HomeMy WebLinkAbout26486-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27543 Date: 02/05/01
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 405 WENDY DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 128 Block 5 Lot 1
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 9, 2000 pursuant to which
Building Permit No. 26486-Z dated MAY 9, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR & AS
PER ZBA #4396.
The certificate is issued to RAYMOND & ELIZABETH PELLEGRINO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-96-0076 01/26/01
ELECTRICAL CERTIFICATE NO. N-544423 12/05/00
PLUMBERS CERTIFICATION DATED 12/15/00 CUTCHOGUE EAST PLUMB&HEAT
Au o}ized ignature
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 WORt AUTHORIZED)
PERMIT NO. 26486 Z Date MAY 9, 2000
Permission is hereby granted to:
RAYMOND PELLEGRINO
405 WENDY DR
LAUREL,NY 11948
for
CONSTRUCTION OF A NEW ONE FAMILY DWELLING WITH ATTACHED GAGAGE AS
APPLIED FOR TO ZBA DECISION #4396 .
at premises located at 405 WENDY DR LAUREL
County Tax Map No. 473889 Section 128 Block 0005 Lot No. 001
pursuant to application dated MARCH 9 , 2000 and approved by the
Building Inspector.
Fee $ 821 . 00
Auth iz d Signature
ORIGINAL
Rev. 2/19/98
Z_D CpnVe\10G+,+41t f-o Form No. 6 C6o3 1) c) Z y— y Z /91 1`f
6G �� l WN OF SOUTHOLD
BUOLDING DEPARTMENT
�9 �� 7655--1 0L
2
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 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 to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .2%n
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . 1 .-7 — U j. . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . Old Or Pre-existing Buil$ing. . . . . . . . . . . . . . . . .
Location of Property. . . (ic. . . . . . . 11J 'U!D�. . .?n L. . . . . . . . . . . .
House No.
C++ Street f/ Hamlet
Onwer or Owners of Property.. KA4kvw.N.�. . .$. . EliAt!1* f1`, _ , X11 Lta�Ll!✓t�. . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . ).? . . . . .Block. . . .'. . . . . . .Lot. . . .0.1 . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. ��OuY�?.`. 4 . . .Date Of Pexmit. . .� 'c1 -Q.b . .Applicant.
`� 1����,�✓S Z.N C,
Health Dept. Approval. . . . . . . . . .. . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .X. . . . .
Fee Submitted: $. . . . S' ... . . . . . . . . . . . . . . . . l
�9� 5i4bt� APPLICANT
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Town Hall, 53095 Main Road y 29 Fax (5 16)765-1823
P. O. Box 1179 .Y Telephone (516)765- '802
Southold, New York 11971 �y�o�
,
OFFICE OF THE BUILDING INSPECTOR '
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: G C S O O
4r� U
Building Permi No. j
r, Owner., Q- w0
'7'i (please pant) i
j�c tL U 1
( 1ko i C rJ�c V�o� cle
Plumber: � s
(please print)
y
I certify that the solder used in the water supply system
1 ;t'
contains less than 2/10 of 1% lead.
�f.
lumbers Signature) -;
t 'i'OnY puhlk„Site OINew"i
Y°' 896788
ncutlnikOn* ^
fnmrauclnn FxOkns.MgY29.�� .a. z,
Sworn to before me this
day of
`o... i Notary PubttC� Count r
o��gUfFO(X�o
o� Gyp
Town Hall,53095 Main Road CODFax(631)765-1823
P.O.Box 1179 $ .F Telephone(631)765-1802
Southold,New York 11971-0959 *1
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
JANUARY 2 , 2001
Mr. & Mrs . Raymond Pellegrino
405 Wendy Drive
Laurel, NY 11948
NOTE : Notarized letter from homeowner required regarding
landscaping before Cerificate of Occupancy can be issued.
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)
No Underwriters Certificate on file.
XX The check is (not on file . ) $25 . 00
XX No Health Department Approval on file .
No final inspection has been made .
XX No Plumber Solder Certificate on file .
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26486-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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Vvenz.� �y,�v-�. Z,Fav�Zl
ARTCO DRAINAGE CORP.
P.O. BOX 1132 MATTITUCK, NEW YORK 11952
(631)298-9660
Health Department Ref, No.: R 10-96-0076
Name of Applicant: Mr. Raymond Pellegrino Phone:
Address: Wendy Drive
Property Location:
Hamlet: Laurel Township: Southold
Subdivision: Lot#:
Type of System Installed:
Septic Tank
(a) 1000 Gallon Septic Tank
(b) Precast
Leaching Pools
(a) 2- 8' diameter x 6' deep
(b) Type: Precast
I hereby certify that the private subsurface sewage disposal system described above has been
installed according to current criteria of the Suffolk County Department of Health.
Date: November 15, 2000 Signature: ea,4,g;PP
Title: President
PAGE 7 - MINUTES & RESOLUTIONS
Regular Meeting of July 24 , 1996
Southold Town Board of Appeals
Appeal £4396 ACTION OF THE BOARD OF APPEALS July 24, 1996
APPLICANTS: PETER and LISA GEVINSIiI .
PROPERTY: 405 GVeridS Drive, Laurel, NY.
Parcel ID #1000-128-5-1 .
BASIS OF APPEAL: June 26, 1996 Building Inspector's Notice of
Disapproval.
CODE PROVISION APPEALED: Article XXIV, Section 100-244B
RELIEF REQUESTED: Reduction by three feet of rear yard setback at 32
feet instead of the required 35 feet, for southeasterly corner portion
(closest point) of proposed new dwelling on a substandard size lot-
MOTION
ot_MOTION BY: L. Tortora SECONDED BY: S. Doyen
RESOLUTION ADOPTED: Granted variable setbacks as shown on the May 17,
1996 survey map with 32 ft. at the closest point to the rear property
line, and variably on a slight angle (and greater distance as shown
thereon.)
Note: The grant of this variance is based only on the Building Inspector's
Notice of Disapproval as written and noted above, and does not apply to
any other sections of the zoning code or other provisions of law.
REASONS/FINDINGS: The subject lot is located at the end of a cul-de-sac
and contains a lot area of 22,244.8 sf. (.51 ac.) and 100.0 ft. frontage
along Wendy Drive in Laurel. The setback requested for reduction to 32
feet in the rear yard is to the east of the proposed house. The property
adjoining along the east line is that of Half Hollow Nursery used for
agriculture. The relief requested does not create an undesirable change or
detriment to adjoining properties or surrounding residential areas. The
relief requested is minimal at three feet (a variance of less than 15% of
the requirement).
VOTE OF THE BOARD: Ayes: Members Serge J. Doyen, Robert A. Villa,
Lydia A. Tortora, Gerard P. Goehringer. This resolution was unanimously
adopted 4-0. (Member J. Dinizio was absent (out-of-state)) .
ZBA:Ik
PAGE 7 - MINUTES & RESOLUTIONS
Regular Meeting of July 24 , 1996
Southold Town Board of Appeals
Appeal 44396 ACTION OF THE BOARD OF APPEALS July 24 , 1996
APPLICANTS: PETER and LISA GEVINSKI.
PROPERTY: 405 Wendy Drive, Laurel, NY.
Parcel ID # 1000-128-5-1 .
BASIS OF APPEAL: June 26, 1996 Building Inspector's Notice of
Disapproval.
CODE PROVISION APPEALED: Article XXIV, Section 100-244B
RELIEF REQUESTED: Reduction by three feet of rear yard setback at 32
feet instead of the required 35 feet, for southeasterly corner portion
(closest point) of proposed new dwelling on a substandard size lot.
MOTION BY: L. Tortora SECONDED BY: S. Doyen
RESOLUTION ADOPTED: Granted variable setbacks as shown on the May 17,
1996 survey map with 32 ft. at the closest point to the rear property
line, and variably on a slight angle (and greater distance as shown
thereon. )
Note: The grant of this variance is based only on the Building Inspector's
Notice of Disapproval as written and noted above, and does not apply to
any other sections of the zoning code or other provisions of law.
REASONS/FINDINGS: The subject lot is located at the end of a cul-de-sac
and contains a lot area of 22,244.8 sf. (.51 ac.) and 100.0 ft. frontage
along Wendy Drive in Laurel. The setback requested for reduction to 32
feet in the rear yard is to the east of the proposed house. The property
adjoining along the east line is that of Half Hollow Nursery used for
agriculture. The relief requested does not create an undesirable change or
detriment to adjoining properties or surrounding residential areas. The
relief requested is minimal at three feet (a variance of less than 15% of
the requirement).
VOTE OF THE BOARD: Ayes: Members Serge J. Doyen, Robert A. Villa,
Lydia A. Tortora, Gerard P. Goehringer. This resolution was unanimously
adopted 4-0. (Member J. Dinizio was absent (out-of-state)) .
ZBA:Ik
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----- ------------ -
— JANET V.STER'.4RT
NOTARY PUBLIC,State c!'New Yark
No.52.46633485
Guamo in Suffolk Gct;:H/
I _ Commissian.Fxpues4ay.30,2000 ----- - ----- -- ---
i
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 03/09/00 Receipt#: 0
Transaction(s): Subtotal
1 Septic Permit- Construct- Resid. $10.00
Total Paid: $10.00
Name: Connolly, Doanld R.
22 Centerbarden Blvd
Yaphank, NY 11980
Clerk ID: LINDAC Internal ID:3799
THE NEW YORK BIOARD OF FIRE UNDERWRITERS PAGE 1
1001381 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Dare DECEMBER 05,20W Application No. on file IOS262f,40/00 N 544423
THIS CERTIFIES THAT PERMIT NO. 26486
on the electrical equipment as described below and introduced b the applicant named on the above application number is in the remises o r
only 4aiP Y aPP PP P f D
RAY PELLEGINO, 405 WENDY DRIVE, LAUREL, NY
L
in the following location, [L-1 Basement ® lst FL ❑ 2ad FL GAR/ATTIC/OUT Section Block Lot
was examined on DECEMBER 01 ,20M and found to be in compliance with the National Electrical Code.. u
r-
FIXTURE FIXTURES I RANGES I COOKING DECKS I OVENS I DISH WASHERS EXHAUST_FANS r
OUTLETS RECEPTACLES SWITCHES 1NCANCESCE FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. N.W. AMT. N.P.
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43 42 42 43 1 1.2 2 F v
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DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. N.P. NO.OF FEET AMT. WATTS
4
1 F 1 20 1 v
SERVICE DISCONNECT NO.OF S E R V I C E v
METER No.OF CC POND. A W.a,
AMT. AMP• TYPE EQUIP. 1 JW 1 3W ] JW J R IW PFR a or CC.COND. NO.OF MAEO OF HPIEG NO.W NFUTRAt3 OF NFUIRAI N
L
1 200 1 CB 1 S
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OTHER APPARATUS: D
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CO DETECTOR-1
PADDLE FANS F-4
WHIRL POOL BATH-1 E
3.5 TON AIR CONDITIONER-•1
MOTORSil-3.5 H.P. ,1-F H,P. E
PANELSOARDS:1-1 CIR. 60 E
G.F.C.I:-9
SMOPM DETECTORf -5 \ L 1 B
«a Continued on Page 2 »> B
GENERAL MANAGERE6
6p
Per 6n
This eedi0cate must not be altered In any manner;return to the office of the Board It Incorrect. Inspectors may be Identified by their credentials. P
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE FAUST NOT BE ALTERED IN ANY MANNER.
P
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
R
1001381 BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038 "
e
Date
DECEMBER 05,2000 Application No. on j:le 10$126200/00 N 544423 m
THIS CERTIFIES THAT PERMIT NO. 26486 "
"v
onlythe electrical equipment as described below and introduced b the n
y applicant named on the above application number is in the premises of v
r.
L=
RAY PELLEGINO, 405 WENDY DRIVE, LAUREL, NY n
in the following location; El BasementL
® Ist FL ❑ 2nd Ff. GAR/A'S"i`IC(OUT Section Block Lor °-..
n
was examined on DECEMBER 01,2040 and found to be in compliance with the NafionaI Electrical Code. 'v
r.
i
FIXTURE RECEPTACLES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST_FANS.
SWITCHES
OUTLETS INCANCESCEM FLUORESCENTOTHER AMT. I K.W. AMLK.W. AMT. I K.W. AMT. K.W. AMT. I H.P.
v
E_
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC-PT. TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.C. AMT. NO. A.W.G. AMT. AMP. AMT, AMPS. TRANS, AMT. H.P. NO.OF FEET AMT. WATTS
e
E
n
SERVICE DISCONNECT No.of S E R V I C E '
METER
AMT. AMP, TYPE EQUIP. I! 3W 1 0 SW S 0 SW 3 4 IW NO,OF CC GOND. A.W.G. NO.OF HI-LFG A'W'G' NO.OF NEUTRALP A.W.C.
PER 0 OF CC.GOND. OF HI-LFG OF NEUTRAL E
OTHER APPARATUS:
E
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PUMILLO ELECTRIC! LIC.#2300—EEPer
` . - L E
P.O.BOX 323 E
LAUREL, NY, 119CS GENERAL MANAGER
11 B
This certificate must not be altered In any manner;return to the office of the Board if Incorrect. Inspectors may be identified by Meir credentials. E
COPY FOR BUILDING nFrPARTMFNT THIS COPY OF CERTIRCATE MCAT NOT RF Al TFRFn IN ANY MANNER
401�� x
M-1802
BUILDING DEPT.
NSPECTION
[ FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE f& CHIMNEY
REMARKS: ymw ' -(d15,,,,
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY �J
REMARKS: ��i ---
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ j FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
.e �
,DATE ®'S DD INSPECTO
sarr� Gni ,
70-1802
BUILDING DEPT.
INSPECT10
[ ] FOUNDATION IST [ ROUGH PLBG.
[ ] NDATION 2ND
[ ] INSULATION
[ MING [ ] FINAL
[ FIREPLACE & CHIMNEY'�2' 64,a �l<t
ARKS: —
GJaLt'� —
DATE INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: U
DATE Y!7j-"- INSPECTOR
Clf�
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE B CHIMNEY
RE ARK rcv .�-ice U�c
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
Viii [ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE &// ,CHIMNEY
REMARKS;, V-/�S� T Wf
�� /1/l �iliys
DATE_6ZL/ Oz� INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ l FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
,DATE Y t+'`17 INSPECTOR 'S
p J
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ r//FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: CIO
;DATE INSPECTOR
FIELD_. PECTION REPORT �_xDATE cx COMMENTS _ �
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ADDITIONAL COMMENTS:
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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 qa` . . . .
Examined•..•... p.......... 20MAIL TO: . . . . . . . . . . . . . . . . . .
?...1........I ....o 0 Pennon No. .��`<. & ...............................
Disapprovedarc .................................. ................................
.............................. ...... ..... .....•..
F f 7— �faeteiy
-, (]iulding Inspect17
' APPLICATION FOR BUILDING PERMIT
Date. �. - - . - . . . - - , 20.1--
INSTRUCTIONS
a. This appliationualetely filled in by typewriter or in ink and submitted to the Building Inspector
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 mist be drawn on the diagram which is part o
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. Sur
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
0=4xnucy shall have been granted by the Building Inspector.
APPLICATION IS FEIEBY M61E to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Iaws, 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 inspections.
1� +J t ���E n"Ic fco re Dis 1C'^1 S :T c(" G '
.................. --...-...-..---.....
(Signature of applicant, or name, if a corporation)
a1 CE-ITCt &4f2DEnl0tVr� x/{f(�/FJ✓ f19�
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil
-pF-P.................................................................................................
r / �
Name of owner of premises ....1.2.14'✓"?9!y.741- I? 5.(�Tt' ..-�Q��1 2 Q.! /U u)
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer-
... ....... ...
(Name and title of corporate offii1
Builders License No. �1.u1. �.... L...
Plumbers License No• ......................... CL`t-C�106,�tk Z<,stL. �PC�2lC .
Electricians License No. ..................... P ln' �IfirSJ- �EC�rI C.
Other Trade's License No. .....................
.. 55 1
D +Zi.J{ :.-.-LrAVt :.............
1. Location of land on which p reposed work will beBorne-.-.�1 .-r!....�.-.D..
............. .....••••um2,v? C-�,���
House Number S t hamlet
` QQ�
County Tax Map No. 1000 Section . r2 4 .- Block .•.6 5 ........ Int ....-l^.j.-......
Subdivision ...................................... Filed Map No. ............... int ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .............................................................................
b. Intended use and occupancy 'EA6n"` 4 ... Q-`J•1 JQ^!CL-.. ......-.
I ,
3. Nature of work (check which applicable): New Building ..K...-.. Addition .......... Alteration '......... 4
Repair ............ Removal ............. Demolition ............ Other Work ...............................
(Description)
4. Estimated J.p �.�.t .'..�4 fee ..............................................
(to be paid on filing this application)
5. If ckaelling, nnber of dwelling units ............ Number of dwelling units on each floor ................
If garage, number of cars ....cl.C'�s Z ......................... jj
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.....�{.11k.
7. Dimensions of existing structures, if any: Front....N ...... Rear ..... ....... Depth ...............
lleiglit ...... ................ Number of Stories ...............
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth ................... Height ................... Number of Stories r L
/ II
8. Dimensions of entire new construction: Front ....��......_. Rear ..-1'. ........ Depth ....I.�..
height ........................ Number of Stories .... ..��.".�:,�....
9. Size of lot: Front .�,i.7.tJCNumber... .... Rear ...17:3 /...(.�.. Depth ...I O.. cc
10. Date of Purchase 4r� 30,.fR99.._. Name of Former Owner ... 'L.E1 1,45,1-1.1 .........
11. Zone or use district in which premises are situated ...
.......................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..................
13. Will lot be regraded .................... Will excess fill be removed from premises: NO
! Y�RS�
0 r L 5 c,j 4 v a- r51.� ��
14. Names of Owner of premises J.l N L t A.-:I�-�II4 f��! Q. Address ... ✓: ?? Z I uN....l l?e Y.... Rye No. d..' ..
Sy cJ ✓ OS T 30 W Fr OE L6 w� y
Nae of Architect G....2...;5.4....(.......... Address ...(�::...5.42:t.T?'t!i; P�+Plrore No.oZ�3.;.535'
.:...... ..
Name of Cantractor �/ G l2N:4vE,CuRQ,. .Q[Sikhs ^lscldress P,d r?4?5..�17 ny�ceJ tE ...Phone No. a1Z 4, j Z
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ..�.....
*IF YES, SON11ULD WAN TR NrW-S PERMIT MAY RE RE¢JII&D.
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.
SCAIL• OF NV yow,
SS
CLYINIY OF .......................
01, ....................be ing duly sworn, deposes and says that he is Lhe appl.icanL
(Name of individual signing contract)
above named,
lie is Lhe .............G2.<:t1 rJ 2_rC......� r2.2SJ..
..... . .........................
(Contractor, agent, corporate officer, etc.)
of: said owner or owners, and is duly authorized to perform or have performed Lhe said work and to make and file Lhis
application; that all staLemenLs contained in this application are true to the best of his knowledge and belief; and
Lhat the work will be performed in Lhe manner set for Lb in the application filed therewith.
Sworn Lo before ne Ibis
...... ......day of �Gs!?�1-... .20.D�...
Notary Public ...�: .t!u ::' :.l,:cCa�(J(J.��-........ .�,L. �2�u'lG....I.4:..�tTJ?'vI_
7 (Signature of Applicant)
LINDA J.COOPER
Notary Public,State of New York
No.4e22663,Suffolk County
Term Ewes December 31,TK 210 C0
SURVEY OF PROPERTY
� w
SITUATED AT
LAUREL
TOWN OF SOUTHOLD
5 K SUFFOLK COUNTY Y NEW OR
5
S.C. TAX No. 1000-128-05-01
SCALE 1"=40'
►' MAY 17, 1996
= FEBRUARY 5, 2DO REVISED PLOT PIAN
AREA = 22,254.7
=Comm NPAXTm 1't Olt}!i al'HgPJtYICBt.
f
NaUff 1KiR ApniaVAL O!K t10"�1tUCtM PW A
mis FA'Nmv RUIDENCE ONLY
,. .,. RRRSSS
x g K a CERTIFIED To: DAA �a ,rt0,2d„i 0 •��...().,-�?
RAYMOND PELLEGRINO
;3� ArPxb�6
s
E(,1R MAXIMUM OP...(i -DEDR0014
I A .+ 1. ELflDas ETOWS LEVATIONS TIONS Ao�N DATUM
2. REFER T5 DLED MAP FOR TEST HOLE DATA.
�/ 3. MBWMIIM SEPTIC TANK CAPACITIES FOR A 1 TO A SEDIOOM NOUEE IS IAN GALLONS.
! "f)l J-'. } ` r® • ` ' ''"" 1 TANK; Or wT. �
La . 4-3'RIDE. $'-
�p 4. MINIMUM TEACHING. SYSTEM FOR A 1 TO 4 BEDROOM "OUSE R SOO p N SDEIVALL EA.
AR
zoo I J, , / ��® .,f •�. yM I POOL. 12' DIP. i'
l �FRD'06ED E%PNtIOx MOL
�.•.�/} FW.waxn LLMOmma MOL
'�Y d' •d^+' •• 'S`-s "'�N �. PROPOSED SPIR:T4K -
01 i
S. THE LOCATION W VAaa AM CESSPOOLS SHOWN HEREMN OBSERVATIONS AND/OltDATA MARIO FROM OTHERS. ARE FROM F1ElO
O .y�4 S. &C D USE OQTMEE W-40
1 •/�////-��/� /e 1�'� OOOP'dT'p 7. ACA.N3. IERRENCE Mo. MO-SS-057i
jo
I 9 �
AND
'TEST HOLE
DATA .N
.��� `• TEST HOLE DUG BY McDONALD GEOSCIENCE ON MAY 14, 1996
I a �lip w
o•x Mow TNro+�
0.5 f
�` -`�y L.za«• � wow�Rrr sNo � afi,f>Y*��./. � _ _- ._.. ..,.. -----�T.j• - ' 60y.)�OQ
M'" r O F fi1F.
/ N.Y.S. Uc. NO. 49665
OMNRFN52ED ALTERATION dT ADOMON
-� �`"° B � STATE Joseph A i e o
E �R.THIS� P n9 9n
roTHE LAD TIf3 EUR.ET MAP Nm WFAPRp
$ RS E Land Surveyor
rC. f (^P•"` j49 ,a.c aar w ne DRi mMR wiwMwiwEr
l TIRE mwrow awww,BIENrr FA TBI, &rmN% - SUEBMNom - STH %m - CombuFBon L"w
T� IERDWM W611MION tBTER NERIDM.AW
`' g0 NRFR N FNE ETNNT ro TIE A>mIMlDS OF TRE LEOBT9 NMiF
,rt rRE TO raRME sMn
Tu .C0TIRICM10RI5 ARE MOT 1RYINWBIE. PHONE (516)727-2090 Fax (516)722-5093
11aRI
1� i, 1G� 17• THE AMD%EXISTENCE
OTR DOF TREF WAYS
OFnCES LOCATED AT YVMG ADERM
`• �,t �• ANT. MOT &IOWM MR MOT 0.wANTEED. Om IABOn Squ P.O. BOX 1931
w'LOw� AGO AgAbopPL MLR YOD 11931 Mww t*A NYah 11901_
TWI4
SURVEY OF PROPERTY
SIM TED AT
LAUREL
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
w S.C. TAX No. 1000- 128-05-01
,0" SCALE 1 "=30'
m
• £ MAY 17, 1996
FEBR_ 5. T PLAN
EMBER 13O2000 FINAL0 REVISED
\ AREA = 22,244.79 sq. ft.
\ 0.511 ac.
�!► \
I. lON 19 USE.DISTRICT R-40
2. 1C.D.H.S. RmmD CF No. R10-00-6076
N \
k1a
looll
O
0:
0!. 7` `'• �`r11R' �•�i
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r
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• I %.. • � ' .•• YON.
I � •� ; ••• �. �A�Ii11T QTY••' •
! r
• 4
• .. 1,00
• �
SUFFOLK COUNUY DEPARTMENT OF HEALTH VICES = 'k
t..2s.4e1 R,6ofletAPPitO�Ai•OF CONSTRUC Y'ED NVO FOR 'Fri
A SINGLE 1r AIM LY RES:DEN -
J
DatAN 2 6 2M H.S.Ref.No. J r
iv f ides
The sewage disposal and water pt thI3 location have beW
Wpp, rrf es and found to
inspecte6 andlor certifitd oy this Dep r ogFtter age.I3R'JOIvcs
e sat: S.
UNATHONZED ALTERATION OR ADDITION
J hti.^f' :ori FOR .ASCI To THIS SURVEY Is A VIOLATION of
Z+ f f3` SECTION I'M OF 1K NEWRK YOSTATE
( EDuCAYM LAw.
St hell A.Costa,P.E.,Chief COPES OF THIS SURVEY IMP WT 0MM
Office of Water and Wastewater Management THE LAND SURVEYOR'S NU® SEAL OR
EMOOSSED SEAL SHALL NOT 0E CONSIDE7lED
9 TO SE A VALID TRUE COPY.
4 CERTIFtCAT10NS WOICATED HEREON SHALL RUN
O�I ONLY TO THE PERSON FOR WHOM I S~V' IS PREPARED, AND ON HIS MWTHE
TITLE CERTIFIED T0: °. 11D
TO TW UMOM MU—
RAYMOND PELLEGRINO C IV TIos ACRE Wt IRANW VA
ELIZABETH PELLEGRINO
�' t11G CONTINENTAL CAPITAL CORPORATION
L- Q�,GO ITS SUCCESSORS AND/OR ASSIGNS TNERMOF AY
AS THEIR INTERESTS MAY APPEAR
=/I*Wcrr st>oMrH ARE M49= ED,
PREPARED IN d1CCOMANCE WffH THE WOO"
STANDARDS FOR TITLE A1SHED � A. 1ge
WTTIELLA.LS. A AND ANDD AOOA0OPRD
MR SWI44 UN 0Y THE NEW STATE LAND
Lerma Surveyor
G
• m `
1`Me %nve - - Ske Plans - Colwbudion Layout
PHONE (631)727-2090 Fax (631)727-1727
O�1V P OFFICES LOCOM AT MAILM AD)OMW
N.Y.S. Uc. No. 46668 1380 P40ANOKE AVDOUE P.O. em 1931
RNERHEAD, Now York 11101 Riverhead. New York 11901-4M