HomeMy WebLinkAbout26232-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26871 Date: 01/05/00
THIS CERTIFIES that the building ACCESSORY
Location of Property: 405 PRIVATE RD. #15 ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 15 Block 9 Lot 3.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 29, 1999 pursuant to which
Building Permit No. 26232-Z dated DECEMBER 29, 1999
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 ACCESSORY TENNIS COURT WITH 10 FOOT CHAIN LINK FENCE AS APPLIED FOR.
Z.B.A. #4769.
The certificate is issued to DOUGLAS MORRIS & WF.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized 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. 26232 Z Date DECEMBER 29 , 1999
Permission is hereby granted to:
DOUGLAS MORRIS & WF.
1488 LAUREL HOLLOW RD
LAUREL HOLLOW,NY 11791
for
CONSTRUCT ACCESSORY TENNIS COURT WITH A 10 FOOT BLACK CHAIN LINK
FENCE PER ZBA #4769 . THIS PERMIT REPLACES BP#14691-Z .
at premises located at 405 PRIVATE RD. #15 ORIENT
County Tax Map No. 473889 Section 015 Block 0009 Lot No. 003 . 004
pursuant to application dated DECEMBER 29 1999 and approved by the
Building Inspector.
Fee $ 35 . 00
Au Tried Signature
ORIGINAL
Rev. 2/19/98
Form No. 6 t
TOWN, OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 sig rJ b te�?ap -
If a Certificate of Occupancy is denied, the Building Inspect r-,ShalT''stat ,
reasons therefor in writing to the applicant. i
C. Fees -__i +
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwellng $;25:00.,,, j
Alterations to dwelling $25.00, Swimming pool $25.00, Access y bnaldvg;; , �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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential +$+ 15((.00, Commercial $15.00
Date . . . 0Ut�lrl�. . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . Oldf 1Or Pre-existing Building. . . . . . . . . . . . . . . . .
Location of Property. . C.`Sf. . rP Jo le U-1�. [ . . . . . . . . . . . . . . . . OC . . . . . . . . . .
House No. Street VIA `H/amml�et
Onwer or Owners of Property.. ��..!!k. . . . . .�1. ...�i ... . . :�: 1�1 ' :. • ��•S • • • • •
County Tax Map No 1000, Section. . . . . . .Block. . . . . . . . . .Lot. . G U. 3:��
Subdivision. . . . . . . . . . . . . . . . . . .. . .... . . . . . . .. . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Z . `"1 .
Permit No. . . . . .. . . . .Date Of Permit. . . . .Applicant . . . �
� ... . .
�
Health Dept. Approval. . . .. . . . . . . .... .. . . . . . . . . .Underwriters Approval. . . . . . . . . .. . . . . . . . . . . . . . .
Planning Board Approval. . . . . . ... .... . . .. .. . . .. .
Request for: Temporary Certificate. .. . . . . . . . . Final Certic
W)l 4\ 10
Fee ,Submitted: $.. . . . . . . . . . . . . . . .. . . . . .. . . y S (_
/1
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUG PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE S CHIMNEY s
REMARK : ��O�
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INSPECTION DATE COMMENTS
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FOUNDATION ( 2nd ) —2 . J
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INSULATION PER N . Y.
STATE ENERGY
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ADDITIONAL COMMENTS : jl
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FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
DATE; October 21, 1999
TO Kevi McLaughlin A/C Morris
PO Box 1210
Southold NY
Please take notice that your application dated October 8 1999
For permit for as built tennis court and fence enclosure at
Location of property 405 Private Rd # 15 Orient NY
County Tax Map No. 1000 - Section 15 Block 9 Lot 3.4
Subdivision Filed Map # Lot#
Is returned herewith and disapproved on the following grounds fence enclosure around tennis
court is+ 10 feet tall this not permitted pursuant to Article XXIII Section 100-231 which states...
Fences walls or berms may be erected and maintained subject to the following height
limitations:
A When located in the front yard of residential zones the same shall not exceed four(4)
feet in height When located in the front yard of nonresidential zones the same shall not exceed six(6)
feet in height.
B When located in or alongside and rear yards the same shall not exceed six and one-half
(6 1/2) feet in height.
- - - - - --
Authorize 'gnature
FORM NO. a
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)
N° 14691 Z Date ...... .r Vii....a 1.................... 191
Permission is hereby granted to:
.
............ 9j .WL .... H:I... .5.�:.�r. ..r.
�. Px...!Y!41........... ..........................
ra ...2AAM�S.IQ`�......a �.....a �.S!c? 4 � . ...v A�n.!1 9......
� ... 1..........Q� 3...........
. ...............................................1......................................,............I............................
at premises located at . 11 ...�.5 ..............ol. ..................................................................
................................................................................ ................................................................................
......�rl 1. .......................................
County Tax Map No. 1000 Section .......4?1.. .......... Block ......Q.a....... Lot No. ........ ..iD
pursuant to application dated ...... S1rS Gyn..�� .�.................... 19ifW., and approved by the
Building Inspector.
Fee $. `./...
Building Inspector
Rev. 6/30/80
/ FORM No.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date
To /t cctil4l�. .!!O!� cl,lvG!k �
. . . . . . . . . . . . . . . . . . ��c `Jua��.05 l7oK�tS
PLEASE TAKE NOTICE that your application dated . . . . . 4!. . . . . . ?. . . . . . .. 19 o.P�5.
for permit to Q,o�vs•TiC< c�7. / c'ty!3. .(,?.y/Z . . . . . . . . . . . . . . . . . . . . . . . . . . . . at
Location of Property , (�S• • • •! �T. •?p. �a. . . . . . . . .Qiz/F.i`��, - N•�/
Mouse No. Street Hamlet
County Tax Map No. 1000 Section . . . ���� . . . . . Block . . Q.',/. . . . . . . . Lot . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . .QAD:5. . . . . . . .
is returned herewith and disapproved on the following grounds . . .L41'/Vf ,. Gt.iZ 4 5 • •f��
F!5Z7 . . .�rlctt
�� . . . . . G. . rQ?G - .30. . GD. : . . . . 1//✓ .t�C . .i7 . . . . . . . . . .
. . . . . . .
. . . . . . . . . . . .
. . . . . . . \ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
RV 1/80
1 APPEALS BOARD MEMBERS ..-- O 0 gOFFO(�
Southold Town Hall
53095 Main Road
Gerard P. Goehringer, Chai E
James Dinizio Jr. t o P.O. Box 1179
Lydia A.Tortora E DEC 2 I � � Southold, New York 11971
Lora S. Collins y �� ZBA Fax(516) 765-9064
George Horning a. „ 1 � Telephone(516) 765-1809
:ToVyN G, _SO_011C v,
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF DECEMBER 14, 1999
Appl. No. 4769 - Douglas Morris
Street & Location: Private Right-of-Way (#15), extending from S.R. 25 (Main Road),
Orient; 1000-15-9-3.4.
DATE OF PUBLIC HEARING: December 14, 1999
FINDINGS OF FACT
PROPERTY FACTS: Applicant's property is a 2-acre parcel on a private road off Route 25
in Orient. It is improved with a house, cottage, garage and 50 x 100-foot tennis court in the
rear yard surrounded by a 10-foot black chain link fence.
BASIS OF APPEAL: Building Inspector's Notice of Disapproval dated October 21, 1999
denying approval for the tennis court fence because Code section 100-231(8) limits the
fence height to no more than 6.5 feet.
AREA VARIANCE RELIEF REQUESTED: Applicant requests authorization for the fence
as built, in order that he may obtain a Certificate of Occupancy that includes the fence.
REASONS FOR BOARD ACTION DESCRIBED BELOW: On the basis of testimony
presented, materials submitted and personal inspection, the Board makes the following
findings:
(1) Applicant obtained Building Permit #14691Z, dated March 21, 1986, for
construction of the tennis court. The Permit does not mention the fence. The tennis court
and fence were built but no Certificate of Occupancy was issued.
(2) The fence is of the sort customarily found at tennis courts. A fence of only 6.5
feet would be inadequate for a tennis court, and applicant therefore needs a variance if he
is to have a workable tennis court.
(3) The tennis court and fence have been in place for 13 years. The fence is made
of black chainlink and is relatively inconspicuous. The tennis court is at a rear corner of
the property and does not intrude on neighbors. For these reasons, grant of the requested
variance will not produce an undesirable change in the character of the neighborhood or
detriment to nearby properties.
(4) There is no evidence that grant of the requested variance will have an adverse
effect or impact on physical or environmental conditions.
Page 2- December 14, 1999
ZBA Appl. No. 4769 - Douglas Morris
Parcel 1000-15-9-3.4 at Orient
II!i
(5) Grant of the requested variance is the minimum necessary and adequate to
enable applicant to enjoy the benefit of a tennis court while preserving and protecting the
character of the neighborhood and the health, safety and welfare of the community.
RESOLUTION/ACTION: On motion by Member Collins, seconded by Member Horning, it
was
RESOLVED, to (GRANT the variance as applied for.
Vote of the Board: Ayes: Goehringer, Dinizio, Horning, Collins. This Resolution was duly
ADOPTED by unanimous (4-0) vote. (Member Tortora was absent.)
GERARD P. GOEHRINGE /CHAIRMAN
12/21/99 Approved for Fill g
11 I
CONSENT
TO
ane INSPECTION
SGS r IJV"�h► cJ�6 ° �Of ( � S
Owners) Name(s) the undersigned,
do(es) hereby state;
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at �C>_j � � �-�
which is shown and designated on the Suffolk
County tax map as District l000, Section
. , , Block (Y:( , Lot 3,
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following;
W-A (—C) �� cru` SSor
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of he awn
thold.
Dated: 1 �Q ` <T
signature) i11 p
(print name)
(signature)
(print name)
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE -
OF OCCUPANCY
It des.
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APPROVED AS NOTED
DQTE: 3�aJj _. $ " 149/
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ARTIVENT AT ( - v
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WITHOUT CERTIFICATE ----
OF OCCUPANCY
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FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date . .�-!c. <0 e:! /G . . . . . . .
To c
Xv 5
PLEASE TAKE NOTICE that your application dated . . . . . �z. . . . . . .. 19 S.
for permit tovs4< . . . . . . . . . .�.. .. . . . . . . . . . . . . . . . at
Location of Property () S. . . .! .�!T. ! !�r�p. . `i�. / . . . . . . . . . .
House No. Street Hamlet
County Tax Map No. 1000 Section . . . G��� . . . . . Block . . Q(?. . . . . . . Lot . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . .
is returned herewith and disapproved on the following grounds . . .��! a!!5.,. . s
Cce. �. . . . . . CiS� Ar�LS NGT rS ism fi4 ,c�C�.I. .
. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
RV 1/80
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL..: 765-1802
Examined . . . . . . . . . . . . . . . .. 19 . . . Received . . . . . . . . . . 119 . . .
Approved . . . . . . . . . . . . . . . .. 19 . . . Permit No. . . . . . . . . . . .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date a? . . . . . . . . . .. 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy-
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspes�ons/
. . . . . . . . .. . . . .fid. .f. . .ie . ...he . . . . . . . . . . .
(Signature of applicant, or name, if a corporation)
7 1r Sf 0yeevI �� � r i
✓. . . .� . . . . . . . . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
H .e:.: �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . .1l �' /a ` ° v i s
. . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation sign ture of duly authorized officer.
. .L � . . . . . . . . . . . . . . .
(Name and title of corporate officer) j
Builder's License Nos.O. . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. .J. . . . . . . . . . . . . . . . . . . /� y�
1. Location of land on which proposed work will be done. . lZe F.?.! e . !. .�.?_74"
S vt e—14
® . . . . . . . ,. may. . . . . . . . . . . . . .
House Number Street Hamlet St
County Tax Map No. 1000 Section . . SP4 t.-,. Block Block . . . . . . .�. . . . . . . . . . Lot . . . . .13. . . . . . . . . . . .
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 . . . . . . 42.S!. . .a . . . . . . . . . . . . . . . . . . . .... .7. . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy . . . . ,y�'.5.i e. ?1 . a.Gr : . ,]lj Toy!y!>. . .� agril. . . . . . . . . . . . . . . . . .
Repair . . work (check . . ch applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . .
3. RepairNature of work (check which applicable):
. . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work Anxr,3 . . .
/� (Description)
4. Estimated Cost . . . . . . . .11,. . . . . . . C. . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . .
g � g
Ifarage, number of cars . . . .!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . ... . . . . . . . . . . . . . . .
7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . , . .
Depth . . . . . . . . . . . . . . . . . . . '. . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new const) action: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . Nu�Per of Stories . t�
9. Size of lot: Front . . . .•2R.A ('IX . . . . . . . . . . Rear . . . . . . . . . . . . Depth . . �?41157i. .1g. . . . . . . . . .
10. Date of Purchase . . Name of Former Owner . . . . . . . . . . . . ... . . . . . . . . . . . . . . .
12. Does proposed construction violate
. . . . . . . . . . . . . .� ./
pp
11. Zoner use district in which premises are situated . . . . .any zoning law, ordinance or regulation: . .N.�. . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . . . . . $ . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No
p
14. Name of Owner of remises A, ✓. 1&1% 9oro ri 5 Address . . . . . . . . . . . . . . . . . . . Phone No; . . . . . . . . . . . . . . .
Name of Architect Address Phone No: .
Name of Contractor pzc ; I
!t .fg.✓, ��1:P ?. . . PAddress . ,�. ./��. . . . . . . Phone No: .
PLOT DIAGRAM
Locate clearly and distinctly allbuildings, whether existing or proposed, and,indicate all set-back dimensions from
property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether
interior or corner lot. /
ffaV)75 711ai/ h2u2 beevl yeWoUP_
STATEOF N Y RK,
COUNTY 0
• • • • • • " • • . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual sr ni, g contract)
above named.
Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contrac r, agent, corporate officer, etc.)
of said owner or owners, and is duly)) a horized 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 tI•(t�hiis��
. . . . . . . . . . . . . t.4. _• . .day of.II,. ,r�T .... ::, 19
Notaryblicr . . . . . . . . . 1 tom. . . .IL . . . . . . . County
ELIZABETH ANN NEVILLE Er�,. � . . . . . . . . . .
NOTARY PUBLIC,State of New York (Signature of applicant)
No.52.8125550,Suffolk
Term Expires March 3q ICogptV
FORM NO. 1 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
p TEL.: 765-1802
Examined . .
, 19& ,/ I Received . . . . . . . . . . . , 19 . . .
Approved . .!!G Q L I. ., 191(0. Permit No. 1.'C b.
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i.<< . . . . . . . . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . . . . . . .March 21; 1986.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans,accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildin code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ins ns.
� . . . . . . . . . .
(Si ture of applicant, or name, if a corporation)
Abigai A. Wickham, Esq. , as Attorney
Q. ,sox .1424% .Mattituck, New.YQrk..11952. . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Attorney.. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . .Douglas .& .Monique .Morris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. .38 Southold Town SRichter Home Improvement Co.)
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . .
.?rivate Road IF15 , , , , , , , , , , , , , , , , , ,
. . . .
405 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Orient.. New York . . . . . . . . . . . . . . . . ..
House Number Street Hamlet
County Tax Map No. 1000 Section . . . . . .1-5 . . . . . . . . . . Block . . . . .9 . . . . . . . . . . . . Lot . . .3. . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . ... . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
�y
a. Existing use and occupancy residential, , , , , , , , , , , , , , , , , , ,
b. Intended use and occupancy . . . . ,reidential with tennis court. ag' 8
,ia:h?gC•riG�
3. Nature of work (check which i!applicable): New Building . . . . ... . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition Other Work Tennis ,Court
(Description)
4. Estimated Cost . $20,000.0.4. . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . .I. . ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . .
Depth . . . . . . . . . . . . . . . . . .',. . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . .2$4.7.4 . . . . . . . . . . . . . . Rear . .343:6Q . . . . . . . . . . . . . . Depth . .265,45. . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . ',. . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
proposed premises are situated . ,residential , , , , , , , , , , , , , , , , , , , ,
12. Does 11. Zone or use district in which
g folate any zoning law, ordinance or regulation: .No . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Will lot beore raded construction violate Will excess fill be removed from premises: Yes No
14. Name of Owner of premises . 'JM149144 ,Morris . . . . Address 14 ,3a[fmill ,Rd; • , , • • Phone No. 367-3619. . . . . . .
Name of ArchitectNY
� . . . . . . . . . . . . . . . Address Huntington, . . . . . , , ,Phone No. . . . . . . . . . . . . . . .
Name of Contractor Richter 'Home Improvement COYddress Greenport, N;Ye Phone No. 47770998
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.
Barns marked "X" have been xiemoved.
Plot plan attached.
STATE OF NEW YORK, S.S
COUNTY OF . SUFFGLK . . . . . . . .
ABIGAIL A. WIC
g 1 ing KHAM
(Name of individual si m • •contract)• . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
above named.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ie is the . attorney , , , . . . . • • (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 mannas set forth in the application filed therewith.
Sworn to before me this
. 21st. day of. .Ma h. . . . . . . . . . . . . .. 1986.
Notary PublicG� .�f ..(� lkCountyL` ///
JULIE 6AUERNff NO�6t" � % r �����.•��,.�.�•�
. . . . . . . . . . . . . .
Notary Public,State o . . . ,
No.4796275,Suffolk 061101 (Signature of applicant)
CO@I Miro Expires March
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