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Home My WebLink About7280-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No~690~ ....... Date ............. ~. a.l'.e.h.....~. .... ,1~.,, THIS CERTIFIES that the building located at R.l~..'q.°..°d...~.0a.~ ............. Street Map No. Blgh~.Q~.. Block No ........... Lot No..9 .... 8.o~..t;.h.o..],.d...~. :.~.o ........... conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... May.. 28..., 19 .~.. pursuant to which Building Permit No. 7.~..8~.... dated .......... .~..~....2.~. .... , l~.bf..., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued isP.~.l~.t.~. ~..f..a~..1. y..d.~.e..1.]...~.g ........................................ The certificate is issued to .R...o~q....&..Ca.~.h.e.1,.l.n.e...~!i..~1 .ak. i ...... . .~el, s (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~£.. ~ .~9~...bY..R. ~¥.i.1.1..a ......... UNDERWRITERS CERTIFICATE No..~..~67..L~.~.,. ~..~....~..8...79,?.6. ............. HOUSE NUMBER ..... ?~0 ..... Street .... ]~l~.v.q .e~..R..~..~ ..................... FOB. M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........ Date ] 9 ........ t Permission is hereby granted to;, , at premises located at ........................................................................... .~.. ............... ..~.. ...................... Building Inspector. TO~N OF $OUTHOLD BUff.DING DEPARTM~'T Town Clerk's O~ie~ Southold, N. Y. Certificate Of Occul ncy THIS CERTIFIES that the buil~!,~g located at. ltt$1~mod, t/oad ........... Street Map No...HSghv00II. Block No ........... Lot No..9. ....ltouthald.. }t,¥~ ......... conforms substantially to the Application for Building Permit heretofore ~ed in t:.hi~ office dated .............Ea~...28., 19..7~ pursuant to which Building Permit No...7280Z dated .........~lay.. 28 ..... , 19.7!+., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy tor which thi~ certificate is issued is .. Prl~at~..one. Iamtl~.. dwal 1 ing ...................................... The certificate is issued to Roman .&. Catherine.. Milinski ....... (~me=s ......... (owner, lessee or tenant ) o! the aforesaid building. Suffolk County Depa~-huent of Health Approval .A.u.g...6.. ~9.7.~.. bY. ..R,..V.$ll& ...... UNDERWRITERS CERTIFICATE No. 29D~l~Jlg ................................... HOUSE NUMBER.. 2.~.0 ........ Street ... HJ, ghwo.~d, lto. ad ....................... BuLld~ng lnspoct~r FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office 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 Inspector with the following; for new buildings or new use: I. 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 installations, 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 in- formation 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 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... ~..~.~...~....~-~....~......-~ Or Owners Of Property ..~.~...~~....,~/x.~ ........ Owner Permit No.'~' ~ ~/'..~..~-.~...~ Date Of Permit .~.~.x~pplicant ~ ....................................... Approv~...~.,./...~.'..~ .~....' ......... Labor Dept. Approval ................................................ Health Dept. Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ............. ..~...... ................. Final Certificate .......................................... Fee Submitted $ '~'' ~ Notary Public .............. ~/~. · ~/~ County Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this -~/~~~~ ~"~":~'~: THE NEW YORK BOARD OF FIRE UNDERWRITERS n~ BUREAU OF ELECTRICITY J~ J~5 ,JOHN STREET, NEW yORK. NEW YORK 10038 ..,. January- 28.",1976 A..,,~.,~,,,,,wo.o~/.. ?64858 N 267245 THIS CERTIFIES THAT Roman Wilinski. 750 Highwood Rd.. Southol~d. L.I. Sdctio~ Block. was examined on January 26, 19 76 ,~ ,h a,*dfound to be 'a co,npllanc~ w~ttl the reqmre,nents of thts Board. FIXTURE RANGES DISH WASHERS OUTLETS I SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number ~,~d7 ~t~-- APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATE~ SUpPLy 1. Applicant 0,,~/~ ~_)'~ Ii ~ RI" Phone ~.3 -~4/~q~ Address-[~s~-czz~, k~rx ~ ¢~.~ ,~ ~ I,-). ~ 2. Property Location ~,Lqqk~.~,~¢? ~m~ne ~- o~ Village~ ~ ~ ~-~& ,~(d Town~hip 3. Public Water Company N~me 4. Lot size: Width/D~.~feet Length j~/~.~ feet 10. 11. Sewage Disposal System: A. ~O~gallon septic tank: Precast~iEquivalent Block B. Leaching pools: Number of pools Precasti~Block ~pecial If private well, fill in the following blanks: A. Tank capacity ~ gallons 5. Subdiv.H,__~ cc~c~t~ 6. Section ~ ~T - 7. Lot Number c~ 8. Private Well dm5 9. Public Water ' Distance to main (For Health Dept. Use) B. Pump G.P.M. / 0 /~ C. Total well depth ~ / D. Depth to ground water /~' t ~ E. Amount of water in we 1 The undersigned CERTIFIES: "Construction of authorized installations will with the Suffolk Coun~ Department of Health's current standards thereto. be in accordance This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this p)ot. APPROVAL DATE E~/'~f~ SIGNED C~ ~ S-15 Rev. 4/1/73 Disapproved ale ............................................................ (~ ~/~/~, ~.,.- ..................................................................... ...... ............... APPLI~ON FOR BUILDING PEblT ~t, ...~1.~..!....~.~. ..................... , 19..~.... a. This application must be completely fill~ in by ~ewrit~ ~ in Ink,tot, with 3 ~ of pl~s, accurate pl~ plan ~ ~ale. F~ acco~i~ to ~h~ule. b. Plot plan shying I~ation of lot and of buildings on premises, relationship to adjoining premiss or public stree~ o~ areas, and givi~ a detoil~ de~ription of layout ofpr~e~ must be drown on the diagram which is Builder's License No ..................................................... Plumber's License No ................................................. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this applicatio~ 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 port 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. (Signature of applicant~ or name, if a corporation) ....... ........ (Addres~ of applicant) fl' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ............................................................................................................................................/. :e ............ Nome of owner of premises ...~.~)...~....~.....~......~....~..~..~..~'~.~,.~,.I.~....~......Jo..~..~.~....I...l~.....~..~-~J ....... ~ ......... ~..~,I~.T~..~.'~.I[.~..~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Electrician's License No ............................................. Other Trade's License No ............................................... l. Location of land on which proposed wOrk will be done. Map No.: ...... ,~.,~,..~,,~ ................... Lot No...~~ .................... Street and Number ...~r~.~.~..t~...~,~.~..q~.~......~,.~...~..~. ............................................................................................ Munidpality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ~.~...~.....~ ......................................................................................................... b. Intended use and occupancy ..... .~...~.~).~..'~....~.~..~..~..~...{.t~..~. ............................................................ 3. Nature of work (check which applicable): New Building-.,.. ........ v' ...... Addition .................. Alteration ............ Repair .................. Removal .................. Demolition.....:..~ ........... Other Work ...................................................... ~, (Description) 4. Estimated Cost .......... ~..~. ........................ : ............. 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 ....c~ .................................................................................................................................... 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 ................................ Height ............................ Number of Stories ................................ Rear .....~..~...'.~. ............ Depth .~-~....~... ....... 8. Dimensions of entire new construction: Front ..~...~..:~. .................. x , , Height ..~'~...l~'...:.. Number of Stories ....~. ................................................. ~ ............................ ,_,e, __ -,_ .4,a,~~' ............... ~";; .......... \ 9. Size of lot' Front /.~..~....~ ............................ Rear . /..,~.~* ~...~.... Deptl~.~.,~.~-~/.(~.~&,~..~fl 10. Date of Purchase ....... il~..14.c~...~/...~..]...~...~, ............... ..... ~J 11. Zone or use district in which premises are situated ..................................................................................................... o .~ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~/~ ............................................... 13. Will lot be regraded ..../~.,,~ ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect ....~..~...¢~c~......~...~.....~/....c~...~ ................... Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ........"'~; ................. Phone No ....................... 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. lbS, ul' STATE OF NEW YO~K~/~ COUNTY,~ ~ ~. ..... ~.~..~...,being duly sworn, deposes and soys that he is the applicon! -/' (Name o~idual signing c~trac~ above named. He is th~ ........................................................................................... ; .................................................. (Contractor, age~, co~orote officer, etc;) of said owner or ownem, and is duly authorized to peHorm or have perfo~ed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will ~ per~rmed in the manner set fo~h in the °Pplicati~ fil~ ther~ith. Swam to~me this ......... ~<...~ o~ .;...~,..~-.../ 19~ Noto .................... ~ - ~ (Signature of ~plicant) JUDITH T. BOKEN 9 ,5, FRONT ELEVATION ii ,,I L RIGHT SIDE ELEVATION DETAiL "A" , , APPROVED AS N'O'~ED 3. FINAL WHEN JOB ,-~M?LETED I REAR ELEVATION LEFT SIDE ELEVATION 1027 ' CHK II ,,SHEET- 2-. · I, r'~."~.!.;_...,._~.\ .?.. ~ ,., .,',~,, ..... .., ) ,-~ ........ ~" ' ~ ~ .......... , "-': .... ;4 ''',.., ................. ' t,,® ' ' ~.:~,:.5~,_,%,.~.,..~.L~ _ ,~ ,~ :~" -7'.'I, ,--~ ::.,~- ~!. n .. ll~=l~._.'(~" "I~) ,[', '[ BREAKFAST ROOM ~I '" (~' , I~ · ' [ ~' :~' ,, -~ ~' "-~[ 'T-:,, .,.;I. ~ ' ' 0 ?-,,~.,_ v=,,l .~ .. 1~; ~; ~"~.'/;4':~.~' q'.~" : Ll~o" ~ ' I~ I~ClO~~ ~ .4-1~' , ~ (~'~)l~t------ -- ~.~ /f-~ (,~ f z - ,~T ,~ 1V1 ': /////,; ' FAMILY ROOM ' ~'~ O ~-~ r~ ~lM/.t-~ .-' ~) .~ ~tlTPI-IFU ~,-~ J H ~'~ ir--J BONUS ROOM ~ J~ ~1 ~ ~ '~ ~ -:~ : ~ " ~ ~ ,' II ,~' ~ HI ',I~ ~ - ~'-~'~'-~'~, ~ ; ' -, ~ , ~ ~: IF " ,, ~' o; ,, ~,, /~ c ,,, lOC ~,, 7~ 7" , 'S~5" ~' 7~' . ~°'/ . 7c°" OVEN 6~ RANGE WALL FIRST FLOOR PLAN BED ROOM BED ROOM OR STUDY BAT H: HALL : CLO. ,@ 4'-0" SECOND FLOOR PLAN BED ROOM BED ROOM REF'6, E~~ DESK WALL SINK WALL ~-~e/~c~'~' .-COUNTER ELEVATIONS KITCHEN C~BINET OHK-II t . BASEMENT PLAN ~,,~,~-,,~ GENERAL NOTES /~r~ ~, ~o,~. ~.7 ~ o~,~<~,;~:;:~p~ ~o ~u~ ,~.,~o~ /"~"~'~' STAIR DETAIL PLOT PLAN ~ ¢~ ', , ' , ' ~--' ' ' ~ ',-' 102 ,,, ; , CNK~'II ' ..... ,