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Home My WebLink About18118-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219125 Date JUNE 8, 1990 THIS CERTIFIES that the building ADDITION Location of Property 56861 R.O.W. OFF MAIN ROAD SOUTHOLB House No. Street Hamlet County Tax Map No. 1000 Section 63 Block 003 Lot 17.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 1989 pursuant to which Building Permit No. 181182 dated MAY 16, 1989 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 CONSTRUCT A GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to VINCENZO & ILEANA DOLOMITE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N110568 JAN. 16, 1990 PLUMBERS CERTIFICATION DATED N/A Gz-e ? i1d ng Inspector Rev. 1/81 I roans xo. s TOWN OP 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°- 18118 Z Date 19.x.9 Permission is hereby granted to: ...~?a.<....,,~~.~...~~~..~.....~ y r,/ of premises located ot .~~+...Rr~t.~....~1~/A~...~4....~~.~'1....... ! ............................................9.lct~Gf.~O000.................................................................................. County Tax Map No. 1000 Section :3..... Block .........~..1........ Lot No......~lt..f........ pursuant to application doted ......U~./1~ 19. and approved by the Building Inspector. pD Fee ~Bui ng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD I I ~ e~ BUILDING DEPARTMENT (J TOWN HALL 7 may, 765-1802 1 ~1 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN FSOU~'~ 1HOLD 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 1y, lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from~architec*_ 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .s~/~5r/~Q New Construction........... yyOld Or Pre-existing Building. Location of Property.. V.19./....~°. Lc /'V1,r~ ~~.........~ICt U.Tl7l,~~, l J~ House No. Street Hamlet Onwer or Owners of Property.Y:"7C~'~~.77~`,~G~An/!f (~0~~~i-j. TF........r~ County Tax Map No 1000, Section....~':f.......Block...~ .........Lot.l 7..`~ Subdivision.../~.././.pJ.2 ..........................Filqed Map..........I./.Lot...................... Permit No...~GS. C~ ,4-....Date Of Permit.../~~ 1.....Applicant. Y/:`!~~:!Z:a ...~..~.G, ,a!hi'T~... Health Dept. Approval ..........................Underwriters Approval...°.N..~ ~L E . Planning Board Approval ' Request for: Temporary Certificate........... Final Certicate...."....... ZS DO Fee Submitted: $.........~wK 5 e,il/ G, a z APPLICANT ~~~~qo THE NEW YORK BOARD OF FIRE UNDERWRITERS t"+;c"' 1 1 11'1'1(} } BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK. NEW YORK 10038 Date JANiIAkY ih, 1'.+`111 APPfiretionNo.onfile F,hplh'$`1/8''1 N I1h!ifitt THIS CERTIFIES THAT only the electrieel equipment er described 6eloro and introduced 6y the opplicent nerved on the show opplieetlon number in eheprcmteee R/ '!'Itil'b;N'1.0 f)(SL,QffiiTM,, Kl1, Ii+lfait;i MK(r•1 k4r„ :i171I4'FI(N,li, N.'Y. in thefdlotainR kecaNon; ? Bee ment ~--ry f;Ait i11(I's LJ 1st Fl. ~ Pnd F'l. Section Block Lot DF,f:F:NHF:R 19$9 uqs examined on endfound to 6e in cornplianre uif.h the reyuircments of thin Boord. NKTUM EttACeRi fWI7CNE5 XTURK RANORS COOKING DECKS OVENS DISH WASNlRS lXNAUST FANS OUTLETS INGNDESCENT F1U011lSCEN7 OTHER NAT. K. W. AMT. K. W. AML. K.W. AMT. K. W. AMi. N. P. e I fl 5 DRYERS wRNAC! MOTORS wTUR! AMUANCE MEDERS SMCIAI REC'1T TIME CLOCKS E!u UNIT HEATERS MUITI.OUTLET dMMERS AMT. K. w. al N. P. OAS N. P. AMT. NO. A. W, c. AMT. AMP. AMT. .AMPS. TRANS. AMT. N. P. SYSTEMf AMT. WATTS NO. M IHT SERVICE DISCONNKT NO. CM S E R V 1 C ~ E AMi. AMP. TYP! 1 / TM 1 / TV 3 X ]W 3 X AW GYFR 4COND. Of CC. COND. ~ NIiEG ~ ~ HI'~~ NO. OF NlUTRAL] Gi NEUO!AL OTHER AMARATUS: 4"tINi.Nti FQR [iAftA ii k: I'ci(q V1':K`:itTf~ I .+.F.i~-f: i ;1.C. ba.NC'PRIf- tNl'. !,11~.$iH'l.; F; 1'.O.RUX 4IK LkUNRL. N'/, f ' 4,9 OWRAE MANA06l 1E Psr This ceAificaN must not ba aksrsd in any manner; return to the office of the Board if incorrect. Inspectors may ba identified by (hair credentials. I DE ARTMENT. IS A D N 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]/FINAL REMARKS: DATE ~~J~ ~ INSPECTOR % i T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] 1R000H PLBG. [ ] FOUNDATION 2ND [ ~ INSUL`A''TION [ ]FRAMING [~INAL~;J~ REMARKS: ~~/~~/"""""~v~ P ~ ` DATE d ~ C~ INSPECTOR < 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL REMARKS: ~~}~-~Yif~2~~t/~ DATE ~ ~3 a ~ INSPECTOR ' BOARD OP HEM\LTH FORMN0.1 3 SETS OF PLC\N~...`~........ SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC r•oRM • TOWN HALL SOUTHOLD, N.Y. 11971 NOTII'Y ~p /fC, TEL.: 765-1802 CALL_ / a . Examined. ~`..........,19Y.~ MAIL T0: Approved . / .~i6........., 19~.~Permi[ No..~~'/~•b"• ~l~Sw.ta.o ~ ,C ~ ~ 10 0 Disapproved a/c g D BLDG. OEP ¢{(}Lt7 .l TOWN OF 50tH ~(Bu ino Inspector) APPLICATION FOR BUILDING PERMIT Date . 1 INSTRUCTIONS a. Tlus 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 appB- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. t 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 Re;ulations, 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 oi' 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 ~.?17.K`^.'e . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) s . Builder's License No. • Plumber's License No. ~ .T.^.. t~ t. u Electrician's License No . . m~iN . Other Trade's License No . ~ ~ 1. Loc ion of lan~1 on which proposed work will be done. • , , • . , • . • G~'~ ~ ~ . a So . Ilouse Number Street, • • • ~ • ' ' ' ' ' ' " Hamlet ~ ~T~-~1~ County Tax Map No. 1000 Section ~ B]'ock , , , , • , • • , • Lo[ ~'.7; Subdivision Filed 1<Iap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing wse and occupancy ....~~~.I~..-...~~t.Q.r~ . b. Intended use and occupancy . • • • • • • • • • • • • • • • • • • • ~"°~'~f0~~~"'t~t- r,;,;. ~i"r'tt~~ib! ~ . S,.,tnJ ~'S ~f?ut~ .t3~ac:.: tfl- ~w r,~.. . A~ P . P~ sario9•r?1 a~tbtq?1 m=~: P • • • • Re aPPlicable): New Building Addition Alteration . 3. NRett~i of wort. check whichmoval Demolition . , Other 1Vork . 4. Estimated Cost . .Fee . ,~`Z) Od O . , (Description). . (to be paid on filing this application) 5. If swelling number of dwellins units , , , , , , , , , , • , Number of dwelling units on each floor , , , , If ara e, number of cars . . . . 6. Tf business, commercial or mixed occupancy, specify nature and extent of each type of use , , , • • , Hc,ight S i•es, if any: Front , . Nu Rear Depth............... ' tuber of Stories . , . Dcmp,~tons of same1structurc i I, • • • . • • • structuWtth alterations or addi ' ns: Front . , Z-~f Rear ..~;-f,t • • , , , Height J.7. , ~ Number of Stories . Nutruction:Front Rear Depth Hetltt nberofStories 9. SDize of lot: Front , Rear ' 10. ateeoftPurchase ttre new cons ~ Depth , • , , , , , • • • • • ""•••'••••••••••••.••....NameofFormerOwner 11. Zone or use district in which ~cmises are situated . . . • P P plate any zoning law, ordinance or regu]atian: A........ . 13. Will lot bee waded truction vt Will excess fill be removed from premises: Yes No _ P 14. Name of Owner of rues V: ,Ata lo.~ i ~:e. , , ,Address . . ........Phone No.7 b.5 . z, ?~E3.~ , • Lame of Contractor ' ' ' ' ' ' • • Address . . . . .Phone No. f e esArcSouct R~1`! .................Address Phone No................ 15.Is this propert Gated within900 feet of a tidal wetland? *YES....NO.... * y thold 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. , i STATE OF NE1V I' COUNTY OF .•~~~"}~~,C7.I~'... S.S I .7. !11. ~G. tl! ~'e~ . ~YNamc of individual si~m~a ~4YIt~L° • • ' ' being duly sworn, deposes and says that he is the applicant ' ~tg contract) above named. He is the . it (Con, agent, corporate officer, etc.) of said owner or owners, and is duly, authorized to p5rform 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 Itis knowledge and belief; and that the work will be performed in the manner set forth in the application f}Icd therewith. Sworn to before me this ....................day of l..., ]h~•/• Nota Public, ' • u~l~ County N M Publ~b,SUboNfNwvlfalt (Signa[ure of applicant) 6miros 81~,1~9 BAST 1~"LA.f~i;~k.~' ~i..~r:r~ !ntc `1 ppr~ ~'y~ LL_ t 72:V? _ - ~ r s _ ~ ' 3~} ~ w a 1 u. ~ ~ , ~ r ~t ~ l ~ 1 ~ 1, - 1 f .i , ,-.p N F ' tl T L;t. Q i,l 1 i ~ry r 1 u_ i ~ E` ro^ f ! r ~ 1__ 1t~~C~~}C~3~ ~ I ~ o ~ ~ < t t3~ ~rsr - ~ I _ i a ~ , ~ --.3.i-~--.- - f ~ z Q ~ , ~ z- ~ '1 "-~Tt5T:F1DCE--- Yl~ '1 ~ ' J \ l ~ ~SO~.- ~ - ~ ?„r _ ,t., BAST i5LAt1t~T2 H4!Y taxi"+~ 1` j { 91 ~1._'9' r. ill v~ ~ y ~ f i idF s i ~.~1~t~1 .~~1rS~' t !j t~E. t"t ? .w ~ - ' . rv i - !/~S ~ J~ 1 F^ ~ 1.4~V V"y~ ~.7QJ ~ ~ ~ F~ki , ~ NL. 1~~Y 1 n"' ' ' tl; _ .n , Tt.~ 1 ~ :~.:if:11v F_i.. 1 . _ t _ _ fir,,- . _ .r i. . , n r,; 1~ J --SS:i- STAT~; `1E~1T ,J~-INTE_tJ`I' f T,aE wATF~_ 3UPL'L1' d. 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