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HomeMy WebLinkAbout18296-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT pffice of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218864 Date MARCH 8, 1990 THIS CERTIFIES that the building INGROUND POOL Location of Property 1000 BRIDGE LANE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 001 Lot 016 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 7, 1989 pursuant to which Building Permit No. 182962 dated JULY 12, 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 ACCESSORY DECK, INGROUND POOL WITH FENCE. AMENDED TO INCLUDE POOL HOUSE. The certificate is issued to JOHN & ALICE FIFE (owner, xxxxxxxxxxxxxxxx) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N109810 1/8/90 PLUMBERS CERTIFICATION DATED MATTITUCK PLUMBING 12/21j89 uil ing Inspector Rev. 1/$1 1 rosai No. s TOWN OP SOUTHOLD BUILDING DEPARTMCNT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) p') r N° ~vG~~7 Z Date .....~Ll..~`.~ 19..0,/ Permission is hereby granted to' 8......... /~1. y..//..:........1.193..... ro 4.-".~~!%.'~G,~.r'~u X11•....... ~.~..Q.~{,6~!~/G~~2f%~f~`~:1. of premises ocl ated at ...~Od~...... ,c~,/~ County Tox Map No. 1000 Section Block ..............1...... Lot No.......... ~:6 pursuant to application doted~/ ..~a.~ 19g.~.., and approved by the Building Inspector. d Fee ......Q~J°-L.....qqr....... wL? / Bt~Bin I tar Rev. 6/30/80 ~_r TOWN OF SOUTHOLU BUILDING DEPART2fENT ~ - TONN HALL ~ ~ ! ea ~7~-~~~~. SOUTHOLD, NEW YORK 11971 ` ~~~f ~ ?s ' 765 - 1802 2y ~ ~ ~ ~ { ~ ~ ~ } ~1~t5~.~g~:c~:ci~Pr: r..a~~-~~ 70V+fN OF aOUTHOI.D ~ APPLICATION FOR CERTIFICATE OF OCCIIPANCY ~._,.~.--o~~>~«~----------~~ DATEDec..2or19Q~3..... NEI7 CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING......VACANT LAND..._._.. Location of Property. 1000 Bride: Lrune_.Ctz~cho~ue____________________________ HOUSE NO_ STREET HAMLET Owner or Owners of Property. John Pc_ 1.1S.Ce.k'i~'©_______________________________ County Taa Map No. 1000 Section Block ..l_... Lot"..~.~J..... Subdivision aded Map S of Sec $ p 7P9 ,Lot.209r210_. Idr~S53t1:1~o~rif;'"•.• Filed Ma Pewit No .],~2 .~}Ea .7r .Date of PermiC 7~,~,2~/gS~..Applicant~G~V'~YlO CdiKlB td'~.~ag''~.9 •~t1C ~ ~ ~ ~ for Osane rs , Health DepC. Approval Underwriters Approval,........ ~ , I Planning Board Approval ..tV~~ Request for Temporary Certificate Final Certificate Fee Submitted: ~jr.DD APPLICA T. /c . ...........T~Z:g,gj,{~P.Slt . n~ironmen t, Inc. ~ 3 g o 9s" 3/~~y6 Po-ee ~ 3~ G~vYt..r..tLQ 3 y a ~I `l 3/~l y~ ca Y ev, 10/14/88 .I . L M FORM NO. 6 , > ~ TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN IIALL 765 - 1802 '.-s~:A2;PL~G(~EION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be'filed in typewriter OR ink and submitted to the Building Inspector with the fo1loR.ing; 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 IIealth 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 ]Z lead. 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 Board ,Approval of completed site plan requirements. B, For existing buildings ~PII.Or to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land uses: 1 I. Accurate survey orf property showwing 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 abstract of title issued by a title company which shall show single and separate ownership of Yhe~\\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 of the 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 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 en 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 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial -ev. ]p/14/88 TEL. 765-1802 p~~FF~Ch~~O~ TO'4YVN OF SOYJT~OLID f , '-r. < OFFICE OF BUILDING INSPECTOR ~ t' S „ ~ P.O. BOX 728 J'~~'' ~ TOWNHgLL g~( ,r ce~i , SOUTHOLD,N.Y.11971 `jFl.° °~~l ~ ~~o t1~C ~ ! C E R T I F I C A T I O N sJJ7NCIt~i h..~~ . Date 1~ Building Permit No. ~~~~r~r Z- Owner ,j~l,~y? ~ (please print) I'// Plumber~~ ~ J „ d-~Ic.,,~; ~ (ple~as~e print) ~ I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. J (plumber's siyna Sworn to before me this /~/~~day of ~.~i~~/~1~~~ 19~~. Notary is Notary Public,~~Ct.~~~~1/l-- County EDITH f. JNt~(Stkl Notary Public.492~0788~ Yak OvaGfled in Svtlolk County Term Expires Feb, i 6,1990 ~ ? 2- 8~~1 THE NEW YORK BOARD OF FIRE UNDERWRITERS FAGS 1 1001093 BUREAU OF ELEGTRICITV 85 JOHN STREET, NEW YORK, NEW YORK 10038 ats MARCH 03,1994 gpplicatbnNo.onJile 83581594/94 N 306158 THIS CERTIFIES THAT only the ekxtrbtl pufpmant w dsecribsd 6dom and Jntreduced by tke applicant named on tke abode application number in the prorrsisee of ALICE FIFB, 1000 BRrnrIDGE LANE,rnrnCUSCHOGUB, N. Y, in tbefdbtrin;r lorntion; L1 Basement LJ let Fl. ? Ynd Fl. DUT Sertiuw Blaek Lot was exomined on F B 8 R U AR Y 2 8 ,19 9 4 to ~ in compBance wUk tAe National Blsctrical Cods. NXTYR! ACIn RXTURlS RANOBf CDOKIIIO DECKS OVENS DISH WASNBRS EXHAUST FANf OUTteiS INGNnlSCFNT FIUOefS[tNT OTHER AMT. R. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. r. 18 8 8 13 5 1 3.4 1 ~.4 DRYERS FURNACE MOTORS IlttItRE AFNIANCE nmetS SMOAL REC'Fi 71MEt10CR3 pLL tltNi NEAnRS ~sllst ~T1ET DMAM~S AMT. K. W. OIL N r. GAS M. AMT. NO. A W. G. AMT. AMI. AMT. AMTS. TRANS. AMT. M. r. ~ tR~ AMT. WATTS 4 2 600 SERVICZ OKCONN[CT NO.OF S E R V 1 C E AMT. AMI. TYPt ~ t/1W 1/AV S/3W ]/MV NO.O~ COND. ~ CC C ~ D. NO. OF N4llG Of~~IEG NO.OF NEUfRAlS Oj ~ EN UIOtAI OTIRR AM~ARATUS: G. F.C.II-7 ~o~ DOR08[Z &LBC. INC. LIC.i2941-8 425 NONSBLL LAMB CUTCHOGU6, NY, 11935 o1NEBAlMANAau 11 Psr- This artificote mwt not be shared in any manner; rNum 10 11Le offiw of the Board if incorracl. Impactors may be identified by their cndsnfials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAt,i Uilf1U9 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date JANUARY IiN,199ft APPlicationNo.onfile 65R%'111A9JNy N lUyN3U THIS CERTIFIES THAT an{)• the ahrctriea! puipment at dsecrihed 6dole and introduced hY the applicant rwmed on the chose applioatbn numfPSr irK the promisee of JniiN 1'ft'E, 181111 tSRTDGF. L_ANk., C~11'HO6UE, N. Y_ intMfdbainR locoNonS ? Basement ? Ist Fl. ? Snd Fl. (IUI .Sertion Block lot mas examined on OEf,kMNF,H 19,1gR`.+ andfoundto 6e in compliance with the reyuircments of this Board. RXTORi RXTURK RANOK COOIIINOORCKS OVlNS DISN W RX T FANS WTIRTS Aa6 SYYITQIRS INCANDESCENT mUOI1ESCENi OTNEW NAT. K. W. AMT. K. W. AMT. K.W. AMT. R. W. AMT. N. P. 5 9 /i 1 1 I DRYHK RIRNAC! MOTORS IUi11R! AMMIANCR IRRRMf SMIOAI RK'?T i1ME CIOpIS pLL UNIT NRATlRS AIIAT40s111Q OIIAIASRS AMT. K, w. al N, r. GAS N. P. AMT. NO. A w. c. AMT. AMI. AMT. AMrt. TRAM{. AMT. N. r, rp~~ ~ NN. wA1rs LU 2 6U SRRVIC! gSCONlNCT NO. or S E R V 1 C R AMT. AMr. ME ~ 1 / t`M 1 / .TV S / TV S X ~W ~'COND' Ot C COND. NO. Of N41EG NO. p NEUIMIS pr NEUAAI OTNRR AMARATUS: LARANA-1 MO1(Ik°,i;l-F H.P. PANi~i 8(IARD~:I-2 r,TR. 1n0 'USWIHMING PUOL) (his r,erLir icatr revrrs complie±nre nY the dWfe ut 1tav~eC4.lOn gt11Y. HnC»119P, O1` UISlI x; 11 ¢Il environments it is ndvistlhlr to have frequent ter1F, dnd; nr r1-r~~tir~; Cenf. tnued nil Ptrpe ORNBRAI'RRANAO« Per ~ This cartilicata mIM not be ohered in airy monnsry Murn ro tFle office of the Board if incorrect. InspMOrs bR isiwRifiad bythair cradaMiok. THE NEW YORK BOARD OF FIRE UNDERWRITERS i'A151 Innnra-; BUREAU OF ELECTRICITY 86 JOHN STREET, NEW YORK, NEW YORK 10038 Date JANl1AkY lIN;I9°a(I APPlicationNo.onfile <'!'87[17K9/N9 N U9kiU THIS CERTIFIES THAT owly the elecerkd equipment w aleecrihed hdow and introduced by the appNcant nomad on the rhooe application numher in the promisee of .nIIIN II~FF, 1gU0 Uk TUGI~_ LAFdP. IIIiNpr, i,it., N.v. let Fl. ? Ynd FI. Section Block Lot .in thefollolrinR lococion• ? Basement litil UEf,~hl8tk 99, 1'?N? rest examined un and found to he in compliance with the reyuirementt of this Bwrd. ItXriEI RXTURlS RANO~ COOIIItiO DECKS OVENS gSXW XAUST FANS W1tET5 ~ EYt1T INCANDESClNT fIUORttCENi OTHER AMT. K. W. AMT. K. W. AMT. K.W. AMi. R. W. AMT. N. P. DRYERS f+tN1EA TORS wluu /awaits Kaoat EvECtkt REC•n TIkY CIOCits tNU uNtT t1EAlERf MULT40YTIEI RIEAkIlRS AMT. R. W. qt N. G N.I. NAT. NO. A, W, G. NAT. AAV. AMT. AMrS TEAKS. AMT. N, r. ~ a ~T NAT. WAlit SERVFt! ~ NO.'01 S E R V I C E AMi. AMr. 11R 1 / eW 1 r tW t / 7VI 3 / AW No. p COND. A. W.O. No.OF N4lFG A' W.O. NO. M Neu1KA0i A. W. G. rt~r a cc. c o. q NI-uNA q NEUrtAI OTHER AMARATUS: wrrdF by H duAli'fied Person. GAkY D{)k~SKC LCC.g2'')41 [i 6711 MONSh t I I N. CU1tlil?GUF, NV, 1t93`~ O~ALtYMIMBM 11 Per Thit nrtificaM marl not be alNrad in any mam+ar; return to the oHia of tfla Eoord if incorrM. Intpsttort may b idaMifiad b1' Nrir eradaMiok. COPY FOR WILDING DEPARTMENT. THIS COPY OF TIfICATE MUST NOT BE ALTERED 1 1= LD IGS: EC: iU:~ ~~Un! C. ~OMMLNT° m ~ . ~ H - y OUt1DATI0N (1st) ~ Y ~ 'OUNDATIOiJ (2nd) _ D o 0 LOUGH FRAME & PLUMBING W ti ~ rn y~ 3 . H IIJSULATIOPI PER N. Y. ~c STATE ENERGY CORE ~ a 4 . ~ . FIiJAL o ADDITIOPIAL COMMENTS: ~ 3~e ~s 3 ~ Q . x \ - H 5a a . y o ~ I m b \ • r ~R` H C' Z b m -o H • TEL. 765-1802 S~YFO~c o~p D~ TOWN OY~ 50UTHOLD OFFICE OF IIUILDING INSPECTOR P.O. I30X 728 ® `c' SOU IOLD IN.Y 11971 ' yyo~ ~~o DECEMBER ~1, IQ8Q 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. ENCLOSED /~f No Underwriters Certificate on file. fig/ The check is(outdated/not on file.) ;'25.00 for C.o. 36.00 to amend B•P• No health Dept. Approval on file. ATo final inspection has been made. Please contact our office on this matter. Thank you for your cooperation, Building Permit ff 1 8 2 9 6 2 FIFE Building Dept. ***/xl~ No Plumber Solder Certificate on file.. ( all permits involving plumbing being issued after April 1,1984 ) SENT TO ENVIRONMENT EAST ~ ~fi . ~ ~ Uri /u'~ , ~ /1 -f!/~ OP 50t)T L ~ i ~ ~ •tl ~ ~~f~C(Q`vCULL ~ /J 'U} ~ ~LGG. DEPT ,.~I t _ Environment East, Inc. r~ R. R. No. 3 - 3075 Indian Neck Lane Peconic, New York 11958 516-7347474 o~~p ~3ca~+~aatiFa~x '~g~~ Southold Tawn Building Dept. Town Nall Main Road Southold, NY 11971 Re; ;?ermit # 182962, Eife, Bridge Lane, Cutchouge Dear Si:r~, Enclosed ?re sets of plans showixng •the amendment requested to: thr: aiio~~,~ mentianlci~-~-pn~.t. yf th~wre are an sepu stions or additional fees, please let u:, It now . ;~ince~vly, { F>r:ttx k. Stou enburgh Pzesident Er.;~~ironment East., Inc. Encl. ' fi S: jm ~~~.k„~` • Fy,_c ~ ~ `l~ 4: m` , ~?1'S' ~w` t •y^ ~ °S x ~'J (k~ ~JF"'ye k ` ~ ~ /CP~P/l (?/11~ ivLC / Qd ~ l J l..-~, ~ jSSS ~1 ~C.W~a.~..._." , u- _ , ~ r, &1 ~ a~n E c,~e ~ ~ ~ t0t1V ? T 1~3 ,1~ ~ g ~ ~ ~o~ad~~a~~~ Q 7 ,.,r~:`, s Y~ 4' 4 ~1 i 1' 1 - _ ~ Environment East, Inc. a~ q R. R. No. 3 - 3075 Indian Neck Lane ' - Peconic, New York 11958 516-734-7474 - ~vO~00~On1~' _ Ivov:zxul.>~r. 15, 1989 Southold Town Building Dept. Town Hall Main Road Southold, NY 11971 Attn: vary Fish Dear Mr. Fish, Enclosed i.s an updated survey oi' thy: rife property on Bri~.zge I.i ii rl F.', Nassau Pointx,,v^^"Cutchou- showing Lhe wo.rh covere3 under px.rm:it # 18w962. t It thore~ are any q a,stio s, plea~le give pis a ca11. Si.ncc~ruly, Ppl'~Y' i~. ;;toutenk>urc' Pr~sid::nt Env.i.ronment East; Inc. E n c l. 8 ~>,,,,,a t~ f A ~ ~ ~ ~ y r~~ M %4.,,~ r., f ~~r~~,' 4.~ X ~\r...) . ~ ~ ~ n "p Z-*p i1 ~ tY(y (1' ~ r'~ 1 y J ~J ~ 4t s~ O a lb~'~ i ~ lfyYfJ,{ ~ ~ t ~ y 'i x~ ~ ~ of y~ ~ f 1Y ~ by 1 , ~I~e ~ 7{'i f _ 'k a "1~ ,~ln ~f~ c.~ i ~ ~~K~ f~ j~ ~Y+ ~ • ~ t Y' t;~ Y rJ 4 " f~~ ' y,(_ x ; y,, ~ c' r~ . ~ a~ ~r~ a -1'_' ~ ~ ~ ~ f i ~ ~ ~ . ~ . _ ~ ~~dt~ ~ ; Y~ l . t Qi ~ ~ ~ ~ ~ (/'~1 a°j L.-^ ~ 4). ~ ~T ' ~ 1 ~ I MS Vb .3 ~ y, O ~ Say' „ ~ ~ * ~ ' p / Id ~ I ~s.; 0 y ~ 2 ~'x t ~~0 1 b 4 ~ $ _ ~ ~ , F - W ~ ~ , ~ S~ ~ 1 ~ , ~1 ~ ~ ~ ] i~` y, ~ri 4t 4 4 7 r r ~..^a. ~t1 - ~ t~ s ate; t~^; ~ ~ ~f:. . ~ ~~'r d'.~ ~ a 1 ~ f y~ ~ aa~ ~ ~s, ~ A ~ /Yl )n ~v I ~ ! h `:lam .M.i a ~ '.tip ~ ~ ~ ~a=~' A~~ rv ~./y~.+, ~r~~ sf' ~ ~ ~8 s'' r Tti ,vim , y, ~ . ~ e DTI \ 4 f f ~ Il _ _ Environment East, Inc. R. R, No. 3 - 3075 Indian Neck Lane a~ Peconic, New York 11958 516-7347474 o~~~ / q, ~i~,...~ r " r; .~wj OCT 2 ~ , , X89 October 23, 1989 ~`~"~S' 7OWN~DG ~JEP~~°' r ~ ii OF S Southold 't'own Building Dept. ..,._.~uTyOL~,, t Town Hall Main Road Southold, NY 11971 Re: Permit 18296, 7/7.2/89, Owners: John & Alice Fife Dear Sirs, Due to the awners request we would like to ;amend permit # 18256 to include a pa~rl°'hous~ and bath. If there are y'" uesti ns or additional fees, please let us know. J Sincerely, Peter R. Sto enburgh President Environmen East, Tnc. F.ncl. ~ ' ~ t l i ~ 1 ~`j ! J ; 4;7~ F i w 1~ ~ j ~ I ~ s ~ ~ ~ w 1 ~ ri ` 4 ~ ~ ~ ~ s`ti ,..1~ ti ` i` 1 k,< } _y,_.,,y ; ~i ~ ~ ~ wt 3 ~ ~ ~ i / .•~1~ e) Y 1r 1 S ~ ~ ~ ~ s 1 'i ~ '_6.< ~ - - ~ ~ t ~ ~ ~i ~ ~ a e 4 s 1 ~G ~ ~ ~ C~ w~ r w w BOARD O~ALTH 3 SETS OF PLANS . FORMN0.1 SURVEY' / ' TOWN OF SOUTHOLD CHECK V• . ~5~~~.......... . BUILDING DEPARTMENT SEP•CI'C"k'oRn ' TOWN HALL SOUTHOLD, N. Y. 11971 NOTIE'Y , ( '1 I f~ TEL.: 765-1802 CALL 7'1 1 `i . MAIL TO: Examined ..7 //7~........, 19 ~~j~ G / ' Approved ..1~~ ~Y......, 19 6.Permit No. •lA .off. 9!O~ ~i Disapproved a//c ~ l • uildi nspector) APPLICATION FOR BUILDING PERMIT Ljate ...Sung. 5 .19i3•`} 15 . ' INSTRUCTIONS a. This application must be completely fi9led in by typewriter or in ink and submitted to the Building Inspector, with 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. e. 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 6e occupied or used in whole or in part for any purpose whatever until a Certificate of Occuganck shah have been granted by the Building Inspector. ° ` ~ ~ ~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Peritrit 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 demolitiori, as herein described. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~:rlY~1:4r1aleRt 5;ast,• Inc•.• • • • • • „ • (Signature of applicant, or name, if a corpoiauon) 3075 Indian Neck Lane ~ P.e c c n3.c, . riT~ .1195>~ . (Mailing address of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...CQCitr.s?Qfr9F Name of owner of premises .....3ohn•I)•Fc•tali:ce•S•.•,F'ife•• (as on the tax roll or latest deed) If a ica t rs r sr nature of duly authorized officer. ~,~~i~~...... ..PPS ~.1,~e rlt. (Name and titl~orporate officer) Builder's License No. .FI. L .~j~b . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. . ....100.0........... ~ Bxid~e..LStrce.......' • • Cuteholue House Nuntbcr , ' Hatnlet County Tax flap No. 1000 Section 11.fl Blpck Lo[ • , 16 Amended Map 13 of Sec B 20 21i Subdivision..Nassau.I'•ai tlt••••••••••••••••••••• FiledMapNo. ,,,•.78.9...... Lot ...........~a.. (Name) 2. State existin use and occu .rnc of remises and intended use and occu anc g p' y p p y of proposed construction: a. Existing use and occupancy flea .Family'. Avtall inR • . b. Intended use and occupancy ~O~- ~a~~)-`~..~~e)-~~0~'•.:~}~'~~~;€,y~~=l'~~nd 13oek ,,...,.»W.._ I ~ , 3. Natpure of work check which alpplicable): New Building Additional--Alteration v~ Demolition Other Work Re air Remo 1 ~YGK ~ ~~'1~/~~r .~2~K1"~-'~ (Description) 4. Estimated Cost..~5d9Q0.OA Fee....................,..,.............. (tc be paid on filing this application) 5. If dweilsng, number of dwelling units . , ~ Number of dwelling units on each floor . . . If garage. number of cars 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Froht . . Rear Depth . Height Number of Stories . Dimensions of same structure With alterations or additions: Front Rear . Depth lIeight , ......Number of Stories . ' 8. Dimensions of entire new constnuction: Front Rear Depth . Height Number of Stories . • • • • • • •~.73y........... . 9, Size of lot: Front 21.5' . Rear ...blr 9~'• Depth , 10. Date of Purchase .............................Name of II~~~orm r caner . Resiclent~a~ 12. Does ro osed construction viocmisea are situated . . . . . . . . i , 1 1. Zone P r tP a district in which p=late any zoning law, ordinance or regulation: , No, , , , , , , , , , , , , , • , , , , , , , , , • • 13. Nil] lot be regraded ..1110• • • • • • • • • • • • • • • • . • • • • • Will excess fill be removed from premises: ~ No 14. Name of Owner of premises .,lf', Fh, A, ,Pi~'e........ Address~rid~e , lane, Phone No.. 73~'l:. . Name of Architect . • Address ,Guteho~izel~• • ~ ~ • p one No. Name of Contractor~.nVlr.Rrlmp4~t. F'ast,,,.Ine.,Address~07~. ~ndia~rtyz Iileok p~oneNo. 73~'~~~'?1i:.. . IS.Is this property located within 300 `feet ~~aQn~g~laT"'wetland? *YES....NO....~ *If yes, Southold Town Trustees PLOTDIAGRAM a required. Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all setback 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. See Attached Diagram 1. Pool aproximately ~zg sq ft. 2. Reek surroundintt'pool approximately 500 sq ft as per code ~ 3, high fence and pates as per code 4, Pool to be over l5' from side yard 5 ~ ~ o G *tL ~~C~ too cy~-TED ~~.1~ r~`OdSE ~~i~~' ~i~ ~ ~ 6. Pool elevation;Rr©ater, than 2Q' above sea level 7. Pool a pproximatplyl8d' from bulkheaded water line STATE OF NEN OR ' S.S COUNTY OF . v. ~A. ~Pd.~ d!J .k.f~.. being duly sworn, deposes and says that he is the applicant (Name of individual stgn,mg contract) above named. lie istlte i..............,......................,.....,...... (Contractor genf;corporate officer, etc.) oC said owner or'owners, and is duly autlton ed to perform or~havc performed the said work and to make and file this application; that all statements cont~incd in this applic~3tion arc true to the best of his knowledge and belief; and that the work will be periornted in the manner set.forth in the application filed therewith. Sworn to before me this \ ~ ~ / 1 Notary P blic, w..... ~"Z . • Co ty ~ ELIXA9ETHANN (tgnature•of applicant) Note Publlo.8tl~NNOf YpM'k( T rm~Exp~rae B~~SUrft31k1~9 H/J