Loading...
HomeMy WebLinkAbout20551-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22154 Date FEBRUARY 22, 1993 THIS CERTIFIES that the building ADDITION Location of Property 73795 MAIN ROAD GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 45 Block 4 Lot 3.2 Subdivision Filed Map No. Lot No.~ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 10, 1992 pursuant to which Building Permit No. 20551-Z dated APRIL 16, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ANTIQUE WAREHOUSE STRUCTURE AS APPLIED FOR The certificate is issued to MICHAEL & JOY DOMINO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-032689 - DECEMBER 30, 1992 _ PLUMBERS CERTIFICATION DATED N/A ~ Buil inq Inspector Rev. 1/81 FORM NO. a 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) NMI 205512 Date Permission is hereby granted to: ~.1..0.e- G ~,~Q Yu~...... to ..1. a On .....g.: ? : .....u... . s,...... ......................"1 f ~ at premises located at g.. M.41:t-.».... . .:........~.~.,R.P.:~l.,(.~,q`:v! / V IZ3 ....................1.`................................................... + County Tax Map No. 1000 Section Q.LIs..... Block Lot No....3.: - ! pursuant to application dated ....QV LID 193.Y and approved by the 4 Building Inspector. Fee S•~~'4`~:• ~C?.q.. Building Inspector Rev. 6/30/80 Q•7 l Form No. 6 p0-"y'Uj`?A/~/1 s.Y1 .1 - wx TOWN OF SOUTHOLD ° °ix•-u BUILDING DEPARTMENT TOWN HALL FEB 1 91993 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 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 $15.0110, Commercial $15.00 Date :7 . New Construction....!!...... Old Or Pre-existing Building Location of Property.r)y3G3. /nI4/N. CZr .....4rf,"4eW.47e. f House No. Street Hamlet Onwer or Owners of Property,14jrAQ.4./..Y.~zii.•IJ.QrnInU County Tax Map No 1000, Section ...1420A Block y.5/........ Lot. .4/.7. ..Zr......... Subdivision ....................................Filed Map............ Lot.... Permit No.a 0 S $ ..fir ...Date Of Permit Applicante:zr/ 4/- Health Dept. Approval.// .......................Underwriters Approval.4,?1 a44A Gl Planning Board Approval Request for: Temporary Certificate........... Final Certicate...~..... Fee Submitted: GYf!If2Z~dcN . ti,,h CkG, ~~JSfl3 ~YI~X~ r L, 0 olo~ 1.J APPLICANT INSPECTORS Victor Lessard Principal Building Inspector- Curtis Horton 'Ap SCOTT L. HARRIS, Supervisor Senior Building Inspector CZ) v~ r # Southold Town Hall - Thomas Fisher Building Inspector P.O. Box 1179, 53095 Main Road Gary Fish Southold, New York 11971 Fax (516) 765-1823. Building Inspector„ `V Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD FEBRUARY 16, 1993 CRACRERBARREL ANTIQUES MICHAEL s JOY DOMINO 73795 MAIN ROAD GREENPORT, NY 11944 MAILED TO: P. 0. Box 151, SHOREHAM, NY 11786 To Whom This May Concern: We are unable to complete your Certificate of occupancy because of the following reasons: XXX An application for Certificate of occupancy is not on file. (Enclosed) ffi No Underwriters Certificate on file. XXX The check is not on file.) $50.00 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 # 20551-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 91 1. FOUNDATION (1st) Y C A 7OUNDATI011 (2nd) m 7b 7 -2- o ~ :OUCH FRAME & D Qa7 -PLUMBING ~t U~ 11 L my~ 3 , y m INSULATION PER N. Y, m y STATE ENERGY CODE I * T y FI41AL _ c O ADDITION L COMMENTS: x S y 1~ . y W ^v ~ y~ 477-2525 SOUND SHORE EXCAVATING CORP. 477-1870 Located at I10`J 2 1992 SOUND SHORE SERVICE STATION Main Road, P.O. Box 159 East Marion, New York 11939 As of July 1, 1972, a CERTIFICATION for each completed private subsurface sewage disposal system will be required from the contractor or installer prior to the issuance of final approval by this office. This ccrtificat-ion is to be on Company letterhead and shall contain the following information: HEALTII DEPARTMENT REFERENCE NO. 4, / p - -0 / Q NAME OF APPLICANT M IGfja ~L y~ PIIONE , 51 to-12y - 1 _ 0jr ADDRESS u as o•3oxr/ Shoreham Ny~~£t(o PROPERTY LOCATION (include tie distance to nearest cross street) V r1Cat Cro 55 S-f• _ ADOO R G S L 1AX y3GS" MAiN Qd• 6 r- ~el efi" N/ M4LET ~r ran ~o nt ToidNSIiIP C +h SUBDIVISION LOT NUMBER (Oh n Z TYPE OF SYSTEM INSTALLED: Septic Tank (a) Volume '1200 Gallon (b) Type (precast, equivalent, block) Precast Leaching pools: (a) Number and size of pools Three 4' x 8' (b) Type (precast - block) precast I hereby certify that the private subsurface sewage disposal system described above has been installed according to current criteria of the Suffolk County Department of Health. DATE: Nov. 12, 1992 SIGNATURE TITLE pres. PAU5R544 92127003 IIIIII~IVVIIVIIIIII nmLO C'U m N OI L 9 E 0 E m m\ p l(7 I I LO m O to Z O V\ a V O n Q w¢ p 0 w v J a U' w 2 Q U w Fw- S W Q~ d o m Nmooa oO_ Q ~ 3 N N N N ak a o. n a OXD a a C:) U) o N Q to m m IP N m O In N N H O In ¢ W U U N (mrl ¢ H J O O O 4 U O 0) w u V U 0 a l0 O H M H NO O N N co w o v} ~v o ao a n LD 0 3 a ax m m X o S 3 W N N ^ N O D. G O O ~L Qa O o Q p CL ¢ 4O iy J J In X <~°':e oho mu U N co co 0 .,D o w~'' m e a cu u CL i. m a' oz f C o ~p cu Er CD ON h W ¢Z~ 5ff r Fw-~J+ p Z z as ¢ UI- O Q a HW 3m.~°.oS 00 HZ w°H GLLOm~Wo H4 O m adz ¢o n x =w 00 °a N J O tD I Ja O O~ N ^~~fS~o W,~~Jm U) z¢ m Z° w = Ho NNm oLL x, ak qk '7 I ¢ ¢ w Zti Z O~. ww oo ZZ am o w S,av~I= H H W LL] (IJ 1--I o 0 as ¢o M *w wo °°N~ 00000 w ~ WO X ¢m 0000u 0 XX IL NNN Q^ CO I~ J O Z U) O O ¢ DON wN X I I. O. oow ai m to a 0 Q 0 vU ao J¢ H 00000 0 ~0m aw a 0000000000 a F• TOWN OF SOUTHOLD Y. ; ' „~i•'„ ENVIRONMENTAL ASSESSMENT - PART I PROJECT INTFORidATION NOT:C_. Vnis dac=emt is designed to assisQ•tn deter-Tning whether :ae action proposad may have 3 sienificant er ecc in the envircnment• Please cormleta tn-- entire n~ata Sbeec. answers to these °uestions gill be cnnsioe: is oart of the aoolicat:an for aporoval and ,nay be sub4- to furtner vert-icat:on ind public review. Provide any aaaicional information you believe will be neeced to comolete PARTS Z and 3. - is axtec:ad tnat at=l';tion of the EAF will be dependent in information currently available and will not involve new studies, rasear_i or investigation. If tnforatroii' r=_anirinq such additional nark is_unava-;401e, 10 indicate and saecify iaen instance. • RAVE -IF ?40JECT:. wl:-E,AND IoCRESS OF NNER i!f Differ_nt) ' ~n G1l7a~Y~ WPM -1170 •'IANE OF 3Po7_Ir:IT: rjtreecl a 40 T &.a,l %.v ~J.9•; (State), (c:P) -4A/ iV (~'Ct " 3US!4E_5 PHGttE: (Screec: ore llY. ( ca ca) Wp) 0E r.11.1 r, .OF..ecO,;£.': (Srier'ly describe type of project it action) • ?414-j'+.f% rL {~i l~ a re (PLEASc COMPLEIF EACH QUEST:MA - Indicate 3.A. If not ac:;Hcaole) A. Sic ir]bZiPT:Gii "laY';' '.i,:ii:•.'i''•:1C: E e!`•1' « (:hysiLl set:in; of overall project, both deveiocec and :mdeveict d areas) .;fierw•`•',;.i:,:. 1. General oiaractar tf the land: Generaily uni-.arm state eneraily uneven and roiling or irreguia Pr?sant '.and use: Urban , Industrial Cofnerctal ~.Suouraan ;Zu---I*-, Forest Agriculture Other 3. local dcriace of ;roject area: - 4racres: gt; - dtoroxinace acr?age: Presently After Comalat'.on Presently Aftar temole [T 7l',1 d°lveadcw Or 3rusnland + -L5icres . _•_cres (Solar Sur.'aca An.3 _acr?s Aacres -?s Vnve^.etaced '^cx, ~ =aresrd' - . Iti.S _ _Ces fern - earn or fill; C r - -3 ^ ag r'C71 t_RI aCre3 _ reJ LCdCS. aL'I ld."s ;'.ect dnC ~ 'esawdC?.^ Or and t.:9r pdV?a Ql ricai :er arii:las Sur-ic_s + .1tr?s p -5 434 ITnll Q :a, r _,cres _,c-.. ;•ncica- :7ae) '_cres a "n'" ` Gl too A 4. lihd: ii dre:eGl: non! soli t%7e(s) an 7ro;eCt a~ 5. a. Are iecr?cs pu~:.corngs an :njec: Si:_? -2-is 'jjL 1 tear:cx? 0 ;is 'aet) b. %l at is coos ca 6. Approximate percentage of proposed project site with slopes: O-IOt V 0; 10-15: Y; 15: or greater _ 7. Is project conti5caus to or contain a building or site listed on the National Register of Historic Places? Yes No 8. What is the depth to the water table? feet 9. Do hunting or fishing opportunities presently exist in the project area? Yes No 10. Does project site contaiq ar~y~Species of plant or animal life that is identified as threatened or endangered - Yes ~~ao, according to - Identify each species 11. Are there any unf,que or un s land forms on the project site? (I.e. cliffs, dunes, other geological formations - _T es %ell .(Describe 12. areahe project site entiy used.by the community or neighborhood as an open space or recreation - Yo. - Yes 73. Does the presen ite offer or include scenic views or vistas known to be important to the community? 14. Streams within or contiguous to project area: a. Name of stream and name of river to which it is tributary 15. Lakes, Pondss,'detjland areas within or contiguous to project area: a. Name (V# e b. Size (in acres) 16. What is the dominant land use and zoning classification within a 1/4 mile radius of the project (e.g. single famil residential,R-2) and the scale of development (e.g. 2 story). a. PROJECT D-cSCRIPTIOH' 1. Physical dimensigns and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned by project sponsor 6 acres. b. Project acreage developed: .t nacres initially; •33a acres ultimately. • C. Project acreage to remain undeveloped . SD ?y , d. Length of project, In miles: if appropriate) " e. If pro e t is an expansion of existing ndicate percent of expansion proposed: building square fec age i; developed acreage p55 Rri+t f. Humber of off-str--t parking spaces existing proposed. 9. Maximum vehicui,ar trips generated per hour - ,2- upon completion of project) h. If residential;' Humber and type of housing units: Onl'e'FamiIy Two Family Multiple Family Condominium Initial Ultimate I. If: Orientation HeIighbornood-City-Regional Estimated Employment _ Cosrarcial Industrial l J. Total height o tallest proposed structure ~_fI eet. l.. y , . 2. How much natural material (i.e. rock, earth, etc.) will be removed from the site - 7 tons ^ ^ cubic ya 3. How many acres of vegetation (trees, shrubs, grouna covers) will be removed from site - N04'aeres. 4. Will any mature forest ( er 100 years old) or other locally- important vegetation he removed by this project? Yes No 5. Are there any plans for re-vegetation to replace that removed during construction? Yes - Ll~-LNc 6.. If single phase project: Anticipated period of construction 10 months, (including demolition). - 7. If multi-phasgd project: a. Total number of phases anticipated He. • b. Anticipated date of commencement phase l month ___year (includin - demolition) c. Approximate completion data final phase month __year. d. Is phase 1 financially depen nt on subsequent phases? Yes 8. Will blasting occur during construction? Yes No 9. Humber of jobs generated: during construction 3 ; after project is complete 10. Humber of jobs eliminated by this project Yo N e- 11. Will project require relocation of any projects or facilities? Yes ~No. If yes, explain: 12. a. Is surface or subsurface liquid waste disposal involved? Yes ~l"o. b. If yes, indicate type of waste (Sewage, industrial, etc.) e. If surface disposal name of stream into which effluent will be discharged 13. Will surface area of existing lakes, o , streams, bays or other surface :waterways be increased or decreased by proposal? Yes No. - 14. Is project or any portion of project located in the 100 year flood plain? Yes ::~~-_No 15. a. Does project involve disposal of solid waste? Yes .X No pl b. If yes, will an existing solid waste disposal facility be used? Yes No e. If yes, give name: _ location d. I•lill any wastes not go into a sewage disposal system or into a sanitary landfill? r_-Yes 16. Will project use herbicides or pesticides? Yeso 17. Will project routinely produce odors (more than one hour per day)? Yes-~_~No - 18. Will project produce operating noise exceeding the local ambience noise levels? Yes ~No • 19. 'dill project result in an increase in energy use? Yes No. If yes, indicate type(s) 5.4me- G I< c•f'Ki (.dif A**,aA-d -6 r l/ 5lvt% A , 7- 1 20. If water supply is from wells indicate pumping capacity ONQZ~gals/minute. 21. Total anticipatad water usage per day V. Zoning: a. What is dcminant'zoning classification of site? bV s-!Aenc /p(yr/y pp~ b. Current specific zoning classification of site VS i A•e' e, e. Is prepo<_ad use cpnsistant with pre>ant zoning? d. If no, indicata desired zoning ~z oil 0 26. Approvals: a. Ia any Federal permit required? Yes r\~No h. Does project involve State or Federal funding or financing? _Yes ~o c. Local and Regional approvals: Approval Required Submittal Approval (Yes, No) (Type) (Date) (Oats) City, Town, Village Board City,; Town, Village Planning Board _ City. Town, Zoning Board City; County Health Oeaartrent Other total agencies• Otherf regional agencies State Agencies Federal Agencies C. INFORNATIGUAL DETAILS ` • v. Attach any additional information-as may be needed to clarify your project. If there are or may be any adverse impacts associated with the proposal. please discuss such impacts and the measures which can be taken to mitigate or avoid them. PREPARER'S SIMATURO: TITLE: j....... REPEESZNTING: .I. ~/w l .(/?~r/1 DATE: i I i W, I 1 i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8036430 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10,038 Date DECEMBER 30,1992 Application No. on file 79028792192 H 032689 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in thepremises of i- GREENPORT-'ANTIQUE CENTER, 74'36S MAIN, ROAD, 000'-45-4-3.2r,GREENP©R T, N.Y. in thefollowing location- ? Basement ®,Ist Ff. ? 2nd Fl. Section 100%1oeh45-4 Lot 3.2 was examined on DECIEMBER 28,1992 and found to be in compliance with the requirements of this hoard. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W AMT K W. AM} K, W, AMT K W AMT H P 6 21 4 6 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS _ AMT. K. W. OIL H P. GAS H. P AMT. NO. A.W. G. AMT. qMP. qMT AMPS. TRANS. AMT r H. P, NO.ST SYSTEMS FEET AMT. WATTS ..F.,.. Ems......- R.. --V' -SERVK:E"DISCONNECT""' ' NO OP - 1. _ METER AMT. AMP. TYPE EQUIP. I A yW l ,a 3W S,a 3W 3 JF dW NO. OFFECC COND. OF CC. COND NO OF HI-LEG A. W. G. LS A. W G. - NO OF NEUTRA OF HIAEG OF NEUTRAL A OTHER APPARATUS: fp ~ I `QA AMOUNT FEE PAID 'ORDER TO THE ORDER OF THE NEW YORK BOARD OF RES UNDRRWRITERS MICHAEL DOMINO ! AS CASH SENT BY MAIL WILL BE AT i 5 SUFFOLK DOWN PO BX, 151 RISK of FENDER. SHOREHAM, NY, 11784 ~ 15 YOUR BILL FOR SERVICE RENDERED AND IF NOT A'CERXIYR"GATE OPCOMPUANCE. THIS § PAYABUI AT THE NEW YORK OFFICE; 05 JOHN STREET, NEW YORK, N. Y. 10038 i M-1802 BUILDING DEPT. INSPECTION [ I FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL REMARKS: DATE ~ ~ ~ ~ INSPECTOR M-1842 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU (ON [ ] FRAMING INAL REMARKS: ~i?~ ~rl~ d7 DATE INSPECTOR SL4AV T M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [Z-r'FRAMING [ ] FINAL REMARKS: Gds 'ell DATE INSPECT M-1802 BUILDING DEPT. INSPECTION [ ?f'FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: I~ G L~ i ~ E DATE d'~ INSPECTOR F, Ih CARD OF HEALTH 3 SETS OF PLANS ..y . EI FORM NO.1 SURVEY TOWN OFSOUTHOLD CHECK V: BUILDING DEPARTMENT TOWN SEPTIC FORM HALL $OUTHOLD, N. Y. 11971 NOTIFY: _ -73 TEL.: 765.1802 CALL Examined.. 19R~- MAIL TO* Approvcd2l 4. 191 ~ Permit No..°...... . . Disapproved a/c r (Building Inspector $i _ i~t~ l3 ) APR 0 I992 APPLICATION FOR BUILDING PERMIT Date -7.... , 15 90 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 0Y 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 Baild_7g 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 ether applicable Laws, Ordinances or Regulations, for the construction of buildings, additions of alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housinlg code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspect (Signature of appYcant, /or nam//e, ifa corporation) P°. ljdx !S/...14 are. h. cvk,.. Ivy, / / J1p~. . (Mailing address of applicant) Statc whcther applicant is owner, lessee, agent, a-chiteci, engineer, generai contractor, electrician, plumber or builder. t~ W x G*' Name of owner of premises ~e 01 %.vo (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. Plumber's License No. Q h Electrician's License No. IV. tq Other Trade's License No . 1. Location of land o which proposed work will be done; House Number Street. 4 Hamlet County Tax Map No. 1000 Section ~a~ . Block Lot Subdivision Filed Map No. Lot . (Name) State existin° g use and occupancy of premises and intended use and Occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ,SAS fi• S iry r 1'~JC~/i,, It1fiY•dd~~< r (BFFkA$~w .t:f-ittir;4?~ ....Ali .J~_._. 3. Nature of work (check which applicable): New Building Addition ...1F• • • • • • Alteration . . Repair RlimoVal Demolition ..............swimming pool........... . Tennis Court Accessory Building . . . . . . . . . . Fence .......Other Work............ 4i 2Y Fee . . Estimated Cost . r. (to be paid on filing this application) 5. If dwelling, number of dwelling lupi3V . •K• • • • • • • • • Number of dwelling units on each floor . . . If garage, number of cars 6. If business, commercial or mixedioccupancy, specify nature and extent of eac ype of use .OYFS "!try 7. Dimensions of existing structures; if any: Front 4~4~ 141,x....... Rear , , . ~j°..'....... Depth . , .y°.~ ~ , . . Height ~/a........... Number of Stories .I . j . . Dimensions of same structure with alterations or additions: Front p. • • • • • • Rear ? 7.T......... Depth . , , (QOM ...........1 . Height /.4... Number of Stories l "r`lt . 8. Dimensions of ntire new canstn}ction: Front 45`Q ~4w Rear Depth ,G,4 . . Height .....G6.`...... Number of Stories • 9. Size of lot: Front ..40! Rear ...44 Depth ~Q :r . 10. Date of Purchase 6. lk .T Na . e of Former Owner . . 11. Zone or use district in which premises are situated ..d #W W*0A . . . 12. Does proposed construetpn violate any zoning law, ordinance or regulation: ; V o ....r.... . 13. Will lot be regraded . 4`! p n Will execs i 1 be r moved from premises: Yes No °91? . 14, Name of Owner of premises t~ts (To ,1l. W.A.AAddress 4 owe 'hone No..7 "r. Name of Architect Address PG. t t . P 'Phone No..`t`7~ _ ? Name of ContractorKe"goj"~. C4~6. ~e . Address f°/AFF...... Phone No.. 7X .-X14 FI.- , . , 15.1s this property locaFed within 100 feet of a tidal wetland? *YES NOOW- *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ~tumber or description according to deed, and show street names and indicate whether interior or corner lot. 99,Y~ Pre osea ~ExttnSionl j --7, ~',~a~+& B[.Od ~ ~ v q'e ~RRKiN\ N o a 51,a V~ CX ~5 2 S•r!e~~r z4.7 tFa7 p //OS~# tmr4er h1NiN RA • N.y.S, Rte. LS STATE OF N'1V Y R COUNTY OF , , !k , S.S ~Q.. 1 VI 1 ~ being duty sworn, deposes and says that he is the applicant . (Name oY individual si=ghing contract) above named. He is the .II,....... 0 C~vL. ? (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dt)ly 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 uciufe file this C~k .day df...... l9?./ Notary Public,• . County CLAIRE L OLEW (Signature of applicant) NftY Public 8tete of Now y4* QuailfleNd In Suffolk , Cenuw..u...C ~'.out>ti L~." S, lCl9Z- 77' Z. 1 I _ 1 i II j ~A l I ~ 1 ? t~ raew i ' fRObt-!" H-e"V(.-rt Df~ T ~ ~ K(GN-r 31 p0 7 7 PUGF ~ YITC(! (a Nd7CM EKISI~fyG ._,,,~_3 FRV=~ _C)EvIGn! 'o ri„ Z ~-Y ZroJ_ u < t J / 20`o t,G, enR-,~,~ * rc -~-f T14F fx-'Srr„:G y J~ ~ FPUM YB l z1l~ $`Vo P O 417 7-0 -r"r{V-'r is VE It-,r oor, .v O li, G tE OF NF~yY 1 a row,c anal.- . 1~..~a 0 - 4f~g Xr~nlS ior~ Jau-is - - TL 1, V LL, ~r. I I- LiYrnw'~ w i lb `FO 4322561 _ J- ~FESS9U8P - Mine 30~ - C1i~S9 S~<<rf~iV - AL'FP:NFie I 1n~ FL UMBER CEH I /I-H, AN UN , (0 ON LEAD CONTENT BEFORE 0m rz 11.~ q a ° y y I CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER pLUMBING Nd re : VEI i°( iii"ER310p~,5 D IKE NOTIFY 0 _ SUPPLY SYSTEM CANNOT ALL pWMBING WASTE EXCEED 2110 OF 1% LEAD. & WATER LINES NEE0 FOLL111 " TESTING BEFORE COVERING s t' o s 1 C;R f+. B 1%,50 . '.1o if copper tubing is used /~pppp p5p ,Y yr n one 477-0400 Main Road ~ 2. RYj~- 4 FINPI It, I for water distributing OC ~~eeG W RA C J DIY jap i GREENPORT. N.Y. 11944 gE:-n; em: piping shall be s , ~..=;~i'1. of types of Korlonl USE 2 tl,>, Dbf4mf c Mtr:~ THE ftr. rlUfpff,fl Er'[C ;1F VK NY i47F fi1G156F?i 8'100+' lw FNErtid"I ~,.es ~ ae=: ^r has±[s9 E FI,;, OF 0~curf"Ac°/ ow~.~(EVA~~~fIS ~1' C'raSS ~rC7or r_ ~ P~Jf"f`r it p,f ..-ciGNi9ri CtiL'sam1(4IO64 -'III UNW&UMITIRCATE RWIM °•N Nfi 1~ 14-0 ' o„ -~1 6 ' I oweK Pots ` 0 EXIT DbG~ Ayl; - j F~IkME ~ i q i I i r (Gn1 Clx L-h F1.Dla ~~[X 1'P iu 91GH JOINTS i .I r i a f'1 m } w i - Z TY Pi CA DDU6~- 2F b Ooll z ~}iEC SP;aCI Tc TS055 - Q r i s- ~ c) i~-i o o K(_ Lnwc~ Fo r~ ~=I I~ 3C rxoPt dj , GuT ou7 ~ ~ Fci2 g0.DOOit~dnr+g ~ ~i ~ EF r'ovE c F LE V Y- it - - ll veRFf"1 Ln CP'a oN ~ ~x~s+ pacr r .'t+12 ~rt CiA 1,4 Q.~NI /=rw. co ~h Pe rw) ~ ( Gtlr ocF rr~ P Sues r+c=r i ~1F hT ~y ~ ~ ~ y Ln i ripe .~I I i `4I ~I a _ EX i s-r ~ tZa o f-- - a ~ I m I m ~I Wj ~ OF NE{y 'f ! ( IF ~~~:WE~~ ~y Yf'~rle rL In0-1 s I LL I 4 40 O3 54-1 / P9OFESt IcIAX~6 K9It VEr, IF`( DItVLA( 34er; ; Canpr rr nai~ pad N!,~ c.. Dor• r a {~5 ' F,Jy 1n3~ / ~ STK- ~ t7L' z :/Y, REMOVE lG f, lni! i6J 70 n, fUl OVj Phone 477-0400 s „ Main Road . r JI GREENPORT, N.Y.,11944 u I(_. _ Ixrsl~uno r. C;'i DO NI ttit O (.'I t. K L . i1'-. C1 I o~ qq! ciU tit ~PT~G hi, Plh-N oPALCppa.tTi-b ~A _3 ri_ Iz1 L- IGALF' I