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Home My WebLink About23866-z FORM NO. f 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) N° 23866 Z Date .99.�.-...../......................... 14 Permission is hereby granted t ... ....... ........ .. ... ........... ... -. r...... ... ......... ...........0......... r ...... I ... ... ................... ......... .. .,:�...- ..... � . .. ............ .. ............... ........ ... .�... . .. .....1..._ J /,� . ...... a premises located at /�.... .�... ::. ......... .... .�.... ......... Z . ................................................................ °.....C...�.... .... ............................................ County Tax Map No...1000 .Section .........�.�... Block ...........� Lot No. ....... pursuant to application dated .............. b. .:.�.2�..........0 19..&, and approved by the Building Inspector. Fee $..... ... ....... AV .............. . .......................................... ................. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F_ 85 JOHN STREET, NEW YORK, NY 10038 Date jl'u^iC3xl''rz '. ,.1.`"r)7 Application No.onfile THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ti'TI ?,i I I od ^l,L.Eli�Yv i- IRP- 11 R, ROUT r 413, MA` TITUCK, N.Y. in thefollowing location; ❑ Basement ❑ 1st Ft. ❑ 2nd Fl. OUT Section Block Lot teas examined on 'f llr`T'7-j l- os r 1997 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. NO.OF FEET WATTS SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. TYPE METER �,4W I 3W 3 0 3W 30 IW NO.OF CC.COND. A.W.G. NO.OF HI-LEG A•W G. NO.OF NEUTRALS A.W.G. EQUIP. PER Ar OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: SL uf...l.aUT RECEIPT.TMD.'20--7 ! \tiiG`1.t_2�IsAlTs'JC7 E'J(.�s This l.::f.:.r •is G' covers ti,:Ot.11:t.ii_iai1c ai-- •i 61E` (l,li'k3 of only. Bec"a.3t;C-` C)f i.alill.'S.'_i;l f L GENERAL MANAGER _ Per 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. gmm THE NEW YORK BOARD OF FIRE UNDERWRITERS; vGf�4C142 BUREAU OF ELECTRICITY F— 85 JOHN STREET, NEW YORK, NY 10038 Dace -Tr' `N f+Y Ga`�, g97 Application No.on file �.31'fi.l`_�7/ 7 II 053'IC THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of WILLDIU 1 1- BLLEN BIRFILTBR, ROUTE, 48, I VITTTTUCK, N.Y. in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Ft. OUT Section Block Lot was examined on JANUARY 03,1997 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT[FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. NO.OF FEET A H.P. SYSTEMS MT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER �,4W 3W 3 0 3W 30/W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A•W.G• EQUIP• PER% OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: WHIMLLLEId D_iRi1Tk�R LL BOX 784 MATTTTUCX, NY, 11552 GENERAL MANAGER _ Per 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. F I 1.'1:1). 111 11;1.1.. IW1,01H, DAI V tj 1)AT I N FOUNDATI011 2 NO -srmrra----ten-------- F-ItAtIX o I NO MOILATI()Il pirit tj ---------- ------- ---- - — - ----�m��mmnxm.,rmn-._ 007e� ----------- ------------------1.------- vn- ----------- - ---------- ------------------- ------------ -- ------------ ----------- ---------------- t:j �4. / 1 ON Vp UNAU THORILED ALMATICN OR ADDITION i0 TNI SUIY(Y A VI LAIIL7N CE \ ' • I � , ;I CTIJ', 7209 Of Ittt NEW YJI:r. :7ATE EDUC":I LAB: O s N. I O � ♦♦' . C^•I _F t ..' ;TY '.'Al NOT EL^f:ING� .. . \v GL. TV' i... aE6:. .r :Halt r,144 � ♦♦t9_o�� • , .: Itrt $L:RVET NorF� Ut..r to I:I ..r. � �•n:•: .! ♦`\�: + 1� P.E..I L .'•„ `.•,.^I. IHc � - = ONUA/ENr a Ti1Ll L:.::�t".;•, ac r:.4t AL tNCY AND tii S�yr5 �J •< LENDI..L; I l•;N L,.!EC NIuON, .rw I Q 2 t•1, • �b• / TO liF :..:{:`. _i t_f 1.,E Lrl L�lj,A LSTI- . lk ° ti R � F , v. 1L ,... ' 1UIIt.•:1 t..�.�-�,�`•" Ai; N41 Uv�,�SFir.A Y.LE �K• �Q •'�. > >�' J' \�•o+S, �� \ !O n0.;i!Il:t�.41 a„tllU RiiN] OR :u.:.L.;tN! r2p�. No 1�, '£ O REVISIONS YOUNG gs YOUNG d 400 OSTRANDER AVENUE. RIVERHEAD, NEW YORK o0 ALDEN W. YOUNG HOWARD W. YOUNG O' PROFESSIONAL ENGINEER AND LAND SURVEYOR LAND SURVEYOR. N.Y.S. UC. NO. 12843 -N.Y.S. LI C. NO. 48803 C �A•' ', 'y .\li. SURVEY FOR: r •� 4� - A • ALFRED J. GROSSENBA.CHER,JR. & CAROLYN A. GROSSENBACHER , „ i AT GUARANTEED TO: \ MATTITUCK SOUTHOLD SAVINGS BANK \ TOWN OF SOUTHOLD GUARANTEED TITLE DNISIONOFAhtERICA' TITLE INSURANCE CO, SUFFOLK CO., N. Y. EY \ - 4 SCALD: „ 1 GATE: NO. I - 40 DEC. 5 , 1972 I 72- 921 • .._ IIr.tS ---- �.- BOARD Oh IILAi;P11 . . . . . . . . . . . . . . . i_- I FORM NO. 1 3 SETS OF PLANS - - - - - - - - - - - - - - - ,R TOWN OF SOUTIIOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . ! i TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: Cxarmirred.... .. �.. 19 7� MAIL TO: . . . . . . . . . . . . . . . . . . . . l.t�, 1..._ Approved.. ��.., 1971P Permit No. 4�2 .................................... Disapproveda/c .................................. .................................... ............................................. ........ (Building/- I" tor LICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. 11ris 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 application. 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 permit: shall be kept on the premises available for inspection throughout die 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. APPI.L('11PTON IS nEREBY MADE to the Building Department for the issuance of. a Building Permit pursckant to the Building Zone Ordinance of the Town of Southold, Suffolk CcxmLy, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or dermolition, as herein described. the applicant agrees 'to comply with all applicable laws, ordinances, building code, housing code, and regulat:ions, and to x-iji,Ji'�1>tlx rsi- `9fitt;p ors on premmises aril in Wilding for necessary inspections. �. (Signature of applicant, or name, if a corporation) (Mailing address of. apTggl�ieantyy�)'-�? wC91v{6�. .r G•a�_.fir i,� .� . State whether applicant is owner, lessee, agent, architect, engineer, general contractor 'electr n+oci--Yuilder. .................Cr�Gc�J.v,lf.'�.................... ......._............................................................ &--nne of owner of: premises ...Gi,2l.��E11 �—�� ./l�/�7!� ...................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ..._.... �X� ..................................... (Name and-title of corporate officer) Builders License No. Pl.rnirers License No. ......................... Electricians License No. ..................... . OtherTrade's License No. .................... 1. Location of land on wTric]i proposed work will be done. ................ ........ - s �77-`f .i.� �!.Al a.................................................. (louse Number Street Ilamlet Canty Tax Map No. IWO Section .......I.7.O.. Block .......;r,?..._... Lot .....e ...... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... C Y...................... ............................... 1). Intended use and occupancy ..... .r-. ..................................q, ,°S�i ,� ..�;ii1.;`.:3 q .......... A .R F 6 i ). Nt(nre of cmrk (d)eck Nliicli applicable); New Ikrilding, ......... Add ition Alteration IIC>g>irir ............ Removal ............. llernolitiOn ............ Outer Work (ilescri Pt iott) /I. Esst iuktted Cost .�'5-00:b0........_. "1C . .. .. fee .............................................. (Co be paid on filing; this appl.icatiot) 5. if ckaelling, rtudter of ckaelling; units ...?I ... tinbter of ome-fling units on each floor ...:�?l...... 'if garage, rxrrdter of cars ..... J'r............................ 6. If Ixtsioess, connercial or imixted mcupancy, specify riature aril extent of each type of use_1%/1 .. ............. 7.. Dintensions of existing stmaures, if any: Print................ Rear ............... Depth ................. lk:ig)rl' ------------------------- Umber of Stories ...................... Dinrensiorns of sane sCnrcture with alterations or rxklitions: Front ............... Rear ............... Depth .................... tieig;)tl .................... Umber of Stories ............... 8. Diutensiorns of entire new constmctior: Front ................ Rear ............... depth .............. lieiglrl ......................... Nurixer of Stories 9. Size of lot:: Front .................... Rear ..................... Depth .................... 10. Date of Pcrrchase .. �C�,-9.3..... Maw of Former (Mier .G'l4 f6�Y?�...b/o$S�' ?� (,<e 11. Z.ote or use district in which premises are siLvated - ...................................................... 12. ioes proposed construction violate any zoning law, ordiriance or regulation: ................. 13. Will lot be regraded ....../ /r4 ........ Will excess fill be removed from promises: YES NO 14- Names of a-mer of proid ses W1 r/4r:<l./n.8..9,1/.4 9 v.. Acklress e7-.':#/4r,.405 Phone No. Name of Ardritect .................................... Acklress .............................. Phone No. ............. N;rrre of Contractor ................................... Address ...............................Plone No. ............. 15. is this property within 300 feet of a tidal. wetland? * YES .......... NO . 1�..... *IF YM, SOilll ND lum m luf;Lti.S Pizlimrr 1MY 191E MkAJiRIED. PLOT DIAGRAM Locate clearly and distinctly all buildings, x4tetiter existing or proposed, and imlicate all seL—back dimensions Fran property limes. Give street and block mminer or description according to deed, and show street mires and indicate wlteLlwr interior or corner lot.: � UNDERWRITERS CERTIFICATE REQUIRED IVA 1 AP30 5 v L R DAT 0"'CY u PRO ED AaS NOT D IMMEDIATELY FEE• !EEnv ENCLOSE POOL TO CODE �01 1 NOTIFY BUILDING CEP AT UPON COMPLE7104 7'65-1 R02 S AM TO 4- NI FOR THE •-VRr"WA' R" �N HR�Tnouff TIMI A FOLLOLI'ING INSPECTIONS: ` � 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE uruwPANCY 2. INSULATION FRAMING & PLUMBING 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION. & ENERGY s(nnE M. New WNW, CODES. NOT RESPONSIBLE FOR, ss(XAINIX (A' DESIGN OR CONSTRUCUOU ERRORS �....... • •......................Ix!ing duly ;warn, deposes aril says Thal he is the appl.ir.<ntt: (mme of inclividrk-tl. signing ccmtracL) alxnve rnmied, Ikeis Lhe ----Q ?.leu.ce.................... .................................................. (CcmCractor, agent, corporate officer, etc.) of said niter or owtxers, arxl is duly aul.horized to perfotnt or have performed Lhe said work and to nvtke and file t.Itis application; that: all. sCaLettents cotLah-K-d in tams application are Lure Lo the hest of his knowledge aril Ixil.ieH aril that: the work will ie perforntted in Lite mounter set Forth iri Lhe appl.icatiim filed Lherewidt. rrn to before me t.hts . .-.2� .......clay of .. . 19....?... Notary lirblic (� .. ...� ROBERTI. SCOT Jp. (Signature of Appl-icanL) TARY PUBLIC.S e of N.Y. Rlo.4725pS9,Su k co u Term Expires M 31. 19 iueLoA- 0(sc q72 Scl 8 T