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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-19446 Date OCTOBER 15, 1990
THIS CERTIFIES that the building ACCESSORY
Location of Property 1545 RUTH ROAD MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 7 Lot I1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 19, 1988 pursuant to which
Building Permit No. 17453-Z dated SEPTEMBER 20, 1988
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 INGROUND SWIMMING POOL & FENCE AS APPLIED E'OA_
The certificate is issued to ROBERT & VERONICA CIDONE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA
UNDERWRITERS CERTIFICATE NO. N-040539 - OCTOBER 18, 1988
PLUMBERS CERTIFICATION DATED NjA
uilding Inspector
Rev, 1/81
gosat xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(TH PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 017 4 5 3 Z Date .......~.lr.:.a.~eA.....~ 1L......, 19.~Y
Permission is hereby granted to:
.....A:..~~'~~.. ..~-..........
...~~.x..y..3 ~ ..............................................
~ ~ i 9 s ~.--..
ta ..1,r~:!~.`.:-9M^.":~'..g,•Y,....5•:"•:~,tl.:!l'•`•-!~!!~.~.....~.1'.~:P...d.~....~!.~w!.~,R.......Q~...:a.~..
at premises located at ...~..,~.~:.,~......C...M................~.S4rti:QK- ...............
County Tox Map No. 1000 Sectione........~ D ~...... BlockC.....~.~......... Lot No... ~.~ .................
pursuant to application dated ......~?~T~9'!^:i~...~...1.........., 19.~.~., and approved by the
Building Inspector. VVV
Fee $.. ~..~~.~•.`. ~-'
Building Inspector
Rev. 6/30/80
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 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residenti//al//~~$15.00~~,//''Commercial $15.00
Date ..[.Y.~ ~ J./. .~ ........................
New Construction....... ... Old Or Pre-existing Buildin ........... ..
Location of Property....~~ ~J ...............~U7./~", ~OCI~ .........(ul~:T_.1.1 TG~ ~1~.......
House No. Street Hamlet
/~ i _
Onwer or Owners of Property.....~ngeP:.r..~}A1D..vE/`oNIC~,,,~[,DoN~,,,,,,,,,,,,,,,
County Tax Map No 1000, Section.....! ~.SQ...Block...... 0~.....Lot...... /. 1 .............
Subdivision ....................................Filed Ma ...........Lot......................
O 1;7';15. z ~- a o -,~~' ,/~., /~e,lly.. ~::~:n-S ..~:~
Permit No.. .Date Of Permit ... ...........Applicant.
Health Dept. Approval ..........................Underwriters Approval... ~...................
Planning Board Approval ..................
....... /'no L. d- ~2 h C~
Request for: Temporary Certificate........... Final Certicate... n/~
Fee Submitted: $.~~ ~ ...................
~_
(~jee. yo6B'f~ ................... .
..... .
....... ...... ......
Cn~ 1'9tf4G -- - APPLICANT -
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
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OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 15, 1990
Robert & Veronica Cidone
1545 Ruth Road
Mattituck, New York 11952
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Re: Building Permit #Z-17453-Z
Premises: 1545 Ruth Road, Mattituck, N.Y.
Suff. Co. Tax Map #1000-106-7-11
Dear Mr. & Mrs. Cidone:
Enclosed please find Certificate of Occupancy Z-19446 for
your inground swimming pool and fence.
As per our conversation on October 2, 1990, a Permit and
Certificate of occupancy is required for the deck. Please fill
out the enclosed building permit application and submit it to
this office with three sets of construction plans.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Gary J. Fish,
Building Inspector
GJF:gar
Y,
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TO~Cfii OIL SOUTIIOLI3
OFFICE OP GUILDING INST'EC'I'OR
P.O. IlOX } 1 7 9
TOWN IIALL
SOiJT1[OLD, N.Y. 11971
October 3, 1990
ROBERT & VERONICA CIDONE
1545 RUTH ROAD
MATTITUCK, NEW YORR 11952
'I'o [9hcm This May Concern,
,~
TEL. 7C,5-180?
We are unable to complete your Certificatr_
of Occupancy because ,of the folloc~~ing reasons.
/_,// An application for Certificate of Occupancy
is not nn fi].c. (ENCLOSED)
/ / *to Undcr~~~r-itcrs Certificate on file.
/~// 'Phe chec[: .i;:(Y~x~i(.R%~not on file.) $25.00
/_/ D]o Ilca].th })ept. Approval on file.
/_/ Nn final inspection has beet: made.
Please contact: our office on this matter.
Thank you for your cooperation.
llu.ilding Pcrmi.t-. II 1 7 4 5 3~
IIuil~7inq Dupt.
~'t'/J/ tlo Plumbr_r ;;older Certificate on file.
( all permits involving plumbing being
icsucd aft.cr ~1pri1 1,1954 )
NOTE: PERMIT REQUIRED FOR DECK.
:'lELD I;;SPEC:iU;J ~ ~llATr, ~ i;Ot`4MENT° ,~.,~
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PLUMBING
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ADDITIOP]AL COMMENTS: x
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OI'i~1CE UP fSUILDING INST'ECTOR
1',O. IIOX 1 1 7 9
TOWN IlALL
SOiITI10LD, N.Y. 1 1971
October 3, 1990
ROBERT 6 VERONICA CIDONE
1545 RUTS ROAD
MATTITUCK, NEW YORR 11952
To P7hcm This May Concern,
~~
TEL. 7l,5-1801
4.e arc unable r.o complete your L'ertificatr_
of Occupancy because of the following reasons.
/,,// An application for Certificate of Occupancy
is not nn fil.c. (ENCLOSED)
/ / CIO Underwriters Certificate on file.
~S~// 'Phe clicc}: .i:: (R>R1d%1R>I~%iglnot on tile.) $25.00
/_/ D:o iical.th Dept. Approval on file.
/_/ No final inspcc:t.ion has been made.
Please r_ontact: our office on this matter.
Thank you for your cooperation.
11u.ildincJ Perm.i.t Q
IIuilclinq Dept.
1 7 4 5 3 Z
M:4k/-/ t10 P1Um1>Cr Solder Cerl•.Lficate on file.
( al.l port:tit:,• involvi.ny pluml,iny briny
i~sucd att.er April l,19A4 )
NOTE: PERMIT REQUIRED FOR DECR.
~ 7y~3. ,
7G5-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ~ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
DATE ~" INSPECTOR
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/ ~ ~,~~ 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING
[ FINAL
REMARKS:
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DATE ~~ ~ INSPECTOR
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE '
1fi0138t
t,y., ~:~,,.. EIUREAU OF ELEGTRIGTTY
,;
~
85 JOHN STREET. NEW YORK, NEW YORK 10038
()("1'ORP,R 7R;79k$ 5t11d?.5tSA/SS iv 04()53?3
DOLP Application No. on file r
THIS CERTIFIES THAT
only the electrical equipment a. deserihed Freloso and introduced 6y the applicant nomad on the shove opplicaNon numher in the premise+ of
R(')Nt;itT CCTH)NT;, 7545 RUTH ltOAA, /POt,6 #~7?; MA')'Z'1'C(ICt(: N.Y.
in thefollotrinq locati ~ Beaepygpt Ofl'1'
^ Ixt Ff. ^ Pnd Fl. Section Block Lot
~
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scaa examined un and found [u 6e in Kromplionre Pith the rPyuiremend of this Buord.
RXTUM WXTURES RANGES Ct)OIIINO DECKS OVENS dSN WASHERS EXHAUST FANS
OUTIETf ACLES EWRCMES ILICANGESCEM ~ PlUGI1EtCEM y AMT. K. W. AMT. K. W. AMT. K.W. NAT. K. W. AMT. M. P.
t
DRY95 RJRNAC! MOTORS RJiUM ANUANCE RIEONS fFEOM EEC'-T i1M[CIOCKf pLL DIRT REAiEES Mf
~
s DErYNERS
Y51
f
AMT. K. W, dl H. P. GAS H. P. AMT. NG. A. W. G. AMT. AMP. AMi. AAVS. iEANS. AMT. X. P. ~. ~ ITT AMT. WATTS
~ 20 7 4t7
SERVICTf gSCONNECT NO.OF S E R V I C E
AMi. AMP. TYPE b~. 1 / tw 1 p aW ~ / tW S / Avr NO' ~EM%COND. OP CG COI+o. ao. a KLIEG ~ ~ HI ~~ ra. Of r~EUnuu -:-:: ~A' . G.
orREE uruuTUS:
G.F.C."f.:-?
*(Sli]F1M7NG Pool) this certificate
cnver.s coRpliance at the date of
inspection nnly. Necause of unusual.
environments i.t i.s advi.sahle to
have frequent test/and nr repai*4
made by a qual.i.t'ied parson.
~o~
PAT hANF.
MAT9']4'tICK, NY, ).'195'), OBRAI ~Ap~
7J Q
LiC[~;NSE No. 2,3G0 R par
Thit certificate must not ba shared in any manner; return to tM offiu of fhe Eoord if iIICOrrM. Mspecton may bs idegtifirad by tlseir crtdentials.
COPY FOR 6UILDING DEPARTMENT. TNIf DOPY OF CERTIFICATE MUST MOT:EE ALTERED IN ANY MICR.
rah
SONNY
"IMMEC
ENCLOSE P(
"" ~Y+ON CO
BEFORE
OCCUth7NCY OR
WRHOUT CERTIfiCgTE
Of nCCUPANCY
~AN~
APPROVED AS
DATE. 9 ~ Y ~ B.P.
-~_
N
768-1802 8 AM _.., .~., ~ rvlcrv ~ 'qT
FOLLOWING INSPETCOT ONS FOR THE
i. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH -FRAMING & PLUMBING
3. INSULATION
4, FINAL - CONSTRUCTION MUST_
8E COMPLETE FOR C.O.
All CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y,
STgTE CONSTRUCTION & ENERGv
CODES' NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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3 SETS
FORM N0.1 SURVEY
~I-i~ i g ~g~ OWN OF SOUTHOLD CHECK
B ILDING DEPARTMENT SEPTIC
TOWN HALL
BLDG. DEPT. N 0 T T FY
TOWN OFSOUTHOt.O OUTHOLD, N.Y. 11971 CALL
a TEL.: 765-1802 MAIL
Examined . ~a4~- ...fin., 1948. `'
Approved . ° . .~9'~'1~ ~?, 19 ~ ~ Permit No. ~ 7 ? S. ~L;.
Disapproved a/c .................................... .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
~F HEALTH /
OF PLA~~IS .~.'~4~...
0 I~
.3.%3.`f~'... .
FORM ~.........:
TO : P Q .Ci3~.... .
~Y(d,7~.
Date ... ll~~ ........., 19~~
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 Depaztment 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 cor'po/ration)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ... ~UJ.3.E'?4~.. ~... ?f"... G!~:7z.Qn!~C09.... ~°: I .{~Q/.~~' ...................... .
(as on the tax roll or latest deed)
If a plic s a corporation, sig a re of duly authorized officer.
....... .l~ .. ...........
(Name and title of orporat er)
ALL CONTRACTOR'S MUST BE SUFFO K COUNTY LICENSED
Builder's License No. ... 2.~r ~ . ~ ..,y~ ...... .
Plumber's License No . ....................... .
Electrician's License No. . ~ Y~~~l?~..~s~/~iG`C,
Other Trade's License No . .................... .
1. Location of land on which proposed work will be done. .../.4 ~ ~~ ... ~r~~.~~....j!yl.1`~." ~i !. Z/~:CJC.... ,
House Number Street Hamlet
County Tax Map No. 1000 Section .... ~~ ~i ......... Block .....~........... Lot .... ~ ~........... .
Subdivision ..................................... Filed Map No. .............. Lot .............. .
(Name)
2. State existing use and occupancy of premises and intende~?d use and occupancy of proposed construction:
a. Existing use and occupancy .....~L?.~:~~T~!1 L :............................................. .
b. Intended use and occupancy ..........~~1~~~~~~Z:.... ~!l~, .), 7,~<~, , , ,~~?IL . . . . . . . . . . ...... .
.. ,, ,..,,.,m.u~... ,~ Lv l n.,.., ~uG peat.
.m.~. .... -~ r=C-m. c.L=
3. Nature of work (check which applicable): New Building .........: Addition .......... Alteration ...~..... ;
Repair .............. Removal .............. Demolition :............ ,Other Work .......x ...... .
' , °-' (Description)
4. Estimated Cost ..... ~.~~. b.'', ~ .................... Fee .... , .................................
g g ~ (to be paid on 61ing th~s application)
5. If dwellin number of dwellin nits ........... . ... Number of dwelling units on each flSdi":.............. .
If garage, number of car`s .....' .......................................................
6. If business commercial or mixed~occu ant s ecif nature and extent of each t
P Y. P Y YPe of use .................... .
7. Dimensions of existing structure, if any: Front ............... Rear ..... , ........ Depth .............. .
Height ...............NumberofStories.........................................,.......,......
Dimensions of same structure with alterations or additions: Front ................. Rear ........... , ..... .
Depth ................... . : .Height ...................... Number of Stories ..................... .
8. Dimensions of entire new constru
-... ction: Front .......... . .... Rear ...............Depth ....... , ...... .
Height ...............NumlierofStories........................................................
9. Size of lot: Front ........... : .......... Rear ....... , .....-......... Depth ..................... .
10. Date of Purchase ........... : .......... . ......Name of Former Owner .................. , ......... .
11. Zone or use district in which premises are situated .................................................... .
P P ~
13. Will lot be egraded truchon viol ~y zoning ]aw, ordinance or regulation : .................. ...... . ....... .
.... Will excess fill be removed from premises: a No
14. Name of Owner of premises ... ~.'..C~.'n~.ur! ...Address ...~J/,2~~ ~:~... Phone No.
Name of Architect ....... .... .. ..... Address ...................Phone No.. r~~.
Name of Contractor ../~.~.l~~'I;4~Y.~-. ~.. , .Address ..f?>~"Tl. `•T~~~C.. Phone No.. r~/~ .~t~.b.~~ .
15.,Is yhis ro ert located ithin 300 £eet of a tidal wetland? *Yes ..... No ~..
P P Y W
*If es, Southold Town Trustees Permit ma be regwired.
PLO DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block qumber or description according to deed, and show street names and indicate whether
interior or corner lot.
S~ ~°~~~~~ ~un~~-~
~ .---
STATE OF NEW YORK
COtiNTY ~O,F , .,$"t~F.I o~lC ~ 'S
~~...,
~~~ (Na ~ of individual si m~~ r ~ ~ • ' ' ' ' • being duly sworn; deposes and says that he is the applicant
g ng contract)
above named.
He is the ................~~~~ ~..... ......... , ................ .
' (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
................ /. 9 ... .........., 19 y.~
...day,Jo/f . //
Notary Public, ... 1~.. ,JC, : ~~ fah- .... County
............~^.Q............ , . .
HELEN K, DE VDE
NDTARYPUBUC,StaMbfNewYoAt (Signet a of pplicant)
1um~Expfres Mirk30 l~ua..JC.~