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Home My WebLink About34530-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector. Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY i No: Z-33630 Date: 04/01/09 THIS CERTIFIES that the building ADDITIONS Location of Property: 875 HENRY'S LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 74 Block 1 Lot 15 i Subdivision Filed Map No- Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 25, 20.09 pursuant to which Building Permit No_ 34530-Z dated MARCH 25, 2009 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 SUNROOM AND DECK ADDITIONS, WITH ABOVE GROUND SWIMMING POOL & FENCE TO CODE,JTO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN M SR & LAURA C HELF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT' OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ . 1077725 09/11/02 PLUMBERS CERTIFICATION DATED N/A A the ized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the.following: A. For new building or new use: 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 2/10 of 1%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: 1. 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 L 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. New Construction: Old or Pre-existing Building: (check one) .Location of Property: House No. // Street Hamlet Owner or Owners of Property: # Suffolk County Tax Map No 1000, Section T Block / Lot Subdivision Filed Map. Lot: Permit No. �3 Date of Permit. 3 2 I�o' Applicant: `�D/`A� C Health Dept.Approval: "�- Underwriters Approval: �� /ydt/ 1/L' Planning Board Approval: Request for: . Temporary Certificate Final Certificate: check one q P �' ( ) Fee Submitted: $ ? � cz) -j 3� � *Appficant Si nature I;l's"''EcTiu;l JJDATE C0il,0if N T S F0U14DATI-ON ( 1st ) c ' FOUNDATION ( 2nd ) 2 . 0 ROUGH FRAME & .PLUMBING 3 . . x on INSULATION PER N . Y. • • H STATE ENERGY CODE 4 . ��H FIidAL / Co 1 E . z ADDITIONAL COMMENTS : x 4 ra � f�1 H � 7p F-1 � c G z 1 • x r �H d H C 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 C� 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 C5 5 JOHN HELF JOHN M HELF e 5 HENRY'S875 LANE 875 HENRYS PECONIC,NY 119 8 PECON C, NYL1958 5 5 55 5 Located at 875 HENRYS LANE PECONIC, NY 11958 C 5 5 Application Number: 1077725 Certificate Number. 1077725 5 5 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 5 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring,described below, located in/on the premises at: 5 5 First Floor,Outside, 5 5 5 r55 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5 j found to be in compliance therewith on the llth Day of September,2002. 5 5 Name OTY Rate Rating Circuit Tyne 5 5 Additional Charges 5 FINALED ON 9/11/02 5 5 BY INSPECT R.RICBERT 5 5 Wiring and Devices 5 5 Outlet 2 Fixture 5 5 Receptacle 6 General Purpose 5 Switch 3 General Purpose 5 5 Fixture 2 Incandescent 5 5 Paddle Fan 1 5 5 5 5 5 5 5 5 . 5 5 5 Seal 5 5 5 5 1 of 1 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 o ��E, REUR��1�P��aaEPLPLPLp�� MI THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8072028 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date NUGUST 13,1998 Application No. on file 16503798/98 H 060972 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOHN & LAURA I-iELF, 875 HENRY LANE, PECONIC, NY in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on ` UL11 30,1998 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENTI FLUORESCENT I OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: Si+1IMING POOL-1 ME CLOG{—AMP.12�0-1 G.F.C.I-1 JOHN & LAURA HELP L 875 HENRY'S LANE PECONIC, NY, 11958 GENERAL MANAGER 11 Per phis 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. FORM NO 3 r 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. ' 34530 Z Date MARCH 25, 2009 Permission is hereby granted to: JOHN M SR & LAURA C HELF 875 HENRYS LA PECONIC,NY 11958 for SUNROOM POOL & DECK ADDITION AS APPLIED FOR. REPLACES EXPIRED BP $# 28627 '� at premises located at 875 HENRY' S LA PECONIC County Tax Map No. 473889 Section 074 Block 0001 Lot No. 015 pursuant to application dates] MARCH 25, 2009 and approved by the Building Inspector to expire on SEPTEMBER 2 Fee $ 316 . 20 Aut ized gig n ure ORIGINAL 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) PERMIT NO. 28627 Z Date AUGUST 5, 2002 Permission is hereby granted to: JOHN M SR & LAURA C HELF 875 HENRYS LA PECONIC,NY 11958 for SUNROOM, POOL AND DECK ADDITION AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED BUILDING PERMIT # 24386Z at premises located at 875 HENRY' S LA PECONIC County Tax Map No. 473889 Section 074 Block 0001 Lot No. 015 pursuant to application dated AUGUST 5, 2002 and approved by the Building Inspector to expire on FEBRUARY 5, 2004 . Fee $ 316 . 20 or' d Signa ure ORIGINAL Rev. 5/8/02 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 i COMPLETION OF THE WORK AUTHORIZED) I� N° 2*6 Z Date ............. .................................. 19.27 Permission is hereby granted to: .T. ..... ................. .................... .,,� � ...... �. .16... .�� ', ............ ....... PL ... ... . ............et� ........&.... `f. . ......r. .. .. ........ ..s. ..........`` P.. ............. ............ . . .... ..... .... .�:........ ..... ........ . .... .......... . ..... .......A'�Af .. .. .. ..... . . ... at premises located at............... ..../ °' ' ...............� ..............�.�..G County Tax Map No. 1000 Section ....Zi—1 .......... Block .....21..... Lot No. ..../ ....... pursuant to application dated ....... ' f%". � �. , 19. Z, and approved by the ...... .... ........... ... Building Inspector. Fee S. �: ..... .... . ... ..... ..... ........... uild' g Inspector Rev. 6/30/80 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FgUNDATION 2ND [ ] INSULATION [v] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS DATE 713 III.'q'8 INSPECTOR 76s-iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: roe DATE OB /S a2- INSPECTOR_Z�2U� I+ktAitii—tTfr tlh Airl 11 :1 SETS' OF l'I.ANS . . . . . . . . . . . . . . . TOWN OF S0UTI101.1) BUILDING DI,,PARTMENT ('HECK _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • . - - • . - - - 9 '( TOWN IIAI,1. r20P•t1 r rnua( SiOUTI1( 1.1), N.Y. 1 197 1 TEL: '165- 11102 NOTIFY: F.x;IIIIi,x>d......?/w. 19.�., - f1A11. TO . . . . . . . . . . . . . . . . . . . . Apinove(I••• �731 t 19.(.� 1'ernait Nu. . _. . �-✓. I)is;Ip nuved n/c: ... ............ ......... .......... _.__ . .. ... ..._. .. ... . ....._...._. . _. . ..... . .......... ...................... ........... .... OkilWill .;Ix, ov i Z I.// APPLICATION FOR If(111,UiNC PEAMI.1' �1 I NSTRUCI'I MIS ;r. 1LIi:; npplicn cx nr e LiI If-, h cotip el fi eIy llecl in by lyIw.wriLer or iunlc i aIKI sulani(IRd to the Ikaildinl, InsIxvtor will+ 1 :;c•l:; of plans, accurate blot: plan to scale. Fee according, Lo schedule. h. Plot: plan la)(minl; location of lot: nlKI of Ixlildinl;s on prc,ni,es, relatAou,iaip to mijoiniol), prc,ni:,r-s or InIh) is stwels Or ao-ens, arKI giviol, a detailed descriI)Lion of Inyool: of prolxrrcy must. IM ch-rnrn on I.h(-- dinp,rr.ncAIICII i:) twin of ;Ippl i(-;Ilion_ c _ 'ILe Milk covered by this applicaLion rr)y 00t: Ile ccxlnx:nced Ixfore isc;unnce of Ikaildill I'ernlit. d. (Ilxm approval of this ;I(rplicaLiOo, the !k)ildinl, lospOCLOI. will issue a Mildinl, Permit to the applicant. Such Ix:anli(: shall I)C Ikel)t- (xI Ole premises arvnilahle for inslx.cl:icni Lhl-Ooj)I(A;t the e_ Pk) buildiog :;bill lxi occupied or used in whole or in part: for any Ixarl,o,e,%-AmLever until a (ercificale. of Occ•upalwy ,hall. hnve lwen !,ranked by the Iklilding lospector. AI'I'1.1(;NHON IS III.Wi11Y JW)E_Lo the Ik)ilding, 1)elnirtuxnl for the ismiance of a lklildinf, Permit lxar,unnt to the Ikli ldinl, 7A)ne Ordinaix:e of the T(-Xna of S(xalhold, SAaf.follc CA)-onLy, New Yorlc, and ol.her applicable haws, Ordinm)ce:) or• IZ-lpllat:icnaa, for LIK: const-nictAcm of Wilding;:;, w1dil:ious or alterations, or- for rc.vuval or dc-imliciou, n, liviein described. •Ills• oppl icnnt allrees to cl-vaply with all nppI ica)hle I'mm, ordin;awes, Ixli ldinl, c(xle, 1Kxasing, axle, mxl rel,ulaticnl9, n,xl Lo nAuil: ;n)Lhorized inslxx:Lors oo premises DIKI in Inlildinl, for necessary inspecticn)s. ••c•. iM1 ,.qy; .q p _. � .. ......... . . . ........... . .. or' nnnr. if: n corlxrlal.ion) t-►-• -' > address of a pi icant.) a. i - t.il.t t!f'�.tir CtE�l J't•..t�� ci 4� ,Its :' i Y' , Stale i,if`IlilliO.r }ilryff':ic�tnL+i ,'c7waxir 'le:; ee, al;enl, archit.ec.l, enl;iawer, l;eapral conLraccor, electrician, p1mber or Inlild(er. 0. kfElL '.•+F� .;`� 1 • 7(.;if`iur�!}t'. ..... . .... ................ .. ..... .. ... ... . .. .. .... t/ L k' l, S- �c7 c�N:Mrr! n iYiIiA. _�� ratr 'l ;c�F'yr' / � -. . .'... .... _. .... 1 .............. ... . ... ... . . t•;;;;a ;: (as ('At lh(a tax Io*II or lale:,l deed) II' npplri''ctiial�: is n 'c;S�rjx�rnl tin, nigimutmt of duly officer. ................le- cif. cos w ):� iCCrcer Iklllder!; License Nn. ......................... PItIIbers I,icc:alse No. .......... .... .... ....... Elect ricimm license Nu. ..................... Other Ti-mW s l,icen,e No. .................... !. Irx•alloo of rood cm tAaich prolx),ecl tank will I)e do,x�.... ... ............ .. .. .... ................... . . .. ....... ..... rr7 /* ....... ... ... ....... .... Ikxl^e hknlx'r- `il.reeL ...-.- .. 14t,IileC (knnal.y Tax Kip Pk). ��(x)Q� SceL iocl ...�7�: D�.. Iil cxac �/• ��. ._.. .. .OiS:fJO S(dKlivi,iun ... . �L ..1:/1h1r- ... ... Filed R•Ip Nu_ i,ol' ............... 1. Slnce exi,t:inq use alxl ac:culk)a►cs /Off pr(anire, nlKI intelxled use aril mc-ti ancy of propo.wd consl mAJon: ;a. ExintAnl, use nrxl occ:ul):ux:y ._r).FS! pFa/c' ........ ........................... I.. . ... ....... h. lilt one aaxl cx:(a)l)orx:y its 'l(� ....0(... `T � G/� 1. Rllur(! of %Aril( (dwck Olifll sl 'IIi(mile Fk,� Itetlldin. . . ... . .. . .Irt ): 6 n(Idilinn .. . .... A arfil.ion . . • II,aulir Ik,ixilil.ioo Ullter lhrtic L .�� •Y33irl/E,C�cc�//(/JJ (DuacvI Jill iCHI) D cK illiitl(!(l Coal ..��v�. 7�r?cla �07�U f(:(! .. 0o Ix! Iwid on H I inf, lllia Islip] Ical:lon) i. II` (kx!Ilinl,, Ieufler of (h4ei'liits unila .. . . . .. ... .. Iknlx!I- of A'K!IIinl, unil'n on eorll flcxrr II' I;iuiy;c, Iitnlwr of (;sua .... ... . . . .. . .. . . .. .. . ... . . . ... .... . . . 6. I f litudiwns, c(imif rc]nl or mixed r.x:cuparx:y, 'six c:i l'y "'I7t.""! "I'll exf(:uC of each I.ylx! of. line...... .. .. . . .. .. ... . .. !. Iliux:n:Il(xis of exlnl lnf, aLrtuaure!ei, II` ally: VI-orll .. . . ... .. . Rear .7U'.L..... . . . ....... .... . .. . . Iknl>er of Slorir:n . . .�- . .... . . . . . IlillKnud(Nls of sixix! al'rtx(lire with ollera(.1ona or suldiCion::: I'ronl ...?�.L .. . .. .. hear .��:? 1k:lllIt ... . Vic. 14F..... .... 1k If;lil: Iknf>er of :il'orien ... ........ II. Ilillc ludoils of: aril he Ix!(! ccxl:sl'ttu:l:icxl: FI(xIl' . .C.. . . . . ... . I((!;r . .K/�`,�'. ...... ... ...... . ..... . Ralifter- of: :ilcrt ]e!:I . .. .r.. . .. .. .... .. . .. 9. ;iize ol: lot : Frrxil: 5E_'•Iv / K v 10. Ilirl c of flu clioac f�/f :J�iC.Cz G� S2 .............. ....... I(ixtx! of: F(Iitix:I' (kJix!t- .. .. . ... . . . .... ... . . .... .:. .. .. ... . . . . . . I I. :"Hu! or uaa dlalricl: in tAtich prunisea .ire si.(oal(rcl .. .. JCS%: .. /000 12. Ikx::; ptol)0aed ccxial itx:1-loo violiat! Tiny zoldol, low, ord'Inalwo or rel,lll lit,loll: . R. . I'). Ili II IoY Ix! iegrxk!d ....AVi7. ....... ... Will exxreaa fill Ix! ruix-rved frcxn pron]sea: Y13fi Ih . Nixlx!n of Owlwr of prollifen i/°fi`xJ CAzr.rr9 A(klrean .. .... . . ... . L/l.1rE 111orx! 1kI. 7!S-.SG.IS' Him! of: Ardiilecl ..... ... ....... ... .. ... ... .. ... . .... Acllivea:I 151(rlu: tkr. tlixlx! of: 0xll rncl or ... wrvE�.. ..... ....... ..... . Ad(h eas ... • . ... . . . ... .... .. 11xxk! 1kr. .... . .. . . . . . . Is Illis Illolier(y within 3(X) feel: of a lidnl IJel:IfilxT? * YI"i 1/ .. ,. III? YI .(i, :ifAfllt(lll) 'ICXJII 'll(ll;ill l!`i 19?I4•II'1' my IV,? I(vipll(lm. PLOT I)I ACI(AI.1 I(x:slle clenrly slixl (lisl:il)cl:ly fill Inli]dlnl;e, Olelher exi"'0118 or prolxrsed, filxl iixlicnl:e all acC-hnrk�diuir:.ntsirnl!l fi(rn prnlx:Ily IIIiC;I. (71ve al:riee:l: olxl him lxillx!r or desc.1-iplion according fo deed;-alul alxxa alreel: n:nx!n nlicl ilxlif.nlr! tAu:lhin inlr!t for or corru!r loll. ,•�.y:. APPROVED AS NOSED DATE: B.P.0_+ � FEE �� BYc NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: •1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & FLUMM46 3. INSULATION 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION m ENERGY CODES. NOT RESPONSIBLE FOR !;I'A'rn: (11-" IV.41 Yt)lac, DESIGN OR CONSTRUCTION ERRORS (Willy (X. .. . .. . . . . .. . . . . . . . . .... �R. .. . . . . . . . . . . . . . . . . . .h(:infl (Italy :Zxlrn, delx)sea soul anyts lllnl: he I;I the nlgrllfunl (Plinx: ul ilxlividunl siglihi, coolracf itlNrvc niiilx•(I, ,Q 11 III(! . . .. .�!1II-IC- .. . . . . ..... . .. . .. . . . . . . . . . . . . . .. (('(nllrn(:lor, nf,aol:, collmi'ale officer, ol` anitl OIJIN!1 (It' 1)<Jlxlra, nlxl is duly sIi-lhorized to Ix!t roll" of ""IV(! Ix!I'I(rllIX!d the nfiid %A)1'1( (Ilxl to azll((, atxl I il(! Alin rllg)liffilion; Ilml rill Walcamllln conlaimil in Illia oppli(:;Iliost ale Itlw to. Ill(! hrnl. of liin Iclxn+ledg(! Alin Ix!li(!I; MINI Iliill the in)Ili will IN! lx!lfonlx!d in lilt! octnn(!I- ael: forth ill the applicnl.ioo filed Illetcwtill►. :k.vni lm!IuI(! law! Ihia . .I. )YCEM.WI'L*KINS (I( I). .. . Ik -.W.. I il ory 111h1 It: . ... /��' Sigivittive of: Alit rail.) J Notary Public,State of Now York No.4952246,Suffolk Court Term Expires June 12,19 I;ol(M No. I :)' SINS OIL PLANS . . . . . • . . . . • . . . . L� }ivlJ fLS� 'l li �•,Y=a__ _� �_� l; I'owN or SOUT1101.1) SURvrY . . ... . . . . . . . . . . . . . . . . . . • . qIIUI.Li)1NG - - - - - - - - - - - - - - - - - - - - - - - - - 2 9 hJ7 MWN IiAI.i. rnrrr rnnr( , - Sol)'1'I1pi.11, N-Y- 11971 -- _' '--•- � '1'I'si.: 765- I002 HOT[FY: - CA).1. . . . . . . . . . . . . . . . . . . 17.x:wniIKA......� ..., 19.V MAL1. TO: . . . . . . . . . . . . . . . . . . . . Approved.... / ..._., 19.�.� Permit No. ..........I......................... 1)innilwovecl .1/(. ............... ................... .................................... ....................................... ............... ......... �._.. (Ik1i Iclin, I .ilx> . .or) APPI.iCATION FOR IIUII.I)iNG L'i;RM1T i)a L e.,wlS �. , 19 �. 1 NSTRUCTI ONS a. Ihi, appl icaticxl rritrsL be couplelAy filled in by gpewr-iter• or in iik aixl sulxnitAed Lo Lhe ikiilding Inspector will) ') "X-C of plans, accurate plot. plan Lo scale. Fee according Lo schedule. b. VIOL plan slxxaillg local:icxr of lot: aril of Imildings fn premises, relaLionship Co w1joininl; prcanise s or ixibl is sl:rcet s or areas, arxl giviol; a detailed descripCion of: laycm)t: or- property most. Ire drmm On Lhe diap,rarn wlricli is part: of this alilAicaLion. c. 'Ill(- work covered try this appl.icaCicm rroxy 00t: lie comix-need before issuance of lklilding PermiL. d. Ulxxr approval. of: Lhis application, die lkii.lding 7.nspecCor tail.l issue a ikiilding Pennit Lo Lhe appl scant:_ Such permit shall. be kept: oo Lhe premises available for inspecLim Chrcniglicxat Lhe work. C. No boiIding drill be occupied or used in wriole or in part. for any ixirixise ralratever until a C:erCifi.cnte of: (k:cupncy shall, have Ix�en graTiLed by Lhe Wildinl; Inspector.. AI'L'l,1CA'1'1.ON 1S 111KIT-MY MATE-Lo Live Ikrilding 1)epartmienL for Lhe is-mance of a Ikiilcling Permit rxirsuanl to the Iktilding 7,00e Ordin-mc:e of the 'i mi of SmLliold, Suffolk Counl:y, New York, aril ol.her allAicable ].us, Ordinancps or RegUlaLicxis, for Llie coosLrtwLi.w of lxrildinhs, additirnis Or alte_raLlomn, or for revuval or dc-itnliLion, as herein ikt scrilied. 1114 aplil icanL ai;reer; to c(.Kll)ly with all. alyl icable l xas, OrdiUMICeS, lxri ldinl; axle, Ixxrs ol", Code, arxl reglilatims, aixd to wituil: mLlxrri?ed 111Srx`cLOrS (x) prc:riu ses nix.l ill building for necessary inslx=cLimr. owlV111, g 14 ,i1;r>uCure of p I.icanl', or name., if a corix)rai:ic)n) _ r q�} ,,, p*�..,,,,,�.,.o�. ...-,,y,�,•,�„�.,„,,,o,,,,,�,,y,�j; 't�g (t•L•)i I.inr; address of allil icatiL) r• _ -- i�6 S6'�+4��'iQ�'��:A�.l gi�Y•� h � 1�171+.t v}' StaLe �I A I l"�Ic nri46 i '1x l r t1>AF4 agenL, architect, engineer, general contractor, elecCric_ian, pltliber or builder. .......................................................................... ...... N:I<11Q ( -f •i-c-sJ tri°../ -. _ ... ......... .......................... t f,• , b^tcxl'.Clie Lax roll. or iaCe sl deed) If app' c<n 15 r ;pr 11'.i.;•itni,. siigc,a.etrrp'uf duly atrLllori�e<1 officer. T R1'y'i .4.'_AK? 'rlNT<i.;f;f Me, s - . . . arJ ¢; 5"4ti'sfi:ti� ig':i .ti.#................. (N:■r><'s�-'s� :,��1�(i�P°�?e�er�e ��:Pl�a��ri c�F),•.> �?��g �g�ggJ .��}I�ri+.��:�a•i �'Sxr��ag�� .gw�;�:t'4sr::+ k`�e6�L4X�64r'}' '�S:4r,.�-��'"i4$�itr4e*ad' Y"i�.�+ 2"li..".p'•..'�.s ' Ikiilders i.lceose No. ......................... PltsAw.r s License No. ......................... Electricians I.Acen se No. ................... Other Trmle's f.icense No. .................... I. i.(x:aL.ion of larxl m ukich limix)sed work will be doix'................... ........................................... ..... ..........._ �f L �q,:!0�........................ Ikxise Rviber / SLfPf?L' Matilel• UxnlLy Tax My No. ,�(X..X//) Sf>clicnr ... :D�.. lllcx:k d/.00....... I�rll: .. :Oo..... Sttlxlivi dote .... � ��N.�. - ..... `............. I ilecl )L1ii No. ................ Lot ............... 2- Stal:e existing; use arxl cxxalpaocy of pronises aril 'in(eixled use arxl (x:cuixirxy of prgx).sed consLruct-ion: a. Existinl, usa 11A occullm)c r-.Zt . /......ry....... ............ .....I.......... ... .(............. b. InLemled-u se a(xl occx)pa y '�/ittl �3/J O_�_ .PCcI,c— ......_..... 0-1.3 //3 1. h•Ilure of, IAtlt( (epee(( %Alidt al�)Iicohle): Nu(a III liIdiof. 14!l>ttll" ....... ..... I117110V(lI Ik7tY)I11:InllpOdL(/�X3.... . S'v��S'ee�F�J �dL l?7e1 J (.(t:;t: fee ....... ..... .. ............. ...... . ...... . .. (fo Ix? iglicl on ri I inj; shin appl icatiexl) i. l l` IkA!I l ing, ntlulx?r of ((well ing units Ikuixlr of (hrel l iog units Oil each floor .. . . . . f ((;bilge, ll(,lber of cars ....... .. . ..... .. .. .. . ... h. If Ixl:;ilea:;, c(lilllercial or mixed (x:culxtlx:y, 's(IecJfy, nill.ure alit( exleot of each tyl)e of use......... ........ 1. IIilmm.-drxts of: exisling sLr►e:Urres, if ally: Proof .. . .l0.-..7 .. . Rear ?U',L....... Deplll -�:... .. .. . .... .......:.......... Umber of 81.ories . ..�.'-' UinYlosi(xls Of' m sae strte:(ure wilh alteraLi/xts or. auldiCloo;: 1ronL' ...��.? .. . .... Rear . �:Z IklplIt ... . _..... . .. IklJl;lll: g .��. .:� .. .... . .. ... . .. .. . Id<n1lter of Stories .. . .1/ /i lI. IIIII11M."1(nlu ol: eol.l re Ix_wa c(N lstrl e:(:I(nl: 1'I'(xlt _ ... ... ._.. Mal ..�C, ,,,,_„ lkll)111 C„�.. . . r................. tJlnlx?r of Stories . . . . .. . ............ . . ... .. 9. Size of: lot'. 'Frcxtf ....I '•;?v.... ... IZ<a . 10. Mile of" lllrchilse It-xlK of Forlll(:r (.alter I. hxte or use (lisfri(:L' io %,Aticlt pranJses are situate!(] ...•AfS% /040 ........... .... ...... ............................. . .. 12. Ikx?s prolx)s(!(I conlslrtu:Lioo violaare any zlnliog lrlw, ordioale.e or" vegulal:ion &�,,,,,,,,,,,,,,, ,,„ H. Will lot: Ile regraxkul ....Ng........... Will exee:;s fill Ix! romwe-!(1 frc.n preynises: YES X) / - 14. tIYIK9s of (.alelr of prenlses ClfzlFL!/ A(klr(a 7� s `a . .......... Hlotw! Pk).. ...... . . . . N'rIK! of Ardai tent .... Acklress .. . ..._.. I1er(x! tkt. ... . .. . . . . ... Mille ol` GmItractor ..."�GT/a/�: .............. ...... Ackh'ess ....... ... . ... ...... ........l1tole? Nit. ..._... .. .... 15. l?; this I)Iolx:rly within 3(X) feeC of it tidal weLland? k YES NO Ali" YE'S, :>Yllllll(NI) 'ITJIdN 'I111INUS l7s'Ith11'I' JIAY lu1, 1(gpil(l:l). PLOT I)lAGRAtd lrx:ale clearly a(xl, (1JsLioc:l:ly all Imildings, tatether existing or itl-olxtsed, mul iaxlicate all set-bac0dimeni of I11111 prolx! ela rly lil . (five stneel: aril bl(xac 'miller or (lesrripfi(xt according; fo (leed;-a(YI slutw slreel: ntnlet; atl(I icxljcate %Aellh 1- iolerior or rorlxlr lot:. ASN FEE:/'�-�` BYc NOTIFY BUILDING DEPARTMENT AT 765-1602 9 AM TO S rM FOR.THE FOLLOWING INSPECnON&- 1 FOUNDATION - TWO MUMED FOR POURED CONCRETE 2 ROUGH - FRAMING • PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR :;tall.". tH' lald Y(mm, DESIGN OR CONSTRUCTON ERRORS SS cz>tllrlY l>t. ... .. . . ..... . . ... . ..... . . .. .10... . . . :..,� : ... . . . c .In!Jnjq duly :;wore, delmses alxl says (It'll: he is the appl icaol. (N'rIK? of iI1clJvi(lu<al signing; con(ract) . . . .. .. alxlve o'Yttrcl, . . .. ... ... .... . ......... ...... ..... . ..... .. .. (Qm(.ractor, agent, corlx)rafe ofricer, el.(:.) or Imid owix!r' or (xalx!rs, olxl is duly authorized to lx!rforal or have Ix!I I'(IfI1Kld [Ile ';'aid cxtrk and to make Ilxl fit(! This nlg)l icatioll; Thin. of I slal(vii:n(s contailwd in Olin 'ippl icalion are (llx! to the lutul: of his Iclxrwl&dj"e rtlxl Ix?I ief; anxl Illnl. III(! %Alit( will be lxrfonlK<I in the ulranx!r see: fort(( in the ;it it) :aCiuo filed IIiercwaioI. 'Xomo 1(() 1)(!lol(! aY! This Qom` )YCE oIM.WILKINS rW .. . ... ... . .... . .. .. . . ... . J ;i I j;nal ore of Ali one.) Notary Public,State of.New York No.4952246,Suffolk CounvA Term Expires June 12,19 ,,fig _ ? y _ l_/v TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET �/ VILLAGE I DIST.i SUB. LOT j er L�.V a LT4 e I-F S( / /-' a r v -J l d� C A. / C ;:ORMER OWNER _ N E ACR. F -�P4.°CiC� ilP�ff.0 .�S:S S W TYPE OF BUILDING ES ' O SEAS. VL FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS loe e- n Q D !� 5 /L 7 �f �/ �� d + � - ;'t J J �Q V� �� lc�ir � 4` 706 296d c�� / 7C c� ?ter ✓ �9' o .�/ : 7/ I 'c 7s�v��p ,.��a.0� 7Z�� ,Za3 I n E S BU NGSONDLTIO�N ✓ /�� r '-G 0 3� Ce J114 e EW Go m BE J M ABQ-VE //•�c�/�Y /cCe �E X.i`% /%9�-3a� �cc .�/c�� r 7 Qo v =A Acre P+� Value Per �/ alug� /o/zy/�5 i3 �3 S C n5fh ezc�lj/ �/c Zol :(]able 7 g) � � l 3illable P2 l-f� sf E CL L — + , �o adD 7-nZ 9 i ` Kec/rew Ow u�S Q2 v /,aokASaO VA�(�a / 3 �oA 9 y FRONTAGE ON WATER ushland I FRONTAGE ON ROAD 'ouse Plot I DEPTH ��— I BULKHEAD � j I 'ota I I I DOCK r r • • ■■■■■ No Ism MOM ■■■■■IT ■■■■■ ■■■■■ MOM ■■�J■fib■■1■■■I■■■■■■ -' ■■■ ■■�■■■■■I■■■■■■■■■ ■■■■OMEN ■■ ■■■■■■■■la■■��■ EEMEM ME■■■MEMI NEE■■■■■■ SURVEYED FOR:-/DA//-/ /`✓f /�ECyC- SR. L�YJc�q �'. ,�,/EC� '� 1 �� LOCATED AT TOWN OF SUFFOLK COUNTY N.Y. LOT MAP OF �ECo�//C yOMES EC. / CO. CLK. NO. Z1,31 FILED OCJ. SCALE 1" _�o �C /!�7•� 30•E /710. 38 SUFFOLK CO. TAX MAP DATA:- DIST. /000 , SEC. 07,�!.00 rn VI BLK. 0%00 LOT 0/5 G� � U UNDERWRITERS CERTIFICATE - REQUIRED 'rr.ETS F�cC'�% 57nlic I L 37 .6.. = 6L 43.5 52o W r0 RELATIVE -GUN["R.Y LO jE ON SURVEY, ARE FOR A � �'` o_rs"4F — m SPECIFIC `uSc' ONLY, AND �= y SHOULD NOT SE USED FOR m g o — AscW. p4�vE CONSTnIJCTION Of FENCES 3. Ok OTHER TF LJvC—T IRES. � _ a. y Q p W c N N o � � P,NCY 0R. N o OCCUP I USE IS UNLAWFUL WITHOUT CERTIFICATE S 47 "50•moo ..� � /75 73 � /RST �MFR/c4,v 7i OF OCCUPANCY �il/SC/Rq/vcE CoMpq,v�/ SURVEYEDv 28� 1992 BY A ��I�. � RAMPART SURVEYING P.C. �7 Pro Box 377 / JAMESPORT, L.I., N.Y. 11947 z NYS LIC. 34408 FILE NO. /�3�O�o PAGE e<5 o J�r,� GRIDG-¢� DRAWN BY y,'/� i st!DE DOOIZ Brrc K 90o fL n �-- ----- - ---LiVNC)- Rbor4 W!i.J p A Si'� 1' 7" ,z 63 15" --- ; w I, ® EGAo ® \ goxall AI, CC f p K �14 o N e E,i pftc o /oiC3 17 ^LV( L GEmF—rT PISS 5 1� f}�f tc�c / S •�OH�.�T�RN 2}� }' I o7l4-L l�GL/L frYLE�' -COV I�t_1J — ��o� 5Ga sf A / —— - _ tr a � I I O � I .� Fnrs f�uS tvl t \ d I N � N ,, , r � FEA-,v15 - i ® Z K to96 Awe i . I 0.!LZ INTO a2x1Z I d �. 6l/N,PAT/o/J gz _ oc. ewr ! I I Dom, r( 3D�T"�D J� n ► — . -t-A1�31L�1� A.{P lo> 3 a e Ted DSnITO �r�2S �X►oKl6 �c� � �ox� 72 VAL rc booz _2�d ' S1.IDSq 4—S/ —� �Lv -7y°suflER W uN ! 1}f'Pgox i g'fs4 FT. � N L 7 LaF�r' -to — _ d o co �6,, /6zi o It, k !no t''ifLo�u X'. 'J1 yotb for 6 a." a� 10 ++ty-S Lq ioTht_ CEO ACSA, PIS gK $�C rsr, ------------ ---- I11 1 BLDG.DEPT. - T(116 r'nG S-T!THnt 'u DEuuni�Sy QEDk+I I N 1 n � � oai?1tifi} b•YQ3.� ?yI.-�Nrx�3C��'►. _ A 19 1r3w3J O? l Lip St�li�I I -X . �7 p \AZ 3Xi-hgyp ••.•$�� fiei• ante �� a ,� 7►a� ., lyoo�,l, 1r33y'�s/nn'.rv_ � . Fv.eCf4:d _ 51.SIo1` $XZ 7 Jo? 9JoZ oloo r t N a . o . -_57 ' a li -49 ° - s a,oaArM —ve M ' � � 5►LQ C%,:�tl �11 O t..J.� �c�, "��GT. �— ��V1�•� �"� �71 9 SURVEYED FOR:-/O/-//-/ /t/f yELF Sq• L�,Z?4 �' Alee.,,-7 LOCATED AT QKO.t//G , TOWN OF--5DUT'y06,f:;l , SUFFOLK COUNTY N.Y. LOT B MAP OF PECoti//C yoMES SEC, / , CO. CLK. NO. d1,51 FILED OCJ- SCALE 1" =_30� �C/117�� 30~E /76.,36 SUFFOLK CO. TAX MAP DATA:- DIST. /000 ,SEC.07Q.00 •� BILK. 0/.00 LOT 0/5-00c') � U OF-FEETS FROM STRIJCfu: LS � � -97'6K TO RELATIVE 30UNDRY LINES. ON SURVEY, AP,E FOR A. SPECIFIC USE ONLY, AND SHOULD NOT 3E USED FOR rn Z , ,�,_ ASGi/• OR�VE CONSTRUCTION OF FENCES OR OTHER STRUCTURES. cb p O Gv4RA�7-EEo To. 0 5UN i?oa 4 -eLUIv C-4UR�4 C. dN4i,V L/vc f-ENGE �'VTR t/157 p4Ay � S �17 "50'� ••�iV /75. 7.3 �tilSvR4�L/cE � SURVEYED-/4A,/ 28� 199E BY 0 RAMPART SURVEYING P.C. �'T� �• /��-5-00�3 �• �• � ��• P/O BOX 3TT / JAMESPORT, L.I., N.Y. 11947 NYS LIC. 34408 FILE NO. /.3201a PAGE 2d GRIDG-¢0 DRAWN BY 1--I- J -- ' y I ' -L . I.. ivjOUP / r �F C.d,(�s.l AX—f ►.� � ; rl— (J �f � '++.r f' __ ..aw.0.»nlw.nw+`^wwe....-.nrn•'o'w'""`v"`�..�. <.--�..�...._ ..'+.sv?.�W.��ay... .a<+sWN� _ .2nraa<n+iscxa.WrC.m+�vw�+^nw'okv.,vw»w..-..:....,Y a.�n�w�.. x.. nvcsn.a+cv r.�-xP �.GUIN POOL L ffn- 16 - IA . -. Fnrs �� I to m 1 G 0*T ST�il�7't/r`J �JZL Gf//NDejYt/S /AvooPA<—vr✓ - L o 246 16 Lev .15o r - I- -, ►S�� J 5�8 LAC I L u S41= jj. PSI POP aUN� /0A ra e 1 r oc. zxlox tb' loxZO ® os t TO P�marts . a r . �X►o?�rb �c,� jox�w � = .,. ' xfa I i 1 f A `�� i. � �� f— _ � � i 1 -- - — - s� _ _ _ _ ! T'— _c �_�,';, ��- �' ... r. "+a� •tier :�� '. L _ � � � - �__ ��:�' � � 4 + '-..? �'yi �_ <'� �. - �y '�`... .` .;1.. •---r �4 ., R , if►. �w s r