HomeMy WebLinkAbout26055-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27967 Date: 09/26/01
THIS CERTIFIES that the building CONDOMINUM
Location of Property: 635 M41 CALEB'S WAY GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 40 .1 Block 1 Lot 41
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 14, 1999 pursuant to which
Building Permit No. 26055-Z dated MARCH 16, 2000
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 CONDOMINIUM UNIT M-41 AS APPLIED FOR.
The certificate is issued to MOORES LANE HOLDING CORP.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-011 01/19/95
ELECTRICAL CERTIFICATE NO. PENDING 09/24/01
PLUMBERS CERTIFICATION DATED 09/21/01 WILLIAM DOOLEY
11111)
/4/ 44)
Authorized Signaiire
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. 26055 Z Date MARCH 16, 2000
Permission is hereby granted to:
MOORES LANE HOLDING CORP.
P.O. BOX 1143
CUTCHOGUE„NY 11935
for :
CONSTRUCT MULTIPLE RESIDENCE UNIT M-41 AS APPLIED FOR.
at premises located at 635 M41 CALEB'S WAY GREENPORT
County Tax Map No. 473889 Section 040 . 001 Block 0001 Lot No. 041
pursuant to application dated OCTOBER 14, 1999 and approved by the
Building Inspector.
Fee $ 592 . 63
111
0 I
Authorized Signa , re
ORIGINAL
Rev. 2/19/98
f 6 Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
„ 4 :7;._
765-1802
SF
I — i APPLICATION FOR CERTIFICATE OF OCCUPANCY
C
!-A-- Tfh4t apple 9 at 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 Building - $100.00
3. Copy of Certificate of Occupancy - .25e.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $115.00, Commercial $15.00
Date !/O�/�
New Construction ' Old Or Pre-existing Building
Location of Property �� 694/3.5. li4c-/ 6-'2n/30i/et
House No. Street Hamle
Onwer or Owners of Property 9cV,QfS /9N! ./hYi/0O# 1*,
County Tax Map No 1000, Section Block..Y.%.Q Lot
f ✓j
Subdivision 7� bipi,o/�Pa� Filed Map... ac? Lot [
Permit No. .oi40r-✓ Date Of Permit Applicant. .. . /7117..�O�c//
���AaFie
Health Dept. Approval Underwriters Approval
Planning Board Approval
Request for: Temporary Certificate Final Certicate
Fee Submitted: $
B.k,G, Coal, Z ICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195099 - BUREAU OF ELECTRICITY
. - 40 FULTON STREET, NEW YORK, NY 10038
Late OCTOBER 05,2001 Application No. on file 11652101/01 N 571821
THIS CERTIFIES THAT
oab the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
MOORES LA DEV.CORP. , 41 CALEBS WAY, GREENPORT. NY
In the following location• El ® 1st Fl. 0 2nd Fl. ATTIC/OUT Section Block Lot 41
Ins examined on
SEPTEMBER .2001 and found to be in compliance with the National Electrical Code.
FOLIURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER _AMT. K.W. AMT. K.W. _AMT. K.W. AMT. K.W. AMT. N.P.
23 30 26 23 1 11.0 1 1.2 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMI. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. X.I. NO.OF FEET AMT. WATTS
2 F 1 30 1
SiRVICE DISCONNECT NoTER OF S E R V I C E
ME
AMIAMP. TYPE EQUIP. I e SW I e ]W )•]W ]e 4W NO.orPcc a oax. OF CO wAND. NO.OF 111-11G OwGO NO.OF NEUTRALS dart,.
,.
1 150 CB 1 X 1 1 1 1
OTHER APPARATUS:
CO DETECTOR-1 •
2 TON A/C CONDITIONER-1
PANELBOARDS: 1-1 CIR. 60
G.F.C.I:-4
SMOKE DETECTOR:-4
—
4, ..C. ‘ 14................ ?auft
JIM SAGE ELEC. INC. LIC.#3635E '2 '1 ; ;I •- '
PO BOX 38 •r • - GENERAL MANAGER
GREENPORT, NY, 11944-0038
' e-' Per 11 e
UNE oedSRoate muM not be altered In any manner,return to the office of the Board If Incorrect. Inspectors may be Identified by their credentials.
I,
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
7"1111
07/12/1939 12:30 2081573 DOOLEY PLUMBING 01
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OFF CE OF THE EUILDING INSPECTOR
TOWN OF SOUTHOLD
Z R T I F I C A T E O N /�q
DATE: !q/(//a/
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pores: MAO 2.14) L a Alf p F U. el
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765-1802
BUILDING DEPT.
7 INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS'ACOa",41 1 OVeiagara‘
,clazpi7 LoCeree-a- r--",
DATE 3/#i INSPECTOR
ft-'
frij k765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ d�OUGH PLBG.
[ NDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY��
REMARKS: LZ� i. sa4za £,ci -
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DATE C/ INSPECTO ► L O/
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765_1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] R5LIGH PLBG.
[ ] FOUNDATION 2ND [ kINSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
RKS: oCken-
&Vita
Mk
DATE % ‘11%
INSPECTO I
G2`1'
/1/AwI65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG LBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE CHIMNEY
/
REMARKS: ., / 21-0 '
DATE r l i D/ INSPECTO
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ADDITIONAL COMM `tAlyENTS: Qom,
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BOARD OF HEALTH • •
FORM NO. 1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
ryry�� Qp CALL
Examined...f D.)a D , 19U• MAIL TO
Approved.-.16).24 , 19.9. . Permit No.a.Go.?.-5
Disapproved a/c
(Building Inspec(((LLLlllor)
_'L I OCT 14 1999 %✓ 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 wi
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 application.
c. The work covered by this application may not be camienced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the prenises 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 Tawn 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 amply with all applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in building for necessary inspections.
pt 't'ff G•i t' fl�1 c-/74
(Signature of applicant, or name, if a corporation)
�e 3,45- 0'3 &TX-l6,ae At 03S_
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner-of premises git-welf ./046-4,17 �aR�
(as on the tax roll or latest(/deed)
If applicant is a corporation, signature of duly authorized officer.
( and tit f corporate officer)
Builders License No.
Plumbers License No.
Electricians License No. ./7•2 t
Other Trade's License No.
y/ 7
1. Location of land on whi work will be done
V %/
House Number Street// Hamlet County
County Tax Map No. 1000 Section "``L b,/ Block j Lot ... . 7J
Subdivision Altifi13d'/ A//61 Filed Map No. lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy a TrpppsG44pp ion:
1OY.. 'i �ATnt1
a. Existing use and occupancy 1(:ws:, ch .nL3
b. Intended use and occupancy .../f /G'`i/ 11 ��F f� O,l�/(J lv+ti!;c•.t .-
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition 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
If garage, nether of cars
6. If business, ca nercial 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 sane structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front ...00 Rear /tO Depth S`/
Height 14 Naber of Stories /
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner / ,�
1 I. Zone or use district in which premises are situated �F5�41 f�� "�/9fl
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded /�U / lei Will excess fill be removed from premises: YES ND
14. Names of Owner of premises .1.�PQe� .hr Address in3 C414/7605?/4- Phone No. `/77 ft5/6
Name of Architect .�./Ylq�A/. eQ�.'s/ Address/.!P.M-1Ilf•P mom..6-! .. Phone No.
Name of Contractor ..Adm/ ate /7 /(4#61/11Wttddress ,/?°EN(.cF'.�� ilk. .d. 'if.Phone No. 7a?Z��1�
15. Is this property within 300 feet of a tidal wetland? * YES NO
U
*1F YES, soma]) 1flR TRDSTEES PERMIT HAY BE REWIRED.
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 amber or description according to deed, and show street names and indicate
whether interior or corner lot.
SCAIT•, OF MW YORK, SS
CUMIN OF
being duly sworn, deposes and says that he is the applicant
(Nae of individual signing contract)
above named,
Ile is the
(Contractor, 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 be re ne this
day of a, „2'i 19. /" .
Notary Publ i ... atg. .. . / 4
-*-27:4447ETHASTATHIS (Si meant)
NOTARY PUBLIC,State of New York
No.01S18008173,
Expires Jue Suffolk,