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Home My WebLink About15406-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19t26 Date JUNE 8, 1990 THIS CERTIFIES that the building~ ADDITION Location of Property 775 MIDWOOD & 55 PINEWOOD RD. House No. Street County Tax Map No. 1000 Section il0 Block 03 Subdivision Filed Map No. CUTCHOGUE r N.Y. Hamlet Lot O1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 9~ 1986 pursuant to which Building Permit No. 15406-Z dated OCTOBER 17, 1986 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 SCREENED PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. WILLIAM LOMBARDI (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-8t1520- MAY 26, 1987 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 · 0~ NO. Jl TOV~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. BUILDING PERMIT (THIS PERMIT MuST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .................... ................... ..o.. ~ ~:.....~. .............................................. ,o .~~....~.....~..~....~m........~.~..~,.,...~...~ ~ ..... ~' ..... ;'~ ...... ;:,"'"~"L ........ at premises located at ..~..~... ~ ~ ~~ ..... ~.~' County Tax Mop No, 1000 Section ....... J./....O.. ........ Block ....... .O.,~x .... Lot No ...... .(~...1 .......... p,rsuon, to application dated .....C~.....~.'~..~......~. .................. , 19..~..~ ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY &. This application' must be filled in by typewriter OR 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 statefi~ent from plumber certifying that the solder used in system contains } less than 2/10 of 1% lead. 5. Commercial building, indus, trial 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 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 o£ 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 Building - $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 ate ........................... New Construction .......... · Old Or Pre-existing Building ................. Location of Property....~.C.'.7-~.O.~lp.~ ...... .~.2%-- b~'Oa .... &, ........................ House No. Street P/armlet 0nwer or Owners of Property..~..f~.:..Z,O./~..~.J] ...... County Tax Map No i000, Section... 7./...~). ..... Block ...... .-~. ....... Lot./. .................... Subdivision - Filed Map Lot '~~]. Date Of /.O,l~../~C~. rmit No,lS, /. Mealth Dept. Approval .......................... Underwriters Approval.....~..... ............. Pla ning Board Approval Request for: .Temporary Certificate ........... Final Certicata ........... Fee Submitted: Co ~- IV/o?(,, TOWN OF SOUTHOLD OFFICE OF BUILDING IN~P£CTOR P.O. BOX 728 TOWN tlALL ~- SOUTItOL~), N.Y. 11971 HAY 31, 1990 TEL. 765-1802 A. REILLY & SONS, INC. BOX 434 HATTITUCK, N.Y. 11952 RE: WILLIAM LOMBARDI TO Whom This May Cogcern, We are unable to complete your Certificate of Occupancy beca%]so.of the following reasons. /--/~/An application for Certificate of Occupancy is not on file. (ENCLOSED) /--/_//No Underwriters Certificate on file. /~The check is(Q~<~d/not on lithe.) $25.00 /5/ No llealth Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit tt I 5 4 0 6 Z Building Dept. ***/~ No Plumber Sol~[er Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS [(~0['~'~* BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS ~ERTIFIES TNAT Wm~ ~ombardi~ ~a~:wood Dr,~ pi~wood Rd,~ & ~idw0od Rd,~ C~t~og~e~ ~ in the following I.cation; ~ ~,e,.e.t ~ ~ ~7, ~ ~.d s. O~tside .sea,lo. Bilk Lo~ was examined on ~ay [0 ~ 19S7 and /ound to be in compliance with the req.irements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS ~JTLETS SWITCHES FLUORESCENT UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I' C E NO OF HI-LEG OTHER APPARATUS: NO OFECCCOND'pR~' A, W, G, O~ CC COND, A, W, G NO OF NEUTRALS A, W, G OF HI-LEG OF NEUTRAL Jody P~millo P~t~am Lane 1~952 lic.~2300E MkNAGRR This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE I~UST NOT BE ALTERED IN ANY MANNER. 'OUNDATION (2nd) tOUGH FRAME & PLUMBING CODE FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION L~FRAMING [ ] FINAL REMARKS: DATE ////~/~,, INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~"FINAL / DATE/ ~% :' 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEL,: 765-1802 Examined .Q).~. !.-/ .... 19~.~. Approved O. 9-~...ee~.... ).'~ .., 19~.k Permit No. ]..~7.~.O..~. ? Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,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 Permi! 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 necessary inspections. ..... .... (Signature of applicant, or name, if a corporation) (Mailing address of applichnt) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Z.,o .,r; ~,:q,,e. o I Name of owner of premises .... .~...'~. ' · ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate offiger) - ' < Builder's License No .... .g/..~..' ................. Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done..,~_~ ............................................ ....-7. z.& ....... .c7. (.v. House Number Street Hamlet County Tax Map No. 1000 Section .... //.Q ......... Block ...~. .............. Lot. / ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... /...,~..,~..,~.../.~/....fl..../,~..~..~..~./..~..6'f ........................... b. Intended use and occupancy ..... .--'~.C.4~.~. ?../.'.~..~..~.... ~...~.~...~.~.:~..- ....................... ~ ~ i. 3. Nature of work (check which applicable): New Building ... ' Addition . .. Alteration ' . ........ Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4 Esti dC Fe · mate cst ............. ' ............ e '.., ............. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling uhits on each floor ............ :-.; If garage, number of cars .......................................... ! .............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each iype of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ..... ' ......... Depth ............... Height ............... Number of Stories .......................... 1 .............................. Dimensions'of same structure with alterations or additions: Front .......... ! ....... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... '-,8. Dimensions of entire new construction: Front .......... . ..... Rear .............. Depth ............... Height ............... Number of Stories .......................... 9. Size of lot: Front ...................... Rear ..................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ....................... 12. Does proposed construction violate qn~ zoning law, ordinance or regulation: ..~ ............................. 13. Will lot be regraded ......... ./~'. · ·: ........... ,.. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .~d.~ .... ~..°/P..'~.;I. ~'/)1 Address ............. i ..... Phone No ................ Name of Architect ........................... Address ............. i ..... Phone No..~t.~,~2 Name of Contractor~..,/('¢././-:(-./.-~-...,/~} t~.,~.(./..,~'.~. Address g~,)C.r%'.,~/<..,(";/b~..' . Phone No .................. 15. Is this property located within 300 feet of a tidal wetland? ~¥es ..... No ....~JU~--. *If yes, Southold Towm Trustees Permit maybe 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 shbw street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... ........ S.S . ·. · .~.. ,".'.~,'9~-r~ ...... ,~.~../..~' ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etci) of said owner or owners, and is duly authorized to perform or have performed the Isaid 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 ............ .~9.~.. ...day of /D ........................ ,19... Notary Public, ~ ~' .~...-~. '.~. ·.. County ,-~-,,.--,-- le~m zxplre~ March 30, lO---q-°/ VI~IL~AM £OMBAt?DI ~ PHYllIS I OMBAt?DI AT CUTCHOGU~ 0ATE: NOV, I~ 1985 TOWN OF SOgTHO/.D SCALE: ~ SUFFOLK COUNTY, NEW YORK NO. 83'/0~4 # UN~UTHOJ~IZEO ALTERATION OR ADDITION TO THIS SURVEY I~ & VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW ~,~ #COPIES OF THIS SL~VEY NOT ~ARING THE LAND~~ SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEAVALID TRUE COPY NGUARANTEEE INDICATED HEREON SHALL RUN (~ILY TO THE P~RSON FOR WHOM THE SURVEY IS PREPARED HEALTH DEPARTMENT-DATA FO~ APPROVAL TO CONSTRUCT ANO.~ HIS BEHALF TO THE TITLE cQJ~P~Y, GOVEJ~N- # NEAREST W*~.J~ I~AIN__Mt, -+ N SOURCE OF WATER: P~IM~TE __pUBLIC __ MENTAL AGENCY AND LENDING INSTITUTION LISTEO~'~"~'~[' I~L~FFCO. TAXMAP DIBT I~OOSECTION I"0 ELOCK ~ LOT ! HEREON, AND TO THE ASSIGNEES OF THE LENOING MTHERE ARt: NO D~'ELLINOS WITHIN lO0 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADOITIONAL INSTtTUTION$ OR SUBSEOUENT OTHER THAN THOSE SHOWN HEREON. OWNgRS r~L. '~i ~11_, 400 OSTRANDER AVENUE YOUNG YOUNG NOT~t III ~ .- $~r~/~- ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAN0 SURVEYOR~..Y.S. UCENSE NO. I HOWARD W. YOUNO, LAND SURVEYOR # ~ LOCaY~N OF V~LL(W ), SEPTIC YANK(St1& CES~aOOLS(CP) ~IOWN ~RE0~ N.Y.S. LICENSE NO. 4589 ~ BRANDIS & SONS, IHC. [6[8 ~OVED AS ~oT~ ~LOWING IN~PEC~ONS: EOUNDATION ~0 REQ~R~ ~ ROUGH FRAMING & PLUMBING 3 INSU~T~ON ~ FINAL CONSTRUCTION ~UST ~ COMPLpTE FOR C.O. THE REQUIREMENT5 ~ THE N.Y ~A~ CONSTRUCTION & E~GY ~OO~ NOT ~NSI~E ~R ~tGN OR CGNST~ION ~RORSr OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY