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HomeMy WebLinkAbout19464-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219837 Date APRIL 4, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 750 HOLBROOK LANE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 06 Lot 09 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Buildinq Permit heretofore filed in this office dated OCT. 12 1990 pursuant to which Building Permit No. 194642 dated OCT. 16, 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 WITH ATTACHED GARAGE. The certificate is issued to EDGAR A. & EVELYN JAHN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-66 MARCH 11, 1991 UNDERWRITERS CERTIFICATE N0. N180219 MARCH 25 1991 PLUMBERS CERTIFICATION DATED JOMAR PLUMBING & HEATING 4/2/91 Building Inspector Rev. 1/81 roams xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN FIALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ` N°_ 1946- Z Date......©~:'~^~:~;......~~° 19.9..4? Permission is hereby granted to: .....~~~.~:......~.:.......~1 ..~..~.~....~.q.~ . r t0 ...1r::~'..~. f.91..~....4c~....~r.:....~.. nw4:..~.A1N..YKX'~.~ ...1...~.i.~k~!~l~.r...MM:S^~:.... ~!u.`7..~Q 0 V . . ............:L~......~.. ~U (J 1 L at premises located at ...7..5~1 .............................4....... ..P.r!'b.~,.........~..9Y~~.... i County Tox Map No. 1000 Seetion Block ......~..~P....... Lot No.....5~.9........... pursuant to application doted O. ~..f>.....~ 19.oL V., and approved by the ' Building inspector. c Fee ~ f.:.~ 0..... ' ~U:R :t Bw ding Inspector i Rev.6/30/80 I t ~ _ Form No. 6 ~ _af.~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ ~ TOWN HALL t 765-1802 _ _ FT TOlrs~.," , APPLICATION FOR CERTIFICATE OF OCCUPANCY 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-Q 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 19 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 Planriing Board Approval of completed site plan requirements. For existing buildings (pxior 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. 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 $15.00 Date 3/28/91 ew Construction....x...... Old Or Pre-existing Building ocation of Property ....................S~S,Holbrook. Lane=...,..,...,,,,, Mattituck, , House No. Street Hamlet nwer or Owners of Property.......~$ar,A:.&,Eyelyn,Jahn, ounty Tax Map No 1000, Section...113,,,,,,,,B1ock......6.........Lot... 9 ~bdivision ....................................Filed Map............Lot...................... armit No......~1R4~4.z...Date Of Permit..,10~16(90,,,,,Applicant. RodiCk Copstruction,Co.~ Inc. ~alth Dept. Approval........90„5,0„6,6,,,,,,,,,,,Underwriters Approval.,.,N 180219 . Lanning Board Approval equest for: Temporary Certificate........... Final Cer c 'e Submitted: $.?5;00/ ~,~~`iS~IIcJ/GI/ ..APPLIC. ~~~'t~ir~. TEL.'C,5-1 ~~~~D(..~~C,~ TO~C'N UI~ SOUTIIOI,b t~ :'~76;;;~~ Y;~ OPI'J(:}~ c)I' GU[LDING iNSPI:CTOR u~ ~ r``a°~~~ ~ TOiVN IIALL a •t t- SOiJ'I'IIOI.D, N.Y. 1 1971 . ~~a April 1, 1991 Edgar A. Jahn Bqx 494 Miller Place, N.Y. 11764 'PO iVhcm This, May Concern, 41e arc unable r.o complete your Certificate of~Occupancy because of the folloc•riny reason:;. An application for Certificate of Occupancy ~is not nn file. (ENCLOSED) 1 tlndcr~•~ritcrs Certificate on file. / ['hc clcccF: .i:: (~i?;g~d71gII§II4Xnut an file.) $25.00 / / No tlenl.th Ucpt. Approval on file. - t P:o final ins}'rec:t:ion has bceti made. Plene>e rontact our office on L•his matter. - Thank you for your cooperation. lhc.ilclir:q Pcrmi.t: 1 9 4 6 4 Z IIuilc7in DupL•. • tlo Pl~cmbr_r Solder Ccrt.ificate on file. ' ( al.l permit:; involving plumbing briny i~sucd after April 1,19E34 ) t , 4 ~ ~ e+ m j ti ~ ~ g y,,, s e r r r tJYt r N;. i ; } 2f• y~~• yff'~'Yr S~ ~~~~F^ 4yR' ~.`"i ti~3 .R '~c{~'1~t~~`5 ~ t x r aP+wy{,, ~5 ~ k ~ , k a' 4. ~uK'dhy`~+asV, ;Sf'as~w'~,*9t~,.L^ 4~~ie~~iR'i~~4~..~~~' Y f ~ ''k d ~ t ~ ( i Y~' ~ a1:•sx . + n'~- ~'.ti~~B 't~~1~1L~$i~# 1 1 F THE NEW YORK BOARD OF ~tRE UNDERWRITERS BUREAU OF ELECTRICITY 88 JOHN STREET. NEW YORK, NEW YORK 70038 _ 4[,~1~~,'fi a"i '(9`1J 1F~'-'i3~~91/!?I N 1.:'ti)f~'}<d Dale q~ o o. on,~rl~Tr _ P"H~~~~~tli ~Vt3, I,F THIS CERTIFIES THAT only the electrical equipment as described beloty and introduced by the applicant homed on the above application number in thepremiaea of 3~tR.Fr Mk ~L ,I~ffcY, 9/> Cfi11:b3iai)i7t4 i.~AA1H~,. ~flY`T:f9"lI~:K, N.i~ in thefollouing Inca i B vg nt ~ Ist Fl. ? 2nd, F'l. .Section B[oek Lot ~L~~Y~ff uws exmnined on ortdfound to 6e in corrtpliance with the requireneea to q~ this Board. FIXTURE ECEPTACIE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FWORESCENT OTHER AMT. K W. AMT. K. W AMT K W AMT. K W AML H P. E DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI.OUTLET DIMMERS AMi K. W Oll H. P. GAS H P. AMT. NO. A. W G AMT. AMP, AMT. AMPS TRANS. AMT H. p SYSTEMS AMi WATTS NO.OF FEET 't (i f, f - SERVICE DISCONNECT NO.OF 5 E R V 1 C E AMT. AMP TYPE METER ~ EW t a. 3W 3 ,e' JW 3 X 4W NO. OF CC COND A W G. NO OF N4lEG A' W G NO OF NEUTRALS A W G. i~ EOUIP. PFR .O' Of CC. COND. OF HbIEG OF NEUTRAL 7 ;.176 ('ft 1 :ii '1 4 } :`6 OTHER APPARATUS: , B1il`1'Gkt;tT-f).'1`i 'H.I>, P~U59, 1)fl'f'Et,")'Cit<.; °7 4SGft't'kl ~;b}1C"Pft,f.C 1,IC.~18'3i7w~; 1N7. ,73CAl;l.ti k~. HOCYV Ryl~'!~J'L`, h?y~. :l .lY7f3 6ENERAI MANAGER f i3 Per f .•v This certificate must not be altered in any manner; return to the office of the Boprd if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST N07 BE ALTERED IN`ANY MANNER. ^C:iU;7 ~~UA:c I i:OMMENT.S ro r'Sr:LD it:SP~ ~ ~ /i t y ~ FOUNDATION (1st) s (I'' o ~ ~ l ~ ~ FOUNDATION) (2nd) _ , d P.OUGH FRAME & /r0 PLUMBING ~ _ ti C}l H ~J" ~ CT1 3 . IIJSULATIOt7 PER N. Y. STATE ENERGY Y9 CODE ti cn r H k. FI;JAL 0 z m x ADDITI AL COMMENTS: ~ II 9 Po ? a-a • ~ • x ro •S H t p 9 ~ ~ L H O Z r x .p cn O r r ~ x U, o o i •~0 6 "3 6 1~~~~ T65-1802 BUILDING DEPT. f NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL ' REMARKS: G~~~-- ~ - ~ DATE ~ INSPECTOR _ a ass-isoz BUILDING DEPT. - 1 NSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [)FOUNDATION 2ND INSULATION [ ]FRAMING Q [ ]FINAL REMARKS: ~i`~-~,.~~_~`%f DATE IN8PECTOR 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [`ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: s~ y ~ ~ DATE ~ ~ ~ % ~ INSPECTOR _4 ,x _ ~ - - _ 765-1802 BUILDING DEPT. INSPECTION [ ] FO DATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING J~- [ ]FINAL REMARKS: . DATE o26 INSPECTOR ~ u e~ . ~ ~ 'ss-isoa BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ ~ ` , DATE ~7 ® INSPECTOR ,~%'~l i / T65-1802 BUILDING DEPT. INSPECTION [ FOUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [)FINAL REMARKS: DATE ~ INSPECTOR A^ `"V~ TEL. 7G5-1802 ~oS~tiF~LY~~I~ TO'4YrN Or SOZTTIIObiI f ~ OFFICE OF BL'ILDII~IG INSPECTOR ' ~ ~ti~ P.O,BOX 728 ~ ~Y ~ K~', t ° ~ ~ TOWN HALL ' ~ .+0'~e;? ~0`T SOUTHULD, N.Y. 11971 ~ ^ 2 1991 4 of ~ ~ ~~L~ f: ~ ~ 'i'C)V`J4~.'w,., , ~ ' , k C E R T I F I C A T I O N ' Date 3!4/91 Building Permit No. 19464 Owner' ahn (p ease print) Plumber Jomar Plumbing & Heating Inc. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1g lead. , / i - p1 tuber's signa e? Swor to bef c tr ' s day ofQ~y!~~ 19~. /GCL/ Notary Public 6t0\~~~~.~jy,~U 1/P~ / tlotary Public, County I apt ~0.'~aygl~E,~~i~ .~oommfF°Q ~O~QgUFFQ(~-co ~ Gyp "TRUSTEES y Z SCOTT L. HARRIS John M. Bredemeyer, III, President O ~ ~C Supervisor Henry P. Smith, Vice President ~ O Albert J Krupski, Jr. y~! ~ ~O~ Town Hall, 53095 Main Road P.O. Box 1179 John L. Bednoski, Jr. John B. Tuthill Southold, New York 11971 BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (SI6) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 August 27, 1990 Edgar A. Jahn P.O. Box 466 Mattituck, NY 11952 RE: SCTM #1000-113-6-9 Dear Mr. Jahn: The following action was taken by the Southold Town Board of Trustees on Thursday, August 23, 1990: RESOLVED that the Southold Town Board of trustees grant a waiver to build a one family dwelling as shown on survey dated June 11, 1990 subject to no activity to take place seaward of the boat house and a $35.00 waiver-fee. - If you have any questions, please do not hesitate to.contaet this office. ry truly yours, Q John M. Bredemeyer, III President; Board of Trustees JMB:jmt cc: Rodick Const., Co. Inc. Building Dept. C.A.C. Y ) ~ . • . TICOR TITLE GUARANTEE COMPANY 185 Old CounCry Road Riverhead, New York 11901 VARIANCE SEARCH TITLE NO.: P1290-570 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) David M. Petrie, Jr., being duly sworn deposes and says: That he is an Assistant Vice President of TICOR TITLE GUARANTEE COMPANY and has had a search made under his direction of the records and/or the files of the County Clerk and Registrar of Suffolk County for the purpose of an application for a variance affecting the following premises: DISTRICT: 1000 SECTION: 113 BLOCK: 6 LOT: 9 That such search includes a chain of title as to the premises and all of the adjoining lots since prior to 1/1/57 and such search shows and he does certify that the premises has been in single and separate ownership since prior to that date, except as may be shown by the attached chains of title. That this affidavit is made to assist the Board of Appeals of the Town of Southold to reach any determination which requires a basis therefore the information set forth herein and knowing full well thaC said Board will rely upon the truth hereof. TICOR TITLE GUARANTEE COMPANY i DAVID M. PETRIE, 7R. j Assistant Vice President Sworn to before me this 7th day of Sept. 1990. r BY ~ ~ o~MrARYELLp1?MRRq No, 52.t•g~ltlolt TawE~Fab,29, t! f i i I i J SUBJECT PREMISES: SCTM: 1000-113-6-9 DESCRIPTION ALL that certain plot, piece or parcel of land, situate, lying and being in the Village of Mattituck, Town of Southold, County of Suffolk and State of New York, bounded and described as follows, to wit:- BEGINNING at a monument in the Southerly side of Young's Right of Way distant the following 3 courses and distances when measured along the Northerly side of "Miller's Right of Way" and the Easterly and Southerly side of Young's Right of Way, from the corner formed by the intersection of the said Northerly side of "Miller's Right of Way" with the Easterly side of Mill Road as shown on Map of Jackson's Landing at Mattituck, filed in the Office of the Clerk of the County of Suffolk on March 28th, 1969 as Map No. 5280: 1. South 83 degrees 26 minutes 00 seconds East 402.37 feet; 2. South 1 degree 25 minutes 20 seconds East 641.97 feet; 3. South 83 degrees 11 minutes 30 seconds East 103.74 feet to the point of beginning; RUNNING THENCE from the point of beginning South 83 degrees 11 minutes 30 seconds East along the Southerly side of Young's Right of Way, 90.00 feet and land now or formerly Gibson; THENCE South 0 degrees 08 minutes 10 seconds East along last mentioned land, 360.00 feet to the ordinary high water mark of Howard's Branch of Mattituck Creek THENCE Westerly along said ordinary high water mark of Howard's Branch of Mattituck Creek, on a tie line course and distance of North 80 degrees 37 minutes 20 seconds West 96.43 feet to land now or formerly of Weggelund; THENCE North 0 degrees 47 minutes 30 seconds East along last mentioned land and passing thru a monument, 355.00 feet to the monument at the point or place of BEGINNING. CHAIN OF TITLE 1. Emma W. Young & Wm. B. Dupree DEED: to Dated: 4/25/33 Olive E. Wick Recd: 8/30/33 Liber 1732 cp 123 2. Ross H. Wick DEED: Edgar A. Jahn Dated: 6/7j72 the specific devisees under the Last Recd: 6/12/72 Will and Testament of Olive E. Wick liber 7176 cp 287 a/k/a Olive Wick a/k/a Olive W. Wick to Edgar A. Jahn LAST OWNER OF RECORD. LIBER t ~ 7ACf STATE OF NEW YOKK, COUMTT Or ATassau :a: STATE OF KEW YOLK, COUNTY OF Nyl'j S~ ss: On the 7 ~ day of J U~ ~ 1972 ,before me On the 7 C day of ~ ~ ~ 1972 ,before me personally came personally came ROS5 I-I, WICK EDGAR A, JAHN to me own to be the ' dividual described in and who to be the ~ dividual described in and who execu a ore ins ument, and acknowledged that ex .uted t}te fore~T ins ument, and acknowledged that he executed t xecuted the e. 'r7 `t-_ ~ 0 1. LAhx UNO 7 HAHN Publtc Ste a of Naw Yvak P,d+lbl S! 0 01 17ew 7omk No. 3 -61255C0 Nu. 3 126a00 Qu ~ aenev Counfq~-_ j uaWtdd sn aeeen CovnX7,~~ orm $zplxsn Dforch 50, ]6 l!E/./ Term Esaiitie-N[c>cfr'-'Je:Y9 - STATE OF HEW TORK, COUtdTY OF ss: STATE OF tBEW YORK, COUFSTY OF sF: On the day of 19 ,before me On the day of 19 ,before me personally came personally came to me known, who, being by me duly sworn, did depose and to me known, who, being by me duly sworn, did depose and say that he resides at No. say that he resides at No. } that he is the that he is the of of ,the corporation described ,the corporation described in and which executed the foregoing instrument; that he in and which executed the {oregoing instrument; t}Tat he knows the seal of said corporation; that the seal affixed knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so to said instrument is such corporate seal; that it cars so affixed by order of the board of directors of said corpora- affixed by order of the board of directors of said corpora- tion, and that he signed 1T name thereto by litre order, lion, and that he signed h name thereto by hhe order. ~&Cgain nnh ~YaCe ~eetT SPCTION W1'IHgCOVENAN7T' AGAINST CRAMOR'S AC'T'S . . TLE NO.I .h ~ E ~ BLOCK ~~rr'' ~ EtOSS FI, WICK and couNrr or, TowN~~g~~r`~. ~"'~'~"f CDGAR A. JAHN "1'O ,CU N 1 e' t~~ iDGAR A, JAHN Recorded At Request of TUt Title Cuann[cc Comp+ny y/~ fJ NGTURN nY ?+SAIL TO: :TANDA0.0 EORM OF NCW YORK BOARD Of TRLE UNDfRW0.1TE1i5 (./~"~~J/~~ '~"GGf-~y~ Uirlribufed by d CIIE TI;CL~ GUA~µkyIidNTLls CO/bIP~NY 3y0y r~ Gem-5e. CHw RTFRCO I4B9 y'y~~~il /N N+iW YON,I ~ %~~W\ I ~ ZAP NO.%`j ('v~ @@ ~ V I x._X ~r 'hw.~ ,.s. w..~.nv r . -ra.. - 2~.~. Cam] T ~ h- 1^ :x' k;; rp ' ~ a7 u C. o ~ j c~ i! r ~ ~j V`y la .t: i:ly. CV u- Fi _ L4 '~7 :il t~ ~'7 _J i % 1 ~ c= ~ i ~ r \ ~ ;~y A t ~ ~~a ; ~ 1 ~ i . i T^ t i~t j' .a ~ ~ 1 1 ~ ,h ~ t mm / e` ~ \ F' 1 tF, ~i 1~ ~:J i-i " .j ~ - W, [i ~ ~i i~r4 r fir;, ~ ~ ~ ~ ~ f t to ~ r.F ~ q ; i- r ~s~ ~ 5 s ~ `tF C , t- . ; ; C i Z- r.-s t ~ r1~~1 i 11 r' n~ \ ~.i , 1 ~ i t ~ (Y^ li ~ ~ U i ti-' L 1 f j~ S I C~ t t) t„ L _ t r *t I ~ - ~('t Z ~ ~ ..F. ~ ,t/~~. ~ 6r,F~ ~ ~ 037~'~, ~~%i'~ '6 ' Sfs y,~ . / nµ. 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Q ~ .,1- ~ ~ E C7 r 1tl T~° ~ ~ ~ ~ dM''t ~ ~ 'ri TT'~ ~ lit N, ~ { ~ U~ _ S y f~1 to ~ ~ , . n. v ~ v ~ ~ a o b h _ r v ~ i, .--fi 3, _ e~ t , 1 y' ~ "V ~ ~ ~ N~ ~ ~ 9 O . ~t > r \ ~ ff ! l . ~ ~ .,a ~ 1~. t~ .~s - ~ 'd . ~~y - `1 " ~ e" J f t , i ~ ~ ,~k ~ r n `YYf ; ~ ~ ~ " ~ ~.Q~ _ ~ , . _ ~ ~ : i F. , ti ~n j ~ _ ~ n ' ~ ~ ~ ~ ~ °'C"l wy .mow ~ °`L~3, t'~ 17 yF, "S o T 4 ry , ~ t+3 - } ~ " - ~ +t~ ro t , ~ o n ~ ,Ir ~N ~''lA('~tn~n ir.MMx ~ ~ .gyn. ~ ~p~` /f~~y tea .~y1 1 e~ 41b~ '~u V ~ ~L 5 ~ ~Y l~ v g~„ ' ...,Y ~ j~1 '+i -~i ~ ._t ITt ~ ~v3 ~ ~ . ~ ~ v _ s. ut, v a~mG~ s " ~ ~ rn ~4 ~ e, r~ 7r` t " ~ 4~ 0 f1 f. ~ [ ~ 3a ~ Y ' A kC,A~ s~. y ~ ~ n c ~ ~ t i ~ it ~Y UT x~ _ ~ t Ys $ r q ~ _ ~ ~i l ' 1 BOARD OF HEALTH 3 SETS OF PLAtiS FORrn N0.1 SURVEY 1 ! 4 ~ TOWN OF 50UTHOLp CH£CK . QUlLDING DEPARTMENT 5£PTIC Foltrl 7gWN HALL $OUTHOLD, N. Y. 11971 NOTIFY ~ 928_5440 TEL.:7G5~1II02 CALL ~4p7~~ 19 p ~ MAIL T0: Examined . ~..2'F~la , ~ ~0 Q 1 °I ~ dot} Co, p ~ . ~ , ~ per' • Rydick• Construction• • • Approved O.~ Y~:`: 4 ~.~4.. 19z!' ~ Permit No.. ~ L~ P. O.. Box 494 • • • • • /y~• Miller Place, NY • '15.764 ' Disapproved a/c •dt fi ~ 2 M1 't3Ct7G. t3PT. , ; ~~QL TL7VVN UThd!?!_O X1j F , ~l (Building inspector) i! (ii,~ ` t {plyO APPLICATION FOfl BUILDING PERPi11T Date ..:...~'.ekt_.12:..., 19t3Q . 11~,-w , 43,.. , TOwri t~, _ • INSTRUCTIONS ri-: a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildiry titspector, with 3 stts 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- CatlOn. e. The work covered by this application may not be commenced before issuance of.Building Permit. d. Upon approval of tltis application, the Buildin; Inspector will issued a Building Permit to the appliranL Such permit shalt 6e kept on the premises available for inspection 2hrou~ttout the work. e. No building shall be occupied or used in whole ar in part for any purpose whatever until a Certitipte 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 Buildin; Zone Ordinance of the Town of Southold, Suffolk County, New Yolk, and other applicable Iaws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herin described. 71te applicant agrees to comply with alt applicable laws, ordinances, building code, housing code, and meulazions, and to admit authorized inspectors on premises and in building for necessary inspecrtors. _ Rodick Construction Company Inc. (Signature of applicant, or name, if a corporatwn)• • • .P:O. Box 494, Miller Place, NY 11764•••.• • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................$u$],der...................................................................... NameoCownerofpremises Ed~,ar A., Jahn (as on the tax roll or latest deed) - If a~/pp c ~ i a c ora o , si ature of duly authorized officer. ' (Name nd title of corporate ofticcr) Richard H. Lucchese, Pres. Builder's Liccnsc No. , ..¢.~~~0. ~ : . . _ Plumber's Liccnsc Na. , . , , ,158-P.. _ , , • • , . , , Electrician's Liccnsc No. 890E. . • , , , , , , , , , , • Outer Trade's License No . Location rro77f land an which proposed work will be done; 7~0 . Mattit .......~•S~Q... ,Holbrook.Lanet.......: uck Flouse Number ~ Street. Hamlet Count • y Tai \tap No. 1000 Section . ..113....:....: Block . 6 Lot 9. i" Subdivision F.iicd t`lap No. Lot . ' (Naiuc) ' State uxisting use and occupancy of premises and intended use and ocatpancy of proposed construction: ` 9. Existing use and occupancy , , ...:~~cant" Land , • • • ' b. 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It?:.?ag . • • • • • , • . • • . yldaQ • • • •'i' • • • .,cay . • _l • • • • luor~ :6uc,?!'s'a,n3atus Su!ls!xa ~o suo?suatutQ 'L • • • • . • • asn ~o aU6l yaca ao lualxa puc a,nl~u ,(~!aads',tauednaao pax!w,o ?c?a,awwoa •ssau!snq Jl '9 sma)osagwnu•a«sie3.11 ,oou yaca uo sl!un 9u!lpmp,?o ragwn~[ ' . • .shun 9u??[amp,?o ragwnu'SugpmP ~l 'S (uoilLa![Jdc sell :tu!?] uo p?cc~ aq ol) aa~ .....................Db,S'LS`S'L$' 3soaPalcwns~ 'r . • • • • • • •~ropl ra470' . • :a :7uag • • • • • . • • • .BuipTtnq Saossaaav . • • • . • . »no0 siuuay . ....food 8u?um?ng.. % , , uotl!lowoQ . Icnowdy i?sda21 uotlctal(~~ .......I..',•7i1~PpV.......~..5u?ppnpmaN:(aiqro!iddcya!y.»yaay~).y~on,~oa~nJrH 'f I ,