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Home My WebLink About32934-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 05/01/07 No: Z-32334 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 2045 (HOUSE NO.) County Tax Map No. 473889 Section III HAYWATERS RD (STREET) Block 7 CUTCHOGUE (HAMLET) Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 2007 pursuant to which Building Permit No. 32934-Z dated APRIL 24, 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 WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to CECILE A BUCKLEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-244332 07/21/92 PLUMBERS CERTIFICATION DATED N/A ~~ Authorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEl' ARTMENT TOWN HALL 765-1802 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 2/10 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 I. 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 . / / Dale. jJ~~ New Construction: Old or Pre-existing Building: Location of Property: CJ..OI.f~- I/"'fl)-~J"..s (2j House No. Street Owner or Owners of Property: ('<ltC, l Bv cl.J-Ilj Suffolk County Tax Map No 1000, Section -.--,11-.__________ Block_----2~______ ____ (check one) C~--I-cI;v.J? 4 Hamlet Lot 02- SubdiVision Flied Map. _. Lot: Permit No. .3 0i.'1' 3Lf Date of Penn it. 'f -q- cfr Applicant: ~f'i.....rJ Health Dept: Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certilicillc Fee Submitted: $ _J_lr-- __ (check one) e<<L ~K1~ Applicant Si ature tf....~.f ~ '-f 3~ Co i:-3JJ)V 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) 24, 2007 32934 Z Date APRIL PERMIT NO. Permission is hereby granted to: CECILE A BUCKLEY 2045 HAYWATERS ROAD CUTCHOGUE,NY 11935 for : CONSTRUCT A INGROUND SWIMMING POOL W/ FENCE. THIS PERMIT REPLACES BP # 20766 at premises located at 2045 HAYWATERS RD CUTCHOGUE County Tax Map No. 473889 Section 111 Block 0007 Lot No. 002 23, 2007 and approved by the pursuant to application dated APRIL Building Inspector to expire on OCTOBER 2 Fee $ 150.00 Au ORIGINAL Rev. 5/8/02 ~ t DatE' THI; .NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 JULY 27,1992 ApplicarionNo.onji/. 03332992/92 PAGE 1 1000484 I R 244332 THIS CERTIFIES THAT only the electrica' equipment cu de.cribed below and introduced by the applicont named on the above application number in the premiM8 oj CEcrLA BUCKLEY, 2045 HAYWAfERS ROAD, in thefollowinf( location; [!] Baement 0 1st FI. "",sexaminMon JULY 21,1992 CUfCHOGUE, N.Y. o 2nd f1. OUf Sertion Block Lo. andJound to be in compliance u'ith the rf'lIuirement!C oJ this Board. FIXTURE OUTLETS FIXTURES ECEPTACLES SWITCHES INCANDeSCENT FlUORESCENT OTHER RANGES AMT. K.W. COOKING DECKS AMT. K,W. OVENS AMI. K.W. DISH WASHERS EXHAUST FANS AMI. K. W. AMT. H. P. 1 1 AMT. A. W. G. AMT. AMP. AMT. AMPS. BELL UNIT HEATERS MULTI.OUTLET SYSTEMS TRANS. AMT. H. P. NO. OF fliT DIMMERS DRYERS FURNACE MOTORS PUTURE APPLIANCE PlEDEIS SPECIAL IEC'PI TIME CLOCKS AMT. K.W. OIL H.P. GAS H.P. NO. AMT. WATTS AM!. AMP. NO. Of HI-tEG C A.W.G. OF HI-LEG E TYl'E NO. Of 5 E METER EQUIP. 1 Jl2W l)13W 316 3w 3)1 AW NO. O~Ei'HCOND. R V ".W.O. OF CC. CONDo NO. OF NEUTIl"LS ".W.O. OF NEUTR"L I SERVICE DISCONNECT OTHER APPARATUS: SHIlIIING POOL-1 G.F.C.I.-l PANELBOAROS,1-2 CIR, 100 "(SWIIlIlING POOL) fhis cortiflcate covers cOlpliance at the date of inspection only. Because of unusual ~viron.ents it is advisable to have frequent test/and or repairs made by a qualified person. <<< Continued 00 Page 2 >>> _...., MANAOH p" This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. {f COpy FOR BUILDING DEPARTMENT. THI$ COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. . THI; NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1000484 BUREAU OF ELECTRICITY r- 85 JOHN STREET. NEW YORK. NEW YORK 10038 Oat#' JULY 27,1992 Application No. on Jilt> 03332992/92 N 244332 THIS CERTIFIES THAT only the electrical equipment CIS described below and introduced by the applicant RClmed on the above applkotion number in the prsmiM. oj CECILA BUCKLEY , 2045 HAYWArERS ROAO, CUrCHOGUE, N.Y. in theJollowin.location; ~ Basement D ",Fl. D 2nd f1. OU" S('("tion Block Lo, was examined on JULY 21,1992 andJound to be in compliance U-,ilh the rPfluiremenl~ oj this Boord. fiXTURE ~ECEPTACLES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS I OUTLETS SWlICHES INCANDESCEN T . FLUORESCENT OTHER IoMT. I(,W. IoMT. K.W. >MT. K.W. >MT. K.W. >MT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCe FEEDERS SPECIAL RIC'PI TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS I TRANS. SYSTEMS >MT. K.W. OIl H.P. GAS H.P. >MT. NO. A.W.G. IoMT. 10M'. >MT. AMPS. IoMT. H.P. NO. OF FEET IoMT. WATTS SERVICE DISCONNECT NO. OF S E R V I C E MITER NO. OF ce. COND A.W.G. A,W.G. A..w.Q. IoM1 10M'. TYPE EQUI'. ',I2W 113W 3H3W 3.11.W PERH OF CC. COND. NO. OF HI.lEG Of HI.lEG NO. OF NEUTRALS Of NEUTRAL OTHER APPARATUS: I - I RrCHARO KLEINFELO'!' LIC.t665-E ~~cr( 114 CARLTON AVE GENIRAL MANAGIR ISLIP TERR. , NY, 11752 11 S p" This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COpy FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. --------_.._~--------~-_._- 3 ~~ 3t.f- z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRlJCnON [ ] ROUGH PLBG. [ ] INSULATION [?<(FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnoN REMARKS: c ~ ' r-~ -1ft' A ~ ~ ~ otc, r~>t-~ '~~~, ~~~ ~~B~ ;wf~' 2~ DATE t./- -- '3 0 - 07 INSPECTOR ~~ ----r ~l=:L} I:~S:'=:':::':;:; 1 . FO.!!.!ID~TI..Q.N (1 st) --'- F'OUNDA TION 2. ROUGH FRAI1E & .PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4. na A L " " (2nd) IIJ';:=: iI I I 1 I I ~v~'1~'lENr.: ." 0J '" 'IV :::r ::;: ~ H . . .. o-! -{:. . "" " 1+-31-o7 ,F.' :1 11 I l4.-tDk. v Aft. ~-~ /MJJJ.'/' RD,~' r:J-' ~ ~ ~k I AJid! -- I e:../. J. L"#, -1/; r/. ...L I ~:I'.P _ I ' " I ADDITIONAL COMMENTS: '. . ." > c i't> en ~ [r' z t 0 . \' ~ en f o-! ~ :::r '" '" ~ . . o-! ~ ," :=0 f .,. J J,; o-! ." ~ cl' "t"<] ""f) ". ~ ~. . . l>:I >< ..~ .." H :a ~ "" '~ o-! H 0 ~ - 00 . , . ::t: . ["I] j' "" ~ c- o-! ::t: '" ."~ ["I] ..., o-! . "" \.I ~07&&~ v TOWN OF SOUTHOLD PROPERTY RECORD CARD ~" }1 t Jda n.. 1//- ., - ;J ~ OWNER STREET 2()~~ VILLAGE DIST. SUB. v LOT';;..j' 7.r Cad~ 13(/ c.} It.. t; . . , /I <l Y We t-f!r-.r ,fo A d C l/ rc A IJq ve. J1 /Vd.J"J"<t II A/~ fe/vi R-M. I". Co FORMER OWNER I N ' E AC_~<f I, ~, ltIe~.b 91, ".s. ,..)" [.s!. ;;b~U /I,E:/ifj If 10 r S W TYPE OF .BUILDING l~~ , , ._~ ~~.",. RES.,Zt 0 SEAS. VL. FARM COMM. CB. MISe. Mkt. Value LAND IMP. TOTAL DATE REMARKS P.s1'. f- D~ 7'6 ~ :l. 9 tJ{) 3.3 () (J J I II l-s I?? SVRR09 f"l (Ii c.r. ~.51J1 !I,?? G. S"1AI€J'S I[ 10 I: Wi t3 e ~IIJ J~(!>() ~/C.r ()" " "'?-'/I / ft,I 5hh% :;,.(1 '1y" ~tP tP E. tV'"-/.! ~ tI'rS ftJ d. Hurdle v L. ,fY:l7 , P. /Ez. I 1{J AGE BUILDING CONDITION ) NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre . Tillable.. 1 I Tillable 2 Tillable . 3 Woodland Swampland FRONTAGE ON WATER - Brushland FRONTAGE ON ROAD Id tJ.{r. e: J Jut bY ~ I ., J-YlJff. ' r House Plot DEPTH ~... ,....-. n. - Red..... 9! if. ., . . Total DOCK oS l' , , :?>- 17 : : '~:"'''''Jf'''''''''l~';''J''-'-~'''~, ',r "-, '~',' '~,I'" , ".-.." '~~'j'"" ..~.(. '........'.~ i ~,'" . .'-'.' '''\ \, V'''' ,,:,:. ""f",...l,''7', , ,..., ~'. ,~ " ..' '''iI.~l . i r~'-' \: I I . \,.......,. ,4,. \' .. ,'~ --.. .'\ '/ ,. , -l . - ..... 1 I. I. \' J..-- \ . ,.,,' -- " ,~ ' , iJ, ! /.' . '.:, '.. '''', \ \ ,.c'" ' '''l''} '.',' ," ' ,/, .,"" ' ..' ., ~ . . ;-' ,. '.. .;,r'"," ." . I ~ . .1.\.,' - ~ . , , l.T. 'r ,J i" ~ "'~ '..^ _ '. ' '. "l:- ". "'<'~.:;~' ~. I ,. ..:.:.' \ , \ if:? ,,,I ~ ~ ( ~ M. Bldg, Extension Extension Extension Porch Porch Breezewoy Goroge -Po+io .0, B. Total Ji.j.' ...~ " ~IIIII: II' ., ,;/" e ,r . .~~1 -. .. ! ..,..: .,~, -- ;- , J , ! I COLOR ! cue " I I~; i.. IT:> 1 I TRIM " r { i /. / { I ( I , ; , In I PV^1t' )-fauJ-c ~ 1'\ I It, I~ I' 1- "i IJ Ii 1- 1 ~[..' 2.. "jI.<- _ "'!' l~f....~,II/' If. c. ':It::!. ' P./ t ~ "i f" \ "t"fl , ~ I. 'lL ~~ .., l ;,/ , 1/ '/. Lr ~ I _ I" rr I" r I e- h . , I?X'-7" :::. t/&f L/Cj3 IS3. /1/ I '2--,17 II' /3v IJ:f~/"'A'l:> /c;r q '(. tvr;/~s" (bL- -- ,} 3 p , Foundation cJ3, Both I Dinette - FuLL Basement Floors 7?N.t2.. K. - wtl'~..J .L .A /J 1::.... Ext. Walls I nterior Finish LR. Fire Place ONe- Heat tJ,L If tl/ r'fi,u 9R, :> 37 if7 I~pe Roof /.;ev/-6 Rooms 1 st Floor ,,-'-- BR. .s Recreation Room Rooms 2nd Floor FIN. B. Dormer I ) /l ') ,p1'iveway 16t'tr. c. -;--h", P' .... '-f1J.rf) 17 ~e!7 (67/ /7 'y'J.1J ::- Cj X /1 ': /3 XI'!''' ~ 'Ii /;fAll dJ ~ ;IVMD H-n.t.'P Ih~' Ii , ~ /b/Q / I 3 "" ~""',."f,. r "1)/':"'" ~;f'@ ~ 0 'If} ~ 00 .lit 2 5 1992 FORM NO.1 WN OF SOUTHOLD LDING DEPARTMENT TOWN HALL UTHOLD, N.Y. 11971 TEL.: 765.1802 BO,\~D OF HEALTH .' /"...... 3 SETS OF PLa~S ~........ SURVEY ........................ CHCCK -0... - - - . ... . . . . . . . . SEPTIC Forw ___........... BLDG.DEPI '!OWN F SOUTHOLD . Examincd . . " .~~. " . . ., 199~ Approv~d . .. . . ~&... . ., 199.~. Pcrmit No.~~t:'. . Disapprovcd alc ..................................... r: 07 WI : r ~I JSt./ / C/\ L L ....... _ . . . . . . . . . . . HAIL TO: . . . . . . .. .. . . . . . . . . . . . . .................... . ....... ........... ................ ..... ....... .... ..A~.?~............ . (P1'!i1ding Inspcctor) APPLICATION FOR BUILDING PERMIT D'ate .........;........,19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 'cts 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 Jr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. . 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 . .hall 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Juilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or \cgulations. for the construction of buildings, additions or altcrations, or for removal or demolition, as herein described. fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ,dmit authorized inspectors on premises and in building for necessary inspections. . ~ ~ . . . (Si~~~~ ~: 'ant: 0; ~a~e: if ~ ~~;;~;aii~;)' . . . /lev. ~.. .~:~'. .~~': .~~1.'. .~~~".~l.l.e. .n.y.. .1.1.9.4.9......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent ......... ..... .0. '" ......... ..0...... .0.. ...... ........... ......0.......... ..................... . . Cecile Buckley, 2045 Haywater Road, Cutchogue NY \ame of owner of premIses ................................................... .APPROViD AS.IIGriD. . . . . . . (as on the t:rx roll or latest d6~, ~~~8.p., ~ :r applicant is a corporation, signature of duly authorized officer. . 'fE?/.sZ'.~ BY:~ ............. ..... .. ..... ....... .. OCCUPANCY OR ~:~o=u~ AM Gnf~~M F~~\~~ (Name and title of corporate OffiiefhE IS UNLAWFUL FOllOWING INSPECTIONS: . , . 15, 171 HI U~ 1. FOUNDATION . lWO REQUIRED BUIlder s LIcense No. ......................... FOR POURED CONCRETE , . WITHOUT CERTIFIC.ATE 2. ROUGH. FRAMING & PLUMe 'J(',r' Plum ber s LIcense No. .......:..... . 3. INSULATION O~f\ O^N(\Y 4. FINAL . CONSTRUCTION IV f Elcctrician's License No. .......... . .. .... r t\ \:1 BE COMPLETE FOR C.O. -lnliIlIC ALL CONSTRUCTION SHAll ~ T Other Trade's License No. ................ .1IIiQUlRED THE REQUIREMENTS OF THE/, STATE 'i~TRUc;rION & EM / Location of land on which proposed work will be done. .... .~~'!~ .'!~~~ .~~ .~":~~[S... '. ~l9l$ljJ..~.....t DESIGN OR CONSTRUCTION ER, J Old Menhaden Road 2045 Haywaters Rd, Cutchouge . ..... ....... .... ........... ...... ............... ....... .... ......... .... .................... House Number Street HamlG.t County Tax Map No. 1000 Section ....... .I/.( .. . " Block....7............ Lot...~......... ~., " Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filcd Map No. .............. Lot............... (Name) State existing use and occupancy of premises and intended use and occupancy of Proposed construction: a. Existing use and occupancy one family residence ...... ...... .., ........... '" .................... .................... b. Intended use and occupancy ..... ~~?:'?'!r:'-~. '!~tl!"!'cj.~g .I?'?'?~ . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 3. Nature of work (chec!vwhich applicable): New Building ..... . . . . . Addition.. . . . . . . ., Alteration }<}<..,.... Repair .......,....,. Removal...., . . . . . , . " Demolition ........,..." Other Work. . . , . , . . . . . . . , <<Y,; ;I S ..., (Description) ,5600.00 ~~ ~ 4. EstImated Cost. . . . . . . . . , . , . . , . , . . . . , . . . . . . . . . . . . , . .. Fee . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units.. , . . " , . . " '" Number of ciiv81lihg uniis o~ each /loor. '. . . . , , . , , . . . , . 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 same structur~ with alterations or additions: Front ,....,......,.,.. Rear.....".........., Depth. . . . . . . . . . . . . . . . . , . . . . Height , . . . , . . , . , . , , . . . , . , , . , Num ber of Stories. . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front... ,}.~..,..... Rear,. J.d?,......", Depth . ./~.........., Height ...,........... Number of Stories, .. . . , . , . . . , . . , , " . . . . . . , . .. .. . , . , . . . . . .... . . . . . . . . .. '" 9. Size of lot: Front. . . , . , . . . . . . . . , . , . . . ,. Rear,.........",......... Depth,...,.......,.......... I O. Date of Purchase 0', 0 . . . . . . . . . . . 0 0 0 . . 0 . . .. . 0 . 0 Name of Former Owner 0 0 . 0 0 . . . . . . . . . . . . . . . . . . . . . . . . II. Zone or use district in which premises are situated. . . . 0 . . . . . . . . . . . . . . . 0 0 . . 0 . . . . . . 0 . 0 0 . . . . . 0 . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: o. o. _,............".. 0........... 13. Will lot be regraded .................... ,....... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises. .C.e.c.i).f'. )l)l~!<).!"y. . . . . Address . ?9~~. ~~y~~~,,:~ .l!-~ . Phone No. .. ~~~-:~~l.~ . . . . . Name of Architect . .l\o'y' .J.a,f,f.e.e. . . . . . . . . . . . . . . . Address . ? ~j'?:'~:~. ~:! . ~~~~'Yxb'h~l.:os . , . . 41 . . . . . .. . . Name of Contractor .p'r.e.~i.e.r.e. F.o.o.I.s,........... Address.. ~?. ~:?~~~~~~. :?':Ph-bWe !<lo. t;~.... .~-:~~~~... 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 all 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. ~ ~...__~.. .._. ..c; TATE 0 F NE\~ ~~p~~' SoS ou:-..rry OF . ,-PH '".'......." Afton Mieczkowski 0 , o . . . . . . . , , , . , . . 0 . , .'. . , . , . . , . . , . , , , , . . , . , . . . . ~~M\I deposes and says that he IS the applicant (Name of individual signing contract) CWlll.IlIJII, Jove named. , is the, . , . agl'nt. . . . . . . . . . . . . . . . , . . , . . , . . , , . , . . . ,'. . , . , , . , . . . . , . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor. agent, corporate officer. etc.) , , said owner or owners. and is duly authorized to perform or have perfonned the saId work and to make and file this plication: that all statements contained in this application arc true to the best of his knowledge and belief; and that the Jrk will be performed in the manner set forth in the application filed therewith. om to before me this 0....... .. ,?'!-jtp' , . " ,.day of... ~c..:~....... ,.... ,.19 ,~. . . '1 tarypublic. . ,..~. ,-'-,.......... ...,... County 7" :..c',,: H~R"EV ~ llICtl~RO \100\' N.'" Yo'" IIllARY PUBLIC. 5 k C' .. .. . .. . .. . .. .. . No, 4836010. 5":, 3'i~'i9..v- \ Term ExPires DeCe (Signature of applicant) . -;. .~: r"..., .; .~..-..::. ~."" .'-:,.....--.. -, n, .,:: - .. " .: ~l ft ~ ':::.> . :.~.;~;~./ III . . "-: .;- .' ,rf.: ........... Ii' I ~ .1 n' I -- @ , ~ . .9' STEPS" F>\.-~l---l '/Bh \1.0" . ~-~I . -II ~, '" ~ ." . . 00 ---'-' ~'! 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': f ,,'~1""~").'%'k:;l;'"""'''~ ~:.,"~ ~ , -;'.. 'J.'t\'r,fi ~ ..;u;~,,: ~:/' ,)j: ~ . ~ .-,0,._11.", ' '~',' < .>. Q ~ o t II) n: III f- 1: ~ q: t ...~o' Jf 1~ .... .\1 .... " Il ~ I~ li~ ! Ii I O'-D ': ". r '~~r;~~.$~fii~~'~"-';:"~~,{~:" ~>~~~"T~i:;~~~~.~;~'~i'-~~-.J:',:e';;:. _ . .:'r.~~?~~~I' i ~ ~::. l .7I:tlj.~~.~'f'Jf -' \,?t:i~;,,-~.::.,~~,t;,~~~~t~/-";;f:'(;;:,:~:,~'}:," '::.;~'il,: ' ~ ~ '''''~~f:'F' .r.".....Iii!...;,;... d, 'ti"~.. '1 · .~~~~,,:'^:'J~>:y~W~lHi~~ ..~~~:Fi':t~~fi.:~:.i;;n:~f;;:" . '~'i~ :'~5 ~f= 1 , -.?:ffli. . \..- ",:",~,','"',"'",:/,,,:,',"',:,,~.: .....;,. ':f!~' .It,,;''<:. . f' .,0 'J" 8~ ~f'~ \) ., ~ :'z,f J r,,^ e, "/7 "'. " ~/YH ~ . , . .....,D~/Y ' ~c::>""1D _R> , ....~ . "!.,:': , :. I.PANCY OR . ....), ' , t !C:~ IS UNLAWFUL ",~FV"","", "'-. .",IJ,J.IT!-IQUT ~ER,' TIFICATE '. . n iI i e IV/:). 37+' .r r '. Or O,~CUP ~ Y . ....,: llNDERWRrrERs CERTlACATE REQUIRED ~ " \jX , I x .-{, , '<:.50 7 z x" - , F~ ~ /'- 1 ! , I ~ ". . ~,,"'o,' .' ~. , ,() . "i (b' ~ ( ! '.,9 .~' r> >( ( '( . \.~ /KWH. U ,llh.ClGIII .....Ll. . __ " x U __'11_ . I l( (' ":~ ;,,',. .). ::'lm- t y"J.,..J,z IT) 0) C>) % .... e . ~... CL () t ;! , ;: 8""9"/' .-1';'(." y -'R\ . r ZS-o.o ,:.~:~l .; 1\ ~:. ,-', ,.~.-..-~ <;:_(0.~_< . ~'t" .~,.,;t-, _, -:'-':~ff . ~.. -::;.ii:!;;' :;,~:~)~?!~~;. '-- kj'ji!;..,!,. , Ii o~ :"--"f,,~,..c.._..........~: . - ~ I I ~ ~ -.~ --' ;'j / "'"..'---"- ~ .~ 4 ..' f,. 'Lo f /Yo: 376 "'..'. ,--: .'1.f~'; . --~" . "1:~-'- , --.,~. . ;j"~~~i tli d~J ::~?;'. . ":;,~:~~~," ~il~,...j . '",.::.;,;:,.:.:;.....,;,... ,:~., .:'.~.i.... }, ~:; :.;;i,-i-;,~.i.~ ~ ~. ': -" ,", .f.~.;, Jii:..... ".- 1/ .' , " p. ~ ;. ~~, ,;~J'-f, :~::.. SCd/~ +0,1. =/1'1,' . !,>r;}i,.~ ;'.'. ,:~-,':' .. ~'fl: ~'~jl , ~urvc;~7t:./';~{ :te~(;fkif~: ~i,i.tf: ~ 7iTL~.(;tI~~~~~~fi}jR Ttr~~TI5~' il June /~:/ ~3 /. .~"Uc.~ n, 'lk."u....; " ; '''{'!iif ~:;~m~ }.',~j, ~. - ,. MAP OF LOT No. J 75". " ';~.--. ':'::<+?~,;~". - .. . .-' - - - . .~-~;. - -,:.~. ,;,}1t: ~.:~~:~;~~;r~~<;, .-:.,:'.,~ NA5SAJ!...'I?O/NT . CL UBtf!ttO,r=>f.IfT!g~-1}/NC ;r:;:~' ..5/ TU'" TE;" ~ r. ;~:~;.:~~;~,c;.:'._1-:~.,,':' .!':"- '.~7:7t.: . _ :;'.:.:: ,:\,. P IE: c: ON" c ., ....,,1 1-': :;.;~,{;~'\-,':~,;:;-., ..,.\",~->,,?:-,~ "~1 :F-~f. . . " .',1 "t SUFFOLK CO'J.N.Y., ''':'. ., '. '. ....~.U ~ ~ \nyL. .'. ~:~J~ 2 5 \g32 ~S~. "".'. ...... . ,,-, '~rc:~nro.rt. :"". N. Y.'~ci . ~ ~~~t ". ~.~;r~'; ,.:,n:...., '1(:.:;: -- . 'n~ DEPT. , ,',., ,~, T"OlO ~.;: SOU n ;.1 ,,;,;! ,,:,'.''\ '. 133"1 - 2.. r",,"". ~.::." " :t ,. roBII NO. . TOWN OF SOUTHOLD IUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. IUILDING PERMIT 3~L( (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~Nc} 20768Z Date ...............Y?/-!.:.~.........................., 19.1? Permission is hereby granted to: ........tt~~lS.f€.f:......4f;:...C!.fk:t.tJ;......8..l(ccl.€ ;/ .....f!.(!..:.~....l..f.:!......................................... ......fJ.1:~.@il/.{.........!tr;:......../.tf.){.1 to ....~~'ifL........f1......M!.~.'r1..M./),.........~~tr...........flf.........&..t.e..f.~F..1.................. .......5.Iff......w.il.H........&.~~.....k.Ci!i!:r.q~,..................................................................... at premises located at ...................:2tP.$.:r:.......Nt1fW,dJ:Z€/!:,......kA...................................... .......................................................................~~6.f'I,j{",.........P~........................................ ..................................................................C.f..~i€........~t##!................................................ County Tox Map No. 1000 Section ....il/............. Block ...121............ Lot No. .....ak.......... pursuant to application dated .......................~rl.:(t....................., 19.9!.:; and approved by the Building Inspector. Fee $..../.@.:~.... ......~47:i;i~-....._..._._. Rev. 6/30/80