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HomeMy WebLinkAbout20805-Z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21165 Date NOVEMBER 19, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 600 JASMINE LA.& 60 APPLE COURT, SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 6.8 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. 20805-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 & SECOND FLOOR) The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-52-NOV. 17, 1992 UNDERWRITERS CERTIFICATE NO. N-258427 - NOVEMBER 1992 PLUMBERS CERTIFICATION DATED OCT. 8, 1992 - ARTHUR MALANSSENA, JR. R~~ ilding Inspector Rev. 1/81 rosti xo. s 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 ~t: 2i ~ s ~ ~ Z Date J..............., 19.2.?-- Permission is hereby granted ro: .~.x.... t.~. ~ Gz~ ro .......4...,(.).Y!~L... . ~ p...'..~ of premises located at .lao..C~.~..~~..a.:~t~:...1~ ~~.Q`•:4:tk}!:I:li4... 9..~...Aw~:.. County Tax Map No. 1000 Section a~. Block .......4..?........ Lot No.....Q..~........... pursuant to application doted . 199Ar., and approved by the Building Inspector. Fee s....l.::~~: ......~~d!.!-............~. Q-+.-~ Bui inspector Rev. 6/30/80 - Form No. 6 h _ 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 Euilding - $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.. ~~©,.,,,JA~i~_,,,,~~, ~ 60 APPLE. CT ...SOUTHOLD: NEW YORR...__. . House No. Street Hamlet Onwer or Owners of Property..........,,PECONIC PROPERTIES NANAGEMENT.INC : . County Tax Map No 1000, Section...». ../.Q...Block..r ....I......Lot..... .~.,p,,,,,,,, Subdivision...Ii~O SOOTHOLD VILLAS ...,,,Filed Map...9737. ....Lot... Permit No...20805Z ...,,,Date Of Permit..?~Y.9..1992..Applicant.,DONALD.BRACKEN_., Health Dept. Approval ..........Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $..,.15.00 ...4~~~~:G~~:'.:,~~`:;,G,~i~r~...,............. ~ ~ y Z C ~ ~ a) pl(D ~ APPLICANT s _ t 3 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGB 1 1000837 BUREAU OF ELECTRICITY EIS JOHN STREET, NEW YORK, NEW YORK 10038 Dace NOYBNBSR 25,1992 Application No. an file 78590892/92 N 258427 THIS CERTIFIES THAT 1t only the electrlca! equipment as deacrihed heloFO and introduced by the applicant Homed on the shove application numher in the premises of HBLINSKI-SOUTHOLO-J08 f15, 60 APPLB COURT, SOUTHOLD, N.Y. in the following kFCation; ® Bmement ® /xt Fl. ®2nd Fl, OUT Section Block Lot Feoa exominedon NOVBHBBR 19 , 1992 ondJound to be in compliance mirk the requirernenta of thu Beard. - AXTUR! RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ; OUTIlTS ECHTACIES SWITCHES INCANDESCENT FIVOEESCENT OTHER AMT. K. W. AMi. K. W. AMT. K.W. AMi. K. W. AMT. N. P. 12 33 20 12 1 g DRYERS FURNACE A10TOR5 FUTURE AFFUANCE RlDER$ S/[dAL RlC'FT TIME CLOCKS YLL UNIT NEATlR$ MUITI-0UTIET DIhIMERS AMl. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMI. AMi. AAVS. TRANS. AMT. N. P. SYSTEMS AMT. WATTS NO.OF R!T 1 2 12 2 5lRVIL1 DISCONNECT NO.OF $ E R V I C E AMT. AMI. TYPE METlR 1,I tW 1 F SW ] ! 3W ] $ ~w NO.OF CC. COND. A. W. G. NO. OF NFEEG A. w. G. NO. OF NEUTRAIS A. W. G. ROWF. PEa t) OF CC. COND. Of NLIEG OF NEVTKAL 1 200 CB i % ] 2/0 1 2/0 OTIIFR AF?ARATUS: G.g.C.I;-3 SNOBS DBPBCTOR;-2 ~°l SPUDS BLBCTRIC 96RVICB LIC.f192-B 175 3RD, 9T. BOB 166 z TiOiERAE AWR 3 ST. JANB3, NY, 11780 11 Per This mrtificaro must not be Olrorod in any manner; roturn to the office of the floord if incorrect. Inspectors may ba idsntifiied by their crodsntials. - F ~(~.C TEL. 765-1802 0~0,~./"~~ O? TORN OF SOYJTIIO]LD f l-~ti'"rl' ~c OFFICE OF BUILDII•IG INSPECTOR u°-, z,,: P.O. BOX 1179 .~~"i` 'c TONN HALL • ~Z' SOUTHOLD, N.Y. 11971 ~~Ol ~b C E R T I F I C A T I O N Date 2 Building Permit No. Q ~ J~ Owner (please print) Plumber~'~'7~~/2~9f~jr,SS~,v,4 (pl ase print) ~~~3/-p~ I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) Spworn to before me this -LL~ day of ~C~?~_,• 19~„ Notary Public notary Public, ~ County MARYANNE E. DOWLING Notary Public, State of New York No 5000030 Qualifietl in Suffolk County jj Commission Expires August 3, 198.7. _ _ _ ~ O V ~ ~J_/ ~ I 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING FINAL REMARKS: ~ ~ ~ • ~ DATE ~ ~ ~ ~ 9 i- INSPECTOR V ~ L- _ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ROUGH PLBG. ]FOUNDATION 2ND [D(] INSULATION [ ]FRAMING [ ]FINAL REMARKS: 1~.~-~ I.~.~-r•e~ o k ~o • . DATE ~ ~ ~ IN8PECTOR ~ 0 BaS~ 765-1802 BUILDING DEPT. INSPECTION pQ FOUNDATION 1ST [ ]ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: lav ~?.w.,ole~~`.;,,r, D-~ a.,~ ~ ~ ww ~ ap DATE ~ ~~g t1N8PECTOR -y • C~•L ao8o~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [)Q FRAMING rrFINAL REMARKS: ~ti~.,;,~ u-k_ DATE ~ INSPECTOR • ~ - 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE INSPECTOR ~080~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: 7~vc~ ~o-.u-.,.cQp~ar. e~ O ~ ~v ~ 0. c.L tG~f'Y DATE `7 9 z IN8PECTOR y Q L _ ~O 805.x, 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [)(J ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION Q~j FRAMING (n~ [ ]FINAL REMARKS: c-~ ~ , DATE ~ a~ q ~ INSPECTOR ~ ~ L 1LJ i::S: c..: '_J:i ~I:Jn.n j~ :;Ui•fi•iLNiC , w r • ~ N i, m a 6 H OV - y O ?OUtIDATION (1st) I ~ ~ l~ 9 h' I 'OUNDATIOt1 (2nd) _ _ I s. `0 6' ;OUCH FRkilE ~ I ~ PLUMBING ny / o y 3, y iI ~ :17SULATION PER N. Y. I ~ ~ • H t STATE Et1ERGY II CODE I • I ~ ~ 9 m H I ` FZ;IAL I - ~ • I o ~d ADDITIOPIAL COMMENTS: m t7 2 ~ ~ Cz ,n ~?a~..,.. . . . x H 1 C • . H ~ ~-1 O T m f ~ r y J - _ m~. I H _ ~ a ' BOARD OF HEALTH FORMN0.1 ~ SETS OF PLAt7S TOWN OF SOUTHOLD SURVEY . . . . BUILDING DEPARTMENT Ct1EC1: . . TOWN HALL SEPTIC FORtI SOUTHOLD, N.Y. 11971 TEL.:765-1802 ttDTIFY: ~OS/~ CALL Examined ,~,~{„9„ , I9 Q~ h1AIL T0: Approved ~ . ~ . , 19g2~ Permit No. a ~ ~~.ZL . . Disapproved a/c . - (Buil mg Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neca inspectio s. (Signature of applicant, or name, if a corporation) (0 ~~~3. ..4~e.~~~ - ./1.9~~>~... . (Mailing add~ss of appl~ant) State whet7hler,, ap-p~licant is owne~r/,~l~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. - 9 Name of o er of premises E'.C'41?~-. 0~'t~~Q ~'LU-- . (as on the tax roll or latest deed) If ap ]i i a o ora on, signature of duly authorized officer. C~~.:............. ~ ame and title of corporate officer) Builder's License No . . Plumber's License No. >~n!?.~ ~ , , , , , Electrician's License No. a , , , . Other Trade's License No . . 1. Location of ]and on which proposed work will be done. t . , Q,cY....,(~~f~,~fr'. n Q~- house Number Street Hamlet County Tax Map No. 1000 Section ~4.......... Block Lot . Subdivision ..eJ,nr:~:~'~ ~-A'l. Y ~ Filed Map No. ...7./. Lot . ~S.......... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy f...... ~ . b. Intended use and occupancy , r'~':...~~. 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demo ition 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 cazs . 6. If business, commercial or mixed occupancy, specify natur1e and extent of each type of use . 7. Dimensions of existing structures, if any: Front Rear Depth . eight Number of Stories . Dimensions 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 Stones Size of lot: Front Rear Depth ate 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............... . Name of Architect ...........................Address ...................Phone No............ . ame of Contractor ..........................Address Phone No. Is t is property within 300 feet of a tidal wetland? *yes•••„ - „ No 1~ *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 comer lot. STATE OF NEW Y R COUNTY OF ....~J~~ f • , ~jS.S ,~J • • • • • •~~•'~~•L'~• • • =~/~~~r•~N• • • • • • . • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ntractor, 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 .........,~a•~,`."............ayof~.. ....~v~ ,19.92 Notary Public, S'v'~~o~ Nu ~ ~ i !£?LiG ~ att N.T. ' ' . Nc. 4725089, SuBolk ma~yy,~ (Signature of applicant) Term Expires May 31,19I1- ~ N J~` ~~tf i 1h P~ rs s ss. ! p~, A' z~, 26. ~~o F V QQ 00 ~ Q ~s ~ . \ Q ~ ~ ~ ~ ~ ~ ~o CBS g1 O p / O _ s Z~OZ~ ~ ss tib ~S i~ 4~9 ~ ~ lO I ~C /o. w. ~ ~ M/ ~ iso~s, E ~ ~qNE `'~zo~ AREA . aB,B54 sq.ft. ~ y~ 0 _ /iy3~ SiNGIE FAMILY t~N ~~E O~A~ EXPIRES YEl,~S~M SURVEY OF LOT 15 ~ . of sour~aD vL~AS" FLED MAP MO Preporod !n occordonce w!!h the minimum A T SOUTHOLD slondords for 1/1/e surveys os eslobushed TO WN OF SOUTHOLD by the L.I.A.L.S. and approved and odopled !or such use by The New York SJa/e Lond SUFFOLK COUNTY, N. Y. TUIs Assocloilon. Ths wafer supp/y and sewage dlsposo/ P~~ ~ sys/ems /or h!s residence w11/ conform l0 1he standards of The Su!/o/k County .SC~9~ 1~~ = r °ou~~l~ March 11, 1992 The locollons of weds and cesspoo/s shown hereon are Irom lleld observoNons and or from data oblolned /rom others. ;%e~-. . F SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES - ME+~ G96 FOR APPROVAL OF CONSTRUCTION ONLY ; ~ V~ . ?G' FL MAY ~ N.Y.S. L/C. N0. 496/8 DATE5. REF. N0. `SO ~~a1 199 C ORS, P. C. A~+~ APPROVED yF9/THSF''~~ FS SO p - N. Y. 11971 7- ~ N 6; ~b Pi rs s Bs~ ~~T t, _ j° z," V v ~•F A mss' 4A P~,p ~ ~C ~ ~ 66 ~o~ ~ ~ r ~ / v l _ a.~ ~Or ~ j Y ~ 7~. ~ l 3'~ ~Or 43~ M' J /~/S• y' ~~r lq~ ARFA = ~Q3I a¢ k c~ 20 ~tid wk CE7PTAFiEO ra SURVEY Of P~i>~ n s r cam 'y1fAP AF SOO~J'1IMOILD VILAS" Prepared ~ ascwdavxe wqh /Ja pdn~tnw?p ~~P~ 9~1 sJaidards for NJa swwys es uJa~Yrhed A T SOIJTHO~i,D by Jh. ~.ca.L.~ and aved apd Jed TOWN OrF SOllTMOLD Jw such use by Th. IWw Ywk Slo/e Load rJra Assacabn. Sl~'FOLK COt~NTY, l1L Y. The woler supply and sewage aVrpoaal DODO - 7p _ Q~ _ P/Q pd sysJapc /a a rssldhu+ce wfV conlwm l0 1h. slondards of The Sul/o~Bt County SCa/e: 1 = .?0 r DeporhnenJ o/ Health Serv/ces. MilrCfl ~Q The /ocaHons o/ weds apd cesspools shown hereon ors hom i/e/d .~Y obssrvaJ/ons and w Jrom dola obla~ir?ed hap others. T~ v La~t~s SUFFOLK COUNTY DEPAR CF NEALTN BERVK~i K li,~ FOR APPROVAL OF CON6TRUCTION ONLY % , ° P * ~ ~ .Y.S LIC. NO. 4961@ DATE ~ ~ RiF. NO. V Y S, P.C. T6.'f - 5 do 1 ArPIIOVED o SO .Y. 11971 $titf~~.0ii~?-F CFr~ "nT~4;::idT OF';Eh.CTH SERVICES lac u~ ~ - ~ n Jai rtm~n*. and/or OC'lu ~ I :L;+,,_ M~ ~ tZ 'Sidti4.:f j,.. ~ _ =-.7--°- Chief c( i?ur <u cf'+Na i r~etes P+°anageinent N OJ V, ~ / h s ~o ~1 - ss.2j r® v 2s~ F; Qv \ Q 3, Q ~ 4i c F ~ ~o iBS a ''o. ~ ~ ~ ~ 41' 6 ~ ~ 50p2~. ~ ~ zey 2 0 ~ ~p ~S ~ • `'S ~ ~ ~ d/ T O ~V 10 ~ `e~o~c l~ OI j H. ~ ~ 75~ 43' ~O• B• O T~ ti ~4Sy iso~s, y, .w ~ ~~r LAS ma,,, ARFA =118,854 s¢ff. cERrAFiED -ra SURVEY OF T1E LQIJG /SLAAD SAVYMGS BAMK PECONC PROPERTES A/ANA6EAENT CARP. R®,rlAME ~~~atn~At~AP` Ml~ a~s~ Prepared hJ accordance wilh /he mJnknum 14 T s+w I IM.D s/ar?dards /or Nlh swveya as ss/abNshed by the L.LA.L.S. and approved ono odopMd TOWN QF SOUTIMO~~,D la weh use by Ths w York SloJe LLond nn. As:ac/allon. SUFFOLK COlJ1VTY, N. Y. The wo/er s~ply and sewage dkpoaol ~ ~ - ~ P~~ ~ sys/evrrs la h!s residence wa11 con/am ii i l0 /M s/ondards o/ Ths Sullolk County SC~' ~ = 3~ Dsparl~vll o/ Hedlh Suvkss. ti/~Ch ~Z Y 16, 1!982 (founahtinnl The /ocalkns o/ wells and esaspooh: shown hereon ors Irom Ileld OCt observations and or from da/o ob/o/ned /rom o/hers. SUFFOLK COUNTY DEPARTAENT OF MEALTM SERVICES ~\l'/n FOr'i APPROVAL OF CONSTRUCTKIN OlJLY ~ I~~ YYY~~- ~~~"'lll / N.Y.S LIC. NO. 496/8 HATE w~ 92 SO 52 ppV I3 X992 COMIC S o- YORS, P.C. fST~'! .768 - O P. "O:; ;9`09 ' S.C. DEPT. OF AIAAY - A'OA>7 APPROVED HEALTH SERYICES d SOUTHOLD, N. Y. x1971 8