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Home My WebLink About12077-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No .... g~2.~65 .... Date ........ ?.~l~¥.u.a~' .. J..6. ........... 199.4. THIS CERTIFIES that the building .-.-~r~e~r. ................................ Location of Property 1365 .E,U, (j ? ,n,e. ~. s..R.o.a, d, .C. ut c.h.o.g ue House No. Street H~m/et Cmmty Tax Map No. ! 000 Section ....0,9.7. ..... Brock . ,. D.2 .......... ].x)t ..... .0.2,0. ........ Subdivision.. ~ ......................... Filed Map No, .X ..... Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated November 4 19 82pursuant to which Building Permit No. .1.2. Q77..~... · dated ....... .D.e.c.o. Lnlp.e.r.. 2. .3 ........ 19.8. 2., 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 ......... ~ pr;Lv~¢¢ on¢-fami.lx dw.el, ling. The certificate is issued to ...... (owner, le~e'or-terrttrrt) of the aforesaid building. Suffolk County Department of Health Approval .1. 2. 7.S.O.': .l-.2.1.,..2.[.1.5./.8..4.,..R.o.b..t.... UNDERWRITERS CERTIFICATE NO .......... N...6.2.7. ~ .3.1 ...........: ................... Rev. 1/81 Building Inspector TOW~ OF ~OUTHO~D BUILDING 'D~PARTM~N'~ TOWN' HALL SOUTHOLD, N~ Y. BUILDING PERMiT~ (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S UNTIL I~ULL~ COMPLETION OF THE WORK AUTHORIZED) ~ permission is hereby granted to: . ..~.~...~.~..,~. ....~..~.:..z.~:....~..... , } ' ' ,- 7; :, "' ' ' ,o .:,..~.~..~..~.-.~..~~. i.~ ............. : .......................... at premises ocated at ..-~..~.~.......~ '~t~L~..-~.~.i ............. , ......................... c~ T~ Ma~ No. ,000 Sec. o. ,,,~,~-,,7,.....i. ~i% ~;..~.~ ......... Lo, No.~i....~.~. ........ purS,uon, to application doted .~. ~.~° ~.iI, ., 19...~.~and ~pproved by the Bdil~lng I~spector. Fee I~i...Z~L~ ............. FORM NO. 6 TOWN OF SOUTHOLD I~uilding Department Town Hall ~]outhold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natura~ or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use --Pre-Existing C.O. $15.00 Vacant land C,O. $ 5.00 New Building .....~. ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~... ,/.~..~. ~ ........ '~'-~'~'~'2' -~' ~ '~'' ~-~ .............. ~ House No. Street Owner or Owners of Property . ~/~ 7~ c ./?.~. ~e ~'.~.~ w .... ~. ~/~.~C.~.~..~.~. ¢ ~'.~ .~. ~?. ?..--<-~ ......... County Tax Map No. 1000 Section .~..~....-2. ....... Block ~) 2_~ Lot, ~ Subdivision ............................ Filed Map No ........... Lot No .............. Permit No./'~.?..~2..... Date of Permit ~,~,2. ~/..~Applicant . ?~.. '.27..~?;~,,-..~. ,,~...~. ¢,?. ~-~ .~'.Z: .~.~.~¢. Health Dept. Approval ./~.~, T~..¢~.";/..~,./. ......... Labor Dept. Approval ...... ~. ................. ~. ~2 '-~_ ~: J¢ ~. Pla ni B d App vel Underwriters Approval ...................... n ng oar ro ...................... Request for Temporary Certificate ...... Final Certificate Fee Submitted $ ............................. Applicant., L~;~, .~ ,~,~ ~.~, · ........................... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Oa,e ~.-~r 27, ~a A..c~,~.~o.o./.e =:~m/8~ N 627631 THIS CE~IFIES THAT o~y the e~t~ ~uip~nr ~ ~d~ ~ a~ ~nt~ by t~ ~r ~ on t~ ~ ~ numar ~ ~ ~m~ in the following I~ati~n; ~ B~en~ 1st FL 2~ FL ~tlon Bilk ~t ~ exami~d on ~ ~ ~ ~ a~ fou~ to be ln compl~a~e ~th the ~quire~nts of th~ ~rd. fiXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUCRESCENT DRYERS FURNACE MOTORS FUTURE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS C 1 2 1 2 OTHER APPARATUS: Motors: 1-F., 1-G.F.~., 2--~e DeK, eatcrB. 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. ~T NOT BE ALTERED IN ANY MANNER. ]. FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FEE N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: P.0. BOX 728 SOUTHOLD, N~ 11971 FORM N0. 10 TOWN OF SOI~.~20LD BUILDING DER~i ~IT~ENT (516) 765~1'%02 TOWN HALL MAIN ROAD SOUTHOLD "'~ APPLICATION FOR DMVE~i~??MENT PERMIT Instructions: The application to the Bu~t~ding Inspectoz, includes (each In duplicabe) 1. Form No. l0 filled out in ink or typowritten, 2. vey of premises with elevations above ms~n sea level, 3. Drawings of posed work. The application must give c*mplete information to show tha~ the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as ~, .ood Damage Prevention Law" of Town of Southold. The applicant must s',,bmit approvals that any other agency requires. General Standards as required in Sectio,-~ 46-17 of the law to minimize ~amage i A. Anchoring of structures, including tanks and mobile homes B. Use of construction material an~ methods C. ' Design and location of utilitie~ D. Subdivision proposal with drain~,ge, public utilities design and base flood elevations Specific Standards as required in Secti~,~ 46-18: A. Residen~ia% construction B. Non-residential construction C. Mobile homes The applicant must submit plans and spe~ifications as well as any other information requested by the Building I~,spector to substantiate the fact~ that the structure has or will have tho lowest floor, including basement/ cellar, elevated above the base flood e~ovation or; if permitted by the Federal Regulation, that: 1. such st~, ~ture is flood proofed in such manner that below the base flood level ,d~e structure is water tight wit'~ walls substantially and impermeable to the passage of water, 2. that structural components are capable to r~isting hydrostatic and hydrodyna- loads and effects of buoyancy, 3. appl~ cant must sub~it certification b~ a registered professional engineer or ~ ~mtect that the standards set forth in Section 46-18B (1) (2) (3) of ~ne Southold Code are satisfied. Coastal High Hazzard area (V Zone) 46-1 ~. Applicant shall submit plans~ sp czf~cat~ons including--the required ~ ~'tifications and such other formation as the u~ldmng Inspector ma~ require in that ~e provisions 46-19 are~ complied with. Mobile homes ~.re prohibited. The lowest port'~o of the structural members of the lowest ~loor cannot be lower th~n the base flood elevation with all space bel,~,,~ open except breakaway walls. Sand dunes. If sand dunes exist on the p~emises and the applicant pro- poses $o alter same, plans and specifi~..,~-~ion must be shown in detailed nature of any alteration submitted. ~,u~i~ldin.~ Permit. i Building permit is ,~,so required fo~,, any structure. oDn a ~eveloPment and a Building perm~ '~, must be issued before any work can start in a special flood hazzard z, e ' 4 written disapproval or a p~rmmt must be issued within ten (10) w~ng days. During construcBlon, the inspector shall be notified in make the required inspections. Upon completion, the work mBst be approved. time so he may required certificat ou fo the final elevations and submitted before the approv ~ to use or occupy can be 4/80 (Fill out the form on the ack of this sheet) Disapproval Issued P · ~' ' ' e~t # 19 i.Applz~atzon Recezved: FORM NO. 10 -, APPLICATION FOR DEVELOPMENT PERMIT l In the Town of Southo!d 1. Type of DevelopmSnt Proposed": ~'eW i Structur'e' (including Storage banks~ Addition and/or Alteration~ Flood. Proof Below' Base Flood Elevation~ Other (specify) : . . ' · ,.. Elevation Data mn relation to above mean sea level of: (a) Lowest floor,i elevation, including basement ~ feet ~ . inches (b) In a V Zone,, bottom of lowest structural member ~ 'inch .~. FIRM--,lood Insurance Rate Map, Zone designations -~ .~}. Location of P~op~rty: ,. Co~ty Tax Map Nb., District, 1000, Section ~97 Block'O~ Lot(~2~. Subdivisions.. . ~ z ~./~ "Filed Map'~ _ ~ Lot(s) 6. ~rm~ss~on to be~ranted. ~Owner as above~ Owner Unde~ Cont~ac I Lessee[ ~Cont~actor . . ' - ; ''- ~. ~pp~oval fro~ other(s) before Pe~it is issued: HEz~TH SERVICE .,~F~A C-/~/ ZBA . ~, .' ~wner~, ~ew ~woer~.j, Under Con~ract[ ], Lessee~, Agent] [, Con- trzctor~, and ~gree t? co~ply w~th.all applicsble s~ctzon~o~ the oF the To~ of SOuthold, Co~ty, and State ~d to a~t autho~zzed in- spectors to pmemzses authorized to perfo~ or have pemfommed the said work ~d to make .'and file this application, that all statements contain. ed in this application are tmue to the best o~. my knowledge .and belief and that.the T/omk will be perfo~ed in the mannerset forth STATE OF N~,Y YOM{ ~ [ : ~ ' /,/// ~ ~ ~ ~ ' ~olt ~y Pub~'ic '' Applicant, s mailing address and phone # :if not given above: No. 52 Ouotlfie8 in Suffoik C"c~nly Cemrnl~sion Expires ~M(~r~h 30, NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATIONs. PERMIT W 15276-0301 UNDER THE ENVIRONMENTAL CONSERVATION LAW ARTICLE 15, (Protection of Water) [] ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) ~L_J ARTICLE 36, (Constructioa in Flood Hazard Areas) PERMIT ISSUED TO Steve Mitacchione By: Robert L. Tooker, Esq. ADDRESS OFPERMITTEE North Side Road (No number), Wading River, New York 11792 LOCATION OF PROJECT (Section of stream, tidal wetland, dam, building) Eugene's Creek DESCRIPTION OF PROJECT Construct a nme family dwelling on parcel north side Eugene Road, approximately 1,000 ±~ southeast of Main Road (Rte. 25), and to improve and repair sixteen foot entrance roadway for length of 50'. COMMUNITY NAME (City, Town, Village) J TOWN Cutchogue Southold COUNTY IFIA COMMUNITYNO.' J DAMNO. PERMITEXPIRATION Suffolk 12/31/80 DATE GENERAL 1. The permittee shall file in the office of the appropriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of £nvironmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has ac- cepted expressly, by the execution of the application, the fulJ legal respon- sibility for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the proiect described herein and has agreed to costs of every name and description resuHing from the said project. 4. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plain or deep holes that may have a tendency to cause in, jury to navigable channels or fo the banks of the waterway. 5. Any material to be deposited or dumped under this permit, either in the waterway or on shore above high-water mark, shall be deposited or dumped al the tocality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such ~s will prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. That if future operations by the S~ate of New York require an alteration .n the position of the structure or work herein aqthor zed, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger he health, safety or welfare of the ~eople of the State, or loss or destruction )f the natural resources of the State, the owner may be ordered by the Depart- nent to remove or alter the structural work, obstructions, or hazards caused hereby without expense to the state; and if, upon lhe expiration or revocation Df this permit, the structure, fill, excavation, or other modification of the vatercourse hereby authorized shall not be completed, the owners shall, vithout expense to the State~ and to such extent and in such time and manner ~s the Department af Environmental Conservation may require, remove all or tny portion of the uncompleted structure or fill and restore to its former :ondition the navigable and flood capacity of the watercourse. No claim shall De made against the State of New York on account of any such removal or Hteration. CONDITIONS S, That the State of New York shah in no case be liable for any damage or injury to the structure or work here~n authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of nsvigation, or for other purposes, and no claim or right to compensation shall accrue from any such damase. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shah be installe~d and maintained by and at the expense of the owner, 10. All work carried out under this permit shall be performed in accor- dance with established engineering practice and in a worRmanlike manner. 11. If granted under Articles 24 or 25, the Department reserves the right to reconside[ this approval at any time and after due notice and hearing In continue, rescind or modify this permit ia such a manner as may be found to be just and equitable, tf upon the expiration or revocation of this perodt~ the modification of the wetland hereby authorized has not been completed the applicant shall, w thout expense to the State, and to such exten~ and ia such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 12. This permtt shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the impairment of any rights~ title or interest in real or personal property held or vested ia a person not a party to the permit. 13. The permJttee is responsible for obtaining any other permits, ap- provals, lands, easements and rights-of-way which may be required for this project. 14. if granted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards - Building Permits) and in no way signifies that the project will be free from floodinR. 15. Sy acceptance of this permit the permittee agrees that the permit is contingent upon strict compliance with the special conditions o~ the reverse side. ~5-20-4 (9/75) (SEE REVERSE SIDE) SPECIAL CONDITIONS 16. Improvement to access driveway must not encroach upon adjacent marsh. 17. Home must be at least 7~' from marsh-upland edge. 18. Cesspools are to be at least 100' from marsh-upland edge} 19. Applicant shall be liable for any damage to adjacent waterway resulting from any phase of the permitted construction. 20. Home location is to be staked in field for final inspectibn and approval before construction may begin. PERMIT ISSUE DATE PERMIT AD',~iNISTRATOR .... 4/13/79 Daniel J. Larkin, P~ Cc: U.S. Army ~orpa of Engineers ~SDEC Lgw Enforcement - Region ~'- , .~,~ , P~gulafDry Daf. fairs Bldgo ~0, SL~ - Room 219 Stony Brook~ N~; York 11794 (516) 751-7900 December 9, 1980 RO~ F o FLAngE Co~.~,i ssioner Steve Mitacchione Northside P~ad Box 114 Wading River, NY 11792 P~: TW15276-0301 Steve Mitacchi0ne Your re~ent req%~% to ~e~d ~J~B above pezmit h~ been reviewed .pur~nt to 6 I,A~"P~t Part 661. It has been determined that the r~i~cinent nature of man made conditions v~ich exist at and adjacent to site at t/~ time_ ~hat such perm~it was issued have not substantially d~anged and the site is still suitable for permitted activities° ~lerefore~ the e~oiration date is extended to ,3/31/8,2 This lette.r is ~n am~2qdme~nt to t_he original permit, and ~ SUCh, Should .be attached thereto. All of .the conditions still ~ as origina.!]y %~ritten in the p~_~mit. Very truly yours, P~gional 'Permit Adminis~ator cc: Law Enforcemmnt PERMIT SIGN NOn TW 1276-0301 has been issued to: Steve Mitacchione By: Robert L. Tooker, Esq. address: ~o~ Side Road (No number), Wading River, New York 11792 for: construct a one family dwelling on parcel north side Eugene Road, approximately 1,000 ±' southeast of Main Road (Rte. 25), and to improve and repair sixteen foot entrance roadway for length of 50'. under the Environmental Conservation Law, New York State Department of Environmental Conservation 95-20~1 (9/75) Formerly EA-93 Article 15, (Protection of Water) Article 24, [Freshwater Wetlandsl Article 25, (Tidal Wetlandsl Article 36, [Construction in Flood Hazard Areas) Permit Administrator 4/13/79 Date Issued 12/31/80 Expiration Date TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. Approve ... . dd .... l ..d e it . (Building Inspector) APPLICATION FOR BUI'LDING PERMIT Application No..ff'd~. 7 / ........ INSTRUCTIONS a.. This application must be completely fired 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 ia 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 pursi~ant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable lLaw~, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or deanolition, as herein described. The applicant a~'ees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises and in building for necessa~fl~p~ipns. ~ ~t.~..'-('~' '~--~ (Signature,eT applicant, or name, if a corporation) , ,',e,, x,,:/. ................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 .......................... Plumber's License No...'~....~..'~...-'. ~ ......... Electrician's License No.. ~. ~ ~. - ~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · ..... House Number ............ '~-" Streei ................... ~ .................. Hamlet County Tax Map No. 1000 Section . .~ ~. ~. ....... Block ....O.~ ......... Lot .... ~..~.~. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and oi:cupancy of proposed construction: a. Existing use and occupancy .......... .~.../{/~. ..................................... / ]:a.r~?/.~, c/a~e/I,.~., b. Intended use and occupancy Repair .............. Removal .............. Demolition .............. Other Work ............... //,,,.?.,,~,:. ,, -, ', .~. . ~.~(,~ ~ (Description) 4. Estimated Cost ., ...... Fee ............................. (to be paid on ~ing this application) 5. If dwelling, number of dwellin~ units ...... ./ ........ Number of dwelling units on each floor...(-'./.'I .......... If garage, number of cars .... ................................ &'Cf ................................ 6. If business, commercial or mixgd occupancy, specify nature and eXtent of each type of use ..... ~?~./ ............ 7. Dimensions of existing structures, if any: Front ..... ~'.~.. ~7~'7'. . · . Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... :... Height ...................... Number of Stories ...................... 8. Dimensions of entire new consfruction: Front .... 2~.¢. ~. ...... Rear .... ~.~.t ....... Depth ...~.25.' ........ Height ............... Number of Stories ...... ~- ........................................ ,. 9. Size of lot: Front . .~$.e.~,.~)~irtc, ~ ¢..d.~... Rear ,:...' ....... i'...., ...... Depth · 10. Date of Purchase .... /.///.0.[~.~9_~. ............. ' Name of Former Owner 1 1. Zone or use district in which premises are situated...: .................................................. 12. Does proposed construction viOlate any zoning law, ordinance or regulation: ............................ t 3. Will lot be regraded ..... ~,~,.c: .................... Will excess fill be removed from premises: ,Yes ( No};, 14. Name of Owner of prem~ses~./e,S.~r~.-/~,~e~, .~.b~ddress X~,7.7./t.-.~FPf.b. qfl~.. Phone No. Name of Architect ........................... :Address ................... Phone No ................ Name of Contractor ........ i .................. Address ................... Phone No ................ PLOT 'DIAGRAM Locate clearly and distinctly all build/rigs, 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, : sawr~ OF NEW~).R.K~ ,L~J}~_ s.s cou ¥ OF ...... r .... .~.~.~£.~.~....~. F,~.~¢ ~.[~?.~.. ~., ~.~3$.C~ S..~ [3C.q . being duly sworn, deposes and says that he is the applicant (Name of individual s~gning contract) above named, t ~ the ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and file this application; that all statements contained ~ fhis application are true to the best of his ~owledge ~d be~ef; and that the work w~l be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this : ........ ......... ...... .... . .......... : .... ~o~ ~uc. si~ o~ ~.~ ~'~ / / (Si~ature of apphcant) IAppli~ ation Received ' Disapproval Issued __ FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT · : .,. In the Town of Southotd · '~ l. Type of DeveZopm'ent Pro~ose~':"~'ew Sb~ucture (including storage tanks~ Addition and/or Alteration[] Flood Proof Below Base Flood ElevatlonE Other (specify) ' · ' ' - 2. levatzon Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement ~ feet ~L- inches (b) In a V Zone, bottom of lowest structural member feet 'inch . .~. FIRM--Flood Insurance Rate Map, Zone designations ~/-</ .~:~ ~. Location of Property: Co~ty Tax Map No., District, lO00, Section ~97 Block O~ Lot(~('~2( Subdivision ' ~/~. ~ _. "Filed Map '~ Lot(s) ~ ~Under Contract]--] Lessee ~' ~ Contractor , '~ ,/.'/z/_y./~ 7. Approval from other(s) before Pe~it is issued: WETLANDS (Town Board)_./~//~. HEALTH SERVICE ,;~-.fL'uX~/ BU: LD NG PLANNZ G BOARD x<//¢. O~er~; NeW Owne~~~ C'~ntract)~, Lessee~, Agent{~l, Con- tractor~, and agree to comply with all applicable section~of the Cod of the To~ of Southold; Cowry, and State ~d to a~it authorized in- specters to premises authorized to ~erfo~ or have performed the said work ~d to make and file this application, that all statements contain. ed in this application are true to the best of. my knowledge and belief and that.the work will be performed in the mannerseb forth in the applicatzon, filed therewith. ~///~ ~ . . .. Notary Pub~i c MERRIE YOUN~ ~T~4~cJ/~O Applicant's mailing address and phone # if not given above: NOTARY PgBLIC, Sidle of New york No. 52-46~6077 Qualified in Suffolk h/80 P.O. BOX 728 SOUTHOLD, NY 11971 FORM ~0. 10 TOWN OF soUTHOLD BUILDING DEPART~ENT (516) 765-1802 TOWNHAL~~ MAIN ROAD SOUTHOLD, NY ,~PPLIC%TION FOR DE~_ELOPMENT,,,PERMIT ~nstructions: The application to the Building Inspector includes (each n d~plicate) 1. Form No. l0 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro~ posed work. The ppllcation must give complete information to show that a i ' the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of Bhe Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. ~eneral damage: B. C.~ D. ~pecific Standards als required in Section 46-18: A. Residential :construction B. Non-residential construction C. Mobile homesl The applicant must s~bmit plans and specifications as well as any other information requeste~ by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manne~ that below the base flood level the structure is wate~ tight with walls substantially ~nd impermeable to the passage of water, 2. that st~u'ctu~al components are capable to resisting hydrostatic and hydrodynamic loads and effects or'buoyancy, 3. applicant must sub, it certification by a registered professional ng~neer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. ~oastal H~gh Hazzard~area (V Zone) 46-19. Applicant shall submit plans, specifications including-the required certifications and such other in- formation as the Building Inspector may require in that ~he provisions of 46-19 are~ complied with. Mobile homes are prohibited. The lowest portion of the structural me~bers of the lowest floor cannot be lower than the base flood elevationlwith all space below open except breakaway wa~ls. ~and dunes. If sandldunes exist on the~premises and the applicant pro- poses to ~lter same, lplans and specification must be shown in detailed nature of any alteration submitted. Buildin~ Permit. A Building Permit is also required for any structure. ~th a Development ~d a Building Permit must be issued before any work can start in a special flood hazzard zone. A w~itten disapproval or a permit must be issded within ten (10) working days. During const~uc~ion, ithe inspector shall be notified in time so he may ~ake the requi~ed inspections. E~on completions the~required certification fo the final elevations and work m~st be submitted before the approval to use or occupy can be approved. Standards asI required in Section 46-17 of the law to minimize flood Anchoring o~ structures, including tanks and mobile homes Use of constlruction material and methods Design and llocation of utilities Subdivision proposal with drainage, public utilities design and base flood elevations 4/80 (Fill out the form on the back of this sheet) now or formerly CHAR AL DEVELOPMENT now Or formerly Harry Purnillo 4¢S4 D oW -- now or formerly Harry Pumillo AT CUTCHOGU£ TOWN OF SOUTHOLD SUFF. CO , N. Y. SC,~LE I"-- 50 ' DATE 0CT.26, 1982 OCl~ 2F,1982 NO. 82 - 6.66 GUARANTEED TO: SECURITY TIT~E ~ GUARANTY CO. YOUNG ~ YOUNG, RIVENf~O, N** Y. ,4I.O£N W. YOUNG, ti. KS. P..F. ~ t .$. NO. ;L~G45 . HOW4RO W. YOUNG, N. Y. $. £. $. NO. 45893 ,% NOTE: · = MONUMENt* [] = sr4KE 0 = PIPE now or formerly }oseph P. Zabr/~ki,J..~u' now or formerly /-larry l~um/.llo C~SSPOOLS property is located in an agricultural 'area, th~ pe~Sibili?y existsthat th~ ~ater supply m~y Conf~n tr~c~ a~ounts of pesticides ond/~ nitrates.. Speciaf analysis ~x~ . ,.: ~ EXCAVATION-tj~SPECTijjN [iEQUtllED I'Z, ~Ld' OCCU? I C¥ UR viiYli ]' C[ ' HCATE OF OCCU?A~C¥ II 765~3802 9 FOLLOk~/iNG ibisPECTIONS: 1. FOUFJ~ATIO~ - ~0 R 4 ¸-4 -iH4- i L_ I % iI Se_ch o~ A-A ,/