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HomeMy WebLinkAbout23278-z L FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24329 Date MAY 1, 1996 THIS CERTIFIES that the building ADDITION Location of Property 790 NORTH SEA DRIVE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 5 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 29, 1996 pursuant to which Building Permit No. 23278-2 dated MARCH 4, 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 REPAIR DECK ADDITION "AS BUILT" TO AN EXISTING SEASONAL DWELLING AS APPLIED FOR & AS PER ZBA #4358. The certificate is issued to ROBERT E. GREEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Ins ctor 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) Date .........../ .................. N2 23278 Z Permission Is hereby grante to: � ................. .......................... to ............ orr+ � ` .... ....:.. � c .... ... .... . ..... ..,...� .... at premises located at...................71Y ........�, .. ........ .. . .. ............... ........................................................�QC�............., ........... ........................,........................ County Tax Map No. 1000 Section ........ /........ Block........ .g....... Lot No. ...,1. .............. pursuant to application dated .............. .......r,� C.......... ...... and approved by the Building Inspector. Fee$.1........ . ....... ....... .. . ................... . ..... .. . .... ..... . ................ ' Building In� or Rev. 6/30/80 I Form No. 6 TOw(4 OF SOUTUOLD 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 build_ng or new use: I . 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 1% 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 dwellin S25.00, Alterations to dwelling $25.00, Swimming pool $25.00, .Arcessory bull 4 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 $15.00, Commercial $15.00 Date . . . . .��^ �. . .�.9 . . . . . . . . . . . . . . . . . . . . . . . . . New Constructi.on. . . .�. . . . Old Or �Pr/e-existin Buil/d)ing. . . . . . . . . . . . . . . . . Location of Property. . . . . . .77Q. . . !:".©. . . . . .4e 4 f4. . !"�- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street / Hamlet Onwer or Owners of Property . . . , JLf�� � T • • • .• [�E�M . . . . . . . . . . . . . . . . . .pp. . . . . . . . . . . . . . . . . . Jounty Tax Map No 1000, Section. . .�. . . . . . . .pluck. . . . ... . . . . . . . .Lot. . . ( . . . . . . . . . . . . . . . . Subdivisi.on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Hop . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit . . . . . . . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . . . 'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . *?equest for: Temporary Certificate. . . . . . . . . . . Final Certiclre. . . . . . . . . . . -ee Submitted : $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb�j TOWN OF SOU LD PKOPERTY . RECORD CARD � mac. 3 OWNER STREET o VILLAGE DISTRICT SUB. LOT - FORMER OWNER N /9 ,/ �y E ACREAGE S W TYPE OF BUILDING VRES. �' SEAS. � VL FARM COMM. I IND. I CB. ( MISC. VI Est Mkt. Value , LAND IMP. TOTAL DATE REMARKS (v ;:' r; ✓ a /6 0 a J �Z0°6 11//7 C BUILIDNCON ITICN Z NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Form Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD 3 :1o' AV- Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot Total - 1 �FLLo"f i� yr Y LTIT I, 3 f i Bldg. y 6 ' 23 -26/! 10 'Foundatio �� Bath xtension I Basement ( f(� Floors xt,� xtension Ext. Walls A44 Interior Finish xtension Fire Place Heat t a 13 n ' i 2 n S7 to /0Porch Roof Type ----- -- _ Y , , W' 7 Porch Rooms 1 st Floor/ . reel way 6 Yi7 - is Z Patio k Y6✓ Rooms 2nd Floor /3X� /6x/-7 i y aragg&L Kfy= 396 / Driveway �a , z Dormer - B. -I I IS • s� �� Fg ��SUFFD( .3 BOARD MEMBERS Southold Town Hall And P. Goehringer, Chairman `n,. nz, 53095 Main Road Serge Doyen.Jr. y �� P.O. Box 1 179 James Dinizio, Jr. Ol �a0 Southold. New York 11971 Robert A. Villa Fax (5 16) 765-1323 Lydia A. Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD Appl. No. 4358 ACTION OF TIIE BOARD OF APPEALS APPL,JCANT: ROBERT E. GREEN DATE OF ACTION: February 7, 1996 LOCA'T'ION OF PROPERTY: 790 North Sea Drive, Southold. COUN'T'Y TAX MAP DISTRICT 1000, SECTION 54, BLOCK 5, LOT 14. BASIS OF APPEAL: Notice of Disapproval issued by tire Building Inspector dated Nov. 2.1 , 1995. "Deck addition "as built" . .does riot have sufficient side lot setbacks. Requirements are minimum of t5 ft. on one side with total combination of 35 feet. . . . PROVISIONS APPEALED FROM: Article IIIA Sections 100-30A.3. . RELIEF REgUESTED: Variables between a 14.25 side yard setback at the northeast corner, and as close as a 5 ft. setback from easterly side property lino, for deck areas, built without building permit, and a portion with a building permit, which shows deck variables extending from the edge of the dwelling wall from 5' to 8'3" at its closest points, respectively, as shown on sketch prepared 01-25-96 by East End Drafting & Design Drawing No. 431-SP-1 . REASONS/FINDINGS: None ror approval. It was noted that the deck addition could have been planned without a variance had appropriate permits been obtained for lire areas under this variance. The motion for this action was agreeable with the placement of a Condition that the owner must apply for a variance before replacement or rebuilding of the deck areas within 15 feet of the property line for the reasons that the difficulties claimed were self-created. MOTION MADE BY: G. Goehringer SECONDED BY: S. Doyen and J. Dirdzio Jr. ACTION/RESOLUTION ADOPTED: Granted with the condition that replacement or reconstruction of lire deck areas within 15 feet of the side property line will require a new variance application before activities are commenced for re-consideration by the Board of Appeals in this self-created difficulty. VO'L'E OF TILE BOARD: Ayes: Serge J. Doyen, James Dinizio Jr. , Robert A. Villa, Lydia A. Tortora, and Gerard P. Goehringer, constituting the entire board. This resolution was unanimously adopted. 'Z,IiA:lk M FEB 2t 1 I i t.,)�.i�� int � •L:�.'.r� �.r'i<<�i�-. �7.} - I n I t .^_.�-rF, '•.�j�s �,� Vt tai • ~� � i � FOLE j I i i ; 2 �h LnH\ 1 5rC{._'r ,.. 1 . - 15t r iJ 4� moi) n -r 1 i I Ir iA y APPEALS BOARD MEMBERS G =`1` y� i3 o i 4 19,,06 Southold Town Hall Gerard P. Goehringer,Chairman W ., .. 53095 Main Road Serge Doyen, Jr. • G v i=i P.O. Box 1179 James Dinizio, Jr. �O( �azvvr«r €�t7"}tt1'rI,Southold, New York 11971 Robert A. Villa Fax(516) 765-1823 Lydia A.Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD Appl. No. 4358 ACTION OF THE BOARD OF APPEALS APPLICANT: ROBERT E. GREEN DATE OF ACTION: February 7, 1996 LOCATION OF PROPERTY: 790 North Sea Drive, Southold. COUNTY TAX MAP DISTRICT 1000, SECTION 54, BLOCK 5, LOT 14. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector dated Nov. 21, 1995. "Deck addition "as built" . . .does not have sufficient side lot setbacks. Requirements are minimum of 15 ft. on one side with total combination of 35 feet. . . . PROVISIONS APPEALED FROM: Article IIIA, Sections 100-30A.3. RELIEF REQUESTED: Variables between a 14.25 side yard setback at the northeast corner, and as close as a 5 ft. setback from easterly side property line, for deck areas, built without building permit, and a portion with a building permit, which shows deck variables extending from the edge of the dwelling wall from 5' to 8'3" at its closest points, respectively, as shown on sketch prepared 01-25-96 by East End Drafting & Design Drawing No. 431-SP-1. REASONS/FINDINGS: None for approval. It was noted that the deck addition could have been planned without a variance had appropriate permits been obtained for the areas under this variance. The motion for this action was agreeable with the placement of a Condition that the owner must apply for a variance before replacement or rebuilding of the deck areas within 15 feet of the property line for the reasons that the difficulties claimed were self-created. MOTION MADE BY: G. Goehringer SECONDED BY: S. Doyen and J. Dinizio Jr. ACTION/RESOLUTION ADOPTED: Granted with the condition that replacement or reconstruction of the deck areas within 15 feet of the side property line will require a new variance application before activities are commenced for re-consideration by the Board of Appeals in this self-created difficulty. VOTE OF TIIE BOARD: Ayes: Serge J. Doyen, James Dinizio Jr. , Robert A. Villa, Lydia A. Tortora, and Gerard P. Goehringer, constituting the entire board. This resolution was unanimously adopted. ZBA:lk .F o��gOFFO4COG APPEALS BOARD MEMBERS �� y Southold Town Hall Gerard P. Goehringer, Chairman ,`* nZ, 53095 Main Road Serge Doyen,Jr. �y v D�`� P.O. Box 1179 James Dinizio, Jr. Oj �� SP.outhold, New York 11971 Robert A. Villa Fax(516) 765-1823 Lydia A. Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD February 13, 1996 Patricia C. Moore, Esq. P.O. Box 23 Matt.ituck, NY 11952 Re: Appl. No. 4358 - Variance (Robert Green) Dear Mrs. Moore: Please find enclosed a copy of the February 7, 1996 determination rendered by the Board of Appeals in the above matter. A copy of this determination has been transmitted to the Town Building Department pertaining to the owner's pending building permit application request. However, it will be necessary for you to contact the Building Department (765-1802) to be sure your application request is in complete form and returned to the shelf for re-activation. Also, due to the proximity of this project within 500 feet of a waterway, State or County Road, the Suffolk County Department of Planning is conducting its review, which is expected to be left for local (Town) determination without further steps on your part. If you have any questions, please feel free to call. Very truly yours, Linda Kowalski Enclosure Copies of Decision to: Building Department Suffolk County Department of Planning r l FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date . . . . TO J��C�-62 . . . . . . . . . . . . PLEASE TAKE NOTICE that yoi4r application dated . . . . . . . . . .r�l�!. . ��. . ., 19 for permit to �. . CC/L - . �/). �. . . . . at /J�f Location of Property . . . . . . . /. .��. . .' 6 C.� J! " Q. 1✓�( q ^Gs:'�"Q� House No. -Street Hamlet County Tax Map No. 1000 Section . . . � Kll. . . . . 6 Block . . .-�5 . . . . . . . . Lot . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . is ret need hreew.ith and disapproved on the following nds . X10! G /. . . . • . . . • . • • . . . . . • . • . . . • • . • • • • . . • . . . • . • . . • . . . •• . . . . . . •I . . . • . . • . . . . . . • Building Inspect RV 1/80 93 -7Ft 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ] FIREPLACE 8 CFIIMNEY R/EM_ A-RK/ S• DATE C INSPECTO i — ' reelQ I I A L re I VLZ �` ii r �.. �- . € .'. ':-•fir. �:- �`� ' . __f HULI- A o. - 'Y V'► `�F '. :1ty r r j,, i, r,Tl L i I POE r f i I �, UNIIb10111dd aMNa/011 arm � � � � � tolhksa�wykavbWlond Sedloi 7206 of rn Mnr Ybdt OW Fducstlon Las 1 f l Copies of 0*survey,map not;bwiq tyre lard surveyors tnkod no or embossed"W oW not be-, 'ch j 4 - to be a vd0 trw oopyt; 1 ilk i I awr.m«a tnme.Md t+srasn strlt no t ' onlylaft person for whom ftsurvey nd end an his bafraN M tM f} tencompany, apscy ed 4FldInstitution sted heaosrd� totheessigneesofMNnO had. t tutica.Guarantees aro not h-ske-hN 0 t � � - •'� ,1 _i�'t j �.�', Y'�r.E r- •�J ' i townsionat trstnutbnsaaubssgwt y } 1 s u f l � "r i t t T-71 ,. ._ AA - gyp"4•f. y t} ¢ �(, 7UQVE4�f�,[� f/ F.lia)' `C0. is t LAND 5 } R rw15 � V K ..._, 0Ot{ ! FORM NO. 1 3SETSOFPLANS . . . . . . . . . . n f TOWN OF SOUTHOLD SURVEY . . . . . _ _ . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 BLDG.DEP TEL.: 765-1802 t;DT I FY : TOWN OFSOU 1ii01, _ ii n CALL . . . . . . . . . . . . . . . . . . Examined . . . . . . . . . . . . . . . .119 . . . MAIL T0 : Approved . . . . . . . . . . . . . . . .. 19 . . . Permit No. . . . . . . . . . . . . . . . . . . . . . . . .. . Disapproved a/c . .G%N/ l! . /� . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 appli- 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 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 MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or dem ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c ho e, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecti0 s. (S' n ureof p ican or ame, if a corporation) . . . . . : c� . . . . . . . . Qz . . . (Mail' g address of applicant) State whether applicant is owner lessee g a e , architect, engineer, general contractor, electrician, plumber or builder. > . . . . . . . . . . . . . . . . . . . . . 41, . . . . .. . . `��!1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . "� .�e�Al . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which roposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.9.0. . . . . . . . � . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . .2� . ./. . . . . . . . . Block . . . . . . . . . . . . . . Lot . . .�. � . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . ./.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . ��Cl��. . . �M/ f . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . D . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Ot Y# k_.,I. .,. . . . . . . . . . . . V4 description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed,occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures; if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . .,. Height . . . . . I . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . I . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Numb erof Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . I . . . . . Rear . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot 14. Name ofOwner o regraded .. . . . . . . . . . . . . . • • Will excess 611 be removed from premises: Yes No . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . , . . . . . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. , e�ioru 0,4 D&cam Cow?L4�7TFo .P,vd &&Pe4, Akwd OFCC Ce Al 9 le ve fg Lo qy 6WAlee 7o- deCOX60,4TE J/ :2400L fury 01!5W 9/G I k y -5RF fid' SO-0Vr, 47-T-AcNe0 FO'0- C001p[eye-0 DPrK 1 i , 1V li DWeLLrall- STATE OF NEWYOIdIC�®C� S S COUNTY OF . . . . U „ , . . . . . . . . . . . . . . . . . . . I'!�L. . . !�!. I�. . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . . . . . .A.T7 o e0eY. .,. . . .(Df� . . r�C�(` !`_'-... . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly',authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work,will be performed in the manner'set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . . . . . . day of 9e!�G . . . . .. 19P. Notary Public. . . . . . . . . . . . . . . . County JOSEPH H. GIBBONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC, State of New Yorkt No. 524618265 (Signature of applicant) qualified In Suffolk County Commission Expires April 30, 10��)7 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL vL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 /�� , / Received . . . . . . . . . . . . 19 . . Examined . r'�`�.'�v . /. ., 19y16 �7� Approved . .�.'.!`r!e`'•'/ �•, 194)0. Permit Noc • Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. uilding Inspector) APPLI ION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . ..... . 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. remises or public streets b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining p tion of layout of property must be drawn on the diagram which is part of this appli- or areas, and giving a detailed descrip cation. c. The work covered by this application may not be commenced before issuance of Building Per the applicant. Such permit d. Upon approval of this application, the Building Inspector will issued a Building Permit to 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 MADE to the Building Department for the issuance of a Buil licable Laws,Ordinances nPermit Pursuant to ior Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other'appor demo . ; a regulations, and to Regulations, for the construction of buildings, additions or alterations, or for remo n, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building co 1 admit authorized inspectors on premises and in building for necessary inspectio g . . . . . ure of a licant,or�jae, if a c ora ti (Si � Xm. . . (Mailing address of a icant) •tett, engineer, general contractor, electrician, plumber or builder. State whether applicant is owner, Jesse , agent, arc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) Name of owner of premises . . . . . . . If applicant is a corporation, signature of duly authorized officer. . . . (Name and title of corporate officer) it } Builder's License No. , i FEB 9 F t- Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which propo ed work ill be 0one. • • • • ' Street hamlet House Number County 'fax Map No. 1000 Section • , • , , . . . Block . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ui. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . a. Existing use and occupancy . . . . . . . . . . . . �C?mr A. )) . .��C. b. Intended use and occupancy 6v��� . .,�owt?. . ..D.edl. .� . .{3vr.4�. . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (tobe paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . Number of dwellingunits nits on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . i . . . . . . . . . . . . . . . . . . ° . . . . . . . ° . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . .I . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . p ' 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . .Rear . . . . . . : . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . • . . • • • . • • • • . . • 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . .' Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . :. : . . . . Name of Former Owner 11. Tone or use district in which premises 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. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . .1 . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . .. . . . . . . Address . . . . . . . . . . . . . . . . . . Phone. No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . .. . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . PLOT DIAGRAM Locate dearly asad distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property.likes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. / /2m.eIto 4,/ oj' )erg CVw16bLc_1r0 14110 /> 1'oe (9I6 �� as NoTE® DATO: B.P.# �0 b it NOTIFYBUILDING DE 796-9902 9 AM TO 4 P FOR THE �t'�'"P ARgauo U<ck FOLLOWING INSPECTIONS: FOUNDATION - TWO REQUIRED i i A, e9. FOUNDATION POURED CONCRETE 111 2. ROUGH • FRAMING & PLUMBING lay d. ll�ISULATION tF 4. FINAL - CONSTRUCTION MUST / PAiSE ' BE COMPLETE FOR C.O. r UEt i� ALL i CONSTRUCTION SHALL MEET I( - THE ; REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OFNEW YOR /7 S.0 /�/ ` being duly sworn, deposes COUNTY or . . �Lh //— • • • • • . • • • . • • . . . . . /I and says that Ile is the applicant (Name of individual Signing contract) above named. / IIe is the . . . . . . . . . . 1,0,6tle-K . . .! `: . , . . GC/(JP��--. . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etch'.) 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 work will be performed in the manner set forth in the application filed therewith. Sworn to before me 77this GT" day f. 19 �� Notary Public, . . County J UBLI e Gf68pNs NOTARY PPUBLIC, State of New YoYk No. 524618265 . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0,81,fled In Suffolk Counrp s��7 (Signa of applicant) Commission Expires April 30, 10 C �f �r� L I a6oA� �et 19 3 c�a 7 ti r FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 / TEL.: 765-1802 w, Examined .✓vNr . .��. . ., 19P Application No. ��G�?d0• Approvedj&AAS W. �. . . ., 19FI. Permit No. /tZO . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —��.. (Building Inspector) APPLICATION FOR BUILDING PERMIT 1 Date . . . . . .. J\IL. . ., 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi Inspector,with 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 stref or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 issue a Building Permit to the applicant. Such pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) t 60 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ .4V?:).e.tr'. . . . . . . . . . . . . . . . ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Pt�T Name of owner of premises . . . , . .�. . . . . . . . . . . .o��.�-i:1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . . . . . `!• • n _ Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X96 /IJOY?76 . . . . 5.E.'�. . . . . . hhr . . . . . . . . . . . . S�)0-�-le1z . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . 5 . . , . . . • . • Block . . .C—).! . . . . . . . . . . Lot . . • ��r Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . �. . . . . . /: , G�llf /. . . . . . . U . . . . . . . . . . . . . . . . . .�C K �}� b. Intended use and occupancy . . . . . . . . . . .S. . . . . . . . . lv c.fir. 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . L .V. . . . . Alteration . . . . . . . . . . � Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . Other Work . . . . . . . . . . . . . . . (Description) 0u () 17 ( s 1. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) i. If dwelling,number of dwellingunits . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . ; . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . _ . . . . . . . i. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ). Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . I . . . ). Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ). Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . 1. Will lot be regraded . . . . . . . . . . . . Will excess fill be remov g . . . . . . . . . . . . . . . . �d from premises: Yes No 1. Name of Owner of premises . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . (-(37 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ;tenor or corner lot. III ra , �g v � 'LATE OF NEW Y K S S OiJNTY OF . . . . . . . • . . . . . . . . g y Hoses and says that he is the applicant . . being dui sworn de (N me of individual signing contract) !aove named. eisthe . . . . . . . . . . . . . .nzc , *?!ti , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc;) f said owner or owners, and is duly authorized to perform or have performed the 'isaid work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . . . . . .. . . . . .day of. . . . . . . 5)4f^: . . . . ., 19 . ora Public . . . . . . . . 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