HomeMy WebLinkAbout32711-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32272 Date: 04/03/07
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 500 YOUNGS
(HOUSE NO.)
County Tax Map No. 473889 Section 141
AVE
(STREET)
Block 1
MATTI TUCK
(HAMLET)
Lot 30
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
FEBRUARY 12, 2007 pursuant to which
Building Permit No. 32711-Z
dated
FEBRUARY 12, 2007
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 VICTOR & BARBARA RUTKOWSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N-384779
05/01/96
PLDMBERS CERTIFICATION DATED
N/A
~~~
uthorized Signature
Rev. 1/81
,
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~:f
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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:
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 2/1 0 of I % lead.
5. Commercial building, industrial building, multiple residences and similar buildings and 'installations, 'ftc~ificate
of Code Compliance from architect or engineer responsible for the building. '?~".
6. Submit Plmming Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildiugs 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 Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
I. Cel1ificatc 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. Cel1ificate of Occupancy on Pre-existing Building - $100.00
3. Copy ofCerti!icale of Occupancy - $.25
4. Updated Celtiflcate of Occupa'lcy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Conunercial $15.00
Date Lf/a/() 7
New Construction:
.......------
Old or Pre-existing Building:
,-/ouA/65: Ave
Street
(check one)
p1;f 71, IvC <'
Hamlet
Location of Property:
5'DD
House No.
Owner or Owners of Property: _( ), c..T" tZ 4- '6' PI 12-6.., It."
Suffolk County Tax Map No 1000, Section L/73 R a 'J I 'I IB lock
f2 I.Fr f<( d l4> $ 1::1 .
~OOQ I Lot
03<1
Pennit No.
3'2. 7/I-Z Date of Permit.
Filed Map. Lot:
~/r2../67 Applicant: U,c.-t'c,'l... R,itKoe..Jf'l:"
, /
Subdivision
Health Dep!. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certiflcate
Final Certificate:
/
(check one)
Fee Submitted: $ ;)....5"." 0
~Q.~1
Applicant Signature
~JtC... TJJ 1 I
c..o ?:3J. 'J 72.
THE NEW YORK BOARD OF FIRE UNDERWRITERS ,c..
1_1:?~-'" '7
I
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Oat#'
Ht.:;.,'" J/J, ;,1,''''-,,1
App/icafion No. onfil#'
.? ".; 'C~ . ; , :' ',:: { "
w' '-',^'
,
THIS CERTIFIES THAT
only the electrical equipment CJ8 dacribed beWUl arad introduced by the opplicont named on the above applicat.ion. AU rnber in the premiu. oj
~_ ,\U\~-'_i. 'i.-~!!',p~"',~);>~,:_:", :;(,!(,} "'f.';~nF':-; b.':':'TJ;.W:~_1 i
in thefollorring location; 0 Buement 0 ht Fl.
tt'Os examined on ,::fntJ; .2C, ,l qcp:
~)/ l.l'fL"i.'I'n:~R... '._~: 0 Y"
D2ndf'l. nw
.~...tion
Block
w!
and found to be in compliance with the National Electrical Code.
OTHER
RANGES
AMT. K.W.
COOKING DECKS
""'T. lC.W.
OVENS
AMT. l.W.
DISH WASHERS EXHAUST FANS
FIXTURE
OUTLETS
RXTURES
IeEPT AaES SWITCHES INCANDESCENT flUORESCENT
AMT.
IC.W.
AM!.
H.P.
AMT.
........,. H.P.
MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
AMT. K,W,
H.P.
A.. W. G. MlT. AlAP. AMT. AMPS.
BELL
TRANS.
UNIT HEA TElS
DRYERS
RJRNACE MOTORS
FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS
Oil
H. P. GAS
NO.
AMY. WATTS
....T.
mo,
NO. OF
METER
EQUIP.
S E
lJ12W 1,3W JB3W J'AW NO'~Ei'..rCONO.
R
A.W.G.
0' CC. CONO.
v
C
E
SERVICE DISCONNECT
AMP.
NO. Of HI.lEG
A.W.G.
Of HHEG
NO. 0' NEUTRALS
A.W.G.
Of NEUTR....l
OTHER APPARATUS:
\l\\-
-, '\
)LJ
rvg:r,m-\ Fr,1i~?l:PI'''''
J;',,(),FiX< 1:-.1
l'lr;TClt~()CUF ^ ~iY! :10:-;".:
1;'(( ,:W{i'~ 7
Ll2~
OENUAL MANAGUI
J..;
This certificate must not be altered in any manner; return to the office of the Board if incorrect_ Inspectors
identjfied by their credentials.
.- - .-. .-. .-- .-- -. ~ - .-- .-
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
- --~- -------------------------------
FIRE
UNDERW~~TERS
PN:-O;:
THE
NEW YORK BOARD OF
'-,'>-:~';':'-
I
I?\",:' 0n.;1,;/;t:
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
,~:i ';'>~'l: ~:,";,1:.:'L
~: :>,,'j,<')i
DOlE'
Application No. onfilf>
THIS CERTIFIES THAT
oBly flu! electrical equipment.... deuribed below and introduced by the applicont named on the above applkGtion number in the premius of
in theJollotcinR location; 0 Buement
[:<'rn;; ~;~; J:::}, ':
o I.. Fl.
~:t:~r:N:.:: I~-<V!:::::HJ;. It:\'.rrtTT"lKf~ c
.WiI"'tion
Block
Lo.
';ll'r'~\ :'~ Ki':'J,'I,T:',r~g~' 0 L;0?
wa.s examined on
FIXTURE
OUTLETS
FIXTURES
INCANDESCENT FLUORESCENT
ECEPTACLES SWITCHES
"."
.I.'Il., ".0
o 2nd n
Olrf
andfound to be in compliance with the NaJional Electrical Code.
OTHER
RANGES
~T. K.W.
OVENS
OISH WASHERS EXfiAUST FANS
AMT. K. w. AMl. H. P.
COOKING DECKS
AMI. ICW.
"^"'- I.W.
AMT. I.W.
OIL
H,P. GAS
""T.
FUTURE AmlANCI FEEDERS 5PKIAL REC'" liME CLOCKS
NO.
A. W. G. AMT. AMP. AMT. AMPS
BELL
TRANS.
UNIT MEATE'S
MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
DRYERS
FURNACE MOTORS
H.P.
AMT. H.P.
MloT. W"'TTS
t. :~r
R
....w.G.
OF CC. CONO.
C
....W.G.
OF HI.lEG
E
v
$ERVla DISCONNECT
NO. Of
METlR
EQUIP.
S E
1/1 'lW 1 # 3W 313W 3,1.W No.O~i'HCONO.
NO. Of HHEG
NO. OF NEUTR"'LS
....W.G.
OF NEUTRAL
""T.
me
""P.
OTHER APPARATUS:
;';I-HtHfTNt; POUL- J
111 flI~ ;tt~~('t :-;;-1("1 .~ i~J - l.
G,F.[I,I. I
r' ':HTt.'(ffINr: 1:-\\j_'l..: l'l;,';:J ':~'-'J-t:tt> ':-1.1
'~'~.1~'; ':. '_:mpJ j dn' )t tb~' dd'f" :-.1
tr~~~\ ,>':h!lj ':oni\-" P'P('~!l.Jf~:f-' ("1 Hb.1:
T_l_l'~' .1 "l:~!~\j,;' t r 1, (.~) l\~]_!:'Db: t-' l,._
t?__)
'>:" /,'\i'id
',1' '(!~i',} r
itl..
/.\ ~ ~ (: i
,"<-:l
I!f :n
d~1!'1. ~, ". 'l ", i ;,.;f t~': 1.
.,-. <(. C- .lI,' ; i ~q'.;:,) <'n r _~,'f\ ~' "';'0-
GENPAL MANAGP
~?Iqlr
It/I
,.
j e.
.'", "'\
~"'
Lli~
identified by their credentials.
.-.-.- .-. .-.- .-.~-.- .-
This certificate must not be altered in any manner; return to the office of the Boord if incorrect. Inspectors
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTEREO IN ANY MANNER.
-.----"'"--
j
3 r 711~
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [~INAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
Irn-e ~ ~ Ok
-r- c 1-. f) r
REMARKS:
;L --/{}- --tJ 1
DATE
INSPECTOR.A ~
-
.:;-< -- ~~._..--.---
~
3~111
//)q?/fD~(
r J/.S../
--/~--. I
o. J
,Jl~
~ v\j
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
~FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
~
..,
/~ ~
~ ~ (JY-
~dL- ~ ~~
DATE ). - / ~ -- 0 7
INSPECTOR
~~
=-}:=Ij.-'LI':~ b---:;::t~L~~ ... - ..
~_~~:~-_=~-~-~- ~~~~~_ ~____~~~=___~d!t:iQ~~:=~ r
gl:~_!~i~~"x llJll_HI'~UHT VflTt: _ - COtl~IE/lT~
-.--.----------===-=~-====~f~======-r=D===F===C========================================~====
11 II
._____11_____,___._.__ ------- -------------------------------------
II II
I-----II------~-----------------------------~-----------
II II
~II-----II--~---~--------~-- -----
--- --_..
II
~====~~II~==:==-===:=======~=:=-===-=-- .-=====
~~~!!~nQ~n__i~!!!!L_ _ -II-
_ ___ __ _ _ n _n__ _______~~~~ '==~==_=_I'-~=~==~=~~=~========~=======~~~~~=~~~~~~~~~=========~~~,
II
II
-----11------------------
I -
I
_____ I ____________________~_______
I
_________.1 --.---_____________________.~_________~___._________m___~.__,~__
I
~-- II
I
-----II..---------------~-------------
~==~~=~~~~~~~==========~~~~~~~~~~~~~~~===========~~=~~=-==-~======~~~~~~~,
----II
II
----1\
1-- II
II -. ~-~~-
-=============~=~==~===== :;~= ==~==~ ===~=~~========~~:::~=============-
7;~1 - ~tf;-~~~,'r-J:~~___
__-----+~-~~ -a~.,..z Sr~
II_______!~~ ~~:? +- ~~___ 5?;-?J~~:.--
II-------II-~A A~~f~;C:z,->. -/~~ .
1'1 Nfl!. ~----II . . r-- ~ 6'~ r--/H&.--
r II '~~ c? ,/ ~ _
= === ===========~=~=======-======= ===~-==-====~==================..:~=~===--====-====,
'OlllllMT [ON
( 1ST>
10111;/1 FHMm &
PLlI~lIll NG
/lSIILhTlO/l PEIl N _ Y_
SHTE ''/IF-HGY
COilE
AIlIHTlONt\1. COHHENTS:
=============================================================================-
0.'__.'"'.. _.__._.._.~~._______.___.___~~_____.___.____._________________.__________............______._._____..__..
'"
l~
~
...,
~;
~
~
\.}.)
:3
=
~~V'
,., ['.. ',f
~
, ""
'-;;,'---
a ~
G
~
~
~ ~
rn l'
H~
~
rh
~
l~ ~
H ~'"
~
" (
N
~
<:J
~&:
~~,
'-
~
8j
H CQ
~ J.
H 'Cl..,1
~ \
o
~
~~
o
l~
'"
'..I
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.
32711 Z
Date FEBRUARY 12, 2007
Permission is hereby granted to:
VICTOR & BARBARA RUTKOWSKI
500 YOUNGS AVE
MATTITUCK,NY 11952
for :
INSTALL AN ACCESSORY INGROUND SWIMMING POOL IN THE REAR YARD AS
APPLIED FOR. THIS PERMIT REPLACES BP 23181.
at premises located at
500 YOUNGS AVE
MATTI TUCK
County Tax Map No. 473889 Section 141
Block 0001
Lot No. 030
pursuant to application dated FEBRUARY 12, 2007 and approved by the
Fee $
150.00
Building Inspector to expire on AUGUST 12, 20
ORIGINAL
Rev. 5/8/02
FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
. . 8 :.' , TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765.1802
Examined. . ... .. ./r/s::. 199::- 3,;;,7 /1 (~~
/I..h.;-- Q,;:::/ . fflif9c
Approved. . . . . . /'"jr:%,-J. . ., 19/':"-. PermIt No. . . .. . . . . . ..
Disapproved alc
BOARD Of HEALTH .........
J SETS Of PLANS ..........
SURVEy...................
CHCCK ....................
SEPT I C FORtI _.............
?I ll] : K7?:l
CAL 7g~-.~ {'-:.......
MAIL TO:
................................. .
....................................... ..
. 'A~""~; n~I~~:~I~~p. ~r~""""'" :~~~~........
\: ",-,' ~11", II \\U\j~ U \U;'u\\
~ :Z".~r=: rr~ nl n:\nn !v~rhrqc:n nl APPLICATION FOR BUILDING PERMIT
, ,,~A= ~ \>J) l!o.~ u J >-=ooU"1\ v u U llJi .
\_~;,\ ~ ~:r:)!tjl (CE~~T~f~'C~T[E
, ~~l" (J~c;~iJ'i~[(CV' INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
Date ..I~//......., I~
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, C~d~d regulations, and to
admit authorized inspectors on premises and in building for necess~~.i~~~:(,.. . . .aiVe::. . . . . . . . . . . . . .
- (Signature of applicant, or name, if a corporation)
. . 7c!.~o,l(. . 9. . ./.o.{~~~. . /kY I(?~~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
A -I,.; - L ~ APPROVED AS NOTEO"J 111
. . . . . . . . .L.~tJr? . . . .r{!f:U{ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'DATE: . /;l~dS:p.# . ~. .
N f f . 1I'~ I <4- ~ I v.... '.::-/.f JJ O/.0::5Ki ,p /h.1!Z /. J.M4
ame 0 owner 0 premIses .!~...... ,:~bN-. . , . . : ..t::..:.. /":'........ 'PEE: ./J....... . . . '.' . BY, ./,;1 ./.... . _' . . .
. (as on the tax roll or latesNdlr~ BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION . TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
t;;:, ~~:,~;:'~..;;;~i
::;~ ::~~~7r:;;;,r;:c
Builder's License No. . /~, /k.7.-/-(-T, . .. . .. . .
Plum ber's License No. ........................
.. , . ..~~jJMlE[!)~ji::J'[Ei V"
Electnclan s LIcense No. ............... ''''I\l''"'''''~'" " -=
" ~c.v~o;: !'vO!. TO CODE
, . UPON C(XIliP!.P'~:)f0
Other Trade s LIcense No. ................. !,K:'rOR~ "WAn's"
I. Location of land on which proposed work will be done. .................................................
.. .~()(J................. ~o.~.. .A~............. .~.. .H4#/:t./.e/(.................
House Number Street Hamlet
County Tax Map No. 1000 Section ... /~ I. . . . . . .. Block ... ./. . . . . . . . . . . .. Lot.. d(). . . . . . . . . . .
Subdivision .v.<~r:-. :t. fifrl::ip,./;0.. .'?d.~Q'6K,. . . . . Filed Map No. .............. Lot. . . . .. . . .. . . .. .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy. ./. . ok,!. . . .?f'? . . .duu. . . . . . . . . . . . . . . . . . . '.' . . . . . . . . . . . . . . . . . . . .
b.lntended use and occupancy ./ .;;5,*"'7'" .:1"&.. .pIp~.. ~. .-7?l..~.. .6/<.J;;:rI"'lp~ .?efu./...
3. Nature of work (check which applicable): New Building..... . " . . Addition... .. . .. . . ~teration ..........
Repair.............. Removal.............. Demolition............. ~iW~~JlVO?i,~".-:p'<,1
'. ., .p. (Description)
4. Estimated Cost .-/:1Pa<lkrp. . .. . . .. . . . .. . .. . ... .. .. . .. Fee. . . 75!?t?l?. . .. .. . . ... .. . .. .. . .. . . ... .
(to be paid on filing this application)
5. If dwelling,'number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . . .
. If garage, number of cars ........................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures, if any: Front. . . . . . . . . . . . . . . Rear .............. Depth........... . . . .
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of saIJ1e structure with alterations or additions: Front ..6-.5:'........... Rear. L:::>.:. . . . . . . . . . . .
Depth. . . . .;<(;. . . . . . . . . . . . . . . Height. ./$-.'. . . . . . . . . . . . . . . . . Number of Stories. /. . . . . . . . . . . . . . . . . . .
8 D' . I' t' t. F
. ImenSlOns 0 en Ire new cons ructlOn: ront............... Rear............... Depth ...............
Height ............... Number of Stories. . . . . . . . . '.' . . . , . '.' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front.... ./.?Z?.'............. Rear.. ./.6"7!.'............. Depth.. /'(J.tJ.~..............
10. Date of Purchase .................... '. . . . . . . . . Name of Former Owner .............................
11. Zone or use district in which premises are situated. . ~.61r1.o'+Iq.... ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: .M............................
13. Will lot be regraded .~-6....................... Will excess fill be removed fr~ premises: ~ No
14. Name of Owner of premises II.4>r-A-?k :?<~~J!f Address y~. h.l-fc-/I.I!'!'.~. Phone No. ...!PJ-:-. r.a2.S:. .'
Name of Architect ......... i< . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . '.
Name ofContractor~. .~~. . .'f'!o!. ~N{<:--:"'", Address'?P.'1'W .7.'. h~-H. Ph9{'J No.7.'3'iVo-.:::!-?.t'.;;?. . .. I
15. Is this property within 300 feet of a tidal wetland? *yes........ No.~......
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly aU buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
~~ 6u?.tJEY
~' " .
~b~~~~~~.............. .
~me of individual signing contract)
above named.
being duly sworn, deposes and says that he is the applicant
He is the. . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, gent, corporate officer, etc.)
of said owner or owners, and is duly authofl rform 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 f~n the application filed therewith.
Sworn to before me this "'.~
NO"~P"bb,..&;~c,"";:9YL:r c:lLcL.
CLAIRE L. GL.EW \
Notary PubliC4~'7~~g~ New York Or .. . .... . .. ... .. . .. . .. .. . .. . .. . . .
Oualifi:in Suffolk County fJ:) (Signature of applicant)
Commission Expires December 8, 19
.~
-11 +?t.lI.{O P.~s~~f'~~['?5l-c
F SOUTHOLD PROPERTY. RECORD CARD
00 VILLAGE SUB.
-.J
?ll~!.
LOT
'f?.' S-c r- / t e d.
\
\
,
/ /' .~,
-," .,,/.' ../
(/ /-(' " (/'l-..t ( ("
o./V-{-
S /1 "
f S'UJ EJ" t I J r<,
FARM
RtJ - II
W (,'
/--::/., (.U 0. 1',
"
RES. A 10 SEAS.
VL.
COMM,
CB.
MICS.
Mkt. Value
,/ (,
LAND
. IMP,
. TOTAL
DATE
REMARKS
Of.)
3600
jot>
S.;J.<lD
'7. 'J II. Oiu (J/Q/<,. ,C.c.. ;h>,f"d~'
~. P'\dJ;.{.;on-I-DDwelnf'J~, .
~11 ,P... 75/
'" 0
Of)
~
AGE
NEW
FARM
BUILDING CONDITION
NORMAL
BELOW
ABOVE
Acre
Value Per
Acre
Value
Tillable.
FRONTAGE ON WATER
FRONTAGE ON ROAD
00 I ~
., t> _
7'" ("
Woodland
M~adawland
DEPTH
b-o
Hause Plat
----'~'
-
,Total
BULKHEAD
. ...........
DOCK
~>
COLOR Vv ~~ \ f-e.
TRIM
w f, ~ f -c (!l f-,.,,,,- s '" -t?,,)~
-,
I
,
; ,
i I
I
I
! :
!
/ Ji,N: v
M:L 9i<og,
.1.,[ y-olcy'
I:x~~i.1ln
Extension
Extension
Porch
Porch
Breezeway
Garage
Patio \'
O. B.
Total
11Yl.'26 =' yf/ '/'-14 3~ cf?t/Ji
22)(/2 ::,;{,q
.t~
~-~ (. )
/ U 9 j 7/5 j..J.~ t 3 "2 :3
, I
. ~ _' . , ,~.,., ",~ \ J' ,.r
", ,"'" 'i'~\;_~.-,. \.
'{;-,~" '. ?i 'ri::~" ~
'.', '. . ~,...;~. .-,'"
..~~. ~
-,.':.~..,....
"'. !II!!
-', ..
,
-!II 001
~,,, -
~'~~1~~z~f:~':';J~~~
'........-"""-
c2/Jl.:l(.. -
';;,)(/3=
,-'
i I
I....... ;
It )( z. 1- -:. 3.5"":.!
/J X 1/-=-1'13 ./'
Il'i.'Y::%J
~.'"'' "" v- "~_
"......,
~\
'.
;n: :.r~.;a:...'
r; II.
'-'
1/)-0
,/S
;fL9-
-
I
1- -f--
c--
-'-
1--1-
1-
I
I
I
,
~~
"
r
Foundation
Basement
Ext. Walls
.
Fire Place
,_" ~ i
.,-
3--SZ Type Roof
JSI.~reation Room
96 J96rIT)er
~jj/I;/ .
-~--~
.~
... '
~ . - .-,~ .~'-'
'\ . ..'......
"t./ ~-c -r:-".,;.....
I .
I"'"
..- - --~._--------
r- --t- -- -, - -1-
1-0--
-.-. -
1-.------
~I
, I-
I" It I
,/.
Ii y., .1 I 2l :IZ r . ~ Y :;L
l.. r: I + I? I: i- '5
I
-- -'
1,zIY
I--
. I
I (
I ""
II /?, Bath .j Dinette
Yt,..J Floors . fee-DW,;,....." 1<.
hr. .r A, Interior Finish i~A.(/)d' lR.
YE5~ Heat fI,,-/ fJJ...fp /2~/'",{, 10-.
Gd~\-e. Rooms 1 st Floor BR.
Rooms 2nd Floor FIN. B
Driveway
~
.:-
:;;1'-'
~h
"" ...
no::
;Z;;'"
; "Q '"'
0=
:/'!l
""'....'
... =:t,
:z:;c
....0 .
.~..
-<on
_C
;JOJ'I
:JO:<
...
....
~
:J'lI.
...
H!jfIHH HU fUI
[~~j&.! H... ~~q
" 'ii ~~!l~d~H .&l~
~S,~~~~g' a~~@ ;lS,W,
H~~~"~ ~~~:j . ii
1~liHlil!r' H~ . h~
If i. ~ ~ ~. 511.1
. .1'~RiH (I';'"
"
" ~
~
~
C""""i .
~.
~
';:J:::S
-_._---~_. .-
~.
P \ ~ ~
. .,.
....
c;>
~.~
a: ;>" ...
...b
c:s~. ....
.,.,. !:
... -; p
- ....
c;- m
.....~
~
""C
r-
::I ....,. ,:l:>l
.-1
~ :J"
z::
;.,;.
...~
(n. :t;;:::::Io
c:: '
"'~
<"
~ c::o'
-< . '.
nO "'l'""t..
.~
(4
V1
I"
j...
.....
.
N
...
... .
"'N
"""
'" ,
...~,
~ ~ ~l
In g : I
'" ... 1M
"
,- '1\
i I)
"'~,A
~
~
::J;::::S
00
:t::::>
~
~ '"
"'"
:;.
-----=--...-
'r-'
b
:z:
<::::3
00
:;rc;:s
c:=
.,~.'.
~
C::::>
~.
(J"').
. '. ~ ',' .
~
-..' ,.l:",
, : ;~)\
<, :~':::;'\\;$\.
" (/. [I".
,"'~ . . ~'\ .--- -~ ~.-'~
, ..... -,:?-~.
N <~= "~ ..~. #\
. ;t::::o~~D ~<l! \ a'\
.(.:z:: <~ >It. Q'<r.\''''';''' ~\.
.... _ *" . ~(;l U"'" ~
....,....;r:;. .,n'(l . 0''. .
t . -fm.lI;I;;:: .... ~ . '. A.:::.
c::: :;:t~4n \:"~.;. /.<,~;.!., J ,~
, ." .'. n'. -(1'''.
~-< '.-'fO c;..:... ~,/,'
r-~ r- r.n -;, ~,'-T.)'~
.,............... "~";U . ,>" ~'
"..,......l"t .,/,r">
st' .......""..... .'. r..,.""" :1::>,
:;....;0:; ,. .::::'~ ~'
~'~ ... .- c> . ..,
t.ri Or... . . :1:):. .,...,
c>>;:c;::~.~~ .
.:z: . '" .... ... - .....
". . ~t1,.i :;C'"
en :11:;.... .....,. c:::;.
.. ,M_.'" . ....
-'"0..:. n
\~..,~.:
'01<"1..-
~a.
...
.....,.,..
.~:;:;'
li:.....
....c~.
, ',I
, , J F=t ""
: ." '1: '\ ::;''', ~.'.\::~.;~t~.: .
':"
, .
. . .
. .
-------.._.._.~,-. _. .
. J
. ,
. -..--.....-'
....-., ......~._---.,. --_._..~.~_.....- .----...- .
51~htT
QO~"
.:.. 0.
..fo.... z:
-lAPN'"
'~:<
--:::.
c:::;l
C;;;
=z.::
\tH'14''l.O''~. ..Ion.o
5 U SO. 0
~.
It
r,
-c:i'
. X)
~::JiI'
.n
'"
....
;z: <.n
....
U>
.
....
yo
.....
""
.
"'
'"
1-
/J}}
03'1
C>
Ii
J p
-<
CT"1
...
"" z:
q c:: .
c;>
('l"'1
I
I
U~I\IIP.H
,<~'.,.'.
.,..,' ,.'
.'
'j.~t:'" .
'.
:i.
, ~',
" ."
I
l
I
I
I
I
"-
I~
"
\0
,
"
. tX\
'.'
. ~ .
. ~l'
..:
,"
,.,:(: :
.....,