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Home My WebLink About15375-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-I6048 Date August 14, 1987 THIS CERTIFIES that the building ...0.~ .E..F.A.H..I .L.Y..D..W.E.L.L.I..Np ....................... 425 Brown Street greenport New York Location of Property ............................................ :. House No. Street ............ County Tax Map No. 1000 Section 04 8 .Block 03 . .Lot 2 1 ' S ..... M/o Greenport Driving Park 369 24 uoulvlmon ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 29, 1986 pursuant to which Building Permit No. 15375z October 7, 1986 dated ............................. 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 ......... ONE FAMILY DWELLING The certificate is issued to RIVERS IDE HOME S, INC. ..................... (o~n'e'r,'lJ~sde'~r't~a~'t) ...................... of the aforesaid building. Suffolk County Department of Health Approval 86- 8 O- 127 UNDERWRITERS CERTIFICATE NO.. Iq 814709 PLUMBERS CERTIFICATION DATED: July 8, 1987 Rev. 1/81 lrOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. ~UILDi~G PERMIT ~HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15375 Z Permission is hereby granted to: .......~.~.~..~ ................................................ ...... ...... at premises located at ....~...~.....~......~...~..~...~.:.~~ ......... pursuant to application doted .... ...~~....~..~......, 19..~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southoid, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUP.a Instructions A. This application must be filled in typewriter OR ink, and submitted -- laaaa,m~m to the Building Inspe~ 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 instafla- 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-exis~ing" 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupanc¥ $25.00 -- BUSINESS $50.00 ' 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ........................... NewCons truction .... x.. Old or Pre-existing Building ............ Vacant Land ............ B?O.W.n. St. ree. t Greenport Location of Property , ?.2.5. ........................................................ Housa No. Street Haml~t~ Owner or Owners of Property . .. County Tax Map No. 1000 Section ......... ~.8. ....Block .... 3. .......... Lot., .2.1. ......... Subdivision Greenport Driving Park .Filed Map No. $69 .Lot No. PermitNo. $375Z Oate of Permit 1.0/7./.86. Appli .R~¥e.~s.i.d,e. Homes, Inc. Health Dept Approval 86 SO 127 Labor Dept Approva~ Underwriters Approval ........................ Planning Board Approval ..................... Request for T mporary Certificate Final Certificate Fee Submitted $ 25.00 Construction on above described building and permit meets all applicable codes and regulations. RIVERSIDE HOMES. INC. Applicant ............................................... Re~, 1a-lO.78 Riverside Homes, Inc. P. O. BOX 274 1159 West Main Street Riverhead, N. Y. 11901 Phone: 516 - 727-3395 July 8, 1987 Building Department Main Street Southold, New York 11971 Gentlemen: I have a problem with 2 of my files. I find that there is a bad mixup with building permit numbers. Paperwork from your office has given us 2 different numbers on one and on the other has given us the same number as the other. What do you have for Permit No. 15575Z~and 15571Z. I am now showing Brown St., Greenport at 15071Z and Willow Dr., Greenport as 15375Z. Is this comrect? What do you show for 15376Z T.R.T. PLUMBING & HEATING LTD. 26 CARLTON AV. MASTIC N.Y, 11950 (516) 399-0921 July 8, 1987 Building DepaPtment Town of Southold Town Hall Southold, New York 11971 Re: Building Permit No. 1587~Z Owner: Riverside Homes, Inc. Gentlemen: I hereby certify that the solder used in the water supply system for the captioned job contains less than 2/10 of 1% lead. Very turly yours, TRT PLUMBING AND HEATING TT:eae Sworn~ before me this of' July, 1987. FIELD I ,S, ~C,ION FOUNDATION (lst) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS " ~.03.50~.~i BUREAU OF ELECTRICITY ~§ BS JOHN STREET. NEW YORK, NEW YORK 10038 .*' ,... ~ ~, ~ ~,,,,...,o.~....~,,. ,~z~, N 814709 THIS CE~TIFIE~ THAT U~s exatn~ned on June 01 ~ ~987 and found to be in compllatwe u'ith the requlret)*ents of th~ Board. FIXTURE OUTLETS 14 31 16 14 DRYIUI$ FURNACE MOTORS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTi.OUTLEr DIMMERS SYSTEMS NO. OF FEET ~ItRVICI IN,CONNECT S E .o, o~o... *Special receptacles:l-30amps. ,1-50amps., 1-GFCI 1-Smoke detector A W G OF CC*COND 4 C NO, OF HI.LEG Peter Charbonneau 35 Sheppard Lane Smithtown, NY 11788 Licj/2697 ~ D Per This certificate must nat be altered in any mcm~er; return to the oHice of the Board [~ incorrect Inspectors may be identified by their cre~entio~$. BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION XST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [~UNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [,¢~RAMING FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~SULATION [ ] FRAMING [ ] FINAL REMARKS: ,, '-~,~.~ ~ ~,~/ ~,~./~ / ,,- ........ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION AND [~NSULATION FRAMING FINAL 76S-Z802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DAT£ ,INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]~ISULATION / FRAMING [/] ~INAL ~ REMARKS: DATE /~/~7 INSPECTOR/~ /~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ .1 FOUNDATION ZND [ ] I~JLATION [ ] FRAMING [~ FINAL REMARKS: 765-~.80Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: [~FINAL VETERANS AD ~' STRATION, U.S.D.A. FARMERS HOME ADMtNK %TION, AND U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HOUSING - FEDERAl. HOUSING COMMI881ONEfl For accurate s~istor of caren copies, form may be s~patatod alol~ abo~ fold. Stap~ comp~tod ~ls toscthet ~ ot~ order. DESCRIPTION OF MATEEIA [] Proposed Construction Fi Under Construction Prope~fygddzell ~//~ Brown Street 200' Seventh Street Cit~ Medgeger~'$penser Tlmothv and Susan R~eves _ Con~a~ ~ ~ild~ RIVERSIDE HOME, INC. INSTRUCTIONS {To be in~crted by HUD, FA or FmHA; 326-6th Street, ?..0. Box 274, Rtvet, head,N¥ IAddn~l PERMITTED BY LAW IS PROHIBITED. 3. Work nos ~e~iflcallv deecrlbed or shown will not be bonlldered unleu I. r~cAvA~o~ i~arinf~a, tym As Der board of k'ealth survey test ho[¢ Window at~awaye Footing drains ; foundation wnU Basement entrance areaway i nr.,~-~ T,r~e~. wo]macized sills and sill seale~ ~mcnl~ ~: 8~nd cover ; S~' ~n~M ~ ~ion: 3. Sheathing plyh~nnd Shi~lm Addi~ i~d~: Ty~: ~ ~ fu~; ~ g~-~rnln~; ~ ckcu~ {~ ~ ~i~,) Fi~: ~ng ; ~ni~ $. ~ W~' ~2 and be~e~ W~ft~:~srade, ands~les~v~ 1~" ~.~. ; sr~ ~t.~nd ; ; lhick~ ~: ~ mud ~ ~d ~ smc~; m~l w~l shic~m ~kup mmerlal ~r adb Wi~w In~r~ ;~f~c;: ~m~r~6n8, ~ c~u of Pre~abricmcd (m~tt *nd zi~ ) i; Heater flue site ~ II ~ ~ II '~ ; wa~r ~aler Fkel~.e flue site nih dump ~ dean-~4l ; hearth ;mamd C] Corner bracts. Buildin~ paper at ~1 1R~ ; width ; l-I solid; [] spaced "o. ~.; [] dia~taJ; 't r6u~---~---- ,,vq,, 1 "; l~rl , ypC=&w~~ ; siz,-~ _ ; expmure f't]l fammingnn t ; type ; size ; "; Lath , Lintcb "; facing thick.. ,, "; ~ing ; th~kneM "; ; furri~ £~.ri..~eJng:.~,e~ia! % coaX'of s~ain on Texture Gable wall ~slruc6on: ~ same as main' walls; ~ mher ~~: ~t2 and be~Le~ hemC~ j~: ~, ~, and s~i~ 2 n ~ ~ n ~c~ ~: ~ basement fl~r; ~ first fl~r; ~ ground sup~rt~; ; insuhfi~ ,; membrang Fir ~r ~b: ~wrial ; thk~ess ". Addit~naJ info~ati~: ,, SUeR,OOZING; (Describe underflooring for special floors under item 2 I.) Materlal:iF~doandspeci~__,~/~" ~ _ ~ ~!~,;.:CC~_ i sia~;,.j__.F,_~lt¥1~ first Item; I'l wcond flMr; f'l at6c ~q, fi,i J-I diaional; f'l riiiht angles. Additional inf~rrmuiont 8. RN&~H FLOOIIING: (Wood only. Describe other finbih ~ooring under item 21.) l*i~ floor ..... . s~.~ tlo~. I ~EE ITEM 3 ^tt~ .., I 'l. fi.t / ' DE~.RIPTION OF akkTEi~ I~ ~ ~: ~2 aad better hemfir. ~n8 a~phalt 240~ u~.ar as~hal~ ~atura~e~ BuUt-up F~hing: ~len~ a ] tlm~ ntlm ; ga~ ~ weighl Joim~r~lm~ omrner beadm: taped and mpaa~led - q coats I ~i.,~. L~TEX P~NT THROUGHOUT WASHABLE ,~ND DUR~BI.E PAINT Addillo~al information: Roof ~ru~e~ (see de~il}: gr~ and species 16. INTr~JoII DOOR~ AND TRIM: Dean: type Do~r Irim: ,y~ clamsb$%l ; mi~er~ wh. pi~e Finish: ~ S t a i n Ol~r trim (;~t,.. Addillo~t in~mal~n: 17. W~W~ Win~wl: ty~ ~] ~ d~ ; ~ ~/~, ; grade ~; rizel~; ,ype S t r' ~[ ~ felt: i wcigm o~ mickr~u 1~ ;se ~' ; raue~n~la:Lled ; number of piles ; retracing ma,edal ; ~ IF&vel uo~; I'1 mo~ ~ LATEX pRINT T~Rc, ucHOUT WASHA~L~ AND DU.~ABLE PAINT mica ; model i~emen, ellow 1 . Attic Disappear'lng: makr and model numlx, r ~il- infotmafimt: 1 ; sbelf widlh , ~ , mica ; number Base units: material hardwood and masoB,~l~er mp Back and end splash IP~ ~a Finish of cabinets Medicine cabinets: make Other cabinets an,I bulb-in furnilufe va~i~v i~ bath ~il~l mformad~: Ilead ~Lublng alumiDum ~creen doori: thickness .."; number ~ombinatlon u~rm ~d ~r~n dmri: Ihic~ess 5hu,~n: ~ hiog~ ~ fix~. ~itln~ gxter~ millw~t: 8fade and ~ci~2 ~h~gO pine Paim 0~1 bas~ A~i6o~l informal~n: ; ma~er~al ~lt~mq n}~m ; ~alh INclme~ , Trim: Eye. ; ~r~l PainP1 ~ ~mf.t ~ ; ~m~ c~i Wealhemripping: ly~ pO~V' pile ; mtcr~l hollow flex vinYl ~rm sub, nu~r , ~se~m win~ws: ty~ aW~ ; mater~ WOCd ,; ~r~n*, numar ;~rm mb, n~ , , S~c~l wi~w~ A~iim~l informailon: ~S ~ EX~IOR D~AIL:a~ ~:eel ~aee~ poly~:rene core insulated Main enlr~ d~: material ~ ~ ; width ~ I . ; rhlck~ I ~/'~ I~ramc: ~ierial ~nnd ; ~a ~ O~r enKa~ d~ra: maleriat ff ~ ; wi~ ~ ' ; Ih~cknes~ ~ ~/'~ ~rame: ~wr~l NOC'~ ; lh~k~ ~:~y~elamshel~ ;ma~q~h- tine ;'~2-1/! ; ~rim l~tatn !scribe listed in Cert~ ~ ~nyl ~h~tn~ 1/1~" me~al ~ood ~" hat,bo. gll other rQoms wa!! ~o wail carpet 24 oz. -colcrs ~g owner ~/8 Dol~ur~tha~e ~ ~ Tu~ (F~o~ ~) ~l~ fferam~O, a-I/q" X h-l/a" B~ afoul d ~ub ~a~roemnccesmrles:C~Rece#ed;mmeHal aeramio ;number ~ ;l']Atmched;mawtial ;number Addhloeal h~Tailiea: m.~ 1 kitchen B*ri~s ' .q2 x 21 white L~va~ 1 bath Britts 18" roun(~ owner ~smub 1 ba~h Britts 5 ' owner S~r o~r mb~ I h~th Prio~ Pti ~er 1/2" chrom~ ~u~ Wn~lhtn~ mar~in~ drnim and hnt and nnld onnneot Lnns in b~ semeq~ ~J aunala rod' Ar'I ~ [] Shower pan: ma~aal . · , I~R'l'~l~ R LU ANU~ $] DO -an~ ameu ~ d~: ~ .ublic; ~ ~muni~ ,y.~; ~ mdi~d~l (~va,e) ,y.,~ .CESSPQOL RSLOWNRCE ~I, 300.00-any ........ ~ amo n over and above by owner ~ w~r h~: ty~ coil ,; ma~e and ~1 ; ~g - Buyer ~tl: ~ ~mr; 0 .gl; 0 ~i~n~. Peel ~1: '~C~u~wr. ORe~umpump. ~d~el ~r:m~eedm~l C~lnmb~a # O~M 120 Gravity. ~ F~. Ty~ ~ ~mdal: supply ; mum ~tcr; ~ ~r [u~e; ~ w~l h~t~. Input B~.; outer ~1 ~diti~al in[or,on: ~ ~1; ~ ~u; ~ fiq. ~l. ~; ~ cl~ic; ~ ~ui~nt ~m~ e~l?: ~ ~ ~r, ~vmim ty~. Oil bunter: BI prmure atomizing; FI vapuri~in~ r~ecwic heaJia~ sy~em: ty~ '- Gontrol ; capacity Btu]L; OUI~UI ~ B~uh.; number units ; ~orase capacity Input watts; (~ v~ts; output Bluh. ; capacity 24. BT~qIUC WIRING: Service: 1~ overhead; I-I underBround. Wirinll: I-I conduit: 0 nrmm'ed cable; [] nonmetallic cable; [] knob and lube; [] other Specialoullet~:~qrangel[]waterheater;[~mher Wa.~h~n_~ machine ext. wall outlebOFI, dryer I~l Doorbell. [~ Chime& Pmh-butmn locations fl*t~n~ d~o~ Additional informafiom 25. UGHllNG FIXIUI~: Tmal number.e~ fimu~ 7 TMaJ allowance ~or Sxlu~. typical inuallado~, $ ...$ 5 0.0 0 Nontypical inslallollon.. Additional in,or..matlom Panel: I-1 fu;~ box; I~l circult.brcaker; mak~~ANIP's 100 _ No. cil~ul. ,8 DESCRIPTION OF MATERIALS DESCRIPTION O~ MATERIALS Ro.~ 9" Fiberglass batts - stauled -R-~0 c~{inf q~,t FiberE]ass harts - startled -R-11 wa ~" Fiberglass b@t~s - stapled -R-11 27. MISC~,LANEOUS: (Desczibe any main dwe.~.ng maM~als, equipment, or condruction items not shown eh®where; or use/o pray/de Odctfional information where the space prodded wa~ inadequate. Always reference by i~em numbs' to CQ~r®SpQ4~ fo numbM~ HARDW~(make, mat~at, mndftnizh.) K~iL~t . h~qm .r.l~tpd . SI~CIAL EQUIFMENT: (Sram ma~ial o~ make, model and quan//ty. Include only equipwt and appliances which are ~ able by local law, cuJtom and applicable FHA ~tand~dL Do not include items which, by e~tabli~hed cultom, cve wMed by occupant and removed when he vacot~ I~entilel or chafftes prohibited by law from becoming reolty.) Rear stoop - CC~ · 8×84 ] exJ. s 2~ ' fK( behind main b~ildinl. T.,v--- ...... '[~ from yard; ),ad to t.awm ( .,.kd, a~/.~, ~, #.~14,i ): [:kfronl ~ard . · , ~=, ~1~ side yard~ ~ ,= ,~ H ~ H ; [~ tear Pbadnl: I1 u IIx'ciBrd iud drown ua d~winp; r"l u ~md9 ,~ 4a~duou~ 'cd;Fr. ~. ,reel ..----~-..-', ~'., & I~ Law {Iow~I Irees, deciduem, ' to ~----r--- ~mJbL ~' flilh.frowinI IhrulM, de~id,_,c-__,_% ' m ' Vines, {.ymr ,200.00 zo'r ,4RgA .~625 ~'.~C£$$ O.F' ..'~00 Cq, z) "VACANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES FOR APPROVAL OF CONST ONLY DATE HS REF NO APPROVED FSy THE WATER SUPPLY & SEWAGE DISPOSAL FOR THIS RESIDENCE WILL CONFORM TO THE STAND- ARDS OF THE SUFFOLK COUNTY DEPT OF HEALTH SERVICES GUARANTEED ONLY TO /~IV~-,~$/D£ /.~/~1~"$ /NC' NAME ADORESS TELEPHONE 048992 JOE5 NO 78-/57 FILE NO: G~£,f'#/~'7',P,4'/v/,,v¢ SURVEYED FOR LOT NO, ~,,~ MAP OF ~EEN~RT ORlYt~G P&~ S I T UAT E D AT: G~ENPO~T TOWN OF SOUTHOLD- ~UFFOZ~ SCALE 1' : ~O' DATE FILED MAP NO ~ DATE ~OOK NO Z.Z. PAGE HAROLD ~ TRANCHON JR. RC LAND SURVEYOR SJCCESSOR TO WlLLIA~ G. NORTH COUNTRY ROAD-WADING RIVER NEW YORK 117D2 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined .~..~:~.'~ .... 19 .~.~. Approved .(?...'~...~%....~...., 19.~.~. Permit No. I .~..~.?.q..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ~19... Date ............... ',. ,, 19... INSTRUCTIONS a. This 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 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 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 building for necessary inspections· ... ,.. ...................... (Signature of applicant, or name, if a corporation) ... 2. v. ff :. 4 ,.. x. ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .R. 5. v. ey.q~.d.e..H, qn.~e.a., . I.n.c... .................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. S. Gordon, President (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ...... 2. O.~.O.P. .............. Electrician s License No. 26978 Other Trade's License No ...................... 1. Location of land on which proposed work will be done. tl~ J .'N./.S.. B.~.o.w.n..S.t.:.. 2.0.0.'..S./.0.. 7th S. traet .......... Greenport House Number Street Hamlet County Tax Map No. 1000 Section ...... .~8. .......... Block ....... 3. .......... Lot .... 2.1. ............ : Subdivision Gre~nport D~iving Park Filed Map No. 369 Lot 24 (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land b. Intended use and occupancy ..... .1..f.a.rn.i .ly..d.w.e.l.l}.ng. . .......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Repair .............. Removal .............. Demolition Other Work ......... i (Description) 4 Estimated Cost Fee ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units.. 3 Number of dwelling units on each floor ........ If garage number of cars 6. If business, commercial or mixqd 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 Dimensions of entire new cons/ruction: Front 26 '. Rear 2.6 '. Depth Height ...iff.' ........ Number of Stories 0! -' s.0.,, li2 ...... 9. Size of lot: Front 5 Rear ......... Depth ......' ..... 10. Date of Purchase 7/6/78.1 . Name of Former Owner ¢/illiam Henry Brad~6r;d 11 Zone or di t 'ct in wh'ch p~em'ses are sit ated . use s ri 1 1 u ..................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: N0 13. Will 10t be regraded .... Y. qs..j .......: · .. .......... Will excess fill be removed from premises: Ye No 14. Name of Owner of premises . .R.~v.o.~.s.~qo. fi. qm. qs.,. IH Riverhead .727-33~5. ...... .. ~ddress ................... Phone No ........ Name of Architect ...R. 5. qh&E~..l~.andqloski Address Riverhead PhoneNo 72.7.~3.3. g. 5 i~ , IBc; Riverhead 727-3395 Name of Contractor Rivers e Homes Address ............. Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& 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. SEE ATTACHED, SUR/EY STATE OF NEW YORK, COUNTY OF ~.U?F.o.h.K ....... i S.S ........... ~I~[¢gl~$T~t. 6,. ¢6~1~15¢~g0 ................ being duly sworn, deposes and says that he is the applicant (Name of individual sig6ing contract) above named. He is the ....... bgO¢~. ~O~. O~¢o~[~U$~ ........................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dffly authorized to perform or have perfomed the said work and to m~e and file ~is application; that all statements con~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this .............. y ..... y E~:-~: (i" 'RIV!}.,' , ?f,]li~Ot C, 12 ,/ O~ -r -r m ..q ~, "r t ;") I, Om ~< o~ O~m~ ffi