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HomeMy WebLinkAbout20966-zFORM NO ~ 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y.. CERTIFICATE OF OCCUPANCY No Z-22078 Date JANUARY 5~ 1992 THIS CERTIFIES that the building. INGROUND POOL Location of Property 845 YENNECOTT DRIVE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 3 Lot 16.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1, 1985 pursuant to which Building Permit No. 13825-Z dated APRIL 2, 1985 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 INGROUND SWIMMING POOL AND FENCE AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED STEPHEN & BETH CARR H-032600 - DECEMBER 2I~ 1992 N/A Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22016 Date DECEMBER 10, 1992 THIS CERTIFIES that the buildin~ Location of Property 845 YENNECOTT DR. & House No. County Tax Map No. 1000 Section 55 Subdivision Block 3 Filed Map No. ADDITION TO ACCESSORY 860 TUTHILL RD. SOUTHOLD~ NY Street Hamlet Lot I6.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTFJ~BER 14, 1992 pursuant to which Building Permit No. 20966-Z dated SEPTEMBER 21, i992 was issued, and conforms to all of the requirements of the applicable p}ovisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO AN ACCESSORY SWIMMING FOOL "AS BUILT" The certificate is issued to STEPHEN CARR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 I~OILM NO. ~ TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~'~9 20968 Z O,-,te ................ , ........................... , pursuant to application dated ........................................ .~/,,,/,,./. ....., 19~. -~.., Building Inspector. and approved by the Rev. 6130180 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13825 Z Permission is hereby grante~ , ~ .:..~.....¢:..~ ....... ..L..j~ ...................... ...~..,..,...~-.~ ~ ~..., ======================================= . ,o ..~~.....~...~.~.~....2~.....*......~.~.....~....~. ~ ....................... ~?::...Y...,,~z~..~,~.,..~ ....... ; ................................................................. at premises located a~...~...~.,'.....~.:~:-,,/.~..,..~.~ ................. ...................................................... County Tox Map No. 1000 Section/~.~'~., ....... Block .....,.C~,,...~,, ........ Lot No.. ?..(-~" pursuant to application dated ...... ~,~. ....... ~. ..................... , 19.~.~..'~, and approved by the Building Inspector. Rev. 6/30/80 a,~:!~:~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ' BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 1003~8 Date THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed be~w a~ introdaced by t~ applicant ~med on the a~ve application nu tuber in the premises of in the following location; FIXTUEE FIXTURES RANGES OVENS DRYERS FURNACE FUTURE APPLIANCE FEEDERI TIME CLOCKS MULTI.OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: prevailer indlcaLed," "~1o obviovs tl~sati, sfaci,oL}~ ~o~di ;,iol~ w4~ fo~(ld, S E R ~cec~, ^.wo V I C E NO OF HI-LEG GENERAL MANAGER This certificate must not be altere~ in any manner; return to the office of the Board f ncOrrect, inspectors may be identified by their credentials. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~: ~PPLICATION FOR CERTIFICATE OF OCCUPANCY A. This applicatior 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). 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 anc~ 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- ' ' land uses: 1. .Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application an~ '~ 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. 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 - $i00.00 3. Copy of Certificate ,of Occupancy - $5.00 over 5 years - $10.00 · 4. .Updated Certificate of Occupancy - $50.00 5. T~mporary Certificate of Occupancy - Residential $15~.00, Commercial $15.00 strucgion.. ~. ....... Old Or Fre-extstinM Buildinm. . ~ ........................... .... House No. Street Hamlet nwer er Owners of Property ........ ~ ................................................. ooetyNo 000. Section..©.. q ..... Bloc .3 ............. .............. ubdiviaion .. · .................................... Filed Map ............ Lot ...................... -~rmit No ................ Date' Of Permit. . Applicant -~alth Dept. Approval .......................... Underwriters Approval ......................... [arming Board Approval ........................ ~quest for: Temporary Certificate .......... Final Ce~'icate ........... VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-I802 Town Hall, 53095 Main Road P.O. Box 1179: Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SEPTEMBER 19, 1989 STEPHEN CARR 845 YENNECOTT DRIVE SOUTHOLD, NY 11971 SUFFOLK CO. TAX # 1000- 55- 03- 16.1 Re: NOTICE OF VIOLATION Dear Mr. Brewer: You recently received a Notice of Violation. To date you have not responded to that notice. If you do not remedy this situation immediately, you will have to appear in Court to answer criminal charges for violat- ing the Southold Town Code. Please contact the of Southold at 765-~802 Very truly yours, Vincent R. Wieczorek Ordinance Ins-pec tor Building Department of the Town upon receipt of this letter. B.P. # 13825Z TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 13825Z issued to Stephen Cart & Elizabeth Hansen on 4/2/85 for Accessory is completed and a final inspection has ( ) has not ( X ) been done. An Underwriters Certificate is needed. In order to complete this file, it is necessary ~hat a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use ia unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Victor Lessard Executive Administrator VL:gar encl. INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 20, 1992 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Mr. Stephen Carr 845 Yennecott Drive Southold, N.Y. 11971 Re: Building Permit ~13825-Z (Inground Pool & Fence) Premises: 845 Yennecott Dr. & 860 Tuthill Rd. Southold Suff. Co. Tax Map ~1000-55-3-16.1 Dear Mr. Carr: In reviewing our files it has come to our attention that there is an outstanding Order to Remedy Violation and Notice of violation on your property. According to the order to Remedy that was issued on July 11, 1989 a swimming pool is being used without a Certificate of Occupancy and an expired building permit. Please contact this office immediately so this matter can be resolved and avoid legal action. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. GJF:gar (Cert. Mail) Gary J. Fish, Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date &ul.¥...J. 1 ......................................... 19.8..9. .... TO ~tep. hen Carr & Elizabeth Hansen (owner or auth?rized agent of owner) ........ ~.~. ~...~ ~ ~.R ~.C. Q .~.~.,, D .r. ~..w.~ ,,.,, .S..9..u..t..h...o..1..d., z.' NY (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance CI~P. lO0 Other Applicable Lows, Ordinances'or Regulations ............................................ at premises hereinafter described in that A swlraning pool is being used without a (state character of violation) Certificate of Occupancy and an expired building permit. ARTICLE .'~KVIII-Chap. 100-281 & 284. in violation of .................................................. . .................... (State section or paragraph of applicable law, ordinance ar regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to Comply with the law and to remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 88~ e ¢ t Dri e ................................................................................. County of Suffolk, New York. SUFFOLK COUNTY TAX MAP /! 1000-055-03-16. 1 Failure to remedy the conditions aforesaid and to comply wilh the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. BP #13825Z (Cert. Mail) VINCENT R. WIECZOREK VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 ' Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SEPTEMBER 19, 1989 STEPHEN CARR 845 YENNECOTT DRIVE $OUTHOLD, NY 11971 SUFFOLK CO. TAX f! 1000- 55- 03- 16.1 Re: NOTICE OF VIOLATION Dear Mr. Brewer: You recently received a Notice of Violation. To date you have not responded to that notice. If you do not remedy this situation immediately, you will have to appear in Court to answer criminal charges for violat- ing the Southold Town Code. Please contact the Building Department of the Town of Southold at 765-1802 upon receipt of this letter. Very truly yours, Vincent R. Wieczorek Ordinance Inspector B.P. # 13825Z 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ) FRAMING [ F~L DATE INSPECTOR FOUNDATION 1st) FOUNDATION 2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL COMMENTS ADDITIONAL COMMENTS: 'FORM NO, 1 TOWN OF SOUTHOLD ,,~'x BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~.' J · · · · -~-:. · ~, 19~7.~.~' Approved ..... ~....~. .....  19~...~. Permit No./.~..~.~..~.~'..' .' .~ Disapproved a/c ..................................... [Budding Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. Tiffs 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 tiffs 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 occupigd 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 Y6rk, 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises and in building for necessaw, ',.3n~. ..... ..... ........ : ...... (Signafure of applicant, or name, i~ a corporat,.on) ,. (Mailing address of.applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises v~.' ?~-~-: .~./.~. C~-. ./~. ~..'.~.,..~../~. ?.-r(.r:./.~ [ 2..w.~.gS .~./'2t../"~-:-}.~. ~"~¢ .... (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 .... .~..e_/. [./?. '7/;4,Z~ ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... O I. Location of land on which proposed work will be done ......... :..= .. ........... House Num her Street Hamlet County Tax Map No. 1000 Section ............... Block ................ Lot. .i..J;..;. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ~×isting use and occupancy .' ................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition I · ~ ........ Alteration . I ......... Repair ........ ' ...... Removal .............. Demolition ........ ~ ... Other Work~'[~./. Cosf..~7..iO.~.O ~ ,' (Description) 4 Estimated ' Fee '" (to bel paid on ~ling this application) .a , 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 ............ ....... Dimensions of entire new construction: Front Rear i Depth Height .............. ... N. u.mbe, r. of Stories ........................... ~ .......................... 9. Size of lot: Front ..... (:~I.,.I.] ........ Rear... c~2~t .~// ......... ]Depth ~7~.c]~.0 ~ ......... 10. Date of Purchase ........................... .~,Name of Former Owner i .......................... 11. Zone or use district in which premises are situated ?:~,.~ L~.~..4.~I .'~/~.-....'i ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ... i~.4/.0. ............. ~ ..... 13. Will lot be regraded ............ : ...... 9 ........ Will excess fill be removed from premises: [t Yes) .~ No t4. Name of Owner of premises~H/~&J. '0': .~,~k/~ ~,,. Address .~'.~.~] .~q .~fxTf?!" ~)~, Phone No.7~..~'~'~. ~'.~ ..... Name of Architect . .,,.~ ....... .. .............. Address .... ~.,.~00.T.H. 0..La~, .... Phone No ....... : ......... Name of Contractor . l .~PJ~l'~ .4~. ,.. ~.~?. g~ .... Address ~1 t2.~-~MJ ~ .Al). ! .... Phone No. ~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ifldicate property lines. Give street and block number or description according to deed, and sbt interior or coruer lot. all set-back dimansions from w street names and indicate whether STATE OF NEW YORK, S.S COUNTY OF ................. NOTIFY BUIL,D~NG DEPARTMENT AT 765-1802 ~ AM TO 4 PM FOR THE FOIJ_OWIN~ INSr)ECTIONS: :. 1. FOUN~A?ION - TWO RFQUIRED FOR POUR~h CONCRETE 2, ROUGFI 4 FRAMING ~ PLUMBING' 3. INSULAr[ION 4. FINAl. .-~ CON*S'I'RU(TIqN MUST BE C'~M~ ~TF F~R C. O. ALL CONSTR'JCTION SHAL.L. MEET THE REO~II~,E~FNTS OF TH~. N. Y. STATE CONSTRUCTION & Fh.?iRGM CODES. ~OT RESPONSIBI ~ :m~ D~SIGN OR ~ONSTRU~TION ~AR~. ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. tie is the ' (Contractor, agent corporate officer, etc.i) of said owner or owners, and is duly authorized to perform or have performed the ~aid 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 mannerset forth in the application filed therewith. Sworn to before me this ........................ day of ..................... ,19... Notary Public .................................. County ~ 'i -- ~" , (Signature of applicant) ' SUFFOLK CO.-HEALTH DEPT. APPROVAL , . STATEMENT OF INTENT C~EORM 'TO THE STANDARDS OF THE .... SUFFOLK 6OUNTY BEPT ~ 'EALTH '',.,,,,_ z , ,.-' ., ,' ! .... , ,, -,. ' ',~",, ' NEW, MORK I ¥ 1992 Form No. 6 TO,TN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~PLICATION FOR.CERTIFICATE OF OCCUPANCY 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. Con~mercial building, industrial building, multiple residences an~'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.' 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 applicatioJ an~'~ 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. Fees I. 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. ~pdated Certificate of Occupancy - $50.00 5. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ew Construction ....... Old Or'Pre-existing Building ................. Location of Property:. ]. ~..~.. .......... V'~'~"~' ' '~' ' ' ['~' ' ............. ~ ' '(~' '~'~' ' '~' .... House No. Street Hamlet '' ty . Inwer or Owners of Proper . . .... .... bdivision Filed Map Lot ermit No,, ,~,~,~ ~.,..Dat~ Of Permit..~ ..... Applicant. ~ ~,~. ealth Dept, Approval .......................... Underwriters Approval ...... l~nning Board Approval ........................ / . . ~quest for: Temporary Certificate ........... Final Cer 'cte ~e Submitted: $,, ' ~ ~ - ' ...... .................. FORM NO. 1 TOWN OF SOUTHOLD SEP 1=7 IE~J~ BUILDING DEPARTMENT TOWN HALL .. SOUTHOLD, N.Y. 11971 · "; :' " TEL.: 765-1802 · :,amincd .q..,/.&/ ....,'lg~..z-- BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CII£CK g~c';g~:; ........... :'" CALL HA I L : )isapproved a/c .................... INSTRUCTIONS a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 ts of plans, aCCurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets · areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. - c. The work covered by this application may no~ be commenced before issuance ~)f Building Permit. d. Upon approval of this application, the Building Inspector will issued a BuildLug Permit to the applicant. Such permit all be'kept on the premises available for inspection throughout the w6rk. e. No building shall be occupied or, used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been granted by the Building Inspector. (I~PPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the filding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :g',flations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in ,building for necessary inspections. ~"7) ~ (S~nature of applicant, or nameo if a corporation) - "' ' ' < ~ ' .... ~' (Mailing address of applicant) ate whether applicant is owner, lessee, agent;' architect, engineer, general contractor, electrician, plumber or builder. ........... '¥.~..~ ..C%~~- · &4~%~ .4:I C / C.&~~ c~ tree of owner of premises ...... .~.5..~.. (as on the tax roll or latest deed) · ppticant is a corporation', si~nat!~'e 0(dul auth{~rized officer. (Name and t!i!l%79,f,¢Owovai~e!e, fficer).,.. ,.: , . q,qtJ .O.. -- t4T7 Builder's License No .... Plumber's License No ......................... Electrician s License Nb Other Trade's License No ...................... Location of land on which~proposed work will be'done...~..~..O...r77' .............. 4 %tl / ............. .... : ' . ' ." [louse Number Street HamI~t' .................. :o,mty ,..,., ~lap No. 1000 Scction. .0..sT.T.. ......... B,ock..3. ............... Lol .................. ;ubdivJsion ' ................ (~,/am~) ................ Filed Map No ............... Lot ............... ;tare existing use and occupancy o~. emises and intended use and occupancy of proposed construction: , Existing use and occupancy . . ~__~:~ £t-I ¢::t,a~",,~' ' *;~ :~ ~,~ ~-~;;'~ ......... ,..,. ,~.,. ,,,, ................... ~;,~;~; ~..,2 :; :. '.~, T,, 2:. '; }~.,¢:?~'3'; ...... .................. ~.¢4~ ;..:. :.S.~;~. :;~,m .... :.~ 3. Nature of work (check which ipplicable): New Building ......... Addition .......... Alterillion ....... , OO(~) !2~<~2:)~ . . . .... Other Wot . 'e'7. ~ ~cr/Ffion) 4. Estimated Cost ..... 43/ ....--. ......................... Fee . .~'~. .... I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwc~lling units on each floor ............ · lfgarage, numberofcars . ~ ..:. ature an. h typ .................... 7' Dibuszness' commercial or mix occupancy, specify n d extent of cae e o u ....... · H mensionsofexistingstmctur s, any: font ............... Rear .............. De .. eight ............... Nurpber of Stories .................... pth ............. Dimensions of same structure with .... ' ............................... uaerauons or add t ons: Front .... D pth I Hight . · ................ Rear ................ 8 Di ' f ti truer/ F ' . ......... NumberofStories ...... ... · nlenslons o en re new cons on: ront .......... Re ................ H igl N ~ her or~ ..... ar ...... Depth . . · zeo . font .. .t ........... ear .. ' .......... epth 12. Does proposed Construction violate ~ny zoning law, ordinance or r~-~lat on '' i~ ......... . '.. 15. Is this property within lO0 feet of a tidal wetland? *Yes ........ No... · If yes, Southold 'own Trustees Permit may be required· ' ..... .... PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail set-back dimensions from property l/ned. Give street and block mmber or descr/ption according to deed, and show street names and indicate whether interior or comer lot. '- AP. PROD AS NOTED FEE: ~ BY: ~ ..-. NOll~ 8IJIC/DING OEIgART~ 76S-1802 9 AM TO ~ PM '~R THE FOLLOWING IN~PECTIO,NR 1. FOUNDATION [\,~;~ REOt ' 'FOR POURED CON(:RF'r~ 2. ROUGH o FRAMING & P) L.,~,'~P' vG 3. INSULATION 4;FINAL -. CONSTRUCTION MUST SE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF 'THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION, EflROR8 ....... t .'2_.6[ ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) love named· ' (Confractor agent .... ~ ' corporate officer, ere ) ............................. · said OWner or owners and is duly aqthorized to perform or have performed the said work hnd to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in thc I . manner seti forth m the application filed therewith. ,'om to before me this . NotarvPubllo, SteteofNewYotk ./0~,~ /. ,.~j~ [v.. ~ ; . uummea in =uffol~ coumy cf,~k~ v r ' Commle~lon ~xpires Oeoember 8, 18.,~ (Signature of applicant)