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Home My WebLink About6226-zFORM NO. 4 TOWN OF SOUTI~OLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No .... Z~678. · · Date .......... December.. ·. k,..., 19..73 THIS CERTIFIES that the building located at .. 'Wes'tvie~ .Drive ........ Street Map No... Mason .... Block No...x~c ..... Lot No...xx ..... Mattituck.. N.,¥. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ No~ .... 6, 19.72. pursuant to which Building Permit No... 62.26Z dated ............ No~ .... 6., 19. '7.2, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... P. rivate, one. family, dwell ir~ .................................... The certificate is issued to .Wa.l.ter. R, · $i3,1eck. ......... 0wne.r. ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Heaith Approval .. Oct...1.9 .. 1.9.7.3.. h~r. R,..~fllla .. UNDERWRITERS CERTIFICATE No... N..$~00~ ...... No.w... 29. · · 197.~ .......... HOUSE NUMBER . [. 200~ ...... Street .... Wes.tview -Dr ......................... Building Inspector FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK ^UTHORIZED) N? 6226 Z Dote ........................ ~ll:~e~b~,~.....6 ...., 19...72 Permission is hereby granted to: ........... ~....z.,.~,e.~...~.~?.~ ................................... .................. ~.~..3~ ............................................. ............. ...~....t.~.~ ............................................. to~.Z..~....a..e.~..~...~...a~..~.~.Z..~;t.~ ....................................................................................... at premises located at .......... ..W./...S....W..estview Dr. iy..e. ......................................... ................................................. ~t.~i.~uok....~,~.o ............................................................................ pursuont to opplicotion dated .......................]~¢~.e..6 .................. , 19..~.2.., and opproved by the Building Inspector. FeeS..~"~ .......... Building Inspect~ FORM NO. 6 TOWN OF $OUTHOLD Building DelMr~ment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with ithe following; for new buildings or new use: h ~inal survey/of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Deptl) of water supply and sewerage disp~al--(S-9 form or equal). 3. Approval of electrical installation frorr~ Board of Fire Underwriters. ~,/ /~4. Commercial buildings, Industrial buildings; Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. ,v ' 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey aT property 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 in- formation required to prepare a certificate. C. 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 .D..e..9..e..m.. g..e..~ .. ~.. ,.....1.~ ?...~. .......... New Building ..~e~. .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .'~..~.~.~,~.~. ~..~,ff.~ .~.~..~.~.~..~..,...~.~.~ ~.~ 1~.~.~ .............................. Owner Or Owners Of Property ........... W~,]..~e~,.....~,..RiZ.l.e~.k ................................................................. Subdivision Browers Woods Lot No - Block No. ' House No 2005 Permit No......._..........._/~.-~-~?z (P7- Date Of Permit .............. Applicant .~J~,~..~.~'.....~,,...~.~.~ ...................... Health Dept. Approval ..S~L..~.~.~.C~ ......................... Labor Dept. Approval ..... ..~...L.~_ ...................... Underwriters Approval ...~.~..~...2.~..~. .............................. Planning Board Approval ............... ~ ................... Request For Temporary Certificate ........................................ Final Certificate ...[ .................................... Fee Submitted $ ~o00 Construction on above described building and d~mit ,meets a~pli/~a, ble,, ,, codes and regulations. Sworn to before me this j,,-'~//~c~ ~ d yo .... ............ /' ..... ..y. ...... o Notary PuNic ... , , , ......... County (stamp or seal) ,.,~,.~"~ 7 oC''' SUPPOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference APPLICAT~ION POR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL 2. Property location ~r~,e~ ~"~ 9. SYSTEM Section Lot No. Private well Public water ~f~O~_V~D_) .. ¥illage , ~i Township ~o~&~ Distance to main ~ 3. Public Water Company name~/~ ~~ '(Enter on center plot below) 4. Lot size: Width/O_~--~-feet Leugth_~feet - 10. Sewage Disposal System: Block . N A. 900 gallon septic tank: Precast Equivalent B. Leaching pools: Number Precast~Block Special .. Street The undersigned ;ERTIFIES: be in accordance with the Suffolk ards thereto." Date If private well fill in ' ~-'"~ below: Tank capacity ~AGals Pump G.P.H. ~gO Total well depth~ Depth to G.W. ~o Amount of water Test Hole .S~e Data Peet 0 -- 2 4 10 12 14 16 "Construction of authorized installations wil County Department of Health's current Stand" -FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, is the opinion of the Health Department, that an adequate and satisfactory Se~ Disp°sal System can be installed °n this Pl~' ~ S-15 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~aUREAU OF ELECTRICITY ~ OS 85 JOHN STREET, NEW YORK, HEW YORK 10038 .,.re :;ovem~e~ .~. ~ovs ~..,,~.,,o.~..o.,,,~ ~,,~ m 130045 THIS CE~IFIES THAT "' ' ' * only t~ el~tdc~ equipment ~ ~scd~ ~ a~ int~u~ by t~ applier ~m~ on the ab~ ~pl~at~n numar in t~ p~m~es of Walter ]?. Silleck, We~t View Dr,, Acroes I~n ~rid~e to Brower Woods i,~h~o,o~' Mattltu~L.!, ~trt. ~Z.drt. outside w~ examined on Nover~er ~9, 297~ andfou~tobeincompliancewiththerequirementsofthisB~rd. FIXTURE [ECEETACLE [ W T I FIXTURES DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS A~T. K,W. OIL H,P, GAS H.P. A~T. NO. A. W, G, RANGES SPECIAL REt'PT. 1 SERVICE DISCONNECT I NO. OF I S E R ti ~0 COOKINO DECKS I OVENS [DISH WASHERS *'aT, K.W. J ~',n. ~,W. j, MT. K.W. 1 ?.lJ1 ~.6j ~ 1.5 TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET AMT. A,',,ips. TRANS, ~ SYSTEMS NO. OF FEET OTHER APPARATUS: Motor/s; 1-1bp 1-oost li~t V I C E NO, OF HI-LEG OF HI-LEG EXHAUST FANS DIMMERS NO. OF TRALS OF NEUTRAL 2/'q 1-4.Owatts, 2-21~qwatts, 3-1.25watts, 2-7.5#arts, 4-.5watts, 3-1.0watts B.J..Electric Co. Stil 1water Ave. Cut chogue, L.I. 11935 GENERAL MANAGER Per 11 ~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BUILDING DEPARTMENT Y'.. ~ ~ ~ ~;~ ~ : ~';/}') *PPMCATION FOR BUILDIH, FERMIT ~ ~ ' a. This ~oplieation mu~ ~ com~letel~ fill~d in b~ t~r or in ~ and submitted in tr~l~te to the Buildin~ Inmector ~ ~ns, accurate plot plan to scale Fee accord n to schedu e ''~< ' ' c ~% - giving a al.tailed description of la,out of pro~rW ~ust be drawn on diagram which i~ pa~ of thi~ application. c. Th. work cowr.d by thi~ application ma~ not ~ com~en~d befor~ issuance of Building Permit. ~ U~n ~pproval of thi~ application, the Buildin~ Inspector will issue a Buildin~ Permit to the applicant· Such ~rmit shall be kept~ ~remi~s availabl, for in~ction throughout the work. ,. No buildin~ sh~ll ~ occupi~d or used in whole ~r in ~art for an~ purpo~ what~wr until a Certificat~ of Occupanc~ ~hall haw grant~ b~ the Building Ins~ctor. APPLICATION IS HEREBY ~ADE to the Buildin~ D~part~nt f~r the issuan~ of a Building Permit pursuant to th, Building Zone Ordinanc~ of th~ Town of S~uthol~S~ffoik CounW, New York, and other applicable Laws, Ordinances or Re~ulations, f~r the construction of building% addition~ or alterations, or for r. mowl or d~molition, as h~rein described. The applicant a~re~s to compl~ with all applicable laws, ordinances, building code, housin~ code, and regulations, and to admit authorized inspectors on premises and in buildings for ne~ssar~ (Signature of applicant, or name, if a corporation) 2 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; .............................................................. .................................................................................................................. Name of owner of premises ............. :...,....-. ............................................................. If applicant is a corporate, signature of duly authorized officer, Ill&, .......... ..................... · v 1. Location of land on which proposed~work will be done. Map No.://.C~J~. ..... Lot No. ,,.BJ~--~'I~II~,,,~,;.~.!.~ ............ Street and Numar ..~.~; ~.....~:~2..~.[~.~.....,~.~......~.~..~.{.2(.(.~.[~.,.;.:.:,:;~.. ~ 0 0 b~ MunicipaliW 2. State exi~ing u~ and occupanc~ of pre~s and intended use and occupancy of propo~d construction: a. fix~m~ u~ and ~eu~anc~ ........................... ~[0.~ .......................................................................................... b. Intended use and occupancy ............. ,Nature, of work (check which applicable): New Building ..... ..Z. ............... Addition ..................... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) Estimated Cost ........................ Fee ................ ;;..~ ............. .~ ...... {to be paid on filing this application) If dwelling, number of dwelling units ...... ~ ........ Number of dwelling units on each floor ....... ;~;....{~.~. ............... f,,~r~,~ ,~.,-~h~r,~,-~r, Fart off he~.se ~ ~ ~ , .(1 cai') ~' If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... ..~..~.a...~.?...~. ........... Dimensions of existing structures, if any: Front ...J.~.~ ....... Rear ........ ~..~.~.~.~ ........ Depth ......~.~ ..................... Height ....................... .~....~..~..&..~ ....................... Number of Stories .................... ~ .................................................... Dimensions of same structure with alterations or additions: Front ........ ..~..?..~..~.. ....... Rear ......................................... Depth ............................................. Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front .....~...~.. .............. Rear ........ .~..~. ............. Depth ....~1: ...................... Height .....~..b..~.. ...... .~ .~.~....~.~..~ ............... Number of Stor,es ............... ;~ ...................................................................... 9. Size of lot: Front .......~...~......~..~.~.~....L,... ~ " '~ ~ . ........ .................. Rear .......... ,~. ......................... Depth Height ............... .~..~.~..../. ......................... Number of Stories .................... ~.~;~ ....................................................... 10. Date of Purchase ... ~...?~Z~ ........ Name of Former Owner.;[-~.~&:~/.~;['l 31'~ r .................... 1 1. Zone or use district in which premises are situated ..]F~II~.~.~,../..~B.s;[J~I:~I.]L.~..~..,.~: ......... ~.Y..,.; .................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... [..~..~. ......................................... 13. Will lot be regraded -____.~_ J ........................... Wfll excess fill be removed from premises: [ ] Yes ~] No 14. Name of Owner of remlseS ~..~....~,..~3~1~ ...... ~ ......~l.~......l~&~,l~--~¢.~..;~'~..~o~,~~. ~ ............. P (Address) - (Phone No.) ~Cl8- Name of Architect N..~...e. (~.e..].~') .......................... ..l{:.~¢~... (Address) (Phone No.) Name of Contractor ..~....~.....,~..~..~ .~.....[~...~1.~.~) ......................................... ~'~'~.~..,;.[..;; ............................. (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE,OF NEW YORK, ~'~ .~, - ) COUNTY OF :.......~".~.....~....~..'...{..[~ ........... ) ~5' .. ~/~'-'~'"' '~' /~ ~'~'~"~ being duly sworn, deposes and says that he is the applicant above named. {Name of individual signing contract} {Contractor, agent, corporate offtcer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained 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. ?,,d '~ Ioo ~ WALTER R. SILLECK p. O. BOX 3'0 /~ATT, iTUCK, NEW y&l~K 11~£2 : ~f'O ~L 0