Loading...
HomeMy WebLinkAbout17901-z r , . FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Aall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18342 Date AUGUST 31, 1989 THIS CERTIFIES that the building ALTERATION Location of Property 1295 ROBINSON LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 5 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 8, 1989 pursuant to which Building Permit No. 17901-Z dated MARCH 8, 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 TO EXISTING ENCCASED PORCH OF ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHARLES & CONNIE BOCRLET (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - AUGIIST 30 1989 PLUMBERS CERTIFICATION DATED AUGUST 16, 1989-EDWARD F. SCHZLLER Bx6 ld ng Inspector Rev. 1/81 POEM NO. f 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 o 017 9 01 Z Date ~...8 19R...~ Permission ~s hereby grant to• ~,,s.~.....,~. o~Q to . ...~:~r6fG.~.. .J~~/~"... . ct premises located at ~.~.q-~..........°~.~`.4r.*r?4??~-. ~~:i.?f~:...................................... . .T...~iyl..~ . . . . Caunty Tax Map No 1000 Section g!J . Block Lot No. ......~'L...... . pursuant to application doted 19 and approved by the Building Inspector. D© Fee g.~..° i Buil ng I for Rev 6/30/80 - TOWK OP SOUTUOLD BUILD It{C DCPART:ICtiT TOIiN QALL SOUTDOLD, 2iCH XOtiK I ] 97 i 765 - 1802 ' APPLICATION FOR CCRTIFICATE OF OCCIIPAttCY ' DAITE.. ~~~~J HEN COtiSTRUCTIOH ._.._..OLD ORnPRE-E%ISTIt{G BUILDING._V...VACAttT LAt/tD.......- Locaciao of Propcrty_./_a~~ :id~~~S~~ ~/Y~~__~C~"U~~~'...,,_._.. UOUSE ti0. STRCLT•"'~D~AH/L~~CT~^y~- Ovncr or Ovncrs of Propcrtp..:~:.L~:rJ~4'-?~..0.7:US-§a:<S{-2~r....___. Couoc7 Tsz Msp No. 1000 Section 7 Block Lot Subdivision Filed Mapcc{{........Lot.._.,...._ Permit t{o. `.v~!::Datc of Permit 3~~~~(.ApPLicant Ucslth Dept. Approval Undc rvritcrs Approval___~..__._.. P2snnin;, Bos rd Approval Request for Temporary Certificate Fianl Certificate _ FCC Submitted ~ ~ _ . APPLICAtlT. ~~~'_r.._C.: -~;r1:.: ~'`.-~:~o~~ 1 ~ c~~ - L . ~o,~~ ~v. io~IC~as L1' (~,o.c.3~~y1 co ~i8a°~2 4 FORM NO_ 6 TOWN OF SOUTFIOLD HIIILDING DEPART2fENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. ~ This application must be filed in typewriter OR ink and submitted to Che 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 vausual 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 Firc Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of JS Iead_ 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. 8. For existing buildings Prior to April 9, 1957, non-conforming uses, or buildings and "pre-existing" land uses: I. 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 applicaa[ and a certified abstract of title issued by a title company which sha1L show single and separate ovnnrship of the entire Iot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing [o 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 Ce rti£icate of Occupancy: 1. An application for vacant land Certificate o£ 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 Che applicatioa_ If a Certificate of Occupancy is denied, the Building Inspector shall stare the reasons therefor in writing to the applicaa t. D. FEES: 1. CERTIFICATE OF OCCUPANCY - Nev Ih+clling $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 oo 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. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $f5.00 Residential $SD.Dn Commercial 'v. t0/14 /S8 TEL. 765-1802 c~utiFDC/-~o TOWN OF SOYJTHOb.~? ~4 -v lii " , ~c OFFICE OF IIUILDII•IG INSPECTOR ~ P.O. IIOX 728 ~ z TOIVN HALL `'O l ~ SOUTHOLD, N.Y. 11971 %~Ol ~ ~d0 C E R T I F I C A T I O N Date ~e o / Suildirg Permit No. / (p/lease print) Plumber ~Q'/A)('r ~SCYj! (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1g lead. (plumber's s gnature) Sworn to before me this day of ~ /lK 19~. ppp Notary Public notary Public, ~Au~~_County 470~6T8 Su~RclkCoentY / Tenn ExMra Mach 3p, i9._.~ TEL. 7G5-I 801 p. ~~fF~C'~cC~L TOWN UF' SOUTIIOLD lr<~j E;;~~ Orf'iC1: Op BUILDING INSPECTOR ~ h~ ~~~t4 z~ ['.O.BOX Il74 v ~7'J~'~`°'/'~ r~ TOWN IfALL • ~,y SOIJ7IIOLD, N.Y. 1 1971 .,yap ~_r~ ~ . 3,14 ~ ~ ~.tl?r 1 D f 0 To S4hcm This May Concertt, 4,e arc unable to complete your Certificate of/O/ccupancy because of the follocaing reasons. /~v/ An application for Certificate of Occupancy is not nn file. C~n~-~ /_~,/*to IJnclertrriters Certificate on file. The ciu:cF; i:. (~~/nut nn file.) 16o?S.CJ7~ Dlo health Dept. Approval on file. % / C:o :final ~nsl7out.ion ham been made. Please r_ontact•. our office on this matter. T}tank you for your cooperation. I;ttilcl>.r:~l Pcrnt~t• t! L. ~ ~ ~ ~ Z Builc3inq Dupt. _ t!o mbcr Solder Certificate on file. ' ( a parr, ' t:, involve ng pluml7ing being 6$i't, issued aftor ~~pril 1,1984 ) -lELD I;.S:'ECTlu:i ~~UATE ~ ~OtKMENT° _ 1. m a_ - H _ y FOU1dDA_TILd~%/J/~~~(1st) o~ c ti FOUNDATION (2nd) _ m 2 . 4 ~o - ~ " o c ROUGH FRAME & O•G d ~ fd ~ LUMBIy ~ ~ ~ f p, y H 3. ~ m n IfdSULATIOP! PER N. Y, STATE ENERGY ~ CODE a , a, 9 ~o ~y ~ FZiJAL n ADDITIOPIAL COMMENTS: x m ' x •n H ~ • ~ C H ~ H O rn a~ - H b H .t / ! b ,-~--L,,;~a- - - - \~.J i ~ ~ - I ~ v~,~,- f - - - - ~ ~sa,~.~ 1. - - - - - - - - - - - -r~.- - f ~ ` . - - - - - - ac~PANCY oR - -~~~~uj 7L~ - - - _ ~pp,~3~Y _ ~,~..,t- - - - - - 3 - - o~ ~ j~ , - - --X +5 ~ 1 ~ ~S - - r- -~,3~,c~-_ - -jG~E~?-- ~ J t ,Xµ Syr axyo,u/b"'~cHpee " ~"~/~tG ; ~ ~7 - t __.~~A/1E~t J~UQ G-'XlST~a~G LJAt..L _3 - ~.kl_~t~~1C /~f - - k ~ i -fi- J ~ - - - - ~ Y t L - - - ~;W ~~r 6'R~ - ~U~~•L • - - - - - ~~~,a,~~,- - - - - - - ( Wtwpo~.J - ~ is - ~ - 5 - - - '~~831'`--- - f _ t ~ ~a U t E ~ - ~ f _ f THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000314 BUREAU OF ELECTRICITY 8!S JOHN STREET. NEW YORK. NEW YORK 10038 Date SEPTEMBER a5, 1989 gpplicationNo.onJile 50806187J87 N 093393 THI3 CERTIFIES THAT only the electrical equiprrrent v dseeri6ed 6eloro and inerodured 6y the app/lcent nerved on the e6ooe opplics[ion numlTer in the prorrrrwe of CHARLES BOCRLET, ROBINSON LANE, POLE-4-A, PECONIC, M.Y. in ehefollorcinq locution; ? Bosement ? IAt F1. ©Ynd Fl. GAR Section Blaek Lot uas examined un SEPTEMBER 01,1989 and found to 6e in compliance reith the reyairemenrs of thL Boord. FXTUR! AC1E5 NtATCNES RXTUEK RANGES ebOKIN60ECK5 OVENS DISH WAfILERS EXHAUST FANS OUTLETS NGNDESLENT FLUOIIEECEN7 OTHEa AMT. K. W. AMT. K. W. NAT. K.W. AMT. K. W. AM7. N. P. 10 14 8 10 DRYERS RIMIACE MOTORS lIITWEANDANCE IEWME SMpAl RtC7T TIAM pOC1L5 ENL UNIT HEATERS IAIXT60YiYT MAUNlRS AMT. K. W. pl N. P. aAt N. P. AMT. NO. A. W. G. AMT. AMM. NAT. AMPA TRANS. AMT. M. P. eta L ~T NAT. WAl1S SHVKE DRiE:01EIMl'CT NO.OF S E R V I C E AMT. AW. TTPe ~ 1 / eW 1 / Tv ~ A>\v 7 / Aw ~ ~ oNa. OF CC. CGNG. NO. OF HIAEG ~ ~ HI NO. p NEGAAlS a F IUIGXAI 1 loo cB 1 x 1 a 1 a oTMH AtNAEATUS: GARAGE AND BOON ABOVE ONLY-1 G.F.C.I:-2 .No'( B.J. ELECTRIL' CO. LIC.~a670-E SOR 16,STILLNATSR AVR. CUTCMOGUE, NY, 11935 OEN~At`l~AOER 11 Psr i, Thu artificoh mutt rat ba aherad in any manner; return to the office of the Board if incwrsct. Inspacan may be i nMwd~bY tkak c It. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT tE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000314 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Dote SEPTEMBER 25,1989 gpplirationNo.onfilr 621907$9/$9 N 093391 THIS CERTIFIES THAT only the electrical puipment a. descrihed helo,s and introduced by the applicant Homed on the eltose application number in the promises RI i CBARI,ES BOOKLET, ROBINSON LANE, POLE-9, PECONIC, N.Y. in the fdlotcinp location; ~ Basement ® I Rt Fl. ? Yrtd F1. .Section Block Lot SEPTEMBER 01,1989 uos eramined an and found to he in comp/ianre with the reyuirernentr of this Baard. NXTURE RXTURES RANOES COOKING DECXS OVBiS DISH WASHERS ~EXNAUST FANS AttiS SWITCNB OUTIETS INCANDESCFM PIUpESCEM GTNER AMT. K. W. AMT. K. W. M1i. K.W. AMT. K. W. AMT. X. P. iz to a la a F DRYERS RlRNACE MOTORS lUTURi AMBIANCE INDRRS Sr[gAl RECR TINE CIOCKS pu UNIi NEATERS MULt1.O11TlRT DUAMERS AMT. K. W, dl N. P. GAS M. r. NAT. NO. A. w. G. AMT. AMI. AMT. AMPS. TRANS. AMT. N. P SYSTRMS AMT. WATTS NO.Oi RRi I SERVK7 gSCONNlCT NO. t)i 5 E R V I C E r~~ MIT. AAV. 1rIE 1/TW 1AJW Sd tW 3F,W ~'aPER DCdVD. OF CC. COND. ~.~NI.IEG Oi~W~~G NO.OP NEUTRALS dNWEIIOIAI OTN[R AlRARATUS: 4.5 KW STEAK UNIT-i BEDROOM ADDITION-1 G.F.C.I:-1 SHOKB DETECTOR:-1 B.J. SLECTRIC CO. LIC.#2670-E BOK 16,STILLiIATER AVE. CUTCHOGUE, HY, 11935 DEIIER ~MA~AOE11 11 f~f Per This cartiticaN must not be altsrad in any monner; rHOrn to 1M offits of the Fbord if incorrsH. Inspectors may be i ed by thew erodsMials. Yi_-COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT BE ALTERED IN ANY HAMMER. oQ $ , THE NEW YORK BOARD OF FIRE UNDERWRITERS rAee ~ 10(1111'?.5 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK. NEW YORK 10038 Date .JUNt i,1G, la9p APPlication No. on file 6tl16;S4R4jti9 N t;i2k?3 THIS CERTIFIES THAT only the electrical equipment a. deRCrihed 6ebro and introduced 6y the applicant named on the shoos application number in the prem4ee of i'IiARLES P,QCHk:LET, 12517 RI)1ilN.`,gN LANF_, PECQNIL, N. Y, in thefolb]cinq location; ~ 8aaement ~ let Fl. ? Ynd FL 011 I Section Bfock Lot u'ae examined on MAY 1 G , Y 99t1 and found to 6e in compliance with the reyuiremente of this BYrord. RXiURE NXTURES RANOB COOKING tN!CKS OVENS SNW iXNAUST FANS OUTLETS ACIES SWITCHES INCANDESCENT FlUOI1ESCENT OTHER NAT. K. W. AMT. K. W. ~ AMT. R.W. AMT. K. W. AMT. H. P. 5 6 .3 I f t DRYERS RJRNAC! MOTORS RITURE AMLANCE RNDERS SPECIAL REC'FT TIME CLOCKS ENI YIR7 HEATERS MULT40OTIRT DDAMERS AMf. K. W. Oll N. P. GAS N. P. AMT. NO. A. W.O. AMT. AMP. AMT. AMPS. TRANS. .AMT. N. P. p. ~T AMT. WATp 1 SIJ t 6[111 SlR1RC! DISCONNlCT NO.OF S E R V 1 C E AMT. AMP. TYPE I P ]`N t X TV 3 X TN ] X AW NO' OPER dCO~. Of CC. COND. OP XI-N!O Oi NO, d NEUIRAU O{ N!UrGYAI I zllt~ t:fi I x I 2/o i :~/II OTNEII ARPARATUS: G. F.f. T.-1 ~ 1! IPAR'I pQ(i05k1 L1r,.S?941P: 425 Mi)NSE(_I. LANE CU7cH01;IlE", N't. 11.945 WNYAlRAA11AORR _ ~V Per This cerNficats must not be akered in alry manner; return to the office of the Board i( incorrsd. Inspa¢or?.moy be idaMifiad by fhah crsdentiak. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE M115T E ALTERED IN ANY MANNER. f ~ ~ 765-1802 BUI~.DING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING , INAL REMARKS: /S ~ li( G''~ lO t DATE 2 INSPECTO / ,2Z T6S-1802 BUILDING DEPT. INSPECTIt'N [ ] FOU A ION 15T [ ] ROUGH PLBG. [ ] `F N ATION 2ND ~ ] INSULATION [ ] FRAMING _ r ]FINAL REMARKS: /~e.~ n~~ T ~c~/~( G t~ d d 7La DATE if " INSPECTOf~t'" 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ] ROUGH LBG. [ ] FOUNDATION 2ND [ SULATION [ ]FRAMING [ FINAL REMARKS: ~ 6 z," ~ ~ ~ ~-Yt DATE INSPECTO ~ ~ ~253Tyi. h tR~-~i +..~~~~~"ha,; vM .T, 4 r ,Y v~` 1,w~~~.t~.~~ }~,`f~.L~~ i C4:.{"~',: a>~ u*,v ,}rfF F'a-' ^ r rf'tY g'.-r ~ r.. t` a ,.d. `~n'..^,.,.G ~~'"S~a 3' %M1 -b ' t ~.iT ^ c:., ` i,t ! K"#r`w~ , e.: M' ""'Y` K..- My ~'.~'.M.~•.is'w..iR~~" off,, 31N. ~x v fin ~s~-«~ y..._ _ _ p+~+W+,~y.,_~, ~3.++-:•./;w?'^3"A~' ,s t°vS'~''»'^y ?'~?t'}a~t" ..>s y. ~.g~'_" ~ sc ~+A w !,f,/ ~r""it ~^j~fv`k. "3Y:; `•~`eC"^- %i ~.v-'?~~~~•:<:_ '~'4~.y}it~`euz-,.~.~s ~`v'.crW~*.4 °''~~-'t__. ``v v r._•. .t~', ter' „ft>.W ~'~~¢'t~v~`Y, i+_`;b. ~y».~t •~~,,r•ilC~.. `1..~.. a „ _ „a.. >.~c..a. _ .a^»~;-,~R 4~~ '~_'T_$h~~+Mr aiv T+k;r ~ir'E, ;.~Ay~fi~FrZ~ ~+Y.' ~^^.l ,v~~<~''.iai ~ - - Y Y .•-~ewri . •I'.'~i r`l. jy~ YS~L~rS. ~ v: Y.~ Al ~K I ~ S ~n? ; '-..'nt :h: 4d.`f'r - si Ttl 'y :'k ~ : .a>. w'" Hi,.~.htaat~''~~`~ A. . ~ .y ' .y> ,~R>~F S 's:, .!`.ix.''#" 2r~ - F~} ,^Qb?v~. _ _ 1 - "y~4,~i''~x -s.~ _ r t v+. <..r•i ` ` r Y{..J.f •~-.4 i~~#' rr'K~-aY j - -`iY. _ ^^"'o. Y.u". ^tn i Y y~Y?~r. ney t' .iV •.R'.tW.l r 'ft"~ t y4'p„~~ • ' .@~'? ~ Ktl rS vy { 104 !'t • rr . i - M , a Y~ ,'f'1 t~..c ^ gyp?. ~ , "ur ~ V l v h ~ _ n ` • Y ~fiQ n} 4y ~ ~ ' ~ ~ ;~Y YI , - .r . 1 - M- Y ..,k <.a'~?.' `a `~T •i,` et• N dw~' 1 ~'"X _ ~ r ~~~~,cy~ ~ y -.Cr'T' .:P~~ y*" ".-_.A;Ar: IJ,(,_y(/ `~~uJ ~ E~ ~rn ~~~.,9 '.i ~_<w e'Jw~~- `~~~GSw•.~X'' ~e ~+R',aJ. r,~. y _ ~ ,L"iT/!)' vy r k`,~ •d ~~'J• .IaJOy /}/pMIN' .rt r, :"Y. dti ~.>a.A. tih w+1,J < t ~ ~ z _ ,r...'=; ate%'>~`+''^'~f ~1~zeY el r' y,_5 sYt f•~•`~a #,,.•xaa x {.r. G~!?i~1~a'Y~~+~" iW. "S~ ''fNt~. "'"R u 'xt^~$~,'e.r`# 'e~"' - ,',i~`exr~'s :~:j°s''¢,.riF.xs'a-.~v~':a..'° 5 *t`$-.',r,. r L` e~t~iC!'q.K6 ~i.~ .7>i': +.i. rt 6"~ j' n+ e+r_~'r'' j, ~a ,Y r r `^-'4~' +~T'~ ~,_,,,y ~L~~r.-.ea5~ti. 'rF ~ F `t- ,:a'.Y'?.~`ibin > ~ e>~:,i-'<<. i..i ,,"~"~.¢~~?rr '_:L,ORR !'tila? l~ir6J~R V vWi' `m-:•;.+y •t`~iar st.'. "`3T ~M ~ r.y, s•ti_4ti •>r .•l'~ .s~~-+st,' p~ 1`nV'~'Y:`K ~,;P''!ti xs.t ..z .`.'>3 "„t'}.,t"-~~'`-.-=c°`, L*,' p ^.z'c^4 F-., ~.p'yk R':: f.rn Yp Syr. `.+c,?v '-.S 'r 3 ~ Ca4 ~ r :t~pY C ~3. ~v`•- - Y - =;4C'~^M'~-Y~^`"~"r~- 1.~~.~'"`Y"`?t~v'~'~ iMA~~I~ ~ .t~ ' a q.. _ V ;,,,„,'r ' ' > IjK„r.:.> • y a ~ . > , ux-", aHi' T isms '¢!.~.~''s.-" M,.~t'-~' ~i ;~m'.'S1.,-. 4 Yxc+n j _ :43 «~~r _ - ,ar-<4'-sr ~F4v-~ f r ' ~ y ..,y.,. Wis. E?oG7+rsC.:. r". ~pi1y'' 4 ~ ~P ~ ` 3i ar 4~'+~ ~.~.yy - ~.;r~~;'sxn s'yfy,~A, 1yV~~ i.ip.`. l~'~~K a~i?,~~.„"~~ " "~'i':~ ~r~.".'- ~ ~ .i ~lyr~`y' c±l'.'q'~3',kxyf~ :_-r ~~'.S~:Y 35 li3Pi+k; f^" F~F ,„R IZ C'.7.~~°''' ~V-'~.M~ 4k~.",."M,Y'jU'S- ,J.- ~ ' ~ T'i - z ' -.rz o ~i`-„'9~ s* ~E c r -n s arty r~ atg,a `k'~.~v .^*.~Y~:YI~wr~ ''wi^if .s~'`,r' a• n~ n4,u ~W w~~.".4s>`'~ 9'~tv_~ r.'i _ .z. x'r4-' i,-$~_ . y •7 ti-. rY z W ' > T r ` i'~, 4~ri?' ? .4. M ,C Y;~I~'a ;ol~° - M~'~; sY ,t f a'„f.~-'~' Irv • ^ se r 'C xis' ~ ,ir y,: _ a~+;7~Y! a, r. r"K'^e'' ~ e'ast,.• ^r' y~,:.~ya2;~•vr~,i',;~fi;=-t~.•~4r"t~-'*~•~'p. ~ yf~~'~",. ~-:~s"e. ~n'4.~tR'A~ .:`a_ ~L~"§x'e,'7` a:~, :dr- VIW .~.,..+,-__.e~'ya:>. .t, r;,r..F 5i >i. ..-li t^`5.+"-. sA }'.7~~,.yd ,`i "AN r7. ~,3.~ ,'.a`.tyr ~~.-.'*,+,,n~'tt-^~~p' ,~-r"-*~vs5r~ ~ ` e d- tei%~" ~y'~r ,4'apr~ 'h"{ ~p y ,~k,7' ~Ai~-t~' y~+.u4 v r+k :e i i:~ ~ ;'~F obi.,-~~ ^.~r "'~"i' `.b'n'r4Ti e'i'g. s's'1E h?~" ~ ~X ; axi 'i?Y~~~'~cari+;.:~i''s'Ft-L"~'i44~`~~. wtS 3t R8.$rFc+`;'.=^ « x'211 Fi*~„ err _,`~Y"'M ~t'~~'~vr!`~'',y~ 'fi+ 4' ,F °f~°. ~ ,s„i'~-cC~`€y ~`,~"r~. ,u,,x's y* .~p~~~~ ~y~~ .~~jj _>{a=+~'~~YT +1¢ ".T~,+` .4j'} ~ ,'"`_~i`x. •~.~i ^.'h"- ``,~'A,AS rn/tif:.'7a`,~P'n~" 'f~"`,~~-F. IS.G :spa,' ' - a >,>w n~~ Yr 'ry. n,,2_ t ,=~4. ~`xs iLA~f.3 ` vM`- ; y,'w.. --y.: ~ ~ „~'i, '~s~ ~ t r ~ _ -....3ia~'~"r~,+ts';. c. ~ G• ' r °T' ' v +i..:.,. ~r [ LY. *;.~'-i+r~'~ ~~`r " f, - :y.-~ `.'4i.i e''R3~Yf c _ -ya ta. c"s_~iax`.,#•~, 7~ -r -'ra, ~`df'T_ ?+.`-l, ~xs._-.;~i•~rAa `~~.~y'~ T Y i ^u'~;5~''4^4':'-t 5.` i~ ~r Li'Y a__~ _ y -~Y f-{'y@":~i e^-_.r ;sue +1 r:a' h' N'~~C"Y ~ ai uyl^'-~ .py: er .11~,.s: )it - ,h'~S. Y~~i~S• ~4•"~i~_ X~i ,.5~, Y '.<~'sY.~ ^Ar ~1 y~,~.1k~%.:M..r - ~ t-i ,v~,. :Y~f'"~~' "'~``~.r`~~'~'y.:.i ~ ~ - ~ ~•Te^~+~'rY.. ,S "v5 ~ - - - ~.Iy 'x 1;R:::a~ j s a~w - a.* _ 't;,~._''i?" .i~.~p%~p~v'~_C. ,y~'1.53-'--R~{'~s,x3~ .,mss-.„ems-~- _ --~~Mr~V~r;~° r q[~~syr--s ~+g~~y:~ ~:r ~~~~ir t x.-~ /f'r'~_ _ a."•~ - t a. S.t. - a ~C`-`5tb'r'°'r* an. ,~"M'~ ~ r y~. ` - v, 1>_a"'1 '^,2` ' •5,' r, .yy _ - r.> n a K,', s"~5' p"~r. ^4aA~niF i;'a''••.}~`-.' ~Y..M.,tMn~'r'fxn41r^~,~«,-"~'-,~.'"ia~' s`*`''~., !"f~'v"'.~.' d //,~~y/'[~MJ . r _ _ "~'r _ s" - v* 4 sv~,,s`;F ~!,v Y M .+.~Z'•^, r~`' v44 -•6 '2"~• yc!/' - -'r -V' ~a v: ~A~- ,,"F. <x ":egers 3i'" i` P r;.°;•.?y'ti' ii,- ~ f, yy ~.r: .R- y.. '3't ?,'.~,'^}.°-~"r-= ~ ~i ~~:r~ _ ' ~•'~~'_i` .~v_` +tw'.,f ~.1+3i?A`y', ^hy`;:'..te. ' ~ 5. - ~~ttiv.z ~4~ ~ ii _ fir: ~ _ - ~Y: 4%,r' ; `"'~Zh r'i_>~R . yv ^we. Se z'h- .-r<^ . -~,.2u` i ! r. , _ uF , e: i v . < - a > a- - BOARD OF HE.ILTH 3 SETS OF PLANS FORM NO.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL . SOUTHOLD, N.Y. 11971 NO IFY ~/j~~ . ' TEL.. 765-1802 A~ CALL,./.......... ''JJ Approved . ~~O • • 19`.'! Penntt No~fi7.~~~ D (\/~~~V' Disapproved ajc ~ YA r ~ _ ~y T" M~,k - 31[.389 . ~i .?~w(... ELDG DEPT (Bt ddin~pector) TON:N OF SOUTHOLD APPLICATION FOR BUILDING PERMIT Date 15 . INSTRUCTIONS a. This application must be completely filled m by typewriter or m ink and submitted to the Building Inspector, with sits of plans, accurate plot plan to scale Fee accordtnE to schedule. b. Plot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public stzeet or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of t}us apple ration c. The work covered by ttus application may not be commenced before issuance of Building Permit. d. Upon approval of flits application, the Building Inspector will issued a Building Permit to the applicant. Such perm[ shall be kept on the premises available for inspection throu;hout the work. e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupant; shall have been granted by the Building Inspector. APPLICATION IS HEREBY hIADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Towrt of Southold, Suffolk County, New York, and other applicable Latvs, Ordinances o, Regulations, for the'<=©risfi33ctron`of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to c{pg}~ly vnth ?li applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized in~pedtois an premises and in building for necessary ins/pl e~ct'i~on~s.e . ~1 Y s'I rA'~ p : `-r, ~ Signature of a ant, or name, if a c ration Cta:z.\Y?3Ri~N" ~}CZ:r,~i~.~., ~?~.l4ro..C~s-lfo.~s~' ~wya,~~rlf~g4~... • ~"+!A~1'~R_, ^+i. ' (Mailing address of applicant) State whether applicant is owner,~4€~se~;'agcint;~ architect, engineer, general contractor, electrician, plumber or builder. ~lI9MV~If~rP?21+tIYJ ehr"1 ~ -t~~it°is7 7~ . . Name of owner '~A` ?3C. ~ • • • . ~ ~ 1~~ ~"'yf! )h ~ (as on the tax roll or latest deed) ICapphcant is kdi~;agit?¢orized officer (Name and title of corporate officer) Builder's License No ...4-~:'~'. Plumber's License No . Electrician's License No . Ot}terTrade's License No . . 1. Location of land on which proposed work will be doi~9`S/~P'~.'-°": . h4~%i.v,sor~. 1-Riuur, lJt3c.oruie~ . . House Number Street Hamlet County T~ix itifap No 1000 Section ..Q 9~ B19ck 6.1 Lot ..a . Subdivision Filed Atap No. Lot . (1`Ianic) State e~isung use and occupancy of premises and intended use and occupanry of proposed cons[nichon a. Eeisting use and occupancy ~~!?~ivq,-, , ,~et.as~i8 , . ~JO,q~~ , , . b. Intended use and occupancy ....~~:e~M.. .~?e?r"e~uc;iun? . . . . 3. Nature of work (check w hick applicable). New Building . , . , Addition Alteration ~ . Repair Removal Demolition Oihcr 1Vork . (Desenpuon) . 4. Estimated Cost ~.~yQO:.'. Fee . (to be paid on filing ilia apphcauon) 5. If dwelling, number of dwelling units . J........ Number of dwelling units on each floor . 1f garage, number of cars . . . b. If business, commercial or mixed occupancy, specify nature and extent of each type of use , 7. Dimensions of cxishng structures, d any: Front , . Rear ~ Depth . , .7.~.~a . Height ...1 : Num bey of Stones / . ~ . Dimensions of same structure with alterations 9,cidditions. Front , Rcar / 6 . t,.a........... Dcpth.,,~7,8„ IIcight . J.ry.,,,, r ,,,,,,,,,,.NumbcrofStoncs...,l......l.y...... g. Dimensions of entire new construction. Front /1..... Rear . , /Ea Depth ...'7.8...... . Height Y".......Number of Stones . , / . 9. Size of lot: Front /~.Y Rear Depth . 10. Date of Purchase Jb fl4~b? . ......Name of Poi-mcr Owner . 11. Zone or use district inwhic]ipremisesaresituated..,.RL'.5,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 12. Does proposed construction violate any zoning law, ordinance or regulation• /1).Q . 13. Will lot be regraded .....~1.2 0 . .Will excess fill be removed from premises: Yes N 14. Name of Owner of premises ~?i~r.~ :~{,~Q~ :Address ~Ce~A~Y!!-......... , .Phone No. 7~.Y'.5$,1{ . Name of Architect .Address , .Phony, No . Name of Contractor ....................Address ...................Phone No.............. . IS.Is this property located within 300 feet of a tidal wetland? *YES....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 froi property fines Give street and block number or description according to deed, and show street names and indicate whethr interior ar corner lot. APPRf1VED AS NEtT~d - DATE: d.E N F£E• BY: NOTIFY BUILONIG DEPARTMENT AT 765•il~2 8 AM 70 4 PM FOR THE FOLLOWING 1NSPEC71pNS: _ 1. FOUNDATIpl~f - TWipR'EpUlt1EQ FOR POURED COAICIIETE . 2. ROUGH - lRRAIYtN110 ~ /1 UMdINQ s. ~nlsuunON 4. FINAL - CXfMIa?RUClION IMtRT 8E COINrt#'fE f'01! C.Q ALL CONSTMiC1lON ~FNfj, MlkT THE Rwrs of N.r. s>narE co~c~ron a ¦lewr caoES, ~ ~ Moir , ~slGNal~~ona~t~raietes ' , STATE OF NE1V YO~,~2~~ft,p~ COUNTpY~O,F~ y~3rr-tn:'-~+`~- e S S • • bang duly sworn, deposes and says that he is the apphcar (Name of individual signing contract) above named. Iie is Ifte . (Contractor agent corporate of[icer,ete.) of said owner or owners, and is duly authorized to perform cr have performed the said work and to make and file th =PPhcauon, that all statements contained m this application arc true to the best of lus knowledge and belief, and that tt '•vark wilt be performed m the manner set forth in tiie application pled therewith Sworn to before me tlus .::3..... day af....S'):1....... ,19~. `otary Public„~.R-Q4-t</.. 1] :..K~R..'!~:....... County HHfEN K DE VOti • • • • . NOTARY 4tiBLIC, State of Nevi York S i ^nature o C a No 4707878,Su4fulNCouMy ( ~ pelican Toren lxpires March 30,18 C ! ~ D y~„ „ u^/