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joiwd, �n Town of Southold 4/12/2016 01 A ., P.O.Box 1179 r 53095 Main Rd Southold, New York 11971 X1916f,ill CERTIFICATE OF OCCUPANCY No: 23725 Date: 6/21/1995 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 3525 Paradise Point Rd, Southold SCTM#: 473889 Sec/Block/Lot: 81.-1-15.9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/21/1993 pursuant to which Building Permit No. 21524 dated 7/9/1993 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: one family dwelling with attached decks, balcony&garge in basement has applied for: (aka 3525 Robinson Road, Sona hok i) 4/12/2016 This Certificate orOcciiiwu y has been corrected to change the tax asap lot number from , .8 to 15.9 only. The certificate is issued to Deluca, Charles&Sylvia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-44 April 13, 1995 ELECTRICAL CERTIFICATE NO. N-345349 March 14, 1995 PLUMBERS CERTIFICATION DATED Feb. 22, 1995 K& K Plumbing& Heating hf „6, 0 onz '' i.;ignatt e. joiwd, �n Town of Southold 4/12/2016 01 A ., P.O.Box 1179 r 53095 Main Rd Southold, New York 11971 X1916f,ill CERTIFICATE OF OCCUPANCY No: 23725 Date: 6/21/1995 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 3525 Paradise Point Rd, Southold SCTM#: 473889 Sec/Block/Lot: 81.-1-15.9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/21/1993 pursuant to which Building Permit No. 21524 dated 7/9/1993 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: one family dwelling with attached decks, balcony&garge in basement has applied for: (aka 3525 Robinson Road, Sona hok i) 4/12/2016 This Certificate orOcciiiwu y has been corrected to change the tax asap lot number from , .8 to 15.9 only. The certificate is issued to Deluca, Charles&Sylvia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-44 April 13, 1995 ELECTRICAL CERTIFICATE NO. N-345349 March 14, 1995 PLUMBERS CERTIFICATION DATED Feb. 22, 1995 K& K Plumbing& Heating hf „6, 0 onz '' i.;ignatt e. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23725 Date JUNE 21, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 3525 ROBINSON ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 81 Block 1 Lot 15.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 21, 1993 pursuant to which Building Permit No. 21524-8 dated JULY 9, 1993 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 ONE FAMILY DWELLING WITH ATTACHED DECKS, BALCONY & GARAGE IN BASEMENT AS APPLIED FOR. The certificate is issued to N. CHARLES & SYLVIA DeLUCA (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-50-44-APRIL 13, 1995 UNDERWRITERS CERTIFICATE NO. N-345349 - MARCH 14, 1995 PLUMBERS CERTIFICATION DATED FEB. 22, 1995 - K&K PLUMBING & HEATING 111 c-2/4 I Building Inspector Rev. 1/81 FORM No.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date,..,.Yf9 19.0 N9 21524 Z Permission Is hereby granted to: ... it . . a� . .d amu.,. fart-4.0 � ! ir- �/1 .to . , ,�SuL�� . ,. r/ .....,7, rn,,r 3//7 ..e.c /iins at premises located at `.gS:P'S - ,,,/ 99''9 "+ 7 ' ) js 9 � .. County Tax Map No. 1000 Section �� / Block / Lot No. .zza ..., r pursuant to application dated AH 19.E and approved by the Building Irispector. Fee$..,l/.6 2 o --1 ,71P2- 9-fat gInspector i i Rev. 6/30/80, i +.. . " _ .. it (AA 1St) Form No. 6 1111 171. II VI I TOWN OF SOUTHOLD WAec r \cit N >1 ' 5-6‘ APR 17 1995 BUILDING DEPARTMENT TOWN HALL 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. -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 Buildin2 - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00 Date New Construction Old Or Pre-existing Building ii Location of Property 3 5.2%.5.5.2%.5. V �? A �o v\ C_ S V v` \\ a\� House No. \ Street ` Hamlet Onwer or Owners of Property. . . Ci\\c \c ANCA S$v i c-- County County Tax Map No 1000, Section Block 1. 00 Lot Subdivision Filed Map Lot Permit No. . ? 15,1, f Z Date Of Permit. . . .7J. %h' Health Dept. Approval Underwriters Approval Planning Board Approval Request for: Temporary Certificate Final Certicate • Fee Submitted:p� $ (51 , _ ,.. ..<,..44., e4,,,APPLICANT. DEC 1 4 1994 BLDG.DEPT. TpWN OF SOUTHOLD V (--1\A ; —S . _ - a, A _ �\yw fir. \1u. \3� \" k" 1 wwV' u-S-- SUv �u\ ` \ u Onw. --t--- \lam CL L. - - -- --\\uG. \ ko �arc�$�c ��1 0. .X. C OfC_..w S\ c�An�.e S IN e�u\na,'A v� L.i. � \v a\ W �'v\�� 01/4 V'ce L-`"-�t [• S'N \l '-t''v.\\`•- - . . C.\i--\- C°).. nH Th \ %"\ .\\Ac, pcvw.,- eve 21521{ '2• \NA ' CNuu . `Cewc-v /24,- U.. . IC. Jk.„_ „ictJC--t/--. ., _ _ „ i y, � � • } �A++f., ; i 3a{ TEL 16S'IS2 ;V p ;'{{{',N 7 ,, ,t�,,,�p Co) TOWN OF sr�crru��LD ii 77FF RI ' ON° Fkii Ov.{ orrice or bvILulnce INSPECTOR y ' !till ��fr �r P.O. X '1��;id.. ; J vH, r'Ii VPDX 728 • ill i',. i' + t. p TOWN HALL tr \://q/ `�dO`t'" 50UTlIoLD,N.Y. 11971 ,,i IL., ,, t i.1 V. • C R T I F I CAT I O N 5 r;A' I. ":. •‘ ..1 31 aa,l�s ,:, ill ,' date ,t_ n},,r :u, 1,10 , m' Building Permit NiL: o. xISR `FZ Owner ��o t\2S v co- ' ;� DeL APR 17 1995 p ease pr nr— 1. Plumber �� �wrn�rjtn �' �ea_kk n 1(,+ i• Ip Dasa print) _ . i ' . / e � may. , w is ,« . � ods• 4tti i I certify that the settler used in the watersupply s s}t11M +, �y �r1;1 � _ � aontnins less than 2/10 of 1% lead. Pp Y # , < ��i1.. ) • n Y e'Y ��� li • Y ' ``f,j f. t a } 4 s xi. 5� Y p • • e`i .P k�+ • t'1 1' / S eb i { it /'� i �ytl�}, t ii' (plumber ' s eignaltite) �, ai�ii ' r ;' • Sworn to before ma this day of .--4 ' e 19 iC / � moi/ of airy Public t IID! i et1 manilas i /� ' County �,k ��a J i` • Sys �, i � �,� • t, ''4-.,@4 "� JOYCE M.WILKlNS r3„�i 7 Notary Public,State of New York „ �, i . Y No.4962246,Suffolk Cou i a€,°�R -: ' 1° ' - ,a q, Term Expires June 12,795 r + r i' s§: .k Fs-a 1 ' C•la f5 1pp� 3 ' ENERGY CODE CALCULATIONS (For Non-Electric Heat) Design Criteria 6, 000 Degree Days O.A. 10°F I .A. 70°F FOR: !� GY "" �t PER: /'rnnl la- I /XI° ° l� DATED: 3/4 02 DESIGN THERMEL I SUBSYSTEM AREA "U" RATING REMARKS Exterior Walls (Opaque) 220 C OC 21/' • Glazing 8 q6 33� � -- /7/ e9..s 1*�� �1: �'� L • Doors Ceiling/Roof (Opaque) 2 / 0 ‘ , of 0 Skylights /. y 830 3 ) — /I n ✓f �a `� fi-lf w e �� Floor Z/ 3 • DJ' 0 Foundation Walls Slab Insulation TOTAL 4: 1-- Notes: Z- Notes: Building Envelope Systems to meet requirements of 7815. 2 HVAC Equipement to meet requirements of 7815. 11 't HVAC Systems to meet requirements of 7815. 12 Duct Systems to meet requirements of 7815. 13 Ventilations Systems to meet requirements of 7815. 14 Insulation of Piping Systems to meet requirements of 7815. 15 Service Water Heating Systems & Equipment to meet requirements of 7815. 21 Electrical & Lighting Systems & Equipment to meet requirements of 7815. 31 To the best of my knowledge, 4t0FNEWy belief, & professional 5.0toCE • to09%• judgement, these plane are in /. Q 'scompliance with the code. c ,5 _ . y: W w 26- t 032 : 1 a/ P9wfESSIONP� 33 STA/L7` 5r?77 TRUSTEES ,#01tkIFF0Ur SUPERVISOR John M. Bredemeyer, III, President t'As�frir.Y.10‘ Z SCOTT L, HARRIS Albert J. Krupski, Jr., Vice President =' S ' e Henry P. Smith Z t;co �J" it Z 'Town Hall John B. Tuthill LLc� w, at.'- Q� 53095 Main Road William G. Albertson `��"O '"` ®� � P.O. Box 1179 Telephone (516) 765-1892 q' Southold, New York 11971 .'�,� Fax(516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 24, 1193 N. Charles DeLuca 2401 Halyard Drive Merrick, NY 11566 RE: SCTM #1000-81-1-15.6 Dear Mr. DeLuca: A representative of the Southold Trustees inspected your property at the above referenced location on June 24, 1993 . Provided no disturbance to the soils and vegetation is made within the 75 ' of the body of water as marked on the amended June 22, 1993 survey of Roderick Van Tuyl there is no jurisdiction under Chapter 97 Southold Town Code. Please take note that any disturbance to the rear of the house as proposed would constitute a violation of the Southold Town wetland ordinance. If we can be of further assistance, please do not hesitate to contact this office. Very truly yours, pg. . ,guatir, John M. Bredemeyer, III President, Board of Trustees JMB:jmd cc: Bldg. Dept. \-t Ore3-5;\eS ,Locsx_ bbl- 3 Ff.:7:Lp i :'= SPA:: it :;,::MLtrr2 13 R 1• II . ' , Til /.L _ i� 't I/ i ' i.�. <r a �n— r I- . ._ -'. i / ./ n• H -OU:lDATION ( 1st ) /© �r�Zl� .' /� i i; nx.L , Ql , . -OUNDATIOU (2nd ) m -- 2 �{ / — �� ilk II; V— 4l�lvsnIaac� ,c cp ew ' ,,j. o ?OUCH FRAME & • ,�j I sz„y.3,irya ypa� lee -- - ® • g, PLUMBING . ,4,— A5314Al ,r/gfe ' /Jot t c '� Cl.�Goy 7 m n lSULATIO:! pER N. Y. I - , .a A. STATE ENERGY �� �i ' a� �. . - % _ CODE I I i,/ •/.aJ ,00-- 4.49At Lipp II ®l2z T 11 _.�ICA iy �f ._ FI;lAL . alica n i ______:_____________. . - On' _ to ...- 7--- glee)" '/ill it Allaallni 4111111r.3 : /r - S • y - I. - _ 2 ; .' I a•--Ak !.l .L Wei LA i. mOng41 ' !A S . Li-•1 - _ • • -� . I ' / -• H r8 �G O \ cn H Ss -3 'o FEU YORK STATE DEPA MIFT OF R!'VnOI?'i'EUTAL CONSERVATIOY Regulatory Affairs Unit Eldg. 40, SUM--roon 219 Stony Brook, FY 11794 (516) 751-7900 June 24, 1955 Mr. & Mrs. Charles DeLuca 2401 Halyard Drive Merrick, N.Y. 11566 gg:SCTM # 1000-E1-1-2 & po 15 DearMr. & Mrs. DeLuca A review has been made of your proposal to: construct a single family dwelling and sanitary system on the reference lot. Location: N/S Robinson Road, "Bayview" area of Paradise Point, Town of Southold, N.Y. New York State Department of Environmental Conservation has found the y parcel XXX project to be: XXX Greater than 300' from inventoried tidal wetlands. _ Landward of a substantial man-made structure greater than 100' in length constructed prior to September 20, 1977. Landward of 10' contour elevation above mean sea level on a gradual. natural slope. Landward of topographical crest of bluff, cliff or dune in excess of 10' in elevation above mean sea level. Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Lau) is required at this time since the current proposal is beyond State mandated jurisdiction pursuant to this act. 'Io!.ever, any additional work or modifications to the project may require a permit. It is your responsibility to notify this office, in writing, if such additional work or modifications are contemplated. Very truly yours, Alternate Permit Administrator CTII:DDR:CO's 765-1802 BUILDING DEPT. INSPECTION [ ] FOU ATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ) INSULATION [ ] FRAMING [ ] FINAL REMARKS: tit h } I / DATE /0/5/23 5/3 INSPECTOR ‘,11/ etICIS 765-1802 BUILDING DEPT. INSPECTION /FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL .e REMARKS: C-- The 1, Lrri� , DATE 9tr J: INSPECTOR- �r Pr 0145; (7 t-- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST { ]4R000H PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 4 AO REMARKS: P J ' f,; CSTtCf i4sa 4,-,- _tea 1 r AT ��r ., ilf / / ' DATE / 9 INSPECTOR yrs; 1,it f 1 3-) Vk- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY/� REMARKS: a e /46.s/fie-ea ofee.,&. S DATE / �� INSPECTO ijl, e; / ter. finzY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS a /ckeir0 l C joir A-t! 9-g-1a/ t ilr DATE s I INSPECT"' 'Van a/ 57 165-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING FINAL .R,, MARKS: ®/'"' fe-4240,4 c3�u;G�oi4,de. . , „vi;DATE 02 4' INSPECTOR .414 err-"Tirrrr- 765-1802 BUILDING DEPT. INSPECTION } FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [�RAMING [ ] FINAL REMARKS �/ � �� _ J-'�^-�-_ DATE 5/3/fry INSPECTORA.,c774 g/ 502,y 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL a REMARKS: e a yr S 40 DATEINSPECTOR AI (77/s-,,ty-r-r- 765-1802 BUILDING DEPT. INSPECTI [ ] FOUNDATION 1ST ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 4/414.-- t M-.0 X4/6 0,_ 4 / DATE 1' INSPECTOR i A,i- 1 -4. ..". AsolummismaussamaivangasA. _, THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 •,. 1001071 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date MARCH 14,1995 Application No.on file 83802294/94 N 345349 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 CHARLES DELUCA, ROBINSON ROAD, SOUTHOLD, N.Y. in the following location; ® Basement ® 1st El.,1995 2nd Ft GAR/ATTIC/OUT Section Block Lot was examined on MARCH 10,1995 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 OTHER NAT K.W. MMT. K.W AMT. / K W. MAT K.W. AMT. H.P. • 92 64 49 92 1 6.2 1 6.3 1 1.2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A W.G. AMT. AMP. AMT. AMPS TRANS. AMT. H P. NO.YST OYSTEMS FEET AMT. WATTS 1 F 1 30 15 600 SERVICE DISCONNECT NO.OF S E R V I C E MAL AMP. TYPE METER 12 2W 1 A 3W 3 0 3W 32 4W NO.OF CC COND A.W.G. NO.OF HI-LEG A'W.G' NO.OF NEL�tRALS A�''C^ EQUIF• PER 9 OF CC.COND. OF HLIEG \ OF NEUTRAL 2 150 CB 1 X 2 2/0 2 2/0 ,,i OTHER APPARATUS: JACUZZI-1 MOTORS:1-5 H.P. ,2-3 H.P. ,3-F H.P. ,1-'1 H.P. ,11-F H.P. PANELBOARDSt3-1 CIR. 60 G.F.C.Ie-12 rea? 0 & S CONTRACTOR LIC.#578 E BOX 215 SOUTHOLD, NY, 11971 GENERAL MANAGER 11 Per inane must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. OPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK CO. HEALTH :e" / Iv' •( .F -( H. S. N l;r i s (Jr: F v ii:W U(= 1 Gc(��G_r)' 1-1-3-o Sb 7 :'uav� ec (.- ...x.2 ? / 1 !. Cr : — - 1--- ._ ,r .``7 1 f_ \//r': `_ �1. 'L. i, 'Y,�'""1 L �J ifr4 1 • \ AT 0 STATEMENT OFi \ NMOl °Y7�,/� � THE WATER SUPPLY AND! \1 CC Q SYSTEMS FOR THIS 1 \a‘nr.-°, \\ ZZ I Tovvr. oF- ct-rtan, t,i.\r; :i CONFORM TO THE ST4 ' O SUFFOL O. EPT. Fr \\ „ � A0O APPLICANT + �' � \� :ale ; 5G`= f �Ja SUFFOLK COUNTY DE! IW0 SERVICES - FOR j \\\ w •d t e r 12 CONSTRUCTION ONLY .t l;1 CJuf* : (_orruinrb.rrs c-/(owrr (l,:r; :('/�) Q0 DATE: 1 "lie/ ;> .1:yE tit' SE•,1,.ofY Cs. :e - f, EIEv. 4.2 ,rev-P ( }� H. S. REF. NO.: Cif_ 0 F + r• � `I'` (- her ::::107-C4 rir -the ::.(..1;/-..: c 'e abost ma-vr :.rr anvei e '� APPROVED: - �: r:y�. Iti<: . 7�f. f N Q 3 7 9 n \ i IL SUFFOLK CO. TAX MAP, . \ ,., r: .. orr rrrir lor' : T'✓tSi_-.•r N .1 ..•n!, incri '• ..r_ Y..-h^.'r-ir r'• 1;e:!r°i ,.:erp. (� p) us>a DIST. SECT. .1 rr, root) 28I ` SO AS i . .Z fes, OWNERS ADDRESS: 3 I/ ; - l: ? ;CO{n 240 f Hv!yard \ it it,..�r4 _ . .i t�rra�r , N.Y1 tppp x _ p �. _� 1 I �rotid. bldg. c:nve�(rpe .r, . I LL XX T '7 •0 k: \ j, -�'_ - I 10& ---- : W ...... W 1) 11\ ,< 672 65- iRS DEED: L.-49. 94 P. 3b• i j 1 .. TEST HOLE nage_ Zsr in,�, retas e \ qol} ;' ,04. •f” SATO 34r 7 AIrPr^v �` , p ` 1-15.0 N."C��— - . . _ Foad/; drtermMasindr:cd r I MSS . lir..- UPr Li ler/ m^�6 ` ,$� A -'f ;lid. -. Qlacrr+_ep_ — _ -nail „-: 7 _ r"i rvY :.. a • keo4'' � r JL �A . 6 ar,O«a° „) gre. Le hri I) pt) 61 ���� j (�; � u fry^qd Eft *.i_ '``' 1.431c ARD OF HEALTH 11 FORM NO. 1 7'L -.=f�j SETS OF PLA75 -�g -e-e TOWN OF SOUTHOLD'� # SURVEY BUILDING DEPARTMENT t/<IICCh TOWN HALL . 'SEPTIC FORH -• {'_. SOUTHOLD, N.Y. 11971 TOWN L%FSOU,a':3i.l% TEL.: 765.18027t • L. ' CALL .0�3 0-5-6 7 Examined . 19 AIL TO : Approved . . . .2 . . . , . . , . „ 19/✓Permit No v��6/� • /1 l'eje Disapproved a/c (Build ng Ins or) APPLICATION 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 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 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 nnjspecti ns. / �/ l L fa-✓-12-etv�. — (Signature of applicant, or na e if a corporation)m` ��C k. \-\ 0.\ „A , ,0� �CTc\CV (Mailing addrea of applicant) t IS-(, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0wV.e\C” Name of owner of premises . 1V . . A co\C. A . . .\Je.�" c il" 4 VV (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) c` 2 Builder's License No. --\-- (2-101111. 1"0. CA- Plumber's License No. IS-0 I R�Li ltw,�l7 • Electrician's License No. er 5oFEDLK Si V / ,� _) L.tc erU S Other Trade's License No. ,�, 1. Location of land on which proposed work wil bed � 1{U )\ti S c 'A. ) * (La 6 d .ZrP. . . . . . . . � f House Number (Street / Hamlet • County Tax Map No. 1000 Section ¢ / Block l Lot . Subdivision Filed Map No. Lot (Name) , I State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy U vL c q U"t\ 't e_\\v k <, 3. Nature of work (check which , !/ $pplicable): New Building Addition tion p oval Demolition ,sisk ft W Repair Rem j If (Description) 4. Estimated Cost 9-001,050 , 1 Fee • (to be paid on filing thisapplication) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage,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 Rear Depth Height 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 Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase iName 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 I Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Address Phone No. Name of Architect Address Phone No. Name of Contractor I Address Phone No. 15. Is this property within 1300 feet of a tidal wetland? *yes No *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM l 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. T • • • • • STATE OF NEW YORK, ' C NTY OF /�/ ' � S G�hIC D�- i""f'C " • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. • He is the I dcc_, p IA- . (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. Sworn to before me this co?l.aa- j day of; . . 00 , 19 . .3 Notary Public, ) County w ca ick1/4.i_xtc,.._ LINDA J.COOPER Notary Public,State of New,Yo / (Signature of applicant) No.4822583,Suffolk County L/ Term Expires December 31,10 1 SUFFOLK CO. HEALTH DEPT APPRC VAL N��pl H. S. NO. . `#' (© „,ritnark. hiq" w ordinary 5�2° �= .0•e• —�•d_ {V'i4r-' OF F� O PES - % \\\ . SLICVENCEC' (----7a2 r+T STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL. ?\/ !avV SYSTEMS FOR THIS RESIDENCE WILL TOWN OF. 5 r77-IOL_O, NL`'! CONFORM TO THE STANDARDS OF THE O SUFFOLK CO. DEPT. OF HEALTH SERVICES. \\ (5) APPLICANT S^xle : J'; 1„ SUFFOLK COUNTY DEPT. OF HEALTH t \\ SERVICES FOR APPROVAL OF t \`\ y CONSTRUCTION ONLY ,- 1 w d e r DATE. Note: Lot nombers 51town -b4ici :(?j; (1959) ra 1 rem o"Mcx of (r ryrt Ong �-�lev. GF.2 few H. S_,REF. NO.: Pbrod(se ri+nt f ?ec, pi - rce o%e: �•e above treramSea(eve/. _ ),,. =� APPROVED: �. 'et s ire .au }4?cy YoI 111)1\1-e: '� z SUFFOLK.CO T @JC N}Ats,D 51GNATIO�t er sa; s x, ;�t can mirror S: a it la 2crr �� t� D1ST. SECT.. BLOCK ,PCL _ i - t .rra$.} rnaeae fc�a^ F trcteli f-t.n-r i:cork. E.#) ' R �° i000 O€3t t- I 24 /o /57,..::::, ` : a� _} OWNERS ADDRESS: 1, '; r 2401 Hce--i far d' Dr t ' \ F': l G• �� 0�� 1 [ corlcr. *fo/fnda.et.11.5 1 r -� t \ foul;ara- Foote" e/.9.2 . . ,.\ CN; \ \ `'D % i J t' V L ( DEEB:L.1f:894 Pers` t i61 I V i?. ' i)' 18 ^'—�_J ) grii W P/'. —t... ;fir I) - TEST HOLE to this Se�faJOror ., +` -1 W 0 . aewai rwo ord hawr,Y 1A ' ,, _ YYYY I_\ _.. copies on taw. - \\ /cO r Copies of Ups survey and not bearingseal or '- the land surveyor's l, �O` ,. _ — J - _ ,/Y embossed seal shall not be oonsdered^ /� road' to be a valid true copy. F \` if- ., t"f .� \(.�j(`ia1 1'V _ •` Guarantees indlcG.ed hereto si•atl riT \ �- etacL- FoIP_ r!a iI @ only to the person ror vMom.._,_rvay. vot :f'7 t;5 p9'^ .;elm mai, -' is prepared.and on his M_F i ....__. ___ �l . We company,ye•:e,nr" en"Y ani . . __ {ff �_ __ :''� ; _ C'C�,'y ., lending instiv c."--,..".--zoo and / t., ti to the 255.c:_C_ �riferable' d v see De (,) r to on.cuarac rU) ( i � ' QPS�r+ y[ to addiOonai k:c......,,.-...w.sequ i owners. ( '� ill .,� (VLY C.Ct t?'!') ,i-&1 0 4 �, g �� o c z _ % .I, Art SEAL F — Suorarr ! -Po +ree x fG- t 7 ,v n1.G�'t '0N' 41 Amended fvldr-IS,1993 CHicacao -7-1:zIe insurance C.ort�:�xnz� ,coF NEI" I. `,j a." a?JF':f,: O ' C I C June 22,1993 c 1A CAC very /7---,,, W �„ - OGT. rJ,t993 1, ,, ' % RODERICK VADI TUYL,P.C. e/ _ 5,,.rxte' 400 i ' fe�1�e..._ "� �c_ - S 1:5 -Q t i Arc�cr= 2_Sam r, LICENSED LANDZjEYORS r w �" ,,til' g' o=rroni�{. GREE NPORT NEW YORK 1 �' T a SUFFOLK CO. HEALTH DEPT. OVAL - ` FaAt' ' 'C. �, H. S. NO. �' N TOWN ,-tat'ti- SUFFOLK Cr ,.!Ty 4 wa I DEPT. OF FFtii ti� - �� ' / 7,_. , ' RIVER r;901 ES AF' OF !- LOREG_ . y rd n +r'j 7,'<t ' 'iG"� H_r," 901 SUI2V'EY£=L 1�X2 T I V\ , STATEMENT OF INT '95 MAR 3\? .- 1 �z :o�'�l. C. {. {_s Y1__�1 :) C ;f-- _+�-,. ,� AT ENT — �'V1 FW THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL TOWN OF SOOT-101,-D, N.Y. CONFORM TO THE STANDARDS OF THE \ SUFFOLK CO. DEPT. OF HEALTH SERVICES. 0 • \ (SI iP, tit APPLICANT DETAIL. �; 0 \\ Scale E.50:= in SUFFOLK COUNTY DEPT. Of HEALTH i '1/47) ` SERVICES - FOR APPROVAL - OF r r. \ \\ 'w a t e r CONSTRUCTION ONLY ,; Note: Lotricinrbers ww crr -N*cIL:(\ y Al' 098i)8i) itil \` .-efer -ii, 'Mop of SS-from One Elev. X1.2 jee DATE: , d. .H. S. REF. NO.. 91, 0 j APPROVED: \ Foro.y; ., ice++rt " f:tea rrt -race :. c.'�icri above err�an 4ay�rel. } ._ '' .Tc :'e.- e Q.1.170',.-ie 7s tvta� lW.-. 6761. c-P \ \ \ . . z n� SUFFOLK CO. TAX MAt OtSIGNATN3lM: Greet' -3 1 .e 'O# on Mlriet '+tx"i'v sion J tv ()J DIST. SECT. BLOCK PCL. t abr • icn e '- r tmclit 1-ern i G r�. W \,e - (OOCJ 081 ! � le-" OWNERS ADDRESS: x . 8 OLK COUNTY DEA" ENT OF HEALTH SERVICE:. 4rn It, r SINGLE FAMILY elLY �c a:won 2�C7 IC7 kin rry I lI o. ` apR..t 31905 Ks. , ; No S I I zsmtty °" ' I .. FitJsri}c�p,NO l ' • C2304292ct r aauJlu a \\ I ll J; ,',? t�e�, tu #s ., 6. v - � � .,,,�' DEED: L.494` P. 3614 0 1 • }'� TEST HOLE 1 to be awiaiaC�rxY• J ,�`%.�r- '� 0 l" rwe r :i c� a • V�PM` u 98P11G' - ' amoi N[ 'a 8becllmw~rrtarinYlfp�M ;t /.O�� M w nmwww.la, am :i . s�..� P.E.r1 ar- =1J .. ____..____ ECucetbn law. J ,I l� m. � , tt .d vee cpp� a E i�Ofl C _I nNua01MR111rM erson tor Wain INP Soar 1 Llier ai - ^ 1 e 0 SUFFOLK CO. HEALTH DEPT. APPROVAL ' 1-4AC�P- ',.'7.-:: � ��n� H. S. NO. 91-so 4.r . ,. Ir 5 7-�tMN water' -ie. SUFr �_It COI! TY friq� DEPT. OF.,; "�i : FfiYiCES 7NO n ordaMarf E IC .... RIVE4i;u i_901 7QFQ � �Lj S,•72 ' -- l -, .---,,x- E VEYt t) ( x r r V\ '95 MAR 31 P12O6i tel. Ci..-44/2L--F- 5 P SY1_�\71 - DE-/ V ...1j-) --— 2 4-7- STATEMENT OF INTENT ,G- ��UI�V�/.r THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL N TOWN OF OU?�fGt..O N.Y. CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT OF HEALTH SERVICES. 'L 0 !SI ili\ k3.1 ..... _. APPLICANT �E~TA(L. SUFFOLK COUNTY DEPT OF HEALTH 0 Scale JOrs(., SERVICES FOR APPROVAL OF U'% CONSTRUCTION ONLY Q- .... \ w a t e r DATE. 1a No-Fe: Lo+ nurrtber5 srtowrt -H*cJE: J ;9g4} rifer -Ft, "Map of Sec rah orTe - Elev. 4.2 -E H S. REF NO 91-50-44t�rcacyr r + -cr(ed iri -the ::5..rifc:. above merit! scxleYt,l_ . - APPROVED Cc. c rfe;r k..5 office .'1-5 Nr-bi 111o. -e?6l. N \ \ Z ' ,1/405SUFFOLK CO. TAX MAP DESIGNATION: A^errcrs&3 c f • :o+ 2 Orr rrrirror^ v..$64;vision. N �� UJ DIST. SECT. BLOCK PCL. rr1a) 'ile to f'a felt iciiLie f-bstrf .-:rr '. (13 '� C� : ^ f 2 �'/ 1 OWNERS ADDRESS: 0._\, �/ UNDER 2401 (ie reOr'. s a4 otcK - o}-- 3UFFOlCO3ULNETYFA DE ' 11J� C = LYf € , -'f; Approval o referr-t ,k , N. 1 , p o ' \ T. �, f,_.s ..1 31 .x. .No.ILLS- S 2 STORY ' F Pri StVCCO PO. \ i rn Tli '3`3"4,.„.".„.;. r u••�t ��+' r`�' _ Hct. •p R 'j LL >> - DEED. L. -fc3c.�"I P. pro: W t ofr. r �" �C�9s _ • t • �Ij 'Jtsl"��DiW „f ♦ 7.7:0- ' 1 O TEST HOLE unauttwrizeaM„Mlena (^�t _ 0 SEPTIC' ammo \ 73' to this surveIs a dation ' S �, �Y ��4 1 BWESTONE O�. r� '� s='"inn?208 of the New Yak WO O v �M reon !- i urve ma n 1 i-is Q N.(o�O"13'W. ('� y v a b�arin� /1 or5 inketl seal er to# l r rfe� per.- f ilex/ •.. . 1/ d _—. . {l ;d,Y shaldry not by m nYl B COpy a M• r e 71 U `>ee De�a r I) N \ Q id on his behalf fettle 4,, r1) `4.{ :.'tpany govemmentalag y and V (�. .... _ _ —— a ;..ung msh;uiion listed hereon and V / A !hb Basi Hees of the yrtd� , y � (Si [� ° (Vcx c:a ri�') (k) .Jhen.Gue meas are not grtak♦r ble i (---Np ilk,' Q •J �r /i I `.. zrldRbneiinstitutions orsu yaE 8 / 0 U. SEAL o .,:,..... r 8h.Q —S 8.72^#+o Ear rar i�cxrrrg ,% Sc rartafrr•1 1 c +I-te., a• 0 'p N x .• 6G N4.;,. .°(=�';JG--w T �. asci F'{,: •,k, ,‘-.1...,• rte , Amended Marr. (5,1993 FriCric r.) / i+IC- ;41sari7HC� ,_�rti�-�ti`rtr P\ , \cK vq,� o.` 2t e i P. ON 0 z .7 t <<.;`'..,,,,,1 6/ 0d _-.. . ._ _ Jur • ct E t,L"r.I� 1 pg. 17. N9 i' r �`�i,. ` OG 5, (993 •ROD RICK VAN TUYL, P.0 !* r I *� �1 Scale : 400 - i „ M11R,9 1995 `�' Q e.,.... / A rely` a. 3,..,.._ .4(..: . %;<(>1,,,,4/°. c S 256'- •''' LICENSED LAND SVEYORS .• Fo SJP,rr -4' �,,,1/' v= lr"'r: pipe .....„,,,,,0ND r i GREENPORT NEW YORK TELEDYNE LOST N4tti35 -- ---- _ i — j N (7", - __ ., — .` ._ �__ - .• .. _. . ._-- --- s - . _ lei } r, - _- - .. ry - - . - . —---- -, • . -ter ( . 5770544-0 re., • = �-- - . _ _,—. - - • '- __ tali \'. --. i` fir\ • 0 - Ln v -A Y , ,( _________A Y ��_ -_! — ,.__ _ _ _ _ _ =-_=F - (1 oral i _ t c F _._ - r-='----_ DOIdorPRoct iD u1174 ffArtiaG fog( 9 E UNTIL NE OF 4412V41117/4 FOUNDATION LOCATION �flooD ��?y/ G /� .. HAS BEEN APPROVED �// PLUMBING �' ` C4-" ALLM UMBING WASTE / ry i WATER LINES NEED Zidia-T �( V C..e TESTING BEFORE COVERING "'"-1 ``a{,�/ ki ��/ /�� / 4 o NE{ry 40-„GE r 0.4 N copper tubing Is Used + aP, s LPzV /�71oN5 .—.`RzGLv �Q� n 5 `. for went distributing PrR911ED AS NOTED �e. W system piping shall be l W ottypes KorLon DarEq 9 BP.t+ �/5 � \ �2z54-1 ar FEE: I/Io.Zt BY: 4, FEE: /n 'l lNOTIFY BUILDING DEPA AT .•� 766-18028 AM TO 4 PM FOR THE ( 0 FOLLOWING INSPECTIONS: �y 1. FOUNDATION - TWO REQUIRED PLUMBER CERTIFICATION OCCUPANCY OR FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATIONI a :� ON LEAD CONTENT BEFORE USE _ «. . * CERTIFICATE OF OCCUPANCY USE IS UNLAWFUL 4. FINAL - CONSTRUCTION MUST o ,}fA '.,; BE COMPLETE FOR C.O. 'a ' '_ SOLDER USED IN WATER WITHOUT CERTIFICATE ALL CONSTRUCTION SHALL MEET 1, �y ' THE REQUIREMENTS OF THE N.Y. Plume 4 �-(P400 • . Mares RiOad SUPPLY SYSTEM CANNOT STATE CONSTRUCTION 8 ENERGY EXCEED-2/10 of 1% LEAP. OF OCCUPANCY CODES, NOT RESPONSIBLE FOR C F;E..F1�PORT,N.Y. 1 (4-14' • - • DESIGN OR CONSTRUCTION ERRORS +y,-y- ihL"/ft: VE eIFYAI.c, iJip1ENN SioS�.._.•'.....--_W�7193 COe Luc ' G UNDERWRITERS CERI'IAC111E u 2___ 5 Srw REQUIRED {1'.: _floNT EKvAto,- L -_._ _/scoA_____ r-_-`,-,4,_I_a'� ___1-A!q •. . 4 ,4'`"'" ) X898 31 t yp?,,m7c 31, p/ "� 1 // X50 1.1 . _ _ -- 32-1 I �.+ . - , _- ......... 1 I r-- -.4in r__ 1 , SISIIIVeati. S. 1 j — L . I ? I I ! � i 1. f I I 1 I 11 ii fr-ri f.lr.rte kIaVb - 1 ii mac__-� _ ____ .. 1 __ _ _ __ __ _ __ _. "_ _ _ __ __ I .- I 1 _ o-- --._ — ___—_ — _ __— , Re.T..,N._ � -. i .,."..„ .4, 4I . u,_„cP.r_1.s . I , ib/.W PS�O EK. N. yO S4. of TLT'1\ "-- _�.— v /- i 1 L—_ S' 6' r �' S lig J4 4 if" 4e z ' T� / G-,`/ T L_ 1:_=± ~ /' ,•� �'� oa,e+l tam= { (h�, .. .u�7 #Lry w3r1C __ _ _,__� --. _ . .____ 9032 NPS' �"� � rP)k �',yh pe,• ,,.., j'Z ,� SIO I { -p ? };; ) 1 - i ; FNPOR'C. 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