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HomeMy WebLinkAbout20200-z s' , . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CEATLFICATE OF OCCUPANCY No Z-20786 Date JUNE 12, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 1885 PLUM ISLAND LANE ORIENT N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 5 Lot 3 Subdivision Filed Map No. Lot No. confarms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 9, 1991 pursuant to which Building Permit No. 20200-Z dated OCTOBER 9, 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 DWEIJ,ING WITH ATTACHED POACH DECK & GARAGE AS APPLIED FOR. The certificate is issued to RALPH & JULIA. T. VANACORE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-53 - MAY Il, 1992 UNDERWRITERS CERTIFICATE NO. N-233240 - APRIL 24 1992 PLUMBERS CERTIFICATION DATED MAY 6 1992 - TRT PLUMBING & HEATING B din Ins ctor Rev. 1/81 rosltt xa f 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 2 0 2 0 0 2 Date 198,1 Permission is hereb r me o: ~ r~ ~ - at premises located at ....lc~ ..a:~.....~r=...~4?1. ..........................................................f<~~~................................................................................ County Tox Map No. 1000 Section Block .........~'T.._........ Lot No...........J~ pursuant to application doted .....lQ.~~~ 19.~~, and approved by the Building Inspector. C Fee 5...'1.1..~`.~:...,a~},o ' ~:.1. .fit. ~uild Inspector Rev.6/30/80 Form No. 6 TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT rti?„"~ ` TOWN HALL 76s-LSOZ MAY 2 619~Z t.k~ 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 Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect nr engineer responsible for the building. 6. Submit Planning Board Approval of complete3 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. G. 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, Commercial $15.00 Date ........`~/.:'f~%.Z New Construction..... Old Or Pre-existing Building Location of Property... / f3~.S(....../~Gvr-. . ~s~.~,v~j.. ~g,:'C 6/ciCN~............ House No. Street Hamlet Onwer or Owners of Property... ~;.'~Gi"t/...... ~~G:'~.. , V/fN„4co2c' . . County Tax Map No 1000, Section.... ~.'~......Block....:~..........Lot Subdivision. (~~,~E~;~...!~J:...?~C~... fE:~... .Filed Map ..~Hy`.~.....Lot.....(fs . Permit No..?.°..~:°. :.......Date Of Permit.. ~~/~~~~......Applicant.`~N: c~ ~O`""tJ ,-1-~"c Health Dept. Approval ..........................Underwriters Approval......................... ?lanning Board Approval tequest for: Temporary Certificate........... Final Certicate........... gee Submitted: $..z,S.o°,,,,,,,,,,,,,,,,,,, //~~!///~J%~"/ Q,Q,c,, yyO /1 APPLICANT - ~i9Gc.~-~ eo~ao~gC, , THE NEW YORK BOARD OF FIRE UNDERWRITERS 1~nre .t {.1910 fi4 EIUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 Date ~~~~}r ~~r.19q~ Application No. on file 7bOfA7592/92 N ~3~~~Q THIS CERTIFIES TIiAT only the electrical equipment as deacribed 6elom and introduced by the applieant Homed on the above application number in the premiaea of VAN41C0RF, f?LNt~ CSLANp IIANFI, Q1ET.021Tr H.4. GAkt10l{2' in thefolforcing lncotr n~ 8 ent ~ 1st FL ~ 2nd Fl. .Sertion B(oek Lot Ak~R~L ,1,3`"~§"z was examined on and found to 6e in cootplionee with the reyuiremea t.c qj this Board. FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS ECEPTACLE$ SWITCHES OUTLETS INCANDESCENT fIUORESCENi OTHER AMT. K W. AMT. K W MIT. K.W. AML K.W qµT. H.P. 29 G 29 27 3. 2,'l, ~ 1z DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEtt UNIT HEATERS MULTI.OUTLET DIMMERS AMT K. W. Oll H. P GAS H. P AMT, N0. A. W. G. AMi AMP. MAT. AMPS TRANS. AMi H. P SYSTEMS AMi WATTS NO.OF FEET z 1 ~ e a. ~e SERVICE DISCONNECT NO.OF S E R V I C E $ AMT. AMP TYPE METER ~ 4W ~ 3W 3.e' 3W 3,e' dW NO OF CC. COND A. W G. NO OF HLIEG A W' G' NO OF NEUTRALS A W. G 3 EQUIP. PER % OF CG COND_ OF MFIEG Of NEVLRAL 1 1f}~ ~ ~ 1 ~ OTHER APPARATUS: 1PGFC, Wlt`CRR FINATRRSlt2.9,5 !t_N. G,F.C.It-5 5110 [CF lll';TFCS'ONt-1 -t'~ 5CI3ARADLN l"sLlaC~'RIC L3:C, II356S-N C/~~~ B0S .1077 PAIN ROAU Cll1'C}{OGUCs, N'7, 1,1935 OENERAI MANAGER 11. 4~ Per This certificate mLlst not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials. I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. tr_.__~ - - - - . _ _ . - _ I V~~~~ ~~S~FF~L~~CO.. TEL. 7G5-1802 Town or souT~o~o o ~ OFFICE OF BUILDING INSPECTOR o ~ P.O. BOX 728 ~ ~ ~ -e TOWN HALL ,~,o~ %0~0~ SOUTHULD, N.Y. 11971 _ ~f +„.',~~~c~~ ~'.i'f' ~..~ew C E R T I F I C A T I O N , Date ~ / ~0' ~ Building Permit No. ZoZaa ~ Owner ?Z/~LPH ~ TuLi.9 ~/,4e~ACo2l (please print) Plumber__ iEita,yucF i.~~/S ~7'<c-?' ~<~,~.~5„a ~ Nc ~FT~ u G) (please print) I certify that the solder used in the water supply system contains less than 2/10 of la lead. (plumber's signature) Sw n to before c this day of , 19~Z! ~ Not -y Public Notary Public, ~ Co my suut~re a cnrUr tIQ7'ARY PUBLIC, Sfete d QueNlied is SuMOMf N0. SA•~ QDIIII 765-1802 ~ _ BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS:~~~' ~ ~ y /~q ~ ~ C t f DATE INSPECT ':I~`-~ is;S. EC I~:~ IfLA== if ;;C?R•tENT~ ~ t e~ o _ _ O OUiJDATION (1st) "I 3 ~ FOU!lDATI011 (2nd) cm~ti r ti _ ° \ ~ ~ ~ r',OUGH FRki•IE & •PLUMBING ~ ~1 ~ ~U ~ 1 3 . ~ Y Cf-'S e~ .~'a < ~ ~ m " I1ISULATI0;1 PER N. Y, s.. ~ ~=~L , , -3 STATE ENERGY II I CODE G • ! 1.-" 4, I ~ m 7 Y °e~ y • FINAL I ~ ~ ADDITIOPIAL COMMENTS: x•.~. / • • m x a H ~i O m a - r 1 H Z _ O ^v m a ~cs+-i ~'T~~-~ c,-~e ,4>.,~ copF. ~ AS /-.M~~,,~ti t: ~F A~- ;__i ' .M A 4LG.1-~ 1 ~ \ °i 1 NON 1~~. C. ~ '1i..~ C. ...t}Y 1 'Cr ~C~ - P ~ ~ - t3LD 4 , ~E 51 C? ~3 ~...t -4 ~ ~ r--~,'~, R , c~ a~ t.'r•-+~a~ -ti.7~0} FAtE~,T,~~ glD~. 'm_r~1YC"~,aP~ .a ~ GQ GFR Za«(A~'~1-'',C~~;r~~~•`~,RA\lrl;s ti c., .t E.. c_3u's~ ~.c~M4 V~n:..'S w ~ ~ 4! Tk1C: AR., ~ ~~uLEPT~a~ ; AREA i5 U YW.'~~ RA~ r~ 3S ~ s o c'E~,u~~c, 1 A5 _ ~~c= J - 'L (o o 5 h4 ~ 1-9 zio ~-L - ~,`ra.z~tiG - ~ 10~ ,0 5 r 0 _ . R~9~ E,CT. 17aoc25 ? WA~~ P`fR~Me~E n QJ ~~iPOSJR~ ~O~ ¢ n~l_JE 7~ wn.~~.. U 1f ~ ~_5 _ _ SI.A.$ A-~ ~cLp..91~ ~_g 1w,1 y1.A"C~oa R VA~.v 4 u„ LoMP~ W,"4'~1 Tr1E ~~0+..1~~.,`a'c4'? 5~Ct1o"~S ~,,.a1N~+-ccsaSTRJC'S',o^~ 5111 ~ ~ S~Ei'~+ AS 1~vv~41uA'~w'=- .~Ca3r'._'"Cad 1 S G~~i L''. '0.1€ Cs ~•~tL'~ l^1 a E4 ~iPS'i's s,t~ , 5 - t~c>Rra~=actg. CF rt.v~P~.+c• '~~t , _~8i~.i`~- ~iv:~Qt. c'F K v. A c.' ~y s-c•~ r~°~ S__~ - _F7,8~3.,~ ~ Ta X3.2 c~ t~.tit..'t' - S.'~f 9't ~.".M S - 7 P., f 3. ~ S. . ~i`i,~fL`fI~'Ci~+`3 QE ~S~st~trtLa;~'~'f~~~*~~~yvP~~"~°C ~8~3.>~t~a~?8F3.s'34 'Si[pt~t',c ~ ~ r>,~aS~Tsi~.~T-?8_~~,szt,ra~-~8F3.84 ~~f'~ s>r4c ~ s 813 • ~~R ,\`~lFt4t~tA-s^~o,..~ o!` gEV*l F ~Y - `'"i _ T '"'1 & ~3- b ,.-~q , _ _ a r ~ r t JAN _ 8 , ~ ~ v s K " rr*"~ ;y ' d ~ - o ' LYNCH HOMES, INC. • D _ Investments for Living 321 COUNTY RD. 39A 1725 ROUTE 58 SOUTHAMPTON, N.Y. 11968 RIVERHEAD, N.Y. 11901 (516) 283-0009 (516) 727-0221 _ /h/~-~ f~ S ~-P/ ca"n ~c 2 ,E' E~' u ~ 6-1- h u ? e ,c2 v~ c' /u ~-ec~ `~~t-~ `1-~1 P m c~Q G~~ l'1 5 OYl lJ c.u-Qc0 r yr e ~ ~ ~©a©~ ~°%c~ u.,P hu ~ e I ~P Ci~~ f'Yt-2 ~ l 1/ P ? u D r~ c.~ Cry ~~u.~ Llm~ r ~QPiri ~ ~~e rrr~~y( 5{ k. U f ?r- c~©1~'' 765-1802 Bu~LU~NG DEPT. tNSPECTIO?N [ ]FOUNDATION 1ST [ ~ ROUGH PLBG. (]FOUNDATION 2ND [)INSULATION [~RAMING [ ]FINAL REMARKS: I,L-u~~ ~-`CS'C F _ ,4 ~ ~ DATE ~ .S`~ /~,INSPEC'TOR ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMA KS: ~ t i r i DATE 6 INSPECTOR f ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: ~ .Z/l`~S~f r ~ DATE ~ ~ INSPECTOR 76S-16fl2 UILDING DEPT. 1 NSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ 7 FRAMING [ ]FINAL REMARKS: ~ ~ i i~ DATE r~ ~ ~~INSPECTOR ~s'! t 2-~ ~-e`~'-~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUG PLBG. [ ]FOUNDATION 2ND [ NSULATION [ ]FRAMING [ ]FINAL REMARKS: s~~~ ~ ' DATE INSPECTOR . ~ 020 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [~yt1~SULATION [ ]FRAMING [ ]FIN/AIL REMARKS: ~N~.~" ~^-~~h i e, ~ s DATE ~ L INSPECTOR " I 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] RO PLBG. ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~-d-~-~~ ~ / DATE ~ INSPECTOR SUFFOLK CO.HEALTW DEPT. APPROVAL ~ y H. S. NO. ~r ~Q-!!~~ _ _ ' i y~ Wit, iCV~;.Y~:~;r ~J.2 Lo,P~ ' ~'L ~ f 5 LF~!^J U ~ ~ ~ ' ~ ~ ~ j' !~'1FJt MT OF !1}~tNT ~ A N t _ 50 k # `1 ' I I ~ ~ ~ ( ~ THE 1YATER SUPPLY AND SEWAGt DtR?OR~L ' _ _ { ~ SYSTtMB FOR TNIS RESiDtfICE WILL N.'°"T . ~ ~~~N'~Nr6,. 5,r~? 153Q~~. I ! !"°'''4'S CONPOMtM TO THE STAI+If~AREt•S OF THE ~w.-.._ _ - y G~~ ~~4`n --------_L__-- ~~t ~~E~~,~r ~~~.-._''~f.~~, tU!^PQLK CQ. t#tPT. OF H~kt.7M1 ~'LRYICES. I~4j'' ICAIi'T ~~/2 ~ ~~'T SUFFOLK tOtJfiTY DtP"t. HEAL _Y ~ /J - -~WN {~e9~t.~1`F~+~L,:D N.Y. fERViCt9 -FOR /YPPROVAL 4F r.~__ CGNSTRUC71pN ONLY ` ~ DATt: I i N. S. IKF. NC.: 35 ----y ~cn. FouNDA. ~`'~',tlp__. ~ I~PFR01/tG: 11 i LJT i66 ~ I----Lrr-----~--~ (vatw,~r} i ~ K~O.TiR7c . ~11AGaIJ'Y} 1 ~ Dt3T. ACT. 8fr0~.'~C PG6. ~ t5 1 i iDOO , 015 5 3 .115 ~ ~ ~ 1 Elit ADIDRtls: I ~ t~AS5APL~QUA kl~ IITS~ o \ e ~ ~ ~ Q~} . I r~E3 ~~;~C> w f~q.')C) ~ A~~"~~~ [~4°s_~ owa: ~ A P. ~ ~ Q 1~ - - (yA 4AN'f~ T(l'LE NQr 121-R=SJ85 y ' L~ ~ !£aT? L0T iifvl~~.RESI 0 E1vcE J i f p s r. av r v ~ a n~ c c; ~ ~ ~7T~ ~ ~ d to c av _ - ,u m he . J ~nnh ~~-."i~?N~ 4l ~I~N~ CJ. 1 R1~ ~~i/1~ .iC V.! • ~Ufi~. CO. MAP FtCS. l.~J .l` w r. ono ~ h{AP At+lfiJDL~D-,J;~i1,J.27 ~ h Y f0 ~ I[~i TJ 9~ Q• W " a ~ ~ CESSPC30L> f g~ ~ ~ L S,F - Fir T~~1"JhF' Uf- ~+~hiT Bit' p _ `°o rv~. ! 7: ~~'?k.~C1:~ 'CNf` ~"U1~`F;~~7 ti~Cx~ 5_ C~~.1 T -~1. ~ ~~P~cK Vg2~o9,~r ~ . 1f= s~ R _ . a . , 1 f i 1 ` r.3o_..:..w_,.. w. c .'.-a:.. ~~J ..w ....'r.:... ~ .,a 'L,. Ji.``'~ :m .k _ ~ .e ,Y ~.r,:. a ..C mr~...,r lR^a t sai.. - w,n;zac _.F .w. _r r.~: trH ~ ~ ~ . 'rid' ~ ~ . C,,~ ~ ~ y~i ~ {~j*l ~ l7 F ~ ~ ~ ~~s. ~6t $t lA!' ~ ,.a a as u> r ~i't') tS; ,'`1 _ i rya v ~ , ,r'~ ~ ~ vs ~ ~ } f~ 'S7 ~ ',i ~'44t4 ,°L] k: ~ ,cam ~ ~ ~ ~ (L7~~~ r47T t <o C fey. 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O ~ ilk w q 'h ~ ~ ri S, a ~ ry +{~f p ~ `r Y't'p`,, Oc9 T~~ r~~'N'yya i,~ ~ l~n ~ ~ '7RQ ~ ~ ~ tA.~ O S'~ ~ Y~ ~ y ~ ~ ~ ~ ~ y~ ppyy tV (S ~ X. ~ "V \ ~ ~ W (P ~ ~ W S S ~ J 0 ~ - r~ ~ C,~I ~ Q ~ M V ti N ~r.~,~-'._' ~ ` ~ ~ » ~ ~ > ~ ~ M ~ ~ zt y ~ ~ ran -~i Ij r -trl~~ o ~ , ~ : ~ 'tl~"~ ;t~ 1~ ' r;. Ca ."i ~ s I t~ ~ ~F ~ r r f r;>; 1 A ~ r ~i 1 j i~i 11~'1C't; ~fil ~ in i," ~l f 1~Y~ x w Vii-. ~ 9 til ~ ~L. 4e~ ~9 ~ i f" ~ T~ ~ i~ A Yll ~ - + ~ .~y" ~ ~ tv i 2 C1~ ~ ~ em j- I o ~S r i i Ipy ~~°1 t' ~ ~ I I If_' ~ ~q~ ~ - q 1 ~ ~ - I . r ~ Ck ~ T 'j w . rv" ~ f y,.-- 1. , 1. 1 (t''~ ~I ~ n 7f p l h t_ Q m ~a C 1 i ~ ~ g ~ rO Lt; ij ' ''n R... tn. _ L_-~. _I ,r ~ ~ ~b' m ~ r 2 f3 . ! ~ ' ~ ~ ~ rJ ~ .o ° ~ 0 f~i n ~ A _ r ~ f ~ d H ~ m f -d ' /dy S~' ~ o°s ~ ~S x ~ , _ ~ m / Cr1~" d ~ -Dt _ ~ , d t ~ , ~e ~ ~ ~ z~ i- ~ n, s G N ~ i I - ~ . _ ( - ~l'i.a~ ~ L 1 ~ ~ ~ 1 ~ ~ . ~K i r ~ t=~ (off t y+--• ~ .t ~ ~ i / j~ ~ _ it ! - , i ~I'Sl1,i+ T I t t'=~ , E., ~'p. i ~ ~ F', c p ~ ` n O h. , ( .ra ~ ; s 9y , u~, , v ~ c ; sa> lTy CPT ~ ~ a~,~ ~P I _ ~ ~ ~ 0 .T D S p (1 IA to Vl n U1 N _ ~ m m ~ p0C ~~-DiZm-mn ~?~m ' ~ ~ z~r m ONm O aa!^~<O NOOm~ 'i Nv ~t%, - F: F11.~~,' h~~:F' r „t.~ vii i O m m C n x D x ~ N -Di O tom` ~ x Z n m ~ n ~ ~ r r.°~ ~ , A Ica (n v ~ ar -a n m~ f<n~~a ~ o m O ° ~ ~ p ~ ~ o~ ro~ O ~(11 Vii Ul n O T 2 Z v r~ S ~Y ~ { p 9 yv,z~ -ri D p O x = Jm i;?°o.~7%.-~--- ' $,"'b .~'i is ~ iJ Foes ~ ,fir'` cJ v W Dv S D ~w~ OO !r ~ °do"~";a~9 ~ i~'~.~n.n '.3.4 5+04 ;'i' .'D` Ul O m~0 ~ D ~ N ,`t tD~ cn.r~. ~ X .l7 p ,,rn ,e.Ka~~A~rn $~6r~~a•~ ~~y D GS O ~ ~ pm 41 2 ND ~ r o<is~~'~~ y 3. - z < -n N z m 1 OTro :'~;''-,s ~^P poi = " i , =s' k3 ~ ~s `t :a, v~ -t D m m ~ to ~ YOR -r M it r y ~ j rt ~~Y) ~ 0 r m a7 Q UI W Q 4'` 'n ~ < O1 m sr r ~ S m r r' U FpRht Nq. 1 ~ SETS OF PL,1NS , , , ~ ~ . SURVBX 5 OCT -''41991 TawN or: saurHaLn GFiECK°~ °S~~:I.s. ; ' 8 RUIt.DENG AEPARTMENT SEPTIC POCtPi . . RLpG• DFP'i. TOLVN HALT. g .,...7C?`4~!v~UF Sgt~7h6(1t.[9 CaUTNOLt~. N.Y. 11971 NqT Y FY " TEL,:7G5•it3g2 GALL Examined /a~g.,y.,,..,,, 19 9l MAYL T0: ~ju,.a~ ei;r9.~~, .lpproved ....~Q/~...... „ 29 Permit No. ~~d ~ Q~oi~ l~am•~ `)1 y, 1l 9b 8' nisapprovada/c ( tiding ~ spcctar) APPLICATION POR BUILniNG PERMIT . Hate ..:.1q~9~9!..... 15.. INSTRUCTIONS a. Titis application must be completely tilled iu by type\vriter or in ink and submitted to the .Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to sehadult:. • b,, Plot plan showing tacatian of lot and of buildings on. p'remiscs, relationship to adjoining premises or public strac ar areas, and Giving h detailed description of.layout of progeny must be drawn an the diagram which is part of this appl :soon. The work covered by this application may not be aornrneneed before issuance of Bui,Iding Permit. - d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. ,Such petmi shall ba kept on the premises available for inspection thrau`itouY the work. e. No building shall be occupie8 ar used in whole or in part far any.purpase \vhatever until a Certificate of Occupanc, shall have been granted by the Building Inspector. APPLICATION IS H)rREBY hfAn)~ to the Building nepartment for the issuance of a Building Permit pursuant to ih. 3uifding done Ordinance of the Town of Southold, Suffaik County, New Ynrk, and other applicable Laws, Ordinances o Rc~ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described lire applicant agrees to comply with ail applicable laws, ordinances, buildinw code, housing code, and re;ulations, and is admit authorized inspectors on premises and in building for necessary inspections, (Signature of applicant, ar name, if a coCCrporst3on)' ' ' (hlatiing address of applicant) (I~ (a a State•?vhether applicant is owner, lessee, agent, architect, a gineer, general contractor, electrician, plumber or builder. .rte? r t~:-~.; ed~ . . ,~'amc oCowner otpremises .....lf. i~.~~?ie;~ ,t ...~~:1~ ~.~:'.~t'`~tl::...... , • (as an the tar roil ar latest deed) ° ICnpplicant is a corporation, signature of duly authorized officer. (Name and title of corporate gfficer) Builder's LicWnsc No......... ,~8a. , , , . Plumber's Liccnsc No. , , , , , , ,d~, •O ~C,O.~ 2:lecirician's License No. . , . , ..3;~~f9.,ff , . , . Ctiher7radc's License No . . . Location of land on which proposed work will 6c done. Slr~vlc~ C-Q tsj IiouseNumbcr ~ ~StreeL ~Hamlci .County Tax \tap Na. 1000 Section Q , : Black , .5~ . . . . Lat Subdivision ..~e , F.iluJ plop Na. 3y~~ , Lot . (Naute> . State existing use and act:upuncy of premises and intend4d IESC a?td occt:paney of proposed constrt:ctian: a. Existinguscandoccupancy,,....va~a::^~.. Y+iR,10JHAF~,!"J ~iW1.1iMiatltnY~'.afft?~i'~d'y1~lL~iR• • • • • • , • tN?~~?r83A~.ta4: b. Intended use and occupancy . • . • • S i,~!~G • . • • • • • • ..~t'~~~f~:i ~<,tt~x13 r~i t~t~t~„p . v' ttet~.;,~Cd rt~ix?I ;~nr:~{'Niris~a~ ' • ip'd youfi~ 'H'S O1 cu? 53WOH H3N1,~ WOJd 27:80 g66t-£Z-d3S i., 3. Nature os"1vorS: (chacl: which applicable). Iv'ew (3uiidin5 ...d`.~r Addition • • • A1tct~tion . ' Repair Removal , Demolition , , Other 11"otk , Q. Estimatsid Cost ~ .L~,y,,.~.~.~ Fee L LY. . ^ ^ ~ (to be Paid an filing this application) 5. if dYVeilin,, nurabcr of dwcllind units , ~ Number of dwcUing units on each fiaor . 1 1C garagC, nuntbcr of cars .....I,r,..r,.lC.pa~.`r.,.........r..r.r.,.'... r l...r.r.. if business. commercial ar mixed occupancy, specify nature and uxtnnt of each type oI use . DinlCpSlanS OS Cx1S(ln^~. Stl'uetUiCS, if any: Frant r RCar Depth . Haialtt .........,..r,.NunjbcroCStorics..,.,......rr Dimensions at same stnacturc w{th alterations ar additions: Front r Rear . Depth . 3lcight Number CsStorics . ' t3. Dimensions o(jcs}~~ire new construction: Front , , . Qt4 r , , , r , Rcar . , , . ~ Depth ~Q....... . Height t i~i , . , Nu~rj~cr of rStarics , ~ ' 9. Size of lnt: Front ~,3R . ?t?....... Rear . .1.~.°?.'.74.......... Depth /.~9 ~a-~........ . 10. Data of Purchase Narnc~pf 1?ot7ne Crwnar . 11. Zane or use district in which premises arc situated , , , , , , ,,~~,~,di~:e.... O , 1 Does proposed construction violate any zoning iaw, ordinance nr regulation: • . lg. `~'ili lot be recradcd , , , , . ~ti'ill aeces till a remove fro. ~rcmiscs: Xcs 14. Name of O~~mer of pr tnises t/ rkV1t'~ rp.t? ~ dd ;ROX, jala ~~~hanc No. ~~`f ~ ~8(a3 , ~ . A Tess Name of Architect at'l rtzt , , , , , , , Address . ~ ~':s1:t ..Phone No.. ~ Narnc ofCantractor ..4~(ns~i ~{5:.:........'Address ...~~t°'::`~:-~: Phone No..°.~3: 15.is this pzopertq loaxited within app Jrect n~ n tidal cretluad? *X~S....tiOrX . *l:E pet, Southold Tocrp Trustees Permit may tie requfrnd. PLOT DIAGRAAS • Loaata clearly and distinctly al! buildings, whether existing or prnposcd, and.indicatc aii setback dimensions Iran property lines. Giro street and bloc7~ number or description according to dead, and show street names and indicate whcihc interior or enmcr lot. , ~t)r~T r l ~ ~a.4Zkt-. ~ . , . ~ tCl 4'1~~.~1-, , . bakta duly swotn; deposes and says that he is the appiica: C~amc of individual si;nin4 anntract) :ovc named. , isthc (Cantracto , age t corporate afCiccr, ctnJ said ownct or owners, and is duly autltotizcd to perform or have pcrfarmcd the said work and to make and file t!' i]ication; that ap statements cositaincd 3n this application arc true to tltc Ucst of ltis knowledgo and bcticf; and that t: .tk will Uc pariorntad in !!te manner set fartit in dtc application filed thercwiUt. p.m to befarc me thi ...d~•,''of... I9~ , l ar; Fuhlia,~~.~-ls;,..~,~~.yl/.. ounty tiOUfy P1t~bltl0. 8 is6 qdf~ NIIW Y101k . • . ~~~.J. • • • . QusNfisdf^$uMolkCou (Sirnatureafapplica- /:01^^?tDYt011 7DTAL P. D2