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HomeMy WebLinkAbout20037-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24977 Date APRIL 10, 1997 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1230 RUCH LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 52 Block 2 Lot 36 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 1991 pursuant to which Building Permit No. 20037-Z dated JULY 22, 1991 ' was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued is ADDITION & ALTERATION TO ERISTING ONS FAMILY DWELLING AS APPLIED FOR. The certificate ie issued to DAN & LIDYA POLLOCR (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-291028 - SEPTEMBER 30, 1993 PLUMBERS CERTIFICATION DATED DEC. 30, 1996-R&K PLUPD3ING & HEATING ldin Inspector Rev. 1/81 I 1'OSM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N~ Z Dote ...~y....~..~ i9.~.1.. Permission is hgre nted t : ~G ~ ~ 'L6f /3 . ~ ...r~'^~t' c ...........X........................ ~9~~ ...~i741,~~l. ..~.'~a(a .l.~dx~l:. ....<i7'~ ..B~t ..Q7.€~. '~•.C.,~' of premises located nt . ~~30. County Tox Map No. 1000 Section Block ......trZ.2:...... Lot No. 3cf~. pursuant to application doted ~G..' 19./x/..., and approved by the ~~G 7//9f`~/ Building Inspector. Fee s.af",~.~~.9. C . Buildl Inspecto 4 k i r i Rev.6/30/80 ~`,f1 won ~Q/ Form No. 6 ""'^"'-"~'L ~ J ~ TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3, Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1~ lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ~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 $15.00,ppCoaammercial $15.00 • Date ......~~I~S.~.1.2 New Construction....... Old Or Pre-exist11i11ng Building...?. Location of Property. .1.~,j,0,,,,,,,~~!C~„. L,,Ia1J~......... C~~ .House No. I Street Hamlet Onwcr or Owners of Property... , ,l;y ~ , , o.~~. , . County Tax Map No 1000, Section. ~,~;,,,Block... ©.,~::......Lot....~.~° Subdivision ....................................Filed Map............Lot.................... Permit No...~~.3.~:ZDate Of Permit..~.I.~z ~~~..Applicant Ilealth Dept. Approval ..........................Underwriters Approval......................... ,Llanning Board Approval / 'Roquest for: Temporary Certificate........... Final Certicate...,,,,,.,, 'Ce Submitted: 5..~ APPLICANT ~c'~~},,,,,,~~QQ,,,,1 X es ' at~FFOGN •iBt» 9dl+1~03:<~~', :;'ri. :'a ' CQ~~ TOWN OF Sl)I7TIIOLb ~'te oartc~or• nulLbuar, 1NSrecroR . ,tit ~ c'? ~ 7otVN HALL 9'i~~ r~ SOUTIIULD, N. Y. ! 1971 r• i ,t .a s~ C E R T I F I CAT I O N i ;n ' + , e - - - - --r date t Building Permit, ~ I , \ I owner D \ ~C. ~ ~ f . p tanse pr ntl ~ Pltinl5er ' (P oese punt) l ~ i, T aortily that the soldAr usecl in the water suPP1Y sYsteld^'?r.",',} ..,t y~,fontllins las8 than z/lo of la lead. ''~?.`•~:~•.,r,~, .,r.: :,r ':r:g:y..r: ~,..,,~..'..wx (plumber's eige/atusel _ • ~ - - `~~~`~-'4 ' i~~.. ~.t r Sworn to bel:vro me this r ~ ~ • ° s~. ~~day vE ~ .,,.~r!' ~ t. lA2;Vy .'t., # ffo! ~ N tatty ubli^~ i ~ ar? VubLLa ~ ~ A 5 county ?rte;" ' LIND/t d. CO®PER " i' . C_ ' a: q+~~ Notary Pubiio, State of NexvYork ,f»; No.4822563, Suffolk Cout?1YE~j ~ T®rm Expires Daeembor 31,1 aa..-,F~.+~ , ~ ; , ' THE NEW YORK BOARD OF FIRE UNDERWRITERS eAC~ 1 1295099 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date 5EPTEMAFN 30,1553 ApplieationNo.onfile 7A22455L15L N 2510241 THIS CERTIFIES THAT only the electrical equipment w described below and introduced by the appUcont named on the above application number in the premises of OAN A LYDIA FOLI;OCK, 9.230 RNCI~[ LANN, Nr~Y,T 11, SOU~HOLO, N, Y. in [hefollowinq locations Basgment IJ /st Fl. L"J 2nd F1. ~H~' .Section Block Lot um examined on A N (r N 6 ~ 12 , 15 9 3 and found to be incompliance with the National Electrical Code. FlXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT NUONESCENT OTHER AMT. K.W. AMT K.W. MIT. KW. pMT. K W. AMT. H.P. 30 52 ~9 15 11 2 1.4 2 F DRYERS FURNACE MOTORS PUTURE APPLIANCE FEEDERS SPECIAL REC9T "TIME CLOCKS BELL UNIT HEATERS MULTI.OUTIET DIMMERS SYSTEMS AMT. K. W. Olt H. P. GAS H. P. AMT. NO. A. W G. AMi AMP. MAT.. AMPS TRANS. AMT. ~ H. P. NO. OF FEET AMT. WATTS 1 F 3 5 600 SERVICE DISCONNECT NO.Of S E R V I C E AMi AMP TTpF "METER L RW L a. 3W 3 A' 3W T,e' IW NO. Of CC COND A. W. G. NO. OF HIAEG 0. G. NO OF NFUTRAlS A. W. G. EQUIP. PER .9 Of CC. COND OF HbLEG OF NEUTRAL 1 a~0 cri 1 ~ 1 ~ 2~0 1 z~~ OTHER APPARATUS: , HOPOBSc1.'1 H. P. ,S-F H,P, G.F.C.:[o•13 SMOKN 0F'PNCSORL-L TRACK LIGHTING r.-56 Lz!U,~7 JIM 9AGN ELEC. INC. LTC,~3635-&. P. 0.9Q% 1769 GENERAL MANAGER SOCTTH4LA NY, 11921 1;1 Per This certificate must not ba altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. _ COPY FOR Bl'JILDING DEPARfMEI~IT. THIS COPY~~F CERTIFICATE MUSF~r~NOT BE ALTERED IN ANY MANNER. ~.,r__ _ . _.e c.. fi o~~gOFFO(,~Co G~~ N Z Town Hall, 53095 Main Road "p ~ ~ Fax (516) 765-1823 Southold ONewYork911971 y~O~ ~ Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 25, 1997 Mr. Dan Pollock P.O. Bax 207 Ruch Lane Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. ~}S- No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20037-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *ATTACHED IS OUTDATED CHECK #2549 DATED 11/15/93. d~~,,~,~°~ , 21°~ JAN s,~ti~ t. . DAN POLLOCK POBOX 207 SOUTHOLD,N.Y.17.971 JANUARY 19 , 1993 /J~/~ - ~~~a BUILDING DEPT. TOWN OF SOUTHOLD MAIN ROAD SOUTHOLD,N.Y.11971 MS. JANE BLADOS RE: BLDG.PERMIT # 200372 DEAR MS. BLADOS, THANK YOU FOR YOUR ASSISTANCE THIS AFTERNOON WITH MY REQUEST FOR A TIME EXTENSION ON OUR PERMIT # 200377.. I AM SURE WE WILL~BE READY FOR OUR C/O WITHIN THE EXTENSION PERIOD. PLEASE CALIF ME ('L 12 532-8652) IF YOU HAVE ANY QUESTIONS OR i CAN BE OF ANY OTHER ASSISTANCE IN THIS MATTER. SIN RELY, ~/~h, DAN OLLOCK ®~~~,OFFrD(,~~G ~ , TRUSTEES _~;kr~~~~ ~ John M. Bredeme er, III President ~ SUPERVISOR ~ ~ 'r' SCOTT L. HARRIS Henty P. Smith, Vice President ~ ~ < e,r Albert J. Krupski, Jr. ",<r John L. Bednoski, Jr. ~''tIQ~ ~ Town Hall John B. Tuthill 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD June 11, 1991 Karen Oxholm Oxholm & Daughter P.O. Box 133 East Marion, NY 11939 RE: Daniel Pollock SCTM #1000-52-2-36 Dear Ms. Oxholm: The following actions were taken by the Board of Town Trustees during its regular meeting held on June 6, 1991: RESOLVED that the Town Trustees APPROVE the request for a waiver for the following: To renovate house as shown on survey dated April 29, 1991. The Trustees request that all roof runoff be contained on site. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Very truly yours, John M. Bredemeyer, III President, Board of Town Trustees JMB:jt cc: Bldg. Dept. Eile i I\ New York State Department of Environmental Conservation Building 40-SUNY, Stony Brook, New York 11790-2356 (~I", a~ M(~, .Jan Pol1~K . ~~Iy I t~9 ~ 1- /i 11~ /1~ DATE . / R~CYl Lanz /`CI~J~I1~MCaMl39(.f1' ~S'~ony d6~~~ICG;~'loh~~'~~a~'Oo3~~/0000 "O t_ ~ ~ ~ ~ j ~ 7 ~ Re : iTt Thomas C..lorting ~OC._~'tlo C / ®}I®~~ Commissloner o I (aG 1 ~ GIG LtL Nl~. Dear 1`1i"~ and Mb's. P ~ p Sa~,~:-~-ho,„I,d y A review has been made of your proposal to: ~e/ac~~-~ fey20~~[J ~ a Wiry 0~ -r-he sin~(~ I c~~~[Irhp l oc~~e~ ~f- ~,av~ ~e e en<-eG~ G~(~Q`ICS,S ~'s the sa~'vey 3Ghn ~T, i''1'1 efz a'~ /0 3 f !'~s~- vi ar? ~©~ZS~9o ~nGl t/!< < ifs ~l~s~ p~'~~lt~~~}s Ukhv~n, ~h`~' ~~~~91- ~`'c7rv1 foot/ -os~z-off 36 a e -o a *n o tan u have- submitted, t°he -New York State ;3epartrnent ~ of E vironmental Conservation has determined that the parcel project is: f _ Greater than 300' from inventoried tidal wetlands. _ Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9 20 77. _ Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. x 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 Tidaa Wetlands Act (Article 2.5 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 or other alteration ar diskurbance.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 erection 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 D'epartinent.__ Please contaca this. office if such are contemplated. - Please be further advised that this letter does:noi: relieve you of the "responsibility.of obtaining. any necessary permits or. approvals from other:=<" agencies ` - r ~ . s; a - „ Very truly yours-," Cc ~ Karmen C~~ch~l~ _ - o7o~unos, ao wuwt ~ ~'f ~ , ' •lilgCt pig Deputy Regional Permit. Administrator ~-Y 6F"~' t ~.~r~~ - . _ _ . _ _ _ . _ ~_F~~ _ . _ _ r.~. ~IcLD IGSPECTiutJ ~~DATE ~ ~OMMENT~ l~j, 0 ~ 1. - y r`OUNDATION ( 1st ) ~ } vci` FOUNDATIOIJ (2nd) _ pp ~ 2 . ~ GG' l/ ~~cz, d e o P.OUGH FRAME & _ 0 PLUMBING H l~ - ~ 3. " ca IIJSULATIOf7 PER N. Y. y /-n 9z. STATE ENERGY CODE m 4 . d FIiJAL ~ ~~,pp z^h ADDITIOfJAL COMMENTS: x \ l~ ~G_ ~ a x ro a ~9~ LAC. .`/~~/9 a W ~ a\ • r H~ • - x e m H ~ N ~ ~ G r' CC~D~ L C'C1 ~ ~ ~ID~A~ (FOR NONwELKCTRIC HEAP) DESIGN CRITERIA 6000 Degree Darti O,A, 10°F I.A. 90^T OR ~nh ~ ~/0~, n v e~ - c h R• --3`lJ S ~J ~C ~i A Q E A U '~'p~'hnR L~ Rx M~TR K s /2A?/NU , kkterf ex~ palls (Opagae) G i ~6 , ~ 3 ~ ~7 ~ Dbeltr _ Cetl)no,~reef (Opaque) 73 S" . o .Sk~livrte 96' Rlnt+p Fmnndatlen palls - ~ Sl.b IMenlatien ~o ~f ~ Netee~ Dsildisq E~velepe Sywtesn to Meet regvlrestntn of 961¢~E HVAC' Fgni~weKb to lhetlt regsitesentn of 76l'}.11 HVAC' gFnteKe te'.webt req/~Rresentn of 7al~~lt , . IIect >r~xters to r~eet tegyifr.Kenth e£ 7615.13 , , ' VF.stilltiinM • ~yNtd11M to meet ,req++ire.~ientn of gR15.14 Inne+latieft of Pibfna kFnta*n to meet rrq+yiresehtA of 7E~1'S.15 aefvice rlxter uaxLin~r St+ete*n and Ffjnipsant tb sett Req++irekente ®f 9615.1,1 Llectricxl xn~l Lighting SrnteMn xnd Equipsent to Beet xequirr.~nentn of 9H15:31 ?s tie bbMt ei twr Knerledge, E;;riy`~=~w~ `V~ Vct ~ helief~ xnd vxefeenienxl ,jMaeMent~ these rlxnn aLe in ~~',s ~ cesplianpe Nith the code. ~g f;~' W a • `r;~ ~ ~ 02264-7 ~~'~~FESStO~P~ ~ I ~3 ' y _ ~.4 ..Yr_e., 11 3 j ~ C ~ ~ ~ z, ~ ~~~L g~ u~.rw w~t Z~v~o ~ ~ ti ~ / t~ 4,C~~'~e-n ~q~~ a~ a,~.-eu~~.c~ . c~.e~J -~6wnoC~G~L I . i f 7 i y _ _ _ _ _ _ _ _ _ . R L_ _ - _ _ - _ i r _ _ i V 4 ~ua 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION i5T [ ]ROUGH PLBG. [;FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~t~'-~'C a~'~~ c7"6i... f DATE r INSPECTOR k ~~3? 765-1802 BUILDING DEPT. 1 NSPECTION [ FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: C DATE ~ INSPECTOR < ~ ~ i ~ ~y~~% 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [G~' ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL C,%~;~ -f~= REMARKS: ~ ~ r' L ~~<.a...4" i ,n, DATE ~ ~ ~ INSPECTOR '~''~___g;~/,~, f i+ i' r. _~e -~.e~._ ~3~ ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ )ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ~RAMING [)FINAL REMARKS: t l DATE ~ ~'Y ~G" INSPECTOtt ' k i K _ ~ - ~ _ ~ _..=4._~ I ~~7 ass-iso~ BUILDING DEPT. INSPECTfON [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL .2~v RE ARKrS/: v L (J~ _ N e ~ ~h e e~-~-2~~~- l g ~ DATE INSPECTOR i ! x V _ _ ~-3 - 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL RE ARKS: '`~~-~C, Otil ~L~~~ ~,9~~ ~ s/~j _ /~~~'~/7d~/ DATE ~ l7 INSPECTOR , _ . _ _ f D~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. ' [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL [ ]FIREPLACE 8 CHIMNEY REMARKS: ~ ~ ~ ~ l it i C DATE ~ ~ ~ l ~ INSPECTOR Jf~~~,C~ ca r:..3 60,1F0 OF HEALTit , . , f v ~`,~s U ~~f t_'=iii FOrtM NO. 1 . 3 SETS OF PL,\;7S I TCdWNOFSOUTrIOLD SUItVEY j ~~N Z~©1991 ~ BUILDING DEPARTM[NT Ct1EC1; . • • • _ . _ , , . TOWN HALL SEPTIC COR:[ SOUTHOLD, N.Y. 11~J71 - _ • Fit. s. F7E'4'i""."'~.°~ TO~Vrrly t~``C:U'ii'i0L0 TEL.:7G5-1u02 ttoTlF't; KfFitE1~ gc+10t'F't ~arnincd'a...`~,.~~.~,,'v,,.,,,-~-~,~' c,vLL .~~k{GL+M.£r~7,/44~r1^(~. rtnlt. ro: :,proved ,~/r~.`7i...... , 19 9~Permtt No.'s, ,~:3.7.~ PQ: . ~_?.~J.. . sapprovcd a/c ~:.Ml}RiON,,I~.~]°g93q . . t6'~ 7 l9'6 1_ r , ...13uild'.ta•lnspector)..... ' ? APPLICATION FOR BUILDING PERDAIT Date .~~N~,~~,,,.,.., 199+. INSTRUCTIONS ` This application must be comptctePy filIcd in by typewriter or in ink and submitted to [he Building Inspector, with 3 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 treas, and giving a detailed descriptiort of layout of property must be drawn on the diagram which is part of this appG- qn. 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 il~e applicant. Such permit be kept on the premises available for inspection throughout the work. A'o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy I 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 Sing Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or alations, for the construction of bu%Idings, additions or alterations, or for removal or demolition, as herein described. applicant agrees, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to t[ authorized inspectors on premises and in building for necessary in ections. . ~a~.~ (Signature of applicant, or name, if a corporation) c7~cFtot,~ ?,.II. Al~H'f~~ .P~D. T3pX.t.33 . ~ :M!~kt n.~ ~ .~:`r (Mailing address of applicant) 0939 whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, .............~4la,EN'(' . `I?E:a14NF'C-..,~.,.1G'F$ .~'t~-v,Rpl u~et~fpg_....................... . e of owner of premises ,~,~,~,DY~. ~G.t1!~!Q'~.~ (as on the tqt roll or latest deed) ?lican[ is a corporation, signahtre of duly authorized officer. ~ ' (Name and title of corporate officer) 3uildcr's.Liccnsc No. ~kNR~R>~41u Cpl~p~~ '~v~ E~J/alA)~ll~.~+/ 'lumber's Liccnsc No. K'jj,~, ,~?~„!~}QQ~(J~. , I :lectrician's License No. ~(i,~,'rj,T~~~~~~r (~~i )titer Trade's License No. . c nation of land on which proposed work will be done. /~3© ~tJeH ~q VOdrr/ot-~ ,t4'AlAt~N:r:'~0. ~~~5'(11J~j .3..a~A..~-- L.k~f k~5~,l31;S1~~ . R~c-t~ ~ ...~iSN~+II,I'.tq~M,Q,c~.~. , ~o~o~ . $~?4?~'k+Ql use Number Street Flamlct :ratty Tax \tap No. 1000 Section ...Q,$,,2. Block ..Q Lat . , ' ,division , . Piled t,t:tp No. , Lot .....(Name) ~c existing use and occupancy of premises and intended use and occupancy of propgsai construction: ing use and occupancy , S1N(!„~, ~i<1NUL.'C.. R~~.•.. , , , use and occupancy ~ ..:~~l~?~4~..~t'~14.''~...k?~ ..'4 . . t 3, Nature of work (check which a ' Repair licablc): New Bwlding , , Addition Altcrauon?. , • , , , , , , emov nal Dcrnolition?, . f Other \Vork~DS$S;lt~,Tlpll~.. . 4. Estimated Cost..~r•atyp ~Descnption) . Fcc 5. If dwelling, number of dwelling I' (to be paid on filing this application) • If garage, number of cars , , • ° wits , Number of dwelling units on each floor . 6, If business, commercial or mixed o,ecu tanc• ~ • ~ ~ • • ~ ~ ~ • ~ ~ " " " " " " " " " " • " • " • • • • . 7. Dimensions o,f existing structures, if any; Fror,pecify nature ;utd cxtljetaof each type of use . Height . . Nuntlrcf ol'Storics . Depth . Dunensions of sarhe stntcture with ~;altcrations or additions: Front ~ ~ ~ ~ ~ • ~ • • ' ' Depth. .'HcU,ht. Rear.................. Number • . . Number of Stories . Hcigttt ion: Front , . 3, Dimensions of entire new construct. of Stories , , , , , • • • • • • • , , Rear Depth Size of lot: Front " " • • • • • • • • • , . . 0. Date of Purchase Jh1N,.14°Ia ...I,........ Rear . . Depth • , . , ...............Name of Former Owner . I, Zone or use districf in which premises :ve situated , , , , , , • • ' ~ • • • • • • • • • • • • . Does proposed construction violate any zoning law, ordinance or regulation: ~ 1Vi11 lot be regraded , , ' ' ' ' h ' ' ' ' ' ' • • • • • tiVill excess till be rcmovcil from premises: Yes No p ~ N me of Architect remises , , , , , , , , Address ...................Phone No. Address...'..........., + Name of Contractor , , , , , , • , ..Phone No. . Is this property within 300 feet of a tidaldwetland?~ ~ ~ • ~ • • • • Pltone No. • Yes...?.... No *If yes, Southold Townl,Trustees Permit may be required. PLOT DIAGRAM u'~~' Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and bock number or description according to deed, and show street names and indicate whether ucrior or corner lot. ~ SuRvEY s, "Pi.~'(" PLlrll~ TG OP NCN YORK, ~ JNTY OF S,S (N:unc of individual signing contract ~ bcutg duly sworn, deposes and says that he is the applicant e named, :the . (Contractor, agent, corpaiatc officer, ctc.)~ • • ~ ~ • ~ • ~ • • • • • • • • • , rd owner or owners, ahd is duly authorized ~i,to pcrfonn or have perfonncd the snid work and to make and file this .aUon; that all statements contained in this 1pplication arc true to the best of h{s knowledge and belief; and that the tvill be pcrfomtcd in the manner set forth in the application (i1cJ thcrcwitlt. .r to before me dtis ~ ....dayof.. 19~.(. ff'".'~ ~ y > • County . > HEtEN K, DE VOE a ~m4707878 Su~HolkLb~un7Mk . Term E¢plres Merch 30,19...3 (Signature of ap, i t ri rY~~, ~ , ~-t ) f i 0 7 ~ ~ °~M, ~ ~ ~ I o a ~~-I h ~ n a2 ~ ~ t~, iI C -O I ~ r.f (~f ~ d d~ f t ~ ~i ~~v~ ~ i ~ fTl 9 a ~ ~ ~ co ~ t ~ r q 'n U , ~~U~1 ~ ~ tM III ~ ~ v tO~ N G ~ _ ~ ~ 2 L~ p, _ . _ ._i__..~__ L._- - _ _ ~ ~ I h ~ ~ ~ n 3. ~ ~ s r. 2 ~ ! ~ ~ ~ ' I ~ ~ ,n ~ r ~ ro ~ ~ ! R~1 . Y ~ r, t ~ m ~ d ~ < L, U -1 t~ aD0 l.a`~yFdq,~~ I ~ i'a Sa ~m ~ . I a ~ < ~ ~ AI ~ ~ ~I r ~ I ' t I! ~ l^ s~# " ~PRIYA TE ROAD ASK/A RuCI~! [AAIE S. 56°45'20"E• N.Y.T. 126.80' CONCCU s I C C ~ ~ ~ CNC:',' ~ I CONC. ' 6UY M 119$ - 'FEN. "V 1.3'W ~ SLAB w . I I Q8'W J •O V w: .a ~I .LI NI . w w I Q, (V` ~ ~ a J N ~ ~ 2.3' 2A' 31 i ~ ~ MQ A. O N C ~P „ q O ? N I ty 103' ~ 9.3 - ~ n~- CONC. ~ ~ N, ^O ~ 1 8.9' N rv 7.6' a SLAB ~ 1.2' 2 BTOAY 71 G ' 1. 2' FRAME a1 7.0 NOOSE 3.0' ~ N ~ w ~p ~p CHIM. Q Y Y m W W I 2B' r.3' Q , m a W ~ Q .J/ BRICK q - Z ~ ~1.5' SLATE STEPS W000' , ~ Q Q ~ OECN 2 9R o d ~ . ~ o W ~Q•= _ ~ a Q~' ~ w ,3 ~ 0° o w O . o ^ A o ~ ~ M ~ BRONEN ~I _ 10 - M - CONC. BS`ER3 ~70P OF BANK - - Z MON. - ,CONC. ' BOAiHOU3E IU ~ CONG• WAU~• - ~ H.W.M. Ty _ ~B. C NI E ALON® H.W.N • . 66.85 AREA IS, T65 sq•ft. pRSHAN?~M~'aUE or 0.3619 oore ~ WAgHAMOMUCK POMO) to tie line SUR~Y~EY OF PROPERTY AT CERTIf/ED TO : A R S MA M D MA Q U E PECONIC ABur' TRACT INCORPORATED TITLE NO. 808-5-7718 TOWS O.F $OUTHOLD NOR$TAR MORTGAGE CORPORATION DANIEL POLLACK c. euzio-POLCacK SUFFOLK COUNTY , N.Y. ' 1000 - 052 - 02 - 36 ' SCALE I" 20' .-~o"~,rat~~t~~ OCT. 3, 1989 .1 .¢y;*YL` : "^E~<cR~~~ pet. 25, 1990(add 10' contour) - y, ,n~~;MM:~ e LIC. NO. 49618 - ~ J 6~$ _ " C ~ R.^. P.C. f81a) 7e~ = - , , P. O. BOX 809 MAIN ROAD CONTOUR LINE /S REFERENCED TO N.G.V. D. SOUTHOLID, NL Y. 11871