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Home My WebLink About26493-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27813 Date: 07/16/01 THIS CERTIFIES that the building ADDITION Location of Property: 5035 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Nap No. 473889 Section 128 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1999 pursuant to which Building Permit No_ 26493-Z dated MAY 11, 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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ZBA #4745 DATED 9/30/99. The certificate is issued to MARY JO PETERS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A C r orized 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. 26493 Z Date MAY 11, 2000 Permission is hereby granted to: MARY JO PETERS PO BOX 433 LAUREL,NY 11948 for CONSTRUCTION OF AN "� DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR PER CONDITIONS OF Z .B.A. #4745 DATED 10/14/99 . at premises located at 5035 GREAT PECONIC BAY BLVD LAUREL County Tax Map No. 473889 Section 128 Block 0001 Lot No. 015 pursuant to application dated MAY 5, 1999 and approved by the Building Inspector. Fee $ 75 .00 Auth i ed Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD n� RR BUILDING DEPARTMENT 765NL I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BI G.DEPT. ii a n must be filled in by typewriter OR ink and submitted to the buildii inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings , property line: 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 12 lead. 5. Commercial building, industrial building, multiple residences and similar build 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 ".`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 applicaz 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 - .25q. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $/15.00, Commercial $15.00 Date . . . . .?1.3w . . . . . . . . . . . . . . . . . . . . . . New Construction. .. . :/. . Old Or Pre-existinn Buildi . . . . . . . . . . . . . . . . . Location of Property. 5, .�7.,J � ,�t.. . . . . n ic. Cl . J/. . .lkr . . . . . . . . . . . . . . . . . . . . . . . . . . House No. /Street Hamlet Onwer or Owners of Property.. a r`/ . . fir . . ! .� P` �. . ��R R r County Tax Map No 1000, Section. ). Z g. . . . . . .Block. . . f. . . . . . . . . . . .Lot. l. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . Permit No.,;tQ . 2 . . . . .Date Of Permit. . . .� �0 U . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval.. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . .. . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .�. . . . Fee Submitted: . . . . . . . . . . . . . . . . ./cl_� ..•- /;NT . . . . . . . . . . . . PLI �5r� - Sa-o �S'Soj Form No. 6 ' TOWN OF SOUTHOLD ti BUILDING DEPARTMENT j TOWN HALL t M 765-1802 .` .'',=f un 1 1 1"' a J APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and sublted'" 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 19 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 $25.40. Businesses $50.00. . - 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - I .25%P 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . �. (O - SI.L . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . .. Old Or Pre-existing Building. . . . . . . . . . . . . . .. . so� Q� �. � .tiv . .. . . ./ � �.f. } Location of Property—6-0 .. . . . . . . . . . . . . . . . . .. . . . . . House No. Street Hamlet r Onwer or. Owners of Property./. . A,: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .. . . . . .Block. . . ( . . . . . . . . . .Lot. . . l. .�. . . . . . . . . . . . . Subdivision. . .. . .. m . . . . . . . . . . . . . . . .. . . . . . . . . . . .Filed Map. . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No 02�y1.3-Z.D.ste Of Permit. . .. . . . . . . . . . . . .Applicant. . . . . .. . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . .. . . . . . . . . . . .. . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . .. . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.z . . . . ago liee Shitted: $ . . . . . . . . . . . . . . . . . . . . . � 2'18 1 RUc, s9 -796 . . . . . . . . . . . . . . . . . . . . . "APPLICANT T . APPEALS BOARD MEMBERS p,%IafFO(KC z OG Southold Town Hall Gerard P. Goehringer, Chairman �� y< 53095 Main Road James Dinizio,Jr. ti P.O. Box 1179 �( Lydia A.Tortorap • Southold, New York 11971 1 Lora S. Collins 'fj�O ap! . ZBA Fax (631) 765-9064 George Horning Telephone (631)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD August 15, 2000 Mr. and Mrs. George Orr l 926 White Birch La. Wantagh, NY 11793 Re: Conditions under 1999 Variance Appeal No. 4745 Ip Dear Mr. and Mrs. Orr: We are in receipt of your August 4, 2000 letter with enclosed plan showing a proposed two-ft, high berm with fix to six ft. tall arborvitaes as an alternative to the seven to eight ft, tall arborvitaes along the rear property line area. This Department has no objection to this design and you should proceed with your permit application at the Building Department. We are furnishing the Building Department with copies of this letter and your letter to the Board. Very yttruly yours, GERARD P. GOEHRINGER CHAIRMAN cc: Building Department !�� Attn: Mr. G. Fish, Building Inspector ✓ Neighbor-'5 1,�c.k I-�dv scJ I WOO Ye p 2 -Fco+ berm w/ 5-A-F�oo+v alacs T) E.CK i i I, i oma- No�Se� o�osuFFot,��oG� Town Hall,53095 Main Road p '� Fax(516) 765-1823 P.O. Box 1179 C Telephone (516)765-1802 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD June 4, 2001 Mary Jo Peters P.O. Box 433 Laurel, NY RE: 5035 Gt. Peconic Bay Blvd. , Laurel 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 No Health Department Approval on file• No final inspection has been made• No Plumber Solder Certificate on file• (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT #26493-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT• ,APPEALS BOARD MEMBER O��SVFFO(,( COG Southold Town Hall Gerard P. Goehringer, Chairman =� y< 53095 Main Road James Dinizio,Jr. y P.O. Box 1179 Lydia A.Tortora Southold, New York ill Lora S. Collins y o�� ZBA Fax (516)765-90. George Homing �Ol `�� Telephone (516) 765-18 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF OCTOBER 14, 1999 Appl. No. 4745 - MARY JO PETERS (ORR) 1000-128-1-15 STREET & LOCATION: 5035 Peconic Bay Boulevard, Laurel DATE OF PUBLIC HEARING: September 30, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 6,175 sq. ft, with 65 ft. frontage along Peconic Bay Boulevard and depth of 95 feet. The November 18, 1970 Young & Young survey shows an existing one-family, 1-1/2 story frame house and "as built' open deck addition. The dwelling has a preexisting 36 ft. rear yard setback which is nonconforming in this R- 40 Zone District. BASIS OF APPLICATION: Building Inspector's June 24, 1999 Notice of Disapproval disapproving an application for a building permit for an "as built" open deck at the rear of the existing dwelling. The reason stated for the Disapproval is because under Article III-A, Section 100-30A.3 the proposed deck will exceed lot coverage of 1235 sq. ft. (20%) by 281 sq. ft. and the rear yard requirement is 50 feet. The applicant shows that the "as built" deck addition reduces the dwelling's 36 ft. rear setback to 18 feet. AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance for the"as built' 18 ft. by 22 ft. open deck at the rear of the dwelling with a rear yard setback at 18 feet and total lot coverage of 1516 sq. ft.,or .2455%. (No other areas are noted in the Notice of Disapproval for Board jurisdiction.) REASONS FOR BOARD ACTION, DESCRIBED BELOW: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. There are at least eight lots of similar size located in the immediate area on the north side of Peconic Bay Boulevard which lend to the difficulties in meeting the code requirements for setbacks and lot coverage. For this reason, grant of the requested variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Open decks are enjoyed by others in the area. 2. The benefit sought by Applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance. Alternatives have been considered. Any alternative would require a variance because the lot is preexisting (prior to 1957) with a substandard lot area of 6,125 sq. ft. (15.3% of 40,000 sq. ft. lot area for an R-40 Zone). 3. There are no factors to suggest that grant of this variance will have an adverse effect or APPEALS BOARD MEMBERS o�OgUFFO(,f COG Southold Town Hall Gerard P. Goehringer, Chairman 53095 Main Road James Dinizio,Jr. y = P.O. Box 1179 Lydia A. Tortora k • Southold, New York 11971 A ^ Lora S. Collins d,�0 a�� ZBA Fax (631) 765-9064 George Horning 1 #t Telephone (631) 765-1809 BOARD OF APPEALS rrr" 1111 TOWN OF SOUTHOLD August 15, 2000 C Mr. and Mrs. George Orr 926 White Birch La. Wantagh, NY 11793 Re: Conditions under 1999 Variance Appeal No. 4745 Dear Mr. and Mrs. Orr: We are in receipt of your August 4, 2000 letter with enclosed plan showing a proposed two-ft. high berm with fix to six ft. tall arborvitaes as an alternative to the seven to eight ft. tall arborvitaes along the rear property line area. This Department has no objection to this design and you should proceed with your permit application at the Building Department. We are furnishing the Building Department with copies of this letter and your letter to the Board. Very truly yours, GERARD P. GOEHRINGER CHAIRMAN cc: Building Department Attn: Mr. G. Fish, Building Inspector APPEALS BOARD MEMBERS O gpFFQ( �O CD Southold Town Hall -Gerard P. Goehringer, Chairman �� G'y�h 53095 Main Road James Dinizio,Jr. y P.O. Box 1179 Lydia A. Tortora �+ T Southold, New York 11971 Y • 1. Lora S. Collins -y ��,� ZBA Fax(516) 765-9064 George Horning �Cl �,at ,. Telephone (516)765-1809 �`ZY BOARD OF APPEALS TOWN OF SOUTHOLD October 18, 1999 Mrs. Mary Jo Peters Orr 926 White Birch Lane Wantagh, NY 11793 Re: ZBA Appl. No. 4745 - Variances for Existing Deck Dear Mrs. Orr: Enclosed please find a copy of the Board's determination rendered at their Meeting of October 14, 1999. Please be sure to follow-up with the Building Department (765-1802) and obtain the building permit and certificate of occupancy for the existing deck. A copy of this written determination has been transmitted to the Building Department for their file and permanent records in your building permit request. Very truly yours, GERARD P. GOEHRINGER CHAIRMAN By Linda Kowalski Enclosure Copy of Decision to: / Building Department �J APPEALS BOARD MEMBERS o I$OFK �O C Southold Town Hall Gerard P. Goehringer,Chairman ti-Z Gym 53095 Main Road James Dinizio,Jr. P.O. Box 1179 Lydia A. Tortora Southold, New York 11971 Lora S. Collins y ��, ZBA Fax(516) 765-9064 George Horning �Ol �0 I Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF OCTOBER 14, 1999 Appl. No. 4745 - MARY JO PETERS (ORR) 1000-128-1-15 STREET & LOCATION: 5035 Peconic Bay Boulevard, Laurel DATE OF PUBLIC HEARING: September 30, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 6,175 sq. ft, with 65 ft. frontage along Peconic Bay Boulevard and depth of 95 feet. The November 18, 1970 Young & Young survey shows an existing one-family, 1-1/2 story frame house and "as built" open deck addition. The dwelling has a preexisting 36 ft. rear yard setback which is nonconforming in this R- 40 Zone District. BASIS OF APPLICATION: Building Inspector's June 24, 1999 Notice of Disapproval disapproving an application for a building permit for an "as built" open deck at the rear of the existing dwelling. The reason stated for the Disapproval is because under Article III-A, Section 100-30A.3 the proposed deck will exceed lot coverage of 1235 sq. ft. (20%) by 281 sq. ft. and the rear yard requirement is 50 feet. The applicant shows that the "as built" deck addition reduces the dwelling's 36 ft. rear setback to 18 feet. AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance for the"as built" 18 ft. by 22 ft. open deck at the rear of the dwelling with a rear yard setback at 18 feet and total lot coverage of 1516 sq. ft., or .2455%. (No other areas are noted in the Notice of Disapproval for Board jurisdiction.) REASONS FOR BOARD ACTION, DESCRIBED BELOW: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. There are at least eight lots of similar size located in the immediate area on the north side of Peconic Bay Boulevard which lend to the difficulties in meeting the code requirements for setbacks and lot coverage. For this reason, grant of the requested variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Open decks are enjoyed by others in the area. 2. The benefit sought by Applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance. Alternatives have been considered. Any alternative would require a variance because the lot is preexisting (prior to 1957) with a substandard lot area of 6,125 sq. ft. (15.3% of 40,000 sq. ft. lot area for an R-40 Zone). 3. There are no factors to suggest that grant of this variance will have an adverse effect or Page 2 - October 14, 1999 ZBA Appl. No. 4745-Mary Jo Peters Parcel 1OW-128-1-15 at Laurel impact on physical or environmental conditions. 4. The difficulties have been self created because applicant did not obtain a building permit. S. The grant of the requested variance is the minimum action necessary and adequate to enable the applicants to enjoy the benefit of the existing open deck, while preserving and protecting the character of the neighborhood and the health, safety, welfare of the community. RESOLUTION/ACTION: On motion by Member Dinizio, seconded by Chairman Goehringer, it was RESOLVED, to GRANT the variance, as applied for SUBJECT TO THE FOLLOWING CONDITIONS: 1) As agreed, Owner shall plant a hedge row of Niger Aborvitae along the rear property line at a minimum height of seven to eight feet; 2) As agreed, Owner shall continuously maintain hedgerow of aborvitae in good condition. VOTE OF THE BOARD: AYES: Members Goehringer, Dinizio,,T , Homin , an i . This Resolution was duly adopted (5-0). GERARD P. GOEH G , CHAIRMAN For Filing 10/19/99 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; June 24, 199 TO Mary Jo Peters 5035 Peconic Bay Blvd. Laurel NY 11948 Please take notice that your application dated ,May 5. 1999 For permit to "Asbuilt" deck addition to an existing one family dwelling at Location of property 5035 Peconic Bay Blvd. Peconic County Tax Map No. 1000 - Section 128 Block 1 Lot 15 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds Proposed construction of"as built" 18X22' deck addition on rear of dwelline in R-40 zone_ not in compliance with Article IIIA Section 100-30A.3 • proposed deck will exceed 20% lot coverage of 1235 square feet by 281 sq ft • required rear yard is 50 (fifty) feet " proposed deck shown at 18 (eighteen) feet of rear lot line Authorized Signature i r (COMPLAINT REPORT NAME DATE ADDRESS PHONE# HOW RECEIVED, TEL MAIL IN PERSON LOCATION OF /? COMPLAINT j03S NATURE OF CQMPLAINT • ASSIGNED TO 3�ir 'rpF INSP. DATE 319'4 REMARKS_�,rc/F_9I ACTION ff TAKEN LxfT w� _ "'yih�2 �r��>a-� eA/1!/ ap winf FILE # (IF APPLICABLE) RE-INSP DATE M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH P G. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ;DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS% 44 DATE r dU INSPECTOR f �.' T'J,r- ' -v 0 31 765-1802 ILDING DEPT. t SPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ j FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: i DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS "' S H FOUNDATION OST) II Ij O FOUNDATION (2ND)-- ------------------ � ---------- ---------------------------------- —--------------- I� II II JI x ROUGH FRAME & PLUMBING VA n _ --------------------------- — 1 r INSULATION PER N. Y. STATE ENERGY r CODE u n II p 11 0 � — -- —II II jj �1 c FINAL 1—.— 11 • -.,C _ u _II ADDITIONAL COMMENTS: ______________- -;�w______ ____________= a tzl z —' r � b H ti CA ,o' hip u o k^ f bD 0� o p•� Je `�O-� 7.s �`oi 0 3 � y i a �� h9 �� -'n �v� / .rvADlx0.l3(O.W IYnIXJN V\AYWIxN 1IDV Swver u A vrourpx Or v 3lRpN q Ilry lyw ro1V llAll n 3 ' �'; 0 caa115 a Ixu swot NAr rvJl anvrD • / fIN IAXD IIIIYl1o3'31MIC 41A1 of 'aIW MID Slot SIIR51 Npl N<(IW 1py,o Qto a A vµb nN Con AMfMNfb IrvDIa Al1Y XIMON SW.LL Wll JMl IO Ury ih14r�101 WNUN IN1 SLRV!' s m.nlllD,AIc�, nn ax.0 l0 1X1 � Ill![ON,nlh �•)VIaN1(NIAI nGINCY Ip . .. I.. ....1•ui.IISIfp NIfpN,n1q OIM ASAINla.• SI,IWWG ry ..... �1Xt A. / ani. .w.� .n.n.i• • a•'�naaMW NOrE /+MONUMENT REVISIOA'S YOUNG a YOUNG 400 O.krRANDER AVENUE, RIVERHEAD, N.Y. ADEN W. YOUNG HOWARD W YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR LAND SURVEY0R,N.Y.S.UGN0.M845 N.Y.S. LIC.NO.ISaSS SURVEY FOR SSE Oi ryFk VERNON R. COX & l� ` 0 ko` �* SEL GU RAN 1 T ETI ARAN Co. 7OWN OF R £R AW S aANx SOUTHOLO a Rv Cox SUFE CO, N.Y SCALE, /" a gp' OATE, NOV. /B, BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS . . . . . . . . .. . . . . --{1! TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . ... . . . . . . ^3.DEPT. BUILDING DEPARTMENT CHECK FSOUTHOLD TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL Examined.................. 19.... /1,� p MAIL TO: . . ;-- Approved—At.?...........241`�J Permit No. ..� .?..G��. ........Jnx, Disapproveda/c .................................. ........................��.�. ..................................... .... Luiing' tor) APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . ... 19. . INSTRUCTIONS a. This application meat be completely filled in by typewriter or in ink and submitted to the Building Inspects 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 this application. c. The work cornered 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. Sr 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 MNL to the Building Department for the issuance of a Building Permit pursuant to the Buildipg Zane Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancesor 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 7ildingg for necessaryyiin1spe�ctions�. l...... ..`... .............. (Signature f plicant, or name, if a � corporatiu .................................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu .........................................'............................................................................ Name of owner of premises ......M R 1.....LT p .................................................. (as on the tax roll or latest deed) If applicant is a corporation, .signature of duly authorized officer. ......................................................... (Name and title of corporate officer) BuildersLicense No. ......................... PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done........................................................... SO55...�ci�r�ic �y Blvd. r� .......... ... ...............•--............ House Number StreetJJ Hamlet Canty �Map No. 1000 Section ....1.61.9...... Block .........4...... Int .....1.�........ Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..........,..,.....t....................................................:......... b. Intended use and occupancy ......... ) �Yl �"�;1C ...�. C.... . h 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... , Repair ............ Reuwal ............. Demolition ............ Other Work .................................. . (Description) 4. Estimated Cost ..... (p Dp0.......... fee ................................. ............ (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 ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... ]. Dimensions of existing structures, if any: Front.... 7........ Rear ... 5........ Depth ...`.�'..i.......... Ileight ......................... Number of Stories ......j............... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... AJ.40` 8. Dimensions of entire new construction: , Front ....�. .... Rear ....�...`...... Depth .... ...... height ..... ............ Nnber of Stories //.....c................. "?9. Size of lot: Front ......S06.. .... Rear ....LD ......... Depth .................... 10. Date of Purchase ...3-1.. 95 ...... Name of Former Owner ..l.��.�-J:�:.�............................ H. 7one or use district in which premises are situated ....C).__C�.................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ... M.6 ................ 13. Will lot be regraded .....N ci............�W,,isslll��eexcess fill be removed from premises: YES ND 14. Names of Owner of premises ..... Address!'f �'mr�'`�:U:........ h S�R �O .... ��.. Phone No. ....�...4.. Name of Architect .................................... Address .............................. Phone No. ............. Name of Contractor VMV.-M... ... Address �C'�1;�-M.C3:. �{� Phone No 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ...✓..... *1F YES, SO0MD 10Id1 TRISIMS PMM MAY BE ROWIRIM. PLOT DIAGRAM Innate clearly and distinctly all buildings, whether existing or proposed, and indicate all setback dimensions from property lines. Give street and block cumber or description according to deed, and show street names and indicate whether interior or corner lot. SPAIE OF NW YORK, SS COUNIY OP ....................... 41? 4�.. L�...P� '.......................bei duty sworn deposes and . ng y Lp says (list the is (he applicant (Name of individual signing contract) above named, IV He is the vV neX ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner 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 manner set forth in the application filed therewith. Sworn to before me this //��{{ ....... ..........day of ..M x `1 ........19.`I.-1.. Notary Public J +m'pp ........... HFIENED.HORNE (Signaturef A licant) Notery Public,State of Naw York Quat�sd In Suffolk Comm rasion s may County�p ptrea May 22, 1 c-A $1, N vt\A 000 ss p C?- � d � ao J s 1 00 d rT s 0Y� P�0 2 r� v r he yyJ �v J 0 IS � � — —•DS •. 6h �o �NAUIHOEI r JN 1fH AWf1 O � ck6i r0 TZEO AITE""'NIS SURVEY IS A VIOLATION Or ' �n / \� SECTION 7209 OF THE NEW YORx STAFFEm. - l EDUCATION UW ZZ IHOf PLAND r3URVrrURTHU ,Sr I., r SE' 1 MAP AL URR 10 14 FD SEA) SHAN Npl MCUNSIGHEFO r0 B A VALID IRU) Cp>y {\/ iUARAN(Et5 IND""E` HEREON SHAH.RUN AUY TO ENE IN"— FOR WHOM THE WRVt 'S UECO ED, A111 .1, rnl IIIAfr TU iCF � ITIE COMYANr I:yM vNMfNTA) AGENCY AN ENDING INSrOblly NSTEO HEREON, ANp .Q IHI ASS,inki$ to IHr tFNDi.YG rNiTb 'I uARl r.•('E ARE NOl INANSFERAOII NOTE I= NONUMEVT REVISIONS YOUNG B YOUNG 400 O3�TRANOER AVENUE, RIV£RHEAD, N,Y, ALDEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL EN61NEER AND LAND SURVEYOR LAND SURVEYOR,N.Y,S,LIC.NO./2845 IV.YS. LIC.N0.45893 SURVEY FOR ��ggZ„tt OF lyEw VERNON R. COX 6 V rµ6 �0 _ i r C. A L.' OREL Gu EAT ARAN Cly TOWN OF R ERH AVI S SANK SOUTHOL D y a Rv cox SUFF. CO., NY. _ SCALES /” = 30r DATES NOV. 19, I97 O-3 p R - ..fix,'-.�:'**.:.Y- -' i•FS."�'-, _ i S.r p � No TH RO E FENCE UAjF 70Vv..Gr a0UTk90LD C�RFzuJaLE - Iq FTP CFM T F:6oT/N6 '2 r-T 5� 6 S ` DEcK ELEJaTroN 32 Ftstitr 6�cKub rn • � — C1=ii1�NT FOOTING 1 — Gr�Ps ARS A*ueLFD J 2X S GCA -1 u. oar rG acs 2XG eCq " TERS 04 I L %U D oU Doo Ho STAU- 11 8r�c f+( t� DSK P(A APPa ED AS NOTED . R y RE I AE k)C� V S�t� n0 2-- �y OATS 5o 35 1 CCoWIC gA� BwD. 35 , t -7 Fes_, p ARTM T'AT L-4UR£L Y 7RF-1802 9 AM TO 4 PM FOR TFI FOLLOWINGDATIMECTIONS: /' -t- p I FOUNDATION + TVMO REOIlIRED FOR POMED CONCRETE C� �iL T. d 'l q. RdUGH H1A1rM1a a ILtMG $. INSULKM 4. FINAL - CONSTRIlCT10N Wj" BE COMPLETE FOR C.O. ALL CONSTRLICTM $"L WEE THE REGMEM19" OF TW N I,STATE COMPIA GTION R VWG CODES. lw IM31 FO', DESIGN fel C01{siTIM�t10N NOW, z&14 1 m/ 1 ti \ ; L<C:� i Ot \QO h Ste% os o r- Yi rl lJ 50 soo 0 d o^ 0 i o�c o s$ Q6h OLS lo�� / '�'NUIMURI(FD AlhIIAIYJN VY AWIIItL O D�Sv j / 10 THISSHJRVEY IS A YlptAilON Oi ' 7109 O/ .yI .OUIICATION GATION LA, Ml NEW YORK 11AII CoFK IHF HE NOT AND SURV,,,, IW"RS Al OR R� / iASROyy FD SLAL TALC NOf M IX)161UERF0 f0 Sf A VALID TRUt GORT +UARANTEES INUI,AILI, HEREON SHALL RVN JNLY f0 THE RMt�,n {OR WHOM ME SURVE' RRERAR[D, A•,a 'N t47ALI G !NF IINOTLf COMPANR S,rw E,Sr,o HIR AGENCY AM ENDING INSIIP.I LL.' NSIkO HIRpN, AND U Me ASS, VI IHE LENDING pGTI. j lil(JN ;VARA,�rgS ARL NOT'IRAN111RADLE ♦Ili.. NOTE IaMONUMENT REVISIONS YOUNG 8 YOUNG 400 03TRANDER AVENUE, RIV£RHEAD, N.Y. ALLEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL EN61NEER AND LAND SURVEYOR LAND SURVEYORRN.Y.S.LIGN0.I2845 N.Y.S. L1C.NO..45893 SURVEY FOR SE OF NFIY VERNON R. COX 8 PAC `op r0 A L i4 0REL 6T f AT/ ARAN CO Tt7WN OF R ERN AV! S BANK SOUTHOLD y S Rv cox SUFF, CO, NY SCALE /" c 3O' DATEY NOV. /E9, /9T O-3