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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-24494 Date JULY 11, 1996
THIS CERTIFIES that the building ADDITION & ALTERATIONS
55 PARADISE POINT RD. &
Location of Property 2975 CEDAR BEACH RD. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 91 Block 1 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 8, 1994 pursuant to which
Building Permit No. 22377-Z dated OCTOBER 14, 1994
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 ALTERATIONS, SCREENED PORCH, OPEN PORCH & TERRACE ADDITIONS
TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER ZBA #4256.
The certificate is issued to JON S. & CAROL M.L. RAND
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTIONS CERT. /11495 - JUNE 19, 1996
PLUMBERS CERTIFICATION DATED JULY 3, 1996 - NATTITUCK PLUMBING & HEAT.
Building Inspe or
Rev. 1/81
FORM N0,3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date CTOBER...14... 19.... 9.4...
N® 22377 Z
Permission Is hereby granted to:
SAMUELS..S.. STEEI:??AN..-...A/C, BANDA..JON,. 6,. CAROL
25235 Y9AIT1,ROAD
! CUTCHOGiTE,, NY 11935
to CONSTRUCT ALTERATIONS, SCREENED PORCH, OPEN PORCH AND TERRACE ADDITIONS TO
EXISTING ONE FAMILY DWELLING AS APPLIED FOR AND TO CONDITIONS OF THE
` ZONING BOARD OF APPEALS, PEAL#4256.
f at premises located at......, 2975 CEDAR BEACH ROAD 6 55 PARADISE„ POINT, ROAD SOUTHOLD, NY
I
I
County Tax Map No. 1000 Section 9.1 Block 1............. Lot No.
t
pursuant to application dated .NGX..Pe, 19...9G,......... and approved by the
Building Inspector,
j Fee
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} fill.
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BuilInsector .
ep
Rev. 6/30/80
corm No. o
n (M11 R M TOiaii OF SOUTHOLD C 76 S - /4S 7y d,
1! LUJ LK U BUILDING
DEPARTMENT 'SE VT
TOWN HALL
TOW
f JUL a 101996``! 765-1802
BLDG .DFPT. 'APPLICATION FOR CERTIFICATE OF OCCUPANC7
TOWN OF SOUTHOLD
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:
L. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
3, 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 825.00, Additions to dwelling 825.00,
Alterations to dwelling $25.00, Swimming pool 525.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - .251~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...7/fQ~ 9to
New Construction........... Old Or Pre-exisjtin BuiId' g+... ?
Location of Property. qq7.... CP.{~0.P".LJ~uer3 .OA~ ~ JOCC~I?UfC~a
House No.
C / Street Hamlet
Onwer or Owners of Property.ff . o!) S. qn~( Cc-roI M.L. KogmA
County Tax Map No 1000, Section... q !........Block...............Lot
Subdivision .........................:::.........Filed Map...........r.0LoY1 t.....1......cc..............
Permit No... . . . . Date Of - Permit. . ../~q j,9 C{ . . ..Applicant.
....4o.
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
3eauest for: Temporary Certificate........... Final Certicate...~....
ree Submitted: B
~
q APPLICANT
~?~a~y9~f
o~OSOFFOj/-co
o~ Gyp
H x
Town Hall, 53095 Main Road p ' Fax (516) 765-1823
P. 0. Box 91971 y~ol ~aO~ Telephone (516) 765-1802
Southold, New York 1
7-
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
r : JUL. 1 0 1996 L- remm w July 3, 1996
a~oc ~;~i.r li
TOWN OF 5661 t±Of D
Samuels & Steelman
25235 Main Road
Cutchogue, NY 11935
Re: Jon & Carol Rand - SCTM#1000-91-1-2
Prem: 2975 Cedar Beach Road & 55 Paradise Pt. Rd.
To Whom This May Concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
xx An application for Certificate of occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22377-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
=~O~OgpFFe7(kC~Gy~
L
Town Hall, 53095 Main Road y z Fax (516) 765-1823
P. O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971 y
viol
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
i C E R T I F I C A T I O N
f ~ JUL 1 0 1996 ~ ?
pp DATE
TOWN O S(?. ,
Building Permit No. a~377
Owner: JOr) C011('01 kAr\41
(please print)
o~U~L P~Uan~aoe?n
Plumber:
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signatu
Sworn to before me this
3 day of Ty.L 191/0
Notary Public, Syrrof-,' County
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4 06-27-1996 03:16PM FROM TO 15167651823 P.02
2975 Cedar Beach Road
Southold, NY 11971
June 27, 1996
Dear Mr. Boufis:
I am writing to request a six-month extension of building permit #22377,
which was issued on October 14, 4994 for the first floor renovation of my
home at the above Southold address:
If possible, I would appreciate it ii you could fax the extension approval to
me at 212-3449320.
Sincerely,
I ,--~..flt
Carol M.L. Rand
Mr. John Boufis
Building Department
Town of Southold
Town Hall, Main Road
Southold, NY 11971
} y 06-27-1996 03:19PM FROM TO 15167651023 P.03
4
2975 Cedar Beach Road
Southold, NY 11971
June 27, 19%
Dear Mr. Boufis:
As requested, I am writing to confirm that Rory Klinge of Traditional
Building and Restoration has completed the renovation work, as contracted,
on my home at the above address in Southold. My husband and I will be
responsible for completing the remaining finish carpentry, painting and
floor refinishing.
If you have any questions, or need further information, please contact me
during the week at 212-809-4366.'
Sincerely,
Carol M.L. Rand
Mr. John Boufis
Building Department
Town of Southold
Town Hall, Main Road
Southold, NY 11971
TOTAL P.03
S A M U E L S&
S T E E L M A N
May 1, 1996
Mr. John Boufis
Building Department
Town of Southold
Main Road
Southold, NY 11971
Re: Rand Residence
Southold, NY MAY ' 8 1996
Permit # 223772
BLDG.DEPT
TOWN OF SOUTHOLD
Dear Mr. Boufis,
As per your request, we are writing this letter to certify that the ridge beam in the
Dining Room is adequately supported and that the required fire protection as been
provided. The following is a summary of each condition.
1. The ridge beam has 4" of bearing on the concrete block structure of the
fireplace. This structure has been designed to support the load generated
by the ridge beam.
2. The ridge beam has 8" of concrete block masonry between the end of the
beam and the clay flue pipe at the fireplace.
If we can answer any additional questions, please do not hesitate to contact this
office.
Your Tr ly,
& Steel Architects
e
elman, R.A.
dX
ARCHITECTS
25235 MAIN ROAD
CUTCHOGUE, NEW YORK 11935
(516) 734-6405
FAX (516) 734-6407
~D
~ c ~OSVFFOLI(C
APPEALS BOARD MEMBERS ~y0 ~G9j~
o Southold Town Hall
Gerard P. Goehringer, Chairman H 53095 Main Road
Serge Doyen, Jr. 41F P.O. Box 1179
James Dinizio, Jr. y O~ Southold,,New York 11971
Robert A. Villa Fax (516) 765-1823
Richard C. Wilton Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
August 22, 1994
Samuels & Steelman
Attn: Nancy Steelman
25235 Main Road
Cutchogue, NY 11935
Re: Appl. No. 4256 - Jon and Carol Rand (Corner of Porch)
Dear Ms. Steelman:
Please find attached a copy of the Board's findings and
determination rendered at, our August 11, 1994 Regular Meeting
concerning the above application.
Also, we have transmitted a copy of this file to the Suffolk
County Department of Planning in accordance with the Suffolk County
Administrative Code rules and regulations pertaining to projects
located within 500 feet of a waterway (Canoe Inlet/Cedar Beach
Harbor). Once we have received their written response, we will
forward a copy to you for your permanent recordkeeping.
Very truly yours,
Linda Kowalski
Enclosures
Copies of Decision to:
Southold Town Building Department
Suffolk County Department of Planning
\ SpfFOLA'
C
APPEALS BOARD MEMBERS y~~O OG'yj
Southold Town Hall
Gerard P. Goehringer, Chairman 53095 Main Road
Serge Doyen, Jr. ~p P.O. Box 1179
James Robe t A. Villa -y~01 i ~a~! SoFaxo(5 6) 765- 71
1823
Richard C. Wilton Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
ACTION OF THE BOARD OF APPEALS
I
Appeal No. 4256:
Application for JON AND CAROL RAND. Variance to the Zoning
Ordinance, Article XXI , Section 100-244B, and based upon the July
12, 1994 Notice of Disapproval from the Building Inspector, for
permission to constructlporch addition With reduced front yard setback
at less than the established nonconforming front yard setback along
Paradise Point Road. I The subject premises is nonconforming with a
total lot area of 23,522+f- square feet in this Agricultural-
Conservation (A-C) Zone District. Property Location: 2975 Cedar
Beach Road at intersection with Paradise Point Road, Southold, NY;
also known and referred to as Lot 19 on the Map of Cedar Beach
Park; County Tax Map Parcel No. 1000-91-1-2.
WHEREAS, a public hearing was held on August 11, 1994, at which
time those who desire to be heard were heard and their testimony
recorded (no opposition was received); and
WHEREAS, the Board has carefully considered all testimony and
documentation submitted) concerning this application; and
WHEREAS, the B rd Members have personally viewed and are
familiar with the pre ses in question, the present use and zone
district, and the surro ding areas; and
WHEREAS, the Boa~d made the following findings of fact:
1. The premises in question:
(a) is a parcel of land known as Lot No. 19 on the Map of
Cedar Beach Park, which parcel of land is situate along the northerly
side of Cedar Beach R ad and the westerly side of a Paradise Point
Road, at Southold, contirung a total lot area of .54 of an acre;
(b) is imp Moved with a single-family dwelling, as more
particularly shown on the site plan map dated 7/7/94 prepared by
Samuels & Steelman, w uch information was taken from a survey dated
7/29/87 of William R. immons, Jr., showing an existing front yard
i
Page 2 - Appl No. 4256
Application of JON AND CAROL RAND
Decision Rendered August 11, 1994
setback along the easterly side of the dwelling at 24 feet from the
property line along Paradise Point Road.
2. By this application, appellants have requested approval for a
reduction in the easterly front yard setback from 24 feet to 19 feet
for a corner section 'I of a proposed covered porch addition. The land
area adjoining this property along the west side of Paradise Point Road
is shown to be improved with a wood fence and is maintained as an
extension of lawn area from the subject lot.
3. In considering this application, the Board finds that the 30+-
sq. ft. corner portion of the proposed covered porch addition which is
the subject of this variance request is minimal and will not be an
adverse impact to the essential character of the neighborhood.
Accordingly, onI motion by Chairman Goehringer, seconded by
Member Dinizio, it was
RESOLVED, to GRANT the relief requested for the 30 sq. ft.
corner of the proposed covered porch addition to existing dwelling as
shown on the above-referenced site plan map with a setback at 19 feet
(as requested).
Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio,
Villa and Wilton. This resolution was duly adopted.
ik
GERARD P. GOE RINGER, CCHAIRMAN
II
II
III
II
II
I
'I
III
FORM NO. 3
W
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date . . . . . . JULY>12, 1994
_ ~ > .
To NANCY STEELMAN
25235 MAIN ROAD
CUTCAOGUE, NY 11935
PLEASE TAKE NOTICE that your application dated JULY. 7..........., 19.94..
for permit to CONSTRUCT A PORCH ADDITION at
Location of Property 2975 CEDAR BEACH ROAD SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section At Block 91.......... Lot 9?.. .
Subdivision Filed Map No. Lot No................. .
is returned herewith and disapproved on the following grounds PORCH CONSTRUCTION ENCROACH.
ING ON THE FRONT YARD SETBACK AS SET FORTH IN THE BULK SCHEDULE FOR AN A-C ZONE.
ACTION REQUIRED BY THE ZONING BOARD OF APPLEALS.
iM'...
ilaing Inspector
RV 1/80
R
_ FORM NO.3
A
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date
To f;La..... .
PLEASE TAKE NOTICE that your application dated....... 19 ~V -
for permit to at
Location of Property
~f~tJ!
House No. ~~jj Street Hamlet
County Tax Map No. 1000 Section 9/ Block ® Lot ...OZ
Subdivision Filed Map No. Lot No................. .
is returned herewith and disapproved on the following grounds .
'
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Page 2 - Appl No. 42.1x)(;
Application of JON AND CAROI. RAND
Decision Rendered August 11, 1994
setback along the. easterly side of the dwelling at 24 feet from the
property line along Paradise Point Road.
2. By this application, appellants have requested approval for a
reduction in the easterly front yard setback from 24 feet to 19 feet
for a corner section !!of a proposed covered porch addition. The land
area adjoining this property along the west side of Paradise.Point Road
is shown to be improved with a wood fence and is maintained as an
extension of lawn area from the subject lot.
3. In considering this application, the Board finds that the 30+-
sq. ft. corner portion of the proposed covered porch addition which is
the subject of this variance request is minimal and will not. be an
adverse impaet to thel essential character of the neighborhood.
Accordingly, onlmotion by Chairman Goehringer, seconded by
Member Dinizio, it was
RESOLVED, to GRANT the relief requested for the 30 sq. ft.
corner of the proposed covered porch addition to existing dwelling as
shown on the above-referenced site plan map with a setback at 19 feet
(as requested).
Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio,
Villa and Wilton. ']'his resolution was duly adopted.
GERARD P. GOEL RINGER, CCIIAIRMAN
i
I
it
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04
S A M U E L S&
S T E E L M A N
March 6, 1996
Building Department
Town of Southold
Main Road
Southold, NY 11971
Re: Rand Residence
Southold, NY
Permit # 223772
Dear Building Inspector,
As per your request, we are sending you a revised First Floor Plan of the Rand
Residence. This plan shows the changes we made regarding the steel beam in the
Living Room and the header at the door to the porch in the Dining Room. These
changes are shown bubbled for easy reference.
If we can provide any additional information, please do not hesitate to call our office.
Your Truly,
Samuel Steelm rchitects
ancy St rrian, RA
ARCHITECTS
25235 MAIN ROAD
CUTCHOGUE, NEW YORK 11935
(516) 734-6405
FAX (516) 734-6407
S A M U E L S&
S T E E L M A N
May 1, 1996
Mr. John Boufis
Building Department
Town of Southold
Main Road
Southold, NY 11971
Re: Rand Residence
Southold, NY
.
Permit # 223772 n. MAY -8 1996
BLDG. DEPT.
„TOWN OF SO~ UTNo
Dear Mr. Boufis,
As per your request, we are writing this letter to certify that the ridge beam in the
Dining Room is adequately supported and that the required fire protection as been
provided. The following is a summary of each condition.
1. The ridge beam has 4" of bearing on the concrete block structure of the
fireplace. This structure has been designed to support the load generated
by the ridge beam.
2. The ridge beam has 8" of concrete block masonry between the end of the
beam and the clay flue pipe at the fireplace.
If we can answer any additional questions, please do not hesitate to contact this
office.
4ancy 4.eelman, eel Architects
R.A.
ARCHITECTS
25235 MAIN ROAD
CUrCHOGUE, NEW YORK 11935
(516) 734-6405
FAX (516) 734-6407
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [G]-Ff-N'AL
[ ] FIREPLACE & CHIMNEY
REMARKS:.Z~o-/-::: -
114
DATE 7 INSPECTOR
77-~t
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ IN
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~7s2ee l'd._~,
ep %f
3g-
DATE c l INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG -PLBG.
[ ] FOUNDATION 2ND NSULATION
[ FRAMING [ ) FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:c.~~a~h n~ y d
eC_ 41,
DATE INSPECTOR
I
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOU TION 2ND [ ] INSULATION
[41-`FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:' Dom`u~ r of ~,~v~°~ usds
i
DATE INSPECTO
;L 3 e71'7
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ OUCH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE ~8"CH,IIMMNEY
REMARKS: 9G'
DATE INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ) ROUGH PLBG.
[ ) FOUNDATION 2ND INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTOR
i5-1802
B WIN - ~
t=
INSPECTION
[ ] FOUNDATION 1ST [ J ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTOR
E
BOARD OF HEALTH • .
FORM NO. 1 3 SETS OF PLANS •
D TOWN OFSOUTHOLD SURVEY
JUL a,N I BUILDING DEPARTMENT CHECK . , ,
1001 TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 7651802_ NOTIFY
CALL
Examined ..7.... 19k MAIL TO: . • • • • • . • .
Approved!. a/ ........119.. . Permit No.5U.4 77. .
Disapproved a/c .~??l...... 7 /l/~/ .
.
uildi d In pector)
APPLI TION FOR BUILDING PERMIT
Date 717........, 194.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildin code, housi ode, a d regulations, and to
admit authorized inspectors on premises and in building for necessary, in ns.
. .
- (S' ature of a icant, or name, if a corporation)
L,5 z~ //1f ,v . f~i~fl l7. ti. Y
(Mailing address of applicant) l/~35
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~ r5~i4? 7 ......................E.. a..,..................................
Name of owner of premises ..`9.. ~ / '.~•.G'??A!fP .
(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 . .
q7 ................c /f6z 7C./.......?....... ~
House Number G~Street /Hamlet
County Tax Map No. 1000 Section . Block Lot I . ,
Subdivision Filed Map No. Lot .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
N~`c`.~~r~0a1 fwS1 I
b. Intended use and occupancy ..c~//tJG°lr>../G !~lC~Cleada • • • • . •
, FI
3, Nature of work (check which applicable): New Building Addition ...f+! r . r
Repair Remo val Demolition Ot • Work .
to (Description)
4. Estimated Cost , , ,
Fee............
I / (to be paid on
S. If dwelling, number of dwelling units ! Number of dwelling units on
If garage, number of cars , , i I
6. If business, commercial or mixed occupancy, specify nature and extent of each t pe of use - , , .
7, Dimensions of existing
if any: Front ...(o.~~ .....Rear ~O r. Depth . .
Height .
structures, Number of Stories .
Depth
Dimensions sis of s~nstructure with alterations or addi ins: Front 6 .%t....... Rear 6; 6e.'¢ , , ,
. . GFJ
' Height
Number of Stories Z................
8. Dimensions of entire new construction: Front Rear Depth , , , .
Height Nu ~er of Stories .
9. Size of lot: Front 20 Rear ~QQ Depth . , . f/t ,Q... .
10. ate of Purchase Zone or use district in which pre' ' ' ' ' ' ' ' ' • N me of Former Owner
11. , in which are situated ~
, , , , struction violate ny zoning law, ordinance or regulation: .
1132,. Will Does proposed: lotccon
,
regraded , . Will excess fill be removed from premises: Yes
P . Address .?9',7,`.. i . Phone No..
14. NName of Owner of ame of Contractor . raises . fir, Go, . , . .
Name of Architect
PV AVM K•g'.~,i! . , , ...Address Z-- .4 y!'V~•. Phone No.
property within 3 " " " " '..Address ...................Phone No..............,.
15. Is this 100 feet of a tidal wetland? 'ryes........ No.........
*If yes, Southold X own Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all jbuildings, 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.
I
I
i
STATE OF NEW YORK S.S
COUNTY F
• • • • . being duly sworn, deposes and says thaf7he is the applicant
(Name f individual signing contract)
above named. yy~~
5Heisthe.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn t!$ before me this
• _ ....day of Il . 19
Notaryubl County
UNA FOROSCH IXe4WIJ
NmelyPd* owedNGWYO* (Signature of applicant)
No. 4995983 Suft0mM
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SITE DATA ~lRf1) ARp~ +
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SCTM # 1000-91-1-2 ®CC(IPAR, y OR roject o 9412
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PROPERTY: 2975 Cedar Beach Road d ~ 9,P (e6~~FiJ~ tSIyH()uT CEFMFICATE Drawn By: N9
OF OCCUPANCY Checked By: TG
Date
I ^ ADDRESS Southold, N.Y. 11971 OWNER: Jon & Carol f Rand
26 Beaver Street Scale: ^s sP=Jzl
737 New York, N.Y. 10004 / flf P"•i3Bi `l? l1~ mRt~TF'TE
Tel # (212) 809-4366 22377 ShQetTitle:
Tel # (516) 765-4372
Id64 n=Y ItLd~ ~J4dCi 17FG'f+'rY'PI1f. ? _ F
M18 W, ri F,fJI I"ft/, FOR THE
ZONING. A-C (Agricultural- Conservation) servation) a jv[;,,r, rl;r°Ferlol"5 SITE r~m.,u,aT,oN rl„c.RECZUIREo
SITE: 0.54 Acres F:r, (A-i - FRANTNIG v PLUMMr, PLAN
AREA 21Nr.u1L.r'ait)Id
Y;!tlxL - COW',TRUCTION MUST 5F COMPLETE FOR C.O.
SURVEYOR: William R Simmons Jr ALL. CONSTRUCTION SHALL MEET
Jamesport, N.Y 11947 THE REOUIREMENTS OF THE N.Y.
Dated: 7/29/87 '.:TATS CONSTRUCTION & ENERGY Sheet No: '
0"LN-S. NOT RESPONSIBLE FOR
0FSK3N OR CONSTRUCTION ERRORS
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