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Home My WebLink About25661-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27040 Date: 04/13/00 THIS CERTIFIES that the building NEW DWELLING Location of Property: 739 OLD WOODS PATH SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 1 Lot 23.6 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15, 1999 pursuant to which Building Permit No. 25661-Z dated MARCH 31, 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 DWRLLING WITH COVERED PORCH AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to ANITA DILWORTH of the aforesaid building. (oWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-98-0172 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 o3/14/oo N 516942 03/01/00 04/10/00 K & K PLUMBING & HEATING AuthOrized/ignature 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. 25661 Z Date MARCH 31~ 1999 Permission is hereby granted to: JOSEPH & WF BEAUDIN PO BOX 633 WESTHAMPTON~NY 11977 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 087 pursuant to application dated MARCH Building Inspector. 739 OLD WOODS PATH SOUTHOLD Block 0001 Lot No. 023.006 15 1999 and approved by the Fee $ 905.00 thoried Signature ORIGINAL Rev. 2/19/98 ~ , ~o Form No. 6 · ~ TOWN OF SOUTHOLD APR I I ?~0~ , .... BUILDING DEPARTMENT ~ ......................... .~j , TONN HALL ~ gLO3. Se;'r. ~ 765-1802 7OWN OF $OU'THOt. D _j APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 I% 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. Bo 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 ~ccupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date..~¢4~..... ..................... . . . . New Construction...~--. .... Old Or Pre-existing Building ..... Location of Property.. ]. ~ ......... ~ ~.~-~. ~?~....2~] ] ] ] ] ]... ] ]~ ~/~. ........... House No. Street Hamlet Onwer Owners of Property ...... .m. .... m.d .......... 2 ........... County ~a× Hap No 1000, Section ..... ~.Block. .Lot. S bdivisi ??(~ff~.~ ~' Map Lot · · Permit No ......... Date Of Permit ........ Applicant . ~ .......... Health Dept. Approval .......... ~ ............. Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certific'ate ........... Final Certicate....~... .... FeeAS~bmitted: $:!'~ffCx.~O '~ ~0~0 ..................... ~~~.~. ................ ,; I, SWorn to be£oro mo this (pLumber'a signae~gel ~ ', ~,'", NO~ Public, State of New Yo~k- No. 4952246, Suffo,~ Coun~ , Term ~pJres June ~2, ~o~ .'~ STATE OF NEW YORK I ~g COUNT~ O~ SUl~O~ and Proof~ ef ~t~a ~ndivtdual described and who ~, ~e ~ing ~st~ment, ~d ~cknowledged ~at hds~ execu~d the s~e. THE NEW YORK BOARD OF FIRE UND,ERWRITERS EURE^U OF E'ECTR'C'~V~, 40 FULTON STREET, NEW YORK, N'~'10038 · THIS CERTIFIES THAT only the elec~cal equipment as described below and in~oduced by the applicant named~on the, above applic~on number is in the premises of ~ITA DILWORTH, 739 O~ WOODS PATH, SOUTHOLD, in the following loca.o.; ~ Basement~ 1st FI.--~ 2nd FI. G~/ATTxC/OUT ' Section Block ~t w~ examined on ~'EBRUA[~Y 24,2000 and found to be in compliance with the NaHonal Electrical Code.. 58 55 49 , MC K w, 1 1.2 EXHAUST FANS FIGURES RANGES ~ COOKING DECKS ~ OVENS ~ DISH WASHERS FIXTURE RECE~ACLES SWITCHES INCANDE~ FLUORE$CEN[ OTHER ~ F OUTLETS AMT. K.W. AMT. K.W, ,MT. K,W, AML H,P. DRYERS ~} · FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT, TIME CLOC~S ~ BELL ~ UNIT HEATERS MULTI-OUT/ET DIMMERS SYSTEMS AMT. ~.W. OIL H,P, / GAS H.P. AMT. NO. A. W, G, AMT. AMP. AM1, ,AMPS~ 'TRANS. NO. OF FEET AM~ WA~S SERVICE DISCONNECT ] OO~. ~ S E R V I C 2 TON AIR CONITIONERS-2 MOTORS~2-2 H.P.,2-F H~P. P~ELBO~S:2--1 C~R. 6~ <<< Continued on Page 2 >>> Pe This cefllflcate must not be altered I~ 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 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1135189 BUREAU OF ELECTRICI'¢Y ~- 40 FULTON STREET, NEW YORK, NY 1'0038 192,84899/99 1'I 516942 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant t~a~ed on the aboue application number i$ in the premises of ANITA DILWORTH, 739 OLD WOODS PATH, SOUTHOLD, NY in the following location; ~ Basement ~ Ist FI. ~ 2nd FI. GAR/ATTIC/OUT Block Lot · . FEBRUARY 24 , 2000 FIXTURE OUTLETS DRYERS RECEPTACLES SWITCHES FIXTURES RANGES DISH WASHERS FLUORESCENT OTHER SYSTEMS NO. OF FEET OTHER APPARATUS: E R V NO. O~p~RC~C ON D. OF ~;C~g~Oi' ' C A. WG OF NEUTRAl. Per llGENERAL MANAGER 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. MA~V~LL ELECTRIC 10 RAVENWOOD DRIVE KINGS PARK, NY, 11754-3303 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU'ST NOT BE ;ALTERED IN ANY MANNER. 3/25/99 Southold Building De P.O. Box 1179 Main Road Southold, NY 11971 Att: James Richter Dear James, Enclosed please find 3 prints each, sealed of A-1 and S-1 for the Dilworth residence in Southold. As per our conversation today, the framing is significantly beefed up, with an another girder in the basement, reduced spans on the second floor along with closer spacing on the longer spans. Please let me know if there is anything else you see, and thanks for your input. LEON FULLER PARHAM ASSOCIATES / ARCHITECTURE & HISTORIC RESTORATION 403 TAZEWELL AVE / CAPE CHARLES, VA 23310-3217 / 757 33/ 813~ 11/2/99 Joe Spitaliere Spitaliere Construction 54655 Main Road P.O. Box 552 Southold, NY 11971 Re: Dilworth Residence-"as-builts" Dear Joe: Per our telephone discussion today, thjs~s2o_certify theZollewing c~anges tofhe Dil~dr[li re~'Fde~ce in Southold, New York: The skylight was eliminated in the kitchen and added to the studio The beam picking up the rafters at the South end of the living room is 3- 1%" x 14" micro- lams. Let know m~ng else. Sincerel Lec~ ~ lEON FULLER PARHAM ASSOCIATES / ARCHITECTURE & HISTORIC RESTORATION 403 TAZEWELL AVE / CAPE CHARLES, VA 23310-3217 / 757 331 8133 765-~.802 BUILDING DEPT. INSPECTION ]~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION ] F/oI~DATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL [ ] FIREP~AC.,.~& CHIMNEY REMARKS.~~:'/~ DATE I N SPECT 765-1802 BUILDING DEPT. ,NSP CT,,O FOUNDATION ~s'r I~ aOUGH PLBG. ~Jl~ATION 2ND [ ] INSULATION [r-~FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ !./~NSULATION [ '~ FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ].~ULATION [ ]FRAMING ,~ [//~FINAL [ ] FIREP~ACE~_~MNEY INSPEC~~--'G, 765-1802 BUILDING DEPT. INSPECTION~ FOUNDATION 1ST [ ] R~J'GH PLBG. FOUNDATION 2ND [ ~I'~NSULATION ~/'~RAMING C~,-~...~ [ ] FINAL ] FIRE~HI~u~ I'/'/ / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG, I ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING /~ [~FINAL 76S-1802 BUILDING DEPT. .-. ~.,,~./.~; INSPECTI?~~ ~i~ .,~.~ ~ PLBG.~ [ ] FOUNDATION 1ST [~ ROUGH [ ] FOUNDATION2ND [ ] INSULATION [ //]/FRAMING~ [ ] FINAL Fidelity National Title INSURANCE COMPANY OF NEW YORK &pplication Date: October 27, 1998 Gary Flanner Olsen, Esq. P.O. Box 706 Main Road Cutchogue, N.Y. 11935 12 REPORTS) Report Date: November 10, 1998 Title No. FNT9818388 FEE: $ 120,000,00 MORTGAGE: $ (516)734-7666 FAX: (516)734-7712 Anita Dilworth ) J.o, seph Beaudin and Thomas DeMayo, Esq. Hampton Bays, N.Y. 11946 Applicant to .Send. Survey 10 Old Woods Road, Southold, New York Town of Southold County of Suffolk Filed Map: No, Lot: Dist: 1000 Sect: 087.00 Block: O1.00 Lot: 023.002 VARIANCE 4/1/57 Optional Market Value Rider 795.00 80.00 VarianceWith Fee 225.00 Sub-Total 1,100.00 ,::'.:.,=::*:.:.::.~.:-:<::R;EGORB[NG'=CHARGES,r.-/;' :!,,:-, (;;:;.='.', Conveyance Tax Estimated Recordin9 Char_~es 480,00 200,00 TITLE NO: FNT9818388 DISTRICT: 1000 SECTION: 087.00 BLOCK: 01.00 LOT: 023.006 Town of Southold Southold, New York Gentlemen: FIDELITY NATIONAL TITLE INSURANCE COMPANY hereby certifies that it has searched the records of the Suffolk County Clerk and/or the Suffolk County Registrar for deeds affecting the captioned property and properties immediately adjoining and finds: SEE ATTACHED And the records of the Suffolk County Clerk and/or Suffolk County Registrar disclose no other further conveyance of any of the foregoing lots other than as set forth., FIDELITY NATIONAL TITLE INSURAI~CE COMPANY certifies that the above- captioned property has been in single and separate ownership Joseph Beaudin and Michaelene Beaudin, his wife, and his/her predecessors in title since prior to 1957 except as follows: (see attached chains of title). The liability of the Company is limited to the amount of the fee paid. Dated: 3/3/99 FIDELITY NATIONAL TITLE INSURANCE COMPANY 'before me this March, 1999 /~-~_____~ No~Public GEORGE A. SIMACK Notary Public, State o( New York No 5032470 Qualified ~n Suffolk County Commission Expires August 29, 2~.3 TITLE NO. FNT9818388 STATE OF NEW YORK) ss: COUNTY OF SUFFOLK) SANDRA J. GOLESKI, being duly sworn deposes and says: That he/she has had a search made of the records of the County Clerk of Suffolk County with reference to an application for a variance affecting the following premises: SCTM 1000-087.00-01.00-023.006 That the said records indicate the following chains of title as to premises and adjoining lots since prior to 1957. SUBJECT PREMISES: 1000-087.00-01.00-023.006 Carrie M. Hutchinson Dated: 6/2/32 to Rec'd: 6/7/32 Edith H.M. Pearson Liber 1655 cp 231 NOTE: Edith H.M. Pearson died 1/18/68 (Surrogate's No. 583 P 68), leaving property off South Harbor to her son, John B. Pearson. John B. Pearson to Russell N. Freund and Elinor C. Freund, his wife Dated: 5/25/73 %Rec'd: 6/13/73 Liber 7417 cp 546 Elinor C. Freund Dated: 5/19/77 to Rec'd: 6/7/77 Russell N. Freund Liber 8248 cp 342 Russell N. Freund to Joseph Beaudin and Michaelene Beaudin, his wife LAST DEED OF RECORD Dated: 9/23/78 Rec'd: 9/29/78 Liber 8507 cp 150 FIDELITY NATIONAL TITLE INSURANCE COMPANY BY: Sw~before me this 3r~ day ~f March, 1999 Notary/Public GEORGE A S]MACK Notary Pubhc, State of New York / No 5032470 Oualihed m Suffolk Count~, Commission Exp~fes August 29, ~ PREMISES EAST: 1000-087.00-02.00-002.000 William Woodward Jr. to Aubrey Mealy Jr. and Otha Mealy LAST DEED OF RECORD Dated: 8/28/50 Rec'd: 10/11/50 Liber 3137 cp 468 PREMISES NORTHEAST: 1000-087.00-02.00-001.000 William Woodward Jr. Dated: 8/24/49 to Rec'd: 8/26/49 Aubrey Mealy and Liber 2985 cp 328 Rosa Mealy, his wife Aubrey Mealy and Rosa Mealy, his wife to Rosa Mealy Dated: 11/24/70 Rec'd: 11/24/70 Liber 6845 cp 294 Rosa Mealy a/k/a Rosa T. Mealy to Aubrey Mealy Jr. and Priscilla Mealy, his sister LAST DEED OF RECORD Dated: 4/18/92 Rec'd: 5/21/92 Liber 11470 cp 374 Swo~before me this 3r~rch, 1999 Nota~Public FIDELITY NATIONAL TITLE INSURANCE COMPANY /SANDRA J. GOfLgSK~ GEORG~ A S;MAcK Notary Public, State of New Yor~ No 5032470 Qualified ~n Suffolk Count Commission Expires August 29, ~ PREMISES SOUTHEAST= i000-087'.00~D2.00-003.000 Stuart Woodward Dated: 11/25/47 to Rec'd: 12/29/47 William Woodward a/k/a Liber 2787 cp 59B William W, Woodward Jr. William Woodward Jr. to Aubrey Mealy and Rosa Mealy, his wife Dated: 7/9/63 Rec'd: 8/12/63 Liber 5395 cp 584 Aubrey Mealy and Rosa Mealy, his wife to Rosa Mealy Dated: 11/24/70 Rec'd: 11/24/70 Liber 6845 cp 294 Rosa Mealy to Aubrey Mealy LAST DEED OF RECORD Dated: 8/6/71 Rec'd: 8/6/71 Liber 6981 cp 309 PREMISES NORTHWEST: Cedric H. Wickham and Claretta S. Wickham, his wife to Laughing Water Property Owners Association, Inc. LAST DEED OF RECORD 1000-087.00-01.00-025.000 Dated: 5/29/56 Rec'd: 6/12/56 Libor 4126 cp 500 FIDELITY NATIONAL TITLE INSUP3LNCE COMPANY · SANDRA J. ~O~ESKI Sworn to before me this 3~..of ~arch, Nota/y Public 1999 GEORGE A sIMACK Notary PubhC. State o~ New 'fork No 5032470 Qualified m Su~o~k Count~ _ PREMISES NORTHWEST: 1000-087.00-01.00-023.004 Carrie M. Hutchinson Dated: 6/2/32 to Rec'd: 6/7/32 Edith H.M. Pearson Liber 1655 cp 231 NOTE: Edith H.M. Pearson died 1/18/68 (Surrogate's No. 583 P 68), leaving property off South Harbor to her son, John B. Pearson. John B. Pearson Dated: 5/25/73 to Rec'd: 6/13/73 Russell N. Freund and Liber 7417 cp 546 Elinor C. Freund, his wife Elinor C. Freund Dated: 5/19/77 to Rec'd: 6/7/77 Russell N. Freund Libor 8248 cp 342 Russell N. Freund to Philip Loria and Heather Loria, his wife Dated: 8/12/78 Rec'd: 8/18/78 Libor 8482 cp 551 Philip Loria and Heather Loria, his wife to Frank Citera and Antonina Citera, his wife Frank Citera and Antonia Citera, his wife to Patricia Anne Castotdi (signed Antonina) Dated: 10/19/84 Rec'd: 11/5/84 Libor 9672 cp 71 D~ted: 5/10/88 Rec'd: 5/25/88 Libor 10610 cp 124 Patricia Anne Castoldi to Linda C. Safalow LAST DEED OF RECORD Dated: 5/23/97 Rec'd: 6/16/97 Libor 11835 cp 844 FIDELITY NATIONAL TITLE INSURANCE COMPANY / SANDRA J. C~JLESKI before me this of March, 1999 Not~ Public GEORGEA SIMACK Notary pubhc, State o{ NeW York No 5032470 Qualified m Suffolk Count~.~) CommisSion F. xp~res AuguSt 29, ' -' PREMISES SOUTHWEST: 1000-087.00-01.00-023.007 Carrie M. Hutchinson Dated: 6/2/32 to Rec'd: 6/7/32 Edith H.M. Pearson Liber 1655 ep 231 NOTE: Edith H.M. Pearson died 1/18/68 (Surrogate's No. 583 P 68), leaving property off South Harbor to her son, John B. Pearson. John B. Pearson Dated: 5/25/73 to Roe'd: 6/13/73 Russell N. Freund and Liber 7417 cp 546 Elinor C. Freund, his wife Elinor C. Freund Dated: 5/19/77 to Rec'd: 6/7/77 Russell N. Freund Liber 8248 cp 342 Russell N. Freund Dated: 11/22/80 to Roe'd: 12/3/80 Charles V. Blake and ~ Liber 8924 cp 265 Sandra Gail Blake, his wife Charles V. Blake and Dated: 2/5/87 Sandra Gail Blake Rec'd: 3/5/87 to Liber 10264 cp 118 Charles V. Blake Charles Blake to Thomas McQueeney LAST DEED OF RECORD Dated: 2/12/98 Rec'd: 2/25/98 Liber 11880 cp 240 FIDELITY NATIONAL TITLE INSURANCE COMPANY S~[NDRA J. SworDr~to before me this 3rd ~h, 1999 No~ar~ Public GEORGE A S~MACK Notary Public, State of New Yo~k No 5032470 Qualified in Suffolk Cour~t¥ Commiss~onExp~resAugust29' ~u~ - PREMISES NORTH: 1000-087.00-01.00-026.000 Frank E. Griffin and M. Clarrissa Griffin, his wife, and Byron Rushmore and Marie F. Rushmore, his wife to Cedric H. Wickham Dated: 7/16/35 Rec'd: 8/21/35 Liber 1825 cp 519 NOTE: Cedric H. Wickham died 4/14/72 (Surrogate's No. 625 P 72). J. Parker Wickham and Hull M. Wickham, as Executors of the Last Will and Testament of Cedric H. Wickham to Hull M. Wickham Dated: 4/17/76 Rec'd: 4/22/76 Liber 8021 cp 292 Hull M. Wickham to Henry William Drum and Joseph Saland LAST DEED OF RECORD Dated: 4/19/76 Rec'd: 4/22/76 Liber 8021 cp 266 PREMISES SOUTH: 1000-087.00-02.00-045.000 Josiah C. Case and Dated: Katherine W. Case, his wife Rec'd: to Liber Stanton Mott 8/23/19 s/28/19 982 cp 163 Stanton Mort and Gladys M. Mort, his wife to Henry J. Smith Dated: 12/15/65 Rec'd: 12/28/65 Liber 5885 cp 05 NOTE: Henry J. Smith died 8/26/87 (Surrogate's No. 2304 P 87). Dated: 1/24/89 Rec'd: 2/27/89 Liber 10806 cp 281 Stella T. Smith and Henry P. Smith, as Co-Executors of the Last Will and Testament of Henry J. Smith to Catherine White LAST DEED OF RECORD FIDELITY NATIONAL TITLE INSURANCE COMPANY BY: / SANDRA J. ~<~C~LESKI Swor~/~before me this State of New York No 5032470 Quali~'ied m Suffolk Count,y Commismon Exp,res August 29. ~.oo~ _ PREMISES SOUTH: 1000-087.00-02.00-018,000 Josiah C. Case and Dated: 8/23/19 Katherine W. Case, his wife Rec'd: 8/28/19 to Liber 982 cp 163 Stanton Mort Stanton Mort and Dated: 12/15/65 Gladys M. Mort, his wife Rec'd: 12/28/65 to Liber 5885 cp 05 Henry J. Smith Henry J. Smith Dated: 5/11/71 to Rec'd: 5/12/71 James W. Dawson and Liber 6929 cp 323 Patricia G. Dawson, his wife James W. Dawson and Dated: 1/27/81 Patricia G. Dawson, his wife Rec'd: 1/30/81 to Liber 8953 cp 543 John J. White and Catherine White, his wife John J. White and Catherine White, his wife to John J. White and Catherine White, as tenants in common, the grantors herein Dated: 12/29/87 Rec'd: 1/25/88 Liber 10521 cp 154 Catherine White Dated: 12/30/92 to Rec'd: 1/12/93 Maureen Sodokov, Eileen Jahn, Liber 11605 cp 418 Mary Schmeling, John J. White Jr., Joseph K. White, Michael J. White, Catherine A. White and Jean Marie White, all as tenants in common LAST DEED OF RECORD FIDELITY NATIONAL TITLE INSURANCE COMPANY BY: t6 before me this ch, 1998 Nota~ Public GSORGEA SIMACK Notary Pubhc, State of New York No 5032470 Quahf~ed in Suffolk County Commission Expires August 29, 01qDATION _. C~'~EN~$ UNDATION (2ND) ,UGH FRAME & PLUMBING ISULATION PER N. Y. STAT~ENER~'Y CODE ADDITIONAL COI~gNT$: ...... FOP, It NO. ! TO~N OF SOUT~OLD BUILDING UEPARTHENT TOI~N HALL SOUTitOLD, N.Y. ] 197l TEL: 765-1802 Disapproved a/c .................................. · ~//[PPLICATION FOR BUILDING PBP~IT BOARD OF NF. ALTD ..... 3 SETS OF PLANS · · SURVEY ...................... . CEECK .... SEPTIC FOPu~i .......... Ii, IL TO: .................... Date ...... ,]9 . INSTRUCTIONS a. T~is applicatio~ ~,tqt be c~pletely filled in by t*ype~iter or in i~ ~ ~itc~ to ~ a6tdiug las~Cor 3 ~ts of pl~, ~ate plot pl~ ~ ~ale. F~ ~i~ to ~le. b. Plot -pl~ ~ l~ti~ of lo~ ~ of ~ildi~ ~ ~s, ~laci~ip to ~joini~ pr~s ~ ~lic struts or ~e~, ~ givi~ a &tailM &~ripti~ of l~c of ~ ~t ~ ~ ~ ~ di~ ~i~ is ~rt of :als ~liati~. c. ~ ~ ~ ~ ~is a~li~ti~ ~ mt ~ ~ ~fo~ isle of ~ildi~ Pe~t. d. ~ ~al of als ~lia~i~, ~ ~ildi~ I~cto~ rill i~ a ~ildi~ Pe~t to the ~li~. ~ ~1 ~ ~pt ~ ~ ~s ~il~le for i~ci~ ~$C ~ e. ~ ~ildi~ ~11 ~ ~i~ or ~ iu ~le or iu ~ for ~ ~ ~at~er ~til a ~rcificace of ~1~ 1S ~l ~ to ~ ~ildi~ ~uC for ~ is~ of a ~ilding ~t ~t i ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yol, ~ o~r ~li~le ~, ~i~es or ~;~--~;-;~ ~ i~ of ~ildi~ ~iti~ or altera~i~, or for ~al or ~lki~, ri.~ ~li~ ~s to ~ly da all ~li~le 1~, o~i~s, ~ildi~ ~, ~i~ c~, latin, ~ ~o ~C ~ri~ l~tors ~ ~s ~ in ~ildi~ ~r~~~- ................... ~i~t~ ~ ~li~t, or ~, if a co. ration) State ~r ~limt t8 mr, lo~it~t, e~. ~1 ~r~tor, el~trlci~, pl~r or ~il~ ............................................................. (~ ~ ~ r~ mi1 or late~t ~) If ~lie~t i. a m~at~, ~i~m of ~ly ~t~r[~ officer. (~ ~ title o[ ~rate t~l ~ ..................... roE S~orzes .................. ' ~ress ~ ~ I~cate clearly and distinctly all ~ pmt~rty lines. Give street a~d t whether interior or corner lot. PLOT DI AGRAH Imildings, ~hether existing or proposed, an/ indicate all set-bnck dimensions lock number or description according to deed, a~d sho~ street nines and indicate / .~.~,.,c ..being duly m.~on~, deposes and ~ays that he is tl~e applicant ......... /...;... ~-;- ~ ........ ~ .................. (Na~e of i~div~dua! s~gmug co~tract)] ................ .............................................................. . (~trse~or, ~nt, ~o~rato o~[mer, o[ ~id ~r or ~rs, a~ is ~[y [~tl~rl~ to ~rfom or b~ ~rfo~ tim mid ~ ~d to m~ ~ file this a~llcati~; ~at att stat~nts c~a[~ in ~is a~li~ti~ sre tr~ to ~e ~st of his ~1~ that t~ ~rk will ~ ~r[o~ in tl~ ~m~r ~t forth in ~e a~li~ti~ film ~m to ~fo~ ~ ~is ' .... ~t~ ~lic · ~. ,' ~/~ ~, ~..~. ~~. · · R~L~N~ O. HORN~ N~a~ Publie, Slate of ~w York No. 495~364 ~ . Ouatlfi~ In Suffolk Coun~ ~ ~ ~ommiss~on Expires May 22,