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HomeMy WebLinkAbout26459-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27780 Date: 06/28/01 THIS CERTIFIES that the building ADDITIONS Location of Property: 2430 DIGNANS RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 83 Block 2 Lot 7.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 22, 1999 pursuant to which Building Permit No. 26459-Z dated APRIL 20, 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 DECK ADDITION WITH INGROUND SWIMMING POOL AS APPLIED FOR. The certificate is issued to LINDA DAMBASSIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 548143 01/19/01 PLUMBERS CERTIFICATION DATED N/A 4 /,/�huoorizeS 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. 26459 Z Date APRIL 20, 2000 Permission is hereby granted to: LINDA DAMBASSIS 20 SUTTON PLACE SOUTH NEW YORK,NY 10022 for CONSTRUCTION OF A DECK ADDITION WITH SWIMMING POOL AS APPLIED FOR. at premises located at 2430 DIGNANS RD CUTCHOGUE County Tax Map No. 473889 Section 083 Block 0002 Lot No. 007 . 002 pursuant to application dated NOVEMBER 22, 1999 and approved by the Building Inspector. Fee $ 720 .20 Authori d Signa re ORIGINAL Rev. 2/19/98 7r^kL- Q o mgr ,g�9 _.. - Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT ? �. J1)i1 2 5 TOWN HALL 765-1802 BLDG. LSE S'T. 7'',\/ilOF'£ +UTiY)LD 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 Boardot 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 Building - $100.00 1 3. Copy of Certificate of Occupancy - .2 ("�"✓)Lj "' ' 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ,Date /. . . . .. .. .. . . .. . . .. . . . . . . .. . New Construction. . Old Or Pre-existing Building. . ... . .. ? Location of Property.. Y 7. �. . ... ��'ld2P� ..�occCd . (, .�1.✓.G ! , _ House No. /. Street Hamlet . .• • Onwer or Owners of Property��4 1 . . . . . .. . .. ✓lFfr�iaa�5i.� . . . . . . . . . . . . . . . . .n. . . .. . . . . . . . . . Qouuty Tax Map No 1000, Section. . .P..J. . . . . . .Block. . . ..0 .( . . . . . .Lot. . . +aS .. . . Subdivision. .... . . .yw . . . . . . . . . . .. . . ... . . . . . . . . . . .Filed Map. . . . 4 . . . . . . .Lot, . . . . . Permit . . . . .Date Of Permi .aS"qApplicant y . . . . . . .. . Health Dept. Approval. . . . . .. . .. . . . . . . .. . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . .. . . . .. Request for: Temporary Certificate. .. . . . . . . . . Final Certicate.'. . . . . . . - Pee Submitted: $. . . . . . . . .. . . . . . .. . . . . .. . .. .�� . . . . . . . . . - g1dFF0j.t Town Hall,53095 Main Road o Fax(516)765-1823 P.O. Box 1179 W Telephone(516)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD June 18, 2001 Linda Dambassis 20 Sutton Place South, Apt 17C New York, NY 10022 RE: 2430 Dignans Road, Cutchogue To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file• (Enclosed) xx No Underwriters Certificate on file• xx The check is (not on file• )$25.00 No Health Department Approval on file• No final inspection has been made• _ No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) • BUILDING PERMIT # 26459-Z Please contact our office on this matter• Thank you for cooperation• SOUTHOLD TOWN BUILDING DEPT• F, 410. FIELD INSPECTION REPORT DATE .,..,s1 COMMENTS k ----- - ------- —------�_----____----- ---- ------ ----- g---- FOUNDATION ( IST) II � II FOUNDATION----(2ND)------ISI --il ----- ttl U _________________________ ________ _______________________________________________________ � II ROUGH FRAME h 11 �� Q7 >r- 1 PLUMBING INSULATION PER N. Y. 1 STATE ENERGY I� CODE III jj III II r � FINAL II -ADDITIONAL COMMENTS: ---- -------------------------- O �A r ov - - r _ M G y 9 H O G ' rr � h1 H f1Y[1K � �BIN f[IX ql JO1lD MIIUIYW _ –�" i QTANDIA POOLS OWNER: - BY JOHN J. WYS-0CZANSKI 105 FISHEL AVENUE, RIVERHEAD, NEW YORK 11901 (515)727-5312 NOTE: FOR DIMENSIONS SEE TABLE BELOW RIY lMx[CVvir. 4FA[f 1 PoLY F(vY IYCYIMG WMMNpF➢S%Y ICP PIM1IE 1 �vVll,:MEIi 9aNB.5 PfliNt13 TYPICAL POOL PLAN 11 IvvB¢nmvy � w � ��Niax s { ^ P MAlER4VE ' , EVEIN o � NOTE: FOR DIMENSIONS SEE iASLE BELOW MNL IlYER M { I I TYPICAL CROSS SECTION m, 1 flRpgA4 uCIDFD, RECE _ t OPTIONAL STEP �( F RLQ.TW MIA)R) xw BOTTOM �c�— TYPICAL SIDE SECTION NOTES: ! _ I. 3.500 LB. TEST CONCRETE TO BE USED { IN W UOUS POUR. Bna¢enrm-�-u n-,IrI Z WATER DEPOSAL M BE LIMITED TO OWNER; I N.S.P.I. TABLE OF DIMENSIONS �tO°"'"¢ '-'-"B-'r I PROP To SUIT Lori REcuunoNS. c-aZ 3. TNIS POOL SHAH NOT BE EMPTIED. ' 2.(40 TO aT5 -10 2u:•20 a 301 -_--�-- _ S. WAL16 SiADOTH NONE SKID T1'PE.r✓ ! ' Tom. a�a�� 151s� SLOPED AWAY FROM THE Albert J. Krupski,President �r? ,i��jxpd'. �;,, 'Powe Hall James King, Vice-President ') 53095 Main Road Henry Smith �y k i P.O.Box 1179 Southold, New York 11971 Artie Foster Ken Poliwode U�t T tip' �t Telephone(516) 7651892 a (f� Fax(516) 765-1823 ;�,Z,? «.'�� ,' tf.a�. .`,''t TN7�'a Fp_�.£�✓ti"i.��akJJ September 10, 1999 John J. Wysoczanski 108 Fishel Ave. , Riverhead, NY 11901 RE: SCTM #83-2-7 . 2 Dear Mr. Wysoczanski, The Southold Town Board of Trustees reviewed the survey dated and received in our office on September 10, 1999 and determined that the construction of a proposed pool to be out of the Trustee Wetland jurisdiction, undor Chapter 97 , and Coastal Erosion Hazard Area jur.iscti.ct:ion under: Chapter 37 , of the Town Code. However, any activity within 75 ' of the Wetland line would require permits from this office. This determination is not <a determination from any other agency. If you have any further gnesti.ons, please do not hesitate to call . Sincerely, p Albert J. Krupski, Jr. . President, Board of Trus,t.ecs AJK/djh cc . Bldg. Dept. New York State Department of Environmental Conservation Division of Environmental Permits Rm 121, Building 40-SUNY AM Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0360 John P. Cahill Commissioner LETTER OF NON-JURISDICTION Linda Dambassis 20 Sutton Place South Apartment 17C New York, NY 10022 Date: March 23, 2000 Re : 1-4738-00067/00005 Dambassis Property Dignans Road Cutchogue, NY 11935 SCTM # 1000-83-2-7 . 2 Dear Ms . Dambassis : Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The property landward of the topographic crest of the bluff, determined by the New York State Department of Environmental Conservation to be the 70 foot elevation contour interval north of the dwelling, as shown on the survey prepared by Joseph A. Ingegno on 5/20/99, and last revised on 2/28/00, is beyond the jurisdiction of Article 25 (Tidal Wetlands) . Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project . Such precautions 'may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i . e. a 15 ' to 20 ' wide construction area) or erecting a temporary fence, barrier, or hay bale bermOinistrator Please be further advised that this le teu of the responsibility of obtaining any necessa pom other agencies . e y tru J D y P cc: Tom Quarty Carpentry BMHP File �IK �1 Isl IM:tlf♦b119 ESI.IRylpl I S LAND IA POOLS BY JOHN 1. W730CZANSKI OWNER. 108 FISHEL AVENUE. RIVERHEAD. NEW YORK 11901 (518)727-5312 NOTE: FOR DIMENSIONS SEE I TABU BELOW I( ImI Imc wrAc mnoE raEr raM eaDND WDIMR@FD zxc Tor ImAa wm u¢R e• suAna 11ETURIIS rye I/z srm Bros � OPNmn wL swD a•¢ \ Ir sum TYPICAL POOL PLAN FOEK e IMN6RPBED j PWP NAIEAtNE NOTE: FOR DIMENSIONS SEE TABLE BELOW 1 O -Y LwrED swD 9.. I TYPICAL CROSS SECTION As 1 m3 iLL✓D%iA4 IKKDED i PIEQ OPTIONAL STEP T O F �� TYPICAL SIDE SECTION NOTES: 1. 3,500 LB. TEST CONCRETE TO BE USED (!— j IN CONTINUOUS POUR. a'aHrm eweo-n-w-ena 2. WATER DISPOSAL TO BE LIMPED TO OWNERS e aMNc exeo-r....� , 3 z d Dux e e D -u e_:a R LOCAL REGUTATICNS. N.S.P.I. TAKE OF DIMENSIONS c_ar . TPROPERTY TO SUIT PDO. Slue NOT BE EMPTIED. SIA 9 T-C �D E IFTE N 4. ALL WOOD TO BE PRESSURE IMPREGNATE. { L-- t!I--t' WRH PRESERVAINE 5 1(I�.G I1�3�912R� 5. S1_090 AWAY FRONT THEO POOLID TYPE. ! - BVE IK MWD, xY 1LOf CR ECiTd G1NAM - ------ -- — - OWNER: ISLANDIA POOLS ByJOHN J. WYSOCZANSKI § 108 TISHEL AVENUE, RIVERHEAD. NEW YORK 11901 (516)727-4312 NOTE: FOR DIMENSIONS SEE TABLE BELOW ROI Iq}t mrK aMM mr rau IV�YXO R'luw¢m zzC Tw v m w.x uan "jo TYPICAL POOL PLAN �N.IEBIIxC NOTE: i0R OI UENSIONS SEE TABU BELOW Vier IUYR l I j ems__ I i s TYPICAL CROSS SECTION � U GaAs Manor, Rc� ' T OPTIONAL STEP j F //EKwSfD N L J lnx i rc� I-V TUIRED TYPICAL SIDE SECTION (� NOTES: j 1. 3.500 LB. TEST CONCRETE TO BE USED e aY.NC M lu-RM u-R K IN CONTINUOUS POUR. I e rw+Nc 6o,Rp-r u'e_,R- 2. WATER DISPOSAL TO BE LIMITED TO OWNERS N.S.P.I. TABLE OF DIMENSIONS (Ip�A`� 'T'O-M'F" PROPERTY TO SUR LOCAL REGULATIONS_ _ 3. THIS POOL SHALL NOT BE EMPTIED. SUE A< �-k-18%3TO TO � B r�D 10 J 20A lapa 3 J ____ _ _ K W��p AWAYMV, THE POOL hEr•�T✓ 1 5. WALICi TO BE SMOOTH NON-SKID TYPE. I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULAT [ ] FRAMING [ INAL [ ] FIREPLACE &CCH/IMNEY REMARKS: CSG 17 ,DATE O INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ AL [ ] FIREPLACE S CHIMNEY REMARKS: ,DATE d INSPECTOR 7GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: o7 �- ,DATE D INSPECTOR THI MEIN Y©[t.K .BEARD Qf FIRE UNDERWRITERS PAGE s 1085085 9U$E71� DF E6E07Rrc�T1 . 40 ULTbN PT'9T, N W YORK P1Y�Ob98 pate JANUARY 37;2001 ' 1®941500100 N. 547791 rlVV40,&ton Ngcon file Ti li 16ERTIFlES-TtIAT only the eketrteal egatpment as described behrw:nad Tnbodneed by dw apphcaut named on the above application number is in the premises of` DON & LINDA FR diILLO, '2430 DIGP7AW6 R6AD c CUTCHOGUE, NY .in the joAowiieg iocatioii,-- s1Basement Ist F'C, OU'T. � Seefion Block.:. Lot was examined•'on JANiIARY 09 ,a found to be Tn compliance with the Natwrtai Elecir"i-Code., FIXTURE - -FIXTURES ;., RANGES coOKiN6t nECRS . OPENS DISN WASNER9 EXHAUST FANS= OUTLETS: RECEP1ACUi3 SWRCNES moTitsceM t .SER .AMi:; ._. R,W.. "AMT. = 11F,WL AMTS R.W., "AMi. ;.Ry'. AMT.., 'N.r.:;, - "" L: 37 7�7 ' .DRY,ERS - TURNFUTURE AN'UANC '"FE@bERs SPECiAI REC PTi TTMECtOCK$ REII UNI!NEATER$ MULTI-OUTLEi DIMMERS .� 6As ti.i. AMT I No $%STEMS %N a " ,At1P3, MMf._ AMPS TRANS ."M,P KFEET ,AtTr, WATTS "SERVK3E61b00 E4'i g x_ .,. 9 r' € -fir " R ,. t '" n0 CC.CQND "' A WCIX:.„, „#x .t6 ,;•�xW Si =EQUIP 'T'�41V fi"0'iM� Sh_7,W OiAY., F. Re •• �., , QFaa 60Nt1Y r 'N .O�tll-{E9 , -�.bF`PI-tE6 NO':QCMUO(AfS '^ ,O E �l•=; 200 ' CB 7 ` 210 1 240 � HktRE1F PATtATl13' . s .._ PADDLE E,Ns j s ' c s F.. a �ouMOItF DEEETQ � W 1 , PFtAC Y 7 IHS ING 20 „ ' a. y j $ y ALAN` TR BARD EIgCTRIC77TN LIC #42�5E' :. GENERA NAGEB 4ii c4filNa�le mua nod bk ailorQd iR p rnatm risloim fo jhe ca bflaoutc7iEl Tref 11k5pi1OT5 shay ba ida UTIs �Sy ftTear creTgn ais THE NEW YO-RK BOA ,OF FIRE UN-Dt_:'-' TfR"S PAGE 2 1085085 UItElEU 9f-ELQC7R1fitTh; 40 FUL'TON'-STREET;:NE!N YOFI" NX!0038 .. JANUARY 19"12007 . ]y6 010i'/07 N 5481a3 .-.. :;.: . _ APP.7icahort No.-on file -- TN1S. CFAT1F1ES-TMAT". - ' "only the eteceb3cal agaipment os ateseribeibelery mrd introduced by the applicairt.r timed on the above-application number is in the premises of DON `& LINDA FRANCELLI,- ,`2430, DIGMANS"RD, ;DUTCkO'Ua .NY in the;lalloTving location; "Easerrment: 1st '7: "" 1204Fl. Section Block Lot JANUARY 09;2001 . was,examined on' - ;and fi aqj 'to be in_ev4*2nee"k the Natiotral-Electrical Code..." FIXTURE " RECEPTACLES S,V/aT�NE5 y ='FVCTURES ::.RANGES .: ' OOOKINCsmis OVENS � ISH WASHERS? .EXHAUST-FANSa. AMORESCM 1 OMER -f-ANT, - K:W.;' .AMT: I t.K.W 'ATATS:'j K.W. "AAT..: K.W. ..,AMT. - 4M. DRYERS FURNAI;E MOTORS FUTURE APPUANCE FEEDERS SPECULL RECPT;'TIME C[OC,KS'. gELLUNI2A-EATERS], MULTI=OUTLET DIMMERS: AW._ .-K.W."` 'On," H:f r.. 5Af'- -+A,r' aMr." -`d9;' .Awa.,_.�;lnt.- Att4`,- �Aift�..kMM: 7RAN8 MOT N.P. .. STf4'F FE'- �qq , ;NO. F FEET' ^aEE vt,di PtSCOA1.N AMT ,A"AIP: T1`liE, EQUIP 7.OiS4149'f OW.iL7Vi iO4W';NO OFaROND: AFLOWND, 'NO�OtHl1.EG ':OF?vi6,,, Nb;urnr„vrPAls .'':.orr;EUh �9TilER=AfRARATUS. ... �: ' . .,. " ',.•. . . 3-.t . ' ., , . -:i TRade b' a qu I yed soT> y ALAN N ikRDr 8TOC'IM1AN I�. 4 1a �' . .. P_..0..,_ `42-4,1 t. "• AQUE$,OEit9E, Yw�';; '?,`193.1;i' � GENERAtMAN� ER Thit aertmcgte tTiirEtrio-5b alYared irTpny mannet,t6lErarn to,fMd WHcewffhe Bo6r�yiitnaoreTo9'fi.siealTiit�Ybe itlanl)rfe 6Y theh stTktlenQats i I �� j T:FiE1fVltORS � �k � Of fll t)NtERItRJTE� $` PAGE 1 1085@85 8 77t JJa�#Mk .T PIT ;4D RULTQN 8'f�ftEEF,WEW YpitK; NY 1n09B Date 3Alii�RX9,200� ,.� �ppficaulonXa.oxtilg 1:1650201 143• J1i'IS GER7lFIES FF7hT ; only the elsafrical equ7pnt'eae as dascrlbed below,and inlyddueed by theApplieank Homed an<theaboYe app[ieallon number is,in zke preratses of DON & hINIIl FRI IC�LII, 2430 DTGt hu $D, ;C-,TCHOt7GE Ns r' hi the jollowho8 loeaakon "Basement Zst FL 'Znil.l�Y: ,' BoTnk'; Lot Seedon - was examined-on Ji3 $ 09,30@'1 . '.`and,/onir�tb be fn r»nepHaae with t7tc 1STattonal&lactricaT�G'ode. .. " �FIXTkIRE' ' " DISMASNREXHRANGES t6U(tM*cKs OVENS ST-FANS .:OU1E �,Ik AML _;K•W , .,:,M}w. .K.W..r. ;AMr. _'!DRYERS - RM AOE MOiDRS fBTIfREAPPt1ANCYf# DERS !Pk'CIAIR�EC.yPI .flk3�E-C10C�(S Lt tiktMEASERS M1Xf�lfi1,61MMkTk�Ei OtMMgRS Np OAf:_ S�p,.. .TMS.., H ... AsyN?—� t-. _, ►' AMf� AMhSkAM_4x . SERYl6$Dk§S`O fINfCT 1 :AMtR MIPi ,5. -EoUa? +•imN iy a.. akii ,ik .N?., se^>".° ..ce 71 . a # •" i ktl r i � i e a 3 fjS�HI .E17Jy�cespib-ate ('n( N''u ..S'�• �SJ �� � F.a+na�i'^d tSY. �` '� v .° a sC of e[�4 3speco #'qcY } es ff #t�s�i en U,0,3�men s i saki �� b1 a L s �?(kitcsiilltcdtr,+ri�ttn -iHkniti�nd,ir�;any�natkp�e r�ht!n'�a�hl�itYc cF^ji�'ii'�a�r ,".rn� �77�e� {ot'�i� �A�tc��h�it0tl�tY;lhar�;s���kt?n§�� o 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 �/ �-01d-p� TEL: 765-1802 NCALLY.[20 6 71�. . . ./. Examined. .... .. , _ MAIL pTO:t�SS(d4wal VEAL-5�� Approved. ... ..I./... Permit No. J ���.T.tlSNe �................. Disapproveda/c .................................. .............(......................................... /40 1) ��_�. .D �.spi ...... ........ ( 1l� ng In ) ' SEP Q' 1 k APPLICATION FOR BUILDING PERMIT BLDG OCT. Date. . . l .0. . . . . . . . ., 19 . l OF.g()UTHOLD INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be 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 Zone Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal o demolition, as herein described. line applicant agrees to comply with all applicable laws, ordinances, buil ing ale, housing code, and regulations, and to admit authorized inspectors on premises and ' bur i for a nspections. .......... Si a of a lrcant if orporation) 1 .. 6s .... ... .. ...... (Mailing address of applrcan State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder d.? { ? �tn .................................. ..... Namur of owner of premises .... jd VJ ���.. .. . L 1 ............................ . ............................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .....:................................................... (Nam and title of corporate officer)!_ Builders License No. .....16.. I...I.� PlumbersLicense No. ......................... ElectriciansLicense No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done.............................................................. 0-36 ra �1 ry 3 G e� cic''cl '41-t-- ....wq 117 U t/,. �.m............................. .......................... House Number Street Hamlet County Tax Map No. 1000 Section .........3..... Block .......0�.... Lot .....L/r Z..... Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises lnte useoccupancy of proposed construction. a. Existing use and occupancy ...........1.. b. Intended use and occupancy ` , ......... ...... ....... ... .. . .. . .... . ... . I I� ng .......... Addition .......... Alteration N-cure of. work (check a9nidh applicable): New Building It-pair ............ Etsnwai ............. Demolition ............ Other Work .................................. (Description) EstimatedCost ........ ...... fee .............................................. (to be paid on filing this application) If dwelling, rxnber of dwelling units ............ lbmler of dwelling units on each floor ................ Ifgarage, umber of cars ........11.............................. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if arty: Front...:............ Rear ............... Depth ................. Ile r of Dimensions of same structure with orale rationstorladditio s• .r,.. ...•.. ' .......... tions: Front ............... Rear ............... Depth .................... Height II.................... Namber of Stories ............... Dimensions of enure new construction. Front ................ Rear ............... Depth .............. ,]eight ......................... N.uvber ofl Stories ..................... Size of lot: Front I...... Rear Depth ). Date of Purchase .................I,.... Name of Former Owner ........................................ I I. Zane or use district in uiuich premises are situated ..........................:................................... Does proposed construction violate ny Will excess or regulation: ...... 3. Will lot be regraded ....... .c... fill be removed from premises: NO a zoning law, ordinance, i. Norms of owner of premises .......'.................... Address .............................. Phone No. .............. Nam of Architect .. ��/..•.... ........ �............ Address ../..................fQ.�...... Phone No. .............. Nana of Contractor .. ...:�'d'''�.... C:S......... Address lt� .!� L—..:Y dPhone No. ../Y/..�.�.�... i. Is this property within 300 feet TRMI1 ofa tidal wetland? ,, * YES.. .�.... NO .......... IF YES, SOLM HD MM ESlItCCiIRM. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ran property lines. Give street and bl I ock rurber or description according to deed, and show street names and indicate nether interior or corner lot. I L 'A'.ITi OF NU YIN UN1Y OC ..... SS ••^••• 6•h'►•�... .................. ieinp duly sworn, deposes and says that he is the applicant Jane of individual signing contract) hove vaned, isLhe .............................. _ _............................................................... ...... (Contractor, agent, corporate officer, ete,) ' said owner or owners, and is duly autuorized to perform or have performed the said work six] to make aril file this uplication; that all statements containhd in this application are tnie to the best of his knowledge and belief.; and naL the work will be performed in the rrpnner set forth inthe application filed therewith. " ern Lo f. re me this day of Notary hblic .. .......'.�I. .......... ?(SVMt.ue f Applicant DIANE M.Stun i Notary PLb!!,,State of NhiwYork No.,'191400 Qualified in t.dfeIlk Coonly�Q Commission Expires June 0, I ~ 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 TEI.: 765-1802 NOTIFY: CALL . d Examined... ....... f. , r � MAIL TO: . . . . . . . . . . . .. . . . . . . . Approved. , d9!- Permit No. b..k ?.G..c� ................................... Disapproveda/c .................................. ................................... ............................................ APPLICATION FOR BUILDING PERMIT �� ;II ! NOV l_ 'l 11 Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be 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 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 buildim for necessary inspections. .................. (Signate of applicant, or name, if a corporation) i (Mailing address of applicant) State whether applicant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder ............... ei. -11..4�. X,a J.✓oraV�. ................................................................. Al Name of owner of premises .�urt.d: d��lra'... .,✓Un.. t :.............................. .... ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .......................................................... (Name and title of corporate�officer) Builders License No. PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done..�yLU. . LlL�r.C�K..lV�.. ��d,P ✓L.A.CrICS�..... �GL //........................................................Hamlet County ........................... House Number Street Coty Tax Map No. 1000 Section .d .09..7i.2. Block ................ Lot ................ Subdivision ...................................... Filed Map No. ............... Lot .0............. (Name) 2. State existing use and occupancyoof� premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..Arl.^�olz-�, ................................................................ b. Intended use and occupancy ............................:.................................... Khture of cork (check which applipable). w Building ..........iddition .......... Alteration '.......... Repair ............ Pswval .....L....... Danolition ............ Other Work ...P-r4 f/ ......................... (Description) Estimated Cost ....... fee .............................................. (to be paid on filing this application) If dwelling, nudher of dwelling habits ............ Nurober of dwelling units on each floor ................ Ifgarage, n Tiber of cars .......r................................... If business, camereial or mixed 'occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures' if any: Front................ Rear ............... Depth ................. height ......................... I,ldnber of Stories ...................... Depth sane structure i i ..................itions: Front ............... Rear ............... Dimensions of sans sttrrcturebecn,1`ialCerations or add N.nber of Stories ......... Diirensions of entire new construction: Dont ..V.......... Rear .. .tl? .... Depth .5.X... ..... Height .................... ... Nknber of�Stories c �/2� t4 Size of ]ot: Front .�hr?�?......f...... Roar ..�i.�.�I�......... Depth .. ............. ). Date of Purchase ................:.... Nam of Former Owner ....................................... . I. Zone or use district in which pro Ihises are situated '.........................:.............................:....... 2. Does proposed construction violate any zoning law, ordinance or regulation: .;.lY!/ .................. 3. Will lot be regradedc/Oi<c..y�Ps Ff./ovt... Will excess fill be removed frorn ®premises: YES � 1. Napes of Owner of premises I/dn.+ n�a ./r�rne�cJ!/,., AddressU/'!✓Ze.�dS.y1 Phone No.Villi 9W.22,01 Nane of Architect ........... ,. Address 1172./ &,"4-IQ.M4,Me Phone No.S.4,e ...r s.I. Is this r within 300 feet 1 as tidal wetland... l9i/9..�a l lu�r ......Phone No S-44 Xf-9.7r14. None of Contractor(/luae� rilIW !y 5. property / Q ' * YES ....e... NJ .......... *IF YES, SO(Tl UD MM 1111M7 PERMff MAY BE WGQOIR[-. I PLOT DIAGRAM locate clearly and distinctly all buildings, whether:existing or proposed, and indicate all set-bark dimensions rom property lines. Give street and block rubber or description according to deed, and show street names and indicate nether interior or corner lot. III A'Ni OF NW Y(NdC, SS JUNlY (F ............. �.g•;•g.• �.....hi.. ..............being duly sworn, deposes aril says that be is the applicant dual sr nro of indi con racf: rove named . isChe ...... .,.�a./.' /.:..... ...........................•..................................... (Contractor, agent, corporate officer, etc+) said owner or owners, and is duly authorizer] to perform or have performed die said work my] to make and file this hplication; that all statements contain�cd in this application are true to the best of his knowledge and belief.; and hat the work will be perforined in the inquner set forth in the application filed therewith. horn Co tefor� .dayso[ .�!/ .....Iii.. 19..! . Notary Public .......... .G ..�^..... I. ........ PATRICIA COR WIN I (Signature o!:Applicant) Notary Public,State 0+New York No.01C0501702 Qualified in Suffolkicounty, CorrmissionEviresSept.l3" V/ BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: . �'�''`'�- Reviewed: !//-,'/.Z7/177 Architect/ Date Engineer: Submitted: SCTM #: 7 Z District: 1.000 Section: Block: Z Lot: Project - Location: ��30 ��- Name: Single&separate Required certification: (Yes/Nod Req. $0 DOD f0? 3. Req 1207 .Proposed: District: [Lot size: >r Actual: [Lot coverage °Proposed: Req / Req / 7.2/ Req [Front Yard Proposed: [Side Yard -� Proposed: 1 [Rear Yard 7.s Proposed: 77 0f Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Numbe Suffolk County Health Dept. New York State D. E. C. Town Trustees �l.Q Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: v"K Notes: , . a 7 T`-r 2 - n" APPROVED AS NOTED _ Q X K P- f�.,1 �` l-,r_-•i ) - C°-- . DA �'� BR NOTIFY BUILDING DEPAM NT T 7854802 9 AM TO 4 PM FOR T E -- FOLLOWING INSPECTIONS: --- - -- — --�- / t FOUNDATION - TWO REQUIRE FOR POURED CONCRETE t V. ROUGH - FRAMING 6 PLUMBIN _ > 11� - S INSULATION 4 FINAL - CONSTRUCTION MUS !! BE COMPLETE FOR C.O. �'' '1vA prss ALL CONSTRUCTION SHALL MEE THE REQUIREMENTS OF THE N. STATE CONSTRUCTION 8 ENERG ----- - `I'�-- --t--' - - �- 3 CODES. NOT RESPONSIBLE FO DESIGN OR CO STRUCT10t.1 - - 'IMMEDIATELY' 0 O cLn3m OR, a ENCLOSE POOL ON O S I ;y n, ' Y' F - - tI$E IS UN WFUL BEFORE-WATER' R,w. WITHOUT C 6A — -- Lyd, OF OCCU g i D1IDERWRIIDIS V - W Iii ED E3 V I ! -olk" , Tu Lj � I_ ---- - -- — Ir - - -- - — �� n - - - -L-- -. 'L �' -- - - - - - - - - - - - - - - - -- -- --� - XI •S, _ Iib„ �, 4., q 4., � _q. � •_ „7 ' �� '_,=r c� .�' 4 IM' rml col JJ 1 I v 1 ng 7p 1• �' _ _ — __.__ _I - I bLL 0t---1 to m',rrCrbi Tb T(} - rlV GY EC Gltt"•T fEl,7t7l TtA,w cmc cu - ✓ _ Cobb = Le7 //,,� pp _-___- -- � u. . - r CWL,-L r_,'n L.a n-Irnl.l T>, liP+�� .>L^Hi�tri Cid n� .I 4n >\ ..Fin. (� In f v -r.i: . rte: .., '1 a _ '�- l-f 0 1 � �` `-L i C' i r.V� L="x'r• j2 �E_ --C LF L•_T11,r..,�., �� C 7, _ LONG ISLAND SOU ND .80, MT - � '23' N DE�" ALoyc nlcH wercx S—_ 7 E 79-02' ?I "Go ButxNeW — �� aor", OF W000 BIIUfNEAO �'—= BLUFF � � OECk , ss SJ°o �0 � LWDISNGmgS OF IC41Sr•4���U.PD U ^— m ERo � PNoroa°. JGs 1 V mIX EEK O) "�•t a aF 4B � --_ I �" _- GF � y E€ Vis° BRICK EN>p C e]/' Won FOUNG E - 11 a, Wow DE— ' W carve MBN MG a c _ _ _ - - _ _ — _ _ _ isle' _ Nc uNR � Y STORYoaz• w zI G• mFRAME HOUSE nEPS cb A' I' o� �0 ' YL PC, , �c �N H D c n;c.Y/ o IS.J• n � qg• &I ni i i i UTIUL LITY #23A > ZN �•$ ooh 'dew SURVEY OF PROPERTY g SITUATED AT CUTCHOGUE o a TOWN OF SOUTHOLD \\ �� SUFFOLK COUNTY, NEW YORK \ \ S.C. TAX No. 1000-83-02-7.2 \ i SCALE 1 "=30' ` \Z MAY 20, 1999 NOVEMBER 16, 1999 ADDED PROPOSED DECK \ / AREA = 102,583.85 sq. ft. cb% \\ (TO TIE LINE) 2.355 CO. soi`y \ G� l og\ k AS ESTABUSHEO PSTAREPARED IN ACCORDANCE WITH THE MINIMUM 9�SO NDARDS FOR TITLE SURJEYS wl 9I O BY THE LIA LS AND APPROVED AND ADOPTED \{ FOR SUCH USE BY TA NEW YORK STATE LAND TIRE ASSOCIATIONA. S ,� e n J J F N.Y.S. Lic. No. 49668 O ^ lf;QG •"Egg, . S•\ � \f ' O Joseph A. Ingegno uruTHosrze6 ALreRAnON OR ADDITION •�O TO THIS SURVEY E A VIOLATION OF EECTION 7209 OF THE NEW YORK STATE E2 O� QQP DUCATION LAW. ,)O'\ OO Land y- Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR �J• �I.ti ` L' EMBOSSED SEAL SHALL NOT BE CONSIDERED f'Q\• MO TO BE A VAUD TRUE COPY. HEREON SHALL RUN Title Surveys - Subdivisions - Site Plans Construction Layout ONLY CERTIFICATIONS TTHHESPERSIONT FOR WHOM E SURVEY IS PREPARED, AND ON HIS BEHALF TO THE PHONE (516)727-2090 Fax (516)722-5093 TITLECOMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSn- OFFICES LOCATED AT MAILING ADDRESS TUIION. CERTIFICKTONS ARE NOT TRANSFERABLE One Union Square P.O. 80x 1931 THE EXISTENCE OF RIGHTS OF WAY Aquebogue, New York 11931 Riverhead, New York 11901 AND/OR EASEMENTS OF RECORD. IF ANY, NOT SHOWN ARE NOT GUARANTEED. 99-337A