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HomeMy WebLinkAbout22980-z f FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24399 , Date JUNE 6, 1996 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1500 MT. BEULAH AVENUE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 51 Block 3 Lot 2.14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16', 1995 pursuant to which Building Permit No. 22980-Z dated AUGUST 30, 1995 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 AN ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & ELIZABETH GREENE (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A v Building Inspecto Rev. 1/81 r- FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24400 Date JUNE 6, 1996 THIS CERTIFIES that the building ALTERATIONS TO ACCESSORY Location of Property 1500 MT. BEULAH AVENUE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 51 Block 3 Lot 2.14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 1995 pursuant to which Building Permit No. 22980-Z dated AUGUST 30, 1995 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 ALTERATIONS TO AN ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to JOHN & ELIZABETH GREENE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. 11027 APRIL 30, 1996 PLUMBERS CERTIFICATION DATED N/A Building Inspecto Rev. 1/81 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. 29283 Z Date APRIL 11, 2003 Permission is hereby granted to: JOHN GREENE 1500 MOUNT BEULAH AVE SOUTHOLD,NY 11971 for CONSTRUCT AN INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. (REPLACES BP #12705-Z) at premises located at 1500 MT BEULAH AVE SOUTHOLD County Tax Map No. 473889 Section 051 Block 0003 Lot No. 002 . 014 pursuant to application dated APRIL 10, 2003 and approved by the Building Inspector to expire on OCTOBER 11, 2004 . Fee $ 150 . 00 Authoriz Signat re Rev. 5/8/02 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) ff� Date........................ .., 19... `'�. Nf° 22980 Z Permission Is hereby grant d to; .. . ....... � ............ ...�.� ... .. .... ..... . !...� ' to ....... `. �........,, >' d ......... ..'I�l,���... ......... .......-: ................. .. ....�-.. �... � ........................... . .... , , -� _ram ............................................ at premises located at... .,,1C., .. . . ......... .••••• •-�!�;.`C' ............... .... .. }............................................ . ............ County Tax Map No. 1000 Section ........ �..... Block..............a..,..... Lot No. .. �.. 1.54 ....... .. pursuant to application dated ..............Old. ` L _�....,,e� ........, and approved by the Building Inspector. Fee$... 7,, ....�. i ........ ..... . ... .......`. .... ... ...... ...... ...... Building Inspector Rev. 6/30/80 O c� Gyc Go Z Town Hall, 53095 Main Road - • Fax (516)765-1823 P. 0. Bo rk 119719 y��l � �.a0� Telephone(516)765-1802 Southold 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 23, 1996 Samuels & Steelman 25235 Main Road Cutchogue, NY 11935 Re: John Greene - SCTM#1000-51-3-2 . 14 Prem: 1500 Mt. Beulah Avenue, Southold To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : ' xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber' Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22980-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT.LLA All 'nj �1 LP �� 4 1-/ Jul A. FIELD INSPECTION REPORT DATE COMMENTS - H FOUNDATTON 'I II FOUNDATION ( D) I►i _____ _______________ ===_________________________ - ROUGH FRAME & I-------�{ - I PLUMBING �j-- -�� ---- INSULATION PER N. Y. STATE ENERGY jj II it--- CODE II u � II H II II jj FINAL ADDITIONAL COMMENTS: � H z a r -------- — — ------ d b� 9 YD r6s-ssoz BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTO ,?10 765-1802 BUILDING DEPT. EICTION [ ] FO DATION iST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & C IMNEY REMARKS: DATE IC INSPECTOR � 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] tFINAL ULATION FRAMING [!� [ ] FIREPLACE & CHIMNEY REMARKS DATE / INSPECTOR ,65_1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION - [ ] FRAMING [ ] FINAL [ ] FIREPLAC 8/CHIMNEY _ REMARKS: DATE � INSPECTOR BOARD OF HEALTH FORM NO. 1 ,/3 SETS OF 'PLetl, S . . . . . . . . . TOWN. OFSOUTHOLD •. ✓SURVEY . . . . . . . . . . . ✓C11ECf: . BUILDING DEPARTMENT • • • • -. - - - • • • • . . . . • TOWN HALL SEPTIC FORM . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL:: 765-1802 NOT I FY CALL Examined . . � 19�`1 MAIL TO . . . . . ����� Approved l.�%� �., 19 . . . Permit No. . . . . . . . . . . . (/ . . . . . . . . .... . Disapproved a/c . . . . . . . . . . . . . . . . . . . . .. a (Building Inspector) AUG 1 6 1995 ;. IC,ATI,ON FOR BUILDING PERMIT Date . . . .%. 19c�� INSTRUCTIONS i a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 j ets 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 adjoiriing'premises or public streets )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- . :anon. 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. -he applicant agrees to comply with all applicable laws, ordinances, build•ng code, sing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary i bons. 44 ignature f applicant, or name, if a corporation) „ (Mailing address of applicant) /�3S Mate whether applicant is owner, lessee, agent, architect, engineer, .general, contractor, electrician, plumber or builder. : . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . ... . . . . . .. . . . . . . . . . ... . . . . . . . ... J , ,lame of owner of premises (as on the tax roll or latest deed). f applicant is a corporation, signature of duly authorized officer. t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's,License No. . . . . . . . . . . . . . . . . . . . . . . . .Plumber's License No. . Electrician's License No. Other Trade's License No. . . .` . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . �. . . . . . . . . . . 'Block . . .U�. . . ... . . . . . . . ....Lo.t . . ,2.' / - . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / .! ,rl/e'� , ./G /%� ,C11�. . . . : . . . . . . . . b. Intended use and occupancy . 3. Nature of work (check which applicable): New Building .. : . . . . . . . .. Addition . . . . . . . Alteration Repair l Rem . . . . . . . . . . . . . . ova . . . . . . Demolition _ .. .. . . . . . . . . . . . . . Other Work (Description) 4. Estimated Cost . . . . ��� �9O©. . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . .". . . . . . , , , If garage, number of cars . . . . . . Z . . , , . . , , 6. If business, commercial or mixed occupancy, specify"nature and extent of each type of use . . . . . . . � • . 7.. Dimensions of existing structures, if any: Front .r �f. �c Rear . �.f��—?. . . . Depth Y.?-.F�, , . E7. Height . US, ?=.eqf:/ Number of Stories . . ..__Z . . . . . .. . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front �.1�.`7 . . . . Rear Depth Height . 3 %z� �. : . Number of Stories . :? . . . . . . ..,: . _ 8. Dimensions of entire new construction:- Front /,�?% �, Rear . . .lv�c` `� Depth Height . .. •`AFT. Number of Stories . . . . . . l 9. Size of lot: Front . . . . r` �- �. .��. . . Rear . . � :�` . . . . . . Depth 2/�� �Z. .%-��7 . . . . 10. Date of Purchase .. . . . . . . .... . . . . . . . . Name of Former Owner . ... . . ... . . . . . . . . . . . . . . . . . . . . 1 l. Zone or use district-in which premises are situated . . . . 14._ G . . . . . . . . . . . . . . 12. Does proposed construction violate-any zoning law, ordinance or regulation: . . 13. Will lot be regraded A) : . . :. . . . . . . . . Will excess fill be removed from premises: •... . ..Yes • o" 14. Name of Owner of premises �� -t• 'Address 4*-15 63 s� v.y. t�zi phone No. Name of Architect . , , , , , , Address `�2 `?!�!�!`'. ':/,/y3 phone No. .%'3��(n�o5• . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . , . . . . . . Phone No. 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. STATE OF NEW YORK, S.S COUNTY O � � • . . . . . . . . . . . . . . . . . being'duly sworn, deposes and says that he' 'is the applicant (Nam f individual signing contract) zbove named. leis the . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) if 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 .vork will be performed in the manner set forth in the application filed therewith. ;worn to before me this /.1Z . . . . . . . . . . .day of. 19 lotary PublGIi� . . . . . . ._. . . . . . County UNA FOROSICH l \ �G •� �i�i7!� —�. . . . . . . . . . . . Notary Pubk State of Now York No.4985683,SdokCour►ty ..(Signature of applicant) TOM DO"Sept.3-19,;� .._. ....... _.... ..:ELECTRICAL INSTECTION SERVICE INC -375 DUNTONAVENUE .. ....:.. _,...:. : _...... . EAST PATCHOGUE,NEW YORK 11772....... .::..:,.. 286-6642....... _.. . .... ... 11027_.. _... DATE:.. ........4/3 0/9 6.............:......... .... . . . .. .. -APPLICATION No:ON FILE _. ................ OuAGE: : SUTHOLD O SOUTHOLD TOWN ADDRESS: 1200 MOUNT RFULAHAVF.NU/j........ . _. ..........__ ....................... .. .... ...... ......... ....: . ... .... ....... ISSUED TO- JOHN GREENE INTRODUCED BY.,_ LADEMANNELECTRICINC... ....... . was examined on 4-30-96 and found to be in compliance with the National Electrical Code . ... .............. .... ...................... .. ....... ..... .. LOCATION: Base.. I st ')X 2nd 3rd Attic ._.....Det.Garage.. ...... ...... .. . Hot Tub .... .... .........pool;.. _:.. ...... ---- ---- ---------- ------------- - ---------- ......... .. ......... ...... . ............ . ..... .. ..._..::. . SWITCHES RECEPTACLES FIXTURES IHEATERS FANS GF.I . AIR COND. ......... DISHWASHER DRYER CLOTHES WASH., GAR.DISA I.RANGE., OVEN SMOKE DETECTOR FURNACE 01L I GAS I CIR. MOTORS I BELL TRAN SERVICE DISCONNECT ... :.. ..... .... ....:.. ........::.,...:. ....... ... ...... _.. ........... ...... .. PHASE ... ... .. .. OTHER .. ................... . EQUIPMENT OUTSIDE,RES. 1 DIA0dER... .. . ......... .... 14 oKW ELECTRIC HEAT._..::....... 1-.500KW ELECTRIC HEAT ..... .... IUGO S. SURDO PRESIDL'7JT BUILDING PERMIT NO.. .... This certifica(e must not be elterecl in any manner.... . impedors may be idmtified 6y their cted.6.ts BLUE ORIGINAL. YELLOW COPY.....,PINK COPY OFFICE -)aa, RRry� 4n2.r )I f (� V r o rm Iv o. o 10 ( � l5 U v TOWN; OF SOU T HOLD BtiiLDIVG DEPARTMENT ry MAY , TOWN HALL i 765-1802 I APPLICATION FOR CERT177CAT7 OF OCCUPANCY This application must be filled in bj7 rvpewriter OR ink and submitted to the buildina inspector wit: the following: for new building or new use: 1 . final survey of 'JroDerz7 with accurate 'Location o_ all buildings, DrODertZ lines, Streets, and unusual natural or =ograpnic features. veinal 'ADDrovai from Health Dent. of water supply and Sewerage-disDosal(S-9 form) . 3. ADDroval 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 1;0 lead. �. Commercial building, industrial building, mult'-liDle residences and siml a'_ Du-i dings and installations, certi=irate of Code Compliance from architect or engineer responsible for the building. 6. Submi= Planning Board Approval of completed Site Alan requirements. 6. .77 existinc buildings (prior to April 9, 1957) non-conforming uses, or buildings and "Dre-existin;" land uses: i Accurate survev of proDerty show-in' all DroDerty lines, stre_',s, `'.building and unusual natural or toDograDnic features. 2. oronerlJ completed aDDllcatlon and a consent t0 inspect Si by the aDD licant. 1.f a Certificate of Occupancy' 1S denied, the Building 1nSDeC dshall state the reasons tnerefor ir writing to the applicant. 1 . Certificate of Occupancy - New dwelling $25.00, Addi=ions t0 dwelling $25.00 , Alterations to dwelling S2J.00. Swimming pool S25.00, Accessory. building S25.00, Additions to accessory building `25.00. Businesses S50.00. 2. Certiiicate of Occupancy% on Pre-existing Buildinz- - SIOO.00 -. Copy of Certificate Of Occupancy - .25C. 4. LDdated Certi=irate of Occupancy - S50.00 J. TemDorary Certi=irate Of. Occupancv - Residential S1J.00, Commercial S15.00 Date . . . . .1- . . . . . . . . . . . . . . . . . . . . . ,ew Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . vocation of ProDertv. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . House No. / Street I A Hamlet-)nwer or Owners of Proper--T Q�I,,I - - . !�/ el . . . s�j lY. . . . . . . . . �y . . . �yy �7 ounty Tax dap No 1000, Section. . . f. . . . . . .B1ock. . � . . . . . . . .Lot. . p��. � . . . . . . . . . . . . . Subdivision.//. .Q. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Miiap. . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . 7 prm1.- i10.�`''. ! D _ .Date O permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . :ealth Dept. approval. . . . . . . . . . . . . . . . . . . . . . . . . .underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . 'lanniag Board AI1Drovai. . . . . . . . . . . . . . . . . . . . . . . . :equeSt for: TemDorary Certificate.. . . . . . . . . . . "inal Certicate. . . . . . . . . . . ee Submitted: S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FPLICA11. -2D 5- f--1 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ 441-NAL [ ] FIREPLACE & CHIMNEY .REMARKS: Ary 4z� DATE 9� IN8PECT0 765-1802 BUILDING DEPT. .INSPECTION [ ] FOUNDATION 1ST' [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION C ] FRAMING . [ ] FINAL REMARKS. 6-1 DATE �� INSPECTORC�� suu.uING DEPT. INSPECTION [ ] FOUNDATION 18T [ ] ROUGH PLBfi. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ Q��Z + /J Goo �O REMARKS: �C � DATE � � INSPECTO ., n FIELD ,LrlWrL;lION DATE COMMENTS Q3 FOUNDATION ( 1st) - I cw FOUNDATION ( 2nd ) mp 2 . - z 0 ROUGH FRAME & PLUMBING r- • C t� ir -_= to 3 . - � INSULATION. PER N . Y. y STATE ENERGY CODE r 4 , � 'y 4 FINAL z ADDITIONAL COMMENTS : m IS � O z � x a • r ' x - d r� y FORM NO. 1 TOWN'OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . O: " . ?� ., 1914% J 7 0 Application No. . . . . . . . . . . . . . . . . . Approved .4 c .�� ., 19 Permit No. � ��� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT �`. 10 1 Date . . . . . . . . INSTRUCTIONS A., This.application must be .completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 demolifon, as.herein described., The applicant agrees to comply with all applicable laws, ordinances, build' g code, ho7icodde,'�and regulations, and to admit authorized inspectors on premises and in buildings.for necessary ins eon - -- II (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee agent,�rarchitectengineer, -general contractor, electrician, plumber or builder. Name of owner of premises ?`. `-`-. . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . ." 7. . . . . . . . __ Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . Other Trade's License No. S60 1. Location of land on which proposed work will be done. F.r S. .�f1�'^' ' vL�.. ...`. . .. .. . . � 9. . . . . . . . . . . . . . . . . . .��.?t�.4�. . : . . . . Uv�U'.`). . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . .. Block . . . Lot . % \. . .a: �.? . . . . 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 .2 2., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . 11An b. Intended use and occupancy . �. . . . r. � �'D. L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check whicb applicable): New Building ./Pauli. . . Addition . . . . . . . . . . Alteration . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . .b.��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee .�.KS .�. . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,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 ._ .$S:. . . . . . . . Rear . . . ^- . . . . . . . . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . .L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . Rear . . . . �`-Q. . . . . . . . Depth . . .� . . . . . . . . . Height . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . 0-�;E. . . . . . . . . . . . . . . Rear . . . . . K. . . . . . . . . . . . . . . Depth . ;iF. . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . .. . . . . ... . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . .. . . . . . . . . . . �. . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removee from premises: No �! . rFU«� -aLi?h 14. Name of Owner of premises�z��h �??��!�:�. . . . . . :Address .T 1���. . . . #'hone No. . . . . . . . . . . . . Name of Architect Me. . . . . . . Address/�,1. . �!E.i'r ,titi!�. . Phone No.r:�)\/1 . . . . . . . Name of Contractor . . .%. .` . . . Address Phone No. .' . . . . 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. � G Q (s-Nf A'JG F. FSF�. 7 +� fj y X . STATE OF NEW�YOR S.S COUNTY OF . . . . . A(4 .V.:( ..k. . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�1 \. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, rporate 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. - Sworn to before me this . . . . . . . .�.�. . . . . .day of. . .�, . C .f . . . . . . . .. 1-C� . . Notary Public, !� :�'' �r .• -!`' �. County , F2AN[FS MIE�51'1' \ 40TA4Y FUWC.State of hey' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . caoilllea In S°"°'k c°""`; (Signature of applicant) 40. 57-4649993 -- �Srnm4tlif F+rir�c MorcA !$1ti — a. ., — 4 .....:M._ y� t4 Y { { - 3 _ � Y r� 0 fl ,: S U �`^�� ! 11 . - �R � , ., A�,lD i. . r is tSuff r.'Q, ta►x' Pa rc�I `,, — . I I I - I I I I L— I � p * 11 11 447- t.. 1. �-- -- � LDOQ -051 3- Pt, a 1 Alz€s) 40,©OP Js, r 7; . ' � - . { ' 1. I' y �► urarcn ,• — �NA11TMp�►ZEq ALTE2ATION OR ADt)ITfOh '"- uQrQ i �e � • �1G ��� �;J . t Cb ctri[d'. #e� SGt1��J?C� �01I;It > �:k *�`.-. T03THK SU VEt {5 A VIOLATION Oi , .y ,(t +�+ ,. '�► .. 'EDUCA,k'tt-:.AS 4Q edl1 d�l� l►IV_.,V 1. ��l,�. GA?DES CF T, .r °:AnINc L/r1�f �M �.,�' l�,� �+ "t t . �" . "M THE LA }::':: . i A v, L/i/ .0 ICE A VA;Ai - N OUAhA1?f S {( ,{ 4__ AFL RUN - t. - r A ONIY T TH. : �u r! C.A. idr ii!(YEY„ 4t(.'I�1��1� 4 � �• Qrw; I li'PRE A [t., A C H.� I. tI- tk, THE ' � `, 11TLE C0t1FA!:i A Aw LY ANO �*�� p� 1 �' �� IFNCING 1�5TI1U7,� ' .:, 1 11;(t� AND •C THE.ASSIGFdC S F 11; 1�DIpK,-M1ST1- '� ( �� �., 1 ON:GUA.AK S At;C I JT pLANS,ERAB4- V.IL , 3 ADDITIONAL INSTITUTIONS C SUBSEQU11 ENT. Rt. ;' L®7" 6 I✓�`T L, L/L dI N I ;r:dVl s f, 1 J. i C. .1L/ cB, D,t�J7 Q a�'; r I 1-1 I` { �q iJ.. Sf OafD I. .Zl 22 ..^ 11, ' F S � I'i N ��, �� I y ' } 6o�;r - , - I . �' z 3fy o �' I �o_ �.:: � .� � L '� - � �,J ~ g -� s ' J •i I z ' qt a k:' car�csllrrv� . r , 9Q 1W �Q ` _ �11 l�� '� -t 4} +4 i 4�'r' l C;L r' . . , , U L ;�' ' a� c �� '{{yy i ,�i ,,':, I, , . . I ., .�,- v- � � ." I L -, I 1, -L'I I.�l. ,.I I- �.-,- ; ,�-���:� , ,. I L I . L,_, � ['-1 I, - 8$ O h. 1Sar ;,A,,-o' Ikoc , 1- 'd, . . . — �— — A VENUE 50 LOT . ro Subdivision - "MOUNT BEULAH ACRES" V SUFFOLK CO. FILE NO. 6984 , 219.22' N. 88°04'50' E. p C 0 O CA �ro� sdnwev ��O C .o� C y, Z 0.0'E. sonc. p a N �o rift t, n � 493' i4.5�' r O N � Cont. drivLp e 26.3 0 b A ; NFIE - - - - - n' — O � CA O C I 4 ra y. 215.66' S. 88'04'50' W. , N/O/F BARBARA KOCH SURVEY FOR JOHN & ELIZABETH JANE GREENE = AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 51- 03 - 2.14 Scale: 1" = 40' May 7, 1996 CERTIFIED; TO .. :. JOHN,GREENE: ELIZABETH: GREENE Rt OF N��, T, M6rrc , ARf'A 40,010 sq ft. 49b16v,�r �,. ANY,ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION Sv�J OF:SECTLON 7209 OF THE NEW YORK STATE EDUCATION LAW, , EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS .Y.S. L/C. NO. 496/8 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY/F SAID MAP OR-COPIES BEAR- THE IMPRESSED SEAL. OF THE SURVEYOR WHOSE SIGNA?URE APPEARS HEREON, PECONIC RVtYORS, P.C. ADDITTONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' (5/6) 765 - 5020 09 MUST,BE USED;BY ANY AND ALL SURVEYORS UTILIZING A COPY P. O. BOX OF ANOTHER SURVEYORS MAP. TERMS SUCH AS 'INSPECTED' AND 1230 TRAVELER STREET BROUGHT-TO=DATE'ARE NOT IN COMPLIANCE WITH THE LAW. SOUTHOLD, N.Y. 1197/ 96 - 162 a , a n a , -- - ., .. } .,x , •� Y"F -� 17 �' It7`70777777"77 ^`z' 1711777 �", L. k R . . ,. , �, , r , ... :. , , .,, r ,. .. `,Y, , t. F : '1 I. 11 , �1 ,r ram+ ,�'toxic -�Ibl ,. e^ ,• ..;ti. -A+ , .. w s r' , .. r - 011, r ,. - _ _ < A 1, s!x _ 11 _ , - v , r - _ � 8 r: , . f 5 v� , S o�45 0 01 A� � I . 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N 1 I # I y ST �p ,� I . < {xa 'its. .IC - , 1. ' . \ C'A.T� T`�1U ST-. i "3 {, - I��- Ny3 34 } TtIM � _''-- -- 54 x Cv `.i=R.lE7 B17 1 �° , S)�L.�-GLOS1hl ' 017 3-1 :." . ��:�,,!�: �:,. _:'L . -'. I 11 : _;I//''/ - __ --: " , :, SITE sf I . I I , 11 ,�"� . ., �� I. . ,_. - .: ,-. 1 � i � � I ! - . 1 : . � I . L. . I . .., I .I, - ,.. I - I I - I 1 . . , \ �\,�, , , �F__ = ­1�i � � . 11 . % � I I � i t _� I � G , `�� I f77 i I . / ,' . .1 . �­* . � ir� � . I . 7. ,.; 90AN I�n - T?.,co INC. TO: : �.,�GIA.. ' : r ; roject 11 1�1D RS ANS q5 ' C • ! I' SCTM # 1000 51 3 2.14 , - W I N DOW 4Tt2 Z422 i ; , Drawn B . i _ I Y� , J I w ►Nr :� c ? , ^ - I \ I \, H� u-r . { I ; P RTY: 1500 Mount Beulah Avenue I I Q , ROPE �.; I t �.X 12 iOR. ?21i_L. 1 �� ,,. ,., x ; ___ ___..._. . .�_.-_.... G S - , +\ ; ADDRESS Southold N.Y. 11971 y 16 T M-- J , \ l \/ i Checked B k' jp-.t , 'it _ �'t t. - 1 i ' i _ ,. `t,- � Date: 3 i N I' 1 k ! ,, r ,# I 4-. I I� J + . . \ , OWNER: John Greene and / 5. } ;• fI / . �` 1 i :: ,, I i I e reene:3; 1. li beth an G t � . i r 1 I E za J ,, Scal . I A 9 J 0 r� , 1 E,� T 1 t t. # 7B r treat A East 63 d`,: 1 5 a S i 2 E �- i P y � L, { , N / �. 1 . K, �LL / . i _ - I i. -_. i 1 \ 10021\ York, N.Y.�'.�. ��� i I New Y Y N-'- M - IJ Y. r ,,`. ILt:....D 2 4 Sheet Title: s :a 3� , , . a.i I1..L.. - _.___.__ . ;r -- - �N Y - -}. . 1 _ p. SITE ,. I i I , r �. f I Ai.. w I. s 1.. ,/ I :>• # t i SITE: 40,009 sq. ft. .t . C \ P i PL AN N fl . 1 (/� i p , l ?ZO 5, I AREA , << VCD N . i C a: {f ,,_'.,�_ sPHA, T 1=iSNINC�LZ:5 ► TE '. �� ;ON'.30 s3i1iLQ I~1C. , :3 ,, \ SURVEYOR: Roderick Van Tuyl f. ; -s I 1 i L. C7 % I i . s N T rra-rc.:N D E TA I. �. LS ': ��Ap�12.•. . RFIMOV'� �. �: I . Greenport, N.Y. .11944 - ;, _ _ � I- ,.,_ -� I 1-! N �L�S bN A;2 A �. 5 I T1N 1t' r,SY=- License # I_S 25626 s . •,XIS �Da'F:SN L _ L t,e t �. w: _. __ _____ _ ._ C3 _ . _ _ ��I T . 1 / ! 1 a� 4 Dat ed: 1 3 s�P` kj! _ 3 . . . 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