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Home My WebLink About21294-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23256 Date SEPTEMBER 30, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 1225 JASlIINS LANE SODTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot 24.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 1993 pursuant to which Building Permit No. 21294-8 dated APRIL 1, 1993 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued ie ONE FANILY DWELLING WITH ATTACHBD GARAGE & OPEN PORCH AS APPLIED FOR. The certificate is issued to PECONIC PROPERTIES MANAGEMENT CORP. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-23-DEC. 12, 1993 UNDERWRITERS CERTIFICATE NO. N-285224 - AOG. 4, 1993 PLUMBERS CERTIFICATION DATED JONE 1, 1994 - A. MALAUSSENA, JR. < Y~d7-~ ldii g~pec or Rev. 1/81 sows xa s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDINd PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N° 2129 Z Date .........~~.....1 19..Q..~ Permission is hereby grou~ted to: to ~P-...g........~....`~~... ?:-~....~....~z~.... ~c . at premises lasted at ...................~fX.+ircrXkf!r.?a..... ............:.........~..~..........................:~.3...........................~~ County Tox Mop No. 1000 Section Block ....~C......... Lot No.....!~:SQ pursuant to application doted ....57/.~....~.' 19q.c~,., and approved by the Building I(n~spector. Fee S..!}64.t~a.P....... ,,A~C.~P.ir.......... uil Ing Inspector Rev. 6/30/80 Form No. 6 r 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential '$1'SI.000, /Commercialn$1/~5.00 Date ~~"'N^'..1. ~~..../7 7Y........... New Construction... Old Or Pre- fisting Bui,l~g.• Location of Property . ~':4~t5~ • • ~Y~`~:Z`~+ r+",'~• House No Street Hamlet ~ • Onwer or Owners of Property.~.B7~.44.~/~~~f?~~./.~ County TaxM,,ap((~~No 1000, S//e//ction...., r./.s... ..B1ock.....V.......,./..Lot. ~ SubdivisionW.~~. l~~~G' ..Filed Map. 7 V.7 Lot.. ..~.-pfi. . Permit No.~~~.J.~.~.Dat//efOf P~ey~rm>it..~/7~,r..!~...ApplicantkA~dX.LC~YF~~~~~~~~ Health Dept. Approval~1~?l.jT,~ SQ~L~./.Underwriters Approval Planning Board Approval Request for: Temporary Certificate........... Final Certicate..:l....... Fee Submitted: $ .............................t~ -AJE'!! ' APPLICANT `~~5 eo ~~t~.S THE NEW YORK BOARD OF FIRE UNDERWRITERS PncE i. 1999837 BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 AUGUST 04,1993 fi19'1'1993i93 N ~E15'1'G4 Date Application No. on file THIS CERTIFIES THAT only the electrical equipment a. d'eaerihed hebw and introduced by the applicant named on the afrooe application numher in the prenaisea of PECONIC PREP HGT., S/S JASHINE LONE, SOUTHOLO, N.l'. nTTIC;OUT in thefollosrinq loco4ga,~ - ,ga~rr~ent ~ IRt Fl. ~ 2nd F'l. .Sertion Block Lot tCera a:ermined on 7. and found to be in compliance with the National ElecMcal Code. NXTUR! RXTURES RANffES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS EFTACLEf SWITCHES INUNDESCEra FIUMtSGENT OTHER AMi. K. W. AMi. K. W. AM1. R.W. AMT. K. W. AMT. N. P. ?9 36 "'E ^R 1 DRYlRS RlRNACE MOTORS NTURE AMBIANCE IE~ERS SFldAI REC'eT TIME CIOCKS YU UNIT HEATERS MULTI.OUTLET gMMBK AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMi. AMP. AMT. AMPS. TRANS. AMT. N. I. ~ Of I'EET AMT. WATiS 1 F i 3 - 1 SERVICE DISCONNECT NO.Of S E R V 1 C E METER NO. Or CC COND. A. W. G. A. W. G. A. W.G. AMT. AAV. TYPE pU1F. I / tw I / TY ] R ]W J / AW PER 1 Of CC. COND. OP N4LEG Or NI.LEG NO. Of NFUTIIA4i OP NEU1Ml 1. 159 r,E t t t t t OTHER AMARATUS: HOTORS:2-F N.P. G.F.C.II-8 SHOES DETECTOk:-1 / Gc'~~ SPUDS ELECTRIC SERVICE f,IC.tt92-E 1'75 3RD.ST. E0B 166 ONIRAI MANAGER 5T. JAHES, NY, 11?R0 ll Per This certificate must not be altered in any manmr; return to the ofiite of the Doard if incorrect. Inspectors may be identified by their crodentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. INSPEC~'I'ORS , ,r,:~~g11FF0(TC- , ~ Y • ~ G~.Ss~, SCOTT 1.. HARRIS, Supervisor s, h ~ ~ x s% Scurhold Town Hali Thomas Fisher ~ w P.O. Aux 1179, 53C95 Main Road Building Inspecrrn . r` a Southold, New York 11971 ~ Gary Fish -.~`~i Fax (516) 765-1823 Building Inspecrrn ~ ;t lr-- Telephone (516) 765-1800 '.cv- Robert Fisher Assiswnt Fi.e Inspeao* OFFICE OF BUILDING INSPECTOR Telephone (516) 765.1802 TOWN OF SOUTHOLD C E R 'f I F t C A 7 f 0 N DATE: / /~~f Building Permit No. ,T!__________._ Ovnez: _ (please p~int)~_ Plumber:, v/~ ~/~LA?5S Q V (please priu[) I certify that [he solder used in the eater ssupply system / i contains less than 2/10 of Ix lead. j / / / 7/rci~ _ lumbers Signature) Sworn to before me [this day of _.51.11Q.1~.C~• 19 Notary Public, County No rp Pub is a MARYANNE E. 001IM{J113 Nobry PuNlo Naw llorlt QwIMIW in $uMoNc Cou~r Commfpion ExpMa Aupusr 3, lflr! lt~` „ ~-~aqy~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ]ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: c~ DATE INSPECTOR ~~z~~~ 768-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~RAMING [ ]FINAL REMARKS: 6.~..,. DATE ~ a'S~ IN8PECTOR ~-i~5~~ ,65.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING ~ [ ]FINAL REMARKS: -tyl3r~i C DATE ~ ~ INSPECTOR ::=1cLD IGSPEC:iUt] ~~UA:E ~ %OMMLNT° _ ~ m y,, a ~ ~ ~ ~ _ _ H _ ~ FOUIIDATION (1st) m FOUNDATI011 (2nd) , 2. o ROUGH FRAME & .PLUMBING ti m 3. m H I115ULATIOP] PER N. Y. STATE ENERGY x CODE ' ~ m G aY ~ ! D*~ . ~ .e n 4. L o P FZi1AL ~ 0 0 cn c~. x ADDITIONAL COMMENTS: [*1 . x ^p . ri p z ~ ~ ~ H .q O ~ Z . ~ ~ a CN r i x d 1 m ~ •o H _ _ BOAFD OF HEALTH . ll~ I,~JL--{. FORMN0.1 3 SETS OF PL.1NS TOWN OFSOUTHOLD SURVEY ~31~ BUILDING DEPARTMENT CIIECI: SEPTIC FORM i t:~.,,.,....._.,._.._,.,._ TOWN HALL Ut SOUTHOLD, N.Y. 11971 'fOv ~ viT"" ~ TEL.: 765-1802 r:OTIFY , CALL Examined 19ry/.22--+. PSA I L TO Approved ..L 19g~. Permit No. ~ J. ~ ~ . . . Disapproved a/c (Bui rng Inspector) APPLICATION FOR BUILDING PERMIT ~y /J ? 7 Ddte ,~~1. ~~~C~i ~ 19 /,J INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupancy hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Legulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ''he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for nece a inspection . /....~2:t.~-~.~ GS-~r :l$ Ct~.Pi~.t/. - . (iG~,,2~. ~lll..+:~!r~Q~? Signature of applicant, or name, if corporation) mar/ ~ r,- (Mailing address of applicant) hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Vame of owner of premises .(ll.~~:d."1~.;~C°-..~j./.LA~:~~'~::./.:~:~;~• • ~!~:~t . (as on the tax ro or latest deed) ff applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No. . Electrician's License No. I Other Trade's License No . . Location of land on which proposed wpork wi~llybe done. ..C~?~d'. y.(~~G!•~, ,/!'/!Lfi,~ .~`:/~C~.-....... . ~ CI~~.~-t-~.. ~ii~'~- ~?-d-~ i'~6-~~ 9 ~ . ~ r . use Nwnber Street ~ Hamlet County Tax Map No. 10/00~S~e?ction/f....~..~.y Block Lot . Subdivision .Q~il.6rtl~~lc-t!-(/..~.G-C ~~i Filed Map No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy f.......~ ...Qc~.trx'•'.r. • . Addition Alteration . 3. ATature of work (check which applicable): New Building Repair Removal , Demolition Other Work . (Description) r~-y o P] 4. Estimated Cost.....~...y..C~d Fee (to be paid on filing this application) 5, if dwelling, number of dwelling units Number of dwelling units on each floor . ,Ifgarage,numberofcars 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 0. Date of Purchase . .....................Name of Former Owner . 1 1. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will ]ot 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 ...................Phone No............... . 15. Is this property within 300 feet of a tidal wetland? *yes........ No......... *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. r >TATE OF N&~l~(~~ S.S ,OU OF . . X51-1.~`. , ~ r~L.Z~.~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. [e is the (Contra or, a orporate officer, etc.) f said owner or owners, and is duly authorized to per or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. wom to before mce t~hi-s- . ~.1 .......day of . . ~ , 19~.~ rotary Pubh CLN(tEE~~ County //fj Nopry Public, State of Nsw Yak U~ No. 4879606' ~ Qualified in Suffdk County (Signature of applicant) Cemmiasion ExpYea December 8.18 F.NRItGY C.'ob6 F2GVIEW , (non-electric) ~ 7014 (part 5) 6~0OV degree~ctaye / I For l Y hl ~1iSJt ~ per Uc+ge CI/~ ~i (.,o~Si °~'J ~ bated ~,L EnVplOp9 Car~patenk R-Value t•.xteriot Well tt-10 hoof/Ceiliny It-19 Floor tt-19 Folmdation Wall ti-10 Slab Edgs Insulation R-lu clazirtg 0-l."l - /j„ ~j~ F.ukrattc9 boots 0-2.5 All IIVAC Equipment to meet requirements of 7014.11 All IIVAC Contro~ 9yatettd to meet regttitementa of 7014.12 All buct syet~ma to meet requirements of 7014.13 All Venkileting Syatema to most requirements of 7014.14 All piping Ineulatlat to meet cegtNtements of 7614.15 All 9erViC! Woter Iteating Syatetro and Equil~nenl• to meet regtlltemente of 7014.7.1 All Eleckric systems to meet tequiretnents o[ 7014.31 1b kits bAat of my knoa.ledyet 4 0~ r bellA!? and professional Z-,~,•- v ' judg6menk? tlteae plans are h in Cort~liance with the c«le * ~ 4 Q J G / ~ 1~ h d% . " ~ PR~FESSIO~tP~ t~ ~lipp~ ~t~1TY oePARTweNr aF N~LTN seRV~s f~DII APPROVAL OF CONSTRUCTpN ONLY P~ ~S? DAT'~"IAR 3 0 1993 REF No. 3 Sa - a ~I w~~ s ~ seg. ~ APPlIOVED J) % 3S F, B ~s O s JL QDO u q., ~ ~ i 10 'O~.o. ~ c ,Q ~ SINGLE FAMLY OWELLNG OILY i ~ Ef~B THAEE YEARS FROM DAiE OF APPIIONAL b s, as tie ~°r 0 0~. s~~ SUTt'VEY OF s [ ~~wa~acw~7 Ti~.uat maw rNro^- a ~°r •25~'' TOWN ~ OUTHOLD ~.3 S~~ Ko OL~~TY N. Y. s. fQr v .~s~aalls~ 1" = 40' .a°~, ~G ~ ~ Ma/. 15, 19~i3 ~~~it ~ ~ ~ ~ ~ ~ ~oh ~ S~e~~~ ~~~tJatj 5 q3~p~ ~ J N `~:J h/ so ~ MAR ~ AREA = Z2,2O1 sq. ft OF NE ~ S ,oaN to~~9,p S.C. DEPT OF " i HEALiH SERVICES GZ~,,~'`'~`~C~`i'~'~'~"" f * ~~.^:~a C~'PP TI» rater syvp/y and sewage aYspoad / - ? ~ Prepared /n accordance wiNh kha n~irieNen syslevna !w !h!s resl~dwioe wA1 ceslorm ~ •S LIC. NO. 496/8 r/onabrdc /or NJIs swveys ass es/a~rMaMd to the standards of TM SuMo?rt County S, P.C. The locollons o/ wells and cesspoo/s by the L.LA.L.S and approved and odgpfed Dsparlmsnl o/ hNaNh Servisas. (5l W shown hsroon ore lrom lield observolions /or such use Iy Ths Mar Yank S/de Lard ~~,~,,~qpp P. O. 9 and or /rom dolo ob/dned /rom others. ~ TINe AssocloNeA. To AN Asat.M~ a1a U7 ~t klAbV ROAD SOC/THOLD, N. Y. ll9Tl SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROb"AL OF CONSTRUCTION ONLY P/ 3C ~S~ DATE _ ____J-IS. REF. N0. ~s \ w \ "tea, ~ S F 66• ` ~ APPROVED e, .5~. Pia 3) S F i B° i OO, i P ~ 3~ A0 ~ ~ C h g ° / 77 i o RB o4 t`•o~ n O . ~S ~ °r ti ~ SURVEY OF ~ ~ ass LOT 5 A T SOUTHOLD ~°l a-?3 2~' TOWN OF SOUTHOLD ~ ~ SUFFOLK COUNTY N. Y. s. ~ ~ ~ Q loon - ~o - 01-Pia ~ ~ ~ Sca/e~ 1" . 40' i ~°T a' ~ Mar. 15, 1993 ao ~ oQ/ A ~ ~ ~ April 13, X993 (foundation) f / O~~`~ 4 ~ h m ~2s• \ ` 34 SO~n/~ \ ti Ease .s,•n~ g. N ~5 43'°' w ,z AREA = 22,201 sq. ft. Nom' CORD The water supply and sewage disposal ~ ' I N` .S. LIC. N0. 496/8 Prepared in accordance with the minimum systems for this residence will conlorm standards /or /ills surveys as established to the s/andards o/ The Sullo/k County C ~ S , P.C. The locollons of wet/s and cesspools by the L./.A.L.S. and approved and adopted Department of Health Services. l5l shown hereon ore tram lie/d observo/ions /or such Use by The New YOr6 Stale Land ELEVATIONS ARE REFERENCED P• D• and or tram data obtained tram others. Tills Association. To AN ASSt~o oATU,u MA/N SOUTHOLD, N. Y. 1197/ ? I 911FF01,~ COUNTY DEPARTME?IT OF FIEALTH SERVICEB Fql APPROVAL OF CONSTRUCTION ONLY ti ~S? DATE ,~G, No. 93 SD 23 qs~ w~, ~ s F 3j sssB~p. °'as ~ SUFFOLK C q ov F. SINGLE~~~~L~ F~i ~c~IVLY o .oo. s0 ~3 ~u, N.D. Rel. No.~~ ,~0 ~ ~ a/ ~ The sewage disposal and water supply facilities at this location ~ ~ ~,t~ have been sars:acw:iiy rnspz:~e:i Isy tss ueva~tment and are ^ in compliance w~lh these as~um plans ~ s ~ ~ 1.~. CEC.,O 21893 • ~a~a a"' ~sf ze ~ Ar ~ DATE CHIEF OF GENERAL y Yj 4so r e. s ENGINEERING SERVICES lO~ ~By 9~- N 09 ~ ~ ss. ~ LOT ~ A T SDUTI,~DLD ® P•s3g~~' TOWN OF SOUTHOLD SUFFOLK COUWTY N. Y. -S- Q' ao~o-~-o~-prod DoT " Scale 1" . 40' O ~ IHar. 15, 19A3 ~ti _ ~ Nov. 19, 1993 (frna~) 0 ~ ~ , sl ~ boy ~ ~ ~ ~~~°L:~ ~ N ~s. °`''h. 43jO' w. nI .n /',REA = 22,201 ~ ft. j ~ r ~1(/p~. ~~w eooo 19~ sc. T .~~oF "Ewr S'tP a~ t. METj fO~~ ~1 HfACTk FRV ~ fS ~c o v Q'Qp t~ply and sewnya d!s sal The water s po - ~}N.Y."5'. lC. NO. 4961@ Pr~pa?ed N eceo?atwrae wpli AMe niiMrw? syaJema /or lhfs roaidencs will conform slara~r~r for INIe s+Nwya ac eaJa16~aMod to /he standards o/ The Su//olk CounJY EC S ~ .C. The locaNona of wells and cesapoo/s by AYo L1A.L.S. apd crowd aia0 aporln?enl o/ Hoolih Services. (5161 _N~ ' ® w shown hs»an ere iron !fold obssrveNons ~ ~h as+ by TM Nor Yant S1oN ~gv~ P. O. and or ham dahv ol/ahed from others. 77Ma AsaoeJeAfM. To AM A81tAl~p oa~ AIA/N N SOUTkIOL , !197/