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HomeMy WebLinkAbout18219-z ` FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18474 Date OCTOBER 17, 1989 THIS CERTIFIES that the building ALTERATION & ADDITION Location of Property 8525 NASSAU POINT ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 04 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 8, 1989 pursuant to which Building Permit No. 18219-Z dated JUNE 15 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 ALTERATION & ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & DIANE CASTALDI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-092781 - SEPTEMBER 21, 1989 PLUMBERS CERTIFICATION DATED N/A /. Building Inspector Rev. 1/81 FORM NO. 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° 18219 Z Date ..... ..................................... 19.8� Permission is hereby granted to: io ...�,� � ....�.O:P%.............. to G'r/.t�:r c rKr^ ......... . ...1..'Yl....�GGPX�'... dnl.. .........................!-?� ........ 0 at premises located at ..49fW4'245�..... .... Q ......................... I..7044......................................................... .................... ......................................................................................................................................M......................... County Tax Map No. 1000 Section ...../1,g......... Block a .... Lot No. ................... .... . ......... pursuant to application dated ....0,Ufa......a../................................ 19.�y, and approved by the Building Inspector. �,4: , Fee ......................... B ing Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT Q lh L5 (l V TOWN HALL SOUTHOLD, NEW YORK 11971 OCT 161 765 - 1802 BLOG.DEPT TOWN C SOUTHOLp APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE. . NEW CONSTRUCTION . . . . . . ..(O,LD OR PRE-EXISTING BUILDING. \/. . .VACANT LAND. . . . . . . . Location of Property. . . _?--. N . . HOUSE NO. STREET . . 7. . . . " HAMLET Owner or Owners of Property. . RQr PIAIVJC _ . .C--AS-FA L,' . . . . . . . . . . . . . . . . .1. . . . . . . . . . . . . . . County Tax Map No . 1000 Section . Block ©o Subdivision . . . . . . . . . . . . . . . . . . . . . . . Filed Ma ( P . . . . . . . . Lot .ti/2za; ©90 Z � Permit No. .� „ 7, _ Date of Permit . . . . . . . . . . Applicant . . . . . . . . . . . . . . . . . . . Health Dept . Approval . . . . . . . . . . . . . . . . . . Underwriters Approval . . ._,. , _ Planning Board Approval . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . Final Certificate . . . . . . Fee Submitted : $ . _ _ . . APPLICANT. !'.T. Y /AI/A/Jh111� Cq.STALDO ey. to/ la/Bs lefr blo(:.. 3 B `f HS T o2ti1� r ao f3 C0?_ )3y7y oyn�R� s—n� Gary a FORM NO. 6 TOWN OF SOUTBOLD BUILDING DEPARTMENT TOWN HALL fi 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with 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 Dea!lth 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 solder used in system contains less than 2/10 of 1Z lead.l1 5. Commercial buildings,, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Boardl, 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, buildings and unusual natural or topographic features. 2. A properly completed ,application, a consent to inspect signed by the applicant and a certified abstr I ct of title issued by a e company title p y which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information �required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership oflthe entire lot prior to April 9, 1957 shall also accompany the application. If I Certificate of Occupancy is denied, the Building Inspector shall state the reasonis therefor in writing to the applicant. D. FEES: I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 S. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial -ev. 10/14/88 ��, TEL. 765-1802 S�FFOLK��, TOWN OF SOUTHOLD .`«a Lla�c •r -c OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 414 � To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy is not on file . No Underwriters Certificate on file. The check is (outdatcd/not on fi e. ) r;'�S . 000> No Health Dept . Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. II � � 1 � � Building Permit It V Z RJR . '6S Building Dept. �� o- � No Plumber Solder Certificate on file . ( all permits involving plumbing being .issued after April 1 , 1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000062 BUREAU OF ELECTRICITY "�•- 7 88 JOHN STREET, NEW YORK. NEW YORK 10038 Date 5BPTENBER 2.1 , 1989 Application No.onfile 63681'189/89 N 092781. F THIS CERTIFIES THAT only the electrical equipment as described helots and introduced by the applicant named on the above application number in the premises of ROBERT CASTAL,D; , 85-25 NASSAU POINT RD. , (E—SIDE ON VATER, CUTIHOGUE, N.Y. in thefollowing location; ❑ Basement ® Ist Fl. ❑ 2nd Ff. .Section Block Lot aws examined on SF".PTEMBER 01 ,1 9R9 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT I OTHER T. K W. AMT. K.W AMT KW. qMT I K.W AMT. H.P, 1 6 2 A. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS I H P AMT. NO. A.W G AMT AMP MAT AMPS. TRANS. AMT H P N SYSTEMS O.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP TYPE METER I�,2W I%8W 3%]W 3 Jr 4W NO.OF CC.COND A W G NO.OF HIAEG A.W.G NO OF NEUTRALS A.W G EQUIP. PER% OF CC.COND OF HI LEG OF NEUTRAL OTHER APPARATUS: 50AMP HOOKUP FOR HOT 1109-1 G.F',C.T:--1 SMOKE DETECTOR:-1 TRACK LIGHTING:-4 moo-( GUSTAV BARTRA LZC #]529—E 227 E. BREAR'WATER ROAD GENERAL MANAGER HATTTTiff-K, NY, 11952 11. 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. 'l—"LD II:SPECTiUN JDATE li COaYMGNT \ -a H `.1 FOUNDATION ( 1st ) zq . FOUNDATION ( 2nd ) ROUGH FRAME & J -PLUMBING 7 f/ IIJSULATIOPI PER N . Y. Q' a E ENERGY y, CODE 4 . m _ y FINAL .2 ADDITIONAL COMMENTS : m x M \ x ro ;\ H x 9 y H � O o7 A _ y T `* Cl. N cm ro H lM-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINA�L REMARKS: DATE INSPECTOR 7%"-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: - 17" DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ;'-FRAMING FO DATION 2ND [ ] INSULATION r ] FINAL REMARKS: G1 ; Al DATE INSPECTOR /, WGN'2 v i niaud Iv + U 1 L.1 oun OUJ+ Ian yap.auJ SA,W,d, wuh Cuvnum apamo Gunw,,Aua-Ind+ndual o, Co,ponuo". r � CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY, 0• THIS UiDEMVRE, made the AV- day of v , nineteen hundred and Eighty-nine BETWEEN ARNOLD BLAIR and KAREN HUDSON BLAIR, his wife, " both residing at 301 East 47th Street, New York, New York xx party of the first part, and ROBERT CASTALDI and DIANNeCASTALDI, his wife, both residing at 100 Nottingham Road, Manhasset Hills, New York party of the second part, WITNESSETH, that the party of the first part, in consideration of TEN and no/100ths ($10. 00) ---------------------------------------------------' dollars, lawful money of the United States, and other gcpd and valuable consideration paid by the party of the second part, does hereby,g rant'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, DISTRICT lying and being huNtidc at Nassau Point, Town of Southold, County of Suffolk 1000 and State of New York, known and designated as Lot No. 67 on a certain amp entitled, "Map of Proposed Subdivision, Section B, Nassau Point SECTION • Club Properties, Inc. , situated at Nassau Point, Suffolk County, New 118 .00 York, made by Wallace H. Halsey, C.E. Southampton, New York, June 7, .L949" and filed in the Office of the Clerk of the County of Suffolk 3LOCK on October 4 , 1919 as Map No. 745 and as same lot on Amended Map "A" 04. 00 filed August 16, 1922, as Map No. 156 being more particularly bounded i and described as follows: LOT 012. 000 BEGINNING at a point on the easterly side of Nassau Point Road distant 603± feet southerly from ,the corner formed by the intersection of the easterly side of Nassau Point Road and the southerly side of Tuthill Road, said point of beginning being at a monument at the corner formed by the southwesterly side of Lot 66 and the northwesterly side of Lot 67 on the aforementioned map. RUNNING THENCE North 82 degrees 00 minutes 00 seconds East, 363. 67 feet to a tie line along the mean high water mark of Little Peconic Bay; RUNNING THENCE along said tie line South 3 degrees 44 minutes 00 second) East, 100 . 28 feet; RUNNING THENCE South 82 degrees 00 minutes 00 seconds West, 363. 34 feet to the easterly side of Nassau Point Road; RUNNING THENCE along the easterly side of Nassau Point Road North 3 degrees 55 minutes 10 seconds West, 100. 25 feet� to the point or place of BEGINNING. BEING AND INTENDED TO BE the same premises 'as conveyed to the party of the first part by deed dated August 27, 1987, and recorded in the Suffolk County Clerk' s Office September 1, 1987, in\ Liber 10407 CP 459. 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, TOCETHER with the appurtenances and all the estate and rights of the' party of the first part.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. i IN WfrNFSS WHEREOF,the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: . .•: " ' •' ARNOL BLAIR ' K YEN HUD ON BLAIR STATE OF NEW YORK, COUNTY OF AlC L' 7 0 •.f-,I SR: STATE OF NEW YORK. COUNTY OF sas 5f On the day of 19 Yi , before me On the day of 19, , before me personally came Arn Id Blair and personally came ' Karen Hudson Blair to me known to be the individuals described in and who to me known to be the individual described in and 'who executed the foregoing instrument, and acknowledged that executed the foregoing instrument, and acknowledged that they executed th same. executed the same. ' Notary Public WYRA FRANCESMM WTARY PUBLIC,Sib of Nw YErk No.244822446 OuaWW In*0 County Cwnmiesion EX0111111f1 r i f S9 D STATE OF NEW YORK, COUNTY OF SS: STATE OF NEW YORK. COUNTY OF ITS: On the I 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 foregoing instrument; that 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 was 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 h name thereto by like order. tion, and that he signed h name thereto by like order. j I Vargain ttnd £Kale Brrh SECTION WI III COVENANT AGAINST GRANIOR'S / Cis TITLE No. 5-994683—A BLOCK LOT ARNOLD BLAIR and COUNTY OR TOWN KAREN HUDSON BLAIR TO ROBERT CASTALDI and Recorded At Request of DIANE CASTALDI First American Title Insurance Company of New York I RETURN BY MAIL TO: STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS Dirhibuied by - Dominick A. DeRiso, Esq,- First Americali Title fltsaratice Company DORSEY, DeRISO & MODENA of New York 158-14 Northern Blvd. ' Flushing, NY 11358, y� cr Zip No. W V W 0 O � u 0 c 0 rc j 0 0 W N K 0 W V t G N _N S H I W 7 W W TUTHILL ROAD Q o LOT 66 O `° fd N. 8 2 0 00' Od' E. 363. 67' 's } I(� ` N r.0'S cnx. /&?C, /• _ �_ 1 Q Z o _ �P/o f 2 9 7 9 6 mon. a 0 1 m _ y' tv��Cts l9 M fnd. a N O ` 3 c LOT 67 �,• h"P ��� 99B a 3 } I) O ZD O � I ao �$ i �o o F lti tort vI 1 O .. c r 3 b ( ct•} Lu slv�is � Z 6 QI $ xa y o f- '�' F- fen SO E A N 305. 21' � ' SoS,• " mon ' }na S. 82000 OO W. 363. 34 ' LOT 68 Propo,ed in accardorce with the minimum Vondards for title surveys as eeabli,hPi b; CERTIFIED TO : the L.I.A.L.S. and approved and adoptea SURVEY OF PROPERTY let such use by The New York State Land ARNOLD B L A I R Title Association. LAND,& KAREN HUDSON BLAIR AT QN tN 9 TERRA MARE ASS TRACT, INC. NA SSA U POINT C�c�Z.�< SOUTHOLD SAVINGS BANK ' o 0 TOWN OF SOUTHOLD N.Y.S. LIC. NO. 49668 SUFFOLK COUNTY , N . Y . f IC v VEYORS 8 ENGINEERS , P. C. 1000 - 11 8 - 0 4 - 12 �,/5020 SCALE 1 40� LOT NUMBERS REFER TO "AMENDED P. O . OX 909 MAP 'A' OF NASSAU POINT"FILED MAY 11 , 1987 MAIN ROA D AUG. 16, 1922 IN THE OFFICE OFTHE APRIL 26, 1989(revise) SOUTHOLD N.Y. 11971 REVISION AUG. 13, 1987 SUFFOLK COUNTY CLERK AS MAP NO.I56 R7 I � � � i � I � EYpE QF colJs�'�2u�•lloty AS GXtS (I�1C� fz x4 " st� asi SIZ.C- APROK 7'12' ?CI0e !"' r i s' ✓ , S j �X t 51t�+ V709`/3' RPAXtIW HT E S 4 ! k t { 4-A / I FRAME JLJ WALL T� LZ MATC. C-;v1 Sir I+,t srkvcT��� 10 $sI-AL.I lUetJ eeDftJ'(,,`OW, LL WflV 2 RdUG 11. N9.1 UL�Tt( M ST' Pl E C.O- WN ' E RJC7 ONI g M, ET T ( Sl ITE CC NS pUjN � F yl I S .�.. SP i I 1 i EfGii I i I l f j I I i I t j IE , Ro6E�t c-A5'fALDt BOARD OF HEALTH . . . . . . . . . . . . 3 SETS OF PLANS . . . . . . . . . . . . FORM NO. t SURVEY . . . . . . . . . . . . . . . . . . . . . TOWN OFSOUTHOLD CHECK . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . . . . TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY /� TEL.: 765-1802 CALL �K CO.97-0 Examined . . . . . . . .. 1907 pp /� MAIL T 0 : Approved . . .� . . . . ., 19 fi Pc I'm it No�U.��7�?. . Disapproveda/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D w� (Bu' ing Intor) APPLICATION FOR BUILDING PERMIT Date . . . . . . . ..1. . . . . .. 19 .71 i INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 tsets 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 r demolition, as herein described. The applicant agrees to comply with all applicaCtte laws• ordinances, building code, h sink code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of a or name, if a corporation) log N51 n N.4 !+g . . .?P: . N 4'.N YR�. ?9 ecK . !�Y•. I10+�0 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. S�!y HE}? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . RgBERC . , ,DiAn/�1E LAS'TA� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . ... . . . . . I . . . . . . . . . Electrician's License No. . . . . .-. . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . .g S,� 5 H ASSAU Poi t4 I P O A D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(,UTE'iqe9 c-5U,9- 1{ouse Number Street Hamlet County Tax Map No. 1000 Section . . . . 1.$.' °0. . . . . . . Block . . . . 4 , o_a , , • , , , , Lot . . . .0.i.-2, 00 0 Subdivision . . . . . . . . . . Filed Map No. . .7. r. . . . . . . Lot . . . . �? 7 (Name) . . . . . . . . . State existing use and anc of occupancy remises and intended use and Occupancy p Y P of proposed construction: a. Existing use and occupancy . . . . • S I hlC1t E FAMi t puJ�( C t µy b. Intended use and occupancy . . . . S�ht . . PAwIt�Y. DwE4ei ryG 3• Nature of wort. (check w•hichll',applicable): New Building ✓ l " " Addition . . . . . . . . . . .Utcration . . . . . . . . . e�ova . • • • • • • • • • . . . . Demolition . . . . . . . . . . Other 1Vork . . . . . . . . . . . . . . 4. Estimated Cost . . . . . . . . . i 1l' . . . . . . , n� v (Description) r Fee . . . t . . . S. If dwelling, number of dwellin / (to be paid on filing this application) . , • g units . . . . . . . . . . . . . . . Number of dwelling units oil each floor. . , . , If gars^c, number of cars . . . . . . . . 6. If business, commercial or mi ed occupancy, p P Y, s ccify nature and extent of each type of use . . . .^ 7. Dimensions of existing structures, if any: Front , , ,36 Height . 1;% . . . . . . ... Nu,mberof Stories . ,';�. • � . Rear . ... .'$6.r. . . . . . . Depth . .��{ Dime sio same 4 turc,With alterations or 'dditions: Front .3�. Dq hI �.> . . ' Height . . . . .j. 1?;' . . . . . . . . . . Rear . . . 3b.: . . . . . . . . . . . 8. Di- en o s of entire new cptistrhiction: Front , 7'/�: ' ' ' ' Number of Stories . . . . .!. . . . H �ht _ �. . Rear . . .7. �L . . . . . . . Depth . . {0 ii ut ber of Stories . • • • • • • • 9. Si e DG Idi'.t `) . , , � x• . . . . Rear . 6:�i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . ?'I?NG bf e Name of Forme Depth . . .3.. . . , , of 11. Zone or use district in which premises are situated . . . . . , , r Owner A,RM6! D tAiq . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Does proposed construction violate any zoning law, ordinance or regulation: . . NC. . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will p �n • ' • • • • • • • . , . • . . . . Will excess fill be removed from premises: Yes✓ No 14. Nameoof Architect ot be f remises • * ** , ,*STq fir,; Address . !49 Ntlrlt 514AK .IZA . . Phone No.6l6),'l37A3 ,( Name of Architect • , , . . , . Address . • • • • • • • • • Phone No. . . . . . . . . . . . . . Name of Contractor . 15 .Is this property located within Address . . . , . • Phone 300 feet of a tidal wetland? *YESYES. �.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 dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . . . S.S �. . (Name of individual sigpniit• A ' ' ' . ' ' ' • • • being duly sworn, deposes and says that he is the applicant o contract) above named. l 4 Ile is the . . . . . . . . . . . . p t.l (.As I (Contractor, agent, corporate officer, etc.) " " " ' ' 'if said owner or Owners, an is duly Iiauthorized to perform or have performed the said work and to make and Cile this PPlication; that all statement contained in this application are true to the best of his knowledge and belief;and that the 'York will be performed in the m ner act forth in the application filed therewith. "vOm to before me this • . . . . . . . . . . . . . . . . .� . . .dayof. ' . . . . . . . . . . . . . . .. , 19E. ;Otary Public, • . . County FLORA CA'srA�DI Notary Public, St1tP'IH WwYork_. , , • • • • • . • • • • • • • - No. 41-4855D59 • . . . . . Qualified in Qucohs County (Signature of applicant) Commission Ex pires'liuno 23, 191F