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Home My WebLink About14925-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15825 Date June 9, 1987 THIS CERTIFIES that the building ...0..n.e.. f.a..m.~.l.y...dy.e.1.1..i .nM.. ...................... Location of Property 1580 COUNTRY CLUB DRTVE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section . . .1.0.9. ...... Block . 0.3 . .Lot 2. 16 Subdivision Country Club Estates ..... Filed Map No. 109 ...LotNo. 19 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 15..a y..8.,..1.9.8. 6. ...... pursuant to which Building Permit No. 14 9 2 5 Z dated .. ~ a..y..1.2.: i .1.9.8.6. ............ 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 ......... .... On.e. fam.il.y. ~i.~.q ! .1 .i.n.g,..2..qa..r.g.a.r..ag.e.: ................................... The certificate is issued to FRED J. & ARLENE B. LOHBARDI ..................... ?o¥,'o;, 'glsi e'x, kYe& ' ...................... of the aforesaid building. Suffolk County Department of Health Approval .... 8. ¢ r .S.q-: J .5.7....~ .a y.c.h...1.6.,.. 1 9 8 7 N78544.7 UNDERWRITERS CERTIFICATE NO ................................................. PLUMBERS CERTIFICATION DATED: June 3, 1987 Henry P. Smith ........ Building Inspector Rev. 1/81 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) Permission is hereby' granted ~ _ .... ~.~:.....~.:~.~.../,~ ..... a~.~..C~.~,~....~.~:. ................ ....... ~..c,r~.~a.~..~....../Z~..~., ,o ~~.%~....o~ ....... ~.~...~//~......~ ............... ........... ~...~...~ ~ ~. ~ . . .~~ x ............................................. ~,~,~e~,~,~ ~, ....... 4~....~~......~.~....~.~ .............................. ..................................................................................................... ..~~..~..~.~.~ ............................ L.~..L...~..4.~. ......... L ................ Building Inspector. ~e ,..~X...~ Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 01071 85 JOHN STREET, NEW YORK, NEW YORK "10038 .a~e December ~3,~6 ..p,..,,o.~o.o. Zil. 42as6s/~6 N 785447 THIS CERTIFIES THAT only the electrical equlpntestt os d~scrlbed below and introduced by the applicant named on the above application nurnber in the premises of Fred Lombardi~ 158(1 Country Club Dr., Cutchogue, N.Y. was examined on I) ec omi) o r 1 ] ~ ] 9 8 6 attd found to be in compliance u, lt h the requ iremen ts of this Board FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES FtUORE$CENT 58 76 59 54 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS EXHAUST FANS TIME CLOCK~ [JNIT HEATERE MULTI-OUTLE DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E 4/0 OTHER APPARATUS: H.P.s, -4~lOOwatt Motors-l-~/4H.P. 1~2 Ton A.C. Unit, 1-4 Ton A.C. Unit 2-Air Hand,ers, Elec, Room Heator-]~].BK.W. 4/o Smoke Detector-1 G & S Electrzc Box 215 Southold, N.Y., 11.971 1ic.#578-E Gk'NL~A£ MANAGER · Per-- 11 ~. l~ ~__ This certificote must not be altered in any manner; return to the office of the Boord if incorrect. Inspectors may be identified by their credentials. HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--3690 Inc. CERTIFICATION D a t e _ J~a~-J~_~_7 ...... Building Permit No.__~ag~3~ ....... 0wner_A_~L~_~E~_~A~_~_~j. Plumber HenEz J. Smith & Sonz Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this _3.ud__day of _~m~u~ ...... , 19_~_7__. Notary Public, Suffolk County ~IERNAO~ L NOTARY PUBLIC, State of New York ~;id~ m S~dlolk County ~mmis~ E~p~res ~ 30, Notary Public #4844893 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ m 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 unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal-(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, B. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing 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 inspection of buildings or premises, or other pertinent informa~ tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O., /, $ 50.00 Date ...~J.c~C..~w .......... J.~,~'.~ NewConst~'uction...v... Old or Pre-existing Building ............ Vacant Land ............. Location of No. =_ -- s;r;;t '"// ...... Owner or Owners of Property . ........... ~ ...... County Tax Map No. 1000 Section.. . ..../0 .~.... ... Block .... .~ ....... .. Lot..(~).~). T.' /~2 ..... Subdivision .... CO. (g,~n ~. C./(-~. J~....~'.~:~.;..Filed Map No ........... Lot No... ~. ~. ....... Permit No. /~./'~. ~.~.~ .~.. Date of Permit.. ~.~/..~/.?.~.Applicant .~.~.-~.J~ .~...~ .~'./0~)1'.. ~/~L../. Health Dept Approval Labor Dept Approval Underwriters Approval Planning Board Approval - ' Request for Temporary Certificate ..................... Final Certificate Fee Submitted $....~. ~..,...~. ............ Construction on above described building anat. meets all applicab~odes and regu Applicant.. ~/1~.(.~... ~,./~'..(~..~. ~...~... ......... Rev. 10-10-78 FIEL~ -INSPECTION [DATE COMMENTS ¥ FOUNDATION nd) ROUGH FRAME ~ '__~~.7~~ FINAL ~ ~ ~ ~ ~~~ ._ , ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL INSPECTOR 7G5-181)2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION AND ~/INSULATION /, FRAMING ~[ ] FINAL REMARKS: 7GS-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE iNSPECTOR,/~~d BUILDING DEPT. REMARKS: ~ ~o~u~ISPECTION [ ION ~ST[ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL ,,, DAT~ iNSPECTOR~'~c~,~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL t~ouse tvo. ' ~'treet ~' Hat.tot County Tax Map No. I000 Section ./..0...<~>. ....... Block 0.~. ......... Lot .0..4~..~: ./..~... Subdivisio~.~.~ .~.°.~. ..... A~C~-'Filed Map No ................. Lot No .... ./.9 ............ s returned herewith and disapproved on the following grounds ............................... ....... X~¢'.,/,<~. ..... ~... ~F.....o. ~ .... Z~c~./~.,~......~..4.~.../_Y..~... Building Inspector RV 1/80 10. 11. 12. 13. 14. 3. Nature of work (check which applicable): New Building .... '.~.... Addition .......... Alteration .......... Repair ! .~ i i~ ~ '" ¥~ ' ' Removal .............. Demolition .............. Other Work ............... ~ ~_~ ~ (Description) Cost..[.~/~''.ta,, 0~... ........................... Fee ........................... 4. Estimated (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 ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same strncture with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number o[ Stories ...................... 8. Dimensions of,enti~e new construction: Front ..... .~.~. ..... Rear ... ~.~. ....... Depth . ,~.O .......... Height .... ,~ ....... Number of Stories ...... ~. ................................... z ........... 9. Size of lot: Front .... ,/.7...g.t ............. Rear ....... /Tr. ........... Depth ... ~. ?'~. ............. Date of Purchase ... ,', ......................... Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposedconstruction violate any zoning law, ordinance or regulation: ..... .,,~..0. ...................... Will lot be regraded . .~. ........................ Will excess fill be removed from premises: Yes 9<~ No Name of Owner of premises /~-d.~./~-~.~. ,~.~O-: Address/.~d~e~c-/2'~'JP.~d,~. Phone No. ~2.3 :-.~;r.2,-ff. .... Name of Architect ........................... Address ...~.~ .~.~.~. ...... Phone No. Name of Contractor ~.; .~ordZ-g~.2. ~{d/f,~9~. Address .~}/ot2'~o~,~ X~2... Phone No. 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 show street names and indicate whether interior or corner lot. STATE OF NEWYORK, _ ~ COUNTY OF ...... ~?. ~ .K'~.. ....S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the.. ~-j~..~.. d~. f~..-. ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said 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 ............ ?. .......... day of ..... .'~...~--'.J. ...........19 .~.~ Notary Public, .~. · .~:....~..O.. ~....~.~ ...... County ...... · n~ ~ ~,~t7 (Signature of applicant) ,V 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y, 11971 TEL.: 765-1803 .... Approved ................ , ]~ ,j.. ~e~it No ............ Disapproved a/c ............... [ ...................... (Bmld~ng Inspector) ~PLIC~TIO~ FO~ B~ILDI~ INSTRUCTIONS Received ........... ,19.., a. ' Tkis application must be completely filled in by Wpewriter Or in ink and submitted io 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 l]~ilding Permit. d. Upon approval of this appliqation, the Building Inspector will issued 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 a Building Permit pursuant to the Building Zone Ordinance of the To~vn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction df buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply wi~h all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on prerflises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of~pplicant) State whether applicant is owner,,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicimt.is a corporation, signature of duly authorized officer. (Name and title of corpqrate officer) Builder's License No .... P1 b's L' ' , um er mense .......... Ele '' ' L' N ctrlclan s lcense o ......... Other Trade's License No... ~ .............. 1. Location of land on which proposed work will be done ............................. ..................... ................................... ~ireet ............................ House Number Hamlet County Tax Map No. 1000 Sec :ion ...... /..O..~. ....... Block 0 P'~ Lot Z'/.~q:~. Subdivision.. ~0.O~7'./~.~. f,~/.,/t~...~"~7"'~ ..... Filed Map No ............... Lot.,./~. ........ (Name) 2. State existing use and occupangy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,. ........................................................... b. Intended use and occupancy~ DRAINAGE AREa PARK & REC. AREA L_o~ ~9 MARSH AREA NOTE: ~:STAKE ~=MONUMENT ~R/A= 4T~259 SQ. FT. SUBDIVISION MAP FILED IN THE ~FFI~ OF THE CLERK OF SU~OLK C~NTY ON OCT. 17, 19~ AS FILE N0.6756 ~THE LO~ON OF WELL (W),~PTIC TA~(ST)~CESSPOOLS(CP) ~OWN ,HEREON ~R; ~0~ ragED OSS;~W~ONS ~D OR DATA OS~AIN;D O SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES* FOR APPROv~ OF CONSTRUCTION OF /Sing~ Famii)/Residence Only APPROVED_ /'--~ ~c.~ UNAUTHORIZED ALTERATION OR AODITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW COPiE~ OF THIS SURV£y MAP NOT BEARING THE LAND ~JRVEYOR'$ INKED SEAL OR DRIVE N. 88°4l'10"W. 4,W. REVISIONS Ld 0 0 AUG ~ 1985 S.C, DEPT. OF HEALTH SERVICES YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD Wo YOUNG SURVEY FOR: FRED J. LOMBARDI 8, ARLENE B,.,>~:;~'""~"~ LOT NO. 19 "COUNTRY CLUB ESTATES~s' SUFFOLK CO., N.Y. BY ~ SCALE: I": 50~ JDATE: JUN I0, 1985 NO. 85-~08 DRAINAGE AREA PARK ~ REC. AREA CoX 75' MARSH AREA ~.y ~.~A, ~ DEPARTMENT ...~ ~ -~ 16 1987 .__.----- DA ~ ...... THE SE~J. LOC~TiO;',, -,.. .... ~' HEALTH DEPARTMENT-DATA -~-NEAREST WATER MAIN__mi -+ ~ SOURCE OF WATER- PRIVATE_~P NOTE: ~=STAKE m=MONUMENT AREA= 47,259 SQ. FT. SUBDIVISION MAF FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON OCT. 17, 1978 AS FILE NO. 6756 ~I~THE LOCATION OF WELL{W),SEPTIC TAM((ST)~CE$SPOOLS(CP) SHOWN HEREON ARE FROM FIELD OBSERVATiONB AND OR DATA OBTAINED FROM OTHERS. UNAUTHORIZED ALTERATION OR ADDITION TO THfS SURVEY IS A VIOLATION OF SECTION 7[09 OF THE NEW YORK STATE EOUCATION LAW COPIES OF THIS SURVEY MAP NOT BEAR&NG THE LAND SURVEYOR'S INKED SEAL OR GUARANTEES INDICATED HEREON SHALL RUN ONLy TO THE PERSON FOR WHOM THE SURVEy IS PREPARED~ AND ON HiS BEHALF TO THE TITLE COMpANY, GOVERNMENTAb DRIVE j Z Ld N 88°41'lO''w. REVISIONS 0 0 AUG. i5, 1985 JAN 25, 1987 FEB. 23, 1987 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: FRED d. LOMBARDI 8, ARLENE B. LOMBARDI LOT NO. 19 "COUNTRY CLUB ESTAT~ SUFFOLK CO, N Y 1-*,,,,... "¢1~ "gILDING DEPARTMENT AT 76~1802 9 AM TO 4 PM FO~ THE 1, FOUNDATION ' ~O REQUIRED FOR POURED CONCRETE ROUGH- F~MING & PLUMBING 3, INSULATION BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL T"E REQUIREMENTS OF THE ~AT~ CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR I~ ~",'-, =-- Y~'-~=~" " ---'--f ~'"I ,. !~'- ~ ~,W~T~ ,'~[tl ~[ I :~- ~ - -=F'- · ~ 1__ ~i~ ~'-! ' T ~ _. ~ . I~ ..... ~ .... . ..... ~ . [ ~ -~~- ~ :~= ,~._ ~, ,t l~-: ,., ~ -- I ~ ---~1 I ~ * , ~' I~ ~d '11~ ~ ~M ~ ~ ~19 %~ ~L~ ~ ~l~ III : ~ I ~ ~'~ u =m ~ 1Mt --- ~ ~'~Itt FI/ ' ~ ~ ~ It ~',?~' / cai ~ ~ ..... ' ~ ...... : ........... ~ ........ ~- ~-- ~- ~" ~ ..................................... ~-- I% i 'I T-L~-L T~,. FF'F1- ~t(~ F- LtEVATIQq T/Hd. lq-