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HomeMy WebLinkAbout19005-z FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20253 Date OCTOBER 1, 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 1425 KIMBERLY LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 13 Lot 20.9 Subdivision PARADISE-BY-BAY Filed Map No. 6463 Lot No. 9 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 1990 pursuant to which Building Permit No. 19005-Z dated MAY 11, 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 CHARLES KYRIAKOUDES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-82 - AUG. 27, 1991 UNDERWRITERS CERTIFICATE NO. N-196402 - JULY 16, 1991 PLUMBERS CERTIFICATION DATED SEPT. S 1991 - CHAS. SAUDERS & SONS. Buil. ing Inspector Rev. 1/81 PORlf NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. BUILDING PERMIT RHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_ 1 900K Z Date Permission is hereby granted to: ' a__ ~ ...L..:z...:44 .......:.....c.....:'.:: ~ t0 ~ .T:...........:...............:.... . ~ at premises located of ...~.~j:::.x'. ~ y.,.~~s-,~=~+,~ :.t..>,.k. k':::('"......:.Y 1 .J.. County Tax Map No. 1000 Section ......4.. Block Lot No...:::~~2....;........ ~ cLt.;. pursuant to application dated Y..i.......h 19..1.::.., and approved by the Building Inspector. ~ Fee ~ ~ C,pL Building Inspector Cti`~~~,c--~ Rev. 6/30/8D FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Flall Southold, N.Y. 11971 765 - 1II02 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- lions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 19571, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property/ lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of Occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ s . 00 , over s years $ 1 0.00 4. Vacant Land C.O. $L0.00 s.undated c.o. $ so.oo Date ....y-~.9..i............ NewConstruction,,,,,, OldorPre-existin Buildin Vacant Land 9 9 Location of Property/~o?J".. i?:'~C,3.E~C'~~ ~><f• ~o-~f,~JoLI~ House No. Street Hamlet Owner or Owners of Property 94 /~tQf....C.,~~1.~.'.1--~'J~, ,~RiA,~qu,J~,~s; , , , , , , , , , , , County Tax M,aQp No. 1000 Section Block 3........ Lot... °?O.": Subdivision /d?P!lb/.~~..~-~./. ~i~f,E.. ~i4~, , .Filed Map No. ~°.`~6-.'....Lot No. . Permit No. /.~4 of ~ . Date of Permit s~ll .Applicant . ~/f J;7`, , ; ; „C',~~~L~%~/G y . Health Dept. Approval ~9. ,°S,o, . , , , , ,Labor Dept. Approval Underwriters Approval ........................Planning Board Approval , , Request for Temporary Certificate .....................Final Certificate . . Fee Subrnitted $ u2~. ~ . . . Construction on above described building and per it s all appli ble co sand regulations. Applicant... Rav. 10.10-78 cad. a o , l17ZLrw:rzh~ 'CL4. 167 1 FSlrl, ~~~r/;~~~U(,4•~~~~, 'TOWN S()YJ'.i'13t)1.g7 ~ ~ OCFIGF C)P llIilLUlt•IG INSI'E1;1'O}2 ~ c•,• cy t? ;=i F.U. })UX 728 f` e TUSVN ffrlf,L .+3kN~;.~~' SOU'CHOLU, N.Y. } l97 t C E R 'i' I F .C C A T I O N Date J ~ / euildirg P9rmit No . 1~i 0 Q.C`~' Owner C.,._ /~g,~~~J~_.~~~~~L~4u ES (please print) e l u rrb e rc~~~.r S,riDcy~ JQNS (pleasE prink) --y- I certify that the solder used in the water supply system contains less than 2/10 nE lb lead. (p cAnber's siynatu>:r.) •d)lt5rt" PUSUC, Silo d I1wvYO,ik Sworn to be£ora me this Pb•SP{818118 .:raixxrl+eron Exp4a~ Np. ~~Q i y 9r - Notary Pu Ac notary t)ublic, /~a~-~k- County ( I jI ~r~ 8uifder antl Land Developer ( 323 Glen Cove Avenue k Sea Ciif1, New York 11579 I (516) 671-0481 r , !~f October 15, 1990 ` Southold Building Department ~ a Mr. Victor Lessard P.O. Box 1179 Main Road ~ 7 Southold, New York 11971 V ~c~/N OF Si7UTii0LU j Re: Dist. 1000-Sect.070-B1k.13-Lot20.9 i 190052 ~ 1425 Kimberly Lane, Southold t I Dear Victor: t Enclosed, please find a foundation location survey regarding the above captioned for your review. If you have any questions, please feel free to call me at the above office number. 4 i i I would like to begin framing upon your review and approval. Thank you. - - - - f ~ _ Very truly your"s~_,~ k ~ Richard Mohring i RM:sc^ Enclosures l i~ ,i 1 I r - - ~ ~ T 765.1802 BUILDING DEPT. rNSPECTeo~ [ ]FOUNDATION 1ST [ ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INS CATION FRAMING FINAL REMARKS: _ r i i 'r i DATE INSPECTOR ~~~~ds- 765-1802 BUILDING DEPT. INSPECTIQN [)FOUNDATION 1ST [)ROUGH PLBG, [ ]FOUNDATION 2ND [ ]INS TION [ 7 FRAMING FINAL _ REMARKS: ` .y~~ F T DATE CL INSPECTOR r.~ f~°~ J rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION ' [ ]FRAMING [ FINAL REMARKS: ~h~~ ~~1 C,G c ~~~~J~ r ! 3 DATE ~ ~ INSPECTOR ~ 765-1802 J BUILDING DEPT, INSPECTION [ ]FOUNDATION i5T [ ] ROU PLBG. [ ]FOUNDATION 2ND INSULATION [ ~ FRAMING [ ]FINAL REMARKS: y~ ~ - ~ & ~t ti DATE ~ ( iN8PECTOR 4 t 765-1$02 BUILDING DEPT. i NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: ~ sr.~_ ` G~t~ ~ ~J _ 1. DATE ~ INSPECTOR ~ l~~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [/i]' ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REM KS: DATE ~ IN8PECTOR TG3-1862 BUILDING pEPT. lNSPFCTION [ FOUNDATION 1ST [ } iROUCaH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMINGi }FINAL REMARKS: ~~~i'.~ r e _ ~/Z ..f.' C Lt DATE ~ INSPECTOR ~ ~G%~t f ~X 7BJ-i$02 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [)INSULATION [ 7 FRAMING [)FINAL REMARKS: ~ _ K ~ ! DATE ~ ® l2- INSPECTOR . 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. f [ ]FOUNDATION AND [~1NSULATION / [ ]FRAMING [ ]FINAL REMARKS: Ar-e.,-~ DATE ~ i / INSPECTOR . r T65-1802 UILDING DEPT. 1 NSPECTt4N [ ]FOUNDATION 18T [ ] ROU H PLBG. FOUNDATION 2ND INSULATION [ [ 7 FRAMING [ }FINAL REMARKB; ~ i k DATE ~ IN8PECTOR 765.1802 BU{LDING DEPT. INSPECTION [ ]FOUNDATION 15T [ ] ROUGH PLBG. I [ ] 60UNDAT{ON 2ND [ 3 INSULATION [ ]FRAMING [ ]FINAL REMARKS: - C r ' C DATE C! INSPECTO l _ T_ ~T _ 900 ~ - THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE t 1000681 BUREAU OF ELECTRICITY 86 JOHN STREET. NEW YORK, NEW YORK 10038 Date JANUARY 49,1991 APPlication No. on file 70766090/x0 N 168306 THIS CERTIFIES THAT only the electrictl aquipmant w daeri6ed 6sbto and introduced by the applicant norrsed on [he above application number in the promisee of _ s~T NOHRING ENTRRPRISES, S/ RINARRLY LANF. 645, SOUTHOLD, N.Y. in the allaTrin location[~RBeyemegR_4 OIJT 070 1.;1 ?.4.9 f R USC ~ 1 ~ 1 Y`J ? /et FI. ? Ynd Fl. .Sertiun Block Lot uwa examined un and found to be in complianre with the reyuiremend of this Board. pXNRE RXTURK RANGES COOKING D[CKS OVENS NISX WASHlRS EXHAUST FANS +S- OOItETS ACTEf iNCANOESCENTPlU0eE5ClM OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMi. K.W. AMT. M.I. ~ DRYERS RJRiACE MOTORS plTW! AIIIEANCf INOMS SFEOAL RECFi i1R1E tXOCKS EML INai NEA7ERf MWi40UT1lT OMIARERS - AMT. K. W, dl M. P. CMS M. P. AMT. NO. A. W. G. AMT. AMI. AMT. AMPS. TRANS. AMT. M. P. SYSTEMS AMT. WAITS NO. W 1@T = SERVIQ DRCONNECT NO.OF S E R V 1 C E ; AMt. AMr. IreE 1 / tw I A SW t / TN J X AW NO. O~CCaCOND. OF C COND. NO. Of HI-tEG oi' w'uc NO. OP NEUTRALS OF 'NWEUTaMiL 1 150 CB 1 R 1 1/0 1 1/(1 OTHER AMARATUS: TENP.SERYICE F(3R BLDG.PURPOSRS ONLY-1 ~e''~ GENERAL ELECTRICAL CONTRA LTC,/533-R G!~~'" 2041 SRELLEY PLACE EAST NEA1)()A, NY, 1.1554 8pµ M~ABER 31 ~ Psr ~ ~ n~ This nrfiRcafs mmt not b• ohered in airy manner; return ro tM office of tM fbard if incorrect. Inspscrors may be idrntifiad by tMir_ credanliok. e! COFY FOR F TM@IT. TMR C.ERTIF AMRT NOT 6L AL WI ANY MANNlR. - r. rv~.e.~,~ :m THE NEW YORK BOARD OF FIRE UNDERWRITERS pncr..3 g' 7.00046!1 pUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK. NEW YORK 1003Y ~ ~ bats AUC+CiST lh,991 gppficationNo.onflle 7.749"1.91%9:. N 200357 THIS CERTIFIES THAT only the a4ctricd equipment as described bslom and introduced by the applkant homed on the ahooe application number in the proaaiwa of KYRI.AKO[*O~R, 9 K.YNFlFRI,Y l.~ANF;, BOU'1'HfJ~;!, N. Y, let FY. ? 2nd F1. .Section Block Lot z in thefollolcinA hwotion; ®8asement OUT waa a:amined un AUGU$T 06,1.99 andfound to be in compliance reith the reyuirementa of this Board. R%TIIR! R%TURSS RANORf COOKI DECKS OVRNS qSN WASHERS EXHAUST FANS WTUTS ACHE INCMIpESCENT fIUOKItCENT OTHER a/AT. K. W. AMT. K. W. MAT. K.W. AMT. K. W. AMT. R. t. ~~yy tp DRYERS IVRNAC! MOTORS IIITUM AMIIANCI IpOMf fNOAIRK'Fi 7M1E ClOCItf ERl 11N1i MEATilS 5~115i~EMf1ET DIItIRAlRS. AMT. R. W. pl R. r. GAa R. r. AMT. Na. A. W. D. AMT. AMI. AMT. AINa. TRANS. AMT. N. I. 1'tD. ~ ~7 AMT. WArn i SlRVICE OISCONt1ECT NO.tX S ! R V 1 C E ~3 AMr. Aw. TvtE ~.a aw i r ~W ] w rv ] ~I .w ra. o~RC ctK~N). a Cc ta'r+o. ta. a RLIEC a ~HI N0. a NEU1RAls o! ~NWEUI~IMI F 2 200 CB 1. X I 4/0 Oi11ER AFFARATIK: C..'C, t'AAINF,'T':-1 k ARTHUR Y. ,JUNGF 1,)C.Y21.4l-Y1 F.O BO% 76R _ CUTCHOGtJE, NY, 1."1.935 OMMtA? MANhArt i :i Psr V ~ This certificaa moat not be aharad in any mamlar; retlnn ro tM offiu of tM Board if -inconecl. bnpaclors ma M identified by their cradaMiala. F COPY FOR BUILDING DEPARTMENT. THIS COPY OF 6ERTIFIGTE MUST NOT 8E ALTERED IN ANY MANNER. _ ~sf THE NEW YORK BOARD OF FIRE UNDERWRITER ~ ~ $AC.E 1 1000450 EUREAU OF ELECTRICITr 83 JONN STREET. NEW YORK. NEW YORK 10038 JULY 16,1.941 APPlicationNo.onfile 719479!)0/90 W ~l96407. THIS CERTIFIES THAT only the electrical puipnsent w described below end introduced 6y the applicant Wanted on the abore application nurrs6er in the prorrsiees of CHARLES KVRIAKOUOF.S, 9 KEMBERhV LANE; HL.070-13, SOU`I'NUG~, N.V. in thefollominR locet(on• nt ~y-~ f,AR/0119' 1000 %0.9 JUl ~ Q~, Baesgte ~ let F(. L' I Ynd F(. .Berrien Bloek Lot uwesoarinedon 1.991 and found to be in compliance milk the reyuiremm~la of this Board. ' RKriN RIiTYt6 ~ RANOES ~COOKIt10 DECKS OVENS JgSN WASNlRSJ_EXMAUSTf~_ OLRNtf ACLS INGNetSCFM f111011F5[tM OTHEN AMT. K. W. NAT. K. W. AMi. K.W. AML K. W. AML M. 1?.S 6 92. 10?. 3.4 t J L0 F gtYE#IS RNNAtf MOTOlS tLTWE AMIIANCE IKONS SNCIAL tlC'K i1Mi GOOKS WL V/NT HEATERS MOlll-0UiIET gMMNS AMT. K. W, pl M. r. 61i5 N. r. AMT. N0. A. W. G. AMT. AMr. NAT. AMIa. TRANS. AMT. N. r. ~ « ~T AML WATTS 2 F 7 30 t R 1.4 600 ~ _S~VIQ DISCONNlCT NO.O? S E R C,~ V 1 C E ~ t AMi. AA1r. IWE ~ 1/tW 1l SW S/SW S/nV ~'aER;COND. OF CC ~OND. NO. OF MI.IEG I Of~X11E0 INO. OF NtNKAi3'I. OF ~l IYIGtAI - 7 ^00 CB l X?. 9(0 710 OTMlR Al~ARArif. ~ _ _ 3,5TON A/C UNTT-1 2.5 TON A/C UNIT-1 C.T. C,ABTNET:-i MOTORS:1-0.75 N.P. G.F.C.I:-11 SMOKE DETECTOR:-?. a= ARTHUR V. JONC.E; i,'IC.ti#1,1.4)-F ~l P.0 BOX 76R CUTCHO(iUR, N1f, 13435 MAMA M C l i 'l` Per ~ This cerHficaN.mud not M alNred in any manner; return to the office of the Board if incorraA. Inspectors may be identified by their creKkntiab. DOPY FOR /WLDMEi DEPARTMENT. TNIt COPY OF CERTIFN:ATE MYST NOT iE ALTERED IN AIIY M~I~NER. rI::LD I~:St'EC3iUN ((UkTE ~ COMMENT° _ _ ~ 1 . ~ a ~ Q ~ ~ ~ ~a "-0 moo O e(,~ J~-~~,e-taa. ~at~ Q FOUNDATION (1st) ~ - ~ =N ,,1 rn FOUNDATION (2nd) 1~„ _ V 2. z o P,OUGH FRAME & _ l~ PLUMBING / ~j ~ V ««~~gQ\..... H ~3 ~ c~ m _ H INSULATION PER N. Y. ' STATE ENERGY _ ~t~ CODE ~ ~ x a y 4. ~ , ~ F I td A L ~ U R.t.~.- ,c..~ l ~ • f ' ADDITIONAL COMM S: x r~ l7-9o r - ' x x ~i o ~ ' D z .a r ~7 ~ - H ~ - . ~ ~ 9i ~ ~ ~ - _ ~ ~ -0 4 m 3 ~ ,D ,0 ~ p ~ ~ CD 9~ N N ~ ~ N ~ K N ~ 0 ~ C7 ~ n 4~ ~ ~ n• =0 CEO ' G LT Z ~ ~ ~ 7 ~ N ~ ~ . i O O N p, O• cD Q Q tri O A~ CD ~ ~ o ~ ~ ~ o o ~ ~ rn 000~•~N ~ tV N ~ ~ r+. ~ N LD O tD Q ~ ~ ~ 0 0 ~ ~ ~ 3 O' 0 ~ ~ ~ r''~ ~ -t O ~ ~ ~ N rn3~~~'°~ o ' a ' 4 ~ ~ ~ ~ ~ ~ x ~ ~~A~ ,,~~r°x~ ~ aM~~ ~~F a < • . ~ rn ~ in :c ~ p ~ y ~ "r1 w 'U ~r Ob Q 1 ~ .~pf ~ ~ Pe Ct FV ~'t~+ Q D ,C t~aPabor aa w(, t!1 % 0~ ~ R W a ~ ~ ~ r.. m a ~d N.asa,.~„m,,~S 18 . ~ ~ ~ ~ $315 M ^t ~ P ' ~ 1 tS o N * ~ . ~ ~ ptl yyy ~ ` t M M `'ry 'AL ~ ~ \V ~ /jf/ ^ ~ t N 1 ~ iw" Xr , ~ N9' ~ e tti4rCtC rptYblt~ ! 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Z o ~ o m m ~ m ~ `o d ~ ~ x a~ ham. Y=°r° sue`' r~4 y . . o+ m ad ~ 6~, ~ y ~ W~ ~ o ~ o ~ . b Z W w fl~i~ ~a ! pQOY dD os ~ 1"lu4tp ~ ~ ff{ ~ n-o D2~k N m ~OyO j W J~ I s__~ Ot 42 f`a~OSb,~ b .og ,\~Y~ z ,34 f • a ~ Q ~ N roe ~pQ~ ~ t y d w° Q r- o f d ta. ?z- w 0 = ~ ~ ~ Z ~ m 1- ~ w X26 wF-W do ~v ~ as ~ m n- Y cn ti i ~ ~ o ~ a m z pz p~ ~ o~, ~o ~ 00 a~ w o '1~~ 7+5~. v~xa° a S~ ~`©9 z ~ O o O y c0 ~ ~ u,, " - ~~~~3 w ~ ~ a o to ,'1'~ „ ~~~~1'~ _ a a ~ ~ S' "~'1CS t ~rr r ? ~1 BOARD OF fiEALTB I~ ~ - Gl~~`~a~ ~ ~ ~ 5 SETS OF PLANS i ~iFORM NO.1 SURVEY II MAY ~ 9I~ ~ TOWV OF SOUTHOLD CHECK - i!iF,fU1L"D.INGDEPARTM ENT SEPTIC FOR,`I ,,...m,.,r-,.-,.„vo„~,,,r T®WhllC7w,•U¢lsT~i'£)I.i't I_.,''i TOWN HALL NOTIFY r ~SOUTFIOLD, N.Y. 11071 CALL r TEL.: 7G5.1II02 MAIL T0: ~ , Examined ~ 19 ,y:4 Approved . 19q~. Permit No. l)06.'e',. Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ,MAY ,7 r. 1990..,, 19... INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building IrispecLOr, with 3 sets of plans,accura[e 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 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 h1ADE to the Building Depaztment 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 Re_tilations, 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, ' for: aTa~st Clemengncy (Signature of applicant, or narrtCx$~1eb~potration).'~' 1,1 ,Village Square. Glen Cove: NY 11542 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Axch~t.ect \ame of owner of premises ,`i$, & Mrs. _ Charles Kyriakoudes (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 MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . T0, ,BE, SELECTED . , . , , , , Plumber's License No . . Electrician's License No . . Outer Trade's License No . • . ' th 1. Location of land on which proposed~~w// ork will be done. s . . . °ff~ ~ ~ 7c7~"Y Kimberly Lane Southold House Number' .....................'Street.......................Hamlet........................ County Ta:c flap No. 1000 Section , 070 , , , , , . , , Block ...13 Lot , , ;9 , , , , , ' , , Subdivision. ~;Parad,ise,by„>rhe BaX:~•..........FiledJfapNo. .,,6463,,,, ,Lot ..9.........., (Name) State cristing use and occupancy of premises and intended use and occupancy of proposed construction: a.Exisiinguscandoccupancy...Vacant,-,Permit,_outstggtlip,g,fox,_cgls;e.famiT~ house to.be_bui b. Intended use and occupancy , ,ONE FAMILY HOUSE ' - : ~ NEW BLDG, 3. Nature of work (check which applicable): Nea' Buildin6 • • • • • • • . Addition Alteration , Repair Removal Demolition , , , . , , Other 11'ork , , , ~ ~ ~ ~ ' r~~~ (Dcscripiion) 4. Estimated Cost $.200, OpR.4o Fee Zo Y ` ito be paid on filing this application) 5. If dwelling, number of dwelling units ..ONE. _ , . ~ , , , Number of dwelling units on each floor , It garage, number of cars . S. if business, commercial or mixed pccupancy, specify/Aature and extent of each type of use . . 7. Dimensions of existing structures, if any: Front Rear Depth Hci~.ht • Number of Stories ' • . Dintcnsions of same structure tvittl alterations or additions: Front N j.A Rear . Depth . Hcigltt Number of Stories 3. Dimensions of entire new construction: Front . L9~#: Rear 90 ~ f .Depth , ~ 54' ' Height . 3.R'.-+~.:..... Nut»ber of Stories . , TWO ± BASEMENT ~ ~ • • • ~ ~ ~ Size of lot: Front .....55: 2z Rear ...1.50'......... , . Depth . . 28.~ ~ . Date of Purchase,. .Name of Former, Owner .MA.hxi.ag.F,nter~pxises...•. 1. Zone or use district in which premises are situated , , , RESIDENCE.. , . , , . • • , • , , ' Does proposed construction violate any zoning law, ordinance or regulation: No . } 3, \1!ill lot be regraded Y•&S . 1Vill exr~gss~i}lr~m~ved from premises: 1kXsY No 3. Name of OwneroF,premises{ihas•,Kyriakoudes,Address a1 a. I; X5.7. Phone No. 718 ,746;8125 Name of Architect .'fASTkC.LEME,NI;.Y,A$CH~.'$$GT~ddress GLEN.COVE~NY.11,S~p~oneNo.516•-676-72'72 Name of Contractor,:. .Address P1Sione No.... , . , ' 5. Is this property located within 300 ,feet•of a tidal wetland?~*Yes YE *If yes, Southold Town Trustees Permit may be reqgu~ired. PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give scree and block number or description according to deed, and show street names and indicate whether tenor or corner lot. f'i , . 'l7 k LOT ly Vr~ LONN{ni iONW~ J/IM1'(K ~ i GGVNK GPfi1 Of HkI~NN t ~ I ~ Y! \~~~A~~~~ ~a m n LOT 10 1 er Gm.rie ` ~ Zo mo J ~ J ~ ~ ti z N.7 i' . SITE PLAN ' , I, A'1"E OF ~Etl' S'ORK, S.S )tip\'TY OF ontract) (;~Rmc of ind •idu 1 sianing c ~ ~ ~ • ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant n'c named. isthc.....Agent..(.Ars.hltec.t.~l (Contractor, agent, Corporate officer, etc.) ~ • said gamer or owners, and is duly authorized to pcrfotm or have performed the said work and to make and file this ~lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the r}; will be performed in the manner set forth in the application filed therewith. ern to before megqthis ........r ..day of-.7~ v1~.........., 19~1a. an' Public, ,r`1-?;Q;P;'f ; I~.•: (ti!~UD,~.... County .a . t1EtEtt K OE VOE . NtlfNtyPUBIIC,SMleatpMr~ ~ •(Signatureota•plicant? No. 4107318, Su11dN ~ P Term Expires 1Vwrch 30,1...,