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HomeMy WebLinkAbout15055-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15660 Date April 21, 1987 THIS CERTIFIES that the building ONE FAMILY DWELL ING Location of Property ...3.8.5..~. 9.o.d..I:..a.n? ............ g.r.e, enport, New York House No. Street Ham/et County Tax Map No. 1000Section 043 .... Block 04 .Lot p/o 25. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · · . 15055z J un e 27, 1986 pursuant to which Bmldlng Permit No ............ dated Ju 1 y I, I 986 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 as applied for * MARIA KOUKOULAS The certificate is issued to ..................... [d~,tie'r,'le~$oX~Ttgr~ ..................... of the aforesaid building. ff lkCo tyD tme tofH lthApp I 86-S0-76 mu o un epar n ea rova .......................................... UNDERWRITERS CERTIFICATE NO N 794721 March 30, 1987 PLUMBERS CERTIFICATION DATED: *Glass doors are not doors are installed. Rev. 1/81 on fireplace. · ~''' Buildin~'I~}~;c't;~ ............. Fireplace not to be used until TOWI~I OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P EP~IT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N©. 15055 Z Permission is hereby granted to: ~.?.~...~..~.~.~T. .......................................... ,o at premises located at ...~..~..~....~,~...~...~.. ....................... ~-~ ......................... Co~,n~ To× Map No. lO00 S~ct~a,~ .....~..~..~ ....... ~o~k ...... .0.~ ........ 'at No..."/.?...~.:.1... pursuant to application dated ..... ...~...~.......~..~ ................ , 19.~...(~., and approved by the Building Inspector. tot Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATE OF OCCUPANCY No..Z.~ $ p~.7. .... Date .D.e..c.emb..e.r..1.3...., 19. {3.5.. This CERTIFIES that the Lot Vacant. Greenport Location of Property .... ~ ............ ~Qg~.~ .......................... House # Street Hamlet County Tax Map #, Section ..... 4~ ........ Block ...... A ........ Lot...PAR.~P:A Subdivision .............. ~ .............. Filed Map # .... ~ ..... Lot # ...... ~ .... conforms substantially to the applicable provisions of the Zoning Code of the Town of Southold. The premises are located in the "A"Resldentlal-' ' Agricultural Zoned District and may be used for such uses as are presently authorized by the Zoning Code in such district subject to, however, all of the requirements of the Zoning Code. Z.B.A. Grandfather List ~2163 7/~2/76. HAROLD ASH The certificate is issued to ............................................ ( owner, ~k~ of the aforesaid lot. Building Inspector Rev 1/85 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m Jmammm 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 features. 2, Final approval of Health Dept. of water supply and sewerage disposal-{S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of 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 inform+ tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3, Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 $15.00 New Building ............. Old or Pre-existing Building ............ Vacant Land .....~ ....... Location of Property'... ,~. B.~.. .................. .~', .~.~.¥). · ."~.'~..~..~... · · · ........... · ....... House No, Street Hamlet qwner or Owners of Property .../..7/./~.. ,'~..~..~,/~. .... ./~...%)~/?. .................................. County Tax Map No, 1000 Section .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .............................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $ ;~c~ Construction on above described building and permi~J~s all applicable codes an,d/r,d/r,d/r,d/~tations. O::~fz~/L{O%~'~ , Applicant . ~~.. ~~ ......... ' .............. 3.0, FORM NO. 6~ TOWN OF 8OUTHOLD Building Department Town Hail Southold, N,Y. 11971 76.5- 1802 BLDG OEPT APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~mmmmmmm 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 features. 2, Final approval of Hca)th 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 instaHa- 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: 1. Accurate survey of property 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 $25.00 -- 8DSINES~ $50.00 ACCESSORY $10.00 2. Certificate o£bccupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over .5 )'ears $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .~\~,u:~.,~,O..),l~,~.;/..,. NewConstruction. .~,., Old or Pre-existing Building ............ Vacant Land House No. Stredt Hamlet Owner or Owners of Property .. ]'7[ ~'.~.~ ..on.... .~ .~4 .Q .~..0-..9 ........................... County Tax Map No. 1000 Sect on [ .O..o..~ Bock .Lt Lot '~'-A ~''~' S~bdivision ............................. ..EJledJMa pJ~!o ..... ~e~LNo,-- ............ Permit No. i ~.~.~..~.~.Z-. Date of Permit ,3 ......... Applicant .. .%% .ftc..~'.'q O. ~ .......... Health Dept. Approval ~,~..'.~l~..~.. · · · .~.~,: ~.~ :~'.7.~'.. Labor Dept Approval ...................... Underwriters Approval .~/.~'l~??.. · .IX'.). ,',7.?.~.?..~)-. I..Planning Board Approva, ........... ' ' Request for Temporary Certificate ..................... Final Certificate ,. ,~,, ................ Fee Submitted $ ~-~, C:) C~ Construction on above described building and permit meets all applicable codes and regulations. Applicant . .. ....~ ....................... Rev. 10-10-78 IELD INSFECTION OUNDATION (2nd) C OM~'~ ~;N TS OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ~ ~-~'~ ADDITIONAL COMMENTS ---_-7'21 TOWN OF $OUTHOLD OFFICI~ OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.150~ Owner ~o~O~ /<O0/~O0/fk~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumbdr' s signature) Sworn to before me this ~0 day of ~ · Notary Public, County Notary Public HELEN K. DE ~I)E Imm ~xphe~ ~i~mh 30.19~ -J THE NEW YORK BOARD OF FIRE UNDERWRITERS ~_00070~ BUREAU OF ELECTRICITY ~_ 85 JOHN STREET. NEW YORK, NEW YORK 10038 ': Koukoulas, North Side- Wood Lane, off Manhasse~ Ave.:~ Greenp I ~NGES ~ lC~K NSP~KSt OVENS DRYERS ~-~JRNACE MOTORS G.F.C.I.-2 Smoke Detector-1 lic. #1049E Per D ~ f I This certificate must not be c:)terec~ in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials, Sal Prato, Electrician Wiggins Lane Greenport, N.Y.~ 11944 FORM NO. 11 TOWN OF SOUTHOLD BUILDING DEPARTME~IT TOWN HALL S0~HOLD, NY DEVELOPM~T PERMIT Permission is hereby granted to: tO st p~emises located at pursuant to application dated~, 19_~., and approved by the Building Inspector. Building Permit No. / ~'--o ~'~ z ~/80 Building Inspector 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2~N FRAMING REMARKS: ~/~,,~- /~ ~ INSPECTIOH [ ]~~~ [ ] ~ ~ [ ] IIOUNDATION ~ND [ ] INSULAI'ION [ ] I,IMmme BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~']~iNAL rREMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL ..... INSPECTOR 7G5-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ~.ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS: .... ~//~ ,~~ ~,~, " ~~ .... DATE, INSPECTOR 765-1~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~/~ ~/~-'/~/~ DATE ,//////~/~/ INSPECTOR/~~, ,. 7GS.180:~ BUILDING DEPT. INSPECTION [ ] FOUNDATION '~ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [L.~JI~SULATION [ ] FRAMING [ ] FINAL REMARKS: ~/ -/ 7 '-I ( INSPECTO~__~ FORM NO. 11 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY DEVELOPMENT PERMIT County Tax Map No. 1000 SectionO~Block pursuant to application by the Building Inspector. , 1~_~, and approved Building permit No. ! ~--o ~'~ z 4/8O Building Inspector, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR ~ P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 April 7,1986 Robert T. Acker Counselor-at-Law 170 South Merrick Ave. Merrick,N.Y. 11566 Re: Sec. 043-04-025.001 Dear Mr. Acker~ Your letter of Feb. 26,1986 to Mr. Lessard has been referred to me for reply. The denial notice I sent to you dated Feb. 21,1986 was in response to the application you submitted to my attention which was dated Feb. 14,1986. On this app- lication a plot diagram was made showing a 25'-0" front yard set back. There being nothing with the application substantiating an average set back of 22'-5"; my only course of action was to deny your application. Your letter to Mr. Lessard included a survey dated Jan. 27,1986 showing the average'set back. If this sur- vey had been included as part of the building permit app- lication a denial notice would not have been issued and therefore would have saved you and your client this un- necessary delay. In my past discussions with you and your client I recall mentioning average set back as a means to allow less than required 35'-0" for this lot. The lot cover- age permitted for th'is 5,000 sq. ft. is 20% which amounts to 1~000 sq. ft. The residence you propose is 25'-0" x 40'-0" which equals 1,000' sq. ft. Any further coverage will require a variance. Trusting this will clear up any questions you have relative to this matter. If you have any further ques- tions contact me at this office. EH:dsm ~, Building xc: Maria Koukoulas Inspector RE}BERT T. AP-KER Feb. 26, 1986 Mr. Victor Lessard Executive Administrator Buildin~ Department Town of Southold Box 728, Main Road Southold, N.Y. ll9?l Re: Sec O~J,~ Block 0/~ Dear Mr. Lessard: Lot p/o 25,1 At the recommendation of Linda Kowalski I have enclosed the followin~ documents: 1. Notice o£ Disapproval 2, Certificate of Occupancy 3. Permission of Zoning Board to subdivision dated June 4, 1976 4. A copy of application for building permit Copy of survey shewing average setback for lots within 300 ft. of subject premises. I have been in the process of preparing the papers to sub- mit to the Zoning Board of Appeals. In that regard, I contacted Mrs. Kowalski who informed me that she did not think that a variance was necessary in that the property is under ~0,000 sq. ft. and the planned construction would observe the present average setbacks in the immediate area. She suggested that I write directly to you so that the issue of whether or not to proceed with the appeal could be laid to rest. I would greatly appreciate your remarks regarding this re- quest for building permit. Thank you in advance for your anticipated cooperation. Very truly yours, Robert T, Acker cc: Maria Koukoulas ' e' '" O FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL . .,1~.~. .~. . ...¢.0.~(.. ~.~ ..................... PLEASE TAKE NOTICE that your application dated . .~~... for pc~it to construct... ~ ~.~..~.(~ .~. ........................ at Location of Property County Tax Map No. 1000 Section .. 0.~. ..... Block .. ~.~ ....... Lot 0~ .4 ..... Subdivision.. ~ Filed Map No. ~ >' Lot No. ~-~ . is returned herewith and disapproved on the following grounds..~.~.O.'i~..O~..~tq....~.,~.,~, i.~.. .... ~.F~..~.~...¢.~.,,-z.-e~.. ~., ..... ~..'..-:~.:: ..................... ........ .,/~.,~..~-- - ~zx.'... ~_.... ~.o. ~.-:.. ¢. :...~z ~....~..~...,,~':.":. ~./..,4/. - Building Inspector RV 1/80 e TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATE OF OCCUPANCY This CERTIFIES that the Lot Vacant. Location of Property .... ~, ........... .W. qD~..LA~.e ....... 'i .. o.GAe, e.~pP.r.% ...... ' House # Street Hamlet County Tax Map #, Section .... 4.3. ...... Block... 4 ~ p/.q 25.1 Subdivision .............. ~ .............. Filed Map # .... ~ ..... Lot # ...... ~ .... conforms substantially to the applicable provisions of the Zoning Code of the To~% of Southold. The premises are located in the "A"Resmd~tial-' . Agricultural Zoned District and may be used for such uses as are presently authorized by the Zoning Code in such district subject to, however, all of the requirements of the Zoning Code. Z.B.A. Grandfather List 92163 7/22/76. HAROLD ASH. The certificate is issued to ........................................... (owner, ~ of the aforesaid lot. ............... ............... Rev 1/85 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To/'~.~,~r~.. ~-a~.c...,.~O.~.~'~.~. ..... · ../~ ~ ~:.. ,{~ . .~ao. ................. 77.~..~../. c~ ...~.,~.?.. ~":.e. ...................... PLEASE TAKE NOTICE that your application dated ...~./~... ~..C/./~..g~..~rf... (.4.., 19 .~... for permit to construct...O[.~.~...~/9~.~.~.(~ .~....' .~.. (e~.~..~.~../~..~.~ ................. at Location of Property. Houso No. ' ' Stroet Hamlet County Tax Map No. 1000 Section .. ~..e~..~. ..... Block .. (Q.~. ....... Lot ~. ~.~ ./. ..... p N "--" Lot No. . ~ Subdivision.. - J'- Filed Ma o ..... : ........ is returned herewith and disapproved on the following grounds..~.~.q'~.q.~.~t~. .... ~.'T..~.~. / ....... .. ~.~.~.~...c./~....rC.e..~.~,e.~...~..~ .... .,~.~-.~. ......... ~ ........ .~. ~../~:.'...~.... ~.o..o..-.. ~..~.. i~./.~...~..~. ~.~':... ~./.~..- Building Inspector RV 1/80 RE}BeRT T. AGKeR (516) 379-733S (EVE) BLDG DEPT, ~Vf~! OF SOUTHOLD Feb. 17, 1986 Buildin~ Inspectors Office Town of Southold Town Hall Southold, N.Y. 11971 Att: Edward Hinderman Re: Section 043 Block 4 Parcel p/o 25.1 Dear Mr. Hinderman: Enclosed pursuant 7o our lasts, telephone conversation is a completed application for bui~'ding permit. Upon receipt and review of the ~application please contact me so that I may learn if I can startl.proceedings to appeal the determination. Thank you in advance for your anticipated cooperation. Very truly yours, Robert T. Acker TOIYN OF SOUTIIOLD, NE~' TORK ACTION OF THE ZONI~(~ I~OAI~D OF APPEALS Appeal No. 2163 Dated June 4, 1976 ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD To Mr. and Mrs, Harold J.. Ash Wood Lan~:.. Greenport, N~'"i1~44.. .(Rudolph Bruer, Attorney) Appellant 1971 at a meeting of the Zoning Board of Appeals on was considered and the action indicated below was taken on your ( ) RequeSt for variance due to lack of access to property ( ) Bequest for a special exception trader the Zoning Ordinance (X) Request for a variance to the Zoning Ordinance ( ) the appeal 1. SPECIAL EXCEPTION. By resolution of the Board it was determined that a epeciaI exception ( ) be granted ( ) be denied pursuant to Article .................... Section .; .................. Subsection .................... paragraph .................... of the Zoning Ordinance and the decision of the Building Inspector ( ) be reversed ( ) be corffirmed because 8:45 P.M. upon application of Harold J. and Ruth F. Ash, Wood Lane, Greenport, New York for a variance in accordance with the Zoning Ordinance~ Article III, section 100-30 an'd Bulk Schedule for permission to di~vide premises with dwelling into two lots. Location of property: west side Wood Lane, Greenport, New York, bounded on north by J. Getches; east by Wood Lane; south by W. Hickson; west by Sterling Homes Subdivision. Fee paid $15.00. 2. VARIANCE. By resolution of the Board it was determined that (a) Strict application of the Ordinance (would) (w~uld luot) produce hardship because practical difficulties or unnecessary SEE REVERSE (b) The hardship created (is) (is not) unique and (would) (would not) be shared by all properties alike in the immediate vicinity of this property and in the same use district because SEE REVERSE (c) The variance (does) (does not) observe the spirit of the Ordinance and (would) change the character of the district because (would not) SEE REVERSE and therefore, it was further determined that the requested variance ( ) be granted ( that the previous decisions of the Building Inspector ( ) be con/lrmed ( ) be reversed, ) be denied and SEE REVERSE FORM ZB4 ZONING I~OAHD OF APPEALS After investigation and inspection the Board finds that the applicant requests permission to divide premises with dwelling into two lots, west side Wood Lane, Greenport, New York. The findings of the Board are that the majority of lots in that area are 50' lots. The Board finds that strict application of the Ordinance would produce practical difficulties or unnecessary hardship; the hardship created is unique and would not be shared by all properties alike in the immediate vicinity of this property and in the same use d{strict; and the variance will not change the character of the neighborhoodv and will observe the spirit of the Ordinance. THEREFORE IT WAS RESOLVED, Harold J. and Ruth F. ~sh, Wood Lane, Greenport, New York be GRANTED permission to divide premises with dwelling into two lots, west side Wood Lane, Greenport, New York, as applied for. Vote of the Board: Ayes: - M~ssrs: Gillispie, Bergen, Hulse~ Doyen. t~,,~ ~,~m~'~*,'~y; .,, ?,., TOWN OF SOUTHOLD ~ ~c ~. ~i,~ BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 7654803 Examined ...~.~.~..., 19~ Approved . .~. ~ , 19~ ¢. Pemit No. [ ~.~.~.~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19.,. a. This 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 or areas, and giving a detailed description of layout of property must be drawn on the diagrmn which is part of this appli- :~tion. c. The work covered by this application may not be comlnenc~d 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 ~nspection 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 qmll 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 3nilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or g'a'.gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. ....~ -- -- ~..~'m ~.~.T~UT~.~ ~.....~. E.~xIO.%. ..... (Signature of applicant, or name, if a corporation) .... '~..c>... ~ o.g...~.0.3. ~ ..................... ....... (mailingPaddress of app Lcan ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... .~..E~Kt~ ..... .Cp. ~g..~. ~'.~...¢.. ................................... Narne of owner of premises ............. MA.R, A . . KO. U.K. Q .U.L..A. 5 .................................... (as on the tax roll or latest deed) It' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate 9fficer) Builder's License No ..... .l~.~ ................ mmber'~ License ~o... ~-3 ~...Vf.. ......... Electrician s License No ....................... will be. sugmltted Other Trade's License No ...................... ~,~ ~ ttouse Number Street Hamlet County ]'ax Map No. 1000 Sectiont..~ ...... 0'4:3' Block . ..4 ............... Lot. D./.°...2.5, t..I Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy VA CA N T e~{ 1 lam. RESIDENCE b. Intend use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building ...X ...... ~lition ' ~...,. Alteration .. .... .. R pai Rem al Demolition ' Other Work (Description) 4. Estimated Cost . 47,500.- F (to be paid on filing this application) 5. If dwelling, number of dwelling units 1 ............... Number of dwelling units on each floor ........ : ....... If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each typb of use ............ :,. ....... 7. Dimensions of existing structures, if any: Front n o n e Rear ....... ~ ..... Depth Height .- '. 7 Num bet o f Stories 7 7 Z - 7 Dimensions of same stracture with alterations or additions: Front ............ i .... Rear .................. Depth.. Hei t ' ' · .................. gh ..... .- ._..-. · ........... Number of Stones ........... 8. DnnenmonsofentIrenewconstructlon Front. ..S f't ;~r ~5 ff Do,,+b 40 ~f. Height ........... .2.0.. Number of Stories..2 .................. ~ ....... , .............. 9. Size oflot: Front....5.q.ft Rear 50 [t .... r~,,,,h"' lOu 10. Date of Purchase ... t.~.~.~.?? ............... ,;. hName of Former Owner .~.H.A.R.O.L..D..A.8.H. ............... 11. Zone or use district in which premises are situated A RESIDENTI.A.L/~,GRiCUi~TURAr. 12. Does proposed construction violate any zoning law} ~);~tin'a~'c;'o'r'r~;t]l'a'tio'n': ..... iiq'O' ' ' ' ' ' ' ' ' ' ' ............. 13. Will lot be regraded ....... jV~/~[~/~.' [<'^~ ~,~,.. w ~ ~-.. Will e~.-"-'- -- "fill be r0nloved~ "" ' 'from premises: Yes 14. Nmne of Owner of premises ! ~.u[. ~ut.ta. aAddress ~_z.~,~. nwoogrerr~cet ph,,,,~ ~,~,, 201; 224-4674 Name ofArcintect PL~P~RB R,.F.O$SrP...E.. Y ....... AddressP~Z..¢olu"~n~ ~lv~,,k Phone No.S[d' 752-2 15. s th:ts property located within 1.00 feet of a tidal weeland? * Yes ..... No X .... · If yes, Southold Toxm Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andAndicate all set-back dimensions fi'om 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 YORK, COUNTY OF ................. ................................................ being duly swum, depo~,s and says that he is the applicant, (Name of individual signing contract) above named. He is the ............................................................. ~ ........................... (Contractor, agent, corporate officer, etc.)i of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hisI knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... day.y.. 1, Notary Public ....... ~ ....... County (Signature of applk!ant) 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEL.: 765-1803 Exanfined ................ , 19... Approved ................ , 19... Permit No ............ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~.ab,. Z.~ , a_.956.., 19 ... 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 applicatiofi 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 bnilding 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant,~ '- - -'~or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · 99&grac.t .ver~ctee...(.CloaS.ng. s.c. hed~l, ed. 2/. J. 9/.$.6. ) ......................... . ................ Name of owner of premises . .Prs.s. emg..o, wmor.-: .gar.i~ld. Ash .......................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work ~qill be done. u..n.5-.m.P.r. 97.d.. p.a.r.~, e..l..a.cl.3.a.q e..n~..~.9 ............... 225 Wood Lane ~reenport House Nmnber Street Hamlet County Tax Map No. I000 Section ¢3. ............... Block .. ?. .............. Lot. P/.q .2.5...1. ........ 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 .u..n.5_.m~w.g.v.e.d. ........................................................ b. Intended u~e and occupancy f.. 9.r..qn.e. ;f. gLn~J_~..c~v~J_.~:t~g ......................................... 3. Nature ofwork (check which applicable): New Building.........,XX · Addition.......... Alteration ..J ..... ;.., Repair .............. Removal .............. Demolition ........... ;., Other Work ............... $60 o-g. 4. Estimated Cost... ,000. O0 (Description) ~ (to be ~aid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor. 7.. If garage, number of cars ............................................ : ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . .~.a . 7. Dimensions of existing structures, if any: Front ........ Rear . ' Depth Height ............. Number of Stories ......... ' Dimensions of same structure with alterations or additions: Front ........ :...: ..... Rear .................. Depth ...................... Height ...................... Number of Stories ............. 8. Dimensions of entire new construction Front 2..5..f..~. ......... Rear . .2.5...f.~. ! .......Depth . .~.0. Height .. 3~5..~.~ ....... Number of Stories 2 9. Size of lot: Front . .50. J2t .............. Rear. 5.Q .~'.~ ................ he,,th 100£t 10. Date of Purchase .2/.¢9/.~}0 .................... Name ofFormerOwner . .~.~,~.'°.l. 01 11. Zone or use district in which premises are situated .'7.'./-deq.-5. ]o&~..C4&tr./[q:.~gt ~:qJ~,'fO~t~t, .................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...¥~S .......................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14, Name of Owner of premises Maw. ia. K.o. ukouiLas.. Address~,233. ,~r~p.o.d, .?.eF~..~hone No.29.1.~2..2.0.-.~6. ?./4.. Nome of Architect Address ...... '," Phone No Name of Contractor .......................... Address Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed property lines. Give street and block number or description according to deed interior or corner lot. o STATE OF NEW YORK, COUNTY OF .Naasau ...... ... S.S .... ~A .~IA .KOU3;OULAS~ ....................... (Name of individual signing contract) above named. and. indicate all set-back dimensions from and shoW street names and indicate whether .0 O being duly sworn, deposes and / says that he is the applicant He is the .O.W.N.E.R.. ! 9.o.n. ?~.a?.~.. y.e.n.d..e.e.) .................................. i ............................ (Contractor, agent, corporate officer, etc.i of said owner or owners, and is duly 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 hi* knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ! ............... day of ?. .ary. .......... ,19...86 Nota~l~blic, .. -~ ......... ~..~,~g.~ .......... County NOTARY pUBLIC, Stale of New York ................ No. 41-4689870 qualif*ed in queens County ~ ~ (Signature of applioant) Commission Expires March 30, 1 RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. ~'~>~> STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL ~YSTEMS FOR THIS RESIDENCE WILL !'CONFORM TO THE STANDARDS OF THE SUFFOLK CO~ DEPT. OF HEALTH SERVICES (st ' ,,~/¢ APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ON~ DATE: ~ APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST· SECT. BLOCK PCL, OWNERS ADDRESS: TEST HOLE STAMP SEAL .... ;... ?'P+. _;7, ~gs&. RODERICK VAN TUYL, P.C. LICENSED LANO SURV£YOR$ GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WiLL CONFORM TO THE STANDARDS OF THE SUFFOLK . CO DEPT OF HEALTH SERVICES .,~/¢ APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: APPROVED: suFFOLK CO. TAX MAP DESIGNATION:' DIST. SECT. BLQCK PCL OWNERS ADDRESS: t~'ST HOL~~ STAM, SUFFOLK CO. HEALTH DEPT. ~VAL FEB I0 1987 ~ ~,6 ~ , , $C ~pT ~ " I ~ STATEM[NTOF INT~NT ~ . I /~4'-' ~ THE WATER SU~Y AND SEWAGE DIS~AL .:~ k ! k~ ." SYSTE~ FOR THIS RESIDENCE WILL ocCUPANCY OR USE iS UNLAWFUL ~Nll'HOUl' CERllFICAIE OF oCCUPANCY LEAD. I $OOHJ. 3W aNY ~'I¥1~31YW a3SOdO~ld -IO SNOH,II~tD$3a ~SONIM'~IC]dOHS iIWgrIs 0.1. ' S~hJ.~¥-I~i NYW=S~O/~I~Ig ¥:1 ! I" 1'2 4"-4' IL" ~'t~ 4"..'C lo" W//[~L' 'x I N 0 T E S : 4"~ lo" W/ p~. CONTRACTOR OR MANUFACTURER I$ TO CHECK AND VERIFY ALL MEASUREMENTS AND cONDITIONS , AJ~D BE RESPONSIBLE FOR ~,L SETTING OUT. THIS DRAWING I$ INSTRUMENT OF SIR¥1~E AND IS THE fROPEI~TY OF THE,'~NER. ff IS , THERtUN~R~ ~ R E V I'.S'l 0~ .S~ OF :$':]/0 N I S(]OHI]W 0NY (]~SOdO~d 40 SNOI/dI~DS3(] "SONI/'AV'dOdONS LIV~fl~F1S OI ' S~hJ.D¥:~n NYW=SI:IOJ.'v~I~8 YJ : S :t I O N .j ~0 .) DATE: