HomeMy WebLinkAbout33464-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32796
Date: 12/19/07
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 2978 LIGHT
(HOUSE NO.)
County Tax Map No. 473889 Section 50
HOUSE RD
(STREET)
Block L-
SOUTHOLD
(HAMLET)
Lot 15.1
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
OCTOBER 1, 2007 pursuant to which
Building Permit lIIo. 33464-Z
dated
OCTOBER 11, 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 WINDOW REPLACEMENT AND PERGOLA ADDITION TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to MICHELE BROTHIER
(OWNER)
of the aforesaid building.
SUFFOLK COU1lTY DEPARTMEI!IT OF IlBALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~iZ~
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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This application must be filled in by typewriter or ink and submitted to the Building Department with the fOllowing:'1
A. For new building or new use: Mq)
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (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, 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. -12.,/10 I Of
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: --2i!1" ~,~ ~J A.P J rv> ~
HouSe No. (J>treet
Owner or Owners of Property: ~c.Cu ~Uili'IE R.
Suffolk County Tax Map No 1000, Section ':}7) a?\l.j,l"il/~ Block5o -3 -16. I
s()~
Hamlet
Lot
Subdivision
Permit No. -:, '3~' 4 'Z---
Date of Permit.
Filed Map. Lot:
Applicant:--.N~ ~,
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ J!7.~
CD ~ ?>,:rl96
~ c 1"35~~
Final Certificate:
><. (check one)
AP~rp
-
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.
33464 Z
Date OCTOBER
11, 2007
permission is hereby granted to:
MICHELE BROTHIER
328 EAST 52ND ST APT 10
NEW YORK,NY 10022
for :
RENEWAL OF BP#22538Z AND AMENDED TO INCLUDE PERGOLA
at premises located at
2978 LIGHT HOUSE RD
SOUTHOLD
County Tax Map No. 473889 Section 050
pursuant to application dated OCTOBER
Block 0003
Lot No. 015.001
1, 2007 and
Fee $
200.00
oriz
Building Inspector to expire on APRIL
ORIGINAL
Rev. 5/8/02
N~
22538 Z
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPAIlTMENT
TOWN HAll
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ......~~....ril/.......................... 199;!..
Permission Is herebygr~~~~~........~IY.-1(e~.........
......;?...~~.~!Yd......tf..~............................
AI ....................gg,.f?.~.(j2(fJ.i:...l!/.x....II.f..Yy
to ...&P?1,A1i..~....~.....pe.e.-k......I:1::.t)/2/..*./...an......d1.1(....(?...............
.......w../..~DQ.~......../.f'..:e.f?It.f:.~~..a:?.e.&.f:-:....1.6..........d:.~...€0x~1(('7'
...;:?'c.11(1/-e.....fA:~.~./y.....1l...~.:f!:.((..(,d.~.........4..s.....Af?;2./r...~.tff
........{o..e...~....................................................................................................................................
.................................................................................;.:......................................"R;{l............................
at premises located at.........d..?7~......6..(.j:.{,i:d.t?..~.~..................:............................
....................................................~o.~~.!rR....................................................,.............
County Tax Map No. 1000 Secflon ......~Q....... Block ..........P-............ Lot No. ..I..~.f........
pursuant to appllcaflon dated ....................Q.~~...........7.'......... 19..?..':f...... and approved by the
Building Inspector.
Fee $...7~..~..
Rev. 6/30/80
...... ..7!1~4
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING AfFINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
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DATE
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INSPECTOR ~ ~
,3 31/faL(- 2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCTION
~
REMARKS:
~ -
~
[ ] ROUGH PLBG.
[ ] INSULATION
[~FINAL A:
[ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
5;11vt E ~ L{ !.-,- 1}-5
10 - ;;l-3 --() 7 '
DATE I/)~'J-i ~,11
INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING P{FINAL k..,
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
REMARKS. S~
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DATE
/0 ~;;tJ--~1 INSPECTOR ~~
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONS1RUCT1ON [ ] FIRE RESISTANT PENETRAnON
REMARKS:
;&: /6 IJ< d-o /
/~~
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S~~S-07
DATE
INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
o FINAL A. i
[ ] FIRE SAFETY INSPECTION
[ ] RAE RESISTANT PENETRATION
~
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DATE
/;;..~/ y~ 07
INSPECTOR *~
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LAND
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Acre
FRONTAGE ON WATER I
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DATE
REMARKS
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FARM
aUILDING CONDITION
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AaOVE
Acre
Value Per
Acre
Value
House Plot
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
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Tillable
Woodland
Meadowland
Total
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COLOR
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Garage ~ype Roof Rooms 1 st Floor SR.
Patio , Recreation Room Rooms 2nd Floor FIN. B
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
.
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.N orthFork.net
PERMIT NO. 33 ~ 64~
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Storm-Water Assessment Form~
Examined
Approved
Disapproved ale
,207
,20_
Contact:
Mail to:
,
Phone:
Expiration
,20
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Uvl
APPLICATION FOR BUILDING PERMIT
,.~
\_.~__T,:-. --.-- -~--- -' .--- .
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance ofthe Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
...-' ,"
DatelO f'i>l
,2007
INSTRUCTIONS
(Signature~/:!'f1 or lliUuo;if a corporation)
';Z'il e- 52. ,,04c:.1- Jlt:> tro {{'it. ULJ (DO Z.L
;l.\ Z. '~8 ~ 55 ()..... 9 (Mailing address of applicant)
oU~ 15'3 fH~ e?i 7-'567 fff'
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
~Jr1Il.aA,./
Name of owner of premises M.\~ BP-o't'It1: e-R
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
5 b'~ ~ /5
I. Location of land on which proposed work will be done:
H~~ ,,~_..._"""~
Coi"t:l -;;;..~ ~ Z. rdbo Section '50 O,?:>
Subdivision
$o~J
Hamlet
Block
Filed Map No.
...~ o{. Ib
......~. W1A1Q4
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tInuoO JRo~u2 ". IJ.Jb...JO
_,C$M.......3~
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~ ll..r .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size ofIot: Front
Rear
Depth
10. Date of Purchase
Name of Former Owner
II. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO_
13. Will lot be re-graded? YES_NO_Will excess fill be removed from premises? YES_ NO_
Phone No.
Phone No
Phone No.
Address
Address
Address
14. Names of Owner of premises
Name of Architect ~ Oh.thM.o
Name of Contractor .
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES_NO_
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
&f/d SS'
COUNTYO 'V..) .
t-.{l cke.\e.. '8~\ € V-- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
6\.())\e('"
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
20Ql
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No. O1lW1t_
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N.Y. 11971
q" Bl.DG.OEPT. LD TEL.: 765-1802 .
ExallJined . . ~...;11. . .. 19 ?Y . :J. .
Approved. .X!<< f?f...., 19,?}I;ermit No.~.~.~f,
'm~ ~::.:m ~I
BOARD OF HE^LT~ '.~"'"
. /3 SETS OF PLMIS"........-'.......
SURVEY..L...............
/' CIICCK ..!fr.. 9!!I.:J.'M . " . .
SEPTIC rOR~1 ............
r:OiIFV: oo-/;Y3-fJJ.7
CALL ~ . . 'i}J7,,:. '1"-1/' . .
tlAIL TO: I.{ 1/"1' .
. . . . . . . - . . . . . . . . . .
Disapproved alc
.......... ..0. ........ ............ .O!
. . . . . . .. . . . . . . . . . . .
.....................................':.........@
Date... F.l.'2Jr:t......., 19...
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 street:
<;>r 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.
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, fllr the constru'itio" Of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agree:Uocomply-with 'aII'applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspecto~p~ EI'emises.and in bUi.lding for necessary inspect(~s. -:L . '.
~_._- . . .. \\\.~o..~ ~___
' ..0. ....... ..... .... ..........................
(Signature of applicant, or name, if a corporation)
~'+ 5cU\J..~ ~lIf(b GI',Ei.toll'cit.T. N.'i \\qlt'i-
................. ..............................
(Mailing address of applicant)
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State whether applicant is owner, lessee,age~t, architect, engineer, general contractor, electrician, plumber or builder.
. ~ .
OUl!\lE\\ '!.'. .
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. .
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Name of owner of premIses ........,..... .;. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
' . (as on the tax roll or latest deed)
If applicant is a corporation, signature cif duly authorized officer.
...... ..... ........ ....... .....;.,... .'.... .......
(Name and title of corporate: officer)
Builder's License No. .........;...............
Plumber's License No. ..:...........~..........
Electrician's License No. ...........;..........
Other Trade's License No. ........ 1 . " . . . . . . . . . .
I. Location of land on which proposed work will be done. .................................................
2'\1~ L\G\\\"Ct.lS~ RM~ 50UT\\IlLD
...... '" ...'........... ..... ...... ........ ...... .......... ..... ...... .........................
House Number Street Hamlet
County Tax Map No. ] 000 Section '" :~~P. .. . . . . .. Block " ~ ~. . . . . . . . . : . " Lot.!~................
Subdivision. . . . . . . . . . . . . . . . '.. . . . . .. . . . . . . . . . . . .. Filed Map No. .............. Lot...............
. ~=~. .'
, State existing use and occupancy of premises _.... ~. ;.J:~.. occupancy of proposed construction:
a. Existing use aBd occupancy. . . ".~\\l~:t.1:, . . ~\Ll.~':':-\~~. . . . . . . . . .: . . . . . '.. . . . . .': . . :. .: ::. ......... . .. . . . .
.. ., , ~~ -.' ." ' ,.. "~
~\\li>.-n:. ~iil'-\N" ,
. b.lntended use and occupancy ........ '.' . .. .. '" . .. .'. " . ... . .... ..;; :,':,":'" .. .. ..... ",_1.;.;~""",
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~..,~..,> ....,?~..";';:.~.'cJ;-f;~~~;.:~7:.:"';.--'~'1.~~_'_ ',,-,-- ..~~ --;''''','~
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'3. Nature of work (check which applicable): New Buildi~g .:.......: Addition.. .?"S . . ..' -Atteraiion . .>::. ; . '"
Repair .............. RemOval . . . . . . . . . . . . . :. Demolition ......;........ .~ther W . .'. . . . . . . . .', . .
. oJ' , - '. '. ' . _ " (Description)
. ~~~-.' .
4. Estimated Cost. . . .7...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee. . . . . . . . . . .,_~~. ._ .,~.........'~~. . . . . . . . . . . .
(to be p~d: oii:mi~UJisrnpplication)
S. If dwelling, number of dwelling units. . . .l : . . . . . . . ", Number cif dwelling units oneach-fi~~r . " . . . . . . . . . . . .
. If garage, num ber of cars .......................................................................
6. If business, commercial or mi.xed occupancy, specify nature and extent of-each type' cif use ....................
7 D. . I'" t 'f'F' 4-o'u." R 4-o''i'' 1"'19"... '.2' '....
. Imenslonso, eXlstmgs ructures,l any. ront...., .-,........ ear.. ............., Depth ......... .fq.<:.
Height .. ill. . . . . . . . . . . Num ber of Stories. . . I . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . " .... . .
Dimensions of same structure with alterations or additions: Front .$fl':"l~......... Rear.....:.:.::::::::::
Depth. . .. : .'. .. .. .. . . . . . . . . . Height. . ; . . . . ~ . . :. . . .. . . . , . ; Number of Stories.. .
8. Dimensions of entire new construction: Front. . . . . .. . . . . . . .; Rear........... . . . . De'p'th' : : : : : : : : : : : : : : :
Height ............... Number of Stories. . " ... .. . . . . " . . . . . . . .. . . . . . " . . . . . . . . .... .
9. Size ofIot: Front. . ~'I'c:.,'f:'\" . . . . . . . ..... Rear.................. ~ ... De~t~l':"""':":'::::::::::::
10. Date of Purchase .........'i................... Name of Former Owner .0\.. .\,,~ .lL ~5;. ~ . .
..........
II. Zone or use district in which premises are situated. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: .\':l.ll.............................
13. Will Jot be regraded . .\',l!l. . .: . .. . . . " . . . . . . .. . .. . Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .\l:"l"!-~~. .'?~t<~~l{ . . .. Address ;3~;~~,!~ !~.ll ~.~~"!~..t: Phone No. ~.1 ]'. !'tJ.I.. '...
Name of Architect ............................ Address . . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . '-.'.
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . ; . . . . . . . . ; . . . . . . Phone No. ..........:....
15.' l,s this property within 300 feet of a tidal wetland? *Yes........ No.llIP......
*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. . .
:
See IIr ~"-' "'e.~
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. DATE: au 5. r
FEE:~'" ~ BY: . '
NOOFY BUILDING DE ENT
765-1802 8 AM 10 .. R THE
FOLlOWING INSPEcno :
1. FOUNDATION . TWO REQUIRED
F:OR POURED CONCRETE
2. ROUGH - FRAMING a PLUMBING
. '3.II\ISULAT/ON
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
~t;t~~~~~~~~jk .s.s
. . . ":T~~~fY-:o . .I;l.... .~ ~~.~~. . . . . . . . . .. . .. . . . . . . " being duly sworn, deposes and says that he is the applicant
(Name of individual signing cqntract)
lbove named. .
,
le is the . ;...Q~~~~. . . . . . . . . . . . . . . : . . . . " ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'. . . . . . . . . . . . . .
. (Contractor, agent, corporate officer, etc.) .
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
:ork will be performed in the manner set forth in the application filed therewith. .
worn to before me this
.,..,'.. '~~~l\. '/7'" .day Of.):>~ \...., 19:"'!- .
O"'YP,wi',L~L~o,,,, \\ --..
' NaMry~:~~NewYark?f \ ......... \. ..~..~. :.c:::.-;?,:,,-!-:~..........
No. 4879606 (Signature of applicant)
Qualified In Suffolk = 19
CMI.mIlllon Explree o-mtler
-~'
Thomas Bannon
34 Sound Road
Greenport, NY 11944
Office Telephone # 800 243-9227
Home telephone 477-1471
December 6, 1994
Town of Southold Building Department
Town Hall
Southold, NY 11971
Application for a building permit to perform the following
alterations:
1. Replace 7 windows as shown on attached plan
2. Build 10'x20' deck attached to the front of the house.
Address of property:
2976 and 2978 Lighthouse Road, Southold
Tax Map numbers: 1000~-03-14 , 15, 16
.:1"0 -
Applicant is the owner and will perform all the work.
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APP V DASN~~~qo
~ II B'P'#<;;oR
DATE:
BY'
FEE' ~' ARTMENT AT
NOT BUILDIN~O~~~M FOR THE
765.1802 8 AM TIONS:
FOLLOWING INSPE~WO REQUIRED
1 FOUNDATION' NCRETE
. FOR POURED MC'~G & PLUMBING
ROUGH - FRA , -
;'.i1<lSULATIO~J"~Tq.U. c. TiN MUST
4 FINAL.COI~,. ...=, O.
. BE CbMPLE I ~ 'v' 's ALL MEET
ALL CONSTRue liON TH 'CODES'OF
REQUIREMENTS O~ RESPONSIBLE
YORK ST ATE. N~STRUCTION ERR
DESIGN OR CO !
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OCCUP/\~jCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY,
7B. '~~AIL.
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BROTHIER RESIDENC
2'976 LIGHTHOUSE RD
.SOUTHOl,D NY'
, .
CHORNO ASSOCIATES
architects.
SOUTHOLD, NEW YORK
NEW/:>t.~"~d
APP V 0 AS NOTED
DATE: (0 A . B.P.#~
~~ FY BUILDING ~i~;-
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS: .
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL _ ;' .' J MUST
BE CO~WC:::; ,- "".~ \-'.' .
ALL CONSF'.J(, iIO;< SH L MEET T
REQUiRE;,iHTS OFTHEDES OF NE
YORK STATE. NOT RE~?tJNSIBLE FQ
DESiGN OR CONSTRUCTiON ERRO
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USE IS UNLAWfUL
WITHOUT CERTIFICATE
OF OCCUPANCY
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B13-0THIER RESIDENCE' .
., _ .. 2976 L1~HTHOUSE RD
. SOUTHO~D NY.
CHORNO ASSOCIATES
architects.
SOUTH OLD, NEW YORK
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