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Home My WebLink About29730-Z G FORM NO. 4 i TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall t Southold, N.Y. i CERTIFICATE OF OCCUPANCY No: Z-30021 Date: 02/13/04 MIS CERTIFIES that the building ALTERATION Location of Property: 1155 CEDARFIELDS DR GREENPORT (HOUSE NO.) (STREET) (HAMLET) .County Tax Map No. 473889 Section 40 Block 5 Lot 1.16 `Subdivision Filed Map No. Lot No_ .:conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2003 pursuant to which Building Permit No_ 29730-Z dated SEPTEMBER 12, 2003 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 2ND FLOOR ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT" . The certificate is issued to JOHN M & DIANE HESS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A j: ELECTRICAL CERTIFICATE NO. 1.168291 09/29/03 PLUMBERS CERTIFICATION DATED 09/22/03 BURTS RELIABLE 1 AuLdorized Sig-nature - Rev. 1/81 FORM NO. 4 I TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-30022 Date: 02/13/04 THIS CERTIFIES that the building ACCESSORY ..Location of Property: 1155 CEDARFIELDS DR GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 4,73889 . Section 40 Block 5 Lot 1.16 Subdivision Filed Map No. - Lot NO conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2003 pursuant to which Building Permit No. 29730-Z dated SEPTEMBER 12, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the lazy. The occupancy for which this certificate is issued is ACCESSORY STORAGE SHED IN REQUIRED REAR YARD AS APPLIED FOR "AS BUILT" . The certificate is issued to JOHN M & DIANE HESS I:. (OWNER) of the aforesaid buiI lding. I . .SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUM13ERS CERTIFICATION DATED N/A_ Aut orized Signature Rev. 1/81 FORM NO. 3 t TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. j l I� 1 BUILDING PERMIT (THIS PERMI�C MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) I PETIT X70'_ 2,9730 Z Date SEPTEMBER 12 , 2003 Permission is hereby granted to: { granted M & DIANE HESS 1155 CEDARFIELDS DRIVE GPEENPORT,NY 11944 for CONSTRUCTION OF AS BUILT LTERATIONS AND CONSTRUCTION OF AN AS BUILT SHED. TWO COS REQUIRED. ADDITIONAL CERTIFICATION WILL BE REQUIRED. at premises located at I 1155 CEDARFIELDS DR GREENPORT County Tax Map No. 4738891 Section 040 Block 0005 Lot No. 001 . 016 pursuant to application dilated SEPTEMBER 10 , 2003 and approved by the Building Inspector to expire on MARCH 12 , 20 _II Fee $ 450 . 00 i AuthQtized Sig i 1 I ORIGINAL Rev. 5/8/02 Form Nu.6 TOWN OF SOUTHOLD BUILDING DEVARTMENT vm TOWN ELALL 765-1802 i I APPLICATION FOR CERTIFICATE OF OCCUPANCY T]ms application must be fillbd in by typewriter or ink and subm tted to the BuildingDapartment with the following: A. For new building or nepv use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features 2 Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3 Approval of electr" installation from Board of Fire Underwriters, 4. Stsy i n�tatemeztt o plumber certifying that the solder used in system contains less than 2/10 of l% lead, 5. Commercial Y'41ding industrial building, multiple residences and su irlar buildings and installations, a certificate of Code Complkiftct"'£rorri architect at engineer responsible for the,building. 6. Submit Plat nnif�g Bgrd Approval of completed site pian requirements. B. For existing buildings(prior to April 9, 1957),non-conforming uses, or buildings and "pre-existing" land uses: 1 Accurate survey ofn operty showing all property lines, streets, building and unusual natural or topographic features. Z A propel h eomplele application amd consent to inspect signed by the apphcsmt. If a Catificalc of Occupancy is denied_the Building nspector shall state the reasonstherefor in writing to the applicant. C Fees 1. Certificate of Occupahtcv - New dwelling $25.00, Additions to d%vellm,$25.00, Alterations to dtvellin f,$25.00, Swinuning.pool $�y.00, Accessory building $25.00, Additions to accessory building $25.00, BnSiJld$Se3 $50.00. 2. CeltiFeate of Occupancy on Pre-existing Blllldillil- $100.00 3. Copy of Certificate oOccupancy- $.25 4, Updatcd Certifieale o1Oecupancy- $50.00 5. Tcmporm V Ceitiffcat OfOceupnnc} Residential Rli.00. Commercial $1i-00 Date. 495 - -- -- Nevv Construction: Old or Pre-existing Buildine: X (check one) Location of Property: (° e or Hous No. Street Hamlet Owner or Owners of Property: �ehhSS _ Suffolk County Tax Map No 1 00, Section 0 Block O$ Lot /, 6ji SubdivisionC 1 Piled Map. g�((2Lot: /G Permit No. Date of Permit. Applicant: hA,)I G heaVe/ Health Dept. Approval: I #J10r Underwriters Approval: Planning Board Approval dJ(J JY} Request for: Temporary Certtl 'ficate Final Certificate: (check one) Fee Submitted: $ a� Applicant Signature Farm No.6 TOWN OR SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in y typewriter or ink and submitted to the Building Department with the following: A. For new building or new us 1. Final survey of property ith accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Hearth Dept,of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical in allation from Board of Fire Underwriters. 4. Sworn statement from pl ber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planniug Board Approval of completed site plan requirements. B. For existing buildings (prio` to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of Drop y showing all property lines,streets, building and anusual natural or topographic features. 2. A properly completed ap lication and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Insp ctor shall state the reasons therefor in writing to the applicant. C. Fees 1_ Certificate of Occupancy -New dwelling$25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, eeessoty building $25.00, Additions to accessory building$25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- 5100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of OLupancy- $50.00 5. Temporary Certificate o`Occupancy -Residential $15.00, Commercial$15.00 Date. New Construction_ Old or Pre-existing Building: X( (check one) Location of Property: :o/�� e r�'ie1AS Qf, House Nb. Street Hamlet E S Owner or Owners of Property 1 Suffolk County Tax Map No 100 ,Section p yp Block ps Lot ,r Subdivision 'W441Filed Map. Lot: 1` Permit No. Date of Permit. _Applicant: 5ev9d C� h'-2nvBl Health Dept. Approval: Underwriters Approval: r Planning Board Approval: y� Request for: Temporary Certi icate Final Certificate: _ "�_ (check one) Fee Submitted: $ Applicant Signature G,55 0 Co -,L- 3oo'�/I �t CPCPCPLPCPCJ3I�CPLJPiJ�CfCaPCP�fCPCJ�CJ�CPLTFJ�CPCPCPCPCPCPLI@PCPCPCPC.FPCPC.ILCPCPCPLI@.I�C.I�CPCIefC.T3CPLr�SaCPLI�CI�L'�CPCPLI�CPCPCPu� 5 BY THIS CERTIFICATE OF COMPLIANCE THE § NEW YORK BOARD OF FIRE UNDERWRITERS `5a BUREAU OF ELECTRICITY . 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by i ' JOHN HESS JOHN HESS 1155 CEDARFIELD%�DRIVE 1155,CEDARFIELDS DRIVE GREENPORT,NY 11' 44 GREENPORT,NY 11944 i Located at 1155 OEDARFIELDS DRIVE GREENPORT, NY 11944 Application Number: 1168291 Certificate Number: 1168291 Section: Block: Lot: 16 Building Permit: BDC:NS11 Described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below, located in/on the premises at: Second Floor, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was found to be in compliance therewith on the 29th Day of September,2003. aine QTY Rate Rating Circuit Type Alarm and Emergency Equipment Sensor 1 0 Carbon Monoxide Sensor 3 0 Smoke Wiring and Devices eceptacle 15 0 General Purpose Switch 9 0 General Purpose Fixture 4. -0 Incandescent Paddle Fan 2 0 Receptacle 1 0 GFCI �f seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. CPCPLI�LTLTLI7CPCPCPCPLI�CPLTCPCPCPCPCPLI�CPLPLPLI@PLI�LPLICPCPCPC faCPCPLI�LI�CPrJLPCPLPCPLI�LI�LI�CPLPCPLI�LI7CPCPLPCPLPCPPCPCPCPCPLI�LIPLLIr3j ------------------ FEB-13-2004 14:11, FROM:CRMINITI & GIBBONS GM 765 5902 TO.631 765 9502 P.001z001; FROM MarkSclwartz,RIR-Rrchitect PHONE NO. 63173441I3°3 Fels. 13 26044 96:35PM P1 -� c I 1 —_ t `sect, PLLfw'' f ftt *ria=4%0 blew irmk. J(61)734-41&3 �ce:onber 26,20Q(3 SOR-told Town Building Department Maix 'Road Southold,New York. 11471 Atte: Damon Iiauia Re: Ress to Krudewitz House 1755 CedarBelds Drive CreenpoM New York SCTM#1oo044k -om.oIS Dear Rallis: I have inspected he second floor and shed at the aforementioned address. To the best of my knowledge,the second floor areas and me shed meet or exceed the New York State and local code requirements in glace when iba work was completed. Please call this office if you have any questions or require additional information. ry Very Ural.. r ."411 be AL Mark&hwartz Qk a � ild23� �O aE oF,>s6� III 3]C�KI.Y�W l,l.W1V 1 i I � BUTTS- y/ #RELIMLE The Finest in SERVICE& INSTALLATIONS September 19,2003 (" li CFP 2 { l The Town of Southold �"`' € "`` >-• ; Building Department f. Main Road R 'J(G` [.OUT..�ynY,�I� r' Southold,NY 11971 _ Dear Sir Or Madam: Please be advised that North Fork Plumbing& Maintenance is a company purchased by Buns.Reliable several yearsago. This company no longer operates. North Fotk Plumbing&Maintenance did do all plumbing &heating changes for the second floor renovation at the John.Hess residence located at 1155 cedarfield Drive,. Greenport;NY. All plumbing work to best of my knowledge was in accordance to existing code We will include with this letter,.,a solder certificate for this job from Burts Reliable as.a.courtesy since NFP&M no longer exists I£I can be of any further hell,please call me at 765-3767. Sincerely, Donald G.Bracken Jr. ' Operations coordinator cc. Mr.John Hess Mr.Paul CRMMI Uti FUEL OIL DIESEL FUEL HEATING PLUMBING • AIR CONDITIONING - K1T(?4iMAfflh41SPWPN �RLI�TiRAsWFiFcTAIXTAL PHONE: [PHONE NUMBER] • FAY.: [FAX NUMBER] 1515 YOUNG'S AVENUE • P.O. BOX 696 • SOUTHOLD, NEW YORK 11971 • (631) 765-3767 it -ttjz�o c O, s 6'zZoulp, StiDrtfittal of this plan bearing the seal of the 1155 Cedarfields Dr. !undersigned NYS licensed Architect is not intended Greenport, NY Ot3lz lr r otnoyv, � oto certify conditions that we designed or that we 4n_� ;represent in compliance with applicable architectura[1000-040-05-1.016 or engineering standards, or government codes. APPROVED AS NOTED Application of the Architect's seal is intended to indicate that this is a true i on of the current DATE ?////,f B.P.s c9g7 S -tL as-built conditions. T Finished second floor -- FEE•. BY; NOTIFY BUILDING DEPARTMENT AT 7854802 8'AM TO 4 PM FOR THE g- r TWO REOUIREO . 6'4 R POURE CONCRETE R fF WING 8 PLUMBING IO `rr1NS�U skylight 451PINAL 14LICTION MUST 2068- BEO L ,� FOR CZ. A ON SHALL MEET TH 68 -R U) 11TS FTHt CODES OF NE T RESPONSIBLE f0 iCo g o OEN OR`; S7RUCT11 ERROR . Co N t)r N N N a " CD ` �} P CY OR N S KOUNvAWF SATE 154 UT C ERTI UP CCUPANCY CE 1860c11 �I N N Co 26210 26210 26210 26210 Pre-Manufactured Shed U, �y IN Sc. a floor joists 16oc wall studs 24oc It s, _J 33 �a°fes 12 siding - 518 T111 °p H j �'; 1619 2668 2668 1619 �Q��gpfFO(k��G� '3 .'F:s . MILD Nall, 53095 Main Road y , x ax _ P. O.Box 1179 Telephone (516)765-18412 Southold,NewYork 11971 a � OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E T I I C A T I O N n DATE: pS 03 Building Permit No. Owner: J64vt 405,5 115 feWerP +�re��( �Riv2� Gfz2en�o��, rt/v (please print) Plumber: eLjp\+,5 RQ t ld bCry 3 � 1 (-please print) ' I certify that the solder used in the water supply system ' contains less than 2/10 of l% lead. (Plumbers Signatt [✓ ' { I Sworn to before me this I a (4 day o fp/11 F v,�fQ&0BERNADETTE L.7APLIN 1 f NOTARY PUBLIC#4844543 { Notary Public, WSJ i9l� County Slate otNew York R�sid'urg in Suffolk COOMY Comp ..evExp,tea J d7, a`d's b'1'C-ry `fdIV.99,3 TOWN OF SOUTHOLD PROPERTY RECORD CARDp - OWNER STREi VILLAGE ��. 6m, I :,UB. LOT �( .s.&-I�w....a.�..,... �fCtY� �t�' 4� r( �� v� f1Ve r_✓xc ACR. RE ARK 5 noc:S TYPE OF BLD. ! ` � !r-�. ,,i . -.-*%ate ' •:� -�`� .,'.�(a .,ak-Y"T- �--'` �! / .'�j�r f� �V�kr12. v J 4 I G PROP. CLASS �r 'r c-km emu to :F�[. LAND IMP. TOTAL DATE . -"sem' I 40�gyp. -Z44.Aon=4tI 3. FRONTAGE ON WATER TILLA� IE FRONTAGE ON ROAD 'W"ODLAND` Q\u ' DEPTH MEADOWLAND l BULKHEAD HOUSE/LOTq t TOTAL / , COLOR ; } es`.a', f_. . s� li�. 6 i 6 TRIM . M. Bldg. 1 Y, 9Z \75 4(,4 - -Foundation Bath t Dinette tzy.2-4 2 ( (R �{ 1 (obi u Extension Basement SLAB Floors w�v'j Kit. azS - yi. Ext. Walls v\,aL 0-0? lnteriorFinsh 1nQ-e-�voc L.R. Extension K 211. 7 �� } �p Fire Place Heat bkD.R. W Oa, Patio Woodstove BR: Z 6 Porch Dormer Fin, B. Deckq' X ,.,.a �O i� (� Attic F � ? ram Attic 1 Breezeway 9 ,p Rooms 1st Floor Garage 10K20 Driveway Rooms 2rrd Floor v N W '= O.B.- �-24 Pool �,T-., B4`7 _ 11 v1 ov.aonra.A A-S=0jlll� ' ` - =- F- 1'/14♦41 Y iC 11\111'\�-1\V11L V111111..11 y Y DATE REVIEWED: q /ice-f0 j APPLICANT: -smko'r 04"e'46- DATE SUBMITTED: `L/fb /0: SCTM#DISTRICT: LOW, SECT°°II7ON: _ — BLOCK:' , LOT: 1,646 SUBDIVISION: azwa6ZS ADDRESS: 4W5LQ.CITY: FU27- ZONING DISTRICT: CONFORMING? .f/ BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y ORO --Z/C/o Z-/ , INFO /'BP Z/c/o z_ ;INFO BP -Z/C/0 Z- ;INFO /BP, - - -Z/C/o Z- ,INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 3000.,2- 5.Merger.( nmW--k ming 0 anyt1time aft'REQ. LOT SIZE: ACT. LOT SIZE/ � REQ.LOT COV. �/ ACT. LOT COV. ✓ REQ, FRONT a PROP, FRONT ✓ PyE.QSIDE ACT, SID7E � REQ. REAR PROP. REAR Z REQ.HEIGHT PROP. HEIGHT PRWECT DESCRIPTION: ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: WATER FRONT? DESCRIPTION: PA NEL # FLOOD ZONE: _ I APPROVALS REQUIRED i SUFFOLK COUNTY I3EALTI3 DEPT: YES or NO, (BED_#): DTE: / / PERMIT #: TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: PRE-DEC 9/1175 YES or NO DTI;: PERMIT #: SOUTHOLD TOWN TRUSTEES: YES or NO DTE: / /_ PERMIT #: TOWN ZONING BOARD APPROVAL: YES or NO DTE: _ PERMIT #: TOWN PLAN. BOARD APPROVAL: YES of NO DTE: —/ / PERMIT TOWN I3ISTORICAI; PRE (SPLIA): YES or NO NEW YORIi-STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: l FEE STRUCTURE: FOUNDATION: SF f FIRST FLOOR: SF P SECOND FLOOR: SF II OTHER: SF INIT OTHER TOTAL li j' TOTAL: SF FEE FEE FEE 1. ( SF)- SF)= SF X 2. ( SF)- (— SF)= SFX 3. ( SF)- A SF)= SF X $4—+$_+$—= $ II FINAL TOTAL: $ t I� >...� r. .q •' 541, z -. ;.. __ ._ t _,.,.. . -.. .. .a .n A , .. NEW YORK STATE CODE COMPLIANCE CHEECMST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Lead: 45 Wind Speed 12OMPH Seismic Design Category:B Weathering:Severe Frost Depth: 36" Termite:M-H Decay: S-M Design Temp: 11= Iee Shield Underlay: YES_ Flood Hazards. USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: YIN GIRDERS: YIN CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS:YIN LUMBER SPECIES AND GRADE: YIN DESIGN LOAD CALCULATIONS: Y/N LIVE:YIN DEAD: YIN SNOW: Y/N SEISMIC: Y/N WIND:YIN WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N ;h EGRESS 5.7 S.F.: Y/N 91 LIGHT 8%a: Y/N VENT 4%a: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: YIN PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE?Y/N (RETURN TO PAGE ONE) G 1 i M-1802 BUILDING DEPT. INSPECTION ] FOUNDATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ j I SULATION FRAMING FINAL ] FIREPLACE A CHIMNEY REMARKS. 4?0 d� DATE INSPECTO ` � Zee 765-1802 BUILDING DEPT. INSPECTION j [ ] FOUNDATION IST [ ] DOUGH PLBG. i [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING [ NAL [ ] FIREP `E CHI NEY REMARKM s ol IF DATE INSPEC 7-7- it it FMD:INSMCTION R?VPORT DATE C011IlYg NTS :` f FOUNDATION(1ST) a a FOUNDATION(2ND) 'ROUGH FRAMING& ti PLVNUMG i IINSIILr1TtOP3 PIItN.Y. STATE ENERGY CODE "3 c I r� FINAL lop i x.. ADDTITON9T COMMENTS C i r rte. O z r � r t b X M i i i TOWN OIV S&TAOLD13UILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD NY 11971 3 sets of Building Plans TEL: (631) 765-1802' Planning Board approvat www.nort�631765-9502' O/ C) —L7-7 � Survey www.northforlt net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.0 d Trustees , . Examined ! -5 20 3 Contact: Dllil C-GMV Approved 1 r-L. 20.3-- Mail to: 90 bio X 16.-9 Disapproved a/c S�,v ti61�1 ',I/.V 11971 - Phone: 637 '746S-JAM - + Expiration f %!20 S Buildin sp DEE- JC3 J� 2000:, APPLICATION ION FOR BLILDING BUILDINGPERMIT Lr:VaE'-i, Date Le 20 aq 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 waterways. 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 issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work- e. orke.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter, a new permit shall be required. 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 applicable Laws, Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal 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 inspedbrs on premises and in building for necessary inspections. IIS (Srgnkare of applicant or name,if a corporation) Qd Bo,r 1(oSYI `Snc rk6nld "l #9/71 (2aaihng address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber'or builder Name of owner of premises Ng) i„ �,E5,e, (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) 'Builders License No. E Plumbers License No: Electricians License No, Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet lk" 0� 1 County Tax Map No. 1000 Section a yp Block 05' "r fit' Subdivision Ledsr 'i ��ds Filed Map No. 89&6 ! (Name) f 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy rrt„,,1 b. Intended use and occupancy, S� ��+r5H 3. Nature of work(check which applicable):New Building Addition Sre� Alteration ke Repair Removal Demolition Other Work (Description) 4. Estimated Cost PM 904 Fee Lo.00 (To be paid on filing this application) 5. 'If dwelling, number of dwelling units . 1 Number.of dwelling units on each floor__L_ if garage, number, of cars 6. If business, conunercial or mix%ed occupancy,.specify nature and extent of each type of use. I 7. Dimensions of existing structures, if any: Front Rear Depth He'Ig Number of Stories 4ee.k�Acted I Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front ate Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner j 11. Zone or use district in which premises are situated eS, 12;: Does proposed construction violate any zoning law,ordinance or regulation?YES NO 13. Will lot be re-graded? YES_NO )C Will excess fill be removed from premises? YES_NO 1116s- jud-4- 'kids 14.,Names ofOwner ofpremises sk,, SSS Address C ,.-reeNfoA.S Phone No. 4/77-36eZ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO _ * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES No-x--- IF O-x_IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16.Provide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) ii SS: COUNTY OF ) hxav A ig, t:aaAt d being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the pwz , "A- ( ontractor,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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn tefore me (� day of 2YK iC tary Public WigmnaturofApplicant BONNIEJ.DOROSIO Notary Public,Stets Of NWYA No.01006095328,Sutfolk r* Term ExpiresJu47,20 (C R. 4&) NORTH OR MAIN 'ROAD MIDDLE ROAD FND 792.24' MON I ,p 774.49' p LOT 15 W N 73' S8' 10" y0 282.00' i U E I gg O o I UNE I i Q O '°I WATER ✓ a moi• _ Q 2 STORY —.41.0' _ 2 SCENIC I "� FRAME I,+t ' p 4i LOT 76 ' o BUFFER NausE b I^°� AREA = 21, 150 sq. ft `z - - - - -i9 - - - —9TEPa no ps �I 4 I F SURVEY OF 125 2 ' S' p L O /r CLIi `28L88' f S 73' 58' 10 W °p SUBDIVISION OF CEDARFIELDS FILED JURE 27, 1990 FILE NO. 8966 i ^I A T GREENPOR T LOT f7 a TOWN OF SOUTHOLD al I SUFFOLK COUNTY, N. Y. I 1000 - 40 - 05 - P/O 01 H. S. REF NO. 90 - SO - 94 Scale 1 = 30 July 11, ��f�f o _ P!9 Bled i!t accordance with the minim pm J.7 atanarda for title surveya as eatablishad by theY.I.A.L,S. andap roved and adopted Aug. 3, 1990(found. IOC) for "%,Mae by Tha w York State Land - f oaiatron: , Nov. 16, 1990 (final) CERTIFIED TO= TiNs bsa4 Nn FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK `S METS TITLE Na 605- S- 8740 � p HARTFORD FUNDING LTD JOHN Al /E'SS DIANE /ESS ffi N.Y.S. LIC. NO. 49618 N e YORS, P.C. 9 MA A SOUTNOLD, N.Y. 11971 U U G 00 � b � w Z N/F m g d ALFRED R. GREBE, JR. ggg d S 86'4440 'N tlto ._. 124.61' vu `III p 4FFi11 \ A nln � N fill I I I I I I \ LOCATION MAP SCALE 1 "=400' I I I \ I \ I I I I I z \ !v OC, r� I m �; f I I I I \\ I I \ MAP REFERENCES O 1.) PLAN OF PROPERTY TO BE CONVEYED BY WEST END LAND CO, INC. TO a I \ EUGENE R, PUSKARZ AT FISHERS ISLAND NEW YORK; SCALE; 1"=40 FT.; Q ,g I \ CHANDLER & PALMER, ENGRS.; JAN. 1957 I I o. ' O I < \ p 'T tl9TE5 O O Mr I 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED F- U Y C I HEREON, ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO 0 I I In BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE wy. >1 O I I ENGAGEMENT. liZ ? I I 2.) IT IS A VIOLATION OF THE STARE EDUCATION LAW FOR ANY PERSON, UNLESS ¢ OZ LIJ W Z ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN U J I ITEM IN ANY WAY, �j w O w p¢ O I 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S > 03 Z J MON. SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF O LL.I w Vl I I CT1 THE LAND SURVEYOR. !n Z O I 7E (n I Q\ Of�f LL.I w 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC W mTl� �pG`� (FNDJ I SURVEY TRIANGULATION STATION PROS" 0.. m p 1 STONE LI 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP 1000, Of U' WALL �I �'y�V' I SECTION 006, BLOCK 7, LOT 9. a Z 1 EXISTING f 4 - W 6.) TOTAL AREA = 1.023 ACRES. Q 1 - I 7.) SITE IS LOCATED IN R-80 ZONE. I Q CERTIFIED TO 3 I as R� HEDGE I COMMONWEALTH LAND TITLE INSURANCE COMPANY AND WALSH PARK BENEVOLENT > COPOTNEW IN STATEACCORDANCE WITH THE AMINIMUM STANDARDS FOR TITLE SURVEYS OHE TITLE NO. RH80031405 I STEPS z 0 Z tti a A � I I O w N s EXISTING) `� r \�i -- I N o c �a}. RESIDENCE,- R o — MON, ORCH �� > Io o Pm . (FND.) —_ o / w m RICH I g2' E ` N 4363.45 FENCE N 615%0 W 412.04 I G PNV\NG -- z F -560 EOGE � _ — - - CONCRETE E PJENO � i MON. WALKS pE�1N/ " MP 3 0 o m N N 0 W 7 � In ✓, m D O o 0 Z W W m s 3 . o O O I/l 6 I+/ U' J ,+- DATE: 06/14/2003 SCALE: 1 " = 30' QUALITY CONTROL CERTIFICATION I crrNn GROUP REWED DATE N/F NOW OR FORMERLY RRoJECT maNgc[a /LCFy SURVEY 4y" LYC Dr y VOL VOLUME ENVIRONMENTAL 30 IS 0 30 SHEET CIVIL PG PAGE 1 OF 1 srRucnRu SF SQUARE FEET GRAPHIC SCALE IN FEET ARCHITECTURAL FILE 3