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HomeMy WebLinkAbout19822-z i r" ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22993 Date MAY 11, 1994 THIS CERTIFIES that the building NSW DWELLING Location of Property 3655 PSQUASH AVSNOS COTCHOGUE, N.Y. House No. Street Hamlet Covnty Tax Map No. 1000 Section 137 Block 2 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29, 1991 pursuant to which Building Permit No. 19822-Z dated APRIL 29, 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 ONS FAMILY DWSLLLNG WITH ATTACHED GARAGE & WOOD DSCR AS APPLIED FOR. The certificate is issued to GREGORY & THEODORA LSPSRIDSS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO--109-MAY 3, 1994 UNDERWRITERS CERTIFICATE NO. N-276188-MAY 17, 1993 PLUMBERS CERTIFICATION DATED FEBRUARY 23, 1993 - HARDY PLUMB.&HEATING i ing Inspector Rev. 1/81 FORM NO. TOWN OF SOUTHOLD r 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~ 1 9 8.2 2 Z Date .............~..9................., 19~~. Permission is hereby granted to: to ..~.~.-...~....v.~l.......~~~.~..,....~...~°~.. . , Imo. Q0.. J~.:.. ~ .........9 . j Q of premises Iota ed at .c~.!P.~~....~t........~.:$~4:cr.Y.t............!~:...... ~:!M,.~,,,,...... J ``p ~ ~ ...C....~l~:~:~ County Tax Map NoII. 1000 Section( Block ....Q:.~::....0., lot No...s~::~ pursuant to application doted ....1„~J(.~:CI.Lac,f:....a..~ 19./,~..., and approved by the Building InLs~pector. U Fee 5.~~.J.•:..`~ S Building Inspector l ~ Rev.6/30/80 w.,,. Form No. 6 j r ~ ~ ~ , ~ TOWN OF SOUTHOLD ''~,»..vr, BUILDING DEPARTMENT :f~1~.. ^ z 1993 TOWN HALL . {1111 765-1802 70Wi~<-r' ..APP$ICATION 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 pproval 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 certifv~ng 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. H. For existing buildings (prior to April 9, 1957) ron-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, Commercial $15.00 / Date New Construction....!!..,,, Old Or Pre-existing Building Location of Pro ert ~ c Cl P Y.... f.. 4Sf;E5N„!~9V~",~,,~'•tl,i.Cj./OC-,!it .`~.`7;3 House No. Street ~ r ~ " " Hamlet Inwer or Owners of Property. C'I.~i.Cj.~~4 ~ , , , , j ,~~t?.~tJ~.~ ~ ~~4 . ;ounty Tax Map No 1000, Section...,„~ ;~,,,,Block....L'2.aka......,Lot....ra~.4`~ ubdivision ..............................q..~../.).Filed Map............Lot...................... ermit No.(~~~„Z,,,,,Date Of Permit/./~~e.(:,2~~,J`~~~Applicant.~/~~~'?~{~,G~pNS'!<~.o!`,-~'~~1i4=,t'~5+~ ealth Dept. Approval......,.,,.ff.// .................Underwriters Approval.........., fanning Board Approval....4:`.~,'.....,.,,,,, aquest for: Temporary Certificate........... Final Certicate.,;!,,,,,,, :e Submitted: $.~.f`~ . 6:-e.G ~ y ~ 3"x/0 ' ~ . .C~~ . . ' ~ APPLICAN " cn ~ as 9g,3~ ~ = . _.~..~~,a~.. ~ 11 U f2. A:.. ML~,~..,~-..~ • BLDG. DEPT. TowN o~ uTho~.a _ _.1-~~ / l 1 - ~ ~ - - /J~2-'t - ~ ~ ~ - ~y~ f _i.~,; ~ - - - _ ~iic . ~~Z~, - - - - - ^i - - - 1 l ~i~ rlr ,~'~U~ TO1ViV JIB" ~vi~'I`~~~,~9 J,'.~~/'=~ ~~ih'~"y'° ^'-L Oi?P1CIiOP9t1ILD1;i.; ~iVSt'E(.SOR n r i s. ~j~~~~ SOilTHO~D, ~ l.X. 1 1971 ~r~. JUL ° 21993 st~c,,:~~ - , C C R T I F I C A T I O t1 Date FEBRUARY 23, 1993 Building Permit No,_~ ~1~ Oorner LEPERIDIS (please print) Plumaer HARDY PLUMBING & HEATING NORTH, INC. (please orint-) I certify thar_ the solder used is the water supply system contains less than 2!10 of 1~ lead_ ~,q~...L.il ter, ~.G ~~r~-~--`~Cc-G~~ (plumber's signature) Sworn -to before me this .23 day Of lt~rr~:-~r<--~ ~ ~ 19~ ~ `To ~a y blic Nota_" Poh~ic, j~>~+~~._~-. County ANTHONY J.ENAKiHT Notary public, State of New YbAt Na.487870t Qualified in Suffolk County _ ; Commission Exurres P,prii 8, 197.1 F, 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] R~k1GH PLBG. [ ] FOUNDATION 2ND [ I/NSULATION [ ]FRAMING [ )FINAL REMARKS: ~ ~~r , DATE U INSPECTOR 6 ~ ~ l / _ 76S-18U2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ['~OUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: ~ li-~a-,,.i ~v'- ~ ~L r~ DATE a S INSPECTOR ~ 1 ~ ~ 3 rss-isoa BUILDING DEPT. 1 NSPECTION FOUNDATION 1ST ( ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL 5 REMARKS: a~ w `k E DATE ~ INSPECTOR _ , -i::LD 1;:s:~ec::ua ~~ua,:; co,~r~~cNrs ~ Cu J. ~ ~ ~ . _ H FOUNDATION (1 ) FOUNDATIOI (2nd) ~ 2 . ~ , z ~W ROUGH FRAME ~ ~ o "A PLUMSIN~ ~ cn H 3 . ra ra H I1ISULATI01.1 PER N. Y. STATE ENERGY \ CODE x CGS .,I P] 4, y FINAL E ADDITIOPJAL COMME TS: ^ ®,.,7 h ~ ' / R J~Q x\ -o X18\ yo H O J x ~ a r - x ~ O b l c~ ~ ro \cO H `J INSPECTORS Victor Lessard t ; ~d3j ~ r(2; `4 Principal Building Inspector e9 Curtis Horton r'~A`:° SCOTT L. HARRIS, Supervisor Senior Building Irspector ~ ~ j =G Thomas Fisher i " IF'~<` ~ a~ Southold Town Hall w l k;; iii,. ~'Pl Building Inspector ~=.'s' , ~°c ~ P.O. Box 1179, 53095 Main Road ^.;a~ _ ~`r'rGY Southold, New Yotk 11971 Gary Fish ~ n,~~~_~ Fax (516) 765-1823 Building Inspector a, a Y' Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 20, 1993 GREGORY 5 THEODORA LEPERIDES 50-35 213th STREET WAYSIDE, NY 11365 RE: PREMISES @ 3655 PEQUASH AVENUE, CUTCHOGUE, NY 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) RRR No Underwriters Certificate on file. R~ The check is not on file.}$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984}. BUILDING PERMIT # 19822-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 1~1~Q121 THE NEW YORK BOARD OF FIRE UNDERWRITERS Pn(,E BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 70038 Dote MA"t 'l7,7.~99:i A 7RD(-0254"19? N 276183 PPlicotion No. on file THIS CERTIFIES THAT only the electrtcal equipment w described belofn and introduced by the opplicant Homed on the obove opplicotion number in the premises of GREGORY IIFPNRiD1,S, 113--f~~i5; PG;jllA3H AVCT,, CCr1'C,UpQIJFi, N.L', in thefollorvinq (ocot'onf L'J Borement ~ /st F'(. ? 2nd Fl. '~~~~('t DNS .Sertion Block Lot uma examined on 1~P[cIG 29,'1993 and found to be in comptirtnce With the National Electrical Code. FIXTURE ECEPTAGLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENL OTHER AMT. K W. AMT. K.W. AMi KW qMi. K W. AMT. N P. a $ 3 3 L '13.!3 t 1.G DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS UNIT HEATERS MULTI.OUTLET AMT. K. W. OIL H. P GAS H. P, qMi. NO A. W. G AMT, qMP AMT. AMPS. TRANS. AMi H p SYSTEMS DIMMERS NO.OF FEET AAIT WAtTs SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. TYPE METER 1 9W I X JW 3,e' 0W 3,e 4W NO.OF CG COND p. W, G EQUIP. ~ PER .e' OF CC.COND. NO.OF HIdEG A~W~G. Of HIAEG NO OF NFUiRAlS Oj NEU PAL OTHER APPARATUS: MOTDR`J14~5 8.1?.,1~3 H.P, PANEI,130AP,Ui;'1, 1 CT!?. 6F~ G.IP.C'.i';-1. f?AU1', R. f1U11N,"i LSC.P242-13 "~r~ 275 4`OWN lIARl3DR LANE G/j~~ • 90UTflOLD, P1Y, 1.1974 OENERAI MANAGER ! :I. This certificate must not be altered in any monner; return to the office of the Board if incorrect. Inspectors ma~be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. l~~~~- 765.Z80Z BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. (}FOUNDATION 2ND [ ]~LATION [ }FRAMING [ FINAL REMARKS: ~~%~f _ d"~a,~o ,u~ I r. DATE It INSPECTOR INSPECTORS ~~$OFFO(!(~O (516) 765-1802 ~y0 G,y SCOTTL.HARRIS,Supervisor VICTOR LESSARD, Principal ~ CURTIS HORTON, Senior y Southold Town Hall VINCENT R. WIECZOREK, Ordinance ~p ~ P.O. Box 1179, 53095 Main Road ROBERT FISHER, Assistant Fire y ~ ~b~ Southold, New York 11971 Building Inspectors ~ ~a Telephone (5 6)5765? 800 THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 9, 1991 Gregory & Theodora Leperides 50-35 213th Street Wayside, N.Y. 11365 Re: Building Permit #17391-Z (New Dwelling) Premises: 3655 Pequash Ave., Cutchogue, N.Y. ' Suff.Co. Tax Map #1000-137-2-20 Dear Mr. & Mrs. Gregory During a review of our files, it was noted that the above building permit has expired and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold Article XXVIII 100-281 and 100-284 a building permit is needed for any construction of additions, accessory structures, alterations or new dwellings, and it is unlawful to occupy or use said structure until the Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar l T6S-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. i [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: _ E ,f DATE INSPECTOR r , . x. 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ) ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [ FRAMING [ 6~]`~FINAL REMARKS:f .,~..u r-~ :.A~.~-,.,~.~~~ t~.v~e 'fit ~ ~+jt ~G A., ~~'°'~ti"~F"°°a ~e'.,iP.,q.. .,1"~M._ ~'c,a. ~a~ f~'~ a~, s8:n+•. n ~ tt R.,4 sx'~;.a,'$.,~Ra" _+,c ~'7..4+MJn.a...t..w..., ~ //f ~J r, ~ ~ 'K°~G.e.x DATE ~ ~ .z INSPECTOR ~ f 765-1802 ' ILDING DEPT. 1 NSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSU ION [ ]FRAMING INAL REMARKS: C~ 4 r DATE ~ INSPECTOR i roam xa s 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) Nfl o1~3s~ Z Dnte ...~i~!l 19...L~~ Permissi is ereby grante to: , G'o, d~ oS,l, ,1lyc, ~ moo, ~ ~ ct premises located at ..~.(~.s.l.~.. ................................................................I~~~................................................... Caunty Tax Map No. 1000 Section ..../1~.7....... Block .......,Q..~-:...GLgot No........ir?...~....... pursuant to application doted ....~,l~.G.•.•.•••••••••••••••••••••••••••••~•. 19..Q,A, and approved by the Building Inspector. / ~C~l Fee ~t?., ~f ..65 r7~.~~Z~'~'1~ G~ C~---!*f~ B ing Inspector Rev. 6/30/80 E INSPECTORS ~~gpFFO(K~O . (516) 765-1802 ~~O G~ SCOTTL.HARRIS,Supervisor VICTOR LESSARD, Principal ~ ~ CURTIS HORTON, Senior °w x Southold Town Hall VINCENT R. WIECZOREK, Ordinance p P.O. Box 1179, 53095 Main Road ROBERT F15HER, Assistant Fire ~ O~~ Southold, New York 11971 Oj ~ ~,0 Fax (516) 765-1823 Building Inspectors Telephone (516) 765-1800 THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 9, 1991 Gregory & Theodora Leperides 50-35 213th Street Bayside, N.Y. 11365 Re: Building Permit #17391-Z (New Dwellings Premises: 3655 Pequash Ave., Cutchoque, N.Y. Suff.Co. Tax Map #1000-137-2-20 Dear Mr. & Mrs. Gregory During a review of our files, it was noted that the above building permit has expired and a Certificate of Occupancy has never been issued. According to the Code of the Tawn of Southold Article XXVIII 100-281 and 100-284 a building permit is needed for any construction of additions, accessory structures, alterations or new dwellings, and it is unlawful to occupy or use said structure until the Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar 4 ~ s~` W ~ > ~ ~ aaaN~ W Y ; a ~ ~ ~a~, . W ~ ~ r tiJ ~ ~ £v 2,, i P- ~ ~ / ~.u v s I~ O I~. fJ U. W / M y A `l) ca ~ 0 4 i Qi, ~`y~ ~ ~ \ t~ Q ~>W q Q, d ~ 7-, ~ O i ~ ~ o~~ /.J n ~ N F ~ M ~ ~ ~ ~ o ~ ~ x 4£2 ~ ~ ay ~ O ~ S ~ ~ 4 ~ a w ~4 4 n ~ ~ ~ ~ w ~kYv , U J ~ O k1 ~ O O 0 ~ ~ ~i O O 4 p O 0 d z p ~ ~ H `rl ~ ~ M _ ha ~ ® Q M 4 ~ ~ p r~ ~ a ~ h ~ a Q ~ Q ~.1 4 ~l i r6~n~: ~ " . h W Q ~ 4 ~ u I ~ ~ Q f ~ ~ ~ si<`~ d ~ .-1 rl ~ `n ~ ~ n ao i E. 0 n ~i w ~ ~ n~ a 'L~..l " a d ~ ~ 2 ~ ~ ~J H ''z~~z ~ ~ ~ D V ~ F.~ ~ D 'HHC7W W ~H ` ~ ~~~~a~~ ~ I + au ~ 4 _ _ ~ i~ _ ~ .r r. . r-1 cV r1 V' ul ~D 1 ~ . g P ~"'cku' ku'^.GXYLKd~WvSeYd%3~"';~}S+ LA"., ~ ~ _ w - .e ~ ~ )p WELLfNG) ~ I VBLL l Cf++rDOL OVEP MO' r (pWELLlNOI I p//O/F ANNABEL,. " a N/O/F RYNlEO ~ s 3 N 'y 111.49' N~ C~ ^ S14a12'40"E cr I .e.u 748.89' vv°E h , E va +.e~N ~e'N S 42 Z4` 00' c .o ti YON _ ~ .L. I _QIPE E/e I ssa / 88.71' A ~~~1'40' .It e I T• V. /V ~ CNAIN LINB C ' 6b.yM MAC • PPP rfxcf I u 18.0 N 48'91'10 UY ~D wOLV" 4~ 1 waas.c p. b I V »v~a ~ I ' ~ 4 ' dol. oven leo• ! eeLL a OPIM 210' ING> (DWELL v - _ 3 a B ~ SURVEY OF ~ nz' lea' 22' nes'„~_ va 24 Ai- y fOUXDAiIOX yD 22~ °e ~ L O T 4 _ a,.i~ MAP OF PEQ UA SH ACRES FILED MAR. 30, 1972 FILE NO. BB84 A T CUTCHOGUE , qaa TOWN OF SOUTHOLD _ ~ SUFFOLK COUNTY, N. Y. 1000 - 137 - 02 20 ~ Scale 1" = 40' ~ July 5, 1988 _ . .,,r......~„_. OCt °9, 1988 (foUndOtion) E~~ - ~ ~ ~ ~ e a~ ~7reP 'p,,.sa...e~ ~ p~ G~ O __.r y~d9l9f z 3 ~ n Gs ~ \ u~ AREA 49,020 S0. FT. ~wo.a/~5/ _,I ~(•9 ~ I cf wa~~acP ~,~.d r i~o W o ov.A ISO' : ; ¢ ~m.z o ° _ ~ a ~e` 4 U, Z C STOP. 0.7+ fi/e oeLe A p a ~ „ua l`a ' µg0. 16' 30,• yN R O ~ ee.9 z le9.oz_ 1se.Be K ~ - •384.62' NCIl . T GG FLEE ~,wl,.,~,~ . CERTIFIED TOE ' ~ ~°~`A.rt~. GREGORY LEPER/DES ~ h axordoin rIM lAs mNWN+rI The woler supply and sewage dr:poac/ 7HEODORA LEPERIDES ~P ~d+ la 1/Ns rave es eafablkned sy:lams /o/ INS retldenca w1U conlorm Y+ fo fhe ala~dardc of 7hs SuJJOA Coady 1 /y Ne L1A1 R o/W goprovsd and adoyHd Oeparlmenl o/ Hsal/h ServlOSa. ' +ecb ws by The Hew York Sfals Cond Hn+ Assodallon. TM faealbne o/ reY+ Aad eanpoals ahowN Mrson ais lram /ls10 eMwollons aM or /rom dole ablabNrd //om oxrorp- ~ LANO SG SUFFOLK CfH1NTY DEPARTMENT OF HEALTH SERVICES 10! Oe~p~ A /'VCp~ < F FOR APPROVAL OF CONSTRUCTION ONLY 'i/ O O - ~ - N. L/C. NO. 48888 DATE HS REF. N0. ~ ~ ~6f 1 URV~YO P.C. • 'APPROVED ~p~ O. /8Q4`N y yMAIN R ' ~ SOUTHOLD, N.Y. 1187x"' , +B8 - 449 • BOARD OF FfE~ LTH , 3 SETS O1~AN5 .l/.. , , , FORM NO.1 SURVEY • TOWN OF SOUTHOLD CHECK , , . , , • BUILDING DEPARTMENT SEPTIC FORM t~. TOWN HALL ` °Z 9 Q ~ ;OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 Cnf.,I. Examined ~g ~1Z`L~. MAI ~ r~ 19 ''v . Approved ~~~~-2.~~.9 19 . cnnit N~~-!r~9Y ~ / ~ ~-'AC/f21.11-t,eQ ~µ~''l Disapproved a/c V D a ~ ~i~~ TOWN UF' DEPT. . SOU'fFIOLD (B 'ding Inspector) APPLICATION FOR BUILDING PERMIT Date .~.~j, 19~~ U INSTRUCTIONS a. T1ris 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 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 t}re 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 Bui]ding Zorre 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 necessaary inspections. t~.~'~:.~ 61S~;C, t;\e~~i;D7 ,aQ, ~ .~,L, ~iOC. (Signature oi' applicant, or name, if a corporatron) O:P~v~:..': Ys.`1... ~R..e~.~-~: mss:... \.l9 ~~I j " ~ ~ (Mailing address of applicant) f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1 I Name of owner of premises . ~,c ~&OS.:~I, . ~ heo.e~.AT',tn, , , y, • • . • - • . - ~ v (as on the tax roll or latest deed) If app rc nt is a cor oral' signature of my utho~rize~~d~officer. (N r e and title of corpo22ra22te officer) ` Builder's License No. ~~1Jg~~~~....... Plumber's License No. . ` ~o. ~ S.. P . Electrician's License No. . . Other Trades License No. . 1. Location of land on which proposed work will be done. 1. ,O, OC!•, ,t,~:~•-, ~ ~ , .3 S~ . C House Number Street Hamlet County "fax fvlap No. 1000 Section Block ..:b .c`~........... Lot .....v~~Q . Subdivision ....~C~.~IA.GlrG10...r"5C.-~:~.~ Filed Atap No. ~r7, .~o Lot (Name) 2. State ceisting use and occupancy``of~premises anrJ intended use and occupancy of proposed construction: a. Existing use and occupancy ..v.Or-C1}~`}.... Ct?.~.~-.~~~ c ` { b. Intended use and occupancy ~ ~ • • • 0.~~{`\•~ , c~,~.~~l~r ~ i . . 3. het ai[ of work check wlticRle applicabf New [3uilding Addition Alteration . p • • • • • • rpoval Demolition Other 1Vork . (Description) 4. Estimated Cost ...Dl. (~4~.~'.-.0~ Fee . n , Number of dwclli ntot nets on cachhng this application) 5. If dwelling, number of dwelling units g floor . If garage, number of cars ~ • • 6. If business, conunercial or mixed occupancy, specify nahtre anti extent of each type of use . 7. Diiiien&ions;of existing stnrctu'Fcs, if any: Front . . Rear Depth . e> He~g}it' Number of Stories ISin~nsio s ctuic }vith alterations or additions: Front Rear . Dpth,'~~r~t~...,• i•„Ileight. ,Number of Stories. 8. L11•n~ensions of entire new construction; Front , ...(~¢.,•Q~' Re r .,>~.q. D~tth . ,Cp,$, ~ H~'(g1iY"' ~ , Nui~tber of Stories . .cam" • ~ ~ ~.(I~~c~ ~ ~ ~ d ~ • • 9. Sjize ok"1of;~Ftont ao~f to ~ Rear ......rot.:'j ,(q Depth t? $ to ~ . . 10. Date of Purchase ~,0.,rp~ , , ~.t„(q • . , Name of Former Owner 1>osEa~ , ~e, , , 1 1. Zone or use district in wlticlt remises are situated . 12. Does proposed construction viPlate any zoning law, ordinance orOgulation:...A.l .9 . . 13. Will lot be regraded ~kS~..-b.~es-~bliFh. ecpR4C ~ cAAcWip excess fill be re{~oved from premises: ,Yes Nt~o~' 14. N.•une of Owner of remises c: x. e' ~o '3~ ors p ~'~'i`~,`~~~1-epe A~'ddrass.t~.y.~1J~.,.N.•~I.~13kyPhoneNo.`11$-.1031;,0,(03,x; Name of Architect ~-,a~~.ry • , ,.;~:~:h'~L1, , , , , , , , , , Address~Ax. ,1~,5 , ,C~s~snga~. Phone No. N'~1.~,I.b S~ . . Name of ContractorF~axbor, C.o.'nst, C.i: ~ S.L.t:>~x~c~. Address'Qpx .^IS.'T . , , . • Phone No.'7!'l~:.3 3 U4.. . - IS.Is this property located within 300 feet of a tidal wetland? *YES....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a~l buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interioryo~rlIcorner lot. i ILl r~ s ~ s ~ ~I', v' e ~ ~-~-°~o~ c~ ed I' • i~ i STATE OF NE1 YO K, COUNTY OF`.lK, . , I S.S ~.o~ ~ ' ' 1' ' • • • • • • • • • • • • • • • • • . • • • , being duly sworn, deposes a„d says that he is the applicant (Name of individual si ~r)ing contract) above name//d~~. He is the . C:(:2s••f S,~'~...4:~.F .~P:C~~r..~P.r,~~r~~°~iion..~-A.•. t~.:~ t~FaRr: . (Contractor, agent, corporate officer, etc.) - of said owner or owners, and is du~y authorized to perform or have perforred the said work and to make and file this application; that all stateptents contautrd in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this I l~ .day of . . d u.SG-' , t 9 .4.~' Notary Public, L ONARD GEORGE F RFER~y ' . ....r. ~NO Akf PlJ9L1&,'Stateal No. 4690406, Suffolk County Cnmmisslon Expires May 31,190 (signature of applicant) • ~ ~ ~q~wEC4tr~Gi ~ ~ - I - N'ELt d CE'SSPOOL' DVEA Id0' (pWER41N~+' I Nf[?!F ANRABlc•R~~ NJOJF RYNtEC•i a ~ ~ N 344'4?'40"E I4 .9'q X48.88' P"~E ~ ~ / • Y a.e~p :n'N $ 42e ~4` Q~.r E ~ 4. C Q 7.!'~ 6AAA@E ~~j~y - O ~ .t. ~~p IP ya.d q ri' ~ B8;`, a CNAIN 41NK ~ y yv 0,£w FENCE I a ;f~.AW' • ~~0~ W ~ L~~.~{ ~.~AF~ . a~ , I u N 4s3 89 ~j ~.o~a"~« 9~ it W H~.LipN ~ ~ 1 ~ . wE4L, d CE8sP001. OVER 100' ~ - 2t.o' . ~ ro,w~r.'wrN~~ W m 3 ~ ' 1i.2' ib.D' 2:3r' ~49.g'_ $ ~ ~V/ I~ ~ I' Fr Y Q• vs MAP ~~~1?Cl~i A ~R~'S ~ ~1lED M1tR~. ^3?0/, ~1^9~7~2*+ , ~l/tE~/N!~d~. /~BB.t ~ , ' ~~(~/~~./CAW ! V ~t?~~."7~,~/VJ'~~] } Rr l S~/YYX.Y /'74<L© Sl/~FOLK -~QfIN~'Y, ~L Y. .Jul ar3', »t88 , L=-~ - - ~ am,~,Dp ~ ~ ~ y~agl9i~ ~ ~ ~ . AREA 49,020~~&Q..F'~. ~~G++~'" ~ ;.3;rt1 cv ~ e~w. air= P cam ..vx ` h _ A rt r p. C Nb s3 ~ 2 ~~t~o B/w ,,.r 'Q . _ 77T~~~" _ ' g 89 ~ 189A2'..~ ~ •.3&4:52', w'~ G' ~ ' ~ ~ ~ c~rriF>~'p :~r©~~ ~AaA~~ s~~®o~y. c~'P~t~rp~~ wlih lhs rMi ~ Tfio wafer supply and sew d/a ' T}IEOAOF~'A L~P~'RI~ES •4r syslekrs Par tn1eF rswi~~yyRa~i~ eoR .veyY tis sstablfahed io"iha slohgiar~ii a~ T~ Sk~r GgWify ~ ~ I~~r~~'~`pY ewQY•o~ ~ala~~an~ Dgl+arlnwnl of ~a/ih 5srvkhx . '(Ytfs Aric~l/an. . - ~ The /ff&bNo,~s-aF, • s ~d ~~sspoole ahQws hyreon oro from field - ~ - ~ ~ ~ ~ ' - ohLswaJlohi'aatl iam data oAlafinritl;/ram offrers. I.ANOSG ~F0Lk`$0~1N1~Y''dfePARl'MFNT 0~ FI~ALTH SEttV1~E`S lr~R Af~f'ROVAI OF C0NSTRt~CT10N ONLY: ~ ~ ~ o ~ M ~ ic. Na. 48s88 `;Cfk'!~ HS Rat=. F70.-'•^~----•:-. + p-•..--- ; +7~PWk0VtO - . ~ ~ ~ x rF k l i ~:9"'.~i7 (DWEL L FNG! y wELL t cessvooL ovER reo• I"` (pWELLING) i NIp/f ANNABEI., N/O/F RYNIEO ~ 3 N 117.49' •4?'40"E CP 8,N r FND N Q 4 ~ A ? $44 ~ • E 148. P,PE ~ . s:s•N .a•N g 4? ?4 00 h a. ~ C: ao p 7.1'N~ GARAGE ~ /1EW ~~~e~H t?._-•-x p d 1 ~U.tWF / F.H 4a.3 y .L. I IPE r. _ ~ Eiw A~ y I Orr y{f' plf ~i aa.3 gg,7F' ay ?~I'4 O w S.d..- CHAIN LINK I M ~ FENeE I oe 76.0 N .9714" W 6u.$N Af' '~I l m ~ ~ 4 ~ wca~"" Co o e wea~•cP• ,p' ~.vK",Ga,J t 4 WELL 6 CE88pOdL OVER X30' ~ _ PROP (pWELLINGI ~ ~~~k~~~ GARAGE ~ SURVEY OF PROP d0"' ~ ze.e' HDUSE ^--------LOT 4 ~ ~ v, MAP OF Eas ; PEQ UA SH ACRES R~~y«g ggQ~1C ~p FILED MAR. 30, 1972 FILE NO. 5894 cover to ~ro~y f A T CU T CHOC UE TOWN OF SOUTHOLD SUFFOLK COUNT Y, N. Y. " ~Ai~~ looo - 137 - oz ~ 20 . scale 1" . 40' - ~ ~ July 8, 1888 ~~r•P pwcis~+~e~ ~~~~'~P~ d - c~~ ARE;4 49,020,34. FT. CDw`,,~~.,o~ We~to-oP ` ~ ~ ' © ovrR ISO' O .P ~o °w p4YN ~ G n ~ Q ~ 4A7 ~ LL' ~ A gNTK O'OLO E/w o •P"'`=~ °e.i g8r N 50' 16 30 ~ ~ O E q=,9 t89.o2'~ 129 . 384.2' N ~ ~ Hl?RBOR CONSTRl1~T10N ~d• E ae,a~ RTE. 114, 80%.457 C t \ SNEITER ISLAND; N~ T G r~ v,t~k~"~) dA~~ CERTIFIED TOr ~ tea C3RlrGORY LEPER/DES ~~~Q",~~~ ~ l The wo/w supp/y arrd sewdga disprsGl THEODORA LEPERIDES _ P~s~ h- i u~h~ systems for Ih/3~ re;ldence wJd.coalagn LjD~ r py the !L and Quad and adoyled /o the standards o! The Su//d/k ~ounly (f such arse, A '~.Tha ew Ydrk 91a1e Lond Department GI Heodh $ervldea. ~'irre AstaCYdl~ad.,;~ ° " SINGLE I=AARILY D1J',lEi.l.~-N~ ~~lt~' rhe`~ooxans ~d"sesa~oola shown hereon are from Hera -n~~O YEpRS FROAA flA~~ of Ap~RbVAI~. ohser~Nons ond±~~om Bola otrlsinPd hom olhDrs. ~XPIR~S 1 y• ~g g :LAND a, '$WFFgL,~ CDUN~~~ARTANENT OF HtrALTW SERVIG~3 ~ , d?7 N A.'NG 09G ~ f APP ~ OF CONSTRUCTION ONLY . ~ ~ fi ~M.c ~~-S o~i~~ ~ q ~ `3'~ ~ : ~.tc. ~NO, ~r~ssa ~a~r ~ 3 fi EF. Y. P.G. ' ~ ~ f ~ED Q*k AAPROVED ~ ~ ~ M/f/. ~ ~ d0 3GiU~H . ' ~19~,X"~ . . - ' , , CA • (DWELLING) ht , - ~ hdor ~ WfiLL t CESSPOOL OVE~Jt ~f_ ~ _ .~~~L._. (pWELLIN(3J N/4/F ANNABF~t~~ ~ (iJ 55 ~!'1 y°~~ I ~ N/O/F RYNIECi f 117.48' ~ v 3 m v S44°42'40'~E cP I •e'u ° ~ E 148.98' PIPE ~ A ~ no" ~ . s.e•q .a•N S 42 24 ~ h q N p 7.1'r{ CARAOE /SEA _ _ ~ ~ MON i ~ FN 44.3 .L. I .~-r ~IPE ~ ~ , ~ E/w II ~ _ 68.77N 470°~1'40'r O ,W 5~ CHAIN LINK - ~ FENCE III u / 7S, ON 4 . e " 1A/ 66.81 MAP \ 8 87 10 CD „,oar-IAOoy) O! I I i WELL t CE88POOL OVER IDO'np , 12• Q fDWELL1N61 W N ! v`J ~ 9t D m SURVEY OF 11.2 15.0• 49~6~ 4 r b 2 2 9?ORY _ . I! FR NpUSG A d 7~CWMMGY I L O T / 24.4 f G.ARAes N IRS r R tl' 4a.o 'f ¢pEGK Y WDDO , MAP OF _ DLGK °1 ~ PEG? UA SH ACRES ` $M / ~ FILED MAR. 30, 1972 FILE NO. SB94 A T CUTCHOGUE ` WPE 03 ~ TOWN OF SOUTHOLD ~ SUFFOLK COUNTY, N. Y. 1000. - 137 - 02 ~ 20 ' < Scale 1" = 40' w 5 19 July ~ . ,A,. a . - . - ~ _ 4_~. , , - ~ a Sept. 4, ,1993 (final I M T N well I~ O ~ CAI/M'YQLPIIRTMEtii'q~HEALTH8ER1t ~ a ' ~ Z SW©LE PANIiLY DWELLtNt3 ONLY \ Y 0 a ~a+~Nd wmlla I K.S. ~ s 0 / 9 A/~EA = 49,020 S0. FT. Th9 eavra~t LS:;;z! 15s~t®r ~~~~~~yy v~olc ~ ~ itttde M:.i+Yfu» ltY•.V6 Gc~iil M~eVY®d8nd/gr P3o5P~W I o oerGlledtra~;::~Ocs,^.artrnentorWher L/c \ o rki~d t0u(id t0 tN188tl918Ctpf~ra N N ~ ~ . a ~ atAr and w~t®YUBter ~l ° h a IU' Z STK, ' ~ 0'pl SO E/W , N 5D°,8 ~ D A D Z jg9'02- 128.g9r a a_.e 384.52' „~ol~ ~ ~ i! R ~ 3os ~ f~ 6 ~i; Y' 8 4~•'! ~ ,3 E'3 FEET CAW`°"~~~ MaY i i ~,tt -~i~ CERTIFIED TO+ T D ~v P• P"R~ GREGORY L EPERIDE . Prepared N aacadancs- wph h1e ml/dmum The avofer supply and sewage dlspasal THEODORA LEPER(DES standards for NNe-adrve s os eslabllshed systems for this res/dence wU! conlorm byy the L,AAI.L,S ono approved and adop/ed to the standards of Tha Sul/o/k County (oi such use by The New York Stole Land Department o1 Health Servleee. Tllle Assoclallon. The /ocallons of wets and cesspools shown hereon are from /!eld P,`~pF N('wyG observallons and or 7rom data oblalned /ram others. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~--;rs;~~ so .tk FOR APPROVAL OF CONSTRUCTION ONLY B8 SO 109 ~ / V _ ~Y L/C. NO. 49818 DATE HS REF. N0. p V S, P.C. APPROVED P. O. OG6N9 MA/N - SOUTHOLD, N. Y. 11971•, 88 - 4.49