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Home My WebLink About26565-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27237 Date: 08/09/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 380 KIMBERLY LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 13 Lot 20.18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 9, 2000 pursuant to which Building Permit No. 26565-Z dated JUNE 9, 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JOHN D & TRISHA MOHRING (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 277518 06/03/93 PLUMBERS CERTIFICATION DATED N/A m"-ti Autho ed Signature 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. 26565 Z Date JUNE 9, 2000 Permission is hereby granted to: JOHN D & TRISHA MOHRING PO BOX 1721 SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. (THIS PERMIT REPLACES BP#21354 ) at premises located at 380 KIMBERLY LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0013 Lot No. 020 . 018 pursuant to application dated JUNE 9 , 2000 and approved by the Building Inspector. Fee $ 150 . 00 Au ri ed Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUIL1`;,-; DEPARTMENT 1'O WN HAIL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildir inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings , property line; 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 2110 of 12 lead. 5. Commercial building, industrial building, multiple residences and similar buildi 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 '.'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 applicar 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - _ .25o.. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . l /C�. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . '�Old Or Pre-existing Building. . . . . . . . . . . . . . . . . rn Location of Property. . . .3K . . . . .. . . . . . .�4t!M �� J � . . . . . . . . . . . ? � tfX . . . . . . . House No. Sreet Hamlet Onwer or Owners of Property.. . .c1f�C1N. . . . � rt�nl� . . . . . .22��{!yvc . . . . ... . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .20. . . . . .Blocic. . . .�.J. . . . . . . . .Lot. . . g. . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . Permit No. . S�S.. I. . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .,�. . . . . . O� Fee Submitted: $. . . . . ��s. . . . . . . . . . . . . . . . . . . . ..= Ne � -� a3� � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT o�Og�FFO(� Town Hall,53095 Main Road p :'� Fax(516)765-1823 P.O. Box 1179 y Z Telephone (516)765-1802 Southold,New York 11971-0959 dol 41 Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD July 6, 2000 Mr. & Mrs . John Mohring P.O. Box 1721 Southold, NY 11971 RE: 380 Kimberly Lane, Southold. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) .No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26565-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 .077 BUREAU OF ELECTRICITY Bis JOHN STREET. NEW YORK. NEW YORK 10038 Date JUNE 03,1993 Applicatl6n No.on f** 04586293/93 N 277513 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of JOHN MOHRING, 380 KIMBERLY LANE , SOUTHOLD, N.Y. in the following location; ® Basement ❑ l st Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on MAX 20,19 9 3 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTS ECPPTACLES SWITCHES INCANDESCENT1.FLUORESCENT I OTHER AMT. K.W. AMT. —..W. AMT. K.W. AMT. K.W. AMT. H.P. 3 2 2 3 1 T- DRYERS FURNACE MOTORS FUTURE APPLIANCE REDERS SPECIALREC'PT TIME CLOCKS "LL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. WATTS NO.OF FEET 1 40 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE � 1 X 2w 1 X 3W 3.i 3W 3,#4W NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W G. NO. NEUTRALS A.W.G. PER a OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: SWIMMING POOL-1 MOTORS F H. P.-1 G.F. C. I. -1 MOTORSs1-1.5 H.P. " (SWIMMING POOL) This certificate covers compliance at the date of i-nspection only. Because of unusual environments it is advisable to have frequent test/and or repairs <<< Continued on Page 2 >>> 09*M MANAGM Per Y� This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. r' THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1185077 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date JUNE 03,1993 Application No.on file 04506293/93 N 277518 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of JOHN MOHRING, 380 KIMBERLY LANE , SOUTHOLD, N.Y. in thefollowing location; ® Basement ❑ lxt Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on MAY 2 0,19 9 3 and found to be in compliance with the National Electrical Code. FIXTURE RICIE"ACuS RXTURES RANGES COOKING DICKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE AMUANCE FEEDERS SPECIAL REC'PT TIME CIOCKS I UU UNIT HEATERS. MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT, AMPS. TRANS. AMT. M.0. SYSTEMS AMT WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E TER AMT. AMP. TYPE lQuip. 1,/2W 1 A'3W 3 0 3W 3 A'IW NO.PER�•COND. of CCW.O,OW NO.OF HI-LEG OF A.H•LEG NO.of NEUTRALS 'W.NEIUTTR.AL OTHER AIPPARATUS: made by a qualified person. ROSLAK ELECTRIC LIC. i3677-9 F.0301 164 CUTCHOGUE, NY, 11935 OREM MANAGER 11 j Per This certificate must not be altered, in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. s I o�osut:Foc�.�oG o� y� y x Town Hall, 53095 Main Road p • Fax(516)765-1823 P. O. Box 1179 y Telephone (516) 765-1802 Southold, New York 11971jW OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 27 , 199 Mr. Robert Mohring 380 Kimberly Lane Southold, NY 11971 Re: Building Permit #20983-Z & 21354-Z Premises : 380 Kimberly Lane, Southold Suff. Co. Tax Map #1000-70-13-20. 18 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284 , it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector Print Key Output Page 1 5738SS1 V2R3M0 931217 SOUTHOLD 09/27/95 08: 35 :55 Display Device . . . X5 User . . . . . . . . . . . CLAIRET NYSRPS ASSESSMENT INQUIRY DATE 9/27/95 473889 SOUTHOLD SCHOOL SOUTHOLD SCHOOL ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 70.-13-20 . 18 TOTAL COM SITE 380 KIMBERLY LA ACCT NO 08 = OWNER & MAILING INFO ===!=MISC !________ ______ ASSESSMENT DATA MOHRING JOHN D & TRISHA !RS-SS ! **CURRENT** RES PERCENT 380 KIMBERLY LANE ! 1 !LAND 1, 600 **TAXABLE** SOUTHOLD NY 11971 ! BANK !TOTAL 14,400 COUNTY 14,40 TAO2256 **PRIOR** TOWN 14,40 ! !LAND 1, 600 SCHOOL 14,40 ! !TOTAL 14,400 ==DIMENSIONS =__ !______= SALES INFORMATION ACRES 1 .03 !BOOK 11435 SALE DATE 03/10/92 SALE PRICE 325,00 !PAGE 274 PR OWNER OVERLOOK COURT DEV CORP __=====TOTAL EXEMPTIONS 0 _____________ !_= TOTAL SPECIAL DISTRICTS 4 CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE !FD028 !PK070 !WW020 ! SWO11 Fl=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC 75 . 10- 03-011 F6=G0 TO INVENTORY F9=G0 TO XREF F10=G0 TO MENU o01cm g1�FF0(,�c0 H = Town Hall, 53095 Main Road cp Fax (.16) 765-1823 P. O. Box 1179 y�Ol � Teophmo (516) 76;-i 802 Southold, New York 11971 ,1L OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD `^ March 27, 1996 Mr. &.vet Mohring 380 Kimberly Lane Southold, NY 11971 ***** SECOND NOTICE ***** Re: Building Permit #20983-Z & 21354-Z Premises: 380 Kimberly Lane, Southold Suff. Co. Tax Map #1000-70-13-20 . 18 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284 , it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector Print Key Output Page 5738SS1 V2R3M0 931217 SOUTHOLD 01/7.4/96 08 :25 :2 Display Device . . . . . . X5 User . . . . . . . . . . . CLAIRET NYSRPS ASSESSMENT INQUIRY DATE 2/14/9 473889 SOUTHOLD SCHOOL SOUTHOLD SCHOOL ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 70 . -13-20 . 18 TOTAL COM SITE 380 KIMBERLY LA ACCT NO 08 OWNER & MAILING INFO ===! =MISC !________ ______ ASSESSMENT DATA MOHRING JOHN D & TRISHA !RS-SS '. **CURRENT** RES PERCENT 380 KIMBERLY LANE ! 1 !LAND 1,600 **TAXABLE** SOUTHOLD NY 11971 ! BANK !TOTAL 14,400 COUNTY 14, 41 TA02256 **PRIOR** TOWN 14 ,41 ! !LAND 1,600 SCHOOL 14 ,4( ! !TOTAL 14,400 ==DIMENSIONS =__!______= SALES INFORMATION ACRES 1.03 !BOOK 11435 SALE DATE 03/10/92 SALE PRICE 325,0( !PAGE 274 PR OWNER OVERLOOK COURT DEV CORP =======TOTAL EXEMPTIONS 0 _____________!_= TOTAL SPECIAL DISTRICTS 4 CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE !FD028 !PK070 !WW020 !SWO11 F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC 75. 10- 03-013 F6=GO TO INVENTORY F9=G0 TO XREF F10=G0 TO MENU STEP APPLICATIONS :B-6 ,----msDi--- 6 5 ASIDE E 6 � - 6!CA Step B Steo 6� 'Ir nOlt E I, A 6 RANCLS� ARnuppEO C D NAv ;S AR. FRf.o,c 6 5 SERIES OF a OURN-LOV T BnACE51a AR.111T RwNEL FASTERERE v �wxEl A B A cDnNERG ICT AV x. s A."OSE ______J �TnoV uNwL iD CORIURAi y}E VRxfN MEL A - IN su AiNEL — < ..NO e'LEN4TN$ ID ` 1%asx I li `ADJUSTYENThN - c}.B -is - —REAR LEVELING STAKE -. LEISURE STAKE _ SERIES OF w vL. SERRATED AEOGE$ DIAGONALS: A = 22 -2" C= 33'-7%4� __Y I A¢N~4a M 9 = 25'-7�rr D= 29'-63/4 �! •` I I .. ur e y I I ',D �� ft 4505 I I 3'd.,.w•,e' i. it: f�Si0kai 11F'� 4Ex ERA-x0•ES _ A`CMCRE'E DECY I 7-c-/_�/_ i_:ER'CA,DINENSIOYS ARf FRO.LINE, AE'\F-R:E.^.w'6•:'C':w R, 7`=- rTnLS Cn ON•-_GC.'.. A.u4 :ORN:- 2:LE55 :rvERw'SEFETCAeRO::ARC _T_ _- { �J - Y y7 n5• - -EJ: MEn'- FTOBE ' JSEt _ NeEO.IIO"El-TcaEUL.tN'- Ew BfAN: - :_Ne[i " FROY DEER EN:wi._ - -" B.;.sAA:E OPTIONAL 1 1 fxaV�10+1ETEE _BANr F:54Ru+E.CL $'^AN,_ARD SC_ •eSf M.F'MUM SEARING CAAi:' ROF NA11-fi<_ L- SAN: TIC RSF CFAE'-MN: BAAC£ ;CA T, TOROF F00_A-LEAST,ABOVE <�--_- }E.PrvONSNA-_BE: -A OER'N>x N00_ T -, '� FART- A..AR:JH. F- v0105 U6'DER BASE OF AN,'C "SAME <NE.bTAYNwE. A ypet-- SNOUL.NO' iKAiCO AATER aN I". AA:eF +5IiS"Ly'YORE'FAn'.^ w Ee-El_- _ s-:._2 - E KCEEL NE:G.'T ec TAMPEE -- vN REBAR—ODTIONAL-Only Reaaved In Certain States sc?F-, _A YORE TeAF 12 = VE RACVVTE ON ^� 5 B" .,F' TC BE SAN:GRAVL DN Oi NEN 5AN: :CNI.Fb x11-Er<AIE.1E MA-IBA- R - -TEc } etIE-T.." DESCRIPTION _ r '<� ' SP'RE .. 20' A 43' Ld$\"L tri QITC� IrOK.I•�� Rolf USE}-LB REBw50 MAi ERIAL-STRUCTURAL FOAM MOLDED WY�YNE R 'JC COxnNUS AROJN': NEmuf TCR IFOOBOND BEAU SCALE NOlptl (DATE 1 2990 �OOLS� TNrS BROCHURE IS FOR ILLUSTRATIVE PURROSES ONLY ine m nuraCl YF•' la'Warm"" I I Ir F1-1.<r areal• nrlSOe,FIVI., A.,Orrr[r rlp<SenlanOn£ ear.11 peTer era or rM to IM convenor m.•n •AQ.A n,a.n5RTReucml IN, < F. FI, .nanub .... are I - ula0le ro rnee<allr anO as lM Fam/a[rer Onir Tn....1,Or ConIr ,n1 PIONEERS OF .us n•• r.•Ipmsan•noelwne.'mconrracm anen<unapenl _NON-CORROSIVE POOLS AND STAIRS ..mAnRTs Yv . P,x,1. Inc T',." I,"" m<IrmsnwvnleO rHOME OFFICE AIRn.es loges ane.11 nm.IF--A,,=conomo'i: r, •ma.OF Fj 10 EOFFI Dave aeall.nn.I nr•cauuonumn +noOsol Lrv6N u...nn Tn<rnponFlou,ps ' In•crv.aouu Fall WBYM I.R.O.469)4 ��SOFFO(,�co� hyo Gym, Town Hall,53095 Main Road p -� Fax(516)765-1823 P.O.Box 1179 co Z Telephone(516)765-1802 Southold,New York 11971-0959 Oy dol 41 Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD July 6, 2000 Mr. & Mrs. John Mohring P.O. Box 1721 Southold, NY 11971 RE: 380 Kimberly Lane, Southold. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) ;25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26565-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. TOBM NO. f 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) N°N° 21354 Z Date ................. .. . . ......... ........... 19.2..4 Permission is hereby granted to: a. .. � . ... :............ to .Q�.�-. . .... ,. ....... a...... `........................................................................... .. ....... ..... .. . .......... ............. ... . ...... .... . at premises located at ...az-p....... �n. ... ... ......... !4 A"C........... .......... ........... _ .................. ........... ..... . .....................................................I..................... County Tax Map No. 1000 Section . .07 6......... Block .......1.Z........ Lot No. .. �.:..�.g pursuant to application dated ..... J..!4.................. 19lik and approved by the Building Inspector. Fee S14;�•;............ Lb 1... ............ .... �.... .. ... . ...... .. .......... Building Inspector Rev. 6/30/80 STEP APPUCATIONS fi 5 stop 8'StRO 1 T f CPui ARE MOFRfO d - 1 3-IAUWL3 ARE PROVIDES fi 5 \ ' D PURE3 pi Aau1CS.LDII -j FRFEL C iMdIEED 1 22 ACORNEE3 M,XELTASTENEM MWEL A 8 ' d PcaWERs PAP°x'REI I PP CAUDED 6 ' I f 6 6 d STIIVCIWK d zs-d__� _.� STRYCTURK COR11fR PE1EL d �NYCd «y1 PANEL WL \\ IAXD VLENTXi Y DYDE `AOVUS11I PAM 34' 3 RIGHT RFM LEVEtIM STAIRS —TA-1 -��^f, IfVEUYD S}AIIE 11 A-C SERIES ar l MARATED VRTNZI 0 DIAGONALS= A = 22'-2r' C- 33'-7%F 8 = 25'-7W D= 29'-6 '4 - `sFF'Faktiy MR.+l505 ]r OExfRK NOTES RE CONCRETE DECK A / I.ELLVERTICK DIMENSIDMU S ARE FPOYNER REINFORCED W/6n6 r0/gMMF f1' 4N ENTRUSION 011 ALL POOLS /'1'VN ECP'NS \ Y'y 2 UNLESS OTMEN•xl$E MOVED ILL POOLL ARE �__-Y " Y' -17 N 3 Pr TTPE Z ANO TYPEII E W INYEN'I$TO BE U3EO TYIEII OIVINSEOUIPMENTTOSEMOUNT EOXO YORE THAN 2O DROVE PATENS TIP OF4 DOIPD"ALL BE]r3 ROY OEEPENO .S6N SPACE OPTIONAL- i £4PIDIL IOAVE MIN PANELBE _ 4Yti RAW RUN,GRAVEL OF $TAMMIID tSOIL-0 HAVE YINIMIMI BEARING CAPACITY OF ��FILL$AM6 PANEL DER$-ILW BV.CE 200p K F .r' 11NJTf TV CF TOOL EV LEAST 1'AROVE CAPT.SURROUNDING HAND ELEVATION - EARix 3 ALL WiTiON SHOUND,FILLREY LARGERSASE �Q^ I USE NO EXPANSIVE ALL MOUND,TILLVOID$UMpER RE$E OF '- ARTER'4LS FOR ti EL$RL-P YELL - tr / SAUFLLL t RAUTILL$SHOULD NOT EXCEED MATER VINYL LINES-� WIWT ST MORE THEN III;WAVER LEVEL SMNLO NOT EXCEED HEIGHT OF TAMPED RE4R�DPTIONAL-ODIY RSQVITRE 10 ClFf010 $t036f RACXFilL ST MWE THAN IY 3VERYI[Vl1TF CA ".-.i • S16CNFILL VO BE SAN WAVE,,ON OTHER SAND CONCRETE MOM-ESXSIVE MATEEW. "/ ':r 1-�FpOTER M ° DEPTH NP DESCRIPTION _ < ri$n'RERu 20' x 43' Lazy-L (right) v �� _ � �- NOTEUSE]-]/!"RERMSP MATEIIJAL-STAMUAAL FOAM MOLDED roc DDxnNpous.ROUND - J _ FEMMETERdR DREAM SCALE yded DATE V29180 �L kTASS SSOCISUSSE is FDA SIUSTAATWE"POSES ONILY. TXA mRnV4gbP Fol W.fwlz.M T%K bUT 1MRe aA Nya t1a°z whCN MI NRIO°ARl WIRI .A N,i4rydMf IFDIRYN11R1RIK {J 5 1 Aebwn°F b=mNitl{IHMk*.bMp oA oW iMNXCKK M D4 - S E f FAPR S �1• C...roMdMD w+NNi v°bRAW erINARANINARAVANA,w INmuynrMP w - .— ® • `Mhos= =1 wPW NNbFOPwPYDwr RI/RDeIW , TE CAAROS"PDOLS AND STAINS . ;!;}L°i bwNMWeafen WJFFIe Rv°k.MLTMeb RAUR,,AAu,X IUYrotl .}NAHAE D#10E «e TrgDRMMm eM wir«IhyOPIN$IeMr+toblNMt THIN NYi'D$ 51OSumgr DFFeR q �.- MNMwW PIIUYrrDn3 NNW'PM�SIYIRi OIfMWWWPTNR I'EePmJMNVY F�Y': 1M WrY%ri fdTWa/FIE.IFRRMi 46204 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR ,l 765-1802 BUILDING DEPT. p? �� INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING FINAL [ ] FIREPLACE & HIMNEY REMARKS: Z2 4� DATE �.2- CXJ INSPECT M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING &,,J4 AL [ ] FIREPLACEA CHIMNEY REMARKS: e z CEJ > DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: A �'�d�C%��-• -`r ? Q DATE INSPECTOR IELD I::S:'EC;IUy llATE NTS till, FOUNDATION ( 13t) c FOUNDATION ( 2nd ) 2 . o Q� ROUGH FRAME & o PLUMBING ti H 3 . x nn I14SULATION PER N Y. y � STATE ENERGY +O CODE x Al a 4 . ►� FINAL olp ADDITIONAL COMMENTS : x,1a d. c� H a •19 H (� O •-1 z ra H x ty. m -o H BOARD OF HEALTH . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . APR I 6 (L)TN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . B VDING DEPARTMENT CHCCKI . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 q,.p TEL.: 765-1802 too'` CALL . . . . . . . ExaminedI MA Approved# 105 Permit Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ing Inspector) APPLICATION FOR BUILDING PERMIT pp Date . . . . .' (s . . . . . . . .. 19 f: INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans,accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi shall be kept on the premises availabie for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for necessary inspections. fL .,CGS w /GG S SGS' S. e . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . c )�!rx, c 76< . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . .�S�H/V . . . �". . . �f 7 (CA4 . . .Mo.fftlt ov G . . . . . . . . . . . . • • (as on the tax roll or latest deed) If appy nt/is orporation,s atauthorized officer. . . . . . . . . . . ri . . at . (Name and title f corpor) Builder'sLicense No. . . . . _ . .f . - /fes . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. .�(c>GLi91� , (re-(7��C', Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . �Grrh �lcxc Y 4 �:,. .Jdk� 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . .�f.Uu� . . /�•.! . . . . ..?�cd. . . . . . . . . . . .K.1lij4024Y. . . 4�ii/tr, . . . . . . . . Qc4 �.�'J . . ./ .y. . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . 70 . . . . . . . . . Block . . . . .13 . . . . . . . . . . Lot . . . c2b:.1Y . . . . . . . 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 . . . . . .!Yv�ies!�14r- /rj . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . ... . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . ./. . .! 124111 77 . . .�"! �. . . . . . . . . . . . . . . ,6-/rz�vc r 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . ... . . . . . . . . . . . Other Work . . . . ,X. . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . ../70 `.� . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business,commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . Jam. . . . . . . . . . . . . . . .Will excess fill be removed from premises: Yes 14. Name of Owner of premises . . .04AMC!4 !?!r+. . . . . Address . . .St�x,-7Ac4_9. . . .Phone No. . :?4{,-ef 9,/e Name of Architect . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . Name of Contractor . . A. :�04f. .?`�a?`J . . . Address . �lf??��-�1� . Phoke No. . 124J?-Jlp 6. . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, _ S.S COUNTY OF . . .14.4: � y� J�( l.��2✓. . !.`ra�L�. . . . .T `. .'. . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. n yam ' ieis the . . . . . . . . . . . . . . . . . . . . . . �` �n T7 l L � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer,etc.) if said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in the manner set forth in the application filed therewith. iwom to before me this � . . . . . . . . . . !. . . . .day of rl. .(. . . ., 19107-:1 lotaryPubli f. County c/ CLAIRE L GL-W . . . . . . . . . . . . . . . . . . Notary Publie,State of New York (Sign re a No.4879505 pplicant) Qualified in Suffolk County Commission Expires December 6,10_,.. H 0 N No. 89 - SO - 75 ,t ssroOL i'VFR /50 (DWELLING) ��yy (DWELLING) SURVEY OF rr PROPER T Y 'g A T SOUTHOLD _ Se•°WOL®CO�NTY,OLDN 30 73.6 /�6 E ! �``"5 '" r" ( 1000 - 70 - 13 - 20. 18 Choi e' so" ^� b Scale 1" = 40' No v. 7, 1988 Q vI r o O zo I Sn b May 15, 1989(prop. hae.) S`nR JULY 7. 1989 (under const. ) ones 0.14 a OCT 7 , 10- 89 ( r1F/nL ) 2 STY • � n W I X26 z"COLOOR „ FR HSE 10.0 y (V WEL L ING) I GAR SVCLI y` % x x m " 'FPL:. l CESSPOOL 4I K 25 � �\ -VER 150' K an zs. 7 rp C • .. Y... ZI'V *. 0 70'1s 5 U z!.^ / 'IY MEDIATqGL7 .�� •Ra� 3s , W y " ._ 143' S,' s5' 1/� VS VRYi/�f1RS1iR� is (PIF. 4, QD so CA -film �Gx L•n!' wii l In NG LS fill r n • � � _ . _ zo.9 zL6 � < a 'SdUC'TtE u n , T C.O. 1 $ 8Q• 06' S=„ OCCUPANCYl�R .9 ALL 1. i1 SMALL P t. x S.M C THE seo.se' .A.. USE IS UNLAWEUt [1; t ,,ygg ppg�ypy y �+ }� {t gr TAT, z.raT EtdEr :. n WISHOU CERlIf1cATE O I m o� accuPar�cr ( TELL/N3) MJCTION ERR ; z y., I O WELL a cESVOOL (VACANT) OBER ?0' CERTIFIED r0' F6�NooNEo COMMONWEAL rH LAND TITLE INSURANCE L. Pit NOR rCOMPANY K BANK AND TRUST APR 6 -u' EL TOTASSUMED DATUM. IONS ARE ENCED ' • �ANDSl�9 ME . , QS. LIC. N0. 49618 NOTE' LOT NUMBERS REFER TO MAP OF PARADISE BY THE BAY' O• Prepared In accordance with the minimum FILED NOV. 4, 1976 FILE NO. 6463 AT THE OFFICE OF THE (�'�� londords for flAa sums as aslo!/lshad /� ' ` 1 y $r P.C. SUFFOLK COUNTY CLERK. ('OxAI , br lhs L.I.A.L.S. and No proved and adopted (1 for such use b The or York Slots Land P Tf Title Association. AREA = 45, 182sq.fl. M., SDS OU t Y. 11971 .. �+ q 88' CJ8a7 [Jp