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HomeMy WebLinkAbout18742-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19755 DATE: February 25, 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 1945 BAYVIEW AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 6 Lot 37 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 22, 1989 pursuant to which Building Permit No. 18742-Z dated JANUARY 19, 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 PHILIP SALICE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-5I-JAN. 31, 1991 UNDERWRITERS CERTIFICATE NO. N-174308 - FEBRUARY 14, 1991 PLUMBERS CERTIFICATION DATED OCT. 26, 1990-HARDY PLUMB.&HEATING INC. / C / ui ding Inspector Rev. 1/81 Fosx xo. a 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) N 0 .L 8 .T ~ ~ Z Date ..../~~ ...................................... 19.9 Permission is hereby granted to: to .~~.~~~.............~~ .....~..:~.~...~~.....~ ............... r:.....~~... of premises located at ...1...l...yY..'c.7..........RSr. :-.r~>Q ::o.:~~P.d .............. J.......~5~(l..r~/..4LC ... ................................................................................................................................................................. County Tax Map No. 1000 Section .......1~..~°...... Block .........~.......... Lot No.......~~..,/........... pursuant to application dated ..1. ~~~.: ~.- ........ ............. 19..~, and approved by the Building Inspector. '~~ ~~ ° ~~~~~ Fee $r~..'~`.~Q..r.. .. / / Buil g Inspector Rev. 6/30/80 _____r _: _. .. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAG):; ] a ®UREAU OF ELECTRICITY YO ,ONN STREET, NEW YORK, N 36 SW 3TE$RUARY ] 4. 1.991 90/90 N 1743178 Applicotion No. on file tTIF1E3 THAT rctrlcel epuipment v described 6sloto end introduced by the applicant nomad ow tka abode appdation number in tAe premLes of oaL.xl,e., AAYVIEW AME, HATTITUCK, N. Y. AT'P 1:;; /~lI'i' k ~ ~ in t efdbtcing loco let FI. Pnd Fl. ,Section Block Lot t'RU ""[ail Ieee examined on and found to be in cornplienre u~itk the reyuirernente of this Beard. HXTIIp RXTUlES RANGES COOKING DECKS OVENS DISH WASHEES OfNAUST FANS ACAEf fWITCIIlS OLITIlTf INCANDlbClNT RUOIIlSClNT OTHER AMT. K. W. AMT. K. W. AMT. R.W. AMT. K. W. AMT. M. P. 44 45 38 37 1. 30.2 ] t.2 b F DRYERS RlRNACE MOTORS lUTURE ARLANq REDERb STECIAL REC'~T TIME CIACKL ~L_ YNIT HEATERS M DTI ~ DIMAIlRS AMT. K. W. Oll N. P. OAS H. P. AMT. NO. A W. G. AMT. AMI. AMT. AMPS. TRANS. AMT. N. P. ~, ~ ~T AMT. WAITS ] 3Ci 1 SERVX7 DISCONNECT NO.O! S E R V 1 C E AMT. AMP. 1'TE ~ 1 / t1V 1 l Te 3 B SW S / AW ~' ffM `COND. ~ a NO.OP X4V:G ~' ~.~ NO. Q NlIRKAIe OF P EViG11Al OTMR AMARATUk 3 TON A/C UNITS-2 FRACTIONAL AIR HANDLL~FS-2 G. F.C.I:-4 SNORE AETECTOR:-1 ~~ 5CHARADIN ELEC.TRIt: L'IC./3540 BOX ].077 RAIN ROAD C,tITCHOGUE, NY. 3.1435 pMIpIAL RAANAOs ]] Per Thit eartifkab Tnosf not be alNrad in any manner; Morn to 1M office of She Board if incorrM. Inspectors may be itMnfifisd by fMir credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT BE ALTERED IN ANY MANNER. `~ :r .1': ~T ;!1 ~ 1'.'.II '~~SiD it `-. ~~.. T:J _.i~, '.!{nc", f', %'i4 TV G: i•1 OF :>0[1'1'Iit7L1) ~j 1__`i(.J~`~` i... 1 -~.. _.. 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S't:~:.. _.. ~ .. , ... ~ ...... ,.iJc„t,.R:~zzCa^. z`5 .r°~yaT>r'ov=5 ~l _ ... ........ .... .._.... rt', {15 ~, n:7.1 k'i,l 1.}/+(l rYJ y, ~,]~, .. ,. ~.~~. ............. ~~J1~~1~~' ~~yy uest fort :Y<~ur,~>x,a:~y C2rr:iC:~'~~t,z,.,e..,.,... kinat ~;~>ti'~..irati-...Y.a...,, Subaa,iGr,ed: r„..2~.va~ ................. ~y ~!/~' ' /6~~ ~ /, , , , , l_~°~rr H~a~sn2a Gy,~.cfi ,~i~,-eJ .~r-c~ CO ~, J975~ ~oral_ ~~.~:~~, I QE'f'ICE OL' B~U~TLDdfi1G Ln~ISPEL-TiOR ~rO~v~ I::..LG SOUTHO::D, Ni.X. 1:1.971 C G R T I F I C A T I. O. td. T:EL. 7G~ -1802 ,, ,C~ ' ~ ~_ FEB 2 5199) ~_~, ~~ 'i(.~lYVfd Ui= S(r'b' ,; f dY3k.H3 Y. ~.w A ~ 4 .,...,_.~ Date OCTOBER 26, 1990 Building Permit Nb. !I ~~y~ / Owner LYNCH HOMES ~~! sq-~/C (please print) Plumber IL9RDY PL. & HTG. NORTH, INC. (please print) I certify thatll~l,thc solder used in the water supply system contains less than 2!10 of 1~ lead. Sworn to befo ~_day of 19Q Nota:° Pvh:.ic ~/'~-~~ ~ (plumbe~'s signature) Rotary Public oun:.y ~nn~,an~~.~a~(N,v F1da~y Pub11~, Slats cl New Yost No. W5fiEli0 ~aaliiied In SuHo~c c:ciuunty Ca~nmis; lun a"r~Ztros May 9d. 99•~~ ~ ~~~F al.KcC~~ ~;, t r? /-+~a'~~~~ y~ ~ ~ i~ Af~.~e~ f 4 ~r2^ (n '-4''T- ~i~• ~~ ~(},(~y ~y~~ ~_ ~~iYY' To~rrr or sou~o~.o or•I~u:7, or >iu1LDiNC iNSrrcroR ['.O. QO;C 1 1 79 TOWN l TALL SOi7TIiOLD, N.Y. 1 1971 Lynch Homes, Inc. 1725 Route 58 Riverhead, New York 11901 RE: PHIL SALIGE 'PO Whom This, May Concorn, TEL. 7G5-180? 4;e are unable r.o complete your Certificatr_ of Occupancy because of the folloc~~ing zeasons. /~ An application for Certificate of Occupancy 15 not on fil.c. (ENCLOSED) 1 ! '~to Undertrriters Certificate on fi1c. / / Che checF: .it: (mod/not on tile.) $25.00 / / No llcal.th Dept. Approval on file. ' /_/ P:o final insl~~cct:ion has been made. Plensr.. contact. our office on this, matter. Thank you for your cooperation. Ilu.ilQiccY Permit I! 1 8 7 4 _2` Z (NEW DWELLING) Duildinc pcpL'. ~~ "t'"/~/ tlo Plumber r5older: Certificate on file. a~ ( al.l pnrmitu involving plumbing briny i~sucd after April 1,1984 ) cc to: Mr. Phil Salice 244 Woodhull Ave. Port Jefferson Sta. N.Y. 11776 .. .i1{~t~YNoyeY'T~.•YW'.T:44~'(i~!P"IM4iRi\NAil9iil'e! ~Yi4.r ~ i:e./.~r M\Nn ~..T". !er Y~ai~j4.F"Ji+t'1~+6~J41~"" ~' ~4 G~~ ~ 7i~i-1A02 BUILDINQ DEPT. INSPECTION [ ] F'OtN~IDATION 18T ~ ROUGN PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ] FRAMINt# ~~ ~U /li REMARK8: / h max. ~~ [ ]FINAL / ~..Zir/S„ c~~~ _ ? ,~ 0 /` ~, ~ T ~ ~ 2~.; ~ ./ -, - '- ! i DATE ^~ INBP ~ L r I ~ n 1 1 ~ . .e c ._. H ?OUt1D.;TIO`! ( 1st ) " f ~~ c ~ FOU'lDATI0;1 (2 drf ) - ti ~-(~ _ 2 . ~, ` , o OUGH FRki~1E & ° . , ~ /~ y0 ^ ~PLUM9ING ~a '~ H 3. ~ m rn IIJSUL:,TI0;1 PER N. Y. •' y ST„T°_ EilERGY CODE I ~ ~r~ 2/ d - B'Y! '/ FI::AL °~~ .. o ADDITIOPIAL COi~JMENTS: ~ ~~7 ~ / x ~v N _ ~ . 9 H H O m • r H v m H ~Y RODERICK VAN TUYL, P.C. 21 S FRONT STREET GREENPORT, NEW YORK 1 1944 5 1 6-47791 70 TO Tom Fisher oars Southold Town Building Dept. Town Hall susdecr Main Road Southold, NY 11971 Dear tor. Fisher: ~.~ February 21, 1990 Salice Enclosed is a print of the revised survey map made for Philip Salice on Mattituck Creek, showing a proposed retaining wall 10 feet from the house. The retaining wall and the proposed deck also are shown to be 75 feet from the high water mark. Mr. Salice asked us to send this copy directly to you. If there are any questions feel free to call. Si~ere A.`- ~~ Colin Van Tuyl CVT:sjz .._........_ ....... .. ........~o~..~..~N ,,,u loot FOLD AT(-)TO FIT DRAWING BOARD ENVELOPEpEW10P l~ ~~- rss.isoa C BuaD~NG DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [Ca-r~~AL ~e~eQrcc• DATE ~ / ~ O INSPECTOR °'~~'~1 ~P7 ~L 765-1802 BUILDING DEPT. i:Fi~~~iiC~7:' [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~n~..~~~ ~/~ DATE ~ c~ INSPECTOR ~~ l g7~~/ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [~OUGH PLBG. [ ] FOUNDAT{ON 2ND [ }INSULATION [ ]FRAMING [ ]FINAL REMARKS: ,.~~o ~/~ ~ - DATE `~ `~~ INSPECTOR ~'` rsS-is62 BUILDING DEPT. f NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [~]' FOUNDATION 2ND [ ]INSULATION DATE ~ ~ ~ ~~ 9n INSPECTOR ~1 [ ]FRAMING (]FINAL I ~ ~ (,~L,,,,~. .r-°°"~~'..._ 765-1862 / J BUILD{NG DEPT. INSPECTION ~~" [ FOUNDATION i5T [ ) ROUGH PLBG. [ ]FOUNDATION 2ND [ ~ INSULATION ~..~,~- - u i _ ~~. DATE `-' ~ fNSPECTOR _=~ [ ]FRAMING [ l FINAL .~~~y~ ,~_><$ox BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION ~RAMING [ ]FINAL REMARKS: /`~~~.,~ ~~ DATE ~'~ ~ ~~ /, ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~..}-FfNAL ~ ~~ ~ REMARKS: ~..s~„~~ o_/~~.,~~ `~. DATE New York State Department of Environmental Conservation Building 40-SUNY, Stony Brook, New York 11794 (516) 751-7900 Thomas C. Jorling Commissioner AMENDMENT TO PERMIT 1 ~ -k'6-ob ~~ Former Permit # (if any): Ownec: SCTwt /lid j6zsp_ (66~~- 6-3r( RE: Permit No & Location: ID-$b -b 68'6 Ma#~~~~k~~~,e~-Jt3~^.yvi~w~-~-2 .-F-.h ~.e {- ~SSati0. t~S ,P~lif t~ a.o.diCx., u,.e,,, ~4`lC •Q ~ ~f y n1 ~ ~ ~ ~.U ll ~-e Pa,(~- ~eFf.~us~-, Ste. N~ 11T16 Dear 'X~ZC Your recent request to extend the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that there has not been a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; therefore, the expiration date is extended to .S4kwaw7 3~,f990 ___1_~ Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore, the permit is amended to authocize: N~} f~d~Q 9 -~cia. ~ ~z~,-.c~c~-~v,-, 5 TG~•e hu~ld~µc~ ems, ~~ c's r~.,~Cu<.~~Q 6~ ~v~~.ef- -E-o -1(-(-.fl c.re~F crn ~Q N1~~.c'f~.ec~.~~' c.ar,.._o.,r a-~F KGs c,,~s~vav-ed' ~Jlay S,~ ND Qm~~-t~-w~ ioi~~~[dC~riciv i-uln~~h °2~~ 6~"k~s ~~Orc$'(/~~nn.c~ (~i!f(h W^ (lMR (~ A.O ~!"ff~-F S{,~jNa![l•py- .SuYv-~-'y _I This letter is an amendment to e original pgrmit and as such, shall be posted at the job site."i~'S t~"`("""'fi ea~nnaf F~~e FwPfP~~1 +nn~.-~..-a-~ ~~~ All other terms and conditions r main as written in t e ori~nal per it. Very truly yours, ~~~ ~ 2 wT cc : ~~ ywt/wwr B ~v~~r~. Deputy Regiona`~ Permit Administrator ~~ FRANK A. KUJAWSKI, ]R., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, II[ JOHN L. BEDNDSKi, jR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOKN OF SOUTHOLD Town Ball, 53095 Main Road P.O. Box 728 Southold, New York 11971 February 2A, 1989 En-Consultants, Inc. Roy L. Haje, President 1329 North Sea Road Southampton, New York 11968 TELEPHONE (S 16) 765-1892 Re: Philip 5alice to construct a one family dwelling on property located on Bayview Avenue, Mattituck, N.Y., Tax Map Number 1000-106-6-37. Dear Mr. Haje, Please be advised that the Board of Trustees inspected the above referenced property and it was determined that the project proposed is out of our jurisdiction. This determination is only a determination rendered by this Board. Any other approvals that may be applicable are required prior to the commencement of the project. Thank you for your courtesy and cooperation in this matter. Very truly yours, Frank A. Kujawski, Jr. President Board of Town Trustees FAK:jmr cc: Bldg. Dept. Board of Appeals D.E.C., Stony Brook ~ ~ t ;cgg --.~ ,- (J[(. PIRMIt NIJMhik ,10-86.-0680 FACILIS YfPROCRAM i F ~A '~ ^Article 15, Title 5: Protection of N'ater _ ^Article 15, Title 15: Water Supply ^Article 75, Title 15: VI'ater Transport ^Article 15, Title 15: Long Island Wells ^Article 15, Title 27: Wild, Scenic and Recreational Rivers ^6NYCRR 606: " Water Quality Certification PERMfT Under the Environmental Conservation {.aw ^Article 17, Titles 7, 8: SPD£5 ^Article 19: Air PolluUOn Control ^Article 23, Title 27: Mined Land Reclamation ^Article 24: Freshwater 41'etlands X®Article 25: Tidal Wetlands N [f Ff Ctlvt Unll 10/15/86 EXPIRATION pATf (f) 10/31/88 L~Article 27, Title 7: Solid N'asie Management ^Article 27, Title 9: Hazardous Waste Management ^Article 34: Coastal Erosion Management _ ^Article 36: Floodplain Management _ ^Articies 1, 3, 37; 6NYCRR 380: N-New, R-Renewal, M-Modification Radiation Control C-Construction, O-Operation, (lt Applicab{eJ PERMIT ISSUED TO ~ " Inlet Associates, Steven P. Sanders, Pres. ADDRESS OF PERMITTEE 13-28 208th P1.,3rd F1.,Bayside, NY 11360 AGENT FOR PFRMITTEEKOr:TACT PERSON _ 7ElEPHONE NUMBER N/A la >. uc tee nor ens n Bayview Ave. LOCATIOn' OF PROTECT COUNTY TOwN/CIja~Ttpt7tplE UTM COORDINATES Mattituck Suffolk Southold DESCRIPTION OF PROlECT1FnCRITY Construct a,one family dwelling within building envelope shown on referenced plan; install septic system a minimum of 100' from tidal wetlands/mean high water line shown at end of Bayview Ave, and a minimum of 120' from ordinary high water mark to north of property shown on referenced survey. GENERAL CONDITIONS By acttptantt of this permit, the Permittee agrees that the permit is mnlingent upon strict compiiantt with the ECE, all apPlita6le regulations and the conditions speufied herein or attached hereto. 1. Tlie pertnmee shalltile in the office olthe appro0riate regional permit administotoq or other office designated mthe apetid condaions,a notice of intention to commence work at lean ag boon in adwnce of the time of commencement end a1wN abo noiNy hmdher promptly m writing of the etRnpletion at the work. Z. The permitted work shall be wbjen to inspection by an authored reprcxn4trvt of the Department of Environtnenul Contemtbn which may order the work suspended N the public mtextt ao reouirn. 3.~ The permmee has accepted <xprnsly, by the executron of the appiiceuon. the lull kgal responsibtlrtY for all damaf<t, dues or mdrrctt o1 wMtev<r nature. and by whomever auNered, arising out of the Drolen dsxribed herein and has agreed to indemnify and uve harmless the Sate Iron wru, anions, damages and torts o! every name and deKrsp lion retultint from the uid Drojen. ' ~. The Department reservts tht right to modity, suspend or revoke this permit at any time alter due rrotice, and, N reouetted, hold • hearing when: a) the scope of the Protect b eueeded or • vrolatbn of any corditron of the pem+n m provisions of the ECl and pertinent retulatiorn are lound: or ' b) the permit was obLirxd by misrcprpenution or failure to dittlox rckvent Ant; m ' q rawly discovered inlormatron m signarcam phyiul chango arc discovered since the pennn was issued. - S. The perminee b rpponsPok for ketpmf the permit naive by submmrnt • rox.val appliutron, including arty forms, tees m wpPkmenul informatron whith troy be reouired by the Department, no kter than 30 day Da0 day for SPDES or Solid or Haxarduom Waste Asanagemeni pemriul Prior to Me expiratbn date. ~6. This permit shall not be construed at conveyinC to the apPliuni any right to tmpus upon the lands m intederc wah the riparian rights of other in order to perform the permmed work or as authorising the impairment of any righn, title or interot M red or personal property held or vested in a person not a party to tht permit 7. The ptnnittee b rmporoibk for obtaiMng any other pertnbs, aPProwls, Fsndt, eu<menn and rifhtvot way which may b< required for this projen. a. Issuance of thrs permR by the Department does not unless expressly vrovided for, muddy, wpenede m rcadnd an order on conxntm determinaoon by the Commusioner issued heretofore by the Department or any of the terms, tonditroni, or requircmentf conuined in such order or determination. 9. AnY modlLUtion of this permit footed bV the Department mutt bt in writing and attached hereto. - ~ ' PERMIT ISSUAN(iF. DATE ADDRESS AUTHC~RI2ED SIGNATURE -~ - -l - /-[~- ~~~_ _ I Paae 1 of 3 cc l huul.~Uhhi hihi KAL IV:~U111Uh> fVK /.h 11l LLJ 1> II tlIC >I, [9, U, J. ~uQ 40 t 10.'That is future operations by the State of New York require an al- teration in the position ,of the structure or work herein authorized, or if, in the. opinion of the Department of Environmental Conservation •IUShall cause unreasonable obstruction to the tree navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner maybe ordered by the Department to remove or alter the structural work, obstructions, a hazards caused thereby without expense [o the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be com• pleted, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Emironmentaf Conservation may require, remove all or any portion of the uncompleted structure or fill artd restore to Its former condition the navigable and flood capacity of the watercourse. No claim shall be made'sgainst the State of New York on account of any such removal or alteraton. 11 . That the State of New York shall in no case be liable for any damage a injury to ttu: swctuse a work herein authorized wfiicfi may be Caused bV or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other Duryoses, artd no claim or right to compensation shall accrue from any such damage. 12. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law. such lighu and signals as may be prescribed by the United 5[atei Coast Guard shall be installed and maintained. 13. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, Ieachate of arty other environmentally deleterious materials associated with the project. 74. tiny material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cauu damage to navigable channels or to the banks of a waterway. 15. If any material is to be deposited or dumped under this permit, either in the waterway or on store above highwater mark, it shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material into the waterway. ' 16: There shall be rso unreasonable interference with navigation by the work herein authorized. 17. If granted under Articles 24 or 25, and if upon the expiration a re vocation of this permit, modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to wch extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No Claim shall be made against the State of New York on account of any such removal or alteration. 18. If granted under Article 36, this permit does not Signify in any way that the project will ise free from flooding. 19. Ali activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. on drawinf~ R.VanTuyl Such approved plans/were prepared y latest revision on 6/12/86' SPECIAL CONDITIONS 1. There is to be no placement of fill or grade changes on the site until such plans have been submitted to and approved by DEC. Supplementary Special Conditions (A) through (J) attached. DEC PER/.fII N~6g0680 . PROGRAM(FACILITY NUMBER N/A Page 2 of 9 .. ~ rn o (~ O C C W a NY.^+O ' ~ L :w... E CZS E .Q ~ o o~ rn ~ C~ ~ ~ E E a° m z .~ L ~ ~ (~ y ~ i N.O lO () Q1 L .r C ~ ~ C C a_ C++C~~n L O L B O G p i Z~ "' ~," ti" C G/ r ~ C V I - ~ ~ Q, ~~y a. 0 C C7 1n N H O ~ ~ W I.V Y ~ ~ - V - - - cn E ~ . o .~. O (~ ~ `~ a c c ~ c ..-. c E .~..a a~ o ~ :. to d-+ ~> C ~ O N O r-r -- 7' C ® C (~ ~ u1 N W _ w~ c~ o~~ ~ .F.+ +~ ~,.~ ._ L O cA. c ~ - ~ to ~ ~ V _.. O Q ~ '' U Q) - ~..- ~ E E i c ct~ O c O' i E .N 3 ~ ~ Q '~ O N ~ c c O ~ ~ ~ -~ w~ 3 c fl: E o ~ D .. s. u, ~.O ~,-o~.. ~z - - - ;.:. .. c~ . E Q. ~ a w FORM NO. 7 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL .SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~,/.il........., 199 ~j Approved ../.~~./~........., 19/~.~. Permit No~C~~~2.5~ Disapproved a/c .................................../. ~i..... ~Build'~ g~Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~-~s,~,.P , r yo ~ Received...........,19... 1.14ff~ ~' i ~i~ G 0~~ ~ ~ ~~ ~ (- ~& L, i,„ Date~e~:~'. m~~....., 19~~ a. This 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 the work. " e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp i s. ~ l7~?"~ (Signa rere oft~~, or me, if corporation) /72S 7~~e,~/~iver./Jedcy~ ./t/~j~9~/... . (Mailing address of applica t State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... Name of owner of premises 1f~/,4Jcz~~GC~ :........................................................ . (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. . ~/~~ .................. . Plumber's License No. . f ~ ~ ~ .~........... . Electrician's License No. .357 ~ . ~-......... . Other Trade's License No . .................... . 1. Location of land on which proposed work will be done . ................................................ . .L~.r `-~S......... ,tea . ~ ~. ~2aff~ ~.c~C.~ ................. . House Number ~ eCl~ ~~~~ Hamlet County Tax Map No. 1000 Section ....~~.~........ Block ..... ~ .......... Lot ~ .......... . Subdivision ..................................... Filed Map No. .............. Lot............... (Name) 2. State existing use and occupancy of p/re'mises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... V, 7,~.c~...(l~........../ ...............,.,~.'..`........................ . b. Intended use and occupancy .~ .-~-~.~r.~ . -..~~.t.l,~~IC:,,.'~C~,.(Y.l.l~, ,4~1~;~ ~ E ('jQ . . . . . . . . . ..... . (;uea?[dde 3o am;eu3?S) ~ ~;uno0 ..... sI'ez e3i's3aidx3 wa31 ~noa ~I7oiins'ssoascro roN MHOA M3N i0 31tl1S `0118nd ANtl10N A113 i'e AHLOWIl .........aJ~~'S' ............at[gnd,Sze;oH 6I .... ~ia'9'w~~ ~'..... 30 ,cEp........ ~~ ~.r ......... . s?q; acu azo;aq o; tuomS •q;?mazaq; pa[tl uo?}eo?[dde au; u? t{;zo3 }as zauuEUZ aq; u? pauuo3zad aq [[?m ~[zom aq; 3Egl pue :3a?[aq puE a2pa[mou~[ s?t; 30 }saq aq; o; anz; axe uo?;Ea?[dde s?q; u? pau?e;uoa s}uauta}E;s [[E ;Eq; `. 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