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Home My WebLink About8639-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ........ g.q..37.~.c).... Date August 9 ., 19~..5. THIS CERTIFIES that the building .... ~. ?.w..c3..~?~.~.J:..~.~.. ............................. Lo~ti,~. ,~' p~,~.~t~. 695 Theresa Dr. Mattituck House No. Street Ham/et County Tax Map No. 1000 Section Il 5 .Block ? 5 .Lot 6 Subdivision~.e.e.p. Hole Creek Estates .Filed Map No. 4256 .Lot No. 40 conforms substantially to the Application for Building Permit heretofore fried in this office dated J~a~e ~1 ~1 19~..6 pursuant to which Building Permit No. 8639Z . dated ....... .~.u~. p.. ?.~. ............ 19.7.6., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Private one-family dwelling, with attached one car garage. The certificate is issued to JOHN A. & THEW_gSA A. HOFER (ow~er~ ...... of the aforesaid building. Suffolk County Department of Health Approval ............... .67-.S.0.-77 9.0 .................. UNDERWRITERS CERTIFICATE NO ........................ .~5.3.Q .o.~ ................. Building Inspector Re~. 1/81 FOII,~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORLI~ Certificnte Of Occupnncy No....ZT~.l .... Date ...............MaF. .... ~.., 19.. THIS CERTIFIES that the building located at ...Tba, e~...D~l~ ......... Street Map No. l)~sp. ROi®. ~]~ock No ........... Lot No...1~0 ..... I~tt:i. tnek ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. Jtme- .l[ 19.76 pursuant to which Building Permit No... dated .............J. ttn®..1.1., 19..~.6, was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. P~ivato. o~e. family, dwellin$ The certificate is issued to . 8p~ueewnod. Pax'k. Ho~aes..Ine ...... 0vne~ ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Eal?.. 29...19~7.. b~..1~,..~.ill& ... UNDERWRITERS CERTIFICATE No.. lq3~001 .~ .... 1~... 2~..]97.7. ............... HOUSE NUMBER ........ &9~.. Street ....~l~el~&. D~ ......I~;titu~k ......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8639 Z Dote .......................... '.....,,L ...................... 19 ........ Permission is hereby granted to: pursuant to application dated . ..d U ~,[ 1'~ , 7~ .......................................... : .......... 19 ..... ., Ond opproved by the Building Inspector. Fee $ ........................ Building Inspector TOWN OF $OUTHOLD , Building Department 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 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: 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 in- 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 $$.00 3. Copy of certificate of occupancy $].00 ........ New B~ildin9 ....,~- ........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~,~.~/,,~,~..~..,..../~,~/~..~¢~'...~.J~,.0...~.,~..~:.,~.,...:/~.~.:. ,/~,.~-A~.~'~/~..~ ----~~F2._I/J.,Tr._~ Owner Or Owners Of Property ...w?,OZT/,/.C-c~c:~c~.~....~..r~..r~....gT.~.~...~,.~/~.~..~..' ............................................. Subd,visian ..... B,oc Permit ,o. ~.~ ..... ~o,~ O~ ,.r~,, ..~.~./~:~..~,,,,~., .~F.r.~.~.~.~.~&.g~..~ ,,~,~ ~,. ~,,o,~ ...~.:~..::..~ ................ ~o, ~,,. ~,,,o~ ................................................ Unde~riters Approval .... ~.~.~,~ ....................... Plonning B~rd Approvel ........................................ Request For Tempom~ Ce~ific~te .......... ,~ ....................... Fin~ Ce~ificote .......................................... Fee Submitted $ ~,..' ............................. s a ,~pp ,~s Construction on above described building and permit meet ~ regulations. Applicant '"~~t~ ~/ ~/77 .................................. Sworn to before me this ~oto~ Public ....~~'. ..... Coun~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ia ~ to the Building In, spec- ter 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. 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 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZOperty 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. C. Fees: 1. Certificate of occupancv $5.00 2. Certificate of occupancy on pre-existing dwelling $ ]. 5.0 0 3. Copy of certificate of occupancy $1.00 . /// Date ....... t ............ New Building .; ........... Old or Pre-ex~ Building ............ Vacant Land ............. Location of Property ..................... .... ¢.~, ,J'?, . ~' '.~,. .... ,/~. ,~. · ,(:~,(' {~'~ House No. Street O, nerorOw,ersofProperty A. COUnty Tax Map No. I000 Section .... l .t.~.'~ ......Block... f ~ ......... Lot .... · .~...... ~... Subdivision..~, ,P?.¢.. ~..(~..2~PC.e,. ~.~..~. · .~¢.~iled Map No, .(¢..~.: .~...Lot No...~ ....... g¢.:¢. · .... .... Permit No . ZQ. Date of Permit .......... phcant ............ ' -- 0 Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... Fee Submitted $ .... ~..x ....................... 'Construction on above described building a~~~n~ ~J'~':-J¢~-;~-'l '~ ~'~"P- ~' Applicant .~,...~.~..~.. ,43~, 'i lations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y. 11971 TEI,. 765-1802 October 13, 1987 TO WHOM IT MAY CONCERN Regarding Certificates of Occupancy #Z13729 #ZI3586 and #ZI3159 1 have reviewed the files and applications on the the Building Permits for these certificates and found that the corrections coul. d be made. Victor G. Lessard Executive Adminkstrator THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BE, JOHN STREET. NEW YORK, NEW YORK 10038 ~IFIE5 THAT Sprueewo~ Park H~es, E/S Theresa ~. ,630' S/O Ne~ Suffolk Ave., Mattituck, L.I. ,~,~*.~ ~s~, [~ ~,~'~. .] ~,t F~. Outside .~,.~,,. 2 ] P 1 2 1~ 1 30 x 1 2 1 Smoke Detector Towle & Sons l~nc. 33 Lincoln A,e. Mastic Beach, N.Y. 11951 TOWN OF $OUTHOLD ~s ~ ~ ~-n /~ ~ BUILDING DEPARTMENT~/?~~ ~ ~ ~K~ ~ ~ ~ TOWN CLERK'S OFFIGE ,'.~' ~ ~ ~ ~~ ~ ~ ............................................ __pp .............................. ~ ................................ ~..il..-.~ ................... ~.....~....~ ........ ~....-~, ~ ~ ~ M ( U d ng Inspector) APPLICATION FOR BUILDING FERMIT CS~/.~ ~'~ ff¢~ Date ...... d.~.~....Ll .......... :::::::.., ]~.]& ...... M INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Ir~spector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Iot and of buildings on premises, relationship to adjoining premises or public streets oF areas, and giving a detailed description of layout ofproperty 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 the applicant. Such permit shall 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 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .... ..................... (Signature of'applicant, or name, if a corporation) / (Address of applicon't) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... '.:.. .::-:....l.:..,..: z .c .................................................................................................... '5 ............................... · ) O Name of owner of prem,ses ..x./=.c.~t¢.~.~.....c2..~....r...~.r.>~..~../.Rt~.~.c?.~...Zt~.c, ........ u,~-~'~7"~'~'"'"' .............................. If appligant is a corporate, sigr~re of dul~ authorized officer· ..... ' (Name and title of corporate officer)...... ,,1u o/ ~' Builder's Lic~se No ..................................................... Plumbers License No ........ ~.~. ............................ '~'~- Electricion's License No .... ~.,~..~. ..................... Other Trode's License No ............................................... Locotion of land on which propgsed work will be done. Map No.:: ........ 'f~/-~..~..~.. ............... Lot No. ,..~.~. ............... Street and Number ........... :7./7.¢~,..Z:.~.,~.'..r>Z......~..~/.~..~. ............ i: ...................... ; ............... /~.~/.'~..Z".~...~..e-F~ .............. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ~.~.C,~.~.'.~.. ................................................. ...................................................... / b. Intended use and occupancy ..... ./......C~..~./'Z/./.'.~..../~....~-'..~.~ ................................................................................... 3, Nature of work (check which applicable): New Building......../~ ....... Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior~ .................... Other Work ................................................... (Description) re ................... .................................................. 4,Estimated Cost ............ erx.~.~}.w......~¢ ............................ e (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 oars ...........~...~..~. ........................................................................................................................ 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~..7..~., ................ Rear ,...~...7...';..~. .......... Depth ..,~..~...'.~... ........ Height ..../~'. .......... Number of Stories ...... ~:2~('..../~.. .................................................................................................. 9. Size o~ lot: Front ............. //..~. ................................... Rear ......... /../.~2 ......................... ,~-- -- ~--- .I n,D-epth ..... /,~,,~, ............... 10. Date of Purchase ............... /.~¢,~.~. .............................. Name of Former Owner ~..~l.ll~.t~...~..'....t~..l'~l.J:..~..(/Z' .... 1 I. 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: ~, ,),Yes ~0 No 14. Nome of Owner of premises~.~..~.~r-~.~.~..?~.i~.,~.~ll~.~..~.Addres~-~.;_.~-~?f~.4t~.~. Phone No. Name or- Architect ....G.l.J.b~K..~,,..~..:.~.~..¢./'/.~.K...J/~. Address .....~...~'K~.~ ....... r~',' Phone No. ,~/~.~-~ ...... Nome af Contractor .~.FrM.*~ .l~..RnfJ../~.*..k.t:-~9.1~s.~..9.¢.: Addres~;.,,.~,a. mf~l~.~.,¢ Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner '0. D STATE OF NEW YORK, t c c COUNTY OF.. ............................... f'~"~ . ............... ............. being du y sworn, deposes and soys that he ,s the opp'can, (Nome of individual signing contract) (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 oil statements contained in this application ore 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. Sworn to before me this ~P~LICAN T ....... Arb~ss ...... ' ......... TEL DEPARTME~2 The sewage disposal ~d waser suppl~ for thi~ lo~tion have been NEW SUF£o L K AVENUE 1 /1/. 8;'* tot. $9 · -' SUBDIVISION MAP ~0 IN ~ O~ICF HFA~K ~LI~ W~ ~N :4~ f GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE ~R$ON FOR WHOM THE TO THE TITLE COMPANY, GOVERNMENTAL · REVISIONS YOUNG & Y 400'OSTRANDER AVENUE, RIVERHE ALDEN W~ YOUNG SURVEY FOR: dOIqAI HOFER ~ TEt?~$4 LOT ~ 40 "DF~ ~ C~FFK FSTA~S '~ MArrlrUCM r~ r,~ ~.r~ m S~FHO~D a Lo4~ HOWARD W. YOUNG SUFFOLK CO., N.Y. SCALE: ! "-' ~JO ' DATEi M42.25, 1977 NO. 77- 166 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELO OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTE OR THIS RESIDENCE WILL CONFORMsEEViCE~ TO THE ~T E ~~~. ~Y~D S 0 THESU OLKC Y ARTMENT OF HEALTN / SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL O~ CONSTRUCTION ONLY ,ATE. .... ¢'~ ~, .~ ,E~. "0.__(~- SO'I o ~ . ~ . ~0, ~ VENUE 1~2.00 ' 18~.00 ' ~ -' MONUA~NT "[3; STAK~I SU~OI¥1$/I~N MAP f'ILEo hV TN~ OFFICE OF ~"t~C~£1~ OF SU~O~KCOUN~Y ON m~v,sJO.S ' YOUNG & YOUNG 400 OSTRANDER AVENUE, RiVERHEAD, NEW YORK sU'RvEY FOR: ^"~' ¢; ' ' LOT NO 40 AND T0 THE ASSIGNEES OF THE SUFFOLK CO., N.Y. I t ' I E L E V/-X, 3'-I NOTIFY BUILDING DEPARTMENT AT 765-2660 9AM TO 4PM FOE REQUIR- ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA- TION OK START FRAMING A. BEFORE COVEAING PIPELINE 3, HNAL WHEN JOB COMPLETED NOT ~ESPONSIBLE ~R DESIGN OR CON- REOEIVED BY TOWN OF SOUTHOLD DATE HOUR DEPT· EL E \/Aq-I O~ ELE \/~T ~ t S~DE. ELE; ~'~-L Fog, +"~mc F~,. ~L r ~Ok3 l~.} .F~/x,q-- IOtO t HO, LL