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HomeMy WebLinkAbout20801-Z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22023 Date DECEMBER 14, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property Z50 APPLE COURT SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.5 Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 pursuant to which Building Permit No. 20801-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 MAxAI;F'xRxm INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-49-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258830 - DECEMBER 2, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALAUSSENA JR. Oa.. M. uilding Inspector Rev. 1/81 10ftM N0. f TOWN OF SOUTHOLD IUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°1V° 20801 Z Date )93.a.- Permission is hereby granted to: ~.A~.r?w(t...lY~6t,e. GInMR4wr7. ~1 .~tx...l.f.~ 3 to .~~Sl!!`.'A~AesA~..91.c..4~Y.SA..... 4~Y1M~... f.R?'4 ...A!~....Y~:~~. .....1.................5,~.,~..~.......~................. ~ ~ at premises located at ...wZi k:,Rr4S!'R!7~..... .~:;a...e.........l.. . County Tax Map No. 1000 Section .....Q~.~........ Block Lot No....~..~........... pursuant to application dated a++.s 19~~--~ and approved by the Building Inspector. Fee S..'...L7.~ ......1 ~..t u i I or so-. Rev. 6/30/80 1 Form No. 6 ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL L~_'v ~ I ~u`~2 765-1802 APPLICATION FOR CERTIFICATE OF OCCU1yANCY 'fHOLD ......,m 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...c~..S.Q.... -Q4-. ~-.4?^~?t' .SOUTHOLD: NEA YORK. House No. Street Hamlet Onwer or Owners of Proper ty...........,PECONIC PROPERTIES MANAGEMENT INC: . . County Tax Map No 1000, Section..._ 7 ~ ......Block....f...........Lot...(P:~ Subdivision..M(O.SOOTHOLD,VILLAS,,,,,,,,,,,,,„ piled Map.. 9737.....Lot..J~................. Permit No. ,14.2='.~.~ ....Date Of Permit..:~Y.9~.1992..Applicant..DONALD.BRACREN Health Dept. Approval ..........Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitlt`ed: $~./...25•~~ A,g /q,~/~J/~ ,p `3~-LC.~ l So~.~QY' • •if l~'F~CF:LL~?:-:,1:4~i~~:(/ C ~ ~ O APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS Pnc6 1 1.000B31 BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK, NEW YORK 70038 Date DBCBHBBR 0'1,199[ APP/icationNo. on file 7870599"192 N 25BB30 THIS CERTIFIES THAT only the electrical equipment as deurifted bebRO and introduced by the applicont nomad on the ohoDe application numher in the premises of LYBURT SOUTNOLD VILLAS, 250 APPLB COURT, JOBO1Z, SOUTHOLD, N.'i. in thefol/auinA location; ®Baaement ® let Fl. ®2nd FL OIIT .Section Block Lo[ nos examined un NOVEHBBR 25,1992 andfoundWbr in compliance uifh the requirenwnts v/this Buard. HXTURE ECEPTACLES SWITCNES RXTURES RANGES COOKING DKKS OVENS DISH WASHERS EXHAUST FANS OUTLETS MCANDESCFNifIVORESCFNi OTHER AMT. K.W. AMi. K.W. AMi. K.W. AMT. K.W. AMT. N.P. 15 25 15 15 DRYERS FURNACE MOTORS WTURF APPUANC! FEEDERS SPECIAL REC'?T TIME CLOCKS FELL UNIT NEATERS MIHTI-OUTLET DIMMERS SYSTFMS AMT. K. W. Oll V N. P. GAS H. P. AMT. NO. A. w). G. gAMT. AMP. AMi. AMPS. TRSANS. AMT. N. P. OF FEET AMi. WATiS Y 1 1< f. d SERVICE DISCONNKT NO. of 5 E R V I C E AMi. AMP. ME METER 1,I ]W I ,e ]W J d ~W 3,e KW NO. OF CC COND. A W G. NO. Of HbIEG A' W' G' NO. OP NEUTRAIE 1. W G. FOUI?. PERb Of CC.LOND. Of NEIEG Of NEVTRAI L 100 CB 1 % 1 4 1 4 OTNFR APPARATUS: HOTORSt1-F H.P. L. F. C. T1-3 SHOKB DBTBCTOR:-1 - ~s~ SPUDS BLBCTRIC 96RVICE 1.IC'.11926 G/~~~ 175 3RD. ST. HO% 166 OENRRAL MANAGER ST. JAN6.5, N1', 11780 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenliols. COPY FOR BUILDING DEPARTMENT. TN S Y ICATE MUST NOT BE ALTERED IN ANY MANNER. c~VFF~(,~ TEL. 765-1802 o~~ TORN OF SOriJT~OLD ~ < ~ ' ~ OFFICE OF BUILDII.7G INSPECTOR P.O. BOX 1179 c?? ~ 'r TOWN HALL %,~Ol ~bp~ SOUTHOLD, N.Y. ] 1971 C E R T I F I C A T I O N Date ~ Q~ Buildirq Permit No. p8'p/ Owner ' Q~(~p~lea//sJe print) ~`w Plutsber rl~tc/H41~/~(a/~(~~c'nftVi~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of lg lead. _ ' (plumber's signature) Sw n to beforn_ mo this .day of d 19~. otary Public tlotary Public, Sll~n~~ , County Notary Public, 5 ate Oof New York No. 5000030 Ctualifie0 in Suffolk County Commission Expues August 3, 198 aQBo~-~ ~6s-isos BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ~j FRAMING [ ]FINAL REMARKS: DATE I,~ ~ L INSPECTOR ~~i L ~oBa~~ ~ ~i 7~~1~~. suILDING DEPT. 1 NSPECTION (]FOUNDATION iST ( )ROUGH PLBG. ]FOUNDATION 2ND [os] INSULATION [ ]FRAMING [ ]~FI•N,AL REMARKS: o-~c °P'o C~wwK DATE ~ z INSPECTOR aC~$ol ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ( ]ROUGH PLBG. [)FOUNDATION 2ND [ ] INBULATION [ ]FRAMING FINAL REMARKS: o-~ C. a DATE ~ ~ ~ ~9 ~ IN8PECTOR V F~ =1~LJ 5;:.~-.:L~..~~.;1 j~`J.::.. j~ .;Ui-[i9LNT~ 1 . J R -v 0 H ?OUtIDATION ~(1 s t) I -3 ~ I ~ • I c ~ 'OUNDATION (2nd) ~ 1~ ~ m 20UGH UF}l~ki•IE J p y 0 I ~ ~ PING • V ~ ti 1 , o m 11SULATI0;1 PER N, Y, I m . y STATE Ei1ERGY II _ CODE I • I~ A • ~ ~ m H . ~ ~ - N FZ;IAL I p I _ O~ (f ~ ADDITIO1fAL COMMENTS: ~m~ t~ /1LwQ 11l 1 /~fl A (]`2 rU' 7 I ~ 7 /9 Z x~ . m x .Q ~ '9' H _ ~ ~ . 9 H ti~ ~ O . ? ~ r i - _ _ S (A 6 - o . ! ~ i y ~A a 1 ' BOAFD OF HEALTH FORM NO. 1 3 SETS OF PL \:15 . TOWN OF SOUTHOLD SURVEY _ _ . BUILDING DEPARTMENT CIIECt: _ . _ . TOWN HALL SEPTIC FO[ttl SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:oTIFY; sJ6~ 6r3~~ CALL Examined ~ , ~ , , 19 ~ L hfn I L TO : _ - Approved . q, 199.. Permit No. aZ. R $,O ~.'~t.- _ . Disapproved a/c o'~ ..~ti G~ . a.~ ' (Building nspector) APPLICATION FOR BUILDING PERMIT . ~ o~ Date C~~.t~-~ 19 . INSTRUCTIONS u 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 ne ary insp cti s. Q - (Signature of applicant, or arY me, if a corporation) ~.~~.1~~ ././~3 ~ ~ ./1.9.3. (Mailing address~bf applicakY) State whether applicant is owner, lessee,/agent, architect, engineer, general contractor, electrician, plumber or builder. . Name of o er of premises . ,~!j~..(1 hd-`LkC'. %:•?~?C . (as on the to roll or latest deed) If a p ' i a por ion, signature of du(ly~authorized officer. ame and title of corporate officer) Builder's License No . . Plumber's License No. ~ .~.~.11, . ~ . Electrician's License No. . l ,~.o~. ~ . Other Trade's License No . , 1. Location of land on which proposed work will be done. d~~~9?:~"...!!4~i.~?!.. e`'~;~?~. . ~ ~h/~ house Number V Street Hamlet County Tax Map No. 1000 SectiJon/~//.p..../. Block d Lot ....6 . Subdivision ..>:~4~/!f~=.Cd.,1'l Filed Map No. 7:3.7.... Lot ~c~...... . (Name) Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy I . U . 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 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 YPe of use . Rear Depth Height Number of Stories . imensions of same structure with alterations or additions: Front . Rear Depth Height ......................Number of Stories . 8. Dimensions of entire new construction: Front ~ ~ • ' ' ' ' ` ' ' ' ' ' • Rear De th Hei ht P g • • • . • • • ........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 .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. STATE OF NEW Y~2f~. COUNTY OF ,u/.\~?/\~~y~, , S.SLL " • • .~O.,r~! • •L11< ~~~F:N • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (C ractor, 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 er set forth in the application filed therewith. Swom to before me this ~ q .........~--~e~ y of^... ..~v.~. 19 . t~ Notary Public, ~.J`)' Count~1 ROBERT I. SCOTT, 9t. NOTARY flIEIIC, State of ~ . No. 4725089, Suffolk ~ (Signature of applicant) Tenn Expires May 31,19. I' hip~F RUs ~<< . ~9~ & \ ~qN \ s. ~4 86 ~ '~$5 13/app' E ~ / ~ \$6 tih o N ~ N0~ ~tO~pe ~ s /63, p3. P~-EP tieR` ~s way ate _ ti° ~ ~ i Sa~y~a v~dec a~ti~e ~ , , _ _ 0 ~ ° ~ ~a~' s / 56 / o •55 v ~~o ti ~ c~3 / s 3' ~ ,V e zo F p ' N`ro ti9 d,r ~ ~ c a ~~O \ C1 X00 o Z F Nom- P / t tij e/ Z s e: 24 / e/ ^ ~ 276' f1. 272.83' 0 \i N. S. 8752'35' W. O 000 / V ~ryh~ h 13 e R= o $2S 3T ~ d ~ o s? o ~ ~ ~ci ai O ~-o goo ~ J 1 ~C) / Z r ~ . ~~2~92T ~qNE JASMINE SINGlE t`AMIlY GWE!lING ONLY EXPIRES 3 . YEgRS FROM DATE ®FA~?PR01JAl: AREA = 27,459 sq.ft. . ~ //13 suRVEr OF LOT 12 of sournocv vrcAS„ FLED MAP MO. Prepared In accordance wllh the minimum r~~j~i, ~ AT SOUTHOLD standards /or !q!e swvsys os established y TOWN OF SOUTHOLD by 1M L.I.A.L.S. and approved and gdop/sd ~ ~ for wch ure by Ths New York Sla/q "Land ~1/vIJJ SUFFOLK COUNTY, N. Y. TIIM Asroclallon. ' The wo/er supply anti sewage disposal SUN 1 1992 - 70 - 01- P~~ ~ systems for h/s res/dence w!N conform ii - ~ to the standards of Ths Su/idk County ~ SCB/e~ ~ - Ds~pa' n/~ alG~Serv' ~css./ ~ HEALTH~SfRV ~ES Mel'Ch 11, 1992 ~TN'e locations of weds foada~c~s`a'spaols shown hereon ore tram /laid observations anti or /ram data obtained Irom others. ~/S "3 Da- 3aa 1.ANOSl~ SUFFOLK COUNTY DEPARTA~NT OF HEALTH SERVI ~y ~E~, 9~ FOR APPROVAL OF CONSTRUCTKNr ONLY 4tV f I - , ~ N.Y.S. L/C. N0. 496/8 DATE JUN O21~wS. REF. No. 01 ' ~ P S YORS, P.C. Nj, - O '9 •as ~ O 9 APPROVED N. Y. I l97/ 87-s7~ ~2 'coif ~t ~ _ ~ d .kj,9N'~ s. B6 L ~s C, '3y~Op•tc ~ l O ~ ~a0 tih o N ti s ~ p3, a F • s. q ti ~ g~6' / ~ r / g q 0 • ~ . a 20 c~` ~ ~ O e ov. ~ 1.3 w O ~ ~ . ti .ry ~I Zqi ~ b/acg. enve% J, ~ as .~rL- e/ ^ Ir. ~ ~l G/ Z8 I. .I P/ 2¢ / 27L'- ~ 272.83' 0 N. S. 87.52'35' W. V ah ~O . ~ Q, s v d E '~•2s ill ~•zs3j w ~ ~ 4 ti~ O t ~ J ~O ~1' P'Z39? A~ L ~q~ - ~.Na AREA= 27,459 sq.ft. ~~M ~nF~o Ta ~coi~ r~s ~e ~ r corm SUU4VEY OF LOT 12 of sov~r,~a~© viw aas ~nb ~?s7 Pryarsd in accorda?ce with x?. m~xwn A T SO~IlTMOiLD slondads /or Nl/e surve~+s a< .ela~Nshd TOWN O,F SOUTHOLD Oy hYe L.L4.L.,~ and goproved and ~ophd for such use by The IVew York Srafe Land rna AssackHon. ,SUFFOLK COIaNTY 11l Y. TM wa/sr sgoplr and sswoye a~sposal - ~ ' ~ P/~ srsJsrnt /a /hhTis res/dence wNl con/am 'ss= 40r to the standards of The Su//o~Mr CounJr SC~9r Depa?hnev?1 0/ Hed/h Services. _ ~ . J~ Y 16, 1S91(fou~dstianl TM /ocol/ons o/ weNs and cssspoais shown hereon are /ram /hi/d a6servadons and or lrom data ob/ained lrom others. .4.~ ~"Ay S/fz"~~. 4. 9UFFOl.K COUNTY DEPARTAE2lT OF HEALTH SERVICES W~ 6,g,~ 118. FOR APPROVAL OF CONBTRUCTION ONLY f ra ~ 'LL N.Y.S LIC. NO. 496/8 DATE wa REF. N0. ~ oYORS, P.C. 1! 909 S0~/THOLD, N.Y. 1197/ 87 s7~ _ .._...._.._..__..___._.__.__......_.___..__.__,_.7 k f: I N4V 1-'7~ 1992 q~_sQ_~9 ~ M _ ~ ~ p,F ~S~ Ciii?f e~ Eu ~~u of V@as;e~na,e~~i~adag°in~ ~V 66 n '3/00' E l O ~ ~g0 tih o N ti `S' /s'~03• / ti° F / s / v o ~ ~ ti 56. E' ~ i O 0P 3~~~ ~ y oo ~ + \ e M O ~ N N ZO ~N~ LV ~~i. u ~ ti ~ APT t ,35 _ W.~ ~ i tl O ~ ` z72.es' ~ ~ J N. S. 87.52'35' W. 2 O 000 / 0' ~h,~h 13 v 0 25,~j W o O ~n'pp ~O ~O ~ J ZO 125• Z~. ~~f~9 LANE ~ASWIINE AREA = 27,459 sq.ft. cERr~D ra a~irc°iNSP ~r~s ~ r coRP SURVEY OF 03~f ~/y3 Cu-~..~ //93s" ~~T 12 'Xb4P OIF SO~I/TIMO~LD ViLAS" FLED~2~ 982 AfAPMD. e2s~ Prepared !n accordance wllh Jhe ml~mum A T SOUTHOLD s,a?dads for llfle surveys os eslai6NsMd TOWN OF SOUTHOLD by 1M L.AA.L.S and approved and od~p Jrd for such ucs by TM New York S1a/e Lond SUFFOLK COUNTY, N. Y. T/Ne Assoclallon. The wafer sup/y and sewage d/sposo/ x000 - 70 - 01- OMB systems /or h!s res/dsnce wNl conform i l0 1M a/andards of The Su/lo/k County SC8I9~ ~ = 4~ Dspor/menl of Health Services. March 1982 .IIX Y 15, f992 (faxrdation) The locallons o/ wells and cesspools shown hereon are from f1e/d Oet.23,1992(fina/) observallons and or /ram dolo ob/a/nsd liom others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY ~~+~~~I~~ / 4~\~ K~~"'1JJ i~~ N.Y.S. L/C. NO. 496/8 DATE I,,o, 92 SO 49 NDV i 3 1992 P,ECOIVIC SUR ORS, P.C. 75161 765 - 3 S.C. DEPT. OF ~ 0•. BOX~- 9 APPROVED HEALTH SERYICES ~ Sp~UTtiBE~; N. Y. 1197/ 87-s7~ ~2