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HomeMy WebLinkAbout19860-Z 11'0_ NO. I TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH OLD, N. Y. elD -=H d. ~Lj.l BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N!! 19860 z Date .............1Y\..~..J..~.............., 19.~..1. Permission is hereby gran~:..~i."5....:.:a.~...................... ..~~.(:...~....~.................................. ~.~.....U.:~.,....l1..'1..(.~...... to .S:~f.:~:~kFk:...~.....~..~.....I?~..~.....tJ.~.~.~.. ~.~...Oc.I...~~k........................................................~....................................... at premises locoted at ....1.~;.....~-t.A........R..{.........~.~.......................... ................................................................................................................................................................. ................................................................................................................................................................. County Tox Map No. 1000 Section ..L~.~........... Block ......9..J......... Lot No. ..~..I............... pursuant to application dated .................~.~...'i.............. 19.~.'.., and approved by the Building Inspector. ~ Fee $..(..$D.,...-::::' i;:&.._. ..._...~_.._ B I Inspector Rev. 6/30/80 s ~o NN\O.l. - ''''0tllr~Oa '~a\9 ~ y. 'l.i" .., \lI'ir _6 - JlIl\ n ~~IDl&G ~ @'ID "mmed. .~.~. J.~... 19~.1. rproved . .~ ~ . .I.~. . " 19'11. Pennlt No.1 ~. !.lQQ. ~ . isapproved alc ... '.' " . . . " . . . . '" . " ... . '. 2" ".. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :... J"!.' . . . . . . . .. ... .~.;~~ .. .....~.~....... FOf1M NO.1 TOWN OF SOUTHOLD BUILDING DEPArHMENT TOWN HALL SOUTHOLD. N.Y. 11971 TEL.:~65'1802 \ 80,11;D Of HEALTH ......... J SETS Of PLA~S .......... SURVEy...... _............ Cl/eCK .......__........... SEPTIC rOR:I ._............ ;:07; F'!: d)...9fS-~ 10 I? CALL ......_....~........ flAIL TO: n . .. .4</.~. '''C; .................................. . (Building Inspector) APPLICATION FOR BUILDING PERMIT . ~ ~ ........I..~......, 9/ 19.. . Date INSTRUCTIONS a. This application must be completely fillcd in by typcwriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. c. The work covered by this application may not be commenced before issuance of Building Penn it. d. Upon approval of this application, the Building Inspector will issued a Building Pennit to the applicant. Such permit 1l 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 II have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tre lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ;ulations, for the construction of buildings, additions or alterations, or for remllVal or demohtion. as herein described. : applicant agrees, to comply with all applicable laws, ordinances, building code, housing code. and regulations, and to lit authorized inspectors on premises and in building for necessary inspections. . ...'I)..A .v:Y!'W,-..... fl'k~................. (Signature of applicant. or name, if a corporation) t- ..... .:7i?r:. .~/{.. /4..!?Z. ff.~. (Mailing address of applicant) te whether applicant is owner, lessee, agent, architect, engineer, general contr3.ctor, electrici::m, plumber or builder. .....................9.<<1/.1 Ef7-:.................................... ;......................... ~e of owner of premises ......... !7'?.'?~ .. .. Q("(:Q. J... . ... .. .. ... .. " '" . ... .... .. ............ (as on the tat roll or latest deed) Jplicant is a corporation, signature of duiy authorized officer. ........... ..... ...... .... ...... ..... ....... (Name and title of COrporate officer) Builder's License No. ......................... Plum ber's License No. ........................ Electrician's License No. ...................... Other Trade's License No. ..................... ,ocation of land on which proposed work will be dOlle. ........................... ..................... ,.... .1/.11.5-:........... .'....... .6?d;(.. .!f'..cf......... qpiJ~'I"I.{.1.S.~ ouse Number Street ;iZ;I~t oUllty Tax Map No. 1000 Section ..... /~. 9.. . . . . .. Block........ 7. . . . . . .. Lot...... .'?I.. . . . .. " Ibdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot............... (Namc) atc .eX.isting Use and occupancy of premises and intended l!.::C ~ occupancy of proposed construction: . EXIsting Use and OCCUpancy A-2, /J .. ~ if.~.. d. - A /2,_ -:'\/ ......"'~.. ;fP:~;/. ?II '~.' ..~...n.:r).1.:i,.~...;......rr.... Intended use and OCCUpancy ........ ~... . .~.qc/.. .~.... . :.P"'~~ ~~ ,;;,..,. '. ..... .' /: '.rI'~'~ .. , ';..t."'~{,.~.."'M" , J. 1"oture of work (check which applicable); New lluihJmg . . . .: : . . . . Addition. . . . . . . . . .,,,,)/[eratlOn .......... Rep;ur .............. Removal. . . . . . . . . . .. " DemolItJOn .............. Othef',VJ,rk J I,:.;. . . . . .. . . . - ~ ~ (Descnption) 4. Estimated Cost. . /.t?P. ~ . . . . . . . . . . . . . . . . . . . . . ... . . .. Fee. . . /5-;;7.-,:-:-:-:-. . . . . . . . . .. . . . . . . . . . . . . . (to be paid on filin~ this application) 5. If dwelling, number of dwellin!; units. . . . . . . . . . . . . .. Number of dwellin!; Ulllt, on e:rch floor. . . .. . . . . . . . . . . . If !;arage, number of cars ....................................................... '. . . . . . . . . . . . . . . . . 6. If business. commcrcial Or mixed OCCUpancy, 'pecify uature ;md ex tent of each type of U,;e . . . <. . . " . . . . . . . . . . . . 7. Dimensions of eXisting structure" if any; Front. . . . . . . . . . . . ."" i~ear .............. Depth. .'. . . . . . . . . . . . . Height ............... Number of Stories. . . . . . . .. . '. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . Dimensions of same struetur~ with alterations or additions; f'ront ................. Rear.................. Depth. . . . . . . . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . NUlll ber of Storie, . . . . . . . . . . . . . . . . . . . . . . 3. Dimensions of entire new construction; f'ront . . . . . . . . . . . . . .', Rear............... Depth ............... Height ............... Number of Stories. ... ......... ..... . . ..:. .,.. . . . . . . . . . .. . ..... . ... . . . .. '" 9. Size of lot: Front .... . . . . . . . . . . . . . . . . " Rear....................... Depth ...................... O. Dote of Purchase ............................. Name of Fonner Owner ............................. I. Zone or use district in which premises arc situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . Docs proposed construction violate any zoning law, ordinance or regulation; ..... .". . . . . . . . . . 1/."? . . . . . . . . . . . Will lot be regraded ............................ Will excess fill be removed from premiscs: Yes No 'lame of Owner of premises. . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ... . . . . . . . . . . . . Name of Architect ........................... Address. . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . Name of Contractor. . . . . . . . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ..... . . . . . . . . . . Is this property within 300 feet of a tidal wetland? *Yes........ No......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM J. Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether lterior or corner lot. 10 '-1,-_ __.____ ~--~- -f 15," - ,. Q-r , .,:5:'- // / ~ ~~ 11 z 16 / I~ I --= ., . I <;0 /0 " (j2o f!\- D \TE Of' NEW Y~R,K. S.S JNTY Of' .. . " .).Ht~\t... . . . ........ .ANN 9.. . .C?'f .'1.0';1.... . " ....... '" . (Name of individual signing contract) 'e named. ;the.................~.~............................................................... (Contractor, agent, corporate officer, etc.) ,id OWner Or oIVuers, and is duly authorized to perform or have perfonned the said work and to make and file this cation; that all statements contained in this application are true to the best of his knowledge and belief; and that the IVill be performed in the manner set forth in the application filed therewith. 11 to before me tl~iSIf: ~/, ~ ~';u" : . . . ~ ;I. . .d:X, /' .. . " .. ...... .S\\~~~ " blIC, ~~.. ..~~.... County / ' ..... J}~.... .V.t~'??...... ...... ........ (Signature of applicant) being duly sworn, deposes and says that he is the applicant .. . .-~--.-.-:... ~"..UIIL: UI1'Oflner U\VIlCr ............................. I. LUlle or use dIstrIct in which premises arc situated. . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . _ . . . . . _ . . . . . . . . . ' Does proposed Construction YiOlate any zoning low, ordinance or regulation: ......'......... .1/.~.. .... ...... Will lot be regraded ............................ Will excess fill be removed from premises: Yes. No ','ame of Owner of premises. . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . _ Phone No. .... _ . . . . .'. . . . . Name of Architect ........................... Address .. . . . . . . . . . . . . . . . . . Phone No. .... . . . . . . . . . . . Name of Contractor. . . . . . . . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ............... J. Is this property within 300 feet of a tidal wetland? *Yes........ No......... . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAt\1 Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from copcrty lines. Give street and block number or deScription according to deed, and show street names and indicate whether terior Or corner lot. 10 '1\_______....._...______ _-1- IS - .~~ ~~~ ~~i ~ ~J .' O-r ,,~- ~f~ lJl. I'F It I /6 / ~ of , I c;0 \ to <I I ---------__J. TE OF NEW Y8,'f~ s:- "1;'0 T _'f - 520- "J:> -- .~ NTy Or: . . . . . . .1.1 .\.f.-. . . . . _ _ _ . . . . . . . . . AN N P.. . .0 'f .'1. os.. . . . . . . . . . . . . . . . " being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~ named. thc.................~.~............................................................... (Contractor, agent. cornorate orric<'r O'r \ :" ~.. IIRIB.....,. CEllf\flCATE IlEQUIRR' OCCUPANCY OR USE IS UNLAWfUL WITHOUT eERTI FICATE OF OCCUPANCY APPR VED AS NOTED DATE: S.:. B.P. # J 9 'flfr.O.:t. FEE'/!:.'7>.- BY: Y. G'.L._. NOTIFY BUILDING DEPARTMENT Al 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 ~lELD I:;S~:2C710N IIlJh7t. 'I ''I. ' ,OUIIDA TI..Q.N _ -.!.., s..!l.. FOUNDA TIOU (2nd) 2. ROUGH FRAME & .PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4. FINAL . . ,~;;:~'M:.1.i;' :.\ .~._.,...<__<,.. '. . COIfMEIJTS . ADDITIONAL COMMENTS: . .' .:;' . . . . <; ,,<::.: ..,..",~. '.' (, .'"'' ... .." .J1' '" "" 00 -'- 6' H 0 " >oj rJ. "" -Up- cg f en ... "'... :1> If: 2: 0 . . .L. I" .'\ ~~ '" ~~ " >oJQ- . . ~r ,-J6~ () .~ l~ z ~f p . " ['> >< - ." - H- "" " ;:;.~ ::: -.4 z r .. !- . ;; ~ ,.. r- - o-l 4>, :I: ,_ .,,'.' - ;:;' '. ~ ..)~:~~ ." ...'..1 ."'~~.,i. ~~ 3. :'\ature of work (check Which applicable); New l3udumg '" . . . . . . . Addition. , , . . , , , ,. ,\lterotJon , ' . . . , . Repair .............. Removal. . . . . . . . . . .. " Demolition ...'.......... Other Work.. . . . . . . . . . . . . . -:z: . ~ (Descnptlon) .1. Estimated Cost. . /.~ ~ . . . . . . . . . . . . . . . . . . . . . . . . . . .. Fcc... /.5))"r, .~, . . . . . , . . . . . . . . . . . . . . . . . (to be paid on filinl; this applicatIon) 5. If Jwelling, number of dwelling units. . . . . . . . . . . . . .. Number of dwelling unIts on e:rch floor. . . . . . . . . . . . . . . . If garage, number of cars ................................,...........,.........,......,.......... 6. If business. commercial Or mixed OCCUpancy. "pecify nature and ex tent of each tYpe of U':e , . . . . . . . . , . . . . . . . . . . . 7. Dimensions of eXisting structure", if any; Front, . . . . . . . . . . . . . . Rear .............. Depth......... . . . . . . Hei~;ht ............... Numher of Stories. . . . . . . . .. . . . . . . . . . .. . . . . . , . . . . . . . . . . . . . . .. . . . . . . . . . . . . . Dimensions of same structur~ with alterations or additions; r-ront ,...........,.... Rear.................. Deplll . . . . . . . . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . NUnJ her of Storie" . . . . . . . . . . . . . . . . . . . . . . 3. Dimensions of entire new constnlction; Front. . . .. . . . . " . ... Rear............,.. Depth. . . . . . . . . . . . . . . Height ............... Numher of Stories. . . . . . . . . . . . . . . . . . . . . . . . '. . . . . . . . . . . . . . . , . . . . . . . , . . . . . . . . 9. Size of lot; Front. . . . . . . . . . . . . . . . . . . . .. Rear...................... Depth .........."...,...,.. 'J. Date of Purchase ............................. Name of Fonner Owner ............................. !. Zone or USe district in Which premises arc situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . , . . . . , . . , . . . . . . . . ' Docs proposed construction violate any zoning I.1w, ordinance or reguiJtion; .....;'.......... JJ.~. . . . . . , . . . . . Will lot be regraded ............................ Will excess fill be removed from premise>: Yes No \lame of Owner of premises. . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . PIrone No. .... . . . . . . . . . . . Name of Architect ........................... Address. . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . . . . . . . N;ulle of Contractor. . . . . . . . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . PIrone No. .......... . . . . . 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 'operty lines. Give street and block number or deScription according to deed, and show street names and indicate Whether tenor Or comer lot. /0 l./ ~/5-~ /6 / ~/l1~ rL', ./S--t' ~~ ~ ~f --I \ \ , i I \ i \ It I .-' /1 z of , , ! \ .\ \ i ..--" \ / <;0 /0 <f I ~u T ~ rf20 A-.l:> TE or- NEW y~~~~ S.S NTy OF .. .... .I.'t .'.t-. . . . . . '" . . . .ANN P... . .0 ~ .V,f)s,. . .. . .. . . . . . . . .. " being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) . named.. -" ------- ~ the......................~............................................................... (Contractor, agent, corporate officer, etc.) J Owner or OWners, and is duly authorized to perform or have perfonned the said work and to make and file this Jtion; that all statements contained in this application arc true to the best of his knowledge and belief; and that the .viII be performed in the manner set forth in the application filed therewith. to before q::iS ~ '^^.D;y. 9J ,....: .. . " . ./. . . .dZX' /'. .. . . '/.. " . 'ci\~~k.' .' rubbe, ~(~....~~...... .... County /' ,. .. .. . ))tW-h-.. .. . . 9. t~~ . .. .. . .. . . . . . . . . . . .. (Signature of applicant) ~o W;\Ol CllC)\..'tSb~s'!)ai9 ~G6616-Ml n \~\l~lJS\:\ 'ID @ ~ \$l~ xamined ..~.~..l.~...19~.J. pproved . .\I:\,:,-:,-~. .I.';.... 19'1l. Permit No.! 1.o.~9.:t:. isapproved ale .............................. 'J!' " . . ) . / . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . /:'~.: . . . . . " ':.. 0 J~~..~ Q~?~:-.,,:,":-:-:-. ... . . . (Building Inspector) FonM NO.1 80,\1;0 Of HE.\LTlI ......... ] SETS Of PL~3S .......... SUit V E '( ...... _ . . . . . . . . . . . . CIlr:CK ....... _............ SEPTIC ron:t .............. TOWN OF SOUTHOLD BUILDING DEPAf1TMENT TOWN HALL SDUTHOLD. N. Y. 11971 TEL.;~'1U02 \ ::O';:;F'f;d)...9g~ 1011' CALL ......._...~........ ~I^IL TO: n ...W~..' ...1'1 . c- (J ...................... . APPLICATION FOR BUILDING PERMIT 'J//;. H. I??f Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector. with 3 ; 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 lreas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- on. 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 :J 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 I have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tre ding Zone Ordinance of the Town of Southold, Suffolk County. New York. and other applicable Laws, Ordinances or ulations, for the construction of bU;ldings, additions or alterations. Or for rem,)VJI or demolition. as herein described. applicant agrees. to comply with all applicable laws, ordinances, building code, housing code, and regulations. and to it authorized inspectors on premises and in building for necessary inspections. . ...'6. .A .~. . . . . P.t/kf!:). . . . . . . .. . . . . . . . . (Signature of applicant. or name, if a corporation) t- ..... .Y0.r:. .~/{.. /4.. (}J.,. fI.fu:;. (Mailing addrcss of applicant) e whether applicant is owner. lessee. agent. architect. engineer, gencral contractor. electrician, plumber or builder. . '" . . .. . . ... . . . . . . . t?W.rJ ef:7-. . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . ;'. . . . . . . . . . . . .. . ... . . . . .. e of owner of premises ......... .4.Q/?~ .... qt'(:Q. J. '" . .. .... . .. .... '" . ... .... .. ......... '" (as on the tcrt roll or latest deed) plicant is a corporation, signature of duly authorized officer. .' ................ ........ ....... ..... ....... (Name and title of COrporate officer) Builder's License No. ......................... Plumber's License No. ........... '. . . " . . . . . . . . Electricbn's License No. ...................... Jthcr Trade's License No. ..................... )cation of land on which proposed work will be done. ........................... ..................... .... .f/.i?5-:........... ......... ./Cu?;(.. .!f:cf.......... ~~)J~'I' ./f.<f.S. ~ )USC Num ber Strcct ;r;Z;I~t unty Tax Map No. 1000 Section ..... / q. r;;.. . .. ... Block ........ 7.. .. .... Lot.......'?-. I.. . .. .. .. bdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filcd Map No. .............. Lot............... (Namc) ~e.e.~isting use ~nd occupancy of premises and intended t',:'e YJl oecupJncy of proposed construction: . OXlstmg Use and OCCUpancy.. ... .~~....~ ~~.. '~'4? 'X. ... ....~~~.."jJ..... nle~de~ u.se and OCCupancy.:....... ~... .l.q/.. '~~+~~~J1~ - . . . . "'''''- Ut .I.' Ullllr.:r U\VIlCr ............................. .. LoU"e VI l"e 1llSlflctlIl which premises arc situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' Docs proposed Construction viobte any zoning bw, ordinance or regllbtion: .....;'.......... 11.~. . . . . . . . . .. . Will lot be regraded ............................ Will excess fill be removed from premises: Yes. No \iame of Owner of premises. . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . .'. . . . . Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . . . . . . . Name of Contractor. . . . . . . . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ............... l. Is this property within 300 feet of a tidal wetland? *Yes........ No......... . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM .. II tuau:llaA.uc '" Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from :opcrty lines. Give street and block number Or deSCription according to deed, and show street names and indicate Whether CY OR tcrior or corner lot. OCCUPAN fUl '" "T . -f - - ~~~~T ~~~~~ICA1E IS - .~ W\ Of OCCUPANCY t1/~ ~ ~~~ .' Q~ 'I~- //( ~ 1./.. /q z /6 / \~ It / APPROVED AS NOTED 'DATE:~f/~i91 B.PI! J9~j'("o_i:. I ~...,., - BY' V- Ei. L . FEE: ~. . ~--;_.~. NOTIFY BUILDING DEPARTiIiIEr" A. 765.1802 9 AM TO 4 PM FOR THE FOlL.OWING INSPECTIONS ,. 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 REOUIREMENTS OF THE -NY STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS .. , TE Or- NEW Y8.,~l\, 'NTY OF . . . . . . .I.'\~\-\:;... . . " S.S ........ .ANN P.... .0"f.>l.OSl................... being dllly sworn, deposes and says that he is the applicant (Name of individllal signing contract) o named. I 90 '\ I . N\i.OV>- ~~~ ~ 10 <I A- ro---~~EI'>" <tv T~.---li2o __,_____ ~ . ~ the......................~............................................................... (ContrJctor, Jgcnt. C()rTlnr:lt~ nffirr'r ....f,... \ ~ , r , f S'?' tH::' "'" . TOWN OF SOUTHOLD PROPERTY RECORD CARD ~ )// ? '\ -J (~ /00"' - /) ;) - / ~ OWNER STREET VILLAGE DIST. SUB. LOT lit" };' )/-' ;' r~d:: 9 ( , , (: i' (') I.' ,) \.\.1 t::: -.", , t1 fI ..-/ -i/ ~s)l.;I .), .'- \. V ,. , . vvt _ '-'<':~( . I ///U~~.' i' . FORMER OWNER N'i-ct~ rC_t( Eo', )1, Lf; . , ACR. ! 1......,..,' '\ )-1 I' ( 1,,_ \ '157 S :!(jNSEI W.- ~J" t, ;~k :tl; OF BUILDING ...... K..l...1 ~:.<;. WALT[IP ':r " . I /{ f ~/F I,':"o/.l 'S.;; ! , ~. . ( .." ~ J for! Woo d /"v.:..,,-.,., ri.. r: ,i ri t.rl/ /-1 ; S J -- 1-' RES'),J /) SEAS. VL. FARM COMM. CB. v MISe. Mkt. Value ~lIg;~~E~:" LAND IMP. TOTAL DATE REMARKS -- --..-.-... - ...fC) 0 ....\0 0 (J /" ,,( / 1/ <,." r"Jt'l.-- / ~ J-- ","'" ,. .' ..- &6 0 JOr) 70 0 -;,' v/ '"(; .(' ~.lLr:, X';, .j,.: IC7 h-l I r. -' J 1 1(,7 Ii ; <.'I":!',:,,;../ I v 'oJ:) , s-/Fi ~'g ~/12h, 114,,, . ,/ , . I ? '7'1 j b6{) YS-zlJ 0'/66 .'J~ L D I. 0, .' (, I ' y', ~', ~ ToN. Ofr-'r-,'"' :/ ~; '" ii'." I,. .J ,I. t/ '" . '. , - ~S r, J .. 'F (:\5 1/ ,j- 0 0 S300 ),l;). /?y' z .., P-!1 , AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER (g0- ;f , FRONTAGE ON ROAD off @ - / SP Brushland I 0 I Hause Plot. DEPTH I 7 1--tl BULKHEAD '-' ......... DOCK Total - - . ! , COLOR i I - i~?" , I /)" J -- - I"!,' (' ,'''' ~ I , i 0' : . 'I TRIM , ). ", , I " . J 1)//.;1 e i I 21 I" , /l- I " ~ ) 2- X ~ :;. J /2 i" ; Rt~/( I ~'- 1- (1, . ~ j J IIA'~3 j 2- 2 .) 1/'1 , I ~, , a' >(I. '5' I L .::.0:. " rf /, . I ' f (. ( ~! IJ j- I Foundation '1, 'j$I?g. \' 0 1 ::..,s-SD / f\,_,""IG'I''''''. Bath / ~~, Dinette ,. ..... f'-' . '!, ~ ':' I :;,2.1 ~sement Exte?rion 12.5 V 'i " .:: ts" 6 ( )/'8/... J 'U'i Fu II Floors C) (Jf( K, ., I. ..' ~- J. .')'-1(, I.- Y - Pill 0. c~ '-' ,; ,1 j , ,~ Extension 2:7 y J "- g /. Ext. Walls Interior Finish j it ,f LR. -fB 'F 1_ .\ i'''', \~.'c.k act., Extension Fire Place /VOlle Heat g. 'i? J' 'Ii DR, \, 0, 1/, Ii. Type Roof Ga 6IC Rooms 1st Floor BR. "F~~s() I Y X! 2.. - J{,f, / .ft "'By R~creation Room Rooms 2nd Floor FIN. B. - tI ~- ,:,'r ) l~ x. 'I : I't '0'.'1 f~r~~,1 ) ') Y -1 : 11. ~ I ~ " ,7s /(,'1 DOImer ;,'" . Breezeway Driveway Garage )2 XIV .: J6~ V'. )1.L.f' J'fs ,/ Patio , O. B. Total '117 ) ( I v v ...,..J