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Home My WebLink About16334-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, CERTIFICATE OF OCCUPANCY No Z-17770 Date FEBRUARY 17, 1989 THIS CERTIFIES that the buildin~ Location of Property 305 NORTH SEA DRIVE House No. County Tax Map No. 1000 Section 54 Subdivision FOUNDATION SOUTHOLD~ NEW YORK Street Hamlet Block 4 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1987 pursuant to which Building Permit No. 16334-Z dated AUGUST 14, 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 APPROVED CONCRETE FOUNDATION ONLY~ The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO, PLUMBERS CERTIFICATION DATED MONROE & BEVERLY SONNENBORN ~uilding Inspector Rev. 1/81 FORBS NO. ii TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULl COMPLETION OF THE WORK AUTHORIZED) N~_ 1~334 Z Permission is hereby granted to: .......-~...Lu.~ ................................................. ~. .... ~.~.~.......~.;.~.,....,..!..~.~. ........ ,o ...~.,~...~..~.~....u,..~..'..m.....~..~.~- ..... at premises located at~...&....~........~....q~:~.~...~t-..:......~ .................. County Tox Map No. 1000 Section ...... ~.~...~. ...... Block ...... .~A...~. ........ Lot No .......~.,...~'.. ........... to application dated ..... ~..A"~...'~....!....? .......... , 19.~....']..., and approved by the pursuant Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDINC DEPARTMENT TOWN HALL SOUTHOLD, NE~ YORK 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING..X...VACANT LAND Location of Property .... 30~ ............... S~ Drive Southold ., ~ort~ ............................... HOUSE NO. STREET HAMLET ~O~rP~ ~ D~v~F~y ~opnenborn Owner Owners of Property ' Gounty Tax Map No. I000 Section ..~.. Block ~ ..... Lot Subdivision ....................... Filed Map ........ Lo~ .......... eermit No...........16334 Z Date of Permit . ~/~/~F...AppllcantRp~p. ,.............Bids for Owner aealrh Dept. Approval .................. Underwriters Approval Planning Board Approval ................ ~equest for Temporary Certiilca~e Final Cer~i£icate X Fee Submitted: . I~or Owner ev. 10/14/88 Environment East, Inc. R. R. No. 3 - 3075 Indian Neck Lane Peconic, New York 11958 516-734-7474 February 10, 1989 Southold Town Building Dept. Town Hall Main Road Southold, NY 11971 Dear Sirs, Enclosed are our check and an application for a Certificate of Occupancy to satisfy permit # 16334Z dated 8/5/87. All additional work is covered under permit # 17168Z dated 6/27/88. Approvals required, will be met upon the completion of the work cov~d by' This permit. If Sincerely, Peter R. Stou~nburgh President / Environmen~E~st, Inc. Encl.~/ PRS:jm / /?~ / ~ / FOItM NO. 11 %?OWN OP SObPI'IIOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY DEV ELO PMI:4NT I'ERM Ii' ?ez~lisslon i~ hereby granted to: Catty Tax Map No. 1000 Section pursuant to application dated by the Building Inspectom. Building PexElt No. Building Inspocto~, 4/80 New York State Department of Environmental Conservation Regulatory Affairs Unit Bldg. 40,SUNY, Rm. 219 Stony Brook, NY 1~794 (516) 751-7900 Thomas C~ Jorling Commissioner July Zl,' 1987 Monroe R. Sonnenborn 79 W. 12th St., Apt. New York, NY 10011 14F Re: 10-87-1187 Dear Mr. Sonnenborn: 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. Very truly yours, 1 Region No.: Office: Amount: $ /~ ~ OO Application Identification No.: 10";~'7 'lis Permit Type: -r"L~ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION UNIFORM PROCEDURES ACT Receipt No,U DRA - Stony Brook Check [Z]~/ Money Order Check or M,O. No.: dO~ 32-14-13 {9/77) Robert A, Greene Reg, Permit Admin, TITLE 95-2~)-g {9/g6)-- 25C DEC PERMIT NUMBER 10-87-1187 EACILITY/PROGRAM NUMBERIs) N/A 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 PERMIT Under the Environmental Conservation Law [-'~ 6NYCRR 608: ~ Water Quality Certification ~ Article 17,SPDES Titles 7, 8: ~ ~ Article 19: [-----1 Air Pollution Control* ~ Article 23, Tit,e 27: ~ Mined Land Reclamation ~-----~ Article 24: [-~ Freshwater Wetlands N--New, R-Renewal, M--Modification, r---'] c-construct (*0nly), o-operate (*0nly) EFFECTIVE DATE 7/21/87 EXPIRATION DATE(s) 7/31/92 rMe 25: ida{ 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 Monroe R. Sonnenborn ADDRESS OF PERMITTEE 79 W. 12th St., Apt. 14F, New York, NY 10011 AGENT FOR PERMITTEE/CONTACT PERSON J TELEPHONE NUMBER N/~ I NAME AND ADDRESS OF PROJECT/FACILITY iii different from Permittee} 305 North Sea Dr., Long Island Sound LOCATION OE PROJECT/FACILITY COUNTY TOW~,~/.it,lgJ~:~ UTM COORDINATES Southold Suffolk Southold DESCRJPTDN OF AUTHORIZED ACTNITY Relocate existing dwelling 150+ ft. landward of present location as per attached NYSDEC approved survey last dated 6/19/87, GENERAL CONDITIONS By acceptance ot this permit, the permittee agrees that the permit is contingent upon strict compli- ance with the ECL, ail applicable resulations and the conditions specified herein or attached hereto. The permlttee shall file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a notice of intention to commence work at least 48 hours m advance of the time of con~mencement and shall also notify him/her promptly in writing of the completion of the work. 2 The pem ted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation whkh may order the work suspended if the pubhc interest so requires pursuant to ECL §71-0301 and SAPA §401(3). 3 The perm~ttee has accepted expressly, by the execution of the app[ication,, the full legal responsibility for ali damages,, direct, or indirect, of whatever nature, and by whomever. suffered, arising out of the project described herein and has agreed to ~ndemmfy and save harmless the State from suits, acbons, damages and costs of every name and descDp- A.y rnodification of this permit a~pg~ O.~e , I17.I PERMIT iSSUANCE DATE PERMIT ADMINISTRATOR ADDRESS 7/21/87 ' Robert A. Greene Bldg. 40 SUNY Rm. 219 Stony Brook, NY 4 cc: C.T. Hamilton 95-2~6a (1106) - 25c ADDtTIONAL GENERAL CONDITIONS fOR ARTICLES 15 (title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 ( 10. 11 13. That if future operations by the State of New York require an al* ) other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation 14. it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused ' 15. thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fi)l, excavation, or other 16. modification of the watercourse hereby authorized shall not be cam- pie{ed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of ~nvironmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 17. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused 18. by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. Granting of this permit does not ~e~ieve the applicant of the responsi- bility of obtaining any other permission, consent or approval from 19. the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or Ioca[ government which may be required. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any project. Any material dredged in the prosecution of the work herein permitted shalt 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 dame. ge to n~vigable channels or to the banks of a waterway. There shall be no unreasonab[e interference with 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 t!nvironmenta) 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. 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 HYS Department of Environ- mental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations 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. Ali 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 plan~ were prepared by on . SPECIAL CONDITIONS 1. Exzstlng sanitary system will be utilized. 2. Place 100± cubic yards of clean fill arouBd new foundation. in from upland source. 3. First floor elevation must comply with local reqnirements. Supplementary Special Conditions (A) through (J) attached. Fill to be trucked DEC PERMIT NUMBER 10-87-1187 PROGRAM/FACILITY NUMBER N/A Page 2 of 3 SUPPLEME~TARY SPECIAL coNDITIONS The following conditions apply to all permits: A. If any of the permit conditions are unclear, the permlttee shall contact the Division of Regulatory A~f~irs at the address and t&tephone noted below. B. A copy of this permit or approval and supplementary conditions shall be available at the project site whenever authorized work is in progress. C. The permit sign enclosed with the permit or a copy of letter of approval shall be protected from the weather and posted in a conspici~us location at the work site until completion of authorized work. D. At least 48 hours prior to commencement of the project, the permittee shall complete and return the top portion of the enclosed receipt form certifying that he is fully aware of and unders~auds all provisions and conditions of this permit. Within one week of completion of the permitted work, the bottom portion of that form shall also be completed and returned. E. For projects involving activities to be accomplished over a period or more than one year, the permittee shall notify the Regional Permit Administrator in ~iting at least 48 hours to the commencement of resumption of work each year. ?. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require sub- mission of a new application for permit. G. All necessary precautions shall he taken to preclude contamination of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other envlro~mentally deleterious materials associated with the project work. H. Any failure to comply precisely with all of the terms and conditions of this permit, unless authOriZed in vt!ting, shall be treated as a violation of the Environmental Conservation Law. I. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, New York, NY 10278, (Attention: Regulator)* ~unctions Branch), prior to commencement of work authorized herein. J. The granting of this permit does not relieve the permittee of the respomsibilit~ of obtaining a grant~ easement, or other necessary approval from the Division of Land utilization, Office of General Services~ Tower Building, E~pire State Plaza, Albany, I~f 12242, which may be required for any encroachment upon State-o~med lands under water. Regional Permit Administrator NYS Dept. of Environmental Conservation Bldg. 40, SUNY--~oom 219 Stony Brook, NY 11794 (516) 751-7900 DEC # 10-87-1187 Page 3 of 3 C}IAPJ~ES To ItA~ILTOU Chief, ~ARINE REGULATOFJf ~PfS DEC, Bureau of }:arine I1aDitat Protection Bldg. 40, SUMY, Rm. 225 Stony Brook, ~. Y. 11794 Permit ~o, Issued To. Contractor's Address. Contractor's ~one # Dear Sir: Contractor's Name Pursuant to General Condition Mo. ! of the abov~ referenced permit ~ou are hereby notified that the authorized activity shall commence on · This Notice is to be sent at least two d~,s i~ ~d- vance of commencement of the project. The Permit sign will be pestled at the site and copy of Permit will be available ag site for inspection. Submitted by FAILIng TO NOTIFY OR POST SIG~ UILL LEAV~ O~ER/AMD/OR CO~TP~CTOR SUB JECT TO APPLICABLE PE~ALTIES FOR ~0~3-COI~LIA~]CE'1~ITH PEI~tIT COS~ITIOP~. C1L~P~EE To }LA2iILTO~ Chief, Marine Regulatory Section X~S DEC, Bureau of ~Iarine Habitat Protection Bldg. 40, SUNY, Rm. 225 Stony Brook, N. Y. 117~4 Re: Permit ~]o. Issued To. Contractor's Addr~SSo Contractoz~s Phone # Dear Sir: Contractor's Hame Pursuant to General Condition No. ! of the above referenced Permit, you are hereby notified that the authorized activity was completed on guhmitted by DATE: THIS ~OTICE, WITH PHOTOS OF CO}'~LETED %IOP/~ AND/OR COMPLETED SURVEY, IS TO BE SENT TO ABOVE ADDRESS PROMPTLY UPON CO~LETION OF PROJECT. FAILURE TO NOTIFY U!LL LEAVE OI~'ER AND/OR COntRACTOR SUBJECT TO APPLICABLE PENALTIES FOR NON-COI,~LIA~CE I~ITH PEP~IT COS~DITIONS. New York State Department of Environmental Conservation NOTICE 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 PermitNo. J~ "~[_~' Il ~'--/ Regional Permit Administrator NOTE: This notice is not a permit S 50° ~6'00"£. N/O/F ELLIOT PASKOFF CROSS SECTION 309.95' KENNEY'S ROAD MONROE ~'- ~ooo 0 :7 SON AT SO~ TOWN OF SUFFOLK - 54 SCALE JUNE 19, AREA ,~ :31, 174 SQ.FT. 5 N.Y.S. 020 362 'FORM NO. 1 TOWN'OF SOUTHOLD CHECK BUILDING DEPARTMEN~ SEPTIC TOWN HALL $OUTHOLD, N.Y. 11971 dt~ ~ TEL.: 765-1803 CALL MAIL E, xamine .~...~...t.., 19~..~. Approved~..g~..~-../..~.., 19~..7. Permit No. Disapproved a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ........... FORM j ............ : TO: Date.. ~.{..~' ........... , 19~.'~. INSTRUCTIONS This application must be completely filled 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 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 ~ 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 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 demolitions herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code/an/o/regulations, and to admit authorized inspectors on premises and in building for necessary inspection~., t9 o { / .......... ........... (Signature of applicant, or name, if a corporation) ?..,.,.,.,.. t*. ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. o. or,.. Nameofownerofpremises e~l"'X'.... ~[ ..... d~...~.....~..o..o,?..~..~. ~.~.~.~ ....................... (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 HUS_T lie SUFFOLK COUNTY LICENSED Builder's License No.. I..~.~I].~..~ ~ ............. Plumber's License No. '1.,% t,,.t.,. ~ Electrician's License No. ~.,4'Z. t~ Other Trade's Licerise No ......... .'7. ........... d 1. Location of land on which proposed work will be done. ~ ' · ' ~ House Number Street Hamlet County Tax Map No. 1000 Section ..... .~..~ ......... Block .... ?..~. .......... Lot .... .o..~. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: I T~%~ a. Existing use and occupancy .: ............................................................... b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable) New Building ..... ' ..... Addition .......... Alteration .......... Repair ........ :.: ....RemovaLa ............. Demolition .............. Other Work..~ ........... 4 Estimated Cost . · · · Fee ~ " (to be paid on filing this application) dwelling, number of dwellin* units ..... [. ......... Number of dwelling units on each floor.. ! ............. 5. If If garage number of cars 6. If business, commercial or mfx~d occupancy, specify nature and extent of each type of use ' -- 7. Dimensions of existing structures, if any: Front....'~.'~Y.~.~. ..... Rear ...~'..~-..'? ~ .... Depth . ~ .~..':~..Z ...... Height . .I.'~..'D?. ~ .......Number of Stories ...... '.~; .... 2 ................... '..'...'. .... . .' ............. D/mensions'of,~s~ amc structure with alterations or additions: Front . .~--..I..-?-~..? ........ Rear .'. t 't,~--~ ~' He' t }~'"'~ ~ · Dep h .......... -. ....... ~... lgh ...................... Number of Stones ...................... Dimensions of entire new construction: Front .. ~ ! .~z...~,. ..... Rear . .d/.~. 7?. ~ ...... Depth .?..~.?. ~ ....... Height I~."~ * Numbe of Stories Size of lot: Front .... [..~.. :.~. ........... . Rear ....I..o~..'. ?.~ ............ Depth . .~..t.?: .~...~_. .......... Date of Purchase ' Name of Former Owner Zone or use district in which premises are situated ................................................... Does proposed construction violate any zoning/aw, ordinance or regulation: .... ~..~. ......................... Will lot be regraded ..... .~..~ .................... Will excess fillbe removed from premises~ ~es No Name of Owner of premises~.~.~..~*3q .~.~.o.~...~.~.*~.q*Address~, .~.'*.R .~..t~..~.~.* .o.~,... Phone No.~ .G.~...%. ~..~.~. .... Nme of Architect ....... ~ ................. Address ...... "?. ............. Phone No....'~. ........... Name of Contractor . ,~l.....I.(.[, .~ ~, ~.~.~. ........... Address"~..~ ! ! ~..~..o.~..~.~..?... Phone No."[ .~.~*..* .'t:..~.~.'~ .... 15. Is this property locatedI within 300 feet of a tidal wetland? *Yes ..'~... No ..... · If yes, Southold Town TrUstees Permit maybe 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 bloc number or description according to deed, and show street names and indicate whether interior or corner lot. 10. 11. 12. . 13. 14. STATE O F NEW cY~ RK...,~-, COUNTYOF...~..~.[.~..[~.., ........ ~.~ ~..~~ ................. being du1~ 'sWorn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................................................................... ~ [ (Contractor, a~ent, corporate officer, etc.) of said owner or owners, ~d is duly a~.thorized t6 p~rform or hai~ ~effo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~nCr set fgrth ~ the application filed therewith. Sworn to before me this I ............ ..... d o.f. ............ ................... u ~LlZAS~H ANN h~ILLE (Signature of applicant) FORM NO~ 10 TOWN OF'SOUTHOLD ~U~LDiNG DEPARTMENT (516) 765-1802 P.O. BOX 728 Southold, N.Y. 11971 Town Hall Main Road Southold,N.Y. nDPLTCATI~N FOP DEVE!.nDMENT PEPMIT Instructions: The application to the Building Inspector includes (each in duplicate) 10 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 must give complete information 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 Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 46-17 of the law to minimize flood damage: A. B. C. D. Anchoring of structures, 'including tanks and mobile homes Use of construction material and methods Design and location of utilities Subdivision proposal with drainage, public utilities 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 factq 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 manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2.-that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazard. 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 the provisions of 46-19 are complied with. Mobile homes are prohibited. 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 applican% pro- poses to alter same, plans and specification must be shown in detailed nature of any alteration sub$itted. 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. During construction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification of the final elevations and work must be submitted before the approval to use or occupy can be approved. (Fill out the form on the back of this sheet) 11/85 -Application Received19 Disapproval Issued 19 'Permit FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT IN THE TOWN OF SOUTIIOLD 1. Type of Development Propose~: New ~tructure ~inc4u~ing ~orage ~an~s Addition and/or Alteration Flood Proof Below Base Flood Elevation__ Other (specify) 2. 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 me~er .___ ~e~'t .__ inches 3. FI~--Flood Insurance Rate Map, Zone designation~ 5. Location of ~Property: House 9 Street ~ Hamlet County Tax Map NO., Dist. 1000, subdivision Section ~ Block ~ Lot(s) _~ Filed Ma~# Lot(s) 6. Permission to be granted: _~ Owner as above -_ Under Contract Lessee Contractor New Owner Phone It Name if not given above Mailing address Approval from other(s) before Permit is issued: DEC /~-- ~ -- 7/ ~ wetlands (Town Boa~d) Health Services ZBA Building Permit _/__~ ~ Planning Board I, , the applicant, am the Owner __, Co-Owner , New Owner , Under Contract , Lessee , Agent __, Contractor __, and agree to comply with all applicable sections lof the Code of the Town of Southold; County, and State and to admit authQrized 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 iand belief and that the work will be performed in the manner set forth in the application filed therewith. STATE OF NEW YORK COUNTY OF ~Pj.x~/~'~_~ SS SWORN TO THIS /~ DAY OF _~~- ~ ..., .,~ ) LINDA J. COOPER ,~-'~/v .-~./~. ~/~/~.,.,,~,~.., ~/NotarYPubllo, StateofNewYork Applicant's mailing address and phone # if not given abov~ ii/8 If ~opper tubing il ul~4 for waler dts~'|butln~ ~ piping shill b~ d ~ K or L only SOLDER USED SUPPLY SYSTEM EXCEED 2/°I0 of CONTENT B£FORE CEIIg'IFICA~'E O,F OCCUPANCY O~U~N~ OR USEISUN~WFUL Wl~O~ CERTIFICATE OFO~U~N~