HomeMy WebLinkAbout26056-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27637 Date: 04/27/01
•
THIS CERTIFIES that the building CONDOMINIUM
Location of Property: 635 M42 CALEB'S WAY GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 40 .1 Block 1 Lot 42
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. 26056-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-42 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 04/26/01
PLUMBERS CERTIFICATION DATED 04/24/01 WILLIAM DOOLEY
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Authorized Sign/re
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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. 26056 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-42 AS APPLIED FOR.
at premises located at 635 M42 CALEB'S WAY GREENPORT
County Tax Map No. 473889 Section 040 . 001 Block 0001 Lot No. 042
pursuant to application dated OCTOBER 14, 1999 and approved by the
Building inspector.
Fee $ 592 . 63
e (-04-1 /
Authorized Si• ature
ORIGINAL
Rev. 2/19/98
Form No. 6 516 . 635 ' 998'
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 I% 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.
0. 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 - .25c.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ... !(t?xk
New Construction Y Old Or Pre-existing Building /
Location of Property yZ }/FIf,S�S 4)"Y G./��f�tJD"
House No. g� Street , f Hamlet
Onwer or Owners of Property / • VttFJ t�NC Oiel'�Y �oi[� .�/
County Tax Map No 1000, SectionJ7 Block. ..1/4Y- i1 Lot !.2
Subdivision /,�i/gattlf X1 Filed Map a' Lot
Permit No. .240J 4 Date Of Permit Applicant g4Y 42/41;W;4'
Health Dept. Approval Underwriters Approval
Planning Board Approval
Request for: Temporary Certificate Final Corticate
Fee Submitted: $ . . `�3�� LICAN
..�
gat. 5'f 35 y T
Co 27437
73/4
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195099 BUREAU OF ELECTRICITY
I- 40 FULTON STREET, NEW YORK, NY 10039
Date MAY 04,2001 Application No. on file - . . ".:i'1', 1 N 5'i 1 544
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
MOORT'S LA DEVE.CORP, 42 CSS WAY, GREENPORT, NY
in the following location; ® Basement ® 1st FL 0 2nd FL Arm O'Ut Section Block Lot 42
was examined on APRIL 26,2001 and found to be in compliance with the National Electrical Code..
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDUCEm FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. X.P.
24 31 26 24 1 13 .7 1 1 , 2 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLETSDIMMERS
AIM. K.W. OIL N.P. OAS X.P. AMT. NO. A.W.G. AMT. AMP. AME. AMM. TRANS. AMT. H.P. NO.OFAFIEBET ANT. WATTS
2 F 1 A/C 10.12 1 30 '_
SERVICE DISCONNECT \O.OF S E R V I C E
TER
AMT. AMP. TYM EQUIP. 1 e SW 11 SW 3 e SW S e SW NO.Oi CC COND. A.W.O. NO.OF XI-LEO A W.O. No.a NEUWAu A'W'O'
MR• OF CC.GOND. Oi XI-MO OF NemAL
1 150 CB 1 X 1 1 a
OTHER APPARATUS:
CO DETECTOR-1
WHILPOOL BATH-1
Cr.F,C.I:--5
SMOKE DENAIMUR:--4
,
JIM SAGE EIEC. INLIC LIC.413635E . I
PO BOX 38
GREENPORT, NY, 11944-0038 GENERAL MANAGER
11 ..•
. .ems . Per --
This certificate must not be altered In any manner; return to the office of the Board It Incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
07/12/1939 12:30 2081573 Dm FY PLUMBING PAGE 01
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Someic,Yew'tot* 1 197" 4ify ittiT
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
Z 5 R T I F I CAT I O N
DATE: y/VA
au±ldang Permit 'Ta. 24.051
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certa.ft taat the solder ussc _a the water supply system
coat4ins lass than 2/LO o 13 lead.
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�- �� 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ✓] FIREPLACE & HIMNEY
REMARKS: OILL-w
DATE I '--- (m INSPECTOR _71174.:il
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P.. 765-1802
BUILDING DEPT.
1 NSPECTIO
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ 7.1318DATION 2ND [ ] INSULATION
[ AMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: 42/2A7fraidaerae---
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DATE / 7 d/ INSPE / %' i
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: __ ct / epi Jim ,,,/
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DATE /7 6/ INSPECTOR-' A _
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE 1LCHIMN
REMARKS:
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BOARD OF HEALTH
FORM NO. I 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL
Examined.. b i ll) , 19. . MAIL TO•
Approved..JO U , 19/. Permit Na. .P60�6
Disapproved a/c
111-J1
. (Building Inspector)
r-)
i
IA!i OCT 4 �( ' APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date , 19. . . .
t
a. This application oust be completely filled in by typewriter or in ink and submitted to the Building Inspector wit
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 propertymist be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be ca menced 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 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 MALE 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, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in building for necessary inspections.
...•fr i'e.'" 4 v i C 1 C.4ri fi!//L` 2/
(Signature of applicant, or name, if a corporation)
/6 ay //3 Pak/laguf Ay,/7 '3f
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plcnber or builder
1¢Gf,rf
Name of wncr of premises ..•27/4""ir /1�,-,E / Z-4 - C;74;"
(as on the tax roll or lates deed)
If applicant is a corporation, signature of duly authorized officer.
( and tit f corporate officer)
Builders License No. //
Plumbers License No. .'43./,
Electricians License No. /7,2 45-
Other Trade's License Na.
6// 7'`/'147 4/
orkI. Location of land on which proposed wwill be done
/ iv9 (Al/1/l Gig/ Aeff tia/t/4-
House tinter Street/ Hamlet
L
County Tax Map No. 1000 Section 1201 Block fInt ....0.a.
Subdivision �f/f11I.gr171 /a' Filed Map No. lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed eoastruetion:
a. Existing use and occupancy MluC..r. ,44.,.,.'i,.a t vi
b. Intended use and occupancy ...Al/e ",-1/14(1 '4/ ,/p � c
3. Nature of work (check which applicable):GP ) 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 timber of dwelling units on each floor
If garage, number of cars
6. If business, comnercial or mixed occupancy, specify nature and extent of each type of use
7. Dimensions of existing structures, if any: Front
Rear Depth
Height timber of Stories
Dimensions of same structure with alterations or additions: Front
Rear
Depth
Height Number of Stories
8. Dimensions of entire new construction: Front .,,//U Rear /(0
/ Depth s`/
Height l 4 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 A5(C4A1//¢L
12. Does proposed construction violate any zoning lav, ordinance or regulation:
13. Will lot be regraded Will excess fill be removed from premises: YES N)
14. Names of Owner of premises .11/(14 4/41-1( 4/e1 Address //V CZ/4-nL Phone No. `/77.5'85/0
Name of Architect .CA/mmit1...ef S/ Address/IOW/!°l, 59.6:/4 11(ee.e. Plane No.
Name of Contractor ..Ao,e/#A,fiAwito- isixo Address /4. 4!1: ‘f ,.f./Q�{f/�f)f)�4' .Phone Nos. 7a2Z- O
15. Is this property within 300 feet of a tidal wetland? * YES N) Q
*IF YES, SOUENO D ICUll TRUSIEES PERMIT MAY BE REQUIRFD.
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 ember or description according to deed, and show street nares and indicate
whether interior or corner lot.
SIAVE OF EW YORK,
SS
CLAMMY OF
being duly sworn, deposes and says that be is the applicant
(Name of individual signing contract)
above named,
He is the
(Contractor, agent, corporate officer, etc.)
of said caner 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 me this
/
day of �CjT( /6-a1 19. `
Notary Publi k4'�CJ., ,, '. . / / 40
E ETH A STX1113
NOTARY PUBLIC,State of New York (Signature of i.cant)
No.01ST6008173,Suffolk County
Term Expires June 8.20)