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HomeMy WebLinkAbout16157-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17205 Date AUGUST 18, 1988 THIS CERTIFIES that the building Location of Property 350 RABBIT LANE House No. County Tax Map No. 1000 Section 031 Subdivision ONE FAMILY DWELLING Block 18 Filed Map No. EAST MARION Street Lot 08 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1987 pursuant to which Building Permit No. 16157Z dated JUNE 30~ 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 ONE FAMILY DWELLING~ DECKS AND ATTACHED GARAGE. The certificate is issued to WORTH ENTERPRISES, INC. {NOVIN ENT. INC.) (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 85-SO-22 UNDERWRITERS CERTIFICATE NO. N017177 JUNE 16, 1988 PLUMBERS CERTIFICATION DATED K & K PLUMBING & HEATING 6/23/88 .... Bu3~l~ing' Insp~c{or ' ~/ Rev. 1/81 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) Ne 16157 z Permission is hereby granted to: ...~...~-...9...~ ............................................. ...~.L~~....~.:.q,:....~.L~..~. ................................................................... ot,rem,se,,o~ote'' d at ..... ~,~.....~.~...~ ........ ~.~.~...~..~ .............. County Tax Mop No. 1000 Section ..... ..~.....~..~. ........ Block ........ )..~. ........ Lot No ....... ~. ............... pursuant to application doted ........ 4.~.......~.....l~.. ............... , 19.~..'L, and approved by the / Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD Southold,BUilding DepartmentLl~[ N.Y. 11971 765 - [802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANC~ TOWN OF SOU~OLD Instructions A. This application must be filled in typewriter OR inN, and submi~ed I~ to the Building In~ec- tot with the following; for new buildings or new use: 1. Final su~ey of pFoperty with accurate location of all buildings, prope~y lines, ~reets, and unu~al naturaI or topographic 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 ~ire Unde~riters. 4. Commercial buildings, Industrial buildings Multiple Residences and similar buildings and in~alla- 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. ~OF existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-exi~ing" land uses: 1. Accurat~ ~ey of p~perty showing ail property lines, ~reets, buildings and unusual naNral or topogFaph~c ~eatures. 2. SwoFn statement of owner or previous owner as to use, occupancy and condition of buildings, 3. Date of any housing code OF safety inspection of buildings or premises, OF other pe~inent informa- tion required to prepare a ce~ificate. C. Fees: Aaa[~[o~s ~25.00 2ooLs ~25.00A~A~ION ~5.00 1. Ce~ificate of occupancy NeN DN~ll~ ~25.00, Accesso~7 ,~10.00 ~us~es$ 2. Ce~ificate of occupancy on pre-ex[st[ng dwelling ~ S 0.00 ~. Copy of certificate of occupancy $ 5.00, ove~ 5 7ea~s ~10.00 4.Vacant ~m~ C.O. ~ 6 20.00 . NewCom$~ruct~om ~.. Old or Pre existing Building ............ Vacant Land ........ Hou~ No. Etreet Ham/et Owner or Owners of Property ... o....c .. ,.... ~...... ~ ................................. County Tax Map No. 1000 Section ...~.~ 1 ........ Block ..... .I.~ ....... Lot ....... ~ ........ Subdivision ................................. Fired Map No ........... Lot No .............. Permit No. J ~.1. 5.'7... Date of Permit . ,~../.3'.0/$7.Applicant ... N0 VJ ,v ~..~.~.?f~,?,....~..-.~ .~.. c. Health Dept Approval t~*'~ ~ ' .~ q Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate / . Fee Submitted $...$L.5...o. ,b... ,~, ./.~L..~. ......... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOIJTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Building Permit~ No. Owner ~'-~ 0~"~ '~ (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) Notary Public F~O~ NOVON Ente~p~±aea, Ina. Box 508 East Marion~ NY 1i939 TO: Town of Southold Southold, NY 1~971 Enolosed is a ~25.00 Cheok and Application for Certifioate of O~oupsnoy on Building Permit Number 1 61 57 Z. We have been in tou~h with the Health Department about the administrative delay in sending their approval and have been assured they will forward it aa soon as possible. FORM NO, 11 TOWN 0F SOUTIt0LD BUILDING DEPARTMb~T TOWN HALL S0[fl'HOLD ~ NY D~n/ELOPM[~T I ~,RM[ ~ Co,~ Ta~ ~p ~o, ~ooo s~o~o~ ~-.L m. oo~ ..L~__ ~,ot, _3_ pur,~uant to application dated __.~~....~_~ ._.,, 19~, and app~'oved by the Building Inspector. Building Pormtt No. J ~ol ~-7 z Building lnspocto~, 4/80 FOHM NO. 11 TOWN OF 50UTHOLD BUILDING D~PAHTMb;NT TOWN I{;%1~ SO~i~HOLD ~ I~Y I)EVELOPNENT I'f:ILM fl' Pez~isslon ia hereby granted to: pur~uan~ to application dated _~ ~.~ _., ].9~, and approved by the Building Inspector. lguilding Permit No. Bui. £din[~ ]jn apoc t o,~, FOHM NO, 11 TOWN 0~' $O~HOLD BUILDING DEPARTMENT TOWN HAIL SO~5'HOLD, NY DE~ELO PMI~T PERMIT pursuant to applioation dated ~~__, 19~_~o,, and approved by the Building Inspector,. Building Permit No. I L~I ~-7 ~ ~ Building Inspocto~ 4/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION FOUNDATION 2ND FRAMING ~J~OOUGH PLBG. INSULATION [ ] FINAL //// / BUILDI7651 /GS ID2EPT' INSPECTION FOUNDATION 1ST [ ] R/OUGH PLBG. / FOUNDATION 2ND [~/]' INSULATION FRAMING FINAL 765-1802 BUILDING DEPT. INSPECTION ]FOUNDATION 1ST [ ~UGH PLBG. ] FOUNDATION ZND [//] INSULATION FRAMING REMARKS: FINAL INSPECTOR U~fDJTION {1st) UNDATION (2nd UGH FRAME & PLUMBING SULATZON PER STATE ENERGY CODE FINAL · ADDITIONA'L COMMEN NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT ' PERMIT NO. 10-84-1355 UNDER THE ENVIRONMENTAL CONSERVATION LAW ~,~ ARTICLE 15, (Protection of Water) ~ ARTICLE 25, (Tidal Wellands) ARTICLE 24, (Freshwater Wetlands) ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO Ted Dowd ADDRESSOFPERmI~E~ 1 ~h T~erra Verde, Florida 33715 LOC^TlONOFPROJECT(Sectionofstreum, tidMwetland, d~m, buHdinR) North and south sides of Rabbit Lane, Marion Lake and Gardiners Bay, East Marion. DESCRIPTION OF PROJECT Construct a single family dwelling on south side of Rabbit Lane approximately 19' landward of mean high water ~ardiners Bay). Install sanitary system for this lot on applicant's property on the north side of Rabbit Lane, approximate', ~50' landward o~ mean high water and 125' south of Lake ~4arion. Construct thr~ single family dwellings with decks on north side of Rabbit Lane *** (cont. on East Marion COUNTY Suffolk 1. The permittee shall file in the office of the appropriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work. 2. The permitted work shall be sub)eot to inspection by an authorized representative of the Department of £nvironmental Conservation who may order the work suspended if the public interest so requires. back) Southold GENERAL CONDITIONS project, 95-~0-4 (9/75) (SEE REVERSE SIDE) ATC~ 1 DESCRIPTION OP PROJECT (cont.) approximately 50' south of Marion Lake. Sanitary systems for three northerly lots will be located between houses and Rabbit Lane approximately 125' south o Marion Lake and 150' landward of mean high water. Approximately 500 cubic yards of clean fill will be trucked in for the sanitary systems and are to be placed within 15' of the base of three houses on the northerly lots. SPECIAL CONDITIONS There shall be no disturbance to the vegetation or topography within 35' of Marion Lake. Eot the three houses on Marion Lake, not more than twenty percent (20%) of the lot area can be co'.vered by impervious surfaces. Ail construction must meet local and Federal flood plain ordinances. SPECIAL CONDITIONS A THROUG~ J ATTACHED. SPECIAL CONDITION M ATTACHED. ~£~IT ISSUE DATE 2/19/85 JPERNilT ,ADMINISTRATOR ADDRESS Bldg. 40, Suny, StonyBz~ok, L~ ~ 11794 NEW YOgi{ STATE DEPARTMENT OF E~VIRONME~fAL CONSERVATION Regulatory Affairs Unit Building 40, SLaY--Room 219 Stony Brook, New York 11794 / ~ Your recent request to extend the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that there has not been a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance qf._t~e ~sting ermit; therefore, the expiration date is extended to )~ ~ '1C~)7 P' recent request to modify the above permit ha~s~ been reviewed pursuant to 6NYCR~, ~t 621. It has been determined that~ thg ~roposed modifications will not substantia%ly.~ehange the scope of the permitted actions or the existing permit conditions. --. Therefore, the permit is amended to authorize: This letter is an amendment to the original permit and as such, shall be posted at the Job site. All other terms and conditions remain as ~rritten in the original permit. Very truly yours, Regional Permit Administrator C"fH:DDR:co~s Sent to: Van Tuyl Plot Plan ATCH 4 $outhold Town Board of' Appeals MAIN ROAD- STATE ROAD 25 SOUTHOLD, L.I., N.Y, 119'71 TELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No.3464 Application Qated February TO: Mr. Ted D0wd 201 13th Street East Tierra Verde, FL 33715 (NYS D.E.C. Action 2/19/85) 10, 1986 (Trustees Action 9/25/86) [Appellant (s) ] At a Meeting of the Zoning Board of Appeals held on November 3, ]986 the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section IX] Request for Variancesto the Zoning Ordinance Articles III , Section ]00-3]- 8u]k Schedule and Article IX, Section lO0-119.2(~) _ [ ] Request for Application of TED DOWD for Variances to the Zoning Ordinance, Articles III, Section---l-O1]-r3-F, and XI, Section 100-119.2 for permission to locate new single-family dwelling: (a) with an insufficient front- yard setback, (b) with an insufficient sideyard setback, (c) with an insufficient rearyard setback, (d) with total lot coverage in excess of maximum-permitted 20%, (e) with insufficient setback from tidal wetlands. Location of Property: 350 Rabbit Lane, East Marion; County Tax Map Parcel No. 1000-31-18-8. WHEREAS, a public hearing was held and concluded on October 1986, in the Matter of the Application of TED DOWD under Appeal No. 3464; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and 22, WHEREAS, the board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the board members have personally viewed and familiar with the premises in question, its present zoning, the surrounding areas; and are and WHEREAS, the board made the following findings of fact: 1. By this application, appellant requests permission to construct a new single-family dwelling structure: (a) with an insufficient frontyard setback at 20 feet at its closest distance, (b) with an insufficient easterly sideyard setback at five feet, (c) with an insufficient rearyard setback at 19 feet at its closest point, (d) with total lot coverage in excess of maximum- permitted 20 percent, (e) with an insufficient setback from tidal wetlands at 19 feet (from Ordinary highwater mark), all as shown on sketched survey revised April l, 1985. 2. The premises in question is a described parcel of land located along the south side of Rabbit Lane, East Marion, TQwn- ship of Southold, New York, containing a total area of 4,734± sq. (CONTINUED ON PAGES TWO AND THREE) DATED: November 3, 1986. Form ZB4 (rev. 12/81) CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS ATCH 3 Page 2 - Appeal No. 3464 Matter of TED DOWD Decision Rendered November 3, 1~986 ft. with 50.36 ft. frontage along Rabbit Lane and lot depth of 94 feet. 3. The subject premises is located in the "A" Residential and Agricultural Zoning District and is vacant. Abutting the subject premises to the west is a parcel improved with a dwelling structure set back 24± feet from Rabbit Lane. The premises immediately east of the subject parcel is also presently vacant. 4. Article III, Section 100-31, Bulk Schedule of the Zoning Code requires a minimum: (a) frontyard setback at 35 feet (or the average established within 300 feet, 100-33); (b) sideyard setback at 10 feet, (c) rearyad setback at 35 feet. Article III, Section 100-31, Bulk Schedule, limits lot coverage to a maximum of 20 percent of the total lot area. Article XI, Section lO0-119.2(B) requires all buildings proposed on lots adjacent to tidal water bodies other than the Long Island Sound at not less than 75 feet from the ordinary highwater mark. 5. The amount of relief requested in relation to the zoning requirements are: (.a) front yard, 15 feet, or 43% (b) sideyard, five feet, or 50%, (c) rearyard, 16 feet, or 46%, (d) lot coverage, 703.2 sq. ft., or 74.5%~ _ (e) wetlands setback, 56 feet, or 75%. 6. The board finds the general configuration and contours of the parcel lend to the difficulties in locating a principal structure, and strict adherence to the code regulations would not be feasible. 7. It is the opinion of the board that the percentages of relief requested in relation to the requirements are substantial and are not the minimal necessary under the circumstances. In considering this appeal, the board also finds and determines that in granting reduction in the relief as an alternative: (a) the project will not be inconsistent with those generally existing in the neighborhood; (b) the relief will be the minimal necessary under the circum- stances; (c) the circumstances of the property are unique; (d) there will be no substantial change in the character of the area; (e) the variance will not in turn be adverse to the safety, health, welfare, comfort, conven- ience or order of the town; (f) in view of all the above factors, the interests of justice will be served. Accordingly, on motio~ by Mr. Sawicki, seconded by Mr. Grigonis, it was RESOLVED, that the following relief be and hereby is GRANTED in the Matter of the Application of TED DOWD under Appeal No. 3464 in the proposed placement of a single-family dwelling structure: 1. The frontyard setback not be less than 24 feet, in line with the existing dwelling abutting this property to the west (presently Moor); 2. The easterly sideyard not be less than nine feet, and total sideyards 24 feet (15 and 9); 3. The total lot coverage for all..str~ctures not to exceed 22% at this time; (CONTINUED ON PAGE THREE) Page 3 - Appeal No. 3464 Matter of TED DOWD Decision Rendered November 3, 1986 4. No construction or disturbance of area within 25 ft. of ordinary highwater mark (except for bulkheading as may be recommended by State, County or Town agencies, and after receiving appropriate approvals in writing); 5. Setback from rear property line and ordinary high water mark be not less than 25 feet. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Douglass and Sawicki. (Member Doyen of Fishers Island was absent.) This resolution was duly adopted. lk GERARD P. GOEHRINGER',~CHAI~RMAN November 12, 1986 TOWN OF $OUTHOLD BOARD OF SOUTHOLD TOWN TRUSTEES $OUTHOLD, NEW YORK WETLANDS PERMIT. This Wetlands Permit No.....................330 has been granted by the Town Trustees according to information furnished in Application No....3..1.9. ............. filed by Applicant ..T.e...d..~.o..w..d. ............................ ........................................ on ...9../..1..9../,.8..5. .............. 19 ..........A map of the proposed work will be kept on file in the Trustee G'ffice under the application number given. - To construct a s±n~le family residence Permitgrantedto do thefollowing WOrK ...................................... u ................ ~.....~ ................................. on pilings 30' from Orient Harbor (C~f~j~..~Z).L ........................................................... 350 Rabbit Lane~ East Mari(2n, i~.y Location of property on which work to be done ................................................................................ Orient Harbor Creek, Bay or Harbor fronting property ..................................................... ~ ........................................... 44' Size of work: Length.... . ....o. · · · · ... · ............... 30' Width ...................................................... Height Above High Water Depth Below L~w Water., .LLT.7.7.7.-~i.7.-iiiiZT. ......................................................... . yards to be ~:xcavated .................................................................................... Yards to be Filled ......................................................................................................... Manner in which material is to be removed or deposited ~/A Residential Intended use of property ......................................................................................................................... . See standard recommendations. Conditions ~r any .............................................................................................................................. Expiration Date August...._.... 28, 198'~................................if work has no~ ~.m..m.~..n.9.~..d. ~. ~.~...~l~%e ........................... Number of Inspections Required ..2, i.T..r..u.~..~re to work. 00 Paid Inspection Fees $5 ...................................................... Liability Policies in the Amount of ......................................................................................................... The validity of this permit is or may be subject to the approval of other governmental or municipal authorities. The Town accepts no responsibility in applying for or obtaining such approval, In the event that such approval is necessary, the holder of this permit shall not commence operations here- under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subject this permit to immediate revocation by the Trustees upon receipt by the Trustees. of written notice from such other governmental or municipal authorities of its refusal or disapproval. ATCFI 2 Application Received119 Disapproval Issued 19 Permit # 19 FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT IN THE TOWN OF SOUTHOLD June 22, 1 ~9 87 i. 'l'ype of ~eveiopment Proposed: Addition and/or Alteration dew mnz~ucture ~inciuding storage nanksx__ Flood Proof Below BaSe Flood Elevation Other (specify) 2. Elevation Data in relation to above mean sea level 6f: (a) Lowest floor elevation, including basement 11 feet (b) In a V Zone, bottom of lowest structural member 3. FIRM--Flood Insurance Rate Map, Zone designations A-7 4. Owner of Premises Worth Enterprises, Inc 5. Location of Property: ~ ~7~ Rabbit Lane 9. inches feet inches (9') East Marion House ~ County Tax Map No., subdivision Street Hamlet Dist. 1000, Section 031 Block 18 Lot(s) Filed Map# Lot(s) 8 Permission to be granted: x Owner as above New Owner Under Contract Lessee Contractor Phone # 477 Worth Enterprises, Inc Box 106 Southold, NY 11971 Name if not given above Mailing address 2402 7. Approval from other(s) before Permit is issued: DEC Nr 10-84-1355 (Arch 1) Wetlands (Town Board) Nr 330 (Arch 2) Health Services855022(Atch 5) ZBA Nr 3464 (Arch 3) Building Permit Planning Board 8. I, Ted Dowd , the applicant, am the Owner__, Co-Owner .., New Owner , Under Contract__, Lessee , Agent x , Contractor and agree to comply with all applicable sections of the Code of the Town of Southold; County, and State and to admit authorized 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 the application filed therewith. COONT OF SWORN TO THIS ~=~f~ Applicant' s mailing · address and phone ~ if not given above 11/85 FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P.O. Box 728 Southold, N.Y. 11971 Town Hall Main Road Southold,N.Y. Instructions: The application to ~the Building Inspector includes (each ~[n duplicate) 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 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. Anchoring of structures,' including tanks and mobile homes B. Use of construction material and methods C. Design and location of utilities D. Subdivision proposal with drainage, public utilities design and base flood elevations ~pecific 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 facts that the structure has or will have the lowest floor, including basement/ cellar, elevated abo~e 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.,iarea (V Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- :formation as the Building Inspector may requi~e 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 applicant pro- poses to alter same, plans and specification must bs shown in detailed nature of any alteration submitted. 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. iDuring 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 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examin.ed . . .~ . .d-,3'/~......,~..., 19 .~.'~ Approved . ..~ ,O,-tl~..~..., 19 .~.Q. Permit No. }..~./..~. ?..~.. Disapproved a/c ..................................... ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 1¢4(oqo Date . . · .J. qn..e. 2.2, ......19.8.7. INSTRUCTIONS a. 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit 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 code, and regulations, and to admit autliorized inspectors on premises and in building for necessary inspections. ...N. Qy!.N..E.n..t.e.r.p.~i~.e~ ,. Inc ................. (Signature of applicant, or name, if a corporation) .~Q;q .~QB~..Eas~ 2~arian,. N,~.. 1~.¢39 ...... (mailing address of applicant) '_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent . . Name of'owner of premises .W.o.r..t.h..E.n..t.e.r.p.¥i F.e.~,. l:aq ............................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Self: ............... Plumber's License No. ?.q .b..e..s.¢~.teO ....... Electrician's License No?Q .]~..~elec. tect ....... Other Trade s License No ...................... Location of land on which proposed work will be done.' ................ ~ ...................... ' ........... ~O Rabbit .Lame. East M~r. ion. House Number Street Hamlet County Tax Map No. 1000 Section .. 9.3.1 ............. Block .. :~.8 .............. Lot..8 ................ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... .s.i.n.g .1.e...ar~.y..Bu2,1d~n~..Lot. b. Intended use and occupancy ...... .F.a.m.i..ly..R.e. $.i.cle. r~ce ........................................... 3. Nature of work (check which applicable): New Building .... .x ..... Addition .......... Alteration ....... ... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4 Estimated Cost ~t9t 500 Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling uhits on each floor.. If garage, number of cars i . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .... 2 ~: 3.0': .... Rear .. 24.' 2.0 '.'. .... Depth .. 2,~t: 2 !' ....... Height . ~.3.' ........... Number of Stories .... 2 ................................................... Dimensions of same structure with alterations or.additions: Front .......... ; ...... Rear .................. ' Depth Height Number of Stories 8. Dimensions of entire new construction: Front ..... 24.' ,I,Q':... Rear . .2. z~ ~ .1.0.'[ ...... Depth .. 2.9. '.2'.' ....... Height 33 ' N bet of Stori ............... um es ...................................................... 9. Size of lot: Front ....... 5.Q '. ............ Rear ..... 5. Q: .... Depth .. 9.4.' ................ 10. Date of Purchase ...A. gg.u, at;. ~.5. ............... Name of Former Owner ... G~hir~aL~ ...... 11. Zone 0r use district in which premises are situated .l~e~i.d~er~ia]. ................ .. .......... ... ...... ..'" '" ' r" 12. Does proposed construction violate any zoning law, ordinance or regulation: . .YRs. . .( .SRo. .b.~.qh...~) ............ 13. Will lot be regraded ..... . .N..o ................... Will excess fill be removed from premises: Yes No x 14. Name of Owner of premises .. lt/Q.r.t;h. E~.t; ~. %r~C. Address . B. qX. J..0.~ · ~9.~L. tggJ-l~hone No...42.7.. 2.4D.2 .... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property located withinl,00 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. See Atch 4 STATE OF NE~Q~ COUNTY OF/~7~4t,.~., S.S ............. ?..~d~.//p.o.w.d. .......................... being duly sworn, deposes and says that he is the applicant (Name o£ individual signing contract) above ,amed. Agent I He the ......................................................................................... is (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du]y anthoHz~d ~o p~fform or haw p~rfo~d ~h~ ~aid work and ~o mR~ and ~]~ application; ~ha~ ail sta~men~s contained ~ ~h[s application ar~ tru~ ~o ~h~ b~s~ of h~ ~ow[~dge and b~H~f; and th~ ~h~ work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ~ .......... ~~ ..... day°["~~~''"~'~f~~ ~ ~~MNMYo~ / k // ' ~ ~ (Siun~f a~icant) Q 0 0 /¥ -0 0 0 7 S .q.-