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,%~/,~,rq~..~: Form No. 6
1993
APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial 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 of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
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
Date .... ~a3..10,....1~ ...................... . .
Construction .......... .' Old Or Pre-existing Building .................
~tion of Property ....... 5685! MAIN ROAD ~..~.~.L.D.,..N~.~yp.~..
House No. Street Hamlet
VINCENZO & ILEANA DOLOMITE
or Owners of Property ................................................................ . .
Tax Map No 1000, Section ..... ~% ..... Block. 3 .... Lot. !7.4
)division ................................ .... Filed Map ............ Lot ..................... .
No .... ~%~ ..... Date Of Permit..!~8~ ........ Applicant. A'..R?7~.~. PP~'. 7~.' .......
alth Dept. Approval ........................ .. Underwriters Approval... ~-~97~. ............. .
Board Approval
for: Temporary Certificate ........... Final Certicate ...........
Submitted: $ 25.00 ~~~.'~
INSPECTORS
Victor Lessard
Principal Building Inspector
'Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
SCOTT L. HARRIS, Superviso~
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 1197t
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
I~b-Y 5, 1993
VINCgNT & ILEANA DOLOMITE
56861 MAIN ROAD
P. O..BOX 14~3
SOIH~OLD, ~ 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
~ An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is ~not on file.)$25.00
No Health Department Approval on file.
No final inspection'has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT $ 13743-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT,
FIELD INSPECTION COMMENTS
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
QODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. 13743Z issued to Vincenzo Dolomite
on 3/8/85 for Accessory is completed and
a final inspection has ( ) has not ( X ) been done.
In 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 is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Victor Lessard
Executive Administrator
VL:gar
encl.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTUOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ..~.. VACANT LAND ........
HOUSE NO. STREET ~A~LET
'ermit No ........... Date of Permit .......... Applicant .~./~ ~o/o~z~
ealth Dept royal ............... Underwriters Approva ...... ~ ....
lann£ng Board Approval ..Ae~ ...........
-~quest for Temporary Certificate .~.. .... Final Certificate ................
~e Submitted: $ ....................
APPLICANT. . .
'- ]o/14/88
FORH NO. 6
TOIl/ OF 80[ITI~LD
BUILDING DEPARTHENT
TO~/NHALT.
765 - 1802
~PPLICATIOX FOR ~ERTIFICATE OF OCCUPANCY I~STRUCTIONS
A. "This appllcation must b~ £11ed in typewriter OR ink and submltCed to the Buildlng
Inspector with the foll~wlng; £or new buildings or new use:
1.
Final survey o ' ·
f property wzth aCCurate location of all buildings, property lines,
streets, and unusualinatural or topographic features.
2. Final approval o£ Health Dept. of water supply and sewerage-dlsposal(S-9 form).
3. Approval of electrlc~l installation from Board of Fire Underwriters.
4. Sworn statement £romjplumber certifying that solder used in system contains less
than 2/10 of 1% lead~
Commerczal buildingsi industrial buildings, multiple residences and similar.
buildings and instal~atlnus, a certificate of code compliance from the &rchltect
or Engineer responsibl~ for the building.
6. Submit Planning Boar~ Approval of completed site plan requiremen'ts.
~. For existing uxldxngs (~Prlor to April 9, 1957~ non-conforming uses, or buildings
and "pre-existing" lan~' luges:
i. Accurate survey of pr,~perty showing all property lines, streets, buildings and
unusual natural or to~ogra-hlc fe--
2. A:preperly completed~applicatlon, a consent to inspect signed by the applicant
and a certified abstrhct of title issued by a title company which shall
s~nw Single and separhte ownership of the entire lot prior to April 9, 195~.
If a Cert~flcaEe of O~cupaney is denied, the Building
Inspector shall s~ate the
reasons therefor in Wiring to the applicant.
3. Date of any housing c~de or safety inspection of buildings or premises, or ocher
pertinent informatlon~requlred to prepare a
C. For Vacant Land Certlflc~te of Occupancy:
I. An application for vacant land Certificate of Occupancy shall be submitted,
and a certified
abstract of title issued by a title company showing single and
separate ownership of!the entire lot prior to April 9, 1957 shall also accompanF
~he appllcaClon. If ~ Certificate of OcCupancy is denied, the Building Inspector
shall state the reasogs therefor in wrlCin§ co the applicant.
D. FEES~
I.
ge '
CERTIFICATE OF OCCUPANcy - Ne~ D~elling $25.00, Addlt~ons to I~e[llng $25.00,
AlCeratlon to l~elillng $25.00, Swlnn~ing Pool, $25.00. Accessory building $10o00
. Addition to Access?fy buildings, $10.00. Businesses $50.00.
Certificate of Occ!upancy on pre~existing dwelling - $100.00.
Copy of Certlfieat~ of Occupancy - $5.00 - over 5 years - $10.00
Vacant Land Certifllcatc of Occupancy ~ $20.00
~pdated Certif~cat~ Of Occupancy - $50.00
Temporary CertlflcaCe of Occupancy - $15.00
~'e~,. IO/l'4/~g
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
Date OCTOBER 5 89
........................................................ , 19 ........
VINCENZO DOLOMITE
(owner or authorized agent of owner)
.~.6..8..5..1.....~..LN. R.O...~.. ~ SpUT~OLD,..NY.
(address of owner or authorized agent of owner)
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance CHAP. 100
Other Applicable Laws, Ordinances-'or Regulations ............................................
at premises hereinafter described in that A swinnning pool is being used w£thout a
(state character of violation)
Certificate of Occupancy and an expired building permit.
in violation of A~TICLE xxviII-Chap. 100-281 & 284.
(State section or paragraph of applicable law, ordinance or regulatian)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned IMMEDIATELY
The premises to which this ORDER TO REMEDY VIOI~ATION refers are situated at
56861 MAIN ROAD, SOUTROLD,
................................................................................. County of Suffolk, New York.
SUFFOLK COUNTY TAX MAP l! 1000- 63- 03- 17
Failure to remedy the conditions aforesaid and to comply wilh the applicable provisions of
may constitute an offense punishable by fine or imprisonment or both.
B.P. # 13743 Z
(Cert. Mail)
VINCENT R. WIECZOREK
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING ,r. ~/FINAL
REMARKS: ~
DATE_/O//, ~/~ '~
INSPECTOR (//~ ~f)f~
'FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
~amined .... 1~ 0~..~...~..., 19~.~./'
pproved....~q~ *~,~'[ ."~ .... 19~.(. Permit No..}..~.~..~.'.~..~.
[sapproved a/c .....................................
.............................. ......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s 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
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 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
all 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
all 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
filding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
· ,gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
mit authorized inspectors on premises and in building for necessary inspections.
.... t~' ....... ~ ........ 2 .....
(Signature of applicant, or name, ~f a corporation)
(Mailing address of apphcant) ~7 ~. '
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
x._ .......................................................
........
aneofowner of premises .~ Z0.G~?D.. :7-~.O.. :t~.. /'~t~'.~.~. . .~O.,ql./..)~'~.. ....................... (as on the tax roll or latest deed)
I~ apl~t is a corporation, signature of dul~authorized officer.
(Name and ti~~'~r') .........
Builder's License No ........ ./..O. ..............
Plumber's License No .........................
Electrician's License No.. ~}~J?/~.~- /gtll.a.¢ (~
Other Trade's License No ......................
Location of land on which proposed work will be done...~J~/. ~.~../~..-.....~..~P.. .... (~) .~.....~..~....c.~. ~ ....
.... ..............
House Number Street Hamlet
County Tax Map No. 1000 Section ...... .O..~.~ ....... Block ..... .~. ........... Lot ..... ./.~. ...........
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 ............ . .~?.5/..~...~.~d..' .7.~../.~..~. .....................................
b. Intended use and occupancy ............... .~. ~.'~../~...~.'~. ...........................................
3. Nature of work (check which applicable): New Building .......... Addition . ~ ........ Alteration ..........
Repair ............ Removal .............. Demolition ......... ~. ·. Other Work
4. Estimated Cost ......... ~ ............ Fee ....
'~ [to bel paid on fihng this apphcatlon)
5. If dwelling, number of dwelling units ............... Number of dwelling un,ts 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 structure with alterations or additions: Front
........... t ..... Rear ..................
Depth ...................... Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear . . i ....... Depth ...............
Height Number of Stories
9. Size of lot: Front ...................... Rear ......... j Depth .. ........
10. Date of Purchase ............................. Name of Former Owner ~ ............................
11. Zone or use district in which premises are situated ..
12. ' x ....... · .....' ...... ~ ............................
Does proposed conStructlon v39Iate any zoning law, ordinance or regulation: ... i ............................
13. Will lot be regraded ...... r~*~' .............. :_... Will excess fill be remov,e~from premises: Yes (~
14. Name of Owner of premises .~r.~'~... (~2~.O .t~. t. FI.{. Address .~'I~/~..~o.~.O../~tt. .~.. Phone No ................
Name of Architect ............... ., ........... Address .............. ~ .... hone No.
Name of Contractor.. ~.-./'/.1:.~..~..t,..~. t,7~b.a,4C.... Address . .t~t. ~.T~/.2'J~.~..~. Phone No.. ~...~.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, ifidicate 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 coruer lot.
STATE OF NEW Y..~RK~,~
.......... ~.0..~. ~1~1 lq/ .... ~ .... ~.'[~.k.. ~ ....... being duly sworn, dePdses and says that he is the applicant
(Name of individual signing contract)
above named,
He is the ........................................ , .....................
(Contractor, agent, corporate officer, etc.j
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 hi~ 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 i
Notary Public, ....... ount,
~n~ 9 AM ~0 4 PM FoR TH
u.,c 'FCTIONS:
FOI ~
FO ~ P'
2. ROIjfm~ '
3 INc~9 '~''
4. '
ALI- Cr),~ ~q
T~IE RF~ - ,-,--rc r,~: T}IE N.
STATE
CODES. NOT RESPONSIBLE
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