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26445-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27656 Date: 05/09/01 THIS CERTIFIES that the building NEW DWELLING Location of Property: 5125 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 76 Block 2 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 24, 2000 pursuant to which Building Permit No. 26445-Z dated APRIL 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 ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE, AND COVERED FRONT PORCH AS APPLIED FOR. The certificate is issued to MICHAEL PISACANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0233 04/12/01 ELECTRICAL CERTIFICATE NO. 003079 01/12/01 PLUMBERS CERTIFICATION DATED 05/09/01 LAWRENCE J. LISO /' Z'r�t i ho ized Signature Rev. 1/61 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. 26445 Z Date APRIL 10, 2000 Permission is hereby granted to: HELEN VERITY & ORS. 865 NAKOMIS RD SOUTHOLD NY 11971 for CONSTRUCT NEW SINGLE FAMILY DWELLING ATT. TWO CAR GARAGE COVERED FRONT PORCH AS APPLIED FOR & TO CONDITIONS OF CHAPTER 46 (FLOOD PREVENTION) at premises located at 5125 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 076 Block 0002 Lot No. 022 pursuant to application dated FEBRUARY 24, 2000 and approved by the Building Inspector. Fee $ 377 .40 $100.00 fee for Flood Permit ine. c Author' d Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT r TOWN HALL 765-1802 1 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. 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 Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - Z5k1 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $152.00, Commercial $15.00 DateJ _ p ' New Construction. . . .. . . . Old Or Pre-existing Building. . . . . . . . . Location of Property. . . . . 51g - Mf � gft^(u12 J 2` Is001-H-e/c: . . . . . . . . .. . . . . . . . . . . . �. . . . . . House No. Street ( ppp Street Hamlet Onwer or Owners of Property.. . . .V\& y`�//`��. , l.S"�:cA`('3 County Tax Map No 1000, Section. . . . . .(.. . . . . .Block. . . . . ..Z . . . . . . . .Lot. . . . . .. . . . . . . . . . . Subdivision. . .f.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . Permit Noc7./G.riIS' . Z. . .Date Of Permit. . . .Applicant. . 4t� . . r� � ., . . . . . . . Health Dept. Approval. . . . . ./.. . . . . . . . . . . . . . . . . . .Underwriters .Approval. . . ./X1 . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 . . . . . . . . . . . . . . . . . . . CO APPLICANT si•".AM. ,.) oazw, �x»az. �aa�n ti�' 1'S A ��mQtsxnr,',,._. z•��� ,Cy, �L. 3 a - gFJry�'a !ir 9 lk b. -77 Eh' '4, ca In p c 0 , . a ! {t caL¢�umprm p�g079 s ;308East(astloW;Avenue s . Easf Mea'OW;NY 11554 G"�det s,OltAld9l.d,, (¢18)794,0{100 _FAX: (618)9946854 1� WEBSITE wy+.eteotricalinsped(ors cym 7rSxLOC �LL�;�. }� E-MAJL infoaj"tric'Jinspsdars.corv. �LECTRICALAPPROVAI,Vk'RTItICA1E o} Mail.Toc County Electric woneE, Philip Ta'CYoehrmg,4r. .� CfslrienY Ch`�Qf ,epCfi$aLIrl$ efi,o�c- William pstar `! ( P O Box 12 7y Northpol , tree: �, bA 1003$ 1/f2l01 r 1 IN$PZTION Q1t PR1CPSd IS 1 A 1# L6W APPI IC�iT�ON #s ( � e�ee �Y�U1 �PGP MSke Pisacfilio t N 5125-Maui}�ay�lew ' , � :a fiouiolc A1tEAS I XSTFD 13 L V Axpi� f w„ I3Yx l ryjU-T F¢ONpII 'Fr- NA No Usual defect;were found To tRe el LfJfcal l8,$'pecijod ard�5i edy°,No obVl,Sus {Srgy.a ko f�)oP�s''�{`eFe�foyiYd in(t+6 a'¢eis� ere Irlgelow , NewH y e O$$,*, Ba$�116f1t Af< ,H)�h t.'raWl.mkt, x c e n ci' *°„ z ? i rt 3 y sfYSEe '1st F166P 2'13athro6fns 3 Predroams gt$h 'Ro6rSf IIS d rqx p�"Xep` 'tCh@'}r, B ri i'%"Rd�m P3iC�c�1�xU1+ Ik"jn 1 ("/dr AI'taC..h2S).Gprag@ s=..aevessea extures s 15tipres�ZeeYep "ales a smoke flan OUt ets a lad n c G6ndec9d,�Y3"et oaa B4pWer 6 1F2edefiatCist 1 +i ja�dc—t xturee'l -Apphancg � � L" s N 200 Amp Ovethead BerVroe%QBI� fV)�,4 . 2Qt7�#htF'1 {aid ,��lsf1`e'�„�e -,*O jy .32" i. �. MXqf G� 2 / WHIN jf,�* r '�ew9Y.5Wp H -''«u ;ast� �°5� "�.as„,,..r,a,. Pra la's• ++��" x .11 w 1 O 9ool .: �gOFfOlk u K ��O Gym TOW�v�0 F 6.,.;��-�;")r_n.�..�.! 0 Town Hall, 53095 Main Road H Z Fax(516)765-1823 P. O. Box 1179 • Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. Owner: MICA&/&— PIS'ar-A"C) (please print) Plumber: LRwZeNcF- J 1 S C (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( lumbers ignature) Sworn to before me this day of NotaryPublic l�{ (J� County DOLORES 1, LISA Netsry Public,State of New York 847olk County•No.4841022 Commiselon Expires Oct.31, ut,,-I " �' TMainown Hall, 53095 Main Road ,JUDITH T. TERRY ) +- '' I P.O. Rax 1179 TOWN CLERKLn Southold. New fork 11971 REGISTRAR OF VITAI"STATISTICS Fax IS 161 765-1 821 MARRIAGE, OFFICER �OTdcphonc 15161 765-1901 RECORI)S MANAGEMENT 017FICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under. the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93) ) . ' I 5;'•V. LGr TOWN OF SONAOLD d?�Judath T. Terry�'��-� Southold Town Clerk August 25, 1993 APPLICATION #_ PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sign), 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE BEST OF MY KNqNLEDGE, TRUE AND ACCURATE.- (APPLICANT'S SIGNATURE) //i'/4�_s 'cam' DATEI� y SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICAN n NAME ADDRESS TELEPHONE APPLICANT t Cl1 fes' L BUILDER f"Ct`i wd ENGINES UV L t v't t4 Le_ PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. To 7- Iq &!yr4'7�J�R° Sd yww-eo /600 '/G — 19 — —1 2 FDP(93) APPLICATION r PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE PYNew Structure esidential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT s /51; 0 Qea B. OTHER DEVELOPMENT ACTIVITIES: E Fill ❑ Mining ❑ Drilling 6Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review_ SECTION 3 FLOODPLAIN DETERMINATION (Tote.completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additipipi instructions. SIGNED-7�JiL? � /-�/ a• -7 DATE l� rr f APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REOUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale,and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor(including basement), types of water resistant materials used below the first floor,details of floodproof ng of utilities located below the first floor and details of enclosures below the first floor. Also ❑Subdivision or other development plans(If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 110-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity: A. ❑ Is B. ❑ Is not in conformance with provisions of Local Law #_, 19_. The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. • APPLICATION # _ PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? O Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community s local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? O YES ❑ NO SECTION 8CERTIFICATE OF OMPLIAN E(To be comnleted by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: C/C(93) TITLE NUMBER 641-S-00849 VARIANCE SEARCH JEANNE ANSTETT, BEING DULY SWORN DEPOSES AND SAYS: THAT SHE RESIDES AT 386 MARCY AVENUE, RIVERHEAD, NEW YORK AND IS OVER THE AGE OF 21 YEARS AND THAT SHE IS THE OFFICE MANAGER OF PECONIC ABSTRACT, INC., AND THAT UNDER HER SUPERVISION AND DIRECTION, TITLE WAS EXAMINED TO THE PARCELS OF LAND DESCRIBED ON THE ANNEXED SCHEDULES. THAT SAID EXAMINATION MADE TO INCLUDE 212000 AND SAID TOWN TO DISCLOSE IF SUBJECT PREMISES IS IN FACT SINGLE AND SEPARATE OWNERSHIP AS APPEARS FROM THE CHAINS OF TITLE ANNEXED HERETO AND THAT THE EFFECTIVE DATE OF THE APPLICABLE ZONING ORDINANCE IS 1954. AND THAT THIS AFFIDAVIT IS MADE TO ASSIST THE BOARD OF ZONING APPEALS OF THE TOWN OF SOUTHOLD AND TO REACH ANY DETERMINATION WHICH REQUIRES AS A BASIS THERETOFORE THE INFORMATION SET FORTH HEREIN AND KNOWING FULL WELL THAT SAID BOARD WILL RELY UPON THE TRUTH THEREOF. DATED: 2123/2000 SWORN TO BEFORE ME THIS PECONIC ABSTRACT, INC. 23RD DAY OF FEBRUARY, 2000 cue e4-" 00--kj NOTARY PUBLIC *ICE NSTETT ANAGER My01{ELLE VAIL NOTARY PUB LIO.STATE 01VA4W989077�J3 SfUERM EypIRES D EMBER 15.1g0 f �O t VARIANCE SEARCH TITLE NUMBER 641-S-00849 SUBJECT PREMISES: 1000.76.7.22 GEORGE W. SMITH DOCUMENT NUMBER 25844 GEORGE HERBERT SMITH CERTIF. NUMBER 10435 DANIEL T. SMITH DATED 3110150 WILLIAM B. SMITH RECORDED 3112151 TO GEORGE W. SMITH AND SONS, INC. GEORGE W. SMITH AND SONS, INC. DOCUMENT NUMBER 57991 TO CERTIF. NUMBER 31169 JOSEPH A. SAMLUUIS AND DATED 816155 EVA, HIS WIFE RECORDED 8126155 EVA SAMOULIS DIED SUFFOLK COUNTY LEAVING JOSEPH HER LAWFUL HUSBAND, ON 1119192 JOSEPH A. SAMOULIS DIED SUFFOLK COUNTY ON12117196 INDEX NUMBER 2397PI996 LEAVING HELEN VERITY, EXECUTRIX HELEN VERITY,AS EXECUTRIX OF THE LIBER 11900 PAGE 285 ESTATE OF JOSEPH SAMOULIS DATED 12111197 TO RECORDED 6119198 HELEN VERITY,ADELAIDE FLYNN AND NELLIE SARKUS AS JOINT TENANTS (SHOULD HAVE BEEN FILED IN REGISTRARS OFFICE) DEED THEN TRASNFERED FROM TORRENS TO COUNTY CLERK HELEN VERITY,AS EXECUTRIX OF THE LIBER 11944 PAGE 573 ESTATE OF JOSEPH SAMOULIS DATED 12111/97 TO RECORDED 219199 HELEN VERITY,ADELAIDE FLYNN AND NELLIE SARKUS, AS JOINT TENANTS LAST OWNERS OF RECORD: NELLIE SARKUS, DECEASED 111/2000 SURROGATES 235P00 SWORN TO BEFORE ME THIS PECO STRACT, INC. 23RD DAY OF FEBRUARY, 2000 \/\ NOTARY PUBLIC JEA E A TETT OF ANAGER MICHELLE VAI NOTARY PUBLIC,STATE OF NEW YORK SUFFOLK COUNTY•N0.01VA-4R9798 TERM E%pas DECEMBER 16,189!01 VARIANCE SEARCH TITLE NUMBER 641-S-00849 SUBJECT PREMISES: 1000.76.7.21 (WEST OF SUBJECT PREMISES) GEORGE W. SMITH DOCUMENT NUMBER 25844 GEORGE HERBERT SMITH CERTIF. NUMBER 10435 DANIEL T. SMITH DATED 3110150 WILLIAM B. SMITH RECORDED 3112151 TO GEORGE W. SMITH AND SONS, INC. GEORGE W. SMITH AND SONS, INC. DOCUMENT NUMBER 59338 TO CERTIF. NUMBER 31751 HENRY R. CAPLAN AND DATED 8111155 MARY Z. CAPLAN RECORDED 10117155 HENRY R. CAPLAN DIED 12123166 ORDER DIRECTING REGISTRAR TO VEST TITLE IN MARY Z. CAPLAN DATED 911183 DOCUMENT NUMBER 297006 CERTIFCATE NUMBER 120853 MARY Z. CAPLAN DOCUMENT NUMBER 297520 TO CERT. NUMBER 121022 RALPH SOTO DATED: 9127183 MARY ANNE SOTO RECORDED 1013183 LAST OWNERS OF RECORD: SWORN TO BEFORE ME THIS PECONIC ABSTRACT, INC. 23RD DAY OF FEBRUARY, 2000 NOTARY PUBLIC J N ANSTETT FI MANAGER MICHELLE VAII NOTARY PUBLIC,STATE OF NEW YO"K BTUEpµLE%PWES DECEMSFA 16�19Y a 001 VARIANCE SEARCH TITLE NUMBER 641-S-00849 SUBJECT PREMISES: 1000.76-7.23 (NORTH OF SUBJECT PREMISES) GEORGE W. SMITH DOCUMENT NUMBER 25844 GEORGE HERBERT SMITH CERTIF. NUMBER 10435 DANIEL T. SMITH DATED 3/10/50 WILLIAM B. SMITH RECORDED 3/12151 TO GEORGE W. SMITH AND SONS, INC. GEORGE W. SMITH AND SONS, INC. DOCUMENT NUMBER 89900 TO CERTIF. NUMBER 44365 TERRY J. DE ROSA DATED 912159 ROSE DE ROSA, HIS WIFE RECORDED 9111159 LAST OWNERS OF RECORD: SWORN TO BEFORE ME THIS PECONIC ABSTRACT, INC. 23RD DAY OF FEBRUARY, 2000 NOTARY PUBLIC JEA NST TT OF ANAGER M001E VA1L NOTARY PUBLIC,STATE OF NEW YORK SUFFOLK COUNTY-N0.01VA-4989798 TERM EXPIRES DECEMBER 16,,J99-O+ d 0 VARIANCE SEARCH TITLE NUMBER 641-S-00849 EAST OF SUBJECT PREMISES SMITH DRIVE SOUTH OF SUBJECT PREMISES MAIN BAYVIEW ROAD SWORN TO BEFORE ME THIS PECONIC ABSTRACT, INC. 23RD DAY OF FEBRUARY, 2000 NOTARY PUBLIC JE ATETT 0 FIC MANAGER MIOHELLE VAIL NOTARY PUBLIC STATE OF NEW YORK TERµLF.KXPIREUS DECEMBER 6.98 a p0{ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU LBG. [ ] FOUNDATION 2ND [ SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR ^^ 14 L 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ Vel---ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _T '_�uM, DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ kfzROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 4,��6-ex or-1 n.� DATE 0-7 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] F DATION IST ( ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ( ] FRAMING ( ] FINAL [ ] FIREPLAC HIMNEY REMARKS: DATE �l �� INSPECTOR M-1002 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY f� R ARKS: -, 00, DATE INSPECTOR 6p6ws^ 4� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUG PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACCE & CHIMNEY RE ARKS: lkk�-QP Adm- - ,DATE 7 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARK ; ��-- � J;;Vl r / "CW) Com/W:o , r=/ - ,DATE - INSPECTOR INSPECTOR ;x M-1802 BUILDING DEPT, r.s INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA : el ....Z DATE °� `' INSPECTOR � � ' � ' � • � it �of �/, � ,20�i� llfj ✓i ��� /� �i ! , ,, MWO ME i .i , I r .�1�� . 1 _�'�a�J /Il ✓ Irl i /` 1 w i i �L1�il' ✓ I� ��� • 4 !'<�)aJ'P3I,J~�:�:bL'ri;'•;?I3+ 8'�rt.ah`;Y+r3aii�'J'�Ya a%J?/��.T%I:°�?R�CrS Ee A 's�'7riTd.��IS FAP,9i➢�:,�t I�1;�A'���4��9Y�9e ar APPROWD FOR MAXUVfJM OF 13 RO AAS f f EXPIRES TJJREF`TEARS FROM DATE OF APPROVAL d•.P.EL.=9,9 NS E,O Lgry�� LEW, Z,✓` 6a1 �wxu/lova y r✓7svV v OrJ ��y0'q�t�� eel rIM . � ,Wis'J"aeR r.V.o"s�L61f.A^arv,✓ �'"+�c�r v u�� ' � ��c'", f-ru,�'To mELvurrJcavvo i IA CPO 2� - /0/8/99 E Q�q ��Q N.39°ao'E /✓©•C��D � � 'MJ as $ .. ° ---� 539"cxa'y✓ ._.. /_�"`�� ___ \���' 4)W*o'6 721o"nor f Z. ,�, �'L•/J i2 � �L/TT�.""' �^'"Y.'�c'c'��/ \\ ,�c✓c..'�s� �r't4 Ptd f�7c9�' O �.s.,o✓6ys'oe• ✓Q5�,.�,�G'�t�-Vim`✓.�"'• •4N�'�'�-'►A/�' K/•Lt'w.4.YGi7I�4f.(wi Loy 90, 7'ti" �9.v d cw GrxtrL���"�c AUX~ Lcc�,rg�jYcW �rs'L��zsr�.�,�'Cby"r✓r✓ rc/Y Le/ =tea ' pow.ea nw :P gLUMMERG.INC.,LAW PUDLIGHERS pee—statutory Form AA. JO 70 OADWAT AND 1 RECTOR BLr.NEW YORK Warrents Deed with Full Covenants.6ration. , j i 1 Made the 6 day of August , nineteen hundred and rlrliY'"r1V0, 1 ' 1 I I a corporatiomorganized under the laws of t * Stats sr #(**t hoVins its PAS* plora on fork art of the first art, � of bagalnegs at Southold„ 8uriblk County► r party p . and joaspit hr 4 wjoka and zvA s".;p.Lgo his wire„ as tenants br the astiretro btu raddins at a Tem Watt streets *0*114kBe Yar1y I I +, part 1401 of the second part, �I ltlYe��tQt ► that the party of the first part, in consideration of 1( !i ......«»».«»..,. "bo/)ars, /awful money of the United States, and other goad and valuable eonslderstloty � ) I' paid by the part leg of the second part, does hereby grant and release unto the part leg of the of the second part, I their heirs and assigns forever, i that 0ertaln traet, parad or view at land,, aituetes lylsg and bolas at my YIewC�ntter Sougnld, In 00 Toon or Soatholdt 05=ty ar 8sMU and State Of Now xork. being kna>ru and designated as sats numbered to sad so at a owtsis i1.entitled t►ed i neap or Goose !lefty situate at Bay Yloert or Saattwldl l6atl30lit counts► a . by as wo solth a Bans,* same by Otto V* Tett 701s Llama" Sarvalf4w, Breetlporto 11.1.0 end died In the Surf0lk County Clerkto offloa on Rseresbsr goo s to and by !!Ile i 110 o 16670. with all the rights tltls and lstssregt, If sayo of the party or tete first Porto In and to the hlgltMyS In front 0r "d absttlgg said prgaisel0' to the we►ter 1105 �I 11 tharsof, I to be i or the first parrt by OWIP9e ndog MaiapSbbtl� AOatberf thes by deed datadoylarele�lllr�l9t1►�aesd iletd In the orrlae Or the Registrar or Surrollt QMty under lsnd 'Title RsglatZon Cartiria �I elate nd*dr %sw on wrot Is$ 19b1 a to tfety state or rests an +sanuftts sir way shows provided snake d oit net render the title WMVkOtabl** wlth the right to us*e rot all raaaaftble purpossese !at e0snon with ethers aub�sst to ouch r ook rules end regulstlons with 1`4111164% f* the tore ►eret►r as the per or the rust pert sols from tb* to 'time Put into srrsOts that portion er tote 11aa t37 ietttion a epart of Marty or t e fi39 rst part to sold Mod, bnown as graat to then pporttiisa or laecondbolus partt theme game rights that r but heretotbPe posited to athar grantees of lots on geld fpr �I SUNNOTO howevers to the rbll0wlut Oa+e'Mleelta and restrltUatlai" , I 1. No !sedge or rens# 0011 be allowed to be eanstruoted eves` four (4) feet is height E. That no dwelling buildups "It be ereOted an gold prsmis" vhieh 01o11 east loge ' than IsSoo oo nor shall any dwellitgg,house have a flat two agent approved by the per I. I i of the brat part* All raaara nhaall ha. ai' a6b&stosN aed�r or eampoatiti� tttixt6le a>� eo I , ill prapdeod plane *ft t o bs SAISitttlt4 to rani" tahall be mid own wlilt rolie4 twcflntl the party aC the Dart part for written approval and ahead be appatYattaid tate taaid party or the Carat part,` uoh written apProol titan. net be uosesatably°, At*eidr Plane to I be sntamitted at th office br 'tetry to Irviali kttorawaj�, 11t1h streetk 11*4l614 hies zo*r 3: No buil6ing or struataare�' whother tate toms be tete actin deeiilnat; house ar %W nares&, shed or any ootbUl.14n6 oval be built ahase'f, "All" (6) t"eet Crich 64 Niawttdttry line End not closer then at"irtuaen (tai) al's&t frowl the iti>ttatasy• i on SNV Par 4, No outside toll eta•or wttterolosetoa•st I be Permitted to be great �t&d by Balt t or all of the premises hsreby oftt oyodr Oat ad&rtabte eewta"aiie Sys appr 6uttalk aty.0 1th �epertmetst et�l be.eoassiNOted,..rcad n fnta d to la aa1 r o • ,the Sao~ dlapsaai+t, All proia06ede�idq�±t�ttrk ,i�tatt 0 +fid �, � '1 �� e!ulSl ba suet kIled in .+aecoi^owe with. the Viten App bd bViiia Yo e � tog ,rt. } ment of Matti oil April tool, p. iter rowl, ponl#yi ax L lit`1sftak doll be lulpi� a1n��i4sM �iid hous&holA Pets. lttlatt neuter the Peru", of the ascend part. attetr their hdmr dletrAutoso or haul, or will funuataoWrd, er se31k cat j*W#, poat to be aenttfasktsir4d car jj Sold Oft. ed 6 e or >aterelmdlse of spy 1 sold' on et►y ptrrtloti of the pareaiesa rier&hay eat'a'ey r �' 1� . at said preaisee,' xind and AM11 not warty ani. ear po#4t to be tarried Vuy. an sty► pact anp+ tre+�s bUaln�aN or paxate#�dAl r�uip rdr�r; or Soyba+ttdi� +; ' 1. The, promises atiall be eableat t6 olestrisa; 61e8tria U&th, ps and telepbo" easements on tate awrace or below the ►se Sl+ the,Wb4js ham' I aotgaSt to said premises., ' !I s, S. 'rust neither the panties or the eeoand pest na1P theirhirer t�stribntees or Itseeialltsr adtall or will perrmit any atlmisame or hoiss au*61eat>tte ane oM'eneitre.to the �f persctts aottwpyittlt adloinit>b paremiees�so saewatilatitatt or inbbi*� UstoritIe,of affy kind* l Vii, up ,ttetk ahtall be Permitted to r*Wt& do Wdd praffisas.r gr Ifo more titian owe {i} dwe119n13 hatunaax dwell be er&ote4,04 tit& 4014,paretd4eao' II rot th►e 1►wAft4t tt hair 111,11V area of, the da>e"f.11mg WON ft be, erse'tred, ori A11111111j tor' 1, premised $bffil etottimin at least Wo 60ave fee# ;ot flebr:atFsa . . ,' lir' 'PkAt the exterior of the dwelling riauae shall be aAtlly lstod befor& oesaapeacy ea & ditellitts boas&.' 1>s: trioti- the said daysatents etre 'b 4461" to be eov+atx h 0 attaaried to treed running with the lettd.k' 1}+e Sold daVibOits emd ttmtriottom amy"be released eh°,altateLd !1 by the party +of the Carat Peat at tom} UL withto this to , the right bti i>aidj for all tali onAbls fadthrpossa► $a ttomm with oti heft Party Or the CicatesorAble #0100 Old pear Melly gym,time time�pu t intra time tt t%S itellee113>IE deset gibed prep&rtyt hlt0tttlix at'a pet at oa ,the doattheaeterly' %if* at aeith wive t9orttt► t671f feet norlrieaeterhar aitotat!,, uaid line tlr M tats tt+trl'la oeoteru lies or Visa BVIflow Meed arut heated g6 root sorthdat►terly from thtt tteeti t .eatrtter si ' 611 djaM ata is gee kAtdtledr , "W of "ft* Welk 600to at '�1eee �l� id, �l� y�� iM'f#�6dwthr OO its ��a�' i 1663t rung MIN thrid paairat of barglttniali. its btSAI land at,1rm " t4 ®rr t #ti!gstt u�t ta11 rid r � d©t Is '16 tbet to the �� twk�'°�tnbpa� �lttlol'�dti`a;tt¢'.�t������., southwea at'yY alotttt isdd Aredsod tel" to* p6IM-1g root bouth0titerly CaFoae the is d4 ' scribed pdiattt ate>aStlr^hd at right sntdles .tit alai ieiat dee>ettbed iltae{{ tatare'6 f I( e er►t+er afloat abt tot Ni" ps f1a+ ti01 t Cts mr iar !3 i' iiia idthe t 1kt iti►►rd + ' a datrtrt trflk os6etai Mi sa d ! I dnaai` ft tart the aboVs d4*10 f 64 p +t a !1 atrf6ter11 ddtratt +nti,ts; rru►x I with the "t to U116* ibr til rteta[tar>wte ossar''I*toasan with othtark0 an l suet row"itablo males sad tragul01ORa wfth e�raat * the itss thareot' as tahrs. 11 party of the first P0,114 SAY tPOIS time to Vim# 010 Ilf$**ft-IS t tot **A 6n Said,rM►pr+ it art ' of,the�6rst part in and I �ogetber with the appurtenanges and all the,dstate and rrighis ol, the p y ii to said premises. go babe aUb to bulb the premises herein granted unto the part irwr of the second part; 7 their helrla and assigns forever, flub the party of the first part pants as follows: _fl't0t.—That the party of the first part is seized of the said premises in fee simple, and has J � good right to convey the same; � I &CCOUb. —That the part leg of the second part shall gnfetly enjoy the said premises; Qirb. —That the said premises are free from incumbrances; � I yfOtMtb. —That the party of the first part will execute or procure any further necessary as rance of he tit/ to said remises• su the e� 4 P., �.;. t....:.',c, fisf'pat'will forever'waIrrapt thq"tittesfo said premises; � ab .=The grentor,in compliance with Section 19 of the Tien Law, covenants that the grsntorl will receive the cpnsidergtjgv for this conveyance and will hold the right to receive suchconsiderate as x, fa trust fund. o be a Had first for the purpose of paying the cost of the improvement and that the an�, t PP P P P Y Bh gi will apply the same first to the payment of the cost of the improvement before using any part of the total, of the same for any otherpurpose.' i I ZItY WitHCO! ., ttrCOfj the party of the first part has caused its corporate seal to be hereunto affixed,and these presents to be signed by its duly authorized ofillcer the day and year first above written. �n �re�ence of: � I� f331iX�'ft .. OOAB X10 < �•sef �...... ........................ ...a...... fir............... .......... �q ?C � _: D�W.( Ilr{e tY7 1'71['� ¢.•,tE :1, I.Cd'1'G'A'+� +8 ({i1 YN _ ' i VP 44'r �Gr A r Form No. 120 — IM 2/6e THE LANAITLE REGISTRA ON LAW (Owner's 743uptiratr Cnrrtifiratr of Cttie No. -------------311-69--------- FIRST REGISTERED --------------NVI-oh--`p5,1-946------ TRANSFrR....RQX.....CERTIFICATE No. ..............---1621fI............................. I, WILLIAM H. FRY, Registrar, of the County of Suffolk, in the State of New York, DO HEREBY CERTIFY that JOSEPH A.SAMUOLIS and EVA SAMUOLIS,his wife, of as tenant* by the entirety, 35 Ten Hyok Street,Brooklyn,New York, is the owner of an Estate are in fee simple ` in the following Land: ALL theh certain traot,paroel or piece of lAnd,situste, lying and being at Bevy View,near Southold,in the Town of 13Authold,0ounty Cr Suffolk and State of New York,being known and designated as Lots numbered 79 and AO on a certain map entitled "Map of Goose Neok,situate at Hay View,Tcwn Of Southold,Suffolk County,N.Y.,ownsd by G.w.Smith & Sons." made by Otto We Van Tuyl,Licensed 1urvsyor8.Greenport,N.Y., and filed in the Suffolk County Clerk's Office on November 22,1948#asand by File No.1663. SUBJECT to the a states,easements#encumbrance a and charges hereunder noted. WITNESS myhand and official seal at River. head,N.Y.,this 26th.day of Augu ,1955. i Y { z ° a d F4 N IT Wy `J �io Cl •-n � z " z a H ; Extract From the Real Property Law, Constituting Chapter 50 of the Consolidated Laws SECTION 400. RIGHTS OF REGISTERED OWNERS; EXCEPTIONS; INCUMBRANCES, ET CETERA, TO BE FILED—A person who receives a certificate of title pursuant to a judgment of registration, except in case of fraud to which he is a party, and a purchaser of registered real property, who takes a certificate of title for value and in good faith, shall hold the same free from all incumbrances, charges, trusts, liens and transfers, except those noted on the certificate in the registrar's o0ice, and any of the following which may exist: FIRST. Liens, claims or rights arising or existing under the laws or constitution of the United States, which the statutes of this State do not require to appear of record; SECOND. Any tax, water rate or assessment, which becomes a lien on the property after initial regis- tration, and for which a sale has not been made; THIRD. Any lease or agreement for a lease, made after or pending registration, for a period not exceed- ing one year, where there is actual occupation of the land under the lease or agreement; FOURTH: Easements or servitudes which accrue against the property after initial registration in such manner as not to require their registration. Except as specified in the foregoing statement of exceptions, no incumbrance, charge, trust, lien or transfer shall take effect upon or over real property the title to which has been registered, unless the instrument creating and setting forth such incumbrance, charge, trust, lien or transfer has been filed with the registrar, and a memorial or notation thereof made upon the certificate of title covering the property. BOARD OF HEALTH . . . . . . . . . . . . . . . . :.we. . ,. ��'�"". _ ' ' i !�!) FORM N0. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . �� •i a 1' j� TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . FEB 2a BUILDING DEPARTMENT CHECK i TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 .,....., .w.<_.,_,�.•....n..� TEL: 765-1802 NOTIFY: `�O _ 3! �J7 7 ry� CALL C! � . . . . . . . . . . .. . . . . . 20. MAIL TO . . . . . . . . . . . . . Approved.... .......l..., ?w Permit No. ........... .. ................................... Disapprovedarc .................................. ................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. . . ' . . . . . . 20,?". INSTRUCTIONS a. 'Ibis application not 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 may 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 UMW MAIL to the Building Department for the issuance of a Building Permit pursuant to the BBuildi'ng 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 de Dlition, 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,pr ssary . tions. .. ............... (Signature of applicant, or name, if a corporation) ..1..,931..... 'Sl.rf4cf�- 1�) (Mailing address of applicant) State whether applicant is weer, Aeyssee, agent, architect, engineer, general contractor, electrician, plumber or builder .............f .�<o�1 E i�.; ff.rt.S�d.. L ��)1� ............................................................. Name of owner of premises ........! L. .........IC..��r ........................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... PlumbersLicense No. ......................... ElectriciansLicense No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.. ..................... ....................................................................................................................... House Number Street .7 O Hamlet County Tax Map No. 1000 Section ... Block .... ....... Int ................ .. Subdivision ...................................... Filed Map No. ............... Int ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: T a. Existing use and occupancy ..... ............................................................ L �4 yy( W H/ b. Intended use and occupancy .....rte..�.'��?.�........ ..... c6 3. N•nture of work (check which applicable): New Ikril s" ` • Pp ding ..�Aoldition .......... A1�' ra`tion-.:'.:...... Repair ............ Removal ... ......... Demolition ............ Other Work .................................. (Description) 4. Estimated Cost fee .............................................. / (to be paid on filing this application) 5. If dwelling, •l•rrg units ...f........ Naber of dwelling units on each floor .../........... Ifgaragenumber of cars ...D..... ....... .......... 6. If business, exitrercial or mixed occupancy, specify nature and extent of earn type of use...................... 7. Dimensions of existing structures, if any: Front................'Rear ............... Depth ................. Deight ........................i Naber of Stories .../................. Dimensions of saw stricture with alterations or additions: Front ............... Rear ............... Depth Dei I!It .................... Nutber of Stories ..........'..... 8. Dimensions of entire new construction: Front ................ Rear .............. Depth th .............. ilei it ..... I Number of Stories ..................... 9. Size of lot: Front l . Rear /�o.......... Depth O 10. Date of Purchase 7:,'!'nt?C!(-.�. -;o0 0_, Hare of roarer Owner .......... II. 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 .......... ......... Wi��ll excess fill be removed from premises: YES 14. Nares of Owner of premises Address ............ Aron No. t�*J.YKP Name of ArchitecC .zl't'. ..�!r.'!'�� :Z....... Address .............................. Plxxme No. Name of Contractor ................................... Address ...............................Arne No. ............. 15. is this property rC within 300 feel of a tidal wetland? * YRS .......... NO .......... Ir YES, SO[MI11) 'TOWN nl#ms PEIictl'1' MAY BE RE¢IIRF.D. I r PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street andlblock ember or description according to deed, and slow street nares and indicate whether interior or corner lot. II STAIR (H? Now Yin !III! OUINIY OC ....... .. SSI ... ...� .. .....being duly sworn, deposes and says Lhat he is the applicant (Hare Of amdividual. si sin conlracl) , above named, lie is the ................................................................................................... (ContracLor, agent, corporate officer, etc.) or. said owner or owners, and is drily authorized to perform or have performed Lime said work std to make and file this application; that. all statements contained in this application are tnce to the beat of his knowledge and belief.; and that the work will be performed in the manner set forth in the application filed therewith. .%worn In bef re this 1...:..:..da of 4../� o Notary Public ./ HEIENED.HORNE (Signature of Applicant) Notary Pubge,&tate of Naw York No.4961384 ! Qua lltiN I"a Suffolk Co n1t� Commission Expires May 2?4 010 0� i i 0&14 1p ryQ S �J� �iS3T7dt/IDAP/!Ty'r✓�1'NF7 v��� W. LEW,�� �9n� D w.greR is on�E�ra,o,/ Q'OL* vat /Z, /v/e/y� rq�q N39°ao'E /�O,oD ' o �� t1 35./' "c 69' ��� 2 !„we. I fop ruv.//•A i� v /oo nR 2z, L yrca�"xr P.ei✓i9�Ewc�tts . 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[Front Yard Proposed: �A / 1 [Side Yard Proposed: [Rear Yard Proposed: Project Description: AD AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES S/ umber Suffolk County P Health Dept. ✓ ,�/o — 9�- O .i 33 New York State D. E. C. C j� -►yam Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Notes: