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HomeMy WebLinkAbout17023-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18845 Date FEBRUARY 23, 1990 THIS CERTIFIES that the building ADDITION Location of Property 315 AQUAVIEW AVENUE EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 21 Block 2 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25, 1988 pursuant to which Building Permit No. 17023-Z dated MAY 23, 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 SECOND STORY DORMER ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to VINCENT C. GEROSA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-050688 - DECEMBER 19, 1988 PLUMBERS CERTIFICATION DATED OCT. 6, 1988-HENRY J. SMITH & SON INC. _ wilding Inspector Rev. 1/81 goaai xo. s 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) Nfl 017023 Z Date ....`.~~~.r~...s~ 19.C~„~, Permission is hereby granted to: ro . ...,r1(.. S7~ ct premises located a~~~.f-°i~...~........ ..........f..................................................... s~.~~.. County Tox Map No. 1000 Section Block Lot No.................'-....... " s~ pursuant to cpplication dated 19,!x/0...., and approved by the Building Inspector. t ~7 d~ ~v~4`rI~D 1 _ J y U J Buil g Inspector Rev. 6/30!80 k ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ s...® to the Building Inspec- torwith 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 Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions S25.00 POOLS $25.OOALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory $10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5 .00, over 5 years $ 10 .00 4.Vacant Land C.O. $ 20.00 / / c~/r~~. S.Updated C.O. $ 50.00 Date :G.~(~ t l.d d:........... New Construction,,,,,,OldorPre-existin Buildin Vacant Land ~~J~ 9 9 Location of Property-/~~~~.~/'i-rv~~~~~ ~R~/ ....l.~!a-P~.............. House No. ,,~~~~..yy Street Ham/et Owner or Owners of Property !/..~~!~T" ~~ip"~~ County Tax Map No. 1000 Section Block Lot.....d.~~...... . Subdivision ................................Filed Map No./ ..........Lot No. . Permit No. ! 70.2. Date of Permit ..........Applicant v4t~~..~Myr~a-~/~~~( Health Dept. Approval . .........Labor Dept. Approval . Underwriters Approval ...................:::::Planning Board Approval Request for Temporary Certificate Final Certificate . Fee Submitted , , , , , , Construction on above described building and rmit ets ap ica fe des and~gulations. APPlicant... Rev. 10-10-78 ~'oc.39~?~~.5 en ~ Ig84s February 21, 1990 ; m, x t ~~~~I Mr. Gary J. Fish J Building Inspector B~DG.4EPT. Town of Southold TQWN UF5OUTHOL.D Town Hall, Main Road P.O. Box 1179 Southold, New York 11971 Re: Building Permit # 17023-Z Premise: 315 Aquaview Avenue East Marion, New York Suff. Co. Tax Mgs. # 1000-21-2-3 Dear Mr. Fish: Enclosed, as requested, is a xerox copy of the Underwriters Certificate. In addition, I have enclosed a check for $25 to the Town of Southold. Please issue the Certificate of Occupancy at your earliest convenience. Thank you for your prompt attention to this matter. Very truly yours, i ' V. C. Gerosa Encl. HENRY J. SMITH & SON, Inc. PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765-3890 C E R T_I_F_I_C_A_T_I_0_N_ ,y Date_October b~ 1s88___ I. Building Permit No.__~_I~~ I Owner_Gergs~,~s]Z_~n~.l,rion_C~oT15~ruet~lon, GC Plumber_,Henry_J__Smith & Soni_Inc_ I certify that the solder used in the water supply system contains less than 2/10 of 17 lead. Henry P. Smith Sworn to beFore me this 6th day o£ October____, ~ 9_88 G~'Jl1~~Q~~~-~+7 Notary Pu lic Notary Public, Suffolk County EERNADEITE L TAP11N '40TARY PUBLIC k4844393 State of New York Residin{ in SuOdk Cauaty ~q Cxnmission Expires Sept. 30, 199.1. r J THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICYTY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Dote DECEMBER 19,1988 Application Nu. on file 56447188/88 N 050688 THIS CERTIFIES THAT only the electrical equipment as described 6eloto and introduced by the opplicont named on the strove application number in the eremites VINCENT GEROSA, AQUA VIEW RD., /POLES 3, EAST MARION, N.Y. in the folluming location: ®8oaement ? Ist FL ~ 2nd F'1. OUT .Section Block Lot u~os examined on DECEMBER 12,1988 andfoundtu he in curreplianer kith the reyuireneen 6s q(this Roard. FOUTLUETS ECEPTACIE$ SWITCHES FIXTURES M u r RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS INGANDESCENi FWORESCENi rApe AMi K W, aMT K W qMi NW. AMT N.W AMT N P 7 12 8 7 1 F DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDE0.$ $PEt1Al REC'PT TIME ClOCNS REtt UNIT HEATERS MUlT1.0UTUiT DIMMERS AMi K. W On N. P GAS H. P PMT NO A W, O qMT AMP AMT gMPS TRANS. pMi N P SYSTEMS I NO.Of FEET Ami wgiis SERVICE DISCONNECT NO.Of $ E R V I C E qMi. qMP TYPE METER I .a 3W 19 3W 3 $ ~W 3 $ IW NO OF CC GOND A W G EQUIP. PER .e' OF CC CONO NO OF HIdEG A W O NO OF NFVTRAlS q, M' G OF NI-LEG OF NEVTRgI 1 200 CB 1 X 1 2/0 1 1/0 OTHER APPARATUS: ..I:-1 SMOKE ~ TOR:-1 ~I i _I, ch , e II N +i t.%u. - m iu;a PAUL R. BURNS W cfc° 275 TOWN HARBOR LANE u. o SOUTHOLD, NY, 11971 OENERAI MANAGER .u.W._....,.,. = ~ LICENSE N0. 282E Per ~ L' I Ica a mus not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. M '.1 A Ixlll?xrn,T TEL.76S-1802 `\o~~FF[)~LX`c~l, T'f3tt'N 41I~ SOUTII0~,~3 orrrcr; oh rsulLUtr~c tNST'E~CTOR ~ I°.O, UOX 728 r~' ~P " '1'OWP~lfALL ~~/ar D~~(~~" SOt7'I'E[OC.I'?,N.Y.1t971 pica; t 1, t To W}rom This Ntay Concern, D7r_ are urrablc to complete your Certificate o_f.,~occupancy because ,of the following reasons. 1°/ An application for Certificate of Occupancy is not nn file. C~~~!~ 1?_I/ `to tlnrlerwr.itcrs Certificate on file. The check .is(~°^,~',,~1/not on file.)3las'.u`o No Health Dept. Approval on file. P!o final inspect:i.on has bean made. Please contact our ofL-ice on this matter. Thank you for yaur. cooperation, i3uiidinel Permit iS ~ ~ ~ ~ ~ 7 DuildincC Dept.. No Plr:mber Solder Certificate on Pilo. ( all permits involving plumbing being i::eued afL-er April 1,19119 ) I oS~FFOUr~D VICTOR LESSARD O L Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~ P.O. Box 1 179 (516} 765-1602 y0 • ~ Southold, New York 11971 FAX (516) 765-1823 ~Ol ~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD February 5, 1990 Vincent C. Gerosa 39 Rugby Road Manhasset, N.Y. 11030 Re: Building Permit #17023-Z Premises: 315 Aquaview Ave. East Marion, N.Y. Suff.Co. Tax Map #1000-21-2-3 Dear Mr. Gerosa: During a review of our files, it was noted that the above building permit has expired, and a Certificate of Occupancy has not been issued. A final inspection was made on October 5, 1988, and everything was okay for CO, but we needed your application and check for $25.00, a Plumbers Certification, and Underwriters Certificate. We have received the Plumbers Certification, but do not have the Underwriters Certificate. Since your check for $25.00 dated October 17, 1988 is outdated, we return it herewith. Please send us the Underwriters Certificate and a new check in the amount of $25.00, and we will issue the CO. According to the Code of the Town of Southold, it is unlawful to occupy a dwelling until a Certificate of Occupancy has been issued. Please correct the above violation immediately. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar encl. 't VINCENT C. GEROSA ~ 9~73p~ JOAN T. GEROSA Qom- 39 RUGBY ROAD MANHASSET, NV 11030 1.8!230 PAY TO THE^ ~ ~ ORDER OF ~ ~ $?t~~ j ~ 8' laU DOLLAR 5 Citibank, N.A. C/I /BMN~O 1110 Northern Boulevard Manhasset, N.Y. 11030 233 rL iN a ~(~j MEMO ` ~/~'21+r-// 7t~o~J z ~P~./l. S~a~tct_ ~ . ®F:028000082F; 233 1693278511' 7301 i _ ` i - - r~-~T~:~r:r. T£L. 7G5-1802 ~~~~Fh(ItkC~`;~ 7'0~~'N OI~ SOUTIIO~,~ 1~,:~3~~ OPt'ICIi Ot: il[)ILUING [NSl'[:CTt7R '~ri. ~ -:s. i°.O. [l~X 728 M@ ' u' ' , ~ TOYVN l[ALL t ~ u~ cy, ~ .„t <~e' SOUI'IIOLU, N.Y. 11971 u ~T~ 3 q Q J'.. To Whom This May Concern, 47e are unable to complete your Certificate of~Uccupancy because of the following reasons. An application for Certificate of Occupancy is not qn file. Chu-Qu~Q~ :Io Undersriters Certificate on file. The check .is (:~•n,.~;/not on file. ~s, cr-p f:o wealth Dept. Approval on file. C,o final in:;pect:ion has been made. Plensc contact our gfL-ice on this matter. Thank you for your. cooperatign. auildinr Pexmit it L ~ Q ~ ~ Z [luilciinc[ Dept. fio Plc.:mber Solder Certificate on filo. ( all permits involving plumbing being i:,sued after April 1,19fl~ ) ~7~°~ 3 '~-iso2 BUILDING DEPT. INSPECTION [ ] ROUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [v] FRAMING [ ]FINAL REMARKS: G~~ Qy~ ~ \ DATE ~ 0~ INSPECTOR ~t l~ ~ a 3 rss-isoz BUILDING DEPT. 1 NSPECTION [ J FOUNDATION 15T [ ~OUGH PLBG. [)FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: - ,..e. _ ~ G 4 k v < DATE ? a 2 ~D INSPECTOR ~ 13 rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [)FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL d RE ARKS: '!~~~s. DATE ~ ~ INSPECTOR ~ _ , . i 7o.z3 ass-isoZ su{LD{NG DePT. INSPECTION [ ] FOUNDAT{ON 1ST [ ]ROUGH PLBG. [ ] FOUNDAT{ON 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~J~~~wC ct~uiy," (,9~C-, ~.,=rl~Q-~..,~ s 4 DATE P~ ( INSPECTOR ~ , i / ~~~I ~ BUILDING DEPT. IIVSPECTIQN [ ]FOUNDATION 1ST ] R GH PLBG. FOUNDATION 2ND [ INSULATION [ ]FRAMING FINAL REMARKS: ~ti~ti~~yM Z DATE, y INSPECTOR ~ ~g ~ f 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDAT{ON 2ND [ ]INSULATION [ ]FRAMING [ INAL ~ REMARKS: `~iy~ ~ ~'K/ ~'7 . ~ ,emu i E F DATE ~a INSPECT ~ ~ ~7©~3 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ]FRAMING [ FINAL REMARKS: DATE U ~ INSPECTOR G -1LLL pin.., ~ .,v:`~P1 t.V l:. - f ~ ~ 4V ca 7 . ? ~ w 7 _ y ` 'OUIJDATION (1st) `1AV1+ T - ~c 'OUNDATIOIJ ( 2nd ) ~ ~ O t/.~'!~- ~ o ~ TOUGH FRAME & ~ ~ ~ G` PLUMBING 7 ~y ~ y 3 . m m y iIJSULATIOAI PER N. Y. rSTATE ENERGY '7v~-~ + • CODE .C..~ vo F' m \~S' - FIiJAL ~ SEI o ~ ~ ~ z ADDITIONAL COMMENTS: x e i ~ • x -n ~ a W H ~j O m a\ • r. H~ x c7 m ^o H r ~ '~k~~, 3,$,•'W a Y y~y~~;9r~fPlj3~trc~`~~~~y,vL ~`i+'~~j"r~'~'d~ .Iw ~~td ~ ,r^w. ,,eT•~~; ~ ~ ..,i.,, _ > N n~ .wi J .y~°yK T.~, . nay 't~l~,^t~Pu(J \1if,'F" i ~ ~J'~t`~S'ta~'..r2Ri? ,~,dyY ,~3.Td Fi~`~~'rp'1„ f \ u , ~ R t G3 1M ~ p } ~ ~ ~ ~ T.t ~ ~S ~ d ~S„ `g Y `r' { . } T~ Q rt 9 Y4 ~~.y w.~~ ~.t~ iti' iP ~ a. a z: N. 13'`45' f 4" lV. - 246.0, ~ H ^ ao ~ A Jam..-~ t.7) ~nA u. T. t P ? Fh x o ~t~ ' ~ s ~ 1 a1 O ~1N ' O C.SI ~ a = ' q ~u~ p _ _ Y'..' ~ ~ v ~ m~ I I n x er+ J ~ ~ ~ . - i+~ p 1 ~ ~ ~ • 1 c~xavs~ na~vcw~r ~ ~ ~ n = ~ cry ._.__._____C" _ o (n b o ~ 1 R Z' Z o ~ 1 I , ~ S 13'45' 10" E. - 250.0 ~ lADKANt1 -i r p C.J~ m n c-~ z • o a . ~ Z crY C ~ ~7 T C11 Q ~ ~ ~ r W 11 ~ o a>, b ro - ~ b c ~ ~ ~ r-. ,~1 ~ ~ x, -c o V" -1 KC .1..~ xa ~~K~ vl ~ R ~ N tD to '1 _ r m a~,~,,~ ~-_a JOHN ~AMISANO ~ ~ ARCHITECT A('I~ 2 ~ 188 s~ ~ ~s'~>~~~---~°-_~~~ 72 NORTW VILLAGE AVENUE rc~vUw"z~~ ais ~®i_r~ ROCKVILLE CENTRE , NY 11570 ..~.a-..., __~..an.~..,e,.w.~.w„„,<v„w, 516.536. 0042 APRIL 25 1988 TOWN OF SOUTHOLD PROJECT: GEROSA RESIDENCE BUILDING DEPARTMENT 315 AQUAVIEW AVENUE TOWN CLERK'S OFFICE EAST MARION, N.Y. SOUTHOLD, N.Y. 11971 SEC. 21 BLR. 2 LOT 3 ~ ATT: MR. THOMAS J. FISCHER BUILDING INSPECTOR DEAR MR. FISCHER: I AM WRITING THIS LETTER TO YOU REGARDING THE PROJECT INDICATED ABOVE. AS DISCUSSED BY TELEPHONE IT IS UNDERSTOOD THAT THE PROPOSED ADDITION OF BOTH: A. BREAKFAST ROOM TO SIDE OF RESIDENCE B. WOOD DECK TO SIDE OF RESIDENCE WOULD NOT BE ALLOWED UNTIL APPROVED BY THE BOARD OF ZONING APPEALS. IT IS FULLY UNDERSTOOD BY BOTH MYSELF, THE PROJECT ARCHITECT AS WELL AS THE PROJECT CONTRACTOR (CENTURION CONSTRUCTION CORP.), AND THE OWNER, MR. VINCENT GEROSA THAT WE WOULD ONLY BE ALLOWED AT THIS POINT TO CONSTRUCT THE PROPOSED SECOND FLOOR ADDITION, AS INDICATED ON PLANS. THEREFORE WE REQUEST THAT THE BUILDING PERMIT BE ISSUUED FOR ONLY THE PROPOSED SECOND FLOOR ADDITION. THANK YOU FOR YOUR ASSISTANCE REGARDING THIS MATTER. Y TR Y RS, 0 AMISANO-R.A. FDRM N0.3 ' ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 50UTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ...April 15.x 19.8$. John Amisano c/o Vincent Gerosa To 72 North Village Ave. Rockville Centre, N.Y. 11570 PLEASE TAKE NOTICE that your application dated , ,Marc h 2 5 , , , , „ 19 8 8 fotpermitto CONSTRUCT ADDITION TO EXISTING DWELLING ,,,,at Location of Property ..,,315 Aquaview Avenue East Marion, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section ~ Block ?.........Lot ..3 . Subdivision . Filed Map No. Lot No................. . ARTICLE XI-100-1I9.2A is returned herewith and disapproved on the following grounds . Proposed construction will be closer than 100 feet to bluff or bank. Action required by Zoning Board of Appeals and DEC. y G.~ . B ild~ ~ nspector RV 1/80 v FARM N0.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTAOLD,N.Y. NOTICE OF DISAPPROVAL Date ...April 15.x 19. 88. John Amisano c/o Vincent Gerosa To 72 North Village Ave. Rockville Centre, N.Y. ]1570 PLEASE TAKE NOTICE that your application dated , ,Marc h 2 5 , , , , 19 $.8 for permit to CONSTRUCT ADDITION TO EXISTING DWELLING ,,,,at Location of Property ...,315 Aquaview Avenue East Marion, N.Y. House No . Sireei .......................Ifamlet County Tax Map No. 1000 Section ~ ~ Block ?.........Lot ..3 . Subdivision Filed Map No. Lot No................: . ARTICLE XI-]00-119.2A is returned herewith and disapproved on the following grounds . Proposed construction will be closer than S00 feet to bluff or bank. Action required by Zoning Board of Appeals and DEC. :..:.::f ' " Bu~ldin~Inspector RV 1/80 sy ~ Ad.~ ''off ¢St'~fv~ _~e'~.4"w~*y~~~q~ r`+N'4''M1,.~,~ 1w~~ M"" .4~r,~t'~., b ~~ee~ irk n~,t~~, ~ ' ' ~y $ r _ ~~a. ~~~ii` T. .'1.~b 3'' ~~,'r6':v,~ ~ ~iV +C,'F +c ~u'`°^!?e.*".i, r .ayr d a'~~+$t*`F e,~~,~'~y 'F'N,Y~. i f1s'.~ w 'r h .~r Fr sR w ~ t^ c Q ~ ~ ~ ~ 'a ~ M ~ o ~ A ~ is w z i tt I °y a iy o 'R. (K i ~ p Q LN i ~ ~ b ouw ~ 7a In 3 ~ O~'w ~ r n i m K _J i ~ w d a m ~ " a I .r' y b ~ ' c,RnvE~ -~nxivc<Y~r ~ I ~ ~ ~ ~n R-1 p ~N v I N 4 e ~ ~ ( I ~ o ~ C S 13'45' 10" E. - 250.0 ~ utoRaNn r Q ~y9 m n z > y O W = C'~'1 t77 C • ~ ~ ~ C 3 ' ~ i "p.' cn , ~-1 O ~ .a" w tS-"~ ,,tea N ~ c ~ cry t-.--- ~ " w =K i...< ~ p vs m S.'7 a . i ~ a p m z p L'S-""1 ~T'~_l p~ N a ~ ---I m ~ ~ ~ ) m 3 p .n Ra' m n ~ C.S.-,~ o L- N ~ c~ R A -G c ~ A ~O -i ~ -t w ^i - r ~1 BOARD OF HEALTH , 3 SETS OF PLANS ~ ~ FORM N0. 7 SURVEY . TOWN OFSOUTHOLD CHECx BUlLD1NG DEPARTMENT SEPTIC FORM TOWN HALL NOTIFX SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 ' MAIL T0: Examined s 19 Approved • , 19~~Permit No. ~ ~~.`..`a~. Disapprovedz/c . i (B iidin nspector) APPLICATION FOR BUILDING PERMtT Date ~~~~19~~.~ INSTRUCTIONS a. This 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. 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 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 le Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for emov Na~lig s herein described. The applicant agrees to comply with all applicable laws, ordinances, uilding ode 'o ego ulations, and to admit authorized inspectors on/p/remises and in building for necessary in pecf s. ~ rS ! [9 ~3~i -G~V` x`07 g ~d6 . i na/t'ure/o~~ ican >i ~ p ration) . ~p/ !vu's y~ 1 dr ~ICCGS~~ (Maili ~ ssx~E i'¢ t) ~y j~J ~0 n~ State whether, applicant is owner, lessee, agent architect engineer, general contractor, e1°e`~trfdian, plumber or builder. .....................~.~,....:~~c/~ Name of owner of premises 'tl~~~:~..4:•'• ~.=!~=-~L'"C~~%~~•••••••••••••••••••"•""""""' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. /:".'a:3 ~ ..N•~• • • •C°'"'~-"tee-`:~'~ ~-Q"'° • C°'~°' Plumber's License No. .~~a ~ . Electrician's License No. T p • . Other Trade's License No . _ 1. Location of land on which proposed work will be done . . House Number rr}} Street ~~''yy Hamlet County Tax Map No, 1000 Section G"../ BIock .......v-.C Lot ~ . Subdivision 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 C~~~.. • . • • ~ [~,~5 ~D~~~c~s • b. Intended use and occupancy • ~1-~ • • •~Z~ 'i`L~L=.ZJC<1=• •(i(f~~i~~?~'f'~ 3. Nature of work (check which applicable): New $uilding Addition Alteration Repair Removal , Demolition Other Work , . _ (Desci9plion) 4. Estimated Cost . Fee ~v~ ? f~$~j~,c ,:.v~. "EJts ='~5,5_ ' (t~o be paid on filing this application) 5. If dwelling, 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: Front .~1^... Rear ..?~F-:1":..... Depth ...~~T.... . Height . Number of Stories ~w...... . Dimensions of same structure with alterations or addit~ion-s: Front . 4~t"-,I:.~ ~1....... Rear ~ ~'1"......... . Depth 2. ~ ...........Height ....~~y.~. ~l. ....Number of Stories ~1/:~-:.. ; ~ ...l....... . - S. Dinlen~ions of entire n ~~on~ action: Front . ' QI ~ ' : ' . ~t~r ~ ~ Depth ~q th ~ . Height ± . Imo.,'. ~'i f.~....... Number of Stories . Rea~..`~G. s o:.. Z........ . 9. Size of lot: Front f.... c..'.... ~ , 10. Date of Purchase .............................Name of Former Owner .W IU.IA,wt ~ ~l~l~ . 1 1. Zone or use district in which premises are situated . , .~~v~~19?::..-~'~. °:^,a, ~r ,",f~`,`, , , , , , , , , , , , , , , , , , , , , , , , , 12. Does proposed construction violate any zoning l,aw, ordinance or regulation: N:~ . 13. Will lot be regraded !"1.4? ...................Will excess fill be removed from premises: ~ No 14. Name of Owner of premises ~JN4eu1'.G?~?E?SA•.. Address3~,Rct7By, Rp,gdJ.uaHlaslef• photte Noxl~~~a??"l!~.g?7.. . Name of Architect ~.°.N!`~ ~M1~ia©. Address"~'Z.•.~1?-1VICC„4ui~• (LuG, ,phone No.51~? :S~lo,~;pp d.2 Name of Contractor G°frt~TUPlo1J ~m1J3.17Z ~n-+,(~~?. , , Address`.? UI~~•.~?~-, RUii!. Phone No~l6: X36' ©~~r.3. . 15. Is this property located within 300 feet of a tiidal wetland? *Yes No *If yes, Southold Town Trustees PermitpLO~DIAGKAMed. 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. uNtlS~OYt o'Q~2 - '3 „QI „5t'.81 ~ r Q ~ ~ ~ - ~ N u ~ -Q - R®M:ADDITIOh).::' ~ ° ° 1-u I `tl ui R mow, ~ ~1.. ~?I'~y t,f~ ~ ~ ~ 4t ~,f"'- aYA1a~1~lU 1'1Atlyt7 W w . CL' ~ ~ -...-,~_~I M ~ ~ _~:fo 1 ~ I~aap.DecK. a 'x":14-o.es'. • a ~ r ~ t_u GL w ~ w ~ for ti-..t blGs;eS` - - _ = K ~ ~ o ~ a,_ ROP./wFD~T~..- w 't a .°n fiW ui ~ ~ s~-~-~XTPJ4g10h1 A`r.. ro * w o~ Cam} STATE OF NEW YORK, S.S t,~t,~~,> ',i'- COUNTY OF . 1.S/?. SS,/~~ ,.r-- . 1S/-~-~U f~J~.~~r.41 . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (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 contained in this application are true to the best of his nd belief; and that the ',work will be,p,erforrned in the manner set forth in the application filed therewith. ~F,~BD QAe (Sworn to before me this ~ > R•y0 ~ 19.~ a~a o~N AM'S r ~ Note Public ~ ~ ' ' .day of !/s~ ~ ~ ry ,~.k~~rGLdC~"~~ . County I , h`i3•:"~~~~ a- ; - BERNARD T. FUSCO - Notary Public, State of Now York No. 30.4612309 ~ r . . 1 Dualifled in Nassau County ~ a in nature Of a ) ~ommisalon Expires June 30, 1 ~ tdtr pplicant . PLUMBER CERTIFICATION ON ~AD CO~E~ BEFORE. CERTIFI~TE OF OCCUPA~ SUPPLY SYSTEM ~NNOT EXCEED 2/10 of occuPmCV or UsE IS WITHOUT CERTIFICATE OF OCCUPANCY ~..c::~-=: J. ENERGY CONSERVATIO~ CER2I~IOATION These drawings and specifications preparedby ar Lmder the eetien of the ~ndereiEned and to the b~st of the undersiEned's e, informatt the York State Eno Construction APPROVED AS NOTED ' , BY: 7fi5-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPEcTIONR: 1. FOUNDATION - TWORE~UIRED FOR POURED CONCRE~ 2. ROUGH - ~ · Iq/JMING ~. INSULATION 4. FINAL - CONSTRUCIlONMU~T BE COMPLete FOR C.O. ALL CON$11~UC~O~ ~ MEET THE RE4~.II$ Ol: ~ N.Y. STATE CON~I~IJOTIO~ · IV co~-~ ~ iiIeIII ~ DESIGN OR ~ ~ SIGNIN~ gRCHITECT NOT ~'S~ONSISLE FOR CONSTRUCTION SUPERVISION. ReVisions ITideb s~le 1"7. i4D' FT No. I 4 / Revisions ~a_ 13ate !Description [ S~ ~X"= [tO'~ Job No. Dwg. No. ; O~ Revisions =0 -l ' ? I Revisions No. Date Description 4, Revisions Date Description I / I,, Revisions No.Date Description Z = ~ 0 U 0 u ~ o~ ' 'Revisions ! ,Scale "/4",¢-¢" ~ Le~-'r' 5i~'e'' i~.~v~-rl~d," ....::?~':1'<.¢. ., Revisions