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o�OgU F4l'G Town of Southold 9/23/2024 0a y� P.O.Box 1179 o _ 53095 Main Rd 4,0 � ,� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45166 Date: 9/23/2024 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: Private Rd,Fishers Island SCTM#: 473889 Sec/Block/Lot: 10.-5-5.8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/20/1980 pursuant to which Building Permit No. 50562 dated 4/17/2024 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: seasonal single family dwelling as applied for. The certificate is issued to Mastroianni, Shaun&Mastroianni,Antonio of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 10-SO-63 10/20/1981 ELECTRICAL CERTIFICATE NO. N623990 11/18/1983 PLUMBERS CERTIFICATION DATED Autho zed Signat e i �o�SUFFot,��o TOWN OF SOUTHOLD aye BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 50562 Date: 4/17/2024 Permission is hereby granted to: Mastroianni, Shaun 5 Union St Stonington, CT 06378 To: New Dwelling as applied for. Replaces BP#10981 **no office.file** Replaces BP#44804 At premises located at: Private Rd, Fishers Island SCTM #473889 Sec/Block/Lot# 10.-5-5.8 Pursuant to application dated 2/29/1988 and approved by the Building Inspector. To expire on 10/17/2025. Fees: PERMIT RENEWAL $126.03 Total: $126.03 l Building Inspector ��SUFfO1,�Co TOWN OF SOUTHOLD moo �y� BUILDING DEPARTMENT H x TOWN CLERK'S OFFICE wo . SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44804 Date: 3/16/2020 Permission is hereby granted to: Rokita, Alix 115 Jaffee Ter Colchester, CT 06415 To: New Dwelling as applied for. Replaces BP#10981 At premises located at: Private Rd., Fishers Island SCTM #473889 Sec/Block/Lot# 10.-5-5.8 Pursuant to application dated 3/16/2020 and approved by the Building Inspector. To expire on 9/15/2021. Fees: PERMIT RENEWAL $51.00 al: $51.00 Building Inspector I FORM NO.4 r TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. T E M P O R A R Y Certificate Of Occupancy No. . 7;1G9J.U-.? . : Date . . .Marcy. A . . . 19 A THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property N Jlain. Rand. . . . . . . . . . . . .F j h:,jjj . Tp%l4nd, House o. Street Ham%t County Tax Map No. 1000 Section . . .010. . . . . .Block . . .Q5 . . . . . . . . . .Lot . PA t, of Block Subdivision . F'.isberz. . .FiledM-e-P No. !i.Q . . . . .Lot No. . a ... . . . . . . . . ment: Corp . ( FIDCO) conforms substantially to the Application for Building Permit heretofore filed in this office dated . . .C c.t o b e r. .2 0. . . . . . . 19 I,.Q pursuant to which Building Permit No. .1908.1. .z dated . . . .,%To.vembe.r. .?5. . . . . . . . . . . 19 5A ,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 . . . . . . . . . a.. .Vr.i3jate. pnel'rfar,qzly. .dt-I 1.J..�r)ig... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . .Edwar. . &. AAix. AQ9 C ..q . . . . . . . (owner,ire yr-wnand of the aforesaid building. Suffolk County Department of Health Approval .1.0-S 0-.�e3 , . .1.Q/. p J.P 1 a , R o b r t , U?11 a, P .E. UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY. Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- 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 "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildi• gs or premises, or other pertinent informa- tion required to prepare a certificate. .`. : C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . . 2r�,`�$2 . . . . . . . . . . . . . . New Building . . X. . . . . . . . . . Old or Pre-existing Building . . . . . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . . . . . . . . . . . . . . . . . . . . . . 6�1�taJ Rc �� V t�t�cp5 ZSLAa;U. .y.VV House No. Street Hamlet Owner or Owners of Property Y. . . . . . . . . : . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . 1C . . . . . . . . . Block . . . . . . . . . . . . Lot Subdivision . . .V!DgO . . . . . . . . . . . . . . . . . . . . . . . .Filed Mateo. g0 . . . . .Lot No. . . . . . . . . . . Permit No. 105M .� Date of Permit .U-:?-.OQ.Applicant . . . . . . .R.0z TA. . . . . . . . . Health Dept. Approval . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . .. . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . . . Fee Submitted $ . .`J:q� . .. . . . . . . . . . . . . . . . . . . . . . Construction on above described building and permit.meets all applicable codes and regulations. Applicant . . . . . . . . . . . � .�C&{2?.G,`'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rev.10-10-78 a��(��act FORM N0. 2 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) V 10981 Z Date ... . ..... 19...RQ Permission is hereby granted to: .......Grp. _ ..... ............. .......kd4. .rFt&.... to ......... 7 ............. ......... . ........ _ .7' ......................................................................................................... ot premises located at e-1 ..................................................................................... ................................................................................................................................................................. oo County Tax Map No. 1000 Section ....QLQ........ Block ...0.5............ Lot No. .............. pursuant to application dated .......�O.............................. 9 and approved by the Building Inspector. Fee $........................ U ii ing Inspector 4 ing Inspector Rev. 6/30/80 FORM NO.6 TOWN OF SOUTHOLD Building Department F Town Hall - FEB Southold, N.Y. 11971 .o 765 — 1802 �aUv �ur APPLICATION FOR CERTIFICATE OF OCCUPAvti Instructions A. This application must be filled in typewriter OR ink, and submitted =6l ie to the Building Inspec- tor with the following;for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- 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 ""pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or. premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15. 00 3. Copy of certificate of occupancy $1.00 4 .Vacant Land C.O. $5. 00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . .Y. . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . . . . . . . . . . . . .k.AbT a D R.oAb. . ; . r—kSNe-2s T-SLkU1) 1 NY. . House No. Street Hamlet Owner or Owners of Property . . . . �.�� . �kc`TA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section :. . . . . . . . . . Block .7.5. . . . . . . . . . . Lot . . . . . . . . . . Subdivision . . ... .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . .Filed Map No. . . . .`:. . . . .Lot No. . . ... . . . . . . . . Permit No. Date of Permit 2�.�a Applicant . . . RQKkTA. . . . . . . . . . . . Health Dept. Approval . . .. . . . . . . .. . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . .x. . . . . . . . . ... . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . ... . . . . . . . . . . . . . Fee Submitted $ . a5.od . . . . . . . . . . . . . . . . . . . . . . Construction on above.described building and permit meets all applicable codes and regulations. Applicant . . . . . . . . . . . . . ..,�eQ.,af'. . . . . . . . . . . . . . . . . . . . Rev.10-10-78 ii. I - I cal c+ :u- .r ao ao_ _TH N E=W: .yp:R g? p' € _ , -=,,,-_1:. 1:i .;!I _,, K;' O RD-_;=OF" 'lRR:E_UN_,.,R'WR!IT'ERS . #� - _ - �t- -- ;tom ,_•:' =1l1_-=ill-'l1I '-' --i ._...,,._•;: - - •i�=_P 'n�- - �-il---" -- - - - �..__. .I__. -+,•- �e_ - - - •BUREAU.OF-ELE'CTFZICI �YI-•1• i - - _i- - +1.= "' "Iz•;I ;..�-�::,''::+''jc- - - - .85:�' - - - -rll=;-ii;-!;,--�(€i�:.;'{=_, '.-•'; JONNj;STREET,':IVE'W;r !ORFC NEW_''-YORK- 10038 I� , ._T__. -� --1i -_ t, .:is .1- _a: r!. -u,__rl. __ =•i:i=_ _ ii�_. 'if:. , - i•.-_.•'__rl -:I_ _Fr:-:,'•_ ILi I [� ;f!i�}11!Dal ==Hr.�r,l= ;11--APPlicatibn'1Vb;�biifile', '- = ! -, — - .: :1[0:93-7.3;-81�_' r ' _ ,.i_ ;I _,il<'H!S_,CERTIFIE$'THAT,...,.:-•'.; .. . .__;.;r_.i� ,'�.:�- - - !i.�!cv;+:.v�r:,o_ ~;. i. - - - -�• - -- - - - 1+.-- ';- .;only Che_electrccal•equrpment as described be16w7-and introduced.-by the a licaiii,nalmed ihi!the a6ove a Iicationrnum6er€injthei iemises.o -. - ! _ _ _ ..... ,:,. ... . ,. - =.. dc�arCllrRcikita East"EndRd� 'rFsliers-:Island•''tiNl��� :.li 1:._i•Wit! i•. _ :I �i- _. ❑-Basement':: Est Fl: O'"2rid:iFl€: :. .._-}-I_�l1IS`1C12 t,`,;: T- ; _..:'+ -! 110-•L. :I,__:11t: _ .1=cn,tl�G ollowing.;locatcon•, %=• -��_ -'!i�:,, `--- _I __,, ._.f .: _ -- -- - - -- - =--ii=-- _ - _-:Sectcon=�'• _Block"•T: "c=" - -- -- -,11=t11=-Li•-all` _!!, �€ (1=::: -- �! t:- -;i,. ,-'�.=!I_ 'r,�,,;��...__.,;- ,. ,r�=,l==).,;_��:+:.._;,:�.,j;. ,�4t sio exarrecri d-o - -':r�l. •:;::=i1i: _(' :€;: ai=-:. -,i.._I,:_;. _ _. _. �thcs=Bb'ard:-•,; _,I1�Ii!'-ii�lI�II,.- ,I�,;�Noveiiiber': ::8 =`1`983�= s-=-! =:",,_.��! _, -,,I-.�^ - �: •i'� '� - - �,' --�' -- - - -.i -1 -- i- •i_ — - -' - ^ =lliFIxTURP,-Ii-' + I't +"_" F•IXT,URES. •:'.' t"' ;:.- -;j,.RANGES._ jCQOKINGDECKS;,-_-,i`OVENS_i;i='DISH.WASHERS-fEXHAUS7_i FANS'- j[ OItTLETSjlI ICEPTACLES {SWITCHES'i INCANDESCENT:FLUORESCENT MERCURY•,,-:.p, -VAPOR - „nMT1€: =_K;•W.--[11:'i€A61.T1I a:.1!iK _:1i!:_.fl)=.'., ' .'..- E!: � >*.!t=1i:=- - .. --„ _:.II1- _ - _ .,. - - - - _ -1••-. - t • I:-_If11 1, �;; ,I,�:=i: -- "-"I!_ li:__ _= 1= '•I==•', � ---�I=!I - - - t'- ,� !';;,_.,•:. - lli :n1 2.3;.1�.,{�,301€__:1-,.25 23 _ , _,;;:-; , :.il_€€- ii::€I€-`i l _- - ,s- :r; N€=DRYERS'ilE=ll'='iisPURNACE MOTORS':i FUTURE-7APPLIANCEFEEDERS SPEC[ALREC'PT'=TIMECLOCKS1=-gE��;ii UNIT HEATERS=.MULTI=OUTLET j;-: :D �+..r --- -- - - - - - _ _ IMMERS'. -..i ' - TRANs " aAr. :':_H.P r+i 1,',SYSTEMS_.1'!' `;vii• ::W_: 11?^T11-:[{ -`�l�rl;-1110f4il-s.!H_P:_.':!GAS= H:P. i4A1TtS':.:iticNO,r,ltA;W.IG.= ;I€AMTic itAMP7ti-LAl6T!{!�:p1MPstl =, ;NO:-_OF::EEET:-'j ATTS: : 1-1 i-i,4 it-71 _ONNECT NO.OF' a.: S ... -1iI.Ej;!- w:��,• _ .L-{ :a, C E -I,_ METER R ;V=n'' vl`: - _... . 1 0 2W l tf 3W-3. -3W 3/B 4W_ ,NO.OF'CCiCONO. ';r 'rA W.G.'f!:';,,c_NO.-OF HI-LEG` A•W.G. '`NO.OF.NEUTRALS'• G:•" : _,..-,.._r•_r„_!•T:r. 't. EQUIP.". .,,.. •, .. .PER'.B';-G!' '.:OF.CC'COND:-. -,r. . OF w4m, .. - Of NEUTRAL:-', ill's, 0:0:`- __CE. 2 ii_.!',. .; ; ;,!.. : TJER7APPARA'Tdsc — _,. ._I--^l_i {...,hI M.'_I-o! o5 r`__...GG 4--,,:L..f1_�2.:��.:_F;.I!I.::..C,•:- . ', - � -..I,"":;r_-:.!...!:"„:_I_•r '.1,"—^i"-:i:-€{1.'�,I'i-i'k=__t:i_:,:1:.-,- I__I-{:,1`:i_i::!__..-::__;_._�;(,_€.:':t'-:1�`__i1ai_!;._-I__!.�—i-1i;l1a 1!l;t=_'l�_—�:__"sI.'•!#":,j�_i�7t;_:`,1!__L�-_=i::—.!11:}ii;i__:'_,.i!:i_:—:r:,:',e,_:r—_'`;tl'f" -,-—! ,::L.i,_-.,.I_!.::.'(!•!I._:�+._fr:"am,I--{-{c_:_1!�.i_G1c'�,;,I.=i:€_�.!s 1i i1=�:"=.- 7:{_:{- ..l_ii =e€;: --H = ` �_ r Heater 14 -,SuxJc-a_.�stectors - - - - , ,-_ `E_` -'i.; it-.�.�=�cll -, _ .€I�_y;i--�!•-.fl.�:f';r_4ii- _;�jYl�l_ - __ :1 7. #� _{�_i i, - _ _ - •lei- t:i:._::i'i„ - _,, _ il.- iti:._ .. _ - _,-�_,- �r dwaxdsJEdwards..Electr:._: _'} !i= ..: O _3]'li=_Petminsula-Rd. ;•' ,. ;}`,w:.i: ; =_Fshersl:Island N.Y: 06390 -IIC.' 1297'v;;• GENERAL!:MANA`G - i-�q lt:-�;'_:,`-_ '{' _ '�1'�;: li; a,-,li!='::s;t���• 11` itu��' 7., - - r _ �• .. �=€,1:.:ii G:�i. Per i.•_ ,'' :��:' , :;..'.:.i'i�!:"•C" .� '—. �' ''''-.,,i'^t�l:,,, <. i _ F .' certificate;must.not be altered"in any manner;return to the office of.i"the Board'if:incorrect:-inspectors may b'e'identified'6y their credentials. 00 OFSO(¢yO h� # # TOWN OF SOUTHOLD BUILDING DEPT. °`ycnu 765-1802 INSPECTION . . [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION.2ND ° [ ] INS LATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O Ale REMARKS: �Y c DATE INSPECTOR of SOUIy� I.� TOWN OF SOUTHOLD:BUILDING DEPT. �ycourm, ' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]' FOUNDATION 2ND [ ] I ULATION/CAULKING- [ ] FRAMING /STRAPPING [ FINAL [ ] -FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: y DATE INSPECTOR OF SOOTyO� ---- ��� # # TOWN OF SOUTHOLD BUILDING DEPT. `ycourmN�'' 631-765-1802 -INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: � h r DATE O 3 a 2 3 INSPECTOR ho�aOF SOUTyo� �n # TOWN OF SOUTHOLD BUILDING DEPT. `yco 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING jV� FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ], CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: DATE Gt 2412_5 INSPECTOR ho�apF SOUTyO� TOWN OF SOUTHOLD BUILDING DEPT. °`ycourm,N�' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION-- [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE !0 3v 2� INSPECTOR 0f 50U1�o� fl # # TOWN OF SOUTHOLD BUILDING DEPT. �yca 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: e. 41eA c. 0. - DATE INSPECTOR l�l _ r r f � � II� im- i 1 /lei ✓/ G i r =- �- FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 } �� TEL.: 765-1802 Examined.oC .Z . . . ., 19 dp Application No. . . . . . . . . . 1.3 Approved . 2... . . . . ., 19 . Permit No. . �Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e -1,?Izt4� . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . .. 1980. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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. mac. The work covered by this application may not be commenced before issuance of Building Permit. vd. Upon approval of this application, the Building Inspector will issue 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. �!. . . . .C&U.W. . .�. ' u. . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) J A � TAR Cot-�NESTcR� Cl . . .�9.(Mailing address of applicant) c36416 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . .()WN KR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "Name of owner of premises . . .F.Q W t�R:t�). ,P�.1-1 X . .R U V YT A. . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . ... . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. P.A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . 'Plumber's License No. tvP T . k4- l�2 D d�S `�L [ C R 6 e- ,p_� ',-u A�- IS LR, . Electrician's License No. �.Aoi Other Trade's License No. . . . . ... . . . . . . . . . . . . . . . ,'I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CvN k� R :Ls1-lk4,b R� V-iSto62S ,Lsl-kmb tl1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. . . . . . . . . . . . . House Number Street Hamlet 70 , County Tax Map No. 1000 Section . . . . . .'. � . . . . . . . . . Block . . . . 0 .5. . . . . . . . . Lot . . . . .,Q o'er. . . . . . Subdivision . :-�/. . . . . . . . Filed-M-ap--No. . . . .'., Lot/.I/.. . . . . . . . . . . (Name) 1,/2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . ``!o. YAu c_Y . . . .` . . . . . . . . . . .. . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . ..—. G'.N.c:L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i �3. Nature of work (check which applicable): New Building : V . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . .'. . . : . . . Demolition . . . . . . . . . . .. . . Other Work . . . . . . . . . . . . . . . (Description) ✓4. Estimated Cost .4 550,A©a. . . . . . . . . . . . . . . . . . . . . . . . . . . ..Fee .dam— z�+ �$-�: . . . . . . . . (to be paid on filing this application) 15. If dwelling,number of dwelling units . . .I. . . . . . . . . . . . Number of dwelling units on each floor . :.. . . . . . . . . . . . . If garage,number of cars . . . .0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . r-. . . . . . . . . . . . . . . . . Height . . . . . . . ... . . . . . . . . . . . Number of Stories . . . .-. . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . .+B... . . . . . . . Rear . . . .4E`. . . . . . . . Depth . .:34... . . . . . . . . . Height . . A 4.. . . . Number of Stories . . . . . 2 . /9. Size of lot: Front . . . . . 2.FT. . . . . . . . . . . . Rear 0.0. .�T... . . . . . . . . Depth i ,y b.VT . . . . . . . . . . . . . . /10. ,Date of Purchase . .i�Qup.►. , .j.q-tp . . . . . . . . . . . . `IName of Former Owner Fkstw .T%*Pp. ✓`l 1. Zone or use district in which premises are situated . 9745T.iXP .er. zSLAQd?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or-regulation: .R0. . . . . . I . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . Will excess fill be removed from premises: Yes (1 /14. Name of Owner of premises �144;&WA t-A4l .RA-iS L. Address L.C.C. . . Phone No. Name of Architect . . 5L�(A . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . Name of Contractor . fDVJAe4). .PQV4kA. . . . . . . . Address C�cl 5 4��f-����??-.iAT Phone No.U37�M: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or rp oposed, 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. 5 4 au C'N- Mai_k �LCu, 33,U ZR� P _R01T s � e ?j\ 45�r ! 6 f�%! A AG r2. S y( Q,o STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . .s. . . . --- . . . . . . . . . . . . . . . . . . . . . :'. . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named: Heis the . . . . . . . . . . . . (�3llfc'. . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 " . . . . . . . . . . . day of C/. ! . . . . . . . . . . . .. 19M Notary Public, . . County subscribed and Sworn to bef e m a AN* * ;_ Public, in and for County of_ _. and State nnecticut, finis_.- 9._day of (Signature of applicant) !" FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL FileNo. ........................................................::..... Date �............. 19 ....................... ..... 1- ...... .................... .... o � �;........... .°..... � r PLEASE TAKE NOTICE that your application dated ....504Z-To..f.�.4 r<....... 19. for permit to construct ..............at the premises located at .................................... Map ...... Block ...............�.'� ..;............. Lot ......T.l:.........Q.v. ........... is returned herewith and disapproved on the following grounds ��1t1 .... `...!(Jd � ................... .......... Af. ..:..�4,�.4. ........... . lC. ...-..... ... ....� .�........ ��'it Building Inspector r'— L/ o�2 • �,a F Z7-e Ac;= /wox— e7C li 7 el��-- C/0,; A)d7-E-w5 f/w 17 I Po ------------------------- -- -- r- li -- -� ,z9-------- l C -2.s� -- mm --- ---- r�� Vic.C-' �.�----'- --- -�- -- • - ---�.'-- - � � Jr--------- . --_-- I; I " r.. Ej -„bra-Gc E= //'7Z-._C'T_ ,' r ,r Edward Rokita 1 2 3 J�fP fe Terrace Colchester, Connecticut 06415 ®c7 . 51 , 1CASO `Toww of SOUT\-\oLb BUILb\NG MN\N RD. pEa�R S\R; `T1}E. Fo1..1_�\.u\NG CBR.2,�G'CIVI.�S HAKE '�EE� MAb% "CU Vkj V -N*SS AS SuGGES C ED 6`t `�ovR REV\cW, 11 51 SQ FZ 1-4A.S BEE► RtMcveO FF�OM THE LOST , jHE 'NouSE iS NeW C e4.ow 1, F\pST GRao� Oata��.As t=M w\L1. IBE USEb k wU �S" 5"1��\- z bEAN\ roR 6\RDeRS At-So. pip N1 - STAIR CASE \AJiLt- $E A F1vC FOOT a NiT. ►�AUE No'r NEGOTIA'ii b W\TN A coMPA1�Y AS `t.eT. � 4 . SM�kE pE,Tte°T�R Pam\Tia>JCD L\3 {-l�a�� t��AR VA aR BEED R©OM- 5 , N0R-VN MAS'CC-P- %r=bP-voM w\isbCW RC MAGEb 'To jAeF-j eS5 Co DE- O IU\: wtv3 bo LL) P,owoep -c o w eST r5 l D'i: o 4.C1 F'C 10 M E E'C (tl M�G�-tF�N1G�iL. VEVYKOOG ?L-F.NNEb FOR 114S1lIE P�ATA (tO0 M . 9 , {AAve P1..PcED �cv�Q�4 waccs , wlND�l�s T�CPL AND u FAC.70R ) Pep-cu:WTA6c aV: WiMbCUJS TO Wink-L AREA' JNSvL,A 1 1uN AWb FkRPLACe pATA ow Ki tivs , AVvkiC,pTko N HAS F,eEN N0-corazCp Awz, GIC."ED. E0 CL-as Eb 1S A C1-1E:Ck< F-op Fee SoGGSESTep G. INCE2Lt-,� ) Memorandum from . . . . t. = BUILDING INSPECTORS OFFICE i, ��lr',4s. .•'L�''=.crr�'., �fl;%•,jt`:':vs,�,G` �J.��'^� � °/°•.`f...i7,=� TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 �z vu J76L: wc,:v /JY1�C,Ly�'0 X4 ,sj' �i.'.'� q;T.,Pq•'}I?ya'•;`P`• i�: tio �';:�s;r+��� :.,'�r�i::'rs;�aa�:.xi�w�:�'str::�;:h..,<.:.�•r.� Z & S CONTRACTING, INC. BOX 202•FISHERS ISLAND, NEW YORK 06390 Tel: (631).788-7857• Fax(631)788-5600 zandscontracting@gmail.com February 26, 2020 To: Attn: Sue Town of Southold, Building Department Concerning: Rokita House Tax Map#1000-10.-5-5.8 Dear Sue, as per our phone conversation I am enclosing: • $51.00 for permit#10981 I • $37.50 for permit#19941 In order to file for a final C/O Please let me know if you need any further information. Sincerely, Thomas J. Shillo Z.& S Contracting, Inc. MAR - 3 2020 :�` NOTE - Coordinate distances are meosured from r ---- I U.S. Coast and Geodetic Survey ToP Uv 'RoN PtP; iron Triangulation Station"NINE ALE V. 33:0 pipe f S 740 F e ` f QG� A \0�6 4 4g E �rJ9 520 � ''�`� \ \ `t r�lnn --✓ /69 5\ 9 ZA-51 f 1 A 3 o r / \ S o o� r �S° _ 61, ° h oe yw_ j i�c 2g'� pia Jo-` \ S l410.06 N ( a® \ t 36 34, W2772.t3 �� `J°'� BLOCK 4 RJd5_W riw:tj /J LOT 14 2.OT �� \• �� r AREA = 1.30 FAcres m ; 0 Dr / C o z �O o��o oCb `L co 05 IZ/ i SUFFOLK COUNTY DEn ARTnti NT OF HEALTH SERVICES ware FOR OF OVAL COiV APPROVAL STRU'CTIOIV ONLY a R� o` ^� ✓� DATE° �0 4:�V �' HS REF. No. Zo SD��'3 n , e disposal �r .�" �\ �Z.oy�- � The water supply and sewa g �2�Ti system for this residence will con- � �9 "6 form to the standard of the Suffolk PROPERTY PLAN i o �15 County Department of Health Service. SCALE : 1" = Ioo ft. SITE PLANuG� � � SCALE: I"= 2Q ft. 1 • ° , s°p'�� T PL AN MADE FOR ¢s. �t •� - N O T E.S t. X 1 1 �l CONT �:) �<s EDWARD ROKITA 23 Jaffe Terrace Z. m NOTES PROPOSED •• Colchester, CT 06 , X� PROPO""ED RESIDENCE CONTOURS FISHERS ISLAND, NEW YORK 203 537 3331 37704 ���� ALL TREE I TO REMAINSCALE -AS. NOTED CHANDLER,PALMER aKING � NORWICH, CONN. j L J U.N E 1980 1. 1 NOTE - Coordinate distances are measured from BENCR MARK U.S. Coast and Geodetic Survey Top OF IRON pIPE Triangulation Station"NlNrr E.LEV. 33,0 iron pipe cox. MSL S 74 0 169..91 , e�OCK 40 SOT o� G Ao s Ty N o S pG 0g6 f gb 2 ��`� \ 0 3T i� ( ,, S '410.06 tN 300 6 T o t 4• r W2772.13 5A.00 BLOCK 40 Rod 45`W C) LOT 14 642.0T, AREA = 1.30 f Acres m 1 '\ Az� •9 „ o \ ,� Qo ��,• ,`, `\" �� 1 acy wet o��o o QQA O�O O" \�\ 57_ o _ \19 vi °j Q fl 1.Co \ \�b' �_,let 6'p. .h� g\\ � 1 WII , \ servi NOTE- Measurments for septic tank \ and dry wells by Health Dept. 5/5/81 PROPERTY PLAN o SCALE : 1" = 100 ft. SITE PLAN _ SCALE : I"= 20 ft. GiwoA�< �ti - NOTES EX15-T �1C� PLAN MADE FOR �Q 41c� = aNTOURS EDWARD ROKITA ✓ �' m NOTES PROPOSED PROPOSED RESIDENCE ' - yr. 3 ,►l CONTOURS FISHERS ISLAND, NEW YORK 37704 sp/ ALL TREES TO REMAIN +, ./ SCALE -AS, NOTED CHANDLER,PALMER MING g OF "i r, NORWICH, CONN. JUN E 1980 information on septic system added 10/9/81 NOTE - Coordinate distances are measured from I' BENcE{ MA(ZK U.S. Coast and Geodetic Survey ToP OF 1 KON P1PE l� f ;r� i �f:.h# ; ?JI F#f ,'�1. I FI Triangulation Station��NIN�� ELEV. 33.0 ' \ I�pipe ?-f.•I;( + . N.Y. Do.k jm- a cox. MSL S 74� 3 181 OCT 19 AN 11 54 ,1. \ \ 51111 D 8 0 \` 40 va, d 1 e�OCK 4 Ot3 0 SOT17 ?.I � N I JC o G� 6tp 3q'45 f ` \ o -b\ oe, - __�/ 25, �'p \ %P w 4- r S '410.06 N 36° N >q°\9 � \ Dttb V W2772.13 5`''.00 BLOCK 40 �oLV LOT 14 AREA = 130f Acre, s Dt ^ Qpy �' ,moo' I �\;, �� 5 , any v,e\1 40 CO 1610, . „ M �/ ,� _ %- any '" A u Tf \ Wrlserv� � 0 `� NOTE- Measurments for septic tank 4\A- �� , and dry wells by Health Dept. sr 9 "G 5/5/81 PROPERTY PLAN o SCALE - 1" = 100 ft. SITE PLAN SCALE : 1 = 20 ft. r" ,�� � 0PV SUFFOLK COUNTY HEALTH DEPARTMENT _ PLAN MADE FOR �' � �® Aq �� NOTES EXISTIt\1� DATEOCT2O 1981 H. D. REF. #t0-so•6�3 c � N-T0uV,' EDWARD ROKITA fn he sc •a ' NOTES PROPOSED �j d ,�csal r..n? . _ .__ �. ,ly PROPOSED RESIDENCE fact 1-. 103 i z)r t_ '3 ZC .. .. t ^,. been CONTOURS _ FISHERS ISLAND, NEW YORK inspeete3 by this t.0 [.c:3 found -- '� ALL TREES TO REMAIN 377®4 °�, to be satis:actory. � 7 /� y SCALE -AS, NOTED CHANDLER,PALMER&KING NORWICH, CONN. r' 'Chief of General Engineering Services JUN E 1980 information on septic system added 10/9/81 All,r b AP nOVED AS NOTED 110 L DATE:,/ Z B.P. lig tO-q ra FEE: BY; [1111`ji�i U" NOTIFY BUILDING*DEPARfMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: J. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 48 0 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N. Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, CLL.L&7- +UnP, - .4"(/AIN) POUREDCONCRETE OVER Co- GRAVEL 15,6.5Z -r-OLY vn."POR baRRIZR f FOOTINGS 70 CARRY ?-'x?-* KL--(\V&Y `l�� 15 Z Yoe�5 4 OPENING IN kVLLI BAD - c-, ON UNIT R-01 + 5" -------P -PE:LLA 0X46C-5 8-34, 16,0" -TF 4-- /0 1'o /0. P. C. 59 3200 16 te5-L zz J zo/o" I I 470UNDA-F10N \VAL� 4 CONCPF--FF- BLOCK-7 EXCEPT -TRO/N!�F- \VAU- -P C, Z6't 94" Ll NER\ 0- 50)L LINE GP,,\Dt- J E 10 FLU UNER----)F-T 4b i" 200 Lu - 5PV- NOTE-3 FOR 7PJY/Of- W&LL rCMiu-) TT:Zo5-7 WALL 0-7 -RF-v 10. 16.79 —2-4 TR05-r WALL 1;oonNG A2_11 "TF:),0/ABF-"UAL-L IDF--rAIL I INCH = I 1--COT FRof 65t b RulslbENICE �bvj, RO-Y-1-TA t f .yam r� c—At7 rz`i L(a ,u v A: t o t-! 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