HomeMy WebLinkAbout16790-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17616
Date DEC. 20, 1988
THIS CERTIFIES that the buildin~
Location of Property 240 WINDJAMMER DRIVE
House No. Street
County Tax Map No. 1000 Section 071 Block 02
SubdivisionHARBOR LGTS SEC. 2 Filed Map No. 4681
ONE FAMILY DWELLING
Lot
SOUTHOLD
Hamlet
11.2
Lot No. 42
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEB. 24t 1988 pursuant to which
Building Permit No. I6790Z dated MARCH 10r 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 ONE FAMILY D~FELLING WITH DECK AND SCREENED PORCH.
The certificate is issued to BRUCE & EDITH ROMBOLI
(owner, ]Q~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-04 12/14/88
UNDERWRITERS CERTIFICATE NO. N04609 NOV. 21t 1988
PLUMBERS CERTIFICATION DATED MC SHANES PLUMBING 12/6/88
Building Inspector
Rev. 1/81
FOW,.M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_16790 z
Permission is hereby granted to:
..............
.~..~....~.:...~.....t!....7..~..o. .... . -
.......
County Tax Mop No. 1000 Section ..... ..O....-J...l ........ Block ........ ..O.....'~r.. ..... Lot No....~.~..~.....~m'... ........
Building Inspector.
Fee $ · ,~, .~., ,/., · .~. ·..~. · ....
and approved by the
Building Inspector
Rev. 6/30/80
TOWN OF $OUTHOI,n
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
' Buildin~ g Perm~ ,No ~_ ~z
Owner ~~, '~ -.~
(please prin~')
I'certify that the solder used in ,the water
contains less than 2/10 of 1%
supply system
Sw. orn to before, me this
19~. ~ay of ,,~.
Notary Public,
~IILLIAH u. ~;,ii.,,,
NOTARY PUBLIC
Building Department
Town Hall ,
Southold, N.Y. , 1971
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~>.~ ~b~,,~ //~/
/~..~_.~ Instructions.
This application must be filled in tvpewriter OR ink, and submi~ed ~ ~ to the Building In~ec-
.... tor with the following; for new buildings or new use;
1. Final su~ey of property with accurate location of all buildings, prope~y lines, ~reets, and unu~al
natural or topographic fea~res.
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 Unde~riters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and inmalla-
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 "pr~exi~ing"
land uses:
1. Accurate ~ey of p~perty showing all property lines, streets, buildings and unu~al na~ral or
topographic featu res.
2.-_ . ·
3. Date of any housing code or safety inspection of buildings or premises, or other pe~rma-
tion required to prepare a ce~ificate.
C. Fees: Add~o~s $25.00 ~O0[S $25.00A[~A~[ON ~25.00 1. Ce~ificate of occupancy ~e~ Dwe[[~ ~25.0,0, Accessory ,~0.00 ~us~ess ~50.00
2. Ce~ificate of occupancy on pre-existing dwelling ~ ]00.00
3. Copv of cert[ficate of occupancy $ 5.00, ove~ 5 yea~s ~]0.00
4.V~ca~ ~a~ C.O. ~ 20.00
5.U~G~eG C.O. $ 50.00 Date ..~;~ ...............
NewC°~st~uct~o~ Old or Pre-existing Building Vacant Land
Location of ProperW ....... /.. ~ ~.~ ............ ~ ,
Hou~ No. Street Ham/et
Ownor or Ownersof ~rope~g ...................................... ....... ..
co tv o0o .. ........ ......... ..... .......
Subdivision ................................. Filed Ma~ ~o ........... Lot ~o... ~ .......
Permit No ..... Date of Permit .......... Applicant ..... ~ ~ .................
Health Dept. Approval ........................ Labor Dept. Approval .......................
Unde~riters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulations,
Applicant .... ~..,~. )~.~.) ...........................
Rev. 10-10-78
FOUNDATION (2nd)
ROUGH FRAME/
.?LUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
DONALD G. FELLER · ARCHITECT
:,'?.~ ......... ,r..,,:?~ ~-H Ole Jule Lane · MettJtuck, NY 11952 · (510)298-5250
B ?_ 91988
February 27, 1988
Town of Southold Building Dept.
Main Road
Southold, New York
Re: Proposed New House for Mr. & Mrs. Bruce Romboli
Windjammer Drive, Southold, New York
Dear Georgia:
As per your request, enclosed
with seal and signature.
Thank you for your attention
are one set of prints
in this matter.
Very truly yours,
Donald G. Feiler
1319 Madison Avenue
West Islip, N. Y. 11795
Febz~%~ry 25, 1988
Dear Georgia,
Thank you for contacting me. Please find enclosed a check in
the amount of $10.00 for Cesspool permit. I contacted Mr. Feiler,
my Architect, about plans needed with his seal.
this shortly.
Thanks again.
You should receive
Sincerely,
/l~'~Yio~'~d-~t ~ t eAl~ep ~ I~ e~ i~ ,E I~v~ r~.m ~ ~ t, al ~ e r v at i o n
Room 219, Stony Brook, NY 11794
Dear ~%(.~.9i~(;
A review has been mad of your proposal to, O,.~'f~'~
Based on tt~e informat±on you have submitted, the New York State Department
o~/Epvironmental Conservation has determinedLu~a~ the _~%/%./ parcel
~,%3~ project is:
Greater than 300' from inventoried tidal wetlands.
Landward of- a substantial man-made structure
· greater than 100' in length which was constructed p~'ior to
Landward of the 10' above mean sea level e'levation contour on a
gradual, natural slope.
Landward of the topographi6 crest of a bluff, cliff or dur, e whi. ch is
greater than 10' in elevation above mean sea level.
Listed in Part 661.5 of 6NYCRR (Tidal Wetlands Land Use Regulati~¢.,s)
as a use not requiring a permit or notification letter of approvDt.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law). Please be advised, however,
no construction, sedimentation or disturbance of any kind may take place
seaward of the 10' contour or topographic crest without a permit. It is
your responsibility to. ensure that all necessary precautions are taken to
prevent any sedimentation or other alteration or disturbance to the
ground surface or vegetation in this area as a result of your project.
Such precautions may include providing adequate work area between
10' contour'or topographic crest and the project (i.e. a 15' to 20' wide
construction area) or erection of a temporary fence, barrier, or hay
bale berm.
Please note that any additional work, or modification to the project as
described, may require authorization by this Department. Please contact
this office if such are contemplated.
Please be further advised that this letter does not relieve you of the
responsibility of obtaining any necessary permits or approvals from other
agencies.
Very truly yours,
Deputy Regional Permit Administratoc
765..1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST ,[ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING [/~INAL
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION
[ ] FRAMING
REMARKS:
ROUGH PLBG.
2ND [ ] INSULATION
~FINAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ J FOUNDATION 2ND [~INSU~TION
[/J/FRAMING [ ] FINAL
DATE ~'~/~/~/~? ,INSpEcTOR ~/~/ ~'-~
BUILDING DEPT.
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION AND ~'~SULATION
INSPECTION
FRAMING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION AND []INSULATION
[~FRAMING []FINAL
REMARKS: ~/:~.g._ ~,
765-1802
BUILDING DEPT.
INSPECTION
[~F.OUNDATION 1ST [
[ ~FOUNDATION
[ ] FRAMING
ROUGH PLBG.
2ND [ ] INSULATION
FINAL
DATE
iNSPECTOR L.)~ ~I,
~oo~oas THE NEW YORK BOARD OF FIRE
UNDERWRITERS
· * BUREAU OF ELECTRICITY
{~ ~ , ~ ~ JOHN STREET NEW YORK N~Y~K~OO3B
I ~IS CE~IFIES THAT
~ ~ ~ ~ ~'h 071 02
4/0
.,
., 197.~. Permit No. 1..~.?.?.~..-~
Examined,~..~./. 0..
Approved · . .~. ~. ~.O..
Disapproved a/c ......................
................................ ......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
a.
BOARD OF HEALTH --~--
3 SETS OF PLANS .......
'FORM NO. 1 SURVEY .~...-g--.,
TOWN OF SOUTHOLD CHECK ~-,-~- -~ -'(J
BUILDING DEPARTMENT SEFTIC FORM .............. :
TOWN HALL NOTIFY Z~/)
gOUTHOLD, N.Y. 11971 ((~Of.~ ."~ 7.~ ~ ~
TEL.: 765-1802 CAL~ ......
MAIL TO: t ~ ~B~,C~ ~V~
BLDG. DEPT.
TOWN OF $OUTHOLD
Date ................
INSTRUCTIONS
This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sgts 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, hoJ~rrg)code, and regulations, and to
admit authorized inspectors on premises and in bnilding for necess~spections. ' ~",--~,,~_ ~ t,~ ~.
.... i' .........
(Signature of applicant, or name, if a corp. oration)
1319 ~iadison Ave., W. Islip, N.Y.11795
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Owner
Bruce & Edith Romboli
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 co~orate officer) ·
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No.. ~9. ~. P~.%~¥~ .....
Plumber's License No. TQ..]P¢. p.e.t;erraJ-~ed.
Electrician's License NoT.°. .b.c...D.e.t.e..r.m.i.n.e.d. .....
Other Trade's License No. T.o...b.e..D.c..t.e.r.m.i.n..e~...
1. Location of land on which proposed work will be done ..................................................
· ¢.4.9 .W..i.n.d.j a..m~..e.r...D.r.i.v.e. ..................... S, outho.],d .....................................
House Number Street Hamlet
County Tax Map No. 1000 Section .1.0.0.9.-.0.7.1. ........ Block . .2. ............... Lot....1.1.: 2. ...........
Harbor Lights Estate ...........
Subdivision ..................................... Filed Map No. .4.6.8..1 ......... Lot . .4.2
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Vacant Lot
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy ...S.i.n.? .1.e..F.a..m.i.l.l(..D.w.e.l.~ %.n.g ........................................
3. Nature of work (check which applicable): New Building . X Addition .., ........
.......... , Alteration ..........
Repair .............. Removal .............. Demolition ........... i... Other Work ...............
(Descrip~tion)
4. Estimated Cost $180,000. Fee
' (to be paid on filing this application)
5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor N.A.
If garage, number of cars .None.
6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use .. N...A ...............
7. Dimensions of existing structures, if any: Front...I5!,/%. ......... Rear .. N, A..! ....... Depth .. N...A .........
Height N.A. . .... Number of Stories N.A. .i.
Dimensions'of same structure with alterations or additions: Front N. A. i Rear N.A.
Depth ..... .N: .A... ............ Height ....... N., .A... .......... NumbercfiStories ........ kl.. p, .. .........
-' -8. Dimensions of entire new construction: Front . .5.7.. ;~.t..6..'~ .... Rear ... ~1 ~..fig. Depth . 52..fg ........
Height 26 ft 4" Number of Stories .1.¼ stories
9. Size of lot: Front ....1.0.q ...59 ............ Rear .... 1.00...5. q ........... ip. epth 300..~t;..(~.~e. ~.u, rve¥.)
10. DateofPurchase September 21, 1982 Nameofl~rwmarOwn~E;l]-ene Christie & Lester.
............................................ ~ ........ , ................... l~ttr'cjatcn
11. Zone or use district in which premises are situated., gone A - RgDi~den.tia:l
12. Does pr0posed construction violate any zoning law, ordinance or regulation: .... i. I~IQ. ..
13. Will lot be regraded . y.e.s. ....................... Will excess till be removed from premises: Yes (No)
14. Name of Owner of ~remises Brclce/Edith Romboli Adttra~Wes't Islip ! ..............
~ · ..... ~ ....................................... Phone No. 669-59,74
Nmue of Architect . .D?.n.a.l.d..G:..F.e.~.l.e.r .......... Address . .M~..tt.~t:.u.c.k. ..... !... Phons No. 2.9.8.~5.2.5.0. .......
Name of Contractor 7~P. 1;:9. l;~:~roti~e~l .......... Address .... : ..........
15. Is th±s property located w±th±n 300 feet of a t±dal wet:l_and? ~Ye~s .X... No .....
~lf yes, Southold Town Trustees Perm±t may be raqu±red.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. in ]icate all set-back dimensions from
property lines. Give street and block number or description according to deed, and she' v street names and indicate whether
interior or corner lot.
SEE ATTACHED SURVEY
& PLOT PLAN ON ARCHITECT'S DRAWINGS
STATE OF NEW,y, OI'CK.
cou v OF.. ..... s.s
................... [~P, bLc,~,,.,. 0PI ~.o.].} ........... being duly sworn, depOse%and says that he igt~-~pvlicant
(Name of individuaI signing contract)
above named.
He is the .... C0'9..7~..,9 £~T.O. f'(- / ~0ohO .~- ~ ~ ~ ~
(Contractor, agent, corporate officer, etc.)i
of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and file this
application; that all statements contained in this application am 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
................. of.. ........ 19
NotaryPubl!c, ................... .~..C¥.~.F.O.[~.." County ~ ...~.~.~
~o. 52.3~}~. su,~ k ~, y.., (Signature of applicant)
Comrai~ior~ [,,xpi~$ MaTeJI SO,~ l~l'~'f
[ ! SUFFOLK CO. HEALTH DEPT. APPROVALH S. NO.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
APPLICANT
SUFFOLK COUNTY DEPT OF HEALTH
SERVICES - FOR APPROVAL Of
CONS'traCT,ON
DAtE 0 ! 1988.---,
~ov~ ~ ~A~~ ,
?' · [[":i : '' i ~.,] SUFFOLK CO. TAX MAP DESIGNATION:
' ' .. !J . ~'//~ -,,j: , OIST. SECT. BLOCK PCL.
" '
, /,-' R(~.O~R(gK VAN TUYL
uc~sED ~.~ su~wvo~s
~EEN~RT NEW YORK
_J
f
.4>
VAN TUYL, P.C.
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
SUFFOLK CO. HEALTH-- DiEPT. APPROVAL
H.S. NO.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
APPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCT ION ONLY
DATE: ,
H. S. REF. NO,:
APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
OWNERS ADDRESS:
~EED: L.' N/A P.
TEST HOLE' ' STAMP ......
sewage d,spos~.', and water sgpp{} ,~_,i(it~a6 ~ ~
!occuoa have been inspected by this Ecpa~t a~/~
o,ner~c~ and found to ~
GREENPORT NEW 'YORK
SUFFOL~ co. H~.LTH'DEPT. 'A.~,Rov AL
STATEMENT OF tI~ITENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF 'THE
SUFFOLK ¢0. DEPT. OF HEALTH SERVICES.
(SI APPLICANT
SUFFOLK COUNTY DEPT, OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCT ION ONLY
APP~VED:
~FFOLK CO. TAX MAP D~GNA~ION~
DEED:
SEAL
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