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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-19012 Date MAY 2, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 610 THE STRAND EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 21 Block 5 Lot 1 _ Subdivision PEBBLE BEACH FARMS Filed Map No. 6266 Lot No. 131 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 1988 pursuant to which Building Permit No. 17501-Z dated OCTOBER 4, 1988 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 ONE FAMILY DWELLING WITH ATTACHED WOOD DECK AS APPLIED FOR. The certificate is issued to NINA MAGEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL JAN. 9, 1990-88-SO-116 UNDERWRITERS CERTIFICATE NO. PENDING - JANUARY 17, 1990 PLUMBERS CERTIFICATION DATED FEB. 9, 1990-JOHN L. TERRY Building Inspector Rev. 1f81 eoaaa xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ U 17 5 01 Z Date .. ~:.!~...4~:.........7 .............. 19.~.R Permission is hereby granted to: ......~.a.i..... ... .2..~.....~ 1..A... ta ...l..t),n-R~l/)..t,L.~-...4,:...~?1R..~~ ../..~'(:/':K~!'~j ..!~-!rS~r.S~....'~,+?-!~: {~~ ` 10. .... ... ....... at premises located at ...~?.~.Q............~R.....~^^f~:...........-~`.a:°.~.....Q.~L-lrr:'1...... Counh Tax Ma No. 1000 Section Q ~: ~....... Block ...... 8.a~......... Lot No. ....0..' pursuont to application dated ... ~ ~.. ....T ........... ....... 19.4.6.., and approved by the Building Inspector. Fee $.~...t.~.t.~~ ~~~- -~. ....................................................... Building Inspector Rev. 6/30/80 a~ ', ,;' T0I1N OP SOUTIIOLD BUILDING DEPARTf7EtiT \,...,~»N. TONN IIALL ~(y'}' ~ ~j~~ ~~J ~.~ SOUTDOLD, NE{7 YORK 11971 El 7es - taoz ~ EB - i 1990 APPLICATION F0A CERTIFICATE OF OCCII .. DATE.. ~~. jc:...... NEH CONSTRUCTION .y~,.,,OLD OA PRE-E%ISTI27G BUILDING...... VACANT LAND........ Location of Propcrty......._.._. T~~.. fT~/~niJ ......... ~>/_L-~T~.,yiP/o~cl UOUSE NO. ~ STP.EET UAMLET •~~~ Ovner or Ovncrs of Propcrty....N!/~~L__i?~,3¢GEN County Taz Map No. 1000 Section .?:~.,_ Block ..:~ / R _. Lot' .... .... SubdivisionQ:~'61:.y/;t;~__F<;a. ._ Filed Map ..~~~G_Lot..~3~.,,_ Fermit No. ~7 ~~..Date of PcrmiC o:-y-,y~B~.Applicant {;/::~,f~°:{;Z^:/N~r-~/1- i"^,<fG-Ei-J Fi~ealth Dept. Approval .................. Undcrvriters Approval.............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate .. nn.// ., t~...._....... Pee Submitted: $._ 2 ~ ~ ~__.,...._.. APPLICANT... ~. w ..... u rep- 10/14/88 ~~• 3 9 yas ~ 0 ~ iqo 1~- >... . ~4 ~.-.N I,, _. :~ J A. B. C. D, FORM NO. 6 TOWN OF SOUTIIOLD BDILDING DEPARTMENT TOWN ITAL. 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must be filed in typewriter OR ink and submitted Co 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 Dcalth Dept. of water supply and sewerage^disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from ',p lumber certifying that solder used is system contains less' than 2/!0 of IZ lead: 5. Commercial buildings, industrial buildings, multiple residences and similar, buildings and installations, a certificate of code compliance from the Architect or Engineer responsiT}le For the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" land~iuses: ' 1. Accurate survey of popcrty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completedlapplicatioa, a consent to inspect signed by the applicant and a certified abstFact of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of pccupancy is denied, the Building Inspector shall state the reasons therefor is i~riting 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. For Vacant Land Certificate of Occupancy: I. An application for vacant Iand Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership o~~f~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. FEES: I. CYiYt'IfF1l;ATli OF l7,CCYTPANCY -New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Duelling $25.00, Swimming Pool, $25.00. Accessory building $25,00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Qccupancy 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. Dpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$15.00 Residential Commercial ,~' ev, 1pJ14JS8 V~6._.N_~'t_ l.i'h OVA ~~~~FFOt.N~ 4;; rA. ,~ ,~. ,.. ,rl r ~- `~.__ r. _rrv 'I'OSVP! ()F' SOUTII(?LE2 orrlcr or nu1LU1NC uJSre•.cTOR I'.O. IlOX 728 '1'Ori'iJ l1ALL SO[TI'IIOLI), N.Y. 11971 April 12, 1990 LYNCH HOMES, INC. 32] COUNTY ROAD ~39A SOUTHAMPTON, N.Y. 11968 RE: NINA S. MAGEN To P7hom This May Concern, Vle are unable r_o complote your Certificate of occupanr_y becau~c of the following reasons. TEL. 7G5-1 £07. J' //! An :.application .or Certificate of Occupancy is not nn file. (ENCLOSED) / / `lo Underwriters Certificate on file. ///~ The check .is /not ou file.) $25.00 /L// t:o !Ienlth Dept. Approval on file. /_/ t:cr final inspection has been made. Ple,ise contact- our office on this matter. Thank yor.r for your cooperation. Duildinr, Permit It 1 7 5 0 1 Z Builclir. Uept-. $kk/ / Pto Plumber Solder Certificate on file. all permit:; involvin7 plumbinc3 being .iasuecl after April 1,1909 } NOTE: ADDITIONAL FEE OF $57.00 DDS BEFORE CO CAN BE ISSUED. _____~~ t~llM ~'.±~~~1~C~__LUt~s:"~.-.-. ~.~ . _ *~~8c~~_~_sa~.krs___t6" 0.e.o ~t,~. ~ ~~ • ~ ., ~ ~' C i~~.U1tv~~S.~_ -° -4~6 era ~iat~o~~.~~_ ~. ~±_._: _,~_- ~---~- .. - a c r ~. ~,,,.4~9~'~ar ON G~K1c. FooTi t~0,2cr Z n6 zx$.3UlST ;.. ~~AQ~ri~ , ~Kpi ~ Y R i It ~'S' 16'o~c, n .~.-. xg Gi~E . ~,~~+~c~ ~! ~ ~. ~ .A ~ ~,,., . n ~oiS`i; . ~.. Zx S~~s~ .,•, Z~ 8 80~ 16"a.c ~ ._ ; man ssc, ~ti , ~: ,'• ~~~:. .~ ~., .4x~ G~rz~r~~ ~ '~~~' t~Tti`ws-,S"M'~, co ;. 2..X 6 No ~2 ~~'~~ ` ~~..h. ~` . ~ ~~~,. ~f ~ ~.... ~~ t.~~~° Y ~ ~ ~ ~~~~ P ~ C~ f '" ~~ fey, 'yt ,.., ~ d5'j«, ' • .~~„ ,..+..n«» +m++.kw~+*+n.....~nrvr+4w.~'""~IPrvtl+*l4^'R i' ~~ ~ ~F ~~~ w &i ,; ~ , a ~... ~~ ~ ~ -~,, ~.t+ - , , a ~~ ~~s~ ~e.~~;~ ;'.. 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F'~p ~~ ~ x ~~.~a dns;_ awe .r' 4 w j ~~~~V ~ ~d ~ ~62~ , v k 4 ~ .' ~ ~d /i l~ iM QQQQQy ~~' . .. ~ - ,y~¢. y ~. r <"r'. ~. ~ ~ ~~~ ~ ~ ._ ~ ~ yw~fp '~ .,~ ~ c , ~ . o. „ . i ,. , W t y ,~ q ~ rp~.,'R ^a'~ ~ . '1~. .. : "T v J J'Q ~ d Rv~r ', {'F'~' J H ~,~ s.') U ~ d%~,...,...~ . , » ...„_ .. y" ~ / * y~~ x-' . ~ ~~ ' ,~~ ., ~. , ~, .x~ r « \ 4.~~ "A~~`TM Y]n..'..w~aaruwn...wavr~v.,wwrn..'MU. ~'s~- ,~` ~~*'... , N ~ ~~` , x ' F A ~~ ~©~O D~ TO'4YrN OF SO'UTSOd~D f'• ~~ ~-° ~ OFFICE OF BUILDING INSPECTOR ~ "- P.O. BOX 728 ~,. ~~~ -e TOWN HALL 001 ~,~p'r SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N TEL. 7G5-1802 w ' '~[ I!~ ! APR 2 Q 1990 ~ , ; ,,s E2l.t,C~. L7kPf. 7L1 OF q~31l7H49lp~iv~~~ Date 1 ~-q , q, / q q a Building Permit No. /7,'f o/ Owner__Njy~. ,,,,~rgGE~ (please print) Plumber_ "SqH ~., Le ~~j~ (please pr~nt)~--T- I certify that the solder used in the water supply system contains less than 2/10 of l; lead. (plumber's si~jnatt'ire) Sworn to before me this ~_day of ____~ ,~ PETENE,sWAHN _ No-mY A~lio, Stote of Nett York 19~, No. 52.825~2g0 Not ry is InStAIo6rCawgy , Notary Public, c ~~County " °~~aeSept9q~ i z ~~/ 765-18Q2 BUILDING DEPT. ttVSPECTiON [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [)FOUNDATION 2ND [)INSULATION [ }FRAMING ~INAL REMARKS: ~~--~ ~____ ' .. ,~L.. r DATE ~ D INSPECTOR .. ~~7~~j 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ~ ROUGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ :~ S d ~ 765-1802 BUILDING DEPT. 0 NSPECTION [ ]FOUNDATION 1ST [ ] R GH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL f J~ ji REMARKS: ~-~;~ ~;~ ~-~., DATE .~ ~ INSPECTOR __ :. ~ ~ ~ 1 765-18QZ BUILDING DEPT. lNSPECTiQN [ ]FOUNDATION i5T [ ]ROUGH PLBG, [ ]FOUNDATION 2ND [ ]INSULATION T DATE C~1~7 4 / ~' [ ]FRAMING [ ]FINAL NG DEPT. tNSPECTtON [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ,_ `°-g= •~ `- %~~_ D n//1 l DATE ~ ~ INSPECTOR = ~_~ ~ o'~z 7 f ~-~ ~,~ ~-'~i, 17~~1 ~ 765-1802 BUI4DINt5 DEPT. INSPECTION [ ] FOUND/xT1ON i5T [ ] ROUGI~i P4BG. [ J FOUI~ATION 2ND [ ] IN C 7 FRlKMING [ l REMARKS: ~' D 1 ~-- (Z.,u 9-107 f° ( O ~ 4~ :~~~ u~i~ et cn ~a z 5 ~v ~~ _f~rr --- v DATE ~~INSPECTOR~~L~?, 7654802 G~ C ~ G~ " r BUILDING DEPT. ~ ~v~J~ INSPECTION [ ]' FOUNDATION 1ST ( ] ROUGiH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL DATB~~ ~ I f REMARKS: ©~ ~~ ~7~d~~ 765-1802 BUILDING DEPT. r~.~~~~ir.~ [ )FOUNDATION 1ST [ ) ROUGH PLBG. [FOUNDATION 2ND [)INSULATION [)FRAMING [ )FINAL REMARKS: DATE ~ 2- 8'$' INSPECTOR ~~ d~t~ ~~~ 1 ~ ~'®! 765-1802 BUILDING DEPT. INSPECTION [j°] FOUNDATION i5T f ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL ~~~~~ ~ REMARKS: "~~_.T ~-- DATE Z ~1 ~ INSPECTOR I ~~'~l (65.1802 BUILDING DEPT. INSPECTI®N [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE ~ INSPECTOR ~~ ~~ ~~ - . 765-1802 BUILDING DEPT. ~NSPECTOON [ ]FOUNDATION iST ( ] FOUNDATION 2ND [ ]FRAMING ( ] ROUGH PLBG. (]INS CATION ( FINAL ~~ DATE INSPECTOR REMARKS: _~.~c'~~ ..~~ ~6 C, 765-1802 BUILDING DEPT. INSPECTION [ )FOUNDATION i5T ( ] ROUGH PLBG. [ ~ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL . 1) ~ ~ I Tss-iso2 BUILDING DEPT. tNSPECTlON [ )FOUNDATION 1ST ( ) ROUGH PLBG. [ J FOUNDATION 2ND [ ] If~l-SULATION [ ]FRAMING [ /~/FINAL REMARKS: I /__ ri YC_.SL~N ~'~'- Gi22~'~~~-' l ,c,.~ ~~ ~ DATE~U ~ INSPECTOR -~~ I Y i h! ~ 4 ~ ' ~ ptv ~ 5r ~I~ "^iN' ~~N'~ '~e~ tihF rt4~a Ar '-n~}E y°y+.v~t~ Y~ M1 ev ~~ v v,~(w' ~ ~ •• r, ~I ~ 1~ ~i ." 'C z n~h~ '° ~' ~ u~ ~ ~~~ [ ~4w1 c ti ',i4~ 'S 7~ ` ~ Q ` ~ ~ ' ~ •• ~~ !5 r ~1 ~ ~ ~ ~. v a, ~. ~ ~ G~ '.° 1 J F ~.' ~ wi s• i * - ' f~ ~ ~:.~. 1Y ~ i ~ / „_, bsj r ~ ~ ~ ~ ~ ~' ~ • i~~ i'Y ?~ F~Y~t~rnF i ~'t P°v~i ~,~~~~`'k~81P~y~o~4 ~Y" ~"e ~l~~Y ~~ Y~ ~~ ~ fZ~~ - r~y~~,~a ~~ I~f~} ~V J d4b. I 1 ~ ~N ~'Fef~'RV~~E 1 ' Ik ~ t ) LrN' r n r,~~i l~~Y~ f1J l4IP i5( ' '.i' ti " ~ ~ a .,.:. Y~~~t u s t 're Sr y~~~R~1f'~~, ~S ~ '~ re~~J4„F Ct ~~ ~~I n', t '"h1 } v t ~ ~ Un,~~b5, ~ ( t ~ , ~ ~~_ ~ i~ ' 4 ~ ~ ai o' ~p ~1 ,~ w , N i 1 ~ +'",~yat t .~ ~ ~y C ~ Y ~ i~1Ji ( ~'~~ t, f _ i f t~ ~ pmrwwr - C' {N i .FI <r r S ~ n ~' 'e ~ 414th 1 4°. ° i ~ 7 1 ~ .~ ' n r' ~.JA Y r.'+~ i 1~ ~ ~~~ 4 ~~ ~k~ ~~• ~ ! ~r.vl 1 (~tl i ~ F i ~ 44 4~ ~ ::y __ "~~: 1 ~ ,, Y ~ ~ ~ 4 '('.. _, ':t.~'-..,~ """\\\-.`a\\„lam \ i ~~\ E ~„ ~ I ~~~~,; ~_.,..:.:~.,... d. ~ ~~:, _._EE N.C.E,..fi.CJ3 Q E N 1 I .6cnTON~il~~7ER c~-• ~. ,«~. ',.~ a '`"~ ''r~r"~ ~'hD'j'" .~ > ~ ,` ~~ ~ ~~ , ~'~ ,. .,~ ~ a : I , x ~~ f ~;~ ~ i .. ~..F tira Y, ~ ~ ~~ " ~~~ . ' , ~ ~. ~ . ~ ~~ ~ ~4 ~ lV ~,u*%~'~ir ' '9; ~ti ~,~~'~~ :'1c:LD It:SPEC~i0t7 ~~UATE J .'; ~ .~.~ ~2 d r'OUtJDATION (1 FOUNDATIOtJ (2nd) 2. /Z ROUGH FRAME & PLUMBING G9~1 3. a a IIJSULATION PER N. Y, STATE ENERGY CODE 4, FIiJAL i oorrr~c~rrs A ~I-K ~-~~-- .~- " R.Lwr1 .GD ,." n ~ /V % H n / t - - C 1 ~ ~~ ~ ~ ~ 0 ., 6 G ~ ~o ~ c ti H C1 [~J ,.3 rr // ~ V~ ^ ~ ,~~ _ r ZN ~ H ~~ d I~ r .- 4 _ P ~- ~ - o z COMMENT S : x v /^/ - '..•.l(~,-yn'~ i - - ? -~., .~ ~ H G1 ,$- ~ ° z O q fi ~ cn ob o0 ~ I / -e . ~_ H ~ o v O { a ,.. l %/ ~o ~ ~ ~ _ ~ ~ , q . '-, a v H N - ~Pa ~" m : •.. c- p ~5' ~ 0 `'3 Q ! • m .y /~ H Q "`°`"-~""" ~-~ FORM NO. 1 ~L~ ,~ Q TOWN OF SOUTHOLD I9B8 BUILDING DEPARTMENT TOWN HALL BLDG. KEPT, SOUTHOLD, N.Y. 11971 NN.OF SOt1THOLD TEL.: 765-1802 Examined .R~'~?~,.'7'..., 19~$, Approved .q ~~}., . _~'„ 198. Permit No. I.~~~.I. ~?. BOARD OF HEALTH ... ....... 3 SETS OF PLAN$ .!~..... SURVEY ....../ .......... CHECK ........1~............ SEPTIC FORM NOTIFY ,~°,d'c~~. d c~ rJ CALL a. ........ MAIL T0: Disapproved a/c ....... . ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 1~... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 gets 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- ~ation. c. T1te 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 ,hall 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 ;gall 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 3uilding 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. I'lte ap~>licant agrees to comply with alt applicable laws, ordinances, building code, housing code, and regulations, and t~ uimi[ auUtorized inspectors on premises and in building for necessary inspections. (Signaritre of applicant, or name, if a corporation) ,~2.I,Coun Rpacl3~•~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. ................................/~~.~/...^..,.p.....F3ul! )Berry...d..~.%.....~.j...........:............ . Name of owner of premises ......../ .N.1. [ ."1.7:1 ..... ~ ~.....! ° .V l l..v71 ,~~. ?.T ........................ . (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. . ~.~J, ~, ,~, ,~ , . , , ... , , , Electrician's License No. 3~~0 . ~........ . Outer Trade's License No . .................... . 1. Location of land on which proposed work will be done.. , ~ , , . House Number, , , , , , ~ ~~ , , , , „ , , ,Street , T~ S'(;rAY'1Gk ,Hamlet ,~`~f ~rtOY~ .... .., County 'Pax Ivlapp No. 100,^0 Section ...!~. ~........... Block .. ~• ........... Lot .... L ............ . Subdivision ...r ~' b ~ t4 . ~.~r~~.. ~~rl•1r1.sS... Filud ;iiap No. ..'~1.~~,(o, .... Lot . ~.~ .~ ..... . ., (Name) .. _'. State existing use and occupancy of premises and intended use and occ/upancy.}o-f proposed construction: a. Existing use and occupancy ... V4Ci~f :1~ ~./4+!/~!i~t01~'Q/Y.. ~Q/ ............................... . b. Intended use and occupancy ... 9• • • a ..~;,~,1~~ ~ z , x ~t. „;~s ;v?~z~`, , ,, , ,,, , , , , , , , 3. Nature of work (check which applicable): New Quilding .... V..... Addition .......... Alteration .:....... . ,Repair .............. Removal ..... , ........ Demolition .............. Other \Vork ............-.. . 4. Estimated Cost .. ~ i. ®0~ , . ~ CD~scl'rfption) ~..... .. ®.0 .... ..... Fee .............;,:,. 't ... . 5. ; If dwelling, number of dwellin 4 (to be paidion filingahis application) s g nits . , .... ~........ Number of dwelling units on'' each floor .. 1 ............ . iIfgarage,numberofcars .... li .................................................................. 6. If business, commercial or mixed' occupancy, specify nature and extent of each type of use .... . .. . ..... . ...... . 7, Dimensions of existing structure, if any: Front ...... , .'....... Rear .............: Depth .. , ........... . Height ............... Number of Stories .........:.... , ........................................ . Dimensions of same structure with alterations or additions: Front ................. Rear ..... , ........... . j Depth . ......... . ......... !..Height ...................... Nwnber of Stories ..................... . 8.' DTrnensions ol,entire new construction: Front ...`~.~t ~ ........ Rear , .3a~......... Depth ~?~,~.. , , ..... . I Height .a$....... ~ Number of Stories .:.,..'~...: , ., ....................... ............... . ..... 0., Size of lot: Front .~ ~ . , . 1 ......... .. , Rear ...... ~0, ~ ............ De th .~ ~55.' .. . .... ..... . Date of Purchase ~ ............. . {~, , , p t A'l F3 . , , .Name of Former Owner ~.~~.~'6°...~?.-:4~.hr...~".aR'Olg. 1., Zorle or use district in which remises are situated ............................ ..... , ........... . 2. Does proposed construction violAte any zoning law, ordinance or regiAation: .. /~Sa ...... . .............. . 3.' Will lot be regraded .yes ....:........... . .......Will excess fill be removed from premises: Yes No 4. ~ Name of Owner of premises ,Aa'M/A...1?'1 ~.9,Ps11(.. ,Address ~~`/ : `.~.5 . A, 5/ ~'~J'etmlclr Phone No.7/S.' 734; ,'? (O~ ; , Tt~o!r'fi4S TI.~V, Frv~$o to I Name of Architect Address. , m.~`P~a?-t~ . Phone No.!`~'~S.'937~.. . Name of Contractor!-Y^?~µ..'~^~:......,Address?e'~l.fiF.y.P{l3,gA,5'~"'~k"'`PhoneNo~!6,-a?~'~.~a~. ISI.Is this property located within 300 feet of a tidal wetland? *YES....NO.~"~ !*If yes, Southold Towq Trustees Permit may be required. PLOT DIAGRAM I' Locate cleazly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from >roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. ~TATE OF NE V\~-'~''Oi~~ I'~/ I S.S pU 'I'Y OP ....~.1 1 `~ ~ i ins a ~~. ~(Nam~ int~ dual Slg ' ' ' ' ' bCing duly sworn, deposes and says that he is the applicant Wing contract) bove named. l ....,,,..... ,f is the ................. ...... ............... I (Contractor., agent, corporate officer, etc.) said owner or 'owners and is duly authorize erform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of Iris knowledge and belief; and that the vbrk will be performed in the manner set forth in the application filed therewith. ;v4orn to before ma thts ~~ ~ day of . _..._.,.19- 1'otary Public, County // ~~ N lC1A~IgB4.!QLBW ~`~~ ~ C///'~ . ! ~Y Na~,~g~fNrwYMk (Signature of applicant) QuelNkd ih Syffolk Cou Commission Etcpiree December 8;19._,,, _ a ,J ~' v' x o ~i K • ` r i i -r . ~ ,~. ~; K ~;~ ~~ i 0 v L ~o r -r x,~ a' h ~~) O w i Imo. • °N e /Y - `j ~ ~ A O ~ V W 7 ~ i~ ~ q S W ~ '}u ~- v 5 2 .7Y ~ ~ 4 ~ ° a ~ ~. ~ M ~~ ~,: x ~ x ~d ~. _ N ~ ~n a ~'~'' 4 LL , -! n 6 ~ 1 ~ . ~ ° h~ } U ~ ~ f ,''i i~ I it ~~ ~~ Ri 1 i~ ~, ~~ ' ~, ~ ~:, r' ~. 1~ / ~i /iQ iZ 1 ,, 1 } y rNv v ~ ~~ ~ '/ 4 ..r-' ---•----~- ~o -~.j t --- „n n rl;il M 'Q, moi Xrnj~- uI I ~ w, ~i ] ~4 r~ ~ ~.~~-. ~, ~ ~, ~, --------r ~ d Qhs Nyoayog9x~% "'~eM1~' ~~ ~ ~~~s.~ r \ `'~~ n_ \. ~~~ ,' ._ _~ I ,.man ~' $ s 7~3 !" n°` I i /~ ~~ I. a, cz ~~Q 4~ ~ ~'?~-~ ? ? ~A ~ \ I~ ~ ~ \ a x ~¢~ ^ ' ~~ ~ ~ l 1 '~" I' ,~~ ., ~, ~~ . >< ~,I ' ~. ~~ t' o. e~ 1 r _ ~ I i ~ o , ~~ ~~ + ~ ~-' ~ i D~ a u V~ n~ J C/~ J ti ~,•„i z .n Po ~ ~ m ~y M ~` f ~ ~ ~`i H~ ~, Q ~ o e Q,'~- V N ~ r: cu ° ; ~; v~ ~ 3 c~ ~.: ,r z o a u W ~ ~ ~, ~ r„» ._~ r_. _E '~. r - `~ ~ { ; Dir ~ p a (~ i ~ . _ .{ ~~, a ~` r ~ .R Z ;. ~ ~ o ~ p Q ,.C ~ ~ x ~ W W ~ c1` ~ O W r"' ~ ? ~ V ~ u m N' '' SAY ~ob~ ~~ Q N~ "~ E ~ N ~~ ~e ~ .W~aS ~~.. ~ W m ~ a o T 0~ ~ us ~~t0 '~h~J ~~ ° z =_ ~ ~ J z ~p• pb ~"" '~ v~ 4~~ 4 C`311! a 4 u Z W Q O @r~~ ~ti" ~ d G ~k~c4'~,~ ~j~~ N it ~~ ~ ~ ~ V ti o ~ ~ ` 04ei Q.~~ %L`a o ZZZ Q ~ ~ J Q o ~ t/'~ Q~ N V~ W J l1~ o~ w rc ~~ Q ~ O h ~ ~ 7 ~4i~of~ ~~ a Oao ~ M W ~ ~ ii ~,1 ~' G~ p i 2 ~ n z ~ ti (n ~ ®- ~ ghoo3; ~- WWI ~_~ Z w ~`-~ °~< ~~o i `% C4' ¢ a ~ to Z J Q ~ N 'o fY. 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NOTIFY CIPLI i4VG OF Pa RTMEPIT P.1 765 ISOC H AIN TO ~~ "`s FOF. THE FOLLOWING LN4~'F ('ilO~15. 1. fOUNOAI ION ~ nN0 REQUIRED FDR POURED CONCRETE 2. RDUGH -FRAMING t0 PLUNKING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONBTRIICDON S ENERGY CODES, NDr RESPONSIaLE FOR R16NT ELEvRTIO"~ -ASy c I vl r.iCx rG, / or '3 N 1 nl R . 5. N1f~EN L Ef T ~ IEVATic~~ ~I~~~ \ / / y~ scq~L - ~,~- I'O" ~ ' ' , r r ~ l I i I I i I ~ ~ _ ~ __ . ~'. l I I ~ T I ~ ' - r ~ I I ~ ' i I I i l ~ I I i IP,. i _ i.. li d I I I ~ ~ I 1 I I ~ ~ n '. ~ I I l i I - ~l i l l ~ II I ~ ~ I I I , i 1 1 i l l l I I I , I CI ~~ ~~ Uu~,~; ~y,~cN N~Mts Irva ScAtc ~a/~ = ISO" ~ _EHSy </V/N 6r' P4 3 ~ c ~ FRDN I ~(,CUA-f10aJ N/n(A S MA~jEN, "" S ~ ~ k ` _ c° h? . ~ oh ~ N 0 NoTg : A<< eaEC. AS 0° QF0. CDD6 ~~___~~ Ko- 59x47 ~~- .J °x 4°qc o2W ---_--_ 1 i J ?I~ a°rvPo ~ tt %z v2j~ ' J iKiiT r ~ d ~ . 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ZSanys - ~~ _ ~ ,~ -1±__L~------ -- - ~ - p-~ ----J --- ~ --- ,f ~ I U,I ,, - ~ x ~ ; ;,,c';' +3 a 'F ai r- Y I o m i ~' I~-' o„ ~I ,n y T ~~~ °~~~~~~ ~~ U i~!~ A T t U 1~ ~.L s1 /`~ S~Acc ~'~-1 'd" Pte, .7or- S ' r1~~1A.5 MRLZEN L'~~;:Irl:m; lie•~ i~~i~ !~y au-eptr~hl-• Practn_e F•Cri ~ flerr'ie~rl"5tai: Eneia'~ ~onservalron Cmv~triittlr_ai Gud? d!1i~37 }:~_ ~~~ 11[.'`JD ~.r~'i TJ SUt=~ Jr-vr ac ,SAP. SEw, ~.~,~i14. i=ou;;t~; ni•nn Dpgr5e u~ys I I f'~~i!nl;~irn Ti~_•rl~ial F°: torrnance 'Jclues For hlOil El rr~l_n cs~l Htatvig ~',~-~:;~~-~;n;in .rSU F.'19 _. OSU f.ld I I I .:il~llpl'rv~ll~ USLI PI`S Glu_li:q 58 LI i, ~ (nnt to ex~~e•d 2~~a r( yruss ~w51U Er~,lr-r•~,c ~1-,~,- d0 U I r,,._ - -L 1 ~f II„ .I ~._. ~~~ 7~ <__~~ ?y 3;<S iJiN.4 5 M/~~~~