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HomeMy WebLinkAbout20796-Z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21162 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 95 APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 Lot I8 Subdivision SOUTHOLD VILLAS Filed Map No. 9737 Lot No. 7 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 20796-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-44-NOV. 17, 1992 UNDERWRITERS CERTIFICATE N0. PENDING - NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992- ARTHUR MALAUSSENA, JR. ing Inspector Rev. 1/81 If0>mL N0. f TOWN OF SOUTHOLD lUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°~1° 2079BZ gate ........~....9 ~9..Y~-- Permission is hereby granted to: to . \.:!~:^~,-M:isS.~.-....fd.,.. V,l1.Q.... --..d..~~:KaGe!'.`.~ ...~....~.~.~I.1..~...... at premises located at ...L.~...:."~r11~:4.q....:~'?~!~u c~'R:isfsL/:ie.~.PR:...............~...... County Tox Map No. 1000 Section .....C'~~.0....... Block Lot No....Q..N pursuant to application dated .....~..,~rt~4.)......~.- 19.Q.~c; and approved by the Building Inspector. „JJ I Fee 5...1.~1.:.~~. .....,tit~.11.w. . Bui ing inspector Rev. 6/30/80 r Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOSJN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, 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 aad 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.l8,.1992. New Construction........... Old Or Pre-existing Building Location of Property...,,,.95 APPLE CODRT SOUTHOLD, NEW YORK . House No. Street Hamlet Onwer or Owners of Property..........,,PECONIC.PROPERTIES.MANAGEMENT INC:. . . . County Tax Map No 1000, Section...69.........Block...3............Lot...18 Subdivision..N(0•SOUTHOLD.VILi.AS,,,,,,,,,,,,,,,Filed Map.. 9737 .....Lot..................... Permit No..ZQJp~~........Date Of Permit..:~Y.9,,1992 „ Applicant.,DONALD BRACKEN Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Fin Certicate........... Fee Submitted: 25•~~ Qz.~ . fI S ? I y APPI.LCANT cD-~a~i~2 _ _ _ _T i I THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1.Nq%837 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEMPER 25,19A7 Application No. on file 7Si705492/9"L N 258436 THIS CERTIFIES THAT only the electrical equipment as described bebta and introduced by the applicant homed on the above application number in the premises of ~ HAEG~SOUTNOLD VILLAS, 95 APPLE COURT, 30887, SOUTNOLD, N. Y. s` ~ in the ollouin location; ® Basement f g ~I let Ff. ©2nd Fl. OUT .Sertion Block lut una esarnined un NOVEMBER 19,1992 ondfound[u br in cornplianre with the reyuirententa q(thia Board. t FIXTURE FIXTURES RANGES COOKING DFCKS OVENS DISH WASXERS EXXAUST FANS OUTLETS ECEITACLES SWITCHES INCANDESCENTFIVORESCENT OTNEfl AMT. K. W. MIT. K. W. AML. K.W. AML. K.W. AMT. N.P. t. 76 15 11 1 F DRYERS FURNACE MOTORS FUTURE APPIIANC! FEEDERS SPKIAL REC'PT TIME CltxKS RELL UNIT HEATERS MULTI-tX1TlET DIMMERS ` AMT. K. W. Oll N. P. GAS N. P. AMi. NO. A. W. G AMi. AMP. AMT. AMPS. TRANS. AMi. N. P. NO. OF FEET u^T~ WATTS F 2 5@RVICE DISCONNECT NO.OF S E R V 1 C E AMi. AMP. TYPE METER I g tW 1 ~ 3W O .a 3W ~ A ~W NO. Of CC COND. A W G. NO. Of HLIEG A. W' O. NO. Of NEUTRALS A. W G. EQUIP. PFR d OF CC.COND. Oi NbIEG OP NEUTRAL 200 CB 1 R I 2/0 ! 2iP ii OTHER APPARATUS: ~.II-2 SMOKE DETECTOR:-1 i - ~ ~ ! SPUDS ELECTRIC SER.ViCE LI:C.#192E Y ?.75 3RD. ST. BOH 166 ~ OENERAI MANAGN ST. •.7AHES, NY, 117hF 11. ~ I Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thlir credentials. CO I DING DE ARTMENT. HIS CO OF ERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. y S~FF~(~-`, TEL. 765-1802 o 1_ TOWN OF SOR7TDOLD f ' " - ~c OFFICE OF IIUILDIIQG INSPECTOR ~ T P.O. BOX 1179 TOWN HALL • O/~~! ~,OQ~ SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N a Date Building Permit No. Q ~ 9~j Owner - (please print) Plusher r(7F~ut°_ ~G,QrjlS,~N~Vif~ (pease print) 31 -p~ I certify that the solder used in the water supply system contains less than 2/10 of lg lead. (plumber's signature) Sworn to beforn~e~_,m`~e- `~this day of ~17~~r 19 , Notary Public notary Public, County MARYANNE E. DOWLING Notary Public, State of New York No. 5000030 CommOiss on' Exoires August 3,t199~ - a o 7 91s 765-i80Z BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ROUGN PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [pQ FRAMING [ ]FINAL REMARKS: o a~_ DATE ~a ~ ~y INSPECTOR a079to,~.,, 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ ~'o ~s~c~ DATE ~ -Zg °1 INSPECTOR 07 91, 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING (DC] FINAL REMARKS: e~ ~ C , e. DATE l °I 9 INSPECTOR Y ~i L I~ I~ ..U:`(i1tNi~ 1. - / ~ _ m ~U • I ~ H ?OUtIDATION s t l I G' ~n c 'OUtJDATI0;1 (2nd) 7 ,Z WYL m b • 4 y. o .p ;OUCH FRki~IE ~ I N PLUMBING 3 . ~ 0~61~-- ~ y m =21SULATION PER N. Y, I y STATE EilERGY II CODs I ~ : • I ~ y • FZ;IAL • o ADDITIOPIAL COMMENTS: x~, ~~._..pp m _ H ~ d • ~ t H n C.o o ~ cJ~c - m •Jv a ~ ~ y ~ ~ m ~ ~ ~ y a t ' BO.\RD OF HEALTH FORM NO. t ~ SETS OF PL \tiS . TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT CI(CCI: . . . . TOWN HALL sl:rTlc Foatt . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:oT1FY; ~6~ 6~r/~ q CALL Examined 19 ! p Q [•IAIL TO: APProved J.. , 19Q1. Permit No.e~<?~.f.~~.~ . • . . Disapproved a/c . r5~~'`•'. ' (Building Inspector) APPLICATION FOR BUILDING PERMIT p Date/~ a......, 19 70~ INSTRUCTIONS L a. Tlus 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 neces inspections - , (Signature of applicant, or n me, if a corporation) (Mailing addr ss of app]' ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ .:..~ti . / Name of ow roof remises ~ 0 (as on t e tax roll or latest deed) If ap lic a or o lion, //gnature of duly authorized officer. S~ . ~ e and title of corporate officer) uilid`ellr's License No . . Plumber's License No. ~ ~,31..~.......... Electrician's License No. ~ 9a. ~ . . Other Trade's License No . ~I~ y9 I. Location of land on which proposed work will be done. A. , ~~ti~/ aj'~ House Number ~jStreet Hamlet / County Tax Map No. 1000 Section ,/.Q......... Block ~ ~ Lot . o o Subdivision . ~ .'9-e:L~~O:'~~' CC ~~Q:.......... Filed Map No. ..7. 3 Lot . . (Name) 2. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy • • A~................ . b. Intended use and occupancy f .1 . . f c~ 3. Nature of work (check which applicable): New Building Addition Alteration epair Removal Demolition Othet 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, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each t 7. Dimensions of existing structures, if any: Front Rear ype of use . Depth............... Height Number of Stories . imensions of same structure with alterations or additions: Front Rear . epth Height ......................Number of Stories . 8. Dimensions of entire new construction: Front : ' ' ' ' ' ' ' • Rear ...............Depth eight Number of Stories 9. Size of lot: Front ' ' ' ' • • • • • • Rear...................... Depth 10. Date of Purchase " " " " • • Name of Former Owner Zone or use district in which premises are situated . oes proposed construction violate any zoning law, ordinance or regulation: . 3. 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 .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 ]ot. STATE OF NEW YgRI~_ COUNT OF l~ S.S t~N•~•~ • • • • • • • • • . • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ontractor, 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 t manner set forth in the application filed therewith. Sworn to before me this Notary Public, ~`-\J~ , , • • • • • S~• • .County ROBERT L SCOTL llY. . ~~~:~~~LX~i ;~'~u'!v!'.. . NOTARY PUBLIC, . Na 4125089, (Signature of applicant) Term Expires May 3 ,19 1 ~ v -N- `S's ~1F~ pfi 4'~O y- T -JN `j5 ~ O ~o ~ / , x~ ~ ~6~ (o p vY + ~ T J~ 0` ,i 3y~SC1 V `v/ _ V ~`C ^y. ~"a°' bO ~3,y33 ~ 'V S~~c1~~J,1,1~L8JJ~---..__. lT~ M1y, t ./q lq~ AREA= 10,093 sc}ft. ~ ~ ~ ~ ~ 9 3s-- SURVEY OF F"MU.v ~rouarc ar~Y LOT 7 E~PtRES 3 YE~RSf~t'IM p,~T~gFIY+PROYl11.. ,yam o,~ soun~ato vuAS•• FtEV ~ Prepared !n accordance wUh the mJn/mwn 14 T SOUS-`y1 s D slandards Jor 111/e rurwys as ss/obUshed ~ /7VL by /ae L./..4.L.S. and opprovsd and adopted TOWN OF SOUTHOLD for such uce by Ths New York S/ols Land SUFFOLK COi/WTY, l1~ Y. Tills Assoclol/on. The wa/sr supply and ssways aYsposa/ X100 - 70 - 01- P/D Od systems /or hh: rsr/dsnce w!ll conlorm , ~ l0 the s/ondards o/ The Sul/opt Coun/y .SCale~ r = 3U D1e~a menl o/nnHeaJJh Serv/cer/ n I ti/~T/C/'/ ~ 1Yfe ~22.~~ ~CL~~~~C~9X~~1 /ocollons o/ wells and cssrpools shown hereon are /rom /le/d observollonr and or lrom data oblalned lrom others. 4`/ S `~'f • 340 0- o o ~(~?0(/q~,; J~ ~ ~o ~.nNO sty SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ` ~ L~ 1] + ~t • ~E 9 6~ ~l,~:~, a C `8` FOR APPROVAL OF CONSTRUCTION ONLY ~x V~' ~A ~~X ~ N.Y.S. LIC. NO. 496/8 °..r . DAr REF. N0. ~ ~4Y'2g 1992 ~ EYORS, P.C. ~ /a~ ~iko 09 APPROVED NEACTH ERV ~E S N D, N. Y. 11971 1 ~~IP s~~~ ~r ~k 3s O ~o ~ / ~a. 'A" P~> `~h ~ t p 6~a `OC~b r ~S , v - o 0 rye. V v ~Y\~ v t t f , ~q~ AREA= 1I0,0~3d~ft ~'1~ 9y~ Vag. $~~y ~ QERTiFi~ TOt ~A/~ savers euuMr LC~T ~colrrrc Pl~Rrl~s ~uaiwaow~Nr cc~,? "#~f~P QFS+GlIThKaLL? VLl./IS'N R~.~E2~et ~ts~ Prepared !n accorda?n with the ~hlmorn A T s+~xy~ ~ t/anafaraEr for Ntie swveyr as er1al~Mihed r0~~ ~ ~s [~rvs.IVT~~O 1 liie L.LA.L.S au~d approved aad led ~rta ~,~o %ir~. rh. New Ywk Sla!°~io~d .Si/FFCKI ~ C:~O~LNR`Y 11 L Y. The walsr syop/y and sewage aYcporal - ~ - ~ - P/D syshn~s /a Mb rer/dencs wLY co~nlorm ~ , to h1e rlandara~ of The Sulloht Counly S~ ~ s Deparlmenl of Hsalhl Services. ~ g1 Y ~~OfOli~ Tla /ocaNons of we/k avrd cesspools shown hereoM ore /ran ,veld observahbns and or lrom dolo o6lalned lrovs ohlers. • ~~IANDSli fit. ~eF~ 9L ~ F suFPOUC ccwwrY oErARr?o+r of ?~Eea.rH sERwcES ~9 `o ROR APPROVAL OF CONSTRUCTION ONLY n~ r ~ .S. LIC. NO. 496/8 DATE No. S, P.C. i ~ 469 APPROVED 1 MadN SOL7HOL0, N. Y. 1197/ g7-(070 (7) • E. 9 NO V 17..139 gar S Q ~ ~ a Ci `Jfy ~ o. 'sNS,t~x'at°r h?anagement -N- ~ `S's ~1a ~~s O`?~ 2F~' q O 7 6 ~ G,ir 35 .h h 3 ~ ~,o" ~ ~~o i 3 "'s a ~y yk1 a 6i~~ ti h 'a ~ o P r ~ o~ N, e S a ~ ~ (00\ `~S ~ ~ ~O ' O /3933- Q liy~~T ^p _ ~8 ~ QQ ro S Q o- ['qNE AREA= 10, 093 sq. ft. SURVEY OF CERTIFIED TOE / O THE LONG ISLAM SAViWGS BANK PEC011pC PROPERTIES A/ANAGEXIENT CORP. ~~MAP ~ S ~(ASrr 0 13~ I/Y3 ~~~~'f`°~'"~ J~~ //935 FLEpJr~1~E25.1~82MAPM0 9287 Prepaed In accordance wllh lle minlmum A T SOUTHOLD s/andarda for 11l/e surveys os es/ab/lshed TOWN OF SOUTHOLD by 1M L.~A.L.S. and pproved and adop/ed /or such by the Msw nark S,a/e Lane SUFFOLK COUNTY N. Y. T/lb Assoclallon. ~ ~ Ths water suyyp/y and sewage dlsposal - - ~1- PLO ~ sys/sms /or Ihls residence wpl conform SC~d9~ 1~~= 3f~r to the s/andwds o/ The Sullo/k County Depar/msnl o/ Health Serv/css. March 11, 1992 .IUL Y 15, 1982 (forar~dat/on) The /ocoJlons o/ wells and cesspools shown hereon are /ram /le/d OCi. 24,1992 (fN1Bl) observollons and or /ram data ob/oined /ram others. . 9UFFOU( COUNTY DEPARTMENT OF HEALTH SERVICES t( ~M ~y ~ FOR APPROVAL OF CONSTRUCTION ONLY y y~/ 1 4~1~ .S. L/C. N0. 496/8 92 SO 44 DATE REF. NO. NOY IS 1992 P lG: SURVE , P.C. ~ ~ 'l ''l S.C. DEPT. OF ~ ~ O APPROVED HEALTH SERVICES SOOT !1971