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Home My WebLink About25599-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27527 Date: 01/22/01 THIS CERTIFIES that the building NEW DWELLING Location of Property: 230 THE STRAND EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Taxx Map No. 473889 Section 21 Block 5 Lot 6 Su3odlvision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 1999 pursuant to which Building Permit No. 25599-Z dated MARCH 15~ 1999 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 AS APPLIED FOR. The certificate is issued to WILLIAM & MARIETHERESA AUSTIN (OWNER) of the aforesaid building. SUFFOLK COUNT"f DEPARTMENT OF t~L~_LTH APPROVAL R10-98-0106 ELECTHIC3%L CERTIFICATE NO. PLUMBERS CERTIFICATION DAT~3 Rev. 1/81 09/28/00 33297 08/09/00 01/11/01 K&K PLUMBING 7 HEATING Authorized~ FORM NO. 3 TOWN OF SOUTNOLD 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. 25599 Z Date MARCH 15~ 1999 Permission is hereby granted to: WILLIAM & WF AUSTIN 8 ROSEMONT CT ~: .. GREENLAWN~NY 11740 for : CONSTRUCTION OF A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 021 pursuant to application dated FEBRUARY Building Inspector. 230 THE STRAND EAST MARION Block 0005 Lot No. 006 10 1999 and approved by the Fee $ 1~075.00 ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF Ao This application must be filled in by typewriter OR ink lng inspector with the following: for new building or new use: i. 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 o~ 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~ - $I00.00 3. Copy of Certificate of Occupancy - ~ -2~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .~z~....~.f~ ..~...{ ................... New Construction .... .~.. .... Old Or Pre-existing Building ................. Location of Property .......................................... House No. Street Hamlet Onwer or Owners of Property... ~*~f/~fg..~..../~.../~. ~ .'.~-.~.~.7~..~?.~.... ~ ~'~ County Tax Map No 1000, Section. ~[ .Block..[.~P.~.O. ~ .Lot...~ ~ Subdivision .................................. .. Filed Map ............ Lot ...................... Permit No.A~q~Tff .... Date Of Permit. 3. .~~-/~ ...... ?...Applicant~. .... ~ ....... ~. ......... Health Dept Approval Underwriters Approval · · Planning Board Approval .................. Request for: Fee Submitted: 6k . Temporary Certificate ........... Final Certicate ........... APPLICANT Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (516) 765-1823 Telephone (516) 765-1802 October 23, 2000 Mr. & Mrs. William Austin RE: 230 The Strand, East Marion To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX XX . XX XX XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. 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. / (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 25599-Z Please contact our office on this matter. Thank you for cooperation. NOTE: SOUTHOLD TOWN BUILDING DEPT. Notarized letter from homeowner required regarding any w~rk not required by builder. Town Hall, 5309 ~ Main Ro~d P. O. Bop ~1.79.'' ' Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. 'J'J~['~/~ Owner: ~~J ~~ ~ (please print) Plumber: ~/~ ~)/U~.-~J~.~.,,~/ ''///~(~ '(pi~ase prf~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before ~ this ]/ day ~~ , ~.~3~/ Notary Public ~_~~ ,~ .~(.f~ounty JOYCE M. WILKINS N~a~ Publi~, State of New Yo~ No. 4952246, Suffolk ~un~ Term ~piresJune3~ ~j DATE; 8/9/00 ELECTRICAL INSPECTION SER VICE INC. 375 D UNTON A VENUE EAST PATCHOGUE, NEW YORK 11772 (516) 286-6642 33297 APPLICATION No. ON FILE VILLAGE: East Ma~ion TOT/N: Southold ADDRESS.x Lot ii 136 "Tbs ~gtranrl" ISSUED TO: William Austin INTRODUCED BE' Joseph C. Calamita LIC No: 3732-E was examined on 08/08/2000 i,nd found to be in compliance with the National Electridal Code~ LOCATION: Base.. X 1st X 2nd X 3rd Attic Det. Garage Hot Tub Pool SWITCHES RECEPTACLES FIXTURES HEATERS FANS ] G.~L AIR. COND. 64 60 68 4 12 2-40Amp DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN SMOKE DETECTOR 1 1-20amp 1-40a FURNACE OIL · GAS CIR. MOTORS BELL TRAN, SERVICE DISCONNECT 1-4rrac x 1 200U/G OTHER EQUIPMENT Outside Res. 2 20amp Air Handlers 1. 20a Cooktop, 1 20a Jacuzzi ~ 1 1/2h/p Dooropener 1 20a Kitchen Ext. Fan, 1 20a Microwave, 1 Central Smoke Alarm System 1 Carbon BUILDING PEIUfflT No. 108 PRESIDENT FIELD INSPECTION REPORT FOUNDATION ( DATE , ./ COI~IEN~S ~OIINDATION ( 2ND ) INSULATION PER N. Y. STATE ENERGY CODE ^mado M. Ortiz, ^1^ Architect CERTIFICATION To: Attention: Date: Project: Permit #: Southold Building Dept. John Boufis 9 February 2000 Austin Residence 25599Z Page i of i Mr. Boufis-- This is to certify that substitution by contractor of ~Anthony Power Beams' for LVL girders at first floor construction is acceptable. This substitution will adequately support the live and dead loads required, within designed deflection limit. Amado M. Ortiz AIA cc: Jim Naples Construction William and Marie Austin 516 329 -1547 96 Newtown Lane/East Hampton, NY 11937 Amado M. Ortiz, AIA Architect FAX MEMORANDUM ********************************** PAGE 1 OF 1 TO: Att: 'Southold Building Department John Boufis Date: 8 June 1999 Re: Permit #25599 Z Residence for William and Marie Austin Mr Boufis-- Attached are Wall Buttress and Wall Fill detail drawings for above project, as per your request. ~~are being forwarded to your Thank you for you~ attention. Amado M. Ortiz, AIA 516 329-1547 96 Newtown Ln~le/~Ea~t Hampton, NY 11937 Arnado M. Ortiz, AIA Architect FAX MEMORANDUM *********************************** PAGE 1 OF 3 Att: Date: S.outhold Building Department J~ohn Bouf~ 14 June 1999 Re: Permit #25599 Z Residence for William and Marie Austin Mr Boufis-- As per my Site Observation on 12 June 1999 of foundation for above Project: 1. Wall Fill Reinforcing as installed, with 3 #5 rebars horizontally and vertically (instead of 4 as designed), i~s acceptable for the given lateral load condition. (Refer to attached Detail, as submitted). e Wall Buttress .a. Wall reinforcing was installed as designed, but footing reinforcing was not placed, on both walls. This needs to be done, and tied to vertical wall reinforcing, as specified. b. Height of Wall Buttresses should be 1'.-0" below retaining walls previously poured, to allow top of butresses to be buried below grade, as designed. Reinforcing as placed should be cut accordingly. Bard copies of aboye are being forwarded to your office. Thank you for your attention. Amado M. Ortiz, AIA cc: Jim Naples Construction William and Marie Austin £.?'.-x L.? R 516 329 -1547 96 Newtown Lane/East Hampton, NY 11937 DE~T 01/09/1994 12:84 FAX MEMORANDUM *********************************** PAGE 1 OF 3 To: Att: Date.: Re: S. outhol~ Building Department John Boufis 14 June 1999 Pezl~Lt ~25599 Z Residence for William and Marie Austin Mr Boufis-- As per my Site Observation on 12 JUna 1999 of foundation for above Project: Wall Fill Reinforcing as installed, with 3 %5 rebars horizontally and vertically (instead of 4 as desig~ed), i__s acceptable for the given lateral load condition. (Refer to attached Detail, as sub~itted). Wall Buttress a. ~Atl reinforcing was installed as designed, but not on footing'reinforcing was _._placed, both walls. This needs to be done, a~d tied to vertical wall reinforcing, as specified. b. Height of Wall Buttresses should be 1'.-0" below retaining walls previously poured, to allow t~ of butresses to be buried below.grade, as designed. Reinforcing as placed should be. mt accordingly. Hard copies of aboye are being forwarded to your office. Thank you for your attention. Amado Mo Ortiz, AIA cc: Jim Naples Construction William and Marie Austin ~16 329-1547 g6 NOWTOWn Lnne/EiII Hampton, NY 11957 81/89/1994 12:04 516-329-1547 AMADO M. ORTIZ, AIA PAGE 02 01/89/1994 12:04 §16-329-1547 AMADO M. ORTIZ, AIA PAGE 03 I II Ill · II 01/02/1994 16:27 Blg-329-1B47 AMADO M. ORTIZ, AIA PAGE Amado M, Orti'z, AIA ^rchi~ect '~outhold ~uilding Department TO: Att= Date= Re= 8 June 1999 Permit %25599 Z Residence for William and Marie Austin Mr Boufis~- Attached are Wall Buttress aha Wall Fill detail drawings for above project, as per your request. Hard copies are being for~arde~ to your q~fice~ Thank you for you~ attention. " ~nado M. OrtiZ, AIA 01/82/1994 16:27 516-329-1547 AMADO M. ORTIZ, AIA PAGE 82 01/0~/1994 16:27 616-329-1§47 ANADO ~4. ORTTZ, ATA PAGE Am ado M. Ortiz, /%1/% Architect BLDG. DEPT, zow~ o~ souT~~ CERTIFICATION ************************************** Page 1 of 1 To: Southold Building Department Att: John Boufis Date: 6 July 1999 Re: Permit ~25599Z Residence for William and Marie Austin Mr. Boufis-- This is to certify that Retaining Walls On this Project, as constructed to date, comply with drawings submitted as part of Building Permit issued 15 March 1999, ~25599Z, and also comply with detail drawings submitted 8 June 1999 as amend- ments (copy attached). cc: Jim Naples Construction William and Marie Austin 516 329 -1547 96 Newtown Lane/East Hampton, NY 11937 Member of tile American Institute of Architects 02t0g/2000 11:58 516-329-1547 AMADO M. DRTIZ, AIA Amado M. Ortiz, AIA Architect CF~TZFIC~TXON ****************** P&~ 1 of 1 To: $outhold Building Dept. Attention: ~ohn BoufiS Date: 9 February 2000 Project: Austin Residence Permit ~; 25599Z PAGe Mr. Boufis-- This is to certify that substitution by con~ractor of ~Anthony Power Beams' for LVL girders at first floor construction is acceptable- This substitution will adequately ~upport t~e live and dead loads required, within designed de{lection limit. Amado M. Orttz AIA cc: Jim Naple~ Construction William and Marie Austin Albert J, Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Pollwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765~1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 14, 1998 William & Marie T. Austin 8 Rosemont Court Greenlawn, NY 11740 RE: SCTM'#21-5-6 Dear Mr. & Mrs. Austin, The Southold Town Board of Trustees reviewed the survey dated and received in our office on August 14, 1998 and determined that your proposal to construct an 18' X 35' at grade patio adjacent to the existing house, to be out of the Trustee Wetland Jurisdiction under Chapter 97 of the Town Code. However, any activity within 75' of the Wetland line requires a permit from this office. This determination ts not a determination from any other agency. If you have any further questions please do not hesitate to call. ' Sincerely, Albert J. Krupskl, Jr. President, Board of Trustees AJK/dJh cc. Bldg. Dept. SUFFOLK COUNTY ~'ATER AUTHORITY Michael A. LoGrande, Chairman Melvin M. Fritz, M,D,, SecretaP] James '~B. Tripp, Member Eric J. Russo, Member John E. Gee, Jr,, Member William & Marie Theresa Austin 8 Rosemont Court Greenlawn, NY 11740 Adm~mstrabve Offices; 4060 Sunrise Highway, Oakdale, New York 11769-0901 (516) 589-5200 December 8, 1998 Fax No.. (516) 563-0370 Re: Application for Water Service for SCTM # 1000-21-5-6, Pebble Beach Farrns Lot 136, East Marion Dear Mr. & Mrs. Austin: The SCWA has made a determination that addition capacity is available to provide water service within the portion or our water system in the area of the above referenced property. You have applied for water indicating that you building a house at the above referenced premises. Based upon'the ~.bove, the application for public water to the subject premises is APPROVED, upon payment of the following SCWA fees: $3,000.00 "Key Money" Fee $800.00 Tapping Fee $175.00 Meter Vault Fee Payment of the indicate fees is required upon application for individual water hook-ups. Although not indicated above, if the Authority determines that a service line is required or that the meter should be set near the premises property line, a Tapping Fee and/or Meter Vault Fee may be required at time of hook- up. This approval is good for one year from the date hereof, and a re-application is required if you do not hook-up in one year. This approval is not a guarantee of water availability at the time you hook-up and is subject to reeission. Very_truly 7ours, // Attorney CC: Herman Miller, Deputy CEO for Operations' Ron Blake, Regional Manager O REPLY TO ATTENTION OF DEPARTMENT OF THE ARMY NEW YORK DISTRICT~ CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING NEW YORK, N.Y. 10278-0090 March 23, 1998 Eastern Permits Section SUBJECT: Joint Application with New York State Department of Environmental Conservation William and Marie Theresa Austin 8 Rosemont Court Greenlawn, New YOrk 11740 Oear Mr. & Ms. Austin: We have recently received a copy of the Joint Applicacion for permit you filed with the New York State Department of Envirohmental Conservation (NYSDEC). Please be advised we have reviewed the copy of the Joint Application sent to this office by NYSDEC. Based solely upon the information provided, it appears that a Department of the Army permit is not required for your proposal. The Department of the Army regulates construction activities in navigable waterways and discharges of dredged or fill material into waters of the United States, including inland and coastal wetlands. If your proposal would involve such work, and has not been portrayed as such in your Joint Application, you should contact this office immediately so that a project-specific determination can be made as to whether a Department of the Army permit will be required. Any inquiries can be directed to this office at (212) 264- 3912, 3913, 6730, or 6731. Sincerely, ~e s~2 Ha~ag~e ~ ~ief, Eastern Permits Section New York State Department of Environmental Conservation Building 40 - SUNY, Stony Brook, New York 11790-2356 Telephone (516) ~.~.-0365 Facsimile (516) ~.4~.-0360 LETFER OF NON JURISDICTION -TIDAL WETLANDS John P. Cahill Commissioner Date: April 30, 1998 William & Marie Austin 8 Rosemont Court Greenlawn, New York 11740 RE: 1-4738-01889/00001 Austin Property The Strand, East Marion SCTM 1000-021-05-06 Dear Sir/Madam: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the property landward of the topographical crest of the bluff as shown on the survey prepared by Stanley J. Isaksen, Jr., dated September 15, 1997, and last revised April 27, 1998, is beyond Article 25 jurisdiction. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundmy, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Permit Administrator cc: Bureau of Marine Habitat Protection, NYSDEC File DMG Pebble Beach Farm 125 Harrison Street Garden City, NY 11530 July 9, 1998 William & Marie Austin East Marion, New York Dear Mr. & Mrs. Austin Thank you very much for submitting your house plans dated February 12, 1998 for the construction of a home on Lot number 137 of the Pebble Beach Farms Association. I have reviewed the plans and am pleased to inform you that they meet all three requirements of the Pebble Beach Farm Association. These include; (1) a minimum of 1000 sq. ft. of living area in the first floor, (2) all gable roofs, and (3) a minimum of one car garage. Yours Truly, Michael Prois Architectural Plan Evaluator for Pebble Beach Farms Association Stella Vanguestaine Secretary Pebble Beach Farms Lot Owners Association PO Box 387 East Marion, NY 1'1939 July 22, '1998 Mr. and Mrs. William Austin 8, Rosemont Court Greenlawn, NY 11740 Dear Mr. and Mrs. Austin: By now you should be in receipt of the enclosed letter from Michael Prois confirming that the architectural plans you submitted meet the three main construction requirements under the C&Rs of the PBFLOA. Good luck with the construction. We would like to remind you that in addition to the construction requirements, there are other C&Rs that you must be in compliance with after the construction is complete. These C&Rs include, but are not limited to, a proper driveway and landscaping as defined in the C&Rs. Please contact us if you require another set of the C&Rs or if you wish clarification on any of the points. We hope your project progresses well and look forward to having another "full time" resident in Pebble Beach. We know you have been a member of the community for some time, but officially welcome you as a "soon to be homeowner" in the development. If the Board can be of any further assistance, do not hesitate to contact us. Secretary ./INSPECTIO~~ [~/]~OUNDATION 1ST I ] ROUGH PLB~ [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY INSPECTION~ OUNDATIOH '~HD [ ] INSULATION [ ] FIREPLACE & CHIMNEY ~~ DATE /_ ~ /_ IN 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ I ROUGHPLBG. [ ] FOUNDATION 2ND [ ].~ULATION [ ] FRAMING [,~]' FINAL [ ] FIREPLACE & CHIMNEY " · / ~/ / 765-1802 BUILDING DEPT. INSPECTION INSPECTOR 765-1802 BUILDING DEPT. , INSPECTION /~ [~/ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY . DATE ~'~': 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL INSPECT~/~ 765-1802 BUILDING DEPT. I~ISPECTION [ ] FRAMING [ ]FINAL [ ] FIR"=P~AC~,~_~CHIMNEY REMARKS. ~~ 765-180;2 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE~ ,,//-..~& CHIMNEY REMARKS: .... ~ ~ 765-180Z BUILDING DEPT. INSPECTION [ ] F~I:)NDATION 1ST [ ] ROUGH PLBG. [~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION O~-- FOUNDATION 1ST [ ~ROUGH PLBG. [,,] F/OI~..~TION2ND~~ [ ]INSULATION ~MING [ ] FINAL FIREPL~ & CHIMNEY'POt2 - ~~ .i-/.- ~- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ UGH PLBG. [ ] FOUNOATION2ND [ ]INSULATION [ ] FRAMING [ ]FINAL 765-1802 BUILDING DEPT. INSPECTION Il ,ou.o~,,o.,,, ~1 RO,,O. PL,,O./~-~ //~ ~"] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATIONIST [ ] ROUGHPLBG, [ ]FOUNDATION2ND [ ]INSULATION [ ]FRAMING [ ] FINAL [ ]FIREPlACE&CHIMNEY 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] R/0UGH PLBG. FOUNDATION 2ND ['//] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY DATE ~//~ INSPECTOR 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R~J~H PLBG. [ ] FOUNDATION 2ND [~'~] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC~,~& CHIMNEY REMA KS= DATE ~///~ INSPECT~ L ..... TOWN OP ~O011~OL~ ~ FORM NO. I TOWN OF SOUTHOLD BIIILDINO DEPARTMENT TOW~ HALL SODTHOLB, N.Y. 1197 TEL: 765-1802 Dise~rreved a/c ...................... .. ... · · · ... BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: ¢/>.,(,.. CALL ....... HAIL TO: .................... INSTRUCTIONS a. This applicatian umst be completely filled in by typewriter or in ink and submitted to the Building Inspector witl 3 sets of plmm, accurate plot plan to scale. Fee according to schedule. b. Plot plm showing location of lot and of lmildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be dra~n on the diagram which is part of this application. c. The ~Olk covered by this application may not be ccrmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Pemlt to the applicant. Such pemit shall be kepE' on ~ premises available for inspection thmngta~t the ~)rk. e. NO buildlng shall be occupied or used in qaole or in part for amj purpose whatever until a Certificate of Occapascy shall have been granted by the Building Inspector. APPLICATI(~I IS ~l ~ to the Building Department for the issuance of a Building Pemit pursuant to the lkfilding Zone Ordinance of the Tewn of So~thold, Suffolk C~anty, New York, and other applicable Laws, Ordiassees or Regulatioas, for the constxuction of Imildlngs, additions or alterations, or for r~noval or demolitian, as herein described. The appli~t agrees to comply with all applicable laws, ordinances, Imilding code, housing code, and regulations, and to admit anthorised inspectors on premises and in building for necessary i~sl~ctions. ............ (Simmture of applicant, or nan,, if a corporation) (Mailing eddreas of applicant) State ~hether applicant is mr, lessee, agent, architect, eegieeer,' general ~tractor, el~trici~, pl~r or ~ilder. ................................................................................................. ~ - IJ~A ~T~ ~ of ~r of ~m, ..~.t~'.,>.~,~..--..-,-,-,--,-~-~ ................ ................................. (~ ~ ~ ~ ~11 or latest d~) If ~lic~t is a ~ati~ si~ of ~ly ~ti~ri~ officer. (N~e and title of corporate officer) Builders License No .......................... Plm/mrs License No ...................... . ... Electricians License No ...................... Other Trede's License No .......... I. Ix~catian of land on which proposed ~ork will be done · ~_ O .T. /da .l .~ .~' c'[-~ ~- Boose Nt~ber Street Ba~let County TaxlCmp No. I000 Section .....~).~v..I ...... Block .... ~..~.. ..... Lot .... ..(~..~2 ...... S~lxlivision .................... :-~ ............. Filed Map No ................ h)t .... ..~. .... (~) 2. State existing use and occupancy of premises and inteeded use and occaI~ney of. propased coastmetian: ,ting .... .................... ' ...... '. ............... '. .......... b. z.t,~a,-a ~ a~ oco.~,,'~."',] .................................. 't'""" ........................... , 3. I&u~ure of ~ork (dmck ~id~ spp icable): ~ ~ildi~ .......... ~i~i~ .......... Alter~t~R l~Dir ....... ~al ~ ........ , .......... l~liti~ Otlmr ~ ...... ; ................ (~ripti~) (to ~ ~id ~ fili~ this a~l~tlm) ' ~ ............ If ~rage, ~r of ~ra ..... [ ................... 6. If ~i~ss, ~rcial or ~ ~, s~ci~ ~re ~ ~ten~ of ead~ ~ of ~ ...................... 7. Bi.nails of ~ia~i~ st~s, if ~: ~ ................ ~ar ............... ~pth ................. IMi~ ........................ ~ ~r of Stories ...... ~. ............ Bi~nsi~ of ~ st~e ~th alterati~s or ~itlons: ~nt ............... ~ar ............... ~pth .................... ~i~ .................... ~r of Stories ............... 8. Di~nsi~ of entire ~ ~s~t~: ~t ................ mar~. ............. ~p~ .............. ~i~,~ ........................ [. ~ of Sto~i~...~ ................ ..... ............... I~. ~e of I I. ~ o~ ~ di~rlet m ~ p~ a~ ~t~ .............................................................. . ., [ · m~ /~ ~rtl'Z ~ree~a~ /~, V,/I 7~ B~~ .y,,~ ~ o A~ut~t ~ .... ~ ..... , ....................... ~ress ..~.~g~g~.~A.A~.. ~ ~.../FL.Z/... ........... I .................. : .......................... . .............. ~ ~ .............. 15. Is arisp~rL~a, ia~ f~o~a tial~tl~ *~ ~ m ~ l~ate clearly ~ disti~tly a~l ~ildi~s, ~flmr ~isti~ or pro~, ~ ifli~te all ~t-~ d~nsions ~ p~r~ lima. gi~ at~t ~!bl~ ~r or ~scripti~ ~co~i~ to ~, ~ ~ strut ~s ~ iMi~te ~t~r interior or ~r lot; (Nam of individual Slgtlltlg contract)i ,~ ,, ,,,~ ........ ~.~.fi.......e r ...],. ............................................... . ....... . ...... . ... .... (~tractor, ~ent, ~or~rate officer, etc.) o~ ~ia ~r or ~rs, a~ is ~ly ~thori~ to ~rfom or h~ ~rfo~ ~m ~id ~ ~ to ~ ~ file this a~t~catxm~,' · that' all stat~nts' - c~t&t~.' m' d]zs' e~l. ieati~ are tn~ to ~e ~st of hfs ~1~ aM ~llefi a~ that t~ ~ wilt I~ ~rfo~ in tl~ mm~r ~t forth in ~e a~licatlm fil~ ~. · I ~ to ~e ~ ~s , / , ............... .... HELENE D. BORNE I Nota~ Public, State of Ne~ York N0. 4951364 [ Qualified InSuff~k Coua~ ~ Commission ~pires May 22, 19 ,~ · .heirgg duly s'~re, deposes ar4 ,says that he is tim appl ie~a~t