HomeMy WebLinkAbout26838-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27586 Date: 03/23/01
THIS CERTIFIES that the building ADDITION
Location of Property: 295 ALSO DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 126 Block 2 Lot 9
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 4, 2000 pursuant to which
Building Permit No. 26838-Z dated OCTOBER 12, 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 NEW ENTRANCE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ALLAN F & HELEN TUTHILL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ 47452 12/05/00
PLUMBERS CERTIFICATION DATED N/A
Aid
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. 26838 Z Date OCTOBER 12 , 2000
Permission is hereby granted to :
ALLAN F & WF TUTHILL
ALBO DR
LAUREL,NY 11948
for
NEW ENTRANCE ADDITION AS APPLIED FOR WITH ZBA #4850 APPROVAL.
at premises located at 295 ALBO DR LAUREL
County Tax Map No. 473889 Section 126 Block 0002 Lot No. 009
pursuant to application dated OCTOBER 4 , 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Authorized Signature
COPY
Rev. 2/19/98
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FOLL01 .G INIONS:
1 FOUNDATION - TWO REQL', �)
FOR POURED CONCRETE
2 ROUGH - FRAMING & PLUMBI-G
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION k ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
OCCUPANCY OR
i fSE IS UNLAWFUL
`i q 1 iQUT CERTIFICfJi
u OCCUPI 91CY
UNDERWRITERS CERTIFICATE
REQUIRED
PROVIDE OPENINGS FOR
EMERGENCY ESCAPE AS
REQUIRED BY PART. 714 OF
DO NOT PROCEED WITH I111.1: STATE BUILDING CODE.
FRAMING UNTIL SURVEY
OF FOUNDATION LOCATION
HAS BEEN APPROVED. 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 WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 OF 1%LEAD. PLUMBING
ALL PLUMBING WASTE
&WATER LINES NEED
TESTING BEFORE COVERING
Form No. 6
TOWN OF SOUTHOLD V C I
BUILDING DEPARTMENT
TOWN HALL
765-1802 v'n
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
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 o� Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar building;
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 app nt.
If a Certificate of Occupancy is denied, the Building Int to s a St�Ste1Q
reasons therefor in writing to the applicant. "
C. Fees ` r _OJJ
<_
1. Certificate of Occupancy - New dwelling $25.00, Addition - to dwelling $25,,98,
Alterations to dwelling $25.00, Swimming pool $25.00, Ac es�q�ry buid$a�t2 00
Additions to accessory building $25.00. Businesses $50 00. ; ._ °'.' t
2. Certificate of Occupancy on Pre-existing Buildine - $100.
3. Copy of Certificate of Occupancy - .25v)
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
,/ Date /V3�0ALC,ay
New Construction. . . .?! . . . . . Old Or Pre-existing Building. . . . . . . . . . . . .
Location of Property. . . ?: .71 . . . . . . . . . .q J . 0.R . . . . . . . . . . . . . . . . . .�' g V ar i . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. L C_ g N„ e'``r vTHIL- .. . . . . . . . . . . . .
County Tax Map No 1000, Section. . !-:!_:”. . . . . . .Block. . . f . . . . . . . . .Lot. a . . . . . . . . . . . . . . . . -
Subdivision. . . . . . . . . . . . . . u73PP%-1,, a .q v
Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
70
Permit No.�G237. . . . . . .Date Of Permit. !f ,.�/. . . . . . . .Applicant 9 �c ?"/ r`7 I4-
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . �� . . . . .: .:� �C;%.. . . . . . . . . . . . . . . . . . . . .
•Q?�C J�.Z d r
APPLICANT
CO ��158"L
yyyry. �' ♦ y S
+r 1 `+ •.ta. 2'� t�' F11 .., ,^•tll•�r fs rU i Z�`"�.�t ft ,
INA
r3 )1}• 'vi
• yitl ti Jt7£> SLS` 'v ,i 78L} t{ + r$iii'; • i is tit •/fiRi 7Y 1.'R'} .l£• •iS t�ix' tlt'�S LL '• t& ^/t.. 2 3 u;,
v'•ff1i L t£�: t 1£ :t +•,t, L t Ss
;sal`AW .ss
rlec rico/ Inspection ever ' ' 5' to
C l)NSF
• �,%: Electrical Inspection Service, Inc. {
375 Dunton Avenue
may East Patchogue, New York 11772
<. (631)286-6642 �u>r
Y �
Date: 12/05/2000 Application No. : 47452 z�
Issued to: Allen Tuthill
"n Street: 295 Albo Drive
Village: Laurel Zip: 11948 Town:Southold =ut,
tjS
Section: Block: Lot: ; -k<�••
Introduced by: Lademann Electric Inc. Lic.# 4141-E te))'•"
was examined and found to be in compliance with the National Electrical Code e„L
t: ❑Attic ❑lst Floor ❑ O/S Residential ❑ Pool ❑ Det. Garage
' ❑Basement ❑2nd Floor ❑ O/S Commercial ❑ Hot Tub ❑ NV Defects
r> Switches Receptacles Fixtures GFI Heaters A/C Fans 0m-
3 3 2
Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal
Furnace Oil Gas Circulator Smoke Detector Bell Transformer
Meter Amps Phase Motors Telephone Television Carbon Monoxide
x.
Other Equipment:
l _ •'�., � /NNS•.•-�
r
«a Hugo S. Surdi ;;;•^ ~
President
:s
Hca.'J I t. •.
�
Building Permit No. This certificate must not be altered in any manner •: �.
Inspectors may be identified by their credentials
n • Y.
1 4~� Z�C£1�:, '�t i:5�: 4'� ii�•lil. , i v£ tel' i�'tl •'. �' `t t lty t+� ^I.. �" /� Rn �r� � �)N
�t f S ♦;.f } is'f i Ss i s �v t '� C M1. i i� 't � �'( `�J! - Yt ♦1
)£� i •fr''it n�, I f'it� f �!i e , ••.. S , ,1 !� S{t�'Iw a t•.4 !• {hti 'Fi �1 d r7(�4.i '^�:
dyN ��'����/�`�i1��3 II Z�%1�� y��,l.'•te`:.�.t 3. •} i,l •g 1V'Nl£ •�'?.•• •_ ••iti 4y«• I
MELD INSPECTION REPORT DATE COMMENTS
11�========i�===_ _______________________________________________= ro U
11
FOUNDATION ( 1ST)
cl
FOUNDATION (2ND)
� N
ROUGH FRAME h
n
PLUMBING II ii
IlliII
II
1711-----J0
.. �
-_�_-=/_=ee=====__ �T
INSULATION PER N. Y.
11 H
STATE ENERGY n l
CODE ! I
CAA
I II H '
II
Ill II
II -0
II 4
1
FINAL
n
ADDITIONAL COMMENTS:
re�
o
x �
r
0
ro
- y
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
ii-
[ ] FOUNDATION 2ND [ -INSULATION
[ ] FRAMING [--] 'FINAL
[ ] FIREPLACE & CHIMNEY
� f
REMARKS:
,DATE INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE HIMNEEY
R ARKS:
l _
DATE / INSPECTOR
X01 � � ��..:
APPEALS BOARD MEMBERSSpFFO(K
��0 COSouthold Town Hall
G
hZ` y 53095 Main Road
,GeranTP. Goehringer, Chairman o= < P.O. Box 1179
James Dinizio,Jr. H x
ni Southold, New York 11971
Lydia A. Tortora Oy !� ZBA Fax (631) 765-9064
Lora S. Collins '�Oj �`a0 Telephone (631) 765-1809
George Horning
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF SEPTEMBER 14, 2000
Appl. No. 4850—ALLAN and HELEN TUTHILL PARCEL 1000-126-2-9
STREET & LOCALITY: 295 Albo Drive, Laurel
DATE OF PUBLIC HEARING: September 14, 2000
FINDINGS OF FACT
PROPERTY FACTS/DESCRIPTION: The above-referenced property is situated on Albo Drive
approximately 244 ft. east of Bray Avenue in Mattituck. This lot contains 23,000 sq. ft. of total
land area (including marsh) and is improved with a one-story frame house with attached garage.
This lot has 100 ft. road frontage and a lot depth of 230 feet (average).
BASIS OF APPEAL: Building Inspector's July 21, 2000 Notice of Disapproval, disapproving an
application to add a 50+- sq. ft. foyer at the front of their dwelling with a setback 28 feet from the
front property line at its closest point. The size of the foyer as proposed is 7' x 7'. The Code
requirement is 35 feet or the established setback, at 33.2 feet from the dwelling (or 31.2 feet from
the cantilevered roof line).
AREA VARIANCE RELIEF REQUESTED BY APPLICANT: A Tx 7' foyer addition as an entry
replacing the front stoop. The new setback would be 28 feet from the front property line instead
of 33.2 feet.
REASONS FOR BOARD ACTION, DESCRIBED BELOW:
On the basis of testimony presented and personal inspection, the Board makes the following
findings:
(1) Grant of the area variance will not produce an undesirable change in character of
neighborhood or a detriment to nearby properties. The dwelling lacks reasonable entry with a
small enclosed front porch, and the entry will replace the existing stoop area also at the front of
the house. This entry is consistent with the character of this residential neighborhood.
(2) The benefit sought by the applicant cannot be achieved by some method, feasible for
applicant to pursue, other than a variance. The house is presently 33 feet from the front property
line.
(3) The requested area variance is not substantial in considering a two ft. difference (7 x 7 front
porch verses the code's setback exemption for a 5' x 6' front stoop).
(4) There are no factors present to suggest that the grant of the front entry will have an adverse
effect or impact on the physical or environmental conditions in the neighborhood or district.
Page 2—September 14, 2000
Appl_ No. 4850—A. and H. Tuthill
1000-126-2-9 at Laurel
(5) The situation has not been self-created and is related to the layout of the premises and
surrounding properties.
In considering this application, the Board deems this action to be the minimum necessary and
adequate to enable applicant to enjoy the benefit of security of an enclosed entrance at the front
of the house, while at the same time preserving and protecting 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 relief, as applied for.
VOTE OF THE BOARD: AYES: MEMBERS HRIN O RA, HORNING,
and COLLINS. This Resolution was duly opted
ARD P. GOEHRING CHAIR N
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
DATE; July 21. 2000
TO Helen Tuthilll
295 Albo Drive
Laurel NY
Please take notice that your application dated June 2. 2000
For permit for addition to existing dwelling at
Location of property 295 Albo Dr. Laurel
County Tax Map No. 1000 - Section 126 Block 2 Lot 9
Subdivision Filed Map # Lot#
Is returned herewith and disapproved on the following grounds; Proposed addition not permitted
pursuant to Article )MV Section 100-244B which requires a minimum front yard setback of 40
(forty) feet. Proposed project on lot+/-23000 square feet front yard setback shown at +/-28 (twenty
eight)feet
1
Authorized Si na ure
A1?17EALS BOARD MEMBERS o�pS�FFU[�CoO Southold Town Hall
w� y 53095 Main Road
Gerard P. Goehringer, Chairman c P.O. Box 1179
James Dinizio,Jr. ti Southold, New York 11971
Lydia A.Tortora Oy �4F ZBA Fax(631) 765-9064
Lora S. Collins '�Oj .1`a� Telephone (631) 765-1809
George Horning –.—._--_--
r
BOARD OF APPEALS
TOWN OF SOUTHOLD 4
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF SEPTEMBER 14, 2000
Appl. No. 4850—ALLAN and HELEN TUTHILL PARCEL 1000-126-2-9
STREET & LOCALITY: 295 Albo Drive, Laurel
DATE OF PUBLIC HEARING: September 14, 2000
FINDINGS OF FACT
PROPERTY FACTS/DESCRIPTION: The above-referenced property is situated on Albo Drive
approximately 244 ft. east of Bray Avenue in Mattituck. This lot contains 23,000 sq. ft. of total
land area (including marsh) and is improved with a one-story frame house with attached garage.
This lot has 100 ft. road frontage and a lot depth of 230 feet (average).
BASIS OF APPEAL: Building Inspector's July 21, 2000 Notice of Disapproval, disapproving an
application to add a 50+- sq. ft. foyer at the front of their dwelling with a setback 28 feet from the
front property line at its closest point. The size of the foyer as proposed is 7' x 7'. The Code
requirement is 35 feet or the established setback, at 33.2 feet from the dwelling (or 31.2 feet from
the cantilevered roof line).
AREA VARIANCE RELIEF REQUESTED BY APPLICANT: A Tx T foyer addition as an entry
replacing the front stoop. The new setback would be 28 feet from the front property line instead
of 33.2 feet.
REASONS FOR BOARD ACTION, DESCRIBED BELOW:
On the basis of testimony presented and personal inspection, the Board makes the following
findings:
(1) Grant of the area variance will not produce an undesirable change in character of
neighborhood or a detriment to nearby properties. The dwelling lacks reasonable entry with a
small enclosed front porch, and the entry will replace the existing stoop area also at the front of
the house. This entry is consistent with the character of this residential neighborhood.
(2) The benefit sought by the applicant cannot be achieved by some method, feasible for
applicant to pursue, other than a variance. The house is presently 33 feet from the front property
line.
(3) The requested area variance is not substantial in considering a two ft. difference (7 x 7 front
porch verses the code's setback exemption for a 5' x 6' front stoop).
(4) There are no factors present to suggest that the grant of the front entry will have an adverse
effect or impact on the physical or environmental conditions in the neighborhood or district.
Page-2—September 14, 2000
Appl. No. 4850—A. and H. Tuthill
1000-126-2,.9 at Laurel
(5) The situation has not been self-created and is related to the layout of the premises and
surrounding properties.
In considering this application, the Board deems this action to be the minimum necessary and
adequate to enable applicant to enjoy the benefit of security of an enclosed entrance at the front
of the house,while at the same time preserving and protecting 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 relief, as applied for.
VOTE OF THE BOARD: AYES: MEMBERS -HRIN
O RA, HORNING,
and COLLINS. This Resolution was duly opted
ARD P. GOEHRIN CHAIR N
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SURVEY OF PROPERT,<Y:.
AT MA TTITUCK •` ��
TOWN OF SOUTHOLD ;'
SUFFOLK COUNTY, N. Y.
� .
1000 - 128 - 02 - 09
SCALE:
3, 980'
I 19
e.
OF NEw
AREA = 23,000 sq. ft.
ANY ALTERAMN OR AW77aV TO TNS SURVEY 7S A VIOLATION
OF SECTM 7209 OF r1E AEW YaW STATE aICA770N LAW
EXCEPT AS PER SECn W 7209-SLBA 4WN 2.ALL CER7fA Abw
AFREaV ARE VALD FOR 7NS WAP AAV COPES MWOF a1L Y f I w
SAD WAP OR CaW L7EAR ))E 9IyLE9SM SEAL OF 77E SURVEYOR � — S. LLC. NO.�496/8 +
MOO.ABPA nW APPEARS TEL ON
Aisr �iY�AAV AU MV LAff 7W sSMEYYORS U MW ArCPYeY• 5l 5ihN9 , P.C.
OIF ANo71FR S7.RVEYORS WAP. 7EW SM AS YPSP£C7E0'AAV P. O. "
tuRoua+r ro-oA7E•AHf Nor N CAueuaNCE MrN VE LAW. I230 TRAVELER STREET r
SOUTHOLD, N.Y. 11971
98 = 2$71
PORN NO. 1 J SETS 0P PLANS . . . . . . . . . . . . . . .
TOWN UP 5011'I'I101.11 SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . .. . . . . . . . . . . . .
TOWN HALL SEPT I.0 FORM . - - - - - - - - - - .
SOUTHOLD, N.Y. 11971 -
TEL: 761- 1602 NOTIFY: e� �y
CALIA11 -5:1
F.xnnined..l�./o MALI. 'I'D. . . . . . . . . . . . . . . . . . . .
Approval...�� �o....... dC) Peill it NO. ..... �"
Uisnlgrnrval a/c. .................. . .......... ..... ......... . . . .. .
Win
_ � -._ (IGlilding Incl M�ct or) �_
JUN APPLICATION FOR I11111.I1TNC I'IiNM I'1'
,•2"717 r o
5
a. This alr{dicatiot nest be, calpletely filled in by lyllewriter or in iih nld subutilled to the Building Insplector with
7 nets of plans, nceurate plot- plan to scale. Pee necording to schedule.
b. Plot plan showing Iceatial of lot nnol of buildings Int prcmisen, relntiniWdit to :xljoining prcnvir:en or poblic
stre•eta or areas, arxl giving a detailed (Iescription of lnyma: of property nest. Ire drawn cal the dingrml which is llarl of
thin nlpl ication.
c. 'lure work crrverecl by this alrlrlicaticnt eny not. Ire ecnneltr_ecl before issuance of Building Permit.
if. Illicit ropprowal of this application, the Building Inspector rail] insle a Building penniL to lite applicant. Surh
lenoit shall be kept at the prenises nvai]nhie for inspection thrmlgho ut (he work.
e. No hailding shall be occupied or used in whole or in hart for any pinflose whatever witail a Qrlificale. of
%iglancy shall. have leen granted by lite Hoilding Inspector.
APPLICATION IS IAUO-AY MADE-to the Building ])elinrhmnt. for Lite issuance of a Building Permit lntrstnal- In lite
Building 7<nte Orolioatee of Lite Town of Soothol0, FMuffolk CAlonly, New Yook, aol other atgdicable Laws, Onlirxneen ur
By;ulatiOnS, for the COOSIJOctiot of lnuildings, rxklitiols or allpiat ions, or for retrrval or deltnlit.ion, an herein
(lo•scrile(l. 'Ile applicant: agreen to corply with all algdicnble Iowa, Ordinances, boildiug axle, booming vale, aml
rrgtdatiots, sxl tO adttit sdaroriza) inspectors at premises atnl in Inlilding for necessary inslrectioln.
. ..... . ................ .. ..... . . . ..... . .... .. ...
(Sigonl:are of applliicant, or nam, if a corllolal.ion)
(Moiling srr/, nj Iicaut
�- x?
Slate whether alg)licant is owner, lessee, agent., ardtilect, engineer, general contractor, electrician, punier or builder.
. ... .. ..... ............................ ..... ...................... ..... ....... ........... ... ...... ....... ....... .. ... . . .
Kwe of ownei of pionisen #Q-.q �- .lit.Q N 1,111 'II............ ......................... ...... .. ..... . ....
.... .............................
(as cnr the tax roll or latest deed)
If applicant: is a corlloratiol, signator of duly sn(borizccl officer.
.. .. ...... .. . .. ......... .. ............ .............. . .. . .
(W.n: aml title of corlera(e officer)
IGi
ni lckrs Licence Ml. ........ ...05....H... ..... - \...�-
Pludrers License No. ....... r!............
P.lect r icinns License No. ..!'�. /31./eC.C..... ..
(Aber Tr:xk's License Not. —/V/f.. ..........
I'. meal:ion of Ilool at which proposes] work will Ire (low....--........ ....... .... ...... .......... ... . ... . . ..........
0 'S A bo Arlt /e � /-d t)1-12
.. ..................... ..... .... . ....... . ..... . ..... ... ....... . . . ..................... ....... . .... .. ....
IGnn:e Maier Street ILppnilet
Otolity Tax fill) Nu. 1000 Fectiot ....Ah...... Block ...�.°�.'....... .. Lot ..�.(.......
/��3 HU ""o - a-�./1/�
tw IIxI1V1.^•I(A1 ........... ............... .. ...... . .. Filed FLIp Nct. ."...... U. L . Int .... ...0 a.....
(Nate)
2. State exist'.Ing tine still occoltano:y Of prOMSeS :TIMI Ilaellfhd 1n.^.e anxl (('CUI)aCy Of prnlx)Sed conA-rixtion:
:I. 1'.x1..^.t.ung use aml occulFlooly ...... ..O0.11.'0.11.'e.. ... V �
�I .✓ d.tN.L'l�//1C).. .... . ......... ....... .... .......
. . . ...rOL... .✓.. ... . a
b. Inlenow use aml occuinrxy ....... ... ..... ... .......... . .. . ........ ...... .. .............. ..... ...... ....
I. Rilloe of Innk (cl Neck tAlidl algdicahle); fkv ItiliidIn.
6 Poklil ion . . . .. ... . . Alfcrul.ion
... . . . . . . . . . . . .
ILaNII1 I""W'I IknnI11.I.... . ... on .. . . . . . ... .. Ol her fknk
A Est inn(h1 (ml ... Z✓„V.. ' . . fee .. . ...
. . .. ... . . .. .. . ... ... . . ... .. . .... . . . .
(Io Ix? lxlid Ixl fl l ing 11115 app' IcalJoil)
'i. If l6xalinl;, Ixulx!r of IAx?ll hq; units IFnlx:r of IA.relling unite exi rfich floor
. . . . . . .. .. .. . . . .
If gut sgC, I.A wl of culu . .. . . .. . . . . . .. . .. . . . . . . . . . . . . . . ... . . . .
6. If Ixlatllea;l, cuullerClill or Mixed (wculvilwy, specify nalule elul exleul: of each I.ylxe of use... . . .... ... .. .. . . . . . .
. ��11 a6 '
/. Iliunlnt
csis of ext sf felt-, sl naw
ues, if uny: IrrlMd .. . 6C Hear .. ..Go' s"'
Depth
. .. .. ... . . . .. . ..
.. . . . . .. . . . .
Ik;il;h 1. lX of x:r of Sl or iea
. . . . .I. . . ... .. . . . . . ..�0 / r
Iliur!u;;ials of sone el'nxaure will' ullerillienls or iuklil.ions: Proof . . . . . Itefir
. ..
. . . .
E'... ... . .. .. 14!i1;I il: Iknlx:r of 1;(odes .. . .... .. . . .
�/ e 7 /
If. Iliucnr ilx is of Lilt e
l irrv4 c[MlsrnuJ.fix): Pr ./.
lxrf . . . . .. . . . . . . . . 14�ty . .. .
14:11;111. linlN?r of Slot ies . . . .. .. .
^ �I�
9. Size of: lot : Prtnll ioq 14:nr EGD �� r��• cZ3S
III. Ilse of 111rchnsc StJn0? . �1 . . Wnr! of Pulern- WiwiR�+,IPA_.r" Orf�I/IE• {n6 r-S6 rA . . . . . . .
II. LIMu: or use diell iclin %A11ch pruld lies lire sifualcil ... ... ... .. . . .. . . . .. . .. . ... .. . .. .. .. ... ... . ... .... . .. . . . . . . . . .
12. Ikn;s pugxlseel clxlsl nr.11oo violate any zooing lou, ordinwu-e or fegultr0oo: . . .Nii
. . .. ... ... ... .. .. . .
17. Will Int Ile regr:vk?d ......NC . . Will excess fill Ile ralrweil f-ran prrsises; YES I1;)
.d./.. .. ....//.//.�� ,,(, / L 7T��_
ILnr;s of 1).av?r of prryn(ses /.I1l�i'A f.f(Y��n.f(!tG(!(l. , /vklrese t�q!!FA1bP. ..1�!1-_ .(� ut-e �.
/y . . . . ... ILaw .. . ... . .. . . . .
'lime of Archlte(al . .. .. .... .. . �//.. .. . .. . .. . .. . .. .. Arkh ess Illolle No
Milk: of (:(xllractor ..... .�(((!.Q_I'h S......... ... . . Mklress fp:P. .aOX_96,C�i5711
ftrl0'l.Ilxav: fkr.y77- 700
.
Is this plolx:Yly Within 90) feelof if filial IfethI l? A YES .. .. . . . . ..
IJO . . . . . . . ...
nIP Yli.`i, :XXIIlYY 11 'ICXJN 'I1Ul:illiCS fle, ff k"y lVe I11!'.(11111(BD.
I'U)'I' UTA(AtAlf
I lx:ale clearly wvl distinctly fill Ixli)dings, IAlelher exisling or prolxlsed, illvl ilvliem a all ser-back dlurosion;:
I'u In 0`1'elly lilies. Give street alvl hlrx:k lurdler or 41esc.ripl ions according fo rleed; alvl slsai slreel: Flown will irxlicille
O wIl cl interior or conver lot.
SIA'I l; (X• 11)4 Yl Nll(,
(MillY (M+ .. . . . . . . . . . . . . . . . . . . . . .
. .. . . . . . . . . . . . .':r .�. . . . . . . . .. . . . . . .t N:iug duly moru, IIelx ISPs soil eilys Oum he ill file appllcnnl
(Nnu! of ilul'Ivldunl eig(t111g cool rocl )
nlxwc 1vowd,
W in I11: . _ . . . . . .C
. .. . .. ... . . . .. . . . . . ..
(knll rata or, ngenl., cur lnunle officer, etc.)
of ;;aid Inn N:r ul In+lxn-s, lion' In duly aulhur iced to Ixerliaul of bave Inar fumed the said Milk flint to ncike alNl Isle This
appl irul ion; Ilnll all mil(mi?ula cnnlallx'd In Illin applicill ioll ale IIIM to the Wail of hill lox"led;!
11 :IIMI IN!I II:Ii i11MI
I lull the "Ilk MIII IN! lx'_rI(1I111P.11 III Illi! IMI II N'Y ;fe?I- 1(11111 111 IIID' nppl Iloilo.lull Illell III(:rctilllh.
k.unl lu I`N-'7Iow Ill. thin
/. . . . . . . .11 f . .. . 1,1, 2.006
Wcllary Hlbl if: .. . . ..
JOYCE M.WILKINS (Signalise ill Appli( anl )
Notary Public,State of New York
No.4952246,Suffolk County
Term Expires June 12,-Plow
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED: 16 l oc
APPLICANT NAME: DATE SUBMITTED:
PROJECT LOCATION n
STREET: �S /4z..4 o A rr., CITY: SUBDIV. NAME:
ARCHITECT/ENGINEER: /-i cr'-`el FAST TRACK: YES oR
SCTM# --- DISTRICT: 1,000 SECTION: /" BLOCK:_ LOT: 9
ZONING:
ZONING DISTRICT R80 AC CONFORMING: YES oA(9 REQUIRED LOT SIZE: /< SQFT.
WHERE ACTUAL LOT SIZE FROM? �u r J ACTUAL LOT SIZE: A?46O6 SQFT.
REQ. I REQ. /At,-CE REQ.
FRONT: f 0 'PROPOSEDI$ ' SIDE YD: /S V-35 ' PROPOSED: '/ ' REAR: SO 'PROPOSED:^M
LOT COVERAGE: ALLOWED: .g % EXISTING: 17 3 sf�S% NEW:49sf.2 % TOTAL: . sf-7-
CORNER?
CORNER? YES o O WAT ER FRONT? YES NO DESCRIPTION:
SINGLE& SEPARATE CERTIFICATION-REQUIRED: YES oR NOTES:
LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.)
PROJECT DESCRIPTION:(/a.ALT.ACC OR N/D: J Xlol e--F
AGENCY PERMITS REQUIRED FOR REVIEW
NEED
TOWN SPETIC PERMIT: YES orko
SUFFOLK COUNTY HEALTH DEPT: YES or , (BED #): DTE:—/—/ PERMIT #:R10-
NEW YORK STATE DEC: YES or
SOUTHOLD TOWN TRUSTEES: o
9
TOWN ZONING BOARD APPROVAL• r NO, fg-570 OIC
TOWN PLAN. BOARD APPROVAL: YES or
FLOOD COMPLIANCE ZONE: PANEL #: FLOOD ZONE: ,
NYS ENERGY: YES OR�1V0
TES: y er+
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR SF
SECOND FLR SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
OTC7�9- SF)- ( _SF)= SF X $ _$ +$ +$ _ $ S