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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-25060 Date JUNE 2, 1997 THIS CERTIFIES that the building ADDITION Location of Property 3100 DEEPHOLE DRIVE MATTITUC&, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 17 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 1995 pursuant to which Building Permit No. 23195-Z dated DECEMBER 19, 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 GARAGE ADDITION TO THE FRONT OF AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA /4330 The certificate is issued to FLORENCE TILDEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO.-H-054221 - MARCH 10, 1997 PLUMBERS CERTIFICATION DATED N/A Bu ding InspekAor 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)�/ C� Date ................/..4.%...�'�....... X6................... 19.7.. NPS 23195 Z Permission Is hereby grante to; " .......G I ................... ..... .......��a . ��.... . .. . ..........�.�.��............ to/ . ......`. .. .LGGt.T G ....... .... . .......... . .., .. .... .......................... ... .................................. at premises located at.................. ©... N c .. .........I........................ ............................................................ . ..........................................-......... County Tax Map No. 1000 Section .........//- Block......./,........ Lot No. .. ................ pursuant to application dated ....................... ... 19.94-..... and approved by the Building Inspector Fee $..� ............. i Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN BALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 ' 3. Copy of Certificate of Occupancy - - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00,, Commercial $15.00 / Date 't F� . New Construction. . . .Y . .. Old Or Pre-existing Building. . . . . . . . . . . . . . .. . Location of Property. . . . 3� . . .. . . ... . ... . .. . .P . . . . . . .. . . . . House No. //'''' Street � - Hamlet Onwer or Owners of Property.. 04.0 . . !: .. . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .i� s �. . . .Block. . . .! . . . . . .Lot'. . . . .W. . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . ... . . . . . . . . .. . . . .. .. ...Filed Map. . . . . . . . . . . .Lot. . . . . . .. . . . . . . . . . . . . . . Permit No. ate Of Permit. . .. . . . .Applicant. P Approval . . . .. . . .. . .. ..Underwriters Health Dept. A royal. . . . . . . .. .. . Approval. . . . . . . . . . . . . . . . ... . . . . . . Planning Board Approval. . . . . . . . . . . . . . . ... .. .... . . Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. . . �. ! Fee Submitted: s. . . . . . . . . .2-.1 ...... . . . . . . . . . . . ... . . . . .. . . . . . . . . . . . . . . . . . APPLICANT c0 a50G, THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 3064889 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date 1"C11 113,1997 Application No.on file 13473097/97 H 0514221 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of MTLTNER, 3100 DEEP HOLO DRIVF;, HATTITUCK, N.Y. in thefollowing location; ❑ Basement ❑ Ist Fl. ❑ 2nd Ft. GAR Section Block Lot uws examined on MARCH 0:3 r 1997 and found to be in compliance with the National Electrical Code. FIXTURE FI%TURESRANGE$ JCOOKINr DECKS I OVENS I DISH WASHERS EXHAUST FANS EN OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FIUORESCt OTHER 1 MT. I K.W. AMT. K W. AMT. K W. AMT. K.W. AMT. HP i k4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCK$ BELL UNIT HEATERS MULTI-OUTLET ET DIMMERS OIL 'H.P. GAS H.P. AMT. NO. A.W.G AMT. AMP. ANT. AMPS. TRANS. AMT. H P SYSTEM$ AMT. WATiS NO.OF FEET i E SERVICE DISCONNECT 140.OF S E R V I C E AMT. AMP. TWE MBTER 1 0 tW I'v 3W 3 d SW 3 X AW NO.OF CC GOND. A.W.G_ NO OF H1 A.W�' NO OF NFUTRAlS A.W G ECUIP. PER% OF CC.CON9 OF HNEG OF NEUTRAL I C ! OTHER APPARATUS: F CF1L EAN (PADDLE) -I f MOTORS: I—F H.A. PANELBOARD ; 1 -H CIR, 100 F i DaNTAN ELEC'PRSC INC. ! 60 DERBY AVENUE ( GREFNLAWN, NY, 11740 GENERAL MANAGER . Per 11 . CThis certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. l COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE AUST. NOT BE ALTERED IN ANY MANNER. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: -- DATE t �7 INSPECTOR . q 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: --r . d DATE- INSPECTOR fIIiLD=�ts3l�''=1�:,;I, )LI=u1=PURl- _ un11; - _ -- -- - cur=irlrtrrs =,.,m._ _ x r•unrn)n'rIo1J ( IST) I ',I cll FOUNDATION====ONO==== MU I1011O11 FItAFII? d -------1 ---- --------------------------------------------...------ zo 'W I'LIIMiI l NO ____________ _ ___ ._______ __=---- ---- -- � JNSIILA'1'fOrl 1'I?It H. Y . I[ S'T'ATE I?NEIICY CODE _____________d=====_®__ ___® __-- -----______------- P I NAI, -- ------- --- --- -- -Ca.'_'���% _ ---�-- - __= a===------======----- �aem=e=cpm ae a_�a=== _6a=_�sz=gym vam oaasee_ _- _ -- o �1 _ ADDITIONAL-COFIME N'f S ___a= --------------------------------------------------------- — -- --------- --- m ..._... ... __._....... .—.----- MAR I 11991 - - - - - - - BLDG,T01NN OF T OIL - I! - - - - �DDP 0 --- --- -- - -- - - fiu,-t, -G# - - - -- - - - - ---- - - mp" r - FORM NO.a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date . 7 ?' . . . . . . . . . .. . . . . . . . ., 19�` To PLEASE TAKE NOTICE that your application dated . . �12- . . . . . . . . lgys ._ for permit to e, 4G . ?a, • . . .. . Gh . . . . . . .. , at Location of Property . . J /• . . . .� ..e . . . . . �: . . . . . . � . House No. Street am et County Tax Map No. 1000 Section . . . . . . . Block . . . . .1.7 . . . . . Lot . . . . . . Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . ./. . . Lot No. . . . . . . . is,rctuurnned)ierewith and disapproved on the Collowino grounds . _ l . . . . . :.�1 . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . J . . . . . . . . . . . . . . .. . . :qq-, g . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14, � . . - - . . . r . . . . . . . . . . . . . . . . . . . Me BuiMing) Qtor RV 1/80 ' + ,,n,��J ��Cr�iey✓ IL (moo � 9 Qod� _-- NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4730-01205/00001-0 S October 19, 1995 FACILITY/PROGRAM NUMBER(S) P E M IT EXPIRATION DATE(S) Under the Envirorm ntat October 31, 1998 Conservation Law I( TYPE OF PERMIT 0 New ❑ Renewal 0 Modification ❑ Permit to Construct 0 Permit to Operate 0 Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR 373: supply Hazardous Waste Management ❑ Article 19: Air Pollution 0 Article 15, Title 15: Water Control 0 Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined Land 0 Article 15, Title 15: Long Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands 0 Article 15, Title 27: Wild, n Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers I Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ❑ Other: PERMIT ISSUED TO TELEPHONE NUMBER Florence Tilden (516) 757-3625 ADDRESS OF PERMITTEE 355 Gr eenlawn Road, Greenlawn, New York 11740 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Richard Miltner, 43 Old hills Road, Greenlown, New York 11740 (516) 757-4721 NAME ANO ADDRESS OF PROJECT/FACILITY 3100 Deep Hole Drive, Mattituck, New York 11952 LOCATION OF PROJECT/FACILITY SCTM #1000-115-17-13 COUNTY TOWN WATERCOURSE NY7M COORDINATES Suffolk Southold Deep Hole Creek CESMIPTICN CF PUTKRIZID PCTIVITY construct garage and make grade changes (excavating and filling) on landward side of the existing single family dwelling. All work to be in accordance with attached plans stamped approved by NYSDEC. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS Roger Evans Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE , AJDATIber 19, 1995 Page 1 of 5 1 New York State Department of Environmental Conservation �g�' mss. Building 40 - SUNY, Stony Brook, New York 11790-2356 Pn a Phone (516) 444-0365 Z ,, Fax # (516) 444-0373 G 2 �O�MFNTAV CP4� Michael D. Zagata Commissioner October 18, 1995 Florence Tilden 355 Greenlawn Road Greenlawn, NY 11740 RE: 1-4738-01205/00001-0 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, r Robert N. Thurber Environmental Analyst I RNT/ls enclosure' 9520-1 (8187)-9d . . New York State Department of Environmental Conservation t NOTICE `a The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number /473SnClzclj/ .1 Wl,�,o Expiration Date F® R NOTE: This notice is NOT a permit (EN&iAL OCADITIGS nspt;ct i ons 1 . The permitted site or facility, Including relevant records, is subject to in- spection at reasonable hours and intervals by an authorized representative of the Departrrent of Environmental Conservation (the Departrrent) to determine whether the permittee is caTplying with this permit and the ECL. Such represen- tative rray order the work suspended pursuant to ECL 71-0301 and SADA 401 (3) • copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Departrrent at all tires at the project site. Failure to produce a copy of the permit upon request by a Depart-rent representative is a violation of this permit. Pe mri t Changes and Rena l s 2. The Departrrent reserves the right to modify, suspend or revoke this permit when: e) the scope, of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL. and pertinent regula- tions is found; b) the permit vas obtained by misrepresentation or failure to disclose relevant facts; c) nervrraterial information is discovered; or d) enviromrental conditions, relevant technology, or applicable IaN or regulation have materially changed since the permit ms issued. 3. The permittee must submit a separate written application to the Departrrent for renenel , rrodification or transfer of this permit. Such application must include any forms, fees or supplarental info m-ation the Department requires. Any renenel , modification or transfer granted by the Departrrent rust be in writing. 4. The pe nnittee rust submit a reneneI application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPCES) , Hazardous \Mste Nbnagarent Facilities (ftfl , rrejor Air Pollution Control (APG) and 50l id Vhste Wagorent Facilities (Sr1VF) ; and b) 30 days before expiration of all other permit types. 5. lhless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination perviously issued by the Departrrent or any of the tears, conditions or requirerents contained in such order or determination. Other Legal Obligations of Pemrittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature and by whorEver suffered, arising out of the project described in this permit and has agreed to indamify and save harmless the State fran suits, actions, damages and costs of every nare and description resulting fran this project . 7. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the inpaimpnt of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit . 8. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-wey that may be required for this project. Page 2of 5 Tidal Wetlands ADDITIONAL. GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 111 Part 608 ( ) n Ihol if fulure operdlinns by the State of New York require an al- other environmentally delelenous materials asso(rated with the 1 m Ili'Domani of tho SIR)(lure or work herein authorized, or project, It In til' opinion of Ili, Deparinumt of I nviromnental Conservation 13 Any material dredged tit the prose(ution of the work herein penoilled II .hall t auso ural eawnable obslru(tion to(he free navigation of said shall be removed evenly,without leaving large refuse piles,ridges a(rocs „db"r. til Ilona flms, of endanger the health, safely or welfare of the bed of a waterway or floodplain or deep holes that may havo n the people of Ilio Stale, or (duce loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of n•.oum es of Ili(,Sldh•, Iho owner may be ordered by the Deparhneut to it waterway ,en,oce oI .dlor Ili(- .nm total work, obstructions, or hazards (aused 1111 I. b, „ithOlil 1p,�Ie.,• In the Slue, .Ind If, Ilpun Ili, expiration lir Id Ihrm thrall he no unreasonable intra en•nuwith ndvn'a nein I+v Ihr walk e r 0..... uI 11,1, p,.rnnl Ihe 10H,Into, fill, ox(ay.nmo, or other herein dulhonied modlh(Munn nl the odt(WOLlrse hewhy authorized Shall not be(c m- I S If upon the expiration or revocation nit thou peronl, the prole(t htnebv pio6al, III, owner, dhMll, elthuul expense to the Stale and to such authorized has not heen(ompleted,the dpph(dnl s11,111,wnhoul expell", ,•,I,tit and Iu.n,h Inn,,and manner as the Department of I nvironmentaI to (lie Stale, and to au(h ,•xlenl and in w(If Iln) • and marmot I, the r.nl I.,va bon I"o, mgnue,n911OV'I all orally portion of fit(-uncompleted Department of I nv[ronmmnlal(on,eivation nt.ry w(Jurre remove all oI .nm liu,. Or I'll and I, ,100- to IIs lunner ((nl(lilion Iho navigable .illy portion oI Iho into onglWed stim, in, of 111 -kind it hN- Ili' .uo .lint flood I,Ip.¢Ily of fie water(mune No(taint shall be made against to its former condlllon No (rum ,hall ho Imide dga[n.l Ilse Mate of 0—titnp."t N.„s toil nn a„aunt til ,lily w(It renurv,d or alteration New York on a((ount of anv ouch ,"Inoval of ahetafor In I h.,, 16,. dill,rat Neo 1 irk shall I,I no,ase be liable for ally damage I1. If granted under 6 NY( RI2 [',Ir1 608, 11,1, N)S DeparIli 'nI of I moon of .... I,tum nr„olk hetero duthnnn'cl who h[nay be(aused mental Conservation hereby(ornficd that the.ubfe(l prole(I will not h, n•.ull holo fulnre 01)`W luno undorlakon by Ihe State for the contravene effluent limitations nrolier hontation,or Nandmd,under nn n dtum rn Inlpin,onrent of navrgauon,or for othor purposes,dnd Sections 1(11, W, 101, 106 dn(d 307 of the Clean Willer A(I of 1977 no(Elim OI IIgh( In,oltgmnda Iron.hall d((rue front any Such damage (PL 98-217)provided Ihdl all of fhe ,ondnlons llsled liemnt Mtn met I r d.Inlmp,SII Ihe,p'IInIt does ml reiove Iho dpplioml of the respnnui 17 All a(tivities eulhonzed by fill,permit mudl he mane I ,on(olnt,uu' blfu, nl 0,1,nnlnq ,rev other p'riniWon, ,onsent or approval from with Ihe approved plans wbm Wed by Ihe appi(dnl or tin agent ds pill Ili, I1 S finny( )rp, of I ngmeors, 0 S It oast Guard, New York Slate of the permit appicalion oft,e of(wiw al S,,, ,I,or lo(III government will(It may be required $, Van TUy l Such appmvod plain wore pmponal bi _ .A n,,c...m Pnaoil mm shall 6' 6tken In precudo contamination 8�30�95 of ,til, „'[land rat nal ertvap by suspended solids, sediments, fuels. uh,•nt, lu6n,dols ,•Doxy utafmgs, paints,(on(rc U•,led chat'or any SPECIAL CONDITIONS 1. There shall be no disturbance to vegetation (mowing) or topography seaward of the wetlands boundary; identified as "wetlands string" on the referenced plan. 2 . Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal . No debris is permitted in tidal wetlands and or protected buffer areas. 3 . There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 4 . All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration, whichever comes first. The approved methodologies are as follows: a. stabilization of the entire disturbed area with appropriate vegetation (grasses, etc. ) . b. stabilized as per specifications identified on approved plans. I q( PI I"III '.I' II:I If I-4738 -01205/00001-(1 19tr t(,I+VAI 41111A NIIs1141 It r 3 NI W YORK 51 A fl DI PARI MF N I Of 1 NV RONMCN fAl (ONNRVA I I(1N DRIP SPECIAL CONDITIONS 25 Tidal Wetlands 1-or NticlE_____--- (- --- c. temporarily stabilized with straw or hay mulch or jute matting or other similar natural fiber matting within 1 week of final grading. Temporary stabilization shall be maintained until a mature vegetative cover is established. 5 . The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 50 linear feet from the tidal wetland boundary. 6 . Roof runoff shall be directed to drywells a minimum of 75 feet landward of the tidal wetland boundary for immediate on-site recharge. 7 . Special Supplementary Conditions (A) through (F) attached. 1111 PI Knell 111 ihilll V 1-4138 01205/ommi-o IAf II IY IU NIIM IiI Ii I'RU[.RAM NUMM R CI 5 OI _, SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenic, and Recreational Rivers Permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page one or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. D. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC Permit No. 1-4738-01205/00001-0 Page ') of 5 MAP OF PROPERTY SUZVEYEP , F02 C� 1C �--IA2D MILT �.IE � AT MATT S"{"UCV- MWN QP 90JTHOL-D , NY ..l �IHhmzotl eAereHm oraJmtlpt M Mk auney k a hoktkP d 7$en'e^�f1B of th New YOM1 Sbb EtlucalpP Leat DoPks o/thrs aurvey maP not 0 F NFA the le b dunmypYs ke0 seal m etl p EeewWbue Il eol be oonakr d mPr. 7z P ty to ihesiriakaletl harem alull n,n r . ��(��" � r * tC PrePereQ eMMhla Oahe beN� I ���E•� Wk compenY.porammmtal epwpy yq kntlppinslaulian luteH 1prem and < —U 11. ho"-S Pnoos Cl IN kntln,p h A , i ND 5 Iyl mn.Gwranteos ere rpt trwW to atldlionel ewaNions or reOle LOT_A2EA•13,050 S.F. TO CH W M SALE -� WEnAP,05 AQEA• 1-C)O S.F (137-) 1 CO • PIPE EXIST, h4OU5G- IB34 S.F. 1 7e WITH PIZOP4GAQ . =2230 S.F. l-1x =UFF. CO.TAX MAP_I000-115-1-7-13_ I i I's SUfNEYEP AUG. 30,1995 WOERICV- VWTUYLY.C, LIC.I.ANP 5URVEYO(ZS. — GREENP0Q'T,W-Y NI 3 SIGUBI_IS�A5 ' 5.7 as E. mm 9i�__ 35.3' I a I PROP a. tn I p or I Cr ros LU O ! w3` 32 � 3 Q I E I Z I y o e 't`2't 3 = a I rIn BOARDWAL T / O Q N kD I N.79°00W. -j' ISO"! 1 I I � r----- 49ya - I I I ELEVATIONSEa'UFEaTO MM 5EA.LEVEL,NGVD, I -- I i I I •F E f I ' u,r, •b <�. Boarustees SCyIjTHbLD, NEW'YORK .. -i`�2 ! re PERMIT NO ..4Si5 . .. . . DATE: October ,2� `19574 $i t a� ISSUED TO c df�,M, tnextfolbrence, Tilden v.�tt �t 5 9 .�ut�urt�tt#tun kN� t. F ; Puesuan+°to the rdvlsiong` f Ohajster 615 of +he Laws of ���� J' the S+a+d'of NeW,Y&k;v'1893; andl'ChapMe 404 of the1aws of the . f � ' 'S+a+wbf',NawAorl 1162; and1heA6+I461d Town' Ordinanee 'en d +itled 'REGULATING AND THLtPLACINGiOF OBSTRUCTIONS ��� IN AND ON TOWN, ATERS 'Af'D':PUBLIC LANDS and the f REMOVALOP°SAND; GRAVEL" 11 `6THER MATERIALS FROM t a • ' �� LANDS UNDER TOWN,°WATERS;,I'k`dnd'in accordance with the y ' i1 tetii�ier8 ' ' n mSe . y, Resolution of The Board adopted at a eeflnq held on P... 199 ', and in cbnsideration of the FBuro''of t50.00 aid 6 „ iy i Richaner tj of N Y, and subject to the Terms ' and Conditwns listed oii` '+ha 'reverse side hereof, \ ? } To�const�ucdt T 4 h Trustees ruste Garathe rliek n emitds etre foloiv` ' 6' B y per Z�uAgApprova��t t tall in accordance with the detailedsspecifications as presented in fhb origlna+Inq"applkafion.`''` IN WITNESS WHEREOF Tha Bald Board of Trustees hare- `6y ere- " f 1 % # c o ,a` Y +; by causes i+s��oFpyrbtei5eal +d bd° fflibd;'and these presen+s +d � S o3a + 6e su618rl6 d:by`A'!MAjbrify of th'b�*f'aldxBoard as of +his da+,e �: �� , ra lr ,ki,n', $ P`k"sr«Jrim��,+;� 1'AX;,� ki$�e"' ,: ,f •➢ bn �• i a,i .; ,. . ,. pay I r"'" b " r � + s .* 'K.� ly , A ............. ` ' r14*.BG �eLYF �l l Itu:�.d�'$`n `yp • ,-sm 1 +®CCiYPi r�„ f 1 e//i { y am • tyy<, •6 q Y � a I * , ¢ I 1, TRMS acid OONbiTlONS The Permittee Pd ChnYd Milt 1 . residing at N. Y,'Al pax of the cottsideralloh' ftlr� th$`�lb!N�YiNtl' of the 061 understand an prescribe to the foil �i lowing: C, owing: �r i 1. That the said Board of Ttm4il s and the 6'*n of. Southold are tkleased from any slid . sit damages, or.daimsAior;damages,4of`�Uitiderlaingldltiedy'or iuditectly se Ila recruit of any oplE atton performed put'd1ia11t to '�W9 prxmiw 'and the Wld�pe61 tee will, at his or her own exped9e, defend any and all such suite-ihddated,by;thlyd.pardes,;tind:fbe said permFtte esswnea fuU llab111ty 3 with respect theretot';to the; mplete ercinslon of the ibw of Trustees of the Town of Southold 2. That this Permit is�Yaed for a°period of �' .hi . 'mos. which Isj coosidered to be the r estimated time required to,complete the work involvedi i hilt'should circumstances warrant, request for an extension may be made to the Board at it liter' date. lei 3. That this permit should be retained lndefinitelyt or as long as thesaidPermittee wishes I to maintain the structure or project Involved, to provide,evidence to anyone concerned that auth orization was originally obtahied. I 4. That .the work Involved will be subject to theAmipectlon and approval of the Board c its agents, and non•compllance.with,the,ptovisions of,the originating application, may be wase for revocation of this Permit by resoludniof the said.-liourd' ' : � 5. That there will be no unreasonable Interference j;kith navigation its I a result of the work gj herein authorized, Jili' G. That there shall be no Interference with the tight of the public to !pass and repass along the beach between high and low water marks, ,,.rI. 7. That if future operations of i the Town of Southold require the removal and/or alterations In the location of the.work he eln 'eulhtltlzedt,or lft'luIJL thIopinion of the lBourd of Trustees, the "� work shall cause unreasonable obstruction to free natlgition; the said permittee will be required, upon due notice, to remove or Alter this work or project,herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Petutlttee or the completion of the work auth- ,. oxixed. requited sup. y, That the Permwill obtain all other petrolfa atlco oats xhat nay be plemental to this permit which may be subject to revoke upon failure to obtain same. i p ' J' y ALS BOARD MEMBERS d$OPFU�a, b�, O� Southold ibwn Ita11,!;,. at 53095 Man,Road` d P. Goehringer,Chairman y i y, P.O. Boy 1179 Serge Doyen, Jr. y ^+ Southold,New York 11971 James Dinizio,Jr. oy • ��� Fax(516)765-1823 Robert A. Villa '�0( �'a Telephone(516) 765-1809 Lydia A.Tbrtora BOARD OF APpRALS TOWN OF SOtfTHOLD September 21, 1995 Mr. and Mrs. Richard Miltner 43 Old Hills Lane Greenlawn, NY 11740 Re: Appl. No. 4330 - Variance for Yard Reductions (Tilden) Dear Mr. and Mrs. Miltner: Please find attached a copy of the Board's findings and determination rendered at our September 13, 1995 Regular Meeting concerning your recentapplication for a variance. In the interim, (a) the Suffolk County Department', bf planning may be forwarding correspondence to you which applies to 'all projects located within 500 feet of a waterway (ref. Administrative Code of Suffolk County). It is expected that the county will refer the matter back to the 'Town rather than taking action for disapproval or approval. No further steps are required on your part since our office sends a copy of your town file to the county directly. b) you may wish to call the Building Departmeul at 765-1802 upon i i receiving the enclosed dotr rmination to, asci sin„ w,htc h other,,docume o P 4'§fq aro needed to t{oifl i�t�th , yi, pera4f� i"'C) iipplldatlons q r . hab'hforwards rd +`of this determation to convenience pur�oshs'l t*o the Building Departtneiit for 1 41"'pekin n ittkebords. , lf: You have questions, please call me at any time. Very truly yours, Linde lski Enclosure t r8' N0W APPEALS BOARD MEMBERS o�oSUFfO�K� _ _ SEP 2 2 X996 may. �Gy S uthgld Town Hall Gerard R Goehringer,Chairman < BLDG.DEPT. X3091;Main Road Serge Doyen, Jr. y TOWN OF SOUTHOLD_rg-O Box 1179 James Dinizio, Jr. O • Southold, New York 11971 Robert A. Villa Fax(516) 765-1823 Lydia A.Tortora �O Telephone(516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD OF APPEALS DATE OF ACTION: September 13, 1995 ADPL. #4330, APPLICANT: FLORENCE TILDEN. LOCATION OF PROPERTY: 3100 Deep Hole Drive, Mattituck. COUNTY TAX MAP DISTRICT 1000, SECTION 115, BLOCK 17, LOT 14. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector dated July 26, 1995. "Proposed construction will have insufficient front yard and side yard setbacks. Action required by the Zoning Board of Appeals." PROVISIONS APPEALED FROM: Article IIIA, Section .100-30A.3. RELIEF REQUESTED: Garage addition with a reduced setback at 28 feet from the front property line along Deep Hole Drive and side yard reduction at nine feet. The size of the garage is proposed at a width of 18 feet and depth of 22 feet with a total height at less than 15 ft. MOTION MADE BY: Robert A. Villa SECONDED BY: Lydia A. Tortora ACTION/RESOLUTION ADOPTED: Denied setback for proposed garage addition as applied; and granted alternative relief for a building 14 feet wide with a setback of not less than 13 feet al its closest point to the side property line and not less than 28 feet from the front property line. REASONS/FINDINGS: Alternative is available to reduce the width and gain distance from the side property line, without further reducing the front yard, without impact or affect on neighboring properties. House is presently situated on a lot of 17,200+- sq. which includes land below ordinary highwater mark. House is set back 36+- feet at its closest point to the front property line. The northerly side yard area is very limited in size and further reduction in this area is not recommended. VOTE OF THE BOARD: Ayes: Serge J. Doyen, Member James Dinizio, Jr. , Member Robert A. Villa, Member Lydia A. Tortora, Member Gerard P. Goehringer, Chairman-Member This resolution was unanimously adopted. GERARD P. GOEHRINVER, CHAIRMAN C COCK.- ���� GLS►-1 d L u • � I r 23 �` I5 NduSE. 1� } i�L_. i �= VL Ls.H All ' FORM NO.3 TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL (, To Date . 1✓. • . . . . . . . . . . . . . . . . . .. 197✓ . �G�3 . r<�.��/.1'G•�!1...���T ij/ �py�� //-'-� C�yJ PLEASE TAKE NOTICE that your application dated . . �. `�'^�j • • . , • _ , . , . , • • , , „ 19 l�J. . for permit to ��� •y• . . G!zX. . . . . . . .`. . at Location of Property . . r r/ House No. F'.Street <� Hamlet County Tax Map No. 1000 Section �. . . . . . . Block . . . . ./. .7 . . . . . Lot Subdivision . . . . . . . . . . Filed Map No. Lot No. . . . . . is retu�rned�ierewith and disapproved on the following grounds . � � • • G : . . . . . . ./. . . . . .I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ming I s . ctor - �A%y/moo• r G% FV i DONALD G. FEILER • ARCHITECT 600 Ole Jule Lane o Mattituck, NY 11952 • (516)298.5250 June 26, 1995 L Mr. Richard Miltner f�clieri 43 Old Hills Lane Greenlawn, NY 11740 Re: PROPOSED GARAGE ADDITION TO THE MILTNER RESIDENCE 3100 Deep Hole Drive, Mattituck, New York Dear Mr. Miltner: Enclosed is one print of sketch plans of the above mentioned project. As we discussed, ;wiMberregWred-fpr the fron�yarf,setbaok,, 2a�fe*ets-skiow0pi,�?-- � 9 feet showrti(15 feet r@ ked,$W- If you have any questions you can call me at your convenience. Very truly yours, Donald G. Feiler JUL _ 3 frog _ M S1rl4 n 4 ZD re ± -roKwOi- SJU.'HOLD, N_Y a # �: toEijr o i SFC:tJr:Tly9 K 71g rFr rpH �'+¢zb"maw. iva i+ i KJKr � � 1 � -_ a •ro THE:cS�.iLy y._- A.1.4 - T i {,, - . >RiF 10 a 77 nit -I t. - .► - �. ..��-_.� _ - _�� o .. Wit• ` - ._ - � Zt r:,O, Julg ZZ.?g : } K.?a Jc;W- 180•_ E C � J _ = �i t^ Y =a - _•-.• __ _. . _ �..� Y+ucdt.c%sdSvrsityo��: - IAI 1 1 1 �O J 'U'L3U 3'U`�0 �'��3vu r , r n _ a , .. .,,. . . ' 91 BROADWAY,GREENLAWNL N.Y. •11740 ',' ,,` (516) 261-4450 , '�` 7"d� 4-;r ��" � � f, CU5TIMORE. t 46,11— PAZ "ski M11, i PHONE. ESTIMATING. • . C, a C Vt,9TIomJ A) CONSTRUCTION. ------------ ` fk 1) DEMOLITION. 2) DUMPSTERS. y 00.0 p Z; 3) STEEL MATERIAL & LABOR. r,,c 4) FRAMING. LA�3o 4 Z,S-tJO.Ob 5) FRAMING MATERIALS. rf�1�^a A>l���rtontz � "' "�, 2rj�_._m� . '�! ti'yPY dOq �•rr n1;z,: 6) WINDOWS EXTERIOR DOORS. ` 7) SKYLIGHTS. a i 8) FASCIA,SOFFITS. ) 1f-L- 7 fid` 0O , 9) ROOFINGrgOWW D1G. 10 ROFFING MATERIALS: 11) SIDING. LbaIb2, • v� .•,lfrrl e , r. 12 SIDING MATERIALS. b `�t7L 7Vl OCC1 p� 13) GUTTERS,LEADERS. e ''°'' Of�,On 14) STAIRS,RAILS. _..ice' • f'•Tit�LL: 15) INSULATION. IOC), 00 «�} r,t le)rT r ) d �7r� 16) SHEETROCK AND SPACKLE. M & L. ' %" 17) OAK FLOORING. 18) TILE,MATERIAL AND LABOR.19) liqua W- 411,11 11101 ,71 44` 20) TRIM MATERIAL: . 21 INTERIOR DOORS. ro , +fir ray' i A L2 ,f / r /'U.G {� t�ttw•l 4y) .. pr I e tb ^ t' I t r�VVVV"J:', ' FONM No.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. CerHficafe Of Occupancy No. . 16465 December 8 1987 0 . . . . . . . . Date . . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . THIS CERTIFIES that the building . . . . . .^dd i t i on . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 3100 DEE.P. not,E. . . R . MA'rrITUCR . . . . . . . . .D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /louse No. Street County Tax Map No. 1000 Section Block i 7 14 l. . . . . i15 . . .Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. conforms substantially to tite Application for Building Permit heretofore filed in this office dated Jan . . . . . . . . pttrsuanitowhich Building Permit No. .1.45867 . . . . . . . . . . . . . . . . . . . dated . March ,2 t 1986 was issued, and conforms to all of the requirements of the applicable provisions or the law. 'rhe occupancy for which this certificate is issued is . . . . . . . . . { dditign ,and„alteration to existing dwelling .Amended 6/ 17/87 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate Is Issued to . . . JAMES It . & PAY V . SMALL . . . . . . . • . • . . • . . of tite aforesaid building. Suffolk County Department of Health Approval N/A . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . .N/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t PLUMBERS CERTIFICATION DATED: N/A' . . ./y. . . . . . . . . . . . . . . . . . . . / Building Inspector ne.. t/at JUL - 3 199tI Aundnd N 1' a I I' i'nr n,A1g11• .I+n p,r.. nrd S,I, 11"d ^.iF Ce.arnrr T.1111 11 1d�,', Arn..ln,lr.ule,},:r t r p.•rn i^^pl. h.., (t (t rl < , ` ` la{ COLISULT YOUR LAWYER IIEEORE 51101141111443 7111S (NStNUMEt4t—tNtS 1",1RUMEHT SHOULD S! USED 1111 LAWVEIIS ONLY. da of A r1l nineteen hundred and ninety foltr ' T11115 INDEN'll1RE, made the 7?_ Y p BETWEENdnMFS H. SMALL and FAY V. SMALL , his wife, residingl. a 350 Aborn 1.ane , CuLchoglle, NY 11935 party of the first part, and FIOUNCL G. IILOFN, residing al. 43 Old Gills Lane, Greenlawn , New York }1740 party of the ceron(t part, p Wi,�!"NESSSSET1}r'tytoft The he sPart I f the fir s tlere`by g ant(and lrelease ion of luntoell rtile Party l(it lthe secoa'1 part, tile heirle s or successors and assigns of the patty of the second part fotever, ALL Ihat retain plot, piece or paTcet of land, with the buildings and iliirrovenrents thereon erected, situate, )YRI nd i in elaold, County of Suffolk and State of New York, bounded and described as follows: i ! sidesof Deep Hole P;GINNTNG at a point on the easterly �f`"'1`' _ rive, as widened, distant 1166 . 14 feet southerly as f ---,t easur.ed along the easterly side of Deep Hole Drive as idened from the corner formed by the intersection of the (� )0 outher.ly side of New Suffolk Avnue with the easterly I `il.o Deep Hole Drive, as widened ; lace of beginning along 10 s*,Running Thence from said point or p south 79 -Int-id now or formerly of E. Nash and thea Canal degrees 00 minutes East` 170 feet more(rfoem�Y1Y nif" . A. line of a former gutter and land now I Smith and ORS . ; islrirI Thence southerly along said last mentioned land 7.00 feet: 1) more or less and ; 1000land now or formerly of ` Thence thru the Canal and along s Cominutes west 180 feet more or less Spr.l.inn Reidy north 79 degree f Deep hole Drive as widened ; to the easterly side o side of Deep Hole Drive North 16 Thence along the easterly point illock degrees 02 minutes ?,0 seconds east ] 00 . 38 Leet to the p or plane of BEGINNING. 11.00 Per are as the grantees in The grantors herein are the same P 1 ill qq c77 Lib yt} 07.. CP 426 . ffl�,�.I 11�'.I�,lvth aeTl tog it, alit and l Ile, . 1 it any, of Ihr patty of the Gts1 part in and to any sirpelnden and f114 .GC1 I nems :l6ulling flip above desrribcd Int Ilk e In the renter linin ts lherin rof; 'I'OGh;1'IIICIZ kith the appurtenances and all Ihr rvlale and rights of the fatty of llretGr'[ �helSeCtlnd(llalt,the hcirlsaidlrrs 11CCs'(xs andlIsSigos of I Ir 11.11 the premises herein granted unto the party ill,- panty of the sctoud j'alt ftn-ever, AND Ihr uR• of tile fill Part rncrnants that the forty (.f the fact part fins not done or -1 fq"Ted :ullthing b n'a\' lchntel er, excel,( as 1,I,e the 'aid premiere hanlr Bern enrilinbel(d in anv f ' ` Illy p:nly of the fitm part. In rongllinm'" u%Wl `:e( in., 1j ',f Ihn I i^n t •rr+ .,,a r, rn1161 �nnll . retie.. . II1' 't llf TCPd to ie r rannn as a lout fund Ut hr :yrydi(•d first for the purpose of paying the cost of the ingroe total alul will apply Cllr same (n sl to Ile p:wiletll of the cost of the itill)rowillent before using lily part of the total of the same for ally (,II)r TI pwpo c. Ar "Ind "p:+ltd• � 'r1°mslrurd as if it marl rrparliea ,Ahruevrr Ihr sense of Ibis itnlrnlure 5n requires. IN WITNESS WIJERE:OF, the party of the first I.art has (tiny executed this decd the day and )rnr Aird above tl'1111 ri1. ; v tnMr.s U, SMALL F`AY a'.± 5Mn1 l "P' 170 ,e FBF NEW YORK, COUNTY OF SUFFOLK 1111 STATE OF NEW YORK, COUNTY OF IR: oil the' ?Z day of Apr11 19 94 , before file On the day of 19 before me personalfy cane personally came JAMFS If. SMALL and FAY V. SMALL to me known to be the individual described in and who to me known to be the individual described in and who rxecuted the foregoing instrument, and acknowledged that executed the foregoing instrument, and acknowledged that I,IIoy executed the same. executed the same. fnLary 71117 Ir PATRICIA L. FALLON Notary Pubblic,stale of Now York Oualified in Suffolk Coun ..n,r,ission Expires Apra 24, 1 r c)t STATE OF NEW YORK, COUNTY OF sit STATE OF NEW YORK, COUNTY OF ss. On the day of 19 before file Ott the day of 19 beiore me personally carne personally carne to me known, whn, being by me duly sworn, did depose and the subsctibing witness to the foregoing ill0in lent, rcith say that he re.aidcs at No. whrnt 1 ant Personally acquainted, who, being by file duly sworn, did depose and say that lie resides at No. that he is the that he knows of the corporation described to he the individual in and which executed the foregoing instrument; that lie knows the seal of said corporation; that the seal affixed described in and who executed the foregoing instrument: to said instrument is sur! corporate seal; that it was so that lie, said subscribing witness, was present and saw a(fixed by order of the board of directors of said corpora- execute the sante.; and that he, cess whereat, tion, and that he signed h name thereto by like order. at the same time subscribed If name as witness thereto. 35argain anb )alt MttD SEc1ION WilN (:ov)NANI AT;AINCI GRANiows ALIS BLOCK TI 1 LE No. _- --- LOT COUNTY OR TOWN SMALL To KewTAed At Bequest of First Arltetican Title Insurance Company of New York TILDEN RETURN RY MAIL TO - --- -- -— -- ------- STAHDARD ?ORAS OI HrW YORK IOARD Of lint IIn011Wa1ttRi Nancy Munson , Esq. 17°'''1,m0d"t' 197 New York Ave. First American 7'itlr 111surnncc Grnlpatly Huntington, NY 11743 n(New York Zip Ne r 4 —_ w V i a 4 ,x 0 w w s N \•1 z - r— w w K rv� __:..rte• - ..;�.a_-»._— „b... x�__ z_. .. _ -... r , TtIRU 9 MUST BE TYPED OR PRINTED {I'k' I ACIC INK ONLY PRIOR TO RECORDING OR (,I TS CO�UNT'Y CLERK 2 29723 3 Number of pages L i I IIra I L.1 f!1 Scrial # Tk;,i Certificate N ed/ e d/Mortgage Instrot nt - _ — Deed/ Mortgage TAx Stamp Recording/Filing Stamps Page/ Filing Fee —_� ._ ----_- Mortgage Anil, flat dling G� t. Basic T'ax TP-584 2. Notation Sup Total EA-SW (County) _ Suh'Total ,_- J. Spec•/Ai il. -- -^- EA-5217 (Stale) - /=,e - TOT. M'UG. TAX - _- -!- s. R.P.t'.S.A- r Dual 'rown Dual County - --- Iteld for A_ppmiionment -- Conlin. of Fd. ��� Transfer TaxAffidavit ,! Mansion Tax Certified Copy The property covered by this mortgage 1s Or will be improved by a one or Hco Reg. Colt)' _. Sul, •Total L�L) ramify 01. 1R•,g ••,.I_•, YES_ or NO _ Other GRAND TOTAL • U NO.sce appropriate tae clause on page !f of this instnnnenl. PF`°n�i, --'Rent I'ropeity Fax Sell cc Agency Verificatimi- - - - -1'ille Company Infunua0on -- Dist Section Block Lot COUNTY ,. 1_000-- 115.00 17.00 014.00J - - _-_C.hkago_-TitLe-Insurance-Co. 6;5 of Company Name of — 9408-00956 - ---- - ---- Title Numlict' !- - -FEE PAID BY: - Cash Check X _Charge t Payer same as 12 & R Nancy Munsoh, Esq. CA j -- 197 New York Ave. Oil: t Nuntington, NY 11743 �/_( AGO_ l c,.0_ ��':i �. ,-- - . _- ---------- -- -------=-. g RECORD & RF:-I URN 'I'O i of nqy 1-)w'eq: ji1ig & cage I This pale forms pati of Tile attached Deed — made by: (Deed, Mortgage, etc.) -� JAMES II. SMALL AND FAY V. SMALL The premises herein is situated in SUFIIOLK COUNTY, NEW YORK. 1'O ht the TOWN of Southold FLORENCE G. TILDEN fn the VILLAGE or IIANILET of Mat.til,uck -- --- --- '� ___ _ .__ �, -- ��- � , ,._ _ ' � : � t-�, , • � - a '� a � , j„ � ; , , � i f � � 3 s . i i �� _ � �� � � - __ � ,� �'�-t�-- -- ...._. � - �� 1� w _ � �- _ _-- �_ __ - � - ._ -� . - - --,___ _ __ BOARD OF APPEALS TOWN OF SOUTHOLD In the Matter or the Petition of NOTICE TO to the Board of Appeals of the Town of Southold ADJACENT PROPERTY OWNER TO: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to petition the Board of Appeals of the 1 own of Southold to request a Variance (Special Exception) (Special Permit) (Other) [circle choicel t _—L 2. That the property which is the subject of the Petition is located adjacent to your property and is des- cribed as follows: ,12Py 3. That theproperty which is the subject of such Petition is located in the following zoning district: y a that bt such Pet1ition, the undersigned will request the following relief: 5. That the provisions of the Southold Town Zonin&Code ap licable to the relief sought by the under- signed are Article 11F A _ Section_ n t7 Jd A [ ] Section 280-A, New York Town Law for approval of access over rights)-of-way. 6. That within five days from the date hereof, a written Petition requesting the relief specified above will be filed in the Southold Town Clerk's Office at Main Road Southold, New York and you may then and there examine the same during regular office hours. (516) 745-1809. 7. That before the relief sought may be granted, a public hearing must be held on the matter by the Board of Appeals; that a notice of such hearing must be published at least five days prior to the date of such hearing in the Suffolk Times and in the Long Island Traveler-Mattituck Watchman, newspapers published in the Town of Southold and designated for the publication of such notices; that you or your representative have the right to appear and be heard at such hearing. Dated: Petitioner /C�_CAO e_OL n /}>.ta;C Owners ' Names : Rure-•.cZ (.d&Q Post Office Address y� c��a t,+,W r Tel . No . Wr,— Y2`Z/ [Copy of sketch or plan showing proposal to be attached for convenience purposes . ) PROOF OF MAILING OF NOTICE (ATTACH CERTIFIED MAIL RECEIPTS NAMEADDRESS 1 STATE OF NEW YORK j COUNTY OF SUFFOLK ) residing at being duly sworn, deposes and says that on the day of 19 deponent mailed a true copy of the Notice set forth on the re- verse side hereof, directed to each of the above-named persons at the addresses set opposite their respective names; that the addresses set Opposite the names of said persons are the addresses of said persons as shown on the current assessment roll of ti he Town of Southold; that said Notices were mailed at the United States Post Of- fice at ; that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before the this day of f9 Y Notary Public I r ( This side does not )jave to be completed on form transmitted to adjoining property owners . ) w BOARD OF HEALTH . . . . . . . . FORMNO. 1 ;3 SETS OF PLANS . . . . . . . . TOWN OFSOUTHOLD ,SURVEY . . . . . . . . . . . . . . . . . Jul — 3 PA BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTIFY Exaned . . �p CALL /t/G1�9/� mi . / e1 td E'Q MAIL TO ; Approved . . . '/.. . . . . . . . 19 . . . Permit N Disapproved.a (Building Inspector DCC 1 ,41995 i �i � AP (CATION FOR BUILDING PERMIT Date ��ys. . . . . . . . . .. 19 . . '. ......J 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 sca15. Fee according to schedule, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stieet or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upop approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc) shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances of Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins ections. . . . .L. . . . . . . . . . . . . . . . . . . . . . . . ( ignature of applicant, or name, if a corporation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . .�jer!d-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises .f,�Q�r!�e. Y4ll , • 3SS 64ee !lath 4Qy�„Q �iLee�(�✓ Z� Ny (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 99 y� I. Location of land on which proposed work will be done. . . ..?1 as . J�'ep. , / /.g. , g�24/?,,f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . m . . . . . . . . . . . . . . . . . . . ,9 7 .i '�U.. h . House Number Street Hamlet County Tax Map No. 1000 Section • , , , , , , • • Block .'. l.�: + cp• • • , .. , , . Lot . U/y: Subdivision . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . ... Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 3. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . f . lt.�7.pm. .I pr . . . . ./.G 4' �i �• b. lntended use and occupancy i -3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . j''*44:S'ft—Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . Other, r� . . . . . . . . . . . . . . ` to dy&cription) 4. Estimated Cost . . .� JOJ:?. . . .. . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . .7S,,&-..% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . , . , , , . , Number of dwelling units on each floor . ..,/o.. . . . . . . . . . . Ifgarage,number of cars . . . . .,!t . . . . . . . . . . . ./.4,4244. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . ,3' �epth . . . . . . , , , Height . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . J. . . . . . . . . Rear . A S!. . .. . . . . . . . Depth ,.. . . . .•y.At .�. . . . . . . . . . Height . . . . /3 • . . . . . . . . . . . . er of Stories . . .�. . . . . . . . . 8. Dimen*ons of entire new construction: Front . . . . .,!.S�r. . . . . . . Rear . . . ./i . . . . . . . . Depth . . .2e_Lr% . . . . . , . . .Height) . . . . . ..y%..r. . . . . Number of Stories . . . . .•/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Frilnt . . . . . . . Rear. . . . ./W.&k . . . . . . . . . . . . . Depth l�D:s tam�µ. . ./70. 10. Date of Purchase . . . .P/7A'4 ? t-. . .� �r1. . . . . . . Name of Former Owner . -Jemej iio�,. . S.M.mt. .. . . . . . . . 11. Zone or use district in which premises are situated . . . . ./6. , , , , , , , , , , , , , , , 12. Does proposed construction violate any zoning law, ordinance or regulation: . ... . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . .. .tf.v. . . . . . . . . . . . . . . . Will excess fill be removed from mi�j s No 14. Name of Owner of premises'rIv!�"".' . . .f%��. . .Addressiss. A&-!� .�0 .�°'"�`Phone Name of Architect PAvP q. .�'` C:' . . . . . . . . . . .Address .fin.�A .4!''r: t'!"1'' .`4-Phone No. .zYk.52$IJ. , Name of Contractor . . . . . . . . . . . . . . . . . . Address y/4 Am-?Afllb.4`.r'"�'"�"�h%e No. 6,( . . 15. ' Is this property within 300 feet of a tidal wetland? *yes. .�G}. . . 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 setback dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEW YORK, S.S OUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. J...4 . . . . . .` . . . . . ... . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )ove named. tisthe . ... . . . . . . . . . . . . . . . . . . . . . . . . . �;J . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . (Contractor, 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-appKcation are true to the best of his knowledge and belief;and that the )rk will be performed in the manner set forth in the application filed therewith. corn to before me this . . . . . . . . . .day . . . .�. QIf/J?�' )tary Public, . . . . . . . . . . County UY N.VOLIMER 4Ui3UC,state of New l#dc No.01 VO4877367 . . • • • . . . . . . . . . ouaiitied in suffos L%C . . (Signature of applicant) itCommission Expires Aup.1v. �7 3 - { 1 1 4 y I � f � } i a ri< !^�._ _ [^. -•,,.y it - ..✓ • ---ce'r.�.�..r:R-,F>..0—v. .'•-aca.a... ___ mz'.sa•...*r�-.r.rN_-v_. �—.._- __. I y LT N e� R. I�k E 0 emo *4 c Fuma V ��U I CPO i • 00::77 � ���� GDti1 d L � �� r' co Esc 1 r NEAP OF PQOPERTY ul f 5VUed-15 4AS SURyEYEP, . FOI< > Q {{ { y^� _ # 1 t A\2 D KLT NEQ ' 5,-? E. f 7t3 aCS) AT i AK- 1`? +T tTt Cts t r op 50Q,-H0 Z t l , .bt qt �.3 �. pypdmd eye noon on of b� #i /e, Q a u t >o�ssaYayaa�a�anw �- , - �?�. satlonrmsofiner+ewvoMamu ; v t`.1 + jy - OF N!^ Education Lew nt 'aDAP+%rWi 2 _ 3 man ne:beonng a { ) s '-"`� - @� GK 11 L - Copies ofthis survey t �, N O the land suveyo(s^•t,t no;t s ccs GereE i •dl _ ' * ir r. bbe av Ihd tree COPY * 1Gaarenlees�dweted herec�mall rW 5 - '^�Y At' # only ,tothe parson fol wM1om Ne survey L ,„. 'Y 26 O his behalFto Ne "�a b. =� :prepared,and on y,(- •�, _ S �S 25 �� r tyle Co. t _ �adn/7"� ' . } �"•f - LAND SUP lending�nstiuIDan listad hereon assignees of the lending mst4 tt j}(,✓/ tutbn.GuamMeesare notirensfenbie teonal ineldulWne Orep11664 gleal i LOT AREA't3, t5 3.a-l. lr�t SCBE AM }, T� 2A t`top Ct3a t3a FIRE ?4k T _-cu5e= l$ t = e a ;:TUFF: CO3TASC MAP': 1000-I iS 4 T-S 3_ �- EIEVA'f`f N5 F i++1; �i SFA LVVEL,t.}Gy . Aa fzyEY Q . 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