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Home My WebLink About15978-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zi5744 Date ..M.ay. !l.,. ].9.8.7 ........... THIS CERTIFIES that the budding a d d 1 t i o n 560 Deer Drive Mattztuck Location of Property Hi, use 'No ....... County Tax Map No 1000 Sectton. 1.1.4 .... Block 1.0 .... Lot . .04 ......... Subdivm~on..DEER P..A.RK..AT MATT... .. FdedMapNo. 3204 .LotNo 16 conforms substantially to the Apphcat~on for Braiding Permit heretofore filed in this office dated Aprzl 8, 1987 pursuant to wluch Bufldmg Permit No. 15978Z dated Ma.y. I I ,. 1.987 . . was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for whtch tins certificate is issued Deck addition The certificate m issued to of the aforesaid braiding Suffolk County Department of Health Approval . UNDERWRITERS CERTIFICATE NO ....... to an exzstzng one fam*ly dwelling FERDINAND & NANCY RUDOLPH (owner. ~l~l~z~?~7~,~z~ X N/A N/A PLUMBERS CERTIFICATION DATED: N/A ~dlng'l~spect~r Rev 1/'81 I~OEM NO. ~ TO~N 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) 15978' Z Perrmssion is hereby granted to: ~"~.~....~....~..~:~ ................................... ,o ..~..~...~;~.....~..~.....~..~......~-- .... ....... ............................ ot premises Iocoted ot ....'~-.(~..~)...._~,,~..~.~.~]~t~.~r% ....... ..r~...~~ ............................... "nV Tax Map No ,000 Sectio. .......... .~ .......... B,~k ...... ~. .............. ~ No ..... ~.~ .......... ~u~uo.t to opp,co,ion do,~ ..... .~.*~...~.. ...................... , ~.~..~.., °nd opp~ov~ ~y ,,e Building Inspector. Fee $.~,.~,~.....: .......... Rev. 6/30/80 FORM NO. 6 ~ TOWN OF SOUTHOLD i'~ Building Department ['~ Town Hall ~. Southold, N.Y. 11971 ti 765- 1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPAI~ Instructions Th~s application must be filled ~n typewriter OR ink, and submitted =, ~ to the Building Inspec- tor w~th the following; for new buddings or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusuat natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dmposal-(S-9 form or equal). 3. Approval of electrma[ ~nstallat~on from Board of F~re Underw.ters. 4. Commercial bulidMgs, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a cert~fmate of Code comphance 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 p:Coperty showing all property lines, streets, buildings and unusual natural or topographm 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 inspect~on of buddings or premises, or other pertinent mforma- tlon reqmred to prepare a certificate. C. Fees: Add[t zons $25.00 1. Certlficate of occupancy New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Cert~fmate of occupancy on pre-existing dwelling $ 50.00 3. Copy of cert~ficate of occupancy $ 5.00, over 5 years $10.00 4.Vacan% Land C.Oo $ 20.00 5.Updated C.O. $ 50.00 Date ~ ~'~ ~ NewC°nstpuct~°n ...... Old or Pre-existing Building .C~...k.~_. ...... Vacant Land ............. House No. ~)~. Street I/m/et Owner or Owners of Property ~-37%...~[;,..k?.~, ,~,?"~.Z ~ ¥. ,~. ,~?, ,~. ...................... County Tax Map No 1000 Sect.on . .~.~. ~ ....... Block ....~..~. ........ Lot ...~ .......... Subd,vls,on .~'¢..~.~-.q-'. ?'~."~.~¥. ...... ~. . .~. lied Map No '~ ~_.c~ .~..Lot No ....... Permit No .......... Date of Permit .......... Applicant ................................. Health Dept Approval . ~o .~. .Labor Dept. Approval ?./.9 Underwriters Approval .... .t~. J. ~. ............. Planmng Board Approval ..... ~ ./..~ ............ Request for Temporary Cert~fmate ................ Final Cert~fmate ..................... Fee Submitted $ ........................... Construct,on on above described bulldlng~j~et~ a.,l apphcable codes and regulations. Applicant .'--~.. ~..~7~.... ....................... OUNDATIO.U ( ls t) OUNDATIO~ (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FI~AL ADDITIONAL COMMENTS: L~' 5 44°F54'40~E, \ LOT 1'7 ~5~ 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥ BERTIFIDATE DF DDI3UPANBY No Z 2817 Date ..... Au.~.usb 23 , 19 67 TIIIS CERTIFIES that thc buildm~ located a~ N/S Deer D.ri. ve .... Street Deer Park Map No ]3lock No. .Lot No. 16~ .Iia.~ti. bu.c!~ I'.~tY.: ...... conforms substanttally %o the Apphcation for Budding Permtt heretofore filed in this o~hce dated .Sept 28 19 66 ~ursuant to whtch Building Permit No. 32[~0 ~ dated ~ep% 28 . , 19 6J , ~vas issued, and conforms %o all of the require- ments of the applicable prows]OhS of ~he /a~v. The occupancy for which this certificate is issued is Private. one f~Dily ~,Vgl~i~g ........................... The certihcate is issued to Fred ~dpl~h ..... 9~2~pp~ .......................... (o%vner, lessee or tenant) of the aforesaid building. Suffolk County Department of }Iealth Approval July 12.~ 196Z..by. ~, .Yilla~ .. BuHdin~ Inspee%~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [,]~/LATION [ ] FRAMING REMARKS: 7GS-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~=I~L Examxned . . ."2('YX ~.~ Approved. "xl~ Disapproved a/c ..... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDINGDEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y 11971 TEL . 765-1802 1 t, 19~] Permit No (Bufld:ng Inspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL · MAI 7&'Ci,: : ' INSTRUCTIONS a. Tins application must be completely filled m by typewriter or an ink and submitted to the Bufld,ng Inspector, war sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing locatmn of lot and of buddings on premmes, relatmnshlp to adjom,ng premises or pubhc str, or areas, and giving a detmled description of layout of property must be drawn on the diagram which as part of tins cation. c. The work covered by tins apphcation may not be commenced before issuance of Building Permit d. Upon approval of tins application, the Bufldang Inspector will assued a Budding Permat to the apphcant Such pe~ shall be kept on the premises available for inspection throughout the work e. No braiding shall be occupied or used m whole or m part for any purpose whatever untrl a Certfficate of Occupa shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the assuance of a Bmldmg Penmt pursuant to Bmld~ng Zone Ordinance of the Town of Southold, Suffolk CounW, New York, and other applicable Laws, Ordinance Regulations, for the constructaon of bufldmgs, addmons or alterataons, or for removal or demohtion, as herein descnl The apphcant agrees to comply wTth all apphcable laws, ordinances, budding code, hoJ,~mg code, and regulations, am admit authorized inspectors on premmes and m building for necessary Q~l~ecta s (Mmhng address of apphcant) State whether apphcant m~owne_r, lessee, agent, architect, eng:neer, general contractor, electrician, plumber or bml~ Nameofownerofpremmes -~.~.~,,,~,~, ~ ~..~:h.o~,_. ~x.D~'o..c:'i(. x--'~,o~.o.~.?...x7~ .......... (as on the tax roil or latest deed) If applicant ~s a corporation, s~gnature of duly authorized officer (Name and btle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Plumber's License No Electncmn's License No Other Trade's L~cense No Locabon of land on winch proposed work wall be done House Number Street Hamlet 2 County Tax Map No 1000SecUon I]~ Block .lO ...... Lot.t~ ..l~. .... Subdtv~s~on~,-o~0~co~ o~ ~,'-X~ o~-~x\ .o~.xc W~'F Fried Map No -~.~c:~.~.. Lot ] {o. .. (Name) State ex~st~ng use and occupancy of premmes and intended use and occupancy of proposed construction a. Existing use and occupancy b Intended use and occupancy 4 5. Nature of work (check which applicable) New Budding Repmr ....... Removal ........ Demoht~on Estimated Cost . -,~f ~. ~. ,.~. C> ........ If dwelling, number of dwelling units . Addition .. -~..~, Altera[lon .... .......,~,he'r Work .'t-~.%.~ ',<_ ..... (Descnphon) · (to be paid on filing this apphcatJon) Number of dwelling units on each floor ......... If garage, number of cars ....................................... If business, commercial or mixed occupancy, sttecffy nature and extent of each type of use .... D~rnenmons of exmtmg structures, if any Fron~~t . Rear .......... Depth ' ~' Height ......... Number of Stones ....................... Dunenmons of same structure with alterations or additions Front ......... Rear ........... Depth ......... Height .... t .... Number of Stones ....... x · ix - 8. Dzrnenslons of entre new construction Front . t./.q .c? . Rear .... ~ .... Depth ...h .%...~.. . Height . ...~. ...... Number of Stones ........................................ 9. Size of lot Front ........... Rear .............. Depth ................ 10. Date of Purchase ..... Name of Former Owner ........................ 1 I. Zone or use district m which-premises are situated .- .............................. 12 Does proposed construction violate any zomng law, ordinance or regulation ...k?. ~ ................... 13. Wall lot be regraded .................. Will excess fill be removed from premises. Yes No Name of Architect .................. Address .............. Phone No ...... Name of Contractor ................... Address ............ Phone No ........... 15. Is this property located wzthin 300 feet of a t~dal wetland? *Yes .~ No · If yes, Southold Town Trustees Permzt maybe re~uzred. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and lndmate all set-back dtrnenmons from oroperty hnes Give street and block number or description according to deed, and show street names and ~ndmate whether .ntenor or corner lot. STATE OF NEW YORK, .-- - - - :ou x, ·...-~...,,~....~...~ .~,,.,,~Z~.u~l_s.l~ .~TL,...q) C% ~. ~t- /(~~ ~ontract) .......... being duly ~bove named sworn, deposes and says that he is the applicant te ~s the . (C.D..t~-.-? ~¢..~:-.v' .......... (Contractor, agent, corporate officer, etc.) or~an~d~[~~ said owner or owne~, ~d m duly authorized to perfom or have perfo~ed the sa~d w and file t~s ~pphcahon; that all statements cofltmed m thru apphcat~on are' true to the best of ~s ~owledge and behef, and that the york will be perfomed ~n the ~ner set forth m the apphcatmn filed ~erew~th. ~wom to before me this / .... .~ n .......... day of ...... q ................... ' UNDA J. C~ ~ ~ (S~gnature of apphcant) Term ~ires ~m~r 31, 19 ~ ~ ,-