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Home My WebLink About25861-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-27146 Date: 06/19/00 THIS CERTIFIES that the building ADDITION Location of Property: 215 GREEN HILL LA GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 2 Lot 48 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 14, 1999 pursuant to which Building Permit No. 25861-Z dated JULY 9, 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR AND AS PER ZBA #4711. The certificate is issued to CURTIS F DAVIDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized Si ature 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. 25861 Z Date JULY 9 99 Permission is hereby granted to: CURTIS F DAVIDS 215 GREENHILL LANE GREENPORT,NY 11944 for CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR & TO CONDITIONS OF THE ZBA #4711 DATED 7-1-99 . at premises located at 215 GREEN HILL LA GREENPORT County Tax Map No. 473889 Section 033 Block 0002 Lot No. 048 pursuant to application dated MAY 14 99 and approved by the Building Inspector. Fee $ 75 .00 AuthorijWd Signa re ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD R 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 17 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 pl70� rms� �' r?B. For existing buildings (prior to April 9, 1957) non-coes, or buildings and "pre-existing" land uses: 2 �Q��1. Accurate survey of property showing all property libuilding and unusual natural or topographic features.2. A properly completed application and a consent to ied',bythe applicant. If a Certificate of Occupancy is denied, the Buildir shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - .25q. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date . �! /M/.,,56. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .. . . . . . . Old Or Pre-existing Building. . .! . . . . . . . • Location of Property. . . S. . . . . . . . . . . . . . .6?elrF v . . . . . . (. . ..* * *tn . . . . . . . . . . House No. n Street Hamlet Onwer or Owners of Property. . Ud� IS :r. . .. . ..�./. .. . .. . . . .. . . . .. . . . . . . . . . . . . . . . .. . . . . ... . County Tax Map No 1000, Section. . . . . . . . . . . ...Block. .. . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.4q:5 .ge.( . . . . .Date Of Permit. . .`. (` 5. . . . .Applicant. . .�� M�• • • • • • • • • • • • Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . . . . .. . . . .. . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT O��c • S �o3� � -- ----------- j" INSPECTION REPORT A _ XMATION ( IST) N r„ N N OUNDATION (2ND) _ N II _-- N N OUGH FRAME ti C Ut PLUMBING H I U N U 'OFSULATION PER N. Y. N H STATE ENERGY u r CODE n q It N � u H N u A p � / FINAL �1 0 ADDITIONAL COMMENTS: I H 0 H z � M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ;71NAL SU ION FRAMING [ [ ] FIREPLAC CHIMNEY &d/;�� DATE / INSPEC 765.1802 BUILDING DEPT. INSPECTION [ 1, FOUNDATION IST [ ] ROUGH PLBG. [ ! INSULATION] FOUNDAT ON 2ND [ ] [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE B g f� INSPECTOR /� TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; May 24, 1999 . . . . . . . . . . . . . . . . . . Curtis Davids To . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 Greenhill Lane . . ... . . . . . . .... . . . . . . . . . . .. . . . . .. . . .. . . . ,Greenport NY 11944 .... . .. ...... . . .. . . .. .. . . . . . . . . . ... . . . . . PLEASE TARE NOTICE that your application dated . May 10 lig for permit to construct a deck addition .. . ..... . . .... .... . . .. .. .. .. . . . . . . . . . . . . ... . . . . . . . . . . . . . . at Location of Property 215 , ,, ,, Greenhill Lane Greenport. _.__._... .. ...... . .... .... .. .. .. . . . . . House No. Street Hamlet County'Taa Map No. 1000 - Section ..33 ---- -- BLOCK .?.... ..... LOT . .. 48 .. .... . Subdivision „Eastern,Shores. ... . .. .... .... Filed Map No. . .. . . . ...Lot No.1ZA . . is returned herewith and disapproved on the following grounds that.the.proposed deck . _. addition encroaches on the rear yard setback. Under Article %%IV, Section 100-244 . .. .... .. . . .. .. .. . . .. . . .... ...... .. . .. . . . ... . .. . ... . . . ... ... . ..... . . . . ... . .. . nonconforming lots require thirty five (35') feet for a rear yard setback. .... . . . . .••• .. .. . ... .. .. . ••• • . . .. ... . . .. . . .. . . ..._.. .. . . . . ... . . . .. . . . . .. . . . . ( 19514.88 S.F. - nonconforming in a R40 zone.) .. . ... .... .. . . . .. . . . . . . . . . . .. .. . . .. . ... .. . . . . .. .. . . .. . . . . .... . . ...... . . .. . . .. . . .. . . . . .. 35' required . .............. . ... . . ... . . .... .. •••• •..... .. . ... .. . . .. ... . .... . . .... .. . ... .... . . . . .. . . . 'ii; proposed ................... .... .......... .•.... .•...•...••• .. .. ..;. . ..... ........ ...... .. .. .... 7' encroaches ............................. .... ...... ........ ..-• •• •• •••. ...... . ....... .......... .. .. . +/- 14Z lot coverage ................... .... ...... .. ...•........ .. . •••• •••••.. .... ...... .. . ... .. .. ... ... .. .. . ........... .... . . . . .. . . . . . . .. . . . . .. .. .... . . . . . . . . .. . . . . . . . . .. . . . . . . .. . . . . .. .. . . . . . . .. .. . . . . . . . . . . . �/ . .. .. . . .. . . . . BUILDING INSPECTOR Michael Verity RV 1/80 � w p r ry: ,- W0 F j nizLAJ co00 a� WQ 2 = iwW � ! a O < 1° z s � � ~ �cOi�Ozperi �• sN LL Zuj = UJ r &� o aQQ 07wt--A ccrIL I- vzj) 0 6CS m01 s[� ,JC)ZO0z0 c#i� Oow yR cn r r� N z W V W W O Q y�j�(D 4 RLL IM JWQOF* w®a J = t- OW Q 66z �.LL oies.r ar- wQ W RBSC ROUTE 25 OREENPORT, NY BILL OF MATER TALf I-UMBER CUSTOMER: ('IIRT DAVID S DATE : 05/04/')0 REF : 9')120164 . ZIP SALESMAN # DUCKY ----- -- -- -- - - -- - -- - - - -- ----- - - --- - - - ----- COMPONENT SKU QUANTITY DESCRIPTION WOOD TYPE --- - - - - - - - - - - - - - - - -- - - - -- - - - --- ------ ----- - ----- -- -- - -- DECKING 654X06X10 130 EA 5/4XGX10 STK CONST CEDAR APRON FRAME 702X04X16 10 EA 2X4X16 CCA APRON FRAME 702X04X10 2 EA 2X4X10 CCA APRON FRAME 702X04X14 1 EA 2X4X14 CCA RAIL CAP 62X0GX12 8 EA 2X6X12 CONST CEDAR HORIZ LOWER RALLI > 62X04X12 15 EA 2X4X12 CONST CEDAR HORIZ UPPER RAJIL 61X0GX12 8 EA 1X6X12 CONST CEDAR RAIL POST 64X04X12 7 EA 4X4X12 CONST CEDAR STAIR POST 64X04X16 1 EA 4X4X16 CONST CEDAR STAIR STRINGER 702X12X10 2 EA 2X12X10 CCA STAIR TREAD 654X06X08 6 EA 5/4XGX8 STK CONST CEDAR BEAMS 702XIOX20 10 EA 2X10X20 CCA JOISTS 702X08X10 7 EA 2X8X10 CCA JOISTS 702X08X12 7 EA 2X8X12 CCA JOISTS 702X08X14 1 EA 2X8X14 CCA JOISTS 702X08X08 28 EA 2X8X8 CCA FASCIA 62X08X10 2 EA 2X8X10 CONST CEDAR FASCIA 62X08X20 1 EA 2X8X20 CONST CEDAR LEDGER 702X0BX20 4 EA 2X8X20 CCA LEDGER 702X08X08 3 EA 2X8X8 CCA LEDGER 702X0BXIG 1 EA 2X8X16 CCA STAIR HAND RAID- 62X06X16 1 EA 2X6X16 CONST CEDAR HORIZ LWR STAIR RAIL2X4X16 62X04X16 1 EA 2X4X16 CONST CED HORIZ UPR STAIR RAIL1X6X16 61X06X16 1 EA 1X6X16 CONST CED GROUND POSTS 704X04X12 3 EA 4X4X12 CCA ---- - - - - - - -- - - - - - - - - - - - - - --- --------------- - ----------- - - - ---- - --- -------- - BILL OF MATER l AI_t3 I )THER MATERIALS CUSTOMER : DAV I Rt, DATE : 05/04/')') RFC' : ')" 1.20164 . ZIP SALESMAN 4 BUCKY -- - - ---- - - - - - - - - - - - ------------- - - - ---- - - --- - --- COMPONENT SKU QUANTITY DESCRIPTION -- -- - - - -- - - - - - - ------ -- - ---- --- - - -- - - - - -- ---- - ---- - ------ - ---- - JOIST - - - - ------ -- - ---- --- - - -- - - - - -- ---- - ---- - --JOIST HANGER , - IN 40242 70 EA JRS 2X8 HANGER JOIST HANGER 1,1/\ I-IS 50275 3 LBS 1-1/2 JOIST HANGER NAILS 3 . 5 IN NAILS 50055 1 LBS 16D GALV NAILS 2 . 5 IN NAILS 50049 10 LBS 8D GALV NAILS 6IN LAG SCREW 861260L 39 EA 1/2"X6 " LAG SCREW 1/2IN WASHER 8612W 211 EA 1/2" WASHER TIE DOWN STRAI 40239 77 EA RT12 TY DOWN JR 2X8 PRIV PT 28140F 13 EA LATTICE 2X8 PT. PRVCY 6IN BOLT 861260C 50 EA 1/2"X6 " CARRAGE BOLT 1/2IN NUT 8612N 86 EA 1/2" GALV NUT 8IN BOLT 861280C 36 EA 1/2"X8" CARRAGE BOLT 4IN CAR PORT PlIKT 40264 18 EA WA44 4X4 WET POST ANCHOR 2 IN NAILS 50045 1 LBS 6D GALV NAILS 8IN SONO TURF 22926 5 EA 8 "X48" BUILDERS TUBE CONCRE'TE, 80I,P• 2223 24 BAGS 80 LB GRAVEL MIX 3 IN NAILS 50051 3 LBS 10D GALV NAILS --- - - - - --- - - - - - - -- - - - - - - - - ----- ----- ------------- - - - - ---- - --- --- - --- - - -- BILL OF MATER I ,�I,. � CUSTOMER : ' 'ITT )AVTll`,' DATE : 05/04/`P) REF : `)') L20164 . ZIP SALESMAN 4 PIJC'KY ---- - - - - --- - -- - - - - -- - - - - -- - - - - - -- -- - -- SUMMARY LUMBER MATERI ! .; ?787 . 78 OTHER MATERIA,!:,! 606 . 51 TOTAL '1394 . 29 (590 . 00 SQ FT, $5 . 75 PER SQ FT) WOOD TYPES 114 DECK DECK PLANKS CONST CEDAR STAIR TREAD CONST CEDAR STRINGERS t 'C7\ JOISTS CCA FASCIA CONST CEDAR LEDGERS n BEAMS (''CA GROUND POSTS C('A RAIL POSTS ("ONST CEDAR RAIL CAPS CEDAR RAIL SPINDLE; CONST CEDAR OTHER RAIL MEMPE'RS CONST CEDAR ----- - -- - - - - - - - - - - - - - - - - --- ------- -- - - - - - -- -- - --------- --- ---- - --- - -- - TO COMPLETE ':' R DEC'N THE FOLLOWING TOOLS ARE REQUIRED: CIRCULAR :'/Vq HAMMER CRESCENT WRENCH CHALK LIPF; RAFTER SQUARE 2 ' LEVEL CEMENT TROWEL MEASURING TAPE SHOVEL WHEEL BARPOW BRACE & BITS 'STRESS ANAL\ :; CUSTOMER: G`I' DAVFD DATE : 05/04/`)', REF : `)'a120164 . ZIP SALESMAN It P.i i 'I 7 -- --- - - - - - - - - -- - - - - - - - ----- ------------------ - -- MEMBER 'PRESS FACTOR COMPOSITE TYPE SI 1'1;r'TOR LOAD LOAD ---- - - -- - - - - - —- - - - ----- ------------ ---- -- - - - JOISTS , DI;I LECTION 193 PSF 1 f ! ! RFT NDING 152 PSF III;AR 150 PSF ( ''IMPRESSION 247 PSF 150 PSF BEAMS 2 DFP'LECTION 180 PSF PENDING 76 PSF f 111PJ1R 71 PSF C(IMPRESSION 263 PSF 71 PSF BOLTS I./ 1790 PSF 1790 PSF POSTS 4XI :;T/\I3ILITY 360 PSF 360 PSF - - - - - - - - - - - - - - - - - - - - - -------- uTAL LOAD 71 PSF DEAD LOAD 10 PSF IIVR LOAD 61 PSF ------- - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - -- - - - -- - - ----- STRINGER - - - - - - - - - — - - - - -- - - - -- - - ----- STRINGER 2X1. . DEFLECTION 1471 PSF BENDING 598 PSF t,IIFAR 360 PSF COMPRESSION 1160 PSF - - - --- ---- -- - ---- ----- --- -- - ---- 1'()TAL LOAD 360 PSF DEAD LOAD 10 PSF LIVE LOAD 350 PSF - - - - - - - ---- - -- - - - - ---- STRINGER 2X1. DEF1,ECTION 1471 PSF BENDING 598 PSF >11EA12 360 PSF COMPP.ESSION 1160 PSF - - - - - - - -- - - - - - - - - -- - - - - -------- TOTA L LOAD 360 PSF DI'sAD LOAD 10 PSF M VE LOAD 350 PSF PLAN UIEb4' CUSTOPAEP -- OURT Dk.VIOS ROUTE 26 04TE 05/04/33 REI" 991:016421P GnEENPOnT. NY I i t= psi a +• 20, LOAD W SUPPORT: Your deck wil support o GO PaF live land. Posts have r�6" btlaw-�roun�rl port nupporl - DECr dl'k7 POST HEIGH i You selected o height of 20' from the kap of decking to level ground. Thv top of 91v deck m pport poste will thwefore be 11,25" ubave ground level Your ealvup4runn ran provid♦ infarnoim far uneven ar vtaped ground JOISTS: s3fo joints on top of beams. IV crntar to center_ NOTE, Tlx- de<zign may require knee braces and bridging hetwfen joiats. You materials eat incbdea the nvcrusary itamu. The ouggeuted deaign is not o finnkaW buildirrg Plan. You are respwrerble for oA mcovu+r4msnhc being corrert, for verifying that the design land any subvttitutianv ar modfications that ,you rrnrkel meets all loco building codes and requirements. To vuify thot the suggested design, and my r Ubf;f tulicna or mndifications, is consistent with conditions at the construction mite, review tho dosign with you architect. Alec saneutt your architect for proper construction and use of mat"AG m the etrurture B4 mLw* to follow the cluck cormtruction dotal available from you stare salcsperv+an. OUT LIQ i Ag�� CUSTOMER -- CURT DAVIDS ROUTE 28 DATE 36/0A/99 RFF 99120164.ZIP CREENPORT, NY Ire !�t I-. 1„ IG•1 . ILI r I F H t G rn LABEL I.ENGTN BEWLS LABEL LENGTH REVELS p ;r:;:a t, '_,, _ -•ra' J cap ]U' 4 1/2' FO S43 E 1rr,_ r .1.4: 5' U L,'4' 1 SGC t.lnn 4' 9 1/4' 1.: jrir_ I 1:1 4' 1..' V cap ]t3' 5 112, F45 S45 ri F p Ii 1C1' k: _.Minn 4' 7 1/8' D 1edcr_r L t_np 1' 2' F45 Sr E loch-f-.4- 19' M cop 5' 5 112' Fi'1 S.45 F F'n=r n 1[I' M Tec+.ion 4' 7 112' F 1s'lr,_i 4L. t enp aD 9v F45 S45 C, jc!clI :r- M cc:C+.Tond' 1tI 11-1 H F'n-rin 21=1' 0 t_op, `;i' 5 1/2' F45 SO H l EiL'.: ' ?' 1- '•. 4' U =.ac#ton 4' 7 112' 1 F cop F <n,_+Yon 5' 3 1/4' BEAPA LAYOUT RBSO CUSTOMER - CURT DAVIDS ROUTE 25 DATE t76/u/99 RFF 99120164.71P GREENPIORT. WY F 1 112, 1' G -14 C Is G• BEAM BEAM P0-8T POST LABEL LENGTH COOT SpAci+1G A 38' 4' B 7' 8 5}I6' B Na' 1 lit' 4 w 3 5116' G of fl' 4 6' b 13/16' D Al' 9' d 6' E 13.116• ray ra moa -k rater, Depth of concrete foo m -- a� inches. ni ronawwNl.,�wPfwi7`4 . ' m ;.a�msas.w..wtar � ��wwl!�� [ //}}fir ••7p�yl.l�lhNiPiwll Pr J � JJ ! .w!•.WNaq. ' 1 � I ...ate!!-ikYPllAlrlPn/�r-�- - .� r • i - c'--yy p�wrwnPldAPRt]P� •.' + � 14.58 OZ iC�E. _ �3£'ztJ ' '�=:.=.. lb,.tllP f✓..PI P.3. �'. V Y•M_..T':siw:]yiasoallOPl�P�r .F in Ln fie t sic I 471nen GIZ P• Aa gu ' SCA LEi 40 -1 LLl ul If •v � y WROTE -Ct 4 yyy ' - , . . '. :r:'_V:,r •. �..:. j:.�S4..�N r'w S_i i,:. `•�s`..,-s,r "'! '" `yr _ -• .>j.:` � �� a `. ;1'..�� _ Q m,i M .•xx.:o•a., -Esc•:•..� _. '-c.:•�-...:��sa'3 � 4APPEAIS BOARD MEMBERS gwJFFO(,� co Southold Town Hall Gerard P. Goehringer, Chairman =� Gam` 53095 Main Road James Dinizio, Jr. o P.O. Box 1179ti Z Lydia A.TortoraSouthold, New York 11971 Lora S. Collins d� 0!� ZBA Fax (516) 765-9064 George Horning 0( �`a Telephone (516)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JULY 1, 1999 Appl. No. 4711 -CURTIS DAVIDS 1000-33-2-48 STREET & LOCALITY: 215 Green Hill Lane, Eastern Shores Lot 123, Greenport DATE OF PUBLIC HEARING: June 24, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 19,500+- sq. ft. in area with-150 ft. frontage along the westerly side of Green Hili Lane. The lot is known as Lot 123 on the Map of Eastern Shores and is improved with a single-family dwelling situated 54 feet from the front property line and 38 feet from the rear property line. BASIS OF APPLICATION: Building Inspector's May 24, 1999 Notice of Disapproval, stating that the 35-foot rear yard setback required under Code Section 100-244 will be violated by applicant's proposed deck with 28 ft, setback from the rear property line. AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance for a 10 ft. extension of the existing deck addition. The extended part of the deck is 10 ft. by 20 ft., leaving a 28 ft. rear yard setback at its closest point. (This May 24, 1999 Notice contains no other reasons for disapproval requiring a variance.) REASONS FOR BOARD ACTION DESCRIBED BELOW: On the basis of testimony presented and personal Inspection, the Board makes the following findings: 1) Applicant's house has a small rear porch 10 feet deep that applicant wishes to expand to a deck 20 feet deep. The house has a front yard setback of 54 feet, which is substantially greater than the Code requires (35 feet). Consequently, the rear yard is relatively shallow and a rear yard setback variance is needed for a deck of reasonable size. 2) Grant of a variance authorizing construction of an open deck will not produce an undesirable change in the character of the neighborhood or detriment to nearby properties because the deck will be consistent with neighborhood character and will be well shielded from the neighbors. 3) There are no factors present to suggest that grant of the relief set forth below will have an adverse effect or impact on physical or environmental conditions. 4) The grant of the relief set forth below is 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 community. RESOLUTION=1170N: On motion by Member Collins,seconded by Chairman Goehringer, it was RESOLVED, to GRANT the variance, as applied for, subject to the CONDITION that the deck shall remain Page 2 -July 1, 1999 ZBA Appl. No. 4711 - Curtis Davids Parcel 1000-33-2-48 at Greenport open to the sky. VOTE OF THE BOARD: AYES: Goehringer, Dinizio, Tortora, Horning, Collins. This Resolution was duly ADOPTED by unanimous (5-0) vote of the Board. /'��i GERARD P. GOEHRIN ER, CHAI AN a BOARD OF HEALTH . .. . . . . . . . . . . . . FORM NO. 1 X 3 SETS OF PLANS . .. . . .,. . . . . . . .. TOWN OF SOUTHOLD )SURVEY . . . . . . . . . . .. .. .. . . . . . . . . BUILDING DEPARTMENT X CHECK . . . .. . . . . ... .. .. ... . . . . . . TOWN HAIL SEPTIC FORM . . . . . . . . . .. .. . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY:�1 �7 CALL :4 . 1 1 Q.1 U?—. . . Examined.. 19. r� MAIL TO: . . . . . . . . . . ..•:-•.., cwt � . . . . . . . . . . .1... 19 Permit .................................... .. . .......... yy Disapproved a/c ..I!.. ........................ � r �, � a , 1"i;"",�._.._, ....n.....�..�. - (Huildi Ie- tor)/Z;�� n(1 141J9� ;�. �� , APPLICATION FOR BUILDING PfiRMIT _1 Date. . . . . . . . • , :,=-r,'' '-`=SOLD INSTRUCTIONS a. ibis application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector witt 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAIL+ to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal 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 buildi for noes "' 1,iinspeec�tions. .................... (Signature of applicant, or name, if a corporation) y .fu.S-ce) MWF .. � �.yY.. ..� :y.... (Mailing address of applicant) State whether applicant is carer, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. D CtI N K ..................../................!........................................................ Nameof owner of premises ..S (>R t(S ._IJ .... ................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's 'License No. .................... 1. Location of land on which proposed work will be done.............................................................. .....Z 5....................G? 4,4ti a"1 ...................... ................. House Number Street zHamlet county Tbs Map No. 1000 Section ... 'art........ Block ..a........... Int ..1�.......... �-y z Subdivision ............... Filed Map No. ............... Int ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... !q .................... Mtt4Tt a"P,'r tYtiS eJ �°1jJ�1`8} " b. Intended use and occupancy ..................................... Y'r .R Y :t s t Sl..... r 3. Nature of work (check wluidn a icable): New Building ........ Addition .......... At Repair ............ Removal .�✓....... Demolition ............ Other Work .................................. L/�� , (Description) 4. Estimated Cos ( F'......}........ fee .............................................. (to be paid on filing this application) 5. If dwelling, nmber of dwellinglumits ............ Number of, dwelling units on each floor ................ Ifgarage, number of cars .....1................................ 6. If business, e®nercial or nixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. beiight ........................ Nrmber of Stories ...................... Dimensions of same structure wi h alterations or additions: Front ............... Rear ............... Depth .................... Nei It .................... Number of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height .........................!, Nuvber of Stories ..................... 9. Size of lot: Front ............i,........ Rear .................... Depth ...............:..... 10. Date of Purchase ..............I,...... Name of Former Owner r....................................... 11. Zone or use district in which p"ises are situated ........................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES NO 14. Names of Owner of premises ....�,...................... Address .............................. Phone No. .............. Name of Architect ..............I...................... Address .............................. Phone No. .............. Name of Contractor .............L..................... Address ...............................Phone No. .............. 15. Is this property within 300 feed, of a tidal wetland? * M .......... NO .......... *IF YES, SOUMD WM TROSII;ES PEMIT MAY BE WAQMRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and lock nwber or description according to deed, and show street names and indicate wbether interior or corner lot. I a� I roE 4/°' 4 soac race NovbC* smms of NW YORK, OORNIY OFFAot SS .............. li .... ..................being duly sworn, deposes and says that be is the applicant (Nage of individual signing contract) above named, C Ileis the .....51(Cantra..... agent.co:..................................................................... rate officer, etc.) 7 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 cork will be performed in the 'manner set forth in the application filed therewith. Sworn IIdt(obejgre methis ,��//�� q ......L 1.......... y of .I...I�....1,....19...9.1. Notary Publiq lE(Y UU ............ .444.///..................... (signature of Applicant) LYNDA M. FIN NOTARY PUBLIC,Sttte Of NtIwVIMk No.018O8020932 Qualified In SuNQIk Countlyy� Term Expires MarI ch 8,20(J( BUILDING PERLMIT REVIEW CHECK LIST Applicant/ Date Owners Name: dnx- Reviewed: 17fforY Z y 1�p9 Architect/ Date Engineer: Submitted: SCTM#: District: 1.000 Section: L Block: Lot: ` Project /sy��C�� Subdivision Location: l/�'a Name: Single&separate Required certification: i) Req. !� Req. Zoning District: f`� [Lot size: �V Actual: S��• (Lotcoverage 4g?'O Proposed: �p OF Req. Req. Req. Y [Front Yard Proposed: [Side Yard Proposed: 1 [Rear Yard S�Proposed: Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N. / NO YES Number Suffolk County P Health Dept. v New York State D. E. C. Town Trustees / Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? X, Flood Zone: Notes: