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Home My WebLink About23862-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25702 Date: 05/01/98 THIS CERTIFIES that the building ADDITION Location of Property: 340 ROBINSON RD GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map NO. 473889 Section 34 Block 5 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 5, 1996 pursuant to which Building Permit NO. 23862-Z dated DECEMBER 12, 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 SECOND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID MERZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 04/30/98 PLUMBERS CERTIFICATION DATED 04/29/98 HARDY PLUMBING �// 6'GLS j /�- `/•- Buildi Inspecto Rev. 1/81 YORK NO. A 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° 23862 Z Date ..... .. . ................. 19,✓ Permission is hereby gran te r . ............... ., % .. ....... ..<.c,........ atpremises located at ..................... ... ..... .. .. .......... .. .... .......................... ...................................................... ......................................................I........................ ................................................................................................................................................................. County Tax Mop No. 1000 Section ...........;� Block .......... Lot No. ..I ice........... pursuant to application dated ..................... ..................................-& 19 and approved by the Building Inspector. Fee $... f'Y. y Buildin I or Rev. 6/30/80 DForm No. 6 n O TOWN OF SOUTHOLD t 17 ( BUILDING DEPARTMENT TOWN HALL BLDG.DEPT. 765-1802 T WN FQUITHOLO ' APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 12 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 Building - $100.00 3. Copy of Certificate of Occupancy - _ •?51�.. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..00, Commercial $15.00 Date . . . 1\.. c .1<5w .. . . . . . . . . . . . . . . . . . New Construction... . . ..�./:,�,Ol Or Pre-existt((ttnng- Building. . .. . . .. ...... . . Location of Property..�?vpIek; .. •. ••...• ••. . • . • • . • '� "• " • . House No. Street Hamlet Dower or Owners of Property.. ��.� �� rr. . . . .. .. . .. .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. ..3 T• . .. . ..Block. .. .-5.�. . . . . . .. .Lot. . . . .. . . . . . . . . . . . . . Subdivision... . . . . . .. . . . . . . . .. . . . . . . .. . .. .. . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No `�a3g�� •Date Of Permit. jl;?J Ia� • . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . .. . . .. .. . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. .. . . . .. . .. . . . ... . . . . . . . Request for: Temporary Certificate. . . . . . . . . .. Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . :44�.. . . .. .. .. . . . c ec. -5Lf . . . . . . . . . � PLIC (� 0429/98 14:07 p 001 F��C T[1. 7G �. TOWN OF SOUTHOLD (•a' ;t oFrtCracnautL/nrracatasrecrox. MAY cx TOWN Is'_'Li �.�•..��t A SOUTHOGO,N.Y. 11971 C E R T r F r C A T I O t7 Date l e Building Permit No. 23 e Owner_DA iyc� �J�Oc r print) Plumber N �\ r Lbti� (p13 •s pr nt) Y' certify that_ -ha solder used :A the water supply system Contains less than 2110 of It lead. (plumber°s signature) Swor� to before me this day of 19 / l7otary Public Nota:, Pt""lic, County EItEEN S NOTARY PUBLIC et lbrk No.Ot Pi Wo Commiui0n 6><yWo 12.2000 �,;4,gOFF0j,t �o Gyp Town Hall, 53095 Main Road y Z Fax (516)765-1823 P. O. Box 1179 Telephone (516) 765-1802 Southold, New York 11971 sjo� � dao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 29 , 1998 Richard Saetta General Contractor, Inc. 4 Bootleg Alley Greenport, New York 11944 RE: 340 Robinson Road, Greenport, 1000-34-5-13, MERZ To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT # 23862-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I DA 11: I oil FOUNDA F toll 2m) -—------------ II0111:11 IrItAlig A ll!;Ilt.A['I()it 11I.At 11 ---------- ADDI'llOtIAL ............ ----------------------------------- Ulf/1 I L. Ju n1:a1 blbLytlb5d4 KOLE MEGH. PAGE: E2 4 •^ Kolb AI&*anical Corp. h►aating and Air Conditioning 11500 Sound Avanuo P.O.Box 106 Mattituck, NY 11962 516 299 5527 516 99e.6534 Fax TRMAF April 27, 1998 lt9Hard 7b &WA Itaft Mich Saetta General Contractor Inc 4 Bootleg Alley Greenport,NY 11944 RE: Merz residence Dear Mr Saetta: I 1 have inclosed some specifications on the fire d ipers that Kolb Mechanical hAU installed in the above referenced job. Sincerely, Kolb Mechanical Corp. An Ib D � ,1 2M APR 2 BLDG DEPT. T WN F S UTHOCD i r , FIRE-LIMIT UmLia Fr Damper Model UL10A vertical or horizontal „ .. Top blade riveted to frame L Interlocking els-" t ades Fusible link It;o0p stondord (roplaceoble) Intl) king come Rollformed one piece steel frome APPROVED BY'YN[ BOARD OF sVANOARDS is .,. AND AP'pF.ALIk FOR OU 4 1/4'�^--�•�_ IN NEW'YORK CITY , q' CM.3e1-do-$A Vgj TICAL MOUNT Sto e$a steel Negator oloeure spring lade look y a a MofNku Slondard 00nelruclion-golvonised deet 0 Solidification for all motorial per Underwriters' Lobftiorlso Standard for Safety ULG&IEye,• I Undrywriteri Laboratories, Labelled for uee In •ISOs oo I0e1er than shown In U.L.Building Materials List . .. In d!¢-hour fire portlllon. Sao Alfoohed meet for eohedula of quantity and sixes oniZONTAL MOUNT . i f pypf '9f nr g� 'kE:. LOCATION y v DAMPER CORP. ""C",ENa. 1,598 Lakeland Ave., Bohemie, L.I., N.Y. 11716 CONTAACr (516)5997431 6/94 I 6t:J1 51b15d=J4 IRELIMIT UL, Fire amper Model UL10A vertical or horizontal FREE AREA(40 FT) IS It a '1 13 .61 .09 .1 1.6 19 I's 2.6 1 A 1.0 2.4 I's 3,1 3.5 8.9 .1 4.4 5.4 53 77 .4 -w-73 1 .0 1 1.0 -77 4.9 1.4 Se [FV.f 1.1 23 1.1 4.4 1.0 L? 6.4 1.4 414 2.8 IJ 3.7 2.0 1.1 1.6 4.11 5,1 4.4 d's 1.4 1.1 9.7- is's al.$ 0.6 7.4 6.4 1-2 J+.1 It.* al.$ al. C9 o As .11 1.1 1.1 SA 9.1 too 11.3 lol 14.2 114 13.5 44 .4 I'l 3.0 4.0 6.1 1.0 1.1 1 it's u 11.1 01 11.1 11.1 t 46 16 a., 17 4.1 .- 74 0.6 11 to 14.1 it.$. 12.1 '1 14,4 16.0 ty's 1.6 1.1 4.5 $4 t.t 6.4 VJ 11.6 12.2 Is's A iss t-1 3-11 4.11 6.1 1.6 11.6 60.4 11.7 I3.1 144 .1 It's 16.6 soe 2.2 8.4 6.1 &a La 9.7 ILI FLOW LEAKA11, 1.9 41 % .4 13 A a 0 of 1 1 -1 Hal f Ifi I ap ? too IN lowN UMN am Fin Atts NO At#@(dt i ftg) Upon far ft/ha) -A ERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( Tidal WetlaFAS ) e operations by the State of New York require an al- other environmentally deleterious materials associated with the the position of the structure or work herein authorized, or project. opinion of the Department of Environmental Conservation 13. Any material dredged in the prosecution of the work herein permitted rause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles.ridges across or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a aeople of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of ources of the State,the owner may be ordered by the Department to a waterway. ,move or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or 14. There shall be no unreasonable interference with navigation by the work revocation of this permit, the structure, fill, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be com- 15. If upon the expiration or revocation of this permit,the project hereby pleted, the owners, shall, without expense to the State, and to such authorized has not been completed,the applicant shall,without expense extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the Conservation may require,remove all or any portion of the uncompleted Department of Environmental Conservation may require,remove all or structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse.-No claim shall be made against to its former condition. No claim shall be made against the State of the State of New York on account of any such removal or alteration. New York on account of any such removal or alteration. 10 That the State of New York shall in'no case be liable for any damage 16. If granted under 6 NYCRR Part 608, the NYS Department of Environ- or injury to the structure orwork herein authorizedwhich maybe caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or improvement of navigatiop,or for other purposes,and Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 no claim or right to compensation shall accrue from any such damage (PL 95-217) provided that all of the conditions listed herein are met. it Granting of this permit does not relieve the applicant of the response- 17 All activities authorized by this permit must be in strict conformance belity of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State of the permit application. Office of General Services or local government which may be required. prl ,2 All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by StLrrrm�7 PI�. T' of any wetland or waterway by suspended solids, sediments, fuels, by Roderick Van Tuyl, P.C. (m 12/18/80 and solvents, lubricants,epoxy coatings, paints,concrete, leachate or any last revised 10/28/96. SPECIAL CONDITIONS 1 . Roof runoff shall be directed to drywells a minimum of SO feet landward of the tidal wetland boundary for immediate on- site recharge . Supplementary Special Conditions A Thru F Attached. DEC' 5 ; I l OEC PERMIT NUMBER PROGRAMIFAC_ILl Ty'NUMBS R Page 3 - of 4 7 N'T, S D 3 C AS APPROVED A PER TERMS 4 c,,a *_F. ND CONDITIONS OF 15 9MOV, 700 Ft.<Jog 7157 :;_F. PERMIT NO.1_y13 �Lol�qV t4-g z-f rz :8 RG5;mscjten�. WAD DATE 6-:- TE EJ >1 , ten rl ;aF SOL I K 4ig_ ib VVI I d CV CA a T 4 c- t V ELEVA,—,J_QN�Z 7Q 5-El� yo Rs Albert J. Krupski, President O�0OFF04��0 Town Hall John Holzapfel, Vice President �� y� 53095 Main Road Jim King y x P.O. Box 1179 Martin H. Garrell O • Southold, New York 11971 Peter Wenzel ��j�l �a0� Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 29, 1996 Richard Saetta General Contractor,Inc. 4 Bootleg Alley Greenport, NY 12944 RE: David L. Merz SCTM # 34•-5-13 Dear Mr. Saetta: The following action was taken by the Southold Town Board of Trustees August 28, 1996: RESOLVED that the Southold Town Board of Trustees approve a waiver to construct a second story addition on part of existing single family dwelling as per plans dated 7-29-96. The Board requests that a 20 ' non-turf buffer be placed behind the bulkhead. This approval does not constitute any other approvals from any other agencies. If you have any questions, please do not hesitate to contact this office. sincerely, / 4a . ieps 'l�A° �i President, Board of Trustees AJK:jmd DEC 5 DEC Wr cNV.rtunrmniAL WNatkVA1LUN DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-01433/00001 ANovember 18, 1996 FACILITY/PROGRAM NUMBER(S) P E I T NEXP ovlemATION ber ,A1999) Under the Environmental Conservation Law TYPE OF PERMIT New ❑ Renewal 0 Modification ❑ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection 0 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR 373: Supply Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined Land ❑ Article 15, Title 15: Long Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ❑ Other: PERMIT ISSUED TO TELEPHONE NUMBER David Merz ADDRESS OF PERMITTEE 2143 Route 4 East Suite 2 Fort Lee, NJ 07024 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Richard Saetta General Contractor 4 Bootleg Alley Greenport, NY 11944 NAME AND ADDRESS OF PROJECT/FACILITY i Merz Property 37 Robinson Road LOCATION OF PROJECT/FACILITY Greenport COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Sterling Basin DESCRIPTION OF AUTHORIZED ACTIVITY Construct a 715 square foot second story addition to the existing single family duelling. Alt work shall be in accordance with the attached NYSOEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS George W. Hamnarth Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE DATE 11/18/96 Page 1 of 4 DEC5 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNN��EY REMARKS: r DATE INSPECTOR 2 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ,ROUGH PLBG. [ ] FOUNDATION 2ND [�/]/INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: e DATE 3 1477 !INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ OUGH PLBG. [ ;],,,FOATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 F BUREAU OF ELECTRICITY I 40 FULTON STREET, NEW YORK, NY 10038 Date MAY 06,1998 Application No. on file 15953498/98 N 452823 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DAVID MERS. , ROBINSON ROAD, GREENPORT, NY in the following location; ❑ Basement ❑ Ist Fl. ® 2nd Fl. Section Block Lot was examined on APRIL 30,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT I OTHER AMT. K.W. AMT. I K.W. I AMT. I K.W. AMT. I K.W. AMT. H.P. 16 10 14 16 1 1 3.4 1 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS JSPECIAL REVPT.I TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS N.P. AMT. NO. A.W G. AMT. AMP. AMT. AMPS. TRANS. AMT. N.P. NO.OF FEET AMT. WATTS 1 600 _ SERVICE DISCONNECT - NO.OF _ _ S - E - R - V I C_ E - METER NO.OF CC COND. A.W.G AW.G. A.W.G. AMT. AMP. TYPE EQUIP. r 0 PW 1 0 SW 0 3W 3 0 4W pER 0 OF cc COND NO,OF HLLEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: C014BINATION-WHIRLPOOL-1 BATH-STEAM ROOM SUPPLIED BY-1 30A GFI CTR-1 20A GFI CTR-1 PANELBOARDSLI-10 CSR. 60 G.F.C.It-2 LAW......... L L TIM SAGE ELEC, INC, LIC.#3635-E GENERAL MANAGER PO BOR 38 GREENPORT, NY, 11944-0038 per This certificate must not be altered In any manner; return to the office of the Board If Incorrect,Inspectors may be IcLi Ttified by their Credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. - I` BOARD OF HEALTH . . . . . . 3 SETS OF PLANS ' . . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OF'SOUTHOLD CHECK - • - • - - • • • - BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . : TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 MAIL TO : Examined . A 2--19 �G Approved . . . No.19 ermit No. a � � Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . WC 5 3� • • • • • • • • • • . • . • . • • • • • • . . • . • • . • • • • • • • • p c.t (Building Inspector) . APP ATION FOR BUILDING PERMIT Oec Date . . . . . . . 1996 19 . . . 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 must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such 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 stiall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances 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 necessary inspections. RICHARD SAETTA GENERAL CONTRACTOR INC . . . . . . . . . . . . . . . . . . . . (Signature of applicant,or name, if a corporation) 4 BOOTLEG ALLEY GREENPORT NY 11944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.,,, GENERAL CONTRACTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... . DAVID L MERZ Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicauLis a co porat•a , sign to of duly authorized officer. (Name and tle of corporate officer) ALL CONTRACTOR' S MUS BE SUFFOLK COUNTY LICENSED Builder's License No. . . . 13.86.HI 1593 P Plumber's License No. . . . . . . . . . . . . . ... . . . . . . . . . 3635 E Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land jon which proposed work will be done. . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —37$- ✓� T O . . . . . . . . . . . .ROBINSON ROAD . . . . . . . . .GREIWQ$T. : . . . . . . . . . . . .. . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section • . . . .34. . . . . . . . . . . Block . . . .5. . . . . . . . . . . . . Lot . . . .13, • , . , , , • „ • „ Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy RESIDENTIAL . . . . . . . . . . . . . • , , , . . , • • , • b. Intended use and occupancy _RESIDENTIAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • , , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . XX . . . . . Alteration XX , Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . , . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . .50,.000..00 . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . NA . . . . . . . . . . . Number of dwelling unitsllon each floor . . . , NA Ifgarage,number of cars . . . . . . NA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specifyy nature and extent of each type of use . . , NA 7. Dimensions of existing structures,if any: Front . .7S�- . . . . . . . . . . Rear . .��r. . . . . . . . . . Depth . 4O` Height 16 ONE . . . . . . . , . Number of Stories . . . .-5: . . . . . . . . . . . . . . . . . . . . . . .i. . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . .7.K . . . . . . . .I'I. . . . Rear . .7.8' , , , , . , , , , , , , Depth . .40'. . . . . . . . . . . . . . . . . . Height . . . . . .24'. . . . . . . . . . . . . . Number of Stories . XWO . . . . . . . . . . . . . . . . . S. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . .i. . . . . . Depth . . . . . . . . . . . . . . . Height . . . . .� . Number of Stories •Rear . . . , . . . .' . . . . . . . . . . . . . . . . . . .]95 r . . . . . . . . . . . . . . . . 9. Size of lot: Front Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . .$RIjCKfJ MR, , , , , , , , , , , , , , , 11. Zone or use district in which premises are situated . . .RINTPF,INIAL, , , , , , , , , „ ,I, , , , , , , , , , , , , , , , , , , , , , , , , , , 12. Does proposed construction violate any zoning law, ordinance or regulation: . . .NQ'',. . . . . . . . . . . . . . . . . . . . . . . . . . . l4. Name of Owner of premises . . . . . . . . . . . . Address .I! , , 'from premises: Yes X 13. Will lot be regraded . . . . . . . . . Will excess fill be removedNo DAID MERZ 37 ROBINSON ROAD phone No. 477-2604 X Name of Architect . . NA . . . . . . . . . . . Address . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor .RICHARD SAE'1TA , , , . . Address . OMNPORT. . . . ',, , Phone No477714 . . . . . . . . 15. If yes, Southold Townerty tTrusteesnPerrmit mayTbe requMedetland? *Yes' . .$. . No . . . . . PLO 300 feet of a tidal Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from )roperty lines. Give street and block number or description according to deed, and showlstreet names and indicate whether nterior or corner lot. ATTACHED I I STATE OF NEW YORK, SS 'OUNTY OF .SUFFOLK . . . . . . . . . RICHARD . . . . . , , . . , being duly sworn de os es and says that he is the applicant (Name of individual signing contract) .bove named. GENERAL CONTRACTOR Ieis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) it )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his'knowledge and belief;and that the cork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . . . . . . . . . . .day of. . ('LL'V”' �! . . . . ., 19 ?9 dotary Public, . . . . . . . . . . 1NCount JOYCE M.WILKINS Notary Public,State of NOW York 'e. . lot. . . . . . . . . . . . . No.4852246,Suffolk Coun Term Expires, 12,78 � {Signature of applicant) ----------------------------- V 44AJ k,)H {nM1F I"' /q. '� labl-{'�jXl(cdt.11LRP . t�imt 4 ��(fG4fu ?.l at�t�, k 4'' ti tom. 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