HomeMy WebLinkAbout11328-zFORM NO. 4
TOWN OF SOU~-HOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z~.1.155 ....... Date ......... Au6u~t 24
......................... 19 82
THIS CERTIFIES that the. building ......... I~'{;:' 'I/d ~' ~'~ ..........................
Location of Property ~..5,§ Do~wood Lane ga~; Marion
ttouse ire. Street Hamlet
County Tax Map No. 1000 Section .... .0.;t~ .... Block .... 9.1 ......... Lot .... 0..0.9 ..........
Subdt~ sion... (]&~d £na.r.a. Bi~t..B$~,t,q~ ~..Filed Map No ....... Lot No ...........
Sect. 2
conforms substantially to the Application for Building Permit hereto£ore filed in this office dated
..... Jthne. 30. ........ 19.. 8~ursuant to which Building Permit No ...... 1.1.3.,2.8..~ ........
dated ...... Aagu~),..%0 ........... 19..~ Jwas issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
The certificate is issued to ~h,~ia Ct. Sambach
of the aforesaid buildhlg.
Suffolk County Department of Health Approval .... .n./.~) ..................................
UNDERWRITERS CERTIFICATE NO ............ ~ §5716..4.
Building Inspector
Rev. 1/81
BUILDING D~P~ARYMI
TOWN HALL
$OUTHOLD, N~ Y.
BUILDING P,ER~:I
(THIS PERMIT MUST BE KEPT ON THE PI~E~I~ :S UNTIL I~ULL
COMPLETION OF THE WORK AUTHORIZED)
Pormis~ion is h~r~b~ ~rontod fo:
Coun~ Tox Mop No. 1000 Soction ..............
/ ~ ~ 19 ond ~pprovod by the
~ursu~nt to applicotion d~t~d
Build~no In~poctor.
~ ~ui ding ~n~ector
6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
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.
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.
Fees:
1. Certifmate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date ......
New Building . ./~,'(,L.(,' ...... Old or Pre-ex~sting Building(Z) ........ =/Vacant Land ............
Location of Property 275 Dogwood Lane Oardiners Bay Estates East Marion
~ '~ I ~. f¢~'[' -~ ',','
House No, ~ ' '%' ~ '-~ ': ' ' '! Street Ham/et
Owner or Owners of Property ~arren A.-') & T~a~_a Go Sambach
.......... ..................................
County Tax Map No. 1000 Section 037 Block 01_ Lot 009
Subdivision..2.7.5 ...... (-j. ~_ lied Map No ...... 9.~5,..Lot No..95..& .cJo ....
Permit No.1.~.3..2.8 ..... Date of Permit 8-11-82 .Applicant ~arren A. Sambach
Health Dept. Approval ........................ Labor Dept. Approval ...................... ,..
Underwriters Approval ........................ Planning Board Approval .................. ,,.,
Request for Temporary Certificate ..................... Final Certificate .. ~. ............. -
' 5 00
F S bmitt dS .'
ee u e ............................
Construction on above described building and BermR'mee(~ all a~ppti,cablg, co_das and regulations, Applicant., ,.~...~.._.~.;..-, ,~ ..........................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRiCItY
85 JOHN STREET, NEW YORK, NEW!YORK 10038
THIS CERTIFIES THAT
only the e~ctrical equipment as ~escribed~l~w~nd introduced by t~ epplica~ ~e~ed o~ the above application nu~n~er in the pren~izes of
in the following location; [~ Basement
~.,~x. mln~doa April i2, ~982
FIXTURE
OUTLETS SWITCHES
2 3
DRYERS
~ 1st FI.
FIXTURES
~FLUORESCENT
[~ 2nd Fl. Section Block Lot
a~td found to be in compliance with the requirements of this Board.
RANGES CO~OKING 0ECKS OVENS DiSH WASHERS EXHAUST FANS
SYSTEMS
OTHER APPARATUS
i-4~,~
E R V I C
NO OF CC COND F A WG ~
AWG
OF HI LEG
Gary
42D Mormell
Cuteho~, N.Y. 11935
This certificate must not be aJtered in any manrler, return to the office of the Board if
COPYFOR BUI&DING DEPARTMENT. THIS COPY
GERE~AL MANAGER
Per~
Inspectors may be idenhfied by thmr creden,fials.
NOT BI; ANY ~ANN~;
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
17 June 1982
TEL. 765-1802
Mr. Warren~ A. Sambach
173 Hillside Ave.
Wllllston Park~ NY 11596
- Applicant
Dear Mr. Sambach :
This is to advise you that the job under Building
Permmt No.11328 issued to Mr. Warren Sambach
on for is completed and
a final inspection has/~7 has not~ been done.
In order to complete thms file, it ms necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed form(s), return same to the above office with a
check for $5.00 payable to the Town of Southold. Please
indicate to whom the Certificate of Occupancy is to be mailed,
and arrange with th~s offxee for an inspection date.
Thank you for your prompt attention.
Very truly yours,
Victor Lessard
Administrator
VL:ec
Enclosures
FOUNDATION (lst)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
~'~· 2849 'by
Appeal No.
TOWN OF SOUTHOLD, NEW YORK
ACTION OF THE ZONING BOAI~D OF APPEALS
application Dated June 30, 1981
ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD
To
Mr. Warren A. Sambach
173 Hillside Avenue
Williston Park, NY 11596
Appellant
at a meeting of the Zoning Board of Appeals on August 6,
was considered and the action indicated below was taken on your
( ) Request for variance due to lack of access to property
( ) Request for a special exception under the Zoning Ordinance
(X) Request for a variance to the Zoning Ordinance Art. III,
( )
1981
the appeal
Sec. 100-31 and 100-36
1. Sl~[~{~f~-~~X~~X~p~M~X~s~%~Yp)~on ( ) be
granted ( ) be denied pursuant to Article ................... Section ................. Subsection ................ para,apb
................. of the Zoning Ordinance and ~e deeJs~n of ~e Building I~pector ( ) be reversed ( ) be
confirmed because Public He,ring held 8/6/81: Application of Warren A.
Sambach, 173 Hillsid~ Avenue, Williston Park, NY 11596 for a Variance
to the Zoning Ord%na~ce., Art.~ III, Sec. 100-31 and Sec. 100-36 for
permission to construct addition with insufficient side yard area and
rear yard setback at Dogwood Lane, East Marion, NY; also known as
Gardiner's Bay Estates Subdivision Filed Map No. 275, Lots 95 and 96;
County Tax Map Item No. 1000-37-1-9.
(SEE REVERSE SIDE)
2. VARIANCE, By resolution of the Board it was determmed that
(a) Strict application of the Ordinance (would) (would not) produce practical
hardship because
difficulties or unnecessary
(SEE REVERSE SIDE)
(b) The hardship created (is) (is not) uulque and (would) (would not) be shared by all properties
alike in the immediate vicinity of this property and in the same use district because
(SEE REVERSE SIDE)
(e) The variance (does) (does not) observe the spirit of the Ordinance and (would)
change the character of the district because
(would not)
(SEE REVERSE SIDE)
and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and
that the previous decisions of the Bmlding Inspector ( ) be confkmed ( ) be reversed.
CG:lk
FORM ZB4
ZONING BOARD OF APPEALS
Appellant by this appeal seeks permission to construct an
addition to existing one-family dwelling leavin~ a total of
both sideyards approximately 22 feet (rather th~n the required
26.3 feet) and leaving a rearyard setback of approximately 38
feet (rather than the required 50 feet). The p~emises in ques-
tion are improved with a one-family one-and one-half-story
frame dwelling with attached one-car garage, and contains an
area of approximately 20,080 square feet with l~8-foot road
frontage. The subject premises are known as Gardiner's Bay
Estates, Section II, Subdivision Lots 95 and 96,1 and filed in
the Suffolk County Clerk's Office as Map No. 275.
In considering this appeal, the Board determines that the
variance request in relation to the code requirements is not
substantial; that the circumstances herein are Unique and prac-
tical difficulty has been shown; that the relie~ if granted will
not change the character of the neighborhood and will be in har-
mony with and promote the general purposes of t~e zoning code;
that if the relief is granted no adverse effect~ will be produced
on available governmental facilities of any increased population;
that the difficulty cannot be obviated by some method feasible to
appellant other than a variance; that in view o~ the manner in
which the difficulty arose, the interests of justice will be
served by allowing the variance.
On motion by Mr. Douglass, seconded by Mr. !Sawicki, it was
RESOLVED, that a variance to the zoning ordinance as applied
for in Appeal No. 2849, application of Warren A.i Sambach be
granted. Location of Property: East side of Do'gwood Lane, East
Marion, NY, County ax Map Parcel Item No. 1000.-37-1-9.
Vote of the Board: Ayes: Messrs. Doyen, ~ouglass, Goeh-
ringer, Sawicki and Grigonis.
APP UvED
Chairman
D, AND I,'I. ¥....
TI*iV. SOUTH '~
Town Clerk, Town of-Sou~ _
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y, 11971
TEL.: 765-1802
Examined ...... ~i .~..c-~. .... 19
Approved ................ , 19... Permit No .......
Disapproved a/c ,~/~',dd.~.~5. ~..
." gAY/
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi
Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan qmwmg location of lot and of buildings on premises, relationship to adjoining premises or public stre~
or areas, and giwng a detailed descnptmn of layout of property must be drawn on the diagram which is part of this ap[
cation.
c. The work covered by this applicat,on may not be commenced before issuance of Building Permit.
d. Upon apprc.'al of this apphcatmn, the Building Inspector will issue a Building Permit to the applicant. Such peru
shall be kept on the prenuses avadable for inspection throughout the work.
e. No budding shall be occupmd or used in whole or in part for any purpose whatever until a Certificate of Occupan
shall have been granted by the Braiding Inspector.
APPLICATION IS !IEREBY MADE to tile Building Department for the issuance of a Building Permit pursuant to t
Budding Zone Ordtnance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulatmns, for the constructmn of' buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant ,agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, a_nd
admit authorized inspectors on premises and in buildings for necessary ila'spections.
(Signature of applicant, or name, if a corporation)
173 Hillside Ave., Willisgon Park, NY
(Mailing address of applicant) '%% 59'6'
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elec{rician, plumber or build,
Owner Engineer
Nmne of owner ofprclniscs .W. arren A. Sambach
(as on tile tax roll or latest deed)
If applicant is a corporatmn, s~gnature of duly authorized officer.
(N amc and t~tlc of corporate officer)
Btulder's License No ..........................
Plumber's License No ...... .A~.O..A?~] ...........
ELctfician s License No. ~ ~-
Other Tradc's License No ......................
1. Location of land on which pr~l,~psed work will be done ................................................
~ 5 !; ~Dogwood'G~diners Bay Estates East Marion
I~1'o t~;e' f,/~ ~r' :'"'~, "p" ~t:~' .?~" '.2.' ........ ~i r;;; ....................... I~I; ' 'lI~ el~
County Tax Map No. I000 Section 037 Block 01 Lot. 009
.......................... Lot. 96
(Name) %~r~C ~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .. oB.e..f0J;a£.l. Tf .r¢.s.iderkc.e,. ~:.t. agh¢.cl..or~o..c.~r .gar. age .............
b. Intended use and occupancy ...... '. family, r. oo~ ..............................................
).
L.
Nature of work (check whicl, appilicable): New Building .......... Addition...~ ...... Alteration ..........
Repair .............. Ren)oval ........... Demolition .............. Other Work ...............
' (Description)
.0.q Fee
Estimated Cost ............................................ ~ ...........
(to be paid on filing this application)
If dwelling, number of dwelling units...............°ne Nmnber of dwelling units on each floor ...............
If garage, number of cars .......... QB~ ..........................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use ....................
Dimensions of existing structures., if any: Front....44 ......... Rear .... 44 ........ Depth .... 26. 8.26.
~4 ' Number o£Stories
Height ............. , ....................................................
Dimensions of same structure with alterations or additions: Front ...39.~.8:: ........ Rear ... 5.[I ~. 8U ........
Depth 2if ! Height ~.0f Nu fSt
......................................... tuber o eries ..... one, ............
Dinlensions of entire new construction: Front .... :: ......... Rear ............... Depth ..............
Height ................ Number of Stories .......................................................
Size of lot: Fro/~t ........... , .......... Rear ...................... Depth .....................
Date of Purchase .. ~.pr£~L .19 7& .............. Name of Former Owner ......
Zone or use district in which preinises are situated .... ~r~$&den¢~5 .....................................
' Iation no
Does proposed construction violate any zoning law, ordinance or regu : ...............................
Will lot beregraded......n.°......................! Will excess flll be removed from premises: XYes No
Nmne of Contractor , Address Phone No
PLOT DIAGRAM
Locate clearly and distinctly all i buildings, whether existing or proposed, and, indicate ail set-back dimensions from
roperty lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
terior or corner lot.
TATE OF NEW YORK,
OUNTY OF ........ : S.S
.......... .W.a.r.~.e..n .g:....S.oAn..b.~q .h .................. being duly sworn, deposes and says that he is the applicant
(Name of indi~ idual sig~ling contract)
>eve named.
e is the Owner-Engineer
(Contractor, agent, corporate officer, etc.)
f sa~d owner or owners, m~d is dOly authorized to perform or have peuformed the said work and to make and file this
>plication; that all statements contained in thru application are true to the best of his knowledge and belief; and that the
'ork will be performed in the mann~!er set forth h~ the application filed therewith.
worn to before me this
..... da ne
otary Public, ~ :¢ // i ounty
i No ~o.' ,..~00 i (Signature of applicant)
I ~ Qualified in Nassau County
Comm[smon Expires ~arch 30,
OCI~II?~AItlC¥ OR
US[ !!,IfNLA.IV__FUL
VVJ~I:~T CERTIFICATE
OF OCCUPANCY
765-780~ 9 AM TO 4 PM FOR THE
FOLLOWING iMSgECTIONS:
1. FOUNDATION - ~O REQUIRED
FOR POURED CONCRETE
2, ROUGH - FRAMING & pLUMBING
3. JN$ULAT~ON
4. FJNAL - CONSTRUCTION MUST
BE COMPLETE FOR C. O,
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N. Y,
~ATE CONSTRUCTION & ENERGY
CODES. NOT RESgONSIBLE FOR
D~I6N OR CONSTRUCTION ERRORS.
MVtldl9 E,(.y)tVl
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