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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-25724 Date: 05/12/98
THIS CERTIFIES that the building REPARI
Location of Property: 1025 PETES HILL RD ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 17 Block 4 Lot 22
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 8, 1995 pursuant to which
Building Permit No. 22639-Z dated MARCH 22, 1995
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 RELOCATE & REPAIR EXISTING TWO CAR ATTACHED GARAGE INTO AN ACCESSORY
GARAGE OF AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER
ZBA #4299 DATED MARCH 7, 1995.
The certificate is issued to ROBERT S HUGHES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N452781 05/05/98
PLUMBERS CERTIFICATION DATED J/ N/A
X'uilding Inspector
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
e4 2~
Date . . v...` 19
Np 22639 Z
Permission Is hereby granted to,
.
at remiseslocated at...... ~Q.a~. ••~+T~ ? S'.• ' r•a• ~6
r
',.45, .7z................../.........V../
County Tax Map No. 1000 Section /7 Block 6~...... Lot N
pursuant to application dated f A?d~1.•"•Qi•••.......... . 19.,7n,(........... and approved by the
Building Inspector. a Y~ l~` ` ~Q
~7~ s?
Fee R•....-... r p` ,
Building Inspec.
Rev. 6/30/80
ro G r a
TOWN Or SOUTHOLD
BUILDING DE2ARTM71
12 1998 rOW' I HALL
7165-i802
BL G. DEPT.
TOWN OF
APPLICATION FOR CERTTFICATE OF OCCUPANCY
A. This anoiication must be filled in ov tvicewriter OR ink and submitted to the building
nspector with the foliowing: for new building or new use:
L. Finai survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dent. of water supply and se 4 age-d4sposal(S-, 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 L Lead.
O. Commercial building, industrial building, multi-Die residences and similar buildings
and--installations, a certificate of Code Compliance from architact or engineer
responsible for the building.
o. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, L957) non-conforming uses, or buildings and
"pre-existing" land uses:
i Accurate survey of property showing ail 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 525.00, Additions to dwelling 525.00,
Alterations to dwelling $25.00, Swimming pool 325.00, Accessory building 525.00,
Additions to accessory building 525.00. Businesses X50.00.
2. Certificate of Occupancy on Pre-existing Buildins - X100.00
3. Copy of Certificate of Occupancy - .25c
4. Updated Certificate of Occupancy - $150.00
5. Temporary Certificate of Occupancy - Residential 515.0 Commercial 315.00
Date 7
New Construction.. Old Or Pre-existing ~Byµildin
Location or Property....C ~v i!S /`.......z r3Y~?J.........
House No. Street Hamlet
)nwer or Owners of Property... 'rz UGC /fc'J
;ounty Tax Map No 1000, Section.... 7.......B lock Lot.... F:.2-..............
>ubdivision iied Map............ Lot......................
?ermit No. 19,.63.91, .L...Date Of Permit.0~~?L(...1. ~....loplicant AJ... . /L .v.~.k~S•
lealch Dept. Approval ..........................Uaderwrit__s Aoproval.........................
?fanning Board ADproval
teeuest for: Temporary Certificate........... --nai Carticata......
lee Submitt_ad: $..1~ ?
CO a ~7a°P Ic. ix/
o~~gpFFO(,(~Co
GA
Town Hall, 53095 Main Road y Fax (516) 765-1823
P. O. Box 1179 u- Telephone (516) 765-1802
Southold, New York 11971 Oy
~~l ~ Sao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 5, 1998
Mr. Robert S. Hughes
P.O. Box 764
Orient, New York 11957-0764
SECOND NOTICE: Two certificates of occupancy required; one for
the garage and one for repairs to dwelling.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX The check is (outdated) $50.00 a v(AAJ'S r-- 1t), ,91
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22639-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
F&LD 'NSPECTION REPORT II DATE COMMENTS
ii ° rroa
FOUNDATION IST) - _ _ I! I
II y
i
i ii ® __2~- aA
il if
FOUNDATION (2ND) II
q~
u u F'
ROUGH FRAME S u O
PLUMBING ii
n n
II II
II II
II i
II II ~ ' \
INSULATION PER N. Y. N µ t+s
STATE ENERGY
CODE
P ii
ii i "
II I zc- H
II II
II
u n
n
FINAL it
ADDITIONAL COMMENTS:
l
r
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ro
H
APPEAL 0ARD MEMBERS ~o~~gOFFO~,f-co
h py Southold Town Hall
Gerard P. Goehringer, Chairman o° 53095 Main Road
Serge Doyen, Jr. w Z P.O. Box 1179
James Dinizio, Jr. O Southold, New York 11971
Robert A. Villa ~!J O Fax (516) 765-1823
Lydia A. Tortora hone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD ~Q pp,
ACTION OF THE BOARD OF APPEAL
g p,
Appl. No. 4299: m ELAT
N<1
Matter of the Application of~ROBERT S HUGHES ~Plu's t
application is based upon the January 3, 1995 Notice of
Disapproval from the Building Inspector, requesting a Variance
under the Zoning Ordinance, Article III, Section 100-33 for
permission to relocate existing garage as an accessory building in
an area other than the required rear yard. Property ID: 1025
Private Road #6, Orient, NY; County Tax Map District 1000,
Section 17, Block 4 Lot 22.
WHEREAS, after due notice, a public hearing was held on
March 1, 1995, and at said hearing all those who desired to be
heard were heard and their testimony recorded; and
WHEREAS, the Board has carefully considered all testimony
and documentation submitted concerning this application; and
WHEREAS, Board Members have personally viewed and are
familiar with the premises in question, its present zoning, and the
surrounding areas; and
WHEREAS, the Board made the following findings of fact:
1. This is an appeal of the January 23, 1995 Notice of
Disapproval issuance by the Building Inspector in which the
appellant has requested an application for a building permit for
the relocation of an existing garage, which is presently attached
to the dwelling, and place the same in the southerly front yard
area at 35 feet from the westerly property line and more than 200
feet from the southerly most (front) property line.
2. The premises in question is located in the R-80
Residential Zone District and contains a total area of 2.588
acres. The survey map amended January 31, 1995 by Roderick
VanTuyl, P.C. and submitted with this application shows this
parcel to be improved with an one-story, single-family dwelling
structure built about 1962, attached garage and two porches. The
garage area attached to_ the. dwelling is shown to be presently set-..-
back
3214" from the westerly side property line.
Page 2 - Appeal No. 4299
Application of ROBERT W. HUGHES
Decision Rendered March 1, 1995
3. The subject garage is 24 ft. by 24 ft. in size and does
not exceed the 18 ft. height limitations. The garage will continue
to be used for garage and storage purposes accessory and
incidental to the owner's residence. The zoning code does not
permit accessory buildings to be used or operated for business or
similar gainful purposes, such as rental for non-owner storage,
habitable area, or as a separate principal use.
4. It is the position of the Board in considering this
application that:
(a) the circumstances are uniquely related to the
property the property technically has two front yard areas: to
the south and east of the dwelling due to the location of a
right-of-way which is used for access to properties located further
north of the applicant's property.
(b) the relief requested is not unreasonable when
considering the character of the neighborhood and the location of
other buildings.
(c) it is not uncommon for an owner to request a garage
to be located accessory to the residence and at a reasonable
distance from a driveway area or right-of-way;
(d) the relief requested is not substantial in relation
to the requirements - the garage is located at greater setbacks
than is normally required for accessory buildings on this size of
property;
(e) the variance requested does not involve any increase
of dwelling unit density;
(f) the relief requested will not cause a substantial
effect on available governmental facilities since the structure is
for enclosed parking and storage of the owner's own lawn and other
items;
(g) the variance will not in turn be adverse to the
safety, health, welfare, comfort, convenience, or order of the
town, or be adverse to neighboring properties, and the benefit to
the applicant is greater when weighed against the health, safety,
and welfare of the community;
(h) in considering all the above factors, the interests
of justice will be served by granting the variance as further noted
below.
Accordingly, on motion by Member Tortora, seconded by
Page 3 - Appeal No. 4299
Application of ROBERT W. HUGHES
Decision Rendered March 1, 1995
Chairman Goehringer, it was
RESOLVED, to GRANT a Variance for the location of the
existing accessory garage, when detached, in the requested front
yard area as described in the above findings, SUBJECT TO THE
FOLLOWING CONDITIONS:
1. That the subject garage shall be subject to the current
and future laws " pertaining to limitations on the use thereof as an
accessory building; there be not be a conversion or modification
from storage/garage use to sleeping or living quarters (or other
prohibited use as governed by the provisions of the zoning code.)
2. Plumbing utilities shall be permitted for outside shower
facility (facilities);
3. There be no inside bathroom, shower or bath;
4. Electric utilities shall be permitted;
Vote of the Board: Ayes: Messrs. Tortora, Goehringer,
Villa, Dinizio and Doyen. This resolution was unanimously adopted.
*
lk
GERARD P. GOEHRINGE , CHAIR N
F
MAR A.9 '95 11:4"All SOUTHOLD TOWN HALL 516 76~ 1623 P.1
Postdf" brand fax transmittal memo
7671 ao1 pages .
Co.
Fro
From
Cn
APPEALS BOARD MEMBERS Phone #
M7,
Gerard P (ioehringer, Chairman c S ass 7 (off- ~a 3
Serge Doyen, Jr.
James Dinizio, Jr. Southold, New York 11971
Robert A. Villa -yol ~y0 Fax (516) 765.1823
Lydia A. Tortora Telephone (516) 765.1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
March 7, 1995
Robert S. Hughes, Esq.
218 Front Street
P.O. Box 1'28
Greenport, NY 119440128
Re: Appl. No, 4299 - Variance to Relocate Garage
Dear Mr. Hughes:
Please find attached a copy of the Board's findings and
determination rendered at our March 1, 1995 Regular Meeting
concerning your recent application for a variance.
For convenience purposes, we have forwarded copies of this
determination, to the Building Department for their permanent
reoords.
If you have questions pertaining to this determination,
please feel free to call us.
Very truly yours,
Linda Kowalski
Enclosure
cc: Building Department
Copy also faxed to 77-0955 ~
L
MAR `Y
Y
- 81995
BLDG DEPT
0 SOUI,~ ,
`r~L I,
rIAR,08 '95 11:47R11 SOUTHOLD TOWN HALL 515 765 18P3 F.
APPEALS BOARD MEMBERS ~a%v Ff ~C
Southold 7bwn Hall
Gerard P. Goehriager, Chairman 53095 Main Road
Serge Doyen, Jr, w P.O. Box 1179
James Dinizio, Jr. O Southold, New York 11971
Robert A, Villa Fax (516) 765-1823
Lydia A.Thrtora Oj ~a Telephone(516)765.1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
ACTION OF THE BOARD OF APPEALS
- D
Appl. No. 4299: co
Matter of the Applicatioxt of ROBERT S. HUGHES. This
application is based upon the January 23, 1995 Notice of 3
Disapproval from the Building Inspector, requesting a Variance
under the Zoning Ordinance, Article 111, Section 100-33 for t,
permission to relocate existing garage as an accessory building in
an area other than the required rear yard. Property ID: 1025
Private Road #6, Orient, NY; County Tax Map District 1000,
Section 17, Block 4 Lot 22.
WHEREAS, after due notice, a public hearing was held on
March 1, 1995, and at said hearing all those who desired to be
heard were heard and their testimony recorded; and
WHEREAS, the Board has carefully considered all testimony
and documentation submitted concerning this application; and
WHEREAS, Board Members have personally viewed and are
familiar with, the premises in question, its present zoning, and the
surrounding areas; and
WHEREAS, the Board made the following findings of fact:
1. This is an appeal of the January 23, 1995 Notice of
Disapproval issuance by the Building Inspector in which the
appellant has requested an application for a building permit for
the relocation of an existing garage, which is presently attached
to the dwelling, and place the same in the southerly front yard
area at 35 feet from the westerly property line and more than 200
feet from the southerly most (front) property line.
2. The premises in question is located in the R-80
Residential Zone District and contains a total area of 2,588
acres. The survey map amended January 31, 1995 by Roderick
VanTuyl, P. C. and submitted with this application shows this
parcel to be improved with an one-story, single-family dwelling
structure built about 1962, attached garage and two porches. The
garage area attached to the dwelling is shown to be presently set
back 3214" from the westerly side property line.
a
MHR,Oe 195 11:46AM '=OUTHOLD TObIN HALL. 516 755 182 R.3
Page 2 - Appeal No. 4299
Application of ROBERT W. HUGHES
Decision Rendered March 1, 1995
3. The subject garage is 24 ft. by 24 ft. in size and does
not exceed the 18 ft. height limitations. The garage will continue
to be used for garage and storage purposes accessory and
incidental to the owner's residence. The zoning code does not
permit accessory buildings to be used or operated for business or
similar gainful purposes, such as rental for non-owner storage,
habitable area, or as a separate principal use.
4. It is the position of the Board in considering this
application that,
(a) the circumstances are uniquely related to the
property the property technically has two front yard areas: to
the south and east of the dwelling due to the location of a
right-of-way which is used for access to properties located further
north of the applicant's property.
(b) the relief requested is not unreasonable when
considering the character of the neighborhood and the location of
other buildings.
(c) it is not uncommon for an owner to request a garage
to be located accessory to the residence and at a reasonable
distance from a driveway area or right-of-way;
(d) the relief requested is not substantial in relation
to the requirements - the garage is located at greater setbacks
than is normally required for accessory buildings on this size of
property;
(e) the variance requested does not involve any increase
of dwelling unit density;
(f) the relief requested will not cause a substantial
effect on available governmental facilities since the structure is
for enclosed parking and storage of the owner's own lawn and other
items;
(g) the variance will not in turn be adverse to the
safety, health, welfare, comfort, convenience, or order of the
town, or be adverse to neighboring properties, and the benefit to
the applicant is greater when weighed against the health, safety,
and welfare of the community;
(h) in considering all the above factors, the interests
of justice will be served by granting the variance as further noted
below.
Accordingly, on motion by Member Tortora, seconded by
a. HAP Oe '95 11:48AH SOUTHOLD TOIJN HALL 516 755 1823 P.4
Page 3 - Appeal No. 4299
Application of ROBERT W. HUGHES
Decision Rendered March 1, 1995
Chairman Coehringer, it was
RESOLVED, to GRANT a Variance for the. location of the
existing accessory garage, when detached, in the requested front
yard area as described in the above findings, SUBJECT TO THE
FOLLOWING CONDITIONS:
1. That the subject garage shall be subject to the current
and future laws pertaining to limitations on the use thereof as an
accessory building; there be not be a conversion or modification
from storage/garage use to sleeping or living quarters (or other
prohibited use as governed by the provisions of the zoning code.)
2. Plumbing utilities shall be permitted for outside shower
facility (facilities);
3. There be no inside bathroom, shower or bath;
4. Electric utilities shall be permitted;
Vote of the Board: Ayes: Messrs. Tortora, Goehringer,
Villa, Dinizio and Doyen. This resolution was unanimously adopted.
GERARD P. GOEHRINGEICHAIR N
- FORM NO. $ ,
TOWN OF SOUTIIOLD
BUILDING DL'PARTJiL•NT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
To l FJ~~reX ?~~u//1'~~CPX7 `t ~~teS
PLEASE TAKE NOTICE that/your application dated ~~yt . _ • . • Ig~.f i'i;~;,~
for permit to Aela ee .,e./.`Z .
~J . at
Location of Property /'(Z///0& .~.~(p
House No.
.
Street-
et
•/lamlet
County Tax Map No. 1000 Section , , Block : Lot
Subdivision Filed Map No. Lot No.
is ret cd herewith and disapproved on the following grounds
• . . . • . . . . . /I~~9~G)E~LG . . . . . . . . . . . . . . .
•.....1~///Vi//.///
1I . • . . . . . . • . . . . . . • . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . • • . . . . . • . . . . . . . . . . .
Building, nspec r
RV 1/80 '3
~Z6-~3
765-1802
BUILDING DEPT.
PECTION
[ FO DATION 1 ST [ ] ROUGH PLBG.
[ OUNDATION 2ND [ ] INSULATION
[ } FRAMING [ } FINAL
[ ] FIREPLACE & CHIMNEY
REM KS:
DATE J INSPECTO
7
M-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ I ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTO
f
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
( ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: "6ev " 1~~?
DATE f INSPECTOR 4 zlz
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & HIMNEY
REMARKS:
DATE INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195099 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date' MAY 05,1998 Application No. on jfle 15953598/98 N 452781
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
ROBERT HUGHES, PETERS NECK ROAD, ORIENT, NY
in the following location; ? Basement ? 1st Fl. ? 2nd Fl. GAR Section Block Lot
was examined on APRIL 30,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
5 1 4 5
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H P. GAS H.P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO. OF FEET AMT. WATTS
SERVICE DISCONNECT- No. oP_ _.S_ E.. R .__V -I C- - --E - - -
IJI METER NO. OF CC COND. A. W. G. A. W. G. A. W. G.
AMT. AMP TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W p 0 OF CC. D. NO OF HIAEG OF HI LEG NO. OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
8 KW GENERATOR-1
PANELBOARDS:1-2 CIR. 100
G. F. C. I:-2
JIM SAGE ELEC. INC. LIC.#3635-E L L
PO BOX 38
GREENPORT, NY, 11944-0038 GENERAL MANAGER
Per / /
This certificate must not be altered in any manner; return to the olllce of the Board If Incorrect. Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
r~ Q N ~ B0,1FD OF HEALTH _
~..~..e.~__..~..__„.~....„, SURVEY V - - - .
FORMNO.1 J SETS OF PL.A.7S . . -
TOWN OF SOUTHOLD • -
¢~,I MAR - g 1995 1 BUILDING DEPARTMENT CHECK • . _ . _ _
TOWN HALL SEPTIC ronn
o' .
BLDG.DEP7 SOUTIIOLD, N. Y. 11971 323 ° 2 Gy4 b
a~ N OF SOUTHOL.D ) TEL.: 765-1802 NOT I F'f
CALL .~J.?Z:100 W
Examined M? , , , , 19Q „ htn I L To
Approved 2P r!G!~~ , lS" . Permit No. ire! • - .
y
Disapproved, a/c .
(Building Inspecto
PP CATION FOR BU LDING PERMHT
Date 19 .
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 stice
pr 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 issued a Building Permit to the applicant. Such perm
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 Occupant
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 c
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, ho s g /code, and regulations, and tt
admit authorized inspectors on premises and in building for necessary i tt ns.
(Signature of applicant, oY flame, if a corporation)
UY
P0,
(Mailing address of applicant)
State whether raapplicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
.r..........0 43/r~F.
N
ame of owner of premises ..,q)q,,,,,~< pYe>G, aS
(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.
I, Location of land on which proposed work will be done.
/ a 2 i..~Fr» s ~7! 4 c. pa 6 «N s
House Number
Street Hamlet
County Tax Map No. 1000 Section . Block Lot... . ~-Z............
Subdivision Filed Map No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy , C /1 fL, , , ,Ce,(E A•~
b. Intended use and occupancy ....4 . , , C r .6A lr .'7~ ~S. , , ,
~aPPlicable): New Building , , , , , . , , , _ :\ddition Alteration
Nature 176 o V I N(. work (k.chk16eck 1 N ~ which,
Repair
• • • • • • Removal Demolition • • • • ~ • • '
L Other Work . .
4. Estimated Cost .....W/ D4 tl. • . (Description)
o, number of dwclliri Fee .
5. If dwelling (to be paid on filing this application)
units . . . .
•
If garage, number of cars . Nuinber of dwelling units on each floor , .
6. If business, commercial or mixed occupancy, specify nature and extent of.each.type of use " • .
7. Dimensions of rexisting structures, if any: Front a, G .......Rear
k• Depth
Height ~ ' mbcrofStorics....1.vv . .
Dimensions of same structure (vith alterations or additions: Front . , Q el , , , , • • , , , , Rear ? y, , , • • ,
Depth ,Cj...... Height Number of Stories 4
8. Dimensions of entire new construction: Front Rear Z-11 De th
Height .1 f Number of Stories . ..1.. P
9. Size of lot: Front r.o d e " , , • .
Rear.......`1 7 U........ D pth Q./....'...........
10, Date of Purchase C( . . . . . . . i ame of Former Owner . , .v. ~,~j, , . , , •
1 I. Zone or use district in which Pr,remis ~ ~ka• •
CM15CS Bra; SitLatarl .
12. Does proposed construction violate any zoning law, ordinance or regulation:
13, Will lot be re-raded .Mil] ex~jess i11 be removed from premises: .Yes
14. Name of Owner of premises a6 S
, o>7dj /yA Ai T. Address t O.,L...7f•1r,Qk0ey,~ • , Phone No. N
Name of Architect ° f
Name of Contractor . • • • • • • • • • • • • ' ' ' ' ' • • Address ...................Phone No..........
Address
15.' Is this property within 300 feet of a tidal wetland? .,*Ye. •Phone No
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.
;TATE OF NEW YORK
.S
:0UNTYOf.. ,v F(-ge_.rc,
r~4.s??%... s•...1lul"/T°.5.............. bcin•duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) bove named.
(Con tractor, agent, corporate officer, etc.) " " " " " "
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~plication; 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 sct forth in the application filed therewith.
vorn to before me this .....day ofA . .!i • , 19 5 _
tary Public \ County
I lfc,Siato Yak
' ignature of applicant)
aw ApI _
BOARD OF HEALTH
(2 t2 M (5 3 SETS OF PLANS
l5 l~J l5 V ~s FORM NO. 1
D 5SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM
Ill JAW -131995 k TOWN HALL ~JJ~_,r~
COUTHOLD, N.Y. 11971 NOTIFY I'"~''1 IL'r 1,4c-t' 0
HLOG. DEFT. TEL.: 7G5-1802 CALL
TOWN OF SOUTWOt~D ~ , „ ~
Examined .................19... MAIL T0
Approved 19 Permit ~N/o...... .
Disapproved
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 1gg
St5.
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 street
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 perm:
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 ctions.
(Signature of applicant, or name, if a corporation)'
my. yI
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
:cryT .
Name of owner of premises ...opi'I , .
(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 proposed work will be done . .
A& 025 ~ i-TA +4lu- 9-D o tZk%S .
.y.
House Number Street
' Hamlet
County Tax Alap No. 1000 Section Block i, , , , , , , , , , , , , Lot 2
Subdivision Filed Map No. Lot .
(Name)
s
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a, Existing use and occupancy ......,'.t."v,Lz fA' m timt ~ma
b. Intended use and occupancy t (lvcu. r* 1Lm Fe5(cot
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work ~ ~j M h 1 OP
1 (t1CSC ton)
4. Estimated Cost . EO101V..7 Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units I.......... Number of dwelling units on each floor .
If garage, 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 (2 0 ...LY... Rear Depth .7-( , ,
Height . , tVt......... Number of Stories , , ,
Dimensions of same structure with alterations or additions: Front Rear .
Depth Height , Number of Stories , .
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories , .
9. Size of lot: Front ...1/..M. ~k~tt9dl~~ tF Depth .
10. Date of Purchase , ; game of Former Owner
11. Zone or use district in which premises are situated ....$Q, . , , , , , , , , .
12. Does proposed construction violate any zoning law, ordinance or regulation: ........~L wr(014Q.F. )
13. Will lot be regraded AP Will excess fill be r oved from premises: Yes
14. Name of Owner of premises .P60~(4 A0065. . Address ads Pis pp Phone No. Sf ta• g2376~~
Name of Architect . , , , , , , , Address Phone No. 4-7.7.-315?
If Southold cicaatt ....,:..'Address PhoneN... '
15.1s this s property loced within 3 300=feet of a tidal wetland? *YES NO.
* yes, 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.
STATE OF N EW YO RK
COUNTY OF. ~U of {L, , , , , S'; S
....W • • • • • . • • • • • • • • • • • • • , being duly sworn, deposes and says that he is the applicant
(Name of individual siening contract)
above named. e~ p~
He is the ......7[W~.4~ .~i ,4th T............
(Contractor, agenf, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform ornhave 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
!!.:4....... dayof...Fi. 19.r(~7
Nota Public, t aunty
+1rulezABETH .............A fUEVILLE
Notruy Public, State of t:ww Bork (Signature of applicant)
No, 52-e 12 ,9^0, Suffolk Oo
Perm Expires October 3t, 19yp{y,
NI/ HUGHES
P 20 P E_2T_Y
MAP OF PQ-0P
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AF RO p~1S NOTED uswyE
DAT4: S B,R p.3a631` - - t
FEE: 802 BY.. NEW
NOTIFY BUILDING DEPA FPn r.ING
765-1802 9 AM TO A FOR THE FOLLOWING INSPECTIONS:
1. FOUNDATION - TWOREQUIRED / z.*Y
FOR POURED CONCRETE
CI 2. ROUGH - FRAMING & PLUMBING
3. INSULATION
DUI 4. FINAL - CONSTRUCTION MUST I - - - " BE COMPLETE FOR C.O./,~"=
ALL CONSTRUCTION SHALL MEET ExIST L - °-----~W~~-----~-- --==-1 wl jJ m
THE REQUIREMENT'S OF THE N.Y.
STATE CONSTRUCTION & ENERGY I '
CODES. NOT RESPONSIBLE FOR
I" DESIGN OR CONSTRUCTION ERRORS - - y~ \n
.4-i -F IL "4 t
_ I
i I
Tn ? LE ZI: TP C u c D rmvFr, - LEFT SI^L= -
T'cr,F. np,ll T,P"F r,on Plr-7E1,. ___M1 rzz
'nljI 'L"~ kL r ,tip-(P REST,
Y,CRLFT EYl6T -golLblr!G- y,i, L,yS nt~s
NOTE: 8.7'rl'OM 01= of-,,4 QU !',FL r(~ \ HI~1 EI" KOO nliJFllu rl CCO F'Jjli-I f- TO
YV'EC+""~AI~tN~ La r.,~l-r,nhl,5
t is w za
III( 1 1 PLUMBING ~I 1 I -
I I ALL PLUMBING WASTE I - - ~ 11 & WATER LINES NEED _ _ _ _ _ -
T TESTING BEFORE COVERING-
NIFSH ~c IN FfFf F, c`A5T
If Copper tubing is used
for water distributing PLUMBER CERTIFICATION system; piping shall be
j ON LEAD CONTENT BEFORE of types K or L only
CERTIFICATE OF OCCUPANCY
SOLDER USED IN WATER// , live 2 gW~r~xrrRA(IL
SUPPLY SYSTEM CANNOT Grp `Xb /S
i EXCEED 2110 of 1% LEAD.
j EI. L/1"
.
X! OCCUPANCY OR 1 l~
I ~ 'paoR S1~L
USE IS UNLAWFUL ~ REA ~'S GRAbL
I 'Lx40 CCA
i WITHOUT CERTIFICATE f n~ 1
OF OCCUPANCY
_ MR.&MKS, t oaLrT NuGN 5 3 (05 'Q ScEIE AIPIIOVEO er
p w +'.°T)D $ 5gE PINN oS"er F'+S NElC GED(3Gl if
BE ~ISID
yf J
p Ag I. J 1 / p DRAWwG NUMBER O OF I
Y_