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Home My WebLink About25967-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26974 Date: 03/10/00 THIS CERTIFIES that the building ACCESSORY Location of Property: 430 SALT MARSH LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 68 Block 3 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1999 pursuant to which Building Permit No. 25967-Z dated AUGUST 24, 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 INGROUND SWIMMING POOL, DECK & FENCE TO CODE AS APPLIED FOR & AS PER ZBA #4715. The certificate is issued to GREGORY MICHELIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-517146 03/03/00 PLUMBERS CERTIFICATION DATED N/A c Authq ized 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. 25967 Z Date AUGUST 24, 1999 Permission is hereby granted to: GREGORY MICHELIS & WF. 4201 235TH ST DOUGLASTON,NY 11363 for CONSTRUCT ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AND DECK AS PER ZBA# 4715 . at premises located at 430 SALT MARSH LA SOUTHOLD County Tax Map No. 473889 Section 068 Block 0003 Lot No. 013 pursuant to application dated APRIL 7 1999 and approved by the Building Inspector. Fee $ 225 . 00 ll nn i f� Authori e Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPARTMENT U3 3 } ,; TOWN HALL 765-1802 ot[7 . DEP T. TO _o,;CrsOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buil inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property 1i streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 fo 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contai less than 2/10 of 17 lead. 5. Commercial building, industrial building, multiple residences and similar bui and installations, a certificate of Code Compliance from architect or enginee 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 building '.'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 appl If a Certificate of Occupancy is denied, the Building Inspector shall state a 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. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . ./! ::?`-: .9. . . . . . . . . . . . . . . . . . " New Construction. . . . . . . . Old Or Pre-existi,,nyq� Building. . . . . . . .. . . . . Location of Property. . .. . .y..��. . . . . ..+. . ./'i4rS�1 . .�V:V . . . . . . . . . . . . . . . . . . . . . . . . . House No. Gr /�� Street`, Hamlet Onwer or Owners of Property. . . . .: C��.Ry-:)o��. . . . .fq�.c "��;S . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .c9 909 . . . .Block. . . . .�� . . . . . . .Lot. . . . 13. . . . . . . Subdivision. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . Permit No. . �-S. ./. �!2�—.Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . .. . . . Final Certicate. . . . . . . . . . Fee Submitted: $. . . . . . . . . . .?:�� . . . . . . . . . . . r S 7/(D . . . . . . . . .APPLICANT. . . . . . . . . . . . . . . . co� � .PB3/10/2000 12:20 17182298785 INTEGRATED RLTY MGMT PAGE 01 INTEGRATED REALTY MGMT. CORP. 42-01 235T" STREET PO BOX 401 DOUGLASTON,NY 11363 TEL: (718)229-4488 FAX:(718)229-8785 FAX TRANSMISSION COVER SHEET TO: A�4 JZe�"�t1, - �a� Qo� :u0GQ PAX NO: DATE: I2000 FROM: TOTAL PAGES OF TRANSMISSION Z INCLUDES THIS COVER PAGE. IF THERE ARE ANY PROBLEMS REGARDING THIS FAX MESSAGE PLEASE CALL (718)229-4488 AND ASK FOR IQ • /'? THE INFORMATION CONTAINED IN THIS FASCIMILE MAY BE PRIVILEGED AND CONFIDENTIAL IT IS INTENDED ONLY FOR THE USE OF THE rNDTVIDUAL OR ENTITY TO WHOM IT IS SENT, IF Tim RECIPIENT OF THIS TRANSMITTAL IS NOT THE INTENDED RECIPIENT,ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE IMMEDIATELY NOTIFY US BY TELEPHONE,AND RETURN THE ORIGINAL MESSAGE TO US AT THE FOLLOWINO ADDRESS VLA THE US POSTAL SERVICE: 42-01 235'"STREET PO BOX 401 DOUGLASTON,NY 11363 TEL:(713)2294488 FAX:(718)229-8785 THE NEW YORK BOARD OF FARE UNDERWRITERS PAGE 1 1001290 BUREAU OF ELECTR1 �tY „ J 40 FULTON STREET, NEW YORk'-N* MARCH 03,20M 20 1'913 ,, 1100, N 517146 Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant nan{idtop` #4060.application number is in the premises of GREGORY MITSLLIS, 430 SALT HARSH LANE, PECONTC, NY k , in the following location• ❑ Basement ❑ 2st Fl. ❑ 2nd Fl. OUT Section Block Lot R&UARY 25 20 was examined on 00and found to be in compliance with the National..Electrical Code., FIXTURE FIXTURES RANGES COOKING DECKS OVENSDISH_ H EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCE FLUORESCENT OTHER AMT. K.W. AMT. X. AMT. K.W. AMT. K.W.' AMT. H.P. 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TMfi:CLOKS,. BELL UN}fi,HEATERS MIiLTI-OUTLET DIMMERS AMT. K.W. Oil H.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. ,AMT:' AMPs.` TRANS: AMT H.P. NO.OF FEET AMT. WATTS 1 20 1- SERVICE _SERVICE DISCONNECT NO. S E R V I C E METIER NO.OF CC GOND. A W(� A.W.6. A.W.G. AMT. AMPS TYPE EQUIP. 1 12W 1/3W 3 13W S e 4W PER• OF CC.C011D. NO.OF NIdEG'° ^'OF HI•LR NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: SWIHMTw POOL-1 GrCI-1' *(SWIMMING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test/and or repairs made by a qualified person. <<< Continued on Page 2 >>> GENERAL MANAGER maw Per� ..r This certificate mud not be altered In any manner; return to the office of the:Board If.,irtcorrect.Inspectorq.,"y be Identified by their credentials. COPY FOR, BUILDING DEPARTMENT. THIS COPY OP CERTIFICATE MUST NOT SE ,ALTERED;IN ANY MANNER. THE NEW YORK BOARD OF FIkE. ,10NUERWRITERS PAGE 2 1001290 BUREAU OF ELECTRIC,ttY 40 FULTON STREET, NEW YORK,xv 111039' MARCH 03'2000 19g3$5�0/0� N 517146 Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named,on the.above ap)phcation number is in the premises of GREGORY MITSELIS, 430 SALT HARSH LANE, PECONIC, NY - in the following location- ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on FEBRUARY 25,2000 and found to be in compliance with the National Electrical Code..'' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENJ FLUORESCENT OTHER AMT. K.W. -AMT. `K.W. AMT. K.W. AMT. K.W, AMT. I N.P. T_ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'Pr. TIME CLOCKS BELL UNIT HEATERS MUOI� T DIMMERS AMI. K.W. OIL H.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. AAMit ,AMPS. 'TRI�NS. AMT.+ H.P. NO.OF FEET EMS AMT. WATTS SERVICE DISCONNECT NO-OF S E RV i C E METER NO.OF CC COND. A.W.G. A.W. A.W.G. AML AMP. TYPE EQUIP. 102W 1/SW 3 i JW •4W PER 1 OF CC.CO D.7 0`OF.HI.IFG OF NI-tEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: ' C-CAT CO./DAVE CHESHIRE ELECTR LIC.#953-E C (_ L 9280 SOUND AVE GENERAL MANAGER MATTITUCK, NY, 11952 11 Per This certllkate::must not be altered in any manner;return t the office of the Board if ,dncorrect,I tageatorpi rrwy bo IdenfiW by their credentials. t'Y, F R L}LDIN EPA TMEN' . HI ) ATE UST N T: t tN cANY MANNER. PROFESSIONAL ENGINEER HOBART ROAD/PO Box 616 SOUTHOW, NEW YORK 11971 PHONE 631—765-2954 FAX 631—614-3516 Date: May 11,2000 Reference: Michelis— Salt Marsh Lane Ed Forrester Southold Building Department Main Road Southold,NY 11971 Dear Mr. Forrester, I designed a sub surface drainage system to contain all runoff from the impervious surface at 430 Salt Marsh Lane in Peconic. The system was designed in accordance with Town Codes and picks up all the runoff generated by the asphalt driveways and the asphalt tennis court. Artco Drainage of Mattituck installed the system last week in accordance with that design. If you have any questions regarding this matter please call. cry truly yours, J seph Fischetti, PE r - 16M FIELDINSPECTIONREPORTDATE —__ _______________________COMMENTS =__________===E=t q FIELD ==I1��DATE =11- -`- ------- j_ II II FOUNDATION ( IST) ii ii m - - - — it 1 C r n FOUNDATION (2ND) n — �--------�--------------------------------PPRP-- PPRP—PPRP-- i II II if JI O ROUGH FRAME & " PLUMBING n n INSULATION PER N. Y. ili H STATE ENERGYII CODE NN iI n.I — II ii PPRP--PPRP-- ---_PPRP------ en II II H �nIt — I FINAL it u=----_ n �--==--=s=====PPRP---________— ADDITIONAL COMMENTS: --------------- c— Cl C_rl m ro H APPEALS BOARD MEMBERS eoSouthold Town Hall Gerard P. Goehringer, Chairman c� Oy� 53095 Main Road James R a y P.O. Box 1179 Lydia rt 'a n tK _ • Southold, New York 11971 Lora S l ins ;! y �� , ZBA Fax (516) 765-9064 Telephone (516) 765-1809 George: ing M BLDG, ;SPT. BOARD OF APPEALS TOWN Os So.1T+OLD _ TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JULY 28, 1999 Appl. No. 4715 - GREGORY MICHAELIS 1000-68-3-13 STREET & LOCALITY: 430 Salt Marsh Lane, Peconic DATE OF PUBLIC HEARING: July 22, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 15,795 sq. ft. in area with 150 ft. frontage along the northerly side of Salt Marsh Lane(a/k/a Lake View Avenue), Peconic. The lot is improved With a single-family dwelling situated close to the Coastal Erosion Hazard Line and top of the bank of the Long Island Sound. BASIS OF APPLICATION: Building Department's two Notices of Disapproval dated June 8, 1999 citing Article III, Section 100-33 and Article MIM, Section 100-231 of the Zoning Code with respect to the proposed side yard location of an in-ground pool (16' by 30� with upper and lower decks, and the proposed 10 ft. high fence around a new tennis court structure. AREA VARIANCE RELIEF REQUESTED: Applicant requests Variancesfor a proposed in-ground pool with deck 10 ft. extension with an easterly sideyard setback at 15 feet from the top of wall and deck area. The pool and deck areas are proposed at the same nonconforming setback of the dwelling from the L.I. Sound (not closer). The accessory tennis court structure is proposed in the required front yard of this waterfront parcel, however,the height of the fencing for the tennis court is proposed at 10 feet. (No other areas are noted in the June 8, 1999 Notices of Disapproval.) REASONS FOR BQARD ACTION, DESCRIBED BELOW: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties because the minimum 15 ft. side yard setback of the pool would meet the requirement for a dwelling addition. 2. The benefit sought by applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance due to the variable elevations of the land. 3. The requested area variance is not substantial. 4. No evidence has been submitted to show that either the proposed pool with deck or the Bennis court fencing would have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. 5. The difficulty has not been self-created and is related to the topography of the land and the FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; June S. 1999 TO Gregory Michelis A/C Joseph Fischetti 430 Salt Marsh Lane Peconic N.Y. 11958 Please take notice that your application dated April 7, I999 For permit to construct an accessory in-ground pool and deck at Location of property 430 Salt Marsh Lane Peconic County Tax Map No. 1000 - Section 68 Block 3 Lot 13 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds; pursuant to Article III Section 100-33 '...In the Ag-ricultural-Conservation District and Low-Density Residential R-80, R-120, R-200 and R- 400 Districts, accessory buildings and structures or other accessory uses shall be located in the required rear yard....' proposed project located in side yard of existing one family dwelling. Authorized Signature w r APPEALS BOARD MEMBERS �p�0 CC Southold Town Hall Gerard P. Goehringer, Chairman 53095 Main Road James M�'ny --g P.O. Box 1179 li �4 y Lydia ! r _a_o _ I Southold, New York 11971 Lora St ( ins y j- ZBA Fax (516) 765-9064 t 11;� 0, Geor e' in Telephone (516 765-1809 S t; 5 ,. ..,. ) I BLDG, -,=PT. BOARD OF APPEALS TOWN OF SOUTHOLD TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JULY 28, 1999 Appl. No. 4715 - GREGORY MICHAELIS 1000-68-3-13 STREET& LOCALITY: 430 Salt Marsh Lane, Peconic DATE OF PUBLIC HEARING: July 22, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 15,795 sq. ft. in area with 150 ft. frontage along the northerly side of Salt Match Lane(a/k/a Lake View Avenue), Peconic. The lot is improved with a single-family dwelling situated close to the Coastal Erosion Hazard Line and top of the bank of the Long Island Sound. BASIS OF APPLICATION: Building Department's two Notices of Disapproval dated June 8, 1999 citing Article III, Section 100-33 and Article XXIII, Section 100-231 of the Zoning Code with respect to the proposed side yard location of an in-ground pool (16' by 30) with upper and lower decks, and the proposed 10 ft. high fence around a new tennis court structure. AREA VARIANCE RELIEF REQUESTED: Applicant requests Variances for a proposed in-ground pool with deck 10 ft. extension with an easterly sideyard setback at 15 feet from the top of wall and deck area. The pool and deck areas are proposed at the same nonconforming setback of the dwelling from the L.I. Sound (not closer). The accessory tennis court structure is proposed in the required front yard of this waterfront parcel, however, the height of the fencing for the tennis court is proposed at 10 feet. (No other areas are noted in the June 8, 1999 Notices of Disapproval.) 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. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties because the minimum 15 ft. side yard setback of the pool would meet the requirement for a dwelling addition. 2. The benefit sought by applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance due to the variable elevations of the land. 3. The requested area variance is not substantial. 4. No evidence has been submitted to show that either the proposed pool with deck or the tennis court fencing would have an adverse effect or impact on the physical or environmental conditions In the neighborhood or district. 5. The difficulty has not been self-created and is related to the topography of the land and the FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; June 8, 1999 TO Gregory Michelis A/C Joseph Fischetti 430 Salt Marsh Lane Peconic N.Y. 11958 Please take notice that your application dated April 7, 1999 For permit to construct an accessory in-wound ound pool and deck at Location of property 430 Salt Marsh Lane Peconic County Tax Map No. 1000 - Section 68 Block 3 Lot 13 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds; pursuant to Article III Section 100-33 ..In the Agri cultural-Conservation District and Low-Density Residential R-80, R-120, R-200 and R- 400 Districts, accessory buildings and structures or other accessory uses shall be located in the required rear yard....'proposed project located in side yard of existing one family dwelling, ff Authorized Signature i A H E F B / r, Fars F, Fee Far<a<Pwnp Te —re R�iwnf rory ww oRa,a) RatlN Wae F Plan A Piping Arrangement �e NnH LIn �#4 Rtl 4G —J' Section R R L—L S So SS00 PSL Gonave i (I t J� Section A-A Typical Wall Section S A 8 C D E F G H AREA CM. ARTHUR ED WARDS FEET FT. FT, FT. FT- FT- FT. FT, FT. SQ.FT, GAIPOOL & SPA CENTRE 720'140- 16' 32' e' 14' 8' 4' 4! 8' 512 19,000 PERMACRETE WALL SYSTEM 16' 36' 12' 14' 8' 4' 4' 8' 576 21,800 929 Route 25A Miller Place NY 11764 18' 36' 12' 14' 6' 4' 5' 8' 848 24,300 (516) 744-7185 FAX (516) 744-0174 ( ) Suffolk License #4436—HI Phm 20' 40' 14' 14' 8' 4' 6' 8' 800 30,000 Nassau License #HI74450000 } BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK • . . . • • • • • - BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . : TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 , TEL.: 765-1802 CALL �9 —• • • • -• • - • • • - MAIL T0 : Examined �'/" " " ' . ., 19 �7 by � 1 r Approved . . . . 2 .. . . . ., 19 .� Permit No. . s ��?. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . p (Building In ec or) APPLICATION FOR BUILDING PERMIT U Date . . . . . . . . . . . . . . . . . .. 19 w DG. DEPT, INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,wi 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 str or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ai. cation. c. The work covered by this application may not be commenced before issuance 9f Building Permit. d. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such pe- 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 Occup: 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc=_ Aegulations, for the construction of buildings, additions or alteratioVildiffing oval or demolition, as herein descril The apMticant_ agrees to comply with all applicable laws, ordinances, de, using code, and regulations, an( admit authorized inspectors'on premises and in building for necessary. . . . . . . . . . . . . . . fall lea , or name, if a corporation) �. ` 4 (Mailing address of applicant) State whether applicant is owner, lessee agent architect, engineet general contractor, electrician, plumber or buil . . . . . . . . . . . r E�ISM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . „ Name of owner of premises . . . . . . .ts e 5. . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � 062 roll or latest deed) If applicant is a corporation, signature of duly authorize MW14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . &//� . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 430 . . . . .5.1.4 m" .�. . . .�� . . . . . . . . . . . . PQM„ . . . . . . . . . . . . . . . . . : . . . . . . . . . . House Number /Street /� Hamlet County Tax Map No. 1000 Section . . . . .C7 . . . . . . . . Block . . . .03 . . . . . . . . . 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 . . . . . .J'�! `" ./ �. . . . . . . . . . . . .((. . . . ...p. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . 1,1.u1C�!'•lHQ . . . . . . . . . . . .(.I.C+ . T 0p , U � 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . V`.� . . Alteration . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . .. . . . . . . . . Other Work . . . . . . . . . . . . . ZD 600 (Descriplion) 4. Estimated Cost . . . . . . . . i. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . If garage, 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 ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . r 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth t..... . . . . . . . . . Height . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '.. . . . . . . . . . . . . . . . 9. Size of lot: Front . . /, . . . . . . . . . . . . . . . Rear . . . /.6:P. . . . . . . . . . . . . .__Depth.570„__�ki.s43 ___.. . . . 10. Date of Purchase . . . . . . . . . . . . Name of armer Owner . .-. . .. . . . . . . . . . . . . . .I i .. . . . . 11. Zone or use district in which premises are situated . . . . . . �'�. . . . . . . . . . . . . t . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . .N� 13. Will lot be regraded . . . . Will excess fill e r owed from premises: Yes 14. Name of f remises6�.-/.r,9 !�!��r/S, . . . . . . Address `f2�. Phone i �Xrf� — . . 7 . n,' Name of A�s�iect . Sc h./34kp r!.� . . . . . . . Address . g Phone No. 76.E�f6l* . . Name of Contractor . . . . . . . . . . . . . . . . . . . . Address r9 Spd7r6e. ., Phone No. . . . . . . . . . . . . . 15. Is this property located within 300 feetyof a tidal wetland? *Yes . . . . . No . . . . . *If yes, Southold Town Trustees PermitPmay be required. Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. APPRO ED AS NOTED OCCUPANCY OR HATE: �B.P If '� 59 � � USE IS UNLAWFUL i =E: essay BY: Eta It WITHOUT HOUT CERTIFICATE ^5;80BUILDING AM TO 4 PM FOR Th OF OCCUPANCY IOFOUNIDATIONE- TWO REQUIRE FOR POURED CONCRETE UNDERy1RVVERSCEOFICATE 2 ROUGH - FRAMING & PLUMBIN REQUIRED 3. INSULATION 4. FINAL - CONSTRUCTION MU BE COMPLETE FOR C.O. ■7� ALL CONSTRUCTION SHALL MF' "WARMWTELY” THE REQUIREMENTS OF THE n &ICLOEEtl M-to cm STATE CONSTRUCTION & ENEP 11I. cowunm CODES. NOT RESPONSt915 F< REFONOMPar DESIGN OR CONSTRUCTION ERRU STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . . . . . . .. DS.QTt1.�) . . WWI . . . . . . . . . . being duly sworn,deposes and says that he is the applicai (Name of individual signing contract) above named. J� 1 Heisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 tr application; that all statements contained in this application are true to the best of his knowledge and belief;and that tl work will be performed in the manner set forth in the application filed therewith. Sworn to beeffore me this . . . . . . . . .1. .. day of.,. . .. . . . . . . . . .1 19� Notary Public, . . . . ."!`."!�!f!'�?. . . . . . County JOYCE M.WILKINS ry Public.State of New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No.4952246,Suffolk Counly (Si ture of applicar Term Expires June 12,19.1 �v j ' � w n �/F• ANL Y.9N 553"So'�o'E � 3 Q LN' Z/'QOM' 3�L3' sso u4oko ti RM ql. LER., O'1p��F �r aaBe + o�Mcw r pi► b;#tE of nqr ��?✓Ey Foz• �r,�EGo.2Y M/C.4�EU5 f �•f •, Lo�rav•PELavjG• Tw.vo.�-�ariY•srxo N. Y. 1 �4 NarE: G'o rl7� EzoaiavAgwwRZ,,vE7xcv,�Qe,,� °• 052e�u NT.4/aNY K/LEKi.9NG�wecti OA�1G'• 9.va�rrie,�99B P,ya>o No• 57 339-83/3wrF7.7oo t/y,B/rylfg °"ESSIO PPv, Rd'491a t �7/yam ✓ouryoc0,nV-),*, /1y7i x9LE•�a��' L MA' -L8-03/3 OF NQ F�Sc.)Awxq �Qa FISCryF, m�"Fa �a 510 ter`" 4,�rtiv .`rca2x C�.f�/H.�.= G`��G�Q`f �W,C.d-kEL15 A aG \\azo QO�Ess pie 5\G- T6'S-.2'9S�F �AlV.1NC�s W�TK S�c.LF cL,pSt N,Ca. GryT� A's REWV\0_EO ET y7 mi. TYcli 7 P,� TECO S 'o.C. r1-¢ Q Pau� o p ryp CL7 P�-"TE ,GLT��C-kIL-� xv 0 0 R'E'T6ti�NG M SES 5i z p�p,MElBZ / G-c�k�G'RCZc Tc 'F`tYlC\LYc� L�ET�/GS i J\ �^-iU(y� 1+OUSE � Ze�t7 sQ.F'L. SQ.FT- Tet-MA\S c-VURT 61\00 Sat. C-r, 4G �i�vu-�wG4 4a\�E t\oo c_�.cz; -T'trTc1._ IS13-7T SC0.Gr. 0--`-1-D LOT- c—vV(—D f*c1E 7y�= ' 1SI�9SSca.F'T. 3 LAT A4-EI> S-A-FT. r1i ,to b '6' O- (n rNN- 36 k 3b y;0. b Ct41` 3Z _ IfZ PoGH ('•6'ecp \ p \ 7w37' 2w�� 4p - - o' ti\�H �wti \ J \ - - - - - - - - - - - PScnvw4 Crx7v-T D(I -�--25 ev- 34 r -- rna+N\ \ - V\ 3L s�u�es �cn waL� Elia �\o� S 1 5 � O' HIGH /L `� Q ZS � GUNMI U1.LK ' �¢T�CP.L SI,PR]RT - • \ FENS /-!f n✓+'C \ /'-FOIJ•1Q V11"f"�Jci I-EG• couvr 60:115' ZG- , 3 TN3z' RETA1ta\w6 WA\L �- Z4 Z2 o OF NP{y ZU (� \r \• I F �' VAGI . �ct1C�ICLgIZ r � — m m -Rax�16 z oszs\� _tet tc� lisNF27R J np�t4NTyF�C7ht� A SVQ YEyC P - ROFecswl+p`� t4RWV �foWC- �-jP,TEb F•ELaW.ASz't ,201 1°t019 i3`f - L- a�,.�C 1/\�'`YV AaV.Et+�l.?� 516.765-295�t P.ly'CH6l�`t' LEW E'N\�OW S`G.\ - SV2UEYOR Application Name: Architect/Engineer: SCTM #: District: 1.000 Section: Block: 3 Lot: Subdivision Name: Req. Req' Zoning District: Lotsim 4900'9*roposed: (Lotcoverage A0 Proposed:—L�� / R Req / eq. / Req. �Q [Front Yard ✓— Proposed: ] [Side Yard Proposed: ] [Rear Yard 0 Proposed: ] Project Description: v� AGENCY PES Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: e •