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Home My WebLink About3467-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEI~K'S OFFICE SOUTHOLD, N. Y. CIEI~TIFICATE nF OOr. UF=ANC¥ No. ~.28~,8 .... Date ............... &t~... ~l,...., 19 67- ~IS CERTIFIES that the building located at II,/B. l~®p. Hole. D~i~I .... Street ep Ro~.e Creek Map No ........... Block No ............. Lot No. 3e .. ¥,att~ttlekI. l~.¥. .......... con£orms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~pFil . .11., 19.67. pursuant to which Building Permit No.~?. Z. dated ............ ~la~... ~ ..., 1§.~.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 .Private. one. ~t~il.y .~¥~llin~ ....................................... The certificate is issued to lIObe~t. Hlltl.. B~[le~' .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval,~tl~..171.3,967..-by. R, .~/~ ..... Building InSpector FOF,~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPART/~ENT TOWN CLERK'S OFFiGE SOUTHOLD, N. Y. BUILDING PERt,41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FOLL COMPLETION OF THE WORK AUTHORIZED) N? 3 67 Z Permission is hereby granted to: '" ; at premises Ioceted et ........ * ...... ;,,.~. ........ , pursuo~¢ to application dated .......................................... , 19 :, and approved by the ~/' Building Inspector. Building Insp-ector S-9 SCHD SUFFOLK COUNTY DEPAETHENT OF HEALTH Bldg. Permit No. ~q/~ ~ ~ TO WHOH IT HAY CONCERN: at The sewage disposal facilities for a structure located (Oive deed loca~ion) have been inspected by this department and found to be satisfactory. District Engineer FOF, a~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, bi. Y. Examined ......................... ~. ....... L Approved ........................................ , 19 ........ Permit No ..... D,sapproved a/c ~ Application No..~....~...C..~'~.. ........... APPLICATION FOR BUILDING PER,MIT Date April ll, 1967 . INSTRUCTIONS a. This application must ~e ,completely titled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall 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 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 all applicable laws, ordinances, building code and regulations. (Signature of appli~~ co~por,a, tion], (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................................... B.uild.ar ............................................................................................................ Name of owner of premises .z.a.v.a~u.P.t....c~.~l....~.~.k,~-4, w,~,~..~,,...~*.~.~,.~ ................................. V If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) "Deep Hole Creek Estates" b ,. .Location o.f ,g.n..d on which~pr,opose, d ~,or~k~,~,il?~e_,,do~n$. ~M~u~J~o:~.2..~.~.~f~..e.~.~.2~../.Z6~0., %o~t Ix~ B~:~.~gg ounc~ary De'G..bk~; eor.oi~artG ~c u,~ ~....-~..u~- ..,-¥,.~..'s,..,a-~.-~,' ,,'.. .L'" ~-.. ~, - u.~ u~ Street and Number Deer Hole Dr.~.,a. long N.szde of Deep. Ho.l.e ~r.ll0' E,to pt., N. 5o, to rt. o: .................................. ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ........... O,~e...,~..,~l,~,~,~/....dl~..eJ~,~,~ ...................................................................... 3. Nature of work (check which applicable): New Building ....... .Z.. ........ Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. [stimoted 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 ........ 5.~ ............... Rear ....52, ................... Depth ....,?..~.! ................. Height ............................ Number of Stories ............................ 9. Size of lot: Front ...... 14~l~.t ............ Rear ........ ,l, 2.Q! .......... Depth .....],5.Q.~. .................. 10. Date of Purchase ........................................................ Name of Former Owner ..~Qo]~f~,~.~..~:[;.~ ........................ 11. Zone or use district in which premises are situated ........ l~.~.sq[.0.~.'l;;[,~,~L ............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~.O ............................................ Peter P.&Patricia .................... 13. Name of Owner of premises 'A';'"']]~:~rSS ................. ;Address .... Bl~X,.l~,~. .................. Phone No. Name of Architect ...................................................... Address ............................................ Phone Ho ..................... Nome of Contractor ...I~%l.~..t{0~e.a,...I~c.,.....Addressll.59...W.,/~&i~..M~..., ...... Phone No..~..A,..7..,,-.!.8...6.~ Riverhead, N.Y. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street ond block numbers or description according to deed, and show street names and indicate whether interior or corner lot. / ' ' ,b~in'g duly sworn, deposes oncJ says that'he s the app icant (Name of individual signing appli~on)~'~ 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 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,JJze~clp~licotion filed therewith. Sworn to before me this r x -~- ............... ~.....,... day,pt ...."~. ~.... .................. ,19...~..~. x~,~ ~---~'~ Notary Public ~..Q~...~.:~~unty'~ ............... i~'~'~;~'~'~";~"c;~c'~';¥i"~ MAP Of DEEP HOLE CREEK ESTATES 4 TOWN OF SOUt HOLD N.83° 40~' W, 95.00' · = STAKE E STORY FRAME HOUSE 3.83° 20'40'E. 05.00' DEEP HOLE DRIVE 3 THERESA DRIVE FINAL LOCATION ,8- 1-67 GUARANTEED TO HOME FARM ADMINISTRATION MAP OF LAND LOCATED AT MATTITUCK ROBERT HILTZ GEORGE H. LUTZ¥ JG.~ ..^~.~, I# - 20' ROCKY POINT~ N, Y,