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Home My WebLink About26344-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26968 Date: 03/09/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 10020 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2000 pursuant to which Building Permit No. 26344-Z dated FEBRUARY 10, 2000 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 ACCESSORY GREENHOUSE AS APPLIED FOR "AS BUILT" The certificate is issued to FRANCES K ACER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A t A horized Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26949 Date: 02/28/00 THIS CERTIFIES that the building ADDITION Location of Property: 10020 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2000 pursuant to which Building Permit No. 26344-Z dated FEBRUARY 10, 2000 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to FRANCES K ACER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A o� zed Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: z-26950 Date: 02/28/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 10020 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2000 pursuant to which Building Permit No. 26344-Z dated FEBRUARY 10, 2000 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 GREENHOUSE ADDITION TO EXISTING FARM STAND AS APPLIED FOR "AS BUILT" The certificate is issued to FRANCES K ACER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ut prized Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-26951 Date: 02/28/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 10020 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2000 pursuant to which Building Permit No. 26344-Z dated FEBRUARY 10, 2000 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 ACCESSORY GREENHOUSE AS APPLIED FOR "AS BUILT" The certificate is issued to FRANCES K ACER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A � t Ao zq Signa ure Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26952 Date: 02/28/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 10020 SOUND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2000 pursuant to which Building Permit No. 26344-Z dated FEBRUARY 10, 2000 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 ACCESSORY GREENHOUSE AS APPLIED FOR "AS BUILT" The certificate is issued to FRANCES K ACER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A hhlzSign ture 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) PERMIT NO. 26344 Z Date FEBRUARY 10, 2000 Permission is hereby granted to: FRANCES K ACER 10020 SOUND AVE MATTITUCK,NY 11952 for CONSTRUCT A DECK ADD. TO AN EXISTING 1 FAMILY DWELLING, 2 ACCY. GREENHOUSES AND A GREENHOUSE ADD. TO AN EXISTING FARM STAND "AS BUILT" AS APPLIED FOR. at premises located at 10020 SOUND AVE MATTITUCK County Tax Map No. 473889 Section 122 Block 0002 Lot No. 008.001 pursuant to application dated FEBRUARY 10, 2000 and approved by the Building Inspector. Fee $ 225 .00 Autho d S gnature AMENDED 3/9/200 TO INCLUDE THIRD GREENHOUSE - FEE $50.00 PAID Ak-*-S 7S 8'7 ORIGINAL Rev. 2/19/98 Form No. 6 �iA HW - T � �`% 'rowN or• sotrruoLu A M 1 BUILDING DEPARTMENT ;. 'TOWN NALL 765-1802 APPLICATION FOR CERTIFICATE, OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the fol-lowing: for new building or new Use: ' 1 . Final. survey of property with accurate location of: all buildings, property Itnes, 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 Ftr.e Underwriters. 4. Sworn statement from plumber certifying that the. solder used in system contalus less than 2/10 of 17 lead. 5. Commercial building, industrial building, nutl.tiple 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. 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 o. 2. Certificate of Occupancy on Pre-existing, Buildin - $1'00.0 3. Copy of Certificate of Occupancy - .251" 4. Updated Certificate of. Occupancy - $50.00 5. 'Temporary Certificate of Occupancy - Residential $$1?5.00, Commercial $15.00 Date . . . . . .g �f1l . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing u tiding. 1 U . Location of Property. . . . . lQQ4:r-1. . .<QAQP R . . .�UE. . . . ./�.`.�.� (.� . . .C. . . . . . . . . . . . . . . . . . (louse No. Street Hamlet Onwer or Owners of Property. . . 8� �� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./. . . . . . . . . . . . . . . Courcy Tax Map No 1000, Sectlon. . . . . . . . .Block. . . . . . .2". . . . . . .Lot. . 8° /. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Hap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. 2. . .Date Of Perini t.o�.).1A.IQQ. . . . . . .Applicant.'EReW, .AgV'4. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final rCer.,ticate. . . . . . . . . . . Fee Submitted: $. . . �5: � . . . . . . . . . . . . . . . . . . . . . L �^.�. . . . . . . . . . . . . . . �+c.S 953 7 PLICANT C OE dG9y9 '; 1` Form No. 6 „ ; s FRO — ��__� •rowN of sou•ruotD BUILDINC DEPARTMENT .:'I. 'TOWN MALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. Thin 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 . Fi.nal 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 restdences and similar butl_dings 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. A. For existing buildings (prior to April. 9, 1.957) 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 0. 2. Certificate of Occupancy on Pre-existing Buildin 3. Copy of. Certificate of Occupancy - .25C 4. Updated Certificate of. Occupancy - $50.00 5. 'Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . `/to/ � p �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . ./. old or Pre-existing[�l;u L[l-ding. hl .RafF, A/YY .S.*t� Location of Property. . . . . IQQ . . (lAl � . . .!?UL. . . . . /rt.( ( ( t H/ C. . . . . . . . . . . . . . . . . . (louse No. /n� �} r Street Ilamlet Onwer or Owners of Property. . . C� /. . .. . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . .Block. . . . . . .? . . . . . . .Lot. . .<�! !. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . .Date Of Permit. .4Z.I.I.Q. . 0.o. . . . .AppIIcant.7 ". 0 . /9�.gfz.. . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final rrCer.,,t,,icate. . . . . . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . . . i� c?t! 1�2c. ,5753 j . . . . APPLICANT . . . . . . . . . . . . . . . . . . . . . . . . cow x4750 _ Iti 11 '�+ I �• Form No. 6 iy1=0 -� 7; •�"� �..1 TOWN OF DSOUTHOLD EPARTMENT BUILDING llLPAR'TML'N'1' 5 : 01, 'TOWN HALT, ..._.. 765-1802 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: J . Fi.nal 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 Jess than 2/10 of t% lead. 5. Commercial building, industrial building, multiple residences and similar buLidings 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. R. 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. Busiuesses 0. 2. Certificate of Occupancy on Pre-existing Buildin - $l'00.0 3. Copy of Certificate of Occupancy - .24 4. Updated Certificate of. Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . gau p . . . . . . . . -. . . . . . New Construction. . . . . . . . . . . Old or Pre ..-, existing u.11ding. ,1hI -1hY162? Location of Property. . . . . IY.ws''. . . �J. . .'�. . . . UE. . . . .... . . . . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . House No'r84 P AC //j� � Street -Hamlet Onwer or Owners of Property. . . `.. .:':'/. . J.:L"� .. . . . . . . . . . . . . . . . . . . . . . ./. . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . .Block. . . . . . .Z. . . . . . .Lot. . . d !. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. 24010*. . .Date Of Permit.010)OP . . . . . . .Appllcaut.F.l3VI A.0€K . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning hoard Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . .. . . . . Fee submitted: $. .oZ$t !rQ . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT Ree, s �S 3 7 Co ?6fs� Form No. 6 I FEB - 7= TOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN HALT, 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building Inspector wLth the following: for new building or new use: 1 . Fi.nal survey of property with accurate location of all buildings, property Miles, 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, industrin.l bui.ldinp, multiple residences and similar buLldings 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. 8. For existing buildings (prior. to April. 9, 1957) non-conforming uses, or buildings slid "pre-existing" land uses: I . Accurate survey of property allowing al.l. property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to Inspect sighed by the spplicant . 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 0. 2. Certificate of Occupancy on Pre-existing, Buildin 3. Copy of Certificate of Occupancy - .25,� 4. Updated Certificate of Occupancy - $50.00 5. 'Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . g,� . . . . . . �m�. I. . . . . . New Construction. . . . . . . . . ./. Old Or Pre-existing Location of Property. . . . . 1QQ�. . ,��„9,(lA.l � . . .�tJE. . . . . /!`.�.( (.17-UCE . . . . . . . . . . . . . . . House No. p A Street 11amlet Cower or Owners of Property. . . `� �"�. ��F� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .f. . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . 122 . . . . . .Block. . . . . . .2. . . . . . .Lot. . . . . . . . . . . . . . . . . Subdivision.. . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. A6.3y1.'.Z�. . .Date Of Permit. aNho . . . . . .Applicant.fR.w .g. nEK . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final(Cer.,ticate. . . . . . . . . . . Fee Submitted: $. ZIP . . . . . . . . . . . . . . . . . . . . . � . . Li . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT cot a6osz w F, I n1 n.,. r. FEB — T = IL._, TOWN 01- 1OII'11+O111) BUILDING UGPARI'NFN1 TOWN IIALI, 7f,,-1802 APPLI.CA'1'IO11 FOR CI--.R"1'I FICA1; til- OCCUPANCY A. Ibis application must be Cll..led in by LypewrlLer OR ink and submitted to Lite budding inspector wLLir Lite following: for new building or new use: I . Final. survey of properly with accura Le location of all buildings, property lines, sU eets, and unusual naLural or Lopogrnphie fen Lures. 7. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 1. Approval of electrical in stnllat inn from Board of Fire Underwriters. 4 . Sworn sto Lement from pluniber cerci fy Ing that the solder used in system conl_a itis less Chau 2/l0 of 17 lead . 5. CommerclaI building, industrial bit lldl_ng, inti ltlple res td ences and sIiniIIr hui1dllips and ingLaIIaLtons, a certificaLe of Code Compliance from architect 0 engl.neer responstble fur Lite buil.di.rig. G. Submit Planning Board Approval of completed site plan requiremenLs. B. For existing buildings (prior to April. 9, 1957) non-conforming uses, or buildhigs and "pre-existing" land uses: I . Accurate survey of property shnwing all. properly Lines, streets, building and unusual natural or topographic features. 2 . A properly completed application and a consent to inspect signed by Lite applicant . If a Certificate of Occupancy is denied , Lite Building Inspector shall_ state the reasons therefor in writing to the applicant . C. Pees 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 0. 2. Certificate of Occupancy on Fre-existing Buildin - $100.0 3. Copy of Certificate of Occupancy - .25p It . Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $$1/5.00, Commercial $15.00 Date . . . . . . `'./`'g.�" . . . . . . 2— -. . . . . . New Construction. . . . . . . . . . . Old Or Pre-existin ufldin h +-• • - Location of Property. . . . . IPQ,-V. . So&,i4 gAE g (n A- ( r C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (louse No. /�l� Street Hamlet Onwer or Owners of Property. . . ��?R� 1 1 � - � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .QQ. . .1. . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . IZ.y . . . . . .Block. . . . . . .Z. . . . . . .Lot. . .U /. . . . . . . . . . . . . . . Subdtviston . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Hap . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit Nu. Dl L.2✓. y /.'.Z�.-. . .Date Of permit. %Q 110140 . . . . . .Applicant.F. R.ey—A a K . . . . . . . . . . . . . Ilealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final/Certicate. . . . . . . . . . . �� Fee Slrl>rnl.tted : $ . . . . . . . . . . . . . . . . . . . . . �.J//� . . . . ..4: .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT Ritz_�5 259-7 t-e 6 BOARD OF HEALTH . s,. . FORM N0. I 3 SETS OF PLANS . . . . . . . . . . . .. . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . .TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . . Examined.....aZ I O , 20.00 MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.....lal 1.0...... AD. Permit No. ................ ................................... Disapproved a/c .................................. ................................... ...................................................... Kspector) t. U 2000 j APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 20. . . . INSTRDCTIONS LL�,--- --i a. 'chis application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 application. c. The work covered by this application my not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 dERW MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Tare Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildinga, 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 ,ece'ssa ryinspec s. (Signature of applicant, or nam, if a corporation) /00d 020 �sovo s1d� /Yl�rllTi/cK ...... ........................../ ............... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general, contractor, electrician, plumber or buildeu ..................................................... .................................................... Nameof owner of premises .... ../<- .................................................................... (as on time tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam and title of corporate officer) Builders License No. ......................... PlrmbersLicense No. ......................... ElectriciansLicense No. ..................... Other Trade's License No. .................... 1. location of land on which proposed work will be done......................... ....�....�........................... �� .��1..........��t^ / I Ir.l_ \ .r•::r��t..................... .........................�..,. louse Number Street Haslet Canty Tax Map No. 1000 Section ..l2 y....... Block .....Z........ 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 ...... 9. � t.5 /3/7/L T - .. .................................................... U. Intended use and occupancy ............................................................................. EG/L- w+uuh 4WIACaWe/: new Building .......... Addition .......... Alteration .......... it ............ Removal ........ Demolition ............ Other Work ...................?.............. 0 nrr.n (Description) i. Est d cwt .ayt V Y. ..... fee ....... .... .... .... (to be paid on filing this application) i. If ckaelling, number of dwelling h rnits ............ Lumber of dwelling units on each floor ................ Ifgarage, number of cars ...................................... i. If business, morercial or mixed occupancy, specify nature and extent of each type of use...................... '. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ,Number of Stories ...................... Dimensions of same structure with,alterations or additions: Front ............... Rear ............... Depth .................... Deiglu:! .................... Lumber of Stories ............... Dimensions of entire new construe tion: Front ................ Rear ............... Depth .............. �. lleigtht ......................... Number of Stories ..................... '. Size of lot: FMIL .............,....... Rear .................... Depth .................... 0. Date of Purchase ................:.... Name of Former Owner ........................................ 1. pone or use district in which premises are situated .............................................................. 2. Does proposed construction violate any zoning law, ordinance or regulation: ................:....... 3. Will lot be regraded ............I....... Will excess fill be removed from premises: YES NO 4. Nares of Owner of premises ......:.................... Address .............................. Phone No. .............. Nam of Architect .................................... Address .............................. Phone No. .............. Nam of Contractor ................................... Address ...............................Phone lb. .............: 5. Is this property within 300 feet of a tidal wetland? * YES .......... NO .......... *IF YES, MIUM TOldi MISI S MWT MAY RE .IifgHRP.D. PLOT DIAGRAM Incate clearly and distinctly all"buildings, whether existing or proposed, and indicate all set-back dimensions 'Tom property lines. Give street and block amber or description according to deed, and show street names and indicate hether interior or corner lot. rNIE OF NW YORK, SS "IY OF ....................... ..... 14:. C.I.J... ........' .....................{eing duly sworn, deposes and says that he is the applicant Hare of individual signing contract.) Love rwi ed, is Lhe (Contractor, agent, corporate officer., etc.) r: said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and list the work will be performed in the manner set forth in the application filed therewith. worn Lo before me this .....dayoC � 20*0 ... ......... Notary Public ...4..".4..&"&v ........... � 71 - ...................................... (Signature of Applicant) LINDA J.COOPER Notary Public,Stata of New York No.4522563,Suffolk'Ccunjyc�OCR Term Expires Decernber 31, ff�� SOUND AVENUE QVORTH P.OAD _ N89_'44'30"E _ 58735'00"E 116.19" 54,12' -, fiO4 �i� �v2 5431 7- 2 l No. Z o 01 ., _ o, .y 0 �: r L \ o Cn N O C) � O 9? o v �L 0 a 0 ,'.FF o, p, I � I N> 1 Oy NN o, >. o N.p; o S o C o o � 0 � ° m o �. o' o� N OF o v. 7 � o. N� > > DATEFEB 25, 2000 ?. SCALE 1"=60' JOB N0.2000-060 p v` CERTIFIED TO Survey for: o ERICH MOENIUS & CAROL SULLIVAN ER n GENIUS �i• N COMMONWEALTH LAND TITLE INSURANCE n LYl 1V 1 ll NO. COMPANY CAROL SULLIVAN HSBC MORTGAGE CORPORATION (USA) O� At �pF NEW 0 Mattituck h oP��D H.F0 Town of * Southold �'- * _ Suffolk County, New York CF 111, 562 T, S.C.T M 1000-122_00-0200-008 001 LAND 5�1 DAVID H FOX NYS.LS #50234 NOTES Ow O fOIIO� 5 FOX LAND SURVEYING 1, AREA = 4 7]92 ACRES o = PIPE FOUND. \ r' PO BOX 224 2 0 = MONUMENT FOUND, SPEONK, N Y 11972 DEED L 9928 CP128 �m0 (516) 325-2902 3 REFERENCE . vv