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Home My WebLink About19277-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY/ No Z19563 Bate DEC. 5, 1990 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 775 MIDWOOD & 55 PINEWOOD RD. House No. Street County Tax Map No. 1000 Section 110 Block 03 Subdivision Filed Map No. CUTCHOGUE Hamlet Lot ~1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27r 1990 pursuant to which Building Permit No. 19277Z dated JULY 27, 1990 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 HOBBY ROOM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM LOMBARDI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Nt60308 NOV. 12, 1990 FRANK J. MEYER DEC. 12, 1990 Rev. 1/81 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~- ~ 92'77 Z Permission is hereby granted to: .... .............. ..~..~~.....~.:..~...:..,..,..~..~. ~...~.~.~.~ .-.- ~_,~,.:., ~u~,~ ~~~ ............I ....... at premises, located at ..-/.....~.r~;....~..~.~..~.....'.'.~...~...2]..~....~, ~...~.: ........ County Tax Mop No. 1000 Section ......... ~.l...O.. ...... Block ...... ~)...~ ...... Lot No....~..[ ................ pursuant to application dated .......... ~....~. ................... , 19.~.~..., ond approved by the I~uildlng InsPeCtor. Fee $..*~**'~*:..~... · B'~ldJng In.~ector Rev. 6/30/80 ~ PLUMBERcoN~ENTCERTIFICAT/O~BEFORE ~ ON LEAD sO ~N~OT ~ .,,~,i~$ ~ LDER uSED IN WATER - ~ ~UPPLY sYSTEM .~, ' APPROVED AS NOTED NOTIFY ~UILDING DEPARTMENT AT ~'~1~ ~_/ I FOUNDAT~OIV )'~NOREOUIRED ~ ~ ] ~ 4. FINAL - CONSTRUCTION MU~T -- ~l' ' ~ BE COMPLETE FOR C,O / ' -- ALL CONSTRUCTION SHALL ME~T ' THE REQU REMENTS OF THE N,-Y, ~ ........... ~ ~ ~ ~ .... STATE CONSTRUCTION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CON~RU~ION ERRORS TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECI'OR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.... /? ~ Owner LO t~/)~4~O/ (please Print) Plumber. ~ ~-. ~&~fZ~F (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ,$.~day of D~&~DE~ , 19 ?~ Notary Public, gvt~u~ ~ County Notary Public Form No. 6 ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 TOWN OF SOU'i'~~ ~ 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 ali 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 ali 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 i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging 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 ............................. ~:ew Construction Old Or Pre existing Building...~. Location of Property...p~..~.g~,O~.F .... ~...~.g/~.~.~(t~. ~.~..~f~..~ .~f~..~/ House No. Street Hamlet Onwer or Owners of Property .... ~L((~ 4~.~.~.~ ~ County Tax Map No i000, Se tio ..2(9 ........ ...... ...... ....... ............ Sobdivision .................................... Filed Map ............ Lot No .... 2'P ...................... [~ermit .~a ..... ~ate Of Permit..~.~.~.~f...Applicant ~ ~af~M~ ~- / / "~ ' ' · t ............. ~, Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval Request for: Temporary Certificate ........... Final Certicate ........... . ,~ Fee Submitted: $ .... ~.~% ........ ~ [~ {~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL NAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 1185077 BUREAU OF ELECTRICITY j-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 o~t~ NOVEMBER 12,1990 ~ppt~,~tlo~ ~o.o. fl~ 70086590/90 N 160308 THIS CERTIFIES THAT only the electrical equipmenr ~ ~scribed below and introduced by the applicant ~med on the a~ve application number in the prorates of WI~LIA~ ~O~BARDI, 55 PINEgOOD RD., CUTCHOGUE, N.Y. in the fotlowing locatlon~ ~ Basement ~ Ist FT. ~ 2nd ~. .qection Bilk Lot u~s examined on ~0~ O~ t 1990 artd found to be in compliance with the reqt~irements ~f this Board. RXTURE OUTLETS DRYERS SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OTHER MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: G.F.C.I:-2 SMOKE DETECTOR :-1 E R V I E NO, O~E~C,~¢OND- AWG O~ CC, COND NO OF OF HI-LEG NO, O,c NEUTRALS P.O.BOX 164 CUTCHOGU~, NY, 11935 /.~i1 /~At MANAGER ~!, certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ~aY ~ied by their credentials. ~, (Building Inspector) APPLICATION FOR BUILDING PERMIT " BOARD OF HEALTH ...... 3 SETS OF PLANS ....... ,I FORM NO. 1 SURVEY .......... TOWr~ OF SOUTHOLD CHECK .......... BUIL1D,'ING DEPARTMENT SEPTIC FORH ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: ., 19 cp.o. INSTRUCTIONS rate .... :7/o?2 ....... a. Tiffs 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 thls application may not be commenced before issuance of Bui/ding 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· ¢. 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 inspectom on premises and in building for necessary inspections· · ./]... ....... ............ (Signature of applicant, or name, if a corporation) · f., .4-. 2 ?.,.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. ~.t)~ .~.. ezr.-2-_v. ~. .......................................................... Name of owner of premises ..... .~. ,IL. .q [, ~ .... .~, O,~ ,~.~ P~O. I .................................... (as on the tax roil or latest deed) If appJJ~a~t i_s a corporation, signature of duly authorized officer. ALL cON, TRACTOR'S MUST ~E SUFFOLK COUNTY LICENSED Builders L cerise No ....~.~ ~'~V.. ..... Plumber's License No .... ~.//~/~-A,/Z,¢,....~...../'~g-q t,~t Electrician's License No.../~..6..,~../.~,/~/ ........ Other Trade's License No ...................... I. Location of land on which proposed work will be done. ]14./.O.t,~. ?/:~ .,~....~.//Y~"J,9'/:Og...~0. V'' 72. . ' . .~. ( ¢.~.o. cs3. , r-,C. . . .Y. /z,~:- .q~.~o. ~ .... ~.~. .. .. ¢ ~_:. ............. ~ /~/~ ..... :. , , ~ , ,, House Number Street Hamlet o3 OX County Tax Map No. 1000 Section .... /(9 ........... Block .................. Lot .... Subdivision Filed Map No Lot (Name) 2. State existing use and occupancy of premises and intended use and occnpancy of proposed construction: a. Existing use and occupancy .......... ~,~f~ ~(~. . .~ b. Intended ~se and occupancy ............. ~ ~.~ ~~ i~t~ ...... 3. Nature of work (check which appiicable): New Bt lding ..... ' ..... Addition .......... Altera~on ......... Repair .............. Removhl ........... ~.. Demolition '. .......... Other Work ~;3J~$~. ........ · ...... '......... Fee ... ;~ ...... ,i · (to be paid on filing this application) 5. If dwelling, number of dwelling ufiits ............... Number of dwelling units on each floor ............... If garaee number of cars 6. If business, commercial or mixed Occupancy, specify nature and extent of each type of use ................... 7 .... iif any: Front Rear Depth D~menslons of existing structures · Height Num~br of Stories .......................................... Dimensions of same structure witli alterations or additions: Front Rear Depth ..................... L Height ...................... Number of Stories ..................... 8. Dimensions of entire new constru6tion: Front ' Rear Depth Height ............... Nmnb :r of Stories ........................................... 9 Size of lot: Front Rear ............. ...................... , ...................... Depth .................. 0. Date of Purchase ............................. Name of Former Owner ............................. · I. Zone or use district in which prerr ises are situated ..................................................... 2. Does proposed construction violat~ any zoning law, ordinance or regulation: .... .P~.. ......................... 3. Will lot be regraded .......................... Will excess fill be removed from premises: Yes No 4. Name of Owner of, premiSes ... ' · .. Address Phone No .......... Name of Architect ..... : ~-..k.l~ ~, .~r'.t2ge. O.. Name of Contractor .//~.""; ................ Address . .~ ............... Phone No.. 5. Is this property located w~thin 300 feet of a tidal wetland? *Yes ..... No ..... ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all b~i]dings, whether existing or' proposed, and. indicate all set-back dimensions from 'roperty lines. Give street and block nffmber or description according to deed, and show street names and indicate whether nterior or comer lot. TATE OF NEW YORK, (Name of individ ual signing Jcontract) ~ove named. being duly sworn, deposes and says that he is the applicant ' is the .- ~ (Contractor, agent, corporate officer, etc.) · said owner or owners, and is duly aothorized to perform or have performed the said work and to make and file this plication: that all statements containdd in this application are true to the best of his knowledge and belief; and that the )rk will be performed in the manner se~t forth in the application filed therewith. ~'om to before me this ............. a "i ...... 19, BUILDING DEPT. INSPECTION FOUNDATION 2ND [ ] INSULATION