Loading...
HomeMy WebLinkAbout20002-z 1 FORM NO. 4 TOWN OF SOUTHOLD F BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20746 Date MAY 20, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 2124 WESTPHALIA ROAB MATTITUCR N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 114 Bloc& 7 Lot 11.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SLILY 3~ 1991 pursuant to which Building Permit Na. 20002-Z dated JULY 3, 1991 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 & WOOD DECKS The certificate is issued to WILLIAM & MARIA SCHENONE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-20-MAY 18, 1992 UNDERWRITERS CERTIFICATE NO. N-228093 - APRIL 20, 1992 PLUMBERS CERTIFICATION DATED E'SB. 24, 1992 - RICHARD GOELZ, JR. Bui ding Inspector Rev. 1/81 mast xa 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) N°_ 20002 Z Date 19..9.1.: Permission is hereby granted to: i mi e5 l~ataed~at : ~.s~~.. `..~S:l! . P!:El:@!:.....~1.......1 I ....`.'~e.....ta~..~..~..~~aaa ~ County Tox Map No. 1000 Section ......I Block ....Q.,.~......... Lot No.....I~~.~~........... `s ~ pursuant to a Ilcation doted PP 19.q~.., and approved by the f f Building Inspector, fi I ~ j Fee S..~Q.l..?.:....... k M ,c.~~.d. ctt(~_ i . Building Inspector l Rev. 6/30/80 w - Form ;;o. 6 ry ~~;'a p,(~~ ~r°" i=;`1`; f~ i'~';i:"~;~"' TO[JN OP SOUTIIOLD , ~ ~fp ~ ~ BUILDING DCPARTCICNT ~3.~.._ . TOfJN fIALL ~ ~q' l~~}J ~ ~ j;;,~;% 765-1802 ~k>oase~ 1'~~4 APPLICATION POR CCRTIPICATC OP OCCUPANCY This application must be filled in by typewciter OP, ink and submitted to the building , inspector with the following: for new building or new use: 1. Final survey of property caith 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-O form). 3. Approval of electrical installation from L'oard of Fire Underwriters. 4. Sworn SCatement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Gode Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. , •i. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and y "pre-existing land uses: 1. ,lc curate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. r1 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to duelling $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 Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date %v4 Construction.... Old Or Prc-~~elxisting 6uildicigp.. .e • • • • • • t.ocacion of Property... r2i ~........W.'~4'~~.~JJ, fI R, I~QSA.......... ~~.iiJ/1[G~; . House No. ,~y~ SCrcet Ham1eC •%nucr or Owners of Property..~/lI!!~'rn..GO/••,d;,,,~q ~ ,p~•••••.••••..•...•. rE'ry/fz , a, ~a• ~:uunty Ta:c Cfap No 1000, Section.... ~~~......Block.... ..........Lot....//~ .;ulidivlsiun ...............................~y.....Filed Pi:ip.........//.JJ..Lot....... er:.il[ ;;o...??Od0 0~ z ,Date Ot Permit.../.: y~ q•/ • • „API>1 icant.(~~~y~e, p,~.j ,e~ :icatth Dept. Approval ~ ` ~ • .......Underwriters Approval.. `.~.~.-,9 !.innin;, I%aard Approv:il . Y '~c9~~cst for: Temporary Certificate........... Final Certicatc........... ..~c Submitted: cn~ao~~f6 ..._._:F::. INSPECTORS Victor Lessard ~c~,VFFIl(~-C Principal Building Inspector Curtis Horton h~ z, SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ z Thomas Fisher Southold Town Hali v- ~ ~ P.O. Box 1179, 53095 Main Road Building Inspector Southold, New York 11971 Gary Fish ~Q( ~ Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD ..m.~; FEBRUARY 7, 1992 3 CREATIVE CARPENTRY CONT. CORD. ;.~~i 266 LAKE AVENUE SOUTH A NESCONSETT, NY 1 1767 TL~'~~,. E i ~ u~~ RE: WILLIAM ~ MARIA SCHENO (NEW DWELLING) To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ~ gxx An application for Certificate of Occupancy is not on file. (Enclosed) ~ ggg No Underwriters Certificate on file. ~ ffi The check is not on file.)$25.00 ~ ggx No Health Department Approval on file. No final inspection has been made. gxg No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20002-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: WILLIAM 6 MARIA.SCHENONE THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1135@31 BUREAV OP ELECTRICITY 88 JOHN STREET. MEW YORK, NEW YORK 10036 Date APRIL 20,1997. APPlica[ionNo.onfile 7517$092191 N 228093 THfS CERTIFIES THAT only the electrical equipment as deacrihed hebw and introduced by the applicant homed on the shove application numher in the premises of WILLIAM SCNENONEr WE5TPHALIA ROAD, POL$419, MATTITUCE, N. Y. ~ ~ in tfLefa(loLVing location; ? Basement ® lst Fi. ® 2nd F'I. GARl ATTIC(OI$T Section Block Lot u'os examined on MARCH 09 r1992 ondfound to he in conLplianeeu'(th the requirements y/thix Board. iIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FIUORESCENi OTHER AMT. K W. AMT. K. W AMi K.W qMi K.W. AMi. N P. 59 62 49 49 1@ 1 1.2 3 F • DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll H. P. GA$ H, P. AMi NO. A. W G. AMT AMP. AMi. AMPS TRANS. AMT. H P SYSTEMS AMT. WATiS NO.OF FEET is 4 8 2 - 't - ~ 1 ~ SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP ttPE METER L a, ]W I %3W 3,e 3W 3,B 4W NO. OF CC COND. A. W. G NO OF HI-LEG A' W G NO OF NEUTRALS A' W' G' EDUIP. PER % OF CC. COND. OF HI~IEG OF NEVTRAL 1 2@@ CH 1 S 1 41@ 1 21@ OTHE0. APPARATUS: ~ - 20AMP GEN. TANS SWITCM-1 A/C IINIT 3 TON-2 i MOTORStI-@.50 H.P. G.F.C.Ie-6 SMOEE DETECTOR(°2 HRIDGEWAY ELECTRIC LIC.#3351-E Gl/~~ 447 HRTDGE ROAq HAUPPAUG$, NY, 117$$ GENERAL MANAG@R 11 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~O~j~FF~(r~'`Os TEL. 7G5-1802 Town or soruT~o~,~ • ~ L:~ ~ OFFICE OF B[JILDI2~IG INSPECTOR c°n ~ ~,i; P.O. BOX 728 +~f^ s~~~M...,.,. c?> ~ T01VN HALL r~ ` ~%ybQ~ SOUTHULD, N.Y. 11971 `I ~.......~.J,'%;,.. ~ C E R T I F I C A T I O N Date ~~~~'2, Building Permit No. °~pO~ -z Owner,//~~m ~ ~.~j , n ///:qY~~l .lam ~,o,,, _ (please prin/t) ss,ce~'12 Plusber_~]L/Jg~ GGE`LZ ~l (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. - (plumb is ig ture) Sworn to befcr~ me this day. of e- ~ 19 qz. Notary Public Notary !>ublic ~_County ao AMJE BAIRTIQC NOTARY PUBUG, Stale df New Y~xlt Nd. 4832!50, Twm Eufh« /.~3~~ - THE NEW YORK BOARD OF FIRE UNDERWRITERS FAGh ~ _ ~.1~3®3~. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date HA9tC:P! 13,,9.092 Application No. an file 7$9,7$891 /$t N 22$~L93 THIS CERTIFIES THAT only the electrico/equipment as described below and introduced 6y the applicant Homed on the above oppGcation number in the premises of wTr.rtiArl ;rclra9~otrr9, w>s$T~Irur.zn aoAla, pOLkE#19, MATTr.r°uC~, ra.e, in thefollowinq location; ? Basement ® Iat Ff. 0 2nd F-l. GAYi1ATT:rC /G(.9T Seetion Blork Lot was examined mL ~9Ari~}I H9 tine andfourtd to be in coneplianre with the reyuireneenLr q(this Board. i z FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS g CO(UTLETS ,1 ~y IN/~C~AINDESCENT FW/yORESCENi OTHER AMT. K W AMT K.W PMi K.W AMT. K W AMT. yx~ M P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS RELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K. W. On H. P. GAS H. P. AMT. NO A. W. G Anti. AMP AMT. AMPS TRANS: 'AMT W. P NO. OF FEET AMT. WA115 4 B 2 y L i ..SERVICE DISCONNECT NO.OF S E R V I C E 2 nMi. AMP LYPE EUOEF. 1 R 1W I ,6' JW 3,e' 3W 3,e' 4W NO. OPER gCOND. Of CC. COND NO. OF MI-LEG Oi H LEG OF NEUTRALS Of ~NEU RAl = 1 20A GB 1 ~ 1 1 7.18 OTHER APPARATUS: , 20AHP G$A. TAN$ $WLTCEf-1 A/C U9d'ST 3 TOPr-2 'T G.F.C.It-fi $MpKI~ DP,TSCTOAs-2 i= F - BR~DG>;WAY L~GSCTkIC L:CC.@83„`i1-E G~~~~ 1' 947 I~.RIrJGP [i0A13 ' }f All f?f~AUGI's r N'lr, 157918 GENERAL MANAGER Per11 '~~f' 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. INSPECTORS , Victor Lessard ~~~~3u1=1•d(~- PrincipulBuilding Inspector ~ ~ Curtis Horton ~a SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ ~ ' Southold Town Hall Thomas Fisher ~ ~r{.`~`.r ~ ~ P.O. Box 1179 53095 Main Road Building Inspector ' a.~;~ 'c ' - r~@ Southold, New York 11971 Gary Fish ~ Fax (516) 765-1823 Building Inspector =3,. Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspectar Robert Fisher Assistant Fire Inspectar OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD FSBRIIARY 7, 1992 CREATIVE CARPENTRY 6 CONT. CORP. 266 LAKE AVENUE SOUTH NESCONSETT, NY 11767 RE: WILLL9M S MARIA SCHENONE (NSW DWELLING) To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %%x An application for Certificate of Occupancy is not on file. (Enclosed) x%x No Underwriters Certificate on file. %1Cx The check is not on file.)$25.00 xffi[ No Health Department Approval on file. No final inspection has been made. RXR No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20002-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT'. CC: WILLIAM 6 MARIA SCHENONE cl=LD II:S:`CalU:7 ~IUnT^ I ~ i:OMMLNTS - 1. ~ m O " o FOUNDATION (1st) ~ ~ - - ° c ~ FOUNDATION ~ (2nd) _ _ m ~ e 2. o~ P.OUGH FRAME & ~ _ ~ ~~ylxc~ ~L PLUMBING ~i ` 6 L 3 . T ~ m IIJSULATIOAI PER N. Y. ~ y P' STATE ENERGY CODE ~ ` x a 4. ~ m • ~ H /C.y . ~i . ` _r_ FINAL l z ADDITIOAIAL COMMENTS: m x . ~ ° . SS- • m • x ' H ~ ~ W H•__ H ~ ' O z W m --0 • b • • - fA S i ' ~ b:;{ m ~ d . '=a~P E.1~: - t .-_,_.7.~ f. ~,[al'l: P;F'C 11 r,. 1 sata5 ~~2~~ .,,vt,e.kS.~ ' , .dc~~-_,~. m8~~et' ~`nrs i`~4'7 ~ gA~ A~ j51d) ?~4~1949 ~~~a"~~a~I>~ i ~ /J A ~ j: ~ti.-'hr, ~/..i.-,S„.?,mow?..~.1~=--3%~-..r //11 4h4~t~~~, j:1.~i;'r'~••/P~L ~"f, a.1 i.$`;.~('~ 1~. ~=G~~ \ t!~ ~ ~ '~~""~1b ~iUi'~:R CJP ~`~s~~~,.m.,.~,.4,..,.._..~___.~,.~~,,,~,,..~..~;~A,t9~Y~? ~~aG) r~ ~ 'i "~1~ '~.~f~ .'~'.~iC t.C;,:s=.'S _'f.%~5'-'' v;f._M....-. /i._.~f,~t...~' G~., t...!'~y:C,,,~ t~c ~ 1 1 n ~ ~ ` ~t,u;,,~J :dJ L(,rf~(a~Y_),1%)~<,~. ~7'.dv'.~,.~t~w-~`a',,G, W.q.i:.f~,~.E~! J',~l'`_.-,....C,.aK~ ~~"'.?.frf C.[y.~_-_.~. ~t~,.y~.,. ~~4i `~~.Jt,~ ,{_!,4-^.4~fj f//L~-;;.Y_~.,Fj.-l: " ~i~ n..m_s.. i_' -C.:6~.d+ sl ~`:..'w. ...~j~~'l ¢ 1 1.C.= F'L ~3.r7~ y v J o~~gOFFO(,~c TRUSTEES ' j GGy~ John M. Btedemeyer, III, President o SUPERVISOR Henry P. Smith, Vice President W ,zn SCOTT L. HARRIS Albert J. Krupski, Jt. Gy • John L. Bednosld, Jr. '11p1 ~a4 Town Hall John B. Tuthill ~ 53095 Main Road P.O. Box 1.179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD May 5, 1991 Tanya Lachenmeyer Land Use 2576 Sound Avenue Baiting Hollow, NY 11933 RE: William Schenone SCTM #1000-114-7-11.3 Dear Ms. Lachenmeyer: The following action was taken by the Board of Town Trustees during its regular meeting held on May 2, 1991: RESOLVED that the Town Trustees APPROVE the request for a waiver only to construct a single family dwelling. As the deck and swimming pool are closer to the water, the Trustees would like a full permit application. Please return to the Building Department for a determination on the need for any other permi~.s which may be required for this project. Very truly yours//, John M. Bredemeyer, II/II~ President, Board of Town Trustees JMB:jt ec: Bldg. Dept. CAC File o~~gpFFO(,p~oG TRUSTEES y John M. Bredemeyer, III, President c ~ SUPERVISOR Henry P. Smith, Vice President W SCOTT L. I-IARRIS Albert J. Krupski, Jr. ~y _ _ John L. Bednosld, Jr. ~Ol ~a0 53095 MaiHii Road John B. Tuthill P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD June 12, 1991 Tanya Lachenmeyer Land Use Co. 2576 Sound Avenue Baiting Hollow, NY 11933 RE: William Schenone SCTM #1000-114-7-11.3 Dear Ms. Lachenmeyer: A second inspection was done on the above mentioned site and it was determined that the construction of the pool and the deck will not encroach on the 75' set back. Therefore, the Board of Trustees will include the construction of the pool and the deck in the waiver previously given for the construction of the house. If you have any questions, please do not hesitate to contact this office. Very truly your~s,~. ~ rJ6_ ' ° ~f.~ . - John M. Bredemeyer, III President, Board of Trustees cc: Bldg. Dept. JMB:jmt Jew York State Department of environmental Conservation Legion 1 Headquarters ;UNY, Building 40, Stony Brook, NY 11794 DATE: r~~ Re: f ~`/7db' -od3da/~/'GThomas C. Jotting /"^'t' ~ ~ / - - Commissioner year. ~f'Ij,,..a 791,, ~-Q-- . _ . ~ review has been m de of y r proposal o: ~~,n~c.c4c ~ ~s / ~ o~~m~-..~ c~ j,/.~h~G~a~~~ /C`~~ X17/ 3ased on the information you have submitted, the New York State Department of Environmental Consecvation has determined that the parcel project is: Greater than 304' Ercm inventoried tidal wetlands. _ Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9/20 77. ~c Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is _ greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation oc other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic-crest and the project (i.e. a 15' to 20' wide construction area) or' ereetion-~~of a temporary fence, barrier, or hay bale berm. ~ - Please note that any additional work, or modification to the project as - described, may require authorization by this Department. Please contact this office if such are contemplated. ?lease 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 . ~ u-.--°l 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ f~ ~ f.~ ` 0 ~ !~'1 ~ ~G DATE INSPECTOR ~1 w _ r n,~~,.. _.r~_w f_ 765-1802 BUILDING DEPT. INSPECTION [ ] FOU ATION 1ST ~ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: oay/ r ~B~~ ~ Sri ~ _ DATE INSPECTO r 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( }ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [~MING [)FINAL ~ REMARKS: tr~~~ 1 I 1 Ir r DATE / INSPECTOR ~ ~ _ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL F REMARKS: ~`~'~=y'"~ . l G { f I _ f c i DATE ~ INSPECTO ~ i~~~ rss-isoa BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING JJ [ FINAL REMARKS:. ~ W ~g~~~livK/ r ° J~_ P DATE INSPECTO~c -a E' _ .:~.~SF--?. 765=1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) RO H PLBG. ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [)FINAL REMARK 1s l <..i.Li:L!1~j'LVt/!/L! ~/iL.. w .J~ /G.r~'l.~a~ e~.~ - 1 DATE INSPECTOR G~ uJ _ h a an m_ fi ~ , ~ ZZv GR~ p ~ 3~a o,,NO ~a' W N= Z J rW ~ V ~ ~ m y G~ ~ a ~ 1~\\ V ~ 4.' ~ W O ~ a ; a _i 2 0 ~ ~ z A zi =`o a o o ~ 4pQQ ~ S ASNG ~~pUN V ~ ~ 2 O ~ N ~ EDG EPM\NE~98' \u \My ~ ~ Q z ~a7 f~-3~p a.~~ _ oN~cea•e' ~ rV 'C U O J ~ woz~ X003 w = ~ ""p Naax ~6 = Y ~ z o ~ < ~ Q L~ Y mm ~ / k ~ P - / ~ ~ ~ ~ O QIL ~ O1 -Q\ t~ r. p~„ = ~JQ~~~ w o ~ i"" ~ ~ Cn ~ G Q I- (n o m z ~ ~ s, ~ i~ / O y ~ ~ ; c' y r `2 v ~ 4 . 1 ' p0.. ~ ~ ~ ~ \ `r a p~ D u •^e O w ~ p a a'. 1 r2 Y ~ O~` 0 ~ / v 7 sa oS~ ( ~ ~ 90 W o m a o' ~ O v ~ I N o ~ ~ 7 ~ Ga \ - N. _ \ ~___-_°6 - ~l ~ d p cn ~ ~ ~ ~ a~ x T 0 pR ? ~ c~~ ~ o~r~ , - m. ~ _ ~ a , ~ ~ Sao ioF. a~~--. st ~ E ~ sec ~~\e a9~ XTr > <0... ~O ~ 028 ~ N G % ;F , ~ w, ao s. N oy ~ N 3 ~ JA ~ `fie Y~ Jyti 3 ~ ~i r6 ~ _ \ $ ro ac ~ ~ ~ d \a,LS Z of Noy ~ o a~ . ~ "'F u5 ,fin ~y y N 3~ ~~w p~ r m 1 . f v i0 h z ~ < a o ~ ~ ~ J=i ~g Zi i O G ~N - yya 3.~~ ~o~ o ~ ~ QO <ZZ <c ~a .a E F~ Z5~ gp~ z3°~°wz C Q~~yy G ~ ~ 4Pay \O in ~p~ E~ZO rgF~i>~ jF ~ t ~ i o~~~ o~a~Y `4 Y I ~ ~ ~u Q W NO Xa~ ' ~-~A N Q61 ~W OWyaJ ' 2 ~Q 2aVp2~ OI-Y00" . ~ n n 'yLL F N W ~QNG~Z • !i, Z_iVM 7 _ ~ . s _ ...3F ~ , . _ i a aaa ~ ion ~ zZao (~i ~ -cioz GR G I ~ ~°a~ JNO W Z ~ ~ a~ • ~ W Z ~ I~I~ z d h ti GJ' ~~P UN w ~ O>3 •CpQQ ~ Y`~ Sp~N6 BVp 7 ,.~pG EµM NEpe9~ II ~ G~ Q z 1I a0 y 3 0 U oEt e•G• U 0 J ` z° w a Q oe~ ' -7 ~ 0003 \ N I W \ ~ ryl Y O G ~ mmm~ ~ III ~ ~ Y mmmm ° ~ I'I - Q ~ O J mMNg ~ a ` ~ J ~ ~ LL W \ W J o I, \ a .7.;~ v lJ~ ~ d, L ~ Y ~d N O N t2 ry ~ a6 ~ C ~ d ~ ~ T•J ~i a J ~ 'r I ~ ~ d ~ ° X60 w,os2: io O J ~ ~ a o ~ d n ~ 'a \ flo i so \ I cs ~ ~ j~ ~ Ili op i7u o'~`z-a~~o \ ? ~ a ~ F 6 d = ~ ~ o \ ~ 8~$ z € o> w Y w E r i z o ~ i~ a i p a o u i o 55 oa w~ K ?gip<", .i~ .o { O ~~e, O i F o ~ z a ~ CJ ~ M ~ Y6 to ~{1 I\ O 3 W Z ~ \ ~ a \~00~ / OBI \ E i ~ ~ ~Ou$~ ~ `~etO`e\\e I \ \ O ~\0Hj 000944 ~O V' ~ \ 020 2 O~ y ~ II, \ N 30 N 3' P°A o I ~oe~ `2o w oc E No 5 ~ o~ o~ d~ I N 3a 2 ~ ~ ~°N\Yy° N O J O ~ V' I~~'< y Mti y'1. I o v ~ yb O -O 6 5 Q O 0 0 ~I \ Pdv ~~P M G ry I ~ yQV ~ ~ 0 J p ~-t v r W ',fit xaLL II l~ti `i a~~. _,a~ Q' Fa-=W^ K ~ l,.p~1,°,rs ~ W O ~ yi 1q y ~NJOF... 'I n ° W yW> ~ ~QNpW Z I 2_N10 a n a ro Nltl~ ~a >o~io zZao ~ o~oZ a-~2U W ~ J ~y. mya ' ` N4 P ~ ~ O} ' ~ ~ OL7 J ~ Z ~ ~ a ~ ~_,PQ ~ 5 pSN~ BYOUNO Z `NET l9 '(OV ~ z,~ ~ 3 Q O ...ED TE 0.M\6E°ys\ ~ = Y o U ~ 0 0 2~~ LL ~ ~ U mmmm ~ m ~ Y L.l.- Q J LL W _~O~I ~ ~ ~ I~ t~- ~ 1-Q ' ~ o / ' A 2 ~ ~ Q f ~ O N Z o ~ 9 / o ~ ~ v P~~a o ~ 936\ n HGE m eE d m ONp~N v ~ q¢ y - d ~ Y .rF ~ 'mod w a~ 00 ~ ~ t rv~~9 S~ \ 02 O /Q O N b ~ ly Z~ ~ Y~'` ~ d Ut y .Oy ~O?q QP ~ 2 V ~y N I 30W '06 yQP~C~ t O ~ i ? a ~4.Z 6 gsi n, o a ~ W O/ 16~ ~Cbr o i71 O ~ 4v G dni v~ ~ ? O O , pb 1 \ ~ 7 ~ J\ 1 a ? ~ OI ~ 90 Z O ~ \ 1 v 1 6 ___N. _.~y_.-.s _s .._~.c~.' ~G< c~'r~ ':~va~.au? '.ta,_::;~ ~'ic~9 k~ O v 1 A < <i i \ ~ \ o N ~ p~ N Q Q ~ a a+x \ al \ Qom axo=~~1 G.' 1 ~ ~ \ bra ~ ~Q~ gzzc s~za ~aa C=> Q ~a\ IJI o o ~ N~~ < Fa a 3 S° a~:3 ¢ i 1~J d,_, c..i .~,.j \~n \ ISM o ; ~'~^^o_ ooW' w~W~-air i~:~ 2 \1 r19 \ Jy ~ G =OWo ~iFO ~i°~'-z<.~ E ~ \1 \ d \ 1 sa a 6a / a ~ moo' \ p"6~ a ,-~i' 1 V o ~ ~ C3 f_. C 0 ~:-v 7r C ~ ~ ~ O~~fj~C~'~~ vv ~ ~V4/o2a~2~W89~a 3 ~ ::~'.'.7.;,ea tf\1 ~ ~ o o~ J~~JLi Nm ` C\y di<'~ Y6 Wo ~ ~~;y s ~W1,9~ ~,~~xi ~ 4 ~,o \a 282° W o< ~~\o~s \ o n i d o ~ ~ ~ ~:cl~. ~ d ~ N'3 nOw J ~G<.f Y N f F,. w... ~a ~ (f1 ~V 1 W li JQ '~D y~ ~y..~ m j Y rn 3T:.ti ~f s V1 0~ i pp,, ='r :~1 r. Gi ~ ~ ~Y ,4. 2 Mti ti . W QOJI N D. 6~ ~ ~ CC37 r.~-Q) w " ` w ~ A tJ'r' of TSI,'~ d„ O 'O ~ ~ yh b w . o r ~l T P u~i s 5 O f U .s9i O p ~ ° b r U a Z ~ X m W = o Q' v ~ c ~=rcm c Pv~ w Z~~m BSI ~ ~WpvlNUl Z ,(Q 2QOO2~ /-r \ ~NJ OF„v ~ `-[`~~G/-J n n ~ I-» [ V" W ~QyO W Z H Z _ N I+1 V' ~~n""'°"°' BOARD OF HEALTH V ~ FORM NO. 1 7 SETS OF PL.1NS . TOWN OF SOUTHOLD SURVEY . gq BUILDING DEPARTMENT ClIECK . ~i ~ _ J~ l TOWN HALL SEPTIC FOR:I . ( SOUTHOLD, N.Y. 11971 ~iLJG.~UL''t. . TEL.: 765-1802 t:OTI Y . ~6 P~! /7 . ^(tnN OF SOU1'KULD,.,..,.,. CALL • . '~!Q . . Examined .~22-..., 199. r. CIAIL T0: Approved .v..., 191. Permit No.a QdQ.o~.. ~ ' ' ' ' ~ ' ' ~ ~ ' ' ' ' ~ ' ' ' Disapproved a/c . (Boil mg nspector) APPLICATION FOR BUILDING PERMIT Date 19... INSTRUCTIONS a.. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of !ot and of buildings on premises, relationship to adjoining premises or public streets ~r azeas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 hall 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 Certifrcate of Occupancy hall 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 tuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 2egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. "he applicant agrees to comply with all Applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessa~jinspections. . /S p.4U?/~:7eC..~/.22~:c.d . c~f~7 t&. . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) / / 7(„7 hate whether applicant is o/~w/rner, l/essee, agent, architect, engineer, general contractor, electrician, plumber or builder, j~~l.C.~~..Is . •Y=-Y~ e..~Jld / ~.A/ C Y. r . / t y r Jame of owner of premises ~N.,.~~J.,9-/YL . 1 . f , .~~1~170.h.~, , ,~~j~/,.{'}, ,~~~ii,~/-j p, , , , , , , , , , , , (as on the tarX roll or latest deed) f appli~ca~nt is a cporporation, signature of duly authorized officer. (Name and titletitle o~t8~of'fii`er) w Builder's License No . Plumber's License No . . Electrician's License No . . Other Trade's License No . p7~p~1~' Q yy~ - Location of land on which proposed work will be done. 1!t!'?StjP~/.~:~1./9. !1~. ~./>./.13-.!?J/LIG~ A. ~.1.~~ . ~D4%~ House Number Street U'9e s°{-~hc~ ~ w~ ~Q, Hamlet County Tax Map No. 1000 Section 1,1 Block Lot 1.~-.~ Subdivision 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 . blintended use, and occupancy : A. l~~-~ ~ ' 94, . ~ J 3. Picture of work (check which applicable): New Building ...!1 .Addition . Alteration 1 Repair Removal , , Demolition ..............Other Work . , . f . ~O(7f(, 0 ~ (Description) Estimated Cost Fee ^ . (to be paid on filing this application) 5. If dwelling, number of dwelling unfits Number of dwelling units on each floor . . If ara a number of cars g g • sneie.r ' t't~r...... . 6. If business commercial or mixed occupancy, specify nature and extent of each type of use . . . 7, Dimensions of existing structures, t(' any: Front ...............Rear Depth . Height .........Numbet!ofStories........... Dimensions of same structure with alterations or additions: Front Rear . Depth k Height , a .~f NumbeJ of dries . . Dimensions of~_e~9},t~re new construction: Front . , ~ , , , , , Rear ..J~t7...~...... Depth •v • ~ • Height ....1!?s... Nu,~nber'of Stories • ~ ~ • • 9. Size of lot: Front . ~ 1!!Y, ..i , Rear ...tt}., 6T . .........Depth . 3(,i~ ~ "-vr~~: Y,~j. 10. Date of Purchase I • • • • • " " " ' • . , ..Name of Former Owner ~}u.~.«s~us. !r, .~x1:~Y,e,!~ €.r . 1 I. Zone or use district in which premises are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . x!© 13• Will lot be regraded ......~Q ..I ...........Will excess fill be removed from re es: Yes Nqx 14. Name of Owner of premises ~~1':I,'';5,~~,~VON~. ,Address 53-~3 CP9i''~•$'l: m~ gn~ o. Name of Architect (,=,g, ~ ~ Se S~''r3 • • • ' ed. Gt¢~I,i.i~•~, , , Address c~qq ; j . 1V:.~~ c,1k,• ~ o o. ~ :.`tdg.-$Sµ Name of Contractor l=.d mun44.:Rvyr?):~ ,err, ~~b ~yva,~_, •N:~,sctti~s~~: , ,phone No.:3loR :3$JB, . 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. K" TATS OF NEW YORK, 'OUN['Y OF . ~u.rrta4.lS S.S - • • d rn•~~•~~~ ~ •~gr~• • • • • , being duly sworn, deposes and says that he is the applicant (Name of individual si nin contj~act) hove Hamad. .p.. , e is the ~1~~r: ('l.C'W Y..:-~. ,~•SfLI!• , (Contractor, agent, corporate officer, etc.) ~ • • • • • ~ • ~ • • f said owner or owners, and is duly author(zed to perform or have performed the said work and to make and file this ~plication; that all statements contained in tihis application ara true to the best of his knowledge and belief; and that the ork will be performed in fire manner s t forth in the application filed therewith. .vorn to before me this .dayof.. 19~~. otary Public, . I, . , County I ~ ~ _ eL01ARY tNOfM S~s~i ~ !Iw Rwk ~ . ~ • :o~nia~~nMp°~ro~ soya • • (Signature of applicant)