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HomeMy WebLinkAbout23302-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24492 Date JULY 11, 1996 THIS CERTIFIES that the building ADDITION Location of Property 1605 POINT PLEASANT ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 114 Block 1 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 28, 1996 pursuant to which Building Permit No. 23302-Z dated MARCH 15, 1996 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER ZBA #4381. The certificate is issued to LARRY RAPPAPORT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-390002 - JUNE 28, 1996 PLUMBERS CERTIFICATION DATED JULY 9, 1996 - HARDY PLUMBING & HEATING L Z4 w Bu' ding Inspector 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) Ne" 23302 Z Date............����................................. Permission Is hereby granted to: ............... //J, ...............................u ......... .r.. .,../.1X7.7 ./.................. To ...� .�'/.1'.F/'7.L'Cf4l. .....41`��........./ (J/Tlr ........ r ).Y......... ...... �,JfT'!r ... .. ..... !.... ........ ✓ 4�4 ..q..........4 ...........'-40.�1��i1..... ..... ... .................................................................................................................................................................. ...... ................................ . .......................... .. at premises located at..........1(Pej.......7..fJ/. .../ .100or ...l.` y y� ................................. /tel � . ............ County Tax Map No. 1000 Section......1/��........... Block......40/.......... lot No. ..5��............... 14 pursuant to application dated .........�f-��.....� .................... 19..... [V.., and approved by the Building Inspector. ou Fee$.......7. ..,, . y :.... .. ........................... B Ing Inspector Rev. 6/30/80 1' Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 �. JUL 1 01996 _ BLDG.DEPT. APPLICATION FOR CERTIFICATE OF OCCUPANCY ; TOWN OFSOUTHOLD A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. _- - -- - -- -- _- 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1 . Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25oC, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . p Location of Property. . . 14°v"5- . . . . . .!Vin7'6.1��+A�_,r�,-,.....��C.� . . . . . . . . . . �c7fi!..cceL . . . . . House No. Street Hamlet Onwer or Owners of Property. . ;�,� r . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `. County Tax Map No 1000, Section. . . . . . . . . . .Block. . . .!�Y . . . . . . . .Lot. . :r'X. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.��.. . .? . . .Date Of Permit. . .`�� .��?.Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . .✓. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final+Certiate. . .Fee Submitted: $. . . . . .li j l.�. . . . . . . . . . . . . . . . � yf� � . . .� . W"l,• 5 151 CANT oo -i, -Nya %rz �D. Qev �Ifi7j+ II � 'L��' � o�gsUFFO(,�co APPEALS BOARD MEMBERS c Southold Town Hall Gerard P. Goehringer,Chairman 53095 Main Road Serge Doyen,Jr. ,y ® �� P.O. Box 1179 James Dinizio,Jr. Oj �a0 Southold, New York 11971 Robert A. Villa Fax(516)765-1823 Lydia A. Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD June 4, 1996 Mr. and Mrs. Larry Rappaport P.O. Box 1692 1605 Pt. Plesant Road Mattituck, NY ll952 Re: Appl. No. 4381 - Variance (Corner of Porch) Dear Mr. and Mrs. Rappaport: Please find enclosed a copy of the determination rendered by the Board of Appeals at our May 29, 1996 Regular Meeting concerning your variance application. A copy of this determination has also been furnished to the Southold Town Building Department pertaining to the pending building permit amendment request. However, it will be necessary for you (or the owner) to contact the Building Department (765-1802) to be sure all your permit application papers are in order before continuing with this project. Also, due to the proximity of this project within 500 feet of a waterway, State or County Road, the Town is required under the Suffolk County Administra- tive Code to transmit a duplicate file of the variance request to the Suffolk County Department of Planning for their determination. It is expected that their agency will not have objection and will forward written comments directly to you. Very truly yours, Enclosure / Linda Kowalski Co les of Decision to: Building Department ✓ '' '9 Suffolk County Department of Planning JUN �'o 6 19.9fi L� .7o 1'hPOLE) � 41 �gUFFOLk�o APPEALS BOARD MEMBERS L� Gym c r< Southold Town Hall Gerard P. Goehringer, Chairman ,W = 53095 Main Road Serge Doyen, Jr. �y • �� P.O. Box 1179 James Dinizio, Jr. Oj �0� Southold, New York 11971 Robert A. Villa ! Fax (516) 765-1823 Lydia A. Tortora !'_Ze : one (516) 765-1809 BOARD OF APPEALSQ TOWN OF SOUTHOLD ��s ACTION OF FINDINGS AND DETERMINATTIO �e<o y G APPL. #4381 DATE ADOPTED: May 29, 19 SOU�T i T APPLICANTS: LARRY and LINDA RAPPAPORT. LOCATION OF PROPERTY: 1605 Pt. Pleasant Road, Mattituck. COUNTY TAX MAP DISTRICT 1000, SECTION 114, BLOCIK 1, LOT #5.1. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector dated April 30, 1996: "Insufficient side yard. . ."as built". PROVISIONS APPEALED FROM: Article IIIA, Section 100-30A.3 RELIEF REQUESTED: Triangular section of porch addition, at 2.5' x 8' (approximately 10 sf. total building area) as shown by the May 7, 1996 updated survey. Building permit issued under #23302Z March 15, 1996, indicated an unclear, illegible setback distance, based upon copy of survey submitted by builder-contractor. MOTION MADE BY: Gerard P. Goehringer SECONDED BY: Serge J. Doyen ACTION/RESOLUTION ADOPTED: Granted corner of porch as shown on survey dated May 7, 1996 subject to the planting of four additional evergreens along this northerly side for screening purposes, and continued maintenance by the applicant, or subsequent property owners. REASONS/FINDINGS: Although the relief requested is self-created, the 2.5 variance is minimal, for a 12.5 ft. setback instead of the required 15 ft. side yard per code. Continued construction under BP #23302Z, and all other zoning regulations shall be complied with. No physical change in theappearance or character of the area will be affected with the additional screening agreed to be added by the property owner. VOTE OF THE BOARD: Ayes: Serge J. Doyen, Member Robert A. Villa, Member Lydia A. Tortora, Member James Dinizio, Member Gerard P. Goehringer, Chairman/Member This resolution was unanimously adopted. i ZBA : LK GERARD P . GOEHRI GER ZBA CHAIRMAN 4 TEL. 763-1802 cL^r Cc!"C Vy TOWN OF SOiJTfiOi,D o .c OFFICE OP BUILDING INSPECTOR o l::ti T tib' P.O. DO" ;28 Z TOWN E..LL � SOUTHOLD, N.Y. 11971 41 C E R T I F I C A T I O N Dat \�r� Building Permit No. Owner \ _(p ea e p int) (please print) (� I certify that the solder used in the water supply system contains less than 2!10 of 1% lead. < C— (plumber 's signature) SvArn to before me this day of �u1��, 19 q�2 Notar Public Nota,.- Pvh_ic, Couni.y mamlE V.BROWN Ndwy ft* &AdB of NM yak No 40W12 Q vJ%d In&*Ik O=q Oommbobn EVW Qct.19,19 0!3 30 3 —• CO ;6-94 L/Y 2 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date JUNE 28,1996 Application No.on file 11861996/96 N 390002 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 LARRY RAPPAPORT, 1605 POINT PLEASANT ROAD, MATTITUCK, N.Y. in thefollowinq location; ❑ Basement 9 1st Fl. ❑ 2nd Fl. Section Block Lot was examined on 'JUNE 24,1996 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT. K.W. AMT. K.W AMT X.W. AMT. H P 15 80 15 9. F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS BELL I UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H,P OAS H.P. AMT. N0. A.W.G. AMT. AMP. AMT. AMPS. TRANS. pMT H.P. NO.SYSTEMS OF FEET AMT. WATTS 1 600 SERVICE DISCONNECT NO-OF S E R V I C E AMT. AMP, TYPE MFTFR I,e'TW t A 3W 3 d 3W 3,e AW NO.OF CC GOND. A.W.G. NO Of HbIE0 A.W'G' NO Of NEUTRALS A.W.G. EQUIP. PER.9' OF CC. OND. OF MAEG OF NEUTRAL OTHER APPARATUS: PADDLE FAN-1 MOTORSt14F H.P. G.F.C.It-2 _ I _ PAUL R. BURNS LIC.#3897 E Ids _ w rz P.O.BOX 1061 SOUTHOLD, NY, 11971.0932 GENERAL MANAGER 11 rd. aS 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. '�TO - S'� u���� TOt1f✓1 The Guardian The Press,Fishman,Rappaport Agency $88 Seventh Avenue/Suite 201 New York, 10106 212/541-880000 a // ( /i S Larry Rappaport,CLU,ChFC '�v G l� "1 General Agent COO �-ty htq (Ooo Sec- o Loti v q'� � , . ( rr`t'v s pct "1�-� �1w CK© Cj /tetLAS Sv 6A l l� ` C �ec� �� , �Fit C U- The Guardian Life Insurance Company of America 0 Est. 1860 5LT ! N I P SURVEY OF LOTS 13,146P/012 MAP OF POINT PLEASANT° ✓" d AT MATT17UCK TOWN OF SOUTHOLO FILED MAY17,1916 NO 720 SUFFOLK COUNTY, N.Y. o 1000-114- 01-5I Lot xs SCALE 1"z 40' d,A May 7, 1996 C SI m E � Op. cyn ns ) f� A 4o a IP °,•P '�, �a ALTO4PON WI A00?pN TO Tlµ'a1NVEY S A V AT 551 `t CO MCT/ON R09 CF nL.KY YQA aM!£Fp/G]KW GM 'Zf"e (O [PCFPi Aa PFAYCTFH]POT9L&MVASILW E ALL 2Y1lXJSMMS °ve,e�'L�y` IER£CN YiE VILLI iOfl]MS NIP AM CYM'ES T/RRECi O.N.Y F W GO MaP Ofl LWCfi BEAR TlE ENRafiFO$JL LY!IE SVflYEI'G �l E1 90° NNpaE NN4TlN£AWGR9 MEiEON , M IC N0,99618 N B]° OgnOMALLY TOC O MITR S LIY 1Yff]E%XLTEAPB IY' AREA = 2.5631 Acres to lie lines ° r x u Ir ANr AIN Nl amnma unmN LATW EcoN¢ uR roes,e.c. OF ANOTAYR fiLAV£YOR'a A41P TERMC S.AR YFWEc1E0'AM /5161)65-5020 N 'BRWpMT-TOM w r NCpPLIINCL ryIN TK 4Y P,O.BOX 909 Im .N'QNR uNEs ARE REFERENCED SOUTHORAD, MYLER 11971 WESTPHALIA ROAD Yo MRI oINN R7 _ Q71 F�L,� JUL 1 01996 BLDG. DEP7 L-10WN.. OF SOUTHOLD,,. , . o�osyFFotk�o Gyp co C042 x Town Hall, 53095 Main Road p • Fax (516)765-1823 New York 11971 9y'Apl �.a�� Telephone (516)765-1802 Southold OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 28, 1996 Harrington & West 665 Goose Creek Lane Southold, NY 11971 RE: Larry Rappaport - SCTM#1000-114-1-5 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) xx 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 # 23302-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. P 11:1.11 PIIS ITC't LOCI It I'OIV1 DA'I'U l'Or111Ht1 IS ruutrorcr 1011 ( Is r) - - VOMIDA('1011 21,10 . i Baa.,»aoaa�a�aaaavaaaAa -ava ��aaaa�„_a-ae�aaaaaa�_aaa„a�saa,�aa�_�aa - =aaaa,.aaa-a=,a, uuucu ritnrn; is HARMING naaaaa------------- ----- - aa= --- ----- a-as----- ------ av - -�aaa_ �aaa„aaaaaasaaaaa=aama aa�aaaat. c INsuLrcrloN PER N. Y . I ` 5'1'A'1'li f.tlliltCY � CODIT, a.-----ava----- r-I VIIIAL .-..'i. -aaaaaaaaaaaaaaaaaaamesaa as <) . a®<�/aa�= ed am vaa6 _ as----- Aa ----- a -- ------aa�a------_aaa=nUU I"r10NA1. COHHEN'r5 a =aa f ,-n ------- �aaa 4 7 f' �h FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: April 30,,.:1996 . _ _ . _ _ __. _. _ Larry Rappaport P.O. Box 1692 . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . Mattituck, N.Y. 11952 . . . . . . .... .. . .. . . . . . .. . . . . . . . . . . . . . . . . .. A r PLEASE TARE NOTICE that your application dated . .. . .F.il 24: . _ _. 19_26 . . for permit to CONSTRUCT A PORCH ADDITION at .. . ........ .. .... .. . Location of Property . , 1605.P0INT_P4ASANT_ROAD. . . . . . . . . . .. .MATTITUCK; N:Y: . House No. Street Hamlet County Tax Map No. 1000 — Section . . . 114. .. .. BLOCK .. .D1.. . . . . LOT . . . .OS Subdivision . . . . . .. . . . . . .. .. . .. . . . . . .. . . . . . Filed Map No. . .. .. . . . .Lot No. . . . . . . . is returned herewith and disapproved on the following grounds . .ff.INSUFFICIENT.SIDE_ . . . .. YARD SETBACK IN AN R-40 ZONE. THIS IS AN "AS BUILT" CONDITION. THE SURVEY . . . .. . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . SUBMITTED WITH THE BUILDING PERMIT APPLICATION INDICATED WHAT APPEARED TO BE A 251 .. .. . . .. . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . .. . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . SETBACK. UPON A VISUAL INSPECTION OF THE SITE A 12' SETBACK NOW EXISTS. ACTION . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . .. . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . .. . . . . . . . . . . . . . REQUIRED BY THE ZONING BOARD OF APPEALS. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. . . .. . . . . . . .. . . . .. . . . . . .. . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . ... . . . .. . . . . . . . . . . . . . . . . . . . ... . .. . . . . .. .. .. .. . .... . . . . .. . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . .. . . . . . .. . . . . .. . . . . . . . . .. . . . . .. . . .. . . .. . . .. . . . . .. . . . . .. . . . . .. .. . . . . . . . .. . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . .. . . . . .. .. . . . . .. . . .. .. . . . .. . . . . . . . .. . . . . . . . . .. . . . . .. . . . . . . . . .. . . . . .. . . . . . . .. . . .. . . . . .. . . .. . . . . .. . . . . . ... . . . . .. . . . . .. . . . . . . . . . . . . . . . . .. . . . . .. . .. . . . ... . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . .. .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . BII D G NSPECTOR GA J. FISH a� RV 1/80 cu SURVEY OF cors13114aP/vr2 - "MAP 8F P01NT PCEASAif17'" AT MATTrTUClf To WN of sourrrato FRED Y{Yr7,19r6 M0. 720 ¢ +r �� va { `•j ` P SUFFOLK COUNTY, MYt� w i q lo 1000-114-0t-5.f ploCk SCALE!'.40• LOT d ram Q i4 drJJ 4 r9,Jstr / z APR, f�, 1989 tta.■-t tf E, { ■° t fr NAr M, pmt Ma`ek n Mir � v 4�O � ¢ // u 'JK 2a � / i •�� J '�� 8 \�-�■yJ� LOT m 1 a Cc tr~�i � � / �pw: .*a•��/'"^���/`�ir»tIN"� 4 n �'� } 1 t i EJ 8 H as n � le �' � e•aR P � -�s� � _ fyr t! J n LOr fS FnpJred it■atwaaioaE wrist tfra+aainonaA 6 11 R ■ at I"La tsand wrEjruaataDGahad �Ja.tuts.rdypwradana ee >n "' CEX71� r0 aara6+na 1t77Aa Naar YwASrrrs and � � fAG47 ALAN AEL.f AA$(LpA� 7tt/a Aarodanat k (Y L'DEAnANY Ga JiEIY FGNPR Ji _ ✓ �, Spr 7r AN2'A: � � 77tiF/A2 iJtP-i_g4tt -_otat9a. t p' ay \ � 33ss!(nrnrta drluvat �A837dAC7 LV.B2 � ," r /• " ►LY.3: LIG ND• � 6YtMC 37ARYEY : zE Es asp n oRg P.r. :a ■a r�iiBf743.3070 WESTPHALIA MX0 ` "' Aoatvaa oafs allE ACfEAE■eC0 E:fqi. soft 02 '�+?; AaaJr o■Jaa ltA9Y-RQAII _ SOU7HpLR MY_ 1197T 765-1802 BUILDING DEPT. INSPECTION [ } FOUNDATION IST [ ] RO GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ) FRAMING [ } FINAL [ ) FIREPLACE & CHIMNEY REMARKS: DATE _INSPECTOR J, `"> M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ - FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDAT OV2D [ ] ROUGH PLBG. CFOUNDAT [ ] INSULATION ( ] FRAMING [ ] FINAL [ ) FIREPLACE & CHIMNEY REMARKS: _ � - i DATE INSPECTO BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF FLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL. SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: . C✓ 2 CALLfes?' Examined ...... I9-Q/(L�.a/P. ))> MAILr. /TO:4o pprovec �i 19 / 1! Permit No. v 73©y2 oJoz�;2Sa�9 Y �l>! Disapproved a/c .................................. .................................... ..................................................Q... Al Buildi��n�IppspeC or) APPLICATION FODUUUUUR BUILDING PERMIT ® cc�jj Date. . ?: �9. . . . . . . . . 19,CI�. INSTRUCTIONS j a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector witl 3 sets of plans, accurate plot plan to scale. Fee according to schedulL. b. Plot plan slowing 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. APPLICATION IS IM-BY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tann 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, sod regulations, and to admit autborized inspectors on premises and in building for necessary inspections. ......�.�..G� ................... (Signature of � licant, or name, if a corporation) ..� C.. �2 .dn..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pludner or builder. .............................................. ............................................................ /. Nameof a..nver of premises ........................................................... as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) FEB 2 8 ��96 Builders License No. .Xk�.� _ t3.......... �i —8 � Lf1G. ..„„.,�,4J Plumbers License No. _ fOWfJ OEPT. Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be clone.............................................................. /41 .f � .. �rte................... house Number Street Hanlet County Tax Map No. 1000 Section ../� ........ Block ..4� ......... Lot ............ Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy ofpremisesand intended use and occupancy of proposed construction: a. Existing use and occupancy .... G ? ,r:::........................................... �. ee .ivb .1lwz. .IIF"4a i ....... 4".. ...... ...................... b. Intended use occupancy .............................» I:PA•h ot6.c„.11,)f;'i* , h'7t3 4laaatto:J:bloPPtn'. ,ht;C#c�I'w.v 1sd .�.„#3X ,Rl.�{cf41 aszvatla:3 m rrs� 3. W.dure of work (check whidi aplA ira6le): New Building .......... A(klition ....tl .• Alteration ........ .. Repair ............ Removal .......j..... DennlitIoil ............ Other Work .................................. (nescriptinr) 4. Rstinvite(I Cost .... ................ fee .............................................. (to Ire paid on filing Ibis application) 5. If (Aaelling, lxnber of (knelling unite ............ Umber of (dwelling units cn each floor ................ Ifgarage, lxnber of care ...............I...................... b. If Inlainess, c nmercial or mixed occupancy, specify nature still extent of each type of use...................... 7. Ilinx:nsia)s of existing structures, If any: Front................ Rear ............... Depth .....I........... lleiWit ......:`.� ............. Nlnber of Stories ....?............... Dimensions of sane structure with alterations or nklitions: front ............... Rear ............... Depth igI . ......... Mnber of Stories R. Dimensions of entire new construela cxt: Front ...o? .r?..... Rear ./..r.... Depth .:/S.P...... llei(;)it ........:C.4............ Mirher of Stories ....................... 9. Size of lot: YYrxnC ../' 2.......'..... Rear .......9.y........ Depth ...�............... 10. Mare of Rlrchase ..................I... &am of Former 0(mrer ........................................ ' ll. Zone or use district in wbidn preni,ses are situated .............................................................. I , 12. Does proposed construction violate any zoning law, orlinn:e or regulation: ........................ 13. Will lot be regraded ........� ..... 111 excess fill be r nloved� ffrff-an��prc�ni��ses: YES 14. Nates of (honer of premisea� .,!'s c,.. A(klress4ee/ :".'.°,`:�::. // ., .... Ptwr)e No. ........ 15, is thispropertywitbin 300 feet ................... Address .............................. Plane No. .............. Notre of A"1 tec.0 / �.. NFne of CcxtCrncCor..y/ hklrea ,,,�/f. C✓� �2• �6r 9z� l`Y ..... .................. ifi� ................... prone Nn. ... ......� f a tidal wetlanl2 * YES .. .... [JD .......... *TF YES, RunCAD 7171df1 91415..5 Pcimrf my IA: w. pim. PLOT DTAGRAM Incate clearly and distinctly all buildings, whether existing or proposed, acd indicate all set-Track dimensions fran properry lines. Give street and Wrack nnber or description according Co (feed, and show street nares ani inlicaCe Mietixer interior or corner lot, SCIVIE (A' MW YORK, 0XINIY (A? .....��.,��Y{r��....... •••• ..•. ..................being duly sworn, deposes aixl Nays that be is the applicant (Italie of indivi( signing contract) alxme nailed, �f�� Ike if the ............ . .................o�_ .............................................................. (C i tractor, spent, corporate officer, etc.) of said amxer or (xnrers, and is duly aul horize(1 to perforin or have (xerfonned Iho said work sail to nrrlce ilrxl file this application; that all statements contained in this application are true to the beat: of: his knowledge and balief; six] that the work will Ire perforiolml in (he i'lanoer set ford) in the application filed therewith. %wo to before tie this .......r78S v ....day f .. .-19...�... Ma ary Riblic .. .. ............... / ROBERT 1, SCOTT R, r NOTARY PUBU ,$ to of N.Y. (Signature of Appi ica . No.bT25089, 3;°t97 Term ExpiresY o- i 1` 77 I I 17PT 7t l.,'•(� 1rc ?�IA�"a1..1 W-� \��- NEW (A�'il��uw� �4 'IIILo.w ,60 99 oo, �kt Ilb�w � �wu1 1Y'r, a , _rfSY7uw3 Y PLUMBING '� —�••-�.� ° ALL PLUMBING WASTE ,r t &WATER LINES NEED. - TESTINGSEPORECOVERING21Y1a�� \•�t�-� ~1� .• �..�� li IS.'1't1�.N1n1�4 'Wp'r � PLUMBER CERTIFICATION ON LEAD CONTE CERTIFICATE OF CCUpA RE _ � 1 iocA� } 7 �t 1S � _ 1 ��c6� G�;�I1 V �•�,w(, .� OCCUPANtt �'Y -- -----. � _ — - '' I SOLDER USED/N WATER � 11T � 1 SUPPLY SYSTEMNNOT 1 �, UNDERWRITERS CERTIFICAIE EXCEED 2110 of 1O LEAD. ( _.___._ _. _.____...__.._..___ _ -'--- — R 5l, D c REQUIRED I a OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE If copper tubing is used for water distributing a oij G s 'C �.c , system:piping shell be �u u�Ta Y2.1� OF OCCUPANCY ofRWRItypes Korlonly - - r f N ,. .. .____.•_. m4Afl sae ilo,.s ,tic. � , UNDERWRITERS CERTIFICATE REQUIRED �1 _ APPROVED AS NOTED __ AA\ 6c vbty L � �— "\ I6 � DATE: ocleN-3' v t k z —. a t 7� i V •. �f3) G sot FEE, BY: �) NOTIFY BUILDING DEPARTMENT AT _ ^ '-'— "-- --'-' _— --- "�C.• ' ( ' 766-1802 S AM TO 4 PM FOR THE I _ I—�_ lloatc� r ♦wL ' --nY ' ^'- _.,_..�__` �- ; . C�. �' KaC` P{,�T6a FOLLOWING INSPECTIONS: u la l 1, FOUNDATION TWO REQUIRED — rl ` A` 4 y L a r FOR POURED CONCRETE T„---^L-- ^•--^—"'^ 2. ROUGH - FRAMING & PLUMBING r3. INSULATION --- 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 'r r f i , i Pc U¢alnn. ly3"R. WF�ndsta v - I - f WI►d11a--�- i � �� �y a k / 4 Q � , --- - - - -- - - • II _ I 1 f ? ot 'C9r"�� Ca� Z" x, � u 0 Wo, Gtru cae. 31 i" (. tt r. jen.. I t}� 2� 74� { t _ �, ._o'Y144. t.G, SL.P�J � S _ A-4. _ . t vcti Ju� i.