HomeMy WebLinkAbout27668-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPA/~CY
No: Z-29048 Date: 11/02/02
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 103 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 JULY 10, 2001 pursuant to which
Building Permit No. 27668-Z dated AUGUST 14, 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 #103) 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 COUI~TY DBPART~ENT OF }IEALTH APPROV~-L C10-97-11 05/28/02
ELECTRICAL CERTIFICATE NO. 1038599 07/15/02
PLUMBEP~ CERTIFICATION D~r~u3 05/17/02 HARTCORN PLUMB.&HEATING
Rev. 1/81
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. 27668 Z Date AUGUST 14, 2001
Permission is hereby granted to:
PECONIC LANDING AT SOUTHOLD, I
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 #103 (CRAWL)
at premises located at 103 THOMPSON BLVD.
County Tax Map No. 473889 Section 035 Block
pursuant to application dated JULY 10, 2001
Building Inspector to ex,)ire on FEBRUARY 14,
Fee $ 522.60
GREENPORT
0001 Lot No. 025
and approved by the
2003.
Author i ~e'd S igna~T~
COPY
Rev. 5/8/02
TOWN OF SOUTIIOLI}
BUILI)ING DEPARTMENT
TO~VN IIALI.
7654802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must bc filled in by typewriter or ink and submitted to thc Building l)cpattment with thc following:
A. For new lmilding or new nsc: I. I:inal sm~,'ey of property x; ith aCCtlNllc I,~calion ul all buildings, l',ropc~y lines, su'cct~, ami unusual ltaltll'al ol
topographic features.
2. Final Approval IYom llcahh Depk ofwatel supply and sewerage-disposal (S-9 h~nu).
3. Approval of electrical installation from Board of Fire Unde~vritcrs.
4. Sworn statement from plumber ce~if)dng that the solder used in syslem conlains less than 2.10 of 1% lead.
5. Con~ercial building, indust~al building, multiple residences and sinfilar buildings and installations, a certificate
of Code Compliance from arc~tect or engineer responsible tbr the building.
6. Submit Plam~g Board Approval of completed site pl~ r~uirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. 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 Cerlificate of Occupancy
is denied, the Boilding 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, Aheratinns to dwdling $25.00,
Swirm~fing pool $25.00, Accessory building $25.00, Additions to accesso~ building $25.00, Businesses $50.~.
2. Ce~ificatc of Occupancy on Pre-existing Building - $100.00
3. Photocopy of Ceaificate of Occupancy - $ 0.25
4. Upqat~ Ce~ificate of Occupancy- $50.00
5. Tempo~~ Cegificate of Occupancy- Residential $15.00, Comlercial $15.00
Date. k~/~O/ O2
-/
/
New Coi~tmction: ~ Old or ere~xistin~Building: (check ,'ne)
Location of Prope. y: ~ <~O M~A~ A~
Str&t / Ha~et-
House N~.0
Owner orOwners of Property: ~=~ ~[~k~.
Suffolk County Tax Map No 1000, Section ~ k~ ~ Block / Lot
Subdiviskm .... Filed Map _ Lot:
Pe~t No. Dale of Pcnnit.~._ Applicant:
Itealth Dept. Approval: __~-~' 2~ Unde,writers Approval:
Planning Board Approval:
Request for: Temporau' Ccflificate Final Ce~ificate: ~ (check one)
Fee Submitted: $ ~ ~ ~
Applicant Signatnre
Town ItMI, 5g0c~5 Main Road
P.O. Box 1179
$outlloLd. New York 11971-0o5tI
(631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOIl, D{ OF SOUTIIOLD
CERTIFICATION
Date:
Building Permit No.
Owner:
~leas~ l~rint)
Plumber:Hartcorn Plmg & Htg, Inc
(please print)
/O3
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this ~c'
dayof' .~.~/ , 20D~ ~
Notazy Public County
(Plumbers Signature)
VIRGINIA M. GOCINSKI
,m~ ~' Public, State of New York
No. 4873841
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
MILLER PLACE, NY 11764, CO]-I'AGE # 103
SOUTHHOLD, NY 11971
MAIN ROAD / ROUTE 25 CO'CfAGE # 103 SOUTHHOLD, NY 11971
Application Number: 1038599
Certificate Number: 1038599
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 15th Day o[ July, 2002.
Nome QTY Rate Ratine Circuit Type
Additional Charges
modular house N.Y.State approval # 19-15
mfg Avis America serial # 683601
Appliances and Accessories
Air Conditioner I 0 42.000 BTU
Furnace I 0 Gas
Wiring and Devices
Receptacle I 0
Switch I 0
Fixture 3 0
Service
1 Phase 3W Service Rating 200 Amperes
Service Disconnect: 2 200 cb
Meters: I
General Purpose
General Purpose
Incandescent
seal
1 of 1
lhis certificate may eot be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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.: /03
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 requiretnents 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:
Gino N. Aiello, P.E.
Dated:
BARTON,~Associates
June 6, 2002
Mr. Michael J. VeriD'
Code Enforcement Officer
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, NY 11971-1179
REz
PECONIC LANDING PROJECTS.
Re: Cottage #103 Code Certdication.
Dear Mike:
In reference to tJle above mentioned project we, Barton & Associates, LLP (Arclhtects of Record
for said project), hereby certify that to lhe best of our knowledge, information and believe that
Cottage #103 has been constructed in compliance ~4th all applicable laws, codes and ordinances.
Very. truly your;
Frank P. Laughlh~, 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 XVATER I
Pressure Pressure
COTTAGE # DATE APPROVED BY
Test Test
5.0 PSI 50 PS1
REMARKS:
March 14, 2002
E. F. Walsh
Developers Peconic Landing
From:
Village of Greenpori
Utilities Department
To Whom It May Concern:
Re: Peconic Landing Sewerage System
Thc Village of Gmenport 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
INSPECTION Pig PORT
~UN~ATION ( IST)'
~UNDAT ION ( 2ND )
)U~H FP, A~E &
· PLUH~ING
~SULATION PER. N.
STATE ENERGY
,. CODE ,,.. -i
.'AD, DITIONAT- ~S:
~UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Approved ~/'/Tp ,20~--~
Disapproved a/c
PERMIT NO.
Do you have or need ~e follo~g, before applying
Bo~d of Heal~
3 sets ofBuil~g PI~
S~ey
Septic Fo~
N.Y.S.D.E.C.
. ' T~stees
Contact:
Mail to:
Phone:
~or
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
sots of plans, accurate plot plan to scale. Fee according to. schedule.
b. Plot plan showing Iocation of lot and of buildings Oh"premises, relationship to adjoining premises or public streed 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 i}Tpart for any purpose what-so-ever until a Certificate of Occupar/
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building D. cpartment 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, ho!lsing code, and regulations, and to admit
authorized inspectors On premises and in building for necessary inspections.
(Signature of appli~nt or name, if a corporation)
,(Mailing a~ar/si of applicar~)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
I
Nameofownerofpremises ~(O/b'~. ~O(IdL'/'tt'2 ~'/7'~617~1ff,;
/ (as on:the tax roll or latest deed)
If ap~l~a.n~ is a corpor~on~ signature of duly authorized 9fficer
! (b/ar~ mad title ofcorporate~office35
Builders License No.
?lumbers License No.
Electricians License No.
DtherTrade'sLicenseNo.
Location of land on which pxoposed work will be doric:
12 0 ,..W 7': ,2 ,...X :'
House Number · Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
.Block
· . Filed Map No.
a. Existing use and occupancy., ,
b. Intended use and occupancy nES~ II(~
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
4. Estimated Cost /~d,~ 700, 0019. 190
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
Fee
(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
g. Dimensions of entire new construction: Front ~,~ ,2, Rear
Height ,~.(/ Number of Stories
-_
~. Size of lot: Front Rear Depth
t0. Date of Purchase 3/]~ Name of Former Owner
l'-
Depth
t 1. Zone or use district in which premises are situated
[2. Does proposed construction violate any zoning law, ordinance or regulation:
3. Will lot be re-graded f~ __ Will excess fill be removed from premises: YES
ti ' Phone No~
I~ Phone No.
5. Is this property within 100 feet of a tidal wetland? *YES NO
· IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
survey, to scale, with accurate foundation plan and distances to property lines. 0/1
6.
Provide
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
;TATE OF NEW YORK)
SS:
:OLrNTY OF'ff4f'f,g,,",/~, )
I(:9,~-V'/7/0 .CQ5 /,tf~--~XJ0f---q;('/'~'' being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
S)He is the
(Contractor, Agent, Corporate Officer, etc.)
fsaid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application
aat all statements contained in this application are true to the best of his knowledge and belief; and that the work w/Il be
erformed in the manner set forth in the application filed therewith.
worn to before me this
~pul~,, ~ d New Yo~
N~,4~1~0~
Signature of Applicant r