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HomeMy WebLinkAbout25850-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: 0-27035 Date: 04/12/00 THIS CERTIFIES that the building ADDITION Location of Property: 625 WOOD LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 86 Block 6 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 2, 1999 pursuant to which Building Permit No. 25850-Z dated JULY 7, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. Z.B.A. 4694. The certificate is issued to BARRY SHAPIRO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized Signure 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. 25850 Z Date JULY 7 , 1999 Permission is hereby granted to: BARRY SHAPIRO PO BOX 254 PECONIC,NY 11958 for CONSTRUCTION OF A DECK ADDITION AS PER ZBA DETERMINATION ON APPEAL #4694 FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 625 WOOD LA PECONIC County Tax Map No. 473889 Section 086 Block 0006 Lot No. 007 pursuant to application dated MARCH 2 1999 and approved by the Building Inspector. Fee $ 75. 00 Authorized Signature ORIGINAL Rev. 2/19/98 BUILDING DEPARTMENT "60.frys4p fro 'TOWN HALL II 1I 765-1502 f�cbr, 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 sewer"a f, -disposal(S-9 form), 3. Approval of electrical installation from Board of Fire Undrwri ,er��."' ;"',-` -- — ---, 4. Sworn statement from plumber certifying that the solder usd In system contains j less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residene;SancAj. 11pa ildiri and installations, a certificate of Code Compliance from a cliitect or enker responsible for the building. 6. Submit Planning Board Approval of completed site plan requ 'remeq,t�. ! 11 1 1 'I;i.7_j B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings at "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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25C 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential x$115.00, Commercial $15.00 Date . . . . . T �.. .. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . .. . . . . . . . Location of Property. . . . . . . . . . . . . . . . . . .4�Yejo�� . Ge_ %. GONG . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . 1:���.`: P����. . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . County Tax Map No 1000, Section. . . . �. . . . .Block. . .U.L? . . . . . .Lot. . ®9.7. . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . 2S� O Permit No. . . . . . . . . . . . . . . .Date Of Permit. .� . .7. �./. . . . .Applicant. . N. . :�!'.�:".--- - - - - - Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. .� ). . . . . . . . . . . . . . . . . . . . . . . . �o03S . . . �!4�'?!� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT 4' n OCCUPANCY OR APPROVED AS NOTED USE IS UNLAWFUL DATE: 1 -"�17t*s1--1 B.P # '75752 WITHOUT CERTIFICATE FEE: t✓BY c*TOF OCCUPANCY NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE �j$7iyG 2 ROUGH - FRAMING & PLUNK 3. INSULATIONts 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. SrT7�9�C! ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. OX STATE CONSTRUCTION & ENERGYs CODES. NOT RESPONSIBLE FOR B PROPOSED DECK DESIGN OR CONSTRUCTION ERRORS Fol 5ARRY S tAplRo % 0 Ali E n� DEC K �EXIS"rl�C� 6UI-tLH - (sm WC. aMe OF ht®nf'Ss�z`sUlcTsan -- 4 t 2� k 1 j i it cjq *i . FIR' I i t b x ROUTE 25 - GREENPORT, NY F �I r 7 4W6iAff DI TC�NY : #? ROUTE 26 Alf ? }?J2R/89 REF GREENFORT, NY I d \■t` t' 29 MAE' LOAD AND SUPPORT: Your clerk will support o 71D PET live lord. Posta hove 36" below-found poet oupporL ' DECK AM POST HEIGHT; You selected o hoight of 42' from tho tap of decking to lave! ground. Tho top of the cloak support pow vAll therefore be S.26' obova ground kvd. Yaur wlcsperaon con provick infomiation for uneven or sloped ground, JOlST3: fief joists on tap of bem-a, 18' center to anter. NOTE The d-ri r, may mgdro knm braces crd bridging betmenn joists. , Your materials list imckides the mcersary items. The suggested design is net a finished buiding plan. You art responrkle for all msaauremants bang carract, fcr,varifyirg that ths.design Iand an subatitufians or recodifications that you make) masts 41.11acd buidkrg codes and To varify thot the ae+ggeiAW dos4rk and any substitutions wmodifk*Wrs. 19 aomsistenf with candrtions at the conctruotion rsite. review. the design with yoklr archit K AJso cowult your orcfiitict for proper construction and use of mateifdls In the st kxture. & sure to follow the d=rF contatruction drtoif nvoila* from yovr store aoiewperuon. " 4-wld`sY 5'iH` 3 iX 5e t t SCAM LAYOUT AM CUSTOMER -- TONY DIA-27 ROUTE 25 - DATE 4208!99 REF GREENPORT. NY I ti 11 1' 114' -. Ilte• ` 3' IJ Sf16' r. 0.1 ti i BEAM 8EA`A POST POST LABEL LENOT14 COUNT SPACING A 2,71 6 13n6" 5 C' 8 alis" 8 25' 9' S 6' 4 81Er c 20' 1 Ill' 4 E' 7 5116" Fait sparnp g measured anter-treerrter. Dep4h of ccoucte footus --- n indim STRESS ANALYSIS CUSTOMER: TONY DIAZ DATE : 02/26/99 REF : SALESMAN # BUCRY -- --- - - ---- - - -- - - - - - - - - - - - - -- --- - -- - ------- ----- ------ - MEMBER STRESS FACTOR COMPOSITE TYPE SIZE FACTOR LOAD LOAD -- -- - --- - - - - - - - -- - - - -- - - - - - - - - - - -- - - - -- --- --- -- ---- ----- JOISTS 2X10 DEFLECTION 363 PSF 161N BENDING 205 PSF SHEAR. 196 PSF COMPRESSION 241 PSF 196 PSF BEAMS2-2X10 DEFLECTION 260 PSF BENDING 97 PSF SHEAR 81 PSF COMPRESSION 247 PSF 81 PSF BOLTS 1/2IN SHEAR 1935 PSF 1935 PSF POSTS 4X4 STABILITY 385 PSF 385 PSF - - - - - - --- -- - - - - ------------- - - -- - -- TOTAL LOAD 81 PSF DEAD LOAD 10 PSF LIVE LOAD 71 PSF -- - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - -- - ----- - - -- - ----- - --- - STRINGER 2X12 DEFLECTION 238 PSF BENgTNG 196 PSF SHEAR 200 PSF COM^RESSION 799 PSF - - - - - - - - --- - - - - -- - ---- - - -- - TOTAL LOAD 196 PSF DEAD LOAD 10 PSF LEVE LOAD 186 PSF ---- - -- - - -- - - - - - - - - -- - - - - - - - --- - - - ---- ---- - --- -- - - -- - -- r 4 APPEALS BOARD MEMBERS ��O�QSVFFO[�COGy Southold Town Hall 53095 Main Road Gerard P. Goehringer, Chairman < P.O. Box 1179 James Dinizio,Jr. y Southold,New York 11971 Lydia A.Tortora ZBA Fax(516) 765-9064 Lora S. Collins 'yilj01 �.a�! Telephone (516) 765-1809 George Horning BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JUNE 7, 1999 Appl. No. 4694 - BARRY SHAPIRO STREET & LOCALITY: 625 Wood Lane, Peconic 1000-86 6-7 DATE OF PUBLIC HEARING: May 20, 1999 FINDINGS QF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property is located at the north side of a private road known as Wood Lane, rn Southold. The property is nonconforming with a total area of 22,738.32 sq. ft. and lot width (frontage) along the roadway of 76.86 feet. The parcel is improved With a single family dwelling with an existing setback 21 feet from the northwesterly corner of the dwelling to the bulkhead and 37+- feet from the northeasterly corner of the dwelling, at the closest points. BASIS OF APPLICATION: Building Inspector's March 17, 1999 Notice of Disapproval citing Section 100 239.4E with respect to a setback reduction at the northwesterly corner from 21'7"(existing) to 14+- feet, at its closest point from the bulkhead, and at it+- feet at the northeasterly corner, of the proposed deck addition. ARFJ> VARIANCE RELIEF RE UESTED: Applicant is requesting an open, unroofed deck at the north end of the dwelling, having dimensons of: end to a maximum width of 24'6". 11 ft. at one end and 24 feet at the opposite The proposed setbacks are: (a) 11 ft. from the bulkhead to the deck steps at the northeasterly encroachment into from the de yardsbisikhead to the deck proposed for the deck addition.athe northwesterly comer. No gEASON FOR BOARD ACTION DESCRIBED BELOW: Based on the testimony and record before the Board, and personal inspection, the Board makes the following findings: (1) The granting of the area variance will not produce an undesirable change in character of neighborhood or a detriment to nearby properties because applicant's proposed deck will be open and unroofed and will not be enclosed. (2) The benefit sought by the applicant cannot be achieved by some method, feasible for applicant to pursue, other than an area variance because the dwelling has been in its nonconforming location for more than 40 years. Page 2 -June 7, 1999 Appl. No. 4694 - Barry Shapir� 1000-86-6-7 at Peconic (3) The requested area variance is substantial, representing a reduction of 11 feet at the northwest corner and 21 feet at the northeast corner. (4) There is no evidence that the grant of the variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because the variance is for an; open, unroofed deck with easy access from the dwelling, for enjoyment of the out-of-doors without leaving the house. (5) The alleged difficulty has not been self-created. In considering this application, the Board deems this action to be the minimum necessary and adequate to enable the applicants to enjoy the benefit of a new deck, while preserving and protecting the character of the neighborhood and the health, safety, welfare of the communit1 RESOLUTION/ACTION: On motion by Member Dinizio, seconded by Member Horning, it was RESOLVED,to GRANT the variance, as applied for, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That there be no further reduction in the northerly yard setbacks noted above; I 2. That the deck remain `open to the sky"and unroofed, as proposed. Vote of the Board: Ayes: Goehringer, Dinizio, Tortora, Horning. (Member Collins was absent.) This Resolution was dt ADOPTED by u -0)vote of the Board. I GERARD P. GOEHRINGER, CHAI AN FOR FILING about 6/10/99 i i I I i I I 1 APPEALS BOARD MEMBERS S1�FF0(k Southold Tow4,Hall Gerard P. Goehringer, Chairman �� G'y� 53095 Main Road James Dinizio, Jr. o ti P.O. Box 1179 Lydia A. Tortora Southold, New York 11971 Lora S. Collins y �� ZBA Fax(516) 765-9064 George Horning �Ol �a� Telephone(516)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD June 10, 1999 Mr. Tony Diaz 12580 Main Road East Marion, NY 11939 Re: Appi. No. 4694 - Shapiro Variance Dear z Enclosed please find a copy of the Appeals Board's determination rendered at our Meeting held June 7, 1999. Please be sure to follow-up with the Building Department (765-1802) regarding issuance of a building permit before commencing construction activities (and certificate of occupancy at the final phase). A copy of this written determination has also been furnished this date to the Building Department for placement in its pending application file and update. Very truly yours, GERARD P. GQEHRINGER CHAIRBy Linda s A BZ - By Lindi Enclosure Copy of Decision to: Building Department Decision filed 6/10 o��g�fFD�kc ti� OGy� Town Hall,53095 Main Road o= Fax(516)765-1823 P.O. Box 1179 Telephone(516)765-1802 W Southold,New York 11971-0959 y BUILDING DEPARTMENT TOWN OF SOUTHOLD April 11, 2000 Tony Diaz 12580 Main Rd. East Marion, NY 11939 RE: Barry Shapiro, 625 Wood Lane, Peconic. 1000-86-6-7 . To Whom This May Concern: We are unable to complete 'your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. )$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 25850-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. INSPECTION--- REPORT DATE ------------—-----------COMMENTS---y=_----sass---- IIINDATION ( IST) w. I c7 )UNDATION (2ND)______ JI -- a u OUGH FRAME PLUMING q— Ij of N H nISUI.ATION PER N. Y. M y STATE ENERGY u p CODE n 8 N p u -------------4 u FINAL ADDITIONAL COMMENTS: tni II H �\ z --- - tv_i M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [L4-1`46AL [ ] FIREPLACE C 1MN 1'r REMARKS; DATE < INSPECTO � Albert J. Krupski, President f�Ocot FFO(jt co Town Hall G 53095 Main Road James King, Vice-President y4 P.O. Box 1179 Henry Smith y Southold, New York 11971 Artie Foster O Ken Poliwoda B'� O`� Telephone(516) 765-189.2 Fax(516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 25 , 1999 Tony Diaz 12580 Main Road East Marion N.Y. 11939 RE: BARRY SHAPIRO SCTM #86-6-7 Dear Mr. Diaz, The following action was taken at the Southold Town Board of Trustees meeting on March 24 , 1999 : RESOLVED, that the Southold Town Board of Trustees grant the request for a Waiver to construct approx. a 21 ' X 26 ' deck onto an existing house. Located: 625 Wood Lane, Southold. If you have any questions, please call our office at 765-1892 . Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc . Bldg. Dept . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date: March 17, 1999 To: Mr, Barry Shapiro 625 Wood Lane Peconic,New York 11958 PLEASE TAKE NOTICE that your application dated March 2 . 1999 For permit to Construct a deck addition for an existing single family welling_ at Location of Property F W No Wood Lane Peconic, Nerw York 11958_ County Tax Map No. District 1000 - Section 86 - Block 06 Lot 07 Subdivision: Filed Map No. Lot No. Is returned herewith and disapproved on the following grounds: Under article XXIII 100-239 4 B Construction within 75' of a bulkhead is not permitted The existing dwelling is setback twenty one feet seven inches (21'-7) at its closest point to the existing bulkhead The proposed deck addition runs almost parallel to the existing bulkhead and has a proposed setback of fourteen (14')+i-) feet from the bulkhead The new deck will be approximately hree (3') feet above grade and will require a minimum of five risers and four treads that will extend closer to the bulkhead and run for the entire width of the new deck Handrails will be required at each side of the proposed deck rX Jam s A. ichter, .A. Building Department Now York State Department of Environmental Conservation _ Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 v Phone: (516) 444-0365 FAX: (5 16) 444-0360 _ John P.Cahill Commissioner Barry Shapiro October 23, 1998 PO Box 254 Peconic, NY 11958 Re: 1-4732-00525/00001 625 Wood Lane, Peconic SCTM # ,1000-86-6-7 - - Dear Mr Shapiro; -- -- - — - ---- — - - - -- Based on the information you have submitted, the New York State Department of Environmental Conservation. has determined that: The property located landward of the bulkhead on the plan by Roderick Van Tuyl dated August 2 , 1993 is not within the jurisdiction of NYSDEC Tidal Wetland regulations. 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 berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. JReurt my yours, E5✓A-1� ty Regional Permit Administrator CC:T. Diaz 't ZONE X ZONE X ZONE X pw ZONE X bI' ZONE31 _ \ ZONE VE ZONE >\ V (EL 81 X \ \ ZONE VE (EL 81 L I LE (SEE c \ \\ \\ \ .,\ '*., \\ \ \ \ \\ \ PECONIC ZONE X \\ \ \ \ \ \ \ \ \\\`\f\\ BAY JOINS _ 0 9� ZONE X 90 mFc� 0 X N i ZONE X ZONE X m ZONE AE o (EL 8) D Z Z A COASTAL BARRIER IDENTIFIED 11-16-90 a '0 (SEE COASTAL BARRIER LEGEND) 2`rOZ ZONE AE (EL 8)\ �j BOARD OF UZALTH . .. . . . . . . : . . . . . �IOU MAR — 2 10 � � , FORM NO, 1 3 SETS OF PLANS . . . . . . . . . . . .. .. TOWN OF SOUTUOLD SURVEY BLDG.DEPT. BUii.DiNG DEPARTMENT CHECK ..... I. .. . . . . . . . . . . • • • • • • TOWN (BALL SEPTIC TORM . .. . . . . I . . . . . . . . . . . SOII'1'NOi.D, N.Y. 11971 TEI.: 765-1802 NOTIFY: r � JJ q CALL . 2o3 :. .�.:1. •/ Ibonined.................. 19. . MAIi. TO: . . .. . . . . . . . . . . . . . . . . Alla-caved... .�-.7......., 19.Jq.1pPenni,: No d,'J�"g. • ••.. ................................... . Disapl>ruved a/c .cur R .. G2�k ?F�. ..�/.��' Z8R 69F6M, .................................... ............... ...................... .. .......fes• .. (Building Inspector) APPLICATION FOR iiUILDING PERMIT Date. .' . . . . . . . , 19 . INSTRUCTIONS a. 'Nus application must be completely filled in by typewriter or in ink and submitted to the iuilding inspector wi 3 Bets of plans, accurate plot plan to scale. Fee according to schedule. b. plot plan slowing 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 mist be drawn on the diagram which is part OF 41110 application. c. 'me cork covered by this application may not be conmenced before issuance of Building Permit. d. Upon approval of this appl.icatiar, the ]Wilding Tnapector wilf issue a Building Permit to the applicant. &mch permit shall be,kept on die premises available for inspection throughout the worwhatever until a Certificate of e. No building shall be occupied or used in whole or in part for any purpose Occupancy shall have been granted by dee Building Inspector. APPIACNrION IS 1LRE" H169 to the Building Department for the issuance of a Building Permit pursuant to dre IWilding Zone Ordinance of the '(ban of Saithuld, Suffolk County, New York, and other applicable Laws, Ordi::ancea or Regulations, for the construction of buildings, additions or alterations, or for remval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regula�tions,,and to admit authorized inspectors on premises and in building ssa inspections. (Signature o pp , or , if a corporation) l2Sf3O i . . .s.. A.`71�fk/21QN.1. /vA- (Mailing address of applicant) IMF State wlmether applicant is owner, leasee, agent, architect, engineer, general contractor, electrician, pludrer or lxrilde ................................................................................ Nam of owner of premises .. � .. `SA�!(LQ.... .. ............................................. (as on the tax roll or latest deed)• if applicant is a corporation, aignatrure of duly authorized officer- ....I......I...11.................... fficer...................................... (Name and title of corporate officer) 1 lkuilders license No. Plwrbers License No. ......................... Electricians lAcense No. ..................... Other Trade's License No. .................... I. location of land on which proposed work will be done...................................................... .... ...62 .......................w©o p.. !UF.......................... .5�u �a...........:.... House N.nber Str,.e,,�e�tt ig // l-ii-n7dlet County Tax Map No. 1000 Section . ?�..` �"•• Block .......( ... .... int ....(........... Subdivision ...... .. ...........I............ Filed Flap No. ........:...... Int ............... (Name) 2. Sl'at'e existing use aril occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... iuG�E„F��t!K( ..p"!F- ...nl4....... .... ................... ................ b. Intended use and occupancy n I. K:lure of Work (dtedtwiiidt erypllceble)t Now Wilding .........., lvklitidt .......55,,.,��AlCerati Repair ............ Removal ...'.......... NMI .......... Other Work ,7 //yy�� (i)escrlRtion) _. 4. Lratbated Coat ...4-s� Y.'....I. ....... fee .. .... ... .. iU'r10 , (to be paid on filing this application) S. if dA+ellhrg, anntnr of dwellLyl Unica ............ Hillier of (haeUina mite on each floor .. . .. ........... Itgarage, rxnher of care ... .r................................ 6. if txrshress, cannercial or all x P occupancy. specify nature and extent of each type of use...................... 7. Dimensions of existing structures, If Boys rront................. Rear ............... Oepkh .. ............... lkii )iniensloos of arms structure wl� alterations of Stories /.............. i gt ...... ••0h elCeretlnne or'axklit•tonek L+ronC ............... Rear ......... ... ... p .................I.. mile it ..................... ,tdnier of Stories .........I..... 30 }� S. Dirienslau of entire new consCrilcCidt: Rt(tC .............:.. hear ...9.4........ Depth ..eZ� .8. .... Ile110:t .......`a?r.............. Umber of Stories 9. SirA of lot,a Rr(al' Rear .................... )>epth —.1—... ......... Ill. Irate of l'urdaase .....:yt(.!/ .... Nalm of )roarer (Mier ../� t l� � 5^��. .... . 11. 2a:e or use district In shida premises are situated ............... ............................................ 11. Ones proposed construction violte any zoning leu, ordinance or regulationt ........................ D. Will lot be regraded ......sVR:......... Will excesa fill be removed from prenisea: YRS 14. Names of DAnar of preaiaea ..Jit AI..".V:g.44PI)?.Q Acklreae ..6 S..orf k9RQ.�9N�,... [hone No. U4.42Z.. Nmre of Ardrltect .........1.". - :............. tuklreas .............................. pilot* No. .......... . . tknne of Contractor . ?—?tlj G 2—r.......... Mires* No. la3S;/4�l. p� Y }of a tidal outland? * YRS ..�.... til ........., I5. Ta this rt Within :1(10 feeC *ir YLr$, avil n 'Im" 7BI MM Miurr MAY i91 w. glinm. PLOT DIAGRAM locate clearly and distinctly all buildings, (Anther existing or proposed, and indicate all set-Ixd;k dimensions from property lines. Give street and block nuri ar or description according to deed, and sliow street nares arxl indicate (Anther interior or corner lot. a6e�- St l IE 'P4#k� C-4CLQSEP ISI II "MM (Mr toll Y(MtK, (111^M YY (Mrd... V. ) u' � �(!� z:........!..................Iniad duly SWUM, detxrSea aril Says that he in the sppl.i(Ums: (Nara: of drxl(vtcKrat signing contract) alxrve darted, Ilein the ...... Q. JYAQ .... ............................................. .. (Ca:tractor, agent,-ror(Iornte officer., etc.) of Said (mer or owrera, and Is dhaly authorized to perform or hove performed Lite said cork nix] to nuke aril file this alg)lleati(nr; lint kill at'atenents caatatr>I in Clris application are tno to Che [rest of his krxx+ledge aril Ixitief; orxi (lint the work will be performed in tin n neer set forth in the application filed Herewith. Dworn to before me tills ....�..�.+.".^.'1......dny o � 19c1�. x+ Notary Rdalic to �OYGp hj (Sits(atur of pl Pu lic,$��UCiN3 7@' 248, :.y cRt k9iRlfes June 12,0 LIZ-- . : .. ION R 5 _ _ a • \ � 1 '", pY i ._a,ceY'.:x Aoix9nn M ` Saciv..)26:t u:i:y Nnw Ynry Sixes . ! �•-c°'.h:5 survey map rnt beams - � .. -a;-„i.sesl shall natbe aonsitleren me.am6aadetl hereon xhaP:+ ln�a�+�-.nai 5uznmwna or E�Wvsya�4. LL i � ''-PCrCE 1 . ei'"t Pic— ' I -0 IG .a t 6 ;HC- BicNi� �',`��'4*'kr"✓`,�VC�,. �., A.. t _ y �{_�z I fJ# „ „ o`, ,-' V,C AND _ -V� . — -- . t x BUILDING PERMIT REVIEW CHECK LIST Applicant/ S44 Date Owners Name: P1 120 A9Z y Reviewed: Architect/ Date Engineer: Submitted: Y3 �q SCTM#: �j District: 1.000 Section: U& Block: Lot: Project / Subdivision Location: CO U� 6L)004) L"41- Name: Single&separate Requ certification: Req. `i Req. Zoning District: [Lot size: Actual: _a�`�'�' 1 [Lot coverage Proposed: Req. Req. Req. [Front Yard Proposed: 1 [Side Yard Proposed: 1 [Rear Yard Proposed: Project Description: Dec"L 0—J)J)1>/e?,.., AGENCY PERMITS Permit RE2UIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. 6(j-rC' RMOF Jr.r-)si0' 'M �73Z ld`Z�`l� �- -b Town Trustees U i RoP V0' per►4 Ib Q���- 3 Z S 9 9 Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: