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Home My WebLink About32582-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32227 Date: 03/07/07 THIS CERTIFIES that the building ALTERATIONS Location of Property: 1155 MAIN ST (HOUSE NO.) County Tax Map No. 473889 Section 34 (STREET) Block 1 GREENPORT (HAMLET) Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 15, 2006 pursuant to which Building Permit No. 32582-Z dated DECEMBER 18, 2006 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 REPAIRS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT W BRUCE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3024048 02/21/07 PLUMBERS CERTIFICATION DATED 02/27/07 GREENPORT PLUMB.& HEATING Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ ,. --'-"\ I';:' .'7\ :"::' r f" ,-;1 \ ~ . APPLICATION FOR CERTIFICATE OF OCCUPANCY ..22 ?r'f7 i, This application must be filled in by typewriter or ink and submitted to the Building Departme~~~\h thefollowiIl82',~__J A. For new building 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 from Health Dept of water supply and sewerage-disposal (S-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 2/ I 0 of I % 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 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: I. 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 Occupancy is denied, the Building Inspector 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, 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. (check oc '\3cl- Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block I Lot r Subdivision Filed Map. Lot: Permit No. '32<;'1'>2-c- Date of Permit. fd) rB-I 0(, Applicant: Health Dept Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: L (check one) Fee Submitted: $ .2<;. ern ~.ez. 7 fC/ tfO co ~ 3dUd/ 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) PERMIT NO. 32582 Z Date DECEMBER 18, 2006 permission is hereby granted to: ROBERT W BRUCE 1221 MAIN STREET GREENPORT,NY 11944 for : REPAIR DEMOLISH AND ALTER AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR AND TO TRUSTEES LETTER DATED 02/22/96 THIS PERMIT REPLACES 23264 at premises located at 1155 MAIN ST GREEN PORT County Tax Map No. 473889 Section 034 Block 0001 Lot No. 009 pursuant to application dated DECEMBER 15, 2006 and approved by the Building Inspector to expire on JUNE 18, 2008. Fee $ 220.60 11 %~UL Authorized Signature / ORIGINAL Rev. 5/8/02 [2l[lJjo1j;;Jr?~M@EJ~ 1iI~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ Located at I Application Number: ; Section: Block: I ; ; ~ ; ~ ; ; ~ ; I I ~ I ; ~ ~ ~ I ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. i?];iJ.EJi?J.ETEI@~ E!IG!E!IG! iii ~ ~ ~ 8- ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ; ~ ~ ~ ~ ~ ; ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS 34. - I - BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 Upon the application of ROBERT BRUCE 1221 MAIN ST GREENPORT, NY 11944 CERTIFIES THAT upon premises owned by ROBERT BRUCE 1221 MAIN ST GREEN PORT, NY 11944 1221 MAIN ST GREEN PORT, NY 11944 3024048 Certificate Number: 3024048 Lot: Building Permit: BDC: NS11 Described as a 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, Outside, 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 and/or 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 21st Day of February, 2007. Name OTY Rate Ratin. Circuit D:nl; Miscellaneous as built 1998 Alarm and Emergency Equipment Sensor Appliances and Accessories Exhaust Fan Furnace Wiring aud Devices Outlet Fixture Fixture Outlet Receptacle Switch Receptacle Receptacle Service I Phase 3 W Service Rating 200 Amperes 3 0 Smoke 2 0 F.H.P. I 0 Oil 23 0 Fixture 22 0 Incandescent I 0 Flourescent 58 0 General Purpose 36 0 General Purpose 31 0 General Purpose I 0 20 amp Air Conditioner 7 0 GFCI seal Continued on Next Page I of 2 ~ ~ ~ ~ I ~ ~ ~ ~ ~ ~ ~ I Located at ~ ~ ~ I ~ ~ I ~ ~ ~ ~ ~ ~ I ~ ~ I I ~ ~ I ~ I ml 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 BRUCE 1221 MAIN ST GREENPORT, NY 11944 ROBERT BRUCE 1221 MAIN ST GREENPORT, NY 11944 1221 MAIN ST GREENPORT, NY 11944 3024048 Certificate Number: 3024048 Application Number: Section: Building Permit: BDC: NS11 Block: Lot: Described as a 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, Outside, 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 and/or 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 21st Day of February, 2007. Name OTY Rate Ratio. Circuit ~ Service Disconnect 1 200 cb Meters: I An as built inspection, of the delineated electrical installation, detennined that an obvious hazard is not present and the installation is believed to be in comfonnance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ml -'iJi I [g] Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Pax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: c9- d-1--- () '7 Building Permit No. ?;;).c, "6').- I1IJC~E.-r l/);I<;;tf)1 &ttLe (Please print) Plumber: ~/2eGf1JPofl:( "PiLL 11/1 hi tvq <+- Hf? )ttIJ(V(.\ (Please print) 0 .j Owner: I certify that the solder used in the water supply system contains ,less than 2/1 0 of 1% lead. . 0" " _7.4"~ ~/?~A~' "'- (Plumbers Signature) Sworn to before me this 2",) day of fY\ fYl."h ,20~ John M. Judge NOTARY PUBLlC6 Stale 01 New York No.01JU605940 Qualified In Sullo.lk County 0-' CommissiOn expires May 29, 20.-.. ~~~ Notary Public, S....~ ~.lk County J 2-~6'2- if- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESlSTANr CONSTRUC'nON REMARKS: [ ] ROUGH PLBG. [ ] I~LATION [~NAL ] FIRE SAFETY INSPEcnON ] FIRE RESISTANr PENIE1RATION CO DATE / /J,~ /tJ7 / { INSPECTOR ~ cJ 3J-?~t 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY ~ [ ] ~H PLBG. [V(INSULATION [ ] FINAL t/' t tg---~ <- ..." ~ ----/ DATE /Y1 ....ilOJ.:)3dSNI J~;?1; 3J.YG C4~~~~ ?/o ~6' ~ ~fI" + 'SlI1IYIG1I lVNl.:I [ ] ONIIAIYH.:I [ ] ] GNZ NOIJ.VGNnO.:l r ] / NOI~~3dSNI "J.d3a ONlalms Z081-S9L ---- ~-- - ------~ 1-?I-~t/~ ------. ~- 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] F~DATION 2ND [~RAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~~ ~. ~ ;:2~ ~ d(/ e/- J1k. ';A' ~ " ~ - ~~if' J5hd ~~~.;:L~ ::'..e-p t? [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL DATE 1/2-L/98 INSPECTOR ~~ ..JOSEPH SCHMITT ---- Consulting Engineers m I'''''', , !! ..-' 12 Wylie Way Stony Brook, NY 11790 (516) 689-7270 Fax: (516) 751-7047 FEB i. February 3, 1998 Mr. Michael Verity Building Dept. Town of Southold Main Road Southold, NY 11971 REF: 1155 Main Street Greenport, NY PERMIT # 23264 Dear Mr. Verity: On January 25, 1998, we inspected the framing structure at the above reference address. Our inspection paid specific attention to the headers over the sliding glass door; the arch at the roof transition from gable to shed between the living room and the rear addition; over the custom window at the rear; the new beams, columns and footings in the crawl space; and the main beam in the basement under the living room. We found that all headers, beams, columns and footings were adequate or oversized for the design loads. cc: Robert Bruce 2085A Shipyard Lane East Marion, NY 11939 JS/dr ~ II .. I I 'I'!' .,., )1/ 111'1'1)11'1' O^.,." CUUlllmrS \.)J.. "11' "' I', 'I (, . '.. .-~. .... .'. ==..--....===7_==""'3-==================-. )l) =_~.'=m~=.:.:u-..=....=m-=ru=----r:.C;;;::;;&:~.:4" ~~.~~.~-.---__.__.u._m ~ ~: """"^'''''' ,,,,,, r~-J=: n.. -n~'m ~~, "m.... -~ "'-".-... -.---.--.-..-- -_____n_____.m t, ---.-----11-----...--. - ___......._n ....-..........._.__.____nn.._. ............... ~ ~ ==n=..umu==m==-----=;:r1=~I= ~~,.-<. ~ ~~ ' I;~dl. ~~~--.--~------~~_=---n-h- m_____II.._____.__.._ _.._".._._~_~_~~~~ __ . ------ml~~~~~-:= --------~-..{"""~r.(c. ._L._ ~~~~~~_:~.~~-~i ._.' ~~~~-~ ~'J ' ~ ----~~~~-~~~e::::t_~~-. _ I ~l~ . . .C?2-------.--.--..----------- '=-~_r~-~fS~~_-1J~_ -_-_~~-=~~~A===___==___==___===___=_____===__=_______==____=__===__. ~~==~===-=~=--==--=------ - 1'1.11111l1NC: "- " ~ \ ~ IIOIH:II FilM'" & INSIHAI'IOl/ !'Im N. Y. ST^TIC IClII!IIGY COlli! ===-=-==-=---==~-=------= ~ i5 C'I .! ^lIlllTIOll^L COlII~mNTS: .=-=~~~~~~~~{j~~~=~~~?-;7iB~~~ -. -~=~--,=-.~~~~-~~~~.~~.~: --~ (\ o ~ ~ ~ . ..~.._.._-=-=-~=~ ..-~~_.=~ ~= ..--~=~=-=--==-. .._~ 1'Tl/^1. 1" ~ t'~ ~~~ ~Jo,' ~~.\ .....~ -" ('. >- ~.i~ ~~ '" :"' r ~~dlnHt TOWN OF SOUTHOLD PROPERTY RECORD CARD \j!;;-2~ //) () cJ --,'1 '1- / - q STREET / Ir;~) -- OWNER VILLAGE DIST. SUB. LOT cKube('t \N t)r l.-{ r_e..-. \ I1AINsf r0. J. -r- /(:) / ,,'.' . . " j .,./' / of' c c.. ~MER ~WNER + leVl\(p \ " / E '/)< ACR. 15;,' )0) , ! / I .f () ( ore C- ___/;;"lv J r//' 1(),P,,1..J ,/l _, '( VI 12.5 . . ~'" ~" ,/' -=r: (" <<) 01- \ of' or) Ke I S W / TYPE OF BUILDING ('0(\ \\f'V\kc.\ \tl"o -:.1 ~\J I -~ . J, .,-//';:,{r', .../ , 'I' /, . .- ' ' .... (" R~.t6 SEAS. VL. FARM COMM. CB. /.,. MICS, Mkt. Value LAND IMP. TOTAL DATE REMARKS \\\C:;\'61S LICS1Q oGlch -\-\f'OK-f' I +r, \ If'<l kf' \ ufo , ) /'.. .... /:,i /h; 3/11 /11- LIlt 7()[)3}7~ flfnkf/ Iv t3(U(~; !3'.::;OO(JD -,- <J ,) , , 0//1 h ]; I / , ., J ,,)~ cJ I ? ,<-7) r./ (J l) ~ , - -_._~---- - -~--- II - - ~--- --- -- -_._-~------- ---- AGE BUILDING CONDITION - NEW NORMAL BELOW ABOVE -----~._---- --- FARM Acre Value Per Value Acre .,------------- -------------. Tillable FRONTAGE ON WATER ---.-....-....--.-.----...--. ~_._---- -----.----~ ~----_._._-------~ -..----- -------..------- --_.----- _._.--_._-----~---,~-------- Woodland FRONTAGE ON ROAD Meadowland DEPTH -- House PI?t _ .. .....,,~ BULKHEAD Total DOCK - I : Ext. Walls I ~+, ,~ i Fire Place ; L)!TYRe Roof I 'I~ation Room I~;:--- , ' - ~ B1 .--,>~~,~ 'Ill.. 'c-"-- . . .11 " I., .,'..,' " ". "" I . ..,,~ M. Bldg. -1':!:7~?F I)!] O.J ~.:,-2-9 /~ Extension _I Extension tS'f"r- ~ It;r;..(. I I--.L ~ --I I u C ~ '1' 1".0 Extension Porch .r'.:. ( .' I 15 Porch Breezeway ~-------I- Garage I i.', ,., Patio O. B. Total /J 2- 2j- , COLOR G"n>e.o./ TRIM l0 (~, ~', ~-.- . [-iT'- ---. --, - --- -..-, - ~ -_._-- e- --- ~- ., -, --- ---- ---- ,," ---- --..- --.. -- -- -, - - - ~ -- -- e--, - -, -- --I- I- --- - -.- -- - , i - -.-- ,- -..- , , -.'... -, e- .- I +- I I i =f+' I -+ -H-l - - - . -- -- -- . :: I I ! --- /) -ii-'+-+-'+-i --- j I i I 1-1111 , I I , 1 I i 1--:- -, I ) t ~ 'TtTT1 i I l=~1 I In I~ T I I ; ! : ! : i ' " TI 1:--1-; it-I , 113 I~,- rT ,.3 I J.../t 2- )( L- I-,-~---:--t--+- tt= ).. i i ! ! ,I I I- I-- . 7x II 1<7 T -T--:;-t I . ' --+- '--i-t--+--+--J---1- i II '" 'i' t I ! I I 1 I..:. t-H-+t 'j'-- ,.oj , . . I I +---- I I I i -----1......1 I i : i i-LL.t...l I i i , "? ...) u Foundation 1'01'--'-' Bath / I Dinette I I 1<. I . LR. I I DR. SR. ST. 'lie. !flR7' Asb I Floors .3f;, ;-;',-(-". Interior Finish ;'::"'/! T ~~'. ..s.te"'J*'1 ",-1.r;As Heat Rooms 1 st Floor Rooms 2nd Floor I I FiN. B I Driveway '.. ....--".,.-......,.......-'.---~ Albert J. Krupski, President John Holzapfel, Vice President ., Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southo1d, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTI:lOLD February 22, 1996 Robert Bruce 36 Huntington Street Southampton NY 11968 Re: SCTM #34-1-9 Dear Mr. Bruce, According to the information given, and an on-site inspection of the property, the Board of Trustees agreed that the renovation of the house is out of the Trustee jurisdiction, under the Wetland Ordinance under Chapter 97 of the Town Code. However any activity within the 75 foot area of wetlands, such as re-grading of the property, or renovating the garage, etc., would require a permit from this office. If you have any questions, please call our office. Yours truly, (la,.J 9. /~: 9, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept.'-/ CAe -''". - " I' , NIl M ~ l i i j C.rz "'fiDDLE . .,8 (~. NoQ F<oAo __ r/./ '<D.) '--.. ----- -----------.. I I / Nj~ WI11-1EIi9PooN N.6-r" '3()"e. '8 !,J,/F FAa.2 SUFG.~O,TA.X JlW' ~~~~l(~fO-~'J'9. 4. ; . '" '.~ ~. ,; ,. .', ",'i"f_'C.: ',,.. ~ ';.'. '..1" """, ',.". -;.Jr' .~ 'i" " f- ;.. .' I" ,t 1 M~ ,..Of PRO~TY ~~ ,. ,.'fQft rzOBE'RTW BRUCE ~. I i I I j I I I I I I I I t I i I , I i I , I I .' , I I . I j I ! i I t , I ~ I ! 1 . fQJe ...... t 110.55 1 i I I I I I , ~.retIonor"""'- 101hls IUMtY is 8 violation 01 $edlon 7208 of the New York SIIIe ............. ~.....__...- ....aand~.......or embolled'" "'-lIlllbeconsldentd trlbe.wId.'" .....................,..MI ............"'_.. ....., 1s.~.......bIfIdto.. 1IIe~__..i...~tnd lending IrlIIluUon .....11INon and 1othe...v-of..1lndlng1nlll- MIon.Guaranteesarenotb..."" to adcIItional insIilutlont, or.......... ........ g Ci : ~ l N ~ I M .'N 2"- , ;Z 1--"-'- S.63"2 10 W, b I tIi l(l \II If..... , ~ t (t) j If) i 2 r ~ ~ <: z :I .__..--.....,-.----~. _-,-~__________~_~.~. _~..,.......__,_..,---.. _..._...~~-..~ ":.-'--c... ____..,...,._ ___..--._........._._.._......v_ .___>..,.....--:.,.,.. " ~~-.1)1 n~a,~_Qrl.J. N$S~' . J~tl._ ~K .~.T9Y"'~fC.. /?V___ i~ .....,.~-. ~'" . fIC.r , -- ~.~ 1O'NN .(F...IJTHfJl,.,D I N.V. / II /l / / / SCALE '.~~. [!I 'MONUMENT 0.PIPE " .- MEA- o.I681f.:_ TITLE NO. 1~4'0'3024 LK:'.~,~ ~.~""":. :,...,L,.~,......<... ~ ~"'. WI m '7 II JAN '6~ 11; I I'-J TOWNBlOG. DEPT. , OF SOUTHOLD j , , r i:~ , t;cc, ,; f"~ .....~ ..' . ,.({,~i.~"" >,: >"", '-, . ',~~'",,:~": _:,~~.::~,~:~'_#"j.;';~ ~'_'r. ~f.~.,:~~,;_.',,'" ,{~"'}i! ~D ' ' ;. .---'.......-, 'i. ';".,\.-f'" , FORM NO. 1 TOWN OF SOUTBOLD BUILDING DEPARTMENT TOWN BALL SOUTBOLD. N.Y. 11971 TEL: 765-1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORM ................... NOTIFY:~ M30/63 CALL z.lP:n3~ E-.ined..~~...... J9t? dL /Ipproved.....~,2..:. 192,? Permit lb. ?:-.~.~.r:.( Dis..w,,,..,d ale ....:.............................. HAIL TO:.................... ..................................... ..................................... ......................................... i:), ~ @ ~ 0 Wi ~-,-,- Ii JAN 1691) lil:;! j.. ,! BLDG. DEPT. TOWN OF SO!!IHOlD j . a. This applicatioo DlI8t be ~letely filled in by tn-riter or" in irit and 3. sets of plans. sccurate plot plan to scale. Fee sccordi'll to scheWle. b. Plot plan llhowi'll locatioo of lot and of buildi'llS on pmnises. relationship to sdjoini'll pmnises or Jd>lie . streets or areas. and givi'll a detailed description of layoot of property DlI8t be drswn on the diagr/IJI ""ich is part of this applicatioo. e. The work covered by thia application may rot be ,-,-""",,,,-ed before issuance of !bildi'll Permit. d. Upon al'l"uv.J. of this application. the lbildi'll Inspector will isllU!! a lbildi'll Permit to the applicant. &rlt permit shall be kept 00 the pmnises llVllilable for inspectioo throughout the work. e. lb buildi'll shall be occupied or used in w.ole or in part for lIl1}' purpose whatever mtil a Certificate of" lkcupancy shall have been granted by the lbildi'll Inspector. " APPLlCAl'IlIf IS IEIlEIlY !WE to the !bildi'll IJi!partnBtt for the issuance of a !bildi~ Permi t pmlUlIDt to the lbildi'll Zone Ordinance of the Toom of Southold. &Jffolk County. New York. and other applicable Laws. Ordinances-.or Regulatiooa. for the construction of buildi'llS. additions or alterations. or for ......"",1 or dmIllition. as herein described. The applicant agrees to ~ly with all applicable 1_. ordinances. buildq code. houai~ code. and regulatiooa. and to adrrit axthorized inspectors on pmnises am in buildi'll for DeCeBBSry inspections. . ........2??. , INSTRUCTIONS .. ./0....199% ICATION FOR BUILDING PERMIT . ed to the !bildi~ Inspector wi th / State w.etber applicant is ownel". lessee. agent. architect. ~ineer. general contractor. electrician. plmber or builder. ....................... .t:f0;:rz/l.... .,..................................... ........................................ Name of ooner of pmnises .......~~~~~~~.~).............,..................................... If applicant is a "'" "",..tion. signature of duly axthorized officer. ~ 2. (Name and title of oolpOulte officer) ;:=~=::!/~{1!~'!;Z O$;~( Electricians License lb.3~. k........ ~ .t{Pa-J,:tc, Other Trade's License lb. ..........~ /J1~d /1)~ I. Location of land 00 ""ich I"~ work will be ~.t!!......................................................... ....J;;,f:?:!...ff)a:o..sr....~~~~...~~.Il/f........ ....W~~........................... County Tax Hip lb. um Section ...3-1-:...... Block ....1.......... Lot ...q.......... Subdivision ........ .............................. Filed Hip lb. ............... Lot ............... (Name) :~;:::i:: ~~.~~!fr~~.:.:.=.~~.~~~.~=~~~:...... b. Intended use ~ occupancy ...... .O~.................................. oon................ "" Nature of work ~ YlidH.ppl,icab)l>l: New fuilding ..,../-... Addition .......... Alterstion ..~ Repair ....V.... Removal ....V...... Ileonlition ....1<':..... Oilier Work .................................. Z lIT (Description) Estimated Cost .:.~.~....... fee ..(~~.b;.~id.~.fiii~.dhi~:~ii~~i~)..... If .u.lling, ....mer of doelling ...its ../....... IUd>er of doelling 'Ulits on each floor................ If garase. ....mer of cars ...................................... 6. If buliness. COJIII!rcial !lr mhced ocwpancy. specify nature and extent of each type of 1ISe...................... 3. 4. 5. 7. DimensiOO8 of exiating atructures. if any: Front................ Rear ............... Deptll Height ......................... IUd>er of Stories ...................... DimenaiOO8 of ....... structure with alteratiOO8 or additiOO8: Front ............... Resr ............... Depth .................... Height .................... IUd>er of Stories ............... 8. DimensiOO8 of entire ..... lXlII8truction: Front.. .. . .. .. .. .. ... Rear ............... Depth Height ......................... IUd>er of Stories ..................... ~ 9. Size of lot: Front....."............. Rear .................... Depth .................... ____r. 10. Oste of Purchaae ..................... IlIIne of Fonoor IMler ....................... ," . . . .. .. .'. ;' ,'.. , . II. Zone or IISe district in .midi premises are sS1;uated I............................................................. 12. Does proposed lXlII8truction violate any ZLlIIing 1.... ordinance or regulation: ........................ 13. 14. Wi 11 lot lie regraded .................... Wi 11 excess fi 11 00 relll(J\l<l(j frao prEJDises: YllS III IlIInes of IMler of preadses ........................... Address .............................. Phone No. IlIIne of An:hitect .................................... Address .............................. Phone No. IlIIne of Contractor ................................... Address ............................... Fhone No. 15. ,Is this property within 300 feet of a tidal wetland7 '" YllS .......... Ill.......... "'IF YllS. &I1l1Ull 'lllIl 'J'IlIISTFES Fmm' Mo\Y BE ~. PLOT DIAGRAM locate clearly and distinctly all blildings. wtlJer exiating or proposed. and indicate !Ill set-hack dimensiOO8 frao property lines. Give atreet and block ....mer or description according to deed. and show street IlWIl!S and indicate tAletlJer interior or corner lot. '. STATE OF NIlW !6flK. . (I SS COUNTY OF . .~ YL~0? . . c. .................Rp.~.";~t'0!..13.{,'>C.-e..... lieing ....ly sworn, deposes and says that he is tlJe applicant (1lIIne of indiviclJal "igniog COIltfllCt) above nmed. He is tIle .... ....~...... ............. ...................................... ...... ...... ............ (Contractor, asent. corporate officer. etc.) of said WIler or owners, and ia ....ly' authorized to perform or have perfonood tIle said work and to make aid file this applicationj that all stat:auents contained in this application are true to tlJe liest of his lmowled&e and lieliefj and that tlJe work will lie performed in tlJe manner set forth in tlJe application filed tlJerewith. &lorn to before me this .. .. .. .. .. .. .. .1.. b. .. ':to>. .. ." .... day of --;s: f1. n. Y'd', H_J" .. .. .. ,Cf./p, .. .. . Notary PuhljCr'l"'"'"%\~ :1ft~~p;Q:ai'~": 1 f. P,'! ~r;'l'll s,,,, e:tiJ:CLtat:!:..L{;cc'-o "I{-cc{~')O" ';' ,^ ~ () ......(Si H 11'1'1 'W "111 """"~ '" IIHHIH I' '" I I I ""'J I" 'I'll' """l$\" "'1 II' 'I" "[J """,,',' "'1'"",,', " '1,1,1, ..... ' I ' ",' I , '>>" l....ne.I'1 ' " 11"[ '.on '. jijllllStart "I' , I'I '1" .,'1 1111111' 1,,,,,,-$$~~''':'7 :;:4"1' _RPS Yersllln 4.. ~.. ". ,.//;"",,;;i/;;+H+y+',""i.',;;d""""i..... ,..; :.,'''.:''.;:;;'';'''''':''''''.'',;'.;;:.: FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMEHI TOWN HALL SOUTHOLD. N.Y. /~r ~}} BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date..........d~..€.?..................... li6... N~ 23264 l Permission ISherebygra.~~:.!fo.~...k/..~~.... '/ S5.. In . \'~ .................~........... .................~.....M...~(........ ;/J~~...~.........~~.......:.:::.............. to.......,....;~~.f...~....~....~......~............ ...~....... """""'~''':'A~~'''~:'''''''''''' ...............~........ .. ....' ..?f~.../h.tv.i).....tiL...-.-.-/~tR~ (' ..............kdf!?4.........E..~...~%19~....~.................................................................. ..................................................................,..........................................9........................................... at premises located at...............I/.J:f.~........7l1..~.~..........:............................................ ~........,..................................,........... ~Iock ......../............. Lot No. 9........................ ...~" 19..f~..... and approved by the County Tax Map No. 1000 Secijon pursuant to appllcaijon dated...... Building Inspector.6& Fee $..J.;].Q.....~ Rev. 6/30/80 . . ~.. BOX 5%1, In r.-t Street Gerden er-p.rt,N.Y.11944 516-477-975% (fax) 516-477-0973 r;D) m @ m II W ~""7" ft,r " ,I, ,,! , FEB - 5 1996 i FAIRWEATHER-BROWN ARClDTJ!:CTS A DESIGNERS :v'!R~8Ec;8Y~:-} TRANSMTITAL Date: 1-,~'1(, Hr..J. ~. \tW4 (~ot. To: Re: p.,fZ<U ~I ~C.cf 1)...1-1 f.-IMtJ Sf. Cc~p(, We are sending, enclosed, the following: [ ~wings [ ] speci1icatiOllS [ ] samples [ ] for your: []use [~ [ ] information No. Date Description ~~. A~ ~ ~ _~o.w~ Remarks By: cc: