HomeMy WebLinkAbout24081-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-26213 Date: 01/13/99
THIS CERTIFIES that the building ACCESSORY BUILDING
Location of Property: 8320 NORTH BAYVIEW RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 79 Block 7 Lot 54
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 17, 1997 pursuant to which
Building Permit No. 24081-Z dated APRIL 29, 1997
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ACCESSORY STORAGE BUILDING IN REAR YARD AS APPLIED FOR.
The certificate is issued to JOSEPH P & THERESA MCCARTHY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
C4 —k 1r
Building Inapecto
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26214 Date: 01/13/99
THIS CERTIFIES that the building ACCESSORY BUILDING
Location of Property: 8320 NORTH BAYVIEW RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 79 Block 7 Lot 54
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 17, 1997 pursuant to which
Building Permit No. 24081-Z dated APRIL 29, 1997
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOSEPH P & THERESA MCCARTHY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
i
Building nspect r
Rev. 1/81
i
WORM NO. D
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° 24081 Z Date ............1.�. ,��........................... 19��
Permission is hereby granted to:
.................................
. F....
14.?.171..........
to ...6�—uucev.......... ......../�..1..... . . � ..... r� ......
.................
................................................................................................................................................................
................................................................ ............ ................................. .
. .............. ..........
at premises located at..3..rlPLf.... .... .... lloc-:
County Tox Map No. 1000 Section .... 1.�........... ..... 1 ........ Lot No. ... T............
pursuant to application dated .. 4 ........1.7...ry.......... 19.6./ and approved by the
Building Inspector.
Fee $.3�.°`°....afa6l��- /g ;o ........................ilr
�Q a�a��f g�t�.Yc�►sYo 6�
a C 0,5 mlw .
Rev. 6/30/80
30» R
O�
" D
CoQ f _ 1 04. 00
a / (m� a
/ pOH
O / /
/ C�NO
CESSPOOL,/ MON
/�
a / TANKSEPTS in /
�cgs� 14.8• . ` G�
>.4�b OIL FILL
t4B
CAP WILL BCHw
erE9
ry FRA, S *OR Y `
pyo 0( s f �y M R�RiC
� 14
0•
%
31AIgCASE ` aab Cf
�K
O
O
WELL
r �...�. �'.� (-1 TOWN OF SOUTHULD
112; BUILDING DEPARTMENT
�g � I TOWN HALL
765-1802
BLDG. DEPT. A3PLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN QF SOUTNOLD
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.
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.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additio wa��tng $25 00
Alterations to dwelling $25.00, Swimming pool $25.00 Accessory b�ding $25.00
Additions to accessory building $25.00. Businesses $5
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - , •Z5�.
4. Updated Certificate of Occupancy - .$50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date „ January 11. 1999. . . . . . . . . . . .. . . . . . . . .
v Construction........... Old Or Pre-existing Building... . .. . . . .. .. . . . .
8320 NORTH BAYVIEW RD. SOUTHOLD, N.Y. .
cation of Property.......... .. . ....... ............. .. ... . . . . . .
House No. Street Hamlet
ewer or Owners of Property.. . . . . ..•.
JOSEPH 6 SA McCARTHY ... . .. . .. . . . . . . . .. .. . . . . . .. . . . . . . .
.. . THERE
+unty Tax Map No 1000, section. ... .. .7,R .....Block... . ... .. . . .. .Lot. . 54,, , , , . , ., , , . . . . . . .
. Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
ibdiviaion. . . . . . . . . . .. . . . . . . . . . . . . . .
//
,rmit No�� - flk. . .Date Of Permit. �G� /• • . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ealth Dept. Approval. . . . . . . .. . . . . . . .. .. .. .... . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
.arming Board Approval. .. . . . . . . . . . . . .. . . . . . . . .
,quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
,e Submitted: $. . .25,QQ . . . . . . . . . . . . . . .. .. . . . . . . . . .
.APPLICANT
c6 t:; a 0
TOWN OF SOUTHOLD // �p�j �/
BUILDINGTOWDEPARTMENT - Z 15- YV
,1 I� 765-1802
AP LICATION FOR CERTIFICATE OF OCCUPANCY
BLDG.DEPT.
F H 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, qr-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.
Fees1
1. Certificate of Occupancy - New dwelling $25.0 Additions to dwelling $25.00
Alterations to dwelling $25.00, Swimming pool. cessory ung $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 - , 451q
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .. Jan. 11.. 1999.. . . . . . . . . .. . . . . . . . . . . . . . .
ar Construction... . .... ... Old Or Pre-existing Building... . ....... . . . . . .
8320 NORTH MVKI l V.....,,., . ;3P=DLD..N.X... . .... .. .. . . . .. . . . . . . . .
Hoouseuse No.
kation of Property... ... . .. Street Hamlet
JOSEPH h TEiSRESA }ScCl1}i�$R. .. . .. . . . . .. . . . • . • . • . . • • . • . . . . . .
aver or Owners of Property... . . . . .. . . . . " "
"inty Tax Map No 1000, Section. .. . .79. ... ...Block.. 7. . . . . . . . . .. . .Lac.54 . . . . . . . . . . . . . . . . . .
tbdivision. ..^ . . .. ...p. . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
trait No. .c�. v�(7•• • .Date Of Permit. . . . .Y,/ pplicant. . . . . . . . . . . . . . . . . . . . .Approval. . . ..
alth Dept. . . . . . . . . . . . . .. . . ./. • . .Undderwriters Approval. . . . . . . . . . . . . . . . . . . .
.anning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
3quest for: Temporary Certificate. . . . . . .. . . . Final Certicate. . . . . . . . . . .
:e Submitted: $. . . 25.00. . . . . . .. ... . . . . . . . . .. `
. .
APPLICANT
Guess ��3
o��gUFFO�,�coG
o� y�
CA
Town Hall,53095 Main Road Ono Fax(516)765-1823
P.O.Box 1179 Oy O`� Telephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 12, 1999
Mr. Joseph McCarthy
P.O. Box 1103
Southold, N.Y. 11971
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. S50 . 00 (2 CO' S)
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 # 24081-Z DECK & SHED
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
,Ij14'I_l:I IUlinll l�l'llill Ilp'I'4:
Uut It 11:111.11
la �
UVIIUn"It(111nnn ( 1t1i1) nnnnnnn V
�� .. _ nn _ 1....._...........� .^.^..•...�....--•--_....•..n........+.��..-n.r.mm�.rn.-t....n.....�rm.....�n..n-.n..,. 1.'
I II II:II 1111AI11! R _- ,z
O
I'I.I11Itl I tilt �q
-------------- •�.Inn..nnnr nr-nn�nmrrmnnn-.----- ------..mnnn--�m.ww..nnnmm—nnnnr..nnr-nnr.
�gnn.nrum rlRll if v . -�.._.m..,.._..
rrinrr. I!nr.nr.v ��
S I
..... �..�....
------------
1'I11A1. ,^
_nn ,,,---------- nnn.nnn --------------. m - S .n..._n--
m
nen .n...,...n-.nnm,.,.,,n n11f11'I'Io11A 1. C------- :
.nn 1i � ,.n.._n..n..,.n_n..n ..n.,mm�mnn_,.n'_n.. y _nn_Tnnnnnn...
7 7�. sgO6
n .172c� . V
_ 51
-o
U�
Ir
h
G
IJ
pore N
ulX S�-jNG
x%006
OCCUPANCY OR c ��w
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
Trtowr po� C
3Ln
t
3' &1.. rAADE !tzr4"x rL" A,ik
r
r5
z
xZXI�
N�
wiTk %a'
qMfot
i
axio f5
«k;
L
CC/.}
TSP.
yxyp•:t slrxgecA
Lx is ccA-12oc
t ryV +
FAIRWEATHER-BROWN
DESIGN ASSOCIATES,INC.
P.O. Box 521
413 Main Street
Greenport,N.Y. 11944
516477-9752 (fax)516477-0973
January 7, 1999
Town of Southold Building Department
Southold Town Hall
Main Road
Southold ,N.Y. 11971
Attn: John Boufis
Re: McCarthy Residence Deck Structure
8320 North Bayview Avenue
Southold, N.Y.
Dear Mr. Boufis,
Upon inspection and review of the above referenced property, to the best of my
knowledge,belief and professional judgment,the deck structure in question, specifically as
it pertains to the connection to and bearing on the cantilevered floor, appears to be
structurally sound.
If you have any questions, please contact me.
Thank you for your assistance in this matter.
Sincerely,
4 ;A�'---
Robert I. Brown, A.I.A.
cc: Joe McCarthy
—with Robert I.Brown,Architect,P.C.
� n
�SLtiDia,G- PL�Iwn�
u
OCCUPANCY OR
J USE iS UNLAWFUL
WITHOUT CERTIFICATE.
yx y,,Get flAt
OF OCCUPANCY
APICAWD VAP ROVED AS NOTED
cem�N S a
B.P.# LIPLZ�-
NOTIFY BUILDING DEPARTMENT AT
765-7502 8 AM TO 4 PM FOR THE
UAL FOLLOWING INSPECTIONS:
t. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSIRUCTION MUST
BE COMPLETE FOR C.U.
ALL CONSTRUCTION $HALL MEET
THE REQUIREMENTS OF THE N.Y.
�l STATE CONSTRUCTION & ENERGY
®p CODES. NOT RESPONSIBLE FOR
S i QINC. DESIGN OR CONSTRUCTION ERRORS
(�SPtdA�,rt
a--iohlflos 30
-19I
r, L661 I
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ } FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
4w�
DATE INSPECTOR
r _
BOARD OF HEALTH . . . . . . . . . . . . . ..
FORM NO. 1 3 SETS OF PLANS . .. . . . . .. . . .. . .
TOWN OF SOUTHOLD SURVEY . . .. . . . . . . . . . . . . .. . . . . . .
SL .
APR 17 W,
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . .. . . . .
TOWN HALL SEPTIC FORM . . .. . . . .. . .. . . . .. . .
:BLDG.DEPT SOUTHOLD, N.Y. 11971 r � ,
TnWNO'Sp-.: TEL: 765-1802 NOTIFY:
11 �yJ% CALL
Examined `ll f..... 19:Qc✓.• MAIL TO: . . . . . . . . . . . . .. . . . . ..
Approved....... ./.. ..., 19,4/ Permit No. .. �✓..• ....................................
Disapproveda/c�.................................. ....................................
(Bu' di In tor)
APPLICATION FOR BUILDING PERMIT
Date. 3/A . . . . . . . . . ig.?7
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector with
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 most 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.
APPLICAITON IS HERR MAIM: 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 or
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 to admit authorized inspectors on premises and in building for necessar
y inspections.
-- a , or nam, if a corporation)
gnati�;�,�oi
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
f)wN�.........ttvv. .....�.µ.............. ........^......,...........�............................................
Naof owner of premises .�l4il4r.T/.`...L..i
Name ...f(TTt���..<�I;..:Y.' Y L::1......................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Nae and title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. .................... p
1. Location of land on which proposed work will be done...`O O....L--7.(.::.7 ,/../�............................
3 d ....N:.. V4e .?
. ' .... ... .................................................................
House amber Street p Hamlet
un
Coty TSc Map No. 1000 Section ...7 :.71.. Block .......2....... Lot ...,Sk.......
Subdivision Ale Ta.................. Filed Map No. "iry?......... Lot ...1..........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... ........................................................
b. Intended use and occupancy ...IDOL 5�0 5 ............................................
AL 71o02.4TA180%
ahuY%Now lc,WlU'.DyidVq V'm*J*
Y7naaU.i liiu4l<ee'ni tasi4itauA7
i3ts4' SC"D�?iO,044
ys?ut zoliqO MIRY
�
f r •'- licable): New Building .�..... Addition .......... Atterat'
3. Repair .. work (clued li a i.......... De clition ............ Other Work ft. t*!• `t-i,
(Description)
4. Estimated Cost �41. ......... fee ........ -
(to be paid on filing this application)
5. If dwelling, nid er of dwellirv, units ............ Umber of dw0 ling units on each floor ................
Ifgarage, uxmher of cars .....,..•......I.....................
G. If business, comuercial or mined occupmx:y, specify nature and extent of each type of use......................
® / ,
�lt.. /
!;f g...... s, if any: PYont...,l.�......... hear ..�� ....... Depth .. .�..
..........
7. Diuuenataua of existing atnuctu Mnber of Stories .......1...........
Ilei ut
r
Dimensions of Ch alterations or additions: Front ...
.�......... hear ...�.d'.�
p ......6 .. it ..��r.............. Na ber of Stories .....I... ..
R. Dimensions of entire new leonstruction: Front ................ Rear ...Ad........ Depth ... ........
Ileiijit .......Y...I. timber of Stories ..../...............
9. Size of lot: Front /l../.L.I......... Rear .... ..... Depth S:Y .......
10. Date of Purchase ...... Name of Former Owner 1fDV.T:.. ....
II. Zone or use district in wlridv premises are situated ...A..�u.................................................. .
12. Does proposed construction violate any zoning law, onlinmuce or regulation: ...,e'VJ
13. Will lot be regraded ,.......... Will
�gexcess fill be removed from ppremises: YRS O
• 14. Names of Owner of premises I45 ff .. �C::':t Y:7..... Address .tP34#>..�!!.Y'IFv! .'..(�...... lixxue No. 11�.4:HIY..
Niue of Arslultect ........... Phone.................. Address .............................. Ple No. ..............
Name of Contractor ..........s,imk................... Aoklress ..............................,ilcanue No. ..............
15. is this property within 300 feet of a tidal wetland? * YES .......... `�.........
*rt' YES, S( nKJD Id14N IWSOMS Prs[Mrf MAY RC MC(il1IRCll.
P1.0'r DIAGRAM
locale clearly and distinctly 4l'11 buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give street arx# block number or description according to deed, and show street nares and indicate
whedier interior or corner lot.
IIS
H
PkON)SEb to OCO ' -RAAAu400o .nlw
� la '�Ito
SETBA(k ±
L
d8; y
Jolt 4
(xltiNIY Q? �f1`FCL/4......... ss njoktN Bapvl& 40SI'A'll? oa ".-,w Y(XU<
..................being, duly sworn, delxuses aux] says that he is live applicamL
( nue of individual. signing contracL),U
above named, o /�
Ile is Lite ...(/•'aN� .5-➢Qitll 'QL,T ,I��.-.....................................................................
(Contractor, g<.^ IPOFPBFR..e orri ar-'ete:)
of said owner or owners, awl is dulyiaulhorized to perform or have performed the said work and to make awl file Lh]a
apps icaLion; Lhat all statements con�aiwed in Lhis apps iention are true to the best of his knowledge and lxil.ief; awl
that Lhe work will be performed in tl�e nemxar set forth in the application filed therewith.
Swann Lo I tore me Lhiei
....day19 ..`.;/...
Notary Public ..... ....... .... ..
� .( ngnalure of Applicant)
�Ilnry
No O1SG7260,
Tom Expires Mer 31.
BOARD OF URALTN
D FORM NO. 1 3 SETS OF.PLANS- .�. . . . . . . . .
TOWN OF SOUTUOLD SURVEY
FEBBUILDINC DEPAR'T'MENT CHECK
FEV 'TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTUOLD, N.Y. 11971 ( „4LL Fok PrcktP
T BLDG.DEPT.DEPT. TEL: 765-1802 NOTIFY:
SOU HOLO
CALL
Examined.................. 19.... MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved.................. 19.... Pennit No. ................ ....................................
Disapproved a/c .................................. ....................................
......................................................
................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT �,J
Date.s�/.�y. . . . . . . . . , 19
INSTRUCTIONS
a. 'Ibis application mist lie conipletely filled in by typewriter or in ink and admitted to the Building Inspector wid
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 mist be drawn on the diagram which is hart of
this application.
c. 'lite work covered by this application may not lie commnced 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 of Ube premises available for inspection thro>g)bout the work.
. e. No building slmull be occupied or used in while or in part for any purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICKfUXi IS MREBY MATE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the 'Town of Sarthold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of luoildings, acklitions or alterations, or for removal or demolition, as herein
described. lite applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and
regudations,jard to admit authorized 'inspectors on premises and in building for necessary inspections.
... ...... ........................
iigrwture of: applicant, - r time, if a corporation)
pp,&-, 71 ..........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plusher or builder.
...........0�.4 00 ...................................................................................................
Name of owner of premises V A .....................................................................
(as on the tax rioll or latest deed)
If applicant is a corporation, signature of duly midurized officer.
...................................I.....................
(Name and title of corporate officer)
Builders License No. .........................
PimbersLicense No. .........................
Electricians License No. .....................
Other Trade's License No. .................... aO
1. location of land on which proposed work will be ckne..9..4........Z. ?w •• -'••••••••••-• -••••O-•••
g.31 ........... N..o.�mbt...M v i.W...Iko/a o................... ......................
House N:stuer Street----77 qq ----77 Uanlet
Canty Tax Map No. 1000 Section ........�.1..(...... Block .....[.......... Int ... ........
Su}xlivisicxu .L Pl"412. .....? /. ............ Filed h4�p Nn. .........+..... Lot ......i.......
(Name)
2. State existing use and occupancy of premises and intended use aril occupancy of proposed construction:
a. Existing use and occupancy S1il?G� ..��dn1L:I...RS4 ^CIS.........................................
b. Intended use and occupancy .lS.(�tJf?;L ....�f}tb?LS\`C... iD ^.' .........................................
N
i. Nature of work (clieck wlnicll a nlicable); New Building .......... Addition ... .... 'er ..f ...
Ropair ............ Itemoval .!�.......... Wan]I L J oil ............ 011ier Work ..... .... ...
fee ....................,........
�J....� �� tl
4. I:stiurLLeci C.cnsC ....J�-. ��. ,.........
(to Ile paid on filing this application)
5. If cimlling, somber of dwellity# units ............ lioiner of dwelling units on each floor .......... ......
ifgarage, Ixnlner of cars .................................
G, if Iluainess, camnercial or mixed occupancy, specify nature arxl extent: of each type of use...... ...............
7. Uiux:usions of existing atnncputtea, if any: 1TnnC....,3A..4/ ., [tear ..�.�..[....... Depth ... ..........
llogI .....
Dimensionsofrne alnx:nrre•w1. Mniner of Stories
............ ...
th alterations or additions: Front
du .... 6.,y...... hear 3�.y........
Depth .....4.............. IleiWnC ...�4.............. Mrer of Sl•ories ...�:..........
R. Dinpnsiona of entire new c:ornstnuction: Front ........ Rear ......... IJepLh ..yR........
.: a
Ik:iglnt ....�............... J. Mniner of Stories .....................
9. Size of lot: Front ... ,......... Rear ............. Depth ...y�J, r..:,y3a',.
Ill. Mile of hrcJmne ....q/.q..-.3....i....... thole of Forner (wcner .Y/ ....A'CS4iCAY ...............
11. Zone or use diatrict In winicll ranises are situated .... :.tj.Q...................................................
12, lbes proposed consl:nlotion violate any zoning law, ordinance or regulation: ...N4.................
13. Will lot he regraded ....N0.�.......... Will excess fill Ix: removed flan premises: YES PI7
1 PN'.7NC�K�Sh../h`4�2CH( Address $3dd.Al:l3(iyJ/lt+tJ. RD......... ['pima No. '76�:.yR�Y...
14. Nalea of Owner of rennase Qs
Muse of Arcall[ecC ........s�Nw...................... Arklrese .............................. [more No. ..............
Ntme of Ccxrtractor .(A.M•'i Acklresa "
...... ...................... Phone lb r., r
15. is this P IrerLywithin
i nG� t.of a tidal wetlad7 * YES ..........
.X .....
* YIuS A77e1SIMS
MINT MAY M It1(X lMM.
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions
f'rots property livres. Give street snol'I block lumber or description according to deed, and allow street nares and indicate
wiletlmr interior or corner lot.
SGS ATrActt-b r
it
it
i
.......... �;•.. 1..•/..•••• C..•"..... !:.1 n duly sworn, deposes acrd says Uent be is Lhe applicant.
(union: of ilxlivldlwd si nine contract)
ndxrve lumm. l,
Ike is the .................."rS—/W '
• --��a�
- ....................................................
(Contractor, agent,•cprpnrate officer, etc.)
of said owner or owntma, and is duly ilji011lH74A to perform or have perforlAc(I the said work ml to make toll file Illis
applicaLion; tont all sLateinenLa axltaicnecl in this appllcaLion are tone Lo the best of his knowledge and belief; all
that the work will Ile perfonsed in the nmmner set forth in the npplication filed lherewiLh.
£,talon Lo beftnr le this
qq
5 .
ttx.a
I
- --......-..6 o.11 ...
' l;nsl-urs of Appl icanl)
� lfa�flt
L
SURVEY OF
LOT 1
MAP OF
LEEWARD ACRES AT BAYVIEW
FILE No. 5599 FILED JUNE 4, 1971
SITUATED AT
BAYVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-79-07-54
SCALE 1" =30'
AUGUST 11 , 1993
SEPTEMBER 16, 1993 (B.0 H. SURVEY)
NOVEMBER 6, 1993 (REVISED HOUSE LOCATION)
DECEMBER 15, 1994 (FOUNDATION LOCATION)
FEBRUARY 23, 1996 (FINAL SURVEY)
W P
`WW� 2?6.DO• NSR
AREA = 40,114.79 Sq. ft.
0.921 ac. 1.Z
HLFMENF A
� s '?'ss'3p„ e VIEW h,0
B.O.H. REFERENCE No. 93—SO-73 /� AD
104.00,
l \bpo
O l l coNc°Ma
/ CESSPUU, N
� rwml l
f4 k iUl l SEPTIC
E,
� Tnxn
b / ^
7m l l M
oa Hu
CAP
2sr
O .. \.
a ry MO 1$do OUSE ry ',&c c
eJdO h
\
140,
1 (P
G1s rW
HS
oy°�MSE OCD wee
CELLIR""�Wa
ENTRRNCE
O
'V
r
WELL �/`•
G ���.
O� 4
N
UNATHORIZED ALTERATION OR ADDITION
TO THIS SURVEY 15 A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION UW.
COPIES DF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY
GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
15 PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOIERNMENTAL AGENCY AND
LENDING INSTITUTION ISTED HEREON. AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION GUARANTEES ARE NOT TRANSFERABLE.
THE EXISTANCE OF RIGHT OF WAYS
Lv AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
O
M PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDAO BY THER°6AF05 TAND AP R ITLE OV
RDS
AND ADOPTED AS
FOP
O SUCH USE BY THE NEW YORK STATE LAND
ToASSOCIATION
3 k9 LAND G
2 CONIMOD
5' QAA A.1
Lor
^ N
colic°MGN
y
NE
64.04 30 CION Y.S. Cm No. 49666
w
L°T p3 a°.s3, C.Nc°MaN Joseph A. Ingegno
Land Surveyor
TGG Surveys — Subdiviemne — SRe Plans — ConstructroP Layout
PHONE (516)727-2D9O Fax (516)722-5093
OFFICES LOCATED AT MAILING ADDRESS
one Union Square P.O. Box 1931
Aquebogue, New York 11931 Riverhead, New York 11901
-21