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HomeMy WebLinkAbout20791-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21155 Date NOVEMBER 18, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 365 JASMINE LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 20791-Z dated JULY 9, 1992 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 (FIRST FLOOR ONLY) The certificate is issued to PECONIC PROPERTIES MANAGEMENT, INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-39 - NOV. 17, 1992 UNDERWRITERS CERTIFICATE N0. N-256227 - NOVEMBER 9, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA, JR. pt Building Inspector Rev. 1/81 10itill N0. ! 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) N 111° 20791 Z Date ........q 19~3.~... Permission is hereby granted to: x.....~.~..~.w~ ~.e...:p' ~...l.a :y.......1.L9~.3.5...... . ra ..`.'~":Afi....S~......rA~f,0...... ~ ..1..~.41.s~AGL ...~a......i C./[X.A~t~.e~.. ~ U I . at premises located at ....~b~....~.9F.:9rrK!:!e!~f.A.,:... 4~...... ~'.~!:i~Sel.~!:~~~ . County Tax Map No. 1000 Section .....Q~.©........ Block Lot No......~..~.......... pursuant to opplicatlon doted .......~~lA.~,(.....~- 19.9.L:, and approved by the Building Inspector. I Fee s....l.~~ - b~ .~t.rl.~ Bu ng Inspector s~ Rev. 6/30/80 w 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 OP, 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 17 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 $15.00, Commercial $15.00 Date ...,November 18,.1992 New Construction........... Old Or Pre-existing Building Location of Property...,~~!.5,,,_ JASMINE LANE .................SOUTHOLD: NBW YORK........ House No. Street Hamlet Onwer or Owners of Property ..........,,PECONIC PROPERTIES MANAGEMENT INC: . . . County Tax Map No 1000, Section..~~..........Block....~...........Lot.6.~ Subdivision., M/0 SOUTHOLD.VILLAS.. ,,,,Filed Map..9737......Lot...o7+~ Permit No.~ ~ 7.~I.~.....Date Of Permit..~Y.9~.1992..Applicant..DONAI.D.BRACKEN,.,., Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Fin Certicate........... Fee Submitted: $...70:00 ~'u~.t/s1..;3 CO ~a , I ~ APPLICANT # . THE NEW YORK BOARD OF FIRE UNDERWRITERS eAC6 1 1000837 BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK, NEW YORK 10038 pate NOYBNBBR 09,1992 Application No. on file 18441992/92 N 256227 THIS CERTIFIES THAT only the electrical equipment oe descrihed helora and Introduced by the oppNcant norrsed on the ahooe oppiication numher In the premises of PAUL & JOAN ZBNB86I, 365 JA8NIN6 LANE, J012, SOUTHOLD, N.Y. _ intMfolloseinq ktcation; ®Baaement ® Ist Fl. ®Pnd F1. OUT ,Sertien Block Lot ' reOa esamined on NOVBNBBR 02,1992 andfound to he in complionre with the requirements of thu Board. • RXTURE RXTURlS RANOES COOKING DKKS OVENS OISN WASHERS EXHAUST FANS OUTLRS NTACIlS SWITCHES INCANDESCENT YlUOetSCENT OTHER AMT. K. W. AMT. K. W. AMT. R.W. AMT. N. W. AMT. M.I. 13 26 18 13 1 1.2 DRYERS IURNAC! MOTORS FUTURE AMRIANQ fiERERS SREGAL REC/T TIME OlOCKS Elll UNIT NEATlRS MUlTI.OUTIET DIMMERS AMT. K. W. ql H. Y. GAS M, Y. AMT. NO. A. W.O. AMT. AMY. AMT. AMYE. TRANS. AMT. N. Y. SYSTEML AMT. WATTS NO.OF FEET 2 P 1 2 14 2 - SRRVIQ OIKONNKT NO.OF S E R V 1 C E AMT. IYPE METER 1 / TW 1 R 3W S / SW S / AW NO.Or CC. COND. A. W.O. NO. Or NI.LEG A' W' G' NO. Oi NFUftAlS A. W.G. EOW?. PFt d OF CC.COND. OF NI~LEG OF NEUTRAL 1 200 CB 1 % 1 2/0 1 1/0 I OTHER APPARATUS: G.P.C.I1~2 SNORB DBTBCTORe-1 $PUDB 6LBCTRIC 86RYIC6 LIC.{192-B t'~ ]75 3RD. ST. BO% 166 oN11tAl MANAGER ST. JAMBS, NY, 11780 11 Psr ~ This certificate must not ba altered in any manner; return to fM office of the Board if incorrect. Inspectors may ba identified by their crodsnfials. Oc~~FF~(/I~~O TEL. 7G5-1802 o~. N. ~ TOWN OF SOrtJTHOd.D a. V.r ~ OFFICE OF BUILDING INSPECTOR '-~S~2y ri: P.O. BOX 1179 c??~ ~ TOWN HALL . %O! Y+,dQ SOUTHULD, N.Y. 11971 . C E R T I F I C A T I O N Date ~ ~ . Buildirq Permit No. 79~ Z Owner " (please print) Plumber ~j¢7l/UQ ~j~Jye}?sS,Fjy~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1$ lead. , (plumber's signature) Sworn to befor^e_ 1m-e1 this -day of 1d~T.]f~~' 19~. Notsry Public notary Public, S County . MARYANNE E. DOYJLING Notary Public, Stete of New York No. 5000030 Qualifial in Suffolk CouOty Cotnm~ssw~~ Cx~;jros ..ugust 3. 199. ao~9J 765-1802 BUILDING DEPT. 1 NSPECTION FOUNDATION 1ST [ ] ROUGN PLBG. ]FOUNDATION 2ND [)INSULATION [ ]FRAMING [ ]FINAL REMARKS: 1 s'~ ~~+L~%M N~ o-~ loo w~. » ~.~.~-?~I DATE . 2- INSPECTOR V Q L 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. J~ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: c~.a~,b Kn.r~ ~ b-o e~a~,~.~,~p~ DATE 7 ao 1_ INSPECTOR G L ~o7q 1 ~ ~6s-tso2 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 18T [ ] ROUGN PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [xj FRAMING [ ] FnINAL REMARKS: ~'~.~%,aTU-~ 1 DATE 1- IN8PECTOR ~ L ao`7~) ass-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ROUGH PLBG. [ ]FOUNDATION 2ND [D~( INSULATION [ ]FRAMING [ ]FINAL REMARKS: )Zd.c,~.w Lrt,..,.~.r..t. a-l~ DATE ~ ~ ~ 9 INSPECTOR . L . ao~9~ ~ ~ss-~ BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [D~] FINAL REMARKS: ~ C . ~ O . DATE " 9 2- INSPECTOR l ~/F~ . r"lrc:.J i;::.:c .iJ:i y.~: I~ I~ „Jiii9tNIC 1 . I +m .~1 ?OUtIDATI09 (~st) I y J .p ~~~I I ~ - 'OUIJDATI011 (2nd) ~ y ~ m I d ~I :OUCH FRki~1E ~ I ° (N PLUMBING y ~ ) . 9' n ~ I fi~ :JJSULATID;f PER N, y, ~ m y m STATE Ei1ERGY II COD'c I ~ ' /7 ~ m y FIaAL I _1 M1 O „ov ADDITIOIIAL COMMEIJTS: m~ o~ ~~Q ~ 11a1 g2 x ~ ~ . m ~ - H ~ a p ' 9 r.~ C.o " ^iJ o ~ r N y / m ~ ~ d • o B0,\RD OF HEALTH FORM NO. 1 J SETS OF PL \:1S . TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT CIIECI: . TOWN HALL SEPTIC FOR:I . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTIFY; ~6~ is0y~ nn CALL Examined , , a~c~t , ~ , , , 19 9 ~ Pin I L TO Approved . 9.... , 1941. Permit No.~O? 9~.~ . ~ . . Disapproved a/c . .T.4 ......°k'- ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . a......, 19~0~ 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 pazt 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for nece rnspectio (Signature of applicant, or rTame, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. , G~~~;~........................J................................. .J Name of n r o pr ices QP,'QZ~e:. YJ/L.Q:~1". , ,Q . ~ 7 ~-C2 ~t.-. . (as on the Hax roll or latest deed) If ap i a o atio si re of dul a orized officer. ...............'......~~¢}~.~V~1...... x a e and title of corporate officer) B ilder's License No . . Plumber's License No. l ...P...... . Electrician's License No. ~ 9 ~ Other Trade's License No . . 1. Location of land on~wh~ch~proposed work will be done. ~.:~~-v: t": V,G-~iC~~/. - ~~[~f.. . Y....... Street Hamlet House Number ? County Tax Map No. 1000 Section /.n............ Block Lot ...b.! 3 ~-~j n Subdivision . ~=.G~C~Cht . ~.<-fi4~=:'........ Filed Map No. 7 ~ Lot . (Name) Z. 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 ~ ~ ~:-~c~V,t .~~~!-4'~~4 . ~i 3. Nature of work (check which applicable): New Building...... Addition Alteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost.~Sa.~.d~3a .......................Fee..~.7.7,•. (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . ,Ifgarage,numberofcazs 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 ...............NumberofStories........................................................ 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 . 1 1. 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 Pha~~ 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 cleazly 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 OF NEW Y R~,( S.S COUNTY OF ...A~~ 1. l • • • • ~.'N..~ ~ •~/1l ~%~'1.~~.......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the "15:.............................. (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. Swom to before me this ..daY~.. . J Vey.. 19 4 s~~~ Notary Public, ` `:.~ounty ART ~~~2'~~:~': " • ~.[1i . . 1. aILK (Signature of applicant) ~~I'31,18 -N- !~Z/* Prop wart a~2y°~'~ s.,s. ./qs LAME ~~OF. <not o . L43 e( Zo ~./s• p ~ of zz R'36'9.7g. R=32/.46' LN1972' L= 51.96' s . Sep~.c ' Pro 4 ~ ? Lys ~ ~l Prof, U Q' ~ hse I ;o V C~~RVgTApyy w /0' y /T E.q I I O ~ Q O .h ~~r L - ~ O /V ~ ~ O `V W Z 70.pp• el 2i ~ Q N 8/ %2~Oryy, rh N y e/ zo O/F /C`Olvc,., ~L ~ 2670' ~ ~~~rt' i ''q~vr ~ CQyPp AREA = 45,004 sq. ft. ~ E NOTE Sanitary sys m ~s rwt to be ~~~iQ-o placed under driveway arse. ~'f~/~y. /i93s~ SURVEY OF EXPIRES 3 YEARS~#TEOF~J~PF'RO~il11. s~u~i?'~a vuAS" t~v ~~rtuu~~ MO. Prepared M accordance w!!A Nre mtn6nwn A T 30U I nVLD, s/ondards /or 111M surve~ as srlabHshed TOWN OF $OUTHOLD 6 /M L.UA.L.S and ap oved and ado led TNIe AasocJo~.The n'Pw York S/a/e Lond SUFFOLK COUNTY, M Y. Ths wo/er supp/y and sswoye d/sposal ~ ~ ~ - P~~ ~ systems /w h!s residence wIN conlorm .SC819~ = 40r to alondards of Ths Sul/odr County Imenl o/ H,e~ja~lth~ ~Servlcss.I M8/Ch ~92 .OZ (~U/uu~7,uJ T e /ocalions o/ wells and cesspoo/s shown hereon aro /ram /le/d observallons and a from data ob/ainsd /ram others. t S 1St S Do- oe D ~R~~ ,.L'~~ SUFFOLK COUNTY DEPART?ENT of HEALTH sEAVICES ~ =v, FOfi APPROVAL OF CONSTRUCTION OILY Vwi ~ 9 N.Y.S. LIC. N0. 496/8 i . DATES. REF. N0. ~ MAY 23 1992 N ' YORS, P.C. 7 O . as p g S.C. DEPT. U~ APPROVED HEFL7ii SER'JIfES SO , N. Y. N97/ -N- /A~,te~,,,. P„P W~M Re2h ZT' s.,s. JA`s-"-'~ ,3 ' ~%O LANE ~ `Q`369~y. R=321.46' L=/19.72' L= 5/.96' ~~n93• ~-M.e9• e112 ~ u ~ z \ J~- - m N w / C~SERVA T/ON a ~ s6..,ede f»:, rw W rn.3~ ~ 35.0 ° _J /1• O /O O b EA'SE6AENT L ~ Q 0 0 ~ J t ma z ,o oo, ~ el 21 3 Q . ti ~ N 8/'/220-W ti FL pw~ ~L 264, e/ 20 ~ 70• ~ VACANT C,' `~rY ~ ~7~J~ ~ - AREA = 45,004 sq. ft. ~ z' Y~~ CERTIFIED TOE SURVEY OF THE LONG ISLAND SAVINGS BANK ~ O PECONIC PROPERTIES MANAGEMENT CORP. ~ S~~aO I~LAS'~ FF~ED JCIIiiE 2s, 1981 ~ 9297 Prepasd In occordonce wilh Jhe mo?rt/mum slav?dards /or 1/1/e surveys os esiobHrhed A T SDUTMOILD by /he L.I.A.L.S and approved and adop/sd TOWN OF SOUTHOLD /or such use by The New York S/o/s Lond SUFFOLK COUNTY, N. Y. TiIM Arsoclollon. Ths wo/er supply and sewage disposal ~0 - ~ ~ ~ P/~ ~ sys/sms for lh/a res/dence wN/ conform to the s/ondards of Ths Sullo~r County . SC8/9~ 4Qr Dsporlmenl of Health Servlcsa. March JG[ Y 15, 1992 (fglrfdBtliW!? The locallons o/ wells and cesspools shown hereon ore Isom /field obrervallons and or from do/o ob/alirod /ram others. .AND g ~n ~9 SUFFOLK COUNTY DFPARTAIENT OF HEALTH SERYiCE3 F`''r„~R Gc<`~ FOR APPROVAL OF CONSTRUCTIQJ ONLY 9 O r- , S L1C. NO. 496/8 rte, • _ DATE ws. REF. No. P fY ~ P.C. (J`/ ~ p P. O. ~ APPROVED MAMI SOUTHOLD, N. Y. 11971 ' 87- fo70 (2) SL'I`fi~~ ~~1 mi , i ~ r, r~r,CS eaT~OV 7~ is tf,.~ ~~t ~ ~ ~ 39 Tf)f yeµ 1Q9 Iilcrn. p a~~i '~qei r ~i nl~r i9 ~ ~_'S fOf Ii~iS J ~O~ieJ^il f..1e uC;.'. _ i i2!~U/vf offieraCt r~;f d~df.:;rda•.+` ~''r'!, ' Chief of vo of+ra>rzw~'.::r .;ianaLera~nt K~M o°~ ~'QSM/ ' R~23 ,2~ S's'43~0 F esis ~E LANE R'36g~•g,, I R=32/.46' L=119.72' L= 5/.96' L.T~~, LM/.B9' i M j 33.q~• ~ I ~ 1 ` /05~. /3.4' ~ 2G.0 W I V CONSERVA T/ON w /03~ o Z.ty/~ Cr. w (w .35.3' ~ `_J S /,'1' O ~ /w ~Q ~ ~A EASEMENT ~ O ~ ~ _ ~ ~ ~ ~a ? • 3 N 8/%22O~W, ti N/p/F F~pwER 6(/~ 2s4,TO. ~ VACANT ~ • CARP. AREA = 45,004 sq. ft. CERTIFIED TOE SURVEY OF THE LONG ISLAND SAVINGS BANK PECONIC PROPERTIES MANAG MENT CORP. ~3~~ //y3 ~~k ~1.~ //93~ ~~MAPOiFSourTi,a~to vuAS„ FLED .IlA4E 2'S, 1992~//'P /MQ 9287 Prspored /n occordonce wph the m/nlmum s/ondords /or 1/lle surveys as et/oDUshed A T SOUTHOLD by the L.LA.L.S. and approved and odop/ed TOWN OF SOUTHOLD Jor ruck use 6y The New York Slo1e Land SUFFOLK COUNTY, N. Y. Tl1M AsaoclaNon. The wafer supply and sewage disposal ~ ~ p~~ ~ sys/ems for ihls residence w!ll con/orm ~ to the slondords of The Su//olk Counly SCA~B~ ~ = 40 Deparlmenl o/ Heollh Serv)ces. March X992 JGC Y 15, J992 (f«ndat/on1 The /ocaUons of wells and cesspools shown hereon are from 1leld pCt.24,1992(filllal~ observaJlons and or /Tom dala obloined from others. ~ lAt~a/F~. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~.N'4• "~~'°'':°{~'A/~ FOR APPROVAL OF CONSTRUCTKIN ONLY LIC. NO. 496/8 92 SO 99 r' ' ?-r- DATE wS. REF. No. ~ ~i ~ PE ~ C Y P.C. rsr ono ~ P. O. . a ypQ' APPROVED ; NEW t ~ SOUTHO 1197/