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HomeMy WebLinkAbout13303-zFORM NO. ~, TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No .... .~,~.~.~? .7 ....... Date ................ .J,~,~?..9. .......... 19 85 THIS CERTIFIES that the building one-family dwelling. R.O.W. o££ Cox Neck Rd. Mattituck Location of Property House No. Street Hamlet County Tax Map No. 1000 Section ...'l.q. 3. ...... Block ......... .7. .... Lot '19.8 Subdivision .............. ~ ............. Filed Map No. ~r .Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~.u.. }~..~.~. .....,195~. pursuant to which Building Permit No... q .~505Z dated ....... .0..u. }7..~.0. ............ 19~.~., 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 ......... New one-£amilI dwelling. The certificate is issued to KEV72XI & ~SLEY MILOWSKI of the aforesaid building. Suffolk County Department of Health Approval ............... ~.~.'7 .~.Or.~.2. ................. N685289 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOV/N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13303 Z Permission is hereby granted to: .~..,.~..,...~...~..~~. ...... ...~~.~.....~..,..~..........t~..~.~... ......... . ~ ,o .~~.....~....~.~' ~~.~.,...~...~e~....~., .......... at premises located at .~,~.:..~....:...~. ~..~'~....~.&~,,..~.~............~....~r~ ............................... County Tax Map No. I000 Sect,on .... I.....~ ............ Block ...... ~ ............ Lot No ....... ..~....~. ...... application dated ...,~..~...~ ............................... , 19.~...~.,," and approved by the pursuant to 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 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, propertv 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. 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building .. Y~'... ....... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property ............................................ County Tax Map No. 1000 Section ./l~. .......... Block ...~..'-) ......... Lot...~./O../ Subdivision./ .: ..C. h i. k ............... F,,ed Map No ........... Lot No. ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Unden~/riters Approval ...~.. .................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~.. ................. Fee Submitted $ ..... ~..~.~. .... .~(,...~. (~(~.. Construction on above described building and permit meets all applicable codes and regulations. Applicant .. ...................... Rev. 10-~0-7e TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. 133C~5 L owner l~'~Vl'fl '+ /v/i/oW k ' (~leas~ p~ifit) (please print)~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (p~umber-' s signature) Sworn to before me this 19~.__ · ~ ~// N~tary Pubic Notary Public County JUDITH B. WURTZ NOTARY PUBLIC, State of New York No. 4787124, Suffolk Count~,,.,, Term Expires FIELD INSPECTION COM~ iNTS FOUNDATION 1st) FOUNDATION 2. 2nd) ROUGH FRAME & ?LUMBING INSULATION FERN. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: Southold Town Board of Appeals APPEALSBOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. ROBERT J. DOUGLASS JOSEPH H, SAWICKI June 28, 1985 Mr. and Mrs. Kevin Milowski P.O. Box 134 Cutchogue, NY 11935 Re: Appeal No. 3243 Dear Mr. and Mrs. Milowski: This letter will confirm that a resolution was adopted by the board at our Regular Meeting held last evening as follows: RESOLVED, to accept the road improvements made concerning Appeal No. 3243, in accordance with Condition No. 1 and No. 4. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Douglass, Doyen and Sawicki. This resolution was unanimously adopted. Please be aware that the right-of-way must be continuously maintained in good satisfactory condition for access by emergency and other vehicles, and that in the event any other subdivision or set-off should take place over this right-of-way, additimnal applications will be necessary. If you have any questions, please do not hesitate to call us o.r the building inspector (765-1809). Yours very truly, £C: Building Inspector Victor Lessard GERARD P. GOEHRINGER CHAIRMAN By Linda Kowalski BUILDING DEPT. INSPECTION' [ ]' FOUNDATION ZST [ ] ROUGH PLBG. REMARKS: ~r~,~ 0~ [ ] FOUNDATION aND [ ] INsuLATIoN [~/J/FRAMING [ ]FINAL DATE INSPE~rOR :~", 76S.i 80~ ,, BUILDING DEPT. INSPECTION FOUNDATION 1ST [/ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INsuLATIoN [ ]~ FRAMING [ ] FINAL REMARKS: ,,, DATe ~ooo77~ "THE 'N'~"~V YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~Eq~ 85 JOHN STREET, NEW YORK, NEW ~YORK 10038 o.,e ~, ~, ~ ~"~"~-~.~"~"~ ~/~N 683289 THIS CERTIFIES THAT o~[y tAe egert~ca[ e~.iprne.t as ~zc~ibed belo~ and int~d.ced by the ap~llca~ rtamed on the able a~lic?io~ ~mber in the premlseg of was examlned on ~'~h ~ ~ i~ and found to 6e i~ compliance ~ith the req~*irerne~ts of rhls Board. 22 2A DRYERS OTHER APPARATUS: i~O.F.I. 2~S'nr~;e Detector. E R 'V C NO 0 COHD OF CC. CO~D Wo 2/O ~mlaad Electric Co, P. 0 Box 14~ M~ttituck, N.Y. 1~52 Lic. 242 This certificate must not be altered in any manner; return to the office o~ the Board if incdrrect. InspectOrs may be identified by their credentials. 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL q*OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ~ .... 19 ~.~. Permit No./..~..~..O:~ .-~.. Disapproved a/c ..................................... Received. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 plm) 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of appl~name, if a corporation) .¢o., ~ .~.o..x...I.&q .,. 6 o.±chc~:o.c., hi .x/.. (Mailing address of applicant) t lc/35 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .©.w.'ae,. C ...................................................... ................. : ............ Name of owner of premises ..~e-/.;n. J~...t £.e~:)e:/~. hq i lO.w~4<i ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..~Sh~. 710.~. 7 Way...(~.~f... ~J~'~.-~.. ~'i .d~ .... .~..&ox..~leck.. Ec~d., .... /~o.t.~. ;.9..o..~L., .... ~0.¥ .................................... !~. eus~ Num%oer ~ Hamlet County Tax Map No. 1000 Section .I.l.~ .............. Block . .'7. .............. Lot..~./O.../.,.~,.. r . S~bd~o~. W.;JI i~.m. d ho.a.[o.K .............. ~iled Map No ............... Lot 71~../~ ..... (Name) (10~.1) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~rO~:l t'l .JIT... [cq Iq ~L ............................................... b. Intended use and occupancy .~ ~ ~ J2GIm - -2~-~i}93 .~'.~'~i'~.C.*lq.~,.~'~ .... ~ ..... ¥ .........~c¥. .................... 3. Nature of work (check ' ~ ' .V/. which apphcable): New Building . . .' ..... Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition ...... Other Work ..... ~. i! (Description) 4. Estimated Cost .. ~.t.O.~..~.i ......................... Fee ...................................... ! ~" (to be paid on filing this application) i - 5, If dwelling, number of dwelling units ..... ]. ........ Number of dwelling units on each floor. JVt~ ........... If garage, number of cars . .' c~. I ................................................................... 6. If business, commercial or mixed occupancy specify nature and extent of each type of use . .t~.~ ................ 7 ..... if any: Front ~/~ Rear Depth · Dnnensmns of ex,sting structures, ......................................... Height Num'ber of Stones Dimensions of same structure with alterations or additions: Front ............... Rear .................. Depth .................... i" Height ...................... Number of Stories ............... 8. Dimensions qf entire new construction Front.~'~J ..... Rear .~.3~. . Depth ~:~ .. . , Height cg~.N ............ Number of Stories t ~¢3, . i ....................... 9. Sizeoflot: Front 10~,0.[ ! 'l~;~r ~:~.3;'~'1~ ............ ~;it~' ~43.~'074~[~0)i '~;.~.' ~) 10. Date of Purchase . .~.'.-,ff.. 7.~q,i ................. ~ Nagte of Former Owner . ~. ~).l~ teD.. ~h. U0[~.61.~.. ..... 11. Zone 6r use district in which premises are situated .#~'....K.~.~. [.CIC/Q'~ ~O,~ 7. ~..~./. i.~, 0l .~./)('(21,~.. ~.~)t0.~, ..... 12. Does proposed constr~t_!o~n vi.oliVe any zoning law, ordinance or regulation: . .ffil~3 ......................... 1 3. Will lot be regraded .:~ '.. NI~. ................. Will excess fill be removed fronl ~l;emises: Yes 14. Name of Owner ofpr_.emises ~?tf~,~¢~i41q'~ .1~. il~.~Address .P..~..j~)~..l~.~.i&q~.c~.~one No.-'l~q~/~QcJ ..... Name of Architect .ff~,O.fi~ ./_?... D.~. ......... Address .~i f.~q 0. ~9.~ .r.+. ..... Phone No.q"/7. l~.~.O~ .... Name of Contractor . b/1~. .... ' ................. Address ................... Phone No ................ ! 'i PLOT DIAGRAM Lo ate clearly and &sttnctly allI 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 NEW YORK, COUNTY OF .......... ....... ............................ ~ .................... being duly sworn, deposes and says that he is the applicant . (Name of individual sighing contract) above named. He is the ..................... i ................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements con[ained in this application are true to the best of his knowledge and belief; and that the work w, gLbe performed in the mann&r set forth in the application filed therewith. Sworn 'to'before me this " ': ....., i9 .. ........ ;.. '?f:';:~/~'. ~...day o~ ....... ,. - ..... I .,-, County . ............... I ~ [I0 470:~878, Suffolk C4untj(, ,,.- O~' ~/ ' ' (Szgnature of applicant) Term Exp,res M,rch a0,jl ,/ // d