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Home My WebLink About33655-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY He: Z-32962 Date: 04/07/08 THIS CERTIFIES that the building FOUNDATION Location of Property: 8145 NASSAU (HOUSE NO.) county Tax Map No. 473889 section 118 POINT RD (STREET) Block 4 CUTCHOGUE (HAMLET) Lot 9 SUbdivision Filed Map He. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 29, 2008 pursuant to which Building Permit No. 33655-Z dated JANUARY 29, 2008 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 FOUNDATION UNDER AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN F & ELVIRA T ALOIA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMERT OF HEALTH APPROVAL N/A KLECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~hor~ Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 I .! l '-"- I r,' i/: ,.J .", "I,' ..J :_~_ JAN 2 5 " ..!Jf' APPLICATION FOR CERTIFICATE OF OCCUPANCY _- This application must be filled in by typewriter or ink and submitted to the Building Department ~ith the fOIlOWib:~! 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 Plarming 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 Owner or Owners of Property: J""O H N A-/IIb { I "f t; LV 14 f<..d 11 I (-U/o iJ I I ( check one) ~I.) ,'-11 O~L? E" Hamlet Date. New Construction: Location of Property: 'B {t.f 5 House No. Old or Pre-existing Building: N "-SSCL\.L. fo 11\+ Street v L.oIA Suffolk County Tax Map No 1000, Section Iv c..s. s-... f 0 i vt-b Block 04- /5 t. Lot oer (p3 Subdivision Filed Map. Lot: Perulit No. Date of Permit. Applicant: Underwriters Approval: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: / (check one) Fee Submitted: $ 75. ~ICJ~\' ~ ;;)..-';,00 ~~ p lcant 19nature ~. 71.(0[,' e.~ t- 32~ (p ~ 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. 33655 Z Date JANUARY 29, 2008 permission is hereby granted to: JOHN F & ELVIRA T ALOIA 39 NASSAU BLVD GARDEN CITY,NY 11530 for : CONSTRUCT A FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.THIS PERMIT REPLACES EXPIRED BP # 17830 at premises located at 8145 NASSAU POINT RD CUTCHOGUE County Tax Map No. 473889 Section 118 pursuant to application dated JANUARY Block 0004 Lot No. 009 29, 2008 and approved by the Fee $ 75.00 Building Inspector to expire on JULY ORIGINAL Rev. 5/8/02 33 ?ss 7- 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 r t..<L ------ . DATE 2- 'J.-7.- /) 1 INSPECTOR ~ ~ . /1 ~'D-e 765-1802 BUILDING DEPI'. .. ~ INSPECTION [~OU~D~TlON 1ST [ ] ROUGH PLBG. . ~ f3J1J.c1i, ['1 FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS:J~ ~~ ~.~ r!J,!::-, DATE 3/~/f{Ct , , INSPECTORU~ (J)~ /tLiOUL,t!t ~ , -- fLy I N'lAS-;'h\-U f I, ~ Ju-)~ (J~ ..- $-'2.2.~ 765.1802 BUILDING DEPT. INSPECTION [~OVNDATION 1ST [ ] ROUGH PLBG. / 'J1 U) C- tc [vr FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS'_P~ ~' ~ ~,/~. ~ ~~ d/lf) ~ " DATE ?-(J t; ( r9 INSPECTORI)~ tJJ ;~ ~'lELD I:;SrJ2C710:~ 1. i'OUlJDATION ( 1 s t) - - -- ~ l,Oc..-r.: i'OUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4 . FINAL ilLJA7E II I~~,/~ . fa;.; tJ I K, ~ I,. r;;j t). k: 'J--'J..7- 0 y 1~ 1!~, ~ 0()HME.Nr~ vtlV, IJWJ. .J/ 10_, ~ /l /.'.-f7t.1.;; .... 0' L4-- ..-r 1; rV /J v l.,z,.. '] \.. /' ADDITIONAL COMMENTS: '"0 "'!AI :;:\."j H~ >-ltll ~o, ~ .." c: CIl "'~ z- o . ... - of'. ""\ ~ t CIlI ;l... ",':" .. .~~ ~j .-J~f . , of. .:.; =<= .1':1 ~ '" C1 .. /" f . !'1 ~~ ~~, >....0 >-l........... ~ t;) =<="'Q .. 1- ". :I: 1':1 > l""" >-l :J:: ~ ~ o. .!'1 "'ll >-l - / (' (' OWNER / /f? . / __" In) TOWN OF SOUTHOLD STREET Cf: 5 ,---; 33 (c ,:;;1:; ~OPERTY RECORD - 33&~-- CARD - VILLAGE DISTRICT SUB. LOT 6 3 FORMER OWNER jJ- ....J ..;. >,' iT .;) C,' ~3 ) (', ( '2V(J t 0--'0 ':>-0 -, .c. -.37:1 (;} vD 2-900 "70(.)0 I Id'tI q ~~RMAL Farm Acre Tillable 1 Tillable 2 Tillable. 3 Woodland Swampland Brushland House Plot -- Toto I 6/"t f?6a<1 {\Vll..-h ~ E f <,"-'7' , ~. lie ACREAGE '/ J S W TYPE OF BUILDING I~ '1'.........'L.<.. I /'1'/" J {Ii. j:;::. - "- ,', VL FARM COMM. IND. CB. TOTAL DATE E,C>/2JC), .....: .-- fj'~ y '!}j' ace'! - ~. On Value Per Acre SP-e- 3'6\0'5 L, 5'5' -- '\ ld.'-\l -- , --! , e" .. , ~ :1 , ;! ;1 - - ;~ '1. 1/4 II aal9f 1: , J , "3' ',," ';;': , --~ 1 D, " . I , I: /,,,= -~ V --.c-. , , '--, I J/ ,.., :' \ / I' ( , I' !I - - - ,- -, .... ' , I / r~ ",. ;.> / 1, / / Q. .--_....------' / " _.__.~_.__._--_.._-'--_..,._.- - -- - - - -,-------- --_.- - / ~ 1 I ' r~ef Y/: B.,',$; I :< ~,. , =------.,p f'" '-4 '-' "'''''''-'7 / Fa ndotion Both r , I .~~ 1 .-:'.. i_iI I -' \. '------.. I ' , , ~tens.ig,n , " ./ '- ,/,,~, ' I I Basement /71/ ',I." Floors " , ,I, / / r ff.{ , / 4/314~T;.~d 1341 / extension , Ext, Walls Interior Finish "'A ('i.: ~ , Extension ) ", '7 , . ", 7 " "--, Fire Place . Healt ;>:'IL -I; "'", ~G; \:O~,G.--\ \ \ >< \ l" -=- \ '7 L. /':'-- ", Porch Attic / 'I \:r-=:::-IL rj \ \ )( :;<.. \ - Z'-', I \. " . }.C; 3 I '3;" . Porch Rooms 1 st Floor ?v .2-"-.3\ ~ ;:;;..... .? 12C/.L' Breezeway 8X-IG - 12-S ///' ~o \~)(\4~ \82- Rooms 2nd Floor " ~"/ / Driveway' / ~ Xl .../ c J.32- 3ZC; 1-4- O...ql 3_-->(,,' ,I ~-~ - " I ^' './ O. B. 1'x/(- /"-- r / , .) ,. 7./, ?- II .;;!_CC'_ - .f!',. .----- - - " . .' J I --I 1 \ \ ,- Gt2.f!c-( \ ~~ y~ i\ (I ~/./ ~ / / ~ ", ~~, (' 1: ~ ~ I" >~ I "'~. ~ ~ - , ~ , ~ ~. 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CO !!t .. n ijj a 0' '< co " I S' (.0 ~ I~ r ( J ..- tll :Il :Il ~ :r :; ." lD 0 0 )> co - 0 .. 0 0 ::: .. co 0 - 3 3 n' 0 - ~ :r 0- 0 ~ '" '" '" '" ~ (,\l '" ~ 0 :!' " ~ ~ 0- < z: " co ." ." ~ (;;' ? 0 0 :r ~ 0 0 I P ~ ~ ~ If\ ~ ~ ~ ~ It ! p r :!' lD 0 r- ^ 9 " ;Il :Il :Il ?= " co lD - - co , I \ , I , I , ; ....:""_.~- c.,~:.,,"'f;-;""<'J:-..<\l!Zi-''"''= ~ .- ~ -!) - . t ~ ... II' ~ F- eil :> it t .. t..-~ ~ ~ .. E ~"_~';"d':":~-'.,_."~"'::::, FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD. N.Y. 11971 TEL.; 765.1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ...........:..... NOTIFY CALL .................... . Examined a~ !1..., 19'j~. Approved ~~ .l.tf. ., 19~'. Permit No. 1."1.9. ~~ Disapproved alc ...................... '"H H : J) ................................::y~~~~...... (Building Inspector) MAIL T.9~ AfdMv' ~ ~ APPLICATION FOR BUILDING PERMIT Date.......... ........, I,.. . INSTRUCTIONS a. TIns 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. ' 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. 'Th~ ,applica~t 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. , ('Ii ,'~ ~ . . . . . ,"-y{.'<..l.4..(h.,.) l .. . . . . . . . . . . . . . . . (Signature 01 applicant, or n me, if a corporation) .... ~<?~r'Ac:;h ~./,N~Y....,................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ... ... .... . ... M~:>.c: y)... .......... ..., ...... ............ ........................ N f f. 17y ''7\elA.... A L 1......cL , ame 0 owner 0 premIses .. ....... U . . . . : ~. . .v::'\ . . . . Y. . . . . . . . . . . . . . . . . . APPROV!tJ AS'NOrFD . . . . . . . . . . . (as on the tax roll or latest deed") DATE' B.P tI FEE BY NOTIFY BUILDING or PMlTMENT AT 765.1802 9 AM TC> " PM FOR THE FOLLOWING INSPECTIO!\:S 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. I L . f I d I ' h . k '11 b . d ' STATE CONSTRUCTION . ENERGY . ocatlon 0 an on w lIC proposed wor WI cone............... . CO...,.,. . ..._ __....... ........ nu,' ................D~ . FOR' . . . . . ....... .fl'f.~....... .1.)c.M~.. .~:t.. .~............... .~~~~~:~~flC?RS House Num ber Street ~ Hamlet . ........ 'f I (]L( County Tax ~!Jp No. 1000 Section ...... / /. . . . . :. . .. Block .................. Lot... (l, 7.. . . . . . . . . . . . " If applicant is a corporation, signature of duly authorized officer. ~ ~~!? . . . . . . . . (N~~~ ;~d iiti~ ~f ~~~~r~i~ ~j-fi~~r')' . . . . . . .t;J ~ t; Builder's License No. ... .1. ;:z 'j. <j. 7. HI . . .h S:~ ~~c,j~ Plumber's License No. ...................~. ~ S ~ ~~~c::5 Electrician's License No. ...................~ i! ~ Other Trade's License No. ................... ~ Subdivision. . . . . . . . . . . . . . . . . ' . . . . . . . . . . . . . . . . . . . Fib1 Map No. .............. Lot.. . . . . . . . . . . . . . (Name) State existing use and occupancy of premises an~ intended use and OCCupancy of proposed construction: a. Existing use and occupancy ......K~. ~.r d?-h r ~.L,-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy ...... /?t?-.!'i IJ~l:lr9l.~.. .... ....................................... , rt~v ~'T, 0\'\- "35' fT It l70 LI e S eo< Le.veJ- e. f)/,L/..fha>.J r~ "- - fle/ {oJ- ~ 1--- ~ ~ "::. --. r JJ~ .-'- ---~oc-'~,_____,_ _ N~",-~-~-=- '[0-'-" '}~$:~~d ...'. ' ~:~ <,~~~. t.;. .~ .~.. -:':!:!t .:" .4~:\. . 'C::' i.'~' ':' , STA TE OF NEW YORK, COUNTY OF .. .. . . . . . . . . . . . . . .. S.S .. ........... .......... ',,0 ........... 0.. ....., ..,..". .~ (Nnme of jp,divid.U;1I.sigljing ,<:Ontrnct) b '~"d'" ~ ",I.~)\l,.. .... a aYe n..llue. . .'.' , .' "(~ "'.. "<.;. '. -, Hejsthe.:;i.'.~..~......:~~<:,,:';'.....:.. '.. .,................................................ ............ ....... -, -:l i i"l.J( .~, ,...,.~ I'., . \ , , . . 'fP'."'" .::. .,;; .i.,' ". : '.' (Contrnctor, agent, corporate officer, etc.) . of said O\vner 'Or owners, and is duly authorized to p,;rfc{m or have performed the said work and to make and file this application; that all statements contained in this appliqtlon arc true to the best of his knowledge and belief; and that the work will be performed in the manner sct forth in the appiication filed therewith. Sworn to before me this . . . . . '" . . . .. .1.. . . . .. . .. . .day of.. . .. t ~. . . . . . . . . . . ., ;'1.1.. Notary Public, . .~. K... .j)~ .c:!~. ...... County being duly 5wom, deposes :md says that he is the applicant ~ HElEN It DE VOE NOTARY PUBLIC, State of New YorIl No. 4707878, Suffolk Co.~ Q Term t,pires MilCh 30, 19~ . ~ ~';';~.Of;;;]~;';;] -- FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL' ZOUTHOLD. N.Y. 11971 TEl.; 765,1802 EX:,"linod ~~ ~'f.." 19j:,\. '. Approvod ~~ ).If . ., 19~'. Permit No. J. "1.9. .~~ Disapproved ale ..............................:,..::..:: () . ................................::yd:~~~...... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORH ................ NOTIFY CALL .................... . HAIL TJ~ ~fdMvf ~ ~ ~~ FfB -4f 'S3 'W; BLDG. DEPT. TOWN OF SOtmIOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date. . . . . . . '" . . , . . . . ., I~ . . , 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 o.r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- c,ati~~. The work covered by this application may not be c~~menced 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, Jor 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, housin~ code, and regulations, and to ~dmit authorized 'inspectors on premises and in building for necessary inspections. ..... c.t~.J~:l4.t_................ (Signature 01 applicant, or n'tffie, if a corporation) ...: .~9.t:'-rJt.~h ~.>,.N~v.... .., ... ........ .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . MO:-.'.7{] Vl ................... .... ........... .............................................................. N f f'. D"", YI e Lt ",' .A.. L t',.." cL . ame 0 owner 0 premises .. .)..... U. . . . . .. L . .'P.',. . . . . Y. . . . . . . . . . . . . . . . . . APP1lOVEU AS 'NOrm" . . . . . . . . . (as on the tax roll or latest deed) If I', '. f d I h' d ffi DATE' B.P /I app lcant IS a CorporatIOn, signature 0 u y aut OrIze 0 lcer. ~ 'c- ~ 10;; FEE BY . ...... . .. ... '" . . .. . . . . . .. .... .., ....... . . .. .;:;:/f! i!! ~ NOTIFY BUILDING DfPMlTMENT ,l.T (Name and title of corporate officer) ,.;:.~~ 1;: ~ 765.1802 9 AM TC' ,t P,4 FOR THE .;~~~ '-:r i:: ~ FOLLOWING INSPECTIO,,:S Builder's License No. ... .1.;Z j,<j.7. J-;[]:.... .,.;,::..":t,q: ~ 1. FOUNDATION ' TWO REQUIRED .::. , ).2J;:s FOR POURED CONCRETE Plumber's License No. ................... (y..c,.;' .1-... 1ft 2. ROUGH. FRAMING & PLUMBING ~ .'~"J <::) 3. INSULATION Electrician's License No. .. . . . . .. . . . .. . . . .!:f:,". ,',* 4. FINAL - CONSTRUCTION MUST . . .:.. ..... BE COMPLETE FOR C.O. Other Trade's License No. ............."..... ~ ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. I Location of land on which proposod work will be done. ..... STATE CONSTRUCTION II ENERGY . . . . . . . . . . . CODES'. . 'Nor' 'RESPOJIJSlBIE . FOR' . . . . . ....... .fl.'/.~....... !-)~~. .~t.. .~............... .~l'f!R.~~~~.~~~~~~...... House Number Street :I Hamlet f I <-( County Tax ~13p No.1 000 S~ction ...... / I. . . . . ... . .. Black .....9: . . . . . . . . . .. Lot... {J, (.. . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . , . . . , . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot............... (Name) State oXisting lIse and occup3ncy of premises an~ intended lIse 3nd oCCupancy of proposed construction: a. Existing use and occupancy ......K~. ~ ! d?-h r.~.L,.. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . b. Intended use and occupancy ...... !?i?fi IJ;I('>:IfC?l.l,..,... ........................................... , ',~~,- POU.e1...\IO"" (A.'It cfe..y ~"f.i Sr;~ 3. Nonure of work (check which ~pplic~ble): New BUilding.... :':.. " Addition.. ... " ... .lftll...5Ien 'tJt:'.~;. . Repair .............. Remov~1 .. . . . . . . . '" .. Demohl1on f" .......... Other Work . .r.-fJ.~ctql/.4'.Y $' (Description) 4. Estim~tcd Cost . . . . .! 9.}. ~.o. ~ . . . . . . . . . . . . : . . . . . . . . . . .. Fe ...7.s; ?!.I? . . . . . . . . . . . . . . . . . . . . . . (to be p~id on filing this ~pplic~tion) S. If dwelling. number of dwelling u~its . . . . . . . /. . . . 0 ., Number of dwelling units on e~ch floor. . ./. . . . . ~ . . . . . . If g~~ge. number of c~rs .............. 0 . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business. cOmmerci~1 or milled occupancy, Specify nature,al1d extent of e~ch type of use . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front. . .. . . . . . . '. . . . . . Rear . .... . . '. . . . . . . ,. Depth.............. Height" '-'n ~_l ,:.:, ~~; ,... Number of Stories 00......0...... " . .......; ...... . ...................... Din1~n'std~ of.S:tnie structure with alterations or ~dditions: Front . 0 . . . . . . . . . . . . . " Re~r . . . . . . . . . . . . . . . . . Depth . . . .. . . . . .. . .; ,. .. i . . . .. Height . . . 0 .. . . . . . . 0 . . .. . . . . . Num ber of Stories.. . . .. .. . . .. .. . .. .. . . . 8. Dimensions~fentire ne'r,~onstruction: Front............ 0', _Rear 0... 0.......... Depth.. o. d......... H . ht " I, 'N b f St . , \. .,. .elg ....... ',:.;';':.oJ.ir.um ero_. ones.. o. '.~,' c. 'to. 0 "':.'~ "0" . 0.......:. . ....... .......... . ,........ - 9.' S12.e,of.lo...",f,ron.t..:.. 0... {o....... .7. 0.. Rear. 0,"':, 0 0.. o. 0........ Depth ... 0................ o. 10. Date qf,Purcha~.:~;;:'::_. :. 0 .1; ~. f. .z.. . . . . . . . . . Name of Former Owner .............. 0 . 0 . .. . . 0 0 " . . . II. Zone or use district in which premises ~re situ~ted . . . . (\12: ':~~'k)" . . . . . . A)' . . . . . . . . . . . . . . . . . . . . . . . . . . 12. D?es proposed construction viol~te any zoning law, ordin~~ce orregulation: '" C~. C? . . . . . .: . . . . . . . . . . . . . ~. 13. Will lot be regraded ................. 0 . . . . . . . . . . Wtll excess fill be removed from premISes: Yes ~ 14. N~e of Owner ofpremises17rt :J,,/".,... tJ.l.'~0<..o 0 Address .C!....t..J...y.....~..... Phone No. ....-........... N~e of Architect 0................ 0 . . . . . . . . . Address . . . . . 0 . . . . " '1 . . 0 . . . Phone No. . . . . . . . . . . . . . . . N~e of Contractor .<!:\"~~:r.~. .B.e.V.'fH....... Address. SA \.0\. TlI;.~...... Phone No. ...... ~........ IS.Is this property located witilin300 feet of a tidal wetland? *YES}l;...NO...<,: *If yes, Southold Town Trustees Permit may be required. . PLOT DIAGRAM . . ... ',+ Loc~te clearly and distinctly all buildings, whether existing or proposed. and, indicate all set-back dintensions !torn property lines. Give street and block number or description according to deed, and show street n~es and indicate whether interior or comer lot. ~__ 'W _________. .~. 15t,-L.rh~", ~:. '- 0-- rJ"V~\I&'\Il- 35" ff It \?.s JIl S e", Le...;eJ- C; . fle/ ,oJ.. ~ " - ''', /' <".' "'1' . ~ ~ ~ "" L GZuctd r ) I dJ N 0.. ? '" Q,. v-. f~,-", j .::- STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . . 0 . S.S (Name of individual signing contract) above named. ................... .......................... .... being duly sworn. deposes :md says that he is the applicant He is the . . . 0 . . . . . . . 0 . . . . . 0 . . . . 0 0 . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 0 . . . 0 0 . . . . . . . . . . . . . '0 . . . . . . . . . . . (Contractor, agent, corporate officer. etc.) of said owner or owners, and is duly authorized to pe,rfy-m or have performed the said work ~nd to make ~nd file this application; that all statements containcd in this appliqtibn are true to the best of his knowledge and belief; and that the work will be performed in tile manner set forth in the appiication filcd therewith. Sworn to bcfore me this ' ~ \ fj? .... 0 0.... .. .'1..... .... .day of.. . t.~... 0........,19'... Notary Public, " ~~. K. . .!)I; .4!~. :. '" County "ELEN It DE VUE ~.. NOTARY PUBlIC, Stale of New ,... No. 4707878. Suffolk Countr; Q Term upires Malch 30, 19-Q...1 .d~~~............ &Signarurc of applicant)