HomeMy WebLinkAbout23271-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24619 Date SEPTEMBER 11, 1996
THIS CERTIFIES that the building NEW DWELLING
Location of Property 16315 MAIN ROAD EAST MARION, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 23 Block 1 Lot 12.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 16, 1996 pursuant to which
Building Permit No. 23271-Z dated FEBRUARY 29, 1996
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 ONE FAMILY DWELLING WITH GARAGE UNDER & ATTACHED DECK AS
APPLIED FOR & AS PER ZBA #4359.
The certificate is issued to EDWARD & ELLEN WILLIAMS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-96-0012-AUG. 12, 1996
ELECTRICAL INSPECTION CERT. #12116 - JUNE 25, 1996
PLUMBERS CERTIFICATION DATED JULY 22, 1996-MATTITUCK PLUMBING & HEATING
- Q" 2"Building Inspect
Rev. 1/81
,1
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) 9 q
Date................... !.•........................... 19.../. .
N2 23271 Z
Permission Is hereby granted to:
F.4W.:A:4......... 1.l.li!4 15................................
(. o..../?'1�,�� �t-�! ......�a I✓
...................
e..��.. .oL�
. .. .....I..... .L :...f.../1 71...........
to ...4rxlJlf$ f.0 ............/✓............® f .......,..6I ? ., .........✓% !�j.f ..... f
. ........Gr/Lt1f.........A..... .......Ci..k........Gome�..`......... !!f.. .. ..
L/.�..... .......1-+1<. .......�r� 7✓ .Y. .......... ....................................................
............
../,j1, s: .......
. ..........................
at premises located at.......... ........... e�1� ...!. T.:.........................................................
................................................. Rs ........ '1���1 ......................................................
County Tax Map No. 1000 Section ....9.2.�............. Block....®`............... Lot No. ....... .......
pursuant to application dated ......... lr/ .........1,t .................... 19....../.. ., and approved by the
Building Inspector.
I i
Fee$...�a.1..5�.-
...............................
uilding Inspector
Rev. 6/30/80
i
Form No. 6
r 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 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 plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"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 Building - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15/1.00, Commercial $15.00
Date . ., .� .0��. 1 J.E?. . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . .. . . . . . . old Or Pre-existing
�Building
.. . . . . . . . . . . . . . .y�. .
Location of Property. . . 315 . . . . . . . : . . . . . . . J!!NIn. . . . . . . . . . . . . . riSy Qk'ION. . . . . . . .
House No. Street Hamlet
a�ca� ry . l(�N. . . G)i.1/16.4a . . . . . .
Onwer or Owners of Property. . . . . • • • • • • • • • • • • • • • • • • " " . . . . . . .
County Tax Map No 1000, Section. . .. 3. . . . . . . .Block. . .C? /. . . . . . . . . .Lot:. . .l.2L'l . . . • • • • • • • • • • •
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.)�7;�.1.1. Z. . . . .Date Of Permit. . B: �q1 •g�• •Applicant. !. •GUl/LF hMs.'. . . . . .
Health Dept. Approval gr.F`# . Underwriters Approval*. lalt�. • • • • • • • • • • • . • .
Panning Board Approval. . Plk. . . . . . . . . . . . . . . . . .
Request for: TempCry Certificate. . . . . . . . . . . Final Certicate. . .1.1 . . . . . .
Fee Submitted: $. .Cx.5l:'. . . . . . . . . . . . . . . . . . . .
{ ( 1. . . . . . . . . . . . . . .
APPLICANT
Co --?-J 9
hl�iF nE; '95 1 f-. 1 J,A,11 I OF SOUTI-I�)LD
Town Hall,53095 Main Road Fax (516)765-i&23
P. O. Box 1179
&mlhold,New York 11971 a ;• Telephone(516) 765.19o3!
- a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C—ER TIF I CATI ON / ��/
DAT);s 7/ 2/ I Co
Building Permit No. �
Owner: � I (E 1A-X
(please print)
Plumber: XeSll
(please print)
I I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
A
( Plumbers Signatix
Sworn to before me this
day of �— SpJG 19 ?6
Notary Public, County
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APPEALS BOARD MEMBERS
o ^6 Southold Town Hall
Gerard E Goehringer, Chairman `". T 53095 Main Road
Serge Doyen, Jr. y �� P.O. Box 1179
James Dinizio, Jr. �Oj �0� Southold, New York 11971
Robert A. Villa Fax (516) 765-1823
Lydia A. Tortora Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
APDL. #4359 ACTION OF THE BOARD OF APPEALS
APPLICANT: EDWARD E. WILLIAMS DATE OF ACTION: February 7, 1996
LOCATION OF PROPERTY: 16215 Route 25, East Marion.
COUNTY TAX MAP DISTRICT 1000, SECTION 23, BLOCK 1, LOT 12.1.
BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector
12/27/95. Insufficient front yard from right-of-way. Lot is a corner lot."
PROVISIONS APPEALED FROM: Article XXJV, Sections 100-244A & B.
RELIEF REQUESTED: Map as amended the date of the hearing, with a front
setback proposed at 35 feet instead of the required 60 feet, from the
applicant's westerly property line which is located within the boundaries of a
traveled private right-of-way (the edge of the right-of-way is shown by the
surveyor to be 7.5 feet inside the boundaries of this parcel. The remaining
yards are shown to be in conformity with the Code at 90 (rear yard) feet, 20
(side yard) feel, and 312+- feet (front yard) from the proposed house to the
southerly property line along the Main Road.
REASONS/FINDINGS: Official Town records show that a front yard interpreta-
tion of yards fronting private rights-of-way have continued with this
interpretation for more than 25 years, which designates some lots to be corner
lots, and others with one front yard (being on a private right-of-way rather
than a town road). (No change in this procedure was offered at this time.) ,
The Board of Appeals has recognized the need for relief when a private
right-of-way is shown on a map, having considered many different scenarios -
depending on the neighborhood and configuration of the lots. This vacant
parcel, a corner lot, has frontage along the north side of the Main Road and
the easterly side of a private vehicular right-of-way. A dwelling is being
proposed with setbacks approximately 312 feet from the Main Road, 90 feet from
the northerly property line, 20 feet from the easterly (side) property line,
and 35 feet from the westerly (front) property line. The west-east width of
the house, including attached two-car garage, is shown to be 70 feet, and the
north-south depth at 4113". Due to the nature of this long, narrow lot, motion
was offered by Member Dinizio as follows.
MOTION MADE BY: James Dinizio Jr. SECONDED BY: Gerard P. Goehringer
ACT ION/RESOLUTION ADOPTED: Approved front yard setback from the
private right-of-way, as applied and more particularly shown on the survey
amended Feb. 1, 1996, prepared by Roderick VanTuyl, P.C.
VOTE OF THE BOARD: Ayes: Serge J. Doyen, James Dinizio
Jr, Robert A. Villa, Lydia A. Tortora, Gerard P.
Goelhringer. . This resolution was unanimously adopted.
I. I ."(.D INSt,I'c1:FON It N)itF DA'I'li 1
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..__.__.-_.__.-_____.__.. _______.____.__._.___.._._-_.____ .-_____._._ __..___.___.__._
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APPEALS BOARD MEMBERS
o Southold Town Hall
Gerard P. Goehringer, Chairman M ,? 53095 Main Road
Serge Doyen,Jr. �y �� P.O. Box 1179
James Diaizio,Jr. �Ol �a0 Southold, New York 11971
Robert A. Villa Fax(516) 765-1823
Lydia A. Tortora Telephone(516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
A.PPL. #4359 ACTION OF THE BOARD OF APPEALS
APPLICANT: EDWARD E. WILLIAMS DATE OF ACTION: February 7, 1996
LOCATION OF PROPERTY: 16215 Route 25 East Marion.
COUNTY TAX MAP DISTRICT 1000, SECTION 23, BLOCK 1, LOT 12.1.
BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector
12/27/95. Insufficient front yard from right-of-way. Lot is a corner lot."
PROVISIONS- APPEALED FROM: Article XXIV, Sections 100-244A & B.
RELIEF REQUESTED: Map as amended the date of the hearing, with a front
setback proposed at 35 feet instead of the required 60 feet, from the
applicant's westerly property line which is located within the boundaries of a
traveled private right-of-way (the edge of the right-of-way is shown by the
surveyor to be 7.5 feet inside the boundaries of this parcel. The remaining
yards are shown to be in conformity with the Code at 90 (rear yard) feet, 20
(side yard) feet, and 312+- feet (front yard) from the proposed house to the
southerly property line along the Main Road.
REASONS/FINDINGS: Official Town records show that a front yard interpreta-
tion of yards fronting private rights-of-way have continued with this
interpretation for more than 25 years, which designates some lots to be corner
lots, and others with one front yard (being on a private right-of-way rather
than a town road) . (No change in this procedure was offered at this time.) ,
The Board of Appeals has recognized the need for relief when a private
right-of-way is shown on a map, having considered many different scenarios -
depending on the neighborhood and configuration of the lots. This vacant
parcel, a corner lot, has frontage along the north side of the Main Road and
the easterly side of a private vehicular right-of-way. A dwelling is being
proposed with setbacks approximately 312 feet from the Main Road, 90 feet from
the northerly property line, 20 feet from the easterly (side) property line,
and 35 feet from the westerly (front) property line. The west-east width of
the house, including attached two-car garage, is shown to be 70 feet, and the
north-south depth at 4113". Due to the nature of this long, narrow lot, motion
was offered by Member Dinizio as follows.
MOTION MADE BY: James Dinizio Jr. SECONDED BY: Gerard P. Goehringer
ACTION/RESOLUTION ADOPTED: Approved front yard setback from the
private right-of-way, as applied and more particularly shown on the survey
amended Feb. 1, 1996, prepared by Roderick VanTuyl, P.C.
VOTE OF THE BOARD: Ayes: Serge J. Doyen, James Dinizio
Jr, Robert A. Villa, Lydia A. Tortora, Gerard P.
Goeliringer. This resolution was unanimously adopted.
ENERGY COOL CALCULATIONS
(Por. Non-Llect-ric heat-) Design Criteria 6 , 000 Degree' Days
y O.A. 100P I .A. 70°P
FOR: �GJ �r (J ( �lCMj PER: 100 gnP
DATED:
DESIGN THERMEL REMARKS
AREA "U" RA'T'ING
Exterior Walls (Opaque) /� S IDS
Glazingn 8
2 V'2 ;"7 A .�'� (A.Sol shieN
r
Doors Wo qoo - Oo
Ceiling/Roof (Opaque) i sd r o) V
Skylights %
Floor - / 5 6
Foundation Walls
Slab Insulation
TOTAL +
Notes :
Building Envelope Systems to meet requirements of 7815 . 2
BVAC Equipement to meet requirements of 7815, 11
HVAC Systems to meet requirements of 7815 . 12
Duct Systems to meet requirements of 7815. 13
Ventilations Systems to meet requirements of 7815 . 14
Insulation of Piping Systems to meet requirements of 7815 . 1,5
Service Water (!eating Systems & Equipment to meet requirements of 7815 . 21
Electrical & Lighting Systems & Equipment to meet- requirements of 7815 . 31
pt NQ Y
To the best of my knowledge, X7.1.1 � � 7
belief, & professional
judgement, there plans are in s
compliance with the code.
k a yh
y� {
`..€�.
2
ENE1tGy CODE CALCULATIONS
(For Non-ElecL-ric heat) Desigu Cr.iLer-ia G , 000 Deya:ce DayS
O.A. 1001•' l. . A. 700F
PER: ( 4SI Lel 1/ro � 0.
.7 (✓I:I3Y DATED:
d UL;SIGN J'f113ItMEL REMARKS
SUBSYSTEM AREA "U" RATING
Glazing bra }
Doors
Ceiling/Roof (opaque)
Skylights $
Floor
Foundation Wa.Lls
Slab Insulation
--
TOTAL
No Les :
Building Envelope Systems to meeL requiremeiL-s of 7815 . 7
IIVAC Equi.pement- to meeL- requirements of 71315. 11
IIVAC Systems to meet- requirements of 7815 . 12
Duct SyuLculu to meeL requirements of '181.5 . 1.3
VenLl.laL•louu SysLems to meeL• rCquia:enleuLu of '7815. 14
1nuu.LaLiuu of k'ipiny Systems Co meet requicemcnLs of: 7815 . 15
Service Water Ileating Systems & Equipment to meeL requi.r.emenLs of '1815 . '2..1.
11ecLrical & JA91IL1119 SysLems' & EquipmenL to meet requlEemeuLs of '1815 . 3L
'1'o the best- of my knowledge, 1� of NEV 1,
belief:, & professional. �����cIE
judgement, these plans are in
compliance with the code. r
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date x/ 1597 . . . . . . . . . . . . . . . . .. 19
y—
To,
lS� yS tr/7J. . . .. . . . . . . .
. . . . . ." ..o;ol . . iii/
PLEASE TAKE NO'T'ICE that your application dated . . .��,G. . . . . . . . , , , . • , 19 2.-s —,
for perinit to � `p% , L911e , c � `
Location of Property . . . . . . . . i �/' yy
House No. Street . ' ` ef��
County "fax Map No. 1000 Section . . .�� • . . . . . . Block . . . . l. . . . . . . . Lot . /;F,!/ . . . . .
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . . . .
is returned herewith and disapproved on the following grounds . C! � , , ,
. . . . . . . . . off
a
. . . . . . . . . . . . . . . . . .
. . . . . . .�- . . . . . . . '. .�� . . '
°t a . . . . . . . . . . . . . . .
. : �. . .
. . . .G . . . � . . .;
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. ..j. . . . . . . .
B 1K Inspector
RV 1/80
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ NSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: ��i _
O`°2
�'CLD�i2 og <
DATEINSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
t/
] OUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE CHIMNEY
REMARKS: G�
9
DATE INSPECTOR
M-1302
BUILDING DEPT.
INSPECTI0
[ ] FOUNDATION IST ROUGH PLBG.
[ ] UNDATION 2ND [ ] INSULATION
] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY �r
REMARKS:
DATES /� INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROU PLBG.
[ ] FOUNDATION 2ND NSULATION
[ ] FRAMING [ } FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: ,� ✓ �
r
DAT '� ! INSPE
765-1802
BUILDING DEPT.
INSPECTION
{ ] FOUNDATION IST [ ] ROUGH PLBG.
( ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS: t'
e _
f
r
DATE U INSPECTOR f -tet
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
V/rFRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: --
DATE INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ) ROUGH PLBG.
[ ) FOUNDATION 2ND [ ] INISULATION
[ ) FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS:
DATE 3 INSPECTOR4z
� 3d � l
/65.1002
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING Joe FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: i
zool
DATE INSPECTO
BOARD OF HEALTH . . . . . . . .
FORMN0. 1 3 SETS OF PLANS . . . . . . . .
TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . .
TOWN HALL SEiT1d FORK . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 ttOi1FY ;
Examined n CALL .. . . . . . . ..
. . . . . . . . .
., 19 9,f MAIL T 0 : -�--�—"
Approved . . . . . . . . . . . . . . . .. 19 . . . Permit No. . . . . . . . . . . . . . . . . . . . . . . .
Disapproved,a/c . . ��/ . . . . . . ; . . . . .
=(Bi il'dir#g Inspector)
APPLI;CATION,FOR BUILDING PERMIT (�
Date .� �. : .?,�. . . . . .. l
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 stieet
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appL
cation.
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 issued a Building Permit to the applicant. Such permi
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 Occupanc.
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th.
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
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 tc
admit authorized inspectors on premises and in building for necessary in c ' ns.
6ti.-. xe GUia
(Signature of applicant, or nameorporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . bGvtil. � . A.V,J.. . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises u+ : 9' �C/� N. .��V!f�tl�ff2.s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �'
(Name and title of corporate officer)
Builder's License No. . . .1,3/D S " DEC 2 6 "j
Plumber's License No. . . . . . . . . . . . . . . . . . . . I . . . . t eLDG,p
TOWN OF SallT4ae-;_7
Electrician's License No.
Other Trade's License No. ... . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done.
. . . . . . . . . . . .
House Number Street Hamlet �f
County Tax Map No. 1000 Section . A �.�.�. . . . . . . . . Block . , �. . . . . . . . . . . : . . . Lot ./.4.qq.e��!� . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises andel intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . .va.cl-a it,! .
b. Intended use and occupancy . . . . .I
i .a
3. Nature of work (check which 4PIicable): New Building . . .X, . . . , Addition . . . . . . . . . . Alteration . . . . . . ,,. . .
Repair . . . . . . . , Removal . . . . . . . . . . . . . . Demolition Other Work . . . . . . . . . . . . . . .
(Description)
4. Estimated Cost . .9 !" Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
S. If dwellin number of dwelling (to be paid on filing this application)
g. g units' . . . . ! . . . . . . . . .. Number of dwelling units on each floor . . . . . . . . . . . . . . . .
If garage, number of cars .
6. If business, commercial or mix0d occupancy, specify nature and extent of•each type of use .
7. Dimensions of existing structures, if any: Front . .x(,1011 F� . . , . . . Rear, . . . . . . . . . . Depth .
Height . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . , . . . .
Dimensions of same structure with alterations or additions: Front . . .A , , , , , , Rear .
Depth . . . . . ... . . . . . . . . . . . .!. . . Height . . . . . , . . Number of Stories .
8. Dimensions of entire new construction: Front . .7¢.� .. Rear . . .7. R . . . . . . . . Depth .zfl
.Height . . ./.�.�. . , �} Number of Stories . . .. ,l.•, A .
9. Size of lot: Front . .J T�.p /,�. . . . ., , . . Rear. . . +'/y•. � . . ., . . . . . . . . Depth .9.5. , . . . . . . , . .
10. Date of Purchase . Name of Former Owner . .W 0.14Qkb. . . . . . .
11. Zone or use district in which premises are situated . . . . .lftv.f�Sir 6-0a„
12. Does proposed construction v�{'dilate any zoning law, ordinance or regulation: . � �� ,�
13. Will lot be regraded /UV . Will excess fill e removed from premises: Yes ' 0
14. Name of Owner of premises Ad-.0444”. -'V41�. . . . Address . S4k Ptd, , , , , , , • Phone No.
Name of Architect . . . . Address . Phone No. . . ,•,
Name of Contractor . . •,/>! S, , , , , Address . SQ { , , , , . . Phone No.
15. Is this property within
1300
300 feet of a tidal wetland? *Yes. . . . . . . . No. .)(. . . . . .
*If es, Southold
;Town Trustees Permit may. be required,
PLOT DIAGRAM
Locate clearly and distinctly alit buildings, whether existing or proposed, and indicate all setback dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
r;
STATE OF NEW YORK,
COUNTY OF . . . . . 'S•S
(IYaoftindi ual . . . ' ' ' ' • being duly sworn, deposes and says that he is the applicant
signing contract)
zbove named.
:'ieisthe . ... . . . . . ... . . . .2 /,il GG�Z q,�'YQ. . . . . . . . . . . . . . . . . . . . . . .
r (Contractor, agent, corporate officer', etc.)
>f 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
vork wilt be performed in the manner,set forth in,the application filed therewith.`
iworn to before me this
. . . . . . . � . , . . .day of •ve9 _` '. . 19 .��
//^ !
Jotary Public, . . . . . . , , County.
JOY6E M.Wit,KINS av . .
Notary Public,State of New York
No.2952 (Signature of applicant)
?r46,Suffolk Cou pp
Term Expjres Juna 12,19
BOARD OF HEALTH
�5 (( (i FORM NO. 1 3 SETS OF S
�^ TOWN OF SOUTHOLD SURVEY . . P . . . . .. . . . . . . . . . . .
B. + BUILDING DEPARTMENT CHECK 0. . .
6@,
TOWN HALL SEPTIC FORM . �. . . . .. . . . . . . .
SOUTHOLD, N.Y. 11971
BLDG.DEPT. TEL: 765-1802 NOTIFY:
_TOWN OF SOUTHOLD___J, CALL 361 ry
Examined...... jyya.`./....... 19.p MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved......G7�. , ✓ �.3 z
/ a 19 ....Permit No. ......... t.... ...........FAw.E,Vklliami•-•-•••••••••
Builder
Disapproved a/c .................................. .........1M Miamehaha8hd............
Southold.NV 11971
......................................................
(Build /or
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector witl
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premis%h,1 l$qqpship to adjoining premises or public
streets or areas, and giving a detailed description of layout of propertyimal be drawn on the diagram which is part of
this application.
tll, u. e
c. The work covered by this application may not be canrenced 1>�tPore(f rssDiuance of Building Permit,
d. Upon approval of this alrplication,,the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the rirkt' t .,hl
e. No building shall be dccipi6d ar useA in whole or 4n part for any purpose'wbatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS 1LIM, MADE 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 building for necessary inspections.
T. ...............
Edw.E.wimamt (Signature of applicant, or name, if a corporation)
Builder
1300 Mimmehaha Blvd,
Southold,NV 11971 ...................................................
(Nailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
0G(2 L ..............".......---... .... ...... . ...............
Name of Omer of premises .�sui..� ... �.. .��,.G.4/ .. .... ...................................
(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. 1.3(G.ir...14.,i........
Plumbers License No. ..9-3.6.6..P...........
Electricians License No. 7/ 41.4.4i..........
other Trade's License No. ....................
1. Location of land on which proposed work will be done..............................................................
.. Aetcl r1
..................... .......................... ... ........................I................
House Number Street Hanlet
Canty Tax Map No. KW Section .. 3........ Block ....I........... Lot ....L.n.......
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Name)
2. State existing use and occupancy of premiise�s, midi intended use and occupancy of proposed construction:
a. Existing use and occupancy ......(l�4<Gr :'l..,T?!h-4P..............................................
b. Intended use and occupancy ...1.. .IS9h.'t!. `.�l.. zr1. :��C�:t4............................................
I. Ntlure of work (clock wltidt applifabie): Ww Iluilding !�...... Addition .......... Alteration ..........
Itepair ............ Removal ..... ....... Dennl!Lion ............ Other Work ..................................
(ik:scri pt i on)
II. I:sLniited Cog . 3�'f ��...'
... ..... fee ............. ......................... .......
(to lie paid on filing this application)
S. If rAxlling, number of dwelling units ..1......... iluber of ckve111118 h flunits on each
Ifgarage, mixer of cars ......................................
G. if Ixisu♦ tlllu Wocial or mixed occupancy, specify naLure and extent of each type of use......................
y. (linen �fdl f l � stnwtures�� If any: Front..//.'n........ Rear tv// ......... Depth ../.(//�.........
IkigluL•...r.•'...••.....•... 'Nudrer of Stories .I..............
i i , alterations or additions: Front .... � .. Rear ...............
Depth
.... of sane structure liei, ,Y�I ......... ......... Amber of Stories
R. Dinenaiais of entire new carustrucliai: PraiC ........Q....., Rear .J�..'�.G.„...... Depth 3T...1,2y,.....
Size of lot-. I�YrxiC L,3.� J3•..�nieer of Stories ...I.................
Irn
ilei nt ....Z 5.
9. ....... Rear .11 L6 H1........... Depth
IO. hale of Purchase ...0.7..77.e...... llam of Forner Qa,er ..nor/4 ?p /
..........................
F premises are siLuated R'gr�
If. 7nrue or use district in whidi nal
.............................. .............
12. Does proposed cnnstrnction violate any zrniin l wi, ordinazwe or regulation: ...)Vp...............
13. Will lot: he regraded -Ed*.C,ftilkeywess fill be renxwed fYan premises: YES
Builder yG- 5._3� ,
14. &tires of omier of premises lalillHanehahe8hd...... Address .............................. Hione No. .......�.
S IhoId,NY 11911 s✓ \ �5......
Adclreas .......... ..........I...... llwne No. 7.
.......
Nene of Ccxil:ractor '.•,......
Nee of ArdtitecC •Gly'•�1'v�u."••.,'.-".••'.•••' �klress .... Edw E.Williams ....,hiw�, �,
Edw,E.Wllh ms � "' "'Bdirdbf...."
15. Is This property within feftild&a tidal wetland? s�lal/.:CJ.1. 1 Minnehaha Blvd.
*1F YI?S, S(X71}IOiD 7O u� 1971 'rr MAY lw RR()tl'TRRJ).� / Sbhlhblil;NY'IT9T1
PLOT DIAGRAM
Icx:aLe clearly and distinctly allllxilldings, wlielher existing or proposed, aril indicate all set-back dimensions
from properly lines. Give street arxI block nnber or description according to deed, and allow street nares and indicate
til,ether interior or corner lot.
xmsdhW.3 wb3
rnbhuB
.1508 00nafliM ORE(
FtCti 1h.blmitumL
S2"-- � Sv2V
Simi? w "i'm Y(AU(,
SS
OtlllNfY U?? .......................
........."'......L•. r.................' ..................Ixeiog duly sworn, deposes aixl says that be is the applicant
W •. C. � fONnS'
(lhie of individual si gain, contract) -
alxwe curled,
O
Ike is the ..... 1 `/. C-�F?`^!':K.,cr'� D .............................................................
(Ccmtraclbr, agent, corporate officer, etc.)
of said umxer or owners, and da duly auiYhorized to perforin or have ixtrfouwd the said work and to nmlca and file This
application; I.hat: all. staterents caitaileed in this application are true Lo the beat of his knowledge and Ixil ief; and
that the work will he performed in the manner set Ionil in Lhe application filed Lherewidi.
.. y .� .19...�6..
%wn to before ne Lhis
,...da of
Nol.ary Public .. G ¢C .S_ fS:CXrC .....
(Signature of Applicant)
LINDA J.COOPER
Notary Public,State of Now Yor
No.b822S63,Suffolk County
T®rm Expires DecembmV 3t,1
CTtZCwI �C�;r9sz �cw, ,
� Cw12 iCw,2 ��
- ' ! MR/ 2 2
�� 2. Yz. T;L,q, SLDG.DEPT.
( j�) +t R14'at_FW. 2x8Y 16"O.L RA. w� D ((� ] I i 2�,o w/r �i6Pl. i e. 70WfY OF SCUTI.IC'D
Q9 (VMFr
ofi
---- t5—��— - - {
! 5-0_"*KVEEWALLS b�,r,• /� , i
i I
jI.
e;_;.r C7_ YYY
4-o me_
41
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RT j C STORAq E �j % 9, IPJ � WQN
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f
o
o:
�. uss war— RR. N Zx6s i0o.C. RREdw
.E WdbM
unde ,
Budder 2-e,✓ � _.._.___
1300 Minnehaha
---- cuthol0.NY 11971
- 7
Ayy �= o �
----- IYR
2 1996
j ( BLDG.DEPT
CWM1iS CWryS Cwt�S j TOWN OFSOUTHDLD
cwls Cw 2s
? ,
1 `
CwItis CWt`.5 Cwl4s S t,1 Cb
2 zx /t5 %z" ss PL, ✓
u5H HDFc. —i 2-2Xros
W10-3-6 std.
DINETi E h _.___ Y FLUSH PIS-R.-
0 IS-R.—
ROOM
M T c \ a .i VENT AF FIRE-`
GG
K, PI A(� dS
U Irl" , 3Yz` 3%z,: N \t MASTER BEDROOM
moo" =o" b LIV1N ROOM —
1
r i M
3
,NS ST4.�wEs fz"
CAstNETS
{( 1
\ SIF. F
�& ' $ 8/ ,
NRYCR WASHY �aoi ` ' jbNj
M ZXro FL HCt�C. ( �0b00 ,
FOYER ,01 �
-S!0Y2" x NI , ,5'/2•. � � MASTER RATN �I i 1
fC 'RAnSoM ABovE
FRONT DOOR UNtT CW 14!5-z
ZX w .M-.-
L ax-n— h 01
i t05H " I Edw.E.Williams
8 Erb
O . d s�'w COlur� �I Builder
r;szxrm's .tb'ac C.W-!3 CW,ys_- �
1300 Minnehaha Slvd.
< SO Y 1
! ,j��\ 0/
Southold.N 1971 /
' <✓ �7` N 1
� -_.1,__ i� h•' �,�Cl I 5_Y2•' i -��i � e -cN�L h S. cn ___
-77777���=777-74-7,—T,
K
tUFFOLIC CO.fitAL +
/a S.140
U.:
T% W0FHMTWW-R%Ci:3
ou , �
of 160 U Ar
N.
L
1 -4 At
STATEMENT OF INTENT
THE WATER SUPPLY ANV,:SEWA.,GE DISPOSAL
7
SYSTEMS FOR THIS RESIDENCE -W1LL� , ,,,
THE STANDARDS
TO cw THE
27
CONFORM
PQOP627Y
SUFFOLK CO. DEPT. OF HEALTH SERV`tC VS.'
5Lfizvft-v4,5v froR oa:wcf wg MOT.
(S)
APPLICANT
ZFONA20 E ELL65N F� WILLIAMSi
5 SUFFOLK COUNTY DEPT. OF HEA�TH
SERVICES - FOR APPROVAL -
E45-r A4AQ toN
CONSTRUCTION ONLY
7ov-,w 01= SoLm-4v-o,
DATE:
b-,z,;- H. S. REF. NO.: 1210-96 712
APPROVED:
�A
3ij
SUFFOLK CO DWON,ATI
DIST.K)00,SECT.023 BLOCKI, OCL
TAi MAP
OWNERS ADDRESS:
V
LW15,MAIt�.1 rff—
A
MAIZ10�4-N)�JAI
TEL.516-4T4
sr-ce 1�
DEED: L.7ZZI 1P.Za7
Area = 54,897 srf*. TEST HOLE STAMP
:oVl k (v
Una
m uth~ I
thjs s wir"y R.a
Fthcafion Lm
7, the land sun"ofs kftdsW"'
AUG.1,1996
�beavaridtn,*CW,
�yfothe�wnforwhwfts
4' asp�.d,and.n his b*mffU,d,x
�coun,an,gove,morqaTsgwq wd
�rnrrgrsuuionr*tedheu%xnand
zZ5901
6
[2-,0A0 Ckjorw"iwwd ic 44yo wafer SEAL
S7-.47EF
A14IN
as 54 -vogod Freb,Z3,19w. OK
itr R-OpgRICK VAN TUYL. P
AC. V4
mark
LICENS D LAND SUR?EYORS.
GREENPORT NEW YORK
T
-oq 0 0
a' SUFFOLK CO. HEALTH DEPT. APPROVAL
yxo resid�neat� r- H.S. NO.
. I THE WATER §U1*LY AND`�S t)
tY9AP C ! J 11 �� e. \� : cessj�ots SYSTEMS FOR, THIS
�(( CONFORM TO THE STANOAROS
SUFFOLK CO. DEPT. OF HEALTH'SEj'V�
I141*
s
� A�pL�cA>wfT .
-- r k ��
SUFFOLK COUNTY DtPT. OF
SPST P ' 124O1V SERVICES — FOR APPROV11 '
;`,.�
3lNhf C:L �G 1(1t_G3, [ Q ?
CA CONSTRUCTION ONLY ;
. 1° / ,err DATE:
r14
{_8a ^._._ _ _. r5o---}�-- -o / H.S. REF.NO.:
€ ;
AP VM
Illy? �J -
Edn.
E.Builder `at aUFFOLK CO I# L
1300 Minnehaha&
300114K MY 11971
v
OWNERS
FFOWNERS
q
r
to,,
�bi'�
i
{S DEED: L.7,zzf
t [i!?C4Sff i. i b A f f
TEST
/ + t
Setbo mo8ofmo NatloO�
!! r t, Section 2208 ofiha NowYaik'SWte uy
t�
Jj _ ,q FaucaLcn Law.
.�i� 'fn56C8ta � �.
_ t sPesoftrveyors inked eel beating
} i '� t3e land d seat Rs in:ced seabt
V t eb. ,.(+� c � M bea valid
Me Copy. be consMemd * ;
� aabaa�alawacopy.
Cuarentees Mooted hg shwf=
muytotAe Genn forwhaathea my
wPre,^.ared,andonhlsbeWtofhe
tTecomoanSgovemn lafsgwlcyend -
lerdigmswufonastedhereonand 4 ^y"
/ tc the cssignaes of We lending insti.
..r.+Y' r �p.1ey rvypp d tutor ws.i.esamnattrensfambte
_ f+r+'rs'� to addawnai n try^:ons orsubsequent
t57
j icarrTiF Irr zeErrtce > QF �E4
VA26
T R 1fAN YL P
f
Ct
EYORS, LAND
7St. 7 ,rA t E .. ff1 AtiR 1 NEW YORK s
�29
Z"IT 1�11-11,--,-
Col.
ywjf�,-nol
SEW&W
THE �Aw�WD .1 "
WATER-MMY AND- 40W
SYSTEW FOR f, we
Q, Fr
M4P ZOPM7Y CONFORM TO T"E ST
S,0�0 c;w
SUFFOLK CO. DEFT. OF TW
(SI 7 7-
A LL/
SUFFOLK COUNTY DEPT,
SERVICES - 'FO'R,
7bwN cs, E5 CONSTRUCTIONAD
PP , A,
N
Y. -MY
DATE:
Wdl
H.S.REr.NO.. Q,
COUNTY DMARTMW OF MALTM SMVICM
APPROVED.
19MAMFORAPPROVAL0
F CONYMUCnON#M A
bwl
SINGLE FAMILY RESIDENCE ONLY SUFFOLK C6,,TA3CMAP-
3 199 DIST-KX)Q.SVCt0Z5 BWXK'I,
bAEB 1
...... PS
APIEWED
OWNERS ADDRESS.
FOR
A
B
A �J-
Expmm rtrims YEAp s pRow DATE Or App, w A'
erd-4
DEED: L. 2W.
Arww -PLEASE NOT
'ry 50"s
Sanifa , sYstem is n nr
b EXCAMIU11 mara, holat
P18ced under drive '
Section 7208 of no NewAittsba
copies of this sumey m4l��*t
too tind Sunwoes inked sees or,,�','
t
-,-bas..d seat SW hat b1=,jdo,,j
Pet), 7,1996 ".3
k\-A f
title contpany.9"a e I
lend.nainsti,fionh he
s ndLngwslf�,�, te�
hd�m Cuaram temblo I
eatone�oflrgos
-.nscrsubseq,ft
*Woe.
If* w1a,
z
w"OLK COIT DEPAR7 OF MALIH
FO "P V OFCO
SIN 1XI no A rUjXC
r M SID C�o
AM
3199
lFz
- Ivr
CK V
P,
-7,
-6
�,VA
M
01 ViMo
iw - -.-�
LICENSEPLA
S
YORK
kAND,
9WORT Ww
aC`, R Mai "1'}1SfV1y
d y t nbtS fe{ar+ePs - H,S NL).
STATEMENT OF INTENT-
} THE NATER SUPPLY-ANDSEWA&E'8t L;
l �„� r1 ceas�oaL� i'1 SYSTEMS FOR THIS- 'R€S#DENCE:'wlW�'=
11 4P OF PQOPe27Y J CONFORM TO YHE STANDARD$ t3E THE ..
: --- _ K CO. DEPT. OF HEALTH SEffffVf .+ '-
-y gam» WILLIAMS 1!1 f
SUFFOLK
L £-a
" .w�. .L:. YV� f1 / .�n� n�Q 1 pause APPLICANT a
i ;
he / L_ —_�� 4
SUFFOLK COUNTY DEPT. Of H)EAL't'kf
E457tF EOSERVICES — FOR APPROVAL
9. a
—(bwoo: SxxjrHot o,MY � o/('br�d E � CONSTRUCTION y' ca
DATE: e
well H. S. REF. NO.:
APPROVED: r"
` !s
i0 0: •," ! f SUFFOLK CO. TAX MAP QgStdNAia �.
D y C• S " yQ K?00.SECT.003 BLOCK],DIST.
A
APR - 4 J� k OWNERS ADDRESS:
f �-A
TdM1Nso : f Hsi fX� 1 k
VX f� DEED: L.72 1 P.IZ07 ( y b �1
AreY = >887cf f R+
Gtr+cef 11 °v ` / { TEST HOLE STAMP
�` l'NR'2'»ttdtt't•.tt'�' £"t -� /
Its this survey to avlotmkna
_ 11 �qq seaba rlos orate wewYaAcal� _ ,:^
�, l V -t�arsOz`i i:ducsuon Lam
Awtld-d Feb. 1,1996 1Copies offtwnsymepnottleaft
!r -'` 1 1 •Q Peb. '7' 1996;�{.,h"_J 1S9% � Me lana surveyors hied seer«
. T� Sal'( embossedsealshaonotbm %.l
ti f
tubae valid true mpy.
. 1 � _. QuawntaesiMkaiedhereonehdlnrr
mp lomepersanrorwhomde wrtrey�plomn a,,ad.�mnarcmthe .�
1,ml9edhereWland
oe C74! ,o.-. -.3..ca vl3lB to Sus&
_'�F'�-------•—......_..__.— ... �,t'57G.13 ..t r doom pansraebb
T lo� z '-.—owsubseaumu
read= 9 lrvy. rxxwt o
4410 �,dter SEAL
K v
�p
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-- II RO RV, (VANLYL,P_ * x° r
y
x ,
M q19 arc s vzq LICEN$ED LAND SOR YORE„
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u
...
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4
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21,
F it
Edw.E Williams
Builder --!
1300 MMnehaha Blvd.
Southold,NY 11971
r -
"4
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t
sCwt p1YwW,M �'
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