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HomeMy WebLinkAbout26065-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26810 Date: 12/01/99 THIS CERTIFIES that the building ACCESSORY Location of Property: 500 DEEP HOLE DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 12 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12, 1999 pursuant to which Building Permit No. 26065-Z dated OCTOBER 21, 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 "AS BUILT" ACCESSORY GARAGE AS APPLIED FOR. ZBA #4756. The certificate is issued to MILDRED I WARREN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 11/30/99 PLUMBERS CERTIFICATION DATED N/A t Bui ding Inspector 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. 26065 Z Date OCTOBER 21, 1999 Permission is hereby granted to: MILDRED I WARREN DEEP HOLE DRIVE MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY GARAGE "AS BUILT" IN THE SIDE YARD AREA AS APPLIED FOR & TO THE CONDITIONS OF THE ZBA. at premises located at 500 DEEP HOLE DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0012 Lot No. 006 pursuant to application dated JUNE 12 1999 and approved by the Building Inspector. Fee $ 35 .00 Authorized Sicffiature ORIGINAL Rev. 2/19/98 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 buil inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property li 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 1% 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 buildino "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 appli If a Certificate of Occupancy is denied, the Building Inspector shall state 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 - •25v. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00QQ, Commercial $15.00 Date . . ! . ..I .. . 1. . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre—existing �1 . . . ( Location of Property. ....��0. .. . ! - House No. Street Hamlet 1ck Onwer or Owners of Property.. . . . . . . . .. . .. . . . . .. . . . . .m �.� �.. .L . . -A:-: ... . . . . . . . . . tt County Tax Map No 1000, Section. . . !./ ;5, , . . . .Block. . . . . . . A?. . . . . .Lot. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . 1� SPermit. Permit No. �� . . . .Date Of . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. .. . . . .. . . . Final Certicate. �. . . . . . $. . . . 00 Fee Submitted: . . . . . . . . . . . . . . . . . O �� . .1 '.. . . . . . . . (j_�� Sri I APPLICANT Post-IC"brand fax transmittal memo 7671 Roe Pages . o� 55 co. FI n n i 2 ELIZABETH A.NEVILLE l TOWN CLERK Phone# REGISTRAR OF VITAL STATISTICS 0 Fax S oZ q0 _ 7 j j Fax S ( V - MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER �0,( -=�v-,Iv -==_--- ------ - FREEDOM OF INFORMATION OFFICER - OFFICE OF THE TOWN CLERK TOWN OF SOUTIIOLI) December 9, 1999 CERTIFIED MAIL C RETURN RECEIPT REQUESTED Brian J. Warren 3920A South Street Seaford, New York 11783 Dear Mr. Warren: Your check No. 513 in the amount of $60.00 dated June 4, 1999 issued to the Town of Southold for the Building Department was returned by the bank because the account has been closed. This office is required to collect the money for the check and an additional $15 charge for each returned check. Payment must be cash, money order, or certified check. The total amount due is $75.00 and must be received no later than Town Hall closing time at 4:00 P.M. , Wednesday, December 22, 1999. Failure to pay this amount within the specified time will result in referral to the Town Attorney's Office for collection and your Building Permit and Certificate of Occupancy being revoked. Thank you for your anticipated cooperation. Very truly yours, ��pp Elizabethilge Southold Town Clerk Enclosures cc: -19uilding Department Town Attorney LD INSPECTION_REPORT_ DATE COMMENTS ________--=_-___'______________ ii ro II II C'�'• ,6 NDATTON ( 1ST) jj it II ii WDATION (2ND) II M u n n ITIt--------- ---- --------- -- -- O G IGH FRAME. S II 11 -----II--_-----------___--'_ ----- ___--_-- PLUMBING - �� II II ii II II it y c it 3ULATION PER N. Y. STATE ENERGY n ri C CODE I -_ iI ii it n oyc All, H t �! p L Ilf----JI II `Aj FINAL ti ADDITIONAL COMMENTS- C H H � z � a l ro j rs �v �s Ott F /q Rk- c-A Tt on/ FOP, &A5 I � _5P a GLUG.DEPT. ,.c n4/ VV F� 1��I`f '� TOY?";OF SOUTHOLDU ,Esq' mc-oezep Lk-4 22re4 PAOP� 5-00 DF EP Kam PR I17r4T—I mqcf�- Town Hall,53095 Main Road P.O.Box 1179 Fax(516)765-1823 Southold,New York 11971-0959 Telephone(516)765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD August 4, 1999 Brian Warren 3920A South Street Seaford, NY 11783 Dear Mr. Warren: Please submit a $25 .00 check for your Notice of Disapproval on 500 Deep Hole Drive, Mattituck. Respectfully, Southold Town Building Dept. FORM NO. 3 TOWN OF SOUTHOLD BIIILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: _July 28, 1999 Brian J. Warren To . . .. . . . ... ... .. ... . . ... .. . . .. .. .. . .. . . . . 3920A Smith Street . ... . ........ . . .. . . .... .. ...... . . .. . .. . . Seaford . NY__ 11783... ... ... .. ..... .. ... June 14 99 PLEASE TARE NOTICE that your application dated .... ..... .. ... .. .... 19. .... . for permit to Construct. . . . an accessory garage "as.built". ... . .. .. . . . .. ... .. .. .. . at . ... .. .. . . .. .. . .. . . . . .. .. . . . . . ... . Location of Property . .... Deep Hole Drive _ Mattituck ... . . .. . . .. . . .. .. .. .. . House No. Street Hamlet County Tax Map No. 1000 - Section . . 115... .. . BLOCK .. . .!?.. .. . LOT 6.. .. . .... . Subdivision . ... ... .. .. . .. .. . .. . . . ... . . . . .. Filed Map No. . . ... .. . .Lot No. . .. .... is returned herewith and disapproved on the following grounds ... .. . .. . . ... . . ... ... .. .. ... that the proposed "as built " accessorY_garage,is.in the side.yard area: . Under tlyrticle_. _ . . ... ... .. ... .. ... .... III, Section 100.33__ accessory.buiIdings, buildings_and.structures or other accessory uses shall be located in the required rear yard. . .. . . . . . ... ... ... ... .. .. ... ... . .... . . .. . .. . . .. ... . . .. ..... ... ... .. ... . . . . ... ..... .. ..... .. . .. .. ... . . . .. ..... . ... .. ..... ... . . ... . . ..... . . . . ... .. .. ... .. ... ..... ..... ....... .. . .. .. ... ... .... ... ... ... ... .. .. ... ... .. ... ....... ... .. .. . . ..... ..I.. ..... .. ... .. ..... .. ... .. ..... . ....... . . ... ... .. . .... . .. . .. ... .. ... .. .. ... .. ... .. .. .. ... .. ... ..... .. .... . ..... .. ... .... .. .. .. .. .... .. ..... . .. . .. . . ... . .. .. .. ... . .... .. .. .. .. ... .. ... .. ... . . .... . .. . . . . . ... .. .. ... .. .. .. .. .. ... ... ... .. ... ..... ... ... . . .. ... . . ....... . . .. . . . .. ..... ... .. ... .. ..... .. ..... .. ... . ....... .. . ... . .. . . .. . .. ... .. . . . ..... .. ... .. ......... .. ... .. . .. ..... ..... .. .. ... .. .. ... .. . . .. .. ... ..... . ... .. .. . .. ..... ... ..... .. .. . .. .. . . ..... .. .. . .. . .. . . ..... .. . .. . . .. ... .. . . ... . BIIILDING INSPECTOR RV 1/80 t y� APP ALS BOARD MEMBERS pFFD(,i co Southold Town Hall Gerard P. Goehringer, Chairman �� Gy_ 53095 Main Road James Dinizio,Jr. ti P.O. Box 1179 Lydia A.Tortora Southold, New York 11971 Lora S. Collins �y O��A r ZBA Fax(516) 765-9064 George Homing Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD October 18, 1999 Mr. Brian J. Warren 50 Crystal Lake Drive Covington, KY 47101 Re: ZBA Appl. No. 4756 - Variance for Garage Location Dear Mr. Warren: Enclosed please find a copy of the Board's determination rendered at their Meeting of October 14, 1999. Please be sure to follow-up with the Building Department (765-1802) and obtain the building permit and certificate of occupancy for the existing garage. A copy of this written determination has been transmitted to the Building Department for their file and permanent records in your building permit request. Very truly yours, GERARD P. GOEHRINGER CHAIRMAN By Linda Kowalski Enclosure Copy of Decision to: Building Department *APPH/ALS BOARD MEMBERS SVFFO(� Southold Town Hall Gerard P. Goehringer, Chairman = Gym 53095 Main Road James Dinizio,Jr. y P.O. Box 1179 Lydia A. Tortorau- Southold, New York 11971 Lora S. Collins y �Z!," ZBA Fax (516) 765-9064 George Horning X01 ,� �a � Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS and DETERMINATION REGULAR MEETING OF OCTOBER 14, 1999 Appl. No. 4756 - BRIAN WARREN Location of Property: 500 Deep Hole Drive, Mattituck 1000-115-12-6 Date of Hearing: October 14, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's waterfront property consists of 23,030 sq. ft. in area with 100 ft. frontage along the west side of Deep Hole Drive, in Mattituck. The lot is improved with a one-story frame, single-family dwelling situated 65. 3' from the front property line, and side yards of 33.2 feet at the south side and 15.6 feet from the existing garage. BASIS OF APPLICATION: Building Inspector's July 28, 1999 Notice of Disapproval denying a permit authorization for an existing accessory garage because it is in the side yard, contrary to Zoning Code Article III, Section 100-33 that accessory structures be in a rear yard area. AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance for the 127 by 12'2" accessory garage, located to the north of the existing dwelling with a setback of 15.6 feet at its closest point. The garage has existed for about 30 years in its present location but a review of building department records found no building permit application. BASIS OF APPEAL: Building Inspector's Notice of Disapproval dated July 28, 1999 denying authorization for an existing accessory garage because it is in the side yard, in Violation of the requirement of Code section 100-33 that accessory structures be in the rear yard. REASONS FOR BOARD ACTION, DESCRIBED BELOW: On the basis of testimony presented, materials submitted and personal inspection, the Board makes the following findings: (1) The garage was built about 1960 but a Certificate of Occupancy was never obtained. Applicant now seeks a CO in order to sell the property, which belonged to his late mother. Page 2 -October 14, 1999 Appl. No. 4756-B. WARREN (1000-115-12-6) Southold Town Board of Appeals (2) Because the garage already exists, applicant must either obtain a variance authorizing its location or suffer the trouble and expense of demolishing it. (3) The garage is an accessory because it is separated from the house by a patio. If instead it were structurally attached to, and part of, the house, the house-with- garage would satisfy the side yard setback requirement. For this reason, and because the garage has long existed in its present location, 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. (5) Grant of the requested variance is the minimum action necessary and adequate to enable Applicant to market his property with the garage intact while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. BOARD ACTION/RESOLUTION: On motion by Member Collins, seconded by Member Horning, it was RESOLVED, to GRANT the variance as applied for. VOTE OF THE BOARD: AYES: Members Goehringer, Dinizio, Tortora, and Collins. (Member Horning of Fishers Island was absent during this resolution.) This Resolution was duly adopted (4-0). ERARD P. GOEHRINGER, HAIRMAN For Filing 10/19/99 i i NEW SUFFOLK A VENUE SURVEY OF PROPER T Y AT MATTITUCK TOWN OF SOUTHOLD ``M"' A rAVCMAMO ; SUFFOLK COUNTY, N. Y. 1000 - 115 - 12 - 06 30' :e ' !• • .�. e. e s or w ao- E duly 5, 1990 Lu ctric 3�1 "! 1 L rsc.x.n #w,mwUA saK uj .L ♦«f ' $ Z 's it a R Ir it, 70- ry o MAMMWEAL IN LAMD ME OMIAMACE GOVAN► CMIM III M! wA� '+ GAMEY RIGA^fr Of R[qi . • hElEk a " L1C. NO. 40M al'o NiftS, RC, neararwn uv ....s. 1 Y r+ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ) FIREPLACE &&CCH�IMNNEY REMARKS: ,1 DATE l INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8077998 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date DECEMER 07,1999 Application No. on file 19465799/99 H 066499 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named an the above application number is in the premises of WARREN B. , 500 DEEP HOLE DRIVE, MATTITUCK, NY in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. GAR Section Block Lot was examined on NOVE14BER 30,1999 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT, I K.W. i T DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS BELL SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO, A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT, H.P. NO.OF FEET AMT. WATTS i SERVICE DISCONNECT NO.OF S E R V I C E L METER NO.OF CC COND. A.W.G. A.W.G A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 dW PER 0 OF CC.GOND. NO.OF HI LEG OF HbLEG NO.OF NEUTRALS OF.W.G.NEUTRAL j L i L OTHER APPARATUS: ELECTRICAL SURVEY AS 11/30/99-1 *NO VISUAL DEFECTS: "An electrical ? survey has been made of the exposed electrical equipment in the premises indicated. " "No obvious 1 unsatisfactory condition was found. I I 1 CELIC REALTY P. 0. BOX 786 GENERAL MANAGER I MATTITUCK, NY, 11952 Per II This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. I COPY FOR BUILDING DEPARTMENT THI CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER BOARD OF HEALTH . . . . . . . . . . . . . . . FORM N0. 1 3 SETS OF PLANS. . . . . . . . . . . . . JUN 14 1999 TOWN OF SOUTHOLD SURVEY . . ..1 UILDING DEPARTMENT CHECK . . :1. .. . ... . . . . . . . . . TOWN HALL SEPTIC FORM . . .. . . . . . . . . . . . . . . . WP SBLDPT.OLD SOUTHOLD, N.Y. 11971 l TEL: 765-1802 NOTIFY: r c9 CALL .. . .. . . . . . . . .. . . . . Examined.�y/.!}.•........ 19Jc7 / MAIL TO: . . .. . . .. . .... . . . . . . 2 60 19... /Permit No. ...... . Disapproved a/c .. .!f..`..1...(„T�,��.'-�`5//� ................................. ................... � ... ................................ N q F (Build' tor) APPLICATION FOR BUILDING PERMIT Date. .l� .��. . . . . . . . 19g. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property 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. Surf 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 anry purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS tOM MARL' 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, otd' s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in build fa nece inspections. ..... . ..................................... (Si ture of applicant, or name, if a corporation) 39OA SoLtrw Sr SFArou yy .......... r.............. ........$ Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil. 6�(D .lam .................................................... .^................................................................ ....... .: Nae of owner of premises k&IL.D R \ t ED �• " '�R'P1F-1q ..................................................................................... (as no the tax roll or latest deed) i If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of lard on which proposed work will be done............................................................. $oo l�r�p �Lf ©21t.1-r...........................WA�rLT-uc;Kc .......................................... .................... House Number Street Hamlet Canty Tux Map No. 1000 Section .r(SU�....... Block ..f Z: ...... Lot ...O 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 ............................................................................. b. Intended use and occupancyRAGE. .......GA...................................................................... 1. Nature of work (check which applicable): New Building .Z... Addition .......... Alteration .......... Repair ............ RwKwal ............. Deolition ............ Other Work .................................. (Description) i. Estimated Cost .....�.....:............ fee ............................. ............... (to be paid on filing this application) S. if dwelling, number of dwelling units ............ Umber of dwelling units on each floor ................ If garage, number of ci+rs ...................................... 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 ......................... timber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... limber of Stories ............... 8. Dimensions of entire new construction: Front .t?:.3......... Rear ............... .3........ Depth .2-.0..?:...... Hei&ht ..... .................. timber of Stories ... ................. 9. size of lot: Front ...qc)............ Rear ...Z I:�`.'�`......... Depth .........Z6 � 10. hate of Purchase '`LST ? ItC��F TRlMESf5jpf)PV j,Do&uN�u, Cu.Of-Q L-GeVr ..•..-.•......4..•- Name of L'onher Owner ... It. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate atry zoning law, ordinance or regulation: Vt=S regraded removed from premises: YES NO 13. Will lot be ailed ....��............ Will excess fill be �3R RN L✓A RAEN JkS 4 14. Names of Owner of premises ...�...................... Address ....... f�v�................. Phone tlo. ........ Name of Architect .................................... Address .............................. Phone No. Name of Contractor ................................... Address ...............................Phone No. .......... i 15. is this property within 300 feet of a tidal wetland? * YES .... NO .......... 3 _ t) *IF YES, SWMD MR ?RDSIPES PMWT MAY BE REQHII ED. 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 amber or description according to deed, and show street nares and indicate %#+ether interior or corner lot. SWE Or WW YORK, SS COWIT OOr ........�. .......5-� .?.q Y1..�..:. ............being duly sworn, deposes and says Lhat he is Like applicant (Name of individual signing contract) .above named, Ile is Lthe .............................................................................. .... (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 hest of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befoT me this � " .3 ....day of l PAgv"er..)9.c1.R-.. Notary Public �'.. RALLY BLADOS .................... NOkuyPLOO,sweofN qff (S tune of A licant) No. 4799955 OuaGfad In t uffoj Courcy Gammen EI a$Juas 30,1919 OCCUPANCY ORAPPROVEu ED USE IS UNLAWFUL DATE: JOL /2DB.P41 AS 240 S7 s` WITHOUT CERTIFICATE 3 ,s d �? o� FEE: S� BY: � NOTIFY BUILDING DEPAR E A7 07 r- 766-1802 9 AM TO 4 PM FOR HE o OCCUPANCY - - FOLLOWING INSPECTIONS. y.. 1 FOUNDATION - TWO REOUIRED m 1� FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING °d 3. INSULATION ',4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C 0. ALL CONSTRUCTION SHALL MEET THE QUIREMENTS OF THE NY - $- - ---��i STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR DESIGN OR CONS-SUCTION ERRORS i i I � 17- E____- GjO u T K A-I. 1 - 31 G y4r . J U) , Q � SII � li 1 AC—.E' CT l�1 BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Q Owners Name: 4Z404�A �ZZui!'l, Reviewed: Architect/ Date Engineer: Bn Submitted: y�,f f 7 SCTM#: District: 1.000 Section: &SBlock: Lot: Project �d0 agoSubdivision Location: Name: Sin&le&separate Required certification: (Yes/No) / "� Zoning District:��to [Lot size: D tW• Actual: ! 780 1 [Lot coverage Proposed: 7o Req. Req. Req. [Front Yard Proposed: ] [Side Yard Proposed: 1 [Rear Yard Proposed: ] Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County P Health Dept. / New York State D. E. C. ✓ Town Trustees / Town Zoning Board approval: V Town Planning Board approval: Flood Plage Elevation ??? Flood Zone: Notes: V tesz �J „�✓�/l � �