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Home My WebLink About12562-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z. 1..2.5.1.6. ........ Date June 6 1984 THIS CERTIFIES that the building 7.-.n.e..w. ,d.w.e..1.1.i.n.~ ............................... Location of Property ...5.6.8.61. Right-Of-Way. off Main Road Southold House NO: .................... 's'de i ....................... County Tax Map No. 1000 Section 063 .Block 03 .... Lot 017.4 Minor Subdivision .... Jp.h.n..$.i.m.~.c..i.c.h. ........... ~lle'd-l~laffNo. 108 . .LotNo. 2 conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ....... J.u~¢. ~ 2 ....... 19 .~ 3. pursuant to which Building Permit No. 12562 g. dated September 4 19..., 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 ......... a private one-family dwelling. The certificate isissued to VINCENT & ILEANA DOLOMITE ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval .. } }7~7 ~P.~ t. ~/.~ ~ ~P.5. ~?~:. ~'..¥+ ~.a, UNDERWRITERS CERTIFICATE NO .......... ~. ~ ~ ~ Y~ .............................. Access road approved by Southold Town Planning Board at meeting of June 4, 1984, as a result of access road report No. 364 by John W. Davis, field inspector. Building Inspector Rev. 1/81 FO~.M NO. 2 TOW~ O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12562 Z Permission is hereby granted to: ~ ...~....~.~.~..!i~.~..~..~L.?_..,... ,o..~.~...~.~.:~..~~....c.~..~~) ........... / ........ zL ....... '. ~.....~~.L4.~ ........................................................................... .~ ...................... . (m~....~.~~~...~ ..................................................................... ,...~....~:~..~~.:~.~ ....................................................... ~,~ ~ ~ ~. ~ ~,~. ...... ~.~.....~.. ~ ....... ~ ........... ~ ~:~.~...~.~,..~ pursuant to application dat~ .... ~ ......... ~ ............. ,.., 19.~.~ and approv~ by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S,c) form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement o~ owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C, Fees: ]. Certificate of occupancy $,5.00 2. Certificate of occupancy on pre~existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ~/ Addition ................ Old or Pre-existing Building ................ Vacant Land Location Of Property .~./.~./?~./~.~.~..~...~.~.~.~..~...5~...~...~.~..~..~.~..~.~.~..~.!.z~.~.~.~ ...................................... Owner Or Owners Of Property ~/.~.~,~.....7.,,.~,~ .~.~.~.f. tT~ ..................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No. ~.~ Date Of Permit .2~.~T.~...Applicant ~1 ~.~,,,.~.~.~'.: ........ Hea~th Dept. Approval .~.~...~. ...... ~..~.~ ............. Labor Dept. Approval ................................................ Underwriters Approval ~ ~7~ . Planning Board Approval Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ .................................... ~ ~ J ~J ~ ~ ~a~c~es ann regulations [~ Construction on above described buildin~ '~ '~' ~ ~ ~ Applican~ ~¢~ ..~..~ ~ ~~Sw°rn to before me this · ~ ~~~ Notary Yubhc~~ ................ B~G. DEPT [ ~ / t No. 6078900 FIELD INSPECTION COMMENTS FOUNDATION ( 1 st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~OD~ FINAL COMMENTS: Southold, N.Y. 11971 (516) 765-1938 June 6, 1984 Ms. Elizabeth A. Cannazaro Riverside Homes, Inc. P.O. Box 274 Riverhead, NY 11901 Re: Access road within the subdivision of John Simicich Dear Ms. Cannazaro: The following action was taken by the Southold Town Planning Board at the regular meeting of June 4, 1984. RESOLVED that the Southold Town Planning Board approve the access road report of John W. Davis, field inspector, No. 364 recommending approval of the access road within the minor subdivision of John Simicich located at Southold. Enclosed is a copy of that report for your review. Very truly yours, BENNETT ORLOWSKI, JR.~ CHAIRMAN TOWN PLANNING BOARD gy Diane M. Schult~e, Secretary : Building Department wi. th enclosure ~ennet% Orlowski~ Jr.~ Ohai~an Southold ~bwn Flannin~ Board John 14. Davis Date, 1~ 15, 1984 MINOR SJBDIVI$ION 108 Of JOHN 3IMIOIOH AT 30U~HOLD FINAL ACCEPTANCE OF ACCESS B~AD I inspected the above access .~ad today as requested. Ail of the recommendations noted in Report No. 351 have been done. ~he stor~ blend top course is now acceptable as ~o depth and width and the ungraded shoulder area has been corrected. I recommend approval of the above access road. 765-1802 BUILDING DEPT. NSPECTIONi FOUNDATION XST [ ] ROUGH P~BG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING [*~FiNAL /~ REMARKS: /~.2f : DATE INSPECTOR ~o~ THE NEW YORK BOARD OF FIRE UNDERWRITERS I~UREAU OF ELECTRICIT~ , Z~ 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 Janizary THIS CERTIFIES THAT only the e~ctr~cal equipment ~ descrtbed below and tntroduced by the appltcattt ~am~d on the able applwatton ~utnbe m the premises of in the following location; ~ Basement ~ ~,, FI. ~ 2nd FI. Section Block Lot was exa~nlned on ~ ~ } '[~ and found to be n compl a~e w th the r~quiren~ents of this Board, FIXTURES ~NGES OVENS DiSH WASHERS EANS FIXTURE SWITCHES OUTLETS FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R * I C OTHER APPARATUS: This certificate must not be altered ,n any manner; return to the office of tb,~ Boa[~f if GENERAL MANAGER be 'identified by their credentials. MANNER. Disapproved a/c ............................................................................................ TOWN OF $OUTHOLD BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Applicotion No ................................ (Building Inspector) APPLIGATION FOR BUILDING PERMIT ~ Date ........... ~.....~r... ......... , INSTRUCTIONS - LL~4~L a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate 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 ofproperty must be drawn on the diagram which is part of this application. 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 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 o 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 buildings for necessary inspections. RIVERSIDE HOMES, INC. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................... ~m.~ ~/. ~ .u..t..Z..a..e..r. ............................................................................................................................... Name of owner of premises ..,V.,J;.r!a..e..n.~...&....Z..];.e.?..e..~....D..9..~ .°,~.L..b..e ................................................................................................ If applicant is a corporate, signature of duly authorized officer. S. Gordon, Secretary/Treasurer (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ~040~ Electrician's License No ..... ,~..6. g..7..B. .............................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ..D..e..s..a..~..~,.b.9..d...~.~.9. g..e.K~7.... Lot No ......................... Street and Number N/S HaJ_n Road ojg._~..o.s±te ~oun [-[arbor hone $outho~d~ NY ~ic~Oi ........................................................................ ........ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Vacant b. Intended use and occupancy ...O..n..e...~.rg.¢.~,y....D..~..e..~.~.n.~. ....................................................................................... 3. Notulre of work (check which lapplicobie): New Buildmg' .....~,X.~ ........ Addition ........... ~ ...... Alteration .............. Repair .................. Removal ................... Demolition .................... Other Work ................................................... ~. (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~ ................... Number of dwelling units on each floor ............................ dne If garage, number of cars ......; ...................................................................................................................................... 6. If business, commercial or ~nixed occupancy, specify nature and extent of each type of use ........................... 7. Dimensions of ex st ng structures, f any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure w~th alterations or additions: Front ....................................Rear ............................ Depth ................................ Hieight ............................ Number of Stories ................................ 8. Dimensions of entire new conbtruction: Front ....... 4.3..' ........................ Rear ....~.3. J, .................. Depth ..... .3..3..' .............. Height ...2.~: ............. Number[of Stories ...~.q ............................................................................................................. 9. Size of lot: Front 180'66" 172'03' 275'13" .................. : ...................................... Rear .......................................... Depth ................................ 10. Date of Purchase .~anuar~. 12 1985 Name of Former Owner J.OD~...U,Cg~.0~-.~,b...J.~.,.,,~,,.J.o.b.n ........ 11. Zone or use district in which premises are situated ................................................ -~.P..J:.9.e..3.'.?..~.~.? ................................. 12, Does proposed construction violate any zoning law, ordinance or regulation: ....N...o. ................................................. 13. Will lot be regraded ..~.e.~ ................... Will excess fill be removed from premises: ( ) Yes (X) No Name of Contractor RLve~J, cle Home~. Zne. Address ~J_vePhe~d, HY Phone No. PLOT DIAGRAM Locate clearly and distinctly al( buildings, whether existing or proposed, and indicate oil set-back dimensions from proparty lines. Give street and blo~k number or description according to deed, and show street names and indicate whether interior or corner lot. ' SEE ATTACHED SURVEY J c~-FA"FE OF NE'~ YORK. I c ¢ COUNTY OF .,.8..U.~?..O..B,,K. ................ f-,.-,, , .................. duly sworn, deposes and soys that he is the applicon, (Name of individual signing contracf) above named. · .... He is the ....A.~.e.~.t,...[g..~....B.g.~;kf~.tr:.....~ ....................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized ~o perform or have performed the said work and to make and file fi~is application; that all mrs contained in this application are true to the best of his knowledge and belief; or~d that the work will be in tee Sworn to before me this .......... ./..../. ........ day Notar manner set forth(~_~he appllc~ti~n~with. .,., 19 ........ ~ ~- ~- , County ......... ~~ ............................. (Signature of applicant) Slate m Su~ 0 k Ca'u.ty No. 52-4S0~884 £0mmisslOn Expires March Z CVS:AN'r) ..:.pi 'THE CHI( 0 .~. f-<OAO RIVERSIDE HOM'~:~ P. O. Box 274 Riverhead, New York 1)901 Z 0 L8 0 -- ~ ~:,,~:~_~_~ ..................... -ro MAIN '1 N O:i'1~ ILD~NG DEpARTMENT~.,Aj,. ~6~-~802 9 AM TO 4 PM FOR FOLLOWING INSPECTIONS: 1. FOUNDAT ON - ~0 REQUIRED FOR pOURED CONCRETE 2 ROUGH ' FRAMING & pLUMBING ~. INCULATION 4. FI~L - CONSTRUCTION MUST BE Cn~PLETE FOR C. O. ALL CoNSTRIICTION SHAL~ MEET , i 1204.00 + 65'00 + 462.00 + "~1 '-~" .___~__~__~ .., 22'00 43'00 336'00