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Home My WebLink About4115-ZFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31734 Date: 08/07/06 THIS CERTIFIES that the building DWELLING Location of Property: 945 WESTWOOD LANE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 2 Lot 6 Sutxiivislon Filed Map NO. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in th/s office dated OCTOBER 31, 1968 pursuant to which Building Permit No. 4115-Z dated NOVEMBER 4, 1968 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 ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE. The certificate is issued to TERRY BUBB GONZALES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPART~ENT OF H]~ALTH APPRO~r;kL ROBERT VILLA EI~-£KICAL C~K'rIFICATE NO. N/A PLUMBERS CERTIFICATION DA'r~ N/A os/o /69 ~/h/ize~Signature Rev. 1/81 FORM 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 AUTHORIZED) NV ~115 Z Permission is hereby granted to: at premises located at ...... ~v~.....~.~....~.~ll.t,~*J~..~l~,~J~ .............................................................. ............................ Ife,~ee~..Le r ....ll~eenpe~ ........... II,~, ....................................................... pursuant to application dated ................................. 1~0$,.....~e, .......... , 19..~, and approved by the Building Inspector. Fee $.l~e,O~. ........... ~B 'Id' g I sp ct . .......... ............. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accesso~ building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: I~ (check one) LocationofProperty: q~q~ {X)e_~,'~.t.~OOC~ LO,_~. ~ GU6.~r~,~o~'~' ~obt-'dc~e~/(~ House No. Street [ Hamlet Owner or Owners of Property: IC.U'F7 Co r3'K.~.,\ e ~_., Suffolk County Tax Map No 1000, Section ~) '~ ~_~ Block O O O _c'~_ Lot Subdivision ~_,T~ ~ ~ ~ ~rhc)r ~ Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~,5~g) ~ Final Certificate: W~ (check one) - ^ppl, $ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~JLATION [ ] FRAMING / STRAPPING [ ,~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REM~~) DATE ~~ INSPECTOR~~~ FOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificnte Of'fOccupnncy No.. Z. 3472 .... Date .......... 1~, ..... 8o ....... , 1~9.. THIS CERTIFIES that the building located at #Jet. WOOd. Lm~e .......... Street Map No. IBae~:ez~... Block No ........... Lot No. 72...Greenpor.t:, .lime .Yoz~ .... Shores conforms substantially to the Application for Building Permit heretofore filed in this office dated .... O~.tOber...$1° .... , 1961~. pursuant to which Building Permit No.. 41.1~. I[. dated .... No~.embez....4, .... , 19.68., 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 . l~rivate, one. family..d~ell~ng ...................................... The certificate is issued to . Rtchar.cl .(Sonzales .................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . M~F. 6.°..19~9o. l~Ol~er~, .~11~ .... ::. .... \ Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ,,ldg. ,er.it .o: ¥/15'P / TO WHOM at IT MAY CONCERN: The sewage disposal facilities for a structure (Give deed location) [ located have been inspected by this department and found to be satisfactory. Distriot Engineer ' District Engineer S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date !~ ~/ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location)' ] have been inspected by this department and ~ound to be satisfactory. District Engineer Disapproved o/c (Bu~l APPLICATION FOR BUILDING PERMI'I' Date ......... Q.~....'.....3./.. .................. ; ......... , , 9..~.~'... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. P at p an show ng location of lot and of buildings on premises relationship to adjoining premises or public streets or areas, and giving a de~ailed descr pt on of ayout of property must be drown on the diogrom which is port of this opplicotlon. 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 the appii~:ant. Such permit shall be k. ept on the premises ayailable for inspection througEout the progress of the work`. e. No building shall be occupied or used in whole or in part for any purpose whateyer until a Certificate of Occupancy shall hove been granted by the Buildin. g Inspector. APPLICAT ON S 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 demol t on, as here n described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of~pplicant, or name, if a corporation) State whether applicant is owner, lessee, agent, arc~hitec~, ~n/~ineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~ ........... ~ ............ .8/~~ ........................... i ................................................ If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be done. Map No.: ........... Lot No.: ......~......~T.. .......... 2, State existing use and occupancy of premises and intended use and occupancy of propOsed constrUction: Existing use and occupancy. ............................................. ~ ~.~...~.~,..~ .................................................................. . . . Intended use and occupancy ............................................ ~ ......................................-..... .................... 3. Nature of work (check which applicable): New Building .... . ...~.... ..... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition....: .......... ~.. Other Work (Describe) ........................................ 4. Estimated Cost .............. ~.~....~....,~. ....................... 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 ............................ 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 ..~,..'..~. ..................... Rear ...... .~'~.Z~. ........... Depth Height ....... ..~....~'. ...... Number of Stories ./../~.~.. ........................ 9. Size of lot: Front .......... .~...Z:.~.. ......... Rear ............ ./..~..5~...j~ .......... Depth ....... ./.~-d. .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] ]. Zone or use district in which premises are situated ....................... ~ ...... . ............ 12. F~.~ ~' la~.,, or regulation? . Does proposed construction vlo ,.,ny zo,,ng ordinance 13. NameName olaf ContractorArchitect .................... ....~.....~ ................. ~ ............ AddressAddress .....................,~',:~,~.~a 2 ................... ~ 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 corner lot. STATE OF NEW YORK, ! c c COUNTY OF ............................... .J'X'~' ....................... ~ ...... ~'/']/)~ being duly sworn, d oses and sa s that he is the a licant (N~'r~;-~;~'~'c~vidual signing ~l~'l~ii'~;~i;~i ................. ~, cl~ y pp above named. He is the .................................................................... ~ .................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicat on; that all statements contc~ined 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,,, , ~ .......... .¢.. .......... . ............ .o.o -- - ............................. ~0.T.ARY.?~B~.Lf~C., State of No. 5Z- .,--(;ii ~0, ~,9~,..Ho. 52-0618].00 Suffolk Count~ .~ommission Expires m., P, ommission Expires March 30,