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Home My WebLink About15746-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy Z-16353 October 29, I987 No .................. Date ................................ ONE FAMILY DWELLING WITH ATTACHED DECK THIS CERTIFIES that the building .. ~,. 'KTTAU'HED' 'G'KRAGE .......................... 300 Jacksons Landing Mattituck, New York Location of Property .................................................... House No. Street ...... /~r~/ei County Tax Map No. 1000 Section I 13 .Block 04 .Lot 05 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 10, 1987 15746 Z ..................... pursuant to which Building Pemfit No ...................... March 13, 1987 dated ............................ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate Js issued is ......... ONE FAMILY DWELLING WITH ATTACHED DECK & ATTACHED GARAGE HENRY & HARRIET THEUER The certificate is issued to ..................... /o'~o'e'r,'/~,~se~%TC~4'~e~) ...................... of the aforesaid building. 86-S0-157 Suffolk County Department of ttealth Approval .......................................... N835364 UNDERWRITERS CERTIFICATE NO .................................................. PLUMEERS CERTIFICATION DATED: October 28, 1987 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15746' Z Permission is hereby granted to: ..~...~.~.....~....~ ............................ c~ 1~ ' . IiCI ;.~ ............ ~ ............. 2..~ ..... ,:..~~ c~....~ :...~.~~....~..~.,.~.~..~ ....... ..~........~q~...~ ........ :.~ .......... ;.. ..~.~;-,.......~._..~ ........ ..,.., ........ ~ ............ at premises located at ~........v~.~..~...(~~..,~.~../..~.C~ .......... ~ .~..~~....~ ....................................... County Tax Map No. 1000 Section ....... l/...~. ......... Block ...... .~...~.. ....... Lot No...~....~..'~.. ........... pursuant to application dated ........~....~...../...~.. .................. , 19~...,~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF DC( BLDG. DEFT. ATOWN~b~ ~b-dffiOtO Instructions A. This application must be filled in typewriter OR ink, and submitted ,~l~m~m~m 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 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 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 px~operty 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: Additions $25.00 1. Certificate of occupancy New Dwelling. S25.00, Accessory,,$10.00 Business $50.00 2. Certificate ofoccupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.vaoant Land O.O. 0.0o 5.Updated C.O. $ 50.00 Date ........... NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property '~0~ (~:~ .~ ~ ./~. ?. ~-'p (~ . .~..~ .~.~ House No. Street Hamlet Owner or Owners of Property ...~...t¢/~-¢~..~.. /V'~W,t~ .~.~ County Tax Map N~t.1000 Section ............... Block ............... Lot ................ ... (V. Subd~wmon ...... (~... t~ ........... ~, ........ Fded Map No ........... Lot No ......... ...~... PermtNo !~'?Y{~ DateofPermit ~]/J]~) Applicant .~..,~.~r[~.~. /r~,;~. ,~] ..., Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. e c~d'7~and Construction on above described building and perm~l applical~l regulation~S./ ppica t..,~' ............................................ Rev. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1 $02 CERTIFICATION Building Permit No. Owner Plumber (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this / day of /~z~ ,' F7 Notary Public, .~ County Notary HELEN IL DE VOE #OT~Y PUBLIC, Sbted Ne~ YWlL - r~). 4707678, Suffolk Cetmty~ ,~ ~,erm E~pire$ ~rch ~0,19...-~ ' THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.00~"~3 BUREAU OF ELECTRICITY ~1~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Benry '~,r, ~/s J~n ~d~ Rd.~ ~st ~ill I~. g ~x ~e~, N~ttituck, N:~, in thefotlowlng location; ~ B~sement ~ Ist FL ~ 2~d FL Section Bilk Lot ~s examined on ~)~ ~'~ ~7 and found to be in co. pi ance u.lth the requirements qf this Board. EIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT UNIT HEATERS MULTI-OUTLET SYSTRMS NO. OF FEET DIMMERS SERVICE DISCONNECT $ E R OTHER APPARATUS: NO. COND OF CC. CONO 2/0 C NO OF HI-LEG NO. OF NEUTRALS 1 OF NEUTRAL ~0~ Goodale Electrical Cont. Inc. 73~5 M~i~ Rd. Mattituck, N.Y. 11952 lico#783-E $F.~EAL MANAGER Per~7~_ ~~ ]J~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ma), be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIC&TE MUST NOT BE ALTERED IN ANY MANHER. OUNDATION ( ls t) OUNDATION ~ ) OUGH FRAME FLUMBIN~ iNSULATION PER N. Y. STATE ENERGY CODE F!;IAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ]FO/UNDATION 1ST []ROUGH PLBG. ['"']' FOUNDATION 2ND []INSULATION [ ]FRAMING []FINAL DATE / / , I NSPECTOR~ ]65-1802 BUILDING DEPT. INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSU ~LATION FRAMING __..[ ] FINAL DATE /P"-~_~--~//~ 7 INSPECTOR~_~d ]65-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~INSuLATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS:, DATE /~./~'~ INSPECTOR~' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ ROUGH PLBG. [ ]/FOUNDATION ZND [ ] INSULATION / [~ FRAMING [ ] FINAL DATE RE: Permit No., Location NEW YOR~ STATE DEPARTMENT OF ~NVIRONM~AL-.C~NS~RVATION.-u..-~_---._--:~=~----~~---- S~ony Brook, N~ York 11794 ' .~///~. t°~ Your recent request to extend the above permit has been'reviewed' pursuant 6I~fCtLR, Part 621. It has been determined-that-there--has not.been-a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance o~f)~t~_.existing permit; therefore, the expiration date ia extended to .............. Your recent request to modify ~he above permit has been'reviewed pursuant ":" to 6NYCRII, Part 621._ It_has been determined _that _the .proposed_.~modif~ications will._ not substantially change the scope of the permitted actions or the existing.. -- permit conditions. Therefore, the permit is amen..ded to authorize: P~e_ ~ C~'~I ~1 other te~ aha conditions re. in as ~ttten in the crig~a~ Very truly yours, Permit Administrator CTH:DDR:co's Sent to: SS OF ION OF PROJECT (Scollop1 ol slleam, ' seaward, of.the'road aw-drd_ t_lands.,, i InstAll, rI ~n~; such damage. JJ~J~' c~i~'play Of Ji~hts and signaJs nn any ~oJk hereby 'Jim& ~ ~hh~t as I~ Deparlm~nl of Envlmnmenla~ConservalJon ~enmv~ i(l O~:any ~rltofl ot the ~c6~pleted slruclme of fill a~ ?f~mef co~liton, N0 ~lal~ ~hall be made axalnsl I~ Sl~, York~bH~aCco~flt ~l ~.y ~uch ~e~val of altefalion. sh~lJ ~t b~'~o~si~ued as conveying lo the appH~,~nt I foal ~ ~r~ofial ~fo~fly ~ld or vested In t t~' f~s~lble fm obla~nln~ any other N. 88? 02'PO"E. I~'~'~> ~;,.~" · 8TAL~T]ON OF THE SEWAGE DISPOSAL SYSTEM, FILL MAY BE RE(~IJIllf£a. 00· - --I0--- KEY = EXISTING CONTOUR : PROPOSED CONTOUR ' ~INGLE / 7'/../ EXPIRES T,^,,-, ,.FAMILY DWEL',~,-- ,. ~RS FROM DAT~ ELEVATION8 SHOWN NEREON ARE ,UFFOtK COUNTY DEPARTMEN~ OF HFS[IH 5E"MLL HENRY G. THEUER & HARRIET G. THEU LOT 3' "JACKSON'S LANDINC" AT MATTITUCK TOWN OF sOUTHOLD SUFFOLK COUNTY~ NEW YORK Examined . .~0,&~.. ! .~.., 19~. .~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~..oMk...c~.. !.~..., 19~. 7. Permit No.}. .~.-?..~.~..'~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19. BLDG, DEFT, TOWN OF 8OUTHOLD Date ...... ?.3.°. ........ 19 .~. > INSTRUCTIONS a. Tins application must be completely filled in by typewriter 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 tins application may not be commenced before issuance of Building Permit. d. Upon approval 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. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of OcculSancy 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to necessary inspections. admit authorized inspectors on premises and in building for ...... /.. ..................... . ........ ~iiJ_~'~l~l;:~'$f apptJ-±ca~t~ .... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .... : ..................................... - .2 · Name of owner of premises ..~...~..~.~..~,/:&.-'.J.-~.....~ .~.O.~..~..rt~<.. ................................ (as on the tax roll or latest deed) If applicanJ, i~'~o, gjaflion, sign3ture o,,f dufi~auauthorized officer. (Name and title of corporate offic ) Builder's License No .......................... Plumber's License No. ~ '~to/t/,)k ~,~o ~,-~v0'-/~Ak~' Electrician's License No. ~ 0 ol0t~[{~ ~-~"t-g~t~'l., Other Trade's License No ...................... ~ 1. Location of land on which proposed work will be done. ~..~.&..t'~....~.~./g. .4.a'.~.~.".~.&..-7~.7'~-.-~..:. ,~-.,:7.-/... ,go, , . /.oF ,x ....................... Street Hamlet House Number County Tax Map No. 1000 Section ..... ~.~ ......... Block .... /Y. ~. .......... Lot..~..b..'~. ............ Subdivision.. J~dyd,f ~/J{r ~/4'MI~ ,~/.G .... Filed Map No.. ~..~'.~ .o. ...... Lot (Name) 2. State existing use and occupancy of premises an'd}(ftrren~,~d use and occupancy of PrOPosed construction: a. Existing use and occupancy ............... ~:.....5~. ............................................. b. Intended use and occu anc ................. ~.t&/.k~.'.. ¢. .... .4..~: ........................ P Y 'x , , 5.If dwelling, number of dwelling units ..... .~..L.-~. ..... Number of dwelling unitls on each floor ................ If garage number of cars .e~. 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 ....... i ....... Depth ............... Height Number of Stories ~ D~nens~onsofsamestructurewlthalterahonsoradd~tmns Front ..... Rear ............. Depth ...................... Heaght ...... ~ ............ Number of!Stories . ...~.. ............. 8. Dimensions of entire new construction: Front (~.'~. :' . Rear .... ~..~. i. · .....Depth . ~. ~.'.~..~...:... Height .... &.3 ' .. Number of Stories ...... 0.~'. ~ ........ ~ ........ i ......... 9. Size of lot: Front' i i i i ).e.~., .~ .~.' ......... Rear .... '~/.,~ a'.~.' ....... ' b~pth' i i 12 ~i ~...~ i~..., iiiii l0 Date of Purchase /.~ ~. ~. Name of Former Owner ~ 11. Zone or use district in which premises are situated ............... ,. 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~.~. i .......................... 13. Will lot be regraded ...... ~.~ ~. '. i ............... Will excess fill be removed from premises: Yes (~ 14. Name of Owner of premises t~¢~..~.~//.~.~tY~.,~.~. Addr~s~s~.(~ .~g.,'.~.~. ~: ./~.ff.,T.'~. Phone No..~.~.,~'~ .~. Name of Architect .... : ..... ~ .............. Address ............... ~ .... Phone No ................ Name of Contractor ~d~.'.~.q.~. .~.~. ~..~/~..../~'.'. Address/.°.~..~(~.q .~...~.~.~.,!q.~. Phone No.'?.'.k~/.4??..~. .... 15. Is this property located withinl~00 feet of a tidal wetland? * Yes ..~.. No ..... · If yes, Southold Town Trustees Permit may be required. 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, S.S COUNTY OF..~"~ ............. t I ................... ' ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ..~..% ~ He is the ............................................... ~.. ~.; .t~ ............. (Contractor, agent, corporate officer, etc.)i of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of his iknowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... · A/t~.~ ........... day of. ~ ~ 19~. ~. Notary Public, ............... ~/~/ .......... Countl ~ ,~ ,. .................. ¢ i (Signature of applicant) otary Publloo State of New ~'~-~1~/' I No. 4822563, Suffolk Cou _nty~ ~ Term Expires Deoember 31, 19' ~ ~ ~ eTA~IlON O~ ?~E SEWAGE DiSPOSaL SYSTEU. ' ~~ "~ ~ . '.. ' ~'°ea ~ '- z ~- I~,~ ~~.~, ~/' ~ o ~.~(g~ ". I ~ ," / , "/c . ' , . ~4 ~~.~ c~., z ' +..... . . //~/,_ --. ' 9INGLE FA' ..... ~OTEJ--' ~'~ ::C..J,': ' ' · '-- --' , , ~ ' ELEVATIONS SHOWN HEREON ARE ~ppro~d'in a~rdar~,~-~ REFERENCED TO MSL DATUM. dete~Jnatlondate~ SURLY FOR ..... ,UFFOLK COUNTY DEPARTMENT OF H~ALIH SER~k: HENRY G. THEUER & .HARRIET G. THEUER LOT ~ "OACRSON'8 LANDING" FOR APPROVAL OF CONSTRUCTION ONLY AT MATTITUCK DAT[: OCT. 17,19B6 ~.~N ~ SOUTHOLD SCALE: I"=~0' OAT~ ~"~ HS REF. NO, ~ ~.0' J~ SUFFOLK COUNTY, NEW ~RK NO. e6-1107 ~EAL~ DEPARTMENT-DATA F~ APPRO~L TO C~STRUC T n.o ~ HIS BEHALF ~ THE -TITLE C~P~Y~ GOV~N- /~~~. '" )~'-,"/ I YOUNG a YOUNG ~OS~NDERAVE~E ~. - ~. RIVER~AD~ NEW YORK NOTE~ ~= MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W, YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N,Y.S. UCENS[ NO. 1~845 SUFFOLK COUNTY ON MARCH ~8,1969 A~ M~NO. 5~80. ~ HOWARD W. YOUNG, LAND SURVEYOR ~ ~ L~T~ ~ ~(W), ~IC TANK(~ C~OLS(~) ~N ~RE~ N.Y.S. U CENS E NO. 45893 ~ ~ ~ ~TI~S ~ O~ DATA OJTM~O F~ OTHEH~ j g . N. 887 02'20" E. A _ SURLY FOR SEPT. 30~ 1987 SUFFOLK ~OtJN~Y D[¢A~E.N~ OF ~A[TH'S~tC~ HENRY O. THEUER ~ HARRIET O. THEUER APR. zs, 1987 APR. 20~ 1987 SINGLE CAMILY DWELLING ONLY LOT ~ ' '~JACKSON'S LANDING" NOV. 12, DAI~ ~ ~ 1~H.S. R[-F NO..~~ AT MATTITUCK o~r[: OCT. 17, 1988 The sewage disposal and water supply facilities for this ~WN ~ SOUTHOLD SCALE= location have been inspected by this Pepartmentand/or SUFFOLK COUNTY~ NEW ~RK 'No. 86 - 1107 other aAenciesand found to.be satisfactory. SURVEY I I VI~ATION ~SECTION 1209 ~ THE ~ ~RG FOR WHOM THE SU~EY IS PREPARED HEALTH DEPAR+MENT-DATA F~ APPRo~L TO C~STRUC T AND ~ HiS aEflALF ~ THE TITLE C~P~Y, ~OV~fl- ~ NEAREST W~ IAIN--~I ~ ~SOURC[ ~ W~TER, ~I~TE~[UBLIC__ ' MENTAL AGENCY AND LENDING INITITUTION LISTED ~ ~ ~F CO. TAX MAP MITIO~O_SECTION !~ ..~CK ~,, LOT_~ HERE~, AND TO ~E ASSIGNE~S OF THE LENOING ~E~ ARE ~ ~ELLI~ WITHIN I00 FEET OF T~S PROPERTY INSTITUTI~. GUARANTEES ARE ~T TWSFERABLE YOUNG a YOUNG NOTE ~ ~ = MONUMENT ALDEN W. YOUNG, PROFESSIONAL ENGINEER ~UBDIVISlON MAP FILED IN THE OFFICE OF THE CLERK OF ANO LAND SURVEYOR N.Y.S. UCENSE NO. 12845 SUFFOLK COUNTY ON ~ARCH 28~1969 A~ MAPNO. HOWARO W. YOUNG~ LAND SURVEYOR ~ ~ L~T~ ~ ~L(W),~pTIC TANK(ST)a CES~OLS(~) ~N HERE~ N.~ S. LICENSE NO. 45893 ~E ~ FIE~ ~TI~S ~ OR DATA OeTN~O F~ OTHERS BRAND1S & SONS INC, 1046 N. 88.° 02'20"E. j41.20 00· Lot 2 NOTE= ELEVATIONS BHOWN HEREON ARE REFERENCED TO MSL DATUM. HEALTH DEPARTMENT-DATA FOR. APPROVAL TO CONSTRUCT NOTE~ I= MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON MARCH ZS,19~g '?- ~v Lot ;o SURVEY FOR HENRY G, THEUER 8~ HARRIET G. THEUER LOT 3 '"'JACKSON'S LANDING" AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUN't'Y~, NE~ YORK YOUNG a YOUNG 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK 4 APR. 20, t987 NOV. 12, 1986 DATE: OCT. ITD 1986 SCALE: 1'=30~ NO. 56 - trOT ALDEN ~YOUNO, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.%S. UCENSE N0.1284§ HOWARD~YOUNO, LAND SURVEYOR N.~S. LICENSE N0.45893