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Home My WebLink About19938-z ~ FORM NO. 4 TOWN OF SOUTHOLD • BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22442 Date JULY 8, 1993 THIS CERTIFIES that the building NEW DWELLING Location of Property 11710 SOUNDVIEW AVENUE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 6 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 6, 1991 Pursuant to which Building Permit No. 19938-Z dated JULY 10 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 DECKS & ATTACHED GARAGE AS APPLIED FOR The certificate is issued to PETER & LOUISE LESICA (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-116-JULY 29, 1993 UNDERWRITERS CERTIFICATE NO. H-029722 - JULY 8, 1992 PLUMBERS CERTIFICATION DATED JUNE 14 1993-PECONIC PLUMB & HEATING Bui ding Inspector Rev. 1/81 I\ II08J1[ NO. >1 TOWN OF SOUTHOI.D 9UILDING DEPARTMENT TOWN HALL seuTUe~e_ u_ v_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 1 9 9 3 Z Date 1991... std ~s~~ ;~1~26~3"~ Permission is hereby granted to: ~ , of premises loeoted of ..../..~.1~®.....Y 1..4~~..~•~/..~..e e~~i.°..`:~ County Tox Map No. 1000 Section .......~T......... Block Lot No....~~ pursuant to application doted ........°,7..../~9 i9........, and opproved by the Butlding Inspector. Fee S.•.•7•~9: J B ing inspector Rev. 6/30/80 . roau xo. s TowN oP 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 18 2 8 5 Z Date 19...1 Permission is hereby grants .....1...~~rr.~--:~::R.p.. to ..CAS!:4:~".:bS1~:...~..4?:~x..~~-rat.~.{...`./..~!.~r.".Qs.~..C...~:5~°,...~.. of premises located at ....~~.7~.Q.....s?f9:.-rrhtcar~l.f.~:'.:~..... .~.t ........!Y.e.......... ..........................................................................ll.rr.~~................................................................................... County Tax Map No. 1000 Section ......Q.:~..T....... Block Lot Na..~.~..... QQ pursuant to application dated 19...1., and approved by the Bui ldin-g7 I~npspector. Fee 3....1..4.1.:../. ,l'C~ fJ~ . Bu ding Inspector Rev. 6/30/80 l FOHSE NO. 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) Nq 16 2 2 5 z Date .9 ~.Z Permission is hereby granted to: ..x.7.42.. Y~,....h!...G~.a-n.s...,.. ~:.~,coL~.~........~.: ~.,...~.c.s.~.a........... fro • • q. ~i .u..u....uu.uo.uu........e.uu.en.....~u..u...en. u..u... u~~'^~,•)• euuuu~..a/~.....,.,un at premises located of l.(..Q...~°~".:!^uV 1.J.5:~::?~!^"ti!!-i.:.~iRc!:kf.l!l-d:~k~-~- County Tox Map No. 1000 Section .....05.~:...q... Block .....04!........ Lot No.....~...~f pursuant to application dated ......~..•I )9~~.., and approved by the Building Inspector. Fee ~ / ~......~.e~. Building Inspector Rev. 6/30/80 Form No. 6 ~ I~ , TOWN OF SOUTHOLD U BUILDING DEPARTMENT ~7r~ IIIILLLLIIIIIIIIIIIIIIIIaaa+ t~'G TOWN HALL 765-1802 U BLDG. DEPT. TOWN OF&OUTHOIb~ APPLICATION FOR CERTIFICATE OP OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to Che 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. .,.r~ 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 - Resident-i(a~l $15.00, tC~ommerci/aCl~L$~15.00 Date .:~1~:h/.s?-....°~:~~...~L.1.':~............ New ConsCruction.. ~ Old Or Pre-ex^isting_/Bu}ilding. ~j Location of Property....l•~,<,I ~........:~.?.D,~~`'!'.Y~.~. ~..,1,T,~2 ~01.4.~~~~~~...... House No. Street / Hamlet Onwer or Owners of Property....~~rl.pr~..~~'?-... ~-:®ul.S//,~,L-PS/'ct~, . County Tax Map No 1000, Section... ~.L......B1ock......~G.........Lot..... ! ~ Subdivision ...Filed Map............Lot...................... Permit No.../.~~~U.....Date Of Permit..~~bl.~~......Applicant. Ld(_(„~,5_~' ~~.5/,~~f,,, Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Tempnor~ary Certificate.........,. Final Certicate..~...... Fee Submitted: $ t ~ 6 r s^ CO ~ y y~ APPLICANT INSPECTORS ,.«o~;-~~ Victor Lessard ~JcFD(f)- z Principal Building Inspector "y'~U,"~ j LPU`~~, Curtis Horton ~Y'h` SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ ~ ' , : e `t ~ v~ k' _ i; Southold Town Hall Thomas Fisher ~ ,A„ p' f.„,.. ~ P.O. Box 1179, 53095 Main Road - Building Inspector ~ Southold, New York 11971 Gacy Fish __''O~ 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 .TITHE 1 1, 1993 PETER & LOUISE LESSICA 770 TOWN DARBOR LANE SOUTHOLD, NY 11971 RE: PREMISES @ 11710 SOUNDVIEW AVE., SOUTHOLD, NY To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: x7~ An application for Certifiaat~ of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. /pJ ' %>Sx The check is /not on file.)$25.0p0 G~+"1.~. x%IC No Health Department Approval on file.,~V7 No final inspection has been made. xx% No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19938-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. S~F~~Uj TEL. 7G5-1802 o~~ C% T0~`YN OI' SOiJTIIO'LD [f~~'~ "~11' OFFICE OF BUILDII•!G INSPECTOR ~ y~vk; ~ P.O.BOX 1179 ' re;~ ~ O// eo ! ~ TOWN HALL ~ ~ L5 u ,~~1 ~ ~b0 SOUTHOLD, N.Y. 11971 ~ 2 SIB 6i..4]Ca. JSEPT. TOWN nJ' SOC9TMOLD C E R T I I' I C A T I O N N r s, ~~~1~0>l~, . Date Buildirq Permit No. Owner ~~~e ~ o Lain s p L~~~ . print) Plumber v (Please- print) !A/G. 1d ~~'./~.lC~ I certify that the solder used in the water supply system contains less than 2/10 of 1, lead. ~ , IP m 's sign ure) Swollrnl/ to before c this =_da y o f NOtar• ~ Notary Pub ~ f Iublic, y~(,~~~UL/~ County KAREN W. RbERCiE3SON , NOTARY PUB11C, Sleie of New York No. 1844180 QoeRfted in 8ufielk Co/~q Canm7ssion Expires by/~/ / / j , r I f~,,3d"-G THE NEW YORK BOARD OF FIRE UNDERWRITERS rncafl t ' f}®~.t f<~f .7 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW VORK 10038 ' Date dU't=Y (?YSr~~72 ApplieadonNo.anfile (332;ih)~2;'~12 H {'?29'%)? THIS CERTIFIES THAT Et;{:tlt;T tiff. 1J938 . only the electrical equipment as described below and introduced 6y the applicant nomad on the above application number in the premiaea of - ~>;raitt~ + t,ouxsi; t~ r.t.~rck, iv.mta, s~u~i>v~as~r tvt;u~r, ~az,~ ~<<~~is~~~r,nt ta.~. in tkefollowinq locotiong ®Basement ® /Rt FI. ®2nd F'l. ~~~~~ir .Seetion~li~ Blockb Lot was examined on Jiii~}`. QGt)~d and found Wbe in contpfiancewith the requirements q(thia Board. FIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS CUTLETS WCANDESCENT FtVORESCEM OTHER AMT. K W. AMT. K. W AMi K.W AMi K.W AMi H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS' BELL UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMi K. W. Oll H. P GAS N P AMi NO. A. W G AMi. AMP AMi AMPS. TRANS. AMi N P NO.OF FEET AMi WAiiS R 1. Z Z2 Z 2 GE7~} SERVICE DISCONNECT NO.OF 5 E R V I C E AM/. AMP TYPE METER ~ tW r ~ 3W , 9 RW 9~ dW NO. OF CC. COND A W G. NO. OF HbLEG A' W G NO OF NFUFRALS A W' G' EQUIP. PER $ OF ~C . COND OF NFLEG OF NEUTRAL Z~~ 4t~ .f( ~~G t u~Q OTHER APPARATUS: JACU'l,-fl ~o~rci,s.t-~I ti.r. ~ t~~t~Ei,Bi)ARit311-s1 CIid, z~~ 8FC~1Kk, lllSTGC4'iJkt-2 TStACtt LIG}iTTNt~L-<l E - E e ~ ' (~f;TCEi trftitS~~ t,lasr.f;a ~ j%~ mawti tiseQOx z,nx~ SPOUT, iSUC,Ur Nut 1197I ~ 6ENERAt MANAGER 11 ~ Per i This certificate must not be altered in any manner; return to the office o4 the Board if incorrect. Inspectors may be identified 'by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTfFICATE-MUST NOT BE ALTERED IN ANY MANNER. FLU lu... L ..v.. ~I~n... II v:....... p 1 1 Q~. ~ r _ !f 3~ - - ~ 1 UIJDATION (1~t) L. _ N t V UIJDATIOtJ (2nd) _ ~ t 0 0 1 UGH FRAME K / ~ ~ J Q PLUMBING H r 3 ~ { . ~ [TJ j~ C~1 H (~"-1 SULATIOPI PER N. Y, 16~`-~'J STATE ENERGY D U~~-~r CODE x m H FIIJAL (1, .''r`h ~ . z c ADDITIONAL COMMENTS: x 9-~ O ~ / ' x ~ ro N . H O z~ ra ~ a ~ • r ~ H x (A d_ ~ P7 ~ b ~ H ~ l ~ 9 ~ v ~z~ 1~~~ . r . 0 f' ~ __-®`7 ~ - - - - - - '7rw~ . ~ ! !Y19'~ - - - ~-T,.~, _~n7 ,WL, ,SCI A--•~/1.,, - ,f/*^-ti y__(~_.~,~!/~~,., ~f?_9~_ ~'D`"~ Ali 1~8g ' / y___ 6 s~~~-~~~ 2 -~~r-mil .e.~ oaf ..))nn f ~ t{ R A ~ S'`~ lV~ `71 ~ 1~ ! ~ ,~,p~ 5~~~~~ "G~~`~' ~ ~ / 99 ~ S ~/io/g~ . " ~ , 7G~ a ~ ~ 1/ ll~~j / 7'65-1802 BUILDING DEPT. INSPECTIAN [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMINt~i [ ]FINAL REMARKS: ~11G ~ ~ I ~ - _ f f i ~ f DATE INSPECTOR ~ ~~~'j'^~ 1~~.~~ ~~-1802 BUILDING DEPT. INSPECTIfJt~ [ J FOUNDATION 1ST ( ]ROUGH PLBG. F UNDATION 2ND [ ]INSULATION [7 [ FRAMING [ J FINAL REMARKS: ~~7~~.~.ett,ai'" l DATE ~ 7 d INSPECTOR ~ a _ ~ ~ u " , u. 7&5-1802 DUILDING DEPT. iNS~ECT'o [ ]FOUNDATION 1ST [ ]ROUGH PLBG [ ]FOUNDATION 2ND [ ]INSULATION l~~,u,~, [ ]FRAMING [ ]FINAL REMARKS: z~~-- ~ _ DATE / INSPEICTOR i~~~ tc?~-iso2 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [)FINAL REMARKS: i~~~~~~ DATE INSPECTOR r j/ 1 '`J ~ 765-1802 BUILDING DEPT. INSPECTION [ ] ~UNDATION i5T [ } ROUGM PLBG. [/]/FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]RIVAL REMARKS: G~ DATE ~ ~ INSPECTOR t / I fi65-1862 4 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND ] INSULATION [ ]FRAMING ( ]FINAL i f REMARKS: ~~a~ ~ DATE ~ INSPECTOR r l~~J 0 rss-isoz BUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN CATION [ ]FRAMING FINAL REMARKS: T"/~~ ~C.ESy ~'~B~~EY~ p,~~~ ~~T ~ ~ v~,/L l~-r .~~--"s. mid f . ~sz~° ~ ~ --T- r~,r~r~la I~i9-yF~az~E.~/T ~?~o.C~ DATE ~ ~ INSPECTOR 3 T 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ }FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: 1,~ s ce~~ DATE l~ IN8PECTOR y` r ~ BOARD OF HEALTH , ~ ~ ~ 3 SETS 0~ PLANS ~ . - • FORM N0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY °.OUTHOLD, N.Y. 11971 ~ ~ : TEL.: Yi65-1802 CALL ,I MAIL T0: Examined ~.CX-~.~ 7 19~ ~ . _ Approved ~ ~ • 19~~ .Permit No.1 ~a-°?S~-~. D Disapproved a/c ~ BLDG. DEPT. TOWN OF SOUTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT n'~ D INSTRUCTIONS VVV a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 slits of plans, accurate plot plan to scale. Fee according to schedule. b. Plct plan showing location of--lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be 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 Ordinance 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections 1/ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) ~~y 7~~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......D.~!n.!~r?a p , Name of owner of premises I. ~:TFi.i~.. /!~c+,.. ~ D t~t•14S ~ ,~,...~rS 1~ . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MU T BE SUFFOLK COUNTY 1/ICENSED Builder's License No. ...~r.T~...~-'.D.N/~.Tl.2[{ ~7'D Plumber's License No. ,No..~~~..~~T.~~. Lh3~~~ Electrician's License No. t .~T! o.~! G Other Trade's License No. . ~ ! ~ 1~~.~r S ' Ea'e AVATnr ~x~s7~nN Non_.ieoi? C~r~, _ Fa~n~ir7i'vn/ 1. Location of land on which proposed work will be done . . ~.~.~.ta .............sownl.d.vr~~...A.l~~r~+~~..-..s: or~7/~oL.4~. ~y,.: - House Number Street Hamlet County Tax Map No. ] 000 Section ...:S~ Block Lot ~ l7 Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises a~n//d,~,,in~/tended use and occupancy of proposed construction: a. Existing use and occupancy ~.,~1). D.ct,~Q.....JJ`-.0, r . b. Intended use and occupancy ~ili~-~. ~1N. p: 4- • • • a ~.~~~Grri"Si,~Q ~~.{~r~l~/.i.~ J/.~1~~~, ,y' 8 L ' LE zegweoeq sezlaxg wzal uno~ rlloBnS'£99Lb84'oN ANN M eleLS'ollgnd A+eioN .;o am;euBlS) tl3d40~'f VaNll .........~~i-i . „;uno0 ~arlgnd ~e;oi G~~ . • ~ ~~6I ~ ~..30 ,(ep.........~ Y_~ . slq; am azo3aq o; uzom~. •q;?mazaq; paf~ uo?;ea?Idde aq; u? q;zo3;as zauueuc ay; uc pauuo}zad aq fIIm Xzo~ aq;;eq; pue'3affaq pue a9pafmou~i sIq 3o;saq acf; o; anz; aze uof;eafldde sfu; of paure;uoa s;uaura;e;s Ife ;eq; :uof;ea?Idd sfu; a1r,I pue axzur o; pue xzom fifes aq; pauuo3zad aneq zo uuo3zad o; pazuoq;ne ,ifnp sf pue `szaumo zo zaumo pies 3 (•a;a `zaaT33o a;ezodzoa `;ua2e `zo;aez;uo,~) ....................~J.~S~7...~5.'ivl.~~................... a43sTaI •paccreu anoq ;ueac dde a sf a e s,Ses ue s (;oez;uoa 3utu3?s Ienp?n?pu? 3o aureN) .I q; u I ql p ~sodap `uzoms 6lnp 9u?aq . 30 ~yrlno; S S `}IgOA MAN 30 ~.Lb'.L' I I ii i ICI •;oi zauzoa zo zofza;u zaq;aqm a;eafpu? pue sauzeu;aaz;s~ mogs pue `paap o; Su?pzoaae uof;duasap zo zaqutnu xaolq pue;aaz;s an10 •sauci ~;zadozc cuoz3 suo?suauz?p xaeq-;as Ife a;ealpuc'pue `pasodozd zo 3u?}slxa zaq;aqm `sScuplmq Ife ~I;ou?;s?p pue llzeaio a;eao7 NIV~IOVIQ .L~O'Id I •pazFn a.x aq em ~Fmzaa saa~snzy uMOy ploq~nog 'sa6 3I~c off •••••',sa~,~ Lpusl~aM Iapl~ e ;o ~aa3 00£ uzq~,:M pa~eaoZ 6~zado.xd sFU3 sI 'SI ................oN auocld ssazPPV zo;ae.r;uoO;o acueH oli aunt{d'%N/V'~N~tu~2YA~.1'~:C'l~aol ssazPPd........ a'nt)~b'J~ •P'~~d~ ;aa;?rlazd3o aureN ...~'£'9Z-;,s'g•G, •oN au~`~~'''~?$~~~irb~•..o'GG' ssazpp~~~'~s~.~vjf'ei~,1,~~ sas?urazd3o zaumO3o auzeN '4I :sasturazd uroz ~ 7 obI a~ 3 Panouzaz aq IIg ssaoxa ff?h1.......... • papzx8az aq;oi [1iM '£I : : : • • of;ein~aa zo aaueucpzo `mei ~uTUOZ ~(ue a;eio?n uoi;onz;suoa pasodozd saoQ 'ZI • ~ • • .'~N• ~~7 •~{IL`~ nS` ~ ' ' Pa;en;cs aze sasfuzazd qa?qm uc ~afz;s?p asn zo auoZ • f f St7jV!/>WW~" S>ln o7/~' • •a~!(~' zaump zauuo33o a~ueN .~.~..~/UYfa(v( asegaznd3o a3eQ 'OI l Q" N 0 ql Q zeag ;uozg :;of}o azcS •6 dl'G"~ 68'G~.~... b..G~.l... sa?zo;S 3o zagcunN ;u2fag , r~9''~O£ g3daQ ; o ' zeag ' "C`r'0/'•'~~~' ;uoz3 ;uo?;anz;suoa mau azc;ua 3o suo?suauc?Q •g S3ozaqumN....,.................;u2faH ......................u;daQ ' ' ' ' ' ' ' ' ' • • ' ' ' • ' • ' zeag • ' ' ' ' ' ' ' ' ' ' ' • • • ;uoz3 :suo[;?ppe zo suof;eza;Ie u;Im azn;oru;s auzes 3o.suo?suauc?Q sa?zo;S 3o zaqurnfi ~uSTag • q;daQ • • • • ' ' ' ' ' ' ' ' ' ' zeal • • • • • • • • • • • • • • • ;uoz3 :,iue 3T `sam;anz;s Fut;scxa 3o suo?suaurrQ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • ~ • • •asn 30 ed,S; gaea ,fo ;ua;xa pue asn;eu ,S3toads `,(auednaao paxTUt zo te[azauxuxoa `ssauTSnq 3I '9 szeo 3o zaqurnu `a5eze9 3I • • • • • • • • ' • • ' • • • • zooT3 goea uo~'s;fun ~ufiiamp 3o zaqurnH • • !?,r•77 ~y.~ • s;?un 9ulifamp 3o zaqucnu `8u?Iia~'nP 3I 'S (uo?;eafldde slq; Suflcd uo pfd aq o;1 ~ ~~'wd~ ~ ~ ~M i........... aag ,L~,, ps o0'P)"~ ;soO pa;eur?;sg •q xzoh~ zaq;0 uoc;?fouraQ . , , Ienoutag z?edag uogezal ,y~ [d UO?~?PPV •1 ~u?pi[ng maN :(aigeafldde ga?gm ~foaga) ~Izom 3o aznleN B0.\RD OF HE.\LTH . FORM1t NO.1 3 SETS OF PL,\NS SURVEY TOWN OF SOUTHOLD C1iECK • ~ • ~ ~ • ~ • • • " , BUILDING DEPARTMENT SEPTIC FORM • ~ • • • ~ • ~ TOWN HALL EOUTHOLD, N,Y. 11071 NOTIFY rr~7/ q TEL.: 7G5-7302 C L . ?.R 26.~~• • Examined .,7„~ 19Yq( D[AIL TO: _ Q~ ~ • • .\pproved [ 19~' 1. Permit No.1 ~.!+Z~.~,Z-, 77b ~x-ruw9dc~ file,"-Y-~ Disapproved a/c D ~i U 1 BLDG. DEPT. (Building Inspector) TOWN O~FSO~U•THOLD APPLICATION FOR BUILDING PERMIT ~~`J • Date f/6......... 15~ INSTRUCTIONS ' a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, will 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 stre- or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apI Galion. e. 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 perr: shall be kept on the premises available for inspection throu:}tout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Oceupan: shall have been granted by the Building Inspector. APPLICATION IS HEREBY hfADE to the Building Department for the issuance of a Building Permit pursuant to ti 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances r Rc_ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descrbe ,ire applicant acrees to comply with ail applicable laws, ordinances, building code, housin; code, and regulations, and ; cdmi[ authonzed inspectors on premises and in building for necessary inspec`(t'i~on • (Signature of applicant, or, or n~ orpo:auon). . , (I`Iailing address of applicant) </v~y. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bui~d .....(~.ti/IVe 2 tiame of owner of premises ....tP'~:7'e~:....'("".. L-,0~(/.,~~, L,e S/,G°.4 _ _ • • (as on the tar roll or latest deed) ~ ~ ~ • ~ • if applicant is a corporation, signature of duly authorized officer. (Name and title ofQco-rrp-orate officer) , " Builder's Liccnsc No. , ,aC, , , ,(;,p~,r, y.,~ - Plumber's Liccnsc No. ~c„i~a~i ~ Electrician's Liccnsc. No. . ,pp~, , , , , , , Q;~.t~61~-~. Other Trade's Liccnsc No. J~:e'uyoi^-0 • ---vI` ' Loe.~ati~lo/n'~of land on which proposed work will be done. f! o? s /..~b~............ . S t rcc t.. ~66-C~ G~ v....... . Hanilct ~ County Tas Afap No. 1000 Section • : Bluck , , • • , ,~j /1 Lot.. f u Subdivision F.ileJ ~fap No. Lot............ (Name) State c~isting use and occupancy o(premis/esan~d i~n~/tte,,nd:~J use and occupancy of proposed construction: a. Existing use and occupancy ......~.'a.lt! F~~^ • • b. Intended use and occupancy .....t[.•••.• • Il . 3, A'ature otwork (check ~~,~hich applicable): Ivew Repair , , , , • ~ Uuilding , Rcmocal Addition ,Utcrauon Demolition 4• Estimated Cost ~~I ~ i• Od ~ • Other 11'ork • • .~s~. (D :crp, O S ree . 5• If dn•clling, nurnbcr of dtvclling units , • •tto be paid on lilin^ this • • • • • • • • ' ° aPPlication If garage, number of cars I , , , , , Number of dwelling units,on cacti floor........ 6. If business, commercial o~ mixed occup~n • • • • • • • • • ' 7, Dimensions of existin^ s[[juctures, if an FY, specify nature and extent of each t • e• • • • • • • • • • ~ • • Height Y: ron[ . , YP oC use , • • . , Number of Stones , ~ • • ' ' •Rcar Depth . ~ • • • • p!~ Ih ~id't~ tS~fib~tj structure with alt ns ' • • • • • • • • • . 4`t`t# ~ cratio DaP ~ or additions: Front . . llcight , Rcar , $ii r of;c ~ c newponstruction: Front ' ' ' • ~ • • Nu t r of Stories • • • • • • ~ • • • • tt ~•t ,NumbcrofSto ••~-V"rte'':•l~'`•~•Rcar.,(„~,~Qt,;' .Dc th•.c~O 9. Size oC lot: Fr~~,~, 8~•• •Q• • Tics , , ~ p ~ , 10. Datum<I?tirc Rcar,,,~~~,•$~.••" • c , 11. Zdne~o.ru'se`di~ '3'/` . Depth 3Q. r. • P posed c~tructio4lt Premises ' ' • • Namc Fo r Ot cr ld~,., /fj„(1,I, D~~a. 1 Docs ro arc situated , ~ 13. 1Yi11 lot be re, P tt0late any zoning law, ordinance or retula4on: ~ • • • • • 1~3. Name ot" Owner of premise • • ' ' ' ' ' • • • Il'ill excess fill be rc~rp ovcd from premises: • • Name of e•~G7e?~. ~:~Ak!£G.~~cr~Address 7 cs Architect , >~+'3i~dt.., • .~.rG.e:y[,,, 0 tv.!'I,AQf~or•~, • Phone No. I~ Name of Contractor . ~ 'N'0 • • • Address .F°i,a1J~'~EIGjc • • No.. 15.Is this ro ...•'••••••"""'••••••..Address. .Phone P pertq 1'ocated with in~00 feet of•a •tidal •wet•landonc*No....... *If yes, Southold Town Trustees Permit may be required. YI:S'•••tt0,(J Locate clearly and distinctly all buildin°s w PLOT DIAGRAM pro ert hether existing or proposed, and. indicate all set-back dimer:sions f P Y Lines. Give street and blpck number or description according to decd, and show street names and • interior or corner lot. tndicatc whci I, • I li it ~~i ` • TATL OF XE15' FORK, OUNTY OF iS.S (Name of individual signing contract) ~ • • ' ' ' ' • being duly sworn, de oses and ~ovc named. ~ p says that he is the applicanl L is the . o~',~ s.~e... L.~ ..~1. r.~....... (Contractor, agent, corporate officer, etc.) card owner or owners, and is duly autltorizcd to crform • • • • ~ • • ~ • • • • ~lication; that all statements conta~ncd in this application arc tare to the best of his knowledge and belief; rk will be performed in the manncr,sct forth in the application filed tPlrcrrovidtd the said work and to make and Glc this om to bcl'orc me this and that the • ...........~l.J/~......day of . 19 8~ a;; Public, 1",~,P~ki; I~ttl~-,t•: r9:e.... County 7~•~~~., N6TmRY P BLMBS a 30,19 ~ q G~~L" ~ - ~•J:t.e'.... . No. 4767878,SuttolkCou ~ • • • • ' • (Signature of applicant) i ~fiC~+VI J J W f/j z u. 4 J Z w f- O z ~ ~ o K o ~ O to x J a G ~i6 eg„~ -IVYI 'Jy ~ 3 re W Q 0 F' O a. ~ Y m3~__-:! Fa„ 'L:>c xp;,~~''c~affi~ W fi %a.'~b o. ...r F- ¢ J 0. VI V r 1 ~ ' to 3 4 ~ ` z W W Q Q d W p i4~ '.,'J i C Y n ~ `c: ~~y ~ .d e<v_> . ~ °'!d ydp ~ `"'~~jo'~y~Q ~ O iN; tL ~ ~ ¢ x W ¢ ~ ~ J } ~ ` b s r~ , r ~5' ~ ~ dS ° ~\GFL~ CY a m L A, cb q~ ~xgP. J ! F- Q } .,Z i y ~ <ic~-aye vw' w W x W J I d ~ Fes- O Z Q .S~I "~fli ~ _ o;Q C4 v.9''a'._233 .7 x~a O i... C N O O U O Q ~ N tf~ ~W t...~ ~ t\i 4t+3 v ...rsZ J ~lC u w F- N LL F- O U O 0 I~ ~ I i J ~ 4 ~ O to w ~ O LL F ~l ~ ~ y~ ~ ~ i ~ r f' ~ Z F- Z ~ ~ W W ~wu v~ .ntnuox¢ O i D 11C~ a ua"~" ~'~i .a ~ n, N ~ ~ t`~ tr' Q ci p O c' ~ . ~ ~ -•1 ,y v, ~ J ~ ~ ~ , ~ ~ ~ 1 ii I ' f ~ ( i i iS ~ t _7 t., ~ :z ~ .7 ~ ro r {.S ~ i ~ (.A j ~ „k. ~ „ Lt) ~1 ~ _ ~,„1~ . r ~i r~ 1~ - -~i . _ ! > > ~y ~'v t ..i" ~ ~ t. _ 741 ~ ~ :V'"y'~, f i ~ :1 ~ ,M1 ~ a _ ref ~ ^Y. ~ ,.i. _ if t~ fZ3 { I Z ~ 1 ~f I i`,f Q~ fvl~~i~': ~~#'i I i eY, ..1 ' i t ' ~ 1 ~ I t U~iRm~~'' ~ ~ ~ ~ ' f, ti t €sb j 1 !y4 i v_.. t > .{c. L~ C Sli x t ~j~ ~`t} f ~ n; cis a r 0 } . _ j _ - SUFFOLK CO. FIEALTN DEI+~. Ai~/RiiYlli _ ~ ~.-~-~-r,_ ~ H. S. NO. .r, D - ti ~ . ` TOYYN S ~10LD _ THE MtIkTER liN1?l.Y ANf~1 l~A~[ ~b~L z r_ . >~STE#Ai P'OR TNiS RElN~1@E + ~ ~ _ + _ f T CDNpEiRM t0 T~/6 sTAf4tiNtDi OMf filE c ' ~ > ~ - ~ V 3fJRIOLK CO. FfEi1'. OF MEALTttI fkil~!'EEi. .ry _ r., . i ~ ~ ~ ~ ~ (5? ArPl.ICAMT c, ~ ' ~ 'E. ~ ~ SU}fKOLK COUNTY DE?T. tiF NEAL1`H SERVICES -FOR APPROVAL 01? CbNSTRUCTIONONLY fir', ~ t ~ / ~QI. DATE: ~ :,x`'r~l.t~'F}Gi~.~J W.S. REF. NO.. t ~ .:r ' - '7^NK L_ ,i"~-w -~3 'J` APPROVED: ~ ~ Tt~WN QF ~..C~UT6-1CE.»u , N~+( ~ ~ SUFFOLK CO. TAX MAP DESKiMAT10N: + T O15T. SECT. BLOCK PCL. ~ i j d ~ ~ OWNER5 ADDRE~ k ~ `t i`FC:~ l'JWhi t-~hv_E2fik. ~..~SN_E_ ~d - ~ ~ 4 ~[>.LL i. i DEED: L. P. ~ T y..: O j c r r. to t k _ ~ e „ t , e ~ ~ ~ I arto r.l N4C7~i.lA';L P,~1" s.,t., b M be is tr , li~ R'!A.<_},,, ct'tYt f e,.raon{ wt thr u'.'.. au tc u`s ie}n B rvi nn h~ a~" ~ h'w com rnY 9nvcr~srat A='.",.r-~ ~ ~n;;t msbtu!ioA Bct hs o J F r~ ~J~ ?~V ~Y'~~, ~ ~ f e ~ to tnf BBr•unaee of the la t r 7 ~.mu ''B{ ^WLIOn ~+L'~I n~ IIt~n60ltBJyB~rW S - _ ~ r~ p p to scdirene ~ j i - 6 .i ~`.iAt'-A~t~.. tJ ,.-'~il' ..'LC-T .71`~Ll_ mwzcr,.. _ 1lClL.{ ' ?if„'~, _ ~ SEAL pF NEk, Y r ~~'f ' i 4 yt1 1 ~ /{a-.; ~ 1.1 F_~ t ¢ -}1.' _ lac _.:-4 ~.1(t. 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