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Home My WebLink About31072-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31657 Date: 07/07/06 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 1010 (HOUSE NO.) County Tax Map No. 473889 Section 79 BRIGANTINE DR (STREET) Block 4 SOUTHOLD (HAMLET) Lot 31 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 2005 pursuant to which Building Permit No. 31072-Z dated APRIL 22, 2005 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 ACCESSORY INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to STEPHEN & LORI GUYER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 2056681 06/03/05 PLUMBERS CERTIFICATION DATED N/A ~ize~ Rev. 1/81 .. Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 JUl 3 I "TO,t':~R~bU~~"')LD APPLICATION FOR CERTIFICATE OF occur ANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (8-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 211 0 of I % lead, 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a ceriificate of Code Compliance from architect or engineer responsible for the 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 survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupallcy is denied, the Building Inspector shall state the reasons therefor ill writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00" \ Date. JUl 3 7/'3 /0 b New Construction: /' Old or Pre-existing Building: __ 'i5ri:,...n~'~ 'Dr. Street (check one) Location of Property: IDIO House No. S,v+k.IJ Hamlet Owner or Owners of Property: -S1t"-f\....e./\ .. Lor; Suffolk County Tax Map No 1000, Section 7 "l bU'f(.... Block .0'-\ Lot $\ %D Subdivision I--\c;..rbor liJl..h j:;'';,.+~cs 310 ,J.- z... DateofPc1111it. '1/,7,/0'5) Filed Map._ Applicant: Lot: Permit No. <;"'1(.... Health Dept. Approval: Plarming Board Approval: '_ Underwriters Approval: Request for: Temporary Certificate Final Certificate: ./ (check one) Fee Submitted: $ :L s: OD -~an~~ ~. 705;),5 co-l.. 31 ~5 7 3)0"1-::>-- @].@] ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ Application Number: I Section: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I @]~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~l!I 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 SHORELINE ELECTRIC P.O. BOX 114 W. SAYVILLE, NY 11796, . GUYER 1010 BRIGANTINE DR SOUTHOLD, NY 11971 1010 BRIGANTINE DR SOUTH OLD, NY 11971 2056681 Certificate Number: 2056681 Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located inion the premises at: pool, Outside, PoolISpa, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code andlor standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 3rd Day of June, 2005. Name OTY Rate Rating Circuit ilI1!< Appliances and Accessories Paoli Spa Bonding Time Clock/Switch Wiring and Devices Fixture Receptacle Switch Receptacle 1 0 1 0 20 amp Paoli Spa Paoli Spa General Purpose GFCl 1 0 1 0 1 0 1 0 (Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. seal 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. ____'15_=- e,.L -, \ FORM NO. 3 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) 22, 2005 PERMIT NO. 31072 Z Date APRIL Permission is hereby granted to: S L GUYER 1010 BRIGANTINE DR SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD FENCED TO CODE at premises located at 1010 BRIGANTINE DR SOUTHOLD County Tax Map No. 473889 Section 079 Block 0004 Lot No. 031 pursuant to application dated APRIL 20, 2005 and approved by the Building Inspector to expire on OCTOBER 22, 2006. Fee $ 150.00 ~ C-lL . Authorized Signature ORIGINAL Rev. 5/8/02 3(07;2-z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING P<t FINAL 4 ~ ~ ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: \.L / .. DATE ~---r--OG INSPECTOR ~.~ 3/071--2- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ;J~ ~ ~ ~~~ REMARKS: ~ J {'~ b? c-8j2t~ d- 3-:30 -y, - DATE 7--6---oS- INSPECTOR ~~ .. " " FIELD INSPECTION REPORT DATE COMMENTS uJ"':l _t'l FOUNDATION (1ST) 5~ V;; ------------------------------------ r\ m~ FOUNDATION (2ND) - '" ~t'l CI 2: P d -'" 0'" ROUGH FRAMING & ~ t'l PLUMBING - ~.., ~ ~ j ~~ INSULATION PER N. Y. ~ 5 STATE ENERGY CODE --- - ...,~t. t>S #0 pooL ~~~ _/ f /_, ~ Jr~~-f) - ~ l:r ~ .- .J/ ~ /l" ,'" ' . fl/? ~ -... ~ -of , _U'.. .L ~ ,;;2..~r .. .P' t7 €; /,/ FINAL /.,..-<1-0 7; , Y"~AO . k:..A ",...J) '/\ r.nr, V () ./"'Y r :/77 . -~- ~ ADDITIONAL COMMENTS (J) I ~o .u__. .-_. ::E z lJl~ 1---------.- ~------- - - -- ------ ----- d t'l ;..: V "':l - IV ~ b ::l r~ - == t'l Lt:: :;l ::i> --'"~ t'l "':l :-' TOWN OF SOUTHOLD PROPERTY RECORD CARD SUB. /1-7 .52) _ ~.~ ):f- S- 0 STREET VILLAGE DIST. I AI/7itrl! lJf(. .( -. 1/ .,C ,{-~~ E S ACR. a .Jf7 TYPE OF BUILDING S Vol RES. c9l i) LAND ?OO '1 VL" FARM COMM. CB. MICS. Mkt. Value IMP. .)f).kV . TOTAL ?vO DATE REMARKS ~ (; 0 w '.. rr. - c 1"::-,;,,, dLsp,y 2-01J res Ol) AGE BUILDING CONDITION NEW FARM NORMAL BELOW ABOVE Acre Value Per Acre Vclue Tillable House Plot FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD Woadland Meadowland Total DOCK -- ...~..... )R c11.-0' L TRIM t ~B ;V ~ In w./ . " 1 . ") ~ , .' 'j 79-4-31 02102 . E%e~rur; ~ 1 )( 3~ ~ lo.E)'3 S:5D S"f1'" , f,v Extension , Extension I~ ZrlP Foundation PC-, Bath 2- 11/ Dinette I Porch Basement FuLL- Floors K. I Porch Ext. Walls IAIA-'~/f Interior Finish LR. I Breezeway Fire Place V6sv Heat DR. I Garage ZZ-,X 4=- 5:J.:X /.7.6' t,(f) Type Roof Rooms 1 st Floor BR. Lf- Patio Recreation Room Rooms 2nd Floor ~ I . O. B. Dormer Driveway Total (p +5?-- _.....~ ( (%D2- ) , , .. ~ c ,.-~1~ . --.. _.,,~- - -- - - - - / / -r-- ---( I I I I I I I I I I I I I I _..-l-----""""" --- "- " - - - - L .,.,~ "'., o''';'''~''i''' ~. . - ;.'~""'- DETAIL A WALL BRACE ASSEMBLY DETAIL 1--2' 2"----' 1 1/2", 43" , 11 GA. -----., GAlVANIZED ANGLE WALl. BRACE ASSEIlBlY 14 GA. GAlVANIZED- STEEL WALL PANEL UNDISTURBED EARTH 2" BOTTOM MATERIAL 7 1/2 x 4 1/2 x 12- BEARING PLATE 3/8" REBAR 1 1/2. x 24. x 14 GA. GALVANIZED ANGLE NOTE: BACKFIll TO BE SAND. GRAVEL. OR OTHER NON EXPANSIVE MATERIAL Lc 1--DETAIL A I A ~ / " T T K S/ G ------------ ...L 1~ ~J J B o '" * NO DIVING BOARD ALLOWED POOL SIZE A B C D E F G H J K L 12 x 2+ * 12 2+ 8 76 6 26 6 26 7 36 2610 1+ x 26* 1+ 26 26 6 26 9 36 29 6 3 8 16 x 32 16 32 8 + 8 36 359 1 + 16 x'36 16 36 + 8 + 8 36 39+ 3 + 18 x 36 18 36 + 8 + 10 36 +0 3 20 x +0 .20 40 + 8 + 12 36 ++8 5 8 1 -NOTE- THESE DIG DIWENSIONS CQUPlY WfT1-l THE NATJOtrIAL SPA AHD POOL INSTITUTE SUGGESTED _IMUM STAHOMDS FOR RESlDEHTW. POOLS. WAJMNC - 00 NOT r.lNF' IN 1J.II:' c:sw I NM END IF DMNG BOMOS OR SUIlES 1ft TO BE USED WITll 1HESE POOlS PlEASE CONSU.T THE lWlUF-'Cl1JRE'S INSTRUCl10NS AND THE HA"I1ONAL SPA AHD POOL. INS11TUTE"S MINIMUM STANDARDS PRIOR TO INSTALUNG OMNG IlllNlllS OR SUIlES OIl lllESE POOlS, FOR NllRIlAllON CONSERNtlG NSl'I _W STAHlWlDS, ~ NAlIOIW. SPA ANI) POOl INSl1TUlE. 2111 EISENHOWER _ AUlWIlAlA. VA 22314 (703) ll3lHlOe3 CARDINAL SYSTEMS 28ll s. Rr. 81 (717 --..73J SCHIMJCIlL HAVEN. PA. (717) _ 1318 FAX. DAlE: lll1.E: 6' R. CORNERS SCAlE: DRAWN: FI.E IWIE: RECT6RC l,wp/i: 01/<0 Olf,; <QOl\-'c W/,p t.or USt.IC ,'- "9 '''41'0" -, ~ ~ ~ "- &$:$: ~~,,'f -~ ~'f ~ -r S?o. ->fe' -- ~O'''' SJ' , " -............ - ~ E" ~ " O!/l \ \ ""~ --....... __ ,f'-1Ic. ['Dc. ~1~/--\\\ <' ,~ / r \\ \ .!!:! I ( (94 ~) )' \ \ ~ I \ u' / )&~>;. ~ \ \ 9~/ / / . ~ /' 9~ ...... '---/" / OJ' \. /- J -----<- / A, <_ 'v">'o. ->fe' ->fo '1y, f1j '" $ !:J f!} q: ~ tl ~ '.t !;j ~ t.o" If,; '51 <QOl\-'c Iv/, P(I, , 1000 GALLON O't./C SEPnc rANK. 1v4r<p (2) B" X 6' DEEP 'r LEACHING POOLS. ROOM FOR EXPANSION, , 'i ~. ~. ~ ... ~ ~ ~ (j'l: ,. It l2 (;j GJ <n g; ~ '., , OjfO (). {i. ,/ "" HOC< TOPSOIL -2' & LOAM ~ 00 -q~ <~ -q-'V ~/ ~ SAND & GRA VEL';ta: WA TI~W' -12' ;.)' -~~~ AREA: 21,508 S.F. = 0.494 AC. ELEVATIONS ARE IN ASSUMED DATUM. ADJACENT DWELLINGS SERVED BY PUBLIC wAtm. r:~::< :1 1;::"'~'1' ',~;A.. ..:::~;,:;~ ,if I~;}~Z ;~ .t: ' "~< ~~i CERTIFIED TO: STEPHAN C. GUYER LORI GUYER . SUNRISE ABSTRACT CORP. MANZI HOMES, INC. IMPERIAL MORTGAGE CORP. SURVEY OF LOT 50 MAP OF HARBOR LIGHTS ESTATES SITUA TE AT BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORk I~ 3, SCALE: 1 "=40' DATE: APRIL 23. 2001':.; S.C.r.M. DISr. 1000 SEC.79 8LI<.04 L6r JI(~Zl~ l .. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE Nor GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF THE SURVEY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COM- PANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS USTED HEREON, AND TO THe ASSIGNEeS OF THE LENDING INSTITUTION. GUARANTEES ARE NOT rRANsFEFlABLE ro AoomONAL INSTITUTIONS OR SU8SEOUENr OWNERS. THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THERE- FORE ARE Nor INrENOED IV GUIDE mE ERECTION OF FENCES. RErAINlNG WALLS. POOLS. PATIOS. PLANTING ARUlS. AoomONS IV BV'LDINGS AND ANY orHER CONSTRUCTION. JOB NO. F3524 MAP NO. 5147 F1LED:AUG. 7, ',968 REVISIONS: fN1~ REVlsm. OS/22/200 t CERr'S ONLY 06/25/2001 REV. PROP. HOUSE 01/10/2001 REV. PROP. HOUSE OB/14/200 I srAKEour OB/IS/2001 Marc Eo Charest. LS. Successonl to Paul T. Canal/zo. Ls. Robert A. Kart. Ls. Good Ground Surve)'Om. P. C. -$'0 0-q "'t>~ < -q 1.-- "'t> /. ~ 00 ~"'t> t ,Q "to ~'I " I -1 ,-$> ~ ..... I ~ I ~ "' ~ ~ ~ ~ ~b ~f ~ ~ CJ JA~.j .' .-;" I, ;' {or ~9 ", N " I {' ,2 i L;_''':~~~''L~.J , ~ lj --L <0~.9 ~~v. ~. ....... {Or .50 ~ "f:t.i ~ &f~ ",,- Q: Q ----- - -11;>0;.: :-_____ 6' ~o W ----- lOr " 1$'7.' P.ID-o/-O/09 -4 ~1'':' r-..l ~~l g '')-1 "'"-.:J , ~.:-:; c.... =:: N W ". ::J:: -~J;:3 \.0 ~ AREk 21.508 S,F. = O.fgfAC:::" -< CLEARING AREA t8,760 s.~fij 4J..J.% -< CERTIFIED TO: STEPHAN C. GUYER LORI A. GUYER SUNRISE ABSTRACT CORP. SUFFOLK COUNTY NAnONAL BANK EASD./ENTS AND/OR SUBSURFACE STRUCTURES RecORDED Of? UNRECORDE:D ARE NOT GtJARAN1ffD UNLESS PHYSICALLY EVIDENT ON THE: PREMISES AT THE: T1ME OF THE sum.u: GUltRANTEES INDICATED HEREON SHALL RUN ONl.Y ro THE PF:RSQN(S) FOR WHOM THE SUR'VFY IS PRF:PARrn, AND ON HIS BD1Ai.F TO THE 11TLE COM- PIWY, GOVCRNMENTAL AGENCY AND LENDING INsnTVrfONs US1FD HERroN. AND TO THE: ASSIGNEES or THE lENDING fNST1TUT7ON. GUARAffT'EES ARE NOT TRANSFERA8LE TO ADDI11DNAL INSmUT10NS OR SUBSEQUENT OWNOfS. THE orrsvs (OR DIMENSIONS) SHOWN HEREON FROU THE S71lUCTURES TO THf: Pl?OPERTY UNES ARE FOR It SPECIFIC PURPOSE AND USE AND THF:RE- F'DM ARE NOT I~NDED TO GUIDE THE rnECTION OF FFNCES, RUAJNING WALLS, POOLS, PAnos. PLANnNG ARE4S, ADDITIONS TO BUILDINGS AND AWY OTHER CONSTRUCTION. JOB NO. F3524 MAP NO. 5147 F1LED:AUG. 7, 1968 REVISIONS: REVISED: OS/22/2001 CCRT'S ONLY 06/25/2001 REv. PROP. HOUSE 07/10/2001 RE:V. PROP. HOUS~ 08/14/2001 STAKEOUT 08/15/2001 I.1NDCR CONSTR. 09/1J/2oot FINAl. 01/12/2002 SURVEY OF LOT 50 MAP OF HARBOR LIGHTS ESTA TES SITUA TE AT BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCALE: 1 "=40' DATE: APRIL 23, 2001 S.C. T.M. DIST. 1000 SEC. 79 BLK.04 LOT 31 rNJ(Qj Marc E. Chard$t, L.S. SUCCduors to Paul T. Canallzo. L.S. Robdrt .A Kart, L.5. Good Ground SUfVtJyors. P.C. ff~, . f-..o.. a/!,,_, p..fl "'\,..., 5.. ~ ~ loA dJ-.,) tbl r,}w.) 1tvl4.~-, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.neUSoulholdJ --{- , BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Boan:lofHea1th~_ 4 sets of Building Plans Planning Board approval Survey 3/6 -Z~~ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: PERMIT NO. Examined Approved Disapproved ale tt~-:: ~~ Phone:~ J uU Expirntion _. .. I () !) 2-,20J2j" L~ 1 ~i .' ',~ -__ ..._-0" '.~'._-""_:"'~ _, I ,. JR 20 ?005 :bl J ! j ~....e- I Building Inspector APPLICATION FOR BUILDING PERMIT bLOb. DEPT. TOW~, QF SQTHOLD Date 4/13/0$' I , 20 0<;' 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. 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. Ifno 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 inspectors on premises and in building for necessary inspec~tiOns. .,' , , V /1/// ~LL CONSTRUCTION SHfL " /'/&n,';gIl~t~~Cantorname,ifacorporatiOn) M !T.., - ,^\ \.. "IMMEDIA TEL V" 'PPP" . e. THE hfOUIRt:MENTS G" ENCLOSE POOL TO CODE JOIl)"h 'QG"tr\/ b( jn,'\'II,,\,,\ CODES Of NEW YORK ST:;rc;: UPON COMPLETION J(Mailingaddre"ofapplicantf . S h h 1'. 1 BEFORE "WATER" . I I" I b b 'Id tate w et er app Icant IS owner, et,f't>lY.lir) areliitecT, lIj~R~ CERTIFICATE ectnClan, p urn er or UI er O\t ltl u') REOOIRED A~NOTED Name of owner of premises (1./ (; B.P,', '~IO~J C ^I 'kllr r911.'l"llatestdeed) I ~(,~ Ifapplicantisacorporation,signatureofQG~ un FEE: , ",--J'J BY::- t . ~ WFUL NOTIFY BUILDI~G DEPARTMENT AT 765-1802 8 AM '0 4 PM FOR THE ERTIFICA TE ;~~~~~~:T1~;~E~~:~UIRED /1"(. (lrC:M01\ Nr,y FOR POURED CONCRETE 101+- - Ie lJ.Ln ' , 2. ROUGH . FRAMING & PLUMBING 3, INSULATION 4. FIN~L ~ CONSTRUCTION MUST o R C.O, ALL CO'" ". '101, SHALL MEET THE ",I FOc;U~l:" -' ''\lrSJFN~W BIOCk~L~I. ' eel' ror. F'I dM N T~b ' .,' "",,0 L r . leap o. ut:SI ~ COI~Sl RUCTION ER:iOh: Builders License No. ';) Plumbers License No. Electricians License No. Other Trade's License No. L ork will be done: / k\ County, TaXj1ap 1'10. \000 ~c~n\ \)9. SubdiVISion 0" boi '~h Q, (} S (Nam 2. State existing use and occupancy of premises and i a. Existing use and occupancy 'H a.. , . nded use and occupanct of proposed construction: I, J b. Intended use and occupancy 3. Nature ofworlc (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost -$ I:' QUO. vo 5. If dwelling, number of dwelling units If garage, number of cars Addition , Alterati9P ", Other WorkXT~'Ill"",.j III Ill.. I ~j)H)\())IyV'f-Vool. (DesGHption) J Fee 1\ Is-a. U~ (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, ifany: Front l, C;; Height Number of Stories Rear I. " Depth ~7 ' Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front , {JJ t Height Number of Stories Rear 3;;;J , 'J,'/., - fi'A.. "- Depth~ 9. Size oflot: Front IDU. ' Rear IOb.7/;/ Depth ;;lal ,J<;; 'nt'J!:lO?,. 90'S€: 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~ 13. Will lot be re-gmded? YESL NO_Will excess fill be removed from premises? YES_ NO L 14. Names of Owner ofpremisesSk pk.u- b~ Address 1000tJ. '31h1,i>.. ~, Phone No.llol'?/" -(.,;)c.,7 Name of Architect Address Phone No Name ofContracto Address 1l;)4A (J~ Phone No. f.,3\-::l."",-~ 10\ ~~ S"'-'....."'a."'p 15 a.ls this property within 100 feet ofa tidal wetlan or a tTeshwaterwetland? "YES_NO L " 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-L "IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accumte 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) SS: COUNTY OF ) '-~ lY... 1.1'\ b\.l~ being duly sworn, deposes and says that (s)he is the applicant (N e of individual gning contract) above named, (S)He is the b~ (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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swom~beforemethl\ \ a~~utJf I>t~(, 200~ ~ O~~bhC ~f~_ ...., lIO. Ol~12l!_ ~u).__it- .7/ '/ r-/' ,/V . ;' -tj/'-"^-t. / -'7 L--- r I . Si7~ of Applicant , ,