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Home My WebLink About12902-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g.l.3. q ~ y ......... Date .... .M.a.y... ] .5 ..................... , 198.5.. THIS CERTIFIES that the building D e c k Location of Property 1200 MAIN BAYVZEW ROAD $OUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section .... 0..7.0 ..... Block .... 0.7 ......... Lot ..... .0.1.9 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 10 19.8p gp 12902Z ..................... , . pursuant to which Buildin ermit No ...................... dated . .~ .a .p.c.h.. 2. .................. 19 .8 ~., 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 ......... Deck add±t±on to an ex±sting one £amily dwell±ng. The certificate isissued toWILLIAM & PATRICIA MILFORD ..................... ................... of the aforesaid building. Suffolk County Department of Health Approval ....... .n./.a. ............................... UNDERWRITERS CERTIFICATE NO n / a Building Inspector Rev. 1/81 IrOF, M NO. ~ TO~VN 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) 12902 Z Permission is hereby granted to: .. .~.~.~ ...~...v.: .... ~..: ..... ~ ~.~.~ ~...~ ............... ~... ...~..~.~..~.....~:.~.: ................................... to .... ...c~. ...'..~...~ .~..... fi2~. ~ ................ at premises located at ./.~.. ~)...~..~%~..~ ....~..~ ~..x~-~i..../..~ .~ ~ ...... .................................................................................. County Tax Map No. 1000 Section ...... ..~....~)..O.. ..... Block ..... ..~....~]. ........ Lot No ..... ..(~...!...~.,, ......... pursuant to application dated ........ ..~.....~..~...~ .......................... ~. , 19..~...~., and approved by the Building Inspector. Fee $ ...................... Building Inspector Rev. 6/30/80 FIELD I~SFECTION 1. FOUNDATION ( ls t ) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING I~;SULATION PER N. Y. STATE ENERGY C,ODE COMMENTS FINAL ADDITIONAL COMMENTS: FORM NO~ 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N,Y. NOTICE OF DISAPPROVAL Date..~..r47~. ¢/./ .... .(?..~ 19 File .N~o. .................. f :5 '~_: ..... PLEASE TAKE NOTICE that your application dated .... for permit to const~ct .... ~[2 r/.4~5 .~}Z., ~a ff~v~7' ' 7) ......... ~.. at Location of Property / ~ O D.. ~.< ~e..Z ~'S~ ~Z ~.~. ~; ........... h~ ~o~ ..... Street Hamlet co.~ ~ m~ ~o. tooo s~o.... ~.7F~ .... ~ .... ~ Z ...... ~ot ,.. ()/. ~ ..... .&~.>,v .... T,~<~... ~[~.~~" · ................... -- ' Buil~ Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1809~ Examined./~t/~ff('.. c_~ Approved. Permit No. Rece±ved..,',~/~.~,. Disapproved a/c .... . . 7:~.':?T...'~.."'...W ........ ~ ...... / (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......... .~/.~ .... 19 .~..AZ 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 ~o comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ... ~.~./.c.a.~,w. e~ ./...~/. ~.,qc.. ........ (Signature of applicant, or name, if a eorporafion) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises... ........................... ~as on the tax roll or la~egt deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..~.~.~..~/d..~.'..~.~./..~.. ?. Plumber's License No ........ . .N.,.~. ............ Electrician's License No ....................... . Other Trade's License No ...................... Location on proposed work will be done ..... .~'..~'. ........................ Of land which ftouse Number Street Hamlet : County Tax Map No. 1000 Section ...... ~.7.~. ....... Block .... ~..~. ...... Lot.. Subdivision ..................................... Filed Map No ............... Lot ............... (Na~ne) 2. State existing use and occupancy of premis/~es and intended nse and occnpancy of proposed construction: a. Existing use and occupancy ....... .~. ~...~. ~t. ~ .............................................. 3. Nature of work (check which applicable): New Building .......... ddition: ......... Alteration .. y ....... Repair ..... ......... Rem'oval ............. Demolition ............ Other Work ............... (Description) 4. Estimated Cost ................................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dweilin: 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 o~f e>~is[ing structures, if any: Front ..... 2. .,?.~ ......Rear ... 2~ ~ ...... Depth .... ~ ....... · '~: Height ...~-~; ........ Number of Stories ....................................................... .... Dimensions of same structure with alterations or additions: Front ...~ .............. Rear .................. Depth ................... :'... Height ..... .'~J/~.t.~./~... ,~. --./~- ~qumbe~ of Stories ...................... 8. Dimensions ofentire new construction: Front .~1~. t~.~..O~'~a~ .... ~... Depth . .:...~.... ..... Height ..... ~ ... Number of Stories .............. ~'2~ ....................... 'I'~~' ......... 9. Size of lot: Front .... ....,~-~.. t..'e. ...... Rear ..... ~.O .............. D. qpJ~h . ~..~ . ...... 10. Date of Purchase .......... i ....i '. ....... Name of Former Owner . .~..d ~ ....... 1 I. Zone or use district in which p~emises are situated ...................... ~ ............................. 12. Does proposed construction vidlate a,ny zoning law, ordinance or regulation:.. ~'. ............................. 13~ Will lot be regraded ........ ,I..~O .... . ........... Will exce~ fi!l be removed from premises: Yes No 14. Name of Owner of premises .44.-..g'~.-...~.,'./£a,:e'.... Address . ~ ~ ........ Phone No ................ Name of Architect ......... ~ .................. Address ................... Phone No ................ Name of Contractor .~-. ~fi?~.t'~..e?.,~/p.. ~-~at.~..~. 4'r~'e, . Address$.O?.,( .2'/~,~. t.~n...~.e.e./(.,~r. Phone No, .7.~.~r. .-. 7..¢.~. ~... PLOT DIAGRAM Locate clearly and distinctly al! 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. STATE OF N~W~R~,// COUNTY OF ~.,Z~...%w,. ~'~ ....... ~. ~.~ .~'~ · ............... being duly sworn, deposes and says that he is the applicant amc of individ ct) above named. / ~ ~ntracto~ g , corporate officer, etc.) of said owner or owners, ~d is du~y aut~riz~form or have performed the said work and to m~. and file this application; that all statements cont¢ined ~i~t]on are true to the best of his ~owledge and belief, and that the work will be perfomed in the m~ner set forth in the~pplication filed therewith. Sworn to before me this i ( ~ $gglhW .P,ublic .....~ .... r... ~.. i': '~ County ~'~-~-.: ............... (Signature of applicant) 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 topograph ic featu res. 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: /D~_~ --~_~0 - ~S' /.~, O0 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use ~ ,~2~ ~'.(~_ - ~x~, 3. Copy of certificate of occupancy $1.00 New Building ;~ Old or Pre-existing Building Vacant Land Location of Property . .1.~(.).0 ......... ~:I{~:i?..2~y.-~.~.~:y...-.~o.,; .d ........... p.oj.z~.o~;q ........... House No. Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .... 0,70 ........ Block ... ,0.7. ......... Lot .... q .9 ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 12902 ZDate of Permit ~/..1~/.~.~. ApplicantEnviron~ent ......................... ,...~ Wm. ~ l-attica iv[ilfo~ Health Dept. Approval .... ~ ................ Labor Dept. Approval ........................ Unde~riters Approval .... ~ ................ Planning Board Approval ...................... Reque~ for Temporary Certificate ..................... Final Certificate ........ ~ .............. Fee Submitted $ .... X'.?~. ,F. J~. 7~.~? ........ Construction on above de~ribed building ap, and regulations. ~ ~r~~ t fica ~':;~ ford ~or ITIC o