HomeMy WebLinkAbout27701-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29042
Date: 11/01/02
T~IS CEi~TIFIES that the building NEW DWELLING
Location of Property: 95 THOMPSON BLVD. GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 35 Block 1 Lot 25
Subdivision Filed Map No. __ Lot NO. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 19, 2001 pursuant to which
Building Permit No. 27701-Z dated JULY 17, 2001
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 SINGLE FAMILY DWELLING (UNIT #95) WITH ATTACHED TWO CAR GARAGE AND
COVERED FRONT PORCH AS APPLIED FOR.
The certificate is issued to PECONIC LANDING AT SOUTHOLD,
(OWNER)
of the aforesaid building.
INC.
SUFFOLK COUN~f DBPARTI~E~Ff OF H~J~T~ APPROVAL C10-97-11 05/28/0~
ELECTRIC_AL CERTIFICATE NO. 1038576 08/27/02
PLUMBERS CERTIFICATION I)AT~ 05/17/02 PLARTCORN PLUMB.&HEATING
Aut hominid S igna~'~re
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 27701 Z Date JULY 17, 2001
Permission is hereby granted to:
LANDING AT PECONIC
PO BOX 430
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED 2 CAR
GARAGE D~TD COVERED FRONT PORCH AS APPLIED FOR I/NIT #95 CRAWL
at premises located at 1205
County Tax Map No. 473889 Section 035
pursuant to application dated JUNE
Building Inspector.
MAIN RD
Block
19, 2001
GREENPORT
0001 Lot No. 025
and approved bythe
Fee $ 707.70
Authori zedVS ignat~e
COPY
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TO~VN HALL
765-1802
APPLICATION FoR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 fern0.
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 1% 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey ofprope~ 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 Iuspeetor 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. Photocopy of Certificate of Occupancy - $ 0.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
Owner or Owners of Property: ~¢~r~ ~,C_
Suffolk County Tax Map No 1000, Section
House No.
Date.
Old or Pre-existing Building:
Strt:et
Block
c57//7 / 2.002_
/ /
(check one)
Hamlet
Lot
Subdivision
Filed Map.
Lot:
Permit No. Date of Permit.
Health Dept. Approval: '-{ - /~ · ~. a o c,
Planning Board Approval: [ ~ - ~{ .. ZaOO
Request for: Temporary Certificate
Fde Submitted: $ ,~--,~' '~
Applicant:
Underwriters Approval:
Final Certificate:
(check one)
Applicant Signature
Dennis M. W~lhelm
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOIJ'I'flOLD
CERTIFICATION
Date:
Building Permit No.
Owner: ~)0_ f. OQl'& Lfl~;tl0
(Pleas~ ~rint)
Plumber: Hartcorn PLmg & Htg, Inc
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this ~' ~
day of /~-~// , 20 d2~-
Notary Public, County
(Plumbers Signature)
VIRGINIA M. GOCINSKI
NO~ty Public, ~tate of New Yfftg
No. 4873841
Qt~llified in Suffolk County
Tem~ expires O~tober 20,
FINAL INSPECTION REPORT
Sidney B. Bowne & Son
Consulting Engineers
235 E. Jericho Tpke., Mineola, NY 11501
PECONIC LANDING
TOWN OF SOUTHOLD
BUILDING PERMIT NO.:
COTTAGE NO.: ~ ~-""
In accordance with the Agreement between the Town of Southold and Sidney B. Bowne & Son,
LLP, Consulting Engineers, dated January 14, 2000, for professional engineering services
relating to the above project, we have completed the final inspection for the subject premises.
In addition, we have reviewed inspection reports and other relevant material for conformance to
the requirements of the Town Building Department for a Certificate of Occupancy.
Based on this review, we have no objection to the issuance of a Certificate of Occupancy for the
subject cottage.
By:
Dated:
Gino N. Aiello, P.E.
June 6, 2002
Mr. Michael J. Verity
Code Enforcement Officer
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, NY 11971-1179
PECON[C LANDING PROJECTS.
Re: Cottage #95 Code Cetliflcalion.
Dear Mike:
In reference to the above mentioned project we, Barton & Associates, LLP (Architects of Record
for said project), hereby certify that to the best of our knowledge, information and believe that
Cottage #95 has been constructed in compliance with all applicable laws, codes and ordinances.
Very truly your;
BARTON & ASSOCIATES, LP
Frank P. Laughlin, RA
Senior Vice President
cc: Dennis M. Wilhelm, RLS
Al Broszeit, E&F Walsh
Bob Ellis, O/N
INSPECTION TEST
GAS AND WATER SERVICE
Sidney B. Bowne & Son
Consulting Engineers
235 E. Jericho Tpke, Mineola, N.Y. 11501
PECONIC LANDING
TOWN OF SOUTHOLD
GAS WATER I
Pressure Pressure
COTTAGE # DATE APPROVED BY
Test Test
5.0 PSI 50 PSI
REMARKS:
March 14. ,~00~
To:
E. F. \Valsh
De,.'dopers Peconic Landing
From:
Village of Greenport
Utilities Department
To x,~.q~o~n It May Concern:
Re: Peconic Landing Sewerage System
The Village of Greenport is allowing Peconic Landing to deliver its sewerage to the
Village Sewerage System on a conditional basis until the pump facilities are complete and
certified, at which time the Village will accept total responsibility for the lift station and
related appuntages.
Presently units 1-45 are allowed to discharge into the Village's system.
The sewerage being delivered is acceptable to the Village sewerage system.
Respectfully,
William Swiskey
Utilities Foreman
WS/js
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
Located at
E.F. MALONEY * PECONIC LANDING
P.O. BOX 6070 MAIN ROAD / ROUTE 25
1007 route 25 A COTTAGE # 95
MILLER PLACE, NY 11764, SOUTHOLD, NY 11971
MAIN ROAD / ROUTE 25 COVTAGE # 95 SOUTHOLD, NY 1197':
Application Number: 1038576
Certificate Number: 1038576
Section: 35 Block: 1 Lot: 25 Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Attached Garage, Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 27th Day of August, 2002.
QTY R~se R0.ting (?~rcuit Type
~dditional Charges
modular house N.Y.State approval # 19-I
mfg Avis America serial # 665401
Appliances and Accessories
Air Conditioner
Wiring aad Devices
Receptacle
Switch
Fixture
I 0 48,000 BTU
I 0 Gas
I 0
I 0
3 0
General Purpose
General Purpose
Incandescent
Phase 3W Service Rating 200 Amperes
;ervice Disconnect:
Meters: I
I 200 cb
seal
I of !
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
)UI~AT ION ( IST)'
PLUNBING
ISuhATION I)ER N. Y.
ST-ATE E)II~G~
CODE
DATE
.'ADDITIONAL
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy , {;
b. Intended useandoccupancy ~S]O]0f/['~
3. Nature of work (check which applicable): New Building ~ Addition
Repair Removal Demolition Other Work
4. Estimated Cost /'4 700.. ~)OO. I00
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
Alteration
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height. Number of Stories
Rear .Depth
Dimensions of same structure with alterations or additions: Front
Rear
Depth Height. Number of Stories
~. Dimensions of entire new construction: Front c.~,2, Rear .Depth
Height 2-(/ Number of Stories' [
). Size of lot: Front Rear .Depth
I0. Date of Purchase ~]~ Name of Former Owner
'7
l I. Zone or use district in which premises are situated
L2. Does proposed construction violate any zoning law, ordinance or regulation:
:3. Will lot be re-graded __Will excess fill be removed from premises: YES
Name of Contractor ~: tlt~c~ 1~ _t_l./al~h Address
5. Is this property within 1 O0 feet of a tidal wetland? *YES NO
· · 17 YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 0//
7. If elevation at any point on property is at I0 feet or below, must provide topographical data on surwey.
;TATE OF NEW YORK)
SS:
:OUNTY OF~,'~'P'",~,,~ )
/~,~"f'/JTd ~ /,t/~'/-J0,t-.57(/wc'' being duly sworn, deposes and says that (s)he is ~e applicant
~ame of indihdual si~ing con~act) above named,
S)He is the
(Contractor, Agent, Corporate Officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
mt all statements contained in this application are true to the best of his knowledge and belief; and that the work v,511 be
erformed in the manner set forth in the application filed therewith.
' / Signature of AppLi/cant
BU_ILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Examined '7//"-'-/ ,20 ~ /
Approved ~/f~7 ,20 ~//
c'
Disapproved a/
PERMIT NO.
t>~J.l~J.l'q,,J rm~vlil ~'~.I~AIIUP~ ~lb.
Do you have or need ~e follo~g, before apply~g
Bo~d of
~.~ 3 se~ of B~l~g PI~
S~ey
~O~-~ Check
Septic Fo~
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
Building L~pector ~'
APPLICATION FOR BUILDING PERMIT
Date ,20
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'~ramises, relationship to adjoining premises or public street~ or
areas, and waterways. : ·
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 issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughotit the work.
e. No building shall be occupied or used in whole or ip-part for any purpose what-so-ever until a Certificate of Occupan
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building D. epartment for the issuance cfa 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, hocsing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name, if a corporation)
{Mailing a~dre-ss of applicarA) -
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
/
Name of owner of premises
I (as on:the tax roll or latest deed)
If ap~lj~.a:nh is a corpora~¢on~ signature of duly authorized Officer
~ ¢,~arr~ ~nd title ofcorporatetofficer~ .
Builders License No.
Plumbers License No.
Electricians LicenseNo.
Other Trade% License No.
1. Location of land on which ploposed work will be doric:
IRO,..T " :'
House Number - Street ' ·
Hamlet
County Tax Map No. 1000 Section Q.~' Block /
Subdivision ..' Filed Map No.
,. ¢T e)
.LNO~I=I
Z
FORM NO. 3
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)
PERMIT NO. 27701 Z Date JULY 17, 2001
Permission is hereby granted to:
LANDING AT PECONIC
PO BOX 430
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED 2 CAR
GARAGE AND COVERED FRONT PORCH AS APPLIED FOR UNIT #95 CP~AWL
at premises located at 1205
County Tax Map No. 473889 Section 035
pursuant to application dated JUNE
Building Inspector.
MAIN RD GREENPORT
Block 0001 Lot No. 025
19, 2001 and approved by the
Fee $ 707.70
Authori~d Signa~'ure
ORIGINAL
Rev. 2/19/98