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HomeMy WebLinkAbout21587-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 5-22904 Date MARCH 16, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 2229 INDIAN NECK LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 5 Lot 11.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 1993 pursuant to which Building Permit No. 21587-8 dated AUGUST 12, 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 GARAGE, OPEN PORCHES & DECK AS APPLIED FOR. The certificate is issued to MATTHEW & JOSEPHINE McKIERNAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-54-MARCH 15, 1994 UNDERWRITERS CERTIFICATE NO. N-303108 - JANUARY 25, 1994 PLUMBERS CERTIFICATION DATED JAN. 6, 1994 - PECONIC PLUMBING & HEATING i 'a~ lje~6 'odi g 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) N2 21587 Z Date 1../..~ 19..3. Permission Is herb granted to: ~j G1Le...~~~ /'4~r~i~l* 'd- -4V- ...!4..44- W/zelA $y ..............r.`1- ~r9./............ to. /r. C{r...... r1~..1.L. V.(.......4"./ `:'F. !!k:t.S!.....!iP.."az'••••Q! ..~~G c'J....C.,.c......... . / . at premises located at.....`~. Kr~r3.... 4" w ~.?A17. d ...445..4d,4*4y / . ! ~G~..................................................... County Tax Map No, 1000 Section .......Rl% Block......: Lot No. pursuant to application dated..G/2 19- and approved by the Building Inspector. Fee .7..4......ao . .~.4r~ wilding Inspector Rev. 6130180 a Form No. 6 TI /7' Yo,23 ' TOWN OF SOUTHOLD C ~BUILDING DEPARTMENT 6 ~X? { 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. A. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and " unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in.writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ate New Construction.... D p Old Or Pre-existing Building........... Location of Property./.ri?,gT,..~oKc~ ,4 House No. Street Hamlet Onwer or Owners of Property. ~4 ~l...41V c/1 le/ !4/ e. /-1 County Tax Map No 1000, Section... 6....... Block..,~ . ..........Lot../Z. A i Subdivision. Gerar.q6~_. .QCJL4 4,J .......Riled Map............ Lo[t.....~.........~.1../..... Permit No.. ~5.`.~. 7, Dat , Of Permit. ~1. ...Applicant ~~fTeY! ?.co ~(s• r. P[. (l/.PJ N/ 8!~~1Q? `~3~9.~.. (v!3/o8 Health Dept. Approval........../.. ..............Underwriters Approval Planning Board Approval ft,,(.Yl Request for: Temporary Certificate........... Final Certicate...... Fee Submitted: $ (m,q)S74 ' .'r" f: nerT.I" cax~ C, 0 ~3:) q o U cwFFULA TEL. 765-1802 ~O 'A TOWN OF SOUTI1OLD l.1 < OFFICE OF BUILDtidC iNSPtCTOR P.O.BOX 1179 TOWN HALL - SOUTHOL)7, N.Y. 11971 C E R T I I I C A T -I O N. bate CL C__ ' Building Permit No. 1427 Owner~~jP4} jflaseh(7l+y~f, lt.'~~'~1~.?'IJf~dU - (p ea e print) Plur•be /0 r n, / (please print) I certify that the solder used in the water supply system contains less than 2/10 of I%-lead. tuber" signature), sworn to before me this -C2-day ofd. 19-:3-Z/', Notary Public t10tar7 Public, v, County r terry P ~pof Now ork No.01ST4844M Cuall* M SUHA Casty commission Erpins SW, 30.19 f ~ . i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date Jr". tIUAE'i .5,1994 Application No. on file F15&5- I. .1 '4 T HIS CERTIFIES THAT only the electrical equipment m described below and introduced by the applicant named on the above application number in the premises of MATTHEW MrKERNAN, INDIAN ti CE LANE, PECONICI 11.Y. in thefollowing location. 7J Baserneot El Ist Fl. D 2nd F1. "AF./OUT Section Hkek5 Lot 11.5 was examined on J AN U AF. Y 1 E , 19 9 4 and found to be in compliance with the National Electri cat Code. FIXTURE FIXTURES RANGES COOKING DECKS 11 OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES w.."DESCENi FLUORESCENT OTHER MIT K. W. AMT. K.W AM1 K.W "I K.W AMT. H. P.. 45 4. 83 1 45 I 1 1-.7 1.4 L P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MUITI-0UTLET DIMMERS v SYSTEMS D AMT. K. W. On H. P. GAS HP. AMt. N0 A. w.0. AMi. WP. WT. "Ps. TRANS. WT. N P NO. OF FEET AN'i. WAiiS R 1 P 313 1 yOG; SERVICE DISCONNECT NO.OF S E R V 1 C E METER No of coryD. A. w c. A. W.G. A. W. G. AMT. AMP. Toe EQUIP. 1,9 t 10 3W 30]W 3,1 AW PER! OF CC.COND NLIFG OF HI LEG ~'a NEUTRALS OF ryEUTMI D 1 200 1 CE 1 c 1 2'0 _ P OTHER APPARATUS: D e MOTORS: a-F H.F. e PA.NELFOARDE:1-1 CIR. 50 G.F.C.I:-15 SMOKE DETECTOR:-2 D n P D D D R D JIM SAGE ELEC. ItiC. LIC.P,3E?5E 350 MARIIIE PLACE GOMAL MANAGER R GP.EENFORT, NY, 11944 4 0 Per P V 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. u D I;:SP~CTiU,J JJDATE OaKMENT3 i r FOUNDATION (1st) / l C FOUNDATION (2nd) ? 2. ROUGH FRAME & of PLUMBING c L 3. ~ INSULATION PER N. Y. STATE ENERGY e~v CODE 3 ` 4. z ~~i• eL~ l FI14AL ~LL~Yi /hit ITIONAL COMMENT o..-_`• a / O o i V 3 2- 710 C ~f 70 1 I Z 2 I m A • r H m ro H ~l 765-1802 BUILDING DEPT. INSPECTION GH PLBG. [ I FOUNDATION 1ST /FINAL FOUNt1AT1ON 2ND LATiON FRAMING REMARKS: DATE INSPECTOR 77r M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLB [ ] FOUNDATION 2ND [ ] IN TION [ ] FRAMING [ FINAL REMARKS: C XC D/IQ~rr~t A41 afl 57 2 l~/rP.6~3 s 1aAS~ihE•~7~ a-te -Ou r ~ SQL T/ iv 0,,m A v DATE o2 1 SPECTOR 65-1802 - BUILDING DEPT INSPECTION PLBG. [ ] FOUNDATION 1ST [ ] RZUTION [ J FOUNDATION 2ND [ ] I [ 7 FRAMING [/FINAL REMARKS: o~~ 4~~ iiLie..- ~~f - ~,~vra-cam 1-2 DATE INSPECTOR ST 7 785-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL REMARKS: &e575 r ' DATE / INSPW 7GS-1802 BUILDING DEPT. [INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [INSULATION [v~'FRAMING FINAL REMARKS: a 9L 0&,) s DATE 0A0 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ I FOUNDATION 1ST [MR UGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ /FRAMING [ ] FINAL REMARKS: I DATE INSPECTOR a is? M-1802 BUILDING DEPT. INSPECTION [ I FOUNDATION 1ST [ J ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ I FINAL REMARKS: DATE INSPECTOR L . o - fAj . / ENERGY CODE CALCULATIONS (For Non-Electric }feat) Design Criteria 6,000 Degree Days 1 1 O.A. 1100F I.A. 70 FOR: G i ` / c k/t{ h C k PER: G~ 0'//4 DATED: / Pt /tT - - DESIGN THERMEL SUBSYSTEM AREA Pluto RATING REMARKS Exterior Walls (opaque) L 5 6 O t t Glazing 2 % 31 -70 , t~sN y ~c Doors °J 0 - Ceiling/Roof (Opaque) Skylights 8 Floor Foundation Walls Slab Insulation TOTAL 6) Notes: Building Envelope Systems to meet requirements of 7815.2 HVAC Equipement to meet requirements of 7815.11 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, S~'a OENE~ TO9f belief, & professional judgement, these plans are in tr compliance with the code. F~ 03I2S~1 ~~~FesstioN~'~' r TRUSTEES pgpfF01,rc SUPERVISOR John M. Bredemeyer, III, President SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President s Henry P. Smith C4 Town Hall John B. Tuthill %~-o ++zi 53095 Main Road William G. Albertson EO. Box 1179 Telephone (516) 765-1892 ~Ol # dap Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 2, 1993 Matthew McKiernan P.O. Box 1637 Southold, NY 11971 RE: SCTM #1000-86-5-11.5 Dear Mr. McKiernan: The following action was taken by the Southold Town Board of Trustees on Thursday, July 29, 1993: RESOLVED that the Southold Town Board of Trustees issues a negative declaration and gives permission to start construction prior to final approval as per survey dated June 18, 1993. If you have any questions, please do not hesitate to contact this office. Ver truly yours, /l~ ohn M. Bredemeyer, III President, Board of Trustees D JMB:jmd cc: Planning Board Bldg. Dept..; F,: c a TRUSTEES ~gUfFD(,~ C SUPERVISOR John M. Bredemeyer, III, President p~ 00 SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President =3 y~ Henry P. Smith y .e Town Hall John B. Tuthill 53095 Main Road William G. Albertson P.O. Box 1179 Telephone (516) 765-1892 Ol Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 1000-86-5-11.5 Chapt. 97 - Wetlands NAME: Matthew McKiernan Chapt. 37 - Coastal Erosion DATE: August 2, 1993 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead Agency for the action described below, has determined that the project will not have a significant effect on the environment. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. A planting survey shall be submitted prior to final approval. TYPE OF ACTION: Type I DESCRIPTION OF ACTION: to construct a 1 1/2 story residence. All material will be re-distributed on property to establish proper grade. Construct a 4' X 50' catwalk 3' over marshland and install post to secure small boat as per survey dated as amended June 18, 1993. LOCATION:SCTM #1000-86-5-11.5 REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board of Trustees. 2. An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. cc: CAC Planning Board Bldg. Dept. i York State Department of Environmentai Conservation ,siding 4`0 5 S ~1o11StPy~~rook, New York 11790-2356 Thomas C. rling Commissioner 3/7 Date: 7/ Re: Dear Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: x--.-e ftzvv- , 1e" el-n 411_31~r- 7_A- Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is-your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Deputy Regional Permit Administrator cc: t TRUSTEES FFOZ f John M. Bredemever. 111, President SUPERVISOR Alhcn J. Krupski, Jr., Vice President a SCOTT L. HARRIS Hcnrv P. Smith ~s John B. Tuthill . ~ ~ Town Hall '.William G. Albertson '53095 Main Road .•,o P.O. Box 1179 z Telephone (516) 765-1892 Fa x (516) 765- 1823 Southold, New York 1197 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 24, 1993 Matthew Me Kiernan P.O. Box 1637 Southold, NY 11971 Re: scTM # 1000-86-5-115 Dear Mr. Me Kiernan, The following action was taken by the Board of Trustees at their regular meeting of June 24, 1993: RESOLVED that the Southold Town Board of Trustees approved the request for a waiver to clear property prior to final approvals. Located Kielbasa Alley, Peconic. If you have any questions, please call our office. Very truly yours, 14John M. Bredemeyer, III President, Board of Trustees JMB:djh TRUSTEES ~~gUfFO(,~-c SUPERVISOR John M. Bredemeyer, III, President SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President y1 Henry P. Smith y = Town Hall John B. Tuthill • 53095 Main Road William G. Albertson ! P.O. Box 1179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 30, 1993 L2 n 6 Matthew Mc Kiernan P.O. Box 1637 SEP 1N Southold NY 11971 eL 1~~. c~cr° r• _ s Re: SCTM #86-5-11.5 TO NdIOFSOUTtiOLD~M Dear Mr. Mc Kiernan, The following action was taken by the Board of Town Trustees during its regular meeting held on August 26, 1993 regarding the above matter: WHEREAS, Matthew Mc Kiernan applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 21, 1993 and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a public hearing was held by the Town Trustees with respect to said application on Thursday, August 26, 1993 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED that the Board of Trustees approves the application of Matthew Mc Kiernan to construct a 1 1/2 story residence. All material will be redistributed on property to establish proper grade. Construct a 4' X 50' catwalk 3' over marshland and install post to secure small boat, as.per survey dated June 18, 1993. Located ROW off Indian Neck LA.ne, Peconic. Permit will expire two years from the date it is sighed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: Fees: 40 foot of catwalk @ $2.00 per foot = $80.00 Due Very truly yours, John M. Bredemeyer III President, Board of Trustees JMB/djh cc. Building Dept. CAC °'L f i ~ ` ~ 9 ~ ~ ? r,:.1 ~ 3 ~ ~ Q.. `M ~ , . iY 1 "t° . 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THIS INDENTURE, made the 22nd day of June , nineteen hundred and ninety BETWEEN RICHMOND CREEK PINES CORP., a domestic New York corporation, with offices c/o John Doxsee, 388 Cedar Avenue, PO Box 388, Islip, New York party of the first part, and MATTHEW MCKIERNAN and JOSEPHINE MCKIERNAN, husband and wife, both residing at PO'Box 1637, Southold, New York party of the second part, WITNESSETH, that the party of the first part, in consideration of Ten ($10.00) I lawful money of the United States, and other good and valuable consideratio. by the party of the second part, does hereby grant and release unto the party of the second part, the heirs cessors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situat and being> W"x at Peconic, Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the northerly line of a 15 foot right of way where said northerly line of said right of way intersec the easterly line of Indian Neck Lane, and from said point running in ah easterly direction 643.95 feet to lands now or formerly of G. Duchow; MX 'XMM: RUNNING THENCE along said lands now or formerly of G. Duchow ~K 396.80 feet to lands now or formerly of Pontino; XX-X District RUNNING THENCE along lands now or-formerly of Pontino South' 1000 21 degrees 29 minutes 20 seconds East, 240.0 feet to the true Section point or place of BEGINNING. 086.00 RUNNING THENCE from said point of beginning South 72 degrees Block 29 minutes 20 seconds East, 300.00-feet, more or less, to 05.00 the ordinary high water mark of Richmond Creek; Lot RUNNING THENCE along said ordinary high water mark of Richmoz 011.005 Creek the following two tie line courses and distances: 1. South 26 degrees 07 minutes 10 seconds West, 125.05 feet 2. South 44 degrees 06 minutes 00 seconds West, 154.61 feet to lands now or formerly of Pontino; RUNNING THENCE along said lands now or formerly of Pontino North 21 degrees 29 minutes 20 seconds West, 337.0 feet to the true point or place of BEGINNING. TOGETHER with an easement 25 feet in width as shown on a cer map made by Roderick Van Tuyl dated June 26, 1973, and last amended December 30, 1980, which map was filed by the Planii Board of the Town of Southold under date of April 7, 1981, which easement extends across other land now or formerly Ger Duchow as shown as Lot No. 1 on subdivision map annexed her: and further, together with an easement 15 feet in width frt the northwest corner of premises owned by Gertrude Duchow to Indian Neck Lane. THIS CONVEYANCE is made in the ordinary course of business of Richmond Creek Pines Corp. and does not consist of subst all of the assets of the corporation. ~,7~17 BOARD OF HEALTH FORM NO.1 3 SETS 0 11 S Z f TOWN OF SOUTHOLD SURVEY 1993 , BUILDING DEPARTMENT CIIECR • • aaY_ SEP IC FORM.. 1 TOWN HALL hDG. Ck-rJ~Fc TOWN LF SUJ1 OtD SOUTHOLD, N.Y. 11971 TEL.: 766,1802 t:OT I F g CALL N.)7.: y~~ d . Examine , , • . , , 19~? MA i L TO : ~C . Permit No. ...~z2/.~7o . Approved . . . . . . 1 W Disapproved a/c . 74 (B ding IrT ector) APPLICATION FOR BUILDING PERMIT Date . t" . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspe( 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 pt or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part o 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. 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, n regulati admit authorized inspectors on premises and in building for necessary insp - ns. (Signature of applil me, if a corpo (Mailing address of applican) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ~~/IcJL-lJ Name of owner of premises P a (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. , S ?.S'lnn . Plumber's License No. C Electrician's License No. C. Other Trade's License No. . SN.~. to 1. Location of land on which proposed work will be done. Pl x)1)7-' House Number Street Hamlet County Tax Map No. 1000 Section Block . , Lot. ../elf~:5 Subdivision ...10.~.r.! v-c1.clt~... vErK.QW Filed Map No . Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vezn- '0 T ..k+. C~lJC . b. Intended use and occupancy X.1~~t°... 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Descriptio 4. Estimated Cost .7./ ; O d Fee . (to be paid on filing this application);' 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, n:mberofcars ....ea2 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front .,~-?A?...... Rear Depth Height ...Number ofStories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories . 8. Dimensions of en#ire new construction: Front S'11 ~ Rear ....-S"~..J'... Depth Height ...C~V Num~er of Stories I ~.x 9. Size of lot: Front 3 3 7 Rear o? 7 ! * . ep th UU h~ . 10. Date of Purchase ..G............... Name ofFormer Owner XjC.h.Itta,A).d.l:~Nrt..~~4 kl 1. Zone or use district in which premises are situated .12. Does proposed construction violate any zoning law, ordinance or regulation: ...4.0 13. Will lot be regraded ....V&5..... Will exams fill be removed om remises: Yes C 14. Name of Owner of premises ~sT!~.e.r15 t'!! 4 I. . Address (k Qtr.!a ~'~oc ~lPhone No.447.7. r.IW3? . . Name of Architect .....:?'t'.~ ~ Address Phone No...... , Name of Contractor ?rl Address Phone No.............. . 15. Is this property within 300 feet of a tidal wetland? *yes... No......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner Iot. Pr 1 u Te)>r+ d lc~ /Nj Av /Uec11 STATE OF NEW YORK, COUNTY OF.. . . . ..........//5.S Ak9. -Irrh. kl „l e (I C.V being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ He is the C,. W J ~ tr J C o ? ri 69.. 7d (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 ...........day of.. Y 14 . Notary Public,-.tl..... County JOYCE M. W0.KINS . Notary Public. State of New York No. 4962246, Suffolk Coun (S;n+..__ r J J W uj Z U. _ Q +r N 3~ U J O Jtm mgg O N. 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I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY,.; i •1 tubuwis used I 1copw no atLypM~ a lm . . 1 1 1 DO NOT PROCEED u7 rT4 FAMM G- PLUMBER CER' UMBER CERTIFICAT/ON ONTM- 8-.11RVEY OF ON LEAD CONTI LEAD CONTENT BEFORE F~~A'A770N HAS BEEN APPROVED j CERTIFICATE OF 71FICATE OF OCCUPANCY d SOLDER USEL OLDER USED IN WATER SUPPLY SeY~STE 9PPLY SYSTEM CANNOT ,1 EXCEED 2/10 4 CEED2H0OF1%LEAD. yp~~~ ML e~une MLVAWI~M , i1 ToneoeronE ~NYMEII ~tlfEf NEED WMIOWMCOVER NQ 1 ~,IF OE NE PO ,y,~ w WNWMM I' _ FESSIOHP~'~ 17 ~ IIII 7~'3 { t F II z ii A - No i ~Jj TT...."'?_ M¢, ii.~~ n.#^' ,pis. F~.q. - r s. i ZI1F i 41 z'A" e. ~ IT r I t~~"~rlc r~~~~ ( g rMi i ixy r r 'T, f~YP, 46- i ILI _ ,U ~l t t(a VENJ'T ry',~ \ c) bl F, Z, 1 i` 1. '1 1~ ./JOIE. F4 LL.''3''~ 's MEnC_ Lo, iS Ix Wo 1eNT 6N I :77 7- 1 14 ®-l 4 ~ ai DII n' = ~P D D AS NOTED 87~ DATE.. 'B.P.-N MpiCFY LING DEPAR, " AT 761- 'd 8O2 9 AM' TO 4' PM FOR THE. ROLLOWING, INSFFCTIONIS;', r~ b. 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