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HomeMy WebLinkAbout15181-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18057 Date MAY 26~ 1989 THIS CERTIFIES that the building. Location of Propert~ 100 GULL POND LANE House No. County Tax Map No. 1000 Section 035 Subdivision ONE FAMILY DW~3.T.ING GREENPORT Street Hamlet Block 04 Lot 07.6 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 8, 1989 pursuant to whzch Building Permit No. 15181Z dated AUG. 9r 1986 was Issued, and conforms to all of the requlraments of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DW~LT.ING~ ATT_ACHED GARAC~.~ REAR DECK AND AMENDED TO INCLUDE SECOND FLOOR DECK. The certificate is issued to of the aforesaid building. ROBERT & CHARLOTTE WISSMANN (owner, X~) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-SO-01 MAY 12~ 1989 UNDERWRITERS CERTIFICATE NO. N057137 FEB. 7~ 1989 PLUMBERS CERTIFICATION DATED K & K PLUMBING & HEATING-APR. 19~ 1989 / ' / B~dfng Inspec~6r Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP~AIT ~.,s .E~M,. MUST 8E K~P~ ON ~.E PR~M,S~S UN*,L ~U~ C~.~,O~ O~ *~ WO~ ~U*,O~,Z~O) 15181 Z Date . ..~..~...~ ................ , County Tax Map No 1000 Sect~,c~ ~ ..(~.~..~ Block ...... .~..~J. ........Lot No....'~: .(~ ....... Building Inspector Building Inspector Rev 6/30/80 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOHTHOLD, NEW YORK 765 - lB02 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION Location County ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ of Property ........................................................ HOUSE NO. STREET HAMLET Owne rs of Property... -~?.~?.~. ~...~/t.~.¥~. fft~...k~, .~._~.~../~.,~..'~..'~. .......... T~. ~ap No. ,ooo sc,tion ¢.~..~.. Blo,k .o..~.... Lot .7.'.~. .... Subdivision ....................... Filed Map ........ Lot .......... Permit No ......../..~:.~./~ Date of Permit .......... Applicant .-~.~ .............../q~' f~ 7 Health Dept. Approval ................. Underwriters Approval .f~f7 .. Planning Board Approval .w~.'. ~ .......... Request for Temporary Certificate ....... Final Certificate ................ Fee Submztted: $ .................. APPLICANT .~iELD I S~~ '~ ' 1. FOUNDATION ~'/(1 st) FOUNDATION 2. (2nd) ROUGH FRAME & I~$SULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 11 TOWN 0F SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY DEVELOPM~T PERMIT to at p~emisem located at County Tax Map No. 1000 Section ~ Block 0 q Lot ' ~, ~ pursuaxxt to application dated ~ o ~,u ~r- ~ , 19~_~.~, I and r~ppvoved by the Building Inspector. Building Permit No. .... /s'-/~,1 z 4/80 Building Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. /~/~/~---- Owner_~, ~%~~ (please prlnt) (please print) ~e~_~ ~ ~5~--f I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~OC ~)~\,~c~k3~C>(~- /-( , (plumber's signature) Sworn ~o mo before this 19~'~ . , Notary Public, ,~~ County ER~C G. KOCH ~ I~ubh=, State of New I~ 52.21621OO ~ In Suffolk County Te~t Expire~..Jmn. 31. 1990 JOHN WICKHAM, FRANK S COyLE HENRY E RAYNOR, Jr FREDERICK E GORDON J ~kME$ WALL Southold, N Y 11971 COPY TELEPHONE 765-~9:{5 A regular meeting of the Southold Town Planning Board was held on Monday, October 30, 1978 at the Town Hall, Main Road, Southold, New York at 7:30 p.mo Present were: John W~ckham, Chairman Henry E. Raynor, Jr., Vice-Chairman Frank S. Coyle, Member Frederick Eo Gordon, Member Arthur & Millicent Gossner, League of Women Voters Franklin Bear, North Fork Environmental Council Douglas Love, L. I. Traveler-Watchman Peter Campbell, The Suffolk Times Absent: James Wall /Sarsl~ Rauch. Jack Sherwood appeared as agent for F~rs.,~Rauch. The other proPerty owners are Mrs° Germansky, Mrs. Brody and Frank Bisk. This was a referral from the Board of Appeals for site plan approval by the Planning Board. ~ On motion made by Mr. Gordon, seconded by Mr. Goyle~ it was RESOLVED to approve the site plan of Sarah Rauch dated October 19, 1978 subject to the applicant filing in the Suffolk County Clerk's~/  ffice covenants that this property will not be used as a residence. Vote of the Board: Ayes: Wickham, Raynor, Coyle, Gordon A motion was made by Mr. Coyle, seconded by Mr. Gordon and carried to approve the minutes of the meeting of October 10, 1978. Mr. Robert Beazley of Ecological Analysts, Inc. had made a ~- presentation to the Planning Board on October 23, 1978 wh~chMr. Wickham and Mr. Raynor attended. The company is geared up to larger projects. It is a resource that is available in case the town does get a large pro~ect. 179 lO/aS 1. That the drainage areas be rectangular rather than trapezoidal. 2. Vail Drive be contmnuous to North Sea Drive to eliminate confusion in a name change on the road to the Sound. 3. That the turnaround be on the west end of North Sea Drive at the contmnuation of a future extension than at the Sound bank. 4. It has been noted by Mr. John Wickham, Chamrman of the Planning Board that they will require that the waterfront lots along the Sound have a building setback line of 100 feet from the top of the bank. Vote of the Board: Ayes: Wickham, Raynor, Coyle, Grebe and Moisa. The following letter was directed to be sent to Mr. Robert Gillispie, Chairman of the Board of Appeals regarding Brody. "In regard to the letter from the Board o£ Appeal's secretary dated October 4, 1974 in regard to Reg Hudson, Brody and others, the Planning Board does not look favorably on any development of thms property. We have discussed this with the Suffolk County Board of Health and they feel that since this is fill pumped in over very heavy bog, there is no possibmlity of getting good water or any sewage disposal and even boat storage buildings would presumably have to have some sanitary facilities. Also,~boat storage buildings should only be in a "C" District." ~~ The secretary was directed to write a letter to the Board of Appeals informing them that Crown Land Lane ms not an approved subdivision. This is in reference to a variance given to Mr. Edson for use of a barn as an art studio predicated on the fact that this was an approved subdivision as stated byMr. Edson. The followmng communicatmon was received from the Town of Riverhead Planning Board dated October 21, 1974. Gentlemen: The enclosed resolution was duly adopted by the Town of Riverhead Planning Board at a regular meeting held on October 9, 1974, and you will note that the last paragraph is for your considerat!on. /s/ Jane A. McBrmde, Clerk FORM NO 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y NOTICE OF DISAPPROVAL · 19 ~(o PLEASE TAKE NOTICE that your apph. cat~on dated .~,,d.,e.~,~_... ?D~.~[ .......... 19 ~ ~ for penmt to construct ~ .0-~ ........................... J at Location of Property House IVo Street Ham/et County Tax Map No. 1000 Sectmn ~.~' . Block .... (~ ~. ..... Lot ..~. fla. Subd~ms~on Fried Map No ...... Lot No ............. returned herewxth and d~sapproved on the follow~ng grounds. O, Jl~'~'%-~ "~ ~ ~ ~ 0'0-11 o~. a .............. Building Inspector FORM NO. 3 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N Y. NOTICE OF DISAPPROVAL .. z o. .~. . .Ca~v co<,,~ . ~,<~Y. . PLEASE TAKE NOTICE that your application dated ..~.~...~ ~ ....... , 19 .~ ~ for p¢~it to ~~ ~. ~.~,~ .~[g~ ............... at cou,~ ~ ~ ~o. ~o00 s~¢~,o, .~.5~ ...... ~o~ . .~.~.. . ~t ~o.7.'.~... Subdivision ................. Fried Map No ............. Lot No ........... ls retumcd herewlth and d~sapproved on the followlng grounds T~LJ/ e~g~/.AJ~. . (-O~. (ddyO.~. ,. ~.~. ~~¢. .~ L.~ :.~ . . ~ . ~. ~a. .~ ~. .~ ~ c ~. . .~ .~ t. . ~/~ . ~o~. ~.naA . ~/~. . ~ ~7~o. . Buildinq Inspector RV 1180 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .~l~.~.~.~,~,..~'x.r~ ~.,..~.. ~ .N~...,. ~!.7t :~ PLEASE TAKE NOTICE that your application dated .. ~ Oxy'....'~ co.~. ........ 19 .~ ~ for permit to COt~ .~..'/r/Z~.c~.~...~. t~sE..~. 6~..0~4~.~.¥.. ~-~/Z~J-~ ~CQ ..... at CountyTax Map No. 1000 Section ....~..~..~'~. .... Block ...Q..~. ...... L~t ~Z).C.)'"].. ~ . Subdivision ................. Filed Map No ................ Lot No ........... is returned herewith and disapproved on the following grounds . .T. I'~. ~.<~,e/4~ .~'~- ¥'v~,z~,,,% .~~~...(~.~... ~... ~ t ~ ~.. ~ .~ ~. ~O ~.,~. ~~ ~ ~. ~ .. ~.~ ~ ~. ~..~.o. ~/~/~ ..... ~ ........ ~'" t ..... ~.~.~ ~. ~9.~% ~ ..... ........................... : ...... · ~ ~ Building Inspector RV 1/80 765-1802 BUILDING DEPT. INSPECTION [ ~ FRAMIN6 ~ // ~~INAL REMARKS. ~ INSPECTION FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING .'MA.KS.- DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~SU~TION FRAMING FINAL INSPECTOR~_~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH FOUNDATION FRAMING PLBG. 2ND [ ] INSULATION [ ] FINAL INSPECTO/~~~ 76S-1802 " BUILDING DEPT. ~/~ ~//? ~ INSPECTION ~/~ FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~lrRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ~//ROUGH FOUNDATION lST FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL PLBG. 7GS-XSQ2 BUILDING DEPT. NSPECTION [ ] FRAMING [ ] FINAL REMARKS.-- ,~ ~/~,~'//~"~ ~ //'-/- ~ , / . . ~ I INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING RF. MARKS: [ ] FOUNDATION AST []ROUGH PLBG. [ ] FOUNDATION :'ND []INSULATION []FINAL 765-1802 BUILDING DEPT. INSPECTION ~~FOUNDATION 1ST []ROUGH PLBG. [ ] FOUNDATION 2ND []INSULATION [ ] FRAMING []FINAL REMARKS:~~ DATE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY B5 JOHN STREET. NEW YORK, NEW YORK 10038 ~te ~pplication No. on ~le TMI~ GE~IPlE~ TMAT ~ examin~ on end found to be in compliance ~ith the requi~ments of this ~rd. ~ FMINACI MOTORS TIM CLOCKS MULTI--tIT INMMERS sY$1~a$ ~RVIC~ D~IN~"T ; $ E R V I C NO. OF HI-LEG m MANA~ Ii ~k ~fica~ ~t ~t ~ alUM in o~ ~n~r; return to the office of the ~ard if incorr~. Insp~tors ~y ~ i~' b~ir' cre~tials. C~ ~ CERTIFI~TE ~ST ~ BE ALTERED IN ~ ~ER. COUNTY OF SUFFOLK Property Tax Service Agency? age 5 of 12 LiST OF ACTIONS TAKEN BETWEE~ JANUARY 1971 and SEPTEMBER 5, 1979 INVOLVING AREA ~£ND/OR ~IDTtI VARIANCES (ALSO REFERRED TO AS VARIANCES FOI~ "CHANGE OF LOT LINES" or "REARRANGING LOT L~NES"): Appeal Date No. Gran ted 1942 9/12/74 1948 10/3 /74 1949 10/17/74 1950 9/12/74 1951 9/12/74 1952 9/12/74 1954 10/3/74 A ,pplicant (s) ~roperty Location SLATTERY, ARTHUR W. Landing Road, Northwest Loop, Lot 273, Nass. Point Propertmes, Cutchogue SAWICK!, JOSEPH S/s North Road, Southold VER~4AELEN, ESTATE OF MARIE W/s Bay Avenue, (Has received a type of P.B. approval) Mattituck SLEDJESKI, STANLEY South end of Sunset Dr~ Matt. DONAHUE, ESTATE OF CLEmeNT B. Tuckers La & Middle Rd, Sthld. ROSENBERG, HERBERT & RUTH Town Harbor La. & Terry La, Sthl~7 BRODf & OTHERS E/s Gull Pond La, Grnpt. (STORAG~ (Was submitted for BUILDINGS ONLY PERMITTED. NO RESI P.B. approval 10/3/74) 1959 1967 1978 1984 1987 1985 1993 1994 2000 1997 2001 2008 2014 2015 2016 2050 10/17/74 11/14/74 12/5/74 12/19/74 1/9/75 4/9/75 1/9/75 HABN, ARTHUR W. JR. DAY, LOUISE O. by Walter G. Kapp, Esq. CHEREPOW£CH, JOSEPH BOUTON SERVICES INC. GALGANO, ANDREW 1/9/75 LEMLEY, ANNE C. 2/27/75 CARLSON, CLAUDE 4/24/75 PHILIPP, BARBARA A. NEW CONSTRUCTION REQUIRES ADD'L 2/27/75 ADAMS, IOLA 2/27/75 BURRELL, GEORGE 5/Z/75 3/20/75 4/24/75 4/10/75 6/12/75 W/s Bayshore Road, Peconic Bay Estates Lots 132-136 inclus., Gr~ W/s Peconic La., Peconic & WI. Main Road & Shipyard La, Crescent Avenue, Fishers Island & OTHERS R-O-W off Northeast Wes%pta Road, Ma~tituck DOLL, EDNA Browns Hills Estate, Orien~ CORWIN, WILFRED & ANNA Sound Ave, Factory Ave. & Wal~ Place, Mattituck S/s Bay Avenue, East Marmon N/s North Bayview Rd, Sthld. E/s Reservoir Road, F.I. - ANY BOARD OF APPEALS ACTION. N/s CR27, Cutchogue R-O-W at North side of Manhanset Ave, Greenport HER~N, WILLIAM N/s Soundview Ave, Sld. Lot No. 5 of "Goldmn", Map 1106. ZAMPHIROFF, ATHANAS E/s Cedar Ave, Southold (LOTS CONTAIN MORE THAN 40,000 EACH.) STROH~iEYER, LORAINE CHASE, STANLEY A. FAULKNER, WILLIAM J. E/s Youngs Road, Orient. Private Road off S/s Park Ave, N/s Winthrop Drive, Fishers Isl Application Received ~o ~-''~ 19~ Disapproval Issued 19 Permit FORM NO. 10 iN OF SO,THOLD ( ~. Type or Development Proposea: New ~tructure~znc±uOzng storage ~anKs Addition and/or Alteration__ Flood Proof Below Base Flood Elevatzon Other (specify) 2. Elevation Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement __ feet __ (b) In a V Zone, bottom of lowest structural member feet 3. FIRM--Flood Insurance Rate Map, Zone designations ~-- 7 4. Owner of Premises ~ ! S 5. Location of Property: House # Street Hamlet County Tax Map No., Dist. 1000, inches inches Section O~ Block Oq Lot(s) Subdivision Filed Map# Lot(s) 6. Permission to be granted: __ Owner as above ~ New Owner Under Contract Lessee Contractor Phone # Name if not given above Mazling address 7. Approval from other(s) before Permit is issued: DEC ~ Wetlands (Town Board) Health Services Building Permit ZBA ~ Planning Board the applicant, am the Owner Co-Owner New Owner , Under Contract__, Lessee __, Agent __, Contractor __, and agree to comply with all applicable sections of the Code of the Town of Southold; County, and State and to admit authorized inspectors to premises 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 my knowledge and belief and that the work will be performed therewith. STATE OF NEW YORK COUNTY OF ~/~.~ ~.~ SWORN TO THIS c'~/~ Notary Public Applicant's mamling address and phone if not given above in the manner set forth in the application filed SS Signature DAY OF UNDA J. COOleR Notary ~b~;e, S~ ~ ~ Y~ NO 462Z663, Term ~ires D~m~r 31, FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P.©. Box '28 So~thold, N.Y. 11971 Town Hall Main Road Southold,N.Y. ~PDTICAT!ON FOP nEVFr,~oMF~ DEPMIT Instructions: The application to the Building Inspector includes (each in duplicate] 1. Form No. 10 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 46-17 o~he law to minimize flooo damage: ud~l A. Anchoring of structures, incl ng--' ~ mobile homes B. Use of construction material and methods C. Design and location of utilities D. Subdivision proposal with drainage, pub!i'--~ d'~i~ities design and base flood elevations Specific Standards as required in Section 46-18: A. Residential construction B. Non-residential construction C. Mobile homes The applicant must submit plans and specifications as well as any other information requested by the Build'ing lnspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight w~th walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazard area (V Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that the provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation with all space below open except breakaway walls. Sand Dunes. If sand dunes exist on the premises and the applicant pro~ poses to alter same, plans and specification must be shown in detailed nature of any alteration submitted. Buildin~ Permit. A Building Permit is also required for any structure. Both a Development and a Building Permit must be issued before any work can start in a special flood hazard zone. A written disapproval or a permit must be issued within ten (10) working days. During construction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification of the final elevations and work must be submitted before the approval to use or occupy can be approved. (Fill out the form on the back of this sheet) Approved Disapproved a/c 'FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.' 765-1802 · ,19 ,19 . Perm~tNo Recezved ........... ,19. (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT Date~..~' klo.~ ! ..... 19.~ INSTRUCTIONS a. Tins apphcat~on must be completely filled m by typewriter or m ink and submitted to the Budding Inspector, w~th sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showing locatmn of lot and of buddings on premises, relatlonsinp to adjmnmg premises or pubhc stree or areas, and g~vmg a detmled descnptmn of layout of prope~y must be drawn on the dmgram whmh ~s par of ~s appl ca,on. c ~e work covered by ~s apphcatmn may not be commenced before ~ssu~ce of Budding Permit. d Upon approval of th~s apphcatmn, the Bufldmg Inspector will ~ssued a Bmldmg Pem~t to the apphcant Such peru shall be kept on the premises av~able for inspection ~rou~out the work e. No bmldmg shall be occupied or used m wkple or m part for any pu~ose whatever until a Cemficate of Occup~c shall have been granted by the Bmld~g Inspector. APPLICATION IS HEREBY MADE to ~e Bufl~mg Dep~tment for the ~ssuance of a B~dmg Pem~t pu~uant to th Budding Zone Ordxnance of ~e Town of Southold,~uffolk County, New York, ~d other apphcable ~ws, Ordinates o Regulations, for the construction of buildings, add~tions or alterations, or for removal or demohbon, as hereto described The apphcant agrees to comply w~th all apphcable laws, ordinances, bufld~g code,.hgum~ ~e, and regulations, and t, admit authorized ~spectom on premises and ~ bulldog for neces~i~s~~ ' (S~~~ ~ corporation) (Mmhng address of apphcant) State whether appbcant ~s owner, lessee, figent, architect, en~neer, general contractor, electncmn, plumber or builder. Name of owner of premises ~.G-%-~7' ~ (as on the tax roll or latest deed) If apphcant ~s a corporatmn, s~gnature of duly authorized officer (Name and t~tle of corporate officer) Bmlder'~ License No.~ . Plumbers ~lcense No L Location of land on which proposed work will be done ttouse Number Street County Tax Map No lOOO Section Hamlet Block ~ Lot ~ :~.~7~. ~. 2 Subdlvlslor~ .. Flied Map No. Lot , (Name) State existing use and occupancy of pmm~ses and intended use and occupancy of proposed construction a EmsUng use and occupancy X~dA ~ t~ ~"7'- o r 3. Nature of work (check which applicable) New Budding .~. . . Addition .... Alteration Repmr ........ Removal ....... Demohtlon ..... Other Work ......... . (Description) 4. Estimated Cost o~o Fee (to be prod on fihng this apphcatmn) / 5 If dwelhng, number of dwelhng umts . v, . ...... Number of dwelhng units on each floor ........ If garage, number of c~ .... /~ .......................................... 6 If business, commercml or m~xed occupancy, spec~y nature ~d extent of each type of use .............. 7. D~ensmns of exmtmg stn~ctures, ~f any Front.. ~q~ . Rear ........... Depth Height ....... Number of Stones ......... D~ensmns of same structure w~ alterations or add~tmns Front ......... Re~ ............. Dep~ ....... He~t ............ Number of Stones ...... ~A ~ ... 8. D~mensmns of entire ne~ construction Front ........ Re~ ......... Depth .......... Height . ../~Ncmber of Stones ~ ~ ............................ 9 S~ze of lot Front .. , Re~ .......... Depth 10. Date of Purchase 11 Zone or use d~stnct in which premises are situated ............................ 12 Does proposed cons~ctmn vmlate any zoning law, ordln~ce or re~lation .................. ~. 13. Wall lot he regraded .......... , ..... Will excess fill be removed from premises Yes N6 14. N~e of Owner of prem~se~( [~ .~(~ Address [o~.~c%~.~ : Phone No. ~ ~ .~ ~ ~. Nme of ~ch~tect ............ Address ......... ~hone No Nme of Contractor ............ Addre~ ............. t-fPhone No ............. ~cate cle~ly ~d dmtmctly ~ buildings, whe~er ex~stmg or proposed, ~d~ red,cate ~1 set-back d~ens~ons from property ~es Gwe stree~ ~d block number or description according to deed, ~d show st~et nines and indicate whe~er interior or comer STATE OF NEW YORK, S S COUNTY OF .SUFFOLK R. ob. ert Wissmal~and Charlotte.. . .. ...... Wissmann being duly sworn, deposes and says that he is the applicant (Name of lndiv~dual slgmng contract) above named. He is the ..................................................... (Contractor, agent, corporate officer, etc ) of smd owner or owners, and ~s duly authormed to perform or have performed the said work and to make and file tlus apphcatlon; that all statements contained m this apphcat~on are true to the best of h~s knowledge and behef, and that the work wdl be performed in the manner set forth m the application filed therew,th. Sworn to before me thru Notary Pubhc, . County ~NN ~,~ A~g~ ................ ....... ~V , ' '~ ' " .- ~,1 ~' ~ ~ / ~. ~ ~ %~.~ ~ ~ . , ~ ......... -Z-t .......... X_ _x ~ xx ~ / / ~-~m,,,,~,,_~_ ' ' .... ' ......... .,~A~ ............ :~ , ~ ' HC~N~ ~0 TH~: WATER ~Y AND ~NAGIE DtlBPOS~. SYSTEM~ FOI~ THIS RES~ENCE WILL 'CONFORM TO T~E ~NDAR~ OF THE ~FFQLK CO DEPT OF HEALTH SERVICES ~LICANT JNTY ID~PT OF SERVICES CONSTRUCTION ONLY DATE'. H. S REF NO,,. APPROVED ,, SUFFOLK CO. TAX DIST. ~ECT~ BLOCK" PCL DEED; N / / _l~j -' MC'KID M E'NIT I r STAT~MI~.NI' OF. ,I,N. TE~T I THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTE~ FOR THIS RESIDENCE WILL Ii CONFORM TO THE STANDARDS OF THE , SUFFOLK C~P~ OF/EALTH SER~CES. J SUFFOLK COUNTY E~ OF HEALTH . s..~r NO. 1H~. 5o $Ol suFF0~'d0 TAX MAp DESIGNATION' DIST. ~CT BL~K PCL S~ ~AL WA, ~ )Et 80 !~ DEC.~X% VAN TU..,~L, P.C: .... G~EEN~RT NEW YORK SUFFOLK CO. HEALTH DEPT. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DIS[~DSAL SYSTEMS FOR THIS RESIDENCE WILl. CONFORM TO THE STANDARDS OF THE SU F f O [~~, T.~F/~ E ALT H SERVICES APPliCANT / ~ SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE ......... H S. EEF NO '~'O} ~OVED ................ ~FFOLK CO TAX MAP DESIgNATIoN:' DtST. ~CT BL~K 'OWNERs ADD~E~: ............... CLAY ' ~ a w*,d true c-~ :l ON IF. AD CONTENT ~EFORE CERI'IRCA~'~ OF OCCUPANCY If Go,oar tubtng,i. Uqd' for water distributing, system; piping "hill be Of tyl~ K Or L only APPROVED AS NOTED FEE' ~.cj ~,'? 0 BY: /' G'./-- · NOTIFY BUILDING DEPARTMENT AT 7~5-1802 9 AM TO 4 PM FOR ,THE FOLLOWING INSPECTIONS: FOUNDATION TWO REQUIRBI~ FOR POURED CONCRETE 2 ~ROUGH FRAMING & PLUMBING 3, INSULATION xt., FINAL CONSTRUCTION MU~T BE COMPLETE EORC O. ' ~ ALI. CONSTRUCTION SHALL MEET ~ TIlE REQU~EMENTS oF ;THE N.Y ', S'rATE CONSTRUCTION & ENERGY CODES. NOT RE~RON~IBLE F~R r~SIGN OR C,,qN$'I~C'~ION ERRORS, f 7 Phone 477-0400 Ii' OCCUP/~gY OR USE IS UNLAWRJL FOLLOWING II~P ,ECTIONS: , FOUNDATIDN TWO REQUIRED FOR POURED CONCRETE ' 2 ROUGH FRAMING &PLUMBING 3, NSuI~ATION ' 4. FINAL, CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHAt:L MEET THE REQUIREMENTS OF THE N.Y ~STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR r '~L~JjGN OR L~.~NSTRUCTION ERRORS, GRE~NPORT, N Y, WITHOUT CERTIRCATE .,,.,,~.h.,:, =ou~a u~= ~v w,~r , , .. OF OCCUPANCY '"'"'" ' ' °~, suer =mm ~ ' , EXCEED 2/'I0 ~ I~/.EAD. , ': -- - ""'? I' ,, - ', .... , ,., , FEiE:~flk'?O BY: ~, *., I ~, ', ..... 5'--'',-{;" --' d! ' ' I '{ ~ .......... 7e6-1802 9 AM TO 4' PM FOR"'THE %¸: ,¸ii ,477 {14d'0- - 'MOin Road / , Woo Phone 477-0400 T I C~OSS be. u'T ON'q .