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Home My WebLink About22816-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-23698 Date JUNE 13, 1995 TBIS CERTIFIES that the buildin~ ACCESSORY Location of Propert~ 805 MEADOWBEACH ROAD House No. Street County Tax Map No. 1000 Section 111 Block 10 Subdivision Filed Map No. CUTC~OGUE, N.Y. Hamlet Lot 18.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1995 pursuant to which Building Permit No. 22816-Z dated JUNE 12, 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 ACCESSORY GAZEBO IN FRONT YARD "AS BUILT" AS PER ZONING BOARD OF APPEALS %4312 DATED JUNE 7, 1995. E. KIRK NOLLAND & WIFE The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22816 Z June 12 ~ Date ............................................................. 19~.5. ....... Permission Is hereby granted to: Jean C. Longnecker, a/cE. Kirk ltolland & 805 J. ieadox~ Beach Rd. '"P'.'O';"~o~"St5 .............................................................. Cutchogue, N.Y. 11935 to .......... .................... ZONING BOARD OF APPEALS #4312 DATED JIINg 7, 1995 CountyTax Map No. 1000 Section ......... I,.!..I ........... Block ......... !,,0, .............. Lot No ....... 1.,8.,.,.! ............... RAY 5, 1995 pursuant to application dated .......................................................... 19 ................ and approved bythe Building Inspector. Fee $ ........ ~,5, :,.0..0. ....... ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEP~RT~'IENT 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 H~hlth Dept. of water supply and sewerage-disposal(s-9 form). 3. Approval of electricad installation from Board of Fire Underwriters. 4. Sworn statement fromlplumber certifying that the solder used in system contail-s less than 2/10 of 1% lead· 5. Comm?rcial building, industrial building, multiple residences a .... and lnstallat~ons,\a certificate of ~ ~ ~* ~ nd similar bu~ldzngs responsza±e for the buildzng. 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-ex~st~ng 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 Buildint - $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 ... . .......... New Construction ........... Old Or Pre-existing Building...~.~.~..~?... House No. ' ' ' 'Street Hamlet ....... Onwer or Owners ,.,f Property.. . . County Tax Map No 000, Section../../d. ........ .. ~ubd~vzs~on ............................. Filed Map ............ Lot ..................... Permit No ................ Date Of Permit .............. Applicant .......................... !{ealth Dept Approval · ' ..................... Underwriters Approval ......................... Planning Board Approval .................... lequest for: Temporary Certificate ........... Final Certicate ........... APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Lydia A. Tortora Southold Town Hall 53095 Main Road RO. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Tetephone (5 I6) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD June 9, 1995 Mr. and Mrs. E. Kirk Holland 4400 Vanston Road Cutchogue, NY 11935 Re: Appl. No. 4312 - Variance for Gazebo Dear Mr. and Mrs. Holland: Please find attached a copy of the Board's findings and determination rendered at our June 7, 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 records. You may wish to contact the Building Department upon receiving the enclosures to obtain your final permit and Certificate of Occupancy(les). In the interim you may be contacted by the Suffolk County Department of Planning pertaining to a $50 fee normally charged by the County for their review of variance and other projects located within 500 feet of a waterway or State or County Read. If you have questions pertaining to this determination, please feel free to call. Very truly yours, Lbxda Kowalski Enclosure cc: Building Department Suffolk County Department of Plarm2ng APPEALS BOARD M]EMBERS Gerard P. Goehringer. Chairman Serge Doyen. Ir. James Dinizio, Jr. Robert A. Villa Lydia A. Tonora BOARD OF APPEALS TOVv-N OF SOUTHOLD ACTION OF THE BOARD OF APPEALS Southold Town Hall 53095 Main Road EO. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1809 Appl. No. 4312: Matter of the Application of JEAN C. HOrJ.AND-LONGNECKER AND E. KIRK HOLLAND. This application is based upon the May 5, 1995 Notice of Disapproval issued by the Builcttug Inspector, wherein applicant is requesting a building permit for an accessory gazebo ( as exists), disapproved on the following grounds: Variance under the Zoning Ordinance, Article III-A, Section 100-30A.4 "Accessory buildings, 100-33 shall be located in the required rear yard." The subject premises contains a lot area of approx~mataly 62,742 sq. ft. (which includes the iow land section). This property was in 1989 zoned R-40 Low-Density Residential. Property Location: Corner of Meadow Beach Road, Lowland and S,m~et Roads at Nassau Point, Cutchogue; County Tax Map ID No. 1000-11t-10-18.1 (prey. 18 & 1). WHEI{EAS, after due notice, a public hearing was held on June 29, 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 thi.q application; and WHEREAS, Board Members have personally viewed and are familia, with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, tl/e Board made the following find~n~rs of fact: 1. This is an appeal of the May 5, 1995 Notice of Disapproval issued by the Building Inspector in which the appellant h~ requested am application for a building permit for the location of an accessory gazebo structure, which is presently "exists" in a front yard area as shown on the sketched map submitted with this application. NIP. Holland at the hearing confirmed that the distaalce to the Meadow Beach Road property line is appro~Smately 30 feet, and the distance to the house is appro~rimately 28 feet. 2. The premises in question is located in the R-40 Residential Zone District. The copy of the survey map shows an existing single-family dwelling. Page 2 - Appeal No. 4312 Applica~on of JEAN C. HOLLAND-LONGNECKEi{. Decision Rendered June 7, 1995 3. The subject accessory building is 28' in dlm~neter and does not exceed the 18 ft. height ~imitation. 4. It is the position of the Board in considering thie application that: (a) the circumstmnees are uniquely related to the property -- the property technically has three front yard areas and the remaining yard area is not buildable for an accessory building due to the l~mlted setbacks as established from the house. (b) the relief requested is not un~easonable when considering the charecter of the neighborhood and the location of other bui]dln gs. (c) it is not ~common for ~. owner to request an accessory building to be located accessory to the residence and at a ai.~tance to enjoy the v-istas of the surreund~n~ waterfront (d) the relief requested is not substantial in relation to the requirements the gurege is located at greater setbacks than is ~ormm~ly required for accessory buildings on this size of property; (e) the var~mnce requested does not involve an increase in living area or dwell~ng unit density; (f) the relief requested will not cause a substantial effect on available governmental facilities since the structure is for enjoyment for the out-of-doors; (g) the variance will not in tu}n 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 agm~nmt 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 Dinizio, seconded by Member Villa, it was RESOLVED, to GRANT a Variance for the existing accessory gazebo in the above-noted front yard location, SUBJECT TO THE Page 3 - Appeal No. 4312 AppLication of JEAN C. HO~D-LONGNECKER Decision Rendered June 7, 1995 FOLLOWING CONDITION: The gazebo shall not be enclosed with wmll.~, however, screening will be permitted. Vote of the Board: Ayes: Messrs. Doyen, DiniEio, Villa, Tortora and Goehringer. This resolution WaS ~mmnlrnously adopted. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL . n Date ..c~./~.. 19~.<~.-~. .... ~~.~.~¢-- ~ ...... ~ PLEASE TAKE NOTICE that your application dated ~ ................. 19 ~ Z~i~:~pr~~'. ~ ~~~, ~~~'~ ~~~.~ · · · at County Tax Map No. 1000 Section .... Z~ ..... Block /~. Lot ~/ Subdivision ................. Filed Map No ........... '. ..... Lft No .... D.... ~ ....... is h~re~th and d~sapproved on the following grounds .~...~~.. ~ ~ returned .~~./~ ~.~.~ ~... ~~ ~~..../~... ~...'~~~. ~ .......... , ............. : ...~ .... ~~:~..~.. ~~~ · ~~~:~.~~..,: ....... C ...................... R~ ~/80 I, 47,5eD 5.F. T~Tv,/NI OF' ~OUrNOb[) ,,~t~', , PEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Lydia A. Tortora BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1809 June 9, 1995 Mr. and Mrs. E. Kirk Holland 4400 Vanston Road Cutchogue, NY 11935 Re: Appl. No. 4312 - Variance for Gazebo Dear Mr. and Mrs. HoHand: Please find attached a copy of the Board's findings and determination rendered at our June 7, 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 records. You may wish to contact the Building Department upon receiving the enclosures to obtain your final permit and Certificate of Occupancy(les). In the interim you may be contacted by the Suffolk County Department of Planning pertaining to a $50 fee normally charged by the County for their review of variance and other projects located within 500 feet of a waterway or State or County Road. If you have questions pertaining to this determination, please feel free to call. Very truly yours, Enclosure / Linda Kowalski cc: Building Department Suffolk County Department of Planning APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Lydia A. Tortora Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD OF APPEALS Appl. No. 4312: Matter of the Application of JEAN C. HOLLAND-LONGNECKER AND E. KIRK }IOLLAND. This application is based upon the May 5, 1995 Notice of Disapproval issued by the Building Inspector, wherein applicant is requesting a building permit for an accessory gazebo (as exists), disapproved on the following grounds: Variance under the Zoning Ordinance, Article III-A, Section 100-30A.4 "Accessory buildings, 100-33 shall 'be located in the required rear yard." The subject premises contains a lot area of appro:~mately 62,742 sq- ft. (which includes the Iow land section). This property was in 1989 zoned R-40 Low-Density Residential. Property Location: Corner of Meadow Beach Road, Lowland and Sunset Roads at Nassau Point, Cutchol,rue; County Tax Map ID No. 1000-111-10-18.1 (prey. 18 & 1). WHEREAS, after due notice, a public hearing was held on June 29, 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, Beard Members have personally viewed and are famillar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Beard made the following findings of fact: 1. This is an appeal of the May 5, 1995 Notice of Disapproval issued by the Building Inspector in which the appellant has requested an application for a building permit for the location of an accessory gazebo structure, which is presently "exists" in a front yard area as shown on the sketched map submitted with this application. Mr. Holland at the hearing confirmed that the distance to the Meadow Beach Road property line is approximately 30 feet, and the distance to the house is approximately 28 feet. 2. The premises in question is located in the R-40 Residential Zone District. The copy of the survey map shows an existing single-family dwelling. Page 2 - Appeal No. 4312 Applicalion of JEAN C. HOLLAND-LONGNECKER Decision Rendered June 7, 1995 3. The subject accessory building is 28' in diameter a~d does not exceed the 18 ft. height limitation. 4. It is the position of the Board in considering this application that: (a) the circumstances are uniquely related to the property -- the property technlealiy has three front yard areas and the remaining yard area is not buildable for an accessory building due to the limited setbacks as established from the house. (b) the relief reques~ted 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 an accessory building to be located accessory to the residence and at a distance to enjoy the vistas of the surrounding waterfront community; (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 an increase in living area or dwelling unit density; (f) the relief requested will not cause a substantial effect on available governmental facilities since the structure is for enjoyment for the out-of-doors; (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 ali tile above factors, the interests of justice will be served by granting the variance as further noted below. Accordingly, on motion by Member Dinlzio, seconded by Member Villa, it was RESOLVED, to GRANT a Variance for the exis(ing accessory gazebo in the above-noted front yard location, SUBJECT TO THE Page 3 - Appeal No. 4312 Application of JEAN C. HOLLAND-LONGNECKER Decision Rendered June 7, 1995 FOLLOWING CONDITION: The gazebo shall not be enclosed with walls, however, screening will be permitted. Vote of the Board: Ayes: Messrs. Doyen, Dinizio, Villa, Tortora and Goehriuger. This resolution was unonlmously adopted. rard P. Goe~r'mgerJ, Crnair~gn Southo!d Town Board o£ MAIN f~OAD STATE I~OAD 25 SOUTHDLD, L.I,, N.Y. 119"71 TELEPHONE {516) 765-'{809 ACTION OF THE ZONING BOARD OF,APPEALS Appeal No. 3361 Application Dated Apri] ]9, 1985 (Public Hearings TO: Michael J. Hall, Esq. as Attorney for MRS. JEAN C. HOLLAND Youngs Avenue Southold, NY 11971 5/23/85 and 6/13/85) [Appellant (s) ] At a Meeting of the the above on your Zoning Board of Appeals held on June ]9, ]985, appeal was considered, and the action, indicated below was taken [ ] Request for Variance Due to Lack of Access to Property New York Town Law, section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section [×] Request for Variance to the Zoning Ordinance Article III , Section 100-31, Bulk Schedule [ ] Request for Application for JEAN C.~HOLLAND, by M.J. Hall, Esq., Youngs Avenue, Southold, NY for a Variance to the Zoning Ordinance, Article III, Sec- tion lO0-31 and Bulk Schedule, for approval of insufficient lot area and width of two proposed parcels located at Lowland Road, Meadow Beach Lane, and Sunset Road, Nassau Point Map Section C, Lots 327 and 328, and Walter Grabie Map, Lots 36 and 37~ Cutchogue, NY; County Tax Map Dis- trict 1000, Section 111, Block 10, Lots 18, 1 and 2. WHEREAS, a public hearing was held on May 23, 1985 and June 13, 1985, at which time the hearing was concluded; and WHEREAS, the board has considered all testimony and documentation in the record concerning this application; and WHEREAS, the board made the following findings of fact: 1. The property in question is located at the west side of Sunset Road and the south side of Meadow Beach Lane, Nassau Point, Cutchogue, New York, is located in an "A-80" Residential and Agricultural Zoning District, and is more particularly ~dentified as Lots 327 and 328, Nassau Point Map Section C dated August 16, 1922,.contai,nin9 a total area of 95,660 sq. ft., and Lots 36 and 37, Map of Walter Grabie, dated April 19, 1938, containing a total area of 21,107 sq. ft. (including underwater land); and identified on the Suffolk County Tax Maps as District 1000, Section 111, Block 1.0, Lot 18, and Lots 1 and 2, respectively. 2. By this application, appellant proposes a re-division of the subject property into two lots: (a) parcel "A" which is improved with a single-family, 1½-story frame house and accessory garage located in the frontyard area, of an area of 61,525 [55,6.60 upper area and 5,865 lower area] sq. ft.; (b) parcel "B" which is vacant of an area of 55,242 sq. ft. [40,000 sq. ft. upper area and 15,242 lower area], and a lot width of 93 feet. 3. In considering the maps submitted as amended June 12, 1985, the dwelling which exists will have a setback from the proposed (CONTINUED ON PAGE TWO) DATED: June 27, 1985. CHAIRMAN, SOUTHOLD TOWN OF APPEALS Form ZB4 {rev. 12/81) ZONING BOARD 2 ~age 2 Appeal No. 3361 cter of JEAN C. HOLLAND Jecision Rendered June ~, 1985 (sideyard) of four feet, ~division line which is at variance from the current bulk requirements of a minimum of 20 feet in the "A-80" 'District (15 feet in the "A-40~' District). 4. For the recor , it is noted that the premises was purchased J~uly 17, 1967, and that since that time, several building permits have ~been i~sued permitting substantial renovations and enlargement of the dwelling on Lots 327 and 328, jointly. " 5. Applicant has submitted ~ Declaration of Covenants and Restrict.ions in legal, rec~rdable form which would restrict all structures, buildings or dWelling(s) of any kind, except docks and bulkheads as permitted by codes, upon Lots 36 and 37, Map of Walter C. Grabie [referred therein as "Parcel II"]. 6. Suffolk County Department of Health Services communications dated June 17, 1985, indicates that Article VI approval for this division of land is required, and that to date, an application has not been filed. In considering this appeal, the board has determined that the application as applied must be denied for the following reasons: (1) additional relief is necessary for the setback of the existing dwelling from the amended division line, and such amendment is beyond the scope of the original notice of hearing; (2) the water table in this area is fragile and such a division of land will require reviews and approval under Article VI, "Realty Sub- divisions and Developments" as indicated by the Suffolk County Department of Health Services. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Grigonis, it was RESOLVED, that the relief as requested in the Matter of the Application for JEAN C. HOLLAND, Appeal No. 3361, BE AND HEREBY IS DENIED WITHOUT PREJUDICE to reapply after receiving Suffolk County Department of Health Services, Article VI, approval. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Douglass and Sawicki. (Member Doyen of Fishers Island was absent.) This resolution was adopted by unanimous vote of the four members present. lk GERARD P. G~RINGER, C~IRMAN June 27, 1985 ~PR ~ Igg5 APR i 4 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 1197] Disapprgved'' a/c ........... TEL.: 765-1802 , (Buildisg Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS B~)AKD'OF HEALTH ......... ---3 sETs OF PLANS ......... ~SURV£Y .................. ---CBECK ';;;d, .............. ' gEPT~C ............. 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. Hot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public st?eets 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 sh~ll 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 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 neces~a.~/inspections· ,.~ ___ ' ..... (Signatur~ of applicant, or name; if a corporation) (Mailing address of applicant) State wh~ther applicant is.~wne..r, lessee, agent, architect, engineer, generaJ 'contractor, electrician, plumber or builder· N~me of owner of premises...~.'~ /~/~ ..~. ~/,Z) ...:.. .................. (as,on the tax roll or latest de.ed) If appbcant ~ a c6~ra~?~i~naTflYe~6f-duly authoriied officer.' Q~orate~officer) Builder's ' ' '~ ~:* ~ :' ': ' ~ L]c~o~ ~'v~.. ,... :.. ............. Plumber's License No ......................... Electrician's License No ....................... Other T adc s L cense No ...................... Location of land which proposed work will be 'done House Number Street Hamlet Couhty T~x Map No. lO00 Section . .,~'/~...' ........... Block i.../.~. ' Lot./~.~.L ........... 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 ~ .---'--Z~, t~*,~,~.~',~ ~ --/.1 ,,, ................. b 1 ded doc ncy '< /~o~*~1~?~ · nten use an cupa ..................... · ................... · ~)~.4~. ................ .3. Nature of work (check which lapplicable, ....... . . ' ' . ' i .~. t,~ew ~u'uamg .... ~: .... Addition ... i~,, Repair ..............Re oval ...............Demohtion ,.,: ....... Alterat ..... [ .. 4. Estimated Cos O~. e '~ ' ' . (Description) $ Ifd elli ~ (to be paid on filing thi~ application) . w nD, number of dwellin~ units ............. Number of dwelling units on each floor .... ~fg b of5i "' · arage, hum er ars ........... · ........... If b ................................................... , .... 6. us ness, commercial or roi.xed occupancy, specify nature and extent of,eaci~ e of use ........... typ ' 7 Dimensions of existing structui'es, if any Front Dimensions of shine structure With alterations or additions: Front .... Depth ' i Height ....... ' ........... Rear .................. · , Number Of Stories . Dimensions of entire new construction: Front ..................... ' Rear Depth Height Number of Stories ...................................... ...... S~z of lot. Front , .,. , . ~. . ~ ............. ' ' '/' ' ', ................ ~ame o~ imrmer Owner . ~..~. k'/~/~'Aff~.. 11. z, un~ or use alSlrlC~ in Wlllcn pl*emlses are situated . . t- · ~2' .... / ....... 12. D°es pr°p°sed construction vi~late any zoning law, ordinar~ce or regulation: ..... '.... ................ .. ....... Will 16t b , ' vr,~ ~' ~..ox. ~./.~. 13. e regraded .... ....; ' .......2"~/, ........ Will excess fill,be removed from premises: y No fp es, o 14. Name of Owner o rem~ses . . p/~,~,r~...Address '. ......... Phone No. Name of Architect ......... . ................. Address ................... Phone No ............ : .... Name of Contractor ........ ~ ................. Address ............ : ...... Phone No ............... 15.' I.s this property within 300 feet of a tidal 'wetland? *Yes ........ No... · If yes, Southold ~own Trustees Permit may. be required. ' ..... PLOT DIAGRAM : Locate clearly and distinctly alli buildings, ~heth~r existing or Proposed, and, indicate all set-back dimensions from property lines. Give street and block ~umber or description a~cording to deed, and show street names and indicate whether interior or corner lot. APPROVED AS NOTEB NOTIFY BUILDING DEPARTMENT AT ?~B-'180.7: g AM TO 4 PM [:OR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUI~I::D · FOB POURED CONCitETE' ' :2. ROUGN, E~j~/IING & PLUMBING' 3~ ~-~UI.-~TIOI~''''~ '. 4. FINAL . CONSTRUCTION ~UST. BE COh/I~L~TI.~ FOR C.O. ALL CONSTBUCTION SHALL MEET THE REQUIREMI~NTS OF .THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOS RESPONSIBLE FOR OCCUPANCY OR USE IS UNLAWFUL OES,GN O. CO.ST. UCT, O. E..O"~ WITHOUT CERTIFICATE, OF OCCUPANCY ~ATE OF NEWJ'YO}~I~ ~ S.,S o~¥ o~ .... .... (Name of individual signin , contract) )Dye named· ., being duly sworn, depose~ and says that he is the applicant is the ., .... :&...., ......... . .................. ' ' ( ntractor agent corporate officer etc) said owner or owners, and is duly ufl~orized to perform or have performed the said work and to make and file this plication; that all statements contained in this'application irue to the best of his knowledge and belief; and that the )rk will' be perfonned in the manner s~t forth are in the applicati6n filed therewith. ~orn to before me this ............ /.o2 .... '...day of .... ' ..... , l~.,f.,o"'- ,~ ,, / :,.'~?...~4.~..~ .... ~.~.g..L.~ ........ ~~ ' (Signature of applicant)