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Home My WebLink About13919-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 13426 Date Nay .9. 198.~ THIS CERTIFIES that the building ... ,g..c .c9.~.8. 9.~Y. ................................. Location of Property 2005 WESTVIEW DRIVE MATTITUCK County Tax Map No. 1000 Section . .1. .0.7 ....... Block ...7. ........... Lot ...4. ............. Subdivision .... .B .R .O.~. E. .R .S..~.0..Op.S ............ Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ... g.~ v. ¢ b..Z Q ........ ,193.5.. pursuant to which Building Permit No....1.3.9.1. .9 .Z ............ dated .... .M.a.y....7 .................. 19 .8.5., 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 ......... Accessory building in rear yard. The certificate is issued to WALTER R. SILLECK ..................... i .................... of the aforesaid building. Suffolk County Department of Health Approval ........... .N./.A. ........................... UNDERWRITERS CERTIFICATE NO ................... .~./.A. ........................... Building Inspector Rev. 1/81 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) Permission is hereby granted to: .~.o..o..~ ~...~...~ - '-~ ' · at premises Iocoted at ............................................................................................................................ County Tax Map No. 1000 Section ..... !...?....--].. ....... Block ...... ...~. ........... Lot No ......... ~. ............ pursuant to application dated .........~..~...~?......~.....~. .............. , 19..~..~.~, and approved by the Building Inspector. Rev. 6/30/80 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 duplicate to the Building Inspec- tor 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 featu res. 2. Finat 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ............. Old or Pre-existing Building $15.00 ..... ..... ............ Vacant Land ............. Location of Property .~. ...................................... House No. Street Hamlet Owner or Owners of Property ..................... .~ ................... County Tax Map No. 1000 Section ...... LO.? ..... Block ....~; ..... Lot .... ~,. ......... Subdivision, $.~,~0T~E'. ~'.., ,~.. ,~. ¢~.~ ........... Filed Map No ........... Lot No .............. Permit No. ~PT.~,/, ,~..~-?. Date of Permit ~/7/.~, .~.,, .Applicant ~/~,~.z~,, .Z~,,..~./. ~, ,~.~..~,.... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ,,,,~ ................ Request for Temporary Certificate ..................... Final Certificate ....................... J/ Fee Submitted $ ............................. Construction on above described building and perm/it meets all apph'c~ble cod~ and regulations. Applicant :z-/S'/Sg ~IEL~ INS[~ECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INsuLATION ?ER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS 'FORM NO. 1 TOWN OF SOUTHOLD BU I LDING DEPARTMENT TOWN HALL · ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 :.~ ..... .~ .... Examined . · .~ .~ ... Approved · .~ .... 19~.(. Permit No. !.~.~..13..~.. Disapproved a/c ..................................... (BuiEFmg Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ~r a~eas, 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 hail 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ['he applicant agrees to comply with all applicable laws, ordinances, building c~ode, housing code,~nd regulations, and to tdmit authorized inspectors on premises and in building for necessary in~~~ (Signature ~ name, if a corporation) (Mailing address of applicant) ~fi.~j ~essee, agent, architect, enDneer, general contractor, electrician, plumber or builder. State whether applicant Name of owner of premises .................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ....... ?. ...... House Number Street Hamlet County Tax M~N~. 1,0~0.0 Section .................. Block...~.~. O. ......... Lot ..... ~ ........... Subdivision .~......~.......~J..~ ............ Filed Map No ............... Lot ............... (Name) State existing use and occupancy of pre~e (and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... /. ~'~...~..'f~' · ...... :. · .~--~..-. .................... use and occupancy ..... ./.~ &~ . w-~e,e~/.' .............. ~'/~ ~r.~,~V2~.~.e. ............ b. Intended o 10. 11. 12. 13. 14. Repair .............. Removal' - '-J ....... Demolition ............ ._ Other Work ............... Estimated Cost ........... , ................. Fee .................................... : *" (to be paid on filing this application) If dwelling, number of dwelling units ............. Number of dwelling units on each floor ........... If garage, number of cars If business, commercial or mix6d occupancy, specify nature and extent of each type of use .................... Dimensions of ex!stin~es,~- -~'"~ if any: Front .... /.~., .~ .... Rear .../..~.:~ ..... Depth ...~.,~ ...... Height ..... ._,~_-~...... Number of Stories .... ~ .................................. 'd ....... Dimensions-ol"~ame stmc~r--e-with alterations or additions: Front ...... ?. ~..,..~.... Rear .../. ~ Depth .... . .~,,~~ ....... Height ........ ~. ............ Number of Stories ....... ~ ......... Dimensions'~e~ire new construction: Front ...L .~..~ ..... Rear../..~. ,.~. ...... Depth .x'. 2e ......... Height ............ ~F ~-~'mv. .~.. Number of Stories ...~ ............................................... Size of lot: Front .......... ; ............ Rear ...................... Depth,. ...... Date of Purchase /.~. ....... i ................... Nan3e of Former Owner f,~,qf.~--~6,'~.. .. Zone or use district in which p~emises are situated ..... /..~.~f. f. ~. ~ ...... Does proposed construction violgte any zoning law, ordinance or regulation: .. ~ .~ ......................... Will lot be regraded ...... .J~..Q ................. Will excess fill be removed from premises: Yes Name of Owner of premises . .r4)~A...~..~.. ~ff/~..c~.% Addresso?~..O&'~'~.f~/~./..q~4.. Phone mo.~?~'..~. ~7'. ~. Name of Architect ......... ~ .................. Address ................... Phone No ................ Name of Contractor ... Address Phone No 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. STATE OF NEW~ORK COUNTY OF...O?. 7~.'~../.~..... S.S .... .~. ~..~:../~../~/~ ..... ~, ./-r.. ~..~...~7..'~.q'~. ......being duly sworn, deposes and says that he is the applicant (Name of individual si~ aing contract) above named. He is the... ~ c_~ .,~. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~fly authorized to perform or have performed the said work and to make and file this application; that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manfier set forth in the application filed therewith. Sworn to before me this ............ ~...~..~ ..... day if..,~.. · .'~. · .~. · .. , 19.~. No, 4707878, Suiiqlk lehn Exp~ es garcl~ '4 19~7