The URL can be used to link to this page

Home My WebLink About5644-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ,~fest View Dr.ly.e .... Street Map No. ~!.!.~.ol? . . Block No..xx ..... Lot No...X~... .l~..att.i.t..u?.k...~.,.~: ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~.oy 2br. , 19 77. pursuant to which Building Permit No..~.6!:;!~. dated ...... ~';ov.. . .2~+..., 197I., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~-Yat;O. ol~e 2a.~i~y. d..wa.l.l~g .............................. The certificate is issued to .-N!¢h.o~,a. ~..BIXl~;i,e.h.. . .O,.~n~r ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l.~,~ .~1+.. j 973 Vi , a .... UNDERWRITERS CERTIFICATE No. ~ .~.6~.~.? .... ~!a..r .~... ?.9.7.3 .................. HOUSE NUMBER .6.~0 . .. Street !'~.e.s.~v..ig.w..V..r.ly~. ........................ Building InspeCt FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~O33 Date t4areh 11~ , 19 73 THIS CERTIFIES that the building located at Weat~iew ~ive Street Map No. ~ Block No. ~ Lot No.~ Ma~tituck N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... Nov 2i~ .. , 19~ pursuant to which Building Permit No. ~tg+l+Z .. dated .... ~.~., . 2.~... , 19.~.2., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.l~i.~.~te. o~ae. fala~ly. ¢~;¢o~l~t,ng .............................. The certificate is issued to . Nicholas Brn~eh ..... (li~ne~ ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No . .]~ 76337 .. [lOUSE NUMBER ~80. .. Street . Idostv&~lq DI"I.VO. Mar. ah A973 ................ .6..197.3 .......... Butldmg Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N.o (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby gmnt~l to: .......... ~~ ......... lolL~ .......................... at premises located at .... W~il!li~l~..~~ ............................................................................................ ...... .~ ...................................... ~.~.~....~...~.;. .............................................................................. pursuant to application doted ..................... ~Jl~ill~ ......... .~. ................ , 19..~....., and approved by the Building Inspector. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No~. ,-~~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS //- ,0/ Approval to construct said systems is requested,pertinent data herewith: Date .... ~' 1-Applicant ~"'dJ\O/,9~; /~. ~,?P~',C'A PhonZ'~*3~7 6-Sub div Address ?¢,~o)6 7~'~.'~ ~ ~'~,¢~ , ,,: ,. 7-Section . ,.. 2-Detailed p~pe~y, lo~ation ~?~ ~ ~/¢ ~,~~ ~ ~/~ 8-Lot No. 9-Private well? ~ ~ 3-~bltc ~te~ supply name DiStance to nearest ~in ~ 4-Lot Size: Width ~ ft. Length /~ ft. (also enter on center plot plan below:) 5-~elling: Singl~ Family ~ T~ Family? //Cellar? ~plab? ~ ~Crawl S~ce? ~ / 10-Pro~sed system. Septic ~nk ~ ;Precast ~Cesspools / /S~tlow ~ols / /0ther /, / il-Septic ta~ inside dimensions~ yol~e , Gal~.Length ,, ft. Width ft. Liquid depth ft 12-Precast sections: ~/Number~Square ~b. Cesspools: Block sizeL incs.D ins. H ins Total blocks below inlet: ~1 ~2 ~3 .... PLOT PLAN I iff Street The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Se~%ge D~isposi~l Sy~tems~. ~,? Owner or /~uilder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date (10/65 Eevis.) $-i5 Signed 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 duphcate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property w~th accurate location of all buddings, 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. 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 topographic features. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date. · · .4~. ~tk .~ ............ New Building ...~:JX ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No, Street Ham/et Owner or Owners of Property : .~. ~ .~.~. ~ .h~ ...~.~.~- .~5.~ .~.....~.. ~----'~... ................. County Tax Map No. 1000 Section ...~ ~ % ..... Block ..... .~ ........ Lot. 2...~'.. ......... Subdiws~on ................................ Filed Map No .......... Lot No ............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Plam)~'rl~oard Approval ...................... Request for Temporary Certificate ................ /./' ~-- ,Final Certificate. ,~..-~... ~-,~. ~. ..... Fee Submitted $, ~ ................... Construct,on on above described building and perm~ ~t~a~licable co.and regulations. R~ 10-10-78 4 t~,OTE_ E-LEVAT~ON.~ 51.,'.~'~,'M~ A~ E BASEL- Oh Alt A5 $ Ui2.V EYE i) NOV: 3, t971 · ' ~ L'~ ..~,..,'~ N TITLE NO. $-$95645 COUNTY HEALTH DEPART/~EN~ ~ ~hicf of General Engineering Services , ~verett YOUNG & YOUNG. 40O O$?RAN~ER TOWN OF SOUTHOLD BUILDING D E PA RTM ENT '~'~'~' z.. TOWN CLERK'S S~TH~D, N. Approved " " 19..'.' ..... Pemit No .......5Ex44.. ~1. ............... Application No ....... ,~.C~ .~.{ ................ ....................................................................................................................... .~/k¢-.~-~ I~'"~ .,c'~' , ~ (Building Insp~tor) ~ ~ , .... [ }~.__~ I ~]' AFFLICkTION FOR JUlL~IN~ ~IR~I Date .............................. , ...... ~. a. ~s a~lication must be completely filled in by ~ewr,ter' or in link and submitted ..... m duplicate to the Buddm Inspector. b. Plot plan showing I~ation of lot and of buildings ~ premises, relationship to adjoining premis~ or public stree~ or areas, and giving a detailed description of layout ofpr~e~ must be drawn on the diagram which is ~rt of this applicati~t c. ~e work c~er~ by th~ a~lication may n~ be commenc~ before issuance of Building Permit. d. Upon approval of this application, ~e Building Inspector wJJl issue a Building Permit to the appli~. ~h permit shall be kept ~ the premises available for insp~tion ~roughout the p~ress of the work. e. No building shall be ~cupied or u~d in whole or in pa~ for any pu~ whatever until a Ce~ifica~ of ~cu~ncy shall have been granted by the Building Insp~tor. APPLICATION IS HEREBY ~DE to the Building Depadment for the issuance of a Building Pe~it pu~uant to the Buildi~ Zone Ordinance of the Town of ~uthold, Suffolk C°un~, New York, and other applicable ~, O~i~nces or R~ulations, for t~e construction of buildings, additi~s or alterations, or for ~moval or demoliti~, as heroin de~ribed. The applicant agrees to comply with all applicable la~, ordinances~ilding c~e, housing c~e, a~ ~ul~i~s. .......................... / (~ddmss of&pplicant) - State whether .,,~,~'icant is OW/l~/.~,..I' r _e~ss,~/agen~_~rchitect, engineer, general contractor, electrician, plumber or builder. .................... 7"Z ' ~../..~4~ "~]~'~ ...................................................................... Nome of ov~l~er of premises ..... ~.~..~.~.m~.~._~ .............................................................................. If a~ant ~ co~mt~ si~n~re~, duly au,~ o~i~r. .. .... _ ......... ........ ............. ~e-~y ,. ~t,on o,,~.~ o. w,,~,,.~~, ~%~, .o., .................. ~;~.~ ~ ........................ Street and Number ............ ~.~r..~x.~..~.T.::..~ ............................. ~.,.~ .... . ~p J Municipali~ ' / ............ 2. State existing use and ~cu~ancy o( premis~ and intended use an~ ~cu~ncy of p~ed c~str~ti~: a. ~is[ting use a~ ~cupancy .............. ~ .................... : ....................................................................... b. Intended us* ~nd ~cu~ncy ........................................................ 3. Nature of work (check which applicable): New Building ................................... Alteration ................ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..~..~; 6~0 /4/~_/#t)~.~.~..' ~,fu~ Fee .~, (to be paid on filing this application) 5. If dwelling, number of dwelling 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 ....Zi ..................... 7. Dimensions o,f existing structures, if any: Front ......... ~ ....... Rear ................................ Depth .................... Height ....... ~ ................ Number of Stories. ............~...~.".~ ........ ~.~ ...... ~....~ ................ ~ii .................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Dimensions of en ire new construction' Front .~....-~.../~/'- . Rear ~...~..,~7-- D__tL '~ ~,~';~7 . ................................................. n .............. Height ../...w...~,.Z ..... Number of Stories ...... .~..~ .................................................................................................... 9. Date of Purchase .......... /.~...~.~.....7..~.'~ ................... '"' '""'"' '"'"'"""~ '' ~ ~ ' '"'Name'°f' Former'Owner'"~~.~~ Size of lot: Front ....... ~..~..,~.- ........ Rear ......... ~....~..O ..... Depth /'J -' ' 10. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zo~ngJaw, o~in~nce or ~.e~u~at. jon? ............. .._...~ ................. ., .... 13. Name of Owner of premises ......... ~....~..~...~.....?...~. ....... '~~'~~o. ~.~-..~.~...~..2 Architect ......... ,~ ............ ,,~ ......... ,:1 ............. Address ..................... ~.~ .................. Phone No ................. Name of Contractor ..~ ........ Address ....... Phone No~6,~.~.~./~'~, PLOT DIAGRAM Locate clearly, and distinctly all 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 comer lot. 3H ITY4 ~4~//'~,F6/.¢7' STATE OF NEW YORK, t ~ ¢ COUNTY OF ..S.U~,O~. ............. $~'~ ............. ~,t~h~.a~..A~..,B~:~s,~cl~ ..................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ...... c.o~.t:~&c:E.Qr....(~g'e.~...~/.C..5~o.~l..~e.~,-le...Tnc ........................................................ · ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and Js duly a~thorized to perform or have performed the said work and to make and file this application; that all statements contoined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this /'~ /9 ,-,,// ~ ~ 2.4. t..h. ~_ · November ,o 71 ~//_ // ~ ')f/ /-'~ . ~ >'/ .......... ~y Or ........... ~ ........... . , ,~ ............ ..... - ........ ....... ................... Notary Public,(--~.~,:~~. County of Suffolk (Signatu~ of applicant) ELIZAI~[TH ANN N£~ILLE ... ~