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Home My WebLink About15276-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bumldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17085 Date JULY 14, 1988 THIS CERTIFIES that the building ADDITION Location of Property 1371 ROW OFF COX NECK RD.~ MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 7 Lot 19.8 Subdivmslon Filed Map No. Lot No. conforms substantially to the Applmcatmon for Bumld~ng Permmt heretofore flied ~n thms offmce dated AUGUST 29~ 1986 pursuant to which Building Permit No.15276-Z dated SEPTEMBER 19, 1986 was mssued, and conforms to all of the requirements of the applicable provmslons of the law. The occupancy for which this cert~fmcate ms ~ssued is DECK ADDITION TO EXISTING ONE FAMILY DW~T.LING AS APPLIED FOR The certifmcate ~s issued to KEVIN & LESLE¥ MILOWSKI (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Buildmng Inspector Rev. 6/88 TO~N OF SOUT~OLD BUILDING DEPARTMENT TOWN HALL SOU?HOLD, Fi. Y. BUILDIHG PER/.,41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15276 Z Perrmss~on ~s hereby granted to' ~e....¢ ..~ ~ ~ ............................. ..... at prem,ses located at ............ I~,.,,...f~.~...,~.~...~ ~,J~..~.,......~.~ ............ Count,/' Tax Map No 1000 SeCtl~l I.~ .... Block ....C:~....~ ....... Lot No .... I...CJ..'~ .... pursuont to apphcotion doted ...~w'~4~.~. ..~.~ ...... , Jg~ g., ond approv~ by the Building Inspector Building Inspector Rev. 6/30/B0 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG DEPT TOWN pF SOUTHOLD Instructions A This apphcat~on must be filled ~n typewmter OR mk, and submitted ia ~ to the Building Inspec- tor w~th the followmg; for new bullrings or new use: 1. Fmal survey of property w~th accurate location of all buddmgs, property lines, streets, and unusual natural or topographic featu res. 2. F~nal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrmal ~nstaHat~on from Board of Fire Underwriters. 4. Commercial buddmgs, Industrial buddmgs, Multtple Remdences and similar buddmgs and installa- tions, a certificate of Code compliance from the Architect or Engmeer responmble for the buddmg. 5. Submit Planning Board approval of completed rote plan requirements where applicable. B. For exmt~ng buddings (prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of property showing all property lines, streets, bu?dings and unusual natural or topographm features. 2.Sworn statement of owner or prewous owner as to use, occapancy and condition of buddmgs. 3. Date of any housmg code or safety ~nspect~on of buddmgs or premises, or other pertinent reforma- tion reqmred to prepare a certificate. C. Fees: Addztions $25.00 POOLS $25.00 ALTERATION $25.00 1. Cert~ficate of occupancy New Dwellzng $25.Q0, Accessory ,$I0.00 Business $50.00 2 Certificate of occupancy on pre-existmg dwelling $ 50.00 3. Copy of certifmate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O $ 50 00 Date ..7..--/.-P. Ta.~. ............ NewCOnstrucClon ...... Old or Pre-exlsttng Building ........... Vacant Land ............. Location of Property.. ~,~///2~ .Y~.,, Owner or Owners of Property . ).z.~ .... ./~./. V. ................... County Tax Map No 1000 Section .... J.J.~ ....... Block ....--] ......... Lot...1.C~! .~. ........ Subd~vlmon .................... Fded Map No ...... Lot No ............. Permit No.~/,-G'z:t?.7~.?~. Date of Perm,t '~./..~/O...Apphcan, ~--~LJ In.fi? ......... L.~..~.~]~_./4,1~i/(~,l.~At... Health Dept Approval ...................... Labor Dept. Approval ....................... Underwriters Approval .................. Planmng Board Approval ...................... Request for Temporary Certificate ................ Final Cert~fmate ...~... ............... Fee Submitted $ ....... ~. ............ Construction on above described budding and p~..Jt meets all apphcable codes and regulations. Applicant...~4; ¢-~.../~. ~,'~'~/~g~,¢~'~ ............... 10-10-78 351to FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~SULATION FRAMING [/FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND []/INSULATION FRAMING [/] FINAL DATE INSPECTOR_S? 7~ ~-'D. ," _BY· V'' ~''''-' ,.~oTt;'¢ ~{uILDING *oEPARTMENT AT , --,. :~ '~802 9 ~M TO 4 ~ FOR THE ~Ou~{~A~'lO~ TWO ~EQUIRED ;0~ ¢,OUR~O coNCREi'E ~ ~iOUO~ ~{AMINO ~. PLUMBING ~. ~lf.~A~. C.(~NSTAUCTION MUST ,~ COMPt E'rF. FOR C.O. ALt. C;Ot~S': FIuCTION SHALL MEET' THE REQUIPJEMENTS OF THE N.Y STATE CONSTRUCTION & ENERGY COOES ~OT RESPONSIBLE {:OR r~E~IGN OR CC~,~iS11~N ERRORS. d q~u' pose-s, ~h~clq ~', I~ be.. ¢.,<tcrde~ ~ug,poc-~s -F'co r~ FORM NO I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.. 765-1802 (Bmld~ng Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. Tins application must be completely filled In by typewriter or in ink and submitted to the Bu,lding Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public street, or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this apph. catmn. c. The work covered by tins application may not be commenced before issuance of Building Permit· d Upon approval of this apphcation, the Budding Inspector will issued a Bmldmg Permit to the applicant Such permv shall be kept on the premises available for mspection throughout the work. e. No braiding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc~ shall have been granted by the Braiding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to iht Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ Regulations, for the construction of bmldmgs, additions or alteratmns, or for removal or demolition, as hereto described The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and tt admit authorized inspectors on premises and in building for necessary inspecti.ons. , (Signature of apphcantl~t~ name, if a cg, rporahon) (Mailing address of applicant) State whether applicant ~s owner, lessee, agent, arcintect, engineer, general contractor, electrician, plumber or builder · .Ow.t .C ................................................... ~meofownerofpr~m,ses. KeV.;n .~ ./-e~.le5/. Ft~ ]cs.¥v::;.]'qt ......... (as on the tax roll or latest deed) If applicant ~s a corporation, signature of duly authorized officer (Name and t~tle of corporate officer) Builder's License No Plumber's L~cense No ......... Electrician's L~cense No ...... Other Trade's License No ....... Location of land on wtnch proposed work will be done lIouse Number Street County Tax Map No 1000Section . .I.[~. ., Hamlet · Block ..-/ ............. Lot. iq, 8' ...... Subdivision ......... . . . . Filed Map No ........... Lot .............. (Name) 2. State exmtmg use and occupancy of premises and intended use and occupancy of proposed construcbon a. Existmg use and occupancy ~ I~I.~[Q--- ~t.D~,}~/ dweltirm . _ ',; : 2 '.: ' '.' ' ' :' .: ..... b. Intended use and occupancy . .~ ~. . IT/. ...... 1]'1 ................... 3. Nature of work (check 'vluch applicable) New Bufl&ng ...... Adx~ ...... Alteration ..... Repalr ..... Removal ......... Demolition ....... Other Work .l~.~g iq' .. (Descnptmn) 4. Esttmated Cost ..................................... Fee ................................... ~ (to be prod on fihng this apphcation) 5. Ifdwelhng, numberofdwelhngumts .............. Numberofdwelhngumtsoneach floor ......... If garage, number of c~s ............................................................ 6 If business, commercial or mixed occupancy, speedy nature and extent of each type of use ~ ~' ~.' pth ~ ' 7. D~mensions of ¢xmtmg structures, If any Front ........... Rear ........ De ....... Height Number of Stones ................. D~ensions of same structure with alterations or additions: Front ................. Rear .............. Depth ........... Hel~t ................... Number of Stones ................. 8. Dimensions of entire new construction' Front ............. Rear ............... Depth ............ Height ............. Number of Stones ............................... 9. Size otlot' Front I~D .0.[ ........ Rear ~¢~,.~ ........... Devth ~. 10. Date of Purchase . .~7 ~ 7 ~ ............. Name of Fom~r Owaer .~[.~] iota..&b~di~. & .... .... :: ;5; ...... .... ( ?: ......... 12. , n n' . ......... ~. · 13. Will lot be regraded .~ ........... , ....... Will excess fill be removed from premises: Yes _ 14 Nme of Owner of premises ~{v.~* eg~g~ ~[~Address ~X~Tq ~O~I~Pg~ Phone No. ~7~.~ Nme of Archttect ......................... Address ................... Phone No ............. Nme of Contractor ...................... Address ................... Phone No ............. 15. Is chZs property located ~thZn 300 feet of a tidal ~ettand? *Yes ..... ~o .~.. · If yes, Southold Tom Trustees PemiC maybe required. PLOT DIAG~M Locate clearly and &st~nctly ~1 buddings, whether existing or proposed, and. indicate fll set-back dimensions fro property lines. Give street ~d block number or description according tb deed, and show street nines and md~cate wheth, interior or corner lot. STATE OF NEW~ YORK, ~' S COUNTY OF~. . ........ }__ .~ ,~ lk4 .,~d/, IQ. ,'~. -.%,~.t ........ being duly sworn, deposes and says that he is the apphca, (Name of ln&vldual s~gmng contract) above named. He is the . C~.~ ............................................................. (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 th apphcatmn, that all statements contained m this apphcat~on are true to the best of his knowledge and behcf; and that work wdl be performed in the manner set forth in the application filed therewith. Sworn to before me this · ..~.~ ........... dayof...~g-~.~: ...... 1 .9~.. Notary Public ........ x,.¢;~.c~ .¢~Cr....~**., .v .. County , , ' __. ........... 8omatPu~io, Sm~l'~r. f- C J (Signature ofapphcar