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Home My WebLink About14745-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 1.6.0.4.1 ........... Date . .A.u.g~u.s.~.. 1.3.,.. 1.9.8.7 ................. THIS CERTIFIES that the building .O.n.e..f.a.m.i.l.y..d.~.e.l.l.i,n.a ............................ sas. qo.!t' Cutchogue Location of Property House No. Street Hamlet County Tax Map No. 1000 Section . .q9.5. ....... Block .... 4. .......... Lot 18.5 Subdivision .q~.~.aqq .Vj.~?. ?.s.c.a. qe.s, ...........Filed Map No. 6.2.4. [ .... Lot No. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A.p.r,i. 1..4.,. !986 pursuant to which Buildiug Permit No. 14745Z dated a,p.r.i;l: .7. ,.. !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 ......... .... 0. n.e.. ~ dwellzng wzth attached two car garage . * Tile certificate is issued to .A.L.L.A.N..H..: .D.!lll.!Z.!O' .... io~n'e;,~~r~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ...8.6,';S.O.-:/!.8. .. July I4, 1987 UNDERWRITERS CERTIFICATE NO ............ pe.n.d. ~n.g ............................... PLUMBERS CERTIFICATION DATED: Allan Dinizio Aug. 7, 1987 Buiknng Inspector in SW bedroom barricaded not to open. *Without fireplace and sliding doors upstairs Rev. 1/81 l~OU~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, Ho Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTEtORIZED) 14745 Z Dote ' 19..~...~ Permission is herebt granted to: ...... .~..~.....~.~......~.,....~ ............... ~ ~..,,,,~C.... lu ,~ , ]1 ,~ d,. ~ ~o ...... ~ .......... ; ................................. L" , ................ at prem,ses ,~oted ot ..~..~.~...~~...~...~.: .......... ~......~. .....'~ ........... County Tax Map No. I000 Section .... ...(~..?J,...~'~.. ..... Block ......... ~ .......... Lot No....)....~...;..~.f ....... ~o,~t to ~p,,cat,on do,~d ........ ~...~ ....................... , '9.~..~., oncJ opproved by the Building Inspector. Rev. 6/30/80 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 i~ 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 featu res. 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: Additions $25,00 1. Certificate of occupancy New Dwelling,S25.00, Accessory,~$]0.00 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...?.~,~.~..~.~ ............ NewConstruction,,.~j., OIdorPre-existingBuilding ............ Vacant Land ..tH, ........ Location of Property..~..~..~. .......... 5i2 ~.~..~. .CO{.'~.,. J~: .......... .~..~..-~....~..1~..~. House No. ~lHamlet Owner or Owners of Property ......... -..-_, J.NJ ~. [ ~ ................................ CountyTax Map No. 1000Section..~).2 ..~. ..... Block ...... .~. ...... Lot..l?'..~':'.'. ..... Subdivision ................................. Filed Map No ........... Lot N~ .............. Permit No,I ./~ .~..~.~'..~Date of Permit .... pplicant ......... ,~ .... ~t ~ ...... Health Dept. Approval...~b~- .~' ~ (~. .Labor Oept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $..~.~..~I~.U~ f~. h' .C....d; .~ . .~ Construction on above describedbui~dir g.a~m~l/~~des and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOIFfHOLD, N.Y. 11971 August 13, 1987 TEL, 765-1802 TO: FROM: SUBJECT: Town Board Victor Lessard Exec. Admin. Refund Please issue a check to Allan M. Dinizio in the amount of $ 36.60. This refund is due to figuring the garage area twice when calculating the cost of Building Permit #14745Z. Thank you. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Owner n (please print~ \ Plumber ~[[~ /~, ~]~'~_~{~) (please print) I certify that the solder used in the water supply system contains less than 2/10 of l%'lead. Sworn to before me this ~ day of ~ , 19 r? Notary Public, JJ~ County HELEN lC DE VOE NOTARY PUBLIC, State of New Yolk . Ne.~707878, Suffolk Count~ germ ~xpiros Y~rch 30, (plumber's SignOre) Notary Public 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~INAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG' FOUNDATION 2ND [ ] IN~.ATION FRAMING REMARKS: ~ !~;~o !~:~ . 'DATE ,INSPECTOR 765-1~ BUILDING DEPT. [ ] FOUNDATION 2ND [ ] INSULATION -~/FRAMING [ ] FINAL REMARKS:, DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~]' ROUGH PLBG. FOUNDATION ZND [~j~INSULATION [ ] FRAMING FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [~_~UNDATION XST []ROUGH PLBG. UNDATION 2ND []INSULATION FRAMING []FINAL,_ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE 5-/g'//,P'~: INSPECTOR /~~ COMMENTS NSI~CTION FOUNDATION ~ (2nd/ 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD August 27, 1987 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 TELEPHONE (516) 765-1801 Mrl Allan M. Dinizio~ 845 Silver Colt Road Cutchogue, New York 11935 Dear Mr. Dinizio: Enclosed is a refund check in the amount of $36.60, which amount represents the amount due you as a result of a miscalculation of a Build- Permit 'fee. Very truly yours, Judith T. Terry Southold Town Clerk Enclosure ///,,/ . cc: Building Dept. TO TH E ORDER OF -- FOR GENERAL FUND PART TOWN DOLLARS 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .(~...'~ .... , Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,.].... TO?J~I'OF '$OUTHOLD Date ................... 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 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 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 insnections. ~ - , (Signature of applican~or nam~e,-if a corporation) (Mailing address of aplhlicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ................................ ; ..... : ............................................. Name of owner of premises ~l[~.~.,..~.:....~.[~.'.Z.j.~. .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of laird on which proposed work will be done .................................................. ...... : ............... ~ ~ ................... House Number Street Hamle~ County Tax Map NO. I0O0 Section .... Uq.~ ....... Block ................ L ...~ ............. Subdivision ~g~0~..~[~W.. ~'h..~ ....... Filed Map No. ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occnpancy .~a~.~.~. · ]~ .............. b. Intended use and occupancy . . ~SJ gB6~. ~ .... 3. Nature of work (check which applicable): New Building ......... Repair .............. Removal .............. Demolition Addition,.. ~ ....... Alteration .......... - i Other Work : (Descfi'ption) [ 4. Estimated Cost 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 ears ...... ~ ................................. - 6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .... : ................ 7 Dimensions of existing structures if any: Front Rear ! 'Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth ...................... Height ..... , ................. Numb~ of ,Stories ...................... 8. Dimens.ions ,of entire new construction Front ...~ .~. ......... Rear .. ¢. ~....' ...... De~th ...~>.~. ......... Height :~, .fi') ....... _. Nur~ber of Stories ..... [11~..~.~.~ ............... j ......... ~. ................. 9. Size of lot: Front . .~: ./~. q. '{-~;,L ~, ..... Rear .... ~.,.'~O ........... 1)epth ...*.3.?~?[ ............ 10. Date of Purchase . ./.via ~c ~. :. ! n. .~. ......... ~. Sql~e o~,f F~ormer Owner . ~ ][~ .fl~ac~. &. ......... 11. Zone or use district in which premises are situated..~e.~gJerc~ 0.[ ............ i. .................. i ....... 12. Does proposed construction violate any zoning law, ordinance or regulation: ../~ ................ ~ ....... 13. Will lot be regmded ...x]~ ............. ,.., ....... Will excess fill be r~mov~d from premises: [Ye~) No 14. Nmne of Owner of pre~mi~es' ,/~l Ita.~....A{,..~.tfl t.&t.o. Address .U./?..[o.q ~.d. ~., }~/~/': Phone No Name of Architect . D.i..e~ . ~ l.cr.[,~ .............. Address..~o~J,m[o~ ..... !..' . Phone Nol Name of Contractor .......................... Address .................. 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 desc'ription according to deed, and show street names and mdmate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF .... ....^ . ,...,.. ~ . . .. ~. ~[~...~.. ~ ].~.l. 7~1. (~ ...................... being duly sworn, depgses and says that he is the applicant (Name of individual signing contract) above named.. : Heisthe .... ~.[.(l~gk..}f~:,..~Jlfl.'.~J'O '- ~--0 (Contractor, agent, corporate officer, etci) of said owner or owners, and is duly authorized to perform or have performed the :said w.brk and to make and file this application; that all statements contained in this application are true to the best of his kn?,Jvlg~tge 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 ........... , Notary ' .... County /) ~, SUFFOLK CO. HEALTH DEPT. APPROVAL / H.S, NO. -" b'l A P '...,' I- '"'~ :'- .~ i~ ,..., ~' t:~~:' '""'~ ' .......~_"'-'"~'-'~,' '~' .,, . :-.-, ! ! ~. ~ , .~C..)~, ~ STATEMENT OF INTENT ~ . ~,-~<~, ~,i" THE WATER SUPPLY AND SEWAGE DISPOSAL 6.j~ ,~', ~', ..... l ~ SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE APPLICANT ~C ~J:~. ' X ,~-~ / 5. _~ . da/ ~,:'~' ,M i SUFFOLK COUNTY DEPT. OF HEALTH - _~T-~'~'~~ ~ ~ ,~% ,%~ ',, ; ~_ ~{~,~ SERVICES -- FOR APPROVAL OF ,. ..... , ......... ~ "-----..~ d ..,~ ,, ~ ~; . .~,~.....,., :. '. =-2 S~F COUNTY HEALTH DEPARTMENT SUFFOLK CO. TAX M~ DES~NAT~ON: ~;~~, ~ '~ D~ST.i~ ~CT. ~5 BLOCK ~ ~,5 PCL. .... ' ........". ", :~ ..~',,~- L~ ~.S~O~ FAMILY CWELLING ONLY ~.~,~.: ? ,.,:,, ..... ~:,~ .:~, .- . . - ~ '~HESEW~GEDIJ~S~,I. AND WATER SUPPLY FACtLIT ES FOR THIS { ~ ~ '*'~ ' ~ ' ~-'"~-,.~-" -~." '.' .... ~ '"~"" ~'~'" [;3"' .,"~ ..... ,*~ , .,~.' .L~ATION '~AVJ[ BEEN INSPECT~ BY THIS DEPARTMENT A .... ~ ~ ' , , DEED: L. P. '~- ~..- .... ~. ~ -: ~,~ ~-~..:::,~v~ ~s~,C~ Chief f V.~astewate anag~ent Section TEST HOLE ~AMP - ~ SEAL GREEN~RT NEW YORK 40'0' ~ ~- z 30.30 I 4- -'- --' 3&'- 0" /6/-.9'' . 'l L 40 L 0" OCCUPANCY OR USE IS UNlAWFUl. WITHOUt CERTIFICATE OF OCCUP~ NOTIFY BUILDING DEPARI~IENT AT 765-1802 9AM TO 4 tim FOR THE Z HUUGH FRAMING & PLUMBING THE flE~UIP~MENTS OF THE ~ESI~ Off CO~STRU~IO~ E~Oil, ;Ii % ......... j