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Home My WebLink About13047-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No. Z- 15694 Date.. April 27 1987 THIS CERTIFIES that tbe building ACCESSORY ANTENNA Location of Property ...8.2.4..5..O.r.e.$.o.n..~9.a.d .......... C.u. tch.qgue.,. New Y. qF.k ........ House No. Street Hem/et County Tax Map No. 1000 Section ... p.9.5.. ..... Block .... l ........... Lot . J ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Apr~l 16, !984 pursuant to which Building Permit No. 130/47. Z dated .... Ap. ril 17.........., 198/4 ....... 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 ......... ACCESSORY ANTENNA The certificate is issued to . HENRY DOMALE SE I .................... io;,;,,'o;, (or i 'ddr .................... of the aforesaid building. Suffolk County Department of Health Approval ......... ~ [ .A .............................. N802829 UNDERWRITERS CERTIFICATE NO ' N/A PLUMBERS CgRTIFICATI. ON DATED: Building Inspector Rev. 1/81 1~0uM NO. S TOWN OF SOUI'HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION O~: THE WORK AUTHORIZED) N? 13047 Z · / Permission is hereby granted to:~ ~-~ ~o ~' ... ~ · ~.... ~ · ......... ..... ............... ..:~.~: ...... ~....~..,..~ ~,.. ~ .............. Co;nty Tax Map I~o 1000 Section ......~...~..~.. ........ Block ......... ]. ........... Lot No ....... I.J. ...... pursuant to application dated .... ~..../..~.. ......................... , 19~...~..., and approved by the Building Inspector. Bullding Insl>ector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - ].802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~a maa=~a~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu~al natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposel-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate su~ey of property showlng all property lines, streets, buildings and unusual natural or topographic features· 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety [nspectior~ of buildings or premises, or other pertinent info:ma- tion required to prepare a certificate. C. Fees: 1. Certificate gf occupancy New Du(,,Ll/ng.$25.00, Acce~socy '~0,00 2, Certificate of occupancy on pre-existing dwelling $ .50.00 3. Copy of certlficate of occupancy $ 5,'00, over 5 ye,re $10.00 5.Uodated C.O. $ 50.00 Date ............... 6. Alteration $25.00 New C on s t r u c t, t on Old or Pre-existing Building Vacant Land Location of Property . ~. ........ Hou$~ NO. i i '.J Street · ' ' Flied Map No Lot No Subdw~slon .......................................................... Permit No.I ~.0.~'J2. '.~... Date of Perm t. 7.,z7~...;....App cant. T~(~.. ~.4~.~....' ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval . Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...~..; ..O~. ..................... Construction on above described building and permit meets al~plicable codes and regulations, %~' 3193A THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ,~['l.[ (~ .]-~8 7 85 JOHN STREET, NEW YORK, NEW~6~j87~o, 0o3~ THIS' CERTIFIES THAT o~y the el~trlcal equipment ~ ~scribed below a~ intr~uced by t~ appl~ant ~med on the a~ve appBcatJon number i~ the presses of ~ry ~oma~e~, ~t~ Orego~ Koad, CuC~o~uo, ~ in the following locatlon; '~ Basement ~ Ist FI. ~ 2nd FI. OUC~de Section Bilk Lot u, as examined on ~h ~0 ~ ~ ~ and found to be in compliance u'it h the requirements of tbis Board. RX;UaE FIXTURES RANGES DISH WASHER EXHAUST FANS OUT.TS ~ECEPTACtES SWITCHES FLUORESCENT VAPOR DRYERS FUTURE APPLIANCE FEEDERS ~NIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S OTHER APPARATUS! E R V I C E A W.G. NO OF HI-LEG OF CC. COND Oregon ~oaU Cutchogue~ ~g 11935 This certificate must not be altered in any manner; return to the office of the Board if incorrect, nspect~'s GE, R MANAGER may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY ANY MANNER. FIELD %JSFECrlO~' ~ i FOUNDATIOI,I (~$t) FOUNDATION (2nd} 2. ROUGH FRAME & PLUMBING INBULITION PER N. STATE ENERGY C,ODE COMMENTS FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ......... .~..& ~ ..... ~..~.~ ~.~..~ ........ · '' ' . PLEASE TAKE NOTICE that your application dated .... .~. O.,h. t.~, ./. O. ...... , 19. ~ for perrmt~go-aoa~.mct.. J .r~...~ ~ .- ................................ at Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section ...~ 9..~.~ ..... Block ..... 12).1 .......Lot ?/o.../] ....... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds .~;t~, .~..~. ~.. ~...%..'~J. ~.~..~z..~..~..'..~....~.0~..~.~.. .......... Building Inspector RV 1/80 March 10, 1984 Southold Town Building Inspector Town Hall Main Road Southold, NY 11971 Re: Application of Henry Domaleski SCTM #1000-095-01-p./o 11 Dear Sir: We would like to request a minor subdivision from the Planning Board for the two lots shown on the enclosed map. By Resolution dated July 26, 1983, the Planning Board granted a set-6ff of the parcel from the remainder of the farm, with provision for a 25 foot right of way over the farm from Oregon Road. I would appreciate your forwarding.a notice of dis- approval so we may proceed with a minor subdivision ap- plication. Very truly yours, Abigail A. Wickham AAW:emu encl. TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ttALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 13047Z issued to Henry Domaleski on 4/17/84 for K¢cessory is completed and a final inspection has ( ) has not ( x ) been done. [n order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy ia to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. ['lease help tls to clear tip this matter so that legal action does not have to be taken. Thank you for yeur prompt attention. Very truly~, Victor Lessard Executive Administrator VL:gar cncl. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1803 ;xamined · · .~.'... ).q. ..... 19~.!. ~pproved . !.~... ;~ · / iLe l'7 .... 19... Penmt No ............ )isapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19...,, INSTRUCTIONS -~ a. This application must be completely fil~ typewriter or m uik ~and submltted to the Building Inspector, with 3 :ts of plans, accurate plot plan to 'scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relation{ship to adjoining premises or public streets r areas, and giving a.detailed description of layout of property must be drawn on the diagram which is part of this appli- ~.tion. c. The work co~ered 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 roll 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 .roll 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinmtces or .egulations, for tile construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to flmit authorized inspectors on premises a~d. in building for necessary insp, ectio (Signature of applicant, or ham~, if a corporation) ... ...... (Mailing address of applicant) ~ (Name and title of corporate officer) Builder's License No .... ~ ~ .~. .............. Plumber's License No ......................... Electrician's License No ....................... {tate whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. of owner of premises (as on the tax roll or~e~ f applicant is a corporation, signature of duly authorized officer. 7654802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNmATION - TWO REQUIRED FO'~ ?~URED CONCRETE 2. ROUGH - FRAMING & pL_UMBING 3. INFU .... c~rcmo r"r ON MUST BE C'~TF FOR C.O. ALL CONSTR'~C-F}ON SHALL MEET ~ ......... THE REOI IorMc-N'TS OF THE N, Y ~1 ~ STAT~ CONISTRUCTLON Loc ' ' ' c done ~e~ r ~ ~' t~T ~ FOR 'atmn of land on wluch proposed work will b .......... ~...'.. County %x M~p No. 1000 Section ...... ~.S~ ..... Block ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... r,.~ ?. ~. .............................................. b. Intended use and occupancy ...~.~ ~..~. ;~.q .................. 3. Nature of work (check which app!icable): New Building ..... ' ..... Addition .......... Alteratjo~ .......... Repair ............ Remov:al ........... Demolition .............. Other Work,.~'I55.,~J~ ~.,fi.~., ~ (Description) 4. Estimated Cost .... s .... ; ................... 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 cars ...... I .......................................... 6. If business, commercial or mixed :occupancy, specify n0aturc and extent, of ea, c.h type ,of use ................... 7. Dimensions of existing structures; if any: Front ..... ~... Rear .. [~ .... Depth ...~... Height...~....NumBerofStories ...................................................... ·, .... Front Rear Dimensions of same structure with alterations or additions: ................................. Depth .................. ~. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction Front ......... Rear ........ De ............. .}.2, ,g.e~.?5 Number of Stories Height .................................................................. ' Rear Depth 9. Size of lot: Front ........... , .................................................... 0. Date of Purchase ...... ., ............. Name of Former Owner ........................... 1. Zone or use district in which premises are situated ..................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ...~/O. ......................... 3. Will lot be regraded .... 3d.q I ~'o~ .~ ................... Will excess fill be removed from premises: Yes 4. Name of Owner of premises . .rl~ r~. ~0~.~otfd~'.... Address ................... Phone No ................ ..~ ......... Address ~i.PhoneNo. ~ ...... .~.;. Nmne of Contractor...~ Address . .I~.LOT DIAG RAM ,~. · · ' osed and, indicate all set-back dimensions from Locate clearly and distinctly all ibmldmgs, wlT~ther existing o prop , ' ,roperty lines, Give street and block number or description according to deed, and show street names and indicate whether, ~ATqE OFNEW YORK, .OUNTY OF ..... ~.V .~:°. · (~. ..... S.S ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .bore named. is the ..................... i ..................... ' .................................. ~ ......... (Contractor agent corporate officer etc ) said owner or owners, and is duiy authorized to perform or have performed the said worl~ and to make and file this pplication'; that all statements con!ained in this application are true to the best of his knowledge and belief; and that the york will be performed in tile manner set forth in the appligation filed therewith. ;worn to before me this . .L~.. .day o~...~4-~. .... NOIARY PtIB~IC, State 0[ [%w YoirI( No. 4707878, Su~i~lk lerrn Expires March 30, County .:. ........ (Signature of applicant)