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Home My WebLink About13404-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No.z13790 Date August 21 ,19.8.5. THIS CERTIFIES that the building .... qn.e...f.a.m. ~..ly..d.¥.e.l.l.~.n. g ...................... Location of Property 2295 OLD NORTH R.0AD .SOUTHOLD hS~s~ ~iol ...................... 's't/e;i ...................... hJd, iel County Tax Map No. 1000 Section 55 . .Block 1 ,Lot 3.4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ~..u g.u.s. ~...2.~ .......... ,19 .8.4. pursuant to which Building Permit No. 13 z~ 04 Z dated ....g .u.g.u. s, .~, .3. ~. .............. 19 .8.4,, 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,, .f.a.m.~, ,i y, .d,~, e. ,I.3_.i,n,~: ........................................................... The certificate is issued to Richard V. Millikan (owner, I~,~'YO~( ~.~;~X X X of the aforesaid building. Suffolk County Department of Health Approval ..... ] 9.-.S. 0. ? .~ .7 ............................ UNDERWRITERS CERTIFICATE NO .... N 6 ? 6387 Plumbers Certificate Feb. 13, 1985 ~ Rev. 1/81 Building Inspector FOB.~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13404 Z Permission is hereby gron~o._~ ...... J~...C;:~..:......~.~ ............. .................................. ...C2.~..~......~...~........JJ..~..T. .,L. et premises located at ............... ,oj, ............. .(~j .~.,.. ......... ~...~ ........ ~... County Tax Mop No. 1000 Section ....C)..~'~......~.. .... Block ......... I ............ Lot No.......~..:...~J'. ......... pursuant to application doted ...~..L~:~....~.........~..~. ............... , 19.~....~.., end approved by the Building Inspector. Rev. 6/30/80 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 im Ili~ 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--lSd9 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ..... ' .~/'~'~ .F./~. '~. ·~· .......... New Building ~ Old or Pre-existing Building Vacant Land Location of Property ........................... t .............................. House No. Street Hamlet Owner or Owners of Property .......................................................... Cou~tv Tax Map No. I000 Section ............... Block .............. Lot , 4/ Subdivision ................................. Filed Map No ........... Lot No .............. ¢/~J/~ Applicant Permit No. a.! ~qO~r.~_..... Date of Permit ............................................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... .~.'..~...~ .......... ~/~ ' '~r~e Construction on above described building an it ets all,~p~.l~_"~ble ~ ~qdes and regulations. Applicant ...~./.~7..... :..-.., ........... ,: :,: i,..~ .:,..../., ......... TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (pYum~r' s signature) Sworn to before me this / %day of Notary Public, ,..~qTCf'o/,L<_ County ~/ Notary Public JANET G. RYAN Not~ry Public, State of New No. 4817569 t~'~pa~gn Ex~r~s March 30,19 ~OOOlO~ THE NEW YORK BOARD OF FIRE UNDERWRITER,.% BUREAU OF ELECTRICITY ~.~ ~,~ ~ i~ ,~,~.,o.~.~.~,~ ~/~ N 676387 THIS CERTIFIES THAT only the electrical equipment as descrlbe~ below and introdaced by the applicant named on the able application number in the premises of in tbe following location; ~ Basement ~ ,st Fl. [~ 2nd FI. Section Block Lot was examined on ~y ~.~ ~8~ and,found to ~e in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: :NO, O~E_~C~yCOND.p AW G, NO OF OF CC, COND. -- HI-LEG A W. G, OF HI-LEG NO. OF NEUTRALS i A W G, NEUTRAL 4 This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by thei~ credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIF Y ANY MANNER. FieLD ~INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2 o ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: 76s.x~oz BUILDING DEPT. INSPECTION £~/I~OUNDATION ],ST [ ] ROUOH PEG. £~/rOUNDATION ZND ~ ~ INSULATION [ )FRAMING [ ]FINAL REMARKS: DATE, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examin~ ~..uza~'...."~.. ~....., 19~\~' Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PER~IT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bui¥injg code, l~ousing c~te, and regulations, and to admit authorized inspec~9~s o¢]premise/~anc~ i,n bulldinl$ for necessary i~¢~ns. ~r~ ~¥7~q.4.C45., t .... ,,,. rv:, :. .... = : : .,, .......... "~ ~ t'~.,I (Signature of applicant, or name, if a c0r_?.~poratio~ ., .y. ..... (Mailing address of applicant) State wh~ther applicant is owrler, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C .............................................................. Nameofownerofpremises .... ~. .... .~.0... ............ . )~l .} ..K~. ...................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 207 ~ Builder's License No..~. tC...~. ............... Plumber's License No ......................... Electrician's License No....~'...~. 7./.~f. · · Other Trade's License No ...................... 1. Location of land on which proposed work will be done...O..Z.~'. ::5L~.O. .................. House Number Street Hamlet County Tax Map No. 1000 Section .... ~ .......... Block ..... f ............ Lot..~.~ ~ ........ 1/ Subdivision ................ (~).._.. ................ Filed Map No...~ ......... Lot..~ ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~.~Co~ ..................... x,~ar.~ jar~o~ .................... ' ' ~/ '~h6~ ~ ~ ~ ,~ ~ b. Intended use and occupancy ~... '~u~ ~a ~ ,~ ..................... ~ ~,~.~ ~ ............. 3. Nature of work (check which applicable): New Building ...~. '. .... Addition .......... Alteration .......... R~palr ........ A ..... Remgval .............. Demolition .............. Other Work ............... ' ~ ~4 g;'" ' ' (Description) oa.,i 0 4. Lstnnated Cost ..... ! ............................... Fee ...................................... i ~" (to be paid on filing this application) 5. If dwelling, number of dwellinglunits . ·· · .. · ...../ .. Number of dwelling units on each floor ' . ........ If garage number of cars ' I 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of ex~stmg structures, if any: Front ............... Rear .............. Depth ............... tteight ............... Nun~ber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .............. Rear Depth ................... :.. Height ................ Number of Stories ......... ~...; ....... 8. Dimensions of entire new consffuction: Front ....~Y'~..~' ..... ii 't~r ...~..: ...... Depth .... .~ ........ Height ............... Number of Stories ........................................................ Size of lot: Front ......... /.~. ?. ........ Rear .... /. [. ~ ............ Depth .~..2 .~..'; ,,~. ~. ........ Date of Purchase ' Name of Former Owner Zone or use district in which pr~mises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ...... ~V'.:°. .................. Will excess fill be removed from premises: Yes No Name of Owner of premises Address Phone No Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ' Address Phone No 10. 14. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y9R?~./~ ,~/ iS S COI:JNTY/,f.. O ~ .~..OF.. ~.,~.~..///~.k, ~ -'.:.~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..... ~ ........... , ................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ autho~zed to perfom or have perfo~ed the said work and to m~e and file this applicationTthat all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ne~ set forth in the application filed therewith. Sworn to before me this ......... ... ~. :. ,day ofi.~ .... ~~., 19 ~ /,~ ~~v~ . // ///~/~ ., ~~ ~~ ....... ~. ¥..~, ~ .......... ~:: ~ :_..~ ...... ~ ~ ~~ ~, 18~V (S~gnature of applicant) J TITLE NO. 1203950 O0 5~LK ~oUN~ ,DEPARTMENT OF H~LTH SERVICES SURVEY : ~F0R APPROVAL OF coNSTRUCTION ONLY AT sOu?HOLD DATE ~ ~, /~ DA~E~ L ~: ' SUFFOLK ~COUNTY, NEW YORK No, 78-7/4 ~ *UNAUTHdRIZEO ALTERATION OR ADDITION TO T~lS ~U~D~ OTHER THAN THOLE SHOWN HEREON. ~OWNERs.TO ADDtTIONALr INSTITUTIONS OR ~ HEALTH SERVICES. ~¢~ ~a~ ~,~/~ TO EXISTtNG S:TRUCTURES ~RE FOR A SPECIFIC ~ = MONUMENT I ALDEN ~. YOUNG, PROFESSIONAL ENGINEER ~ - -~"~' . ...... ~ AND LAND SURVEYOR N.~S. LICENSE N0.12845 ..... '"' " ~ HOWAR W. YOUNG~ LAND SURVEYOR ~E~T~WEL~(W),aE~ C T~K(aT)a~Sa~LS CP SH~ HENEON N.~S. LICENSE NO. 45895 NO. 120~- 950 NO. ~ 284 - 435~ NICH~ND V, N!~LI6~fl FEB 7, 1985 AT SOUTHOLD . . DATE SURVEYOR'S INKED SEAL OR EMeOSSED SEALSHALL ~/C~ ~ ~/~~' H~LTH DEPARTMENT' DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE $URVEY IS PREPARED, AND ON HIS 6EHALF TO THE TITLE COMPANY, GOVERN- OF HEALTH ~ERVICE3 PROPERTY LINES OR FOR THE ERECTION OF FENCES. , RIVERHEAD, NEW YORK ~ = MONUMENT ALDEN ~ ~OUNG,PROFES$1ONAL ENGINEER .... -~ _ , ' ..... "-' - ~ ~" -~- ' ~ AND LAND SURVEYOR N.~S. LICENSE NO 12845 . HOWARD W. YOUNG, LAND SURVEYOR THE ~AT~N ~ WELL (W),3E~IC T~K~S T) e C~SP~LS (CP) 9HO~ H ER EON N.~ S. E lC E N S E NO 45893 AR~ FRO~ F~ELD OB~RVATIONS AND OR DATA OBYAm~ D FROM OTN[RS~'