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HomeMy WebLinkAbout19532-z o¢ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21131 Date NOVEMBER 6, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 5050 PEQUASH AVE. CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 3 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in. this office dated NOVEMBER 20, 1990 pursuant to which Building Permit No. 19532-Z dated NOVEMBER 26, 1990 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 ROBERT H. PETTIT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-33-OCT. 30 1992 UNDERWRITERS CERTIFICATE NO. N-199859 - AUGUST 13, 1991 PLUMBERS CERTIFICATION DATED NOV. 4, 1992 - ROBERT H. PETTIT uilding Inspector Rev. 1/81 "VMN0. 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) W 19532 Z Date .... Q ...... fir......., Permission is hereby granted to: .�. .....rn. . ', ................... ...................... .:y.. ....... .L.9 ..!......... ro ..CS ..."x... ' .. .. ... .. ..1J.k ...4 ... AA.q�. ... .................................................................................... .. . . ........................................ ..................... at premises located at ..J ��.......��Q ..... . . .:........ I:.CJF-4 tnt-A,4 „_...... ................................................................................................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ......V a......... Block ......M.a....... Lot No. .. .............. pursuant to application dated ...... .v*..... .. ..... ....... 19.1.01., and approved by the Building Inspector. Fee S..0.2.a :.��... ` ........ .J.. Building Inspector Rev. 6130180 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT NOV, 15199? TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ' B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. -Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. '2. A properly completed application and 'a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate ,of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date few Construction. . .X . . . . Old Or Pre-existing Building. . . . . . . . . . ,ocation of Property: . . Os-61. . . . .�F� !1?.`l . . A . . . . . . . . . . . . . . . . C;Xmly.Cu4 . House No.f p (j Street Hamlet ewer or Owners of Property. . . . l� :> . . 1/:.. /.!. / . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . )unty Tax Map No 1000, Section. . . . 1?? . . . . . .Block.. . . .Q3 . . . . . . . .Lot. . . -. : . . . . . . . . . . . . . . . ibdivision. . .V-9... . . .. . . . . .. .. . . ... . . . . .. . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . .. . . . . rmit No. . .l �� .Z- . . .Date Of Permit. PQl . :Z4. . OMApplicant. alth Dept. Approval. . . . . . . . . . . . . . . . . . . . .Underwriters Approval. anning Board Approval. .. . . ... . . . . . . . . ... . . . . . . . . quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .4�. . . . . . '- Submitted: 0 � Co z7a113/ ' APPLICANT 195 3 d THE NEW YORK BOARD OF FIRE UNDERWRITERS ' " ' i'f311It I BUREAU OF ELECTRICITY F— 88 JOHN STREET. NEW YORK. NEW YORK 10038 Date AUGt7ST 7,1, .i997 Application No.on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the appRcout named on the ahooe application number in the premises of ROBERT PETTIT, PKQIIASH AVE. , YL.42, CUTCHgGUuI: Oi.Y. ❑ 1st Ft. ❑ Ynd Ff. 011`I' g in the following lucotion• t Section Block Lot Auuscl' R3�� was examined on and found to be in compliance with the requirements of this Board. . FIXTURE �CMACHES SWITCHES FIXTURES I RANOB 1COOKWO DICKS OVENS I DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER "T. j K.W. "T. I K.W. T. I K.W. WT. K.W. AMT. I N.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE MINES SHOAL MC'PT TIME CLOCKS I EBL UNIT HEATERS MI!LflI o TLIIT DIMMERS "T. K.W. Olt H.P. OAS H.P. WT. NO. A.W.O. AMT. AMP. AMT. AMPS. TRANS.. AMT. SYS'""w AMT. WATTS NO.OF IElT _ SERVICE DISCONNECT NO.OF S E R V 1 C E tMG AMT. AMP. TTPE 1 A tW 1 Ur 3W 3 A 3VI 3.e IW �'OPER`COND' OF CC.COND. �.OF HI-LG a'HI' NO.OF NEUTIIAIS Of'P lUOi11Al t S OO C B OTHER APPARATUS: S F;R V T f:F: ONLY-1 *NOTE This is a partial , not a complete certificate. 1 PAW- R. HtiRNS I,iC.#?,k2—R 275 TONN HARBOR LANF: SOUTHOLD, NY, 7.197E OENQAL MANAGER — I Per _ .2 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Impactors may be identified by their credentials. a COPY FOR BUILDING DEPARTMENT. THIS COPY OF ClRTIFICATEMUST NOT BE ALTERED IN ANY MkMER. x. THE NEW YORK BOARD OF FIRE UNDERWRITERS $030$30 BUREAU OF ELECTRICITY r I 85 JOHN STREET. NEW YORK. NEW YORK 10038 _ Dare FEE1RIlARY 24r �.$92 APPIica[ionNo.onfile 72279391/91 Ii 027112 THIS CERTIFIES THAT PERMIT NO. 195327 only the electrical equipment"described below and introduced by the applicant named on the aboue application number in the premises of ROBERT H. PETTIT, 5050 PRQUASH AVENUE , CUTCHOGrUE, N.Y. in thefollouinR location; ElBasement ® )At Ft. 4 2nd Ft. ATTIC/OUT Section I IOBlock3 Lot 25 was examined on 1''EBRUARY 1.$,1992 and found to be in compliance with the requirements of this Board. FIXTURE ECEP7ACtE5 SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K W AMI KW AMT. K.W AMT HP 23 41 19 19 2 P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RRCTT TIME CLOCKS SELL UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMC K W. OIL H P GAS H.P. AMT, NO. I A.W.G. AMi AMP AMT AMPS TRANS. AMT N.P NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO S E R V I C E PMt AMP rypF METER I X PW 1 b.3W 3 9 3w 3 8 4W NO.OF u co 0 A.W.G. NO OF N4LEG A W G NO OF NEUTRAL$ A.W G l EQUIP. PER% OF CG COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: CP.F.C.It-5 SMOKE DETECTORt-2 *NOTkt This is a partial , not a Complete certifieate' ROBERT H. PETTIT 515 MAPLE LANE BOX 7$ SOUTHOLD, NY, 11971 GENERAL MANAGER 11 t_il 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 ALTERED IN ANY MANNER. c�vF��(�•�, TEL. 765-1 B02 p�0 -v, } O✓ TOWN OF SOUTHOLD f" L�ti7 OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 ep TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date l b). 2— Building Permit No.� / 7?5-3 - Owner ��1�2�9�i r7 9✓ �T (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. __ 6tiz•(�I,y�Gq�y (plumber's signature) Sworn to before me this day of 19 / otary Public Rotary Public, jd!/LCcuntl(____ )DEN KRAMER pOTARY PUBLIC.State of New YOtk No.4658322,Suttelk county Term Expuea Feb.28,/q j INSPECTORS Victor Lessard � l1FFD(,y� Principal Building Inspector ob <9� Curtis Horton SCOTT L. HARRIS,Supervisor Senior Building Inspector cn ,.. ; 1 ;-',q*, �'`� Southold Town Hall Thomas Fisher _ r "r Building Inspector P.O.Box 1179,53095 Main Road Gary Fishd � � ^� �', _ p� 4r Southold, New York 11971 Building Inspector p�� Z Fax(516) 765-1823 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 SEPTEMBER 28, 1992 ROBERT H. PETTIT 515 MAPLE LANE SOUTHOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. ffi The check is 9&W0aXMWnot on file. ) $25. 00 ffi No Health Department Approval on file. No final inspection has been made. %ffi No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 19532-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ROD POP ' � � �L> i✓ ��i .d �� - -� - .mod vi � s Wd Wk" 1 / .. . . ,. I _i..7 M�Midi • •ro_. A LI/i ROBERT H. PETTIT SIB MAPLE LANE, BOX 78 SOUTHOLD, NV 11871 j j532 � r WA yyy/ � p u� tu��- ., 7r3 �� 7"-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL REMARKS: k i DATE o���INSPECTOR ROBERT H. PETTIT 515 `4APLE LANE, SOX 78 p p SOUTHS LD' NY 11971 f i M-1802 BUILDING DEPT. INSPECTION [ ) FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ SULATION [ ) FRAMING [ ] FINAL REMARKS: DATE 9 INSPECTOR 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST f ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL I REMARKS: �. r I f 4 i i f t t t k f f t `t DATE INSPECTOR r D 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: I ' DATE a- D INSPECTOR i n 6V 2, M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ RAMING [ ] FINAL REMARKS: k _Q 2 4 I qq DATE 3 6� INSPECTOR JL44 M-1802 BUILDING DEPT. INSPECTION i [t-]"FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION i [ ] FRAMING [ ] FINAL REMARKS: i 4 t DATE INSPECTOR I ROBERT H. PETTIT 515 MAPLE LANE, BOX 78 SOUTHOLD, NY 11971 7S, ( rf l Ktwvod 41. '-f-L Lt per- a Spa SU '&/Q" 0-y\ Wa7 26J i93a MAY A 8 Igo,? 1 s4 C1_ 11MMM7 THIS INDENTURE, made the day of May , nineteen hundred and ninety BETWEEN EDGAR E. DEBANY, Revocable Trust dated 5/11/89 by Edgar E. Debany Trustee, residing at: 4640 D North West 3rd Court, Delray Beach, Florida 33445 party of the first part, and ROBERT PET T, 'residing at: 515 Maple Lane, Southold, NY 11971 party of the second part, WTMESSETH, that the party of the first part, in consideration of SIXTY EIGHT THOUSAND FIVE HUNDRED AND 00/100 -----------($68,500.'00)----- dollars, lawful money of the United States, and other lawful 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 being in the �ct0 SEE SCHEDULE "A" ATTACHED HERETO AND MADE A PART HEREOF '00o 00 �0�AY106� L Y`I TAX MAP DESIGNATION 1000 sec. 110.00 BR. 03.00 l.01(025.000 �lir pL "�E MAV 3� 1990 j�suFeo�K Px 1� COl1N`y i 11075038 Title No. 4C SCHEDULE A c ALL that certadplot, piece or parcel of land, situate, lying and being at Ctxtchogue, Town of Southold, County of Suffolk and State of New York, bounded and described as follows : BEGINNING at a point on the westerly side of Fleet's Neck Road, distant 100 feet northerly from the corner formed by the inter— section of the westerly side of Fleet ' s Neck Road with the northerly side of Cross Road; RUNNING THENCE South 57 degrees 42 minutes 00 seconds West along land now or formerly of Henry Lauber 175 feet; THENCE North 32 degrees 18 minutes 00 seconds West 100 feet; THENCE North 27 degrees 42 minutes 00 seconds East, along land now or formerly of John J. Jessup, Jr. , 175 feet to the westerly side of Fleet 's Neck Road; a THENCE South 32 degrees 18 minutes 00 seconds East along the westerly side of Fleet ' s Neck Road, 100 feet to the point or place of BEGINNING. The policy to be issued under this report will insure the title to such buildings and improvements erected on the premises which bylaw constitute real property. FOR TOGETHER with all the right, title and interest of the party of the first party,of,frf and to the land lying tbMONANCINO In the street in front of and adjoining said premises. Page 2 TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the first past in and to said premises, TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been incumbered in any way whatever, except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consid- eration as a trust fund 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 same for any other purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: tie EDGAR E. DEBANY, as Trustee A l la-7 3d FLORIDA �J /!y1 J/,,LL ys: STATE OF NEW YOM CWNTY OF u' STATE OF;t1k'1f�KYOlKK COUNTY OF /BP�/ /✓ May 19 90 , before me On the day of 19 before me On the day of p personally came personally came EDGAR E. DEBANY to me known to be the individual described in and who to me known to the instrument, and ndividual described acknowledged that elecuted the foregoing instrument, and acknowledged that executed theforegoing eexecuted same. tie &r4otary executed the same } - i:01 Notary Public State of Flo id990 My Commission EXP. Aug. 21 , Bonded Thru General Ins. U d. ss: STATE OF NEW YORK, COUNTY OF�, SS: STATE OF NEW YORK, COUNTY OF 19 before me On the day of 19 before me On the day of personally came personally came to nt, with to me known, who, being by me duly sworn, did depose and whom I amlpersonally acquainted,ewhogbeing byeme duly say that he resides at No. sworn, did depose and say that he resides at No. that he is the that he knows of the corporation described to be the individual in and which executed the foregoing instrument; that he knows the seal of said corporation;, seal;that he seal that it was ed sothatribehe,tsaid and ubscribing witness, w foregoing pressentinstrument; and saw to said instrument is such corporate execute the same; and that be, said witness, affixed by order of the board of directors of said corpora- tion, and that he signed h name thereto by like order. at the same time subscribed h name as witness thereto. District 1000 39again aril+ *ale ;Beeb SECTION 110.00 WI I It�VENANi A(;AINSI"GRAN"I ORS Ac IS BLOCK 03.00 TITLE No. �� �i9Y s/'o_--------- LOT 025.000 --- COUNTY OR TOWN SUFFOLK EDGAR E. DEBANY TAX BILLING ADDRESS To Recorded At Request of Ticor Title Guarantee Company ROBERT H. PETTIT RETURN By MAIL TO: Paul Caminitti , Esq. Dwribuud by P. 0. BOX 992 Main Road cor. Beckwith Ave. Southold, NY 11971 Zip No. FTICOR TITLE GUARAINTEE W u LL 0 C• Z_ p rn =1e 2(47 u, 1poot.. yam (� (`}"� �M1 . ' 7<, t{';Cf�T1 STATEMENT OF iNTEt THE WATER SUPPLY AND SEWAI L ' g7xYf }T` SYSTEMS FOR THIS RESID CONFORM TO THE STANDAR ¢" } SUFFOLK CO. DEPT. OF HEALI 1if � � ?� ;aS`+ CESS ».a S. _ _ .. -- _ l 51 � 4 APPLICANT t SUFFOLK COUNTY DEPT. I Y�6 '; CQNCRFOUNDh. .�. ' j SERVICES — FOR APPR y-' CONSTRUCTION ONLY DATE: H. S. REF. NO.: 35 �> ., } APPROVED: ieu SUFFOLK CO. TAX MAP DESI scwP-o FS;icF Cosa i i .�. C4 \ / DtST. SECT. BLOCY _ \V ICJ i i I + OWNERS ADDRESS: r P.C.HOX 76 Y 1 i C DEED: L.FE4i P. i9 a o CEvSP?JL= TEST HOLE S7 ! or LGAM ��•�_ice: _ ......'.. J� - �f may, ��-4i ,✓ ,.. Ci2J+fiJ .�..•,c Ymo ccNY , Y' .F.!`i v fin:<..-:••C he t a"E - 0EC.20, lgg0 �ecv�ia - .onk�E SnryC t= ... �' _ ,V f� � 1 /� � l � f I / 1 �1 '•' F' f Y I,i� � � 1- L r 1,' �� {" � �' o -r - --- �11���,./ ��.l�, f t -- �tp � �� j ` � ✓��/'i� DfSlCN CP � ,� 2�� ' -- :�, Do� .D_rKt_ ,��� � — o SL 3-, 5 Y j f� � C t�i � r t : , Er for Pi, o vZJ _ o i a�. I tc � /Z- , c^itAzlf An arm' z^ _ S3 -rzr� \ t 1 Lc1-, 45 ARaoF i aPgbLLJ � f: y l 16�`'T S ,ao� aje y� •% I 2�- _ ' ( i I ',-� � I R, t i f ' 1Fotee, ! 7,a -m, L _ of EW :Bu=ding '�Siyelo-- Sysms e -to meet -eq l e- e=ts of 7ffi5.2 (J j _ . Sa she best of 27 Imoxledge. ��N E�� c�9� 'RVAC Mavtiment to meet - �1 equ=rments of 7ffi3 ITVAC Sys em to =eet -eq 'utremeats af' 7M5-= <! • 3m�essloasl ,$ mu--.t systems 'ka meet :eel-taeIIts 7ffi5j.1'3 (9 A AUIi �g,Itt 'these clams s_.'e in `, z�Saace arith the code. Teat:l�lori Systems to meet -equxeaea..s of 7ffi5.1k - :.. `9 7=ula.lon of P1-pine Systems to meet regal-tassts of 7825.n 5 Se_=ylce 7iates hea_'Sa¢ Systems and 331^7seat to meet :eqt-%-emeats of 7ffiS�zl;; . :, j �ndA oazzea-a yam? y_"iect-1u1 ane I.Sghtln Systems ane Soulpae= *Meet =leg=---=e&= Of 7813. ✓ � 9�FESSSfl�A D `-•+r4 BOARD OF HEALTH 402 Oft FORM NO. 1 3 SETS OF PLANS i�„ SURVEY ..✓. . TOWN OF SOUTHOLD CHECK A. ./a7S. . . BLDG. DEPT, BUILDING DEPARTMENT SEPTIC FORM TOWN OF 0 ✓ 'OLD TOWN HALL ea�yp( �.e,,.�/., SOUTHQLD U y_1.1271. NOT I PY , ` 1 TEL.: 765-1802. CALL Examined . NeuC'") a.�., 191 PP MAIL T0: Approved 11�c? ,ti? w�lt� '1A 197P. PermitNo.�QS�1.Z. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. ThIs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with sets of plans,accurate plot plan to scale. Fee accosting to schedule. or b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public scree: areas, and giving a detailed description of]ayout of p cation. roperty must be drawn on the diagram which is part of this appL ca 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 perm: shall be kept on the premises available for inspection throughout the work. C. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupane, 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 o: 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 cod , and regulations, and tc admit authorized inspectors on premises and in building for necessary inspections. �..,/) (Signature of n lican".�!`;`y: . . . . . PP , or name, if a corporation) 1. . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . (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. ... pW�P Plumber's License No. . , , , , , Q W N Electrician's License No. B 0 UF../l,. . . . . . . . . . . . . . . . . . . . . . Other Trades License No. . ... . . . . . . . . . . . . 'I. Location of land on which proposed work will be done: ,S,O,S.O. . . . . . . . . . . . . . . . .pe. - ��'fI ✓� CUf�—tfDCiLI � DCIY Ilouse Number Street. Hamlet . . " ' • . County Tax Map No. 1000 Section . . . . .11(2. . . . . . . . . , .3. Block Lot . . , Subdivision . . . . . . . . . . . -: . . . . . . . . . . . . . . Filed Map No. , . . (Name) • . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . • State existing use and occupancy of premises and intended Use andoccupancy of proposed construction: A. Existing use 'and occupancy. . . . .0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . B. Intended use and occupancy. . . . RfV'� G. . lfQ'tr6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 6 . p r Y; 11ae n vo (POA(R(tirEier4E.4j 577J o47�V[J 3. Nature of work (check which applicable): New Building . X . . . . . . Addition . . . . '• yt Repair • . . . . . . . Removal . . . . . . Demolition . . . Swi *o + Tennis Court . Accessory Building. . . . . . . . . . Fence . . . . Other•,W.or,.lc, 4. Estimated Cost . . ��,�1y0, . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . (ta be paid on filing this application) 5. If dwelling, number of dwelling units . . . . .r. . . . . . . . Number of dwelling units on each floor . . . . , , , , , , Ifgarage, number of cars . . . .ll'10,U: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: FrontV0VV1. -. :. . . . Rear . ... . . . . . . Depth . , ';• - , , Height . . . . . . . . . . . Number of Stories . t.ar^ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear . . . . . . . . . . . . • . Depth . . . . . . Height . . . . . . . Nur cr of Stories . � . S. Dimensions of entire new construction: Front. . . A4,. . . . . . . . . Rear . . . /9 . . . . . . . . . Depth . . .4f• , , , , , , • • Hei-ght . . . . 1- . . . . Num,ber of Stories . . . ..7. . . . . . . . . 9. Size of lot: Front . . . . /,00 , , , , , , , , , , , Rear . . . . . .1.QV. . . Depth . l:l 3 ' • • 10. Date of Purchase , . 1( q�,i• , , , , , , , , , , , , , , , , , Name of Former Owners�. . :. .i� ANS . . . . . . . . 11. Zone or use district in whitli premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 12. Does proposed construction violate any zoning law, ordinance or regulation: . . .V92. . . . . . . . . . . . . . . ... . 13. Will lot be regraded . . . .IJd . . . .Will excess fill be removed from premises: Yes 14. Name of Owner of premises . . ......Address �PX7$,.fdu�2�w... . .Phone No. C%41W. . . . Name of Architect . . . . . . . . . :! . . . . . . . . . . . . . Address . . . . . . . . !! . . . . . . . . . Phone No. . . . . . . . . . . . Name of Contractor . '! .Address . . .. . . :! ... . . . Phone No. . . �! 15_Ls 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 all', buildings, whether existing or proposed, and.indicate all set-back dimcnsinc; property Lines. Give street and block'number or description according to deed, and show street names and indicate'w::c::. interior or corner lot. STATE OF NEW YORE, S S COUNTY OF . . . . . . . . . . . . . . . . . , o individualsigning PUTT r I . . . , , , , , being duty sworn, deposes and says that he is the applica:; (Name contract) above named. He is the (Contractor, agent, corporate officer, ctc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi application; that all statements contained in this application are true to the best of his knowledge and belief;and that t!: work will be performed in the mannCr set forth in the application filed therewith. Sworn to before me this . . . . . . . . . .ZU `-- — of. " fit . . . . . . . . ., 19v Notary Publi . . . . . . . . County JOFIN KRAMER NOTARY FliLi!C, St6to of Now York - . . . . . . . . . . . . . . No. 52-4e58-922 •; Suffolk County (Signature of applicant To:m Expires ,/9y t s SUF'FEXLK CO. A'LTFi ©E#'F.`WPPROvALL H s.- NO �'c 1 �:�.� i_ t ry 1 t tF ` E - STAFEMEtiT<3F1NT t3T K ? g ,kas :c n THE WATER 'SuPf'LY AND SEWAGE OttsPQSpm �tr',� � . :. ., �S SYSTV14S FOR TH#S RESfDENGE N11 a.,, - .. r CO #ORM TO .Tt4E STAiYDARisS �OF t� t, i `F SUFFOLK -CO. DEPT. OF'HEALTh4tERV#LE== OPLICANt t SUFFOLK COUNTY DEPT. 'OF HEALT— u_ �� ' y SERVICE'S — FOR APPROVAL t� -.-._.e- _._._ � / _ Ai _ X }G •'S YM]x�� k,'t n :' `h.„ - � ,---..-•--., C4�NSTR�JCT14NOt�Ft,Y i,. , �` � GATE: ' - r H_� . REF, NO.: i Si APPROVED: c_ - t ti 53k '' SkiPF�3LK Cfl T1KX t31� L�E9J64tJlF)G1V . ritS7. SECt. F3!OCK_ PC;w q R �� QWNEktSA31i+L*c-�SSrS�.�,r 79 dA4%v..t-:G 1 44: i _ T t ST HOLE STAMP F i V - � OL p x sort H. SA4(fl'!'t4h.M c r b<j vo4d truo copY hereon a. - inc,:-a, arch G'<his^n.:_o;i:a w JVNE ZE, t 77W,.� - - k nr0r 5'v e'1i _ PALE IMWts _ t ?4 wlUM 10 SEAL. E OF nt y� t1 fl 3' r '� . v,r" v. 1 c h_ TM AN AN T L"ug N5L%mi -y}'c c�K Vj J a EY, A'L RER VA Y�: `�a. Al l.i .+j"!_' `'a��'`.T. :`.. .. 'E'Er�"' ,✓"�,''..n�i., ,i' �5' �'L Jk' iLE ire�.P&,- Y .. LICtNS66 t-AYoffs WthiCEi:'s fv -- _ CrzREE1tP4 7 4iTW;YORiC, to fl fM` - r # { SUFFOLK CO. HEALTH DEPT. APPRBYA NO. 5Z? 33 Mf PORT,/ ` STATEMENT OF INTENT { { THE WATER SUPPLY AND SEWAGE DFSPOS� SYSTEMS FOR THIS RESIDENCE Wit - I� �"` � � � � � �'GF113fE_._ `! Y"ti •I i st"' :L" �"';, t'w-- C - v--`n r-----r"—!^^ s —d. r t'" $ t i CONFORM O THE STANDARDS OF TI— _.3Af tit, o 11fS`h c5s k-.ice a t- i ; SUFFOLK, 8. 51 . - ����f /#�y '•; ,y�� � J' :.'. ,T---_ra3�-.�.,w----tee .�•c'� f�:3-<,:'��!°�,'2�✓k� � ` rG SUFFOLK COUNTY -DEPT. f?F I�ALT� .a`� 3 .: �" SER•V.ftES- — FOR APPROVAL Oa ?'�.' 1. CONSTRUC'TION'ONLY, ` Arm DATE { ' 't96, wo APPRO�jj: }} t All POOL �a L*WRS AID _ J � � Aifrr - ttf r 7E5 T." r SUFFWA COUNTY DEPAWMENT QE WALTH SE.'iYtCES } �_ --4 I ��, ' ...l�t .`)�<" . i+ -wG _ 7S•�'+F�,tc+'� c B 3Y DWF1�1WONLY" DA7E _�H.S. REF. MO. D,Sll— 3� �sS•� , '=�� -The-Sewage disposal and Wafer 51lrply f@Cift{i25 fGf fiif5 -= _ -- ' > '" 's��. .-�. .. .�r.•g a�e5� P an �r s location !save been irs cted �pe k�msv^e,:..rt�entar�dlor - otrer ageri es a6d uad o k994 hi of Ruresu of Wastewater Management RZ Uc Rr x ,M- tqjR OWN jot i' •x' flY W.,}�"° t'es•: i. - '� — µy._4 � X.1LMde F -'✓ � .l Y' 4 ; ' 'k'A' J SUFFOLK CO. HEALTH DEPT. APPROVAL 30 4 .. i 3' l + ' C- — — + x JUN 19� in M dwmin`,lo it -sit �*M 5004 of�M F1"+ -vx STATEMENT OF INTENT is [ . £io THE WATER SUPPLY AND SEWAGE DISPOSAL z ny ,ih _ SYSTEMS FOR THIS RESIDENCE WILL y s33 ' / OF�E_: ADS p'x "�`, CONFORM TO THE STANDARDS OF THE �o SUFFOLK CO. DEPT. OF HEALTH SERVICES (S) EN-CONSULTANTS APPLICANT 1329 NORTH SEA RD, 1' f7.*Gir� '•.[fi . - __ .__.._,.}.__.._;�j3. _—_�.-,.p r., '"'.t'`_s .., - -�_ y • i �` � ' i SUFFOLK COUNTY I a 1�F HEALTF «LS �3'6360 *- a a '! SERVICES — FOR APPROVAL Of CONSTRUCTIgjg, Y I ,,, DATE: 1�1((jj�Y , 25 ,, — f4 E H. S. REF. NO.: t { ?zC.#. --- LtZ E j APPROVED: s _ � e III `V'J,'- '� Y30.4t2S? FQi"tCEo.S•"a. i b. `S.xk�..di .',��,._� " :.Tc55€'"' i�, i SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK RCL. O- - Lu y>" WELL+ OWNERS ADDRESS: 3 LIkQZ. ` P.C.BOX,78 -501:3 ' LI,r', l.. C o �f� DEED: L,SG4 P, I t cj WE i; GE55flOOL{ q r f TEST HOLE - - STAMP s Una,n trm _a.sra wn or a ron YA:!!S e,(—ni IS 9 YIO}a;iPfl 9f � 5sciton 72J`3 of Ftza New Yo;,t g'tr'zBt I SCALE �/ F k PA`zk B"�'^`"f' Cops or,5vs s,-vsv man nm.basting _ _ _ •��.. t`-— $RiStG`<' kS7i�9 She la;�d;are,•ror` InaFS sea{o. 4{� CC Ifl- _sr-�t�s ';e=t shag no:hs considered .tC��` :'� .r,t'. [a he^.....tl pros c:.'i / id 1 is i--,z,,y d..f t-' BZ42 7Mii`: Gua:smes:,,..ham:: ._hereon shall run _1 L /OAMY 5fJ,4.D cnly �� m t... ^so o, — 3, is orco2:� tixlz ccras�n,,uam-vm�,--�•sP'-nc!and la.-con end AM.E!ADED {A4%Y 2�19 tome Ca::,eeso'tr�I.snc'nar:sti- 1 _.� �``� ta'icn.CLcra.tees ere not Ir:n,,rap io l to_—ditlooa'."StI:unens or aubsequew " "iJNE ZS, t99C' owes PF..E ME.�'JM'?v GoazSE Snap ; I:"I f(7LC CJt3. '?-R02i G'JAY<_At lTesc To ­t-f4;a rv2s7 E!'Uf: �C`. . C, ryr -r s.'z �y)C•—,,tt••..n(.,�'t� -Tq-�•• C P ��?�+k cP .16 - V` "*4:, �".•e x. ���IGtvt'.,�{ 4 . 1 Z..t� 1V�4..e4e.f-ii �s..� �. I 1 1�fT9 s 1 RODER.ICK VANN P.L.JUYL ^i ✓� h �1�0 1 0 0 f yS BLSN ratElGHBE?f�Ir:�.W�s,.i t� .�".•.t^�SL l,S3C�4T'Ift�S f2�:.RG'<_`-!'EJ 6Y ^.�+h!lS�. . F lA§�D`' __:_ _ LICENSED LAND SURVEYORS I7' -- GREE NPDRT NEW YORK MEDYwe post N&W9 ' ENERGY CODE CALCUL/\71ON6 / f I o.-q® I q3 -/I L? C7� 0.0r5 ?; F A NG —PQ=P.= M MEEZ 7813.Z3 75% EFF. %�, PROMSSI®NAL m T RANG' 45 75 DE FAg.ME NEEI . w. JUDGMd r PLANSr CODE- "I �� ?) CIA® G P 7613.32. ` RV .38> IN Z,2sAN m �' s) PTPv' "ZO' 7R13.19 X ; Y -�c� c l N Ue TJN M MEEEZ N.Y.S. G �ti�u. 9 SSi�1�P s � lv� — FRI r S Fttr i o L, - i a- -�I�t�G 5 (d1 l JJ� Lu i LZ®O I IY RKE PAP FELT s l,cKL� � t , _. _ - _ lU fiJf)BW z� 'Y3b$ U -. r. eOuur' -_ Isla � f * T1 LF_ ' , ! ERG GOUNTPR, h�FRI� - — - - "- - :WYER 91 13(/, l 4 �pVaG 6Z G (PA-ves) I (fKtJV/a2 T7cl CU� 41- �P u1S r v ` k .�J�r/u1l �!l✓r7��v - - - 944 (bp no1j) z x� t Rolf 3Q A r2 tf k z�ku1 1 _ CL9SLT D_xrD ALCQUF � ; DALE 24 1�211 ` OA 456 32254-1 P o,� �/71 toweawmalrom CfR1i1CA Or �w vwm u fww APPROVED AS NOTED DATE: B.P H ' 4 NOTIFY BUILDING DEPARTMENT A'. OCCUQ.ANCr OR y 766-1802 R AM TO 4 PM FOR THE, US INSPECTIONSFOLLOWING DUT CER U%LN►FICNIE .. _ s 1. FOUNDATION - TWO REQUIRED villN > FOR POURED CONCRETE QF OCCUPANCY 2. ROUGH - FRAMING & PLUMBING - 8 INSULATION - 4 FINAL - CONSTRUCTION MUST ' BE COMPLETE FOR C.0 ALL CONSTRUCTION SHALL MEET _ THE REQUIREMENTS OF THE N.Y. + STATE CONSTRUCTION m ENERGY • CODES. NOT RESPONSIBLE FOR+ No Rl o(AE 800b DESIGN OR CONSTRUCTION ERRORS ' RkrTF,,gs' g yp"�O,W To wF.O (�Y 1` OhK 011)S + ASPrthai tNhUGLGS I I _ _ Nc_� AREA - - Ifi FLoOn /005 S�QFt' /k�OuA �2A S z"0Fr-oo.t _ sa Fr- 1'' PPour RED R T+VA l3,9 5- s6. Pr FGA,kS' 5"tt•X 3 'I DP 47 �- OLp $ IPFPL(LA I✓/uQo4/.S w.eekrtErY - ---.---_._..�_.._.,........._,...�.,.,_. .„. ._,...._..._.._•__ -,/'ASPIh4Li' 2aLlROa�/.ui f/'r+raOF.O kLL A4,'ov43 5pplo 0VF/cAis �' �, •f �' I�I i� : ..(� �v¢�.� l�r,u�, ALUF�r�iu�; smR•��sc��nr - 'r� , _ 1 .. . 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