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HomeMy WebLinkAbout17227-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218253 Date AUGUST 7, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 737 OLD WOODS PATH PVT. RD. #10 SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 87 Block O1 Lot 23.4 RUSSEL & ELINOR Subdivision FREUND Filed Map No. Lot No. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 8, 1988 pursuant to which Building Permit No. 172272 dated JULY 18, 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 ATTACHED GARAGE AND DECK. The certificate is issued to PATRICIA A. CASTOLDI (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-70 MAY 23, 1989 UNDERWRITERS CERTIFICATE NO. N081976 JULY 21 1989 PLUMBERS CERTIFICATION DATED JOHN E. WALTERS AIIG. 1, 1989 ____`~_S~~ - - ` ~ Building Inspector Rev. 1/81 FOB,M NO. A 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) ~]0 ~1722~ Z Date .......~~.....I....p 19..0 Permission is hereby granted to: / ...~'s.~.... ~ .....~,.......~.:.y.:... ~ ~ 9.~.~~..... to ...~-:~:~..~,.....~.....~.~~r..4:s~a~.....~~...c.~..,... r of premises locoted at////lIll..~.,3.~.~.........~.l..C~"~-~......14.~...........~$-45~r.::!~~ County Tox Map No. 1000 Section ......~gn..l......`.^~Block .......5?.I........ Lot No....s`~.v3.r.~...,..,, pursuant to opplication dated ..........~.....d 19.~~., and approved by the Buildingclnspector. Fee 5.~.~a:..`.E.~... Building Inspector I Rev. 6/30/80 w. FORM NO. 6 TOWN OF SOUT[IOLD BUILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the fo~l wing; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Ileal[h DepC. of water supply aad sewerage-disposal(S-9 form). 3. Approval of electrical installation from IIoard of Fire Underwriters. , 4_ Sworn statement from plumber certifying Chat solder used in system contains less than 2/10 of lz 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 [he building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate surveil of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of Che entire lot prior Co 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 inspectio? of buildiugs or premises, or other pertinent information required to prepare a certificate_ C. For vacant Land Certificate of Occupancy: I. 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 [he 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 OP OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration [o Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over S years - $10.00 4. vacant Land Certificate of Occupancy - $20_00 5. IIpda[ed Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $-5.00 Residential ~ $50.00 Conunercial ry ""-v- 10/14/S$ I E~42°y~~ D,'~ 88/71J01 •nax ~~~~1~ a-IOHxnos a N •la~o ~~o-le ~ 1?" 9nV I I', p0~1 ~.D yty' ~j-~-~%z. . v n I z a aw , J :pa7azngng oaa a7ro~~~ II,z3?7xoA Irvig a~rot3i7xa0 .SxrxodmaZ xoI ]sonbog I ••••••-••+•'s ix•• TrnoxddV Pxroq 3nzvurTd ••'••••••sa:i•••Tcnoaddly sxo~txnxopun ••••••-•-••••y.~~• ZrnoxddV •ldap y~Tran ~PIo]s~~•s2T$noQ ~•8'[~Fz7Ea ]oroYjddV......_... aimaad ~`o a7rp..~~.•'CfG'J4.Ol, 7iciand .....••-Z •aQT........ dry? PaIT3 ~'Arf~k~'~io2~~~~ R'27~s$A$•vo,~:a:nrpgr~S .....~,£Z. 7oT ....tQ. ~IooIII ...Zg. o~,,ai7oaS 0001 •oN drY7 srZ 6~nno0 ••..•...••••..•.......'•••""td10ZSd~'6~b28Y~'d•'••'Qxxadaxd ;o sxaunp xo xaunp Z~Ty7vn , zaa~ZS •oN asnon .•..••.........-•Q70kZf1{JS'•••..•.._......1i~9d~d00h1 •d'Ib•L~L•..6~sadoaa 3o voi~rooT I ~ ONVT 1.NVOVA• • ~•'9liI02IAII 9NIZSI%a-cT7Id HO Q'TO•"}~X•• NOI~.On`3Z5t:00 H3N 68-T-8 -gZVO 3017VdIl000 30 HZVOI3IS7i8~ 2103 NOIZVOIZddV ~ i I ZO61 - 59L I ~LG1t A7I07C tlHN `0'IOnZn00 ' 1`IVIl NHOZ ZN81.Z2IVdHQ ANZQ'IInq 010nZnOS 30 NMOZ' : . ~ , ~L i i ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS # ~-{{l~~'TT'I BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 70038 Date r7UiLY Application No. on fife ~P'''K~'T'~{3fii -ti fli2~~3'fi~ THIS CERTIFIES THAT only the electrical equipment as deacrihed below and introduced 6y [he applicant named on the ohove application numher in the premises of ~.CAS'1'rl#~G'S; 01,1) F~('~13Ci;i laP.`t")~, F`illeN) ~9?xr t~'7~?~'A=b~~Ti. b1.Ye Ir~~ II~~ fiAAIc?u`.~' in thefollowinq l~co44lo ,LJ s ment O lxt FI. ? 2nd Fl. .Section Block Lot sltlP~k, ?fl, ~$t~~s was exmnined on and found to 6e in contplianrc with the requirements q/'this /loord. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FWORESCENi OTHER AMT K W AMi. K W AMi N.W PMi K W AMi. H P 9~ 67 ba 1 t=„8 1. 10.E t 7.a., `9 N' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RFC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. Oll H. P. GAS H. P. AMT. NO A. W. G AML AMP. AMT AMPS. TRANS. AMT H P SYSTEMS pMi WATiS NO.OF FEET Q; #7 9 {i~{1 SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A W G A. w.G A W G. k AMi. AMP. TYPE EQUIP 1 ~ TW 1,e' JW 3 9 ]W 9,e' dW PER 9 OF CG COND NO OF HI-lEG OF HI-lEG NO. OF NEUTRALS OF NEUTRAL OTHER APPARATUS: : (i,5 k~~7 ,S``I'F;Af2 ttidT'P'-i, 2 '!/T. 'POP) AIc7 CbNiJ'_1 PFttxk;i,N{i7~12~;;'!-iF• C.l.it. 1 ;5 SY4iiY;:n. 3)L ~"I,C;T'Oft : - ~ ~J~J~~ GYIS"1'nV if~)t`I')¢r? L,7C,#t"Eri~`~'"E ?.2.7 P;. HftItiA~'H A'['ttY3 tit)%i I) GENERAL MANAGER AtA1"i'PmPIf:K, ~'i', sT9r>:Y ~1- i' Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by bt eir'credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AN MANNER. r TEL. 7G5-1802 Oc~~FFQC,S-~~1// TORN OF St~~3T~Ob,D f ; " , ~ OFFICE OF BUILDIiQG INSPECTOR ~ ' P.O. BOX 728 y ??M1' T TOWN HALL O SOUTHULD, N.Y. 11971 ~/r101 ~ ,~.pO C E R T I F I C A T I O N Date us ~ Building Permit No. ~~7~~~ Z Owner .~ou~~~ ~~~Tt>[-i~( lplease printO Plumber SoltrJ I~RL,rE115 Y4u~++;~j t l~turirtG- (please print) I certify that the solder used in the water supply system contains less than Z/10 of 1~ lead. , (plumber's signature) Sworn to before me this ~~~yyy , day of - ~ . 19~-' ~ l Notary Public Notary Public, ~ / County Ery~g~pirypNEy1LLE No~• 662.8126860, Suffolk Co Term Expires October 81,19~- lELD I}, .S P C: iU,l i~n ~ i:OaKMENrS ? v Z. _ ~ _ H FOUIJDATION (1st) ~ c OUNDATIOtJ (2nd) 2. / z ~ ROUGH FRAME 8~ o PLUMBING _1 ti H 3. m ra H IIJSULATIOM PER N. Y. ~ STATE ENERGY CODE ii ~ x a r m 4. ~ ~ y FIlJAL n ~ z ADDITIOIIAL COMMEN S: x 1., ~ ~ ~ - -P ; ' x ^o H ~i 9 H ~ / O ~ ~'M. 2 ; i • 7 _ 1 ~ w n'7rv,, TEL. 7G5-181!'_ ~5. ~O, T0~'N Ur SOUTIIOLD S i vii ',~4 ..c Ol~i'IC3i Ot: PSUILDING INSPECTOR ~'l`~ L~ c+ A~~,, ~ P.O. BOX 1 1 7 9 u' 1"~'°+`='~ ~ TOWN BALL '~~~yQ'.tl.f3i~~ SOIITItOLD,N.Y.11971 ••~yp~. ~ r~ . Tune 8, 1989 PATRICIA 6 DOUGLAS COSTALDI 855 EUGENES RD. CUTCHOGUE, NEW YORR 11935 'Po Svhcm This May Concern, Ole arc unable to complete your Certificate of occupancy because of the folloo-ring reasons. / An application for Certificate of Occupancy .-~//'is not an fil.c. (ENCLOSED) ~~..~Ji *fo tJndcr~~~ritcrs Certificate on file. ~['he checl: .ir: ( t on file.) $25.00 No I1e17.th Dept. Approval on file. I`a final inspection has beetr made. Pleasr.. r_ontact: our office an this, matter. - Thank you for your cooperation. lAr.i lcl ir,q Pcrm.i Y. I! 1 7 2 2 7 Z Duildinq Dcpt. }kk/d'/ tto Plumber Solder Certificate on file. ' ( all permits lllvalV]_ng plumbing being icsucd aft.cr 11prS.1 1,1984 ) NOTE: CO CANNOT BE ISSUED UNTIL 280A is ATTAINED. ~~~c~~FFO({~~®~ a FRANK A. KUJAWSKI, JR., President ~ y, TELEPHONE ALBERT J. KRUPSKI, JR., Vice-President C (516) 765-1892 JOHN M. BREDEMEYER, III Off, ~ ~ JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 June 17, 1988 Mr. Kevin Knabloch K & K Lawn Care Route 48 Peconic, New York 11958 Re: Mr. Doug Castoldi 1000-087-O1-23.4 Dear Mr. Knobloch: Pursuant to your request for a determination of jurisdiction regarding the above referenced property, please be advised that we have personally inspected the premises on June 16, 1988. We , have determined that this project is out of our jurisdiction. Should you need any additional information, or have any further questions, please do not hesitate to contact this office at the telephone number listed above. Very truly yours, ~ ~ Frank A. Ku awskl, Jr. President Board of Town Trustees FAK:ip cc: Bldg. Dept. Board o£ Appeals Mr. Doug Castoldi file c~UEFDLk~® s VICTOR LESSARD r.xacuTtvr; nt~M»vtsTkn'roR ~ ~ Town Hall, 53095 Main Road (516) 765-1802 ~O ~ ~ off' P.O. Box 1 179 Southold, New York 1 1971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD T0: BENNETT ORLOWSKI, CHAIRMAN PLANNING BOARD i. `h FROM: VICTOR LESSARD, EXECUTIVE ADMINISTRATOR SUBJECT: C. BLAKE 280A ACCESS DATE: November 30, 1987 Charles and Sandra Blake; parcel 087-1-2.7 is part of a sub- division (Fruend) with a road within its perimeters. Even though the approved portion of the R.O.W. has been approved to the point of the entrance to the sub-division by Z.B.A., the applicant, by 280A interpretation, must have an approved 280A to the point or points of entry to the property. When the Planning Board has approved these improvements, the Building Department will then issue a Certificate of Occupancy for the construction on this property. VL:gar ' cc to: Zoning Board of Appeals ` 2 ~ rss-isox BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST f ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMfNG [ FINAL REMARKS: ~ ~ DATE ~ (p INSPECTOR ~7z~~ 7b5-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ( )ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [~NAL REMARKS: ~-~X ~ n~ T ~j// DATE ~ ~ iNSPEICTOR ~~v r ~yy, rss-isoa BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] RO H PLBC. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL 4 RErMA S: ~ t i ~ ~ G~ ' DATE INSPECTOR { l?~~~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [v1 ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~RAMING [ ] FlNA4 REMARKS: .F i DATE ~ a ~ INSPECTOR 1~zL~ rss-iso2 BUILDING DEPT. INSPECTiOiV [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ' [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ 7 FINAL". REMARKS: , ~1~ 4 i I~-~ I ~9~ k may-- 't ~ /'o 'ctGl _n~./ k / E DATE D ~ ~ INSPECTO ~~~y7 7'65-1802 BUILDING DEPT. INSPECTI®N [ ] F UNDATION 1ST [ ] ROUGH PLBG. [ FOUNDAT{ON 2ND [ ]INSULATION [ ]FRAMING [ ] FfNAL ' REMARKS: DATE ~ ~ INSPECTOR . 765-1802 BUILDING DEPT. i Ns~ECT`oN [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION ' [ ]FRAMING [ ]FINAL REMARKS: L~~^,~~ r DATE v`~ INSPECTOR k ~ ~ - ~ ,,~~~oU~~, ~ ~ ~'G~, ~e ~~ut®~d T®~~ B o:;:~ ; ®ard ®f ~ppea~Is ~~OI`M, \~b~~ MAIN ROAD- STATE ROAD 25 SOUTHOLD. L.L. N.Y. 11971 TELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS - Appeal No. 3579 Application Dated November 10, 1986 To: Mr. and Mrs. Charles V. Blake [Appellant(s)] 695 Old Wood Path Southold, NY .11971 At a Meeting of the Zoning Board of Appeals held on January 8,_1987, the above appeal was considered, and the action indicated below was taken on your [X~ Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article Section [ ] Request for Variance to the Zoning Ordinance Article Section [ ] Request for x Application of CHARLES AND SANDRA BLAKE for a Variance for Approval of Access pursuant to ew_ or own aw, Section 280-a, from the east side of South Harbor Lane along Old Woods Path (Private Road No. 10), to premises known and referred to as 695 Old Woods Path, Southold, NY; County .Tax Map .Parcel No. 1000-87-1-23..7. x WHEREAS, a public hearing was held and concluded on December 11, 1986 in the Matter of the Application of CHARLES AND SANDRA BLAKE, Appeal No. ' 3579; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the board members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the board made the following findings of fact: 1. This is an application for a Variance pursuant to the Provisions of New York Town Law, Section 280-a for approval of , access over a private right-of-way referred to as "Old Woods , Path," or Private Road No. 10, which extends from the east side of South Harbor Road, Southold, in an easterly/southeasterly direction 600 feet, and thence 242.85 feet to the existing driveway. 2. The premises to which appellants are requesting access to contains an area of 4.282 acres, improved with a single-family 2-z story frame dwelling, as more particularly. shown on survey amended June 3, 1985, prepared by Roderick VanTuyl, P.C., and garage structure accessory and incidental to the residential use of the premises, for storage and garage purposes only. (CONTINUED ON PAGE TWO) DATED: January 12, 1987. CHAIRMAN, SOUTHOLD TOwN ZONING BOARD OF APPEALS Form ZB4 (rev. 12/81) 1 I I l ~ L86L `ZL ~',~enuep ~ ~ ~ ~i •pa~dope ~'Lnp seM uoi~nLosaa s~yl (•pau~e~sge siuo6iag aagwaW) •i~oLMeS pue sseL6no0 `ua~'o0 I`,~a6uLuyaog •sussaW :sa~'tl :p.~eo8 aye' }o a~o~ I ' •sLeaddy }o p,~eo8 aye }o aaL}}0 aye o~ 6u~~L.~M ui pa~~~wgns aq anoge pauoL~~p'uoo se s~uawanoadwL aye }'o aoue~daaoe ~eyl 'E •(e,adns `ea.~e ~'eManL,~p aye. o~ peon aoq,~e'{{ y~noS woa}) saw~3 LLe ~e uoi~Lpuoo pooh uL pauLe~ -uiew L'L~snonuL~uoo aq L'eM-}o-~y6L.~ aaL~ua ay; ~ey,L •Z •(Lao,~ed a3eL8 aye }o eaue ~'eMan~ap uadd 6u~~sixa aye. o~ peon ,~oq,~eH'~,y~noS woa} 065 ~fLa~eui~xoadde ~u~od a woa}) ~aa} 58'ZbZ L'',euo~~Lppe aye uo} `paLL~} saLoy~od pue `pua[q auo}s pa~aedwoa ~:',o [„Z] sayou~ oM~ y~iM paned aq o3 ~aa} ZL }0 4~PLM ssaoae pa~ona~.sgoun pue uado wnw~uiw a aq a,~ay~ ~.eyl 'L i ~SNOdlI0N00,JNIMOli03,3H1 Ol 103('8 (1S `e-08Z uo~~oaS `Meq uMO,L ~.~o~, MaN ~'q pa,~~nba.~ se ssaoae }o Lenoadde ~o} 3~t/i8 H2fQNtlS. QNtl. 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FORM NO. t SURU,EY O.• , • ~ TOWN OF SOUTHOLD CHE(~K ..~Y.. ~:f ~~0......... . BUILDING DEPARTMENT SEP'h"IC FORM . TOWN HALL SOUTNOLD, N.Y. 11971 NOT;[FY TEL.rJ65-1802 CALL ~1~~.`Y....c? d.l~,.... . 19p0 MAIL T0: Examined . ~ VV OO . 1 \ U gpproved U , 19 Permit No.. ~ 7 ~ . p~e~„ t~ Disapproved a/c . ~rt~/ ~ -i~ (Building Inspector) ~CQ ~ O ' APPLICATION FOR BUILDING PERMIT Date 19 - INSTRUCTIONS a. This application must be completely filled in by typewriter or ~ ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment 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 iemoval 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 nece~sary-i~spectio • • • • • • • • • • • • • • • • (~~-.Civil' u _ (IgAature pplicant, or name, if a corporanon) S5S-~cl,~e;s • /c~A• i •d3'•csjC3 36 ..~?"~t`-O~4!~.~ (Mailing address of applicant) 93s'-- State whether applican/t is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ©W n / ~.u'tu afl~_. ~ avrfr a. c~-o ~r . : . Name of owner of premises `(~s 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. • ~ E~ • • ~ • • • Plumber's License No. .~7rt5Ti` • •~~~+n•rH•~s ~ ~~r~Z Sav~c~,s~ Electrician's License No. ~~~z.~r`~~~ ~~c~zi~ ~Gvs -(3t~-sz_nz_F~~ Other Trade's License No . . 1. Location of land on which proposed work will be done. ~ ~orc0 s • • • • • • • • • ~ 3 ~s t-'t7•rrAS • • ~oc>-T~ Sow-i-0~.ol c~_ House Number Street Hamlet County Tax Map No. 1000 Section • . • ~ ~ • • • • • • • • • • • Block Lot ~3: • Subdivision .~Y\`!^.4}: gi'g' ~ ~'ssc~;L~-~ ~ nor t%rwn~l. Filed Map No . Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~~4.~."'r. ua-^'.~ . / b• Intended use and occupancy • :!-S'. `"j'• •t• S-!o•r•~a • S) r~l~ ~-u--"i lX r~s~ a~-,~cx; •u~,• i IJature of work check which a pCiicable): New Building , . Addition _ , Alteration . . i Repair ~ Removed . . Demolition , Qx~ r y~ . . p wr ~ (D'"esori 4.'' Estimated Cost ..~~i' oe a.. . Fee . g ~ (to be ai, 5. If' dwelling number of dwellin units Number of dwelling units on each floor . If garage, number of cars i , , . . 6. If' business, commercial or mixed occupancy, specify*nature and extent of each type of use , . 7. Dimensions of existing structures, if any: Front , , ; ,.Rear Depth , ~ Num N/A Height ;berofStories Dimensrons of same structure with alterations or additioris: Front Rear . De th . . ~ .Height , , Number of Stories , . 9,S ~ Rear .:~..9.s.:.... , De th . 8. Dimensions of entire new const ' ction: Front p . Height Number of Stories . ~ , . 9. Size of lot: Front .!moo; 9 ~ * i s3;s;az, , , , Rear !;?4•.<?-!.'` , Depth • . s = s 10. Date of Purchase v . Name of Former Owner F, KP-~.~:`:~*? .C! ;F:*:-!-~-, 1 1. Zone or use district in which pre~'mises are situated ..~q..~. (Ze,4 . ; , F1 . . . . . . ' 12, Does proposed construction violate any zoning law, ordinance or regulation: ..!?.b, , , , , , , , , • . . . . . . 13. Will lot, be regraded . ..............Will excess fill be removed from premises: Yes / V~ , Name of Owner of premises .~t,ST.44~i.... , , , ,Address ~'Pq:~!'!4s Phone No..:~~:f.:.~ :o!~,-. . 14. Name of Architect .~~r.~! :-A !~P.~.K!~. , , ,Address arE4u ~G Phone No.. ! :.?'?L 4.. . 15. If tessoSrouthold Tow Address Phone No...... p p yted within 00 feet of a tidal wetland? *YES.l~.NO.... * ~ t R Trustees ermit may be required. PLOT DIAGRAM cate clearly anti distinctly all',buildings, whether existing or proposed, and indicate all set-back dimensions from pr erty lines. Give street d block number or description according to deed, and show street names and indicate whether ' tedor or cbrner lot. ~ i ~ 4 , a r ~_3 Q ~ _ oa i - - ~ ~.PpricNL ~ I N -I- 7~ I - n ~'r /yam M I S ~ M y''I~ : rA R` ~1 ~Y' a I o r~ PA-r i 3 o,R~ } p r~ 2 c. ~ ~ ~e,. a-- r, 'P-, ~ Cs~b~r.d~ .z, 'I S 7H p . / ii y ~ K ii . 9C / r : STATE OF NEW YORK, COUNTY OF ~S.S - ~ s ~ . s ,z (Name of individual signi ~ ~ ~ ~ ~ ' ' ' ' ' ' • • • • being du y worn,_deposes and says that he is the applicant ng contract) above named. He is the ......................~!,I.............................................,.................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this aPPlication; that all statements conta'~ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this p .................~..;~~~pdayof.~./,//~~........, 19~.~ Notary Public, ; !,7.1.r.~1/0~ . County , HELEN K. DE UOE' ~ . . N6TARY PUBLIC, Shte nt NertyY,°,rkp ignarure o f applican t) Term~Exµres Mirch ~30,1>t--G-f i 5ED LANO§ T~'3T f~iYE vG~ ~ ~ . LE ~~ti `9L , O r~ O~ o \ T (l y„Arurl~,v~rs~c ~ a ~ ilSy. AI „,~yY ~ - ~ C f~ 1~7~~ L~.o.76Pls aGsovc O F N e W N C B ~pR~~ on1) ~ ~ ~ ~ ~ w ~ v' ~ ,..ct1( Cf ~ ~ rs' rs' - ~ ~N~ 4~ a Jo,co w W . ~ ~ . 0 ~ ss ~ ~ h ~ ~ ~ ~ ~ o~ ~ o a~ n wer ~ yi3'~ a1~ h - ~ i urrt dtst~rt o be ~O teeL . SAG Ao`t~ ti Q,`a tih ~~~(r. ~ ,a C8SSp00A1 Z ~ P ~ V 4' h D~ Hr N fLi Q ~ µ ~ " JON ro O ~ - Y t 1 ~ ~ ~ ~ PlE SE ~ ' ~l Requires seP~de nk o I ; r , rl ~ r ~d~+rds for A~rovaf and ~g~ ~ ~ ,t- J ( .:i(~+ry (1s .d f ~ Ci ~c'L`Ja¢e ~IS~OS01 $VSt9RIS ~ ~ _ ~~i C^''~~~ ~2 f 5 , , ~ ~ ,r .~n r::cs and will abide by the yvz'85 ~ ~ ~Q~'.,/~° c:.,::~~.,ar.~ ~,rl „-;~~;i tf~..,ci^ rntl on the permit to C ~ ~A,~ ~a»~_ construct. r,(/t~~O~ ~ N> v~ - L~~~~Z. JUN 8 1988 Signature ' ~~d ~ ~ ~ Z G ~ 30~~ Y S,C DEPT. OF ~p~0~ HEALTH SERVICES .:oa~7sue F.POM• u Fo T Tos~bs,P•ossyi My/ /~o~~ J~rarc~EOFt•_©o!/GG%s~ ~l.Pk/.OCi9.ST~G.O% ~o L a.s ~s -I-o 1 e(..~. opt P.~~c'~t Two, A/,vaP~G.a3~~r~ae/,~dt1B' Etii~aCfi«sbva Lc+agnau~ ,Se,rr~aeo, f..~arrlau~~r ~C/•Y. &53' E~a~..~es ~b CvTCH o v oG I N 1143e' ~9t'E'S' = I. 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