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HomeMy WebLinkAbout26787-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27557 Date: 12/13/01 THIS CERTIFIES that the building ALTERATION & ADDITION Location of Property: 1230 FIRST ST NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 7 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12, 2000 pursuant to which Building Permit No. 26787-Z dated SEPTEMBER 22, 2000 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 ALTERATION & ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER ZBA #4821. The certificate is issued to ELAINE ROMAGNOLI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 010077 01/12/01 PLUMBERS CERTIFICATION DATED N/A 9 c A tho zed Signature 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. 26787 Z Date SEPTEMBER 22, 2000 Permission is hereby granted to: ELAINE ROMAGNOLI PO BOX 116 NEW SUFFOLK,NY 11956 for ALTERATION & ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR WITH ZBA #4821 APPROVAL. FLOOD PMT. INCLUDED. at premises located at 1230 FIRST ST NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0007 Lot No. 029 pursuant to application dated SEPTEMBER 12, 2000 and approved by the Building Inspector. Fee $ 175.00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT _ n r TOWN HALL ( �� ;1 765-1802 APPLICATION FOR,CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and s�bmitted- to the bulildin inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 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 survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,- Additions 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 - -2%a 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .a. . . .a�CJ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . .. . . . . Old Or Pre-existing Building. . . . . . . . . Location of Property. . . . . . . . . . . . . . . . . . . . . . . . .�'�3 . . l . . �.7. . . . . House No. Street Hamlet . �� . . . !` 'L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Onwer or Owners of Property.. . County Tax Map No 1000, Section. . .11. 2. . . .Block. . . . . . . . . . . . . . .Lot. . . . ��. . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .�6. .7Q. .? . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.XIC . . . . ;;)„ � Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . Qom. S9Q9-3 7 SS? . . . . . . . . . . . .APPLICANT. . . . . . . . . . . . . . . . . . . . . . . . "A _;%:r111 r.�t�\\� �L �/jl•�. ::tQ\\\ v' //f�..�.i��� �/.%"/�f �\/r �/j^^��i�/y/Gf•...���w /�� ;^ `�, ,ice`,-�: `rl•+.1� �.� � ''jam •r,..'.., .1 l •;l!�-'-� it)4 �c'`� mil. h .'�C'-; ) Elfectrici i i ''East Meadow Avenue East Meadow, hh. <. �- . -0• ' Inspector 15 WEBSITE -- •_ctors.com ELECTRICAL APPROVAL CERTIFICATE Richard 1�\\��� `y E-MAIL info@electdcatinspectors.com �d € WilliamOster _ Northport NY 11768 " - _ ELECTRICAL APPROVAL CERTIFICATE INSPECTION FOR PREMISES LISTED BELOW v PROPERTY rt, JElaine ' . 1 1230 First StreetNew Suffolk NY 11956i.-,� fi AREAS LISTED BELOW ARE APPROVED BY INSPECTION AND FOUNDTO BE IN COMPLIANCE • • Ii��;, No visual defects were found for the electrical Inspection provided.No obvious unsatisfactory conditions were found in the area's herein below only. Closed Wall Inspection ( ist Floor •• • Bedroom, Room. Duplexc• 1 Amp.Single Receptacles, s,2-Incandescent Fixtures, j ))per 2e 30 Amp.Appliance Receptacle.* 1 RR a This certificate is not valid unless initialed by an authorized Ell Employee lf�ik��)"ala -� ./�/ _ / L•.', t,.l _ •.'J `�L' +fes. `�'v J ��. /�� 16 ,.� y,•7@�91'✓� ''J� �( l� �rV�'< �.( 1� :r �'( l� 'rV `'7dg91 �'i':` f �:vv \\ a ��,��J,C��J,C�������•6• 4L;t. ���' , ;�1, r r�,i, ...� /��:\ 1-, " 1 cli - �q r,, 1. ELECTRICAL INSPECTORS, INC. is not responsible for the existing conditions at the subject premises. 2. ELECTRICAL INSPECTORS, INC. is not responsible for corrections, upgrading or replacement of existing electrical violations at the subject premises. Any corrective work shall be solely the responsibility of the property owner. ELECTRICAL INSPECTORS, INC. DOES NOT WARRANTY OR UNDERWRITE THE ELECTRICAL CONDITIONS AT THE PREMISES. 3. ELECTRICAL INSPECTORS, INC. only recognizes the National Electrical Code, the New York State Building Construction Codes and Local Municipal Codes. 4. AN ELECTRICAL SURVEY consists of a visual examination of the premises ONLY: Electrical Inspectors Inc. will comply with the requirements of NFPA 73, latest edition Chapter 1, Section 1-1, 1-2. If violations exist, a Notice of Violation (NOV) will be issued requiring correction by a licensed electrical contractor. After the violation has been corrected, a re-inspection will be conducted and if approved a certificate shall be issued. 5. A SURVEY CERTIFICATE does not examine the actual wiring or devices unless all walls are opened and wires and devices are exposed prior to the survey being conducted. 6. A CERTIFICATE is non-transferable. 7. AN ELECTRICAL INSPECTION consists of an examination of wiring and installations during the rough stages of construction. After completion of the construction a final inspection will be conducted at which time a certificate will be issued provided no violation exist. In the event no inspection is requested during the rough stages of construction ELECTRICAL INSPECTORS, INC. will perform a CLOSED WALL SURVEY that consists of a visual inspection of the wiring and installations only. Since access is limited, ELECTRICAL INSPECTORS, INC. shall bear no responsibility for any defects or violations at the premises. 8. ELECTRICAL INSPECTORS, INC. shall not be responsible to remove any walls in order to conduct an electrical inspection. 9. ELECTRICAL INSPECTORS, INC. will only release information, certificates and reports to the applicant after payment for services rendered have been paid in full. 10. ELECTRICAL INSPECTORS, INC. assumes no liability for the results of its inspections. 11. The agreement may not be changed orally. C2 Town Hall,53095 Main Road y = Fax(631)765-1823 P.O.Box 1179 i0 .F Telephone(631)765-1802 Southold,New York 11971-0959 y4- BUILDING DEPARTMENT TOWN OF SOUTHOLD JANUARY 26 , 2001 ELAINE ROMAGNOLI P.O. BOX 116 NEW SUFFOLK, N.Y. 11956 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file . (Enclosed) XX No Underwriters Certificate on file . XX The check is (not on file . ) $25 . 00 No Health Department Approval on file. No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26787-7 Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ IR PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: ,DATE L � INSPECTOR .�/1 BUILDING DEPT. INSPECTION [ ] FOU ATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J INSULATION [ Z11 FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE INSPECTOR �.�-� M-1802 BUILDING DEPT. . INSPECTION [j,4 F DATION iST [ ] ROUGH PLBG. [ - FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMAR S: ,DATE � � (TD INSPECTOR 79� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ j FRAMING [ INAL [ J FIREPLACE 8 CFIIMNEY REMARKS• c ,DATE � �L 6 / —INSPECTOR UNDATION ( IST) UNDATION OND) ---------------___----- ________ ________________________ I�i �l II ✓ -� ---=1 u UGH FRAME & II it it------II PLUMBING jiIt I�— u II II �y. Who c�1 ZULATION PER N. Y. STATE ENERGY CODE u u u a ----- ---- --------------------------------- H FINAL ADDITIONAL COMMENTS: /: /'� �"�� j�v.�.9�7'sc•N- �t_ A- rdL Re e• -ori .-fiFde- eT'T �,• /fir �'�•f++o o,... .c ifs+.�J dot PO arc. 1 tv \vV O z m �o , JUDITH T. TERRY — Town Hall. 53095 MainIcOad f = � I � P.O. (1<�x 1 17() R TOWN CLERKS � `t, ' ` � Southold. Nc,,� York rk 1 1 17 1 L;. ltECl5('TWt OF VITAL STATISTICS yew (C� � � Fax (S 161 765-1921 MARRIAGE OFFICER _ Tcicphonc (516) 765-1 XOI �A RECOR()s MANAGEMENT orFICER �O1 �� FREEDOM OF tNFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93) ] . ,L::G. GEF l'. TOWN OF SO'J(►+OLDJ T , . Terr �h Y Southold Town Clerk August 25, 1993 y APPLICATION #_ PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL, PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE,T07 EST O O�VLEDG�/E',TRUE AND ACCURA E. (APPLICANT'S SIGNATURE) ( 0_' �J` DATE SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANTI /����y-S ?c7s NAME ADDRESS C� TELEPHONE APPLICANT BUILDER ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project t location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION r PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure ❑ Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commeraal) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). O Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable O The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale, and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the first floor,details of floodproof-ing of utilities located below the fust floor and details of enclosures below the first floor. Also ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B. O Is not in conformance with provisions of Local Law # , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION # PAGE 4OF4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATORI The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? OYES ONO DATE BY DEFICIENCIES? OYES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATORI Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) 3 FORM NOi 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; March 28, 2000 TO Patricia Moore A/C Romagnoli 51020 Main Rd Southold NY 11971 Please take notice that your application dated March 2, 2000 For permit for addition to one family dwelling at Location of property 1230 First Street New Suffolk NY County Tax Map No. 1000 - Section 117 Block 7 Lot 29 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds proposed addition to non-conforming structure on non- conforming lot not permitted pursuant to Article XXIV Section 100-242A which states. Nothing in this Article shall be deemed to prevent the remodeling reconstruction or enlargement of a nonconforming building containing a conforming use, provided that such action does not create any new nonconformance or increase the degree of nonconformance with regard to the regulations pertaining to such buildings. Existing structure has existing non-conforming lot coverage of 23.5%. Proposed 5x12 addition represents a+/-2% increase, for a total of+/- 25.5%. Authorized Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. AMENDED NOTICE OF DISAPPROVAL DATE; May 9, 2000 TO Patricia Moore A/C Romagnoli 51020 Main Rd Southold NY 11971 Please take notice that your application dated March 2, 2000 For permit for addition to one family dwelling at Location of property 1230 First Street New Suffolk NY County Tax Map No. 1000 - Section 117 Block 7 Lot 29 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds proposed addition to non-conforming structure on non- conforming lot not permitted pursuant to Article XXIV Section 100-242A which states. Nothing,in this Article shall be deemed to prevent the remodeling reconstruction or enlargement of a nonconforming building containing a conforming use, provided that such action does not create any new nonconformance or increase the degree of nonconformance with regard to the regulations pertaining to such buildings. Existing structure has existing non-conforming lot coverage of 24 2/3 ° Proposed 5x12 addition represents a+/- 2% increase for a total +/- 26 2/3 °/' o. Authorized ' n re r - - • BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . ... . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.X. 11971 TEL: 765-1802 NOTIFY: q CALL . . :-5�7 � Examined... ........... 20. MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved...y l&........, 2QGo Permit No. ................................... Disapproved a/c ..?j�4-.�'�u d.... ........ ................................... ............................................... . ... m ' ilding•Inspectorj........ APPLICATION FOR BUILDING PERMIT . . . . . . . . . . . . . . . . . . - - Date . , 20. INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 application. c. The work covered by this application may not be meed before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 HEFM MATE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Comity, 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 authorized inspectors on premises and in building fnecessarinspections. ............. .................................... (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 ...... ... ............ ............................................................................... Name of owner of premises ..... /47/ �G .. �'n e1�'n o lc................................................... .... . ....... . ....... (as on the tax roll or latest deed) If app li is ion, signature of duly authorized officer. . . ................. (Name and titleof corporate officer)•. Builders License No. ......................... Plumbers License No. ..... ................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. lVtW ....�23°....'. .est ......... ..� « .............................................. House Neer Street Hamleett County Tax Map No. 1000 Section .... r.7....... Block ..0.7......... Lot .....Z/....... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises acne intended use and occupancy of proposed construction: a. Existing use and occupancy ...... b. Intended use and occupancy ....... ......... .... ..................... Fc.)igx«i mi'Y T 1. Niture of worts (check which applicable): New Building .......... Addition X..... Alteration Repair ............ Removal ............. Demolition ............ Other Work .................................. Q 0 (Description) EstimatedCost ......................... fee .............................................. (to be paid on filing this application) If dwelling, number of dwelling units ....�..... Number of dwelling units on each floor .../............ Ifgarage, number of cars ...................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if any: Dont................ Rear ............... Depth ................. Height ......................... tkmber of Stories ...................310 Dimensions of structure with alterations or additions: Dont Rear Depth ..... ........ Height .................... Number of Stories ....................►-.^........ Dimensions of entire new construction: Front ................ Rear ............... Depth ..a....x...�Z- height ......................... Number of Stories ..................... Sizeof lot: Dont .................... Rear .................... Depth 0. Date of Purchase ..................... Name of Former Owner ........................................ I. Zone or use district in which premises are situated .............................................................. 2. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be regraded .................... Will excess fill be removed from premises: YES ND 4. Names of Owner of premises ........................... Address .............................. Phone No. ............. Name of Architect .................................... Address .............................. Phone No. ............. Name of Contractor ..................................... Address ...............................Phone No. ............. 5. Is this property within 300 feet of a tidal wetland? * YES .......... NO .......... *IF YES, .SOI71I1taiD MM 'IffiMMS PE[aif MAY HE MMM. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions► ram property lines. Give street and block ember or description according to deed, and show street names and indicate hether interior or corner lot. he '' 5 / .2 .ca ole .e-» fit, .,�,c s 5 .vo�vcon farra� ,�TA1T or NZJ YORK, ' SS ...........being duly sworn, deposes and says that he is floe appl.icauit Kane of individual signing contract) hove maned, eis tthe ................ ....................................................................... (Contractor, agent, corporate officer, etc.) f: said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and hat the work will be performed in the manner set forth in the application filed therewith. Worn to before me th i s .....!ZN�D .......day of .... ._to Notary Public ........ .. ....ROMT I'SCary Pubtic,State .....Qualified in Suff (Signature of Applicant) No.01SC47Term Expires Mal/ BUILDING PERMIT REVIEW CHECK LIST Applicant/ n Date Owners Name: ,0-,-LReviewed: % Architect/ Date Engineer: Submitted: SCTM#: District: 1 000 Section: VVI Block: 9_ Lot: _ Project Subdiv3 t st i� SS���`-",� Name: ision Location: Single&separate Required certification: (Yes/No) ,/_ Req. Reg• 2 �{ Zoning District /'�1� [Lot size: Actual: -✓�ads� ] [Lot coverage �<� Proposed:�� Req. i Req. / Req. [Front Yard Proposed:d 3 [Side Yard Proposed: SD [Rear Yard Proposed: Ita _ J V Project Description: /�,d�► — L3, 4�1/ zn ,�� AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees ✓ Town Zoning Board approval: Town Planning Board approval: ✓ Flood Plane Elevation??? Flood Zone: Zx-,, c/ Notes: 9 vKc 7yf A7- -rte -- �uT— sct3ilr�TigG v+ . 813 ���.-t r) ```JC�Q �(4--► r u;s«J -S 7,/ �!"`4+ � yet /r -� a C,Q Gc r�p �ry /4, :- s 1. 5 Cc.Jc'p �C.nst f �2r ICA,• / "Q"" �' �Ov�w/ ✓ex?7F Sr f'L�FcC, �y.0 LAIVO 8` v cl . LEIy 9` Jr gyOO �9 w 1pOP NEW V- D,ecy,�.e� ✓T 82m 33 E GO•c� z6` tc�e D.S D v W, fb L�l'IY�AO h 01 �G.i9.Qb9= 7•,rio'''F_ Z9rj�5�Caic>ct�ia' TTS�1k'i= Z.G 3�✓a C�"r�"-�. �a Aolle 0 n e•�1.,9iy�,�o 91��YaL/ Ivo due✓�►r�.e, ,00N�c•vv8 Ls�ATMN• itIEK/�UICFaGt Tr�N ::U—jLy ,Vd�o,N•� a nc . LEW _ e°pNewYo D,e�,y,9.e� fir• W 82m 33 E G©�� zS' ;ez ae L a l N r K.S,—._tib; �j �G,f�.Qb9- 7v✓rS.•F= z3j�l.c�ct�G� AD .3000fiF �veYFrie•.�L.q/iyE,PoyliRGit/o��� •4.vrXbWY W•lEw.9�vOo�.�i' L,�vo�✓ert�.e ,CecgT�.y• it/E.T/ lO«e{ax'v�8 J� 'Olz zoo Q rFlc E i' SEP r: r;: r ID V, R. FIRE R SEPARATION TO A (1) OFAP R VED AS NOTED G CODE. P!BFEC,L.QS-i syi v6cFS DATE: ' `V B.P /S# F6 FEG r, FEE: l7S BY: p � EelSTi,/G NEW Rcrx ?/� NffiCq Esc-E FOGM /!.,cfUGAj/ON NOTIFY BUILDING DEPARTMENT AT 765-1901 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: / DO NOT PROCEED WITH 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE FRAMING UNTIL SURVEY 2 ROUGH - FRAMING & PLUMBING 3. INSULATION Of FOUNDATION LOCATION 4, FINAL - CONSTRUCTION MUST FSC/ST/ /i /7 oU(E HAS BEEN APPROVED. 9E COMPLETE FOR c H Mo vdCLEL. m 5]17Rd a,+,-w,t i w S�raaur ALL CONSTRUCTION SHALL MEET AYA/CA,BLEFC'R. � LQFr� /u 3 /� ACC=ESS �-NEWLL1cr $� ( EX/$ /'Ar OPEN TO - / THE REQUIREMENTS OF THE N.Y. EkvST/�.[G E STATE CONSTRUCTION & ENERGY W/�OW _- /�"/J- \ CODES NOT RESPONSIBLE FOR NeW / PG/f1GGT£'L� FC D , _ �_ _ DESIGN OR CONSTRUCTION ERRORS yl - 1 N DONT PROCEED ITR d v cTti� �Ez oT — WCUPANCY OR -- 2 x6$ -6[//G�a, WZ4, i�''Jao'e' USE UNLAWFUL NE ane FRAMI G UNTIL SyRVE �G wasyea _ �+� OF FOU DATION LOCATIO Q�6 o cT`/"S q '. 1. ro HAS I EENAPPRovED. 132 04 WITHOUT CERTIFICATE OF OCCUPANUT Qq FLOOR PLAN - k �, =oKc_ c ee m��>Cv l N Ex sr Nom_ _ PLUMBING ALL PLUMBING WASTE �ayc /.� 7a !'_°� t.• ,3#4 I-W BOTTOM &WATER LINES NEED #3 ¢/-0 TA, . TESTING BEFORE COVERING SECTIONA UNDERINRRERSCERTIFICATE" -- -- -- _ REQ / UI NEoMdlcy �' 7-Oc�etNA U- - 7r/ - IIj scaled/4"=T-0" I ' SITE WEST ELEVATION' If copper tubing is used for water distributing system; piping shall be PLUMBER CERTIFICATION of types K or L only ON LEAD CONTENT BEFORE UNDERWRITERS CERTIFICATE CERTIFICATE OF OCCUPANCY REQUIRED SOLDER USED IN 141A TER SUPPLY SYSTEM CANNOT PROVIDE% NR. FIRE Urso WHORNO ASSOCIATES EXCEED 2/10 of 1% LEAD. RATED SEPARATION TO ARCHITECTS•PLANNERS•INTERIOR DESIG PART. 717.3 (f) (1) OF 51020 MAIN ROAD N.Y. STATE 11 ,l CODE. (10 CRA Cen Tffis ELEV) sournDLD,NY 11971hEI - Y (516)765-6530 _ Fax(516)765-4643 7 .3 -2000 [NEW DDITION TO THE HOME OF EB D. C Rpy ELAINE ROMAGNOLI SUFFOLK -,TOWN OF SOU THOLQ N.Y. SOUTH ELEVATION NORTH ELEVATION CHORNO ASSOCIATES / `�� architects, planners. Interior design QUAKERTOWN, PENNSYLVANIA of�-ICF --- — — PROVIDE% HR. FIRE RATED SEPARATION 70 L �� PART. 717.3 (f)(1)OFF C%� N.T. STATE BUILDING CODE A � Fi�GL6:>s SH%✓6cCS Ir-Y/ST/^fC+ NSW RCCJF ?/� ,Uf{/GAgtE FOAM. //vC�UCAT/ON wvI I 570Rd To - �plew 1 OP Elk z9c I lel 2,rc y C� 6•'o.c. /y" - N&W 6rT G04V-_S - -_ — D .HT1 C6 l� ax Wps�r[>t 4' 91 -- - FLOOR PLAN LOFT °' �„ �oEKsceeNr�v��r f T � mTi.✓ .. /�o7Y COY` �. r. z7�7' /�j'S c P�-.' CTION A s7-- -- ,vEw,�F ro Merc.v - I -- -- _ - I - scaled/ 4"=1'-0" 4DP/Tio �t.6 2 S� � I I SITE WEST ELEVATION i aK/ �_ — OHORNO AS OCIAT :a p R&OC /�_ A"ffEGTS•PLANNERS INTEMORDESIGN �J� q�q III 61020 MAIN R D - ROUTHOLDA11 71 416)765-65305 04 (No C,41AN66SS T#/�S J •3 •Zack ADDITION TO THE HOME OF B. x'01 ELAINE ROMAGNOLI yap �; - — -- -- -- - --- - � f } NEW SUFFOLK TOWN OF SOUTHC - -- --- - _=- -- e r N.Y. SOUTH ELEVATION9l' °7sN ' yo NORTH ELEVATION eOF - -ENECHORNO ASSOCIATES y- architects. planners. interior design QUAKERTOWN, PENNSYLVANIA