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Home My WebLink About5785-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... Z. 1. 0..5.5.0. ...... Date .... ,Iv. ne. 3D ..................... 19 ~l THIS CERTIFIES that the building . $..(3 ) ......................................... Location of Property ...220..l~ey. Lane. ~.v.t ,. ,~.c~0. #.1/~, ........... 0r.~.qI~ .~a..N.~.~..Z.o. rk House No. Street Ham/et County Tax Map Ho. 1000 Section .. 2.4 ....... Block ..... 2 ......... Lot ...... 2,1 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to/~eA~l~lR:at~d~r~l~ld~vti0m~her~e.tt~ J~t~is office dated · · · A pr. il. ~ .......... ,19..7~pursuant to which Building Permit No..5?-8 ~ Z..&. 5.7~5 g ..... dated ...Apr'aL1.3 ................. 19 ?-2., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .One. t. amil~t..dwe.Lling..wi~l~ .accessory..garde. an.d .8..b.~'Or.~..7, ~I~,Lrlg. ,R.c. qq~ ory Seasonal Dwelling. The certificate is issued to . R~bert' .Mii.l.~ken. ~o~./~xO~xxx~ ~ of the aforesaid building. Suffolk County Department of Health Approval ..... ~/R .................................. UNDERWRITERS CERTIFICATE NO ....... ,~ / R ........................................ Building Inspector Rev. 1/81 FOB,~ NO. 2 TOWN OF SOUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5784 Z Permission is hereby granted to: ........ · S~,tz~d...~-~:~4,e~aJ.....A,/(~...I[Oi~t,.31&Z3J~ea & #t2e ........... ~outl~o~....~Z, ................................... to ....~'a&].,~...~.. a.~54;,i.o~...&. ~ake...a~-t ~r~,f,j,o~..~..~B~..~a~ ~ ................ at premises located at ...~,.;O.;t~...o,,~.~...~.~.~.~.a.~e..~l. ..... ~l~..~o~r~ ........................................... ................................................. ~)~$e~t.....l~.~]t-, ............................................................................. ~ .... pursuant to application dated .......................... &pV~-.l.-....~ .......... ; I9..~., and approved by the Building Inspector. Fee S.~.~,ZlO ............ FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N~ ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5785 Z Permission is hereby granted to: ' ..~...:~ ~.;, L~..s......~Z~.. ~.~ .~...~. L~,;L~...~ ii, to ~.~,~,..,~,~.,....~ ~..r,~.. ~ -;~r.,.g.e......L ..~,~c e :s,~o,~L 'e ~ ~ .................................................... ......................... .li~O~l,,..Z/~..~e~air.r..ii/Ji...~l.].sle~..z~ ........................................................... at premises located at .............. ~.~,~.,~.~....~.,.~.~ ................................................................................. pursuant to application dated .................................. k.])~';I.~.....~.., 19...'~2, and approved by the Building Inspector. Fee $.1-0~.00 ........... 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, end 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 feeture~ 2. Final approval of Health Dapt. of water supply and sewerage disposel-(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 build, lng. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prier to April 1957), Non-conforming ulms, or buildings and "pm-existing" land 1. Accurate survey of peoperty showing all property line% streets, buildings end 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 e certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existingdwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .. June tl, 1981 XX New Building ............. Old or Pre-existing Building ............ Vacant Lend ............ West Bay Avenue Orient Location of Property · · · House No. Street Hamlet Robert C. Milliken Owner or Owners of Property..... ............................................. ,.. · · · .... 024,00 02,00 021, (~00 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant ................................ Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ planning Board Approval ..................... XX Request for Temporaw Certificate ..................... Final Certificate ....................... Fee Submitted $ 5.0 0 Construction on above described buildin and regulations. Applicant ~~~:~~en~, for n~.10-10.Te Robert C. Milliken IPOI&M BO. 1 TOWN OF SO4JTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................................... , 19 ........ Pemit No ..................................... Disapproved a~C "i.'~' ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely fillecL..in bY typewriter or in ink and submitted in triplicate to the Building Inspector w t~ ,. 3 sets of plans, accurate plot plan to scale. Fee. kccording"to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon ap~ovel of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises ayailal~de fPr insp~,~tion throughoPt she,work, . . . . . e. No building 't~all ~e o~piad or used ~'n wh01e or n pert fo~ an~ put, bsa whateve~ untta Certificate of Occupancy shall have beenT~ granted by the Building Inspector, -4' AJaPLICATI.ON IS HEREBY MADE tothe Building Department, for tthe .issuance of a Buildina Permit ~ursuant to the Building Zone~C~ Or~t~anee of ~h~.Town of Southol~l, Suf~O[l~ Couhtp, N~w Yor~, and othw al~icable Laws, 0rdi~,n~es 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, ordinancel, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necr~sery inspections. (Signature of applicant, or name, ifa oorporation) (Address of appl'icent) State whether applicant ~s owner, lessee, agent, architect, engineer, g~neral contractor, electrician, plumber or builder. ................................................................. ................... : ........................... : .............................................. Name of ownar of pr ~ni~s ...................................................................... If applicant is a corpora{e, signature of duly authorized officei'. (Name and title or. cprporate officer) 2[ State existing use a~d occupancy of premises and intended use and occupancy of proposed construction: " a. Existing u~e and occupancy ....... .~,//. .......... f ...... :. .................................................. --,~'" Intended use and occupancy ~I~...Cd~.......~~ .................. [.....~ .......................... ~ ..~,~ · .:.~:,.-.¢ . ~ 3.' Nature of work {check which applicable): New Building ....~ ........... Addition ........... i ....... .'. Altera~tion....~... ....... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Fstimated Co~: .......... { ~.'....~7... ................... Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ................. Number of dwelling units on each floor ......................................... If garage, number of cars ......... ~ .............................................................................................................................. 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 ...... .~........~......!..I.(~ ........................................... Dimensions of same structure with alterations or additions: Front ....~../~ ........ Rear ....~ ................. Depth ....................... Height ...... ............... Number of Stor es__ ................ 8. Dimensions of entire new construction: Front ..~,~..~.:.;~..~.~..~.. Rear .....~....~....~...!..?...~.. Depth ..~.~..~.?.~..~.,.~....~.~ Height ..... ~....~..~.......'~.. ....... .~...~..~. ............. Number of Stories ...... ~....'....~ ....................................................................... 9. Size of lot: Front ...~...~.. ............................ Rear ....... .~....~.. .......... : ................. Depth ........~...~...~.. ................................. Height ........................... : ........................ Number of Stories ...................................................................................... 10. Date of Purchase ..... I..C~..~.! ...................... Name of Former Owner,.....~t~l~ ................................................. 11. Zone or use district in which premises are situated .......... ~...~..~..~ ................. .{_~..I. .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ ..~...?. ............................................ 13. Will lot be regraded ~ ........ t7 ~,,~ ,/ / j,~l:~..,~_ _ ~ ~_~ /~ ,~,~,.~..--~,~.. ........ Will excess fi[[ be remo~d fcor~ premises:r] Yes [~ No 14. Name of Owner Of premises ..J~.~J~;z.~...~...~...~...~..~..~/..~......./~.ff./~.(~'....~...f.~..q..~..~.~.~.~..... .............. (Address) (Phone No.) Name of Architect .................................................................................................................................................... ~'~ ~ ~[, 0 0" ~..,~'~ ~ (Addr ,~/), (Phone No.) (Address) (Phone No.} PLOT DIAG RAM Locate clearly and distinctly all buildi~, whether existing or proposed, and indicate all set-back dimensions from propert~ lines. Give street and block number or ~lescription acco~r~ii~4,o deed, and show street names and indicate wheth- er interior or corner lot. /'..-, I ,- '~ ' STATE OF NEw YORK, COUNTY OF ...................................................... ~SI' i'I '1, '(Name, of individual signing contract/ ~ .a the ...................................................... ................................................................................................................... (Contractor, agent, corporate officer, etc,] of said owner or owners, and is duly authorized to perform or ha~fe performed the said work and to make and file this application; that all statements contained in this applicatior; aye true t(~ the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. N~f~ry Pt~b c Slq', ~"'- ............................... ?ay .......................... Notar~public ount¥ ~' .... ~' ~,.g~gnature of applieantJ