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Home My WebLink About8818-zFOi~ NO. 4 TOWN OF SOUTHOLD BUH,1)ING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupancy No.Z?.~..t~. ...... Date ............. Jar~..~ ...... , 19..~/] THIS CERTIFIES that the building located at . E/8 Nakom~$. Raad ...... Street Map No.. ~ ....... Block No...X~. .... Lot No .... xX ..... Se~thold ... If,M, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... AU~ 26 , 19.76. pursuant to which Building Permit No...88.~8Z dated ...... Alkg .26.. , 19.76., was issued, and confoms to all of the req::ire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private..one. f~mil~..dwelling ..... (appr. oved..b$,. 1~...App.eals).. The certificate is issued to ... 14i!lwood Homes. Ltd .......... D~:ae~. ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · Jan ...1,. 197~.... by .R,. Villa. · UNDERWRITERS CERTIFICATE No..N. 3.~ .8~+.9~ ..... Dec...28...3[976. .............. HOUSE NUMBER ]~+0~.. Street .Nakomls.-Road .......................... Buildin~ Insp~or FORM NO. 2 TOWN OF SOUTHOLD 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) N°. 8818 Z Permission is hereby granted to: Mtllwood Homes Lt~ ' .!.,~.L..o..~.~.,.... ~ ........... .......... ~..,.~..t..~?. ...... tobUild new one famti~, dwell..~9..~ ..................................... premises l~cated et ...~Z$..~O~..~'. : : .( ~p~O='~..b~..~..~~).'' ........................................... : ~'Oa~?nt to ~pphc~t,on ~ed~..[~:..~...,....~..;~.....~ ......... z~ 19~6, and~,pp~ged b the '~O'R~ NO. 6 TOWN OF $OUTHOLD , Building Deportment Town Clerks Office Sou~old, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Insfructlons 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: 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 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 Dote ....~.....~....~..?...~,..~..~....,.~.~.,¥.~.~...~/. New Bqilding ~ Addition Old or Pre-existing Building Vacant Land · ocotion of Propert ...... ..... Owner Or Owners Of Property ........ ...~... ;~.~.~,~.~,.R,Z~....~...~.....~.?.' ...... ..L..-c.~.. ................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No ..~..~..,.~...~...~.~/Date Of Permit ~.L.~..~..[.?..G.....Applicant ..~..~..,~e..~.~a-'~.....-(~:~-..~..v.~...-~.... Hea,,h ept. ^pprovo, .... .................... ,bor p va, ................ ..................... Underwriters Approval ./..~Z....~./Z ~ Planning Board Approval ....... ~ ............................ Request For Temporary Certificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meet~s all applicable codes and ~egulotions. Applicant ~ ~:~ ~, (...~.. '~-~..~l..c;R....~.,' Sworn to before me this ..... ~ .~..~,~. day of ~'~:~.,..~.~.~7 (stamp or ~o 528125850 Suffolk Cou~y~. ~g~m gxp~res ~larch 30, THEre',NEW YORK BOARD OF FIRE UNDERWRITERS ~,~ ~ ' BUREAU OF ELECTRICITY I j i m .[ ~ 815 JOHN STREET. NEW YORK, NEW YORK 10038 o.t,, Deoemb~,?~8,.' I'976 .~ppii,.a.o,,,~Vo.o,,Jile 855045 N 3 1 8 4 9 5 THIS CERTIFIES THAT ;. , ~, ~ o~y th~ e~tricaJ equi~n~ ~ ~c~d ~low and intr~uc~ by t~ applic~ ~m~ ~n the a~ application number i~ t~ premises of Millwoo~Homes, e/s No Komes Rd., ~00' s/o Heawath~ ~ath, Southold, ~,.,mi.,d o. De cemb er ' 23, 1976 and found to be in compliance with the requirements of this Board. RXTURE OUTLETS SW!TCHE~i RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 15 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO OF FEET DIMMERS SERVICE DISCONNECT " S E R V I OTHER APPARATUS. Motors: 1-Z/2hP 1-G.F.C.I. ,: , 1-Smoke Detector Joseph D. Mazzoni 227 Wave~ly Ave. Medford, N.Y. 11763 NO OF CC COND J AWG OF CC COND NO OF HI LEG C AWG OF HI [EG E Th,s cerhf*cate must not be altered in any manner; return to the office of the Board if incorrect Inspectors may Li c # 482E C,~NERAL D ? credenhals. TOW a.mcs omc, ~pr~ .............. ~....~..E. ........ , 19/~.. Permit No. ~..; .......................... / / ~ ~ ~ ......................... ........ ;P ......... ~N~RU~IONS a. This application must be completely fill~ in by ~pewriter o~ in ink and s~mi~ed in triplicate to the Bui]ding~ Insp~tor, with 3 ~ of pl~s, accurate pl~ plan ~ ~ale. Fee according to sch~ule. b. Plot plan showing I~aflon of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detail~ description of layout ofpr~e~ must be drawn on the diagram which is ~ of this application. c. The work covered by this a~lication may not ~ commenced before issuance of Building Permit. d. Upon approval of ~is application, ~e Building Inspector will issue a Building Permit to the applicant. Such permJ~ shall be kept on the premises available for insp~tion throughout the work. e. No building shall be ~cupied or u~d in ~ole or in pa~ for any pu~ose whoever until a Ce~ificate of ~cupancy shall have been granted ~ the Building In~ector. 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, os 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 ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ ...~...~..~.~.~.~.~_.:...D..~.¥.~>.~.~ ............................................................................................................................. Name of ownerof premises ....~.b.~Y~.:~....~.~.~,...~ ............................................................................. If applic~s: ~:rate, signature of duly authorized officer.~~~ ....... = ...... .... Builder s ,Lic~se No ..................................................... ~ - ' ~ Pl um~r,s, License No. ~.~...~.~.~.~..~ T~ ~o ~, -- ~ ~ ~ S I+o ~ ~ Electricians License No. ~¢~...~..,.~~ - I~b~°~ ~ ~he,.,~'s License No ............................................... ~ ~ -- 1. ~t~n ~f land on which pr~osed work will be done. ~ap No.: '"r ................. 1'"~' .......... Lot No....K..~ ............. S,eet ~ N,~r ....... ............. .*.~.....,.,..a.~.S.......,.~: ..................... ~* ~ ~ OL~ --~ Mun ici~li~ 2. State existing use and occupancy of premises and intended use and occu~ncy of pr~ed construction: Exisiting use and occupancy ................................................................................................................................ Intended use and occupancy ...k....~..~...t~..).~..~ ........ .?...'%..x..~.~r..%'...~. ....... ...~...~..~,..C.~.l.?.!..(~ ................................... 3. N ure of work (check which applicable): New Building, .... v/'.. ............. Addition ........ ........ . Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) 4. Estimated Cost ...~,...O.~,..o...o.....C~.. .................................... Fee .~......~..' (to be paid on filing this application) 5. If dwelling, number of dwelling units ......v~... ................... 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 ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...-,~...~....-..~ .................. Rear ..~..~....q~. ........... Depth Height '"/"F': .......... Number of Stories .....~...~....~.-~. ...................................................................................................... 9. Size of lot: Front ....... /....,.~ ......................................... Rear ..... /...~..~'. ............................. Depth ....Z....~....O.. .................. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... J~.o ........................................... 13. Will lot be regraded' . ..~... ................ Will excess fill be removed from premises: ( ) Yes (v~ No Nome of Architect .............................................................. Address .................... ; ........... Phone No ....................... Nome of Contractor ~..~....~m.....~.. 1.~.~-.~...~.. ................. Address .~ ................. Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil 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 end indicate whether interior or corner lot. STATE OF NEW YORK, ~ c S COUNTY OF ...~,~.=.~..~kJ~---.....~'~' ................................... ,,~,~,.--..~.......~...t.~.S...'J:l...*....~.. ............ being duly sworn, deposes and says.that he is the applicam (Name of individual signing contrac~ 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 thaz the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~ ...... ......... .......... ' .... ........................... ~~ ~/~ JUDITff ~ ~ - , ~ ~ (~gnature of applicant) ~,,'~r,, pu~,- .. ~ 80~[N ~ [xp~r~ ~azch ~, 19 7 7 SU F'F'. CO. DI'PT. 0~' H~;'ALTH ~lrl.{~i'Vl~ ~'rATIr..IvIIL~T CYF FOR APPROVAL OF ~a¥~U~N ONLY ~ WAT~ SUPPLY A~ t ~,~JAN- 04 Z~ ~. ~. R~. ~,,-- Tho ~wet~ ~' m~a! an.] ~,ate~ Supply faet~t ~a~ ~:r this loc:~t~on have been lnsp~t~ ,~ tbl S de~artZ_ent - ;IOC, ! ~ief of General Engineering ~ Services AT' UNAUTHOPIZED ALTERATION OR ADDITION TO 'FH~5 51]RVEY IS A VIOLATION OF SECTION 7209 OF THF NEW YORK STATI~ EDUCATIGN LAW "~"'~"" ! ~" ,~9~ ,A~.,.ovAL oF, ~,U,~'ON 9NLY .... ~'~" DA~: .................. DIS~L SY~ZM5 ] ~ DENC[ WILL ~t' I ~ H. S, REF. NO,: ........... ~AND~ OF SUFFO~ S~nd : OF H~LTH. ~ APP~' ~ ....... ' AP~ICA~ ..... II ELEVXTION _RIFE] ' _ j--Ilq _ tT1F-17'l APPROV.~D AS N~TE~ ~ NOTIFY BUILDING DEPARTMENT AT ED INSPECTIONS: TION OR START FRAMING 2. BEFORE COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED mlLLLUOO,~ HO~,,E$ LTD. SOUTHOLD, N Y 1 97 68.~ 87qO i FI~T FLOO~ PL A~' 7:9" mlLLUJOOD H 0.~.1~ LTL,. .)' mlLLUJOOD HOME6 LT~'. F mILLUJO00 HomEs LTO.