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HomeMy WebLinkAbout21668-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24502 Date JULY 16, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 800 WILLOW POINT RD. & 1079 BAY HOME RD. SOUTHOLD,NY House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 40 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 1993 pursuant to which Building Permit No. 21668-Z dated SEPTEMBER 21, 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 GARAGE IN CELLAR, OPEN PORCHES & DECKS AS APPLIED FOR. The certificate is issued to JAMES & CAROL CASSEL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-106-MARCH 12, 1996 UNDERWRITERS CERTIFICATE NO. N-369282 - NOVEMBER 7, 1995 PLUMBERS CERTIFICATION DATED JUNE 16, 1995-PECONIC PLUMBING & HEATING uilding Inspector Rev. 1/81 FORM NO.B 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) N® 21668 Z Date ......9 ` 1 19.V... ermissllis hereby granted to, 3.'....?% ~s . y,~• .tea........ .:...r~7.,3~ at premises located aT../..~1...- ......?1f~..G...........®~~.~~f . Ag- ..c~.. / ..c.,1 County Tax Map No. 1000 Sectlon S!~!~! Block.. . Lot No. pursuant to application dated 19..Y~' and approved by the Building Inspector, u/ 44 ` Fee $•.,lr•.'~.rFrl.~c,t. ~ G~ y/~ ~ ~ ~ C sex ? a / d' uilding Inspector Rev. 6/30/80 GnD~b c1~3(~ti~d'cRkorm No. b V"i ~iA_.. LS ~ A TOOIN OF S UTHOLD BUILDING DEPARTMENT TOWN HALL JUL 1996 § 765-1802 BLD OF SOUTHOLDD gg TOWN BLDG. DEPT. F 7bWN OFSOUTH04D 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: Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. r 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 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 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 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 New Construction......... Old Or Pre-existing Building.......,././....... Location of Property.k®P........ U4L1_0.~V..8OMIL... Qd7f~ House No. Street Hamlet Onwer or Owners of Property... ex "gala..../mn County Tax Map No 1000, Section.... Ul~Jr....Block ..........I .Lot.....:.. Subdivision........ °x .....y.... Filed Map..//4P.5..,l . Lot...,... Permit No., / ~ ....Date Of Permit.. ! ....Applicant.. f4.4-.Gir~ L/ Health Dept. Approval......... ~ ..........Underwriters Approval....../.. IS Planning Board Approval... I.e Request for: Temporary {Certificate Final Certicate........... Fee Submitted: $...°$J.c U Cam 1 7 APPLICANT J J m. Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 j Telephone (516) 765-1802 Southold, New York 11971-;,,.- - 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : A4 6 -9S Building Permit No. °2lb('-g~ Owner: Of Atfe ,4h/O J ALeIS S~L (please print) Plvtr.her: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( rs Sig tune) Sworn to before me this 1,4 day of v 19~~ Afi A TS EFNOOWSIAa-afl1v, Non pthk' State of New Yak Notary Public, County Ne,0iS a Oualllbd in Suffolk u4ioilc CatnlY @®teml®Olan Cxpo:os Sept.30,116- THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE I 1001071 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVF,(MF)ER 07,190 15) Application No. on file 83931194/94 N 3692£32 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in thepremises of JAMN;S CASSEL, WILLOW POINT ROAD END, SOUTHOLD, N.Y. inthefollowinRlocation; IM Basement ?7f Ixt Fl. ® 2nd Fl. 3FL/CATt/ATTIC/OU'.C.Section Block Lot was examined art NOVEMBER 03 , 1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS 11 DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT K, W. AMT. K.W. Am T, K. W. AMT. H P 44 81 83 85 y 1 4.4 1 6,3 1 1,2 5 F UNIT HEATERS MULTI-OUTLET DIMMERS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL SYSTEMS AMT. K. W Olt H. P. GAS H. P. AMT NO. A. W G. AMT AMP AMT. AMPS, TRANS. AMT N P, NO. OF FEET AMT WATTS S 1!' 4 - 10 SERVICE DISCONNECT NO' OF S E R V 1 C E METER No. of cc cor+D AMT. AMP. ttPE EQUIP 1 Z ]W 1 p 3W 3 % 3W 3,e AW pER % OF A. CC. W. . 0. . NO. OF HIAEG AOF. W W G. . NO OF NEUTRAIS A. W. G. OF NEUTRAL COND HI LEG 2 200 CB 1 H 1 410 1 4/0 OTHER APPARATUS: ' PADDLE FANS'-6 WHIRLPOOL BA'fli-1. WELL PUMP-1 MOTOWS:1--5,0 H..P.,.1-4,0 H.P.,1--3.0 H.P.,1-2.5 H.P. ,6-F H.P. MOTORS:1-F H. P. F7. 7. H.F. PANELBOARDS:4-1 CIR, 60 T.F.C.T,:-6 ' SMOKE DF,TECTOR:-4 Continued on Pacfe.2 , GENERAL MANAGER 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGAN 2 ,1.001071 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date N01/m1iER 07 ,1895 Application No. on file 8 9 1194/ 34 N 3tiCi2E 2 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 JAWS CASSEL, VdH1011 POINT ROAD END, SOUTHO',D, N.Y. in thefollowing location; ?9 Basement © lst Fl. ® 2nd F1. 3FL/GAR/ATTIC /OUTgection Block Lot teas examined on NOVM-MER 03 , 1995 and found to be in compliance with the National Electrical Code. , FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K. W WT KW. AMT K W AMT. H. P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W Olt M. P. GAS H. P AMT. NO. A. W G AMT. AMY. AMT. AMVS TRANS. AMT. H. v SYSTEMS NO. OF FEET AMT. WATTS SERVICE DISCONNECT NO. OF S E R V I C E AMT AMP TYPE METER I tW I 3W J.e' 9W 3,e' 4W NO.Of CC COND. A. W G NO OF HIAEG A W. G. NO OF NEUTRALS A. W. G. EQUIP. PER .B' OF CC.COND. OF HI-lEG OF NEUTRAL OTHER APPARATUS: G & S CONTRACTOR LIt:.9#578-E 130X 215 SOUTHOLD, NY, 12979. GENERAL MANAGER 1.1 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. O~~gOFF01/(ea Gyp ~ x Town Hall, 53095 Main Road "p • Fax (516) 765-1823 y~Ol ~aO~ Telephone (516) 765-1802 P. 0. Box New York 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 26, 1996 Mr. & Mrs. James Cassel P.O. Box 190 Patchogue, NY 11772 To Whom This may concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate Occupancy is not on file. (Enclosed)** :/o No Underwriters Certificate on file.. xx The check is not on file. $25.00 L xx No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21668-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. - ALSO NEEDED BEFORE CO CAN BE ISSUED IS AN ELEVATION CERTIFICATE. r. . 1-LD INSPECTION ~JDATE COmmEN7 ~y ` -z ~I~N 7OU14DATION (1st) FOUNDATION (2nd) 2. o~ o 4 ROUGH FRAME & PLUMBING 'Y n, a _ 3. ~ INSULATION PER N. Y. STATE ENERGY n CODE FINAL' ® o DITIOPJA COMMENTS: ~ x 118' ~ ~ ry z [T] \q y N ' r - y y dQ Ht f M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROU LBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR / M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO H PLBG. FOUNDATION 2ND [ INSULATION [ ] FRAMING FINAL RE ARKS: n may=- C.ts DATE 171 INSPE O f kc e M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ LTIROUGH PLBG. [ ) FOUNDATION 2ND [ INSULATION [O-Fff [ ] FINAL REMARKS: i7-,~c~,., 1- 2. DATE INSPECTOR ` popp- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE 9 INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 4 r i DATE4 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: G 6 4 I ` T !Y DATE ~D ~ INSPECTOR SUFFO(,(-earn c~ ym N Town Hall, 53095 Main Road L2 • Fax (516) 765-1823 P. 0. Box 1179 Telephone (516) 765-1802 Southold, New York 11971 Oj JL OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 3, 1996 Mr. & Mrs. James Cassel P.O. Box 190 Patchogue, NY 11772 Re: Building Permit #21668-Z premises: Boo Willow Point Road, Southold Suff. Co. Tax Map #1000-56-5-40 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. W NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-00837/00001-0 September 13, 1993 FACILITY/PROGRAM NUMBER(S) ( E I t EXXPPI RRAATTIION13ATE(996 Under the Envlrormentat conservation Law TYPE OF PERMIT ¦ New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to Operate t a Article 15, Title 5: Protection a 6NYCRR 608! Water Quality 0 Article 27, Title 7; 6NYCRR 360! of Waters certification Solid Waste Management ? Article 15, Title 15: Water 0 Article 17, Titles 7, 8: SPDES 0 Article 27, Title 9; 6NY6RR 373: Supply Hazardous Waste Management 0 Article 19! Air Pollution ? Article 15, Title 15: Water Control 0 Article 34: Coastal Erosion Transport Management 0 Article 23, Title 27t Mined Lend 0 Article 15, Title 15: Long Reclamation 0 Article 36: Floodplain Island Welts Management 0 Article 24! Freshwater Wetlands ? Article 15, Title 27: Wild, 0 Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers 5 Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ? other: PERMIT ISSUED TO TELEPHONE NUMBER Cassel Leasing ADDRESS OF PERMITTEE 233 Private Rd., E. Patchogue, NY 11772 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Roy Hale, En-Consultants, 1329 North Sea Rd., Southampton,NY 11968 (516) 283,-6360 NAME AND ADDRESS OF PROJECT/FACILITY LOCATION OF PROJECT/FACILITY willow Point Road COUNTY TOWN WATERCOURSE MYTH COORDINATES Suffolk Southold DE9QUPTIM CF AJMIZM JbcMITY construct a single family dwelling, deck, driveway, septic system, place fill for grading, and install a 41 x 800 fixed pier. All work shalt be in accordance with the attached NYSDEC approved plans. By acceptance of this permit, the permittee agrees that the permit Is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special Conditions Included as part of this permit. REGIONAL PERMIT ADMINISTRATOR: ADDRESS Robert A. Greene Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE DATE Sepb 14, 1993 Page 1 of 5 ~II,I.IMII~~~~ITECT X12-O1,q Ito- i~ MINI-rs i Q715~"-~ N l-~ ~I~~l~~ ~~u~1 t-N-~ ~4~~?e~~ ~ 5-t'6uk~-t oY") of -rfz - lwT o -r F1~ I~,DDp ~ A-~-- ?v NSA I,K SCAvuu y-- r5S I V~arv L ~UM+ - or ~-~?zl~s ~-''z VAT OYQ s 1-7, L7 i Ili 0 5 I ~aai Mj a ~ bi•~?~ Hai; YJY ~~b ~ ^ ~ ~ ~ o I I R a ~ 2~f _ ~M1; by „`t~_ pN.O%6 m _ \ n a ~'a \ O 2 - / y N a ? / / o rvIr b d ahN i4 ¢ 5 ~ n~ )I .°A rv. w J' y', aa" Na r , as ^ " _ M i ~ 1 b 4y ~'~Oy ba°' nt of ,ry atp~~ IIry: v ~ ~ a O A3{ id`, • Dpi ' w n ~ a ~ • O 9 • y0 r' 'e OC J • e Jlp:s ~ q : go ~ 4, +d A of 'f ,.a J i 4,t hN hN'M1 i, ,i{ r~ ^PF r T , 6q 4 0 q'•1^ ~ Yttt ^ t wN PJ0 6 b°4 a x ~ w^ ~ 5~ r 1 § f .zt ~i+ JC. 1 J < a „a t'PPK 3 MN o 5 ° °a eN N P M1 d.t ~ ta,i ` § a~ ' 3 r ''rMi r VPU{\F'`' _ - O ~ J 4~ { o N N°^d goro u. . .2 Nd s • N• ^ • 6G N• Y N ' r'tM•M'it0 W 4 '^`1e ' N. ~ 1H 3A IIN IYJYri tl4f boll ,Q•Riil.'E) 4' M/ a ~~aa NN yy a y :°qr x'1: yr ~1, Mii \ygMr MC0 \~~.~x, bYs l.aQ r t rv"N \''~M1T.1 ~tl Dean COtn ajrA°Vl ...wwwwww ~p,~ .~4'4/fi/f .J: /l .~r//. Y f ~lY t • Y~ y,.yer en ? L gr' Kra ~0 V! n „nV.w VFW_ 7.14 FI` r i ^+p^rv'~iT,:;'"r•T?"~°: ~ 1W +M ~~t". y 1 - _ - 'v! Board Of Southold' Town Trustees SOUTHOLD, NEW YORK ie { August 3, 1993 E` ,r7 I PERMIT NO. 4218 DATE: i, P Ca ISSUED TO James & „ Carol Cassel ~ s, a III„r; ~ Pursuant to the provisions of Chapter 615 of the Laws of ~ ' 1893; and Chapter 404 of the Laws of the k~ - 7i the State of New York, State of New York 1452; and the Southold Town Ordinance en- !l, titled "REGULATING AND THE PLACING OF OBSTRUCTIONS 4< ;d IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL DF SAND, GRAVEL OR OTHER MATERIALS FROM fX LANDS UNDER TOWN WATERS;" and in accordance with the l Resolution of The Board adopted at a meeting held on April 29. 19 93 and in consideration of the sum of $ 150.00 paid by 117\~ ` \ James. Caro. Cassel ' N. Y. and subject to the l of Southold.... P" Terms and Conditions listed on the reverse side hereof, 1 , s~ of Southold Town Trustees authorizes and permits the following: • ociated to construct a single family dwelling, ass sanitary syst~ gravel drive, decking, to truck in approx. 750 c.y• of 1., clean fill for grading and sanitary system, permanent natural. buffer zone shall also be maintained all in accordance with R a all in accordance with the detailed specifications as presented in the originating application. plans dated as received July 27, 1993. IN WITNESS WHEREOF The said Board of Trustees here- if f,,~ , • • by causes its Corporate Seal to affixed, and these presents to Board f is date. be subscribed by a majorit~Id L I ~ Trustee Ain "101 A •~d / O~B~p~Ty _ ~ v' S:i(=: f w b Om , A~ , C r r ~p 00 10 !a I c/.4e ii i . F ! -QQ ~ M^ r 'p Y Y 1 y • 441940 a off, ~~i~.:""' q5 ' m\•~. Z~ R o- Psis " ` " 's~ f` - q " U m I Tai O Z V~ Y m ItgA~~ N P X. ~ i1 1 TS ~'4 A' a - C:f I -A fit. 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AN,~a7 (Builg In ctor) E7~ F, APPLICATION FOR BUILDING PERMIT AA-~. Date-4. 1. . I 19Ak, INSTRUCTIONS lllv/// a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 scis of plans, accurate plot plan to scale. Fee according to schedule. r b. Plot plan showing location o~ lot and of buildings on premises, relationship to adjoining premises or public stieets 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. 0. No building shall be occupies} 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, i spections. . ' / (Signature of applicant, or name, if a corporation) d~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ Name of owner of premises 4 i, % e p-a hi2 (as on tl tax roll orHatest deed) If applicant is a corporation, signature of dulyyuthorized officer. 04,4 - (Name and title of corporate officer) Builder's License No. Plumber's License No.~ Electrician's License No. ' . ° "~l er Trade's License / 1a-GaLC~ Gl/~ e Qe u/ / Z p rC_ l~~a 1. LoOcation of land on which proposed work will be done .Gr! . . . . . - a ~,J . ~ ~ . . House Number Street Hamlet County Tax Map No. 1000 Section ....u`.-1`^.6....... Block ......7 Lot .......a Subdivision . . Filed Map No. . ~a tea/ Lot ...`f s) (Dame) 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 • . • • . . V-3 Nature of work (check which applicable): New Building Addition Alteration air Removal Demolition Other Work . (Description) Estimated Cost as1e"-49©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, number of cars , VA 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use . r//r/ 7. Dimensions of existing structures, if any: Front . • ' ' . • ' ' • • • • Hei ht Rear Depth /V d' g ht • • • Number of Stories " 14 Dimensions of same structure with alterations or additions: Front Depth .......................Hei Rear................. tpµ/ • • • Number of Stories . 8. Dimensions of entireie construction: Frotat R. . . . Height ~ ; Rear ~J~ Depth 49"fj . ~ `tf Number of Stories . 9. Size of lot: Front Ile Rear ,3P.'............ Depth S.~.f-..1.79 . 10. Date of Purchase 7-,,/. , , , , , , • • , , • • . Name of Former Owner o C 11. Zone or use district in which premises are situated ....44's (r)fet Cq • • • L, ~V a, 12. Does proposed construction violate any zoning law, ordinance or regulation: . tv~ 13. Will lot be regraded 3'1FYf• ' ' ' ' • . S • • • • • • • • • • • Will excess fill be removed from gemi;_e~s: Pa ' s i ayL 14. Name of Owner of Premises o v~ /~dQ p.4.p ucr ` Yes No C*_1xe,/. •{y41 cl,',,(eACAAddress N........ Phone o. 7S•'^SS!Od Name of Architect lf/)1//A n..fyC/A' /A . • • , • • • • Address SPX < v~1e~i~ Phone No. A'7. `/.-Y•~DrJ Name of Contractor Address 15. Is this property within 300 feet of a tidal wetland? *Yes at¢a No........ • o....~..°6P`s-c:,~sel *If Yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM SeTM # /ao d - SF -S-_~• 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. Gam- - ~ y~ ~ - . . Zz~ STATE OF NEW YgRK S.S COUNTY OF • ' ' . ' • ' ' ' ' ' ...6. c • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ?..!L C~G~Z LpY~, e . r...... D% . 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 knowledge and belief; and that the York will be performed in the manner set forth in the application filed therewith. ;wom to before me t 's PP - `3rcQ 4 `3 • Hof ROBERT 1. SCOTT, JR. ' ' ' ' ' ' ' . . . 19 3 NOTARY PUBLIC, State of KY. lotary Public . 4725089, Suffolk Cou • • County Expires May 31,19 , %3ARIIA12ACU " " Notary Public, St,; . o~ r"ev, (Signature of applicant) No. 52-941305( ul'"iulit <'Q: Texz~BX sP,4orch;7b,Si(Sys . ~ •r \ SUFFOLK CO. HEALTH DEPT. APPROVAL S MAP O ^ WILL01N r-oi r H S NO. SUF"F CC) MAF N0.4652 \ • \ 26; I1,04;,\ CAL)CL ~A~~ STATEMENT OF INTENT Ado 3 ' c q~~ THE WATER SUPPLY AND SEWAGE DISPOSAL A~~ ar?• A~La?tA><.~ r \ A; SYSTEMS FOR THIS RESIDENCE WILL LU•. y r CQNFORM TO THE STANDARDS OF THE rN~ 6Lcr-tCt'G ~A~ JYC: j \ i SUFFOLK CO. DEPT OF HEALTH SERVICES. IG4 oPa 3 `jam c. ` \ - APPLICANT I lob. r t 1 SUFFOLK COUNTY DEPT OF HEALTH R~ 4./fir _ 5TONE/62AVEL .'Tio , 414- aRrWALLs -I. D2WE SERVICES - FOR APPROVAL OF T T Y r 41011{ rev l coNr o r-i-)``?~'?1 \ CONS ilt to d~ T o¢rvn 4 yly .I 4~Q i i! - DATE: PAO 1 _ - - CONN. --'PU eLIG- w I H. S. REF. NO_ Q C-1LL CJT. SOO c'u.VU. OLO LESTNOlE ROV 1.11 1af!kQNY F/ouSE : y 00 ~a SUFFOLK CO. TA MAP DESIGNATION: PG1 DIST. SECT. BLOCK PGL. CLAY ICYX?6 S 40 V OWNERS ADDRESS: I T= m3(w2a l$_ PU c v91t}~iW ti N I -33 PlZIVATE WAD -9 1 / EAST PATCH0C7UF NCY I I'i ~q .A QEVI5EG T'TAL WETLNJG LL'iF_ -_---(S6 -J 4 -STA&_tSHEL ESY N1'SOEC AIaD / TEL_. 284=935f q \ ~r EN-:ANSL.IL7MIT_- JULY 14 , 1993. * 4~ GE_SSfX~OI_ DEED: L.69 IQ P.Z22 REP 6 r v gj t bA A4: EA 26,000 (507, N; TEST HOLE A w OlP d ' ~~'J ,1~1t~ i `v t ~ = 5 TAi`.IK I btfa.~wwrizea j-afamon 1 1.! 1. T - DQ WELL, W fMabnrr Ic...cso" ` ~eOwhi EauoolbnL Ct. q' E'r _JAM t tK ills ...:>y man rot be" W _ r,, Nt:O'wL1 bltl wnayc*wsaw a E A, LE\ EW VD. ano ahtl M LOAMY CLAY OffhOnOd 3" dW r:mwwkaftion rot be cwmMwW f«n11aIM suvy PQ. IS:Lz N !=i_~~~ 7..ONL: A i CLAY 4 020µ1C+ oftlNgbo - AN. 1-7 Iy93lo; nntsae not wamo Olt?• ~ 2 0G~ J 4 FL. I&.0 • r~• A('r'.:",'9B•o,FE13I0, Ia88;NOV.5,t992;FECi.25 1993; `HATER lt; «aa.alw ` ' OUTIIOL-U SAY MAIZ 5, 1993;_JUfIE 25, 1~3;JULY lGr 1993; AUG..3i1993 Bk7Wv :LAY SEAL li S R p Lo~ ~ FIN. 6tL. _ 10.9 -of- ygly /O y- l - 9 c oY s R9 fi A 'sll R t AUG 13 1993 n L fC~' Yk NCV 22 i wArE 471 BI owTll a 1 - 4h' 4' 4 T acs - RqpE11R~~ CK VAfLWYL, P.C PALE 55 POOL (5) 2' WATERPQOOF lC.. ~C ! -,~-••..?t• P't I N.LB» A NG PLAN f TANK - - T 2ET. WALL _ I2 S.C. DEPT. OF II _o~.c: e Attol~ uwo GROUND wATC-2 - - 2.0 NEpLTH SERVICES LICENSED LAND SUR'V YORS L~i $'1 y`r+ - - - - - - - - - - - - - - - - I•'--- Id ----'I - - -oA- - WEENPORT NEW YORK I VAUDYI* po Netzav Owl- it owl Y { hd. htl w ~Fa, i cam' i < { - FJ ,._-___`_'_71ll1tic' xa `j - C) i0 i ;4 V9i 1-79 TM lz om J _ [ L. e' IT lYf'. I•i)ji )i 31~ii - •F7jii(__), f p ~ 1 , 'r` F~ r7,~_ I,~,q wora I ~ u tw~ t~ r cl< lfn'1' ~1~ tin, w ~1,~fi~~ 1 ; ^ i,^"\. G;L~ (i3 1=r f ~'~i ~ C!•' ,gqi F~ ~ ' 1 _ Iwr J r" y SO §.l r° s o w o . ~hilc m'ra n tP r - - ~d~ r ;y~ n 1 !1 N ~N n C7 x cv C D.;p m g r n c~ O o D 2 O n v) w- - w n{ -i m k v D O m c, c p I -A m p A m i< p in Om Om m f m Ul m < M A- r r > O n; a s^ t` n , f, p D. Or- o m D 3 m r <i r _ r pr._ v- r f~j io p Z n ; s(A z c r m O O j U) n p m r. i_ - - _ 1 Q? l? i n n O r O O cn y n r- I O ^3r < Ow n D ~z S ri Z; U a 01 Z = : d''.o~~ hOFJ O.I r,y ~ma T m Z A m i O m 'n , h s 17 m Z i vN ry1~-:rn uo m~~ e r o D ml n m a D~$, .H Q O Y O m G1 Z D m . v,..0-i mzrD ) i Y r „ 6 I ' 4 I 1 1~ 1 1 r `e r t h ~ Y .S ILn iI3 IIIr.°' 1 III I't,~ 55, -71 ,J r S I~ - Owl I E y, u~ /..butt t': W 'an ) { i- I+ d (4 II 1 Jfto -J, 131 r - L/s Milt, ~OCCUPAN OCCUPANCY OR USE IS UNl - ~i.±, WITHOUTCE6 USE IS UNLAWFUL . , OITHOUT CERTIFICATE OF OCCUPANCY - d OF 000UF 4 I I =b j Ail R EDASI APP i APPR EB AS {VOTED p DATE:' '2/JB.P. 2/ 3e.Rn x/668 i` I FEE: 13`y0.' BY: '.0," ev: DO NOT PROCEED LO i Tl4 F 'lRA M / N G d ~v i'FI NOTIFY BUILDING DEF 6UlLDING DEPART ENT AT UNTIL M SURVEY OF 77- 765-7802 9 AM TO 4 F,r G ? - I - - - - FOLLOWING INSPECTIC ' 1, FOUNDATION - T1 NVING INSPECTIONS: op THE FOUNDATION LOCATION AND L~J8Ti 4 1{f NDATION - Two REQUIRED HAS BEEN APPROVED - t`-~' I+w r' 4^"II I ? n I~I { 2. ROUGHVnFFFAIVISN(i V ri III I~ t .I II i 49 }I 3. INSULATION GH - FKAMINGn& PLUMBING r i )LATION IY+IF T ' I t I 4. FINAL CONS'PR ,L - CONSTRUCTION MUST i j I f I BE COMPLETE FOR I :OMPLETE FOR C.U. +{4 - - - , I ALL CONSTRUCTION INSTRUCTION SHALL MEET THE REQUIREMENTS EQUIREMENTS OF THE N.Y. STATE CONSTRUCTIOI ,LL47 d - CODES. NOT RESP( CONSTRUCTION G ENERGY t NOT RESPONSIBLE FOR DESIGN OR CONSTRU( J OR CONSTRUCTION ERRORS \ j towmmcERINOTE i IIEAIIIIIED --4 I; I I I ~ I kilt I G I f I j ~ I, I ~ I I I I~ ~4 v ~ ~ I I I I i T~~ I :j ..n ~ f I en~ ED Apo 1W'" i I TF_- I Itt.M {Y~1i.~,~,.fr I~~__ 1J, 0203`19 i -Aa t °16 0,0 Wx*-..lc~ (btb} s I' .'jt Vv fo' gj !o'j.~ g 1 . - - R i - _ - it - - - I - I ~ i I i v~Nr~cn- pt~1 ryc I ' ry2ory 3 i I pn^ f, L IM - f ~ D I , ~ rt ,a Iry~1N~ a~ Ind / ? 1 0"" II y - , -AA 41 St . ~ t f to ~'qqq"' P~ ~ -1- q.6 % r x-. ~ I rayb I - ~ I f it f t ~ ~ =a ~ S ' t _r x Now f r p li '1hl Gib? l,c~ q -I-__ k ~I If I i ~Zi _j t t 1 yli~-4I,bll N, ..ii -,~•~II l -4' I duo" c' ~ III III ~q Ali 1~ ~ f I ~ s l _ _ I( -+z ~ ~ ' i ~ r I~ ~ i r I . i i~ I I~ ii ~ I~ I1 I l~ I. I' ~I I ~I I .r f - i i ~ 'q i M., y.. ~ED A) C I~JI~•tr~;,~ ~IN~" ~4~~ ~ ~ m e~ 020399 yQ V`dl GPI i r' ,h 1 i t i I 60 I i I ~ ~ ~rttr~~r~. - - „ i ~W~ I i u ~r ~ (,140 ~aI ~~rivt?F~C~x' Sat!~ I i ~ I i I PpM L!L lyll --t I ~ _ ' . I j Fr hi ~ Oki iii t~• 5~#fJ r W.- ry~ A L- 4 I _ I ' ! I r~ `;'I'mo I~h t tf rl~' I 77 f r i I ' I irY-~ Y~ b~~~ f ~ o s 01~i 1- i. K 'rteq~ ~G~~17M* ONff?b~E=- 1 r~-tl. 'I'II .C~'~~'~ 1.. rQ• w L -f J F +!d I I ~ I I ~ _ _ I ~ I acr l I~`?~n- I I I a O 0 i R I ~y 1:0 -IAI~b OF t i-DN I 1 I ze. CALN E I f i 4n -jTi ~ I ~ I I I Ii it I - _ - -r i P1&Alt L'P rt- I'.Y~ .Li, I T i j yy 1;~~II I N~fr~ Nt1~~ C h la ly µED A;?- 020399 OFN 1d- ,/rip1 c if I I i 17r I = ~„_...T n _ _ z 1 i i 1 1 i - - - - - dN ~fll d,~y 1 'l ! 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VINfL, y° i TV -B EF FT KuMo r ALL fiLJ1ASM YIMSm S VAVM LINES NEED @v~~~,G eNiXl7il{a0Pc, TESTING BEFORE COVERING ` 1 !!N Fiv L^J~}tir.G~/ tI~G,~l~ . 1 j al, r Witr~~ fat'-Irm5 - i o J , N ooppsr tubing Is utsd fur water d iftibuting Mmm: PIPing shall be .I~Irwi of types KK aL PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY d' x` /M14 Y ~ Y F k r~1 r~,x -~w you ucro c Ox !J SOLDER USED IN WATER I ~zut40'1JPH SUPPLYSYSTEM CANNOT IVA" m EXCEED 2110 OF 1% LEAD. C 15- q f - 70 _ 8 4 _T t y; i I U -p t1l - L = LLLJ ~ t 1 tt i^Ik 'IE dew Iia. ft .k,r r IBS z LA E E~ D L E ~ T N 71- ; ED Apo ~AI 1 S f11 '1) 0203@9 O rf sib 1' p G ,l _ FOFNE w r:. ~ i Z~vp fi A' L- - ~ ' a ><S ~I •t; Via- - - a - - - - Ij LIP kz~ OKI 0100 I Li _ 71 c~ VIP, I 71 (s )14" 1 1 a- I ell Ff -1 ~y~if~l ~ G~IU,hJ~ ~v15- 11 TAI ~s 4+1 ilafVS is r m. 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