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HomeMy WebLinkAbout20802-Z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22022 Date DECEMBER 14, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 220 APPLE COURT SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block I Lot 6.6 Subdivision SOUTHOLD VILLAS Filed Map No. Lot No. 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 1992 .pursuant to which Building Permit No. 20802-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 & 2ND FLOORS) AS APPLIED FOR. The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-50-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258828 - DEC. 2, 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA JR. Rise a~.O~ ui ding Inspector Rev. 1/81 ItDill 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) N00_N° 208022 Date ............:.~.....9.................., 19.~.a1,- Permission is hereby granted to: 1 ~1{.Gi^1hla~~e11j.hrt ~y+ ~~!?1hAi1...~14C ~a.sa k..1.1.'~.l .....................1............................... sal-r-A... G~~ ....................................................................D......~....1.................. of premises locoted of .~s.~,P....... AXE.... 1~"~C~......~.eR{.A~'g ..............A.~........... . County Tax Mop No. 1000 Section Block Lot No....~.~ pursuant to application dated ........~.'4~1~..•••s~+++••••••••••••••......, 19~?.r:., and approved by the Building Inspector. Fee s.•.~.1'1:.'~.. Building Inspector g Y~4,.~ Rev. 6/30/80 Form No. 6j---",-., I~~'~ { _ ~-°Q ,w r 9 TOWN OF SOUTHOLD BUILDING DEPARTMENT hw I I i~2 TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPI~NCY 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 Orr,„P,,me-exist•_ing.B~uilding Location of Property...°~.~.Q.....v:h~.~.~-1.--_W~ ...................SOUTHOLD, NE4/ YORK........ House No. uv Street Hamlet Onwer or Owners of Property............PECONIC PROPERTIES.NANAGEMENT INC: . . County Tax Map No 1000, Section....7.~.......B1ock...1............Lot...~: Subdivision..M(0_SOUTNOLD,VILLAS,,,,,,,,,,,,,,,Filed Map.. 9737 .....Lot....~3 Permit No.~.V.a }....Date Of Permit..:T~Y.~o.1992..Applicant.,DONALD,BRACKEN,,,,,,,,,,,,, Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: 25•~~ ~ , / C d o~a 6 a 2 APPLICANT ' THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGe 1 1.40083 i BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 100313 pa1e DECSNBER 02,1992 gpp/icationNo.onfile 78706192!92 N ^5BA2B THIS CERTIFIES THAT only the electrical equipment as described 6eloEa and introduced 6y the opplicant named on the obove applicotion number in the premises of EATHLEEN DRA4t8RTDGE, 220 APPLE 1"(1UR.4, JQBt13, SOUTHOLD, N.Y. in the follouinq location; ® Basement ® /st Ff. ®2nd Fl. C111r Section B/ock Lot a~os examined on NDVE NBER `5,1992 andfound[o br in conlplionre with the requirenrentx aJthis Boord. FIXTURE RXTURES RANGES COOKING DKKS OVENS DISH WASHERS EXHAUST FANS OUTLETS KEFTACLES SWITCHES NCANDESCFNTFIVORERCENi OTHER AMi. K.W. AMi. K. w. AMi. KW. AMi. K.W. AMT. N.P. 11 38 f7 11 DRYERS RIRNACE MOTORS NTURE AMLIANCE REDERS SFECIAIRK'FT TIME CLOCKS ~Ll UNI7 HEATERS MUtil-OUTIET DIMMERS SYSTlMS AMi. K. W. al N. P. GAS N. P. AMT. NO. A. W. G. AMf. AMP. AMT. AMPS. 7RAN5. AMT. M. P. NO. OF FEET AMT. WATTS 3 F l ~ 12 7. SERVICE DISCONNECT NO.OF 5 E R V 1 C E AMi. AMP. nPE METER I / tW 1 3W ] / 3W ] $ AW NO. OF CC COND. A. W. G. NO. Of NI-LEG A. W' O' NO. Of NEUTRALS A W G. EQUIF. PER i Of CC.COND. Of NbLEG OP NEUTRAL 'I leg CB 1 R 1 u 1 4 OTHER AFPARA7U5: MG1~r;RS:I.-P H.e. i;.P.C.I. 3 SMOKE DEt1'ECTOR:-2 SPUDS $LECTRTC SRRVICE LIC.t192 E G/~~~ / 175 3RD. ST. BOR 166 OE?EERAI MANAGER ST. JANES, NY, 117130 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorreN. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. - - _ _ _ S~FF~~ TEL. 765-1802 ~ TOWN OF SOUTHO]LPJ ~ < OFFICE OF IIUILDII•IG INSPECTOR u°-r `ti,~ [~'=ati~?~±; P.O. BOX 1179 e. ~ TONN HALL %1 ~ ~.~p SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N Date 9~ Buildirq Permit No. ~ ~ 7 Owner (pleas/eJ~print) P1ur„beri"r~~!//1 /U/~~SS~ik'A ~,Q (please print) 2631-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 befo/r~e_m1e1thi,~s day of 1 u:~C~.~ -t~-~ Notary Public Notary Public, ~t~,~County MAHYANNE E. OOWUNQ Notary Public, State of New Yblt No.GOOpp3p QualMieo in Suffolk ~ounq~ CMnmisssion Expires Au0 S, 1 769-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [b{~ FRAMING n [ ]FINAL REMARKS: D~ ~a DATE ~ Z INSPECTOR a o 8 a 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [~Q INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ Vo DATE ~ ~ I ~ ~ q INSPECTOR y~_ ao~oa ~ 765-1802 BUILDING DEPT. INSPECTION (]FOUNDATION 1ST [ )ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ^ FINAL REMARKS: ~ C . o DATE l ~~`qi. INSPECTOR ~L `1cLD i;:.°.: c... iJ:i II''^-., jl .:J:'(i•ILNTI. a ~ ?OUtIDATION (1st) I ~ N . c 'OUIJDATI0;1 (2nd) ~p~ _ m /D ( o N ;OURki•lE & I Ir fe ~ G ~'-~kG ' b° y Q 3, y m ;IJSULATION PER N. Y. I ~ y b STATE EiIERGY II COD'c I ~ r (/J • m H I FZiIAL I - ~ o ~ ADDITIONAL COMMENTS: G w ~ ~ r: ~ c.a, - a O H ~ ~ O ...fl m i' 1•/ - ~ I - _ N 6 _ o ~ I ~ 1 m _ ~ ~ o f ' BOARD OF HEALTH FORM NO. 1 3 SETS OF PL \YS . TOWN OF SOUTHOLD SURVEY . . . . BUILDING DEPARTMENT CtIECI: . TOWN HALL SEPTIC FORtt . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTIFY•, . ~ S 6 0 CALL Examined .9, , 199 3- MAIL TO Approved ...J..., 199?. Permit No..~.A~~.a~..~. . . Disapproved a/c ..I.k~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . ; D(......, 19 9d~ 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 part 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, ordinanc building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neces nspect' s. / ~ ` (Signature of applicant, or n e, if a corporation) (Mailing address ~'f applican~ State whether applicant is ow er, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. -~~Q~~.. . Name of r of premises ~,~d~~`:~:../~~LJ.d.~~T,(,QO P/lu~GO o ~/l~ . (as on t e tax roll or latest deed) If appl' s c p atio : si re of duly authorized officer. me and title of corporate officer) Bu der's License No . . Plumber's License No. >/~.6.3.~.. . Electrician's License No. ~.a. ~ . Other Trade's License No . . 1. Location of land o~n w~h~ich proposed work will be done. KI~C~~J....'1'/Q:~d .V . " " /L f-louse Number ~7 Street Hamlet County Tax Map No. 1000 Section Block Q Lot . Subdivision .~-i:C.~GL~i`........... Filed Map No. ~ ~ 3•/.... Lot ~3 . (Name) Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,.Q . b. Intended use and occupancy / . 0~~'~ . 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost Fee (to be paid on filing this appiication) 5. If dwelling, number of dwelling units Number of dwelling units on each boor . ,Ifgarage,numberofcars 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 ...............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 Depth . eight Number of Stories 9. Size of lot: Front Rear Depth . 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 Pho a No............... . I5. 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 S.S COUNTY OF /~1 .\k~j.... ~Q.~ •/~•L--ot • • ~Ot~~'/.'. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the 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. Sworn to before me this _ s~~, ~ Notary Public, County ROBERT I. SCOTT . NOTARY PUBLIC, ~ of KC (Signature of applicant) Na 4725089, Su Term Expires May 31,19'L'i: m//MA /N - - APPLE COURT PLEASE NOTE NJ4Y670f Sanitary system ~s not to be ~ Raced under driveway area R'+'71.00' ~'9 \~C ~ry7~%1 uava• ~3 y <'~q R s~4 p5. 0 2 ~ -o M N-o U `sc'- M~ o \ . s~ z N O O ® ~ v 5 3 ~ 6 \ 2 ~0 T e~J y~d,~ / b N / / ~ y "ss ® coNSER~ P1w~ O f C~ EpSE~N 1 13D~g' ~o~ ~ MPK~' 5.' H R'v+ ~i . 1~ EXPIRES 3 ~ Y pATtE FNLY .Q APPROVAL EA - 22,,9 s . ft. ~g~ r~~~~~~~' SURVEY OF I~y3 LOT 13 (~u~~.-u~- r 3 S "Mi4P QF SOUTHOLD VLLAS" FLED MAP MO. Prepared /n accordance wllh the minimum A T SOUTHOLD slondords /or 1/ile surveys as es/abllshed " by the L.I.A.L.S. and approved and odop/ed TOWN OF SOUTHOLD for such use by The ew York Sla/s Land SUFFOLK COUNTY l1l Y. Tple Assoclallon. r The water supp/y and sewage disposal - - ~ P~~ ~ systems for !h!s residence wlq conlorm SCa/9~ 1~~ = 4~~ to the slondords of The Su/!o/k County ~rlm~~ servl~ March 11, 1992 C/N ~ The /ocallons o/ wells and cesspools shown hereon are Jrom J1eld observal/ons and or lrom data obtained Jrom others. YI S/ •3 ~,aa_ Do i..~~~w , , ,y;~ 2~~NS, ~n::ozc9LF SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES G~' ~O Fy p FOR APPROVAL OF COt16TRUCTION ONLY _ - yy~ 11AY 2$ 1992 s Y.S. L/C. NO. 496!8 DAT~~,~}IS, REF. N0. ~`s RS, P. C. HEr~~TI P. NE APPROVED SOUTHOLD, N. Y. 11971 87-670 /3 M//MA APPLE COURT ~ w~r~ F' ro,oy ~ ~+r~too• < ~ / ~ F -i N ~ j5e~ O y ~ 3. . v O /S3 nt~~nb. 95,0" /0 S ~0 ~~e ~ / 6r / ~~in p a~ a - ® - c~,"" 5~"" -o '016. P~ 5.1 cQtTiFEO TOE O 7?E LlXII6 /.~.,AAO .SAIHVGS BANK 3rod ~ PIECONIIC PROPERTES MAN4IBEAENT COYiP. 1 1 q ~l~Z 1 !L. ~4~. AREA = ?2,1?9 s4 ft. SL~V~ ~ LOT 1~ ca~s~v~v~ ~+ccAS~ Prepared !n accordance w1M the Mnkr?rar? ~~P~ 9?97 :la?dards /a ata swreys as estai6MsMd A T SOUT~'~O,LD by Me L.L.4.L.S awd approved and ad~p/sd T0~ ~ S~T~O TNN~ uss~b~~The New Yak S/a/s Cavrd ~'~K C~~TY~ ~ Y TM wo/a ryoply and sewage d/sporol P~ ~ syrNlals /a /h/r residence wN/ conlorm ~ to !h. slandads of TM Su//oAt Counly SCi~: 1 = 4U D~rarhnenl o/ Hedlh Savkea. ~ JU. Y 154 X82 (fou?~G{ttiad TM /ocollau o/ weds surd cearpoo/s shown hereon are /ram J/e/d obsavolkns acrd or from da/o ob/a~kred iron olhas. ~~~~~AEVet? .S!*,9L auFFOUC cDUIrY DEPART?ENT OF FEALTM SERVICES ~ ~ Fp! A}!'ROVAL OF CONSTRUCTION OILY p Y.S LIC. NO. 496/8 DATE ~ NO, S, P.C. P. T AM'ROVED SOUTHO , lKY. 11971 87-670 /3 Tit +:'d, r v ~ r I(ii i " tgl$ APPLE COURT e1hE~ agcrl~~ES r ~l ~ ue s ki+~s7oE Chief of Burea of Wastewater Management ~o.oo• R~171.00' ~ "9~ / uosrr 8~ ,f~~ ~~9% ~ O. R:5 4 05, ~a4 ~ ~ qs. ~ > ~ ~ s~ ~ ~ p _ `~s. Z C \ r N ? ~ m 150 O (n 'ro? ~ µG3 ~5 O ~ .y ~ 56 ,o s 2 m ,o er~bla / b Z ~~il`. ® c~SERVp1j0N o t ~6' Qo~~ K~ S~?~2~ 17 cERrll~A ra ThIE LANG lSLM~ SAVNGS &Ih!( PECOA/C PROPERTIES AIANAfs'ENENT CORP. a, d3~~ ~iy3 I/935~ AREA = ??,129 sc~ ft. SURVEY OF LOT 13 ~wu~oFSOUrf~acn vrtAS~ ft©v~~ a~~MO. a~s~ Prepared In accordance wllh the m!nlmwn A T SOUTHOLD standards /a tills swveys os eslabashed by 1/?e L.bA.L.S and approved and odop/sd TOWN OF SOUTHOLD for such uce by The New York Slo/s Land SUIFFOLK COl~VTY l1~ Y. T/tN AssocloNon. ~ The water at~p/y and sewage dlspoad - - 01 _ P~~ ~ sys/sms /or hk resldencs w/N con/arm SCe/e~ = 40~ fo lhs standards of The Sullo/k County Ueporrmenl a, Heollh servkes. March 1~ 1992 JU. Y 1~ 1992 (farwrrianl Ths /ocoHons o/ wells and cesspools shown Mreon are tram Ile/d QCt. 231992 (find) observal/ons and or /ram data ob/olned /ram olherr. SUFFOLK COUNTY DEPART~IVT OF HEALTH SERVICES 4 ` FOR APPROVAL OF CONSTRUCTKMI 01'LV N04 13 1992 ' J Y.S LIC. NO. 496/8 GATE 9?'SO 5O Ct6NwC EY ,,,~r , P.C. w-s REF. N0. S.C. DEPT. OF rsl6~; 765 - 5020 R.Clei,.pOX 909 HEALTH SERVICES Ngpd ROgp SOUTHOLG~~ N•Y~~11971 87-670 l3