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HomeMy WebLinkAbout29045-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29644 Date: 08/19/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 2755 WESTPHALIA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 10 Lot 20 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permitheretofore filed in this office dated DECEMBER 31, 2002 pursuant to which Building Permit No. 29045-Z dated DECEMBER 31, 2002 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 ACCESSORY ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to THOMAS A & CAROLYN K TAYLOR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 1153303 07/29/03 PLUMBERS CERTIFICATION DATED N/A A t ori/ed Si nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29645 Date: 08/19/03 THIS CERTIFIES that the building ADDITIONS Location of Property: 2755 WESTPHALIA RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 10 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 31, 2002 pursuant to which Building Permit No. 29045-Z dated DECEMBER 31, 2002 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 COVERED PORCH ADDITION, REAR DECK ADDITION AND ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR PER ZBA #4793 DATED 4/19/00 . The certificate is issued to THOMAS A & CAROLYN K TAYLOR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 547327 01/09/01 PLUMBERS CERTIFICATION DATED N/A u o zed S gnature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 29045 Z Date DECEMBER 31 , 2002 Permission is hereby granted to : THOMAS A TAYLOR 2755 WESTPHALIA ROAD MATTITUCK,NY 11952 for CONSTRUCT ADD, PORCH & DECK TO EXISTING 1 FAMILY DWELLING AND AGCY AG POOL WITH FENCE TO CODE PER ZBA #4793 THIS REPLACES #26503Z at premises located at 2755 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 114 Block 0010 Lot No. 020 pursuant to application dated DECEMBER 31, 2002 and approved by the Building Inspector to expire on JUNE 31, 2004 . Fee $ 226 . 80 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 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) PERMIT NO. 26503 Z Date MAY 16 , 2000 Permission is hereby granted to: THOMAS A TAYLOR 2755 WESTPHALIA ROAD MATTITUCK,NY 11952 for CONSTRUCT ADD. , PORCH, & DECK TO EXISTING 1 FAMILY DWELLING AND AN ACCY A/G SWIMMING POOL WITH FENCE TO CODE PER Z .B.A. #4793 ISSUED 4/19/00 at premises located at 2755 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 114 Block 0010 Lot No. 020 pursuant to application dated NOVEMBER 26 , 1999 and approved by the Building Inspector. Fee $ 152 .20 Authoriz d ignature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations-, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing" land uses: 1. Accurate urvey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling$25.00, Alterations to dwelling $25.00, Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00. Date. d l y b z/ _ New Construction: /Old or Pre-existing Building: _(check one) / Location of Property: 9;75S G(//�Qlict t�r �iC° �er{fyy�G !L House No.� Street Hamlet Owner or Owners of Property: Suffolk Comity Tax Map No 1000, Section L/ 7z':3 S'9� /Jlock O a / p Lot d Z O Subdivision c��(� Filed Map. LOC //G 2 Doo Permit No. 57 Date of Permit /�f, 3/Zou2.Applicant: _/7'cc 5 Health Dept. Approval: _Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ G (� T � j1o�5 �3 �� t� Applicant Signatur FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. AMENDED NOTICE OF DISAPPROVAL DATE; April 19. 2000 TO Thomas& Carolyn Taylor 2755 Westphalia Rd. Mattituck NY 11952 Please take notice that your application dated November 26 1999 For permit for addition to one family dwelling at Location of property 2755 Westphalia Rd Mattituck County Tax Map No. 1000 - Section 114 Block 10 Lot 20 Subdivision Filed Map # Lot# Is returned herewith and disapproved on the following grounds; 1 Proposed addition on non-conforming lot(19800 sq ft)in R-40 zone not permitted pursuant to Article XXIV Section 100-244B which requires combined side yards of 25(twenty five) feet the proposed construction has combined side yards of+/ - 24.5 (twenty four and one-half) feet. 2. Proposed deck addition at rear of dwelling creates a condition which places the existingaccesso garage in side yard not permitted pursuant to Article 111A Section-100-30A 4 which states all accessory structures must be located in required rear yard Authoriz 'gnature # I Q ?nnn O cPrJ�rJ�rPrJ�rJ�rJ�rJ@PrJ�r�rJrJ�rJ�rJ�rJ�rJ�rJ�r�rJ�rJ�cPrJ�cPr�rJ�r�rJ�rJ�rJ�rJ�rJ�rJ�rJ�r�rJ�rJ�cPrJ�rJ�rJ�rJ��PrJ-RI-M 1IRIr>PEPI PrJ�rJRIVEI -PE- JE-PROcPr PRIU O S5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY S 5 40 FULTON STREET — NEW YORK, NY 10038 rCj 5 CERTIFIES THAT Upon the application of upon premises owned by 5 GOODALE ELECTRIC THOMAS TAYLOR 5 5 P. O. BOX 1190 2755 WESTPHALIA RD �5 CC5MATTITUCK, NY 11952, MATTITUCK, NY 11952 5 Located at 2755 WESTPHALIA RD MATTITUCK, NY 11952 S 5 Application Number: 1153303 Certificate Number: 1153303 S 5 Section: Block: Lot: Building Permit: BDC: NS11 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Outside,Pool/Spa, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 rj found to be in compliance therewith on the 29th Day of July, 2003. 5 5 Name QTY Rate Rating Circuit Type 5 5 5 Appliances and Accessories 5 Time Clock/Switch 1 0 5 5 Pool/Spa Bonding 1 0 5 5 Wiring and Devices _ 5 5 Receptacle 1 0 GFCI 5 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 frequent test and/or repairs made by a qualified person. C 5 175 5 5 5 5 5 5 5 seal 5 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 01 o rJtJrJ'�rJ' ncnrJrJrJrJ acnrJrJrJrJrJ or�cncnrJrJr1cncPclrJ nr�rJ�l�lr�rJ armor n�l�lr�r�rJ�rJr�r��lrJrJrJ arJ arJ@fAPrJtJcPrJ arJ arPcnr��PrSrJ� l7 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1185152 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date JANUARY 09,2001 Application No. on flie 10600100/00 N 547327 THIS CERTIFIES THAT PERMIT NO. ZB265032 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of THOMAS TAYLOR, 2755 WEST PHALIA, MATTITUCK, NY in the following location; ® Basement ® 1st FL ❑ 2nd Fl. OUT Section Block Lot was examined on DECEMBER 28,20M and found to be in compliance with the National Electrical Code., FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENJ FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 3 8 4 3 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.1 TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.G. AMT. I AMP. I AMT. I AMPS. I TRANS. AMT. H.P. NO.OF FEET SYSTEMS AMT. WATTS I - I FIT SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.6. AMT. AMP. TYPE EQUIP. 1 0 2W 1/3W 3�3W J 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 200 CB 1 X 1 2/0 1 1/0 OTHER APPARATUS: PADDLE FAN F-1 G.F.C.I:-1 REP ELECTRIC LIC.#4727 L sIL P.G. BOX 635 HATTITUCK, NY, 11952 GENERAL MANAGfA 11 Per This certificatsi must not be altered In any manner;return to the office of the Board if Incorrect. Inspectors may be Identified by their credentials. COPY FOR ­BU(LMG- DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. I f � I � fE i , t I - IF ff : t I I ; I � � r fi I � t ' I � n S � MAY f 0 inn ,.6 - da k,..q --- - - ro a� (J I. Paul Coleman, do state that the solder I used at 2755 Westphalia Road for Thomas and Carolyn Taylor was less than 2/10 % lead. Paul Coleman V' V 1 MARY JO CRUICKSHANK Noloiy Public-Stafe of New Y4* NO.D1 CR6M4lS57 Ou n My Comrnizion 6Vfrvx a _ i WEST PE-VAI I A Rll:">AD 100 M DEER DRIVE � Fi. iCi': , �f; 'E f5.C1 i O .n I 1) v � hl t j NOT hr Bu�zrreH ' X11 _i [ � 0 Cl uj ) �t PPPPI(' 4U7'.rr r t �e IL tr.f Z �..— f OD iu iI Z tri (Ali GUARAN r i Ari�`7c Urn„h.rtra!afterotkn M addkion A5 to IN,atavry to e Violation of — 6oe;ion 77051 of the Neve York SWO LO T yl i E(f"len LAW COO”of this awe"law not boaft the lend vervayp a Wiled"of of Or..bcwmd and Wul not be OoneMNlad to be•WN&tW OOM cum an10a0loom hone dm""M "to lfN pato 4 for W11M the soleef• Is prepar6t Mrd On his behalf to the len eongetfl Rnmen aW her agency dand knrkrq 1 Yaae hereon and APPEALS BOARD MEMBERS O SpFFO�� �O CO Southold Town Hall Gerard P. Goehringer, Chairman _0 Gym 53095 Main Road James Dinizio,Jr. y P.O. Box 1179 Lydia A. Tortora 0 Southold, New York 11971 Lora S. Collins George Ho y ��� ZBA Fax(516) 765-9064 ge ming__.• '�O� �0 Telephone(516)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD i i FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF APRIL 19, 2000 Appl. No. 4793 - THOMAS TAYLOR. Location of Property: 2755 Westphalia Road, Mattituck 1000-114-10-20. Date of Public Hearing: April 6, 2000 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The subject property is a 19,800+-sq. ft. parcel-iocated at 2755 Westphalia Road, Mattituck. The lot has 75 ft frontage along the south side of Westphalia Road and depth of 264 feet. The lot is improved with a one-story frame dwelling and accessory building(s) as shown on applicant's survey sketch. The dwelling has nonconforming side yards of 5+- ft at the west side, 24'9" (+-) ft. at the east side, total nonconforming sides at 29'9" (+-) feet, and front yard at 47+-ft. BASIS OF APPLICATION: Building Inspector's February 7, 2000 Notice of Disapproval (corrected April 19, 2000) for the reasons that (a) proposed deck addition at rear of dwelling Section XXIV, Section 100-244 of the Zoning Code requires total side yards of not less than 25 feet; and (b) proposed garage is located partly in a side yard. Applicant is proposing total side yards of 24.5+- feet (5.3+- nonconforming on the west side and 19.6 on the east side) and accessory garage, partly in the required rear yard and in part, the easterly side yard. AREA VARIANCE RELIEF REQUESTED: Applicant requests Variances under Article XXIV, Section 100-244B and Article 111-A, Section 100-30A.4, based upon the Building Departments February 7, 2000, and corrected April 19, 2000 Notice of Disapproval, and the building permit application to locate (a) proposed addition to dwelling with reduction in the existing nonconforming side yards, from the required 25 ft. to 24'9" (+-)feet; and (b) northerly portion of garage partly in a side yard. INFORMATION AND EVIDENCE: In reviewing the original Notice of Disapproval issued February 7, 2000 by the Building Department, the Board determined that the inspector's estimated lot size of 21,780 sq. ft. was incorrect, thereby also invalidating the correspondence code requirement for combined side yards of 35 feet. A revised Notice of Disapproved was issued on April 19, 2000 indicating the actual lot size to be 19,800 sq. ft. and the Code's combined side yard requirement of 25 feet. REASONS FOR BOARD ACTION, DESCRIBED BELOW: Based on the testimony presented, materials submitted and personal inspection,the Board makes the following findings: 1. Grant of the area variances will not product an undesirable change in character of neighborhood or detriment to nearby properties. The proposed side yard variance required is three inches (24.9 ft. 25 ft.) The proposed construction of a small addition to the front of the house follows the existing setback and footprint of the westerly side of the house. The proposed wraparound covered porch will reduce the easterly side yard setback by approximately five (5) feet but will leave an ample minimum setback of 19 ft. 6 inches. The proposed additions will enhance Page 2 - April 19, 2000 ZBA Appl. No. 4793 - T. Taylor Re: 1000-114-10-20 the appearance of the dwelling and have a positive effect on the neighborhood. Although the proposed deck on the rear of the house is in a conforming area, by extending the rear line of the house the existing accessory garage would become partially located in a side yard. This technical variance will have no effect on the neighborhood as the garage has been in its present location for many years. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for applicant to pursue, other than area variances. The total side yards are three inches shy of the Code required 25 feet 3. The area variances are not substantial and represent a three-inch reduction in 25-ft total combined side yards. The partial side yard variance required for the existing accessory garage is not significant since the actual location of the garage would remain unchanged. 4. The proposed variances will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. The requested variances merely allow the applicant to construct modest additions to their dwelling. In considering this application, the Board deems this action to be the minimum necessary and adequate to preserve and protect the character of the neighborhood, and the health, safety, welfare of the community. RESOLUTION/ACTION: On motion by Member Tortora, seconded by Chairman Goehringer, it was RESOLVED, to GRANT the variances, as applied for. VOTE OF THE BOARD: AYES: Members Goehringer irman ' io, Tortora. (Members Collins and Homing were absent.) This Resoluti s dul op d (3-0)&AIr GERARD . GOEHRI ER AN April 21, 2000 765-1802 BUILDING DEPT. INSPECTION [ :Ir/FO ATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA KS: ' �— � l DATE dV INSPECTOR 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F NDATION 2�N.DD [ ] INSULATION [ FRAMING [ l FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY �7 REMARKS: �� DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] GH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,,.; 5aC --� T DATE INSPECTOR 765-1802 BUILDING DEPT. I NSPECTIO [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE / [U'D INSPECTOR c� © 55 7W-lW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ;IF3 NATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: _ W 4d, To DATE L O INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ] FIREPLACE & CHIMNEY REMARKS: f DATE � /0-3 INSPECTOR '�'� FIELB TNSPFCTION REPORT __ DATE - __ __ _ COMMMNTS b g _- __ __ -- i. II c `� 1 FOUNDATION ( IST) ii II u - FOUNDATION (2ND) II a '�41• -----------_______________ -------- -------------------------- w I� —E_-[-/— - n _ ,,". -fell Avol ROUGH FRAME PLUMBING I - F, ! � --� V II 6 R INSULATION PER N. Y- ii STATE ENERGY ate Gia( -- CODE uJ 6'iv -fit -G II II — — n u E � of o� •frd �/9�J ��_�_ �, II 1 c_ L H I� --JI Wt FINAL N u III ADDITIONAL COMMENTS: HW /$ p cn ro H BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALLE.�. .,J. . Examined.................. 19.... h MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved..... r'.�) .���., Permit No. RS -2 �.moi. ............ .. . ................ ..... Disapproved a/c .................................. ....... ..... .. . ................... .. ......................................... .......... pp _ _1 .��C�... ............ ` � I (P.uilding I or) APPLICATION FOR BUILDING PERMIT J INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sharing location of lot and of buildings on premises, relationship to adjoining premises or public ;treets or areas, and giving a detailed description of layout of property roust be drawn on the diagram which is part of his application. 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 issue a Building Permit to the applicant. Such mermit 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 arty purpose whatever until a Certificate of )ccupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY RqE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zane ordinance of the Tam of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein iescribed. The applicant agrees to cdmply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryV ons. .... .. .............. (Signature of applicant, or name, if a corporation) _i}?:�.VV)' hi��i C\. %m;.. 1',)nIiiOtt(.K.l;y..I ItiJ <. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ... Ue, cLw _,e x)..c...nec:................................................................ ........ . ......... . ........ Name of owner of premises ...1_`'10:"rl4$.. A. ��lor .... cn_Z...(�.c.1fC1.�n }� IrAy.�Q�.. .. ..... . ... .... ........... .. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ........... Plumbers License No. ......NX,.. ........... Electricians License No. .T' .11............ Other Trade's License No. .................... I. Location of land on which proposed work will be done. ................................................................................................... .................... House Number Street Hamlet Canty Tax Map No. 1000 Section . 1Up�0...... Block ...10........... Iota.cc C 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 ...b pm 2...cdto-)q-.1kfy� ................................. ........... ....... b. Intended use and occupancy ....\�olne;.,.alAZ6. %*I,)5.................................................. J Nature of work (cedr wimidm applicable): New Building ......rAddition .... /.. .. Alteration ........ .. Repair ............ Removal ............. Demolition ............ Other Work .................................. (Description) Estitwted Cost . . r�. i� .e......I..... fee .............................................. (to be paid on filing this application) If cielling, miner of dwelling units ............ Number of dwelling units on each floor ... ............. Ifgarage, n nber of cars ...................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... i Dimensions of existing structures, if any: Front...`1�......... Rear ...{........... Depth ............... height ........ .. ............... Number of Stories ....I................,. Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth ........ ............ }height ...............I.... Umber of Stories ............... Dimensions of entire new construction: Front ................ Rear ............... Depth .............. lieigimt ................ ..... .... Nuber of Stories ....i................ Size of lot: Front .. ':�............. Rear .... ..i 0............ Depth L'.y:0 .......... Date of Purdmase `30,�. ............ Name of Former Owner ..�l�.;t'k S'rt.LhC"m ............. Zone or use district in which premises are situated .............................................. Does proposed construction violate any zoning law, ordinance or regulation: .M 9................... Will lot be regraded .... !�............. Will excess fill be removed from premises: YES 6.t1c_ FD Nares of Owner of premises .lYl4`m'JK'fii 5:44f9� cl.)�:�.�Y!Address .��.}�5.w4` �!R..R�.. :-more No. Nam of Architect .................................... Address .............................. Phone No. ............. Name of Contractor ....... ............................ Address ...............................Phone No. ............. Is this property within 300 feet of a tidal wetland? * ITS .......... NO .x....... *rF YES, SOUIIlC)<D MM TIAMIMS HUMT MAY HE W3QD RED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setback dimensions v property lines. Give street and block number or description according to deed, and show street names and indicate User interior or corner lot. 3 Or N•,lJ Y(RK, SS fYOr ...... .. . .... . ..... .... ........................being duly sworn, deposes and says that he is the applicant a of individual signing contract) : nnred, the ... . . ... U Jr?ft� i'i r . ..... ...........�.....?... ................................................... (Contractor, agent, corporate officer, etc.) id owner or amers, and is duly authorized to perform or have performer] the said work and to make and file this cation, Ulat all statements container] in Ods application are true to the best of his knowledge and belief; and the work will be perfonmed in the manner set forth in the application filed therewith. to before rte this ��...c.... ...day �of, ary Public HELENE D.HORNE Notary Public.State of Now Yo* Signature of Applicant) No.4961364 Qualified in Suffolk County Commission Expires May 22, 00/ t SII EI l- �p ' r IIS Qa 7D . 1I 5- 27x r . rg-r. L -- - Mk) �' a -'-- - -- `-- f 61151 Z� 111_ I� ;�_ �TII L 1 00 I cc L'L - t' I o I 1 0 a n C9 K v 0 p!L'll Z v et 1 APPROVED AS NOTED a ib5o I DATE: B.P.M -- `.. PROVIDE OPENINGS FOR FEE: / Z — eY: rte` - EMERGENCY ESCAPE AS NOTIFY BUILDING D PARr NT A7 765-1802 9 AM TO 4 PM FOR THE REQUIRED BY PART.714 OF FOLLOWING INSPECTIONS: T - --' = N.Y. STATE BUILDING CODE. DATION - Two REQUIRED . . .-. _ _ . 1FOR POURED CO ` -� 'v- �` - - FOR POU ED NCRETE 2. ROUGN - FRAMING t PLUMBING - + 3. INSULATION 4. FINAL - CONSTRUCTION MUST f �I PLUMBER CERTIFICATION BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET .Y. ,- _.-- I - _ ON LEAD CONTENT BEFORE THE REQUIREMENTS OF THEN V — - — CERTIFICATE OF OCCUPANCY STATE CONSTRUCTION t ENERGY _. M iI i 7 I .I I L �� I� II 'I l i ., _. _ - ..- - ' _•_ CODER. NOT RESPONSIBLE FOR SOLDER USED !N WATER oESR3N ox coHsmuclaN ERRORS SUPPLY SYSTEM CANNOT � Z13 ai T --= =— - 1'-- - - - ---- - EXCEED 2!10 of 1% LEAD. -- - --. iIDIDERWRII`RS CERTIFICATE - - �- 1 ---- -...t.�__.=-uz,- - _u:- -- - -. _'- - - -- -•— -_--I---, -- - ;N:�i71REi) Oi,'o w. ..T kOWC OCCUPANCY OR >> -'-I - - - - - USE IS UNLAWFUL �S WITHOUT CERTIFICATE OF OCCUPANCYPt NOF NEyro p r � 0322541 V If copper tubing is used �P9OPESSIONI� for water distributing P ALL P UM67NG WASTEjAIG system piping Shall be x &wATER LINES NEED types K or L only PROVIDE SMOKE-DETECTING o 1 TESTING BEI COV EFING UNDERWRITERS CERTIFICATE ALARM DEVICES u AS TO PART. 721.1 a N-Y.S BUILDING CODE. a - - - .. - 17 - III Nwl 71 40 LC ` f � I ,; �. A C+ `�� I ±,�� I fit_ It J•- � � � �� I �tF mar ��c 7 4y4 arr 'po�jc , jj _ .,_-✓ J r� ai n J ' I � /A- r'1� C ,tfb9j. �J. . � _� �'� � ,/ ...✓ iL� W,1 ` y a \� _ 4. F. 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