HomeMy WebLinkAbout16333-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18985
Date APRIL 25, 1990
THIS CERTIFIES that the building.
Location of Property 205 NORTH SEA DRIVE
House No.
County Tax Map No. 1000 Section 54
Subdivision
RENOYATION & ADDITION
Block 04
Filed Map No.
SOUTHOLDt N.Y.
Street
Lot 04
Lot No.
Hamlet
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 10, 1987 pursuant to which
Building Permit No. 16333-Z dated AUGUST 14t 1987
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 MOVE HOUSE TO NEW FOUNDATION & ADDITION TO AN EXISTING
SEASONAL DWELLING AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELLIOT & AILEEN PD,$KOFF
(owners)
UNDERWRITERS CERTIFICATE NO. N-016837-JUNE 17r 1988
PLUMBERS CERTIFICATION DATED APRIL 20~ 1990-MATTITUCK PLUMBING & HEATING
Building Inspector
Rev. 1/81
FORM NO. 0
TOWN OF SOUTHOLD
BUILDING D£PARTMJ~NT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLb-I"ION OF THE WORK AUTHORIZED)
N~_ 1 6 3 5.3 z Dote ...~.~.~.....l...4... ........ , ".~..7
Permission is hereby granted t~g~ , A
..Z-JL-..~.....U..!.! ................................................
.~..d.....:....~.....%...i..I...t-/..~. ......
,o ~,,,~..~...~...~.~.~....~..~.....~,,.a....,~...~....k......~ .....
Coun~ Ta~ Map No. ~ooo ~t,on .... ~.~ ....... ~,o~ ...... .~.~ ........ Lot No ..... ~..~. ............
pursuant to application dated ....... .~.~.~.....L~ ............. , 19~.~..., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ~ ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to ti~e bUiid~ng
inspector with the following: 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 i% 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.
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 a 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
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling ~25_~, 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 - $5.00 over 5 years - $10.00
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 .................
Location of Property ........ ~ ..............................
House No. Street Hamlet
Onwer or Owners of Property .... ~.~/~..~....~/...../~.~..~.~'.~....~..~.~..J~..~.~..
County Tax Map No 1000, Section....~.~. ...... Block ....... ~...~. .... Lot....~...~, ..............
Subdivision .................................... Filed Map ............ Lot .................
..~.~. ~. ~.~..~..Date---- Of Permit .........................................
Permit No . . .
Applicant ....
Health Dept. Approval .......................... Underwriters Approval ...................... . ..
Planning Board Approval .................... . .. .
Request for: Temporary Certificate ........... Final Certicate....~......
Fee Submitted: $...~.~.'~ ................. ~~~''
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~re ~pplicatlon No. on file
THIS CE~IFIES THAT
~y t~ ~t~ ~ulpment ~ ~ ~ a~ int~M by t~ ~t ~M on ~ ~ ~t~ numar M t~ p~m~s ~
~ examin~ on and found to be in ~mpllance with the r~ulrements of th~ ~rd.
flXTUl~ / WITCHBS I~XTURES RANGES COOKING D['CKS OVENS DISH WASHI~S EXHAUST FANS
This ceffi~o~ m~t not ~ o~ in any monneo r~urn ~ fhe o~ice o~ t~ ~ord ~ incorr~, Insp~ors may ~ i~i~
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
CERTIFICATION
TEL. 765-1802
APR 2 4 1990
Building Permit No. 163
Owner Ek&toT
(please print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber' s signature)
Sworn to before me this
~-/'~i~/ day of ~/~ ,
Notary Public, ~/~ County
Notary~ic
Elliot Paskoff
174 Cedar Shore Drive
Massapequa, New York 11758
April 23, 1990
212-973-6125
Town of Southold
Building Department
Town Hall, Main Street
Southold, New York 11971
Attention: Ms. Georgia Rudder
Dear Ms. Rudder:
APR 2 i990
I enclose Form No. 6, Town of Southold Building
Department application for Certificate of Occupancy for building
permit No. 16333Z together with the application fee of $25.00.
Additionally, enclosed is an original certification from
Mattituck Plumbing and Heating by E. Paul Wilsberg, duly
notarized, concerning the solder used in the water supply
system.
Please mail the Certificate of Occupancy to my
Massapequa address.
I wish to thank you for your most kind assistance.
EP:cw
Enc.
SiDgerely yours,
Elliot Paskoff
FOUNDATION
(1st)
FOUNDATION
(2nd)
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
CO~Ng~T~
ADDITIONA'L COMMENTS:
New York State DepaAmentofEnvironmental Conse~atlon
Regulatory Affairs Unit
Bldg. 40,SUNY, Rm. 219
Stony Brook, NY 11794
(516) 751-7900
Thomas C~ Jorlin§
Commissioner
July Zl, 1987
Elliot Paskoff
174 Cedar Shore Dr.
Massapequa, NY 11758
Re: 10-87-1188
Dear Mr. Paskoff:
In conformance with the requirements of the State Uniform
Procedures Act (Article 70, ECL) and its implementing regulations
(6NYCRR, Part 621) we are enclosing your permit.' Please read all
conditions carefully. If you are unable to comply with any conditions,
please contact us at the above address.
Also enclosed is a permit sign which is to be conspicuously posted
at the project site and protected from the weather.
_P~ogal Permit Administrator
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
UNIFORM PROCEDURES ACT
Region No,: 1 ~ -- -'
Office: _
Applicant.
Amount: ? , '/~0'00
Application Identification No,:
Permit Type:
n~ . Stcmy Brook
Check / Money Order []
Che k or M.O. No.: ,SS'/
32-14-13 (9/77)
Robert A. Greene
Reg,_. Permit Admin,
95-20-6 [9J861--25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER
10-87-1188
EACILITY/PROG RAM NUMBER(s)
PERMIT
Under the Environmental Conservation Law
Article 15, Title 3; 6NYCRR 327,
328, 329: Aquatic Pesticides
Article 15, Title 5:
Protection of Water
Article 15, Title 15:
Water Supply
-- Article 15, Title 15:
__ Water Transport
Article 15, Title 15:
Long Island Wells
Article 15, Title 27:
Wild, Scenic and Recreational
Rivers
~---'] 6NYCRR 608:
Water Quality Certification
---'-]Article 17, Titles 7, 8: SPDES
l----~"-1 Article 19:
Air Pollution Control*
~ Article 23, Title 27:
Mined Land Reclamation
[-'--'~ Article 24:
Freshwater Wetlands I-----[
N--New, R--Renewal, M--Modification,
C--Construct (*only), O--Operate (*only)
EFFECTIVE DATE
7/Zl/87
EXPIRATION DATE~)
7/31/92
Adicle 25:
Tidal Wetlands N
Article 27, Title 7; 6NYCRR 360:
Solid Waste Management*
Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
Article 34:
Coastal Erosion Management
Article 36:
Floodplain Management
Articles 1, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
PERMIT iSSUED TO
Elliot Paskof f
ADDRESS DE PERMI]TEE
174 Cedar Shore Dr., Massapequa, NY 11758
AGENT FOR PERMITTEE/CONTACT PERSON
NAME AND ADDRESS OF PROJECT/FACILITY (It different from Permittee)
North Sea Dr., Long Island Sound
TELEPHONE NUMBER
LOCATJONsoutholdOF PRO) ECT/FACILITY SuffolkCOUNTY TOWN/(~Southold UTM COORDINATES
DESCRIPTION OF AUTHORIZED ACTIVITY
Relocate existing dwelling 150+ ft. landward of present location as per attached NYSDEC
approved survey last dated 8/5/85.
GENERAL CONDITIONS
By acceptance of this permit, the permitlee agrees that the permit is continsent upon strict compli-
ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto.
PERMIT ISSUANCE PATE ~I~'/~INISTRATOR ADDRESS J
7/21/87 . /Robert A. Greene /Bldg. 40 SUNY Rm. 219 Stony Brook, NY 11714
(~(~/-:.~" (~:/~7,~_.~:~'~.-~ Page 1 of 3
cc: C.T. Hamilton
ADDI3'IONAL G~.NERAL CONDITIONS fOR ARTICLI?S 15 [Title 5~, 24, 25, 34, 36 and
~0. That if future operations by the State of New York require an al-
if, in the opinion of the Department of ~nvironmental Conservation
wa~e/s or flood flows or endanger the health, safety or welfare of
resources o~ the State, the owner may be ordered by the Department to
thereby without expense to the State, and if, upon the expiration or
modification of the watercourse hereby authorized shall not be com-
ple~e~, t~e owners, s~alJ, without expense to t~e State, and to such
and f~ood capacity of t~e watercourse. No c~a~m s~a~ be made
the State of New york on account of any such removal or alteration. ~7.
qq. Tha~ the State of New York sh~ll in no case be liable for any damage
or inju~ to the structure or work herein authorized which may be caused
by or result from future operations undertaken by the State for the
bihty of obtaining any other permission, consent or approvat from 19.
the U.S, Army Corps of Engineers, U.S. Coast Cuard, New Yor~ State
Office of Cenera~ Services or loca~ government which may be required.
of any wetland or waterway by suspended solids, sediments, fuels,
other environmentally deleterious materials associated with the
project.
14. Any material dredged in the prosecution of the w0rk herein permitted
shall be removed evenly, without leaving large refuse piles, ridges across
the bed of a waterway or floodplain or deep holes that may have a
tendency to cause damage to navigable channels or to the banks of
a waterway.
There shall be no unreasonable interference wRh navigation by the work
herein authorized.
If upon the expiration or revocation of this permit, the project hereby
authorized has not been completed, the applicant shall, without expense
to the State, and to such extent and in such time and manner as the
Department of Environmental Conservation may require, remove all or
any portion of the uncompleted structure o~' 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,
If granted under Article 36, this permit does not signify in any way
that the project will be free from flooding.
If granted under 6 NYCRR Part 608, the NYS Department of Environ-
mental Conservation hereby certifies that the subject project will not
contravene effluent limitations or other [imitabons or standards under
Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977
(PL 95-217) provided that all of the conditions listed herein are met.
AU activities authorized by this permit must be in strict conformance
with the approved plans submitted by the applicant or his agent as part
of the permit application.
Such approved p[~s we~'e prepay'ed by
on
SPECIAL CONDITIONS
1. Existing sanitary system will be utilized.
2. Place 100± cubic yards of clean fill around new foundation.
in from upland source.
3, First floor elevation must comply with local requirements.
Supplementary Special Conditions (A) through (J) attached.
Fill to be trucked
DEC PERMIT NUMBER
10-87-1188
PROC RAMJFACILITY NUMgER
~/A
Page 2 of
New York State
Department of Environmental Conservation
NOTICE
Permit No.
The Department of Environmental Conservation (DEC) has
issued permit(s) pursuant to the Environmental Conservation
Law for work being conducted on this site. For further informa-
tion regarding the nature and extent of work approved and any
Departmental conditions on it, contact the Regional Permit
Administrator listed below. Please refer to the permit number
shown when contacting the DEC.
Expiration Date
Regional Permit Administrator
NOTE: This notice is not a permit
MONROE R. SONNENBORN a BEVERLY A. $O~NENBORN
~/o/~ , ~., o/~ ,/o/~
NICK a JOHANNA, TSOURIS CHARLES GANASSA ORESTES ~ EVELYN
~ OTHERS
.... " SURVEY FOR
ELLIOT P~$KOFF 6~ AILEEW PASKOFF
AT SOUTHOLD
TOWN OF SOUTHO~D
~ ..~.. SUFFOLKIo00SCALE- 54 COUNTY,_ 1"04= - 30'N'Y'04 ~:~__.~
;N. Y. s.' LtC,'NO. 49568 :
:ENGt~EERS P. C.
VARVI TSIOTTE S
KENNE¥~ ROAD
CERTIFIED TO:
TICOR TITLE GUARANTEE COMPANY
ELLIOT pASKOFF
AILEEN PASKOFF
AREA = 33, 039 SQ. FT.
SCOTT L. HARRIS
SUPERVISOR
FAX (516) 765 - 1823
TELEPHONE (516) 765 - 1800
OFFICE OF THE SUPERVISOR
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
TO:
FROM:
DATE:
FAX COVER SHEET
Pages to follow:
Additional Comments:
IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL SOUTHOLD TOWN 'HALL at (516)
765-1800
,./
· ~ FOUNDATION ZND [ ] INSULATION
~..~ u,~.,~t BUILDING DEPT,
INSPECTION
[~/FOUNDATION 1ST [- ] ROUGH PLBG. ':;" ~': ?~'
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
DATE ~//3/¢~ ,. INSPECTOR L)~/~~.
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ~r,~3~NAL
DATE _ ~//,~ ~,//~O INSPECTOR~/~~~~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [~]~U~TION
FRAMING
REMARKS:
~r ] FINAL
DATE
BOARD OF HEALTH ......
3 SETS OF PLANS .......
FORM NO. 1 SURVEY ..........
TOWN OF SOUTHOLD , CHECK, -. ........ - ·
BUILDING DEPARTMENT SEPTIC FORM -
TOWN HALL
$OUTHOLD, N.Y. 11971
ned~ TEL.: 765-1802
Exami . .~...~. ( .~.., 19 .~. ?
Appr0v~~/ ~ , 19~..'3. Permit No. l.b.'.~
NOTIFY
CALL ................
MAIL TO:
Disapproved a/c .....................................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter 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 is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d~. Upon approval of this application, the Building Inspector will 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 9 Certificate of Occupancy
shal~ have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing c~d regulations, and to
admit authorized inspectors on premises and in building for necessary inspe~ [J
.........................~ tq--~--~.%~ ............
(Signature of applicant, or name, if a corporation)
...~. ?...~.~.,...3.o.~..? ~ ~:...~. :.-4.. ~.: ~ 7., .......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..................................... ~..~..e...~?.o..~..~...a~..~ .~..~. .................................
Name or owner of premises ...~..i~.:..~...t~. ,?:.g...~.-~. ?. ! ? ?...{.~...~.'.~..~.~..'.'.'.'.'.'.'.'.'~: ..................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) .
ALL CONTRACTOR'S MU~T BE SUFFOLK COUNTY LICENSED
Builder's License No.. ~..~?..'1. ~..~..l: .............
Plumber's License No. "g.'~ t.t. '~
Electrician's License No. ~.~4r~e- t~.
Other Trade's License No ...... ~ ..............
I. Location of land on which proposed work will be done~ .......... '...: ....'. i .......................... ...
...................... ...............
House Number Street Hamlet
County Tax Map No. 1000 Section ..... .~..~/. ......... Block ....... .Kf ......... Lot..~/ ................
Subdivision ..................................... Filed Map No ............... Lot .., ............
(Name)
2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........... ! . .'~...t~..: .~ ....... : ......................................
b. Intended use and occupancy ............... .~. · .~e~....~ffT. ............................................
3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration ..........
Repair ...... ~ ....... RemOVal .............. Demolition .............. Other Work....~. ..........
4. esnmarea ~ost ...................................... Fee ......................................
~ (to be paid on filing this application)
5. If dwelling, number of dwelhng[unlts ..... !. Number of dwelling units on each floor...I
If garage, number of cars I ~ ............................................
6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ...... .'W'. .............
7. Dimensions of existing structures, if any: Front...~..~.".~..? ..... Rear . .~. ! 7.~. .-* ...... Depth . ?.?.: !.*'? ......
Height ~'~'"'~ ?- Number of Stories ~ '
Dimensions of same structure W~th alterations or additions: Front ....~.~.
' Height ~'~..~ I: .. Number of Stories ...I ....
'--8. Dimensions of entire new consffuction: Front . .~.?.~.~..~.... ..... Rear
I ~,.-.~ ~ Number of Stories
Height .............. . ........................................................
9 Size of lot: Front ' ' Rear ~ Depth
10 Date of Purchase ' Name of Former Owner
11. Zone or use district in which pr~mises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...~..~ ...........................
13. Will lot be regraded .... .~.?. · ! ...... ,,~ .... Will excess fill b.e removed from premises: ,Yes No
14. Name of Owner of premises [~..~'.'.%~..['.~. ~i~.' ~'.' i. Address~..* ~.~..~ .~..c~...'~.. ?.~.. Phone No..-f,~. ?...'~.'?.~. ....
N ' ; ~ ddress .................... Phone No...--. ............
ame of Architect ....... ~ ................. A -- '
Name of Contractor . .~.. '...I.(.?.~..a~. ~ .......... Address'-~ .~.'!! ~..~: ??. ~ Y.~... Phone $o.'~..~.?.'..~.~.? .~'~...
15. Is this property loeatedlwithin 300 feet of a tidal wetland? *Yes ."~.... No .....
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW Y~Q~RK
COUNTY OF..
...... .
S.S
(Name of individual sigqing contract)
above named. ~
being duly sworn, d6poses and says that he is the applicant
He is the .................... ~...t~...y.~. ~ .x~.. ....................................................
of said owner or owners, and' is du
application; that all statements cent
work will be performed in the manta
Sworn to before me this
No. o2-8125850, Suffolk Co
~hrm rlxpire? October 31. I(~_~''
(Contractor, agent corporate~officer, etc.)
y authorized ~o'perform oihave performed the said work and to make and file this
ained in this application are true to the best of his knowledge and belief; and that the
r set forth in the application filed therewith.
(Signature of applicant)
ppllcatlon Received
19
Disapproval Issued
19
Permit #
19~
FORM NO. 10
APPLICATION FOR DEVELOPMENT PERMIT
I. Type of DeveLopment ProposeG: New Structure [lnc±uGmng norage hanks
Addition and/or Alteration Flood Proof Below Base Flood Elevation
Other (specify)
e
4. Owner of Premises
Elevation Data in relation to above mean sea level of:
(a) Lowest floor elevation, including basement __ feet inches
(b) In a V Zone, bottom of lowest structural member ~eet inches
FIRM--Flood Insurance Rate Map, Zone designations ~-7 ~'~ ;/~
5. Location of Property:
House #
County Tax Map No.,
Subdivision
Street
Dist. 1000, Section
Hamlet
Block Lot(s
Filed Map#
Permission to be granted: _~ Owner as above New Owner
__ Under Contract __ Lessee __ Contractor Phone #
Lot (s)
Name if not given above Mailing address
Approval from other(s)
DEC /~-- ~ -- 7/ ~
Health Services
Building Permit
I,
New Owner
before Permit is issued:
Wetlands (Town Board)
_ ZBA A3/~
Planning Board
, the applicant,
Under Contract__, Lessee
am the Owner , Co-Owner
, Agent __, Contractor
and agree to comply with all applicable sections of the Code of the Town
of Southold; County, and State and to admit uthorlzed inspectors to
premises authorized to perform or have performed the said work and to
make and file this application, that all statements contained in this
application are true to the best of my knowledge and belief and that the
work will be performed in the manner set forth in t~plication filed
therewith. ·
STATE OF NEW YORK
~rZ/ -- Signature
SWORN TO THIS /~ DAY OF
. - LINDAJ~COOPER ~" ~ / --
~. (~ ~,~'~
, - ~'~ .%c,. 48225~3, Suffolk County
~]~13. ! Term Expires December 31, 19___
Applicant ' s mailing
address and phone #
if not given above
11/85
P.O. Box 728
Southold, N.Y.
FORM NO. 10
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
(516) 765-1802
Town Hall
Main Road
Southold,N.Y.
11971
~P~T,TC~TI~N FOP DFVET.OPME~T PEP_MI~
Instructions: The application to the Building Inspector includes (each
'~) 1. Form No. 10 filled out in ink or typewritten, 2. Sur-
vey of premises with elevations above mean sea level!, 3. Drawings of pro-
posed work. The application ~mst give complete info~mation to show that
the proposed ~can comply to the Local Law No. 1-1980,! Chapter 46 of the
Code of the Town of Southold known as "Flood Damage ~revention Law" of the
Town Of Southold. The applicant must submit approvails that any other
agency requires.
General Standards as required in Section 46-17 of thle law to minimize flood
damage: I
A0 Anchoring of structures, including tanks an~ mobile homes
B. Use of construction material and methods
C. Design and location of utilities i
D. Subdivision proposal with drainage, publiq qtilities design and
base flood elevations
specific Standards as required in Section 46-18: A. Residential construction
B. Non-residential construction
C. Mobile homes
The applicant must submit plans and specifications as well as any other
information requested by the Building Inspector to Substantiate the fact~
that 'the structure has or will have the lowest floo~, including basement/
cellar, elevated above the base flood elevation or; iif permitted by the
Federal Regulation, that: 1. such structure is flood proofed in such
manner that below the base flood level the structur~ is water tight with
walls substantially and impermeable to the passage df water, 2. that
structural components are capable to reszstzng hydrostatmc and hydrodynamzc
loads and effects of buoyancy, 3. applicant must su~mit certification by
a registered professional engineer or architect that the standards set
forth in Section 46-18B (1) (2) (3) of the SoutholdiCode are satisfied.
Coastal High Hazard. area (V Zone) 46-19. Applicant shall submit plans,
specifications includ-~g the required certificationB and such other in-
formation as the Building Inspector may require, in ~hat the provisions of
46-19 are complied with. Mobile homes are prohzbzt~d. The lowest portion
of the structural members of the lowest floor cannot be lower than the
base flood elevation with all space below open except breakaway walls.
Sand Dunes. If sand dunes exist on the premises and the applicant pro-
poses to alter same, plans and specification must b~ shown in detailed
nature of any alteration submitted, i
Building Permit. A Building Permit is also required for any structure.
Both a Development and a Building Permit must be issued before any work
can start in a special flood hazard zone. A written disapproval or a
permit must be issued within ten (10) working days.I
During construction, the inspector shall be notifie~ in time so he may
make the required inspections. ~
Upon completion, the required c6rtification of the final elevations and
work must be
approved.
11/85
submitted before the approval to use or occupy can be
(Fill out the form on
the back of
sheet)
FORM NO. 11
TOWN OF SOI~I'HOLD
BUILDING DEPAI~TM.ENT
TOWN
80L~I'HOLD, NY
co~e~ *ax ~ar No. lOGO soo~io~ ~5~- m. oo~ _~.i.. r,o~ mq
pursuant to application dated ~~..., 199.,._...,~ aad ~,pp~"Jved
by the Building Inspoctop.
!~uildlng Pe~lt No.
Building lnspocto~,
L~/8O
N/o/r
MONROE R. SONNENBO~N iii BEVERLY A. SONNENBORN
$. 50° 24-- O0" E. 295. 84'
/
/ N. 50 36 O0 W. ~ ~OL 34
N/O/r
NICK ~ dOHANNA. T$OURIS
SURVEY FOR
ELLIOT PASKOFF 5 AILEEN
N/ O/r
CHARLES GANASSA
8~ OTHERS
PASKOFF
KENNE¥~
ROAD
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
I000 - 54 - 04 04
SCALE 1" = 30'
Mar. 2, 1989
. MA Y 2,
N,Y.$. L/C. NO. 49668
C,
MAIN R~
SOUTHOLE'l~ST'-. I1971
CERTIFIED TO:
TICOR TITLE GUARANTEE
ELLtOT PASKOFF
AILEEN PASKOFF
COMPANY
AREA 30,166 s.f.
ELEVATIONS ARE REFERENCED TO NGVD
85-284 C
IOCCUPANCY OR
I USE IS UNLAWFUL
WnHOUT CER'nF~C,~'~, ~;
OF OCCUPANCY
APPROVED AS ~OTED
NOTIFY BUILDING DEP&RTM~T AT
,l