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HomeMy WebLinkAbout20316-z y ~ ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20767 Date JUNE 3, 1992 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 3575 STARS ROAD EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 22 Block 2 Lot 24 Subdivision Filed Map No. Lot Na. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER Z, 1991. pursuant to which Building Permit No. 20316-Z dated DECEMBER 9, 1941 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 AS APPLIED FOR. The certificate is issued to EMMANUEL & RnRRURU CARAVANOS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-85- MAY 28, 1992 UNDERWRITERS CERTIFICATE NO. N-232237 - APRIL 15, 1942 PLUMBERS CERTIFICATION DATED MAY 29, 1992 - J.MICHAELMARI B ilding Inspector Rev. 1/81 roses xo. A TOWN OF SOUTHOLD 6UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) No 2031 ~ Z Date ...?J~~.~;~...q 19.9..1. Permission is hereby granted to: ~~.:...~u.:.y....... r.~..!~.J.... of premises located at ..~.a~..7.5.........~°::~0....~.,........,~.~Q:.....~..a:~-~`.C1........... County Tox Map No. 1000 Secti~o'n~.....5.~.~Z:..... Block ......C}.~-..... Lot No...~~ pursuant to application dated .....11..J:!~.C~?!!::'~.~...~' 19.9...., and approved by the Building Inspector. Fee S..ao.;~.:..1...~.. ~t1M Building Inspector Rev. 6/30/80 Form No. 6 . t;:-., - 6 7 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~uN - ? 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 ly, 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 - Residential1 $ 5.00, Commercial $15.00 Date ....i,tJ.~.~~.~ New Construction.. x,. Ol~d^Or Preryexist~°i'n~g~Building...NN...... i•• Location of Property...~~~..~J„~`~.IL-~...IC.1~... ~...C6't:~~~~............. House No. Street n,~ ~Ha{mlet Onwer or Owners of Property.... ,I Y'~ . ~~~~''-.,~5~~}! ...~:+~~~N",rr~~~,~,yy"~~,., , , , , , , , , , , , , County Tax Map No `;-yy1~~0pp,,0~~0, ',S••e11ction.. ®~~:...Block......~j~.......Lot.....G'".1.5........... Subdivision.~~.77..,,~~..~:y.~t,:'':77~wv.~~~,..... .Filed Map..~..1~~~...Lot....~.±i~^ Permit No...Lf::~~~.i~i.Date Of Permit..~2~.~1~~~.•...Applicant...~~~1..1,C"3~.~:...... Health Dept. Approval... .Underwriters Approval. Planning Board Approval Request for: Temporary Certificate........... Final Certicate.... Fee Submitted: C~.•ve. ~(3 y . co ~ ICAN . INSPECTORS Victor Lessard ~s~b+FFd(,,(-c` Principal Building Inspector ~©L p Curtis Horton G~ SCOTT L. HARRIS, Supervisar Senior Building Inspector o &'"''""":~15 : Thomas Fisher ~ .i„ .fix ~ Southold Town Hall ~ ' ~ ` ~ P.O. Box 1179, 53095 Main Road Building Inspector O 2~ ~ ~ Gar Fish ' Southold, New York 11971 Building Inspector : Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 6, 1992 EMMANUEL ~ BARBARA CARAVANOS .~8-~$ 217th STREET WAYSIDE, NY 11361 RE: PROPERTY @ 3575 STARS ROAD, EAST MARION, NY To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: R%R An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. x%R The check is not on file.)$25.00 %%x 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 # 20316-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. hIRY' 1~ 11 ~ 1 TGWPI OF 561_ITHOLD P.2%c c~~~~QLrt'`, ~ 1'EL, 7G5-18ox q,~0 ~1~ TOCV1~1 QI'' SOiJTgt7~,p~ • }'1' OFFICE OF AUILDTi•!G INaPECTO~ emu,. ~=Y, P.O. HOX 728 ~b ~ TOWN HA.Lt, P~~O~~Q~ SOCITHULD, N.Y. 1197I ~ `?9 llf,:y ~ ~ ; C $ R 'I' I P I C A ' ~ T Z O N J(JN 2192 ~ y ~ ~ ~ Date_..,~ Building PErmit tva. Zo ~ ~ , Ownez ~~~J~Ne7S , (please prant) Plu:..be tP,~ Print) X cex*iEy thak the solder used in the water supply system cont4xns less than 2/10 qg 1; le:~d. • p mber''s sig e) Swor~tq be£crc me this ~.~day af: z9~. lJotar• ~ Nocary Publiq 1 ublic,~U~'®//C County • Notary pub State of (~Ny~ Qu f.No.~478~6~858 Expi~ea °J ~~--ik-""" ' INSPECTORS Victor Lessard ~pFFD( Principal Building Inspector C~~ Curtis Horton ~ ti G~ SCOTT L. HARRIS, Supervisor Senior Building Inspector o ~ = ` 1 v~ art; t°':--~'~ Southold Town Hall Thomas Fisher F ~~'~,1 = P.O. Box 1179 Building Inspector d ' ' r ~ , 53095 Main Road d'.Z94~y'. e. Gar Fish . x9~' Southold, New York 11971 Building Inspector `~~l Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher „ ~(r'~ Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD qV4 MAY 6, 1992 mmtnNrru.L 6 BARBARA CARAVANOS 28-38 217th STREET BAYSIDE, NY 113(n 1 ~ . RE: PROPERTY @ 3575 STARS ROAD, EAST MARION, ~uN ®2 r To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: R%x An application for Certificate of Occupancy is not on file. (Enclosed) i No Underwriters Certificate on file. X~ The check is ,not on file.)$25.00 X>~ No Health Department Approval on file. No final inspection has been made. %Xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20316-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~~f,u 14J9.h92& BUREAU OF ELECTRICITY 68 JOHN STREET, NEW YORK, NEW YORK 10838 , Date A~~'1_(t Zh„i.h~2 APPlicatian No. on file ~ THIS CERTIFIES THAT only the electrical equipment oa deacrihed 6elorv and introduced 6y the opplicoist Homed on the shove application numher in thepromiaea of PiAN7N~' CARI7VAN~"u, :i'.i75 ;37'A.RS t2ll., E. ClAIiL~}41, N.~. in thefollorving location;, (}1}~'" Basement ~ Ist FI. ? 2nd F'l. .Section Block Lot AFrLt, 11),1.9 n2 uns examined on and found w 6e in ronLpli6nee with the regnirerneats q/ chis Roard. FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS FCEPTAGLE$ SWITCHES INCANDESCENT FWORESCENi OTHEfl AMT. K.W. AMT K.W. AMi K.W. AMi. K W. AMl H P. nl e~ ~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELi UNIT HEATERS MUliI.OUTLET DIMMERS AMi. K. W. Oll H. P. GAS H. P AMT NO. A. W. G AMi. AMP AMT. ~ AMPS TRANS. AMT. H. P SYSTEMS AMi WATTS NO.OF FEET ~ 2~ i~ k SERVICE DISCONNECT NO.OF $ E R V I C E AMI. AMP. TYPE ME1FR I ]W I 3W J.e 3W 9,e' 4W NO Oi CC. COND. A W G NO OF HI-LEG A W. G NO. OF NEVTRAlS A W G' EQUIP. PER 9 OF CG COND OF HI-LEG OF NEUTRAL 1 rep c>~ x ?~i~ t a~~ k OTHER APPARATUS: ' ~.i7. C:, i.t'~. srtoxL Al,mur,Tas;: - 2ERCC 4i6h'CTIi1:C :iC9RVT(~i4 GTC.tP71.2°~' 54 ~umRRTLIrR ARZVE SHI[26F,'Y, t1Y, 1196'i 6ENERAI MANAGER 1. ~rf 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 ALT,,ERED'IN ANY'PAANNER. ,~~',1::LD I;:S:'c:C:~V:J ~IDi,:^ I i;OMMENTS 1~' ~ t ~ ~ H FOUtJDATION (1st) '3 ~z FOUNDATIOtJ (2nd) _ _ m 2, d z oW PLOUGH FRAME & J PLUMBING ~ 3 . ~ 1 ~ Y -3 /0 x Yt m IIJSULATIOh1 PER N. Y, m H STATE ENERGY ~fig1 CODE 1 4. m ~c H FI;JAL I ~ O _E y ADDITIONAL COMhfENTS: ~ 3b x •M a s, b H ~ a . H `O H O ~N Z M ..Q } ' r ~ v ~ J- ~ 001 Robert Bassolino R. A. Architect 28-55 214th PLACE - BAYSIDE, NY 11360 -X~~Y6~~~9`g~ Z ~ 2-G64bO~55 January 3i,199z Town o£ Southold Office of Building Inspector Re: 3575 Stars Road xppl.;F 203167 Dear Sirs, ~ am the architect for the above application and I wish ° to advise you of the following change: 'Phe thickness of the foundation walls are to be changed from 10" to c3"> _ ~ 5incerel r • tobert li sso1S_no it~i A Q~ q Y~! } R ~ ~ fY t~/ ~W~~~ Mo yy2~' of T6/£ 3TA1E ®4 ~~lr y~ p ~g Libfr~1104~~~ ( SCI~;DULE A:r CONTI"IUABION OF DESCRIPTION) I TOGETHER WITH a right of way over 50' private road lying 180 feet northerly from the premises i - Also with a right of way over a 50' private road lying between land of Stamos and land of Baldes and running from Cedar Drive easterly 120 feet to said westerly boundary of land of the party of the first part, j` Also with a right of way over the KO' private road along the easterly boundary of the premises and continuing southerly about 14160 feet to the 4+[ain Road. Also with the right of way over ~0' private road running easterly from the easterly terminus of Aquaview Avenue Also with t'i= rigl-it of way over 35' private road from a j, aoint about hE30 feet northerly from the norteasterly corner of the premises northerly about 330 feet to said 50' private road running easterly from Aauaview Avenue Also with the right to use, in common with others, a right ~ of Tray over I~0' strip of lard, the western line of which is the ~ easterly boundary of land fornerly o£ Wm. G. Lenz and which runs from the northerly line of said 50' private road northerly about ' I ?~5 feet to Long Island Sound. Also w~tr -.Y_e right to use, in co:rmon with others, a parcel! i, o£ beach about 40' x 9C' lying easterly from the above described ~ 40' right of way. 1~eing and intended to he the same premises convoyed to the ~^rantor herein. by deed recorded in Liber 5262 ep 311 . 11/11/81 J-f~Gv..,,oc~s`"~°~ ~eiv~~ i I I ~ 765-1802 BUILDING DEPT. NSPECTION [ OUNDATION 1ST [ ] ROUGH PLBG. [ , ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FIN . REAf~~~: ;,A - DATE ~ INSPECTOR ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ()FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: < ~ i i DATE - ! 7 1/ INSPECTOR .~i.~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~ _ s i DATE ~ (.P ~ INSPECTOR, 4 .a s' s 9,J 7ii x'~~, .ill ~~6 party of the first part, P'i;ii'IA~ill~~~7, r 6 _ 43rd Streot, Astoria 3, New and FELIX_~~ CONDE, residing at 2~- 1 S Xurk., P I party of the second part, x r ~(~~Q~}~Qtl~r that the part y of thr. first part, in consitIeration of _ Dollars, • ------Une------------- Tlawful money of tha United States, and othor good• and val ueblo consideration _ of the second art 't, paid by the party p . ' . do e a hereby grant and release unto the party of the secatid part, h19 hairs and assigns forever, t, , .x . that certain plot, piece or parcel of rand situate, lying and being' st Raat Marion, Town of uouthold, County o4 ~uffol)< and State oP New York, ~',boundad and doscribod as follows: ~ "~a a, `^"i' I3EGTNNING nt a monumont en the westerly boundary line of th© party said boundary ''`'of the fist' part, S. ll° 23t 3U" E• - 870.51 Poet along ,`-line from the onsterly terminus oP the southerly line of Aquaview Avenue, ' aaid p~~int of beginning Uo].ng 480.0 feet southerly along said boundary ~ , line Prom the southerly litre of a i0 toot :-:1~•a*-~ A^ad and being also the + k southweaterly said lad pfxrUasquez,gNc.z7H°r36ts30d ~ointl? .O©feetito a • running along ``V t monument on the woaterly line of a 51~ foot'Private Ftoad; thence eland of said westerly line, S. 11° ?3' 30't E• - 17.0 feet; thence along ay~ P' the petty of tho fix•st: part, S. 7a° 36' 30 W. 120.0 Yeet to land oY t~"pzenkowskiq thenro nlorYp, said Tand ref Dzenkowskl N. 11° 23~ 30" W. - 170.0 ` • yeet to the point of beginning. ,•k~ Y , 48o feet , TOGETHER W1TI1 a right of wa over a 50 privatt, Toad lying ``,poPtherly from the premises. Also with a right of way over a 50t private road lying between land of 9tamos and land of Isnldes anofrlandn~f~tha peaty efitheefirstl~art~ 'feet to said westerly boruidary ' .Also with a right of way over the 5G' private road along the easterly boundary of the premises and continuing southerly about 4160 feet to the gain Road. Also with a right of way ovor a 50t privato road running easterly `s~.Prom the easterly terminus of Aqua view Avonue. also with a right of way over a 35' private road from a point about y` 480 Peet northerly from the norti~oastert.Y earner of the premises northerly , about 334 foes to said 50' private road running easterly„from"y4uaviow ~`n : Avenue. ;~V;~..-. - . n.. 5'T .4 ~i r. F~. l' l /1 Wi iii '1, ' 3~ S~ R {,r' ~ ~ ~ t ( ~ ~ . ~ y i, w O., ~ ~ v~+t.N 4!' }R. . r .L,rol:.x.., v._.r»... .,.h s...c w..,.., w,. .:sw..::.a..u..v..m,.a. ._.,s°.. W.,,...w.4rx-eu's. f ' { ~ standard N.Y.n.T.U. Fm~m 8002* 11~80~90AI•-norgnin and Sale Deed, with Covenant a6ainst Grantor's Acts-Individual or GOPPOratlpll. (single shee CONSULT YOUR LAWYER BEFORE SIGt'.lNG THIS INSTRUMENT-THIS INSTRUMENT SHOULD E USED BY LAWYERS ONLY. THIS INDENTURE, made the ~ day of idovember ,nineteen hundred and eighty one ~gi BETWEEN Felix F~r~'oric~e' rresicli.n;; at ~5-61 l}3rd Str©et, Astoria, Borough of queens, City and State of New Yot°lc, party of the first part, and L+'mmanuel. Caravans and T3arbr~ra Caravan0s, residing at 3828 ?17th Street, Rayside, Borough of C~ueens, City and State of New `Iork, party of the second part, ' WITNESSETH, that the party of the first part, in consideration of Ten Dollars and other valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs ' or successors and assigns of the party of the second part forever, • ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected situate, ' lying and beinghlXt~9c. eat Fast Marton Town of Southold, County o.f ">uf['olk ,i., and State of New York, hounded and descri.hed as .follows: BEGINNING at a point on the westerly side of Mars Road, distant L}80.79 feet southerly, as meanured along then same, from th® corner formed by the inters®ction of the southerly side of Stars r Road with the westerly side of Stars Road, said point bein>; rtlso at the division line between the southerly side of land now oe formerly of Vasquez and the northerly side of th® her®inafter described parcel running thence along the westerly side of Stars Road , South 11 degrees 23 minutes ar:d 30 seconds East 1"70 i'eet to ti)e ' northerly side of land now or formerly of Town of Southold; thence along said land South 78 deh;rees 36 N'i.nutes ~O seconds West 1?0 feet to the easterly s'i.de of Lot 10 on man of Aquavi.ew Park %r` ;6?1; thence along said land, North 11 degrees?3 minutes 30 s®conds West t;. 170 feet to the southerly side of lane] now or fortnerl.y of Vasquez; and thence along said land,North 78 desgrees 36 minutes 30 seconds East 1?0 feet to the westorl side o.f Stars Road eat the y , point or II c6 place of BEGINNING. ' '~L 1 ( DESCRT.PTIOD? CONTINUED ON SCFTP;DULE A ATTACHr,D) i i ~ ~ _Z.~ i ~ . NJE UBE~~~~~('~SEG>l~ 1'It• i,"i~' t,.;(, ~,,Rt,,,~. ' DESIGNATION f',. , ~ ; ! _...,_..,...~.aN.w Dt:t. ~OGO TOGF_Tf1L'R with all right, title and interest, if any, of the party of the first part in and to any streets and G22t00 roads abutting the above described premises to the center lines thereof; TOGI'l'Hb:R with the appurtenances Son. nod all the csunc uud rights u( the party u( the first earl in and to utid IItrcmisc's; 'f0 IIAVI? ANU 'I'O ~ 11GL1> tbc• prrntist•a herein granted ante the party of tl+c second hart, the heirs or sncccssors and assigns of ~ 13111~2•trJ~ the party of the second part forever. i, t_ottslgo24.00b AND the party of the first part covenants th;u t,hc Ixlrry of the first part has not done or sufTcred anything whereby the stud prehuises have been encumbered in any way whatever, except as aforesaid. ANA the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the lxtrty of the first part will receive the consideration for this conveyance and will hold the right to receive such consid- } eration as a trust {and to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the sarne for j 'n any other purpose. ~ The word "party" shat! be construed as iE it read "parties" whenever the sense of this indenture so requires, i IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written, • \ ~ ~ IN PRESENCE OF' ~/J`/~' v + ~.L~~l~pa.;;~~~c~-,~f b~ELIX F6;RNANDE7. CONDE i 4 1.~.. ~~Et~~.Orar~E2,le~ STATE'"i5k'NEgI'yORK; coulvf r yr Ql1L:L~N S sst STATE OF NEW YORK, COUNTY OF sss On the day of NOV®ttt 1 ~ ,before me On the day of 19 ,before me personally came FeliX F'~~n~~ personally came to me known to be the individual described in and who to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that executed the foregoing instrument, and acknowledged that he executed the same, executed the same. FRANK R. LAND NOTARY pUOLIC, SMte of NaW Yolk , No. 30-7912A7.0 4ua4ifisd in Na550O County ~y~ ` I CnMi1115510D Expires Morch s0, Iq_.(~( f STATE OF NEW YORK, COUNTY OF ss: 57ATE OF NEW YORK, COUNTY OF sst .a,~tg~ _.,xt On the day of 19 be£orc me On the day of 19 ,before me personally came personally came to otc luwwn, who, being by me duly swore, did dcpnvc nwl the subscribing witness to the foregoing instrument, with say Ih:u IIC I'CS:fIC4111 No. whiwl I :uu personally acquuinlal, who, being by tnC duly sworn, did depose and say that he resides at No. that he is the of that he knows ~ y s; ,the corporation described in and which executed the foregoing instrument; that he to be the individual knows the seal of said corporation; that the seal affixed described in and who executed the foregoing instrument; to said instrument is such corporate seal; that it was so that he, said subscribing witness, was present and saw affixed by order of the board of directors of said corpora- execute the same; and that he, said witness, tion, and that he signed h name thereto by like order. at the same time subscribed h name as witness thereto. (~j ~+~16'0 i~TtE fI~SJlR~~tIIE CII ~6ittrgain nnD male ~9eeb ~ V?I I II CO/VIiNA N'1' ACAIN$'I' ~i 11AN'I OR'S ACTS SECTION ~ f~ TITLE NO. U 0 3 Q ~ BLOCK ~ ~ ~ . LOT i.~ELIX P. CONDE COUNTY OR TOWN Suffolk TAX BILLING ADDRESS 7'O I Fr~r~ArruF'L CARAVANAS and BARBARA Recorded At Request of the Title Guarantee Company CARAVANAS RHTURN BY MAIL TO: S iANDARD fORM Of NlW YORK BOARD OF ilnf BNDFRWRirfRS ,ioseph P, Ploriski Es no-Nrnr,,."r r'9 ,36? Willis Avefnue~ TITLE GUARANTEE- r21 noolt~, N .Y. 11 i01 NEW YORK AT(COR COMPANY Zip No. w v ~ O ~ z o ' O LL 0 \ W I W ~ o Y~~~ ~ a ~p W o~, ' 60,1FD OF REALTf{ ~ FORM NO. 1 .~J SETS OF PL.1:7S ` ' TOWN OFSOUTHOLD ,,.SURVEY BUILDING DEPARTMENT ,.~C11LC>; • • • • • • - UE(i - 2 ~~c~~ TOWN HALL SePTIC FORA . . . . '"i SOUTHOLD, N.Y. 11971 M/25. CAxHt/Ai?p~ ' TEL.: 765-1802 (T f F,f `~7~~) as ~ - xe5a~ . ,19.9.1 CALL Ez3minc Re~ hlA L T oZ~ ai~~I ~~RCtif . Approve 19 ~'.I. Permit No.u~.0 ~ 1L g"", . ~AY.S/r~ N y_ . . Disapproved a/c . (Bur ding Inspector) APPLICATION FOR BUILDING PERMIT Date ...?~e.~em'~~/^...~j, 19./.~' 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 or areas, and giving a detailed description of layout of property must be drawn on tfre 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 availab]e 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 Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordnance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, hous}tt~ coder ulations, an~j,to admit authorized inspectors on premises and in building for necessary spectio ~ • ~+~-'^~~..~re-,sue/ (Signat [e of applicant, or name, if a corporation) 38'Z8 Z1JTH. STREET, BAYSIDE,N.Y, 11361 (Mailing address of applicant) State whether app]cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........APP.L.I.GANT„I,S, OWNER. Name of owner of premises .EMMANUEL AND BARBARA CARAVANOS (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 . . . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . ...............`~T~~'s ...R®!~~,....... AST l!?A',eianl Ifouse Number Street Hamlet County Tax Map No. 1000 Section SEC.T.I ON. 2.? Block Lot 24.............. . Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy VAC{jNT, LAND. , a e. • t~ . J . b. Intended use and occupancy ,SINGLE FAMILY HOUSE " • > .rv ~,r ~ t";¢i~a~ 3. R`epaii of work check which a ',plicable): New Building ~ , Addition teration • Oval . . Dernolition Other 1Vork . (Description) 4. Estimated Cost , , . ~ '-7~ DDO• • r Fee...................................... (to be paid on filing this application) 5. If dwelling, number, of dwelling units Number of dwelling units on each floor ~ , , , , , , , , , , • If garage, number of cars , , , g , 6. If business, commercial ormixe 7: Dimensions of existin structure' occupancy, specify nature and extent of each type of use . . . Height Numb' if any: Front Rear Depth . Dimensions of same structure wi der of Stories . . . . . . . • , , , , th alterations or additions: Front ~ ~ ~ ~ ~ ~ ~ • • • • ~ • Depth........... Rear.................. ,,..Height Number of Stones . 8. Dimensions of entire new constriction: Front ~ ~ ' ~ ' ' • ' ' ' ' ' ' ' Height Rear Depth • • • • Num(ter of Stories , . ear Depth 9. Size of lat: Front 7 P Fmises are situate 1~ ~ F T • ~ ~ • ~ • • • ' ' ' • ' ' ' ' ' 3 1~~81 P P T' 10, Date of Purchase N VEMBER,z ,.,,.NamcofFormerOwnnr .F.LLIX.,F...CAN.AE„.,,,,,,,, 4. d 12. Does ~ ouossdsconst u ti~on violate any zoning law, ordinance or regulation: ....:,fY~, , , , , , , , , , , , , , , , , , , • • • 13, Will lot be're raded 0 , ,Will excess fill be removed from premises• ~ e„s 14. 'Name of Owner of premis s E . ,CARA.V,ANO~.... Address 3/,8.:z$, 21,7 , ST; , Phon o 718 #~L.4'75L~~ Name of Architect ./~!t'l~~...~ ~ :.Address ~:~oy ~a"3 ' %803. Name of Contractor • • • • • •/•~~~1'hone o . V 15. Is thislf yes, Southold TI••••••••••••~..'Address oneJtlo. pro err within 3 00 feet of a tidal wetland? " " " " " " Yes........ No ~ own 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 n~imber or description according to deed, and show street names and indicate whether interior or corner lot. ;TATE OF NEW YORK, Z 'OU YOF..S~U/F~~F:O~LK•..••.'a•. , j G? being duly sworn, deposes and says that 1te is the applicant (Name of individual si ning'Icontract) ve named. ~ e is the ..1....1 L1!.~e r ;S . (Contractor, agent,, corporate officer, etc.) ~ ~ ~ ~ ~ ~ ~ ~ ' ' ' ' ' • said owner or owners, and is duly authorized to crform or have erformed the said work and to make and Gle this ~plication; that all statements contained in this applpication are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. vom to before me thi~~ ,gJit p / ....day of .N 19 Mary Public, County CLAIRE L. CLEW • ..~~%!~I.(!`~~ ~r~4~l.Lt~/^~ N Q eli(1 d11R~ateofNewYork No.48'i'9806 (Signature of applicant) SuNolk CouM1r Commisalon Expires l)ecambar 8,19 ......_,.~.__~~~,~~,,J.w.. 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