2505
y s
-------
COUNTY OF SUFFOLK
ROBERT J. GAFFNEY ro(/(���OG
SUFFOLK COUNTY EXECUTIVE NOFSOFpr
DEPARTMENT OF HEALTH SERVICES MARY E. H1 ' .D., M.P.H.
COMMISSI' ER
CERTIFICATE OF APPROVAL OF PLANS FOR THE CONSTRUCTION
OR RENOVATION OF A SWIMK NG POOL(S)
Application having been duly made to the Suffolk County
" Department of Health Services, as provided under Chapter I, Part
6, of the New York State Sanitary Code, approval is hereby
granted for the construction of the swimming pool, located at
PHEASANT RUN AT GREENPORT, N.Y. , subject to the following condi-
tions:
I. That the proposed artificial swimming pool (s) and treat-
ment equipment shown on the plans and specifications
approved this day shall be fully constructed and in-
stalled in complete conformity with such plans and
specifications or approved amendments thereto, within 18
months.
II. That the engineer of record shall inform the Department
48 hours in advance for the purposes of making a joint,
as built, pipe inspection.
III. That the engineer of record shall inform the Department
48 hours in advance for the purposes of making a joint,
final inspection to ascertain conformance to the approved
plans. Two final inspections are included. Additional
inspections are $ 100 .00 each.
IV. That the owner or operator will not open the swimming
pool (s) until a certificate of compliance has been
received.
V. That the swimming pool (s) shall be operated at all times
to conform with the requirements of Part 6 and the
criteria for operation of a swimming pool and to the
satisfaction of the permit issuing officer.
VI. That whenever required by the Permit-Issuing Official,
modifications, additions or more adequate equipment as
needed for the operation of the pool (s) in accordance
with the provisions of the State Sanitary Code shall be
installed, and plans for such modifications, additions or
more adequate equipment shall first be submitted to and
receive approval of the Permit-Issuing Official .
VII. That a certificate of construction compliance shall be
submitted to the Permit-Issuing Official . This certifi-
cate shall be prepared and signed by a professional
engineer or architect, licensed to practice in New York
State. The certificate shall include a statement that the
pool (s) and appurtenances have been onstructed in ac-
cordance with approved plans and is io s.
Richard rkel, P.E.
(5 1 6)85425
15 HORSESLOCK PLACE ■ FARMINGVILLE.NEW YORK 11738-1220 ■ FAX 11854-2505
COUNTY OF SUFFOLK
ROBERT J. GAFFNEY
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P.H.
COMMISSIONER
1'.
October 12, 1994
Mr. John D. Roseberry, R.A.
Hawkins Webb Jaeger Assoc. , P.C.
200 East Broadway
Port Jefferson, N.Y. 11777
SUBJECT: APPROVAL OF PLANS TO CONSTRUCT/RENOVATE A SWIMMING POOL
AT PHEASANT RUN AT GREENPORT (TOWN OF SOUTHOLD)
Dear Mr. Roseberry:
This office has reviewed the plans you recently submitted for the
above referenced facility and finds them in conformance with
Chapter I, State Sanitary Code, Subpart 6-1, for Swimming
Pools.
Enclosed are copies of each of the following:
1. "Certificate of approval of plans for the construction or
renovation of a swimming pool (s) . "
2 . Approved plan sheets.
3 . Approved engineering form 134R.
After construction has progressed to the point that the piping
has been completed in accordance with the approved plans, an in-
spection by this office must be done before backfilling can
begin. This inspection can be arranged by calling me at tel. :
(516) 854-2544 .
y-e53r truly yours,
�I Richard Markel, P. .
Environmental Engineering Bureau
Enclosures
cc. Building Dept. Town of Southold
(w/certificate of approval)
1NORSE9LOCK PLACE (316)834-25
■ FARMINGVILLE.NEW YORK 1 t738-1220 • FAX II654.2505
ooh IC119
NEW YORK STATE DEPARTMENT OF HEALTH
ENGINEERING REPORT FOR SWIMMING POOL PIANS
;a��F poolL(�,,��EL�� Nam_a of P On� '�r.Teran,Villeyer r Cacunry /'(� i, Oete— -11 +
is oecLfAl'�.7InL �����, �'{QQn T1 Jv&Cot!� ION
Jl�
(Cheek one) New Peel Changes to an existing Seel �I
(Horure of Pool Other(describe)
indoor rj Recirculation or Filtration n
Outdeer Chlorination
Og*e of sten of Genseuatfon Estinarad date
eoof•eampioNan Max,ne,of setners to usr eauiree Gree
rtng 1`195 L,� SQ` in') pool at any site tint No.of bothers �S a
' \ Coo severe Feet
i Length 50 a Depths s Pool capacity Typo of construction^_
Width 2D s Mex. gallons au t,
I 20nn Somers loot Min.
Ware• Source er arinoing use Water source rer sanitary use 'Neter source ier swimming use
S°`rnst' oS �r(ntct�� � LW}�1 S¢1' v
ICuantity available Capacity of
fill pump Intercennoctien
GPM N�/-i GPM yes 1 Ne
F ill -'1j1 id seri b•m�thed, site,!eeatian, ba k-Sieh eqe prey tie ) Moke-up.rater line (describe) V-
Recircuietion eume (heed caeacity curve must be submitted)
Make • µ.0 l-" Mo!o1 i.gt�302.0 x_ ;Turnover: gaffs. eoseeity _ .n hours
it) t V M s � �C i qpm x 60
Typo f reclxletin�G Main drain pipe Inlet gees votU V s�I mir�r
15 1 ` 2 "
Slit
�Qa• �t� Length + fp6 t i
i.�+.Z Vefeeity
IN LETS
Ne.
Is occi'g Depth Si se I Adjustable cad soots
-0 mml
or_OLWASTE DRAIN
: oipe size M 01
(length Grate aoening area I Ne. Length of time Describe arrangements ler baekflevr pr vention
50t'� (aa.in.) 11G l needed to emery Seel 10 krS �IC11O }Q
I SCUM 5UTT2-EiS I SXIMMERS
Site (Drain spacing (Type No. Location Pipe size
:
HAIR CATCHER Prne S 5VACUUM CLEANER
o;Se site a et diemeter Mai• Type Piping sic Ln+sngai hese
1000th _inches 4ot feet
FILTERS ;
ee Ma.e INa. %ilhrt�'w7�edi/u�m Aree seen niter j "at": area I
i2,&,,f,At e NQS,+IILA ! FN 5 WO IQf•L"•
•anon rare 'aae+v n ton I PC,*
P•eiSVfe aV 7 contrai:ers I .•r Tenr
(00 sv �_ pm Ser so.I Spm Ser %a.I` It.s I r , c'LC LCM d
jt. sy.:t. it
"i � I
.aa wa0•e��mi- Ma■e 3 yes si feeaer%mrdei rt csntr
i 0 e.tnerw,cal`Max. 3 'ype a: ee.er macer -I...
to be ase.
, te.co rna•r�C. r�no .e.l
5o
ion. '3SR rev. '•) 'Q) or el"a l
Other show••sals to Mske t type ci leedo► (model or Oisinfactian thew. Make i type of feeder I++del +) Capacity of feeder
usell
64 rw.6ks /`�
rJ�-lMf�'�r Wei
1�used _ Vn
r urLol�
fo IDC I&CADCt. tS nD t td '4QnC Ing
rowh
%St"too of Maximum dcsye Paint of applies•
solutten ti" OPERATION CONTROL
pN test kit (lenge) T4 Chlorate residual test kit beep)
CD•a• Qa,�} 0 �4 .CjrC C1� (or C.o.
Desert►a lesilities for sewito y.este disposal II IV
been espror foci. Oescrio facilities llet
,pee�l wastes 41690541 (iwts��tlodins Ni;t of
S� I h Jischetye) 15C.t/WKQ. 1i�0 S 0 t;IC I��0
rP=64Q2k &L,110-105 Y.s Ne C1 Le ri Cnq po"G elyrry $2 uT..Air I A Ma t
Filter"Gott waterr5�
Seuw gutter waste Vaeeaw sooner"Gotta
ujore- IQ h }- WS"M to I2, d15Mt P—d o�
LoMn ,Q,ro� 1ob(sh
FACILITY LOCATION WOMEN MEN
Number Flex Area (sf) Number Floor Area (of)
Dressing meows
sh:ors tJLPia o�S uS�- ou-� N a XXXXXXXXXX IJ A • XXXXXXXXXX
n
La.etetpes �uto 113 V:4 . XXXXXXXXXX ' XXXXXXXXXX
Toilets Ck Vb��SQ� XXXXXXXXXX 1 XXXXXXXXXX
Uri-Is XXXX XXXXXXXXXX N 101� XXXXXXXXXX
Life toeing equipment Qist)b quor4 CVatr rst- >t41A -t irg- 96crd First aid oquianr+ett (list) t
LAODERS Fencing MAZARDS
Nu/neor�f satiate ^
1611,19141 gas storage location Gas mess Location
G/ (L _
Arrelnn omenta ewr,�&ventilation UNOERWATER LIGHTS DECK JUNCTION BOX
1 /—t a-' VEnt,o4 No. Make Madel a Na.`f✓ Metra Model +
UnaerWrtter's Divertqq beards Depth of diving Alter hasa►ds (eaplein)
L�- h. ebe.a �� ��
Water AreoKj 1A it.
Yes ; Na ft,above
water !t.
THE PRECEDING ITEMS OF THIS FORM ARE INTENDED TO INCLUDE FEATURES PERTINENT TO THE DESIGN AND OPERATION
OF A SWIMMING POOL. THE,FORM SHOULD BE USED TO SUPPLEMENT THE NARRATIVE REPORT OF THE ENGINEER OR
ARCHITECT IN THE TRANSMITTAL OF PLANS TO THE HEALTH DEPARTMENT.
SggneEIL
f engine hitect_ Ad rest
A. Professional engineers' a
�C1ns w�� r t5 arehi+eels'lieensa + (er epPIY
seeI)
f'of� �2.GFtsSc�) N v. I I?17� •
4�3 • (9.00
P�
Gen. 194. ,
Ngo 2
C�3,�7 s,
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 TION
[ J FRAMING [ FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS
DATE / INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
u b �\
u
FOUNDATION ( 1ST)
II II
JI----------------it-
FOUNDATION OND) - -it
I - Ili
FOUNDATION====OND)======11
ROUGH FRAME S I u
PLUMBING II II
II II
------
--
INSULATION PER N. Y. ----- p --- --_---- -
---STATE ENERGY
ENERGY II
CODE II
-^------a=xxxxsxxxxxxxx== ^-_-- _ =ax===-saxes axxxxx�xxxxs;=xxxx=xxxxx==xxx=axxx==xx=xxaxx �[jFy\( \
I
II II
-- - --
FINAL II 11
ADDITIONAL COMMENTS:
----------______________________________________________________
/x�==_____
_S�C�----
H
H�
_ ----- --- -------- --- ---- --- Ilk
r
r ,
BOARD. OF HEALTH . . _ . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CiIECK . . . . . . _ _ _ . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 r"IDT FY
CALL . . . . . . . . . . . . . . . . . . .
'll
Examined . . . . . . . . . . .. 19 1 MAIL TO :
Approved :��. , 19 ;Fi Permit . 7 �5 . . . . . . . . . . . . . . . .
Disapproved a/c . X-ev, . . . . . . . . . . . . . �,(� Q� L . . . . . _ . . . . . . . . . . . .
��� \ �
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(B ' diQ spe tor)
APPLICATION FOR BUILDING PERMIT `
19
Date (?(�.4' �. .�. ., !.
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 be 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, b 9 ing code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ' pe tions.
/ (Signature of-applicant, or name, if a corporation) J/
�j
(Mailing address of applicariu') V
State whether applicant is owner, lesseeagent architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises Amef� . P . . . . . . . . . . . . . . . . . . . . . . . . . .
s on he ax roll or latest dee
(a t � 1 at t )
If Tlicant is a corp ration, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . .
Plumber's License No. /A . . . .
(�
Electrician's License No. ./. .l.c�y.}. . � . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
__) r'C -��
1. Location Location of land on which proposed work will be done. S �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
aw
House Number 61 Street � Hamlet
7 E9
County Tax Map No. 1000 Se tion, Y.�: . . . . . . Block . . . �. �. . . . . . . . . . Lot . . . . ` s .
Subdivision ���11 LP�i I�iCrt. > ��.!'l�P.ti�- 1iT.. . . . . Filed Map No. Lot . . . . . . . . . . . . . . .
(Name) J
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . fe�i� _ L17
�=
b. Intended use and occuGrri . 4/( �r4°,� ���
3. Nature of work (check which applicable): New Building . . 1/ . . . . Addition . . . . . . . . . . Alter'"ation
Reair . . . . . . . . ... . . . . Re ioval Demolitiol� . . . Other Work1p
dZ` �Xtiti�lrrG'd G(.�Q� ZX S ��— .���,i e�u-l�— (Description)
4. Estimated Cost . . -.�. .�/l`t"... . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. 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 . . . . . . . . . . . . . . . . . . . Ph!Ze No. . . . . . . . . . . . . . . .
15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . No. l�.. . . . . .
*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 OWN W YORK, S.S
COUNTY, F � . �
/ . . . . . . . . . being drily sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the . . . . !i<� t1L� � e."i � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(o ractor, 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
. . . . . . . . . ... . . .. . day of . . . . . . . . . . . . . 19 �
f n
Notary Public,a�9�:�-�t°:+:t!.(..y-. .� ��:�?4! .�-,�.c Count
Notary Pi!;dic,Stale of New York No.4951364 (Signature of applicant)
�ttct!ifiAd in St.iCfr�IR County �y ''�
Cnmrni�sion rxpirns May 22, 19 7 `S
EXTENSION AGREEMENT
AGREEMENT made this �k T day of March, 1994 , between the
Village of Greenport, a municipal corporation duly organized and
existing by virtue of the laws of the State of New York with
offices at 236 Third Street, Greenport, New York 11944 (hereinaf-
ter the "Village ") and Moores Lane Development Corporation, a
New York Corporation with offices at c/o Robert A. Braun, 350
Veterans Memorial Highway, Commack, New York 11725-0166.
WHEREAS , the Village and John Costello entered into an
agreement dated January 18, 1990 ("the Agreement") pursuant to
which the Village was to supply water to 99 single family dwell-
ing units to be constructed upon certain premises described in
exhibits to the Agreement and which development was referred to
as Mooresland/Cedarfields; and
WHEREAS, by Assignment dated February 24, 1994 John Costel-
lo assigned to Moores Lane Development Corporation his rights
under the Agreement; and
WHEREAS, the Cedarfield portion of the development has been
completed resulting in the Village providing water to 39 of the
99 single family dwelling units referred to in the Agreement;
and
WHEREAS, Moores Lane Development Corporation seeks to devel-
op the remaining portion known as Mooresland, with 60 single
family condominium units; and
WHEREAS, the Village's consumer hook-up deposit referred to
in the Agreement, which deposit is presently referred to as the
Village water up front fee, has increased since the date of the
Agreement from twenty-five hundred seventy dollars
per unit to four thousand seven hundred thirty two dollars
($ 4,732. 00) per unit; and
WHEREAS , the Village presently requires payment of one
hundred and twenty five dollars ($ 125. 00) perG ynit as a tap in
fee and one hundred sixty five dollars ($ 165. 90
) per unit as a
security deposit fee which fees are subject to modification from
time to time by the Village; and
WHEREAS, Moores Lane Development Corporation acknowledges
the Village 's commitment to supply water in accordance with the
Agreement and this extension thereof, necessarily results in the
Villages planning for the additional anticipated demand with a
consquential expansion and an increase in maintenance of the Vil-
lages 's water supply system so as to service such additional
MAR 29
8WG pEPTSOUTHOLD TOWN
O�SOUTNOL ` PLANNING BOARD
anticipated demand and that the cost of such expansion is intend-
ed to be met by the per unit up front fee required by the Village
while the cost of maintaining the water supply system is intended
to be met by the minimum water charges and rates for water
supply the Village sets for its water supply customers;
NOW THEREFORE, in consideration of the representations and
covenants herein, it is mutually agreed as follows:
1. Pursuant to paragraph "Twenty-Second" of the Agreement,
the Village consents to the assignment of the Agreement to Moores
Lane Development Corporation.
2 . Moores Lane Development Corporation shall pay to the
Village as for the increase in the Village's up front fee between
the date of the Agreement and this extension thereof $ 2 , 162 . 00
per unit for the sixty remaining units or a total of $
129, 720 . 00 . The tap in fee and security deposit shall be due
prior to the connection of each particular unit to the Village
water system in the amount in effect at the time the connection
is made.
3 . Moores Lane Development Corporation warrants and repre-
sents to the Village that Moores Lane Holding Corporation is the
fee owner of the premises shown on that portion of exhibit A to
the Agreement and is described in schedule A to this extension of
agreement and within ninety days of the date this extension of
agreement is fully executed, Moores Lane Development Corporation
shall obtain and record and provide a certified copy thereof to
the Village, covenants and restrictions against said property in
a form acceptable to the Village's attorney providing:
a. That on and after March 31, 1999 the owner or owners
of each unit for which an allocation for water supply has been
provided in the Agreement and herein, shall pay to the Village
the Village's minimum water supply charge or service charge then
in effect for water supply customers outside the Village bound-
aries and, in the event such charge is not paid within thirty
days of written notice to the owner or owners of such unit, such
notice to be mailed to the grantee ' s address as listed on the
recorded deed for the unit and also to the address to which the
real property tax bill for the unit is sent then, in the event
the charges are not paid within sixty days from the date upon
which said notices are mailed, the water supply allocation for
that particular unit and the up front fee shall be deemed aban-
doned and thereafter before any unit for which the allocation and
up front fee was abandoned is supplied with water by the Village,
the up front fee then in effect shall first be paid to the Vil-
lage together with any other fees required by the Village to be
paid for the supply of water in effect at that time.
4 . Paragraph SIXTEENTH of the Agreement is hereby amended
and the WORK referred to therein shall be completed within sixty
months of the signing of this extension of agreement.
VILLAGE OF GREENPORT
By: -
-
Mayor Stephen L. Clarke
MOORES E D LOP ENT CORPORATION
i
ws\l\corp\grptwag.mor By
w�
ACKNOWLEDGMENT OF CORPORATION
STATE OF NEW YORK)
) ss :
COUNTY OF SUFFOLK)
On thisday of 1994, before
me personally came and appeared to me
known, who bein y me du so i ,depose and say that he
e ides at 0 �j that he is the
of <ce� the
corporation described in and which executed the foregoing
instrument , that he knows the seal of said corporation, that one of
the seals affixed to said instrument is such seal , that it was so
affixed by order of the directors of said corporation, and that he
signed his name thereto by like order.
NOTARY PUBLIC
JANET E.StNew York 4831949,Suffolk County
Commission Expires July 31, 192'5-
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date . . . . . . . . . . . . . . . . . . . 1961
To �T • . . / . . . .
. . . . ��,. :� . . 11413. . . . . . . . . . . . .
PLEASE TAKE NOTICE that your application dated . . T. , , o? `�Y�pG �7 19 95 ,
for permit to Gic�x�k%/��'�G����6?�lj•?�, � � y�� J.
, did y� . . . . . . . at
Location of Property 7 ��, , , , �� .�y (-/ �Y
House No. ' ' . . `
1/24o/ . . . . . . . . . . . . .�'T/�
Street am/et
County Tax Map No. 1000 Section . . .ly.�.C7, , , , . . . . Block . .
. . ?�. . . . . . Lot
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . .. . . . . . Lot No. . . . . . . . . . . . . . . . . .
is returned herewith and disapproved on the following grounds 'a r
Ll A62
. . . ..4e .
. .
. . . . . . . . . . . .. . . . . . . . .�
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ui—Iq Inspector
• K V
RV 1/80
��SUfFO(�-co
PLANNING BOARD MEMBERS
Richard G.Ward, Chairman W
= Town Hall, 53095 Main Road
George Ritchie Latham,Jr. ^+ P. O. Box 1179
Bennett Orlowski,Jr. .fi O!� Southold, New York 11971
Mark S. McDonald O( �`a Fax (516) 765-3136
Kenneth L. Edwards Telephone(516)765-1938
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
April 20, 1995
George Wiser
Peconic Properties Managment Corp.
P.O.Box 1143 APR I ff -
Cutchogue, NY 11935
Re: Pheasant Run Condominiums
Moore's Lane, Greenport
SCTM # 1000-40-5-1
Dear Mr. Wiser,
On April 17th, one of your contractors on the Pheasant Run project, Artie
Foster, met with us at our work session to discuss the possibility of
making a minor deviation from the approved site plan.
As he explained it, certain of the site work by utility contractors will
prevent the construction of the circle at the end of Caleb's Way exactly
as shown on the approved plans. As a result, the parking stalls will not
align perpendicularly with the curbing as originally planned.
The Planning Board has given Mr. Foster permission to substitute concrete
curb stops for the curbing between the sidewalks and the parking stalls
located within Caleb's Way Circle. Mr. Foster indicated that he would
align the concrete stops in such a way as to ensure perpendicular parking
spaces.
Sincerely,
Richard G. Ward
Chairman
cc: Artie Foster
James Richter, Engineering Inspector
JThomas Fisher, Principal Building Inspector
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