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Home My WebLink About21608-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22793 Date DECEMBER 15, 1993 THIS CERTIFIES that the building NEW DWELLING Location of Property 1060 JASMINE LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot 24.14 Subdivision SOUTHOLD VILLAS SEC. #2 Map No. Lot No. 14 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 1993 pursuant to which Building Permit No. 21608-Z dated AUGUST 24, 1993 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 ONE FAMILY DWELLING (1ST FLOOR ONLY) 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-32-DEC. 2, 1993 UNDERWRITERS CERTIFICATE NO. N-298214 - DECEMBER 7, 1993 PLUMBERS CERTIFICATION DATED NOV. 23, 1993-ARTHUR MALAUSSENA, JR. B ding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOID BUIUDINO DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19C/ N° 21608 Z Date ...if/ 30.1 Permission Is hereby ranted to: ....'.......ev"F s............ to I 6' ,ZeZ14 ,~......Aloe ...MTS.......J..Y..T.. . at premises located at...1.0..,F'a...... ! ~.....~CHc L%ryLY............................................................. County Tax Map No. 1000 Section 0.9....... Block Lot No.... a.7.t.. pursuant to application dated Z 19..?,mP....... and approved by the Building Inspector. Fee .~/2.1~fA.4 Building Inspector 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1~y 5.00, Cl $15.00 Date . ~4 /77D New Construction.. Old Or Pre-existing Build' g..... Location of Property. .~p ~0~,,,,,~?LlticQ,.vtQ ~pCji~pL- House No. Street Hamle 6 Onwer or Owners of Property. f[~i1.~l~ S!~~1 4YO-1 County Tax Map No 1000, Section Q~.. . Block... ~ ..,./......Lot... 7.Z. Y.y......... Subdivision. .e~ ~r .~W46 7 3 ,ko Filed Map ./7. / 40 t . . pq J. ..h.. Permit No.~? D Q 0. Q. Date Of Permit./a,((/,3 . ,Applicant 'ru4'/.L/lG +Y^ : ~~!1% Q/~1 Health Dept. Approval.../.. .J .0 -3 a......... Underwriters Approval..//`' Planning Board Approval. Request for: Temporary Certificate........... Final Certicate.. Fee Submitted: $ Q'G!C / /i,[dfFtCL2i to GLu~~I'13°~ ~ !L.Q~` ......'.rXe4~ .-000/ APPLICANT I/ RAIMSM 11 1111 Fill Ili 111i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1999837 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date DECEMBER 07,1993 Application No. on file 82640393/93 N 298214 THIS CERTIFIES THAT only the electrical equipment as described belove and introduced by the applicant named on the above application number in the premises of SOUTHOLD VILLAS, 1069 JASMINE LANE, JOB-14, SOUTHOLD, N.Y. in thefollowing location; I Basement El Ixt Fl. 2 Ynd IT. OUT Sertion I I Bock Lot was examined on D E Iz E H B E R 0 1 , 19 9 3 and found to be in compliance with the National Electrical Code. RXTURE BTACl6 SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMT. R.W. AMT. K. W. MIL H. P. 14 19 19 14 DRYERS FURNACE MOTORS FUTURE APPLIANCE REDERS SPECIALRECTT TIMECLOCKS YLL UNITNEATERS MULTI-OUTLET DIMMERS SYSTEMS T. K, W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. WT. -IS. TRANS. AMT. N. P. OF PER T. WATTS AM AMT. WATTS 1 F 1 2/12 DIS 2 20 1 SERVICE DISCONNECT NO. OF S E R V 1 C E AMT. AMP. TYN METER 1 R TM 1 R SW J AT sw r R RW NO. OF CC. COND. A. w. G NO. OF HIAEG A. W. G' NO. OF mUTRAtS A. W. G. PER tr OF CC. COND. OF wUG a NEUTRAL 1 100 CB t % 1 4 1 4 OTHER APPARATUS: MOTORS:2-F M.P. G.F.C.It-7 SMOKE DETECTOR%-1 SPUDS ELECTRIC SERVICE LIC.E192-E 175 3RD.ST. BOX 166 GENERAL MANAGER ST. JAMES, NY, 11780 11 per J This certificate must not be *Noted in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. INSPECTORS q~~~~FfO(k O Q ..:'F Gym SCOTT L. HARRIS, Supervisor Thomas Fisher Southold Town Hall Building Inspector 0'.c, kr! P.O. Box 1179 53095 Main Road ~ Gary Fish Southold, New York 11971 Building Inspector Fax (516) 765-1823 Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: J Building Permit No. Q3 pp160 9 2- - Owner: Owner: D frIo lfC eased[ pri )~Plumber: (pl411Z (please print) I certify that the solder used in the water supply system contains less than 2/10 of IX lead. Plumbers Signature) Sworn to before me this day of_, Notary Public, County Not Public MARYANNE E_ DOWUNG Notary Public. State of New York No.5000030 Ouaiifieo in Suffolk Coun Commission Expires August 3,19 lELD I::SPECTI(JN . ~JUATE I OOMMENT° r r FOUNDATION _ (7st)?C FOUNDATION (2nd) 2. z 0 ROUGH FRAME & G O PLUMBING O y 3. INSULATION PER N. Y. STATE ENERGY CODE r, x t5 r 4. m 04 1 FINAL 2n ADDITIONAL COMMENTS: HIV _ R ro 3J a H H O 2 m A • r _ o O m ~ H (GPI BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK _ . _ . TOWN HALL SEPTIC roan SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OT I FY ; CALL _ . Examined .jT 19~ MAIL TO: r Approved y . 102-7-3. Permit No.^...... _ . Disapproved a/c /(Building Inspector) 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, with 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 street 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 permi 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 Occupanc, 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 o: 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, ordina s, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for nec sa inspe ipns. (Signature of applicant, or name, if a corpor Lion) (Mailing address of applicant) State whether applicant is owner, lessee, agent architect, engineer, general contractor, electrician, plumber or/builder . Name of owner of premis . . . (as on the tax roll or latest deed) If applicant is a c rp ra ' si ature of duly thoriied officer. (Name d le of corporate officer) Builder's Li ense No. Plumber's License No. e_<3. Electrician's License No . . Other Trade's License No. . 1. Location of land on which proposed work will be done . House Number Street .......................Hamlet County Tax Ma` No. 1000 Sect' op Block , . . . . . . . Lot Subdivision . k, r(l-(l .f , Filed Alap No. ../1.-~.~.... Lot / . /y (None) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy a D . b. Intended use and occupancy ....J .....ice . 3. Nature of work (check which applicable): New Building ~ Repair Removal • • • • Addition Alteration • • • • . • • Demolition Other Work . 4. Estimated Cost (Description) Fee.. 5. If dwelling (to be paid on filing this application) e, 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 ' ' Height Number of Stories . Depth . . . Dimensions of same structure with alterations or additions: Front . • • . ' ' . Depth .Height Rear 8. Dimensions of entire new construction: Front . • . • . • . . . . • . ' • ' Rear . . . . . . Number . o.f . . . . . . Stories . Depth . Depth . Height Number of Stories . „ 5. Size of lot:l•ront . Rear . 10. Date of Purchase , • • • Depth .Name ofFormer 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 N! 14. Name of Owner of premises Name of Architect ' ' ' ' ' ' • • • Address , ...........Phone No................ Name of Contractor . Address ....................Phone No....... _ Address Ph e. No. 15. Is this property within 300 feet of a tidal wetland? *Yes. *If yes, Southold Town Trustees Permit maybe required No. - PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frorr property lines. Give street and block number or description according to deed, and show street namer interior or corner lot7F s and indicate whethe vr7 ~~AP,P``I~~?~~OVED AS f)OTFA UNDERWRITERS CERTIFICATE LZATE: a' Q B.P# ~IGof REQUIRED FEE: D FAY: ~ T tvOj.IFY Bilh.i?IC~t3 IDEPAl1T1VrENT AT 7=.::.-'1802 9 :Fri TO 4 P5 ,A FOR THE F%1.1.rJ~ N•fi lCIS~TCCTtt~NS: lv, ! REQUIQED PLUMBi; C3 TS~fll .X f'aAl.L MGCI a: _ 't { pz i\Tgi OF THE V.Y. FP,IhR+;`t R~.°~--NSIRL'E F0.:1 yb~ { f,r~T sRl;0TIC3iW ERRORS PLUMBER CERTIFICATION ON LEAD CONTENT 8C: OPE CERTIFICATE OF OCCUe'Ar Y SOLDER USED IN WATEli SUPPLY SYSTEM CANNOT STATE OF NEW YORK, EXCEED 2110 OF 1 % LEAD. COUNTY OF S.S • • • • ' • ' ' . • ' • ' ' ' ' • ' ' • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. lie is the . (Contractor, agent, corporate officer, etc.) :)f said owner or owners, and is duly authorized to perform 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. iworn to before me this d .....day of . ,(1/ { 19;ye rotary Public, ..V. '.(4/-.. C \ ounty /,JOYCE M. WILKINS Notary Public, State of New York , . No. 4952246, Suffolk Coun (Signature of ac • Term ExpirPsJune.12, 19~~ PP ant) &/Owp 496-10. E s> -9009, R, 36 \ ? sc 40 ~ ~P o~. o~ °s@ A A~ 3. or ® by o0 b Z0" SURVEY OF Zor LOT 14 ec .U4P OFSOUT00 o vtu4 &V" rWO ' ,o. A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. A~ 1000-7o-01-P10 6 J Scale: 1" = 40' 35 - Mar. 221 1993 ~'.r t~ p ~ n p v s D~ n/ ti T %0001 y / fly, W stn ~ ~ ~J Cl). JIL w~A n s E YEARi FA F CANE DATE a aftr OF,A The locations of we//s and cesspools ~r shown hereon are from field observations `°r 'w and or from data obtained from others, AREA = 29,626 sq. ft. ro %9' Prepared in accordance with the minimum standards for title surveys as established by Me L.I.A.L.S and approved and adopted for such use by The New York Slate Land Title Association. The water supply and sewage d/spos S~Q~~~ s• MEr2 systems for this residence wM conf m oa _ cFa to the standards of The Sulfa& Co fy o.r:' ~D SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Department of Health Services, FOR APPROVAL OF CONSTRUCTION ONLY yypp ( J~ ~ ~~gQ~s/- Le o 3 Q 1993 N.Y.& LIC. NO. 49618 DATE HS. REF. NO. `3 C - 3.~ fjf UUU H YORS, P. C. r 20 P. O. 909 ELEVATIONS ARE REFERENCED MANN ROAD APPROVED 101 TO AN ASSUA/ED DATL4W. SOtlTHOLD, MY. 11971 3j -9009, 0 \S%C 0 °C'• ° f QI 0 DoT 101f,~ \ o~. bo CT SL N?VEY OF oe ell `OT '~fAP aF SOUM KLAN 9l iCTIgN 7 WID^' O tzm AW,4 XW l,b Ma -,&W A T SOUTHOLD TOWN OF SOUTHOLD • a 3s o SUFFOLK COUNTY, N. Y. tiy, 1000-70-01-P106 CAV SCAV. 1"= 40r 's Mar. 22, WS Aug. 17, 1993 (foundation) n as S A y0 O A v a J o DO. 3JE ~ ~?A t~- aQ 2T0 pp. ~Qv A1gNF The locations of wells and cesspools shown hereon are from field observations and or from data obtained from others. AREA . 29,626 so ft. Prepared in accordance with the minimum standards for tltle surveys as established by the L.LA.L.S. and approved and adopted for such use by The New York Slate Land LAND 81 Title Association. rah t W. - The water supply and sewage disposal systems for this residence will conform 0 to the standards of The Suffolk Counly SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Department of Health Ssrvkes. FOR APPROVAL OF CONSTRUCTION ONLY ®y L/C. NO. 49618 F DATE NS REF, NO. ECONI ORS, - P.C. (516) 765 - 5020 P. 0. BOX 909 ELEVATIONS ARE REFERENCED WAV ROAD APPROVED TO AN ASSIMIED DATIAII SOUTHOLD, N. Y. 11971 Nips 4 ro. E 4~yy 0V s~ 90 09' R Pi 3` \ SC ~iI Oajo° ~s@ A 0 l p j O by o°~. lp~. ti SURVEY OF Oe LOT 14 'U4P OF SOUTH= 11LA$ 6cm w nvow O FLW Aq 4 NO Me ft A-,&W A T SOUTHOLD ti TOWN OF SOUTHOLD 35.h E ,s \Ch SUFFOLK COUNTY, N. Y. 1000-70-01-P106 Scale: 1" = 40' cyti i ~S j. s Mar. 22,1993 5~k Aug. 17, 1993 (foundation) No v. 19,1993(final) J, a 3C . aQr ' ~ yo SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Approval of Constructed Works H.D. Ref. No. -zSO- ~~°~?~o The sewage disposal and water supply facilities at this location J" V have been satisfactorily inspected by this Department and are w~ 21 w in compliance. with these as-built plans 000 ~b QQ DEC.Q'71ng3 DATE CHIEF OF GENERA ENGINEERING SERVICES . ~'QNF CERTIFIED TOr JON F. BAKER SHEILA L. ELLISTON THE LONG ISLAND SAVINGS BANK The locations of wells and cesspools SUPERIOR ABSTRACT shown hereon are from field observations and or from data obtained from others. AREA = 29,626 sift. 1 Prepared In accordance with the minimum standards for title surveys as established SO a~ by the L.I.A.L.S. and approved and adopted for such use by The New York Slate Land Title AssoclaNon. The water supply and sewage disposal, systems for Jh/s residence wiM confor#j;, , to the standards of The Sullok cow jc+ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Department of Hedth Setrvice& 9 FOR APPROVAL OF CONSTRUCTION ONLY 4 e'` N. Y.& L/C. NO. 49618 93SO32 DATE HS. REF, NO. EYORS, P.C. !5161 - 5020 P. 0. BOX 909 ELEVATIONS ARE REFERENCED MANN ROAD APPROVED TO AN ASSL&ED DA TW SOUTHOLD, N. Y. 11971 Ni°iF RU s. ~2. ~AHE<< Mq 46jo- F Mqn;, My 4 3) 90.09, 0 e Q ^ os@~ AP , I m y' SURVEY OF -0 LOT 14 Ell `O/ is .U4P OF MUM= U.44 SPCnnw MID" FLED Aug, d 1888 Fie Na. A-434 A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-70-O1-P/06 Jc~ ,y„ w ryry Scale' 1" = 40" Mar. 22,1993 ' Aug. 17, 1993 (foundation) ~ ye 2 ,s vDU~ ^ry0 J„ . IgNF The locations of wells and cesspools shown hereon are /rom field observations and or from data obtained from others. AREA . 29,626 Sq. ft. Prepared in accordance with the minimum standards !or til/e surveys as estobb'shed by the L.I.A.L.S. and approved and adopted for such use by The New York Slate Land ti~`Pl: asia Title Association. ra t. ti .1 The water supply and sewage disposal v,~ "rte systems for this residence will conform O to the standards at The Suffolk County SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Department of Heaflh Services.,. FOR APPROVAL OF CONSTRUCTION ONLY y S. LIC. NO. 49618 F DATE REF. NO. ECONI ORS, P.C. (516) 765 - 5020 P. O. BOX 909 ELEVATIONS ARE REFERENCED MAIN ROAD PPROVED TO AN ASSUMED DArLm SOUTHOLD, N.Y. 11971