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Home My WebLink About12651-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy Date February J0 19 84 No. Z12258 THIS CERTIFIES that the building ~ =~W..d.w.~ $ ~.r~g ............................... Location of Property 1465 Theresa Drive Mattituck .......................................................... h~Aie'~ House No. Street County Tax Map No. 1000 Section . .1. 1. .5 ....... Block ·. · 1. 5. .......... Lot 01 3 Subdivision...D.e..e p..H.o..1.e..C.r..e.e.k..E..s.t... '.s...Fi[ed Map No. 47.5.6. .... Lot No. · .3.4 .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated September 23 ., 19 .83. pursuant to which Building Permit No .... .~.2.6..5..1..Z. ......... · dated.......Oct°be.........r 1 ..... ... 19 .83.. ,wasissned, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... a private one-family dwelling. . ....................... The certificate is issued to JOHN J. & JEAN T SCHEFFER ; ...... ........... (owner, le~r~ ~r-tena~t~ of the aforesaid building. Suffolk County Department of Health Approval.......,13-S0-.163,....-.........1/30/84~.'''R°b''t' A.. Villa...... UNDERWRITERS CERTIFICATE NO ........ .N. 6. $ .1.0.2.~ ............. ; ................... Building Inspector Rev. 1/81 FOEM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12651 Z Permission is hereby granted~o: [ __ r, rh~ .... ~.~. ....... .~...~,~p~ .............. ........~..~....~..~ ................................................ ..~.~~ ......... ~ ....................... .................... ~~..~.~ ........................... ~, .............................................................................................. ~ p~o~,~ ~o~ ~t ....L~..~.¢...~.~...).D..~....~.~ ....... County Tox Map No. 1000 Section ....... .\..~,.~. ........ Block '.......L...~. ........ Lot No ........ .~...~ ......... pursuant to application dated .....~.~~.,,--.-~-,--~-, ............ , 19..~,.~., and approve~ by the Building Inspector. Building In~ector Rev. 6/30/80 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 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. 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 peoperty showing aH 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: I. Certificate of occupancy ~ 2. Certificate of occupancy on pre-ex~sting dwelling 3. Copy of certificate of occupancy $1.00 landuse--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date... ,ex?. ,-.,~. 7 ,~,~. ........... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property 1~5 . ."~..I~.~"F~ .5,~ ~'~Y''~/6 . .~. ~."~'..~.. i .~. ~.C..~ House No. Street Hem/et Owner or Owners of Property .'~.C_..~..-~....-',~..~ .~..~.,..~ .C.~..~..'~'~.'JC..~,,.Y~'. ................... County Tax Map No. 1000 Section Block Lot Permit No. ! .~.(,.~.. ! . .Z.. Date of permit ] .O.1.'~.~..Applicant..~'.~..~,~, ~.~k~.'~.~..~. ........ Health Dept. Approval .~/.~; .~. 1~-50 -~///,_~ .Labor Dept. Approval Underwriters Approva ................... Planning Board royal ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...0~.~ .0..C:~. .................... Construction on above described building and permit meets,all applicable codes and regula, tions. INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 February 19, 1991 TO WHOM IT MAY CONCERN Suffolk County Tax Map ~1000-115-15-13 1465 Theresa Drive, Mattituck, N.Y. B.P. 912651Z issued to Jack & Jean Scheffer for a one family dwelling included a rear deck. Certificate of Occupancy #Z12258 covers the dwelling and tke deck. Curtis W. Horton Senior Building Inspector THE NEW YORK BOARD OF FI,RE UNDERWRITERS BUREAU OF ELECTR~CITY~ VT 85 JOHN STREET, NEW YORK, NEW YORK '10038 oate Janaary ~3, 1984 2~40/~ THIS CERTIFIES THAT only the electrical equipment as ~scribed below attd introduced by the applicant ~amed on the able application number in the premises of J~k J~ ~ch~fer, ~/0 The~a Drive, 2~' N.O. . enu~y 16, 1984 was exam nea on artd~ound to be in cotnpliat~ce with the requiretnents o~ this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS 21 24 21 DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLE DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V OTHER APPARATUS: Motors:l-F., 1-G.F.¢., L-S~ke I C E NO. OF HI-LEG A WG' NO.O~NEUTRA[$ A-W.G OF HI-LEG OF NEUTRAL 4 Cell Electric 54 Riverhead We~thamptcm Beach, N.Y. 11978 Lic. This certificate must not be altered ~n any manner; return to the office of the Board if incorrect. Inspector~ may be identified COPY UILDING DEPARTNIE COPY OF CERTIFI~ ~' MANNER. FIELD INS?ECTION COMMENTS FOUNDATION ( ls t) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING ] INSULATION ~' FINAL ~/~"/ 765-1802 BUILDING DEPT. INSPECTION- [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ FOUNDATION 1ND [ ] INSULATION. REMARKS= ~/~ DATE ( 3 - /3j~'~ INSPECTOR 765-180:) BUILDING DEPT. INSPECTION FOUNDATION 1ST [ H PLBG.. ! ~/~)UNDATION ZND ~ ~ INSULATION FRAMING [ ~ FINAL REMARKS: DATE,, INSPECTOR Examined .C~)~..)..., 19 .~.g. Approved . .Q.~-~.~. FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 ~ ., Permit No. ·. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ...~. :~. a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, 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 appro,m[ of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. NS 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, buil~g code, h~using code, and regulations, and to admit authorized inspectors on premises and in building for necessary in:y.~s. ~ ..... (Sj~t~ature of applican{ddor name, if a corporation) .... .... .... (Mailing address of applicant) (,} State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . dJ~.J~. ~ .C~.~.~..~. · '~ '..: : ................. · ....... (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 ...................... 1. Location ofland on which proposed work will be done. '.~.~..~.4~'F'~..~.~...~..~.d..J.'?.J...~.~-.'~./?(Z'..~.-F~-~-.{)..~. ..... ........ ............ House Number Street CountyTax Map No. 1000 Section ..... [J..~'.'~. ....... Block .........J..~"~..... Lot ....... J...~. ........ [,)~?,~Z} .~.{~t~- a~}[ ~,,,c)--g~'-.~'~ Filed Map No .q.~....~.0 .... Lot .. ~,g'..~/.. Subdivision. . ,.. .............................. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: '%) a. Existing use and occupancy ....... ~/jg.C. (q...~.'?'... ~../? .............. .~ .............................. b Intended use and occupancy .......................................... 3. Nature of work (check which applicable) New Building f Addition Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... i (Description) 4. Estimaied Cost ........ ."7.Ofi.i.: 6/~. ..................... Fee ...................................... ! (to be paid on filing this application) 5. Ifdwelling, numberofdwellingunits...t~..~.~ ....... Numberofdwellingunitsoneachfloor..0.m'.,~. ......... It' 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 wtth alterations or additions: Front ................. Rear ................. r)epth .................... ,.. Height ................ Number of Stories ..................... 8. Dimensions of entire new constrUction: Front... i .~.~.. ii ..... Rear....~.q ......... Depth . ~J.."A. ......... Height ............... Number of Stories ........................................... 9. Size of lot: Front De 1 0. Date o f Purchase .... /' '~/' i~r'd' 'i ..................Name or, Former Owner ............................ 1 1. Zone or use district in which premises are situated ..... /0.'7 f('~.~' .................................. 1 2. Does proposed construction v~o!ate any zoning law, ordinance or regulation: .. ~. 0 ......................... 13. Will lot be regraded . .~.IMO'.k.~ .~..g,O. q4_.O.: ......... Will excess fill be removed from premises: ~ No 14. Name of Owner of premises . &.~q/?~.~.~./.~ ...... Address ................... Phone No ........... '" .. _ Name 9f Architect .... ..... ........... Address ................... Phone No ................ Name of Contractor }J~/~i /~.~.~. t ~ .~g¢ ..... Address 97'.~¢.7-.iff~4¢{<..4~.. Phone No. ~,~aq. PLOT DIAGRAM Locate clearly and distinctly alli 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 NE~RK,//, ,,1~ 'S S COUNTY O~. ·. ..... (~/-*./~ .~'3..~ 5( .~_.9.'. ?..p,,~, ?. /. /. ./. ./. .~//~ . . . being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ................... ~ .................................................... ~ ' ~(~(Contract_ct_~ agent, corporate officer, etc.) of said owner or owners, and is duly anfI~erform or have performed the said work and to make and file this application l 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 the application filed therewith. Sw°rn t° bef°re me this ...... o?. Notary Public ...... ' .... ~ .... ff') -- ~f_~.n ~.~71~Z? ~-// ~'/ (Signarure of applicant) , t~fm ~or au. a~.~wt**o~ ¢~ ~;r~ms ' ~W~ O~t $O~l'XOtO Lot 0 ~ot N'85°30'40"l~ 76. S4' HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT NOTE: B-'MON. 0-' PIPE SUBDIVISION MAP F/LEO IN THE OFFICE OF ?"HE CLERK OF SUFFOLK COUNTY ON dAN. 28, 1965 AS FILE NO. SURVEY FOR JACK SCHEFFE/~ ~ JEAN SCHEFFEH LOT NO. 34, 'DEEP HOLE CREEK ESTATES " AT M~TTITUCK TOWN O~ SOUrHOLD . c~UFFOLK COUNTy, NtW ~ORK JAN, 4, l~84 NOV, 12, 198~ DATE: SEPT..9,1985 SCALE: / "-' 40 ' NO. G$- 74~ GUARANTEED ro: B/VEt?HEAD SA VI~IGS BANK USLIF~ I'ITLE INSURANCE COMPANY OF NEW YORK YOUNG a YOUNG ALDEN W. YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR N.YS. LICENSE N0.45893 L/ AVENuE NEW YORK SUt~FOLK cOUNTY DEPARTMENT OF HEALTH SERVICES FOil APPROVAL OF CONSTRUCTION O~LY APPROVED__ HEALTH ~EPARTMENT-DATA FOR APPROVAL TO CONSTRUCT OF HEALTH ICE,., SUBDIVISION MAP PI£ED IN OF SUFFOLK COUNTY ON dAN. BRANDIS & SONS, INC, 161i3 J/ 0 I,~ SURVEY FOR JACK SCHAEFER 6~ JEAN SCHAEFER LOT NO. 34, "DEEP HOLE CREEK ESTATES" AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE: SEP~ ~ 19~$ " 40' SCALE: / = NO. 85-?44 GUARANTEED TO: ** RIVERHHAD SAVI~iGS BANK US£1P~ ~'IT'L~ COMPANY OFNEW YOA :h YOUNG s YOUNG ALDEN W. YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR NY.S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE N0.45893 AVENUE RIVERH~AD~ NEW YORK