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Home My WebLink About23140-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24042 Date MAY 15, 1997 THIS CERTIFIES that the building ADDITION Location of Property 200 PRIVATE ROAD #5 CUTCHOGUE, N.Y. ' House No. Street Hamlet County Tax Map No. 1000 Section 72 Block 1 Lot 1.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 9, 1995 pursuant to which Building Permit No. 23140-Z dated NOVEMBER 29, 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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONNA WEXLER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-417927 - APRIL 24, 1997 PLUMBERS CERTIFICATION DATED MAY 8, 1997-H.SMITH PLUMBING & HEATING -""(L / lx~e uil ng Inspector Rev. 1/81 i 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) Date /71 P!J. f........... 19.Y NP 23140 Z Permisslon Is hereby granted tt~. .........A to.. ` ` ~ p. . n.... at premises located at........ ,4Y v............ T. . County Tax Map No. 1000 Section A..... Block .............1........... Loft No. /a.4-7 pursuant to application dated ..Y........ 19......J..... and approved by the Building Inspector. Fee $......Y 7 Building Inspector Rev. 6/30/80 i _ "orm No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~ WV0 765-1802 ' 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 completed site plan requirements. 3. For existing buildings (prior to April 91 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. I° '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, 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 - .25q 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential 515.00, Commercial $15.00 Date ,Wew Construction...C.~l.~ . Old Or Pre-exis ing Building. ".ocation of Property... cr. . ~ . House No. /,gStreet Hamlet :nwer or Owners of Property..... W_J ~ J '.ouncy Tax Map No 1000, Section.... ....Block I........... Lot...`f0 ,ubdivision ....................................Filed Map............ Lot...................... ermit No..•d`aNO.z---.Date O* Permit...Applicant. :iealth Dept. Approval ..........................Underwriters Approvai:L,(~A-................... 'lanning 3oard Approval .....:s- request for: Temporary Certificate........... Final Certicate./AV........ ..ee Submitted: S.. n i Co ~ay6g2 Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 Telephone (516) 765-1802 Southold, New York 11971 A col OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: May 8, 1997 Building Permit No. 23140-2 Owner: Howard Wexler (please print) Plumber: H. Smith Plumbing and Heating, Inc. " (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. e (P1 ers Signature) Sworn to before me this ? 4L Q day of 1A -7 Ue&vj TTE L. TAPLIN pbrlfii%1 PUBLIC #4844893 Notary Public, A County S3omM%ewYork 'K-`O.A+ q SA Suffolk County L) U CamM~yun[po,rN Spot. 30,19.U `f8 k jq3 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date APRIL 24,1997 Application No. onfile 11123996/96 N 417927 THIS CERTIFIES THAT only the electrical equipment ox described below and introduced by the applicant named on the above application number in the promises of DONNA WEXLER, 200 PVT ROAD #5, CUTCHOGUE, N.Y. in thefollowinll location; ® Basement © let Fl. ® Ynd Fl. GAR/OUT Section Block Lot was examined on APRII, 17 , 1997 and found to be in compliance with the National Electrical Code. RXTURE RXTURK RANGES COOKING DICKS OVENS DISN WASNlRS EXHAUST FANS OUTIETS AQfS fWITtlIK NCANOESCENT FWORESCINT OTHER AMT. K. W. AMT. K. W. AMT. R.W. MIT. K. W. mt. N. P. 114 80 130 94 20 2 1.2 3 F DRYERS FURNACE MOTORS FUTURR AFFIEANCR MINES SFICIAL RWPT TIME CLOCKS IEl UNIT MATERS MULT 4UTLU DIAAAMIS AMT. K. W. OIL H .P. OAS H. P. AMT. NO. A W.O. NAT. AMP. AMT. Mrs. TRANS. AMT. N. P. t MIT. WA1T5 NO. Of OF MT 5 F 3 - SRRVICE DrAMNRCT No. OF S R R V I C E AMT. Mfr. TM 'Raiij I.e tW 1 M SW S / ]W J,s AW NO.OF R . COND. OF C CG NO. OF HIAEG OF M .LiC NO. OF NEUTRALS & W. GG..AI 2 200 1 CB 1 X 2 4/0 2 4/0 OTHER APPARATUS: 43 KW GENERATOR-1 150A DISCONNECT-1 300A TRANSFER SW.-1 3.50 TON A/C-1 3 TON A/C-1. 1.50 TON A/C-1 -PADDLE FANS-5 WHIRLPOOL BATH-1~ tdOTORB:°-F H.P.,1-1.5 H. P,,1-3 H. P.,1-3.5 H.P.,S-F ' Continued on Page 2 ONO" AAANAOM Per This certificate must not be ahered 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1td01i''•71 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date APRIL 24,1997 Application No. on file 11123996/96 N 417927 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant noshed on the above application number in the premises of DONNA WEXLER, 200 PVT ROAD #5, CUTCHOGUE, N.Y. in thefollowinR location; ® Rosemont ® IAt Ft. ® Ynd Ft. GAR/OUT .Section Block Lot was examined on APRIL 17 , 1997 and found to he in compliance with the National Electrical Code. FXTUR! !ClnACLfS fYY1TC11F5 RXTURES RANGES COOKING DICKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANOESCEM NUcIIESCEM OTHER AMT. K. W. T. K. W. AMT. K.W. AMT. K. W. AMT. N. F. DRYERS MENACE MOTORS FUTURE AFFIANCE MMItS SPECIAL RWPT TIME CLOCKS so.. UNIT HEATERS MULTIAUTEET gMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. AM NO. A. W. 0. T. AMP. AMT. AMPS. TRANS. AMT. N. P. NO. S AMT. WATTS NSTST MIT SERVICE DISCONNECT NO-OF S E R V 1 C E AML AMR TFn METER I / M I 1 TV 7 / ]w ]RAW NO. OF CC. COND. A. W.O. A, w. c. Up. p NR / d CC. D. NIAEG 01 HI-LEG OF NFUTRAlS OF mU1RAl OTHER APNLRATUS: PANELBOARDS;3-1 CIR. 60,1-16 CIR. 125 G.F.C.II-8 TRACK LIGHTING:--116 G & S CONTRACTOR LIC.#578-E Idsc Lm tt BOX 215 ANN SOUTHOLD, NY, 11971 GtBOM MANAGER 11 ~ Psr 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. Pll„LD 1,MSPECTION Imi'mur DATE COMt1EN1'S FOUNDA"TION___.._,_ ( 1S0 II. .~S PONNDATION===_(2ND)==°===11'===-____'~_=r=-`..t ROUCII FRAME b PLUMBING I r CNSUI.ATION PER N. Y. STATE FNER I Q/ It ------G-C-K-i-~-~cJ G- YY~ CODE I - 11- - - - PTNAL ADDITIONAL COMMENTS: - - - - - - - - ' - H WARD ASSOCIATES, P.C. July 15, 1996 Jot / I . 1 Building Inspector TO 8CD0 wNOFg0UT7 Town of Southold D Town Hall, Main Road VOID Southold, New York 11971 Re: Dr. and Mrs. Wexler Residence Additions Private Road, Cutchogue W. A. Project 9520 Gentlemen; Attached please find an updated set of drawings for the Wexler residence additions, including the garage extension and entry steps approved by a recent ZBA, June 26th, 1996, variance. Please advise if additional information is required by your department for the contractor to construct the garage addition and entry steps. Thank you for your attention. Very truly yours, i EI 4telnce e ley, R.A. f Vice President LMF:ek Enc. 0 I I I i Landscape Architects, Architects, Engineers 1500 Lakeland Avenue, Bohemia, N.Y. 11716 •516 .563 .4800 • FAX 516 •563 •4807 { i : Transmittal To: Donna Iglesias-Wexler Company: Address: City State Zip From: Richard G. Ward Company: Ward Associates, P.C. Landscape Architects, Architects, Engineers Address: 1500 Lakeland Avenue City State Zip: Bohemia, New York 11716 Telephone: 516-563-4800 Date: 11/03/95 Re: Residence Modifications (Phase One) Private Road, Cutchogue Project No.: WAPC 9520 Donna, Enclosed please find (1) Building permit Application, (1) Property Survey, and (3) sets Architectural Drawings. Please prepare a "blank" check made payable to Town of Southold and deliver this package to the Building Department. You will need a Notary on the permit application; that can be accomplished at Town Hall. Dick Ward i- att y 9 ),9i 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 7_INSPECTOR I M-1802 BUILDING DEPT. INSPECTION [ ] F DATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY ~y REMARKS: 4/ - DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ol FOUNDATION 1ST [ Vf"ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA 5:~ -r-~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] UNDATION I ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _ DATE ® INSPECTOR M-1802 BUILDING DEPT. INSPECTION [//]FOUNDATION 1ST ROUGH PLBG- [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY \ REMARKS: DATE INSPECTOR m p 76S-1802 BUILDING DEPT. INSPECTION [ ] O DATION 1ST [ ] ROUGH PLBG- [ ] 0UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:- d9 r DATE f INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CH NEY, REMARK : L-~o~ 9 DATE INSPECTOR M-11102 BUILDING DEPT. INSPECTION j ]FOUNDATION 1ST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING j ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 91c)-( INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] GH PLB [ ] FOUNDATION 2ND [ INSULATION row [ ] FRAMING [ ] FINAL f [ ] FIREPLACE & CHIMNEY REMARKS: 1~c L/ DATE INSPECTO ~i; I~ I~tf BOARD OF HEALTH ,N/A FORM NO.1 3 SETS OF PLANS .X..... TOWN OFSOUTHOLD SURVEY oifw 91995 BUILDING DEPARTMENT CHECK _ _ ...X TOWN HALL SEPTIC FORK SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY Examined ..l~Z"~ ~.C• CALL haxFY Fgeley 563-4$00 .,19QK. °J 1, MAIL TO; Approved Y. f ~~Z..., 19<. ! Permit No. C7. / . 6. Disapproved, a/c . (Building Inspector) APP ATION FOR BUILDING PERMIT Date . •iQovember, • • • • • • • 19 95 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 street ' 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 permi 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances of 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 ncceXal:y (Signature of applicant, r name, if a corporation) Donna Iglesias-Wexler AIPPA arionl•New York (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Nance of owner of remises Donna I lesias-Wexler (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ..1V•A , (Name and title of corporate officer) Builder's License No. Not. selected As• Yet Plumber's License No. Henry, J.• smith Electrician's License No. G 6 S Electrical Other Trade's License No . . 1. Location of land on which proposed work will be done. ;iggtie,Roa4i North of Bridge Lane, Cutchdgue House Number Street .......................Hamlet , County Tax Map No. 1000 Section 7A Block ......1.......:... Lot VQ L Subdivision Filed Map No. Lot . (Name) 21 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Single• Family. Residence ' :pi;'.4900a .f 1pft b. Intended use and occupancy Single FAmily.Resid r~e efal2, lAtI~tYRA'" +~ltuM~7Na?w^.itS~aL1. old . "M 800*3 o I 3• Nature of work (check which applicable): New Building ' ' ' ' Addition , , Alteration X..... . al Demolition , Other Work............... 4. Estimated Cost ..........,$,20,I'.~000 Fec.,.........,.............. (Descr iption) , (to 5. If dwelling, number of dwelling tjnits N/A be paid on filing this application) . Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mVQ1occupancy, specify nature and extent of•each type of use . .N/,A . 7. Dimensions of existing structures;, if any: Front 59.1. - 6" ' ' , Height 31:. c.6:.... Number of Stories , • ' ' :Rear 6'..... Depth ...50' . 6'. Tsan..(2) , , Dimensions of slime structure with alterations or additions: Front . • • • . • • . ' ' ' ' , ' ' , ' Depth .....Same.. ~ .....Same........ Rear $gfi?.......... Height ,Same; . , . Number of Stories Two . (2) . 8. Dimensions of entire new construction: Front . ..N/.A . Rear . . ' • ' ' • • ' • Height Number of Stories Depth . . y. Size of lot: front . .242.2$, , Rear ..217 ,06 . y 10. Date of Purchase , 1995, , • ' ' ' • • • • • • • Depth , . Name of Former Owner Mx.. Mrs..Feln#Vk 11. Zone or use district in which premises are situated , , ,$esidentia-1 IZ. Does proposed construction violate any zoning law, ordinance or regulation: Np.. • • , . • 13, Will lot be regraded . Np. ' ' ' ' ' ' ' Will excess fill be removed from premises: -Yes - 14. 14. Name of Owner of premises . . , . , , Address , Name of Architect . Ward, p,919P0 tep, ' ' ' ' ' ' ' ' ' • ' • • • • Phone No . . . . . Name of Contractor , Not ' • • • • • Address ,$vheml.q,. ,NY , , - ,Phone No... Sb3-4SQQ•, • • Address 15.' Is this property within 300 feet of a tidalwetland? * " .Phone yes. *If yes, Southold Town Trustees Permit may be required. No........, 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. l!~c+u~ i r ~U i 2rGBt~2N MUt2CV li' J l3q>r I rJA 1 p t~ (vacan•EI r -85, t ~ ~•r ,4'70.0: i ~ 9.•9G'l l'20"E - 97E~. /H . , J%nn,M&•. -"o°' 7. Qf' Way l'! LvOfY~'. •y ~0~1 If 9 58 • I ' n477~ e0 'Yrv 1/ M o,r . 0 . 4,i 11 0` 'Qtr ~V r IfA N.gTOb%10"W. rr ~ Ul tt r V4N f30Urec o. J(.)tFN 0 0 1 • ; (pro ko.) I. ~ 1 STATE OF NEW O S .S COUNTY OF . Appna Iglesias-Wexler being duly sworn, deposes and says that he is the applicant (Nam' of individual signing contract) above named. is the . Otmer............ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly; authorized to perform or have performed the said work and to make and file this application: that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. iwom to before me this .............4.. .da o ~bv who , , 19q.~~~ Votary Public, , , Afly PU I. SC l NQiApYt°li 1~OlB.1r. • :1~':"-~, larJ ~e.}1 W472 Donna Iglesias-Wex (Signature of applicant) 3'* ><I, BOARD OF REALTH VA y FORMNO.1 J SETS OF PLANS .X....... OWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIiECK TOWN HALL SEPTIC FOR:I _ ....~~A , SOUTHOLD, N.Y. 11971 19 .1 TEL.: 765-1802 t:o I FY : Larry Feeley. 563-A800 Examined „ CALL C~ tIAIL T0: . Approved 19 / . Permit No Disapproved• a/c (Building Inspector) 4 APP CATION FOR BUILDING PERMIT Date . XoveA er,.,,•,,., 19.95. 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 sheet< 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 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 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. (Signature of applicant, or name, if a corporation) Donna Iglesias-Wexler East. Max~4ps.New•York (Mailing address of applicant) State whether applicant is owner, lessee, *agent, architect, engineer, general contractor, electrician, plumber or builder. ...................Owner............,......... Nance of owner of premises , ,Donna Iglesias-Wexler (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. Not Selected, As' Yet Plumber's License No. tienry,'.J.. Smith Electrician's License No. !W. Electrical Other Trade's License No . 1. Location of land on which proposed work will be done . Private Road/ North of Bridge Lane; Cutchogue Ilouse Number Street Hamlet County Tax Map No. 1000 Section :.79 Block ......1.......:.. • Lot P/,0 ,l • . . Subdivision , . Filed Map No . Lot . .lNarne) 2: State existing use and Occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , Single, Family. Residence b, Intended use and occupancy girkale• Family. Residencet. ~ ; vt: c.,._ti.lllta~r YfiI+~O~! yrti6lo, Jl,Cat1U%' ,E?lit?sSC'k'.iriA . • • 'r . . ..,..t ,t~ yam Volt jxa m101 •3. Nature of work (check which applicable)le: Ne, ' dine A-li Addition X Alteration Repair Removal Demolition ..............Other Work 4. Estimated Cost 2Po,4oP (Description) Fee.................................... (to be paid on filing this application) 5. If dwelling, number of dwellinglunlts One. If Number of dwelling units on each floor N/A garage, number of cars ....i Two, f Addl Canal) 6. If business, commercial or mixed occupancy, specify nature and extent of each type 7. Dimensions of existing structures, if any: Front . , 59: r6:'. Height . Rear 59~-.... of use. , Depth•N/..'A50,''.-6,n........ . Number of Stories . .Two, (2). , ' Dimensions of same structure with alterations or additions: Front g6' , ' ' ' ' ' ' ' ' ' Depth ......56'..61, Rear .....961 Height Sama................ Number of Stories TwQ* .(2), ; 8. Dimensions of entire new construction: Front N/A.. Rear . , , • ' ' ' ' ' ' ' Height . Number of Stories . . • . . • • • ' ' ' ' ' ' ' ' Depth . 5. Size of lot: Front .242..25. Rear 2.17.-P6 Depth ' 10. Date of Purchase 19,9,5' . Name of Former Owner . Nr., aiad .Nz .Wernick 11. Zone or use district in which premises are situated , ential 12. Does proposed construction viol ate any zoning law, ordinance or r No . 13, Will lot be regraded , •X44q , . , • , , , Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..i1z. ,4 ,N1rs.; Wexler, • Address . Fapt, Ni 111'... Phone No. .422-.QM Name of Architect .Ward .Qaso;ciates, P Address . Ap.1wmig.,, t1qX....... Phone No..543-4$00 Name of Contractor • ,1Vgt ,$e'leeted Address . ' ' ' 15.' Is this property within 300 feet of a tidal wetland? * " ' .Phone No Y No......... *If yes, Southold 'rows Trustees Permit may be required. ed. ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all setback 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. o 2 J (HOUSE) B O K I N A O RAEBURN & MURPHY (VACANT) - - - - - - - - - - - - - S-r5 1'20"E 4 0_0_ rv~ Q. so• .tih v / 44 ryp'L PROPOSED ADDMON O N4T08.40"W - 400.00 O VAN BOURGONOIEN O 8 0 K I N A w a_ O i • I PLOT PLAN NOT TO SCALE STATE OF NEW)~O COUNTY OF S abovenamcdI les!"-.Wexler g' ' ' ' ' ' ' ' ' ' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) She -(fie-is the ..•..Owaer (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannegsct forth in the application filed therewith. Sworn to before me this ...........\,~jkc .#ROBEERRT of 1~)0 19 q S' Votary Public, County 1.1 SCOTT, NOTARY PUB C, St of N.Y. Ne.4T25089~Suff IkCou Donna Iglesias-Wex er (Signature of applicant) Ter#Expire s~May31A 19~p <a orV - G i SUFFOLK Cd HEALTH DEPT. APPROVAL H. S. NO. 14Sw~ Est All- r i,e . C~ (v1AP Oi= 1`k2opoQT-y 1 ~~`6 e fit. 06 St~f; vEYEi~ ic=012 D ` E 'bP •~{r j r STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL, - - SYSTEMS FOR THIS RESIDENCE WnL AT CONFORM TO THE STANDARDS Of THE . SUFFOLK Of= SOU rNpt,_D, t`J.Y. SCO. DEPT. OF HEALTH 31$RV{GBS. a J APPLICANT y o _ } SUFFOLK COUNTY DEPT. Of' HEALTh SERVICES - FOR APPROVAL OF m CONSTRUCTION ONLY DATE: tC~ Y'` fib, Ib / Ate. REF. NO.. S M - 7$ r _ yVC `7 ROVED: .M 411\r b i~. SUFFOLK CO: TAX IN P. 100 DIST. SECT. @~ s ~,yrtp fj lOQO 012 t ~ i'lf OWNERS ADDRESS' df ? Scar: 100._1., e f 1-b- u. s1; b j / (Sr~aa i.4?t acrx9 ~ ~ 4 = r1TQrr<um~nt r. ~~e~ \~C> / / / ? neai t -g stk. DEED: L.59 7 P. TEST' L \ COri lr'S tL! r r -Ft; tr1E'L7^1 4'7 ' / ?L4 ievrt , ;V.G-s D. ~Me~Ona~a~4G a ,f b8d61dyeYkevidelbrla ~ SesBm 7108 dNe New Vwk 91eM Sancdy Education law ~ 6aetln0 ,w - / the landdfi,eyGes ~ed seeoldm ^y e~ A,: rV~5~11 ,L, ,.e ssed soars lbla-l stalk 11 - ba concNenC " not bevalitl VUa cop,. X rn 5L71Y([fe! Goaradeesindsodadhersire' llnas { t!I ! only to Me person tot whom the wrva/ ~dq loam hpmpatad, endonhobohalltoma - . r"°r'[G14TJ !(t '~9V to .,p,,,, tlevemmental eDKKV Md ,0 _i A~riE%7 derv Auo, 7f J96F'S ~~,~,~~~4p/y 4', lwbinl inslitutlon listed lwladpetd • - l'! 41991 - JI b tha ar4aees Of " ladall~ e @p. 16' t _ c7~ 3a I0dMr tattoo, Guarantees eras not ltMdntle Oc~ 7, f9$~ tr. cfaq to"VbwtlYrpllWtanwVilmWill" Vaz,- 6, 19,86 45 'RICsand C'I 2$.77 6UntYJrt 6th tp H,vq tyro wwf U. 8. L lfB 7'i?Itc. /rta urar>cC .;,o yPO~ 1° d5 "Sctrve o t r t, ! ROD ER" VAN L. P. G ~lYr LICENSED LAND SURV RS txiiliad ' : GREENPORT NEW Yell K' - - I i NAME. D.\DWG\9520\WR-T7-R DWG DATE. 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TCQJ-- O N ?mm>g Z oar Qiczi h_ I~ S~ 4~i1~c~ Hill I h1h NAME- D'\DWG\9520\WR-RA2.DWG GATE: NOV 02, 1995 TIME: 10:43 AM D Qv ~ N D I 1 N N II ~i 11 ~ ii 11 X m X w 6 r O }Z Z O m X ? \ A II -TI m X z -n ~ E 0 N 7C W mZ mr ~Op N 1~ I A I I u /MX 3 _0 X _ y ti d` N A D ~ I A z D N m z DN O O m z 3 C~ n m ~u r A E Ilii11 o~ ~ m ~ ~ I I r m ~ Dth m 101-6" i V.IF. Z ~ mp ~ r r O EQ EQ. „EQ. „EQ. EQ. d m 6 0 ryry l i m n /~y a Hill D AV m 3 i---------- 1 M: meD myNOX~ m<~o< em( no •EEx;D pp~~D 6~1C D aOr~ LNmu A 0 M,NN Irk ~S m~ p6~~,~Nm Am Ni=3~ m O~ em-~~ ~111, am 0xr-00^ 60 ~N 10.X O mmX~ EA h O m r x_m Am f A E A t) Y` _ ~nz oN oE ~ ~ m vN~ N m _JC- ~i_~NN A TD~ m 12A Nn A r0 mr~ ~~-D mC01 D X r E,' mv0 eg y ~O cD~D N nJ m ~N TO D r z_z O 3~ 8um r On A 4~ ON ~oy~ 1I- / III// r D LOm „ / mil > u~ o g D~ Z _ O r no u S f11-r 1 Z0_ n O a m %R m 3 ~ mx x 07,0 go s~ D = N 1AD_ N' D ~ N n m m mm ~ E g D u+O6 Zm o+ ONE Z'p h3 O~zzOZ cn~ X13 UEON -03m0 DEDX E_Z Ocn(v03 Z - O~ C ~ O w - R~OlD Om DD OONN N rp ADDD mDXO zycn~ ~m pc mD O 0 tn< -6 c-Of+2 g A rODDPD z<T< O O~'U mm-Niy OL=A p z~ D(l -F mm f ~i0tA0AL rp D SD D ZZ ~7D~ =m r~ ON$--i"~ NAc ~b Az D D1 1 ND m AN znmm X O~AEONE OA Om A xZ ~NNO O~ DO O z zz CP 70 mrm 0c A ~N ZSr00r NN O~ ZORU mZ~cp ~A ~ ANN D130 D EOM 0 z ND D- N m z -zz m ID w pt0 Oo DO 1m ~0A ADr cn~` ~~ZZm<0 EizU AmmTO Ic m cn= n0 x: t" =3 znm~1 .~~'mrm cE MMM mm pN-4OND~ii 1: D7C m Dm r3nj'nNp D ,N m~0 3E AD ~ZA Xx 4\D ND(i0 03. 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