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Home My WebLink About8240-zFO]~,~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. ~6965 ...... Date ............... .Ap.r.i, .l...6.,.., 19..7.6 THIS CERTIFIES that the building located at .. We.st;vie.w .l)r~ve ......... Street Map No. :~,~ ........ Block No ..... xx .... Lot No, . ,XZ:..l~la.t.titl~k.. N.,.~, ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~c.t...1.3., 19..~ pursuant to which Building Permit No...8.~.h:.0..Z. dated .......... ,0.Cj4.. }!~ .... , 19.7.~,, 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 . ~ri,v.a,t~. Pn~.. f~.~!~lY. ~.~.~.l.i,n,g ...................................... The certificate is issued to ,..~r...P. a2¢.~!di ..... ~!~ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval A~ril..6 .]9F.6.. by. .~,. ~.:}.llm ..... UNDERWRITERS CERTIFICATE No.N2~5~8~ ..... l~h~l~ · · ~... J 9.~,6 ................ HOUSE NUMBER ..... ~.8P-5- ....Street ...We~vl~w .D~,l.~e ...................... Building Inspector ~ FOENI NO. ~ TOWN OF SO~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SoUTHOLD, N.. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8240 Z Permission is hereby granted to: .... ~.....!k:!:...: ......... C~.:~.C~..L..¢.Z ................. at premises located at ......................... .~./t~5'~ v'f I~, l,,~,,, ........ ~.,k/,~.~ ..................................... 1~ -'~ i--I, qT.I -i L, C l% . pursuant to application dated ................................... ~ ....... (,,~..., 1~.2.~...., and approved by the Building Inspector. ......... Building Inspector THE dl ,:~o~e March 31~, THIS CERTIFIIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC.,ITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO3B 1976 ~p.u¢-"o- No, o-/U~835752 N 276486 otdy g ~hes~electrical equipment as described &vlow and introduced by t~ appl~eanz ~amed on the ab~e application number in the premises of ~Guy Pancald~s Westview Drive Woodcllff & Brower Road, Ma~tituck, L.I. ~ ~%o~*~io,~; ~ ~em~n~ ~ ~t vt. ~ 2~ r~. outs i de ~a~ia~ March 29, 1975 attd found to be in compliance ~ith tl~e requlrements of this Board. ~ ~I~ ; '.,~ ~ ~ ' ] RXTURES RANGES {COOZI~GO~S OVENS ~01SHWASHERS ~HAUST~ Mot~r/s: 1~l/2hp I GFI Gustan Bartra 227E. Breakwater Rd. Mattituck~ L,I, 11952 LIC# EI529 ~r ~A~.~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by ~ir credentials. FOI~ NO. 6 TOWN OF SOUTHOLD , Building Deportment 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 DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, 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 installations, 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey.of 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 formation required to prepare o certificate. C, Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existir~j dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New B~ddmg ..,~.... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..~..I~-,,C.'~.....~/.~-~...~ ....... ~.~x. ................. ~'1.~.7~..!..~,..~...,C.~. ................................... Owner Or Owners Of Property .C-~..?...~,...~.....~.~.(~,.../~../~/,~.. ......... ./?..~., .(~...~...~.,~..,.~..~ ...................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No, .~,..~.~....,~... Date Of Permit ...Z..~.,.,/,./.~,,Applicant ..~..~.4~,.~.Z~., .~."~.. ....... ~,,,~,, ,~../~=,,..,~,,.~ .......... Health Dept. Approval ............................................ Labor Dept. ApproVal ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate / Fee Submitted $ ...,~,¢; ............................. Construction on above described building and per~ ~m~r~]ll app~l~/~/~ and regulations. Applicant ............ .~c...,~_.~ ........ ~¢...~..~ .~¢...~ ,..~e. ...................................... Sworn to before me this ............ 'day of ...... (stamp or seal) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY l. Applicant~,,~oA~E ~J£z~,x~ ~ Phone?~/-5'oFo 5. Subdiv. Address ~-c} Cb~ ~/~ -6. Section · 2. Proper~ty Location~57 v~,z~'~v Oe~-~ '----7, Lot Number Village~V~A?~. ~Tp. You T'm mz~ 3. Public W~Company N~ 4, Lot size: Width_~ feet Length /~'~, fee{ Sewage Disposal System: A. 9~~gallon septic tank: .~recas~'~_~Equivalent ~B' Leaclhing pools: ~ Numar, of pools ]precast~'~Block 10. 11. 8. Private Well ~. Public Water ~tance to main (For Health Services Dept, Us~e) Block / ~_Special ~If pr~v~e well, fill in the fol- ,lowing b'Tanks: A. Tank ~apacity ~/c~- gallons B. Pump G.P,M. ..~ £. Total well depth D. Depth to ground water E. Amount of water in well70~- The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' current standards thereto." This application will be valid for one year from the date of approval indicated below and may be renewed ~f a current local Building Department Permit is in effect. FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presented here- ~i{h, it is the opinion of the Department of Health,Services that an ad~e_quate and satis- factory Sewage Disposal System and Water Supply can be installed~on t~ plot. S-15 Rev. 4/1/73 · TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined ........................ :..~ ........... 19 ........ Approved ........................................ , 19 ........ Permit No .................... : ................ Disapproved a/c ............................................................................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote ............. ~..~.e ......... 19.."[~'....~\ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate 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 o~ areas, and giving a detailed description of layout ofpr°Perty must be drawn on the diagram which is part of this application. ~ 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 issue a Building Permit to me appli~rmit shall be kept on the premises available for inspection throughout the work. f~---- e. No building shall be occupied or used in whole or ir,~oa~L~y~p[~-pose whatever until o Certificate of Occupancy.. shall hove been granted by the Building Inspector. 1~ APPLICATION IS HEREBY MADE to the Building Deportment 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 oil applicable laws, ordinances, building code, housing cede, and regulations, anti to admit authorized inspectors on premises and in buildings for necessary inspections. _~. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ~. ......... (Nor~ and title of co~o~r?te officer) Builder's License No .......... .1...~).....1~. ............................ Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ......... ~'.'~...~ ................. Lot No ......................... Street and Number ..... ~..~...~.. ................................ ...~....~.~?~1~ ~ ~ dram. ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......................................................................................... ~ ...................................... b. Intended use and occupancy ..................... ~ ................................ ............................................... 3. Nature of work (check which applicable): New Building . .X ............ Addition ................Alteration ........... Repair .................. Removal .................Demolition .................... Other Work ................................................ (Description) 4. Estimated ~ost ...~.e~e~,~)O ................................ Fee ..................................................................................... (to be paid on filing this application) $. If dwelling, number of dwelling units ...... 1 ................... Number of dwelling units on each floor ..... If garage, number of cars ................ 1 .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....................... 7. Dimensions of existing structures, if any: Front ............................ 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 ............. ~i~..~i~! ...... Rear ...... ~....~.?..... Depth ...~...: ........... Height .................... Number of Stories ................ ,1, .................................................................................................. 9. Size of lot: Front ................................... .~L~,,O! ......... Rear ........ ~.,~! .................... Depth ....~1,~1~ ............. 10. Date of Purchase ........................................................ Name of Former Owner .~llll~l~ll~.~lllll~..~l~l~i~l~...... 11. Zone or use district in which premises are situated ........ · .......................................................................................... 12. Does proposed construction violate any zomng law, ordinance or regulation: ........................................................ 13.' 'Will lot,be regraded ............................ Will excess fill be removed from premises: ( ) Yes (.)N~ -' 14. Name of Owner of premises ..Ql~'..~ .............. ; ...... Address B4b~.....~.. Phone N~, ........... "...,~:~... Name of Architect ............................................................. Address ~ll,~e ~ Phone Ne. .... . · Name of Contractor ..gelall~.dl~8~ ...... Address ~.LIIIII~ Phone No ....................... PLOT DIAGRAM Locate clearly, and distinctly all buildings, whether exi,tinn~ , or ~nronosed~ , and indicate all set-_~ar, k dimensions from property hnes. G~ve street and block number or descr ption according to deed and/,show~et names and indicate whether interior or corner lot. ~ / Sworn to before me this "?"?"~"'?[~Z'" day of ............................................ , 19 ........ Notary Public, . ................................................... Coun~ MURIEL BI~SN NOTARY PUBLIC, State of New York No. $2-~$22026 - SuffoZk County Gomm~s~on Explre~ March 30, 19 ...... .,~ ~ '~ (Signature of appl/i/~/en, t) ~ · He is the ................................................................................................................... ,, ............................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly afJth~'Z~to perform or-heat.s, meal 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. STATE OF NEW Y~)RK, COUNTY OF '"~'""~z'"""~";-~ ....... ........................................................... ,., ................................ being duly sworn, deposes ond says tl~3t he is the opplicon (Nome of Individue~ above named. 0 SUFFOLK COUNTY F~ALTH 'DEPARTMENT J~ S. 78'4Z'.40' W 171.0 t/~-M M~-DV The sewage d~.sposal and &rater supply nfaCilitle~ for ~hls lo~tion have been spec%~bi~ departzen% and ~ound be sa%i c . 7 Chief of Gene~al ~~~ D TO~ o~ ~ooT~oLo, ~.Y. $CAL~: 50'=1" ~ = ~401dUIvtGI, JT