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Home My WebLink About26329-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27292 Date: 09/05/00 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 755 LIGHTHOUSE LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 6 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 20, 2000 pursuant to which Building Permit No. 26329-Z dated FEBRUARY 3, 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 ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR AND AS PER NYS PETITION #2000-0859. The certificate is issued to JOHN A & VIRGINIA M. BURNS, JR. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 08/22/00 PLUNGERS CERTIFICATION DATED 08/11/00 MIKE JACOBI PLUMB.& HEAT. Authorized Sig urs 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. 26329 Z Date FEBRUARY 31 2000 Permission is hereby granted to: JOHN A & VIRGINIA M. BURNS, JR 755 LIGHTHOUSE LA SOUTHOLD,NY 11971 for CONSTRUCTION OF ADDITIONS AND ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#22366-Z . at premises located at 755 LIGHTHOUSE LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0006 Lot No. 031 pursuant to application dated JANUARY 20, 2000 and approved by the Building Inspector. Fee $ 346 . 80 Authorized Signature \Rev. 2/19/98 ORIGINAL Form No. 6 „ TOWN OF SOUTHOLD Q I b BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, 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 of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in y-e, less than 2/10 of 1% lead. Q �� 5. Commercial building, industrial building, multiple residences alnD7r �i r building�Nj and installations, a certificate of Code Compliance from archit , ylerresponsible for the building. f ) 6. Submit Planning Board Approval of completed site plan requiremets. 1 v t" . B. For existing buildings (prior to April 9, 1957) non-conforming uses or ifiuil Yiig'W',_ n%D 1,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 to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin¢ - $100.00 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . .y. . . . Old Or Pre-existing Building. . .Y. . . . . . . . . . . . Location ,bf Property. . .[.SSS. . . . . . . . . . . . . . fU. . . . . . . . . . ...^rQA . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . q /N. f?. .'f. . .�12�V�1:R. . . it./ .VI� S.� J �� . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .q77�2. . . . .Block. . .0 00A0 . . . . .Lot. . .P V. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .UTA 7t:�?: . .Date Of Permit. � 3 .�'�� . .Applicant. . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . .r1r-C. . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $„ �s6G. . . . . . . CZ2csgYlb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT D t C��lti U i �..., AUG Town Hall,530 5 M�tiS Rq` ��,QEF(. z ,� Fax (516) 765-1823 P. O. B 117 "OVURi "F SOUTHOLD .., Southold, New o Telephone (516)765-1802 -"11971 ,.;,; ., OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N p / DATE: Building �P _t /ermit No. G 32 Owner: I'll- a h d PTrr ' o30r'Al (please print) Plumber: rlI ,C �—c �0.Co� i) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumber gnature) Sworn to before me this // day of C�> Notary Public, G ;/= C County ELIZABETH A$TATHI$ NNoTOR1S7 008 73 SuufoolkNAuntolky Term Expires June$.2052 of Routine Variance Request New York State Department of State Uniform Fire Prevention and Building Code Long Island Regional Office 560 Broad Hollow Road, (Suite 110) Melville, NY 11747 o Albany (518)474-4073 o Cowtney W.Nation P.E.(5 to)755.1095 ❑Richard A.Smith R.A. (SIG)755-1093 ❑Phomas A.L"open C.C.S:(516)755-1091 Routine Variance Petition Number 2060 - Q8 Sq_(For office use only) Instructions ■ Answer all questions. Please type or print legibly. ■ Enclose a check, money order or voucher(government agencies only)for$50 (Filing Fee for Routine Variance Review Process) made payable to NYS Department of State. ■ Send this form, supporting documents such as copy of survey, site plan, architectural drawings, photographs, cost estimates, etc. and the fee payment to NYS Department of State, Codes Bureau - Long Island Regional Office, 560 Broad Hollow Road, Suite 110, Melville, NY 11747. ■ Petition fee is non-refundable and variance cannot be processed until fee is received at the above address. ■ For information regarding the status of this variance petition or need other helps, please call the regional office representative at the number indicated above. Please have your petition number available. APPLICANT FOR VARIANCE Name: _Toa .(' 111[1/tYLSU/Ui<ci! of St/ FatKTelephone: ((D3i )— �`ik - d•� 2.2 Sic. S[SF y�Sr Address: Pin [ yjq) (.d.)_?.S t/Y z*4 4110 rf) [ 13 ('14 n/ y //'; Relationship to Property in Question: o Owner O�bwner's Representative N,Other. Ff ,, G[)rn Property Location: I, /-/'r/-1nyS c: L �.a,tr.4 4,ye "rArer NJHnt ?�, (Street address) ❑ City IWTown ❑ Village S"n„ran> County Sul/o[./ Building Use: 2 If S - S, vS.(' n-9m y Total square footage of building: _2Zoo Sq.Ft.. Code Enforcement Official Name:_ :rn l✓N 13 /-"u t Telephone: (631 )= 76,S - Code Sections in Question: 9NYCRR CCrL ncf [ [drt H * V13/1,A.u1e 131;,r,44 /-//-7GC NOTE: PETITION FEES ARE NON-REFUNDABLE I have enclose�e'tio iling fee for the above referenced property in the amount of$. :5,2 �= Signature: Date: / 5106 New York State Department of State Uniform Fire Prevention and Building Code Codes Bureau Review Summary for Routine Variance Applicant 6-/ Name: So1aN /, rvr ,11 en- VNYc r_ c.r- S�,,rri%jl;hone: 6 .'31- Address: 1 og, zu City: !<,esY Nxl.,,�rn'l Ae/r .e! State/Zip_ //9 7S• Relationship to Property in Question: ❑ Owner IN Owner's Representative P Other_�A,/ , L i1 f o Owner's Name: -rolw -+ 'Ur2c�.ivi/1 Ci�/2NS' Phone: Address: t/ ,A,tFYovs e- Lw SOC1rH p State/Zip Property in Question Property Location /_fc/v7//orxr- 4-6fBuilding Gross Area32oo-1-- Sqft ❑ City w Town ❑ Village of Soc, rlyoL N County ofS�L /n�.L< Zip Is this a Handicap Case? ❑ Yes K No Affected Parties Aggrieved Name -7o171n1 -,�l/i, ��Nii+ fl-./»yr Phone: &3/ - 765 -12L5 Party Address:L rq/r7-Hnr.•t 1- Gey S'0v7`8 n i A N V 7 Code Name: A"r-L) S Phone:/e31 - Enforcement Address: M/arm Sr, S'" ,>r1-/n 1,b /113 7/ iFire Name: Phone: ,Prevention Address: .Architect Name: SvTe 2 9- Sv7-C2 Phone: 611 - 6S3-38'77 Engineer Address:_ ftSSc e Ln Others Name: Phone: w/Interest Address: Representative at Site: Non/ 1 Conversions I I Additions I Subject New Old New Building New Existing Alteration Code Use Use Occupancy Part Class 1265 Rcs yes 701 Construction Part Class 704 Height of Part Building 705 in stories Z Z 2 2 Yes Sprinkler System 705.5 Installed Af o N o A10 /!e) No Sides open 705.5(b) W/Hydrant Largest Fire 606.3(a) Area Allowable Part Fire Area 705 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date PEBRUARY 07,7.996 Application No.on file 11085296/96 N 377337 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of JOHN BURNS, LIGHTHOUSE LANE, SOUTHOLD, N.Y. in tkefotlowinq location; ❑ Baxement /xt FL ❑ 2nd Ft. OUT Section Black Lot was examined on FEBRUARY 02,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS lItKEPTACLES SWITCHES INCANDESCENT fIUOREECENi OTHER IMT. I K W. AMT. K.W AMT. K.W. AML K.W. AMT. H P. 2 1 1 2. 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS I eEll UNITHEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT NO. A W.G AMT. MMP. AMT. AMPS. TRANS. AMT. H.PNO.OF SYSTEMS FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. OPE METER T q'xw 110 SW 51r 3W ],e'AW TIO.Of CC LONG A.W G. NO OF HI LEG A W.G. NO.OF NEU1RAl5 A.M''G' EOU1►. PER% OF CC.GOND. Of W.G. Of NEUTRAL OTHER APPARATUS: PADDLE FAN-1 MOTORSt1—P H.P. G & S CONTRACTOR LIC4578 EL L BOX 215 ANN SOUTHOLD, NY, 11971 GENERAL MANAGER IL 113t Per This certificate 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 BUILDING DEPARTMENT. THI5 COPY OF CERTIFICATE MUST NOT B6 ALTERED IN ANY MANNER. y � )AT ION ( 1ST) If �� CLQ/ ✓�%�L; i� •-9 If If if It - I )ATION (2ND) =7 a� -------------- --„ ------- n _----- -�__ fI FRAM PLUMBINGif ii II y - LATION PER N. Y. I ted y TATE ENERGY CODE I if I / I �r I FINAL I II •„ N „ s ADDITIONAL COMMENTS: I i � ul � o Q i I i ---------------------------------- M-1002 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -zdn. lme,,Ja4w.-� 1,4 DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY/ REMARKS: , AA e ./ o C� & of ee. DATE INSPECTO BUILDING DEPT. INSPECTION. , OUOH ? [ ] FIREPLACE&CHIMNEY REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [[ ]] :OR~NM~NAGTION 2ND [[~FiNAU:ATION FIREPLACE & CHIMNEY REMARKS:~ I FROM : SPITALIERE CONSTRUCTION PHONE NO. : +516 765 6614 No,). 19 1999 12:OOnM P92 STATE OF NEW YORK ) ) as.: COUNTY OF SUFFOLK ) 1 being duly sworn, deposes and says: That deponent is over the age of 18 years, and resides at That on the day of -%-OUQfy ¢999, deponent, being the architect/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans complia ce with the New York State Fire Prevention and Building Code (9 NYCRR). Architect/Enginea �jojm to bef re me this day of 1 ,Notary R'u i Beverly J. Perkowski Not"try Public"SteY2 fti1v ` No, 01PE6011 co -1 Term Expires � �� cc: applicant ZONE AE (EL 8) JOINS PANEL 0158 ZONE T ZONE ti 9095 MECHANIC ! yOegRT s 9p YOUNSS �- PO F� E GLUES w e� Mr�FgR ZONE X M Gq�GO QEC� 90 RD HILL Qq yS R0 90 A �� Uavee'b Q 9Ty �P�\ ae SP r— )ld x 9L F ZONE X PVE ZONE Xa <` ZONE .N gbF'�f3 LIGH X T.. CREEK DR COASTAL BASE FLOC EP APPLY ONLY LANDWA P c O r. � ZONE X n ZONE X a F m�G CRITTENS ST 90 9 0 �L m Z 55 m SC�SH pm Z N O \ AVE S n \ , B' f � Cr(' ,- g �U41 J nnt.0 SURVEY OF PROPERTY J^\ J SITUATAD AT am ,.l Fi3 50 UEI'II01_11) TOWN OF SOUTHOLD �P SUFFOLK COUNTY, NEW YORK Q " S.C. TAX No. 1000-70-06-31 SCALE 1"=40' F k a A4JULY 13, 1992 o� � H f� CERTIFIED T0: ' FIRST AMERICAN TITLE INSURANCE w '}� ^ a y �� COMPANY OF NEW YORK & mala Aa mu TITLE No. 141-9-1825 9"11p0' JOHN A, BURNS Jr. VIRGINIA M. BURNS ( o..t,M•o. I AREA -- 45,030.28 aq. It, '-. � �'••,.Y tro m i1t) 1,0338 Be. wo / meo�i ro"°0'9A9iu� NY1xn a'"`ml ,y •�I•. /. - w NOM ; • j GEED DISTANCES REFER pCCD 0 L19CR ,112] FACE 1369 y fes'✓ /// mNsA ✓e �• tip0 .. �Nw; I. E 275.09' jq. y 0 4'26. 260.00--_N„eb•Jr”'-. Bese WYE Y `'� uµMoltm M+vcmx a.cony ' E .x 1 /aY ro Ma spam a A Houma a MA 8704'20, 4 R 0swoo7---., ea sepal nav ce OR NORrox sA.e 7 11 .., WAY ypw m wmx IA.. [GffT OF ux�Da;,,u•• s"n n ouo mn¢a ns.NAA.ecwwo ADF TO REA V"DOC OXO om1 b-' PWyMron e ''aW1DN fM I91tA N 1, ,./ a e.awfo.rxo w rro awu iR ce Wt mvwc mhmnom}.�u:r.xo lmnwx N M NAlarto xeuM=MA ADM R 1xE Mn- O, ,/ �4yy�. I Nf4t wNMrtES w[Wt�RNSitMplf / GSEYFMRR0 NOTOCO D, Y f 11 XX, )\ MIY•NT SMOWx ARC UVM/xMID 1 O l flipM , MM IM NMYW 1 ".° `n"DRE'° AR `° R, ,'LJoseph A. Ingegno yl �� AL, U10/PIIlOrt4 MO LLCp19 N ifP SllM VY M 111L N!O KNx Slit IMA rmt naocuncx al 1 Land Surveyor .. -' 1 9•lP4gEVN .INQF 09,1• ` - .. . Y Qb. P.O. Box 1.1 i 1 `SIT til � ' Riverhead, Newt York 11'?t'' S. UC. Na. 49869 (516)72/'-2090 FOX # (516)727 5093 OMML• I?IDATIOV ( 1st) '1IDATI00T (2nd ) GH FRAME •• - . = '-PLUMBI jc; . ULATTOII PER N. Y. II a.... STATE ENERGY CODE �\ M FINAL `• o ADDITIONAL COMMENTS ' m H A a H tl i • m 'S'.:.'.n✓•l^'xxbi4e..«i..r.+:w. a++♦r:}Yi.. Lve o.. :r ., -. _ . .., _• _ •_ �n•�§i;,,.-._ .,s,ns.»• T PROPERTY ATT,1D AT P1 1 p rl O LI\f! a W � b v O N> SOUTHOLDO04 � DD n ) NTY, NEW YORK 1000- 70-06- 31 ' -E 1" =40' 13, 1992 0 ti c I � hpGs�gr �,w• AC. UNIT" N tar a , RIpE, ERICAN .TITL.E INSURANCE �� ar ° t 4 CONI 1111 Y OF, NEW YORKPICKET All DWS '0s III 141-5-1625 S''" 300P ; BURNS Jr. M, BURNS ,. SLATE WAut � A[w �+�F"1•:• �` � A R .r 4', 47 0.29 sq. ft. b ''. \:' : to OFMtM W4S 3 ac. n i rn • RDI11O / 111 k NMWOIASS ` • ��pf,•`" am-TO 811ED' NYT%G 1 • --t `-J-Y- J. Lal ,y¢ •�.,V�.. v 2EFER TO DEED ,OE 139 RIOIR OF WAY D1EIrA D N! DEED N � IRRER 98M PARE tSJ Z coNO°01ND"N. / l ry kp C? h 4'2 64 0 0„ 60.0 . N `-JY_""-.._ - N g56�03 ,•• ge Z ,a UNATHORIZE0 ALTERAM14 OR ADDITION W gA' TO THIS SURVEY IS A VIOUTION OF �QA Y „ NSSS: SECTION 7208 OF THE NEW YORK STATE fT O Il n - SO.00' / EDUCATION LAW. 1101 1' RIGHT DE WAY DESCRIBED IN DEED COPIES of THIS SURVEY MVP NOT BEARING USER 11122 PKK: IM THE LAW SURVEYOR'S INKED SEAL OR ,.Ail - 5 e ENBDSSED SEN- SHI NOT BE CONSIDERED TO BE A VAUD TRUE COPY. GUARANTEES INDICATED HEREON III RUN ONLY TO THE PERSON FOR WHOM INE SURVEY IS,PREPARED, AND OH NIS EErf TO TIRE IDLE COMPANY• GOVERNMENTAL AD A__( AND lENOW INSNIIONAISTED IRWON, AND TO THE ASSIONEES OF THE LENDING III TUTK)N. I I- TVNON. GUARANTEES ARE NOT TRANSFERABLE. THE EXISTANCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF .ANY, NOT SHOWN ARE NOT GUARANTEED. / PREPARED IN ACCORDANCE WITH THE MINIMUM BY THE LI FOR 1 AND SURVEYS AS ESTADOPTED ABLISHED Joseph A. I n g e g n a ST THE DS FOR. AND APPVEYS AIR) IMUSHE FOR SUCH USE RY THE NEW YORK STATE LAND THIS ASSOCMDON. Land Surveyor SOF Wk - - --- - LJ yr,P�g�aH .1NpF�0,9t - - -- K P.O. Box 1931 OrRiverhead,s. New Yl 1-11.11"' .1 • (516,727-2090 f , lfr S tic. No 49ra88, - , , ..-,..sA —,.-... • � � o .,. n.,V'A'a .rtiR:i+tNte, .� .. � n ,. .. ., x, .. . m v 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: CALL r').... / . . . . . . . . . . . . . . . . . . Examined.................. 20.... MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.... ........, rP Permit No. ... �F 7J.�. ................................... Disapproved a/c ............................ ..... ................................... .. .... .. .... .. ..... ... (Building Inspector) PPLICATION FOR BUILDING PERMIT J; 11 2 206I Date. . . .. . . . . .. . . . . .. 20. . . . G ' i INSTRUCTIONS a. is applicati .mist(ie'� eteI fill in b np y gd y typewriter or in ink and submitted to the Building Inspector wi 3 sets of 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 mrnst be drawn on the diagram which is part of this 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 permit shall be,kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building or necessary inspection ..... . ... . .. .. . /...... . ................... (Signs LLo icant, or f a corporation) address of icant) State wbether applicant itlessee,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ...:...?? . ........... ..................................... .............. Name of owner of premises .... ....... ............ / ................................................ 7.( on%d%�e tax ml o latest ueIIf a licant is a co ration spp rpognatirce of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. location of land which proposed work will be ..... 1. J.. � ... . ......................................— ............................... Boise Nrber Street7?) / Hamlet County Tax �/ Map No. 1000 Section ...../�....... Block ......�....... Lot ... ./...... Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises and in e[ded use and occ of construction: a. Existing use and occupancy .;, � �. ......... ........ b. Intel use and occupancy .. !! .............:r ,1...... ......,. ............ v I Nature of work (check uiudh applicable): New Building .......... Addition .v....... Alteration ........... Repair ............ Removal ........1.... D molition ............ Other Work .................................. (Description) fee .. Eatin�ted Coat ..35,1 ......... ... ....... ... ............................................ (to be paid on filing this application) If dwelling, number of dwelling units ............ tluber of dwelling units on each floor ................ Ifgarage, umber of cars ..........!............................ If business, emnercial or mined occupancy, specify nature and extent of each type of use...................... Dimnsionsof existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... LA�nber of Stories ...................... Dimensions of sae structure with alterations or additions: Front ............... Rear ............... .................. N-m ber of Stories ......... Depth .................... DeigthL' Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Amber of Stories ..................... Sizeof lot: Front .................... Rear .................... Depth .................... 0. Date of Purchase ..................L.. Rare of Former Omer ........................................ i I. Zone or use district in which premises are situated .............................................................. 2. Does proposed construction violate Many zoning law, ordinance or regulation: ........................ 3. Will lot be repr .:L.. .. Will ehacess fill be r fran causes: YES ND .... .. 4. Nares of Owner of �;a'ses ................ .. ........... . ... .. Rrore No.�k Name of Architect i� ................... Address .AR ..... ..:. .! .. Rhone Naeof Contractor ................................... Address ...............................Rhone No. .............. 5, is this property within 300 feet of a tidal wetland? * YES .......... NO .......... *IF YES, SOD11m TOWN TRIISIE¢.S FEL M MAY BE RE(ifllRED. ( PLOT DIAGRAM locate clearly and distinctly all ildings, whether existing or proposed, and indicate all set-back dimensions it m property lines. Give street and block number or description according to deed, and show street names arm] indicate +)ether interior or corner lot. I i I mm OP N-V yow, _ SS JOUNiY or ......./. t ..........�....•... ......L..................being duly swum, deposes and says that he is the applicant (Name of i ideal signing c tract) -ibove Hamer) leis the ..G. ................................................................................ (Contractor, agent, corporate officer, etc.) of: said owner or owners, and is duly a4horized to perform or have performed the said work six] to make and file Lhis application; that sit statements conta�ned in this application are true to the best of his knowledge and belief; and that the work will. be performed in tbeiihrenher set forth in the application filed therewith. Swum to before me this .... �� 20.G. . ........ ....day of .N.U�9: Y ...'._. O v Notary Rhbli .. c t7ABETHASYATHIS (Signal re of Applicant) NOTARY PUBLIC,State of NewYolk No.01 ST80081'73,Suffolk County Term Expires Jt a 8,20 I,> BOARD OF HEALTH . . . . . . . �' �fI FORM NO. 1 / SETS OF PLANS . . . . . . . . . ." 11 > Fq, TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECi l,f . . . . . . . . . . . . . . ,S�'' �� 1994 �.— TOWN HALL ''SEPTIC FOltrt SOUTHOLD, N.Y. 11971 SLOG. P7 , TEL.: 765-180 itOTiFY 70WNOF CALL Examined . . 19f MAIL TO : Approved . .. 1Y4!! . , 19� . Permit No.�., �� _ . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .?LATION . . . . . . . . . . . .. . . . . r lding in AFOR BUILDING PERMIT Date .. . . . . . . . . . . . . .. . ., I9 : . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation, c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec . nt � . . . . . (Sign re of a licaor name, - a co pp ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . Name of owner of premises !/ . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . . . . . . . . . . . . . . . . I I. Location of land on which p op<osed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number �j Street Hamlet County Tax Map No. 1000 Section . . . . 7 d . . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . . 1. . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended i�n�teendde�d, usse and occupancy of proposed construction: a. Existing use and occupancy . . !`."�/(. . .... . ...""""`. .. . . . . . . np . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . 3, Nature of work (check which applicable): New Building . . . . . . . . , . Addition . .✓. . . . . . . Aj6ration , . . . Repair . . . . . . . . . . . . . . Remova} . . . . . , . . . . . . . . Demolition . . . . . . . , . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. ,Estimated Cost . . .30. . . . .i. . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AP (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . I . . . , . , . , , I . . . . . . . . . . 6. If business, commercial or mixed occupancy, . . . cupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . , . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . , . . . , . , . . . . . . . . . . . . . . . , . . . . . . . . . . . Dimensions of same structure with I alterations or additions: Front . . . . . . . . . . . . . . . . . Rear , . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . I . . . , . .!Height . . . , . . . . . . . . . . I . . . . . . . Number of Stories . . . . . . , . . , . I . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . .I. . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . DeJ7?th -�'�// 10. Date of Purchase r�e?�, l.�f qa7. . • . , , . , . . Name of Former Owner /wR�d fC. 11. Zone or use distric in which premises are situated .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violat any zoning law, ordinance or regulation: 1V,0. . . . . . . . . . . . . . . . . . . . . . . . . . . . 13, Will lot be regraded tl/la. . . . . . . . . . Will exce s fill e removed rom premises: Yes N 14. Name of Owner of premises . ./ /. . . . , . Address hone No. Name of Architect , . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . Name of Contractor . Address . Phone No. . . . . . . . . . . . . . . . property with , , . 15. Is this within 300 feet of a tidal wetland? No. . . . . . . . . If yes, Southold Town Trustees Permit may be required, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. I I I I STATE OF NE OR t CO, OF S S • • • • • • • • • • • • •• • •• , • . , • • • • m g contract) . . . being duly sworn, deposes and says that he is the applicant (Name of individ�fal-�ig above named. 5Heisthe ✓ . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc,) o.L. aid_ow-ner-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 his knowledge and belief;and that the work will be performed in the mannerset forth in,the application filed therewith. Sworn to before me this q. . . . . . . . . �. . . . . . .day o .i . . . . . ., 19�� Notary Pu ic, / . . . County C_., CLAIRE L OLEVI( �.Ai8naiure Notary Public,State of^(ewYodt • • No,4879606 Qualified in Suffolk Caumy / of applicant) Commission Expires Ogcempof 8,19 {' SND f 10-5 � I x ,t. JVRED ARC . i tQ F OF EW �0 -- ry�y �� Fes- •� a; 1 �R I I h i I j - ; n4$� 7�WDiOE 77.7-7 �- ` `ySEgED A Cy�T � � F d `... .,78fl'L .. ___ T9TF OF NEW y0 7-/8-0 S 6826 oe., CHEEK SET NNL TIE UNE 14 4 ,6 IN BUUKH \`�G� 8, ^I 6`�,2 AQ1, BUOY A \ \ \.?UA� BUUQIFAD J o.ec M Q ROIY top 'n_ BULKHEADDO.E. E-' CNC,MON. 9G "W O.p'E SURVEY OF PROPERTY 0 ¢ �� IN "LK Q IN BUIXIIFM NLn ---- < SITUATED AT - - - � Q I SOUTHOLD 0 L oco TOWN OF SOUTHOLDGo " 300' BUIIOiNG SETBACK LINE N UFFOLK COUNTY , NEW YORK � P�E S .C . TAX No. 1000-70- 06- 31 o SCALE1" =40' Far N JULY 13, 1992 MAY 7, 1993 (10' CONTOUR LINE) O 4�i SET SfN(E Su STAKE N fa D N Aa' A G•I,Q Mf ^ 2y, A.C. UNIT CERTIFIED T0: CONCWQ? " 'Jz• �e FIRST AMERICAN TITLE INSURANCE ' S00P COMPANY OF NEW YORK 00F °�" ,�' PICKET SLATE SIOOP ' f ASPRW.T TITLE No. 141—S-1625 $ JOHN A. BURNS Jr. a se' 30,2. — BORN MAY {.9N. VIRGINIA M. BURNS surf wAix s•� , ' , I O I AREA = 45,030.29 sq. ft. (r0 RL UNE) 1.0336 ac. I \\4. N / LAMP / FOUND CONC MON. 1f11UTY E I /r Ntt #W�J3N W000 . FIBERGLASS IF,M+-To sNED C �unmm I ,'� ' s e r— w m NOTE: 1. DEED DISTANCES REFER TO DEED LIBER 11122 PAGE 139 s°' / ,%y��h• .r- 2. ELEVATIONS ARE REFERENCED TO N.G.V,D. RIGHT OF WAY DESCRIBED IN DEED UBER 9388 PAGE 153 Iq zGam" FOUN j' D.O cNc. Mon°.1Q E `nu?n / r e, E HrT 27 .6 < � 04 S0 y 11 OSP — 4'20" / a W 84'0 _ —N 84'03'43 E yQL 260 pp' , 56•00 TNATHTo THIS SUR ALTERATION OR ADDITION SECTION 7209 OF THE NEW YORK STATE 655' . EDUCATION LAW. N -7 04'20» WAY H`--9-S-0 0 30 —~I d W - 6� RIGHT OF WAY DESCRIBED IN DEED COPIES OF THIS SURVEY MAP NOT BEARING 0 LL'' 5 64 p'V• UBFR 11112 PAGE 139 MBOSSED SEALSHALL NOT BE CONSIDERED O INKED SEAL OR I GH T `��- TO BE A VALID TRUE COPY. O y 30 ' — GUARANTEES INDICATED HEREON SHAT RUN ONLY TO THE PERSON FOR WHOM THE SURVEY T p - IS PREPARED, AND ON HIS BEHALF' TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND v 2 LENDING INSTU IN LISTED HEREON, AND D `1 TO THE ASSIGNEES OF THE LENDING INSTI- T H SON TUMN. GUARANTEES ARE NOT TRANSFERABLE. r „ OOG h_Sp tnt tAISIAnct yr rcronl yr nATa I Z ek) v N10/Y " AND/OR EASEMENTS OF RECORD. IF ANY, NOT SHOWN ARE NOT GUARANTEED. Gy m PREPARED IN ACCORDANCE WITH THE MINIMUM O N STANDARDS FOR TITLE AND SURVEYS PS D ADOFrED Joseph A. i n g e g n o O 1 T BY THE II.USE AND APPROVED AND AE LAN FOR SUCH USE BY THE NEW YORK STATE J.ND / ITI1.E ASSOCIATION Land Surveyor NE HA 11V-Yo9 P.O. Box 1931 A �yo� Riverhead, New York 11901 (516)727-2090 N.Y.S. Lic. No. 49668 > - On Fax # (516)722--5093 92- 192A n, J s 68?6,or J C.REFX R `�` r48.rs8, Q ? fed 4C7-0 4Z \ MUND CONC N Q 9.02. SURVEY OF PROPERTY . �` ' S"NAL N RIIIKHFAD SITUATED AT coo OU` HOLD Q TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK awl-FLAO POU! j S .C. TAX No. 1000-70-06-31 SCALE 1" =40' ti w JULY 13, 1992 0 ;� ' I STAKE 00 O h�" o w p PtAW CERTIFIED TO: � �r ami � 6 ' .. t &c. UNIT L, FIRST AMERICAN TITLE INSURANCE " A4 �, � I COMPANY OF NEW YORK 4dsan G MICETITLE No, 141---5-1625 T . i JOHN A. BURNS Jr. I ,aa;" aDr VIRGINIA M. BURNS DRIVEWAY I Oro. .R r 'cm p• %+ 3 5U11E+WLK 7+•• . r a AREA 45,030.29 sq. ft. _ b _.. �. " o wFRNFAn wp" (TO TIE LINE) 1.0336 ac. i� 1 q :, • �' ! W . LAMP�os( 1 r al. CDNC. „ N I WOOD IIIA0»eD Umhr Pat 1 L a NOTE: x ✓ .:: DEED DISTANCES REFER TO DEED LIBER 11122 PAGE 139 N `)f /. !�•�� yWy--- ' RIGHT OF WAY DEXIIIIRED IN DEED USER ON PW IAl � 4 y yah �a 275+•0¢'.. W' y µ 84 04'20' N 8.10UNATH3'x', E 280.001{ M 58.00 TO THIS SURVEY ISRAA VIOLATION OF°N �L N 7g OA - ",l,T N O',55y'�.�- -'-V 65• SE OTN 7200 OF THE NEW YORN STATE A 30.00' O 1' �n ROD OF WAYOF�7tlBtD IN DEED COPIES OF THIS SURVV ANP NOT REARING I x �1 FjTG�l ` 5 0t60g Um 11122 PAGE 77p THE LAND SUR•EYOR•S INKED SEAL. OR 30• lyl _... - - r --' EWBOSSM M SD iRSHA" NO RE CONSIDERED O - ^' aWWlIEES NWA7FD HEREON SHALL RUN TO� r IS,, MEo ANDONHIIS WHOM i o THE I � I CAD 1 l TIRE COAIPNtY. GOVERNMENTAL AGENCY AND INSIUMA O I troENDTNEWLOASSIONEON LISTED HEREON NMIfJ 11ND TUTION. a/NNMFES ARE NOT TRANSFERABLE. "+ I THE E%ISTANCE OF RTOHT Of WAYS -ANY/ IF NOEA ASHOWN ARETS fNOTCOUAGANTEEp, y J)) �I PREPARED RI ACCORDANCE WITH THE MINIMUM . 41 Q �' STSTANDARDS THE L FOR TITLE 9DR OY ASD ADOPTED Joseph A. I n g e g n o THE DS MR AND I U REM NA TMUSHL FpR SUCH USE BY THE NEW YORK STATC LAND TITLE ASSOCIATION, 1 Land Surveyor o — SJo i P.O. Box 193 1 Riverhead, New York 11901 S. Uc, No. 49668 (516)727-2090 A9� P Pax # (516)722 -5093 . ._-._.-.Tiii■uiii �- -� 1 LL ,, I J I A ?LV I STATE OF NEW YORK � DEPARTMENT OF STATE 4 1 STATE STREET r _ ALBANY, NY 1223 I-0001 RANDY A. DANIELS SECRETARY OF STATE ---------------------------------------------------------- In the Matter of the Petition of: DECISION Unique of Suffolk Inc. For a Variance to the New York State PETITION NO.2000-0859 Uniform Fire Prevention & Building Code ---------------------------------------------------------- Upon the application of Unique of Suffolk Inc., filed pursuant to 19 NYCRR 450 on August 15 , 2000, and upon all other papers in this matter, the Department makes the following determination: NATURE OF GRIEVANCE AND RELIEF SOUGHT The petition pertains to additions and alterations to a existing building of Al (single family) occupancy, two stories in height, of type 5 (wood frame) construction, approximately 3,200 square feet in area, located at�5 Lighthouse Lane,Town of Southold, County of Suffolk, State of New York. The petitioner is seeking relief from: 9 NYCRR 711.1(a)(2), which requires that habitable space shall have a minimum height of 7 feet 6 inches, except that for habitable space under a sloping roof the minimum height in at least 50 percent of the floor area shall be 7 feet 6 inches and the area where the height is less than five feet shall not be considered in computing required floor area; and 9 NYCRR 711.2(b), which requires that bathrooms, toilet rooms, kitchenettes, corridors and recreation rooms shall have a minimum height of seven feet. [The petitioner requests relief to allow a bedroom built into the roof area of the second story with a ceiling height of approximately 7 feet 6 inches feet sloping down to 5 feet 4 inches on one side and 5 feet 0 inches on the opposite side with a 33.7 percent minimum height coverage instead of the required 50 percent, in addition relief is also requested for a bathroom built into the roof area of the second story with a ceiling height of approximately 7 feet 1 inch sloping down to 5 feet 8 inches.] FINDINGS OF FACT 1. As part of proposed alterations, a bedroom and bathroom is to be constructed into the roof area of the second floor of the building that is the subject of this petition. WWW.DOS.STATE.NY.US E-MAIL: INFO@DOS.STATE.NY.US ...1--C. Ap Petition No. 2000-0859 Paye 2 2. The bedroom ceiling height is approximately 7 feet 6 inches sloping down to 5 feet 4 inches on one side and 5 feet 0 inch on the opposite side with a 33.7 percent minimum height coverage instead of the required 50 percent. 3. The ceiling height in the bathroom is approximately 7 feet 1 inch sloping down to 5 feet 8 inches. 4. With the placement of the fixtures in the bathroom and the placement of furniture in the bedroom, the ceiling heights are adequate for normal usage. 5. The petitioner has proposed to install a fire and smoke detecting devices in the second floor as required by the Uniform Code. 6. The local Code enforcement official has been consulted in this matter and does not object to the granting of a routine variance under the provisions of 19 NYCRR 450.6. CONCLUSIONS OF LAW Strict compliance with the provisions of the Uniform Fire Prevention and Building Code would produce a negligible additional health, safety and security benefit to the occupants of the building. DETERMINATION WHEREFORE IT IS DETERMINED that the application for a variance from 9 NYCRR 711.1(a)(2)and 711.2(b),to allow a bedroom built into the roof area of the second story with a ceiling height of approximately 7 feet 6 inches sloping down to 5 feet 4 inches on one side and 5 feet 0 inch on the opposite side with a 33.7 percent minimum height coverage instead of the required 50 percent, in addition relief is also requested.for a bathroom built into the roof area of the second story with a ceiling height of approximately 7 feet 1 inch sloping down to 5 feet 8 inches, be and is hereby PROPOSED TO BE GRANTED with the following conditions: 1. That the petitioner installs a fire and smoke detecting devices in the second story in conformance with the Uniform Code. This DECISION is issued under 19 NYCRR 450.6. Unless objected to by the petitioner in a writing received by the Department the decision shall become FINAL after fifteen days of receipt of the decision by the parties. This decision is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give implied approval of any general plans or specifications presented in support of this application. GeorgV— Clark, Jr. Director, Codecs Division DATE: RAS:sg Petition No: 2000-0859 The persons below are advised to TAKE NOTICE of the attached document. The attached document pertains to a petition for relief related to code requirements. If there are any questions, call (518)474-4073 and ask for the Variance Unit. Please refer to the petition number in all related conversations or correspondence with us. JOHN MILLER UNIQUE OF SUFFOLK BOX 447 WESTHAMPTON BEACH NY 11978 JOHN BOFUS J TOWN OF SOUTHOLD BLDG DEPT TOWN HALL MAIN ROAD SOUTHOLD NY 11971 JOHN & VIRGINIA BURNS LIGHTHOUSE LANE SOUTHOLD NY 11971 i Applicant/ I)ate Owners Name --' n five f �t �__4 � Reviewed: Z_' I' OD Architect/ _Q C Date Engineer: C�ay- ( JIA ---- _ Submitted _ — - SCTM #: District: 1,000 Section: -70 131ock: Lot. I_. Project / l .. / Subdivision Location: �" LC1►'LQ__ Name.. Single&separate Requir ` certification Yes/ o �dClS7/w --- Req. RW. Zoning District [Lot size Actual _ � (Lot coverage Proposed Req Req Req (Frons Yard Proposed: ] [Side Yard Proposed ) [Rear Yard Proposed J Project Description: Ae Ls5urli" 223 �RW 's". pgrO--, 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: te • �rA(coI NAI. AnD t1'/fiVS 69 -re,P,Ar r*g s 13'31 5,r, WO 2 2 09 fi 7� Te-e-- 3y (o ✓