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HomeMy WebLinkAbout22051-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23640 Date MAY 15, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 55 PINEWOOD ROAD CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 3 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25, 1994 pursuant to which Building Permit No. 22051-Z dated MAY 10, 1994 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 AN ACCESSORY DECK IN THE REAR YARD AS APPLIED FOR. The certificate is issued to PHYLLIS & WILLIAM LOMBARDI (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A" UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO.3 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) N® 22051 Z Date V 19.. Permission Is hereby granted to: •"...,rav......<!° ....may I m i j . . . to ~ ?.:......A........... ~~.....-.........,f.......... 1-0,,-Vii at premises located at.,........ss. S ~"rf r"rrtpr~ I......... I...............a, ~~*9 County Tax Map No. 1000 Section //.V............ Block 3........... Lot No. ...P/ Ocz pursuant to application dated 1 ........°..z` 19.. and approved by the Building Inspector. i Fee $....~Vo Building Inspector ` Rev. 6/30/80 r Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 17 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. B. 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. C. Fees 1. Certificate of Occupancy - New dwelling $25.0 Additions to dwelling $25. Alterations to dwelling $25.00, Swimming pool 0, Accessory ui ing $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...!~A./, . sj I p M. . New Construction.... ~4;:"":... Old Or Pre-existing Building Location of Property..: V15 . P1ArCWV ®n Ro A~ ~ C~ Tc/,~0~ ~ E ffiEY..Y k........ _ House No. Street Hamlet Onwer or Owners of Property...:ti~:~!h„/R ~ora)/gRD P County Tax Map No 1000, Section ...!!V .......Block.... .........Lot...../ Subdivision ....................................Filed Map............ Lot...................... Permit No. ....Date Of Permit. (AY. (P.. MA. Applicant. W~'6tilp!1„P1.. ~©m.gnRD.I.... Health Dept. Approval....../ ,1,ll ...:...........Underwriters Approval 41r. Planning Board Approval 4ev.I.X7 Request for: Temporary Certificate........... Final Certicate.. Fee Submitted: ~ w~ \ APPLICANT M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION FRAMING [ INAL REMARKS: DATE ' 1 INSPECTOR DAT- COMMENT H 'I 70U17DATION 1 (1st) ~ ~ i FOUNDATION yT~ (2nd) 2.• • z o ROUGH FRAME . -PLUMBING i 3. I m R m INSULATION PER N. Y. STATE ENERGY II CODE m 4. o i-r~C y. FI;JAL r ° ` u- ADDITIONAL COMMENTS: x ~ N\ ' H O m y r\ m a 765-1802 BUILDING DEPT. NSPECTION [ UNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I FINAL REMARKS: eU l t DATE INSP BOARD OF HEALTH I? FORM NO. 1 3 SETS OF PLANS • • TOWN OF SOUTHOLD -SURVEY . . . . . . Ldp 2a BUILDING DEPARTMENT. ~CFIECK _ij lR7f TOWN HALL SEPTIC FORM _ . _ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDT I FY TOWN CALL 7``~' Examined m°~?...., 19 MAIL TO: Approved . P. 4: 19 Permit No. ~7 .2~7 . . . . . . . . . . . . . . . " . Disapproved a/c _ . ( ildmg Inspector) APPLICATION FOR BUILDING PERMIT Date 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 inspections. (Signature of applicant, or name, if a corporation) ,S'S-1)e,r.FW000 RU.,.CulrNoG~''~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ow MIFIQ . Name of owner of premises .I"!!Rh!!a!!1.. pHYAr. S Rorl .r3p. ..Rp.) (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 land on which proposed work will be done . ` ....................../OrN_Wo00. RoR4...........C, ; CHO6Z4'~.................... House Number Street Hamlet County Tax Map No. 1000 Section Block q 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 FEES 1 D ANC pF M/~~tgerl ¢ r,I{ riCh~ /gyp mr3AR r)( b. Intended use and occupancy R! . e? ?H ..A139Yo.F , ,RCs'.'A 11Z.A/: ~ • ~e 3. Nature of work (check which applicable): New Building Addition a t' n , . Repair Rerhoval Demolition . • QfR EE, SA,un~N escription) 4. Estimated Cost 5 p o .06 Fee pion) . - (to be paid lira{ion) If dwelhng+ number of dweliing units , , , , , Number of dwelling units one 3t ~y=+, , , , , If garage number of cars . 6. If business commercial or mixed occupancy, specify nature and extent of each t pe of use , , . , , , , , 7. Dimensions of existing structures, if any: Front 4T'. t. , , . , ,Rear S 1: 9 , , , , a e• ' . th. DP Height Nu{nber of Stories ...'.....•°.'!'E............ . Dimensions of same structure with alterations or additions: Front ......M41 , , • ....d/p. Rear Depth ..A. . Height ......NA Number of Stories . 8. Di mensions of entire new construction: Front ...<5'Q" Height ~o. . Rear :......Depth Number of Stories 9. Size of lot: Front..... /A,AA Rear....! .~.oo........... Depth 0. Zone or use c district in which premises ' ' ' ' ' • . Name of Former Owner 1 are situated .......,q 9A . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . M . , , , , , , , , , , • • 13. Will lot be regraded .YK %T , , , , , , , , , Will excess fill be removed from premises: Yes t'No . 14. Name Name of of Owner oArchitectf premises R ftom9nRO1 , Address !''vEwuoo colcRecu~ phone No. 93 ~.-.?4 d..... , , . Address . " " . Phone No.. Name of Contractor . • • • • • • • • • . Address . 7 Phone No.. 15. Is this property within 300 feet of a tidal wetland? *yeS,,,,,, No. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimensions from property line . Give street and block number or description according to deed, and show street names and indicate whether interior or corner o . Agrc SN'VoINc. wlono CK 1 1 bt I 1 I 4 fouR J Q 1 PROPeSIF0 sfe%~01. fit) ROM HOU.Pl; d'&cIS Q \ /GxgF, d/oGk 3 0 (W (oT a 1 y 77+E Po R e t1 w A s AADAM JAI /4$Gi~y~ SCREEN~C) '4l~a° R.R+Er1,94Yox sl ____.-I_. !°oR 5 _1.4i--1.---- 19-~- Q 34.3' a o / _sl~olgY fRgmk Kovskr d GARAGE t X6.3 969 4. r? a 1 w MI 1 ~ I I 1 STATE OF NEW YORK h /'r MA WVOO) ' - S RoAO COUNTY OF. FF".. !S S' eu_je R. • • • . • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the fi4:J"I'R!1 er oR (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 siet forth in the application filed therewith. iworn to before me thi day of..i Y 111. lotary Publi ...,e County CLAIRE L., GLEW Notary public, state of N6w York a~ G a~/4 506 " ' NO-4879 Qualified in Suffolk County (Signature of applicant) Commission Expires December 8,19. - II 4 ,I OPT ' A6 \25 N 00Q e m 0 v \ OPO `N Lit m . \ 0 . \W- ` N W \ \ JJ' \ U] E g49 CP 'Z 39a~~ - - a o o~ 3 a~ ~y m< 90 4~`J\ cc ' 40 4lT W \ sr -O $3 LAN" 12 wS m 0 O ZR3 \ ~ ~386 i o FEN4E Vol k ~ \N - - q3 ~\L ~51p4ENVE ~Yjemonn Nm 3534 STD AZ SonfDid 5 f~merl'1 I D nD,$ 0r 0 SI7I'1G'T,' COUNTY HRALT:l f9:P ".b i""~7T SURVEY FOR / S U jl o TuJAN 2 4 1984 H WILLIAM LOMBARDI & PHYLLIS LOMBARDI 2- So_iP - OEC 28,198-7 The s..,l,-qty AT CUTCHOGUE DATE NOV 16, 1983 :dc17 ,1'r "O TOWN OF SDUTHOLD SCALE =30 _'I TqunU SUFFOLK COUNTY, NEW YORK NO 83-1004 tr" Ir! J..~ { V, ~I,'s 1r KowuTHOIIn ED urenA ION OR ADD1T0N TO THIS SURVEY 6 N VIOLATION M SECTION tt0G OF THE (,lauC ,r L'Lnorni Engineering NEW YORK STATE EDUCATION LAW jE pf R COPIES OF THIS SURVEY NOT KARWG THE LAND services SURVEMAS INKED SEAL OR EMBOSSED SEAL SNAIL NOT BE CON S IDEREO TO BE A VALID TRUE COPY E,R II I'r K GUARANTEES INDICITEU XEREDN SMALL RUN ONLY TO p`T 1- THE HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTRUCT RRSOM FOR WHOM THE SURVEY IS PREPARED ` AND ON HIS REHALE TO THE TITLE COMPANY, GDVEPN- S { . T ,p 1 Y =EAR[si WATER Wryl- _MI _ f SOURCE Of 4A^!R' MIr1T^ _IU0.1C- MENIAL AGENCY AND LENDING INSLILULION LISTED r F' n I.- HEREON. * AND TO ME ASSIGN [ES Of TXE LE NOIMG iTXCIIE NIE W DW'CILIMf WITHIN 'DO FEET DF HIS PROPERTY INSTITIMON GUARANTEES ARE ORNOi Tqµ SFENA ILE d OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS fVEfEOUE NTH M THE WAY ER fUPPIY AM ![YYY[ DISPOSAL SYSTEM FOR THIS RD IOEMQ OWNERS N pl]4NCCf SHOWN HEREON FROM PROPERTY LINES ! ryp ' rf _ d5S'3' . WILL CONFORM TO TX[ STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT i0 E51]TIN6 STRUCTURES 1RE FOR 1 SPECIFIC Of HEALTH SEIP,ICL! PORPOSE AND 4RE NOT TD BE USED TO ESTABLISH APPLICANT- PROPERTY LINES OR FOR THE ERECTION OF FENCES I'LYp )pS ADORE f! LL YOUNG a YOUNG RIVERHEAD, NEW YORK NOTE; ¦ c MONUMENT 6 = STARE ' AL DEN WYDUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S LICENSE NO 12895 HOWARD W. YOUNG, LAND SURVEYOR wTHELOC]TM OF WELLIW1. SEPTIC TANR(ST1 i CCS]ROOLS(CPI SHOWN HEREON N.Y,S LICENSE NO 45893 ME FROM FIELD DEIERWET ION! AND OR DATA OETAINED FROM OTHERS GR4Nms 4 ]pr,] ~N', IDIR r O T X A G Imo- aJ- `7'4 s ~ T a D ro _ O - - - - .-_.-.~.-_TT - 51 y ~ o~ 7 ~ ~yoy ~'i Z n N D ~ F n ~ it I T I bo b r r y a ~ ~ Q !II A n APPROVED AS NOTED 3 o DATE: sr~ B.P.» 1z°si~ OCCUIPANCY OR m Eas'~ BY: " USE IS UNLAWFUL TIFY BUILDING DEPARTMENT AT 6 1802 9 AM TO 4 PM FOR THE WITHOUT CERTIFICATE. - ~ o FOW INSPECTIONS: TWO OF OCCUPANCY o p ~ J FOUNDATION -TWO REQUIRED II FOR POURED CONCRETE =J _ o p o' a _ O ROUGH - FRAMING & PLUMBING INSULATION t 4 FINAL - CONSTRUCTION MUST (q A D BE COMPLETE FOR C.O. 'K 0 X \ !_L CONSTRUCTION SHALL MEET b dE REQUIREMENTS OF THE N.Y. p' Y 'ATE CONSTRUCTION & ENERGY ODES. NOT RESPONSIBLE FOR _ a y aFSIGN OR CONSTRUCTION ERRORS r l r_ r I r f - ~ L~ r Q'T' 9 J 0 9+ 0 a as h r 0 -b 6 n ~ 1` T~ a a 2 T o r '1 Q 76 X ~ M j w O u u ~ T ~ T n n m z m z 3 3 A A 6 6 a a 0 a 0 a F F t-dkG RiA,hln/G. CAP e-RA.AIUF 4 Pos7s Fv€RY s' T 4Xt 4.N} ceoAR Posr` foR /~S/'s /jo.5l ~D .~{.2.• R9 ~.cs EVER% G••'n!'E'N~UF I~<--RAfhl gA4 ARvvNQ io ~lFaoER axq. INRkklAm QoAAO(((\\\ FOP, EN7RAnICf .Pl4x 6 CEDAR OdECKIN G. ry I a2X~ Jo~df S -j I ~.7x p HFNDFR (3000 lice QEAI`1 PosT Aagl+=R }x} pos/~ x} pose 8AS ~ R'~Fo"" colycgf~~ s'vl PoR f~ . _ _ ~ 36' 4Elow [ S' {i Elow GRADE 1