HomeMy WebLinkAbout14137-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hail
Southold, N.Y.
Certificate Of Occupancy
No.. Z15063
Date October 30~ 1986
................................. 19...
THIS CERTIFIES that the building .Add. ition
Location of Property . 1960 Mill Lane ~ P.econi. c ·
County Tax Map No. I000 Section .. 0.67 .Block 7 ..... Lot 11
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore fried in this office dated
· .~¢D.e.. ~ O ............ 19 .8.5. pnrsuant to which Building Permit No..1.4~ 377, ..............
dated .Ju~y .17 85
.... ~ ..................... 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 .........
Deck Addition to existing one family dwelling~
The certificate is issued to MATTHEW AND VERA CUSUMANO
(owner, ~{exEkoK~x
of the aforesaid building·
N/A
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO .. N/.A.
Rev. 1/81
FOI~ NO. ~
TOV~N 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)
NO 14137 Z
Permission is hereby gra~te; ,
...~...c.....~~.~..~._ .....................
~%..~....~..~......u...~.~..t ...... .
,o ~m.....~.~..~......~.~...~.~~~ · ;--, ..............
..~....~
,, ....... .,,.~"'"'~"~'~'"'~"~~,~ .,,,, o~ ........................................ ~ , ... .................................
at premises located at ....~..~..~.~).......'~.~......~1~.~.......~....~...%~.. ..............................
County Tax Map No. 1000 Section ..... ...(~...~..~. ...... Block ..... :..~. ............ Lot No ........ !..! .............
pursuant to application dated ......... ....~..~.....~...~. ............... , 19..~...~..'~., and approved by the
Building Inspector.
Rev. 6/30/80
TOWN of SOUTHOLD
Town Hall
Receipt NO, 3 0 ~) '~ 0 Southold, New York 11971
Received of .......... ~'~, ~...,. :. ,/~,, .~ ................................................................................................
.................................. ~...~r.. ~ ....~.....././..O..~. .................................................................................. /100 Dollars
,or ............ ...........
Fee for
Fee for
r-~ Yard Sale [] []
E ch
................. ...................
Fee for Fee for
[] H.hC. [] Building Permit ~ of Occupancy ~-] Misc.
Building In~
2. Sword 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 $5.00
2, Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $ 1.00
4.Vacant Land C.O. $5.00
$15.00
Date 9~5.~.,..!~ .......
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
Location of Property ....... 1960 Mill Lane Paconic
House No. Street Ham/et
Owner or Owners of Property Matt, hew. and Vera. Cusumano
County Tax Map No. 1000 Section 067 Block .7 Lot. ~ '1
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No...1.4.13..7... Date of Permit 7../3Z/.8.~..Applicant . .Rpn .N. 9~'.i.;;~9. Jg.q J, ~AR,. ;[nc;,...
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ,~ .....................
Fee Submitted $ ..............................
Construction on above described building
Applicant
Rev, 10-10-78
FIELD Il TION COMMENTS
FOUNDATION
(lst)
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N.
STATE ENERGY
C,ODE
ADDITIONAL COMMENTS:
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
June 21, 1985
TELEPHONE
(516) 76§-189ff
Mr. Ron Morizzo Builder, Inc.
645 Jernick Lane
Southold, New York 11971
Re: Matthew & Vera Cusumano
Mill Lane, Peconic
Dear Mr. Morizzo:
As per your request for a determination on the need
of a Wetland Permit, regarding the above referenced matter,
please be advised that the Trustees have reviewed your plan
on June 20, 1985.
The Board determined that no permit will be necessary,
subject to the adoption of a resolution on June 26, 1985
and with the following provisions:
1. Care shall be taken so as to.preclude the entry of
any construction material into the adjacent waters.
Immediately following construction, all areas of
exposed soil shall be properly protected with suitable
erosion control devices and/or vegetated to prevent
entry of eroded soil into nearby waters.
Thank you for your cooperation in regard to this matter.
Very truly yours,
Henry P. Smith, President
Board of Town Trustees
HPS:ip
cc:
Trustees
Building Dept.~
File
7GS-XSOZ
BUILDING DEPT,
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING /2/~ /~..[ ] FINAL
REMARKS:
DATE .... INSPECTOR
BUILISEFI, INC.
CONTRACTOR
HOME IMPROVEMENTS
LICENSED AND INSURED
SOUTHOLD, NEW YORK 11971
(516) 765-5772
sm~ B,'v~ITT E D TO
CITY, STATE AND ZIP C~DE
PHONE
We hereby agree to do the following:
APPROVED AS NOTED
* /
NOT~FY BUILI.~,%,,; ~,t~,~ARTMENT AT
2. R~);?;~ ' . .,./: v '.'~ ~). PLU~tBING
3, I~ FL=,~.'~. ,N
STATE CONSTRUC[ION & ~ERGY
CODES. NOT ~S~NSlBLE FOR
O~IGN OR CONSTRUCTION
~, - 0t, +
We hereby agree to furnish material and labor - complete in accordance with the above specifications, for the sum of:
.aymenl to be made as foJJows: . O~UY~.~kl~ J
All material is war~anted to be as sp~~~rdin~ lo standard practices. A ny alteration or devi~Hon ~rom above
specifications ,nvolvin. ex,ra co.tsfllx,o--- -- above the esthnale. All a~reemenls contineem upon
accidents or delays beyond
strike~, workers are covered ~y Workman's Compen5aliol3
Insurance.
Sui,s on cmaims of any kind are barred. ~,~K~ril ~)klp~o .,r~tor', (,.,,.r',)receipt of buyer's wri,,en notice of cmaim. New York Stale Law shall
In lhe evem lhat the contraclor (selie~l co~n~al icflons whatsoever ~or (be enforceme0t of buyer obmigaUon hereunder, buyer shall be miable (or aim
arbaralion and cour( costs, reasonable attorney's fees and legal interest meured by the semmer.
Buyer will also be obligated to pay interest on the principal at l-Y=% per month, from Ihe date o~ contract acceptance.
EXCEPT AS PROVIDED JN THIS AGREEMENT, WE MAKE NO WARRANTIES EXPRESS OR IMPLIED REGARDING EQUIPMENT AND SPECIFICALLY DISCL~M ANY
WARRANTY OF MERCHANTABIUFY OR FITNESS FOR A PRACTICAL
Weshall have NO Eabimity for indirect, incidental or consequenUal damages (including lost profits) resumting from oF arising in connection with the provmsio,s, instalbdon or
maintenance of the work herein provided ~or; and except for personal injury caused by our (auh, we shaim not be liab)e for direct damages in excess o~ $5,0~.~.
NOTE: This contract may be withdrawn
by us if not accepted within
days,
ACCEPTANCE OF CONTRACT:
The above prices, specifications and conditions are satisfaclory and are
hereby accepted. You are authorized to do the work as specified.
Payment will be as outlined above.
Date of Acceptance
Authorized signature: Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined...~.%\..'~ .... ,19~.~.
Approved} ...~. I .-[., 19~.~. · Permit No..[.q./..~.~..'~-..
Disapproved a/c .....................................
Received ........... ,19...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tins 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 tins 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 heroin 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/~nspections. . /~,LJ.,L'~(~
............
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...... ' ............
Name of owner of premises . .~..~...~...~.~..~. · .~..~..~..}r.(~...~.. ~,,1~..(~...(~..}~. O .........................
(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....e~...(-~...-7 ................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
.................. ..r/B. ', .L .L o:e,
\q O .........................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...... ~...7. ........ Block .... 7 ............ 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 ~'D~ ~-5.........O-~'XN'~C~. .. ...................................................
b Intended use and occupancy ............... ~ ............
Nature of work (check which applioable)
Repair .............. Removal ....
!
If dwelling, number of dwelling units
N w Buildi ' 'Addition i Alterati.on '
......... Demolition ........... i' ' · Other Work.._¥~.2. C~. ~-~ .....
' (Description)
............... Fee .......... : ............................
,x (to be paid on filing this application).
.......... Number o f dwelling units on each floor ................
If garage number of cars
6. If business, commercial or mixed occupa
7. Dimensions of existing structures, if any:
Height ............... Number of
Dimensions of same structure with aitera
Depth ...................... Hei~
8. Dimensions of entire new construction:
Height ............... Number of
9. Size of lot: Front .................
10. Date of Purchase .................
11. Zone or use district in which premises
12. Does proposed construction violate any z
13. Will lot be regraded ................
14. Name o f Owner of premisesO~(X2k~-ta~t
Name of Architect .................
Name of Contractor ~4~.O..
Locate clearly and distinctly all building
property lines. Give street and block number ¢
interior or corner lot.
STATE
OF
NE~WyCmI~.. S S
COUNTY OF .......... '
......... ,Ch .....
(Name of individual signing contr
above named·
He is the ............................
of said owner or owners, and is duly authori
application; that all statements contained in !
work will be performed in the manner set fortl
Sworn to before me this
:y, specify nature and extent of each type of use .....................
Front Rear ' Depth
eries
:ions or additions: Front ' Rear
! ...................... Number ofI Stories .....................
rent Rear ' Depth
aries ............................ i ..........................
.... Rear ...................... iDepth ....................
Name of Former Owner '
situated ......................... :
~ning law ordinance or regulation:
· ..., ......... Will excess, fill be removed from premises: Yes No
.......... Address ............... i ....Phone No ................
PLOT DIAGRAM
whether existing or proposed, and, indicate all set-back dimensions from
description according to deed, and show street names and indicate whether
............ being duly sworn, depqses and says that he is the applicant
ct)
.ontractor, agent, corporate officer, etc.i
,~ed to perform or have performed the said work and to make and file this
als application are true to the best of hi; knowledge and belief; and that the
. in the application filed therewith.
"7v ::Z~/
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