HomeMy WebLinkAbout17353-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17924 Date APRIL 4, 1989
THIS CERTIFIES that the building ADDITIONS
Location of Property 2395 OLD NORTH ROAD SOUTHOLD N.Y.
House No. Street Hamlet
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 AUGUST 22 1988 pursuant to which
Building Permit No. 17353-Z dated AUGUST 25 1988
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 GARAGE ADDITION & BREEZEWAY ADDITION WITH. ROOF DECK. TO EXISTING
ONE FAMILY DWELLING.
The Certificate is issued to: RICHARD V. MILLIGAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N 062079 - MARCH 9, 1989
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
r~osas xo. a
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~~ 017353 Z
Date ...1~:~..
........., 19. ~.~
Perrnission is hereby gronte to: ~ ~
h ,.
of premises located at ...~..~.7~..~......d.'~..T"`r/"..."'J/A~""'~ "' .... .............................................
..................................................................................
~~.
County Tox Map No. 1000 Section ..... ..........................//........................
.. Block ..........f.......... Lot No. ...............
.....~...1?.-... .............
T.....
/
pursuant to application dated .....~,1..~..~ :......... ........................... 19~.`~.., and approved by the
Building Inspector.
~r 0
Fee ...... u..Q~
~B g Inspector
'---
Rev. 5/30/80
. - ...
. , ~ __
~~~
TOWN OF SOUTHOLD ' ~~~~'-""'"j~'~~°
BUILDING DEPARTMENT APR • 4 i~ci'3
TOWN HALL
SOUTHOLD, NEW YORK 1 197 1 BLDG. DEPT.
TOWN OF SOUTHC
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
' /// DATE.. r! .3~. bGI ......
NEW CONSTRUCTION .Y ....OLD OR PRE-E%ISTING/ BUIL~D~ING......VACANT LAND..._....
i Location of Property.~l31J-.......~j~[.!~.6!'~~..(~'G/ ,,,,,,,,,,,,,,,,,,,,,,,
HDUSE N0. yS~TREET HAMLET
Owner or Owners of Property~~~~. ~.,I.~,I!~'~~1q,(~,,,,,,,,,,,,,,,,,,,,, ,,
County Taa Map No. 1000 Section ~:~... Block ..~.... Lot :~:~.....
Subdivisi~oygn ....................... Fi(~led Map ........Lot.c~.y.y~.......
~( ~7~~3Z ...Date of PermiC ~~6,~~d~ , (~(~L ~~~~
Permit No .. ....Applicant .... .......
Health Dept. Approval .....=~.~......... Underwriters Approval:?~~~O~~a/~~~,,,,
Planning Board Approval .... ~.........
Request for Temporary Certificate ....... Final Certificate .. ~..........
d~
Fee Submitted; $•.~~. ...............
~_~,.
APPLICANT. .. ~.-~.-.-;~!'v""' ,,...,,,,.,
~~. ~ ~9~3
Lo '~ ~ ~9a`{ ~ ~~~G
rev. 10/14/88 ~ ~ J /
yf~jje l t~~~~ c~/~ ~'t.
5 ~
lo~,l;J,I THE NEW YORK BOARD OF FIRE .UNDERWRITERS FpGE I
BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 10038
~~ MARCH tiq,IgG9
THtS CERTIFIES THAT
only the e(eetrkal equlpmsnt w dwcrihed b
ICH NILl.IGAN, OLD NORTH RD.
in thefdlowlnR location: UpQ z4en~`bv
mos e.TOmined on FkHR ItY [v AY
Applieotion No. on file 6Qbb4489; H8 N pb2oJ9
doto and introducd 6y tha epp/iarst nomad on the etwoe applic.tion number in the premises of
Nis, SOU'fHOLD, PI,'f,
^ IAt Fl. ^ Ynd F1. GAR .Sertion Block Lot
and found to 6e in rnmpliance xith the reyuiremenfs of this Board.
AtITUp
OUTIETf AC71:f fYY1TQNf X
NCNIDEtCENi NU011lEd!Ni OTNEn RA
NAT. NWE
K. W. COOKIN
AMT. G WOKS
K. W. OV
NAT. ENS
K.W. gSll W
AMT. AENlRE
K. W. EXNAU
AMT. ET fANE
N. /.
3
DEYlES
AMT. K. W, 1{IRNACE MOTOEf lUTUM AMIIAMOt INOEEf fMC1Al NC'fi
dl N. /. 6A6 N. /. AMT. No. A. W.O. AMT, AMI. TIIAl CIOCKS NHL
AMT. AM/t. TRANS. UINi IK1ATNf
AMT. N. /. A111LT40YT1ET
~ tl! fHT DIIARtlRf
AMT. WAllt
1iMVtQ GlEwfawcT No.or s e E v 1 t e
NAf. AMP. 111t 1 / tw l J 1w ~ J ]W t / AW NO.O/ RCeCOND. ~ ACYWCa. D. gyp. pr N4lEG p ~~ ~~ NO. p NFYnAIt p ~~Ula~Al
vTnea sr-AaATTrs:
G.t.C.It-i
G & S COPf(RACTGk LIf,.E576 E
BOk ''<!5
HUUTHOLD. NY, llvil.
This eertificoN must not be shared in alter mamror; return to ttN oNice of Ma Eo
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CER1
.eeo~
I!
Psr
if incorrect.. Intpsrlon may ba identifad by their cradeMwls.
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tiOi.U,N.Y. 11971
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To Glhom Thin [4ay Concern,
TEL. 7 C5-1 fi0?
Svc arc unable to complete your Certificate
of~OCCUhancy becnu~c,of the following reason.
1'1 :~n applicat.ion for Certificate of Occupancy
is not nn file, f' c~c.u~
///~,:lo Underwriters Certificate on file.
/-// '1'1ie check .io (~~•'-/not oa file. )~,~~I!`fJ
/_/ i:n !Iealth Dept. Approval on file.
1 _/ I:o final in:,pect:ion ha:, been made.
P]en~,e contar_t our office on this matter.
Thank yon for your. <:ooperation.'
3Ui.1(;inr CCrm.it 1( ~ ~ ~~ ~~ ~~ $
Building Ur_~nL•.
'`**/_/ ito I'.lumher Solder Certificate on file.
( nll pcrrnits involving plumbinr~ being
i~:nred after April 1,1989 )
~n.~.~-r-~, r~,a ~ 7n,~.~. ~,~,,,,.~ a I a I ~
l23 s3
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I ULATION
[ 7 FRAMING ~ FINAL
REMARKS:
DATE
~~
/73s 3
~s~-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULAThON, ~~J
[ ]FRAMING [ FINAL G~~'`a-'~~
REMARKS:
DATE ~ ~ ~ INSPECTOR ~~
._
~ 7~ ~s3
Y65-1802
BUILDING DEPT.
INSPECTION
[FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
Q ~~ ~~ INSPECTOR /"~'r~'
DATE 0 __ _~
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R/CHARD K M/ILL/GAN
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~ surroix couNn D~ruzrMa+r of mix samc
Ar SOUTNOLD ' 1, aaTE OfG 1, /I17i
,FOR APPROVAL OF GONSTEUCDON ONLY TOWN OF SOUTNOLD ~ ~ KAL[' /Y~ ~~~
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
~~ / TEL.:765-1802
Examined . A/.~~~"~/........, 19 yB~G~
Approved ../~/!t? ........, 19(!(! Permit No..~.~~33.~
Disapproved a/c .....................................
BOARD OF HEALTH
3 SETS OF PLANS .~...
SURVEY .: V,./~:I~~~
CHECK V
SEPTIC FORM ,,,,,,,,,,,,,,
NOTIFY
CALL
MAIL
.~~GJ~ .~~~~
T0:
~7 ~~
~~
..................................................O o~
(B ding Inspector)
APPL///ICATION FOR BUILDING PERPAIT
~, ~~~
~ 1~
~~ 11988
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, b g code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary nspe tions. ~C~a~ //~~
(Signature f applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor electrician, plumber or builder.
................................. ....`..;...n ..............................................
Name of oGVner of premises ..1!!G~OU• • • t°•~• ~./!~ ................................... .
was on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
..............................................
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE,SUFFOLK COUNTY LICENSED
Builder's License No. ... /...~0`l~/~z .......... .
Plumber's License No . ....................... .
Electrician's License No . ..................... .
Other Trade's License No . .................... .
1. Location of land on which proposed work will be done . ................................................ .
House Number ~ ~reet Block Hamlet
County Tax Map No. 1000 Section .... ... .~ Lot .. ~.Gf ............ .
Subdivision ..................................... Filed Map No. .............. Lot...............
(Name)
2. State existing use and occupancy of premi/ses and/intended use" amend occuJpancy of proposed construction:
a. Existing use and occupancy .. ~/r!~/~....I:G~'.r?: ~b... J)~'.S.I,C/PiV.if~'.-- ... ........ ..~,,, :•.................
b. Intended use and occu anc aJ.~f:~~!~k. • . • • ~-""Xx! . ..~."; . (A.1~C yG`^ •`:: r•~--.-.---.
P Y ,,
3. Nature of work (check which appli
Repair .............. Remove
(~jj' ~
'4. Estimated Cost ...Q.`S`~o
5. If dwelling, number of dwelling i
If garage, number of cars ....~
-6. If business, commercial or mixed
7. I)imenslon~. f existingstructure;
9. Size
10. Date
able): New Building ..,....~..... Addition ...~•... Alteration ......... .
,. ,
.............. Demolition ..............Other Work ..........~.... .
(Description)
...................... Fee......................................
` (to be paid on filing this application)
s ......t! .. , ..... Number of dwelling units on each floor ... ~........... ,
................................... :.1. ........... .......
. . .........
.._, ~~ .
cupancy, specify nature and extent of each type of use ..... . ... . .......... .
any: Front . ..,'; w ~ 1*; °; `ix ` ;Rear .............. Depth ........ .
of$tories....,...> ....................................~. .......
...
Iterations or additions: Front ................. Rear ................. .
fight ....... , . .
on: Front ..:.~-O.. , , ~ ~ ~ ' ' ' • • Number of Stories ..................... .
...,..... Rear ... ~4...:..... Depth .. ~?-.........
of Stories .... .......~. ............................ .
,.
....... Rear'':`.. .,'..:~.:... Depth ......................
r
,.u• ....................... Name of Former Owner ............................ .
11. zone or use district in which premises are situated ..............~...................................... .
12. 1) g p ~ ~~ any zoning law, ordinance or regulation : ............................... .
13. tyilI lot be re raded L ................Will excess fill be re oved from premises: Yes No
14. Name of Owner of remises ~~ .l~.i )I!5a,r, ...Address . va, ......Phone No.
...............
Name of Architeoi roc ion vro e Address ............ .... .Phone No............... .
Name of Contractor ~~t r, ~
.........nil .............. Address1370.1z,1 ~aw,.2 .(~ ..Phone No.`16 : ~~~d......
:15. Ts this property located wi~hin 300 feet of a tidal wet~and? *Yes ..... No ~.
*If yes, Southold Town Trust~es Permit maybe reqgu~ired.
- PLOT' DIAGKAM
- Locate clearly and distinctly all byildings, whether existing or proposed, and, indicate al] set-back dimensions from
property lines. Give street and block nu#nber or description according to deed, and show street names and indicate whether
-nterior or corner lot.
'exlSf rv~G
~~o~c,c. r~°~
STATE OF N~E~W~R~~<<,...~~... !~~...~... s
~~OU F .. Dl..r..'.`'.~ S.
t `~ ~ 2~ • ......... being duly sworn, deposes and says that he is the applicant
(Namme of individual signing contract)
-above named.
f salthe .................. .
. ~ Contracto ,agent, corporate officer,~etc.) -
'd owner or owners and is dul ..... .. • , ... • ' .... , . , • . • . • • .. , ...
,~ y 'auth eiform or have performed the said work and to make and file this
,application; that all statements contairjed in this application era true to the best of his knowledge and belief; and that the
vork will be performed in the manner het forth in the application filed therewith.
,worn to before me this ~ of
_.i
............. /.. y .. ~..., 19
~.. ..
dotary Public, ..... ........~ .. ." . County ~
aAtNBLGLBV~ U (Signature,of
Publb, Stets pt NeYV yp~ . ~ ~ . • applicant)
Qualt}Jed In Su9f~oDIkGCpp~n~y ~/~"(~
Cgmryitssion Expires Docembler 8, 7ga "