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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-23987 Date OCTOBER 24, 1995
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 1935 WESTVIEW DRIVE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 107 Block 7 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 9, 1994 pursuant to which
Building Permit No. 22283-Z dated AUGUST 26, 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 ALTERATION & ADDITION TO EXISTING ONE FAMILY DWELLING TO
INCLUDE 2 CAR GARAGE & COVERED PORCH AS PER ZBA #4213 AS APPLIED FOR.
The certificate is issued to IRWIN PRICK
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-352765 - MAY 23 1995
PLUMBERS CERTIFICATION DATED SEPT. 19, 1995 - JOHN RYDER
/191difig Inspector
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date 19.../..~
N® 22283 Z
Permission Is hereby granted to:
. :yea
f....'il/~~....1...~ ! ..,./.1...7~~.f~.
to /r.......... ..........:...................!f
c9,n/E......./............ 1/.- d
° %
...........2
F
Yp4
3Ssi Is,~.c?
at premises located at /.`j..............
f~...!...... /...f
' =J k.
County Tax Map No. 1000 Section-4407............ Block Lot No.
pursuant to application dated ~~r..... 19..../. Y` and approved by the
Building Inspector.
J
....~~1"/.-....4P~ I -
Fee $
........,1
Building Inspector
Rev. 6/30/80
Form No. 6
TOt4N OF SOUTHOLD
BUILDING DGPARTMFNT
TOWN HALL.
765-1802 '
APPLICATION FOR CTRTIi•ICATc OF OCCUPANCY
A. This application must be filled in by typewriter OF, 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.
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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings,and
"pre-existing" land uses: A
1. Accurate survey of property snowing 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 525.00,
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 - $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 PXe-existing Building
Location of Property..I~3~.. j lGiGk...../~%.;2.-/Y
louse N.oStreet Hamlet
Onwer or Owners of Property.....
-ounCy Tax Hap No 1000, Section ..~U.~....... Btuck.... 7 ..........Lot
Subdivision ....................................Filed Mrip............ Lot......................
7ermlt DaCe of Permit.....
HealLh Depc. Approval ..........................Underwriters Approval.. 1--._.~
'lanning Board Approval....................
?equest for: Temporary Certificate........... Finn1 Certicate.
r 6
Submitted: 5.~ J•C1
oC'~ec< SO 3
e 0~d3gC)
C:(i•1LNT^
OUNDATION (1st)
OUNDATIO;1 (2nd) M
j c.
I o_
;OUCH FRAIME & v~
.PLUMBING
3. I m
n
_11SULATION PER N. Y.
STATE ENERGY II
CODE I _ S
r ,~sr rv
FINAL Gd
e ~n
ADDITIONAL COMMENTS: x
m
p-
H
n ® m
~ i
H
m
Town Hall, 53095 Main Road Fax (516) 765-1823
P. O. Box 1179 . cr Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR.
TOWN OF SOUTHOLD
C E R T I F I C A T I O N p
DATE
Building Permit No.
Owner: SIC U/~/ / N~Gk
(please print)
Plumber: 6#A) 30~~
(please 'print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plu bers ignature)
Sworn to before me this
day of OCTti,5e7t» , 19~
Notary Public, J orf=d G/L County JOAN S.LEHTONEN
Notary Public, State of New York
No. 0't
Qualified in Suffolk County
6j Commission Expires Feh 1, 1{i40
4
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1015052 BUREAU OF ELECTRICITY
F- 85 JOHN STREET. NEW YORK, NEW YORK 10038
Date MAY 23,1995 Application No. on file 87114795/95 N 352765
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
PRICK, 1935 WESTVIEW ROAD, MATTITUCK, N.Y.
in lhefollowing location; LJ Basement ® Ist FL ® 2nd Ft. GAR/OUT Section Block Lot
was examined on I4AY 19 , 1995 and found to he in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWI7CNE$ INCANDESCENT FLUORESCENT OTHER T. K W AMT. K W. AMT. KW. AMi N.W. AMi M. P.
U
69 1 T 74 59 69
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS EELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT K W. OIL H. P. GAS H P AMT. NO. A W. G. AMT. AMP. AMT AMPS. TRANS. AMT. H. P NO. OF FEET AMT. WATTS
2 F 6 - - 5 -
SERVICE DISCONNECT NO. OF S E R V I C E
AMT AMP TYPE METER 10 2W 1 .e 3W 30 3W 3,e 4W NO.OF CC COND. A. NO. OF .1 LEG A. WHIRE NO. OF NEUTRALS A. W
EQUIP. PER .9 OF CC CO.. COW. G. Of NEUTRAL
1 100 CB 2 X 2 4/0 2 4/0
07HER APPARATUS: III
SERVICE DISCONN.AMP.300,TYPE-CB-1 I
MOTORS:2- H.P.
G.F.C.I:-6
SMOKE DETECTOR;-2
ALL STAR ELEC. I4IC.#3681-E
1570 ROCKY POINT RD.
MIDDLE ISLAND, NY, 11953 GENERAL MANAGER'
11
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND SULATION
[ 7 FRAMI [ ] FINAL
REMARKS:
DATE I C INSPECTO
7"-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
INSULATION
[ ] FOUNDATION 2ND [ ;-Fl'NAL
FRAMING [ ] FIREPLACE & CHIMNEY
REMARKS • 54- CZV!f~~'
DATE INSPECT
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS LATION
[ ] FRAMING [ FINAL
REMARKS: (/1q `
f
a
DATE ~ ~ INSPECTOR
C ~y V
M-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST ( ] ROUGH PLBG.
FOUNDATION 2ND [ I INSULATION
[ l FRAMING [ ] FINAL
REMARKS: L'D s
DATE INSPECTOR ~V
i x,.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ Yf/ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
I
DATE INSPECTOR
z1 z-
765-1802
BUILDING DEPT.
INSPECTION
[FOUNDATION 1ST ( ] ROUGH PLBG.
FOUNDATION 2ND [ ) INSULATION
FRAMING [ ] FINAL
REMARKS:
6
DATE 9 INSPECTOR
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IIEC 1 219A4
BLDG. DEPT.
70WN OF SOUTFIOLD
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date 19g.
s
~~..1...........
PLEASE TAKE NOTICE that your application dated 19
for permit to A 479 at
Location of Property 4 . L. ,
House No. Street / Hamlet
County Tax Map No. 1000 Section q.;7. Block j
.......Lot
Subdivision Filed Map No. Lot No.
is returned herewith and disapproved on the following grounds ..~...4G /T
lla~
.~-~'Gc? !Z~e 70 Vie....
........9
g Inspector
RV 1/80 ti
^
APPEALS B OARD MEMBERS Yw . f1
Gerard P. Goehringer, Chairman
Serge Doyen, Jr.
eg, Town Hall, 53095 Main Road
James Dinizio, Jr. 0 ®@° P.O. Box 1179
Robert A. VillaF Southold, New York 11971
Richard C. Wilton Fax (516) 765-1823
Telephone (516) 765-1809 BOARD OF "PEALS Telephone (516) 765-1800
TOWN OF SOUTHOLD _
March 10, 1994
r!'' e+.l 199A
Mr. and Mrs. Irwin Frick'
2 Arlington Ct. T~t1>a s13,'wF
Miller Place, NY 11764
Re: Appl. No. 4213 - Alternative Relief for Sideyard Addition
Dear Mr. and Mrs. Frick:
Please find attached a copy of the Board's findings and determination
rendered at our March 2, 1994 Regular Meeting concerning the above applica-
tion.
Please be sure to return to the Building Inspector and any other agency
having jurisdiction in this project for issuance of other permits and
approvals. A copy of this determination has been forwarded to the Building
Department for their update and permanent records.
Also, we expect to receive comments or recommendations shortly from
the Suffolk County Planning Commission as a result of the referrals required
under the Suffolk County Charter pertaining to variance projects within 500
feet of a waterway. When received, we will forward a.copy•to you for your
update and records.
Very truly yours,
Linda Kowalski
Enclosures
Copies of Decision to:
Building Inspector (Attn: Tom Fisher)
Suffolk County Department of Planning
APPEALS BOARD MEMBERS ~0
Gerard P. Goehringer, Chairman F z b
Serge Doyen, Jr. L Town Hall, 53095 Main Road
James Dinizio Jr.
P.O. Box 1179
Robert A. Villal Southold, New York 11971
Richard C. Wilton Fax (516) 765-1823
Telephone (616) 765-1809 BOARD OF APPEALS Telephone (516) 765-1800
TOWN OF SOUTHOLD
FINDINGS AND DETERMINATION
Appeal No. 4213:
Application of IRWIN and AGNES FRICK. Application for a.Variance to
the Zoning Ordinance, Article IIIA, Section 100-30A.3 (and Section 100-244B)
pertaining to substandard lot sizes) for permission to construct addition
with a reduction in the minimum setback at the southerly side yard. The
existing setback is shown to be approximately 11-1/2 feet, and the addition
is proposed to extend 6-1/2 feet from the existing dwelling structure.
Section 100-2448 requires a minimum 10 ft. setback; applicant proposes a
five-foot setback. This parcel of land has a total lot area of. 13,940+-
square feet and is located in the R-40 Low-Density Residential Zone
District. Property ID: 1935 Westview Drive, Mattituck, NY; County Tax
Map District 1000, Section 107, Block 7, Lot 5.
WHEREAS, after due notice, public hearings were held on February 2,
1994 and March 2, 1994, at which time all those who desired to be heard were
heard; and
WHEREAS, Board Members have carefully considered all testimony and
documentation submitted concerning this application; and
WHEREAS, Board Members have personally viewed and are familiar with
the premises in question, the present uses and existing buildings in the
surrounding area; and
WHEREAS, the Board made the following findings of fact:
1. The premises in question:
(a) is a parcel of land containing a nonconforming lot area of
13,940+- square feet, situate along the westerly side of West View Drive,
Mattituck, Town of Southold;
(b) is presently improved with a 1-1/2 story framed dwelling
structure situated 100 feet from the front {easterly) property line, 11-1/2
feet from the westerly side property line, 15 feet from the northerly (side)
property line along N. Riley Avenue, and 22 feet from the closest retaining
wall towards the existing bulkhead along Mattituck Creek (ref. copy of
survey map prepared August 4, 1980 by Roderick VanTuyl, P.C.)
(c) is located in the R-40 Zone District as adopted in the
Master Plan revisions dated January 10, 1989.
' age 2 - Appl. No. 4213
Matter of, IRWIN and AGNES FRICK
Decision Rendered March 2, 1994
2. By this application, appellants have requested permission to
construct a conversion of a portion of the existing garage area and new
addition at the southerly . side of. the existing dwelling which would leave a
proposed setback at 5.6" from the southerly property line.
3. Today's setback requirements pertaining to lots of this size (less
than 20,000 sq. ft.) at Article XXIV, Section 100-2448 requires minimum side
yard setbacks at. 10 and 15 feet, for a total of 25 feet. It is beneficial
that there will be a greater distance to the outer bulkhead along Mattituck
Creek at a setback of 72+- feet {greater than the established nonconformity
seaward of the proposed construction}.
4. The amount of reduction requested by this application is for a
setback at 5.5 feet instead of the required 10 feet along the southerly side
yard. The total sideyards are also being requested at. 20.5 feet instead of
the required 25 feet.
5. It is the position of the Board Members that the amount of relief
requested is substantial in relation to the requirements, and that an
alternative setback granting relief by three feet specifically, to allow a
setback at seven (7) foot, is also feasible and will under the circumstances
be the minimal necessary, while preserving and protecting the character of,
the neighborhood and the safety, health and welfare of the community.
6. For the record it is noted that similar setbacks have been
established at approximately eight feet for one sideyard, and for a total of
21 to 22 feet for both sideyards, in the immediate area of "Mattituck
Heights" Subdivision {which preexists the enactment of zoning (having been
filed July 24, 1935 with the Suffolk County Clerk's Office)}.
7. In considering this application, the Board also finds:
(a) that the relief, as alternatively granted, will not produce
a substantial change in the character of the neighborhood - in fact there are
other principal buildings with setbacks similar to that proposed herein {for
further information, please see record on lots identified on the County Tax
Map District No. 1000, Section 107, Block 7, as Lot Nos. 8, 9, etc.};
(b) that the difficulties of the applicants' land is outweighed
by any possible public need;
(c) that the difficulties claimed can be obviated only by the
alternative grant for similar, but lesser relief, as described in this
determination;
(d) that the difficulties claimed are not self-created;
(e) that the difficulties claimed are uniquely related to the
layout and general character, shape and size of this parcel and are not
personal to the landowners;
a
Page 3 - Appl. No. 4213
Matter of IRWIN and AGNES FRICK
Decision Rendered March 2, 1994
(f) that in view of the manner in which the difficulties arose
and the fact that the size and open land area is limited, the interests of
justice will be served by allowing a three-foot variation for minimum side
yard setback at seven (7) feet, instead of the required 10 feet, and at total
sideyards at 22 feet, instead of the required 25 feet.
ACCORDINGLY, on motion by Member Dinizio, seconded by Chairman
Goehringer, it was
RESOLVED, that the relief as requested for a setback of 5.5 feet, and
total sideyards of 20.5 feet, be and hereby is DENIED; and be it further
RESOLVED, that ALTERNATIVE RELIEF BE AND HEREBY IS GRANTED
for a minimum setback of seven (7) feet, and total sideyards of 22 feet.
Vote of the Board: AYES: Messrs. Goehringer, Dinizio, and Wilton.
NAY: Member Villa (no alternative was offered but felt a variance of three
feet is substantial). <Member Doyen of Fishers Island was absent due to
poor weather conditions.> This resolution was duly adopted (3-1).
Ik~
GERARD P. GOEHRINGER, Cl ,RMAN
APPEALS BOARD MEMBERS
Gerard R Goehringer, Chairman a e
Serge Doyen, Jr.ti
r'°3 Town Hall, 53095 Main Road
James Dinizio Jr. PO. Box 1179
7111
Robert A. Villa S
outholldd, , New York 11971
Richard C. Wilton Fax (516) 765-1823
Telephone (516) 766-1809 BOARD OF APPEALS ,..Telephone (516) 765-1800
TOWN OF SOUTHOLD
FINDINGS AND DETERMINATION
ita
U i.,
Appeal No. 4213:
L„ .
T 011114 its Sa')i.71Wd LO
Application of, IRWIN and AGNES FRICK. Application for a -Variance to
the Zoning Ordinance, Article IIIA, Section 100-30A.3 (and Section 100-2446)
pertaining to substandard lot sizes) for permission to construct addition
with a reduction in the minimum setback at the southerly side yard. The
existing setback is shown to be approximately 11-1/2 feet, and the addition
is proposed to extend 6-1/2 feet from the existing dwelling structure.
Section 100-2448 requires a minimum 10 ft. setback; applicant proposes a
five-foot setback. This parcel of land has a total lot area of 13,940+-
square feet and is located in the R-40 Low-Density Residential Zone
District. Property ID: 1935 Westview Drive, Mattituck, NY; County Tax
Map District 1000, Section 107, Block 7, Lot 5.
WHEREAS, after due notice, public hearings were held on February 2,
1994 and March 2, 1994, at which time all those who desired to be heard were
heard; and
WHEREAS, Board Members have carefully considered all testimony and
documentation submitted concerning this application; and
WHEREAS; Board Members have personally viewed and are familiar with
the premises in question, the present uses and existing buildings in the
surrounding area; and
WHEREAS, the Board made the following findings of fact:
1. The premises in question:
(a) is a parcel of land containing a nonconforming lot area of
13,940+- square feet, situate along the westerly-side of West View Drive,
Mattituck, Town of Southold;
(b) is presently improved with a 1-1/2 story framed dwelling
structure situated 100 feet from the front (easterly) property line, 11-1/2
feet from the westerly side property line, 15 feet from the northerly (side)
property line along N. Riley Avenue, and 22 feet from the closest retaining
wall towards the existing bulkhead along Mattituck Creek (ref. copy of
survey map prepared August 4, 1980 by Roderick VanTuyl, P.C.)
(c) is located in the R-40 Zone District as adopted in the
Master Plan revisions dated January 10, 1989.
Page 2 - Appl. No. 4213
Matter of IRWIN and AGNES FRICK
Decision Rendered March 2, 1994
2. By this application, appellants have requested permission to
construct a conversion of,a portion of the existing garage area and new
addition at the southerly side of the existing dwelling which would leave a
proposed setback at 5.6" from the southerly property line.
3. Today's setback requirements pertaining to lots of this size (less
than 20,000 sq. ft.) at Article XXIV, Section 100-2448 requires minimum side
yard setbacks at 10 and 15 feet, for a total of- 25 feet. It is beneficial
that there will be a greater distance to the outer bulkhead along Mattituck
Creek at a setback of 72+- feet {greater than the established nonconformity
seaward of the proposed construction}.
4. The amount of reduction requested by this application is for a
setback at 5.5 feet instead of the required 10 feet along the southerly side
yard. The total sideyards are also being requested at 20.5 feet instead of
the required 25 feet.
5. It is the position of the Board Members that the amount of relief
requested is substantial in relation to the requirements, and that an
alternative setback granting relief by three feet specifically, to allow a
setback at seven (7) foot, is also feasible and will under the circumstances
be the minimal necessary, while preserving and protecting the character of
the neighborhood and the safety, health and welfare of the community.
6. For the record it is noted that similar setbacks have been
established at approximately eight feet for one sideyard, and for a total of
21 to 22 feet for both sideyards, in the immediate area of "Mattituck
Heights" Subdivision {which preexists the enactment of zoning (having been
filed July 24, 1935 with the Suffolk County Clerk's Office)}.
7. In considering this application, the Board also finds:
(a) that the relief, as alternatively granted, will not produce
a substantial change in the character of the neighborhood - in fact there are
other principal buildings with setbacks similar to that proposed herein {for
further information, please see record on lots identified on the County Tax
Map District No. 1000, Section 107, Block 7, as Lot Nos. 8, 9, etc.};
(b) that the difficulties of the applicants' land is outweighed
by any possible public need;
(c) that the difficulties claimed can be obviated only by the
alternative grant for similar, but lesser relief, as described in, this
determination;
(d) that the difficulties claimed are not self-created;
(e) that the difficulties claimed are uniquely related to the
layout and general character, shape and size of this parcel and are not
personal to the landowners;
' Page 3 - Appl. No. 4213
Matter of IRWIN and AGNES FRICK
Decision Rendered March 2, 1994
(f) that in view of the manner in which the difficulties arose
and the fact that the size and open land area is limited, the interests of
justice will be served by allowing a three-foot variation for minimum side
yard setback at seven (7) feet, instead of the required 10 feet, and at total
sideyards at 22 feet, instead of the required 25 feet.
ACCORDINGLY, on motion by Member Dinizio, seconded by Chairman
Goehringer, it was
RESOLVED, that the relief as requested for a setback of 5.5 feet, and
total sideyards of, 20.5 feet, be and hereby is DENIED; and be it further
RESOLVED, that ALTERNATIVE RELIEF BE AND HEREBY IS GRANTED
for a minimum setback of: seven (7) feet, and total sideyards of 22 feet.
Vote of the Board: AYES: Messrs. Goehringer, Dinizio, and Wilton.
NAY: Member Villa (no alternative was offered but felt a variance of three
feet is substantiall. <Member Doyen of Fishers Island was absent due to
poor weather conditions.> This resolution was duly adopted (3-1).
Ik
GSA D P. GOEHRRIIINNGER, CHAIRMAN
pr
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'3L,aI.r~r > D(SpJg~/FC. SYSTEMS POR;THIS RE3)
:,•.1,~'t2erf ~ ~ DEN"C6' WdLL,' ~CdNFORM :~Tt7 TI'46
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3. Nature of work (check which applicable): New Building Addition Alteration l .
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost ..........44> Fee
(to be paid on filing this application)
If dwelling, number of dwelling units .....6.......... Number of dwelling units on each floor
If garage, number of cars ............................g .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ~ .
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of `same structure with alterations or additions: Front Rear .
Depth Height Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
X 9. Size of lot: Front Rear Depth
X] 0. Date of Purchase Name of Former Owner
11. Zone or use district in whichmises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation: ../.4v1 P............. .
13. Will lot be regraded Will excess fill be removed from premises: Ye No
A14. Name of Owner of premi es Address Phone No............ .
Name of Architect 1G~. Address p ll-4l7..: Phone No.
J C'ae~j- oiZ . .c-- c
Name of Contractor . Address M c... ne No.Z3 i.: .
15. Is this property within 300 feet of a tidal wetland? vr.e
*If yes, Southold Town Trustees Permit may be r ed.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
4TATE OF NES V CO Y OF S.S
...........K .
r ~.~....f
being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
abo rise named.
HHthe......U WA IZ'~
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
941(-
day of...Pr*I V'T .......,19
Notary Public . ...................County
JOAN S. LENTONEN
NoteryNo, 011.ESt of 4918828w York
Qualified in Suffolk County (Signature of applicant)
Commission Expires Fell 11 less.
yn/ / BOARD OF HEALTH
UJ FORM NO.1 3 SETS OF PLANS
CC// TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CIIECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971 ( r/
TEL.: 765.1802... : `ag a~~O 7
Examined. 4i 19(T ..MA ITL r, 0 .
Approved 19QQ,9/Kermit No. yL2Pjd ,t ~ 1 K,4 ' k? .
Disapproved a/c / lJ t5 .
1994
Bu' spector) BLDG. DEPT
( ilg
TOWN OF SOl1Tl{OLD
APPLICATION FOR BUILDING PERMIT
Date 197/
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'Ibuildings, 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 premisses and in building for necessary ins bons.
f
(Signature of applicant, or name, if a corporation)
Qom.. C? f1~!(/.~Zl. .
(Mailing/address of applicant) 1176r/
State whether applicant is owner„lessee, agent, architect, engineer, eneral contractor, electrician, plumber or builder.
G' C
/o X).L-d2,.
d . -6
4~L!
Name of owner of premises
(as o the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of torpor to officer)
Builder's License No. /..Q
Plumber's License No . . .
Electrician's License No .
Other Trade's License No. ,I
Location of land on which propo` ed work will be done. . WCJ Ve/c~) ? el L16
1,............... .
House Number Street Hamlet
County Tax Map No. 1000 Section Block r~ .,1.......... Lot 6...........
Subdivision Filed Map No. Lot
• • ' ' • ''('Name) L" I
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy !d.
b. Intended use and occupancy ........L~~ . .
e ,envlTlorl.
Fo t iyAzr~ NVa OH
oj 5 1 11 ,Pl revp M N~ 1. ALL WORT( SMALL COMPLY W/ CURRENT NEW YORE STATE BUILDING CODES, UNIFORM FIRE PREVENTION, AND LOCAL REGULATIONS.
2. EVERY CONTRACTOR / TRADESMAN SMALL VERIFY ALL DIMENSIONS
PRIOR TO STARTING WORE.
3. DO NOT SCALD DRAWINGS. WRITTEN DIMENSIONS ARE TO BE
625.2. _ FOLLOWED.
4. ALL AOTDRIOR NAILS SMALL DD 3•X4- CONSTRUCTION ALL INTERIOR PARTITIONS TO BE Z'X{• CONSTRUCTION UNLESS
NOTED OTHERWISE.
5. ALL READERS AT EXTERIOR WALLS SHALL DE ICI 2'X1O" UNLESS NOTED OTNERWISD.
d ; i. ALL FLOOR JOISTS TO BE DGUELED BELOW PARAL"M PARTITIONS, AND FLOOR OPENINGS.
22.0 „ Poor - - - 7. PROVIDE DREDGING AT MID POINT OF FLOOR TOIST SPAN OR
;WT Kai~. A'-OR O.C. MAX. IN ALL FLOOR SYSTEMS.
=I A. ALL WINDOWS TO BE ANDRESEN MANUFACTURER UNLESS NOTED
OTHERWISE.
9. ALL DOOR HEIGHTS TO BE AT S'-B• UNLESS NOTED OTHERWISE.
p~IC FAMIL
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I. yo J Ili' C?1Zb~i" 7e6"TSM 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 95~ 4~1 /
ra- -1. FFOUNDATION - OR POUR 60 CONCRETEflEOUIRED
2. ROUGH - FRAMING & PLUMBING
PL V /PLUM R CERi1~J~C CFMVATIgN 3. INSULATION it,
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CEO CERYW CAFE OF OCCUPANCY BE COMPLETE v OR C O hRp a *5 J011 C f /7~~~\?~ ALI. CONSTRUCTION SHALL MEET
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VI,O a M14v m MIH. II~ 1. ALL WORE SMALL COMPLY W/ NRAENT NEW YORE STATE BUILDING CODES, UNIFORM FIRE PREVENTION, AND LOCAL REGULATIONS.
2. EVERY CONTRACTOR / TRADESMAN SMALL VERIFY ALL DIMENSIONS
141 PRIOR TO STARTING WORE.
or Gdl 14'-all 3. DO NOT SCALE DRAWINGS. WRITTEN DIMENSIONS ARE TO BE
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ALL RETERIOR NAILS SMALL BE ='x1 CUMSTROCTION , ALL INTERIOR PARTITIONS TO BE S.M. CONSTRUCTION UNLESS
RDT>D ammrsER.
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NDIND atimNSER.
S. ALL PI00E JOISTS TO BE DOUBLMD BELOW PARALLEL PARTITIONS, AND FLOOR OPENINGS.
7. PROVIDE BRIDGING AT KID POINT OF FLOOR JOIST SPAN OR
S~-OM O.C. MAE. IN ALL FLOOR SYSTEMS.
S. ALL WINDOWS TO BE ANDERSEN MANUFACTURER UNLESS NOTED
OTHE MISS.
S. ALL DOOR RIGHTS TO BE AT S'-S• UNLESS NOTED OTHERWISE.
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