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Home My WebLink About13606-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14101 Date December 18 1985 THIS CERTIFIES that the building .O.n.e. ~.a.m.J:.l..y..d.~.e..1.1.J..n..g ......................... Location of Property .... .9.2.5. R.0.W. off We.ils Rd. Peconic House No. ' ...................'S'~le~i ....................... County Tax Map No. 1000 Section .. 0.7~ ....... Block ........ 0..6 ..... Lot 01 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ·...S.c. p .t.... 7. ..........19.3. 4. pursuant to which Building Permit No.. J 3.6. Q g ~ ............. dated .. Dec. 3 6 .......................... 198. .., 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 ......... .... One..£.am ~-2.Y.. ql~.e.l. 1. $.n/~ ..................................................... The certificate is issued to ....... ALF.R.I~D. &..BARt3.P. RA. D.Y- .~UN. ZIO. (owner, ~e~.~o~Xe, g~r~) .................... of the aforesaid building. Suffolk County Department of Health Approval ...¢.~ J .4.-.S. 0. 7.1.3.5. .............. UNDERWRITERS CERTIFICATE NO. ¢) N 717903 Plumbers Certificate 12/18/85 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP}AlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13606 Z Permission is hereby granted to: ~.~...~.~1...~..~ ^ ~_ ~_ ...~~~.,...~.:.~.:.....~.~..~,.~.~ , at premises located at '~..'~.'.'~.'~'~.'~:~?.~%.'L~'~;~..~./r~.~.~/'~.~~.~''~.~ .~..~f.~ ....... County Tax Map No. 1000 Section ..... ..C~...'~...~.. .... Block ..... ,C~...~.. ........ Lot No ........ ..~....I ......... ~u.uont to ap,,~a, on do,~ .~.....] ................ , ~9~,,ff.., °nd o~p,o~ the Building Inspector. Building Insl~:tor Rev. 6/30/80 '} 'TOWN OF soUTHOLD · ~:' Building 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 tocat!on~ of all bud ngs, property lines, streets, and unusual natural or topographic features 2,Final approval of Health Dept, of water supp!y,'and sewerage disposal-(S-9 form or equal). :3Approva of e ectr ca installation from Board;of Fire Unden/vriters. ' 4.Commercial buildings, Industrial buildings; M~ltip!e ResideRces and similar buildings and in'stalla~ tions, a certificate of Code compliance fi'orri the A;rchitect or Engineer responsible for the building. 5.Submit P~anning Board approval Of comp eted site plar~ 'requirements where applicabte. B. For existing buildings (prior to April 1957), Non-conform ng uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lin~es~ 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 b~ildi~ngs or premises, or other pertinent informa- tion required to prepare a certificate. :: .; : Fees: , 1. Cer¢ificate of occupancy $5.00 2. Certificate of occupancy on pre,ex st ng dwell ~g or land use 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ., .~., ,.. Location of Property ..~)¢~.(,.-..~,.,/'~,f~.Z2. ,..). ~(-~,c ~ ~'~/ House No, ~'t Ham/et ~r Owners of Property . . ~, .... ~. ¢~( .... County Tax Map No. 1000 Section ...O~ ....... , Block .. ,~. Lot ~/,..'.. Sul~division ................................. Filed Map No ........... Lot No .............. Permit No .......... , Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certifi~te ................ , Final Certificate ....................... Fee Submitted $ ...... ~ .............. Construction on above described building and permit meets all applicable codes aod regulations, FORM NO. 6 .TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~,,-~,,~- 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 natural or topographic featu res. 2. Final approvat 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: I. Accurate survey of p~operty 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 $15.00 3. Copy of certificate of occupancy $1.00 / 4.Vacant Lan~l C.O. $5.00 /,. /~ //, Date J..¥ ./. ~. ./ . ?.' .............. New Building ....J'/f'~. ,\ .... Old or Pre-existing Building ............ Vacant Land .............. Location of Property . .~..~.,.. .~...'0..~.'....k~.~. .. . .~..-~ ........ House No. Str~,,L z Ham/et County Tax Map Ho. 1000 Section ............. Block ~:;> Lot...~..~.. ........................ Subdivision ................................ ,.Filed Map No ........... Lot No ....... ~2~ '~ J~'0 ~-~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........ ~, .-~. ......... Planning Board Approval .......... ~ ....... Request for Temporary Certificate ..................... Final Certificate ,,,., ,~.,.(~ .......... Fee Submitted $...~.~. ~), .................. '. tJ Construction on above described building ancJ, l~rrr~it nleets all apph'c~le codes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS 10001 BUREAU OF ELECTRICITY ~ 86 JOHN STREET, NEW YORK, NEW YORK 100~ onl~theelectricalequ' met d c ' ed lo~ nd' t o ced ea ' a ' ' in the followln~ location; ~ aasement }~ lse ~. ~[ 2nd FI. Section ato~ rot FIXTURE OUTLETS 27 DRYERS RECEPTACLES SERVICE DISCONNECT and found to be in compliance with the r~quirements of this Board. RANGES AMT. K W, SPECIAL REC'PT E R 54 45 METER - EQUIP. OI~ERCC~ OF CC CONg. NO OF HI-LEG NO, OF EUTRALS OF HI-LEG OTHER APPARATUS: %Yack Li~ting3Z' 12 Lites. EXHAUST FANS DIMMERS AMT, WATTS AW, G OF N~UTRA[ 210 ~u~i~ld, N.Y. 11971 Li~. 2816 This certificate must not be altered in anv mo ................ Per_ ~ ../ j.] ~ .~j~ COP~ FOR BUILDING DEP~R~ ..... r~'urn ~o Tne ottrce or tn~ Boar~ ,f r~co~rect. Inspector~ may be jdentified by ~heJr cre~e~tia,s, j~' ~ MENT. THIScoPYOFCERTIF~TE" U~ TNOTBE LTERED N ANY MANNER. - TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No./360~ ~ (please print) ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. '~(p~lumb~'~natur~) Sworn to before me this of Notary Public, .County Notary Public F~ELD ~N~ECTION FOUNDATION (lst__j_) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION FERN. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO, 3 TOWN OF gOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N.Y. NOTICE' OF DISAPPROVAL File No ................................ To . .'~..~..., .~..~...~...x'A'~. · · .~.~.t~. · · · PLEASE TAKE NOTICE that your application dated .. for pemfit to construct ............................. at Location of Property .............................. ~r'o~t' ....................... House No, County Tax Map No. 1000 Section .... .q~..~..~. ....Block ...... .~. ...... Lot .... / .......... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds....~..~.~..~.....~ ~.~.. ..... .......................... Building Inspector RV 1/80 The ;~.Y.$. Environmental Quality k(~View t~cl~ requhres tub- m~Sslo, of Lhts form, and an envtrom~e.,LaJ review ~i11 be made by this board before any action ~;s taken~ pr~rer will use currently available ~fO~jt~On~{co~ce~l~ the p~oJect and the l~el~ ~cts of the ac~io~. It Is no~t e~ecSed t~t addi~ional B~udlcs, research or Other investigations w~A be ~derta~en~ ' ~b) If any question has been answered Yes~ ~e ~:~oject~F be sl~lflcant a~d~a completed Envirommental Assessmen~ go~ is nece~r%~ (c) Y~ All questions ~ve been amswere~ N~ ~ is l~e~y t~t.th~s project ~c~ significant. 1. W~I pro~ect reset tn a la,ge phys~c~i c~n~e ~ to the project site cr physically a~teb mo~e t~n 10 acr~m ~f lan~? · · ~ · ~ · 4 .. · · · ~ Yes ..... ~No 2. Will :here be a ~Jor chang~ ~O aAy~,~1que or ~, ~ ~ unusual lan~ fo~ fo~d' on ~he sl~e~ . , · . · ~ Yes an existing bod~ of water? ~. ~ . ~.~?.. ~., .., Yes ~No ~. W~I project st~iftcantly effect d%a~age ~'~i~ on adjacent sites. · · · , , · , ,.* · * * ~ Ye~ o 6, Will ~roJec~ affec~ any t~eauened 9'r ~ndangered~ 7,I 'd~l project reset ~n a ma or. advo s8 OeffeCt o ' air ~alit7? . , , , , .~..~, · . · ~ ~ Yes ~, W~I proJe~ have · m~J~r =a~{ec~.on ~x~u~l ac~er of thQ cO~uni67 o,r 8~en~ *~W~;or YiS~S~: kno~ ~o be ~por~an~ ~d th~ c~.~uni~y~ , ,'. '~, :_ Yes :~ No Will project ad,or,ely ~pmc% Any Si~t,%:Or'a%~.c~ ure of historic, pre.sisterly, orjp'le~h~olog~ca~ ~ : ~:~/:~NN importance or any site desi~a~ed a~a~cr$:Xcal ~ ~ env%ro~en~l area by a local agency,? ; ~ .~ ~[ , , lo, W~l project have a ~Jor effe~,o~ ~xf~t~$or ~ il. Will project result i~ ~Jor.%r~ffi~p~pplema or~ cause a major effect r,¢ existiq:g ;tra$~b~a~lon ~ 12.~111 pro eec regularl cause o~JecqZona~le odsrs . noise, glare, vibratlon,-~or electrical ~ur~. ~ lg, Will project Affect the ~%YJ. bY ' ' directly Cau$in~ ~ ~r~wth ~n t~On of more ~an period or have a ma3or nqga charac't~7 Of the Is there S!CNATL~E) · Yes o ( ~ p^~l Dy Z. DECK HOUSE. INC 930 MMn.$(m'eet, Aclon, MA 012'20 Phone 16119 259.9450 TO CUSTOMER NAME ,_~~1 ~ ~0 P.O. N0.. DATE OF ORDER~ CONFIRMEO HM= heat mirror ~- SB= solar bronze ~/~/~ :=: ~ PLAN DATE ~ < SG= single glaze :, Iq'"'" TG~ triple glaze ......... ~AKEOFF DATE ( :~ ~ ~= non-tempered · TEMPERED LITES UNIT NOD WIOTH UGH SIDE LOW SIDE UNITS ' ' OTHER .,, 3/16 CLEAR 7/32 FACTROLITE DECK HOUSE. INC phon~ [~1~ 25g.$4~ TO ~ CUSTD~IER P.O. ilO. DATE OF ORDER CONF I RHED HI4= heat mirror SB= solar bronze PLAN DATE --~i~ ._ T~.-:_..1;r~ple glaze TAKEOF~OAI~ ~ _ ~ = non-te~pere~ TEF~PERED LITES ~ OTHER UNIT HO. IIIOTH tlGH SIOE LOW SIDEUNITS3/16 CLEAR 7/32 FACTROL[TE /~..,/i~, ~o,/~'~5~/~' ,~'7-×/ v -y'/'/e," 'd.~-~ ~T~I w~ GO'/.4.'t z~/4q U??~I~ L.~VF::L E:AV] (IISII3~R f'~' .~/ ',-,/ &/~.l ~' ~' ef) PA(~ 2 DESCRIPTION UNIT ~ SHPD 1%0. ~iECrlON "B" (Continued) '" , . .,:,:~ ......... ....... ~ ea k3. sash hand~es ea .4.--N13--sASH WINDOW L[NITS ea NUHBER L/H R/H OOivNENTS ~a) ~12 k ~ ea ..... 'b '~i~ ., ea : {14 , , ea ..... ,. ~ ~s " ea ~) ~14 ea ~ . ~'I~OR ~g P~ (~cl~es al~ ~shold) ' __. ., c)"0 b.~ ( ' ~ ( mi~ ~- ,,, ~it ~'""srrE sI~ .... ) ~ ea / 16 17 QUEST!O.~NAIRE TO BE COMPLETED AND FILED~WITH APpL CATIQN TO THE 7.B.A. The New York State Tidal Wetlands and Use Regula[ions, 6 NYCRR, Part 66i, requires an application to the N.Y.S, Department of Environmental C~nservatlon, Environmental Analysis Unit, Building 40. S,U.N.Y., Stony Drdok~ NY 794, (tel; 516-751--7900), if you have'checked Box fil and/or Box ~6 below. Please eithe~ call their office or personally visit them at their Stony Brook office to~ instructions and application for~S. Once you have received written notification of appro~a please provide our office with a copy (with the conditions) as early ~ possibles, in order that we may continue processing your Z,B.A, apphcat on, J J I. Waterfront without bulkheading . [ ] ~. Waterfront with bulkheading,in [ ] the full length of the proj~e~W [ ] at least 100' in length [ ] 3. Not located within 300' of wat~rlr~,t or wel ands area . ~ ,r~-*ed within 300' of wat.r~,'qt or wetlands area; i~.owever, [ 4. May ue .>~, - ' the following structure sep~rate~ hW t','epe~ty trom this enwron~,~ental area: J ] 50' existing r6ad [ ] existing [ ,] bluff area mol?e :than. 10' i~}~ elevation above mean sea level J 5. This propo,,ed addmon/expanslon bf an existing building will be more ' ~ t~dal w~tlandstwaterf ont areas. than 75~ from the landward ed96 o;~ ' ~ ' 'r :~ [ ~ 6, This proposed add tionle~xpansio~h ~f an existing b~ilding will NOT be ~ more than 75' from the landward c~9e ~¢ tidal wetlands/waterfront area. p e~se b0 aware that any and all subdivisions an~ SeW dwellings will also require an application to the ,.Y.S. Department of. Envlronlhe~tal Conservation ,o.r their review f nd a~p~oval. If you are able to provide them ~iC~l recent ~photog~apns of the areas t wou d help expedite the processing of your apphca project and wetland , ' don, This questionnaire is made to explain the requW~m~?ts of.t is 5tat~ Law and to Receipt N9 19704 .'TOWN of SOUTHOLD :OFFICE OF BUILDING INSPECTOR Town Hall. $ou~thoId, New York 11971 ~' < ; ~ F~ for [] Yard Sale [] [~C~h []] Check' $ .... ~,..o.0.. ~ ~ ~l~hi!ding Inspector ~) TOGETt!)~t', xv:Lth a r~.ght of way, one (~.) ro~! '~u x..'xl,.h, , nr .,m,,,., sa ,."2 cf:.. ta*tn~.nf~ a right off xray o,,,e~ th~ 1,,.ug?,,..O.,. Lit.- t~:.~!s ~. ....... kc. ,,t,,ttt]M ..... t ~.~. 3oink.rig Wells ,1,o.,d, or zn the ovent t~Rt l.~tl,. ~ .... ' -, , zsas herein de,,.,1, kbcc. ' In the event [:ho,tt.o"' ,: p~,rt-y oft:be secondIsa"t,- desires t'o sc!l or eonve~ the premises he,rein described'altar:lng ~he:!i:re::i~n:~ of thc pzttic:-: .c~.5 the part,then and in that evana ~he partios 9f tlm firs¢ part shall have the fir~ option to purchase the said ?:cmises and ='e..ccmvey:,nce thereof. This rig'ar of~ purchase or re-conveyance shall ex~st only c..r...no the 1.tfe~zme of the.lW%rti~s of the_ first p{.rt, or t~ha sm~v~.vor of either oi them =n~ shall terminate upon 'the death of ~he last survivoz'. , FORM NO. 3 TOWN OF SOUIXqOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE' OF DISAPPROVAL File No ................................ ~ro..~'~&..7~ ..o..~..~..~.~.,., .... ....... PLEASE TAKE NOTICE that your application dated .. . for peru, it to comtmct...~ ~ ~~C~ ~:~. at lmcation of Property h3~ ~ ~ ~ ........................................................ s o Street . H~rnlot County Tax Map No. 1000 Section .... ~. ~ .... Block ...... ~ ...... Lot .... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewitt~ and disapproved on the following grotmds g~ ~ G /q , ~ Building Inspector RV 1/80 5T^T£ DEPARTkJEN UNDE! THC [NV( AKTICL£ 15, (lProtection of Water~ ARTICLE 24, ( f~om {;idi file ,Jrt the offi(~e 01[ the appropr Ic~ of. intentii)n to ~mmenc~ w~ k ~, lea~: 48: com~en{ a~ shall als( , ~l~y hint ~ sub)~ ~O ~specl~on b~.a~m it of Eh~o~men al Conse~v~ ~he pu6Jic lnfe~egt so kqu ~es. ~u~nce of th~ ~rm~t, the of the ap~Hca~ion, the or indirect of bh~ever nature ~oject hereto a'n6 ha~ guits, a~?ions~ damak*s ,tioff resdltins~f~om ~he said pro)eot.. id {h~ Pr0~ecml ~r~dum~ u~er his or inter(erenc~ wit~ navigation~by ~ng b~ Lh~· S ~ eof ~ew:York~.reqdlr~ a~ Mt~at or wWk or if, > said wat~s Or fl~ fl~wh m ordered e~ and [~, u[ expiration stT~[lure or }i,lt ~d re,tore {0 its ~drm~r 10~-84:-0520 house is to frdm the eastern and is r £xPIg^noN ~une 30, 1986 inno ca~e be liable for any damage ich may be caused by or * the ~tate for the cOnservahon or perpose§, and no claim or right to i any work hereby authorized d shah be installed and maintained shall be performed in acco,'- the D~P~rtment reserves the right after, due ~otice and hearing to such a m~nner as may be found to {on or re~ocati~n o~ this permit, the $.nOt beef~,completed, the and tn such i may ~equire, to the applicant rights of others impairmeni of any rlghts, aRy other ~efmits, y which may be required (or this 'anted solel~' on the basis Law and Plai~i A~eas having Special Flood ~Jgnifi~s thai the pro ect Wil) be permittee agrees that ~he permit the special conditions on the ~P£CIAL CONDITIONS 16. There shall be no disturbance to vegetation or topography within 50' :of tidal wetlands. SEE ATTACHBD CONDITIONS A - J PLgMIT ISSUE DATE June 15, 1984 Bldg. 40,~SUNY--Room 219 StOny Bro~k, NY 11794 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ,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 adjoining premises or public streets ir areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 'etlon. 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 ,hail 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 iluilding 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~moval or demolition, as herein described. rhe applicant agrees to comply with all applicable laws, ordinances, buildi~d~e~ hog~l~g/~jode, and regulations, and to (Signa~Te_gf applicant, or name, if a corporation) - '~RDIN£E $ BAY CON$?PUcT~0N Cb PO B '; · . .......... . . :.. ......... £tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ............................................... ame r ...................................................... ° .... (as on the tax roll or latest deed) I f a pplic~a~po/~fsignatur¢ o f duly anthorized officer. -J//..., /., /_..4,¢,f/'1,...~,--~ ,-.. ,~ ....... ,a, RDINER'$ BAY CONSTO, UCTION CO. ~ ~me and title of corporate officer) ', P.O. r~ox 302 SHELTER ISLAND, NY (516) 749-0182 ' ' "'f~,~.--~ / U Cerise o .................... ..................... o 5-0 ! d '"' Electrician's License No...~. ................. ' s LiCense No ' Other Trade' ' ' ~ Location of land ~'n which proposed work will be done ty lJ N . · 0 f7 5 ' , mock .... d),v... Lot .0. · Coun Tax Ma o. 1000 Section ................................................ f~..~q) f,.., Filed Map No Lot ' Subdivision.. · ...................................................... (Name) ',, . , 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy,~,. ;'\. · .9- ............................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...... ,,., Repair Rem'oval Demolition Other I!/ork ' (Description) 4. Estimated Cost .. I .~'-.~a. Of)..O ......................... Fee ...................................... ! ". (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If g~rage number of cars i ' 6. If business, commercial or mixed occupancy, specify natnre and extent of each type of use .................... 7 .... ~ ' ' Rear Depth · Dimensions of existing structures, if any: Front ...................................... lleight ............... Nmhber of Stories" ...................................................... ' .... Dimensions of same structure With alterations or additions: Front Rear Depth I lleight Number of Stories 8 Din.,ensions ' ' ' ~ Rear ' .D.e.p.t~ . of entire new construction: I4ront ...... . ..................................... Height Number of Stories 9 Size of lot: Front : Rear Depth 10 Date of Pnrchase ' Name of Fenner 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 regra ....... ,i ......... ........ Will excess fill be removed from premises: Yes No 14. Name of Owner Of premises ..i .................. Addr,e, ss ................... PhoneNo. Name.of ArchiteCt ......... I ............ : .....Address ................... Phone No ................ Name of Contractor ........ ! .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al} buildings, whether existing or proposed, and. indicate all set-back dimensions from property fines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ;'lATE OF'NEW YORK, ! S.S N :OUN'rY OF being duly sworn deposes and says that he is the applicant (Name of individual sig~ing contract) lc is the .................... i r ' · (Contractor, agent, corporate officer, etc.) , ,f said owner or owners, and is du y authorized to .p. erform or have performed the .said work and to m..ako and fie this pplication; it}at all statements cent ~h~ed in this application are true. to the best of his knowledge and belief; and that the turk will be perfornied in the manm'r set forth in the application fil~d therewith. ,worn to before me this ........... '7. ....... dayo .... ......... ' ., z......a;. //! V,,--/,/Z/ BO~R~ OF l PPEALS, TOWN OF SOUTHOLD In the 'Clatter or the Petition of t~O the ~oard ~f Appeals of the lown of $outhold ~ :: ! , OUAR£HER£BYGIV£NNOIICE: :' 7 ~1 :Th~idtention of the unders~gnefl to Oetit~on t~e ~oard t~e~u~st a~arianc~(Special Exception,)(S~eriaJ Permi()~Q~o~):, [9i e ro ~rt wh ch s the gub ect of the pet)t ~n s~lo~ated ad ac NO? CE : ;,: TO DiPERT~' OWNER ; . )~als 0f ihe lown of Southold 210 choice] n.t t6 yoOr property a~d is de~- '' ' ~'. · ' ' : ', : ' !' ~ d' th~e~ollowingzo'ningdistrict: ~'~ Th;Jr'the oroDertv which ~ thc sub ect o¢ such Pen~,!oq Is l~ca~ in 4. Th~l by such Petition, the uncle;signed w. il,, e~ue~t',HeJol(p~g relie 5. That the provisions of the South01d lown ~onmg Comte apphcable, t , ~6, 'Thai within five days ?rom the date hereof, ,~ wr[[ten R~.tit~m f~quest ~e fil~ n th~Southold lown Clerk's Office at'Main [:~a~ S0~I0, exam n~ the s~e dur ng regu ar office ho~rs. (516' ' 65-18, . ~ 7. That bbfore the relier sought may be granted, )a publia Bea~ng must b~ held on~[he matter by the Board 6f Appeals; that a notice of such hearing,muSt be~p~bl:ish~ at[~east five d~ ys prior ~to the date of such .headn n i ~Suffolk T roes and-in the Long Island Tra~el~r-Matt~Ru~k Watchm~ n; news0apers published in the 10~n ~f sou~ho ~ a~d acs gnated for the publication ~a~sUc~h~o[~ce{j th~t~V0u { r your r~presentative have the ~right t~ appe~f and be heard at such hearing. : ' ;: ,Post (~f fi~'~./Ad d ff.,ss he reliefisought by the under- ~g the re}ief specified above wilT' and'you; ma), then and there TOWN OF sOUTHOID, NL:W YORK APPEAL FROM DECISION OF BUILDING INSPECTOR ~ppEAL ~0. DATE .............................. ,~/~p rtl./?ii/iL'. L ,. ~ /, ~W~ ~Street ond ~Number Nome of ~ppeJlont ~ ~/l/ . . ~Z~ ..... , ' ~IZ~,....~... HEREBY APPEL TO Municipali~ State THE 'ZONING BOARD OF APPEALS FROM THE DECISION rOF~ THE BUI~ DING INSPECTO~ ON APPDICATiON DATED: FOR: J~'~J~/~ ~.. . c~..::~......~ ................................... ' Name of Applicant for permit ' ,~ ' ~-.. ~ ~ ~ttL~ ~ ~ L . ~ .................... ~ " , ........ ~ ....... ~""~ ..................... ~n~h~y Street and Number , ( : PERMIT TO USE ( PERMIT FOR OCCUPANCY ,.- r: ~ ; / ~ BuIID ~ ~ .... ~ ' __. r~,~ THE PROPERTY ~.~: .... ~1./ .../'/~':'": ........ Z~ OF ~ ~,.x ~ , ................................. Stree~ ~d ~ULe~ . Zone 2. pROV[S%ON (S) OF THE ZONING ORDINANCE APPEALED ( ndicate the Article Section, Sub- quote the Ordinance ) sectlo_ -r ~ - ' ~ --' ' ~ ~L~ 3 TYPE~0F APPEAL Appeal is made herewith ~or ( ~ A ~ARJANCE to the Zoning Ordinance or Zoning Map ( ?~ A ~ARIANCE due to lack of access (5tste of Ne~ Yerk Town Law Chap, 62 Cons Laws Ar! J6 Se~ 280A Subsechon 3 4, P~Ev~OU5 APPEAL A prewogs oppeo% (h~s) (ha% not) been m~de with respect to this decm~on o{ the [~u[Idmq ~nspector or w~h respect to thy, property. 5t~}~ cppea~ was ( ) request ((,r O special ~err'rHt ( ) request for a variance ' . ....... ~,~t d .... ' ........ ~ ....................................... 6nd was mode in Appeal No. ~ / ~ , e R~ASON FOR APPEAL [ i~ ' A Vanance to Sectmn 280A Subsechnn 3 ( ) A ~c]r:mce to tb~ Zoning Ordmc~ce ( ) ~,,)~.:,~ Zm (Cont,nue on other side] REASON 1, STRI( saryl HARI ; '2.: ~heh( vicinity of :OR APPEAL Continued ~i !~ ' ;~ T APPLICATION OF THE ORDINANCE would prC~gce, practic~! difficulties or unneces- rd~hi p created is UNIQUE and ,no.t ,norea property and in this us~e district bec ,se 3 'l~he Vcnqnce would observe the spir~t'of:the Drdlrfoloc d WQU NOT CHANGE THE C~!A(~ACT~R OF THE DISTRICT because v,~ m f' rt ,~ day of... ~ 19 ............................ Nota~ Pubhc ~FFOLK COUN~ DEPARTMENT OF HEALTH SERVIC~ ALFRED APR. 16, 1984 ~ ~PROV~ O~ CONSTRUCI[ON ONL~ ~T P[CO~IC DITE: APB. ~, 1984 ~ ~ SOUTHOLD SCALE, 1% 50 ' DA~ HS REF. NO~ SUF~KK COUNTY, NEW ~RK NO. 84- ~99 ~EAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ANO~ Ml~ ~LF ~ T~ TITLE C~Y, GOV~M- M ~F CO, ~P M~ $ECTI~ o7~ ~K ~ LOT ~ mST T~TI~. GUARANTEES ARE ~T TWSFERABLE BRANDI$ & ~ONS INC. 1046 zoo,OO' " ' 50 forrcerlY or Georqine n°;cbOel 5 . ~ Zo! 4 TEST HOLE ~lef o~ ~ene~hl Enginee~i~ HE~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUC T NOT~: I=MONU~NT O=PIP~ ~= STAKE formerly ooW G. johO ¢3. 09 ' Lo/ j~ TITLE NO. 07- 106~556 05 "1~. 3~, / sURvEY FOR AT PECON/C TOWN OF ~OUTHO£O SUFFOLK COUNTY'; NEW-YORK OCT 4, 19B5 AU~. /_5, /984 JULY 25, /98'~ APR. /6, 1984 DATE: APR. $, 1.984 SCALE: I"= 50 ~ NO. 84- 299 GUARANTEED TO: AS~FURED ~ DITHo~b~irV~GS~e-~, NUNZIO YOUNG a YOUNG ALDEN W. YOUNG., PROFESSIDNAL ENGINEER AND LANO SURVEYOR N,Y.S, UCENSE NO. i2845 HoWARo W, YOUNG~ LAND SURVEYOR N.Y.S. 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