The URL can be used to link to this page

Home My WebLink About6807-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z~ ...... Date ............... /,1~1't..1. · · 19--, 19..~ THIS CERTIFIES that the building located at . Do~lt. lto~.e. Dx*iv~ ......... Street Map No..1~2.~6 ...... Block No ........... Lot No.. ~ ...... Ma~;~;$~ei~ .. I~,-~ o ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Aug-..l~., 19.73. pursuant to which Building Permit No. 680~/Z · dated ........ &~..2~1 ....... , 19.?~., 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 . .PX*/.vat~. ola~..f~:l..ly .dw~.l.t;I. ng ...................................... The certificate is issued to ~ld:l...-~oh~4.ex, holz ....... 0~l~X' ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...De~ .. 19-..197-~ ..b~ .Ii.. ~.~,11~. · UNDERWRITERS CERTIFICATE No. ][. ~05:21 -- · -][e~. · 'D0" 't'~?~ ............... HOUSE NUMBER .. ~ ....... Street . .l}Z~l~ 'lion'®. l~l*~ ...................... Building InspectoI FORM NO. ~ 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) 6807 Z Permission is hereby granted to: Rudi 8ehlierholz Mattituek Build new one family dwelling at premises located at loi; ~+8 Deep Hole Dee~ Hole Drive ~'~ttltuck pursuant to application dated ...........................A.~I~.....?..~ ............. , 19..?..~..., and approved by the Building Inspector. Fee $..~!..*..?..O. .......... FORM NO. $ TOWN OF SOUTNOLD Building Depo~tmunt Town Clerks Office Southold, N. ¥. 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 dispasal--(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: 1. 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 a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 '..~,/~ /'7;Z Date .;'...~. ............/~ . .......................//~ ~ ti/ New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ....................... '.~.. ........................................................................ Owner Or Owners Of Property __~. c~; ~ ..~. ~ ./.(:..C.. i~ .~.. o / ..~>. Subdivision ,.,.,/...,.,.~.,..K:...........~...?. ........... , ...... Lot No. Block No ............. House No ............ Permit No..(~...0...~...~ Date Of Permit .~.Z./..~..?..7....~.Applicant ...~ ............................................. Health Dept. Approval .~.~.....~.../..~...~.....?....-~..--- -- .............. Labor Dept. Approval ................................................ Underwriters Approval ...1~...~'..~.~....?'....~. .................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ...~... ............................ Construction on above described building and permit meets al_l applicable codes and regulations. Sworn to before me this .......... L..~. day of ...~.....[..~..~..~. ...... (stamp or seal)~'~ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY. r-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 "a'e,ove~,~r ~o, ~?~ Ap,,,,eat,o.~'o. on,,,e d93594 N 130521 THIS CERTIFIES THAT only the electrical equipment az described below and introduced by the applicant named on the abo~e application number in the premises of Rudy Sehllerholz, w/s/de Deep Hole I)r., East, s/o Peconic Bay Blvd. Mattltuck~ L.I. in thefoilowing location; ~ Basement ~ 1st FI. [] 2nd Ft. outs ].de Section Block Lot was exami.~d on NO vemb e r 29 s 1973 and/Bund to be in compliance with the requirements of this Board. A~T. K.W. OIL H,P, GAS H.P AMT. NO, A.W.G. 1 16.~ $PECIAL REC'PT ICOOKING DECKS OVENS DISH WASHERS AMT, K.W. j A/RT. K.W, VRT. K. W* TIMECLOCKS BELL IUNITHEATERSUNIT HEATERS MULTI-OUTLET SERVICE DISCONNECT NO. OF S 1 200 CB X 4/0 R V I C OF HI-LEG EXy Au"s DIMMERS AMT, WATTS NO. OF NEUTRALS OF NEUTRAL 1 2/0 Water heater: 1-~.Skw ~tor/s: 1-3/4bp Elec.~oom heater: 1-2.5kw, 2-2.0)~, 2-1.5k~t, 2-1.25kw, 1-1.0kw Pat Heaney 122 East Montauk ltway Hampton Bays, L.I. 1194g Per 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. APPLICATION SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No.~-/~1 FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM Address~/~-f~¢ ~1,-~-~ /~, ti-1 I'~'~' ~--~--~6. Section 2. Property l~cation ;i~ ~q ~' [~I.~,~D~7. Lot No. Villag~ ~ ~ 7'uC ~ Township ~ ,," ;"~,~ '~ 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Width / ~Q feet Length / ~ feet (Enter on center plot below) Dispos~ys tern: 10. Sewage precast ~E uivalent Block A. ~ gallon septic tank: Amount of water in weZZ Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The igned "Const~ ~ction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards thereto." Date 4~ /~ /~ Signed Owne , lor Bnilder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this plot. Date ~-/~7 Signed C ~ -- S-15 Revised 4/]/72 TOWN OF SOUTHOLD ~/~v~ ~ BUILDIN~ DEPARTMB~T ~/~'~ ~ T~ C~tK'S MFI~ ~( ~,~ ~D, N.Y. ~- ~ ~' ~ Exam ned ~ ~[ , 19 ~ ' Il-~~ ' · ................ ~. ...................... , ~p '~.on ~o. :~..~ .............. ~prov~ .............. '..' .............. :.~. ....... , 19..~ Permit No. ~.~...~.~ ..... ~ ~/~ ..................... ................... APPLICATI G PE~IT ~ a. This o~licati~ must be co~lete[y fill~ in by ~ewriter o~ iff i~k a~ s~mi~ in friplic~e Ink,tar, with 3 m~ o~ plo~s, accurate pl~ plan ~ ~o e. F~ accusing to ~h~ule. b. Plot plan ~h~i~ J~oti~ of lot ond of ~ildi~s ~ premiss, relationship to adjoining pram ~s or pub ic struts or areas, o~ givi~ a detail~ ~ripti~ of I~t ofp~ must be drown on the d ag~ w~ i~ ~, of this apprJcotJ~. c. ~e work c~er~ by this o~licotion may n~ ~ comme~ before i~nce of B~ldino Pe~it. d. U~n approval of this applicot~, the BuJldi~ Iv~or will issue a Buildin~ permit to the applicant. Such permJt~ shall ~ k~t ~ the premises available for in~J~ ~h~ t~ work. e. ~o building shall be ~cupi~ or u~ in ~ole or in pa ~ for any pu~se ~otever until a CeflifJco~ shall hove ~en granted by the Building Ink,tar. APPLICATION IS HEREBY ~DE to the Building ~,ment for the issuance of ~ Building Permit pu~uont fo the~ ~itd~.~ z~ Or~i.o.c~ of ?e tp~.?t ~ut~t~, Su.otk .C~E~, ~ York, ~nd o~he, ~pptic~Je ~, O;di~es ~u ~tons, For the co~tru~t~ UT DolmenS, a~ltt~S or oJMmtJons, or for m~ol or demolition, os heroin The applicant ogres to comply with all a~licable I~, o~, buildi~ c~, h~sJ~ c~e, o~ ~ulotJ~s, admit outhoriz~ in~to~ ~ pmmJ~ a~ in ~JldJ~ f~ n~a~ in~tions. ..................... .......... ..2z ........ ~m~ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ,.Q..~.~../.~ ................................................... .......................................................................................................... Name of owner o, premises ...... "..T.....: .............. .......................................... If applicant is a corporate, 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 ............................................... Locat on Of and on wh ch proposed work w be done /Viap No' ..~.~ .~. 0" 6 Ln, kl,, q~ Street and Number ...~...~..~.~... ~.~i~ ~..~..~.~.~.~_ ................ j~.~.~l( t,,~/,~..~. ...................... ............................. r- ..... ' ............................................ "'"'"'~" ......... ~u:'"~i~i~iii~ ........ State eXisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~.~1~?:~.. ~..~..../~..~ b. Intended use and occupancy / ..~.'~...~.~t~l~,/ ~t~//l'~e. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolitkm .................... Other Work ..................................................... (Description) 4. Estimated Cost~....../...~..?..?...?. .................................... Fee S// ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... J. ................... Number of dwelling units on each floc~r ...... ~. .................... 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 ...... ,~:.../. ........... Depth ..... ~....c~.. .......... Height .J..~...~. ........ Number of Stories ..................................................................................................................... · · Fr t ~'/0 R r 0 /6~/~ 9. S~ze of lot. on ........................................................ ea ..../..~..~ ............................... Depth ................................ 10. Date of Purchase .~....~..~....~.......~.~...../~..?..~. ............... Name o~f Former Owner~...~.../?..~...~...~....~..:.....~..~.~...~'.~....~../. ~,11. Zone or use district in which premises are situated ..~. ........ ~.~'.£...~...~....~.~..~.../. ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... .~....~. .......................................... 13. Will lot be regraded ...~...~ ................ Will excess fill be removed from premises: (4 Yes ( ) No 14. Nome of Owner of premises .~.h~........~.....C..~l.i~.~.[...~..~...J.~, Address ~.~..~.?.~..~...~.'/f. ~l~ph~ lu,, ~...~.~..~..~,::,~..~J~O Name of Architect ~./~t~ ....... ~.¢'.,.~ .......................... Address ~..]..¢J.~...~.~g.l~9~... Phone No. ~.~..~...~.~....~...j'. O Name of Contractor .~..~...~.E........~.~......o....~....¥..?...t. ............... 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 corner lot. .(~r~iVidUaF signing controcf) above nari~.e~ duly sworn, deposes and says that he is the applicam -',hi f(C/6ntractor, agent, corporate of icer, etc.) ' of said owner or owners, and Js duly authorized to perform or have performed,,,i~e said work an~ to make and file this application; that all statements c0ntain~d in this application are tru,e, to ~t~e [Jest of his kno¥'eJdge and belij~; that the work will be performed in the mannel' sef forth in the aPl~cation filed fI~L~i~ - ~ J~ · j.'~, ,~'~ Sw°m to be~; me this ? I ~ /~ /,~,,~v,-- ~ ....................... /day o, (/ f) (/ ~ (Signature of applica~t,~ JUDITH T. BOKEN Notary Public, State of New Yor~ No. 52-0344963 Suffolk Coun.!.t~f(~'~" Commission Expires March 30, 19~.~~.· · ./ /AAF Op' J'%LJI~OL ~ 5Ci.ILi LRi.iL~')L7 ~iTUAT~ AT /A/NTT 1 TLJCtZ T~:)NVN C~J~ '~,~.C3uTI4Ol.,l'~. N,Y. L EDUCATION LAW. i- , ~L ~ .'_~z--?.~ 1 APPROVED AS FEE: G/ /Y4 ' NOTIFY BUILDING DEPAP,¥MENT AT 7~5-2660 9AM '[O' 4PM FOP, REQUIR- 1 BEFORE BACK~:ILLING FOUNDA- A~ ,1¸ t t