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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27301 Date: 09/11/00 THIS CERTIFIES that the building ADDITION Location of Property: EAST HARBOR FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Nap No. 473889 Section 4 Block 4 Lot 16 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 1998 pursuant to which Building Permit No. 25506-Z dated FEBRUARY 1, 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 GARAGE ADDITION WITH SECOND STORY LOFT AREA AS APPLIED FOR & AS PER ZBA #4640. The certificate is issued to ROLLA CAMPBELL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-535245 08/31/00 PLUMBERS CERTIFICATION DATED 08/09/00 A.JOHN GADA ut rized ignature 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. 25506 Z Date FEBRUARY 1, 1999 Permission is hereby granted to: KIM K CAMPBELL 8965 SE BRIDGE RD HOBE SOUND FL, 33455 for CONSTRUCTION OF A GARAGE ADDITION WITH SECOND STORY LOFT AREA AS APPLIED FOR. ZBA #4640 . at premises located at EAST HARBOR FISHERS ISLAND County Tax Map No. 473889 Section 004 Block 0004 Lot No. 016 pursuant to application dated JULY 27 1998 and approved by the Building Inspector. Fee $ 139 .00 Authorized Signature j ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPA1ZT?fEN,r TOWN HALL SOUTHOLD, NEW YORK 1 197 1 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE_-Z-. _ . _ . _ . . NEW CONSTRUCTION . . . . . . .OLD Olt PRE-EXISTING BUILDING. VACANT LAND. . . . . . . . Location of Property. . . . . _ . _ ../�gr_ . �! ?b `�1 HOUSE NO . STREET -HAHLET Owner or Owners of Property. -: i;1-'c ,�,,O�A�'1?$it-!— County Tax Map No . 1000 Section Block _ _ 4- _ _ _ Lot . 14P. . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . Filed Map . . . . . . . . Lot . . . . . . . . . . Permit No . Z5SQ1P7,.Date of P c r m i t: Z: j .ci AppIicant -�3T_ .1�4CKC�$l�,. ,}`. Health Dept . Approval _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Underwriters Approval . . . . . . . . . . . . . . Planning Board Approval . . . . . . . . . . . . . . . . Request for Temporary Certificate Final Certificate . . . . . . . . . . . . . . . . Fee Submitted : $ „� : OQ , , , _ „ • _ • , A1'P/.ICANT. ���1/. ; . . . . . . . . . . . . B,ncmol 111 y rev. 10/ I4/88 (3-,v 58HK6 Co -E7a� 50) -Ao g�yfFD1 �COG� Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 r v Telephone (516) 765-1802 Southold, New York 11971 v ,y O�>✓ OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: 8' 9 -00 Building Permit No. Z 5'p(o Owner: 1-)0.. 12.Q"A CAMPBELL.. (plea�3e '.print) Plumber: 4• �011!✓ 6/104 f (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of r Notary Public, County �� V-A-XI'y BD IbESIGN INC. I�{r, TRA-NSS!M=ALSHEET Q TO: _� FROM: COMPANY: V DATE: PHOh E: FAX- C)Z AX:OZ RE:` ITOTAL PAGES(mdudmg cover sheet): Y2rw�1 i # Z 5 S D Co - 5 URGENT _ FOR REVIEW _ PLEASE COMMENT _ FOR APPROVAL NOTES/COMMEN S: ' ,�,pp�ie�tt3Y'1 �er C2r�i�iC4�'t o� �Ccu�� • Sold.e,r Cer-ki�siea.,�-icrn • C.�ck Sio r �z5 , oc� BOX 447 FISHERS ISLAND,NY 06390 PHONE 631.788.7919 FAX: 631.788.7192 APPEALS BOARD MEMBERS gUFFO(,l eoG Southold Town Hall Gerard P. Goehringer, Chairman =� 'y` 53. Main Road C2 P.O.O. Box 1179 James Dinizio,Jr. as x Lydia A.Tortora � Southold,New York 11971 Lora S. Collins yy� ��� ZBA Fax(516)765-9064 Telephone (516)765-1809 George Horning BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 21, 1999 Appl. No. 4640— KIM CAMPBELL PARCEL 1000-4-4-16 STREET & LOCALITY: North Side of East End Road, Fishers Island DATE OF PUBLIC HEARING: December 10, 1998 and January 21, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The subject property is located along the northerly side of East End Road, Fishers Island, New York, with frontage along the Fishers Island Sound. The property is improved with a single-family dwelling containing a total acreage of 3.99 acres and is located in the R-120-Residential Zone District. BASIS OF APPEAL: The Building Inspector's August 27, 1998 Notice of Disapproval. Under Article III, Section 100-32 the proposed front yard setback is shown at less than the 60 ft. code requirement. AREA VARIANCE RELIEF REQUESTED: Applicant is requesting a setback from a private right-of-way which extends through his property, in the front yard. The proposed westerly front yard setback at its closest point is 8 ft. for an addition to the dwelling. For the record it is noted that applicant's westerly property line is located further west of the right-of-way and abuts the Fishers Island Development Corp. golf course. The neighbor's driveway and right-of-way area shows access to the lot further north to CTM Parcel 1000-4-4-15. REASONS FOR BOARD ACTION, DESCRIBED BELOW: (1) The granting of the area variance will not produce an undesir- able change in character of neighborhood or detriment to nearby properties because applicant's property is 4+- acres located within an R-120 Residential Zone, and with the exception of one property currently owned by Balcolm, applicant's property is surrounded by Fishers Island Sound and Fishers Island Club's golf course. (1) The benefit sought by the applicant cannot be achieved by some method, feasible for applicant to pursue, other than an area variance because the close proximity of Fishers Island Sound limits the applicant's ability to locate any addition to the existing premises. Page 2—January 21, 1999 ZBA Decision—Appl. No. 4640 Re: Kim Campbell/1000-4-4-16 (2) The requested aeiea variance is not substantial because the close proximity of a 20-foot private ,right-of-way owned by the applicant is the only reason for a variance, said right-of}way exists only for convenient access to one neighbor (Balcoim) and actually joins a right-of-way on Campbell's western property line which also provides the Balcolm parcel with another access to their property. (3) 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. (5) The alleged difficulty has not been self-created because it is related directly to the characteristics and layI ut of the land and buildings. In considering this application, the Board deems this action to be the minimum necessary and adequate to preserve and protect the character of the neighborhood, and the health, safety, welfare of the community. RESOLUTION/ACTIN: On motion by Member Horning, seconded by Member Tortora, it was RESOLVED, to GRANT',the variance, as applied for. VOTE OF THE BOARD: AYES: E GOE R C IRMAN), DINIZIO, TORTORA, COLLINS, MORNING. GERARD P. GOEHRINGER CHAIRMAN For Filing 1/75/99 1000-4-4-16 F Sol 1-1.110 I'll Il(.III,I)ING 17fI'�R'1'i\II:N'i' TO WN CC.ER K'S Urt°iCli SOI!'R10I..17. N.Y. NOTICE Or01SAITRovnL Dnle f lk //t . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLEASE- TAKE NOTICE llml ynnr appllcattrm dnlyd . . .� (!t / . . . . . . . . . .. Io for pennil to C/W,, St° d' e . . . . .: . . . . . . . � . . . . . 1 /f✓� "� � 1 °.�j ,,,.�^ e . . . Location of Properly . .�-�'S✓_� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .✓."r';Sdv��q����,+..J h(nu,<e Nn. Swenr Unml f Comity I'nx Adnp No. IUQg Section . . . . . . . . . . Muck . . . . . . . . . . Lot . t14. Snhdivi,lion . . . . . . . . . . . . . . . . . riled Mnp No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . . . . is rchn•nrd harcwilh nail di,lapplovcd on (lie fnllmviuv Irrounrle . . .�� � � . . . .,� . . . ./.�-r✓r. . .y. �. . . . .��=. I�:. . .�= . . .�1�. .',.fir. : . . � �- j�. . . .� '. . 1 6v - 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . .. . . . ... .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t3 i..l r3 ng' Lisp?cl:nr liv [ /fig i January 26, 1999 Stephen L. Ham, Esq. 45 Hampton Road Southampton, NY 11968 Re: Appl. #4640 — Kim Campbell Addition (Variance) Dear Mr. Ham: Enclosed please find a copy of the Appeals Board's determination adopted at the Board's January 21, 1999 meeting. A copy was also faxed to you for your convenience yesterday. Please be sure to follow-up with the Building Department regarding possible issuance of a building permit and any other agency approvals that may be necessary before commencing construction activities. A copy of this determination has been furnished to the Building Department for placement in the building permit application and update. Very truly yours, GERARD P. GOEHRINGER CHAIRMAN Enclosure Copy of Decision to: Building Department Original Decision filed with Town Clerk's Office FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: Augu . . st 27, 1998 . . . ... . .. .. . . . . . . .. .. .... . BD Remodeling 6 Restoration Inc. To . .. . . . .. . . .. . . . . . . . . .. . . . . . . . . . . . .. . . ... P.O. Box 477 .. . . .. .... .. . . . . . . . ... .. . ... . . . . . . . . . . . . Fishers Island; New York 06390 ,,,, , , , .. ..... ...... .. PLEASE TAKE NOTICE that your application dated ... .Suly.7. .. ... . .. . 1998_ _. _ for permit to construct an addition to an existing dwelling ,,, , ,, , , ,, ,, , , ,,,, , at . . . . . .... . .... Location of Property East Harbor „ Fishers,jpjppd.. .. .. . . . .. .. . House No. Street Hamlet County'Tax Map No. 1000 - Section . .4 . ... . .. BLOCK .4... . .. ... LOT .16....... .. . Subdivision . . .. . ..... . . ...... .... .... . .. . . Filed Map No. . . . ... . ..Lot No. .... . . . is returned herewith and disapproved on the following grounds . ...... . being located on a lot in an R_40 District is. required, rp,baye.a.ir9ur.yard.setback.of. .... . 60 ft. . Pursuant to Article III,, Section ,IOQ—V .. .... . . . . . .. .. .. . . .. . . .. .. .. .. .... . . . . . ... . .... . . . . .. . . ..... .. . . . . .. .. . .. .. .. ..... . . .. .. . . . . ..... ..... ..... . . . . . . .. .. .. .. ... . . . ... . ... .. . . ... .... . . .. ...... .. . .. ... ...... ... .. .. .... . . ...... . ............ . ..... .. .. .. . . .. ... . ... . .. ... . .. .. ...... . . . . ..... .......... .. ...... . ............. . ........ ......... .. ... . ... ... . .. .. ............ .. ........ .. . .... ....... ....... .... .. .... . ..... . ... .... ..... .... ....... .. . .. .. .. .. ... ... . . .. .. .. . . .. ..... ..... .. ... .... .. . . . ... .... ..... . ........... .. .. . . .. .. .. .... ... . ... . .... . . .. . . ............ ... ..... ......... ... . . . . ..... ...... ..... ... .... .... .. . .. . . . . . . .. ......... . ....... . . . .. .. .. .... . ... ..... .. .. ...... .. . . . ..... .... .................. .. .. .. .... . ... . ... . . . ... . ..... . . . . . .. . ... . . .. ... .. .. .. . .. ... .. . . . . .... . . ... . . ... . .. . ...... .. .. . . .... . . . ... . . .. . . . . . . . . . .... . . . . .. . . . . . . . . BUILD110IN6PECTOR RV 1/80 BUILDING PERMIT REVIEW CHECK LIST Application Name: b)yV\?Pu"1-, Architect/Engineer: tdTOT P\;%,& Ako ifecr Date Submitted: SCTM #: District: 1.000 Section: Block: _ Lot: he Subdivision Name: Req. Req. Zoning District: [Lot size: Actual: ] [Lot coverage Proposed: ] Req. Req. Req. [Front Yard Proposed: ] [Side Yard Proposed: ] [Rear Yard Proposed: ] Project Description: C---446261 46261 "7 Lot T AGENCY PERMITS 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: 40ML Town Planning Board approval: Flood Plane Elevation ??? v Flood Zone: Notes• TetAL kea I ►r7o sizIts a.�. ,2 Cn IP. ram �Il , DEC, +a 1998 BLDG.DEPTH LD ('OWN f JIp— PHILIP B.MATTHEWS (,e,z.me) STEPHEN I.HAM,]II BARBARA T.IIAM December 15, 1998 Mr. Gary Fish Town of Southold Building Department P. O. Box 1179 Southold, NY 11971 Re: Application of BD Remodeling & Restoration Inc. - Notice of Disapproval dated August 27, 1998 Dear Gary: Last Thursday I appeared at the Zoning Board of Appeals of the Town of Southold on behalf of Kim K. Campbell, the owner of premises designated on the Suffolk County Tax Map as District 1000, Section 4, Block 4, Lot 16. The referenced building permit application relating to the Campbell property was denied last August. A copy of the Notice of Disapproval is enclosed. Among other evidence I presented to the Board were the enclosed letter from Tom Doherty of FIDCO and the enclosed affidavit of Richard Strouse. Furthermore, after several conversations with draftsman Denis Gates of the Real Property Tax Service Agency and based on his research and other evidence I had, Mr. Gates deleted the "road" that formerly appeared between the Campbeil property and the golf course on the Suffolk County Tax Map (on which the Town's Zoning Map is based). ? have enclosed excerpts from the former and recently revised (as of December 10) tax maps. The Zoning Board recommended that I contact the Building Department to determine whether you would now issue a building permit for the Campbell addition based upon my evidence (now supported by the County tax map) that there is no longer a road adjoining the Campbell property on the west. Mr. Gary Fish Page 2 December 15, 1998 I would appreciate your response to my inquiry at your earliest convenience. Sincerely, 1� Stephen L. Ham, III Enclosures cc: Dr. Rolla B. Campbell, Jr. (w/ enclosures) Mr. David Beckwith (w/ enclosures) F�PM : ,FISHERS ISLAND UTILITY COMPANY PHONE NO. 515 788 7798 Dec. 10 1998 01:49PM P1 Fishers Island Development Corporation F.O. Drawer E Fishers Island, New York 06.390 Frank W. Burr Thomas F. Doherty,jr. Praiofent AranagcT December 10, 1998 Zoning Board of Appeals Town of Southold 53095 Main St. Southold, NY 11971 Re: Application of Kim K. Campbell Dear Board Members, I have been asked to respond to an inquiry concerning the status of what the Building Department of the Town of Southold has determined to be a road adjoining the Kim property next to the 17th hole of the golf course on the East End of Fishers Island. I am the general manager of the Fishers Island Development Corporation ("FIDCO"), the corporation responsible for maintaining the FIDCO roads on the East End of Fishers Island. I have served in that capacity through the 1990's and I am fully familiar with ail the roads that FIDCO is required to maintain. Those FIDCO roads are shown on the Map of Fishers Island Development Corporation which has now been filed in the Suffolk County Clerks office. The "road" extending In a northwesterly direction from the East End road that eventually branches off into the Campbell and Balcom properties is not a FIDCO road. It is not shown on the Map of Fishers Island Development. it is my understanding and belief that this "road" would be more accurately characterized as a driveway for the Campbell and Balcom properties and perhaps a service road for the equipment used to maintain the golf course. If so requested, I would be pleased to state the foregoing in affidavit form. I understand you will be relying on the truthfulness of the foregoing statements in making your determination with respect to the referenced application. FROM : FISHERS ISLAND UTILITY COMPANY PHONE NO. 516 788 7798 Dec. 10 1998 01:49PM P2 Finally, I waive notice of the hearing of that application which I understand has been scheduled for this evening at 6:45 FM. Sincere i Thomas F. Doherty Manager FRGM FISHERS ISLAND UTILITY COMPANY PHONE NO. : 516 788 7798 Dec. 10 1998 08:30AM P2 i)EC-09-1948 17:2-5 P.6 STATE.OF NEW YORK ) COUNTY OF SUFFOLK ) RICHARD H. STROUSE,being duty sworn, deposes and says: 1. 1 am a professional engineer,duly licensed by the State of New York(XX.S. License No 059363), with offices at 110 Broadway, Norwich,Connecticut 06360. 2. 1 am very familiar with the real property situate at Fishers Island,New York owned by Kim K. Campbell (SCTM No. 1000-4-4-16)which is the subject of an application to the Zoning Board of Appeals of the Town of Southold I have inspected the property on several occasions for aurvey, photography and other purposes, most recently in November 1998 when I took the photographs that are being submitted at the hearing of this application. 3. 1 have prepared sketches(a)from the existing tax map showing the area around the Subject premises,(b)from the survey 1 prepared for this application, and(c)from an older survey that shows the entire premises of the applicant. I have also reviewed deed descriptions of the subject premises and the Map of Fishers Island Development Corporation, 4. Based upon my review of the foregoing materials and as evidenced by those materials, I have the opinions set forth in this affidavit in Paragraphs 5,6 and 7. 5. Fee title to the right-of-way shown on the survey I prepared for this application is owned entirely by the applicant,Kim K. Campbell. That 20-1oot wide right-of-way provides access from the Balccm property bordering the Campbell property on the north to the main East End Road. Mrs.Campbell awns the right-of--way as well as the land to the west of the right-of-way to the border of land of Fishers Island Development Corporation(golf course). 6. In depicting a road between tax lot 12 and tax lot 16,the Suffolk Count,f Tax Map is in error. While there is a service road which serves the golf course and extends in a northwesterly direction from the main East End Road,the first several hundred feet of that road(aa shown on my sketch)are actually on the Campbell property. That"road"is not a road like the East End Road over which owners of the lots on the Map of Fishers Island Development Corporation would have rights, It is cot even shown on the Map of Fishers Island Development Corporation. The actual road is only about tcn feet wide and the right-of-way itself is only twenty feet wide. True "roads"on the Map of Fishers Island Development Corporation over which the owners of lots on the FIDCO Map would have rights generally are at least forty feet wide and sometimes are fifty feet wide, t know this because my firtk Chandler,Palmer&Kiag,was instrumental in preparing the Map of Fishers bland Development Corporation FROM RISHERS ISLAND UTILITY COMPANY PHONE NO. : 516 788 7798 Dec. 10 1998 08:31AM P3 DE 09-1�ig8 1^:24 F.o_ 7, Even if the Tax\p were accurate in depicting a road in the location shown between tax lot 12 and tax lot 16 in Block 4 of Section 4 in District 1000,the setback of the proposed addition from that road to the Campbell residence would be 75 feet. That setback would conform to the minimum required in the R-120 Zone District. I have illustrated this point in red on a print of the surrey I prepared for this application to be submitted at the public hearing. a, I make tills affidavit in order to assist the ZOndng Board OfAppe als in its determination with respect to the application of Kim K. Campbell knowing it will rely On the trudidUness hereof. Stroum Subscribed and Sworn to Before me This 10th Day of December, 1998 If S° tuy Public T140MAB P.Wmarrry JR, Notary public Siete of New York No.4608SS9 Ouellfteo In Suffolk cc-42?y Term Expires 193110tf TOTAL P,e3 THE NEW YORK BOARD OF FIRE UNDERWRITERS imc 1 1075012 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK; NV 10038 — Date AUGUST 31,2000 Application No. an fle 1951 99 /99 N 535245 THIS CERTIFIES THAT PM41T NO. 25506 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DR. ROLLA CAMPBELL, EAST HARBOR ROAD, FISHERS ISLANE,. NY in the following location; ® Basement ® 1st Fl. ❑ 2nd Fl. GAR/OUT Section Block Lot was examined on AUGUST. 25,2000 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCEN FLUORESCENT DINER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. X.P. 27 16 24 21 $ 3 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.I TIME CLOCKS BELL IUNIT HEATERS MULTI.OMUTLET DIMMERS SYSTES AMT. K.W. OIL X.P. GAS N.P. AMT. NO. I A.W.G. AMT. I AMP. I AMT. AN1P3. TRANS.' AMT. H.P. NO.OF FEET AMT. I WATTS SERVICE DISCONNECT NO.OF S E R V I _ C E METER NO.OF CC COND. A.W. A.W.p, q,W,g, AMT. AMP. TYPE E6UIP. 1 0 2W11 R JW J 0 JW J P 4W PER D OF CC.COND. NO.OF XI�LEG OF HI-LEO NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: PANELBOARDSI7.-•12 CIR. 125 BD REMODELING AND RESTOR. LIC4296-E L L PO BOX 477 FISHERS ISLAND, NY, 06390 GENERAL MANAGER Per. 11 This certificate must not be altered In any manner; return to the office of the Board H-Incorrect. Inspectors may be Identified by their c d n Is, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST,,NOT'..BE ALTERED IN ANY MANNER. , klo 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING SINAL REMARKS: DATE'' " INSPECTOR 1 Y s4 �1 BOARD OF ►IFALTO . . . . . . . . . . . FORM No. I 3 SET'S OF PLANS . • . • . • • . . ' . • . . . T N OF SOU'1'HOLD SURVEY � SUI1 )ING DFPAR•1•IIRNT CIIFCR . . . . . . . . . . . . . . . . . . . . . . . . . �.t 6 — i.r OWN UALL SEPTIC FORM . . . . . . . . . . . . . . . . . SOlrpl . . l Iol.D, N.Y. 11971 TEL: 765- 1802 NOTIFY: K CALI. . . . . . . . . . . . . . . . . . . — 1 19.V MAI 1. TO: . . . . . . . . . . . . . . . . . . . . � At>[rravedl.......2::J...... 19. 9 PenniC No. .......�...� .................................... Disapproved a/c ..7:2.1-V ..6-06µ......... .................................... .................................... ....... 4 lAuilding lnspector) A LICATION FOR BUILDING PERMIT Date!:t . . . . . . 19. Y INSTRUCTIONS a. 'Ibis application must be crmldelely filled in by typx -triter or in ink and stdxnitted to Lhe Wilding Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to sdvedule. b. Plat plan sliowing location of lot and of Ixnildings on premises, relationship to adjoining premises or txd)lic streets or areas, and giving, a detailed description of layout of property mist be drawn on the diagram wlnicla is part of this application. c. She work covered by this algalicatianPlay not be commenced before issuance of Wilding Pennit. d. tllxn approval of this appticatian, the mdldirq, InspecLor will issue a lluilding Permit to the applicant. Such permit shall be kept on Ore premises available for inspection Lhraughaut the work. e. No IxaiWing adualI be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by tlae IAuilding inspector. AFTL)CATION IS UERTBY MADE to the Iklilding Department for the issuance of a Building Permit pursuant to Lbe Building, Zone Ordinance of t e Town of: So ulimld, Suffolk Canty, New York, and other applicable laws, Ordinances or Regulations, for tlae construction of Ixnildings, additions or alterations, or for rowwal or dentition, as herein described. 'Ile applicant agrees to crmply with all applicable laws, ordinances, Wilding code, bxxusing code, orad regulations, an(] to admit authorized inspectors on premises and in Wilding for necessary inspections. -64 el ry (Signature of applicant, or name, of a cor-poration) n• (Mailing addlress of. applicant) State whether applicant is owner, lessee, agent, arclOtect, engineer, general contractor, electrician, plur er or builder. ....A+4f.............jj. ...�..................J_ Iz............................................................ Name of ager of premises .Jlf�:.L�:�I ;..�GN7'l�!rx..!.T.......................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly aauLlnri7xd officer. ......................................................... (mine and title of corporate officer) 2 Builders License No. .a: S4.9.s!...>_( ..... Plmiers License- No. .....L& 7 Electricians license No. • ........ Other Trade's License No. .................... /� G 1. lncatiom of: had on which proposed work will be done..G-`�(A�-.S &t.p4la�(.............................. ....................................................................................................................... [louse PAnier Street ,,yy Itamlet CAml.y 'lax Clap Nn. 1000 Section ...��.T........ Rlo�k .....�.,....... Int ....Lr4......... Sudxlivisidn ...................................... Filed Map No..................`: 1:aC (Nae) 2. State existing use and occupancy pf premises aux] Intended ase and occupancy of proposed construction: a. Existing, use and oeaulnrncy .......................................................... .!WCL Ge_ b. Intended use and occupancy ..•...............................:...............:.... .,,.......... ' ...... VmIIIIte of 1,xxk (dVeck 1AII(Je III i(•.uble): tkd HuII(Iing ..... ..... AMII.Ion .. .... Allerotion ..... .. ... gn)ir ............ Ilelnval .......... Damlitlon .... ........ Other Unk ............... ........ ........... ....... fee It. I:aLI11xILe1I CoCost ) O;OD (Ik.a(a'ipCioF' d�� .. .. .................. ....... . . ..... ...... ..... (to be paid un filing; this application) 5. If eha!IIinit, !miler of (haellintl unila Ihnl)er of: ilimlIIng uniIn two each floor ... .. ... ........ If (;mage, ixnher of cora ....:............ .................. . G. If Walloons, c(aro)ereial or mixr)el o:culmx:y, specify nuluke alxl extent of each type of tine......... . ..... . . ..... ( ]. Ilinensionn of: existing ntrmt-ores, if any: Front r��r........ Item .. .. ?Q........ Depth . .7�............ Ik!1 +1t ... ...................... Hini>er of Stories ....2.. ...............Dinn ' 60 .........r... lh nitersti(x1n or (xklitions: Front .... .9.4.-.G..... Rear ......... ...... ........ ✓'?�.�...... . ... Mrdier of Slorien .. ..i. Ix!p�Innions o�.Jsme etnrLr)rl�il'lht ....... Z. .. ) 2�4� (''...... Iteur ...'� ' .:.P'... .... Ileum, ..26 ll. Nhiennlons of entire new oxisl. t'1x:1:1(xn: Fro(lL ......... ..... . .... III Ik!i X11. ... .......... it of Stories . ..�.�2.. .. .. ....... 7. ;lire of 1nC: IhrNnC .....g-01..... .... Item .....3.36..... ..... Ikpth .....¢&.a........... NI. 14)Ie. of ILrchaae .............',....... Nam of Former Ocaner ..... ..... .............................. II, yANle or use districC in 1Aii(91 Inallifles Ore nitunte(I ......le-:;I 2-..o. ........... . ................... .... .. . ...... . . U. Will lot he rec000Lr 'ate any zodng Lxa„ordioao:e or regulai.ion: ...Aid.................. 17. Ikx!a propxwed constnxafon vlo ...., �q......... NiI1 excess fill 1)e re love(I frota pranisest YES ND r ,psS.�as/ Et WW act S�Fcoar 111. Noma of (mx•r of premises d a--ca pl . rkhlrens ok.S,7)o rft.Fl..�/NSA.... 11KNe Na(e of Architect' ......... Mhlresa .I�.l.lSll�..Lr.7..� "...... 11mile No Nine of Contractor ��. l -P.l. ,F.!:-C,1%,e!CL klress Q• �k.({(j�,�.�j.� . .s �S� N)o()e t*,5/-X ?i41 (U6390 15. In Ihi*e pmlx!rly within :10() feet of a tidal aaatlaol7 * YES .......... NO .......... IF YIiS S(11t1110IO ImN -lidISIIUM Itililll'I' MAY m RE()1)IIUSN. PLOT OlAGRAtt Ixx:ilte clearly nrA distinctly till Ixlildinp, iAlelher existing or proposed, roil hxlicnt:e all sel-lmk dinrnsiona ficin properly linea. Give street nail block (xr(imr or descript-Im nccording to deed, tuxi ilhoxa street nares nlxl irklicnle %AmOKlr interior or corner lot. i I ( NIA'II? (A' MII�YWK,A^ (Milly (IF .vu.l.rl/Y� !!/(.. ....... ... v”:•� ..`:. !�S.�I-lw .'T,r)...... ........... ..IKling duly mals, delxlr:es alxl ally" that be in the applicant (Nola Ilf IINIIV Idtk1l. (i{going cuntrurl') aliove orne(I, Ik! in 111c •. •�U( >nnn�nc n.ol � Y /v !t' ,! corlx) ate officer, etc.) of mild immr or ewnxn'e, nlxl In duly nolhorixed to Iterfuns or have Ix!l'InI11M!(I IIx! said Molt uIXI to rlfllt(I !11x1 Illi! Ihin "plot icuC ion! Oult: of l stmlelentm cogtsio!d in Ihin uppl icot ion ore tune to Ilse least: of bill krwwledlte 111x) but iefj nlxl Ihnl. (lie incl will be Ilerforlled lit the umoo!r net forth in the applicntion filed therewith. .. .Gf..... ........lily ( .... .i.... ... ly .,.<;J•• I � a(i9ilptacto it 1111111 is .... THOMAW1,DONR((1WJWIApplicant) Notary Plume State of Now Ygrk No,aaoease QUellliea In Sutlolk County, TIPI'M Expires/2/31/9e , •N 393000 *'^; /SL AA/p ` SOUNp ( i EC. N0. 130 I xE. Ix Fy sr 1 s 13 a I9t' q> SBO 14 zQ , N '\ fiE D �— /,O Il9 19. 1 1 .. zps 15 � W ci al T 16 p MRP $Flows l�'a pPLO .3 SHORELINE a •M. `02 12 ,A \ ,.•Nw.— 29.7 A(C) r a :,• p 2.2A ~ / ° Q. w® ^ �' ' na•' gO' �x i 'R / P•�� 90a' IQ LOA p „O O t0 fit•^^ ID lad Z 0 J 2 54 A(C) t (ORIENTAL AVE-1 W aWN aan� dNO TO0W 0, dMO 1`yO 9 RD. 12.3 A(C) f/ SHORED Q' W P GGJ� �.'. G� SEE SEC.S-EEC..�\N0. 130 \ NOTICE ITT 1 MAINTENANCE, ALTERATION, SALE OR \J 1 DISTRIBUTION OF ANY PORTION OF THE CDUNTFN TPFRMAISSION y00HIBHEEED - jse 22e 90 I 6 l + 13 47 y .�" G• 14 gPpo� e: \qe 119 \lA 0`00 �°' 15 B , �'� C; „ d Ni5W TAX I� �p MAP PtLENI \P e^°0 RoA> >, Is (-I," k&r MA � SN_ONE u H . 146.. 2,, �'� ��1 V•C _ Lam_ _ �\ ~�' a 1V '1 �P• 12.1 31.2A(c) UA FOR PCL.NO, SEE SEC.NO. pAt 80Sp 005-02-Dols 11 SRR 10,1 90 4.5A(c) 220Se (WIENTAL AVE.) S �a �6 9 O, r �h 9 RD. 12.3A(c) ,53 +3 6 HlY.U. SNOREUNE kt f� V N 389,200 / g N N W OF SUFFOLK E 13' TOWN OF SOUTHOLD SECTION NO fax Service Agency Y AAS VILLAGE OF 004 Riverhead, N Y 11901 M 003 004 200 100 P 130 DISTRICT NO 1000 PROPERTY MAP CONVERSION DATE: Jan.05,1998 i•re N �. (D t\ 1 C4 y[ r. .e. SOUND SOUND ISLAND "—J "aes83 FISHERS aeE sec xU nU _ �C�9' aff aac Nc ase �p�/ py o.eo 2o.e1 � 4 14 L"3s � M' FEP FFr.. s A , R qPri " l �6ffiPS L6< l:slq MA 8 iFP e f £ ieP qp. / in Y9Pltl '<q , � � l t ' 4a N ;. 6.OMd yL4e1 t � � P ! q xl. JIM.) e.YP N i.f/p 3Egtl vl LOq 160.0 JJA O6 eglal �� 19 1 3 S'b'a .aq xii(al e gild lW • „ �(♦� W. wPmN: v1d O 3iun 3. w�gld �1 ' IYNOEIIFIgizzeLMO) J // - (+ ♦ P i„ 21N<I v •exec p r R'QYe / / J}P E 66P T ��4 1 ' x.. poyE YSyP r saw y „ e feP s lE p EY seA eu 1 FEIIItY ( <nnue lila PpPk a¢ syc xU�m \ mmwn rax I ISLAND SOUND NNaMe ..d_ _ � �T"qf © COUNTY OF SUFFOLK +�"a SOUTHOLD xI y — tww` -- —_ n1L O P..e.flL. Real Property Tax Serviea AgeneY•lu+nepf QO(� CaUmY 6ewr wsEvcrlro. 10)0 ... ..• - Wfx. ww I Rivrh•ad,L 1.,New YUrk _ ewxcw.x. PROPE0.TY MAP i .tai: 'Y' 'R P>t. d '!uy . e "iv ; yT.".. •:k; rv4 }m„ N=r">.E, #fr as n'Cer.x fi er' M _ - `Px : '!:.'i. :7e ,G"„ 5 'S . , t''. ."' ,. ,F'r T " " 'a '.pn�i "'v': r ' '�'.k' y-.. 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EXISTING SPOT &RADE _ _ ,,,'- _ r .fi. .. �� : .: :'f .. - sv. , w 'h�l{ L : ..,-' r w Sat ' A 1 .. T: .�h n,;,, ,. : :,, , ,, II .,_ . �: _� -: : , ,' : �. ,' , ..., , , :., _�`., : � , , ,,. ...,r ::,. ,..:. � , n :, _.,. . -�., :.i \ , - 10 -" EXI5TII46 CONTOURS' .. � � � .. , '; .' � - !n 1 :. i f \� h t ., 1 + .,,� !. i.-T ' r \� �� 1� . Ib RO ED. ONTOU 5. of ! : ,' _:, � _ „ . . :nl, n,'{(k;"�9 „' I . ts. b;' i. :a ' L' -'1•-„ �3J, 59acu.� `Y' .I,,,+�' ',c " -,,. �:,".' r fl ;L� TZdbei 4l. a . ,Y:,I, ,', 1.-. . ,., - > :<o-r. ,.;'I „ r; , •-k7, , _ . „ r .z - -' - _ Y�2. 4 \ A -- 1 J: m \ \ . r+ '_" b �. r�' \\\ \ � � 4 4 t - r: : a , \ u - . ,..,,, w : '.r: , i l „�' 'd A,tup! .,,. ' s :,: /.: y. \, -i 9,. ; . {,'r.;q,, _, I r, ' ! 1 1 it \ v _ ' ` � S0, - � 1. �r }e '.r� Jnr.' .r � �\'� \� \ y u; p \{` 'd `, FF;E4$4 7,G ca::' „ .,.., : 1. .. .I 1. + >r.� $ - .,,Y:, h 3:; 1. \�,.-, , ', ._,1:1 1T ` .."'' [:. .' :,' .. ., ,y. . .. r: , 11 : ' rv1Fi, „� ,, :" Yf ! ,,1.. ,�{ �'r r s,rtc „\'�\ \ , . , - 1 lT. B$Krrtie: II',;a' „ I w i - 4,., � . F , \." \ 4-� \,_,�;� - +: 1 , I ' \\ �'_ .--_„ ` NOTES• ,: > y ' 'rt:' rye-.,.fir' _ a ry > -,. ' v 1C1, f „f :' ::' k.,1 1 :'�`.. t,' :, I,Mu, .,r ,, : .•hr'±.+.+.+I-..j,+�.3-m _ \fie -:, �- -J� •' . L:;l� . . . A . , J 'r, .::,.�, : ,,, ,, .. : .»,: „ . , '�,. d. ' SITE 15 LOCATED IN THE TOWN'OF,90UTHOLD.,•COUNTY OP Is ry . ,.I,. �. .r-a I', "�`I :F", - ,��-. 'rte qq ,-' , " ,'IF , 4 ,,, I, ::�I,Ir : 'x �, . ., / _ `SUFFOLK, TAX MAP 1000, SECTION 004,BLOCK' ,-LOT,18 a '• r d :a. { �: : . � P., -, .,,,:, :,.-. , '<' .-. �� ,.. . ..^'I '-: ..':... !={' . , . 2. '5115 LA IN Z 'DIS ICT II 2Of1 :. ,'lA „ _ ,,, . , .-.,'..::. ( W ,-, . '.,il. v 12, - �� TE OG TEG ONE. TR .R I _ ,,I a , - : ." - ., r .,, , w u,l / I d .� ! ,, ., . i �' .. .. T .r :.,':-. ,.,� � .. .; .., :.,,. I .,, � ,.,.- _ r ;,.-- : . ,, , ':;,. :: .3: OWNER��� �� ROLLAEi.� GAM. ! `"� ' . '.. . � �� .�: '' AI . ).. . . ... „ :. ,: � - .: . :m. _` Ln' ,. I� , �: ,_ �, ,I. a kJ.., . V 5.h1f( -:5 , nk"• ,. . }, y..,. . . `r : ` , , .W .- '_,'",I. ry I:.- - 26'T DUNSAR ROAD _ - "' . 7 : ,I, . . " J a,, /� : , " , i :, +„"'-',';r+PrsaS l ..;z� r 1.::,.,�r '� PALM'BF.i1CH PCORIDA 53480 ,I f 13cPo3Ba . I ',:�L ti r •n, _ - z / ' `' ,: �, : � i i ` i i . ', ' , I ... .I '. ', ' ., ,, ' :", -. u r r , . 1; , . !�.� 4. 51TE 15 5ERVIGED 'BY• 'MUNIGIPAL;WATER� AND ON 511'E : ''.'.I'' ,. ,.. . . ( . . ::e .F;^�'< z „ - N COMPL ANCE ITH' THE .STA ARDS, . : ` k.,.- ..., �: '' , . . 1 r� SEWA 5E,915F�Or5A1 1 I W . ND ',: .: . : . 1 : . ^(, /_ . ., L. .. � . �1 /nND-# C�UIREMENT$ 0K':THE SUEPOLIG COUNTY HEY4L.TI DEPT. - / +1 , k �� .n l; r. :,.,r - : . :, .-r'} ,r+''tl',, ,,.: ..; .�,, r �' 5- DA5EPORIWASS: N.6fV.D. 1929: '11 .. - ." , _ .. . ` , i .Ib -[fah,;;> tt ,. .. ., _ ., .� l/ . _ �Mln r' .� .: �S "r r, : ,. ' I„ „ ' , rl r'L' I - '. ,.., ' ,,, :,:, - �. .,, .,. . .�. � � !/ ' 8.� 'EX TI 5 � ��A M ���� �O EIEf - ". .", .1 b '+X x .Ay. ,,. .,.Y,., 7a r.:#, - - 15. N ENT T ,�BANDb,NED.' ",� r , -. :, t : '., L, . ,. „ ' :.r ... . .-:, : , '.,.4 . . .a!.: a .. :6. Jif^:, : ✓� e .,. .,- ,.,.� ",. 1!,� ?.' TOTAL- 'AREAI y'99.+/- ACRES ,I - 4 , :urs ' } . _ I _ r 4, _ :' L ti / !: ,.t .. -.-moi , . . L ,_r B. ' ENTOP LOT LOVE ,: I ,�' <. ..t,d ' w Y ' � " ��.. :� � � � SRC RA 4fK / � , r - , ,. : - , . ."• � i I . . . k -, ,,, ". ., - V 9. INS?A4L_.R MAINTAIN'HAYB,ALES'AND SILT FENCE DURIN'Er i v' -' ^. „ », - -.::,., �,. 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SrNFWA'. 2 - --- SrNRR/5LR5291" - 5fNR7RLN75`Y'PLUS NO-5/Ne V`- N GI.CJSLr Gl.05Lr - HAWPN6 5/DLOPLN �9 roeAP/rL L� G� V�Li�tlC ROOM O 0� UNDERWRITERS CERTIFICATE TIFICATE jS ILS Lpd r °9FU� arrn v WITHO U- .:'GeTIFICATE REQUIRED 0 — Nlwv pPNiffvAr 7-0 OF OCCUF I'ICY NFW GrfKi46f PROVIDE % HR. FIRE RATED SEPARATION To PART 17.3(f) (1)OF APPROVED AS NOTED IC N.Y. STATE BUILDING CODEDATE: 2 1 4 B.P.$ aSS�I ro N Sf0Rr1eP FEE: 13°I BM • �'��*� NOTIFY BUILDING DERYITMENT AT 765-1802 9 AM TO 4 FM FOR THE FOLLOWING INSPECTIONS: Y 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING t PLUMBING /2 .. .. .w.., .. �' B. INSULATION 4. FINAL - CONSTRUC110N MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION $HALL MEET THE REQUIREMENT$ OF THE N.Y. a STATE CONSTRUCTION B. ENERGY J2"O✓LRn/Ne Z '� 9' 'G CODES. 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S��C'G �tNT, r4 Gt117" GT 5 ERIK SSRy/T 3D R'OWLrfiND 57-, MYSTIC, GT OGS (eW) SCAi.E: DRAWN t?anbedrdh :P ff MiZ5, 1:OLLft G�t77 'l3 Tyt 1111 rte REVISED: * sr No_0261 �L� Q� PACK VATION 0 OFNE`Ny DATE: APPROVED BY: DRAWING NUMBER: RroGEVENr\ - - A/R HANDLER-OVER HNTYI - _ SUPPLED HY EX/5T1NG HO/LFR AND NEW AG,G0MPRF550R Z /Z 8 12 2X8, -tOP PL ELEV 28,94 L._.J ROOF SHINGLES ON HUILD/NG PAPERFIR //2" GYP 1/2"FDX PLY ©D ROOF SHEATHING LEJ ZX4 _ 2X10.16" �l5 -� ELFV2/94 3/4"PLY N 2X6 5UH FLR OOELFV ZOOD 8„ 2"GONTIN. 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