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Home My WebLink About23182-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24876 Date JANUARY 30, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 1105 WESTWOOD LANE GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 33 Block 2 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 5, 1995 pursuant to which Building Permit No. 23182-Z dated DECEMBER 15, 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 ACCESSORY INGROUND SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to WILLIAM & JANICE CLAUDIO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-385744 - MAY 13, 1996 PLUMBERS CERTIFICATION DATED N/A Building Inspe or 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) J j > Date ...........( ............... N2 23182 Z Permission Is herebygra ted to: . ...... � ................-......... ... ..�.....:.l�e .. - J... ... ..... �s` -��... .... ... . .. .o .` ,............ .......I....... . ...... . ....... ... ..... . . . .... ....... . .. ....4:� .. ............ .... . .. ............... ...... .... . -..... .. . .............................................................. F.............. at premises located at........��-?........... ......,ll re-'�....................... Vis ..."..................................................... County Tax Map No. 1000 Section ......... .. .... Block......s...... .QQ... Lot No. ......�......... ` pursuant to application dated ........................ ��_... 19....,/..... .., and approved by the Building Inspector. !i0 Fee$..1.<��7J.... . ..... ... ................................J.. -.... ......... ................... Building Inspect Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPART ANT TOWN 3ALL 165-1802 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: L. Final survey of -property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Healch 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 17 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 pian requirements. r 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 525.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building i25".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 . J/P17./1'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old OF Pre-existing Building. .. . . . . . . . . . . . . . . / Location of Property. x/��. /W. .1 . .. ... . . . ... . . . ��/J�°•J✓? House N9_,, Street amlet Onwer or Owners of Property .. . . ..4?"' .. ... . .;-. .. .. . . . . . . . . . . . . .. . . County Tax Map No 1000, Section. . . . . . . .. . . . ..Black.. . ..ctZ.. . . .. . . .Lot. . . .. .. . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,... . . .Filed wap. . ... . . .. .g..".''Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . .Date Of Permit. ( ��/�a . . . .ApplicantS�w/tC �"�?.C.FLvl `.°s� . . . . . . Health Dept. Approval. . . . . . . . ... . . . . . . . . . . .. .. . .Underwriters Approval.N 3?s.7 4q . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . // Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. Y. . . . . . . . Fee Submitted: S . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..- . . . . . . . . . . . . . . . . . . . . APPLICANT THE-;NEW YORK: BOARD OF = FIRE= UNDERWRITERS PACE z _ BUREAU_OE ELECTRICITY- 5-JOHN STREET, NEW YORK, NY 10038 Date-- _ "H�q-23 1go� " -._=- :;c, ;v'. 115291041i05 M ?95744 IS ¢ERTIFIES THAT ! the ataetrice/equfpniesai oe dsse+f6ed Galore and iriirodueed 6y fhe applicant earned on the a600e opp►ieotion num.6er in the premise+of i CLAUDIO, 1105 WESTWOOD LME, GREENPORT, N.Y. in thefoifasainE location; _ ® Basement ❑ Is=F_f. El Fl. OUT .Section Block - Lot 'r uas examined on MAY 03,1996 - - - and jound to be is complioaec with the National Mechical Code. — I RATURE - ACIFS SWRCNES�EoiiTJ _. ._ FIXTURES - RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS HCMIDESCEM nuouisaM I OTHER AMT. I K W. AMT. I K.W. AMT. - K.W. MMT. K.W. DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS ISPECIAL RWP-Tj TIRE CLOCKS I MLL. UNRHEATERS MULT4OUTLET DIMMERS.'. AMT. K.W, an I K I. I GMS I K I. AMT. NO. A W.G AMT. AMP. AMT. MWS. TRANS. .AMI. —KP. IbOf NAT. I- WATTS 1 SERVICE DISCONNECT : NO.OF _ ._ - S - E . R - V - i _ C E - .. - ETE T1TE M[QINPR r A•tw r r aw a r aw a,�aw r+o.rert scoNo. of c="ta+o:- - Na W-1'a Oi n�-'�c NO.OF WMALs a NWEUTGNAL_. OTHER APPARATUS: _ made "by a qualified person. NORTHEAST ELEC.CONTR.INC. 30 JERICHO TPKE.SUITE 282 COMMACK, NY, 117251- GOMM MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if,incorreci. Inspectors may be identified their credentials. o��gpFFO(,�co c� Gym y t Town Hall, 53095 Main Road p • Fax (516)765-1823 New 9y�o1 �aO� Telephone(516) 765-1802 Southold, Nw York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 17 , 1997 Wm. & Janice Claudio 1105 Westwood Lane Greenport, N.Y. 11944 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 # ' 23182-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-11W2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL ( ] FIREPLACE & CHIMNEY REMARKS: C .l- DATE l INSPECTO 2 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ 4'.'FIN IULATION FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS: .-s gill G S�utiyr1L d e DATE INSPECTOR 1 otl tlSl�li--I-- --P01i't' DATE V01111)AT ION ( Is'1') - FO11NDAT ION I ttoucD FRAME. a ---- --- - - -------- ._ __. ------- -- - ------ ---- --- ---------- rLurrntNt; ------=_______ _ N INsul.n'rroN Milt N. Y . S'i'A'I'li ENERGY I COOK? — I -----------.-- ------- Ogj F 1 NAK. ---------------- ADDITIONAL COMMENT . ----- -- -- - - ----- ------- ------ ----- -- ---------- - --- ----� -- - ----- --- - - - ----- --------------- ---- - -- - ----- ----- - --- - _ --------------------------------------- 0 > •�n . ....e.. .. < PJTE ANDNOREo IG CO cm FAA� PRf,,ST CONCRETE PAC Cf3T •�—__- SR�.NEPS 4 m IETUA. Q` tIt {{ TO FYLTEA m OAKS BIt S�� e '3•Y� FRpM SNluu£RE .+ LTER•n0 PUY9 l atli I� O 0 ,m1 O_ F ( FORM TIES a` ^� o E � _ TQ RETL RI.S FA7u MLR m \ I f i s u To v.STE I _ xDIeEDFofN ER - 0 1 PIPING ARRANGEMENT IEETWEEN LINa , `�_� mNTL� LINEA Q .L Co nCA£TE I SiEE 24 AD I '.a• - i rico-wfn STEPS yE:c.al p L A N i ♦ ._Yy 10,090 CONCRETE f v/n LINER -� ,�;.- O •` T`" FI BEAGLSS SEE Tr:Caln � MOULDED SEcr,c - i aiECE S: i Sax1 IS T EEC TION - - FORK TIE �"'� Q �..� i-a•�N., �] i £ L-1• Sano Oo TTON - '-`=""� '1n 5ART OPTIONAL ' STEP� x SECTION B-B TYPE 1. aRa]E iId ' 3 STEPS Ox PLAN r1_•. { TYPICAL WALL 12•� 14R � i . SECTION A- A OPTIONAL STEP TYPE 2. .�]f N. SIZE A i C O F F 4 CM §•' iEET .+. rt rt rt rS nrt . rOTEi CONTRACTOR. D wfl[5 ro BE SNOCTN- NO- SN'O 'PC, S109£D ♦-.1 FRO. POOL pp t'.y C ! RANDY T. RODECKERr IIK. m aTEA O.SSCYL SMALL RE LIMITED TO awrEA3 tf �%i: xp SYi% KING POOLS IRi R' t6 ]2 i E R ♦ • 52 .EDCO PROPERTY TO SWT LOCI REGULATIONS If.]i li 36 rE 6 . R ♦ ♦ STS 20 �� '• " C+'CSSJ=•"� ROCKY PQENT, %Y SSZTB 20. NI 20 ♦O R io K 6 6 ROO 2apo0 I . I 'Jill lxc;.D 0 TD CoxCRETE P.SCSST C %TE - COOTI.4 MIE CxST _ SaM•.ERS m / p } N TO FILTER m [ 8x0.5 B J I i i S+O�RE SERE g FROM Safuu£RS n+ f O cy^'� [1lrERre auu9 IIII Il O � YfORM TIES 111 \�,(`+- FmM FIL3R ' I TO REP RFS � ! • �: TO MaSTE ! - - IR Luo R 0 PIPING ARRANGEMENT '— =1 —Z- L CO xCRETE __ ViM1Tt, LkER Q SIDE Cx Ek0 POVREO COxCRETE � � y mPE yc:Ownc PLAN ' '•' !rxn uxER AKRqus SEE TIP Cel ,.•� .`•, .I I MOULDER •. .ac s£Cnaw -� •• _ I aI EEE SECTION[Si[] - - {{ 1 •i PORN T1E --.. 13 �-.--- a--O•—� IS j £ L 2. S"O 30TTON "^' 3- '-`-""' 31j,SARs OPTIONAL STEP x SECTION B-B . �- ---` s _ TYPE 1. _ ORaaE r`•- 0 3 STERS r- D !:O o PLAN ^o,• teu ^ f' { TYPICAL WALL —Jai SECTION A-A OPTIONAL STEP TYPE 2. yOf YEx, SRC A • C O [ F O UI FEET I IT rt rt rt dart • g,�pc� S t CUNTRAc:TOR D noT / NaLRi lO Bf SUO01x- MO-W Sxrp iTRE, SLOPED Avo sxpM R00L I' ¢ RxNOY T. ROOECKER, iNC. sl .It. DIMUL S..LL 6E LIMITED TO Q-kEWS L +�• ¢ Sum KING POOLS m I6l R' 1t SE • ! 4 ♦ ♦ S4 rbD00 R.OKITTT TO SUIT LOOLL REGULATIONS ^ '�'3+ O �0 4a[551 •fi C ROUTE 2SA tf TSS 16 36 2 , R • R • ♦ Sl[ IO s�p¢ ��-`t��'I• 20'. .0 zo a0 4 10 12 R 6 Doo 2100D �� ROCKY POINT, NY 11776 "I• "'0100' G�N� RFi[ 1x<xONfD IO CoxGEiEL PAC C1ST CWKRETt HE USi SNnwREPS 61 COv1N6 RETVA N$ ` fVl iD FlLrfR N ' C]•]'t. 860.5 B I j'I i S.�PE SWINEFROM Sa1MMER$ N � LTE ROnO FORM TIES sPOw Pi CER .m ' { O RETV RI.S VI TD 1•aSTE � ROLtED FOAN 0 PIPING ARRANGEMENT '! _ / J �SETWEEM uxE0. i a `�__J vINTC LINER Q 'C CDNCPE2E N ' STfv3�Jn'LCn6< PLAN .-t_ nW�RED CONCRETE I <+> vnTt LINER T ♦ 1 13ERDLl$ -.;t •-•• i wOkILVED SEP_ n TT �L -.. --• ^ I '• P TV.T SECTION Pi£CE -� • : SECTION • FORw TIE IS 8=0• y +—2 SsvO 30TT0w 2♦"r6R3 %A AS OPTIONAL' STEP SECTION B-BNTYPE I. CRaOE r ~ � } $TEn] c _�A:6' c P LAN •'•n In IS r1"• { TYPICAL WALL -H .2'I--- -D'I. __f d F SECTION A-A OPTIONAL STEP TYPE 2. NEq. SIZE 6 t < O [ F D 40 FEET rt ,[ nCO rz • SCh, f CONTRACTOR NO.Lt3 A 8f SIIOOT1- N0. SN1D TYPE. SLOnED d'G aMAY FROw POOL p j. t. RANDY T. RODE�R, INE. m WATER OISMUt- SxetL ITE LlRNTEO TO QwNER1 {! 'Lri!= a( SYIN KING POOLS PROPERTY TO SW2 L°GL REGULATIONS 11-e ♦ SR q}00 36 12 8 n • ♦ RERDUTE 25A ♦0 n 10 12 6 6 800 2PpOp CFt•_f RDCKT POINT, NY 11]�Ff vim THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 r1145059 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date MAY 1.3,1996 Application No.on file 11629196/96 N 385744 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant namedon the above application number in thepremises of CLAUDIO, 1115 WESTVIOOD LANE, GREENPORT, N.Y. in thefollowinR location; N Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on MAY 03,1996 and found to be in compliance with the National Electrical Code. FIXTUREFIXTURES I RANGES COOKING DECKS I OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES JINCANDESCENTI FILIMESCENT OTHER AMT. I K.W. j AMT. K.W. pMi K.W AMT. K W AMT. H.P. 3. 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PTj TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GA$ N.P. AMT. NO. A.W.G AMT. AMP. AMT. AMPS TRANS. AMT H.P SYSTEMS AMT. WATTS NO.OF FEET 1 F 1 20 SERVICE DISCONNECT MO.OF S E R, V t C E AMT. AMP. TYPE METER EQUIP 10 2W 1 X 3W 3 e'3W 3X 4W NO.OF CC.COND A.W.O. NO OF H14EG AN' G. NO.OF NEUTRALS A. .G PER a OF CC.COND OF HI-LEG Of NWEUTRAL 'OTHER`AOP41IATUS: p T114E CLOCKS POOL-1 STF� OCKS 48 AMP--I PANFELBOARDS:1-2 CTR. 125 e(SWTMP'IING POOL) This certificate covers compliance at the date of -inspection only. Because of unusual environments it is advisable to have frequent test/and or repairs <<< Continued on Page 2 >aa GENERAL MANAGER aS Per. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identifi d by their it 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 11450059 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date MAY 13,1996 Application No.on file 11629196/96 N 385744 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 CLAUDIO, 1105 WESTWOOD LANE, GREENPORT, N.Y. in thefo(lowinq location; ® Basement ❑ lst Fl. ❑ 2nd Fl. OUT Section Black Lot was examined on MAY 03,1996 and found to be in compliance with the National Electrical Code. FIXTURE RLE►TACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K W AMT. K.W. PMT. K.W. AMT K.W. AMT. H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTES AMT. K.W. ort M.P. GAS M.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF MFEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. I AMP. I TYPE METER I.0 1W t 0 3W 3.6 3W 3 N�W NO.OF CC COND. A.W.G. NO Of HIAEG A.W.G. NO OF NEUTRALS A.W.G. EQUIP. PER.B' OF CC.GOND. OF NI-LEG OF NEUTRAL OTHER APPARATUS: made by a eplalified person. NORTNEA,ST ELEC.CONTR.INC. LL�30 JERICHO TPMSUITE 232 COMMACK, NY, 11725 GENERAL MANAGER 11= 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. � .;Ss. Loi 7F STATEMENT OF INTENT _ g 7' �- /SO.O k + j MAP OF PR0PEF2TY THE WATER SUPPLY AND SEWAGE DISPOSAL ' RVE?CEO FCFc' SYSTEMS FOR THIS RESIDENCE WILL + •'_ .� 4> CONFORM TO THE STANDARDS OF THEI i- SUFFOLK CO. DEPT. OF HEALTH SERVICES. `I Z j c�AM�S P�nro YL RLY�. ��Avr (S) 36.- ki i I A7- APPLICANT PoOI \; rSUFFOLK COUNTY DEPT. OF HEALTH : I� GREENR�R , N.Y SERVICES — FOR APPROVAL OFi N S{ V CONSTRUCTION ONLY DATE: t(j ti C-f Z ..H.S.REF.NO65-50 67 APPROVED: r' ' f SUFFOLK CO.TAX MAP DESIGNATION: -DIST. SECT. BLOCKPCL. °} v� i il?OY3uirGrtt + /000 33 S _? ( _ B • / YON P��G- OWNERS ADDRESS: JC c7' 57.tt! 6re-er)p0r4, New Yrk. ,(fq INLET GONo RO�SG �{ i E/c�a�/rbn3 shower arc iM kc16) inea n Te4z /err I- 1 _ DEED: L. P. ' TEST HOLE _- YSTAMP ' • � A\v' 4�C SIQ CH GC SQA -I � (�y ..--:n Cw.�•�...y,..-�:r `j % AffctIded Air. 27, Ge9 not � �= "IMMEDIATELY" �./�'�. �:•z�_'x yemntx wicn tlott�^ �p ENCLOSE POOLTO COOS �`•�� ::�-� UPON COMPLETION ✓ter —i:r_su�n fx-:-`tr,"Y'? � BEFORE-VW ..fC'S ttO r3[t�SlG..:'i . .� - / GGfi�d 'F� X�' 7F7S+��f"RFK� GO»°�c7nJ cx,t�; SEAL -- LJ.YI ':SS: a e'rr.,ise INGf�c.afed. A7 Oafrber5 S12QWh p�-Sut;j� Via` Fc6vuavc, 5. /986. doe i Y . t'c-T!✓tr- ' -r P O� Gf K4'ri'Y II;tAYcE. J�Ccr/CMY l�rt0 r r"'¢P� 4N G9.c. O _ ". �c'�rd'�n ffiC Sctf�lx Ccccx;lrf r�tr,E's o{fr'cc - �;•��- p�" i!$6'lFscr� �dN7 � '¢4-.Z6 . J4 V mckaCK Y�LLTLYL P.C. ::�r�2o ryec.t. • '� --. Las,05 LICENSED LAND SURVEYORS - -- FORM NO. 1 --'3 SETS OF PLANS . . . . . . . . . . TOWN OF SOUTHOLD ` SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT �CIIECV . • i� • • • • : • • . . • . . . TOWN HALL SEPTIC FORN . . . . . . . . . . . . . . LoA) qf SOUTHOLD, N.V. 11971 P#('*A- 6)6 - qac- tC9,3 C0Ac + <a�nuN `tw✓� YaJ TEL.: 765-1802 NOTIFY ; AL� . . . . . . . . . . . . Examined . . . . lS. . ., 19)J NAIL TO : -� Qr r, - Approved . . �S. . ., 19/. . Permit No. . . . . . . . . . . . t Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �%Q� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) A IOATION FOR BUILDING.P,ERMIT Date ... �z. .s. . . . . . . . ., INSTRUCTIONS a. 'I'Ids application must be completely filled iu by typewriter or iu ink and submitted to the Builduig 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 tine 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 file Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of tine Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulatig s.�. o ,flts.dott&Gl ibf on of buildings, additions 9,K at.terationns, or for removal or demolition, as herein described. The appfikna t 'agrleTs. to, comply with all appli AllK[aWs;,�Yr'.dhlktiG6s,, building code, housing code, and regulations, and to admit autlnorizedr'i hectors on premises and iB r lAonj,1L�itn s�hiyh��inspectioms. l 1 . "Tech J-8-ignature of applicant, or-name,-if_a corporation) (Mailing address of applicant) yIV 1176 Y State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . Name of owner of premises , . . . . . • � v l 0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as On the tax roll or latest deed) IC applican/t is� corporation, si nattue of duly au horized officer. / 1 . .�>�Ct . . . .(1??ic4,4.e (Name and title of corporate ofFicer) Builder's License No. . . . 1D,.-. .7%. . . .V.A -T-. . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other'frade's License No. . . . . . . . . . . . . . . . . . . . . . n I . Location of land on which proposed work will be done., . . . . .``.�S .S..�� G ree�.Qoc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ilouse Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . Lot ; . . . . . .�. . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: it. Existing use and occupancy . . . . . . . 9PAPkdQ . . . cam j�� Y y�ot,N� siu apt e e6e 1 b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .r 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work �- 00 (Description) 4. Estimated Cost . . . . 1 *.—. . . . . . . . . . . . . . . . . . . . . . . . . Fee / a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . hear Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . Dimensions of same stricture with alterations or additions: FrontRear Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • • . . . . . Number of Stories 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear Depth Height . . . . . . . . . . . . . . Number of Stories . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . I Zj r.1.q.r.' • . . . . Name of Former Owner . . . 1. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . JV•O 13. Will lot be regraded . . . . . . . . ... . . . . . . . . . . . . . . . . . . Will excess fill be removeq from premises: �es 14. Name of Owner of premises k\l• CL aydr p . , . . Address . 11.05 +�'�'�"uVd-4-1% Phone No. . .Y.7, Name of Architect . Address . Nape No. ' Name of Contractor SW iu Wo•�, pid?,4-ycAddress C15.7.,411144,P1.9 ! -Thone No. Qa�l C4 3 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . . �p . . *If yes, Southold 'Down Trustees Permit may be required. 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. ' iM uvo ,MMEDIATEIYQ D EN " . Oil APPROVED AS lNOTE�`�Z DATE: / //9_oo B.P.# _ FEE: NOTIFY BUILDING DE AT 765-1802 9 AM TO 4 PM FOR THE ' FOLLOWING INSPECTIONS: 1. FOUNDATION • TWO REQUIRED r i , FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION Ii + 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR�_ �` ALLCONSTRUCTION C SHALL MEET 9 � � 1 k;'t n"k+ ��.` THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR '<«ti, DESIGN OR CONSTRUCTION ERRORS (TATE OF NEW YOR1�, 'OUNTY OF . . .g .-moo, k, S.,S`` t 2-�• LTol E2kc 1. . • • • • • • • . . . . . . . , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) applicant ibove named. /t,� le is (lie . . . . . -�N4�� . 1.41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) )f 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 know ief; and that the York will be performed in the manner set forth in the application filed therewith. worn t o e f re m e this Notary Public,State of New York No.5010509 A Qualified In Suffolk County . . y o _a. .da19 .13 Commission Expires March 29, 9q �,�✓ . Jotary Pu ic, qr C,f . . Count (Signature of applicant) �' ',�'�at,,.•- d - .x�S,`=x`.y`Y.:_.rY; � - .:<:-' •- ''.t.. ''e-�`• �;;.=�:5::,: - '�:7':' _�'!?�'h'.." . . . - .... _- • :' -: •'' H.S. N6: "s'' STATEMENT OF INTENT i THE WATER SUPPLY AND SEWAGE DISPOSAL 7'ao ,� lSo.o k �0 MAP ac PROA6 \ I _ SYSTEMS FOR THIS RESIDENCE WILL .1IS< f Q tt - .641AVIC FSR CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (}AMFSPwro36 ��RLYi�. "favF .i 3�f— p cposel 1lstaral —! ( A7' APPLICANT ISI: pooh ~ Y SUFFOLK COUNTY DEPT. OF HEALTH GREEw�h 4T N. SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY ~ DATE: H.S.REF.NO..40 98-50-67 3 9 9a ft) l( i APPROVED= �j �I � v ) Z�N� /'� SUFFOLK CO.TAX MAP DESIGNATION: \ '� of s v� 1 t3 = N10ffu/Tertf �f aGSJ 93 -� K 6L t OWNERS ADDRESS: - $�� — : — - — — -- — — _— — — — Greevifovd< New OofVO � y t � e . « 77 and re rer 76 m"n sect leve-I. s I - DEED: L. P. - TEST ROLE STAMP i .. ,� � w YGSJp CHGC S'Q< _I I '-.0 ih Lew.�a'..r.Yc':23 Qr .r- - eyoYa bout ewto: �7 V MO"F e':�cxd mNnoderem�mra' i IMMEDIATELY♦/ Arrterded Air. 27, 1989 �. ma . . �. ENCLOSE POOL70 CODE CSG. f . I9&9 t=.uxenexi�eaeadheRena4c?ro UPONCOMPLEMN Lahti '= ftrs waEKe Goma, 1 LJe4t s"..a erw:se [NCitta feat. �� SEAL nurebers ,sh,07 _76 'NA* e,GfSYrYI Jn YtirtS II `G - {r'r�'ln 7flfL^ ,jtt{`fal',e �G1.:tk' [�. Fps 12b fklitP Ake �{4,Z6 . F4Y KV TLYL.P.C. .aioa t`:`rJZS SJ.:, LICENSED LAND SURVEYORS SUFFOLK CO."EALTH DEPT APPROVAL ' H. S. NO. 83-SO-67 pp STATEMENT OF INTENT 0./, 86" 477 "00"G, �SO•G k i� �j/�1p QF' �RUGERT'.✓ THE WATER SUPPLY AND SEWAGE DISPOSAL \ SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE ^- /r-r SUFFOLK CO. DEPT. OF HEALTH SERVICES. (S) APPLICANT �. � � w,lrn3 � lateral SUFFOLK COUNTY DEPT. OF HEALTH Xaa `-z, c J�:= r'�� r ✓. I. v",•,�"`� f SERVICES - FOR APPROVAL OF �I 't ,i• CONSTRUCTION ONLY 1 DATE: H. S. REF. NO.. 88-50-67 APPROVED: LO t 73 9araae �; cont o ! � Scale �f-Q = ! ` SUFFOLK CO. TAX MAP DESIGNATION: p !o DIST. SECT. BLOCK PCL- roe? l�C OWNERS ADDRESS: : _- , ls''e'rir''rr7 p1g4� p 4, Ivew Yo QIAILET !Cr4/1J f�0. � �� fcira lt^.al-rs = 7,0 wp- arc I 'I 7C) r ! I I DEED: L. P. � # L TEST HOLE STAMP fN- irked sezi cc SS,6�VF,I,�r.EDIATELY ' Arr�ertded A' r. 27, f989 �`j7 wb-Q`Zw°uacwv . ENCLOSEPOOLTOR�"`°` " xo ba a valid¢ a mpW \ CODE LLQc• f , t98 UP C MPl E "-- air ass trr�caced heveon a%--"".- u "rn^ ON O„ « ff !{'ca . a.t� aprrsmtcrwlrnrhasu;c BEGORE to -e^.r d,a m an his t shall a:.=s `' C 7/� 7L �' V LfCIdQf?�--E�•�f /" �7 �1 GG? d / l rlj ” lSer ��yyld ?Gt67ty vf9> ^ SEAL /d fr6074err $hGY✓` f� f Y'i <.fC FG VL(QYI� J!i /� �' P�/C'J�. 6� H[[!Yf^�;'� '-,""•�+�G)$-�'�'r,:l .�':::7 i,.•-•� �C/C'�Ts.^1Y,r.j�'K�a `' '� :t`tom`FUCK V4�,T0'`. ' T`Y`f�� 'i'➢ 7jY:s' .,�C.l�"�-:'eK iv,.'_'1�'i;-�...t�,;- a,.,i`:'`t!'• 07�fG� + :'t¢� �'�-"� 1'� � as Map O;{ R ERlCK VAXTUYL. P.C. ^'•:^,\2o=��x �.., y.s•...-- ! 'Y�. ' CS 2591.E LICENSED LAND SURVEYORS GREENPORT NEW YORK