The URL can be used to link to this page

Home My WebLink About18109-z Y FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20418 Date DECEMBER 18, 1991 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1155 ARSHAMOMAQUE AVE. SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 66 Biock 3 Lot 6 Subdivision Filed Map No, Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1, 1989 pursuant to which Building Permit No. 18109-Z dated MAY 11, 1989 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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GUS & ANGELA KLAVAS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-216420 - DEC. 11, 1491 PLUMBERS CERTIFICATION DATED DEC. 9, 1991 - LAWRENCE LISO uilding Inspector Rev. 1/81 i , roes: xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 18 0 9 Z Date .9.5~l. Permission is hereby granted to: ~ ~l' ~ ....~~~.~d~ /S~ at premises located at ..6~c~.~.~~°. .........Lf:! :Z..,,,, „ County Tax Map No. 1000 Section .........Y~.~?...... Block Lot No.......®.~: pursuant to application~+doted .....~~--~..t.~~ 19.0.7, and approved by the Building~/Inspector~~~.~CP~~ . . O / B Iding for Rev. 6/30/80 F08M NO. >9 TOWN OP 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°- 15966 ~ Z Date t9~.~ . . . . . . ' . . ~ . U Permission is hereby gr J.--~ ....~.C~.~...--.o.~....... ~.~:t.~~..:".~d ro....\.G1.X.,4SA~.`k..~?-.d.1....:~?.....~.......r~~....~4-.~ ...Q-w!:,.Yrt4....~....!~"Y~?~'~ ~ . O J .....,.q.~'). ~ ~ at premises located at ...r!.~ 5~....~"!:!'?~n.J.....:...~``.~~#:r!~k:#--~ County Tox Mop No. 1000 Sectio ...C~...~.~..... Block .....~...~.`.1.}Lot No......~*?..~a......... pursuant to application dated 19.d..{.., and approved by the Building Inspector. Fee $.•••}•l ~ ~ ~0 Q P~SybG z exJt- Bui 1ng Inspector ~~.3306 3 Rev. 6/30/80 ~~~FO(k~~ TEL. 7G5-1802 O OGy. TOWN Or SOUTIIOLD .:i~ ~ Ul~f~iCI:OP BUILDING ~ ,~i• ~~~ir INSPECTOR o t', iP '`Y, z cn f- ~-n P.O. BOX 728 cis `~,y T01VNf[ALL ~.~f/Ol ~ ~~'J~ SOUTIIOLD, N.Y. 1 1971 November 27, 1991 Mr. Gus C. Klavas 166-07 14th Road Beechust, N. Y. 11357 To Whom This May Concern, We arc unable to complete your Certificate of Occupancy because ,of the following reasons. /yam/ An application for Certificate of Occupancy i.^, not on file. /X~ No Underwriters Certificate on file. /X~ The check is (,~~y~not on file.) $25.00 No Ilcalth Dept. 1lpproval on file. Nu final inspection has been made. Please contact our office on this matter. Tlrank you for your cooperation. Ilui]di.nr{ Permit 11 1 8 1 0 9 2 t3u.ilding Dcpt. ***/x~ No Plumber Solder Certificate on file. ( all permits involving plumbing being _ .issued after 11pri1 1,19f3~" ) Form No. 6 ' ~ ~ ~ TOWN OF SOUTIIOLD ///jjj f~~ BUILDING DEPARTMENT //~~~~~~~y,C~ _ TOWN HALL d/~`J DEC - 2!991 € 76s-lsoz ~,r; ~ APPLICATION POR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OP, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property caith 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 sire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 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. 5. 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 I. 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 - Residentia~l/x$15.00, Commercial $15.00 " Date 1;'or~/z~~: a~~.1.9.1/... ::ew Construction., Old Or Pre-exi/sting Building., • Location of Property.... ~~SS,,,,, ~~'`JCi /nahyQ,~~~•. /L~~2~,•• ~u?DO House No. ~ ..••••••!-~16 Street Hamlet Unwcr or Owners of Property.....G.Gts a//"~, ~n~'~la~ {~j ~a VQ5' County Tax Map No 1000, Section......~?.~?..., 3 .Block...... .......Lot...... :subdivision ....................................riled Map............Lot..... Pcrmlt No.....~ ,,,,,Date Of Permit.. -y / ..S/.~~.1.~~......Applicant.. ~.S..~ll"~.~-5,..... :!ealth Dept. Approval.... ••••••••••••••••••....Underwriters Approval Manning Board Approval tequest for: Temporary Certificate........... Final Certicate.., 'ce Submit[ed: ~ 5 bf~ " l ~ ~ ~ u' [y APPLICANT i ~ ~ ~ •V - ~ = _ n- a 1 ~ -~~!t} L)~) _ , a ~ t~.~~ ~ ~ S e ~ _ „y,~ ~ ~ , 1110 / fir ft.~y tai 1~, ~ i h ~ " ~ ~ h. v u. ~ r h ~ ~ ~ ~J ~E~/ ~ J ~ S ~ < a - ~ ;5 ~ ~ ni{ rr! ~'i~.l 1 J. ~l V. C.~, F o < ~ ~ ii a ~a ~Cj~^, i yn i ~ I'C ~ ~t w ¢ ~ ~ ti t .r_La ~ ~ ~ ~ ~ ~ m ~ ~ o fi ~ ~ 1~ T A x m Z ~ O N I\ l } r~ ti) .A >ie D. ~ l ~ wYi J i, d' w ~J ~ 4' vi L y ' I _ J ~ W d ~ 'J ~ ~ . ~ r ~ V ` ! Y V ~ v h ~ 1 ~ .4 p/ 1 V ! ~ ~tl H, "C ~ ~ ~ F . ~ T, .`I` a1 •.co rl ~ - ~ ~ C { . , I `3 ~`3 h `I ~ ~ ~ I ~ ~ ` }(t ...-..._,...a. _,...._._.__._...e........-.-,_..__.,,_.~..__...~_._~.._..._......._..._.. ~ --5_ c,~1FF0(,~-~, TEL.7G5-1802 O O~.l-~ 1~ ~ TO'~4~N OI' SOJTFfOI.D t ' ~ < OFFICE OF BUILDII.7G INSPECTOR u°-, r*+ P.O. BOX 728 m+~ ~~e~?_` " TOWN HgLL %O1~,dQ~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N f Date ~ ~ ; ~ C t Building Permit No. Owner CK~n S ~ ~O S (phase print) Plumber ~ G,. w` ~H l - Y1GG h±Si} (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1; lead. (plumber s signature) Swor~ to before me this ~_day of D~z~z,G~~ Notary Public Ito tarp Public, S'u{-sG CC County D~.ORES l.l.ISO Notary Public. State of New Yak No.4841t)?2 ' claalir.eaiassunelkcou,~, ~ Orernmission Expires Oct 91, - THE NEW YORK BOARD OF FIRE UNDERWRITERS +r~~~'' ~i.i ~S ,os~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date llltit7F,i9i;RH '1,),J9~I Ij"r~.;yBRa/>a~ it :~it~~2(3 Application No. on file THIS CERTIFIES THAT only the electrical equipmene as deacrihed below and introduced 6y the applicant Homed on the ohove application numher in the premiaea of (yljti KI~A'4AS~ 3.1 Si? hl.ikiA7~4Aff1~llJ F~ Fl4j'ryllT4CF: ~i~., N, iitiU'4'k101~,1i, iV S' a ~ in the following hrcationi ~ Boaement LJ Ist F'I. ~ 2nd Fl. 7~'1'1'~lC'/l7({'!~ TI:H; 1'1].§1'1~ ill , .l $c1! 9ertinn Bock Lot t:*.~ was examined on ~ and found to 6e in conrplianre with the rerluireneenLr q/'this Roord. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTWTS INCANDESCENT FLUORESCENT OTHER PMi K. W. AMi N W. AMi K W AMT. K. W AMT H P 7~i )ti }'y rif } 1 if ~b 1 'I ,r: DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll N. P GAS N. P MIT NO A. W. G AMT. AMP. qMT. AMPS TRANS. AMT. R. P SYSTEMS AMT. WAiiS NO.OF FEET R I1 ~ .I ~ ~l)i) Y SERVICE DISCONNECT NO.OF S E R V I C E ' AMT. AMP, TYPE METER t,a'}W ly3W 3,93W 3,e'4W NO. Of CC. COND A W.G. EQUIP. PER .e' OF CC COND NO Of HI~tEG OF~M LEG NO. Of NEUTRq[5 Of ~NEU PAL 1 `J, 41 r1 C~LI t z 1. ?lil E 2jfl OTHER APPARATUS: 6I:;4 SY"~31t4 1J1V't`i'S'-l, j~p. {JI t' 1`?.~4hlf(~lr °I'B h1~51'V'~~i ~ff._.i T"ktd7:i,!~U~AI~1'15Y1--fi f`7~2, Jt)('I cA1'{i6; w 1').t'i.7:F;f„ ~'l'rR P " 7 ' 'Cfflr,~;F P,f,.° frill";'"'t"HIt' L~.Ia,`..#p.33:~;t-r'; ~ ,Tfi[T1tr6 A1~TP;i'3lf h' - ~ - GENERAL MANAGER it7.'iJN~i~'!fa7Af), I`!Y, :1;i~3t}f ~ yt Per ~ { This certificate must not be altered in any manner; refur~ 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. /~ryp li L': r. .fpi .Jf~ 4 • ~ ? A V ` f Y r t V _ I _ _ T H OUt1DATI0N (1~t) ~ ~ ~p T _ ~ o,~- ~ - - ~ ~ ~ OUt1DATI0;J (2nd 1 rn ~ . / ~ dNr OUGH FRAME ~ ~ (r PLUMBING N H • ~ ~f c=J t1SULATION PER N. Y. y STATE ENERGY CODE 3 ,30 ~ ~ H • FI;JAL / ~ ADDITIONAL COMMENTS: ~ d ~ ~ x ~ ~a ~ • . x ro H ~ \ 9 H H ~ n z Y c~ a r H ro H f~y~~ 7ss-iso~ BUILDING DEPT. INSPECTI [ ]FOUNDATION 15T p~j ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ 7 FINAL REMARKS: ~ ~~'~T-`~-~ DATE~a .P INSPECTOR r _ 765-1802 BUILDING DEPT. 1 NSPECTIAN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: DATE ~ ~ ~ INSPECTOR ~~s~~~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: i r,,/~ ~ d~ z- ~ I~~ vim. DATE /3 7 INSPECTOR s.~~~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL lC~ V REMARKS: ~r ~~t . ~ DATE I~ /3 ~7 INSPECTOR i ls~~~ 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIAN [ ]FRAMING [ ]FINAL REMARKS: G~ ~ ~ ~ aA~ DATE l~ f INSPECTOR v ~7~-•~~ 765-18®2 BUILDING DEPT. INSPECTION [ FOUNDATION i5T [ ] ROUGM PLBG. FOUNDATION 2ND [ ~ INSULATION [ ]FRAMING [ ]FINAL l~ _ REMARKS: 4 DATE I ~ n ~ ~ INSPECTO ~ ~j L 765-1802 BUILDING DEPT. INSPECTI N [ ]FOUNDATION i5T [ ROUGH PLBG. ()FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ]FINAL REM KS: QtiQ.aaGLSw~ ~ ~'e.~ r c, ( G DATE ~ 0 v 6 ~ INSPECTOR ~ _ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [DOUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: G ac.-?~ , DATE 0 INSPECTOR -..Sv, i..... _ .d._ ..x i. ~..._..i~va... - _ _ .a .n / S`I ~ ~ '~-iso2 BUILDING DEPT. INSPECTI®N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [)FINAL REMARKS: ,G~.,r~J DATE ~,,~INSPECTOR r b sti ~ l ~ 1 'u y,, TJ 'l ~ ~ t I, ~ H 1 A ~j ~ ~ S, i ~ ~„y i> / f R''YY/'~9 i~ ~ ~ U~ ~ ~ P ~y ~ 1 I 4 1. I ~ ' < a - ,.f ..S :i ~ f i _.iy.,.1~ 1 I ,~1 ~ 1, ~i G ~ r ~ ri , ~3 ~ I ; i~__.. ~__I ~ ~ if i II';~ ~ ~ , a rf£~, 1 ~ E 95 NVI~ e.U 4'af. ~ 1 i ~ ~ _ ~ 3 C _I I \ , o I ~ \ ~ . ~ _w l~ V ~ 4 61 ` \ ~CS 4 t,y ~ , f~ ~ tJ i ~ ~~1,1 , Y ti 9 I <~..1 } v.~ ~ „o`~• ' i 0 O 1. ~'~I 1 oS~F~ou~~D,' VICTOR LESSARD ~ Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~S P.O. Box 1179 (s 16) 765-laoz ~ Southold, New York 11971 FAX (516) 765-1823 ~~i~(O~ ~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD December 1, 1989 Bay Creek Builders Box 602 Cutchogue, New York 11935 Dear Sir: I recall your coming to my office and_ ur discussing the floor beam i.e. steel girder on the ) dwelling. After my calculations, I felt that the wood replacement, with the 1/2" x 11" Flitch Plate would more than carry a safe load. This being between the Living and Dining Room. I see by the report of Mr. Thomas R. Harrison P.E. that my figuring was correct. I also remember asking you to get a licensed engineer to be sure. Even today I feel the proper wood replacement was done. Very truly yours, ~SO~UTgH~O.LD TOWN BUILDING DEPT. V ,c cf u-~. ~ `u- Victor Lessard, Principal Building Inspector VL:gar ,u TAUSCHER CRONACHER PROFESSIONAL ENGINEERS, P.C. P.O. BOX 173 265 SUNRISE HIGHWAY - ROCKVILLE CENTRE, NY 11571 MAIN OFFICE (516)766-1018 "OUR 32nd YEAR" April il, 1989 Bay Creek Builders P.O. Box 602 Cutchogue, N.Y. 11935 Attn: Mr. David 6icGahan Re: 965 Arshamamoque Avenue Southold, N.Y. Original consultation December 12, 1987 Original letter April 4, 1989 Dear 64r. McGahan: As per your request, the writer has structurally analyzed the ceiling beams between the living and dining rooms and the kitchen and dinette rooms of the proposed house (as of 12/8!87) at the above address. The analysis is based on the architectural building plans for Mr. and iL4rs. Gus C. Klavas, dated generally in 1987, and as approved by 119r. Lawrence M. Tuthill, P.E. The beam locations in question are shown on sheet 5 of 9 of the plans. Following are the results of my findings and comments. Living Room/Dinin Room Beam While the plans call for a steel, wide flange 10" Y. 30" beam, it is my understanding that you obtained approval for leaving the existing composite wood and steel plate beam in place, for support of the proposed new structure in applicable areas. This beam consisted of 2 - 2" X 12" and one 2" X 10" wood beams and a one half inch X 11" steel flitch plate. Subsequently, the present owner disputed the above, and retained a IVIr. Joseph Schmitt, P.E., to determine that the beam was not adequate. However, a very careful structural analysis of the composite beam reveals that that beam was indeed adequate to support the proposed new loading, as per allowable stress, deflections, etc. Further, my calculations have revealed that at the support on the kitchen side of the beam, an uplifting force will be in effect as a result of the beam support configuration, under design loading conditions. EASTERN, L.I NEW YORK CITY (516) 365-1567 (212) 347-616a WESTCHESTER (9t 4)376-2033 , ~ Bay Creels Builders -2- April 11, 1989 Therefore, unless the beam end is continuously and properly anchored down and into the foundation area below, the tendency of the beam will be to continuously lift upward at the kitchen side. Under load, this can cause unusual deflections in the areas above. Although safe, as a support member of the proposed new structure, through no fault of your own, the basic beam design and support system is flawed and never should have been considered in the first place. Whether or not this was a steel, wide flange beam or a composite type member is irrelevant. This type of poor design is consistent with other deficiencies, such as the totally inadequate design/layout of the measurements and support system above the sliding doors leading to the rear deck, and other items listed in my original report. In short, much of the thought, layout, and design of the original plans was just plain inadequate. Yitchen/Dinette Beam The plans call for 3 - 2" X 10" wood beams plus aone-quarter inch X nine and one-half inch steel flitch plate. A E' X 6" wood post supporting the beam from below is located 7 feet from the living room side. As noted in my original report, the steel plate is actually one-half inch thick. A structural analysis of the member indicates that the beam is perfectly adequate to support all design loads, including a floor joist system framing onto it, rather than partly being parallel to it. Thus, as my calculations have indicated, the beams in question were/are safe. I would be perfectly willing to testify to that effect. It is my opinion that this whole matter of unsafe design, etc. , is utterly without foundation, malicious, and solely intended to avoid proper payment for completed, contracted work. If you have any questions, please call. Very truly yours, ~p~FSS10Nq~ ~ ~I , 4j ~s K. t1gRq ~~'c~, Thomas R, Iiarrison, P.E. ":g`'~ G~ ~C,, a~ TAUSCIIER, CRONACHER Professional Engineers, P. C. . \ s~. ~ on~`•h`~ o~~ ~~'''caa~,-rc*~`a~' i o~ BLDG. DEt'T: TOWN OF SOU7HOLD 166-07 14th Road Beechhurst, NY 11357 October 12, 1988 Town of Southold Building Department Town Hall Southold, NY 11971 Dear Sirs: We would like an extension on our building permit (No. 159662) on premises located at 1155 Arshamomoque Avenue, Southold (copy attached). Please acknowledge copy (enclosed) of this letter. and send in envelope provided. Thank you. `rely, Gus C. Klav~~ BOARD OF HEALTH ` 3 SETS OF PLANS FORM N0. 1 SURVEY . t~. TOWN OF SOUTHOLD CHECK • ~ ~s~• BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY ~OUTHOLD, N.Y. 11971 CALL a^~'~'•~m`'~"~'•"~• TEL.: 765.1802 MAIL T0: i(,C•0~ 1 Q~ Examined 19 ~n~- m..~f ~~ar~ yJ~ r g ~~b a ~ ~ ~ / Approved 19~' 1. Permit No. 11 3s /~/off ~ APR 2 3 ~ Disapproved a/c ......................G~¢ i BLDCi.DEPT. ' ' ' ' ' ' TOWN OF SOUTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS 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 inspections .......~Z~...G, /~.~sv-n ..............r.. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) ~y ~ ~ 3S7 State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises C.. ~:AJ.~ ~ . (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 . . Plumber's License No . . Electrician's License No . . Other Trade's License No . 1. Location of land on which proposed work will be done . . / ~ , ~ f !'T.r, s.Y,a...,,.. o.~e,o cl.lA.e.. ` ~<<z cX/Jy:. L. S~7~q.'v'?~J ...~;..-~l~tr (~?C House Number Street Hamlet County Tax Map No. 1000 Section Block Lot . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~.n ! . b. Intended use and occupancy 3. Nature of,work (check which applicable): New Building , Addition . Y. i • • Alteration . Repair .Removal Demolition Other Work , . / (Description) 4. Estimated Cost .D. c).cl Fee...........' ` (to be paid on filing this application) 5 If garagennu nbeb of adwelling un~i~ts : Number of dwelling units,.on each floor 6. If business, commercial or mixed occupancy, specify n ture nd extent of each t pe', of use . i ' 7. Dimensions of existing structures, if any: Front S, , ~ , , , .Rear . ~ Depth 3S . Height Number of Stories l • • . . Dimensions of same structure with alterations or additions: Front Y . Dimensions 'r ew construction: Front . g Rear/, ~ 'Rear ....y ~ ; i & Height , , . of~t;~ t e n . Number of Sories . , , t1 Number of Stories • Depth II 9. Size of lot: Front . 0. Date of Purchase '-j~, Rear D, . ~.4.?. ~ s-.4............. . .............Name of Former Owner . , epth 1. Zone or use district in which premises are situated : . 2. Does proposed construction violate any zoning law, ordinance or regulation: ...............Will excess fill be re>( p~ed g 4. Namle ofOwner o d remises 4AS , .K, l !~J.?.a.~ ..Address lob, ; Q-~, `C tJ fr m premises: Yes N~ t p • ~ ~ Phone No.`7C6 :~.6 :?~a,"A. Name of Architect ...........................Address ~Gtlu 1~~. !Jk .Phone No............... . Name of Contractor ..........................Address ! t3S~~ ..Phone No............... . 5. Is this property located within 300 feetgqof a tiqidal wetland? *Yes No *If yes, Southold Town Trustees PermitPLOTDIAGKAMed Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show Street names and indicate whether nterior or corner lot. i i- ~ , Vc L IL F-I ~ Ik ~ ~ ~ ~ 1 - - I : ~ ~ 2s u ~ ran o v~ ~ ~ u,~ TATE OF NE ORK, S.S ' 'OUNTY OF~.... . , ~ ...~~~~,-,~L.rV~r-ec~ g y p ,sand says that he is the applicant (Name of indmdual signing o ract), • ~ bein dul sworn, de ose bove named. [e is the .........................~:'Lu'Yt-Q:C~_r.............. .........i.......................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the sat~d~o~k~aS~'!~o make and file this pplication; that all statements contained in this application are 'true to the best of his knowledge and belief; and that the cork will be perforned in the manner set forth in the application filed therewith. (worn to before me thYs ....day of , 19~~ dotary Public, .County G ~~E-~-r--~~ .~G~~>...Sr:.- -,rTii EU7AB~'HANNNEVILLt9 (Signature of applicant) NN NEVILIE Note Publlc, Stets of New York ,taro of New York No. 6~ 8126560, Suffolk Co 36p. Suffolk Col~y Term Explrae October 8t, t!?', etwGer 31, 19.E-(y P.S82 ' +~-Fi/T ,iN~ET ~ ~"f1,L'-\VATE 2PRLYlF//~i s~ G~ uA+~rck. EaNO .Sa~lr .SNE~T ~ TAR „ yy '~t E4K/NGj ~f ~l1e QiTCI>/x+4 ~ QGX7F/Nli~_ D/J 78~ GLIX _ S~ y _ - FLASH _ `APE&EO - ~y ~x~ I T•Y GGQ. -i~r~ 'TRYFV2A,N V nL~/1Y NAIL ~X/V -/(n°Q. G ~ •,G i?%_. -~'D~YwFGG /N~S ULt~T/~N /Unr~s ' . GGh1 ..StEF,.FFP3 ~ 2"Y FUa.R(hY•p TAPERE6 - ~ RISE oN A G2 "RViU. - ' \YATE.4.PAA~F'/rl~ TU LiE ,4Q7':TAR FbuRE~D.QUEIi _S/x/T ~'XEET .mill JS/5 C~GT ~.qK. ~~o fw:~u w+,,r , AGUr~IIiUUnI FLASH/~' To~ G4P3 7.xY ~ /-~"v~~'`/~ p F/~2. 3HDE ~V~ 9 =~*T-•• ro 11E.4-T/BAL. G(P GIN /RCS/DE OF 4GY-~R TQ PREVENT /~';i i` /~AKAsi~• G4VER \Vf `fa" QUA27"ER /2~UNP /~\OVC pINC~: ~ 14, ~ ~ ' z r - _ L' 32254 «s ''e rxsw y°t L~GK L~~T~/L GAL.-E~/"'=/'~^ y/. R ~ i\\a<s ~ u5 - C KG;4~h5 ' scue l~ +vrnorEC ev eeW!~ee~~~-,~, eeviseo ~ ' ' - pert /~/SU eU' ~ - - '~~EFa~fi"~4;tza rr AK'.._ D~cfi - - ~~7'FtZ . ~ ~ °eewwc dareeee - ~ - 8'n~4