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Home My WebLink About29010-ZFORM NO_ 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buil~pector Town Hall Eouthold, N.Y- CERTIFICATE OF OCCUPANCY ~o: Z-30282 Dmte: 07/02/04 T~IS C~'rIFIEE tt~t t3~e h~Lildin9 NEW DWELLING Location of Property: 2865 SOUND DR GREENPORT (HOUSE NO_ ) (STREET) (}LAMLET) County Tax F~mp NO. 473889 Section 33 Block 2 Lot 51 Su~dlvlslon Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 16, 2002 purs%uqnt to which ~uildln9 Permit No. 29010 Z dated DECEMBER 23, 2002 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 SINGLE FA~4ILY DWELLING WITH GAR_AGE UAIDER & CO~RED W~RAP AROUI~D PORCH AS APPLIED FOR. The certificate is issued to JASON & KAREN O'DELL (OWNER) of the aforesaid building. ~u~FOLK CO~ DEP~RTMENT OF ~A~T~kPPRO%rAL R10-01-0206 06/16/04 ELE~-I~ICAL CERTIFICA~ NO. 1167988 01/02/04 50M~EI~ U~TIFICATION DATED 01/27/04 K&K PLL~M~ING & H~ATING Au't~iz ed Si~ture Rev_ 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~ING PERMIT (THIS PSRMIT MUSk' BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 290]0 Z Date DECEMBER 23, 2002 Permission is heresy grante~ to: JASON O'DELL PO BOX 648 GREENPORT,NY 11944 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH GAP~AGE UATDER, AND CO~qERED WP-AP AROL~D PORCH AS APPLIED FOR at premises located at County Ta3c Map No. 473889 Section 033 pursuant to application dated DECEMBER Building Inspector to expire on JUNE 2865 SOUiqD DR GREENPORT Block 0002 Lot No. 051 16, 2002 and approved by the 23, 2004. Fee $ 821.10 ,.-., . Authorized Signature ORIGINAL Rev_ 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by ROBERT L BOGER 455 WILLOW POINT RD SOUTHOLD NY 11971 KAREN & JASON ODELL 2865 SOUND DR GREENPORT, NY 11944 Located at Application Number: 1167988 Section: Block: Described as a Residential 2865 SOUND DR GREENPORT, NY 11944 Lot: Certificate Number: 1167988 Building Permit: BBC: NS37 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement. First Floor, Second Floor, Attached Garage, Outside, 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 2nd Day or Jennet?, 2004. Name QTY Rare Rarinlz .Matra and Emergency Equipment Sensor 2 0 Sensor 6 0 Appliances and Accessories DishWasher 1 0 1.2 Exhaust Fan 1 0 Oven ! 0 30 Furnace 2 0 Air Conditioner 1 0 48.000 Wiring and De'~Sces Receptacle 31 0 Switch 44 0 FLxmre 47 0 Paddle Fan 4 0 Receptacle 1 0 30 amp Receptacle 10 0 Service 1 Phase 3\V Service Kariag 200 .~IJCrCS Service Discormec[: 1 200 Circuit THee Carbon Monoxide Smoke KW F.H.P. Amps Off B~T General lhtrpose General Purpose Incandescent Do'er GFCI cb se. al . . Continued onNcxtPage 1 of 2 Thru cerhflcate may not be altered in any way and is validated onlyby the presence or a raised seal at the location indicated. $1.50 $4 50 $5.00 $2.00 :;5 08 Si0.00 $5.00 $? 75 511.0£ $9.4£ $8.06 $l.75 $t0.0£ $20.0C BY THIS CERTIFICATE OF COMPLIANCE THE ~1~ NEW YORK BOARD OF FIRE UNDERWRITERS ,mm BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by - ROBERT L BOGER KAREN & JASON ODELL 455 WILLOW POINT RD 2865 SOUND DR SOUTHOLD NY 11971 GREENPORT, NY 11944 Located at 2865 SOUND DR GREENPORT, NY 11944 ~pplicati0n Number: 1167988 Certificate Number: 1 '~ 67988 Section: Block: Lot: Building Permit: BDC: NS37 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basemeat, First Floor, Second Floor. Attached Garage, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found be in therewith the 2nd of .Ianuary, 2004. mm-- Nam~ QTY Rate Rating %pe Circuit ~m~ uI~ htvoice Total $100.9C 2 presence of a raised seal at the location indicated. Town Hall, 53095 Main Road P.O. Box 1179 Sourhold, Nex~ York 11971-0959 Fax (631_) 765-9502 Telephone (631) 765-1802 BUILD1NG DEPARTMENT TOWN OF 80UTttOLD CERTIFICATION Date: lead. Sworn to before me this Norm' Public, ~-l~\k-- County I cerdfy that the solder used in the water supply SYstem contains less than 2/10 of 1% (Plumbers Signature) BONNIE J. DOflOSKI Nota~t Public, State Of New Yodt No. 01000095328, Suffolk C~flty Term Expires July 7, 20 ~ '] BUt-LDt NG-P q MIT P ESq-EW-C--H Gt ' Applic. anl/ , OwnersName:'~. Or~f2vXX.¢ ~ }:~'~-~- Architect/ Engineer: j~ SCTM #: District: 1,000 Secdon: ~ 3 Block. [Front Yard/-~C ~r~rs REOUIRED FOR REVIEW N.A. NO YES Suffolk Courtly Health Dept. New York State D.E.C. Town Trustees Town Zoning Board approval: To~m Planning Board approval: Flood Plan~ Elevation Flood Zone: Per'mit · Number ( re,,-o-o/ NOtes: FORM~ER REL SEAS. liVE, STREET PROPERTY RECO~D CARD LAND IMP. ?i"":: :"" ' VILLAGE TOTAL DATE P~EMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Tillable Value Per Value Acre Wood/and / DIST. SUB. ' ' '~ ,/"'"~' /',r~ ~ ~:s ~ [' ' ACR. TYPE OF BUILDING MICS Mkt. Value Meadowland House Plot FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD Total DOCK LOT LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER P O. BOX 162 GREENPORT, N."~ 11944 [631) 477-1652 July 2~ 2004 Mr. Michael J. Verity, Southold Town Building Main Road Southold, NY 11971 Department Head Department Re: Permit ~ 29010 Z Residence Jason 0'Dell 2865 Sound Drive Gresnport, NY 11944 To Whom It May Concern: With refsKencs to the above, mentioned residence, I visited the site during construction for the required inspections of the foundations, framing, insulation and plumbing. It was noted all of this work wes done in accordance with the plans on fil~ with the Southold Town Building Department and meets th~ requirements of the New York State Building Code andI the Southold Town Building Code. i Tuthlll, P.E. ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501 Detached One and Two Fam/ly (For Non-Electric Heat) Design Criteria 5750 Degree Days Zone 1 lB Dated: SUBSYSTEM AREA DESIGN CODE DESIGN CODE CeU~g a~f goo O.~3 0-03~ ~q.~o 2~.~0 ~r ~ U~ Sp~e ~OO O~ 0.05 ~0.~o qO. °° H~ Slab On GrMe 6.5 U~t~ SI~ On ~e 4.5 B~emem W~I O, li Cram Spa~ W~l 0.06 L~ i,81 NO'f/~: · ' ' 1 I moismro ~ontl, ol and 502 1 4 'air leakage ConsOlation shall comply ,nth 502 .... Buildln4 Envelope Sysl~ms to meet requhc~u~n~s of Section 50 ! : The meehaaical ~ra~om8 arid ~luipmcnt including: , H'VAC Equipm~at, l-tV AC Syste*nn: Duct Systems, Ventilation Systems and lnsnlatlon of Piping Syria ,la to me~t mquir,m~ats of Section 503,I $~'vic~ Water Heating Systems & Equipment to moot r~:luimments of S~dan 504 Electrical & Lighting Sy~h,,,,s & Equipment to meet rcquir~mcnls of Section 505 To the bcst of my knowledge, belief, & professional'judgement, these plang are in compliance with the code. SOUTH BAY ABSTRACT INC. 25 Bowden Square Southampton, NY 11963 (631) 283-7215 · F3=X: (63 !) 283-7685 policy issuing agent for: I tuyers lltle rpo tm litle No. SBA-1711 SOUI'H BAY _~,STKACT INC. As Authorized Agent for LAV~tTRS TITLE INSURANCEICORPORATION Does hereby certiI,,, to: X,~TL LIAM PRICE That it has caused a search to be made in the Office of the Clerk of the Count>, of Suffolk in the STate of Nexx York against the premises desctS_bed here~n and premises adjacent thereto on all sides from 1981 to present to ascertain the fee chain of title for the subject premises; and abutting premises, and has found only the returns as set forth herein on the folIoxx4ng pages as they bear on record title; and; Does certify that the owners of thc premises described herein have owned the same in single and sepatate ownership as by law ISom March 2. 1970 to present. This company's liability is limited to One Thousand Dollars ($1,000 00) for ~negl/gence only SOL~..~ BA'~ >d3STP,~&CT, 1NC. ,- ! / ?/ /~/ President Subiect Premises Suffolk County Tax Map Designation District 1000; Section 33; Block 2; Lot 51 Edward Speeches to zktm Popkin Chain of Title for Subject Premises Liber 9110 page 357 Dated i0/29/81 Recorded 12'4. 81 Ann PopI4u to Barbm-a .amn Co>me, Thomas Coyne Ann Pop ~kh~ and George Popkin Libcr 9784 page 556 Dated 4/9,:85 Recorded 5/7/85 George Popkm and Am~ Popkin to Susan Wadswo~h Liber 11251 page 358 Datcd 1,25~91 Recorded 4/23;91 Susan Wadswm~h, Barbara _~M'm Co_~me Thomas Coyne to Jolm O' Dell and Karcn Bogcr Liber12155 page 264 Dated 11/9/01 Recorded 11/27/01 LAST OV~2CI2RS OF RECORD Adjoit~txg Prcmises to the East District 1000: Section 33; Block 2; Lot 2 Sheldon M. Sclmeider, Judith B. Sctmeidcr Paul 1 evenstein and Muriel E. LevensteJ~x to Sheldon M. Sclmeider and Judith B. Schneider Liber 8411 page 336 Dated 1/23/78 Recorded 4/11'78 Sheldon M. Sclmeider and Judith B Schneider to Konstantino Sakarellos Liber 11481 page 80 Dated 5/28'92 Recorded 6i10~92 LAST OWNERS OF RECORD Adjomin-,z Premises to thc East District i000; Section 33; Block 2: Lot 3 H.J.S. Land & Development Co~p. Liber 6873 page 209 to Dated 1/9/71 Judith Sclm¢ider Recorded D2L 71 Judith Sckneider to Konstantino Sakarellos and Elizabeth Sakarelios Liber 11481 page 83 Dated 5/2892 Recorded 6/10 92 LAST' O~3,2NTRS OF RECORD Adjoining Premises to the Soutlx District 1000: Section 33; Block 67 Lot 7 E&x ard W. Speeches to .George Poplch~ and Bat'ba~'a Co?ne Liber 9110 page 360 Dated i0/29:81 Recorded 12/4/81 George Popkin and Barbara A. Coyne to Premier Builders at Island Estates, Inc. Liber 9758 page 241 Dated 2/18f85 Recmded 3/25/85 Premier Builders at Island Estates, Inc. 1:o Homestead Acres at Greenport, Inc. Liber 9758 page 244 Dated 2/2/85 Recorded 3/25'85 .2mthony M. Parlatore 'to Sarasota Inc. d/b/a Crcdit Control Management Liber 11787 page 292 Dated 7/31/96 Recorded 8,'13'96 Sarasota Inc. d'oa Credit Control Management to Schembri Homes Inc. Liber 11820 page 243 Dated 2/26/97 Recmded 3/11,:97 Schembr/Homes Inc. to Eme~ Lamso and Matildo Latuso Liber 11912 page 209 Dated 7, 998 Recorded 8/20/98 LAST OX~,5',TERS OF RECORD Adioining Prcmiscs to the South Disttict 1000: Section 33; Block 6~ Lot 8 Edward W. Speeches to George Popkin and Barbm a Co3me [iber 9110 page 360 Dated 10~29,'8 i Recorded 12 4/81 George Popkin and Barbara A. Coyne to Premier Builders at Island Estates, Libor 9758 page 241 Dat6d 2/18/85 Rec6rded 3/25/85 Premier Builders at Island Estates. Inc. to Homestead Acres at Greenport, Inc. Libor 9758 page 244 Dated 2, 2/85 Rec6rded 3/25~85 Anthony M. Parlatore to Sarasota Inc. d,b,'a Cre&t Control Management Libor 11787 page 292 Dated 7/31/96 Rec6rded 8/13/96 Sarasota Inc. d b~ a Credit Control Management to Schembh Hom~s Inc. Libor 11820 page 243 Dated 2/26./97 Recorded 3/11/97 Schembri Homes, Inc. to Jotm Iacono and Rose Iacono Lib{r 11882 page 491 Dated 3/3/98 Rec6rded 3/10/98 Jotm Iacono aud Rose Iacono to Nell Brenes and Leilany Brenes Libor 12163 page 326 Dated 12/7/01 Recorded 1/14'32 LAST OWi'sqSRS OF RECORD Adiohfing Premises to the South D~smct 10007 Secnon o, Block 6' Lot 7 Edward W. Speeches to George Popkin and Barbm-a A. Coyne Liber 9110 page 360 Dated 10/29,81 Recorded 12.481 George Popkin and Barbara A. Coy~ier to Preiniei Builders ar [slattd Estates hic. Liber 9758 page 241 Dated 2., 18,82 Recorded 3,,'25.,85 Premier Builders at Island Estates, h~c. to Homestead Acres at Greenpm% Inc. Liber 9758 page 244 Dated 2~2,85 Recorded 3/25.85 .~thony M. Parlatorc to Sm'asota Inc. &b.a Credit Control Management Libor 11787 page 292 Dated 7:31.96 Recorded 8/13..96 Sarasota Inc. &ba Credit Control Management to Schcmbri Homes Inc. Liber 11820 page 243 Dated_,26,97 Recorded 3/11..97 Dated: December 3, 2002 Southampton, Nexx York By: Sout~ay Abstract, Inc. //75 ./ ,' : /../. // Clarmme R. BaNis Preside=t Swo~ to bea~e ~ne this .Z_~c~'day ora ~P_~2002. NotaO' Public M!CHELLE KISS-FORBES No.fy p~bf~c, Stat90~ New York No. 01K[5065407 Qualili~d tn Suffolk Cou~ ~ Comm[smon Exp~re~~, CL. .=OC ..',. L '1 · ~,.....-: .-.~ ..~ ..... .~.. ;,-~ ~ ~ ..~L'. ~.~ ........ . !';. NC.~.. L' ":'~ ': ' ,,..2" C;;.I'~ ~, '":; .: _.t .,, · ?( ,,., ..... ., % ,, - . .- . ..... ..; .,. :_.,...,,,,~ , · :.i . I :t .: .: : \.'1 : ; SUFFOLK COUNTY C?.~.RK RECORDS OFFICE RECORDING PAGE TI~a of Instr,,~ent: DF~/DDD ~er of Pages: 3 TRANSFER TAX NUMBER: 01-16332 District: 1000 Deed Amount: Section: Block: 033.00 02.00 H)L~MINEDAND CHARGED AS FOLLOWS $85,000.00 Recorded: 11/27/2001 At: 02:45:14 ~M LIEER: D00012155 PAGE: 264 Lo=: OSl_O00 Received the Following Fees For Page/Filing $9.00 COE $5.00 HA-STATE Cart. Copies $0.00 SC~ $0.00 Co~.P=es $200.00 TRANSFER TAX NUMBER: 01-16332 THIS PAGE IS Above InstL-ument NO H~ndling NO EA-CTY NO TP-584 NO P~T NO Transfer tax NO Fees Paid A PART OF TH~ INSTRUMENT Edwar~ P.Romaine Count"~ Clerk, Suffolk County Ex~mp~ $5.00 NO $5.00 NO $5.00 NO $15.00 NO $340.00 NO $609.00 Notation EA-52 17 (.Cuanty) l~A-q217 Certified Copy FEES Sub Total sc/c>. Real l'ropeny Tax ~en4ce Ag~ey Verification ion Fund Vacant Land ~ rD ~O TD 'rD .~" __ Title Company Information co. Name Suffolk County Recording & Endorsemem Page page fom~s ~t oflhe aRached ~. . ..... ach~ by: (SPECI FY 'I~'PE OF INffIRUMENT ) ~q~.~Q__~ ~/~..~k':~ 'l]~epremiseshcreinissitualed in In the Township of In the VILLAGE ItOXES 5 'II-IRI 19 MUST BE 'D~'PED OR PRL,N t mJ IN BI,ACK INK ONLY PRIOR TO RECORDING OR .FILING. (OYLm Dear Taxpayer. Local property tmxes am payable Iw/cc a year: on or be/bre ,Jamm ,fy 10"' at~d on or before -May 31~. Please eon~aet your local Tow~ Ta~ Receiver with ~uy questions rega~d~ug Irroper~y t~x payment. Brookhaven Town Receiver of T~,xes 250 East Main Street Par[ dcllkrson, N.Y. 1 ]777 (53 l) 473-02~36 Shelter Island Towu Receiver of Tmxes Shelter Island To~m Hall Shelter Island. N.Y. 11964 (63I] 749-3338 East Hampton Towa Recei%'er of Taxes 300 Pan//go PIa¢~e Smilhtoxma 't'olvn Receiver of Taxes 99 West M,'dn SLreci Smithtown, N.Y. 11787 {C>B1) 360-7610 {631) 351-3217 Southampton Towfl Receiver 116 Hampton Road Soulhamp[on. N.Y_ 11968 [6311 283-6514 ~lip TmwnRccelverofTaxes ~311 224 5580 Sou th old To~l: Receiver of 'la.xes 53095 Ma/n Street Southold, N.¥: '1~:971 - 183IJ 765-16031 d% Edx~%u:d P.' Roma/ne 'Suflbkk Counly Clerk- BETWI~EN 995 Oakwood Drive Southold, New York 11971 6500 indian ~eck Lane .ia theyear ~l second pan. . WITNESSETH, fha the party of the irs pa~ in cor~idera~oa et'Tm Dollvx~ and other v~!uable ~o~emtle, l~d by the Susan Wa~woreh ol'N~wYork, County of ~ } ~.: Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 12/07/02 Transaction(s): Septic Permit - Construct - Resid. Receipt#: 0 Subtotal $10.00 Cash Total Paid: $10.00 C erk ID: O'delI, Jason Po Box 648 Gmenpo~, NY 11944 LBOHN Internal ID: 64455 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE~ 765.1802 BUILDING DEPT. INSPECTION [~//FO~NDATION 1ST [ ] ROUGH PLBG. [¥/~ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY DATE 0~////~ INSpIrGTOR 76S-1802 BUILDING DEPT. INSPECTIO N [ ] FOUNDATION 1ST [ ~ ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [~] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /~ / _ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [~J~INAL [ ] FIREPLACE & CHIMNEY DATE ~ ~" INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST ! ]ROUGH PLBG. ]FOUNDATION 2ND i ]INSULATION ]FRAMING i~INAL [ ] FIREPLACE & CHIMNEY [i; ] FIRE SAFETY INSPECTION TOWN OF SOUTItOLD B [I1LD~G DEPARTMENT TOWN HALL° SOU I'HOJ~D, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~vw. nor thforl~net/S ou thold/ ~xamined Diaapprox ed a,'c 1~,2o o ~" Ex'p/ration bh~ ,20~'~ PERMIT NO. BUILDING PER_MIl' APPLICATION CHECKLIST Do you have or nc'cd 6a¢ follow~, b~f~re applying? Board of Health planning Board approval Survey Cheek Sept* For~ Tn~tees Building Inspector / ,x 'k · "-~I~PPLICATION FOR BUlL,DING PER3,11T ~,~ C: ,~x.J ~ '};~'~' . Date g~ ~ ,200~ ~S~UCTION$ sets ofpl~, acc~ate ~'~fo s~e. F~ ~co~ing to sched~e. b. Plot pl~w~g locafio~ of lot and of b~d~gs on pr~mis~, rela~o~p te ~jolni~g ~remi~ or c. The work ~vered by ~s apphcation my not be comm~ before iss,,~ce ofB~i~g P~t. d. Upon approval of ~s app~cafion, ~e B~g ~pector wffi ~ a shah be k~t on ~e prez~ses available for ~p~tion ~ou~o~[ ~* work. e. No b~d~g s~ be occ~ied or ~ ~ whole or in p~' for ~y p~ose issues a Certificate of Occupancy iss~ce or ~s no~ bern completed ~5Ihin 18 mon~ ~om such ~. ~ zoning prope~ ~ve be~ ~acred ~ ~e ~te~ ~e B~!~i~g ~ccmr ~y a¢~ze, addition six monks. Th~eaftm, a new pe~; s~li be r~_ .~PLICATION IS ~BY b[OE to ~he B~]~ng D~m~t for ~he i~ Building Zone ~d~ce of the Town of gou~ol~ Suffo~ Co~, New Yor~ ~d o~ a~cab]~ L~ws, Or~in~c~ or Relation, for ~e constmciion of b~d~gs2 ~tion~ or ~remfio~ or for remo~ or d~o~fion appHc~t a~ees ~o oompIy wi~ all applicable laws, or~c~, b~l~g ~do, housh~g ~d~, ~ re,flora, ~d to admit aurhodz~ ~pecto~ on pre~ses and ~ b~Hd~g For necess~, ~p~o~. (S/g'~-.~-e of applicant or n-~c, ifa c~q~omlion) State whether applicant is o~mer, lessee, agent architect, en~neer, general contractor, electric/an, plmnber or builder (~ on ~e ~ ro~ or latest d~) If applier is a corporaaon, si~amre of d~y auto.ed officer (Name and uric of corporate officer) Builders License No. Plumbers License No. Elec~icia~s License No. Other Trade's License No. 1. Location of land on whickproposed work Mil be done: House N~ber S~ect County Tax Map No. 1000 Section Subdivision EfiSCE£~J Block ~O~Z~~' ,.' '~ Lot Ffli~fI~ No. · 2~. Stateexl~tingnseand~cupan~y~fptem~sesandint~ndeduseand~c~upa~cy~fpr~p~sed~nstmeti~n: a, Existing us~ and occupancy ~/~C~A?'/' ~-~-A//) ~. b. Intended use and occupancy 3. Nature of work (check which aFPlicable)' New Building Repair Removal Demohtion .Addition Other Work 4. Esfinh~ted.Cost :(~ dO0 Fee 5. If dw¢llln g, number o£ dwellin $ units f~ Alteration ,(Descripfior0 (To be paid on filing this application) Number of dwelling units on each iloox 3 If garage, number of cars _ .2-- p~-- ~/o~.~ 6. Ifbnslnes~, dommercial ~r mixed occupancy, speci~ nature and extent of each .type of use. 7- DimensionS 0'fe~istin~ s'~ctures, if any: Front Rear Depth Height Number of Stories Dimensions of some structure with alterations or additions: Front Depth Height Number of Stories 8_ Dimensions of entire new construction: Front Height ,9. Size of lot: Front il0. Date of Purchase //,/~/0/ Number of Stories Rear ~2~g" Rear 2-- Depth Name of Fro-mar Owner ,~c-~Aj Rear : 11. Zone or use district in which premises are situated I 12- Does P~uposed col~kuction violate any zoning law, ordinance or:'regulation? YE S. NO !13. Will lot be re-graded? YES__NO ~/Will excess ~11 bc removed firom premises? YES__ ' 'NO 14. Names of Ownex ofl~endses Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No_ ; 15 a. Is this propelty, within 100 feet of a tidal wetland or a fi-eshwat~r wetland? *YES ~ * IF YES, SOUTHOLD TOWN TRUSTt~ES & D.E_C_ PERNffI'S MAy BE }~J~OU1RED. b. Is this property within 300 fee~ of a tidal wetland? * YES NO t/ ' · IF YES, D_E.C. PERMITS MAY BE REQ[HRED. NO 16_ Provide survey, to sea/e, with aeettrate foundation plan and distances to property lines. ' 17. If elevation at any point on property is at 10 feet or below, must prox4de topo~aphical data on survey. STATI[! OF NEW YORK) COUNTY ~'- ~,~,~ ~. tYdt I/ being duly sworn, dcposcs and sa~ that (s)he is the applicant {'Name of individual signing contract) above named, ' ' ' : (S)lte is the (Contractor, Agent, Co~porate Officer, etc.) of smd owner or owners, and is duly authorized to perform or have performed the said work a~d to make and file this apphcadom that all statements eon~a/med in tkis applleatioa am true to the best of' his knowled_~e and beU el; ~nd that the work will be p~formed in the manner s~t forth in the apphcation filed therewith_ ~ Sworn to before me G/;, dayof (J Notary Public 20(7 - LYNDA M. BOHN NOTARY PUBLIC, State of New York No. 01 BO6020932 Qualified In Sut~31k County Term Expires March 8, 20~-~ 0'att Sigrmmre of Appl/cant 'ROYAL L_._~Y HF~LT~-~ pS~ART~S3~T____J ..' . · ..... SUFFOLK COUNT Aug. 5,200 ' '. S. 89'44'00" W. SUBDIVISION - ANY ALTERATION OR ADDITION TO THIS SURVEy IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAF. EXCEPT AS PER SECTION 7EOG - SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COP/ES BEAR THE IMPRESSED SEAL OF THE SUEVEYOR WHOSE S/GNA TURE APPF~RS I'~REON. ADDITIONALLY TO COMPLY WITH SAID LAW TERM ' AL TERED BY ° MUST BE USEB BY ANY AND ALL SURVEYORS UTILIZING A COPY OF ANOTHER SURVEYOR'S MAP. TERMS SUCH ' INSPECTED ' AND · BROUGHT - TO - DATE "ARE NOT IN COMPLIANCE WITH THE LAW. 335.55' "HOMESTEAD ACRES" SUFFOLK COUNTY FILE NO. 8150 AREA = 32,988 sqft. P.O.B( I~$0 TRAVELER SOUTHOLD~ N. Y. LIC. NO, 49618 (631) 765 - 179 7 S TREE T 11971 02-3 10