HomeMy WebLinkAbout21945-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22950 Date APRIL 18, 1994
THIS CERTIFIES that the building ADDITION
Location of Property 4615 WESTPHALIA ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 13 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 6, 1987 pursuant to which
Building Permit No. 21945-Z dated MARCH 16, 1994
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to JAMES & MARY ELLEN RUHF
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-050750-12/20/1988 & N-842982-11/12/1987
PLUMBERS CERTIFICATION DATED JAN. 15, 1990 - STEVEN O`CONNOR
' uilding Inspector
Rev. 1/81
FORM NO.3
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)
Date ......../4.................... 19..q
.1
N® 21945 Z
Permisslon Is hereby grante to,,
to ....i ¢7d?ST.7 t b~.1.l It ~5?...,. .....1-"
rTi tff c ~
?i~1i~ /i,?GC...... s,... °Gi, !1..... ~
.......................................................................j c!S~F....................................................................
at premises located at :P:~W"!r...................... Cf~-
//°'/TlC
/0111 1 1 Y - 7......,,.....................
County Tax Map No. 1000 Section 11.-3............ Block Lot No. ....0~
pursuant to application dated NOul- 19....0.../...., and approved by the
Building Inspector.
Fee cpf7
r
uilding Inspector
Rev. 6/30/80
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Form No. 6 P
e
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
E L TOWN HALL
APR 1218 Lj 765-1802
TOWNOFSOUTNOl.U APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
4
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in.writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ........7 ///jg 1~/%
New Construction........... Old Or Pre-existing Building.... Y............
Location of Property.... .e-:5#6 1(CA, .RQn,d......I IC4 ~ ~ 1 ~ IAG I~ .
House No. Street Hamlet
?y Jen . t`~.h .
-far or Owners of Property.... 0411 E 5..7 .
County Tax Map No 1000, Section 3....... Block...l3 Lot...0 ~2
Subdivision ....................................Filed Map............ Lot......................
Permit No..Jq y...... Date Of Permit. (kI.l.q .....Applicant
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...
Fee Submitted: $
e-N
~aa1J~ PLIIC
THE NEW YORK BOARD OF FIRE UNDERWRITERS
100071A
BUREAU OF ELECTRICITY
BS JOHN STREET. NEW YORK. NEW YORK 10038
;Tw;r'a:.:~,xh;wi ;t0.14Ri3 5%;i8RO4ui£st't ;11 nh0/5i)
Dole - Application No. on file
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
,JANF;S RuHF, !ti WP;ST PHAr,IA AVM;..:' NATTI'i91'k N.y,
in thefollowing loco~;T,°P;M mRf`f~'t811 /At Ft. ? Ynd Fl. Section Block Lot
was examined on and found to be in compliance with the requirements of this Board.
FIXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ounstS lCBTACLES SWITCHES INCANDESCENT FIVORESCEN AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. H. P.
111 1 "4 .•6i
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPWALMCPT TIMECLOCKS NU ' UNITHRATERS MULTI-OUTLET DUAMERS
AMT. K. W. On H. P. GAS H. P. AMT. NO. A. W. G. NAT. AMP. AMT. AMPS. TRANS. AMT. H. P. NO. SYSTRAIS MT. WATTS
OF PtET
I I i to
WRY" DISCONNECT NO.OF S E R v 1 C E
AMT. AMP. TYPE MEET' IX 3W 110 3W13 d 3W 13X AW NO OIEXC`COND. OE CC.. 0. NO. Of "I-LEG OA NF~INO. OF N"AtS A. W. G.
RQUIP. a CC. COND. F MU i NO. OF N"AIS OF A. WNEUAL
. G.
,I ]00 hH 1 '
OTNV APPARATUS:
G.F.
RIfi,ANll 6;E,i';1:'iF.tt, kt1J,ANtt''
RFSX 143 .
MATTITUt`K, NY'. 7195'), ONMRA HOER
l1
Per
This cattificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE M1i10T BE ALTERED IN ANY MANNER.
?GG1
1000771 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date November 12, 1987 AF'plieationNo.onfile 515504/87 N 842'982
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
James & Mary Fallen Rohl, s/s Westphalia Rd. 04615, shu cor. Bennetts Pond La., Mattituck,
N.Y.
in the following location; ® Basement ® 1st Fl. LS 2nd Fl. Section Block Lot
was examined on November 5, 1987 andfound to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACIES SWITCHES INCANDESCENT FLUORESCENT M
vn P AMT K W. AML K. W. AMT. K W AMi K. W AMT. H P
24 31 23 24 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. Olt H P. GAS H. P. AMT NO. A W. G. AMT AMP. AMT. AMPS TRANS. AMT H P. SYSTEMS AMT WATTS
NO. OF FEET
1 30
v
SERVICE DISCONNECT NO. OF S E R V I C E
AMT. AMP TYPE METER 1.e 2W 1 % 3W 3 AT 3W 30 4W NO. OF CC COND A W. G. NO. Of Hl LEG A W G. NO OF NEUTRALS A. W. G
EQUIP. PER % OF CC. COND OF 11-LEG Of NEUTRAL
OTHER APPARATUS:
MOTORS. 1-1hp.
Ruland Rlectric Co.
P.O. Box 143
Mattituck, N.Y. 11952 lic.#242B
GENERAL MANAGER
11
per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
~f COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
1441at7
1000653 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
Mg 85 JOHN STREET, NEW YORK, NEW YORK 10038
F
Date November 19, 1987 Application No. on file 358901/85 N b44127
THIS CERTIFIES THAT 1
only the electrical equipment as described below, and introduced by the applicant named on the above application number in the premises of
James M. Rahf & Mary ]Ellen Dutuis, West Phalia 4615, Mattituck, N.Y
in the following location; ® Basement ? lst Fl. ? 2nd Ft. Section Block Lot
was examined on November 5, 1987 andfound to he in compliance with the requirements of this Board.
OUTLETS ECEPTACLES SWITCHES FIXTURES M R RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
11 T
INCANDESCENT FLUORESCENT vn
PSR AMT. K W. AMT K.W AMT K.W AMT K.W AMT H P
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS
AMT K. W. Oll H P GAS H. P AMT NO. A. W G AMT. AMP AMT. AMPS TRANS. AMT. H. P SYSTEMS NO. OF FEET AMT. WATTS
SERVICE DISCONNECT NO. OF S E R V I C E
METER NO OF CG COND A W G. A W G A W G
AMT. AMP TYPE EOUIP lq]W 1,e 3W J$3W 3.e 4W pER.9 OF CC COND NO OF HI LEG OF HI-LEG NO Of NEUTRAI$ OF NEUTRAL
1. 100 CB 1 1 2 1 4
OTHER APPARATUS:
panelboards: 1--12cir. 125amps
Glenn Bradley
Box ; 283 GJ/%
Laurel, N.Y. 11948 Lic. 1227 GENERIALL MAN ER
Per.
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
c~~FFU(/1,TEL. 7G5-1802
TOWN OF SO?UTIIOb,D
r 1•::• ' . ~c OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
-e TOWN HgLL
SOUTHOLD, N.Y. 11971
C .E R T I F I C A T I O N
Date I IJ~ 1_~p
Building Permit No. I&k ( Z n
Owner-- =h I~ c r, C-~I yj RkA h1
(please print)
Plumber sieye'A., ®'t o?1nev-
(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
-aq day of
1970
- p`
Notary Public
NOtary Public, County
HELEN K. DE VOE
NOTARY 4707878, Suffolk "Liu
Terre Expires March 3D,1S_.
/J ryf4
Town Hall, 53095 Main Road j Fax (516) 765-1823
P. O. Box 1179°.~ Telephone (516) 765-1802
0
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 28, 1194
Mr. James Ruhf
4615 Westphalia Rd.
Mattituck, NY 11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
%R% An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
%x% The check is not on file. ($25.00)
Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on File.
(All permits involving plumbing being
issued after Aprii i, 1984.)
BUILDING PERMIT # BP# 21945Z
Please contact our office on this matter. Thank you for
your cooperation.
SOU"MOLD TOWN BUILDING DEPT.
1ELD II;SPECTIU,~ DATE COMMENTS
ro ~
e 6 d ~c
FOUNDATION (1st)
m
FOUNDATION (2nd) -
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INSULATION PER N. y
STATE ENERGY
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FORM X0.2
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)
NO 166 12 Z Date 191:1.
Permission is hereby granted to:
''.....a-r~... CZ..J; .1" . ¢
at premises located at .~Z.- 44 s44.s...l............')<~fs i~kJduC
County Tax Map No. 1000 Section I.La......... Block .......l...4....... Lot No A.?c-.........
19.x.7., and approved by the
pursuant to application dated .....l~l..o-4~ .:4Lt.A
Building Inspector.
Fee X71.:.....
Building Inspector
Rev. 6/30/80
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND ( IN LATION
[ ] FRAMING [ ]FINAL
REMARKS:
DATE INSPECTOR
N~,
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING Vj-FINAL
REMARKS: d k-11 I,"q
jo-
i
DATE 3G INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ULATION
[ ] FRAMING [ ] FINAL
REMARKS:
f
f
4
Etp
[ I
DATE INSPECTOR 9%444 ig
___VVV
i
t
/6612
785-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [Y]'ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[y'FRAMING [ ] FINAL
REMARKS: i
cr.
F
DATE INSPECTOR U
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BOARD OF HEALTH
• F, 3 SETS OF PLANS
FORM NO. 1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765-1802 MAIL TO: y 6/S Qaulr-a
Examined A.bw!!+ti~•..~.4., 1951
Approved N ! !"!1 . 4 Q., 1913. Permit No.. 4~! ~ kt- D ~
Disapproved a/c fa ''V +
TOWN
}o- s!a~... .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 1988,,7
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with .
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 street
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
cation.
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 issued a Building Permit to the applicant. Such perm'
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 Occupanc
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
Regulations, for the construction of buildings, additions or alterations; or for removal or demolition, as herein describes
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t
g~
admit authorized inspectors on premises and in building for necessary inspections.
C.X1LA-tJ . .
(Signature of applicant, or name, r a corporation)
_ ding address of applicant)
State whether applicant i ,owner, tractor, electrician, plumber or builde
` . U ^
Name of owner of premises 0.f /eX/J S.............................
qq est deed)
If applicant is a corporation, signatur q~J?~ l~
(Name and title of torpor.
ALL CONTRACTOR'S MUST F
Builder's License No......\
Plumber's License No. .
Electrician's License No.
Other Trade's License No. ...5~~.~. .
I. Location of land on which proposed work will be done .
...............(~2s'h y0...............a>L~..c .
House Number Street Hamlet
County Tax Map No. 1000 Section .....#3.......... Block 1:3............ Lot. . . .
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....(!O jj /C. . . Aq? (4u ,e f.h9 • • • • • • • • • • • . • , • • • • .
b. Intended use and occupancy a4!?l.E.... W .7 • •~cOc( io z . .
3. Nature of work (check which applicable): New Building Addition V... Alteration) .
Repair R Removal Demolition Other Work
(Descriplion)
4. Estimated Cost (Rj v v Fee .
(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 cars ...,:.r
Yrlked occupancy, specify nature and extent of each type of use
6. If:busi-s(S,` '
....d......... .
7. Diip$>y~ions i .S rOs, if any: Front s3 (p Rear 3. (7.. Depth
He(g~ rtrtber of Stories .'f a , .
I! ' erfsio $ r11 t rj~ with alterations or additions: Front a e Rear . Aa"
.
~ h! Height Number of Stories l..z.. ~ cfcli ~a4"
8. Dimencs on s vr¢ ng` ruction: Front .Rear pth
1 P(pl1', wwnwm.wxuw,v~. _ . Nil bPr of Stnflas ' ~ I • c
9. Size of lot: Front 5.......Rear Depth
10. Date of Purchase . . . . Name of Former Owner ilPV 4t
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: Yes No
14. Name Name of of Owner Architect of remises4QV 04ry 6!/~n. 1U Address Phone No..
.
Name of Contractor • Address Phone No.
...Address Phone No..... .
* ..?.JI
15. Is this property Y Southold located o within 300 feet of a tidal wetland? *Yes No
yhi Trustees PermitPLOT DIAGRAM
may be reggui ed.
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back d' ensions.fipm
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. ' .
See o_4-[ac-hed,
i
STATE OF NEW YORK I
S.S
COUNTY OF ,SQ-FA 1. :
. . being duly sworn, deposes and says that he is the applicant
~Namd . of indi~viduual igning contrast)
above named.
Heisthe
(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 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.
Sworn to before me this
..............day I'of ...:N4vE t XI.~J. Y...., 19 l
Notary Public, County g
NEBLI IL DE YOE w York . ` PP
NOTARY No. PUBLI 4707878C, State of Nq x
, Suffolk Coprd g (Si i.{e of a licant;
Term Expires March 30,
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