HomeMy WebLinkAbout20799-Z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22025 Date DECEMBER 14, 1992
THIS CERTIFIES that the building NEW DWELLING
Location of Property 235 APPLE COURT SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 69 Block 3 Lot 21
Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 10
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 2, 1992 pursuant to which
Building Permit No. 20799-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 (1ST FLOOR ONLY) AS APPLIED FOR
The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-47 - NOV. 17, 1992
UNDERWRITERS CERTIFICATE NO. N-258833 - DECEMBER 2, 1992
PLUMBERS CERTIFICATION DATED QCT. 8, 1992 - ARTHUR MALAUSSENA JR.
Building Inspector
Rev. 1/81
l08M NO. f
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~.1T° 20798 Z Date ..........~.....9 19g.~
Permission is hereby granted to:
~I.
c.,rr~e:s:..V.... ..~a~~~,,. c.
4.~..
.C.~~.,rg.,... ~ • I. ! 9 3
at premises located at ..r~,.3~. ~
. ~:~~~~~...........l...o......
.
County Tax Map No. 1000 Section .....0((~~~.0...... Block Lot No.....~..~R...........
pursuant to application dated ......~..A~:~w....,~ 19.q.'~ and approved by the
Building Inspector. 1
Fee S...L1..~!..~...
. .
Bu ing Inspector
sal
Rev. 6/30/80
r? ~ r,"~ w., Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
i
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 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...a3.,~J.. ,~°~}n.;~',,,,,,,,,,•,••••,••••SOUT90LD: NEW•YORR.
House No. ~ Street Hamlet
Onwer or Owners of Property..........,,PECONIC PROPERTIES MANAGEMENT INC:.
County Tax Map No 1000, Section......V.l.....B1ock.....~.........Lot...l!~ !
Subdivision..M(O•SOUTHOLD•VILI.AS••••.•,. ,,,,,Filed Map.. 9737.....Lot..lO
~ ' ~ r r JULY 9 1992 • , DONALD BRACKEN
Permit No.v.~~,(1.. :....Date Of Permit.......... Applicant
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for; Temporary Certificate........... Final Certicate...........
Fee Submitted: $....25•~U /
(~~C • y ~ ~ .
CO ~ APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS enc6 1
1.000837 BVREAU OF ELECTRICITY
BS JOHN STREET. NEW YORK, NEW YORK 10038
Date DBCBHBBR 02,1992 ApplirationNo.onfile 78705792(92 N 258833
THIS CEF2TIFIES THAT
only the electrical equipment a described below and in[roduced by the applicant nomad on [he oboes application number in thepremises of
BBRGONIlBBNJAHIN, 235 APPLB COURT, J08t10, SOUTHOLD, N.Y,
in the following kECationc ®Baaement ® let FL ®Ynd F'l. D(1T Ser[ion Block lot
uoa examined on NOVBHBBR 25,1.992 and found to be in comp/ianre uilh the reyuirementa of Chia Roord.
gXTUIIE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWtTCNES INCANDESCENT-rIVORESCENT OTHER AMT. K.W. NAT. K.W. AMT. K.W. AMT. K.W. AMT. X.P.
it 31 18 11
DRYERS FURNACE MOTORS RITURE AMIIANC! EElDERS SMGAL RK'?T TIME CLOCKS ~U UNIT NEATRK MULTI.OUTIEf DIMMERS
AMT. K. W. Oll N. I. GA] N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMTS. TRANS. AMT. M. SYSTEMS AMT. WA1T5
NO.O? 1@T
3 P 2 - - 2
SERVIC7 DISCONNECT NO.OF S E R V I C E
AMT. AMI. ttPE METER 1 A ]W 1 R 3W ] B ]W ] / AW NO.OF CC COND. A. W.O. NO. Or NI-lEG A' W' G' NO. Or NFUTKAlS A. W.G.
FOUI?. IER d OF CC. COND. OF NI-LEG OF NEVTEAI
1 100 CB 1 B 1 4 1 4
OTHER APPARATUS:
HOTORS:1'P H.P.
G.F.C.Ic-2
SMOBB DBTBCTOR:-2
SPUDS BLBCTRIC SBRVICB LIC.t192 B
~°l
175 3RD. ST. BO% 166
TFNEERAL MANAWR
ST. JAMBS, NY, 11780 11
Per r Y
This certificaro must not be altered in any manner; return to tht office of the Eoard if incorrect. Inspectors may be identified by their crodsntials.
S~EFOL,~-~, TEL. 765-1802
a .:w.,y: 1- 0~~ TOIVN OF SOriJT~Ob.D
f • ~ OFFICE OF BUILDIIQG INSPECTOR
° ~ P.O. BOX 1179
v~~ 31~ rn
e?,~ TONN HALL
O!~~l ~~Q SOUTHULD, N.Y. 11971
C E R T I F I C A T I O N
Date l~ 8
Building Permit No, D ~ ~ ~
Owner '
(plea~Js~e print)
Plumber +t'"Tf{(.~'/°ltlC~{'/5~~16~j~T,P~ .
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of lg lead.
llG.~
(plumber's signature)
Sworn to beforr_ me``this
day of ~LM.~-__i.
19 ~
M I~ Notary Public
17otary Public, lh-Y'r, County
hNA Pub1iN S ace o
New York
Notary No.500003Q r~ty
{lualified in Suffolkust 3, 19>~
rr;inss~on Expires Aug
ao799~.
ass-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST ROUGH PLBG..
]FOUNDATION 2ND [ ]INSULATION
~J FRAMING [ ] nFINAL
REMARKS: ~o `fro-_--~---'~a -
DATE ~ ~ Z-' ~ INSPECTOR Y~„_
ao79 4 ~ t o
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST ( ) ROUGH PLBG.
[ ]FOUNDATION 2ND INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: D-i~'c ~ C
DATE 1 1 1- INSPECTOR G L
a o 7
765-1802
BUILDING DEPT.
i NSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[)FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING FINAL
REMARKS: 1~ 9~. C
DATE t Z ~ ~ ~ INSPECTOR Y
'1' D i;:S: I...:J:i ~~D
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?OUtIDATIOV (1st) I .a
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=17SULATIO;! PER N. Y, I • _ y
STATE EiIERGY II
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ADDITIOPIAL COMMENTS: J
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' BOARD OF HEALTH
- FORMNO.1 3 SETS OF PLAtiS
TOWN OF SOUTHOLD SURVEY . . .
BUILDING DEPARTMENT C3IEC>; . .
TOWN HALL SEPTIC FORt! . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:OTIFY; . •L-,6.~_ ~/o~~
CALL L
Examined . , 9 , 19 qL MA Z L T 0
Approved . 1992 Permit No..ZO~ 9. 1 . .
Disapproved a/c
~s~..
?-~-P~....... '
(Bui ding Inspector)
APPLICATION FOR BUILDING PERMIT
p
Date . ~~~GC~..~ 19 .9.a
INSTRUCTIONS UU
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/~ mspectio
//.~(,S/ignatu/r/e of appli~ca-nit, or n~e, if a corpo/r/ation)
(Mailing address of applicant)
State whether a~p~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
e~~. -:..~~u.4 O~Q~ .
~
Name of ow of premises .~/./.~?Q.~ZL~../~~~6
: , ;t.P-,O ~y~~.. ~a~u, ,
(as on the talc roll or latest deed)
If ap lic a c p r ion, 'gnature of duly authorized officer.
( a e and title of corporate officer)
Builder's License No . .
Plumber's License No. ~ . .
Electrician's License No. E .
Other Trade's License No .
r, _ ~9
1. Location~of lan~d~/o~n w~h/i/ch p~rJoposed work will be done. ,(!,r~ , , ,~;~v( , , .
House Number li ~~77Street Hanilet /
County Tax Map/No. 1000 Section/..... F,l.Q......... Block G?/........r-.~. Lot ...:4
Subdivision ...tihry~-(~:.i!~~~,~?............ Filed Map No. ~ ~ .3 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 . 1..~4~: r~ . ~~U:/.'OGK~ .
3. Nature of work (check which applicable): New Building Addition Alteration
epair Removal Demolition Other Work .
(Description)
4. Estimated Cost Fee..........................
(to be paid on tiling 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
YPeofuse
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 .
Dimensions of entire new construction: Front Rear De th
Height P
Number of Stories
Size of lot: Front Rear .
Depth
]0. 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: .
Will lot be regraded ............................Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ....................Address ...................Phone No......... .
ame 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 YO S.S
COUNTY OF C~ . .
• • •^~ff• ~ • • • ~~~G~~•'• ~ • • • • • • • • • • 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 the manner set forth in the application filed therewith.
Sworn to before me this
Notary Public, ...........`?1, , , CouvnFtyb
~ /
. - - J
OBERT L SCOTT JR. i' ....U. F'~•!rcrGd~t.'.. 'U~
: .
NOTARY PUBLIC, State of KC /1 (Signature of a )
No. 4725089, Suffolk Co~t~ v pplicant
Term Expires May 31,19`C!C
Nip~F
~ , RUSE<< '~'9~1iV
1~9 2 4s~o• F.
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AREA . 1,'075 s¢fi. ~ so.oo"" ~
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SINGLE FAMILY
EXPIRES ,3 YEARS FROM Qgrt
a~Y
SM/NE ~A~, ~KPPROVAi,
o iiy%~ ~ S(~4VEY OF
~~93 - LOT l o
PLEASE NOTE 'MAPQFSOUTHIOILD VLLAS"
Prepared /n accordance wnn N,e mina?,um Sanitary system is not to be A41PNIb
standards /a llx. rwveys os srlaiblkhed placed under driveway area.. AT SOUTHOCD
ay /h. L.ta.LS a?d aappproved a?d odop/sd TOWN OF SOUTMOLD
for such use by TM /Ww Yak Stale Land
Tllh. AssodoNon. SUFFOLK COUVVTY, NL Y.
Ths water supply and sewage d/spord ~0 - ~ - Or - P/O OQ
aye/ems /a thk residence wlM conJam ~ i
10 /M standards o/ Th. Sullolk County $Cab~ 1 = 30
l oua~~~~~ srv,~.. March 1 Z 1982
T e locollons o/ ws6s and cesspools shown Mreon are tram /k/d
obsavatkms and or tram data ob/aJned Iron others. t Ate ~ S,
SUFFOLK COUNTY DEPARTMElIT OF HEALTH SERVICES ~yiL.~~~3~,~~J;'1 9 ~ /~iva~~y~
FOR APPROVAL OF CONSTRUCTION OPLY " " J ~
JUN 02~ p _ ~'"4Y ~ A N.Y.S. L1C. NO. 496/e
DATE REF. NO. 701 J$~ ' ~ 1~ EYORS P.C.
20 ~
n uF~f AIAN+1 OAD 909
APPROVED ~•lr~„g~Rv`~p SOUTHOLD, N. Y. 1197/
. , n , ~ , . , , 67D (!0)
Nip~F
~ ~tis~~ M'4ti1V
8119 ~z 460. ~ M'4~V
2S.
• cONSFRIi 90,pO,
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AREA . 1073 ac~ff. R.5o.o0•, ~
~,~p0~j L=32.94
~ v 2~.~
~ yeos, p0,
~ 0~
W ~ V
T~Q'V
P \O'
'P. V -Z.v~ ~ n
P ~ U ~w
./gSM~NE LgNE
~~oNCTis am sa vacs e,~nx~ SURVEY OF
PECOIWC PROPERTIES A1.4NAGEIHENT CORP. ~ O ~ 10
"MAP QF SO~UTHaLD ViLAS..
Prspasd In occordoncs wllh the miNmum ~~'~~~''f~~P~ X87
standards for 1qM survsys ar salai6Nslred A T SCUlTHOLD
by !h. L.l.,a.LS and o~rovsd and adopted TOWN ~ SOUTHOLD
/or such use by Ths New York Sle/e Land c~^' ~ ^Of ~'Tv AI v
TINe Assoclalion. J VL V V'? '''1ti I.
Ths water supp/y and sswoye aYaposal - ~ - - /~/0 0~
systems /or Pis residence w/N conlarm ~
fo Jhs s/andards of TAs Su/!o/k County SCa/9~ r = .30
Deportment o/ Health SsrWces. ~ ~92
The locaJiona o! wells and cesspools shown hereon ors tram lied .Ir/r Y 1g8?
observoJlons and or tram Bolo ob/a/ned /iom others.
su~otx counrr oFrAR~r aF NTH sExvices ~~a; s,
FOR APPROVAL OF CONSTRUCTION OpLY ,
' .Y.S LIC. N0. 496/8
y
oArE ~ ~ O~ V~ S, P.C.
/ - ao
. $t?X 9
APPROVen ~ N 3 ~
S vJ ~/A/9 7/
- it C.~ 1 1 1 1 /1 a 8~ 8/0 ~N~
Nip~F
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~ s '2.46/0` F ~ ./pqN MgNN
23, coN R~ ~ ~ i
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AREA = 13,073 sq.ff. ~ R=so.oo~, ~
~Oaj ~ x32.94
~0~.
Q
v
~9. L
< yeoo,
OJ
W ~ ~
8~
Pp 5 -
2 ~ ~ ~V 1 ~ i~s2 . ~ ; ~ s o ~j
•
Q'/` O~flc i d4 i 1 /'ir L i ~ ~c r~ I,.t'Uj .
Chief c(~ rzau of Was:e•vater Management
?gsM~NE LgNE
`r~HE'~co°vG
i°s~an~o sa wNGS ean~ .SURVEY OF
PECONIC PROPERTIES MANAGEII~NT CORP.
~ ~ ~~~3 C~~~~ ~~9~ ~ LOT 10
o,F soun~acv visas„
RED.~25. 1~~uwMO 837
Prspwed !n accordance w!!h the minlmum
s/w~dads /or Mlle surveys os eslabNshsd AT SOUTHOLD
by the L.ca.LS and a ovsd and odop/ed TOWN OF SOUTHOLD
/or sud, use by The New York Stole sand SUFFOLK COUNTY, N. Y.
Tllle Assoclallon.
The water supply and sewage disposal - 70 - 01- P/~ OB
sys/ems for his res/dsnce wlN conlorm
l0 1he standards of The Su/talk County SCii/9~ = .~Q r
DspoiJmenl o/ HsaNh ServJrss. l~18/ClI 892
.ICJL Y 15, 1882 (founa(at/on)
The loca!lons o/ weNs and cesspoo/s shown hsrson ais tram lls/d
observoJlons and or tram da/a ob/a/nsd bom o/hsrs. pC~ , _ ~a
~ .
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES [~~/p1?~~~,~~`~
FON APPROVAL OF CONSTRUCTKkI OPLY ~s O
DATE 92 SO 47 ~ ~ "~•Y.S. LlC NO. 496!8
M
uc REF. N0. nY? ZS ~ fJI > RS, P.C.
P. O. 09
APPROVED L s~~
~T ~ MANV ROAD
~~~+iL SOUTHOLD, N. Y. 1197/