HomeMy WebLinkAbout18228-z
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18682 Date IIECEMBER 29, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1371 ROW OFF COX NECK RD. MATTITUCK, N.Y.
House No. Street Hamlet
County Sax Map No. 1000 Section 113 Block 7 Lot 19.8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 8, 1989 pursuant to which
Building Permit No. 18228-Z dated JUNE 16, 1989
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 ATTACHED INGROUND POOL WITH FENCE ENCLOSURE AS APPLIED FOR.
The certificate is issued to KEVIN & LESLEY J. MILOWSKI
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-090194 - SEPTEMBER 5, 1989
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
msas xo. s
TOWN 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° ~ ~ ~ ~ g Z Date . lO.~le 190..(..
Permission is here gran ed to: /
C~~
at premises located at .........~r,~.~~....~~J.
~~~'~1....... 4 ,(„l~X~l~...~
Caunty Tax Map No. 1000 Section ~~3..... Block Lot Na.........~/.t...Q...
pursuant to application dated 19.~ and approved by the
Building Inspectar.
/sue
Fee $.1..?..
Buil g Inspector
Rev. 6/30/80
Y
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
• SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE . ~R~ :A~Q.°.~9 .
Sw~mm~nJo Pc~l
NEW CONSTRUCTION .......-O7LD OR PRE-E%ISTING BUILDING.~!....pACANT LAND........
Location of Property.. ~3{ ~l~x,~eC~__ _ ~Gj f"~~--~-(~(,~
UOUSE NO. STS/REET HAMLET
Ovner or Owners of Property.~~y1~~'{-~~I ~l/~(A~J~~
aa ~ 0
County Taa Map No. 1000 Section ~.~,J.. Block Lot .IJ:.Q...
Subdivision Filed Map ........Lot..........
Permit No, r~~~C~.~'Date of Permit Y .(J.:Vq,,,A (~I ~^M y~
pplicant .11(~t !'J~! ! ~~~I~~(_~~(.
Health Dept. Approval Underwriters Approval..............
Planning Boatd Approval
Request for Temporary Certificate Final Certificate
~~77
Pee Submitted: $,0!5 ~0
APPLICAN'P~.L
rev. 10/14/88
c~880
Co ~ Ig6s`~.
THE NEW YORK BOARD OF FIRE UNDERWRITERS hurl, .1
1ptl~..il'~ BUREAU OF ELECTRICITY
BS JOHN STREET, NEW YORK, NEW YORK 10038
Dace 5f`T>9'I?1S}Y#~,~ r1y, 1.~f1~ Applioation No. on file ~ ~~~~~t {~k
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced 6y the opplicont Homed on the above application number in the premises of
Kh;V7Pl AITI,f)WS%Z7, <`C>X itf??1Ci1. 1211.., E'01.rY'••!#.1.5, MA`P"PC`t"t7C"H, N. Y.
in thefallotvinq lncationg ? Basement ? lat Fl. ? 2nd F!. ~3f1.1. Section Block Lot
was examined on Af7{all ^'I" ~.7>~9£~r9 andfound to be in emnplianee with the rerluireneentr q(this Board.
FIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FWORESCENT OTHER AMT, K. W. qMT K W. PMi KW. AMT, K.W. AMT, M. P.
1 1, ~ t
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTIET DIMMERS
AMT. K. W On M. P GAS H. P. AMT. NO. A W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P. SYSTEMS AMi WATTS
NO.OF FEET
1 1~ ~ L1Cl
SERVICE DISCONNECT NO.OF 5 E R V I C E
AMi. AMP. TYPE METER l~t'tW 1 ,e 3W ~ p 3W 9,a' dW NOAF CC. CONO A. W. G.
EQUIP' PER 9 OF CC COND NO OF HI-LEG Gi H LEG NO. OF NEUTRALS OF NEUTRAL
I~
OTNER APPARATUS: I~
^lS6ixR~7:A1C Nf)t1h) '1'hi=; cars-t:l.fica tea
~7T]YIP;YS ro1n117.iaAt t". <9 $i: ~1~a~~ CIf71: H,+ i3[
i.n:aprattieen oslty. Rctc;~Lra~ ItvnLSaia~.
~nu~ir«nmalrLts~ :i.r ~i.s :anv~ZsaYite tcT
]laves 1'Y€!grst9sTY. to-at anrlJr~c re~ppair
rr~ri~ t~~y a cfaai,i f.i e~{i y~errt~n
~c~
Jt)I1Y I"i1IBI'1.3,(1 D;,IC`.g234U-~;
PA'1' 1sAfiE
rTXL'1"'1'7TUCK., It11r, ;l t yfi~ GENERAL MANAGER
I ~ f,` ,l e
t`..
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS~OPY F CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
1::LD 1;:5: ::lU;: ~It)r~ir, jl ~OMMENTT
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'OUtJDATION (1st)
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'OUNDATZ0;1 ( 2nd ) ~ , m~~.. ~
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TOUGH FRAME &
PLUMBING
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IIJSULATIOPI PER N. Y. y
STATE ENERGY 3~
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BOARD OF HEALTH
3 SETS OF PL.1NS
FORMN0.1 SURVEY
TOWN OF SOUTHOLD CHECK .
BUILDING DEPARTMENT SEPTIC FOR*f
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
TEL.:7G5~1802 CALL
MAIL T0: ~6• otitl3Y
Examined ~ 19~
\pproved ~ 194/. Permit No.l~? ~o. ~ ^
Disapproved a/c D ~JIJIV V
[~l.F?G. C7EpT.
Ttl1~~N CAF .W'aCti3TP40LD
-.:k.«.,.,,..,,.a.;.~,.~..,,.~.,.~,a.,ss
uil g Inspector)
APPLICATION FOR BUILDING PERMIT / /
Date ...U........., 15 e?
INSTRUCTIONS
a. Tlus 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 ar 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.
f,
(Signature oi' applicant, or n~me, if a corporation)
• ~ B~M1'~F.~:~t~ ~`~+tr1Af3 ' " (Mailing address of applicant)
State whether applicant i5^itYwTrer,~le~see;`"aoehtl<architect, engineer, general contractor, electrician, plumber or builder.
i5~'KS1111'A3"bi C'a+l ``r ~s'4~ EAi'~o., pr } i P
Name of owner of Premises ......(~~;Vl,t??r. fr LC$~G . • • . ~?'/!r u Cr~' .
i;?~,#6Yt v!r'~ib 'a,r; " ~ (as on the tax roll or latest deed)
If app 'c is a ryo~r~ra~ ~Si a,vurs,p, d~~y, authorized officer.
~~~}f,~~+t~° :.B, tgt4f~cei)
fl{ }R~ fj ~ tRt
sEt~'~t-F b,t .
Builder's License No.
Plumber's License No . .
Electrician's License No. ~~Or?.~/tJ...~~{.~lC
Outer Trade's License No . .
1. Location of land on which proposed work will be done. l.!1 t'T l :~..C, ~ Cl~ i`F`
....I.3.7.I.....:' 1'Zo W .-....Cox... n~ ~-ccc .....YG.~!4~......... ~1°Il~:7r'.r. ~u~ .
House Number Street, Hamlet /rY
County Tax Map No. 1000 Section BI'ock ........7 Lot ~~b....
Subdivision Filed 1`fap No. Lot .
(Name)
State existing use and occupancy of premisespand in [ended use and occupancy of proposed construction:
a. Existing use and occupancy ......{.~~~.J
b. Intended use and occupancy C ' •1 . • ./®~p , • .
fi D/~~GG~~-
,g1r7-,ec~ ~~.D
~wrr,.~sti~ ~c
3. Nature of wort. check which
Repair , , , • • . applicable): New Building 1=2z~/e~~
( • • • • • • • Addition . / . , Alteration
Rerftoval . Demolition Other SVork • • ~ •
4. Estimated Cost ..........~~o; , , (Description)
i Fee
(to be paid on Cling this application)
5. If dwelling number of dwellins units • . . Number of dwcping units on each floor .
J, I
If ~ara~e, number of cars
6. If business, commercial or mixi;d occupancy, specify nature and extent of each type of use .
n l g es, if any: Front . Rear
Hei~itt ' Nu Depth .
Der.p[h s~onso• e~c'stin structur Rear
tuber of Stories .
a w
D;mens~ons of s st lure ith alterations or additions: Front • • • ~ • • ' ' ' ' ' ' '
lte:ght
' 8. Dimensions of entire new const~ructian; Front , ' ' ' ' ' Number of Stories .
Height Nu~Pber of Stories . Rear Depth .
9. Size of lot: Front Rear
p
Depth
.,,NameofFo Ow~qer
11. Zone or usecdistrict in which rl, • . • • . ,
emises are situated , , , , , , , , ~~/,~fjw'Tj/~ z ' ' ' ' ' ' ' '
12, Does proposed construction vio)ate any zoning law, ordinance or regulation: .
• No
~ViII lot be regraded
Name of Architect Will excess fill be removed from premises: es
14. Name of Owner of premises . .,~+~J(~~15'h-. L • ,Address , ~jlQ~( CG(
n?: .Phone No. .
i Name of Contractor .~,,/.Z.G,17G, • • • Address . ~j~ .Phone No. p
L.y.:r..~?~r~.... Address /.~f~7. l Phone No..~p, :~'Q~ .
IS.Is this property located within~00 feet of a tidal wetland? *YES...-NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all 1, bui]dings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block pumber or description according to deed, and show street names and indicate whether
interior or corner lot.
I~
~ ,,~~z' ~i?~~Z-~ .f'~r~ vt-~
AP'AOIIEb Af NOItO
i ~i DATE: tRN.~.~~
FEE:
! NOTIFY SUILOINp MBA
FBB-1802 8 AM TO 4 F'M FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TYVD REQANRED
FOR POURED CONCRETE
' 2. ROUGH -FRAMING 6 q
UMSINQ
8. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
i 7HE REQUIREMENTS OF THE N.Y.
STATE GONSTRUCTIONN~ ~IEIIRV
CODES..MOI' RESFO FOR
D(cStGN OR CONSTRUCTION ERRORS
STATE OF NE1VxORK, I'
COUNT,lYlOF ~Tro~(~, , ,~fS•S 'yam
• • ` Q~~'~ ' ' ' ' ' ` '/GG • • •v"` • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named, r
fie is the ~~.~~C~ .
y (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~ ~ ~ • " ' " ~ '
'of said owner or owners, and is dul a~utltorized to perform or have performed the said work and to make and Gle this
?Pplication,`that all statements containrld in this application arc true to the best of his knowledge and belief; and that the
work will be'performed in the manner scit for[It in the application filed therewith.
Sworn to bciore me this
~ ; ......day of { • (-t!k . 19
Notary Public, County
~~'~~v
C` ~ uNDA J. COOdEq .
NotaryPubligStateotiNawYork (Signatu pplicant)
k Term Expi?e December
31~ 19~