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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22836 Date JANUARY 14, 1994
THIS CERTIFIES that the building ACCESSORY
Location of Property 965 VILLAGE LANE ORIENT N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 25 Block 2 Lot 20.12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 15, 1993 pursuant to which
Building Permit No. 21251-Z dated MARCH 17, 1993
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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to LOUIS LIONETTI & RONALD BURR
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL. N/A
UNDERWRITERS CERTIFICATE NO. N-299708- DECEMBER 21, 1993
PLUMBERS CERTIFICATION DATED N/A
ild ng Inspector
Rev. 1/81
FORM NO. s
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 N9 1~° 2125 Z 19.1
Permission is hereby granted to.
_
~QG ~ ~ ~ C...6? 6~ fem... 9r• ~~8~' ~
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at premises located at ....~...`.....-r........' S f
County Tax Map No. 1000 Section Block Lot No........6-~~
k
I pursuant to application dated .........`.~d~ 19..53 and approved by the
Building Inspector.
-j'
Fee
$..q-:C' 4/,?C
i
. Build .......tor ,
/ Inspector
Rev. 6/30/80
t -
D rm~.~ 1 FORM NO. 6
JM 14199-4 ~ fj TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
Lisa+<. L`Lr i.
TOWN OH_'C31(„ 765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m ear 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 property 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 $5.00
2. Certificate of occupancy on pre-existing dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
S.Undated C.O. $15.00 Date ?.1. 9
NewConstruction.,,? Old or Pre-existing Building Vacant Land
Location of Property . ~ . . n4• •~.T
House No. Street Hamlet
Owner or Owners of Property 4 F.L. 1A, . e~L;! 4:`:<_7_. , .
County Tax Map No. 1000 Section z Block Lot Z. P. .
Subdivision .................................Filed Map No. ..........Lot No.
Permit No.?!Date of Permit , f ' I//?.Applicant ..!'1f!4'?°~ CO-C/
Health Dept. Approval ...................Labor Dept. Approval
Underwriters Approval ........................Planning Board Approval !.~A .!3 r .
Request for Temporary Certificate .....................Final Certificate
Fee Submitted $
Construction on above described building and permit meets all applicable codes and regulations.
Applicant s - .
Rev. 10-10-78
c o . z~r
gag& Is al agggli
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1'`'.
1000121 BUREAU OF ELECTRICITY '
83 JOHN STREET. NEW YORK. NEW YORK 10038
Date DECEMBER 21,1993 Application No.onfile 05408793193 N 299708
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
LOUIS LIONETTI, 965 VILLAGE LANE, ORIENT, N.Y.
in lhefolfowing location; ? Basement O /At FL 2nd F'(. GAR/OUT Section Block 'Lot ,
was examined on DECEMBER 14 , 19 9 3 and found to be in compliance with the National Electrical Code.
wFI~X~TUR! ECEPTAC ES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FUJORESCENi OTHER AMT K. W. AMT K. W. PMT K.W AMT K.W. AMT. H. P.
18 14 17 17 1 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNI7 HEATERS MULTI-OUTLET DIMMERS
AML K. W. Oa H. P GAS H. P. AMT. NO A. W G. AMT. AMP PMT. AMPS TRANS. AMT. R P SYSTEMS AMi WATTS
NO. OF FEET _TT
1 F
SERVICE DISCONNECT NO.OF S E R V I C E
AMT AMP TYPE METER 1W T $ 3W 3 $ SW 3 AT AW NO. OF CC COND. A. W. G. NO. OF HI-lEG A W' G NO. OF NEUTRALS A' W' G'
EQUIP. PER $ OF CC COND OF .1 LEG OF NEUTRAL
OTHER APPARATUS:
FEEDERS:2-3 # 10 1ST FLOOR TO BASEMENT
MOTORS:1-3 H.P.
PANELBOARDS:1-1 CIR. 60,1-8 CIR. 100
G.F.C.I:-5
SMOKE DETECTOR:-2
PAUL R. BURNS LIC.#282E "
275 TOWN HARBOR LANE
SOUTHOLD, NY, 11971 GENBtAt MANAGER
11 .
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by 'their credentials.'
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS: &6z
DATE O 7j INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO H PLBG.
[ FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE ~ INSPECTOR
n
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [klf ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: ~ "L
i
DATE ,5 193 INSPECTOR
INSPECTORS.
Victor Lessard
Principal Building Inspector Y,q~4. dj
Curtis Horton x. :y t "r'A SCOTT L. HARRIS, Supervisor
Senior Building Inspector
s"('x'. i
Thomas Fisher Southold Town Hall
v ' r
Building Inspector P.O. Box 1179, 53095 Main Road
Gary Fish > Southold, New York 11971
l ~
~ e(516) 765-1823
Building Inspector it Fax
Vincent R. Wieczorek ??zi"'j Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
October 29, 1993
Mr. Louis A. Lionetti
965 Village Lane
Orient, N.Y. 11957
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
RX% An application for Certificate of Occupancy is
not on file. (Enclosed)
%%Z No Underwriters Certificate on file.
xxx The check is (outdate /not an 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 BP# 21251Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
.~ttLNEC
H
'OUi7DATIOI (1st) l _ \ty
'OUNDATION (2nd) m
~y G-
14,
1
0
;OUCH FRAME & C~^
-PLUMBING k'
uev-,,~961 Ole I y
3.
INSULATION PER N. Y. I y
STATE ENERGY
CODE rF x
}
FINAL
ADDITIONAL COMMENTS:
H
x
9
• y
Fi
M
• r
o
CTI
-o
y
_ ~ - LINE AR
3n~no~a~o~ SG°O O O ~ W O ~ 1
VILLAGE" LANE J4
ono ~ Eo=; ;
F A8
«o °z ~Qz_~ m>p N261420 E. 175.87 th i
oz pf
z 26 1
th"
m r o. O' _
! z ~~nO > Z STORY C J ,N
1 z'; A It 41 T D KR. NC. Q O !d pi m`
tri O n AFC. I m e
D firm -n
C C't~ U r fi Z ' '
16,
rn 0 r 57 \ 0. s n oft ~u
o z 10 A v o Vv O, ~ t7~/ N 3-Z5 3- (In
/T, c
1XA 5.21
' 55.66 V'1 I~ i
N ~ (o ~ p to ~
w~.1 O
Ira rn O W (7+ G R
q"~ C rY
x o x,32 j8'pp W - " c
p hi z 109.30 o _
b
.Ot c ; ~'SCNgtEVER ~
a • .e. -
N r' =1 I
<
00
x uo _t
l< 1_2
. ~i~~ ~o6,S..tz.:L`~r~i.6..,~ `~+Y~``)J.•7~~`s~a~~`-"~~.hs.'4... ~ f.. ~ , _
ENERGY CODE CALCULATIONS
(For Non-Electric Heat) Design Criteria 6,000 Degree'Days
O.A. 10°F IpA. 70°F
FOR: f PER:
DATED:
DESIGN THERMEL
SUBSYSTEM AREA "U" RATING REMARKS
Exterior Walls (Opaque) t/~ Ll7-
Glazing 8 r SLO /Z~ / f 44A
7 Z3
Doors
Ceiling/Roof (Opaque) n U~ 0
Skylights 8 J
Floor n ro n
Foundation Walls ) l/
Slab Insulation
TOTAL 9
Notes:
Building Envelope Systems to meet requirements of 7815.2
HVAC Equipement to meet requirements of 7815.11
4 11VAC Systems to meet requirements of 7815.12
Duct Systems to meet requirements of 7815.13
Ventilations Systems to meet requirements of 7815.14
Insulation of Piping Systems to meet requirements of 7815.15
Service Water Heating Systems & Equipment to meet requirements of 7815.21
Electrical & Lighting Systems & Equipment to meet requirements of 7815.31
To the best of my knowledge, "te HF s?1'
belief, & professional ~~rE o®
judgement, these plans are in
compliance with the code. / r
a t
~A At
0332254-1
p9OPESSIO'A
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD
SURVEY v BUILDING DEPARTMENT CHECK • • • " - - - - " • • • • • • • • •
FEB 2 6 1993 TOWN HALL SEPTIC FORM . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOTIFY: c/ eC7 J
} CALL
Exam lr~ed... 1/~? . , 19 MAIL TO :
Approved ...?119gPermit No.. J.~ .
Disapproved a/c
(Buil 'ng I tor)
APPLICATIR BUILDING PERMIT
Date y.........., 19.5.1-7
' 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.
/%9c Oo~-~9~•"J• ,wo o•Q wo~.ei/i!c;- c ozr°
(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
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate fficer)
Builder's License No. /.~..?r''.~
Plumber's License No .
Electrician's License No .
Other Trade's License No .
1. Location of land on which proposed work will be done. .
. P-X... A !~•~r .i F T....................
House Number . Street Hamlet
County Tax Map No. 1000 Section S........ Block 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
b. Intended use and occupancy ......9•%C % • •
3. Nature of work (check which applicable): New Building........... Addition Alteration , . .
Repair Removal Demolition Other Work
!9!rfl= , . ,
(Description)
4. Estimated Cost ° R 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 cars -I.T.~1rr FG . .
6. If business, commercial or mixed occupancy, specify ature and extent of each type of use
Dimensions existing str Number of Front ..A el......... Rear Dep
Height . of str eof Stories .
Dimensions Depth t , of same structure with alterations or additions: Front Rear ,
. Height Number of Stories . .
8
Height . . Number Front .....Y.°. , , , , Rear ..5: Depth Depth t? , . , , , , , . , ,
He
9. Size of lot: . Dimensions o of f entire new co umber of Stories
T r, v s wiz k Rear .
Depth
10. Date of Purchase Name of Former Owner . , KEN.. 1 Tts! ~y!? , , ,
11. Zone or use district in which pre ices are situated
Does proposed construction viola a any zoning law, ordinance or regulation: N.4
13. Will lot be regraded p Nv , , , , , , , , , , , , , , , Will excess fill be removed from premises: Yes IQ_
Name of Architect Address . o A i*i T , , , , • • , , Phone No
14. Name of Owner of remises % , , Address Phone No............... .
Nam
Name of Contractor !l.fT,. , . , Address I?. P.. , , , , . Phone No. 7R 7.
15." Is this property within 3Q0 feet of a tidal wetland? *YeS........ No. l....
*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 lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
f
i
i
i
I
I
STATE OF N Z,
S.S
COUNTY O O
4' • • • • • • ..~C' being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the
j Contractor, gent, corporate officer, etc.)
of said owner or owners, and is duly authorize o perform or have performed the said work and to make and file this
application; that all statements containd 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(' o_
day of 19~
Notary
Public.. .
ounty
CLAIRE L. CLEW , ,G
Notary Public, State of New York
No.4879606 (Signature of applicant)
tlualifled In Suffolk Cr}uMy
Commission Expires Decal gar 8,18
28 d 2 284.2
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DTION PLAQ
INI PLUMBING PLUMBING OCCU PANCY OR
WATER LINES NEEDS
TESTING BEFDFE COVERING UNDERWRIT CERTIFICATE ITE
USE IS UNLAWFUL REQERSUIRED
A,vfflTHOUT CERTIFICATE
OF OCCUPANCY AP RDV D AS NOTED DATE: 7 B.P. q
FEE: BY.' 1T
if copW tubing is used NOTIFY 8 LDI DEPART AT IE
for waW distributing 765-1802 9 AM TO A PM F THE _u w. FN 1 OWING. INSPFCfIONS-
•yst,111: piping su- 1 FOUNDATION - TWO REQUIRED D
of tyv~. K PLUMBER CERTIFICATION FOR POURED CONCRETE
ON LEAD CONTENT BEFORE 2. ROUGH -FRAMING & PLUMBING G
3. INSULATION
CERTIFICATE OF OCCUPANCY 4. FINAL - CONSTRUCTION MUST T PJePj F.
SOLDER USED IN WATER ALL CONSTRUCTION SHALL MEET BE COMPLETE FOR C.O. A :T t~~CE TUT 9,f '
SUPPLY SYSTEM CANNOT THE REQUIREMENTS OF THE N.Y. Y. , ~e y
STATE & EXCEED 2110 of 1 % LEAD. C
ODES. CONSTRUCTION NOT RE SP NSIBLE EFOR DESIGN OR CONSTRUCTION ERRORS R Jj 1 w S _
~SO Qi22M-1 SCALE: .d'~ 1.0" APPROVEOBY: ORM1WNM Lr -
pq~fESS10N~\' DATE: g.°J Z_ nEOISEO 33 ~oui5 bGMF- i f iOt~Aup ugf
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