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Home My WebLink About22963-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Towel Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25014 Date MAY 6, 1997 THIS CERTIFIES that the building ADDITION Location of Property 38535 MAIN ROAD PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 85 Block 2 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 8, 1995 pursuant to which Building Permit- No. 22963-Z dated AUGUST 23, 1995 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 PRESS PAD ADDITION TO EXISTING AGRICULTURAL BUILDING AS APPLIED FOR & WITH PLANNING BOARD WAIVER. The certificate is issued to PETER S& PATRICIA LENZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-416961 - APRIL 14, 1997 PLUMBERS CERTIFICATION DATED N/A Buil ng Inspe or Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOYM HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK /AUTHORIZED) NP 22963 Z Date......... ..... . ...�3.................. 19... Permission is hereby granted to: f-e-4 %'....t. '.,.... ....... ... . .. ................... to . ... ... ...... ..... ....... rA� '., ,. f - -,''..... .. . .��..... .. ......... ......................................................................................................................................................... .................................... ..... .......................... .........`...�............................... ................................................. at premises located at......'3F. 1.3 ...........•.�P( !J. ....14.. ............................... ....................................... ... '......./....1 ..'..� ..R................/........4....f........... County Tax Map No. 1000 Section ......... .. Block....r�.........q.... Lot No. !..7... .............. pursuant to application dated ..................�.. ........... 19...9.V�... and approved by the BuildirVinspector. Fee S..f�T�..... .. Y7. •.., ............. ..... ........ Building Inspector Rev. 6)30)80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT APR 2 8 M7 8.; TOWNo L E765- BLDG.DEPT, TOWN OFSOUTHOLD 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 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 c6mpl.eted 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 525.00, 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 - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . 3�3f�g 7 New Construction. . .. . . . . . . . Old Or Pre-existing Building. . . . . . . . . . Location of Property.... :.. .4��. . . . . .. . . 1.�Q!1<<—. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . House No. Street Hamlet Onwer or Owners of Property. {2d P� at�:� .�4� Z a t! 7 + a . �"!C� �?• `< • 3�3� County Tax Map No 1000, Section. .. . . . . . .Block. . . . . .P.`. . . . . . . .Lot. . 2 t 1. . . . . . . . . . . . . . . Subdivision. . .... . . . . . . . . ... . . ... . .. .. . . . .. . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . .. . . . . Permit No. . Date Of Permit. . ... . .. . . . . . . . .Applican �'` .. . Health Dept. Approval.. . . A/.. . . . . . . . . . . .. . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .YL(qk: . . . . . . . . . . . . . . . . Request for: Temporary Certificate. .. . . . .. . . . Final Certicate. Fee Submitted: . . . . . . . . . . . . . . . . . . . . �i2/C r APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Dote APRIL 14,1997 Application No.on file 13672597/97 N 416961 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 LENZ VINEYARD, MAIN ROAD-RT 25, PECONIC, N.Y. in thefollowing location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on APRIL $9,1997 and found to be in compliance with the National Electrical Code. FIXOUTLET EITACLEs SWITCHES FIXTURES RANGIS COOKING DICKS OVENS DISH WASHlRS EXHAUST FANS OUTLETS INCANDESCENT,FLUORESCENT OTHER AMT. K.W. AMT. K.DICT AMi. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE AMLIANG M!DlRS S/tCIAI REC'►T TIMRCLOCKS KLL UNIT HEATERS MULTI.ONTLIT DIMMIRS AMT. K.W OIL H.P. GAS H.R AMT. NO. A.W.O. AMT. AMP. AMT. AMPS. TRANS. AMT, H.R SYSTEMS NO,OF IST AMT. WATTS h i SERVICE DISCONNECT NO. S E R V 1 C E AMT. AMI. TYPE EQUIR 1 A' 10 SW 3/3W S X IW NO.OF-CCCOND. A.W.G. PER,I Of CC.CON NO.OF HIAEG Of•W.0. i p,Oi NEUTRALS A•W.G. OF NEUTRAL OTHER AMARATUS: SUPPLY # 12 FEED FOR OUTDOOR-1 SELF CONTAINED REFRIGERATOR UNIT-1 G & S CONTRACTOR LIC.#578-E L BOX 215 ANN SOU THOLD NY 11971 ONORAI MANAOlR 11 This certificate must not bebe identified by their credentials altered in any manner; return to the office of the Board if incorrect. Inspectors Per p may . COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER_ �QgOFFO(,I-c O 0 z Town Hall, 53095 Main Road • ,F Fax (516)765-1823 New 9y�Ol � Telephone (516) 765-1802 Southold, Nw York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 25, 1997 Lenz Winery P.O. Box 28 Peconic, N.Y. 11958 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. ) $50.00 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 # 22963-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. -----_INSPECTCT "C ION REPO- DATE _COMMENTS__________________ li n FOUNDATION ( IST) _—_, iif-^-�� --- �2✓S^"='L-- = "=-- -` rc-- — —�� FOUNDATION (2ND) /// - oi -------------------------------- - _ li 7 ii ----- ------------------ — ------------------- - ROUGH FRAME S -- PLUMBING II II I II I II jj y INSULATION PER N. Y. STATE ENERGY CODE II It N -0 FINAL 11II ii II _ ADDITIONAL COMMENTS: V4 H H O x � r r� � c w r , t LENZ WINERY Pmposed Press Pad To all Bidders: 8/1195 The intent of this work is to provide a functioning Press Pad for the 1995 harvest. All work to be substantially complete for the owner's use by September 1, 1995. All bids are due 8/9/95 at the close of business 4:00 PM at the Lenz Winery Main Rd. Peconic,N.Y. 516-734-6010. 1. Dope and Excavation Contractor to provide all excavation and drainage materials,labor, equipment, tools, coordination of inspections as required in the execution of this work. This contractor to provide all excavation and controlled backfill as it relates to the concrete portions of the work, This contractor to provide all subslab preparation to include gravel base material. The concrete contractor to provide necessary layout for related excavation work. The diffusion well shall be furnished and installed by this contractor,and installed in sequence with the other portions of work being performed by others. All subgrade piping and fittings to be PVC SDR 35. This contractor to furnish and install Deep Sump Drains. This contractor to provide final grading and cleanup of the work area. 2. Reinforced Concrete Contractor to provide all materials, labor, tools, equipment and field engineering/layout as required in the execution of this work. This contractor to provide layout for the related excavation for all cast in place concrete work in this scope. This contractor to be responsible for grading final V of subslab grade prior to pouring any concrete. Concrete to main- tain a 4" slump for all footings and walls, and a 5" slump for the slab pour. Conc rete slab to be poured monolithic. Slab finish to be smooth. This contractor to furnish all deformed steel reinforcing,all rebar to be mechanically bent, no heat tempering of bars is acceptable. Contractor to furnish and install 6x6 10x10 WWF as shown on the drawings. Contractor to provide compressible filler at all horizontal to vertical transitions. This contractor responsible for the cleanup of his related debris. 3. Contractor to provide all materials,labor,tools,equipment as required in the execution of this work. Provide demolition of existing wail construct- ion to install the new proposed doorway. Door to be similar in nature to the existing sliding doors entering the existing summer tasting room. Door to be weathertight and insulated for thermal protection. This contractor to provide labor and materials for the attached stair at north side of press pad. All lumber to be 42 Pressure Treated, all nails, bolts and screws to be galvanized. Provide railings as noted This contractor responsible for the cleanup of his related debris. 4. mat, All Electrical work to be performed under the supervision of a licensed Electrician. All work by this contractor to be performed by code and meet the satisfaction of the local Electrical Inspector having jurisdiction. All conduits and fittings to be exterior watertight quality as acceptable by code. as well all conduits and fittings used below grade shall comply with required code provisions for such use. All connections above grade to be watertight to equipment terminations. All light fixturing to be commercial grade watertight exterior type to be approved by owner's representative prior to installation Provide necessary upgrade to existing exterior panel at proposed pad site. Furnish and install exterior type watertight receptacles to include 2-3ph 208v receptacles an 1- Iph 120v receptacle to pad location. Make up plug-in cable connections to match existing equipment needs and pro- posed locations,verify final location with winemaker. Hard wire power to Refrigeration Box feeding wire below the slab in conduit. This contractor responsible for the cleanup of his related debris. FF04 � PLANNING BOARD MEMBERS Richard G. Ward, Chairman y 2 Town Hall, 53095 Main Road George Ritchie Latham,Jr. Q P. O. Box 1179 Bennett Orlowski, Jr. .jr `� Southold, New York 11971 Mark S. McDonald .�`a� Fax (516)765-3136 Kenneth L. Edwards V Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD August 3, 1995 1 j Peter Carroll — 41995 Lenz Winery Main Rd. Peconic, NY 11958 Re: Request for site plan waiver Dear Mr. Carroll: The Planning Board received your request for a waiver of site plan approval in order to install a 3000 foot crushing or press pad. It is our understanding that an application for site plan approval will be made at a future date for a proposed 3,500 square foot expansion of the existing facility. The requirement of a site plan for the 3000 foot press pad is waived. Sincerely, Richard G. Ward Chairman cc: Building Department COUNTY OF SUFFOLK ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P.H. COMMISSIONER January 16, 1996 > I a ' 0 Mr. Peter Carroll Lenz Winery P.O. Box 28 Peconic, NY 11958 Re: State Pollutant Discharge Elimination System (SPDES) Permit No. NY- 0252468 (1/16/96 - 1/16/01) Gentlemen: Enclosed is a copy of your SPDES Permit for: Lenz Winery Main Road Peconic, NY 11958 Please review the enclosed permit carefully and familiarize yourself with the terms , conditions , schedules and effluent requirements. Your cooperation with this department to insure full compliance with permit discharge requirements is expected. If you have any questions regarding the above, please call me at 854-2525 . Very-tr-u-13ryoours, Walter J. Hilbert, P.E. Public Health Engineer Bureau of Environmental Engineering Encl cc: A. Yerman, P. E. R. Hannaford, P.E. J. Maloney, P.E. R. Greene (516)854-25 ID HORSEBLOCK PLACE • FARMINGVILLE. NEW YORK 11738.1220 • FAX 9854-2505 Aft 110bbod NEW YORK STATE DEPARTh+I U OF RWIROAZ=AL CQNSERVATION 144OW� State Pollutant Discharge Elimination System (SPDES) DISCHARGE PERMIT Special Conditions (Part 1) Industrial Code: 2084 SPDES Number: NY- 0252468 Discharge Class (CL) : 04 DEC Number: Toxic Class (TX) : N Effective Date (EDP) : 1/16/96 Major Drainage Basin: 17 Expiration Date (ExPD) : 1/16/01 Sub Drainage Basin: 02 Modification Date(s) : Water Index Number: Attachment(s) : General Conditions (Part II Compact Area: 11/90) This SPDES permit is issued in compliance with Title 8 of Article 17 of the Environmental Conservation law of New York State and in compliance with the Clean Water Act, as amended, (33 U.S.C. sec. 1251 et.seq.) (hereinafter referred to as "the Act") . Issuance of this permit does not acknowledge or imply that permittee is in compliance with the requirements of this permit. PERMITTEE NAME AND ADDRESS: Attention: Peter Carroll Name: Lenz Winery Street; P.O. Box 28 City: Peconic State: NY Zip: 11958 is authorized to discharge from the facility described below: FACILITY NAME AND ADDRESS: Name: Lenz Winery Location(5r,T,y) : Southold County: Suffolk Facility Address: Main Road City: Peconic State: NY Zip: 11958 NYTM-E: NYTM-N: 4 Fran Outfall No. : 001 at Latitude: 41 02' 30" & Longitude: 72 27' 30" into receiving waters known as: Groundwater , Class: GA and: (list other outfalls, Receiving Waters & Water Classifications) Co. Tax Map # Dist: 1000 Sect: 85 Block: 02 Lot: 17 in accordance with the effluent limitations, monitoring requirements and other conditions set forth in Special Conditions (Part I) and General Conditions (Part II) of this permit. DISCHARGE MONITORING REPORT (DMR) MPIIITM ADDRESS Mailing Nam: Lenz Winery Street: P.O. Box 28 City: Peconic State: NY Zip: 11958 Responsible Official or Agent: Peter Carroll Phone: (516) 734-6010 This permit and the authorization to discharge shall expire on midnight of the expiration date shown above and the permittee shall not discharge after the expiratior date unless this permit has been renewed, or extended pursuant to law. To be authorizer' to discharge beyond'the expiration date, the permittee shall apply for permit renewal not less that 180 days prior to the expiration date shown above. Distribution: Permit Administrator: A. Yerman, P.E. James Maloney, P.E. R. Hannaford, P.E. Address: 15 Horseblock Place R. Greene 11iIle, NY 11738 Signature rw . !� Date: 1/16/96 e NYSDEC Permit # SPDES #: NY- 0252468 Part 1, Page 2 of 3 FINAL EFFIVENT i N TnATCHS AMID YAIU7CPJM I2HDtA7 I15 During the period beginning 1/16/96 and lasting until 1/16/01 the discharges from the permitted facility shall be limited and monitored by the permittee as specified below: Minna Monitorina Requirements Outfall Number & Discharge Limitation Measurement Sample Effluent Parameters Daily Avq, Daily Max. Units Frequency Type Outfall 001: Sanitary Waste - 300 qpd - No monitoring required Outfall 002: Wine Press Process Area - 500 clod - No monitoring required Outfall 003: Sanitary Waste - 300 qpd - No monitoring required e Facility I.D. # NY-0252468 Part 1, Page 3 of 3 PROCESS CONTROL AND GROUNDWATER MONITORING LOCATIONS Permittee shall take samples and measurements to meet the monitoring requirements at the location(s) indicated below: (Show locations of outfalls with sketch or flow diagram as appropriate) . I, ua4 Fuflw4.�1i11 I 1 _ .ry,. 1: }� j:. u...3 z� u ' r_ II u I I I I Iill ii' � r 1 wrnk i scvy w>um' - III1I II 4 111111I7 1 an I ' yRN G I`Iil 1ii Y�11evtnwG llw+w+SR � 1 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE S CHIMNEEYY REMARKS: DATE � /a 7 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1 ST [ ] ROUGH PLBG. [.. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR '� , Q nor or larnwr/r FraN C/CeonOritt ✓i .. a Jnr' a � •,rro { a na/n•e � � ■ Q `------------- o 'h "'aw"w ssroso.e. � �sos/t • O r ti '� aSI•J02t r tH0>S i y n151'AtA[w �� v n1 ? G 0 nor or lanrrlT 011e Ktl/ Flo"Ols /M. I sm"Tr FOR 1 COUNTY OF SUFFOLK 1 SUFFOLK COUNTY AEMRTMENT Of REAL ESTATE �COniC WW* ,$OO//K,� FAAMLAAW OEYELOPMEMTMBMM ACOWJ/7lOM PRO~'tT TAKMAP=OYSTA.CT 0700 SECrt]Y005 BC" L LOT n surf"OXWY, MEw nMX SO AW rownSN/P $pDTM�H 5 2aYiMs A-ResQAol r •• • v OWER PMo, /m, A PONicp LMT DEfO•LAAER B7Ri Sc.,E r rcer Moro Road swcE tSs eAc `� •, ,,r•,r+ r,� f}conic. /lC•w Yak //_958 KMR7tE0 r rrwr•.wre.r ACRES COurn. St b/ MSL t rrc.wr ur. 7DTAL AREA KAIO"MewIS+.M••CE CO. • eaw..a Tr rnw w a rs AREA TO NERETA/REO BY OWNfA P3T/ ACRES r w.ns w,w rn w a AREA TO BE ACOWRED 24OW ACRES .rMOtln SMK Y 'k. ! .= uu r.,.,..•curt �- l K F14..vPR�fT • ACRES wETLANOS � �� M. + r .. , na rr w u r /l I/ R000s — . ACRES ,OVA*oa•rwYR AAO&r•[TLMS ru ; :.,r w a w LY CROPLAND 2IB . ACRES SPO OSTAAKDER wE r 'r tt, pN ,...: .nan.�wrirp •yam / 4 - '� " " `�I"' ! I PoWOS —� ' AMS ANEMKAO.ACM LurAr er.d,dM pTMEA �- ' ACWS t -z7S w,..v.wu..m.•r nr wr•r �•.-••� Ku1101M YIYr p NYwM AcaAa Tours.ars Tr.•ts LA:A•ews sc.,ARc :AOS '•^� AOWARt w WOW,NYS " L/C AR•t7ISf SMO•S!S SWTOLK CDLMTY PARCEL AO BOARD OF HEALTH . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . TOWN OFSOUTHOLD a SURVEY . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT — CHECK . . . . . . _ . . . . . . . . . . . TOWN HALL SEPTIC FORK . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 44 94a (�r0(2M, TEL.: 765-1802 N0_1 V rY 9zz Q � CALL .� 6 -•'. .��F Examined . . . �d. . ., 19t/�.�� 11AIL TO : Approved . .124 a.J . , 19/.x?. Permit No. . .. ?;3 Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) AP CATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 perm 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 Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances , Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. DORSET FARMS , Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) dba Lenz Winery , P .O. Box 28 Fe(��ai]mg a'Kess of appl cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder LESSEE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Narne of owner of premises . . . . Peter. Lenz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applican co rats ignaturee of duly authorised officer. . . . . . . .•. .e. . . . . . .,I CS,,Db✓y . . . . . . . . . . . . ame and title of corporate officer) �{ Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . .. Plumber's License No. Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . Lenz Winery , Main Rd . Peconic , N.Y.. . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . I . . . . . . . . . . . . . . rear of existing tank room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . House Number Street Hanilet County Tax Map No. 1000 Section . .085. . 2 17 . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) , 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction`. a. Existing use and occupancy . . . . . . . .Ag1;}szuItPJrAI .VAY..ard, and', wider)?. . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . , Same . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition XXXXXXX . Alteration . . . . : . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . .V500..00 , , , , , , , , , , , , , , , Fee . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage, number of cars . . . ie 6. If business, commercial or maxed occupancy, specify nature and extent of each type of use . . . .Agr i cuj t. . . . _ . . : 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . , Depth . . . . . . . . . . . . . . . Ileight . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or,additions: Front Rear . . . . . . . . . . . . . . . . . . Depth . . . . . .... . . . . . . . . . . . . . . Height . . . . . . . . . , . . . . . . . . . . . . Number of Stories . . . . . . . . . 8. Dimensions of entire new construction: Front . . a ! . . . �2ear . . .30. . . . . . . . . . Depth . . . . . . . . . . . . . . . Height 30 co c1-etA 's1 . . . . . . . . . . . . . . . NumberoCStones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . .. . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: VW No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . •Fwlo. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . I . . . . . . . Phone No. . . . . . . . . . . .,. . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . , . . . . . . . . . . . . . . .Phone No. . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? . . . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. Ji JJ 107' R TATE OF NEW YORK S.S 'OU Y01 ... . . . . . . . . being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) bove named. ieis tile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (WI NVW, agent, M(ICytYWy�GOW>r ) 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 ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this r . . . . . . . . . . . .day of. . . . . !S . . . . . . . .. 1995. o[ary Public, /V11.&.(. ` "�... .-- County DIANNE JOHNSON NOTARY PUBLIC,State of NewY otk . . . . . . . . . . . . . . . . . • . . • . . . . . • . . . . . • . . . . No,01J05019M (Signature of applicant) Oualified in Oueens County Commission Expires Oct 12th, 19% , r 54_ .L Ir'IX>IL Pons 4461? "2&WN•f+ - IV Ari - — - --- �N 4 445Uffa +N4 I q1 _r#41 rE IN�* 7 ' :;YN : _ 2 � Iw ,� P� w A p'. i V. ¢ 5I, - , `_ �;,- - _ .._. - - - -- -4 - — '. _ ' - SER s . ![ 44 ,ZtM ►S,+4Ni9 ' ` Ksr btfk�F14 , 1 . / '' 'r ,�14 ti dz co a 1►'G° -- — 'E'-6L:' 6dIYF� . vii '!Mgt � �qb F ' C3 eta tK WV it r: , I REQ IP" h OCCUPANCY OR hrf7lUII I EI N ;GS S U �.A�IFU L � _ WITHOUT CERTIFICATE OF OCCUPANCY ....................... - L= ' -D'ERINNITERSCMTIF'IGREREQU . . P used APPROVED AS NOTED DA P3� B.P.n c1 � ' LUMBER CERMICATION N copper tubing is FEE: /ori. By: ONLEAD CONTENT BEFORE for water distributingI NOTIFY BUILDING OEP CERTIFICATE OF OC�.'UPfINCY system; piping Shall be mss. 8 AM TO 4 FOR TOE FOLLOWING of types K or L only I tt FOLLOWING INSPECTIONS: _ SOLDER USED_/NWATeR 1. FOUNDATION REQUIRED FOR POURED CCONCRETE SUPPL-YSYSTEM CANNOT U#4M*4?P. i 2. ROUGH - FRAMING 9 PLUMBING EXCEED 2/10 Of, .+�-"+ ,.:•bq of.1%LEhD. a. INSULATION 4. FINAL CONSTRUCTION MUST ,, J{y , '�, BE COMPLETE FOR G.O. ALL CONSTRUCTION SHALL MEET - PLUMBIN i"+ � I tI ' , THE REQUIREMENTS OF THE 'N.Y. /W, G - `^ aI'- I - .STATE CONSTRUCTION 0 ENERGY A �UMBINq - 3I ' {y i Hl4TER'Up CODES, , NOT RESPONSIBLE FOR ESN - E TESTI E N 4 GBEFORE DESIGN,OR CONSTRUCTION ERRORS CFac16TIt i'MIN4 1':=>x _ l I ii, f � 4L 16, � G f- °aM c 1 t' r w' R t AT 0 D�k4FFSS18�n '^ 46 : ry� T,