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Home My WebLink About17750-z,. , FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 19284 Date AUGUST 9, 1990 THIS CERTIFIES that the building NEW DWELLING Location of 1310 2545 House No. County Tax Map No. 1000 Section 15 Block 5 Lot 24.2 Subdivision ORIENT-BY-THE-SEA Filed Map No. 6160 Lot No. 153 conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 13, 1988 pursuant to which Building Permit No. 17750 Z dated JANUARY 9, 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 isONE FAMILY DWELLING W/ATTACHED GARAGE, PORCH & 2ND STORY DECK. The certificate is issued to FRANK & DIANE CONNOLLY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88 SO 170 - FEB. 27, 1990 UNDERWRITERS CERTIFICATE NO. N 138848 - JULY 3, 1990 PLUMBERS CERTIFICATION DATED AUGUST 7, 1990 - K & K PLUMBING & HEATING CORRECTION TO ADDRESS 9/14/90 ~~ _~'L ~' B lding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 19284 Date AUGUST 9, 1990 THIS CERTIFIES that the building NEW DWELLING 1310 RYIlER FARM LANE Location of Property2545 PLUM ISLAND ROAD ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 5 Lot 24.2 Subdivision ORIENT-BY-THE-SEA Filed Map No. 6160 Lot No. 153 conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 13, 1988 pursuant to which Building Permit No. 17750 Z dated JANUARY 9, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. T'he occupancy for which this certificate is issued isONE FAMILY DWELLING W/ATTACHED GARAGE, PORCH ~ 2ND STORY DECK. The certificate is issued to FRANK & DIANE CONNOLLY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88 SO 170 - FEB. 27, 1990 CERTIFICATE N0. N 138845 - JULY 3, 1990 PLUMBERS CERTIFICATION DATED AUGUST 7, 1990 - K & K PLUMBING & HEATING B ilding Inspector Rev. 1f81 Fosas xo. s TOWN OF SOUTHALD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o 017 7 5 0 Z Date ...~.a~-tea...... `~ .::............... 19.E `~ Permission is hereby granted to: ................................................................................ ~~ V~....~ ~ .............................~............................................................ ...g... . ct premises located at ..~.~/.~..~9~~4I.'.'!n.Y.~.`~f.`E:S' I .~k? i~.d.. o1Zc.anld~- . .... .... .... ...... ......' . - ...~.. ... ... . I ...... . .. / . . ~ ... .... .... .................. ... . .. .... .. .. .. .. . . .. .. .. .. ..... ... . . .... ........ .... ... . ... ........ . County Tax Map No. 1000 Section : ........................ Block ...................... Lot No......................... pursuant to application dated .....!..,.~~.5~!^~'`.s-~r.....~.~........., 19.~.~, and approved by the Building Inspector. Fee S. ~~.~:..7.v..... Bu ing Inspector Rev. 6/30/80 ~%.. ~ TOWN OF BUILDING TOWN • SOUTIIOLD 765 SOUTIIOLU DEPARTMCNT HALL NEW YORK 11971 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE `!:~~:.~~.U/~ G_ . . NEW CONSTRUCTION ... \ ./.OLD OR PRE-E~j%ISTING I3U~I n~N/~~.~... VACANT LAND... _ .... Location of Property.. .l '.'~.~ U,. _ ;~~'\.~~5~,.~.Q~,z~X~g(!:~~_...~~~ ~2,-:.~ _ ........ UOUSE NO_ STRRET nHAMLET Owner or Owners of Property..~/.~:~~.~.~~~r~v.~---_~~.~-C~y__._.__.._..• County Taa Map N`o'. 10"00 Section Is. ... Block .,~5,,..,. Lot ..~ 111r !r! Subdivision .l,? 1~~~ . Filed Map lp I (o G .Lot.. S. ,~Z..7-. Permit No. .~,~,/SQZDate of Permit .l/~~~'~„Applicant\,~5~'~~. Uea1Ch Dept. Approval ,~~.,_.,.,, Underwriters Approval':`: .'~____ ... Planning Board Approval ..~;, Request for Temporary Certificate ...... ~ ~~~~//~%- "" . Final Certificate ...._;f.,,._,..._ Pee Submitted: $.,,~;5; W,._...._. ~~ ~:i APPLICANT.~~~-~:::=:~. ................ co ~. 19a~9 ~~" ~IO~Sy reV• 10/14/88 L~ .- l FORM N0. 6 TOWN OF SOUTHOLD BDILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be~'ifiled 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 ~latural or topographic features. 2. Final approval of Dealth Dept, of eater supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying [hat solder used in system contains less ' than 2/10 of 1Z Iead.' 5. Commercial buildings,l~industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the ArchitecC or Engineer responsible for the building. ' 6. Submit Planning Board'~Approval of completed site plan requirements. B. For existing buildings (Frior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of prgperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed bq the applicant and a certified abstract of title issued by a Citle company 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 vc±iting to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information'irequired to prepare a certificate. C. For Vacant Land Certificaite 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 of~ithe entire lot prior to April 9, 1957 shall also accompany the application. If a, Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCCIITPANCY - 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 CertificaCe of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. IIpda[ed Certificate of Occupancy - $50.00 6. Temporary CertificaCe of Occupancy - $25.00 Residential $50.00 Commercial rev. 10/14/88 ~~FF~LS'c~ z ,~ ~~, ~ 1.1~ : ~, ~`.' 3-~, ~0 ~_.~i~ ~~~1 ~. ~~,~'" TORN OIL' SO~JTF30b.D OFFICE OF BUILDI2•IG INSPECTOR P.O. BOX 728 TOWN HALL SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N Date O \ 1`~~ Building Permit No. 1 ~ ~r~ ~'>~-~ Owner_~ C~~'l(1Q~~ (please print) Plu^:er \/. '~ \~. ~` \vt't~\~~~o~ C7.n~ ~c~~~~~il'°F=~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) Swo ~~ .. ~d 19 ~U , tto to r ..o before me this ay of /,(i ,• public, Count TEL. 7G5-1802 e N1MRt~M*~~~~ 1MIt ~~ ~~Ffa~kc ono , ' °°~ ~ :`" ti' , z r ~oyol ~ ra~~ TOWN . OI' SOUTIIOLD OrrICE OI' BUILDING INSPECTOR P.O. BOX 728 TOWN 1[ALL SOUTfiOLp, N.Y. 1 1971 AUGUST 3, 1990 CHESTER ORLOWSKI PEQUASH AVENUE CUTCHOGUE, N.Y. 11935 RE: CONNOLLY TEL. 7G5-1802 To PJhom 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 Underw riters Certificate on file. / ,/ Tfic check is(outdated/not on file.) /, ( No [Icalth Dept. T•.pproval on file. / _/ No Linal inspection has been made. Please contact our office on this matter. Thank you far your cooperation. Building Permit i( 1 7 7 5 0 Z Building Dept. ***/-~No Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after April 1,19£34 )(ENCLOSED) 1 ~, i ~~ Ka~ ,.n h .. _ .. d: 4' . i. iw Receipt NO. -r Q 2 ~ n TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Southold, New York 11971 n Date ....s~..~(~'.~~.C .................. R--e{--ceived of .l..~e...,L.:R.J.~,,:~....!:c'4:\t~:.~~L~,.......~:~1.4:~.(?:b~?: Z.~ ........................................ ./.45.,<,u?:~~C~J....~..ta.r.A:.:t~~x~ln4!? ..:......................................................................... ollnrs For ..L.4~:~.. ~.~ ~~.`:~..__.-~a.~.. ~3f.'... ~. ~. ~..~.~1.~........~:...C.ca-r.~,~ r~:-~.~'~:~ ........................................ Fee for ~~ Fee for Fee for O Fee for Yard Sale rtificate ^ ^ ^ ^ H.I.C. ^ Building Permit of Occupancy ^ Misc. ^ Cash ~Check~79Y ~f Building Department ~~~ ~~~~ ~ ~ ~~~ ice- ~ ~~.z~~~ ~ ~~ . ~ ~ ~~~. ~.~. ,~ °~ ~~ ~~" ~- P-~~- ~~-~~~ ~ ~ ~~ ;I;:~'cCi~iU.7 ~ r'1 LD ~DAT;; ~ COMMGNT° '" ,, ro cn 1. ~ ~ a y H C .j FOUNDATION (1st) ., ~ _ c . cn t FOUNDATION (2nd) - m t - 2 .Z7 . .ZXip4 z '~ O ~ ROUGH FRAME O PLUMBING 5 ( ~ N H 3. ~ < ~ ~` IIJSULATIOPI PER N. Y. H STATE ENERGY 'r'te /~ ODE `~ "~ C ~ d -.-~ y t 4. FIiJAL z ADDITIONAL C MENTS: x , J ~~ _ ~ ' '~ _ ~~ x ro H ~ ~ 9 .a y C H O Z 1 ' ~ a r~ ~ a • r .~ u m o d m T - '+ u H C { t w'.F ~{ , yx, Y... ~- ~r,~ «y 0 ~. .....~r'm. w~.. , A='+ ~.«... v-a..+.YM~'Mw. 'R tr~,'u? to iF y 1 L~ ~' ,~ ~..a..a.....~,~,..L.. ~~W~~.~.."`..o..~+..v.w,~..,,..,._,~ ~ ^~2 ( a ,i ~ _ ~ 3i~ ~ J ., ~ ~ .. ~ 7 ., f ~ ~ ~, m ~ ~~ ,. • ~~: " ' ~' ~ ' ', Zb~~f~ ~ ~ ~ ~' tii ~n K i 1 " r 1 i 1 ~ r ~, ri ~ w L M ~_ ~ ~~ "; £i t ~ ~~ ~ ~.w ~.~ ~, w _' O K ti; .. u ~~ '; ~, ~ ~p.t ~ 'l, y m ~P'wy:Y~ K Z ~,.'.:p~;,., ; ,cam' "' ,, s `wJ,~'-'' s i- .~ `y ~ ~ `sG9`FYOR} +~~ao~ a ~ ~~,+„"G~~~~,,~ -{~~ ~,~~~~,~~~^'~~ ~a3 Sid ~ ~ k F < ro y y ~ ~ ~~ s ~~ ~ ~ ~ _oy~~ a , ~ _ ~" • L~~ y A M R }? ~ Q d r ~ i :t h'`'`; Q ^x j~-d rY3~- ~ ~ d}b'~ i~ Syy~ ,-gc~ i '~a'~Ae~ ~~M1 tik 5 ~ ~'{' . F ~ yyw ~ 5 ~ z 3 a . Q '" ~ N. 9` ~ j}y .CS s~ ~yry l~'td a on> rprp~Qr~ nnR ~~'x ~~ ~4w ~ ~'rx~ ~a~j~,' ~c m S A '`~~S~s~ 14Y~ v 4 ~ " a ~ A ~ ~ o ~dy ~,, ~~ L ~ ~ a ~ a 5~i • n! b l N ~ y Y7 C L {4y'ti' Z; l6 ` j 9 I. p~ r'y~nyc ~~ ~°~ ~" a ~' d..~ , ~~~;SM ~i+.5~3~ f frQ9 d `t ~ ~ ~ @,fi~ IP.J y~,~1 d~$,d 2 n Y.Iwt Ya Si 1 ~-~ 0 q m ~iwe . VV ~~ ~. i, . Z {~ C~ Q ~ ~ r '~ r~ G~ ~~ft[~tt y5v ~. q~~ {' ~~ ~ 4: ~~m~ N("' (~ ~ ~~ a p ~ ~ t{m `~ ~, ~„ f C ~ ~ ~. tt '~! n m p u` q .~ ~. ~~~ a -^ll _ .. _ .+~ u ~~, 3. '~~ ~ 7'65.18U2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [~ FOUNDATION 2ND [ ]FRAMING ( ] ROUGH PLBG. [ ]] 1NSt~T10N [v~FI/NAL REMARKS: DATE t7 INSPECTOR ~~~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [[ __ f/ DATE l a0 INSPECTOR [ ]FOUNDATION 2ND [ ] iN ULATION [ ]FRAMING [ FINAL / ~ `7 ~~ T65-1802 G / BUILD{NG DEPT. INSPECTION [ ]FOUNDATION 15T f ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] {NSULATION [ ]FRAMING [ {NAL DATE ~ O INSPECTOR ~ 177' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~-~'^',u~ u~;7 6~I /~ DATE ~ INSPECTOR /~` r~ (77i~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSl1LAT10N DATE .~ ~~ INSPECTOR /•-~ [ ] FRAMIN(a [ ]FINAL ~~ 765-1802 BUILDING DEPT. INSPECTION [ ] F UNDATION iST ( ) ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ )FINAL REMARKS: DATE l 7 ~ INSPECTOR 7G5-1802 BUILDING DEPT. INSPECTION [ `j FOUNDATION 1ST [ ]ROUGH PLBG. (] FOUNDATION 2ND (]INSULATION [ ]FRAMING [ ]FINAL DATE 3 INSPECTOR ~ ~s~-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. DATE ~ c~-~ ~ INSPECTOR .J~l ~~v,~,~ [)FOUNDATION 2ND [ ]INSULATION [~RAMING [ ] -FINAL :t~>~TTDT>maa~>aTT~a~> ~' THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ L ~4!Tl ~~ ~~ BUREAU OP ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 70038 ~~~hc;°; Dare ~1UI~Y' (jam,"S. ~I9t1 APPliration No. on file F~(1 ~~f~:f q}S'~1ii'~ ~l .f,t l"i~4.$ THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 1?RAhiK fiC~NS~Jt~1,LY, Pf.~t:frt( '('St:A1VU 4,~RIE, CSTtI~.N'K', N,''t. in thefollowinq location, ~ Basement ® ].at F'l. ^ 2nd Fl. ra~)`t1'~~f ~'r't~,t~j~ Sertion Block Lot r~3 una examined on ~%f1f+P'~ S 4 , ~ ~"')f) acrd found to be in complianre with the reyuirerrtenLa q/'this Board. FIXTURE OUTLETS EGEPTAGLES SWITCHES I FIXTURES NCANDESCENT FWORESCENi OTHER RANGES PMT K W. COOKING DECKS AMi. N W. OVENS AMi KW DISH W AMi ASHERS K W EXHAUST FANS PMT. H P ~YJ ~ti f/~ ~Ki t, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'-T TIME CLOCKS RELL UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll H. P GAS H. P. AMi NO. A. W G AMi AMP PMi AMPS. TRANS. AMi H P SYSTEMS NO.OF FEET AMi WATTS q~. 7 7 'l.2. 1. €t3fi SERVICE DISCONNECT NO.OF 5 E R V I C E AMT AMP, TYPE METER EQUIP. L ~, ]W ~ ~ 3W 3.9 3W 3,6' 4W NO. OF CC CONO PER % A. W G OF CC. COND NO OF HbLEG A W C' ~ OF HbLEG NO Of NFUTRAIa A. W. G. OF NEUTRAL OTHER APPARATUS: c7,r•.r,.T:-a <=ta~?t<F .r~F~r~~h.~r=srf+: sr;t~ta.re,zN<;~;r~ ~;f.,rsi°~•f+~.t~ f,~:c.~36~~2~-r ~ &~ I NTiY LANE Ni)R'P}tptait`f, N'V', 1'!.']6$ This certificate must not be altered in any manner; return to the office of the Board if incorrect. GENERAL MANAGER/~ ~~ V Per Tay be identified by their credentials. I I ~' COPY FOR BUILDING DEPARTMENT. THIS 60PY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. .'. j p ~ ~ ~u" L~ IJ~~U1._..~ i ~~ ~ i FORM NO. 1 llnL~i ~(} ~? ~,~ ~~~~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT BLDG. D~F~L + TOWN HALL TOWN OPSr3ur,i0u?- . - ~ SOUTHOLD, N.Y. 11971 - q TEL.:765-1802 / W~-1 ... Examined ~~+:~-t l . , 19 ~'~ Approved `~[i.waeaf~6 .~ ..., 1949. Permit No..~. X7.7 S,?~ ;'~ BOARD 3 SETS SURVEY CHECK SEPTIC NOTIFY CALL MAIL DisaPProveda/c ..................................... .................................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS OF HEALTH ......,,,, OF•PLANS'::::::::::. FORM ............... T0: ............... ~~oK i Date ~ ` ~ .............. l~~- a. Tltis 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. Ptot glare shoving location of lot and of buildings on premises, relationship to adjoining premises or public streets 0 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 i to s.,.~ (Sig re of applicant, or ream)) e, if a corporatton) ' (Mailing ddress of applicant) State whether~appli~cant~ is~owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. //~~ //7~ .... Name of owner of premises .j.,!>„0.,:~.,ys,. ~L~ ~t~!H.f+- ~~~r;,~ .................................. . (as on the tax roll r 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 . ....................... . Electrician's License No . ..................... . Otter Trade's License No . ..................... /~~~(~y ], Lo~catior-Lo and on which proposed work will be done . ............... . ................... . y 6~C.. )>t Y- ~ ............ . House Number i Streets ~„ Hamlet County Tax tap No. 1000 Section..... Black ....~ , , , , , , , , , , , Lot .. >" Subdivision~.1,.~U1.. ....~• ~• • • • • • • • .. Filed slap No. ,So, ~_`,~j ..... Lot ..~.SJ.~...... (Name) ~' -. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... `~ b. Intended use and occupancy •~~~IP'1a.~.XG' . C`~' ........./1,~1~'v~d ~~// ........... . ~-t.-t, 3. Nature of work (check which applicable): New Building • • •'• ?..... Addition .......... Alteration ........ . Repair .............. Rcnloval .............. Demolition .............. ~\~o............ . 4. Estimated Cost ...... ,~ ~ ~,..p'Y'V ................... Fee ..................................... . (to be paid on filing this application) 5. If dwelling, nurnber of dwcllin units .....L .... , ... Number of dwcllin units on each floor , / , , If garage, number of cars .~1.~-y :.............................. g • ~ ~ • ~ • • ~ ~ ' 6. If business, comrnerciat or mixed occupancy, specify nature and extent of each type of use ,,,, , , , , , , , , , , , • .. • . • 7. Dimensions of existing structur~,es, if any: Front . ........... Rear ............. . Depth . Height ............... Number of Stories ....... ~ ~ • • • """ "' Dimensions of same structure rth alterations or additions: Front Rear . Depth .................. ~ .. Ilcight ....... ............Number of Stories ... ................ . 8, Dimensions of en ~re new constntction: Front , , 2....... Rear ..(,~. ;2r:........ Depth .,~,~ ;~ Height .. ,~, ~ , , , , , Nuritbcr of Stories ...~ .~. , ' ' ~ ' ' ' ' ' .... 9. Size of lot: Front ....a',~.~,-d.l. .......... Rear ..... ~•: ~.I ............. epth /. rS; .b,~;G 2 ~. • ...... ]0. Date of Purchase .. . P p ~ ! ~S ... .. 12. Does ro osed constructionn vio ~ ~ ' ' 'Name of Po cr Owner '~7~P/tal:e~r:. , , , , ,.. 1 1, Zone or use district in which ~emises are situated .. ~,~„p„~ h / ' ~ ' ~ ' ' ................................ late any zoning law, ordinance or regulation: ./.s,!^ .' ............... . 13. Will lot be regraded ... ' ' ' ' ' ' • • • • • • • • ...... -.. , . 1Vi11 excess ill be removed from premises: Yes 14. Name of Owner of pre ses q', ~1 wit. / a Address ~'/, . ; k •, . , . , :Phone No ............... . Name of Architect ... ~ 4~~ ..Address . .. .d .... Phone No ............... . Name of Contractor .. ..Address Phone No.~ ~ ~ p; Z,,, , E~~+.Q.+w.~.~..'• .. . 15.Is this property looted within 300 -'feet of a tid$1 wetland? *YES.. N *If yes, Southold Tow{i Trustees Permit may be required. . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block'. number or description according to deed, and show street names and indicate whether interior or corner lot. I STATE OF NEW YORK, ~S.S UNTY ~~ ~~~~ ~ ~~~. Q/~ (N~ dividua~".lu,."".." 'r'''*'.` ............. being duly sworn, deposes and says that he is the applicant r +Ilg COn[I1Ct) above named. ~~~ ~~'' He }s the ...~:N`"`,'ora' r........ ~!, .. .............~1.................. ... .......................... . (Contractor, agenf;~corporatc officer, etc.) of ;aid owner or owners, and is dull authorized to perform or~have performed the said work and to make and Gle this application; [hat all statements cont~incd in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application Glcd therewith. Sworn to before me this ! ... • ........... ~JO. ...day of!~..... h/. P:ccr.... , ..... 19 Notary Public, ..... •b~-Y.Ga~t , ,9.'(~.-. (ll,C-.r!c~:~-:..... County I HELEN K Oki YOE ~.,,~~Y'~~~~~. . NOTARY PUOtIC, StatB of New York ' ' ' ' ' ' ' ' ' ' ' ' No.R7078"lR,$uryolkCounty~q ~ (Signature of applicant) Term Expires Mareh~30,18..:4../ ~~' ~~'~t~J ~ ~ ~ '"~_ r ~ i , _ ~ ~ F .. _ ~ ~ _. ~ a i j ~ 3 r N ~~~~~ ' ~_ , ~ f l& 3^ ~ ~~ e j ~ " ~ { ~ ~~ .~ ~ ~ ~~ r n ~`,:.....€ i Mme' a ~ ~ ~ `- ~ - ~ ~ JL+k . ~ T +{ "J..-L .'py'ifnn.rr •.4..a ~~.n-~... ..,...i...nN..w. ......._ ....tA .~.y.'._ ~.~` ~~ ~ ~ J( ) ~ 'r .. ~ ~- ~ ,. . i J ~ _ { . h y , ^'ry",I~~~'~. ~ ~ ~~ ~ ~ ~ ~Q .,, ., ~ ~r ~ ,.,. r ~s ' ~ - ~' ~ ! -~ ..~,, .. , ~~ - ~~' - ,t ~, .~ . "neC ~' - ~y r F^ ,t ~~ ' a ~ i ~ 1~ t ~ _ ~' . t j! s i. i 1i ~~ ~ LH(]Y ~~ ~ ~~. . _~-bK+~m. ,y~^a.'-- _ ,. _ } -~ f+'~ ~ fir, "` a, . f ..~ ~ ~ 1 ~ - ~ - ' ~ x, a ' t '3'~. t r 4 3.. C Yyf f i~ try .. ~i ~, r +, _ ~. ~ t _ ~It~~fLM k~C3~1M'TY ['rP~h-t`~t'Pv'r ~P• ;IEAI_~;; ,~;, ~..~"S . ~ ,~. i -„~r.l, b. a. ~ ,~t~J6iE`~AMIL'f UrJFiU,~dG pNLY {' ~ f, L~?~~~~~Qs. REF. +~o. ~ s o,_(. ~; ~, Fhb s~x~ 4iSpD~,jt ~rd•Water tocatidn have been inspebted S++PWY tacikt;;s fw Phis ~ ;° a nd fo by tAis Uc~+a: taient,znQ/ot . 20 dsf '~ ~ ~ ~ CAr~ Flur~a'!~~ofNlastewater Managemerk. r t ~ f// a ,~ '~ ~ ~ `~ t, ~ ~ ~~ - r ti 5 ° ~ ~ ~ , . ~ 3"K7 n 'i, n> _~ r x1'...1 .- ~ s x f y#.` ~ ~ - , ~~g ~ ,.. ~ - ~ ~~ ~ - £i,~e - Y ~ ~' ~ ~~.,. ...,_.. ;~ .~ ~ ~ ~ ~,' ~+'~ ~.'~~ ~' ~ c ~,~ . ~. ~ ~ ~ . fir. '~ ':~; ~~`~~= ~ , k~ ~ ~ ~ ~ m ,~ 3 ~. ~ . O ~~ ' ~ '~. ~' r ~` . 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[2~ o ~ L"l f J t ~ ~• ~ ~ 'A m ri•$ Y O rt ~ ~ y ~ i'*""" V. ~ ~ ~ ~ ~ ~ ^'I 1i +lN '~c~ r y ~d a ;'$ N ~ 9 u ~°' ~'~~f ~ b ~ ~ (~ ~"\'?L 1~~~~L~~ ~~v~ xkr av! iy ~ ~ ~~ ~ t ~a 4 ~~ . a a~ r r n -~ r ~.. ~-~ _ ~~ ~ , ~.. y r~ bi ~ ~ 'v+ r ,~ 51~ ~~ ~~) i 4 t y ~~ ~ a 1 ~ :,..5 .. ~ ~ " 1 p ~~i' L ~# ?, r__.._ ..~..._~_-1l - OC21L-'~19'-Plr°.1.HE. :iiE'f~~ SEC: C. G - 5Urh U).MAP M1.U.:I'ab-1,t -- ~ ~ ~ I~ 'I (~' 4 1 ___ _____. _. ,._.-~I ~,., ]7L dr Gi i LS I ._ F- ~--;117 "f ~ U f_:- '~ ---Eros ~-"1 ~`.7AF7r~ WELL) ' •. ~''~ " 'POOL -i ~~ 3AN1L 1 ~, (RE:5IGENCEj 1 I -I q,t ~~ LDT 1[71 1 Liy f06 ( 1 ,~• _.__ i ~. ~ ~~'~ x, ~s, ~~ ~~ A; ~I s; 4; u: I ~~~! (ail ix~ titi~ I,~ ~ff~(~f4ia i -- i AT ... - .__ l' 11 I~WI,~ i7P'~ULJ 1'i-It:7L C; NY V~p7 y.1,~3, LaT rW ~~ `' 50 . ' 9 ~~ tgb•Q~~ , a , !LUf~i (:,lA -' IV.8E126 E. 68.2,E --'"~! e----- - -+~~ V ~ ~M. 6l7 ~p 1 e~ ~~ f Le. `9 wV,, ~ ,; ~ j ' q^, v ~ i . 3~~,,~ 1yy ~'~ --74~ - - r- N - - ---- 74- - - - 2-bT K. ~ PR.IfouEE Il N ~!K SoNST~ r ~~~ TANK Po o t. 115/ I - S;iI~ ~ 25 ~~/. i'! A~I /Ell. ~(` SUFFOLK CO. HEALTH DEPT. APPROVAL H. S. NO._SS-So'~110 r ;. I' ~l o k ~ o , ~ ~- v)1 j -' x ,_ ~,' ~- H 3a3 ' i ~~ ~ n) 6 ~ r O ~ d ~ ~~ ~~ ~ N0. ~ , t ~ ' y e3" ~ c . C'o V ~ r _ 7ANIL ~ v M! ' i' .= I J r3 ' t ~ _' 1 ~E e_~CO:iL i I o ~' i ' eA~s 1 ~ t _,~ ~ _ . STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF 7HE SUFFOLIS..,CO DEPT. OF HEALTH SERVICES. APPLICANT n -ra„ ~ ~, c, o,.. ~ SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -FOR APPROVAL OF', CONSTRUCT~IO" N~ ONLY DATE: 2LLf Q° H. S. REF. NO.: 88- 50 - (70 APPROVED: I ~--~-~°"""'~+~.1 ~ " L' U' I SCAI ~ SUFFOLK CO, TAX MAP DESIGNATION: T .' _ J DIST. SECT. BLOCK PCL. ~ AF~~+.4O82U ~_G ~ ICNJO '1 ~: '; '::;.?. ~ ~ ~: NI Qf~ECJI"t L:_C~I i OWNERS ADDRESS: 1 01 yg - NDTE : " ~ LO7" NU~S.`._F+cOL~IN 7HL1a~(I>3 ~ RErF,~' Tt7 "MA,P OF ' - ------ z2 - g~i~LETic~:,c~I~=J~~5~~~.s;>:rLrar~lrHES~r"F: " PQ6L. ~'; " AMENDEO_MAY 26,(984_ TAN-rcy, > ~_~ ~~_ l _ 4IO, As ~rn(~~e~ . oec.2~a RCpER ICK VAN TUY4, P.C. _SNELL ~ lC :~ /r..... I • LICENSED LAND SU EVORS GREENPORT NEW YORK I DEED: L. LI/A. P. - ~~ ~ ms ni3N~ ralx Stem n,.~..~.r Lm~ - -,: finis s~rvev man not wannq ~N s=al n - ai ,~mn nm be ennaltlared e rt. .. ~Gyl~~rtua onPY. .- intltrfl iFel' nsFGI IV II o ^ er. n \~ ~(~. i~ n his lh.n nli ~a rho r~l ~ »~ornm.~,nnl n~ancy ena - - lZ ~~e ~n emna na-.o aim .;~.n a ln.r. nna inneln „ ~~;in - - m trnnslaraM1la ~, .i n~nl nsnhR0n5 Ot eYSfi9gJlAi I~ ~ a cu Ut ~~~ SEAL ~ 1 %F nl` L . r ~ ti\~a rr \ F ^ 1 ri / l t -~ \ ! ~/ i- ~%FOVNf 109 NEiI]0