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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-22958 Date APRIL 20, 1994
THIS CERTIFIES that the building ADDITIONS
Location of Property 950 STROHSON ROAD CUTCHOGUE, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 103 Block 10 Lot 24
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 12, 1992 pursuant to which
Building Permit No. 21104-Z dated NOVEMBER 25, 1992
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 CHIMNEY WITH FIREPLACE & SHED DORMER ADDITION TO EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to PAT & ROSEANN IAVARONE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-307627 - MARCH 17, 1994
PLUMBERS CERTIFICATION DATED APRIL 1, 1994-HARDY PLUMBING & HEATING
C~v
Building Ins ctor
Rev. 1/81
r
FORK No. f
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)
Date -2-
NON, O 211042 19.Z
-
Permission is hereby granted to:
/rP..
to
z5V
at premises located at gti .l`- ?7......T.. Dat
County Tax Map No. 1000 Section ......1~3..... Block .......,l..T Lot No . :1P
f
pursuant to application dated ~l~.Z 19.5F..7,--and approved by the
Building Inspector.
Fee f. ..0...
Bu' ing Inspector
Rev. 6/30/80
i
Form No. 6
5 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
~ro - 6 ~A TOWN HALL
Fv n 1~ 765-1802
to ~ GE APPLICATION FOR CERTIFICATE OF OCCUPANCY
f F §OUT PTA0
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 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.
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 $25.00, 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 - $5-6~over 5 years - $4 66
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date 9 (
New Construction.......... Old Or Pre-existing Building
Location of Property....... J~....M0'~0h /6~ , Uf-
House No. Street Hamlet
Onwer or Owners of Property....., . .
County Tax Map No 1000, Section..... ~........Block....j40 ........Lot......................
Subdivision .Filed Map............ Lot..
Permit No... .9.n...... Dat, Of Permit ...,3:?
...Applicant... 9,...............
Health Dept. Approval ..........................Underwriters Approval.... 826 A o p/jJLJ,.......
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $...1;;.Y-990..,,,,,,,
1,411 ajl c. ) 7s PLICANT
TEL. 16:-1802
P~~f i=CJ-
TOWN OF SOUTHOLD
OFFICE, OF BUILDIINC INSPECTOR
P.O. 130:' "28 TOWN I:..LL 1
~"~`~C?.s fI
SOUTI-10- N.Y. 11971
aty,
zs ^E,7 f ~ 6
6
tz ro
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C E R T I F I C A T I O F•1 SOUTyo~ a
Date
Building Permit Noe
Owner fir-+~JCS ~H~v,otJ2
(please print)
Plumber Q a a'4v'4nq NA<ASNC•
( ease co i
I certify that the solder used --'n the water supply system
contains less than 2!10 of 1% lead.
(plumber's signature)
Sworn to before me this
;-)3 day of ~-e G - o'
19
17 Public
Kota. pvh_ic, > >~_(.-County
ANTNONYA ENRIOHT
Notary PNo Ste" O1 N"Yotk
Qualified in Suffolk County
Commission Expires April 8, 19
"a's'¢frld4sY,
Town Hall, 53095 Main Road a h Fax (516) 765-1823
P. O. Box 1179 >Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 23, 1194
Mr. Pat J. Iavprone
18 The Hollows
E. Norwich, NY 11732
To Whom This May Concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
_XXX_ An application for Certificate of Occupancy is
not on file. (Enclosed)
XXX No Underwriters Certificate on file.
_XXX_ The check is not on file. ($25.00)
Department Approval on file.
No final inspection has been made.
_XXX_ No Plumber Solder Certificate on File.
(All permits involving plumbing being
issued after April 1, 1984.)
BUILDING PERMIT # -BP# 21104Z
Please contact our office on this matter. Thank you for
your cooperation.
SOUTHOLD TOWN BUILDING DEPT.
NT
OUiIDATION (1st) ~
3 `c
'OUNDATION (2nd) r
I o
;OUCH FRAME &
O
.PLUMBING
INSULATION PER N. Y. I y
STATE ENERGY I \
CODE I * \
y
r~ H
FINAL
E
1 ( ` O
ADDITIONAL COMMENTS: x a
[T1
• X f
O ~p
r
'-I
m . v
-v
H
~~o~OgpFFO(/(~OGy
o ~
Town Hall, 53095 Main Road CA Z Fax (516) 765-1823
P. O. Box 1179 0 • Telephone (516) 765-1802
Southold, New York 11971
~tol ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 23, 1194
Mr. Pat J. Iavprone
950 Strohson Rd
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
_XXX_ An application for Certificate of Occupancy is
not on file. (Enclosed)
XXX No Underwriters Certificate on file.
_XXX_ The check is not on file. ($25.00)
Department Approval on file.
No final inspection has been made.
_XXX_ No Plumber Solder Certificate on File.
(All permits involving plumbing being
issued after April 11 1984.)
BUILDING PERMIT # _BP# 21104Z
Please contact our office on this matter. Thank you for
your cooperation.
SOUTHOLD TOWN BUILDING DEPT.
PETER T. PODLAS. A.I.A.
Architect
LAID LANE
P.O. BOX 285
REMSENBURG, NV 11960
1 (516) 325-0929
TD
age APR 11993
~...:4A~,.r~.wz
TOWN Of VIRMWOLP
n 4"+ _rsn aster.-a . l
1.
~ifoy4
A
Peter T. Podlas, A.I.A.
Architect
516 Box 285, 4 Laila Lane
Remsenburg, N.Y. 11960 ?~d-O
516 -325 - 0929 L~%
March 23, 1993
Building Department
Town Hall
53095 Main Road
PO Box 117'9
Southold,NY 11971
Dear Building Department,
Please find enclosed two sets of plans for a SECOND FLOOR DORMER as a REVISION TO
THE ORIGINAL PERMI . If there Is an additional permit fee please let me know
and it there Is any other requirements that are required let me Know as well.
Owner : Mt Pat lavarone
950 Strohson Road
Cutchogue, NY
B egards,
PviA! 2 6
L'z
Peter Podlas
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ I INSULATION
[ ] FRAMING [ INAL
:
RE77KS,
DATE° INSPECTOR
X110
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
G= ~s
REMARKS:
i
C J/ INSPECTOR
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND [ ) INSULATION
[ FRAMING FINAL
REMARKS:
DATE IOM INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
r1000484 BUREAU OF ELECTRICITY
I 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date MARCH 17 ,19`34 Application No. on file 82639093/93 N 307627
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
ROSEANN IAVARONE, 950 STRHSON~-ROAD, POLE-NYT-15, CUTCHOGUE, N.Y.
in thefollowing location; ? Basement L~ Ist Fl. A 2nd Fl. GAR/OUT Section Block Lot
was examined on MARCH 10, 1994 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K. W. AMT. K W. AMT. KW. AMT K W AMT H.P
3 9 7 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W OIL H. P. GAS H P AMT. NO. A. W. G. 11 AMT. AMP. AMT AMPS. TRANS. AMT, H P SYSTEMS AMT. WATTS
NO. OF FEET
i
SERVICE DISCONNECT NO. OF S E R V I C E
AMT. AMP TYPE METER YW I g 3W 3,e 3W 3,e" 4W NO. OF CC COND. A W o
NO. Of HI-LEG A. W. G. NO. OF NEUTRALS A. W G
EQUIP. PER m OF CC. COND. OF WH1 LIE . OF NEUTRAL
OTHER APPARATUS:
,
MOTORSt1-I? H.P,
G.P.C.r.t-1
SMOKE DETECTORt-I.
TRACK LIGHTING-8
RICHARD KLNINPELDT LIC4665-E
11.4 CAR.LTON TON AV E
GENERAL MANAGER
ISLIP TERR., NY, 11752 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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Ta ~9
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BOARD OF HEALTH
j ~ sil nFORM NO.1 3 SETS OF PLANS
TOWN OFSOUTHOLD SURVEY
NOV + 819 BUILDING
TOWN HALL DEPARTMENT SEPTIC FORM
TOWN H
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 ttoTIFY:
- ' d / 0,; CALL -
Examined ./~J, • 19l. 7- MAIL TO:
Approved /f,/, . 19f~~Permit No..~~~ . .
Disapproved a/c
APP OVE AS NOTED
B.P
7ZO
FEE' C3 11Y:
(Bull g Inspect
NOT FY BU! _ NG DEF.AT AENT AT
765-1802 9 AM TO 4 PM FOR TPAPPLICATION FOR BUILDING PERMIT
FOLLOWING INS3PECTiONS: q /
1, FOUNDATION . TViC REOUIRED Date . 19.`.`.
FOR POURED CONCRETE,
2. ROUGH - FRARAM F'rL.UMPINC; INSTRUCTIQNS
3. INStft 6.1lf'3td
a. 4.T1~ ftlicat6oRh'filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of + Q•to scale. Fee according to schedule.
b. of offr{ oMgJand of buildings on premises, relationship to adjoining premies or public streets
ol, are FdeT'EN R Y of layout of property must be drawn on the diagram which is part of this appli-
catio &
c DjES_ RIOT E ~on may not be commenced before issuance of Building Permit.
d* pon "$p~p the Building Inspector will issued a Building Permit to the applicant. Such permit
shall bRh*gpt on the ure~ sus;lavailable for inspection throughout the work.
e. N}~o building shad be occupied-or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall FF[" g~bYtle Building.Inspector.
n,~4 t,, 7 'F•,A•Si7 _N7 r
A hCAI~hQRS1tPE-RE&Yi-ICg1AE to the Building Department for the issuance of a Building Permit pursuant to the
Build iIa_L~n~ t3t$inarice''bftrie Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
RegulatiQt3S;'"tfor'tlie construction of buildings, additions or alterations, or for r oval or emolition, as herein described.
r''` l b d de, ho -ng code, and regulations, and to
The y~p~lC~rit''agre~^t~i'~~:m~}}~ with a~ apphea }c ifiY?S, Gi dir,an: c5, uuii ui
admit;ar4f)~d~iied iri§jierfiors 8n. premises and in building for necessary inspec
tfUSi?I b~?EF'Jfv
. . .
M3 Y.CIM?p_E7F. FtP,-i t;, O (S' nat f applicant, or name, if a corporation)
ALL CONSTRUCTION SHALL MF3'T ee LL~tr!1 ~ JJlpk'svlCJ fly ~/7~j~
THE RfQUIRFMEN'iS OF THE N.Y,
STATE CONSTRUCTION & ENER(,Y / (Mailing address of applicant)
CODES. NOT RESPONSIBLE FOR
Stat~EtSf@R~}f~RUQST16NrdULelRRgfe, agent, architect, engineer, general contractor, electrician, plumber or builder.
d:.C....v.......
Name of owner of premises ! l..,~,..... .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
flo
UK
(Name and title of corporate officer)
W f p~
Builder's License No . y w ~ €4
l u4 IJ~ID R
Plumber's License No. . ~ 4 J~ CE RI a 'FU a
n. 71 f9.
Electrician's License No. " ~
• ; ~w'(= H ~ qty ~
Other Trade's License No .
1. Location of land on which proposed work will be done .
C! U7C~fP.
House Number Street Hamlet
County Tax Map No. 1000 Scction/O..!.......... Block .....L~ )P Lot ....AvW
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and c~y of proposed construction:
i
a. Existing use and occupancy . . .
A . .
b. Intended use and occupancy ...../Lla-
3. Nature of work (check which
]?plicable): New Building Addition Alterat' .
Repair Removal Demolition , Other Work we W
/ ; .(Description)
4. Estimated Cost i
Fee......................................
(to be paid on filing this application)
S. If dwelling, number of dwelling units Number of dwelling units 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 Rear
Depth Height Number of Stories .
Dimensions of entire new construction: Front Rear , Depth .
Height Number of Stories . . . . . .
9. Size of lot: Front .5r-c> P.car -P........... Depth ~ .
%O'9.
10. Date of Purchase ••.Na eofFormerOwner s! r,,,,,,,,,,,,,,,,
11. Zone or use district in which pre(ises are situated K~(p1:NTii9-v
12. Does proposed construction violate any zoning law, ordinance or regulation: 1y9 . .
13. Will lot be regraded , !y •o , . , Will excess fill a removed from premises: Yes No
14. Name of Owner of premises ! AYI r~ r(~~ • . , • • • • Address !J -"AW-f"// Phone No. 9?L. ~y`f , • ,
Name of Architect ..........L Addresss r y~ Phone No............... .
Name of Contractor . . Address . . . . . Phone No .
property
15. Is this * within 300 feet of a tidal wetland? *yes,,?,,,,, No
If yes Southold Tiown 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.
006 D
6
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5 e,
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PffKZA72/[J t7
i
STATE OF NEW YORK,
COUNTY OFF SS
G a7•,. • U S • r%V •a k being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the E7GUtil 1G5 .
(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 set forth in the application filed therewith.
Sworn to before me this
3. ...day of 19.
Notary Public ty
' ANTON~TSA QEOR8IOU -
Notary Pubflo, State of Now York
No' . 41-4002570 . .
Qualified' In oueens county ~4 (Signature of applicant)
Commission 0xpires March 30, 184
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f r YARYY 3YDCNILrICO Y[$,tone'. iXA44 IIA~I „ FIp)nux x[N5 N{TII ATIA(IjNIFUn o I,A a A M1lptnux or or . aP. NOTSCC: EVIEBC65 PLANS N jN 1Nam o
_ r A4L WSI~f O-INSILZOY{ t0 ..AF ON 1V NISII cOiT E000L6 ILOOi AOI44{. XIONGR Y-y IOVL f Ha IAC4 Mws .Moc SN .o}i0X ae[imwm"NO' Th. Contractor Ya Crante to the Architect that he an. the par ti culp[
as n' Ox Or Or[NI4i qq5 A44 COIU I1 OVLATS IVI c 4Y] CLOO , ~ - - - COOL RNALL COYLRM OY[R AW S0. YIICXItLCt I] YOS [X[,000], INy+iLlgnax oiaocI'mau ea competence and skill in Construction noces..r, to build this project vithmt f c 11 ongin.e ring and arChltncty[al services, and, for the reason that the Gc1 la sot [xr,eeP tax Contractor wish.. to at, upon H. ow competence, the COnr[actO[ or Owner
7 1 <ON{TAYCSIw A IXESACWTIO IOTCCYC{ILAM[]LANY nA[ .I,[qutAxe , tY ux4[v has restricted the Architect's scope Of Professional eadvlemi. In rel]pnce
v I S. A44 COxCFITI TOW - xSN. as an raI an the contractor's warranty and at the express coqueat of the Contractor o awn.,, the Architect he. andett.k.n . limited seep. of professional service..
` ~ ~ l~ Nom' r I• rL006 [4[GNO f 1001 OOIiiG }O ]G The c nstrwctlen documents provided by the limited services shall be termed "suf lda C. Plan.- in recognition of the Conereetoc'a .ophiscieation. Con-
Atvactian will require that the Cantractor adept the -Builders plane- to the field ...fill... encount ...d and make logical adjustment. in fit, Inc.,
di.Pns inn end quantity that ere treated only generally by the 'Builder.
w .r (y" 9L P loon". In the event additional detail or guidance is needed by the Contractor ar Owner for construction of any aspect of the now project, he she]
07 immadlately notify the Architect. Failure to give a simple notice shall rslieve the Architect of responsibility for the consequence.
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LAILA LANE, BOX 285, REMSENSURti, NY 11960 516-225'0828
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