The URL can be used to link to this page

Home My WebLink About21435-zFORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-2367B Date JUNE l, 1995 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1165 OLD F~%RBOR ROAD NEW SUFFOLK, N.Y. HouSe No. Street Hamlet County Tax Map No. 1000 Section 117 Block 3 Lot 8.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1, 1993 pursuant to which ' Building Permit No. 21435-Z dated MAY 15, 1993 was issued, and conforms to all of. the requirements of the applicable provisions of the law. The occupancy ~or which this certificate is issued is ADDITION & ALTERATIONS, DECK ADDITION & HOTEB TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A EANFORD & ELIZABETH FRIEMANN UNDERWRITERS CERTIFICATE NO. N-298891 - DECEMBER 13, 1993 PLUMBERS CERTIFICATION DATED MAY 26, 1995 - SANFO ,RD H. FRIEMANN Rev. 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('I'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted~o: .... ,o :._.~,...~...~~..~..~-~ ....... ~5,~t~ .;...~ ~,,,~,~d~,...~.~..~.~...F~~.....~Z ............. ~ ......... .............................................. ~~~Z.....~...~ ................. ~ou.~ ,ox m~ ,o. ,000 ~e~,,o..1../.~ ...... ~m .... ~ ............. ~o, ,o...~...y. ........ ~uo.t to o~,mt~o~ dot~ ...... ~ ....... ~. ................. . ~.E~ ~.a ~,prov~ by ,~e Building Inspector. Fee $.., .A.,~.,...~.. ;.., .~. ~2 Rev. 6/30/80 Building I~mcfor Form No. 6 ~ .... =.~ BUILDING DEPARTMENT TOWN HALL i; !ii! ~AR 765-1802 L_ ......... A~PL~CATION POB CE~TIFIOA?B OF OCCU?ANC¥ This app~icat±on must be filled in by typexriter O~ in~ and submitted to the building inspector ~ith the £ollowing: for new building or new use: 1. Pinal survey of property with accurate location of all buildings, property ~ines, 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 contairs less than 2/10 of 1% 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $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 Buildin~ - $i00.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5~.Temporary Certificate pf Occupancy - Residential $15.00., Commercial $15.00 ' tV? -- ' Date ....... New Con ~/ ~;gfg.~ .......................... struction ........... Old Or Pre-existing Building ...... .t~..~ ....... Location of Property ..............~). ...... . ................. House No. Street Hamlet Onwer or Owners of Property ..... County Tax Map No 1000, Section ......... Block ............... Lot .................... Subdivision ................................... Fi! cd Mup ............ Lot ...................... Permit No. ............... Date Of Perm ..... Applicant .......... Health Dept. Approval ........................ Underwriters Approval ......................... Planning Board Approval ...... .~./.~. ............ Request for: Temporary Certificate ...... Final Certicate. ' ' ' · ...... APPLICANT HAY 26 '95 OI:S?PH SOUTHOLD TOWN HALL 516 ?65 1803 Town Hall, S~3095 Main Road P, o, 8oX 1179 $outhold, New York 11971 Fax (516) 765-1823 ?e[ephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T,I O N DATE: ~/~/~" Building Bermlt No. Owner( .~/~/~2_,~ //. (pleaSe print) (please print) I certify that the solder used in the water eupply system contains less than 2/10 of 1% lead.. Sworn to before me this day , ~.e*~*4,.a..ry Public, _ 5c"/c'/~,~/-*'~---, County . ~ No. 4961037 . Ouallfle~ In ~k ~ ~C~mi~lon EXDI~ Jen. ~ /?~ ~ Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 24, 1995 Mr. & Mrs. Sanford Friemann P.O. Box 968 Cutchogue, NY 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/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 # 21435-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE ADDITIONA'L COMMENTS: 'APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Richard C. Wilton Telephone (516) 765-1809 Mr. and Mrs. Sanford H. 155 Pinewood Road P.O. Box 968 Cutchogue, NY 11935 BOA/{DOFAPPEALS TOWN OFSOUTHOLD May 25, Friemann 1993 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road PO. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Re: Appl. No. 4165 - Setbacks to Bulkhead Dear Mr. and Mrs. Friemann: Enclosed please find a copy of the findings and determination rendered by the Board of Appeals at our May 20, 1993 Regular Meeting. Please be sure to return to the Town Building Depar~tment and any other agency which may have jurisdiction in this project for issuance of all permit(s) or other approvals before commencing any construction activities. We have furnished copies of this approval to the Building Department for their update and permanent recordkeeping concerning its issuance of the April 20, 1993 Notice of Disapproval, as well as a copy to the Suffolk County Department of Planning in accordance with the rules set forth in the Administrative Code for projects located within 500 feet of waterways, and state or county properties. Very truly yours, L~nda Kow~lski Enclosure Copies of Decision to: Building Department Suffolk County Department of Planning APPEALS BOARD MEMBERS Gerard B Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Richard C. Wilton Telephone (516) 765-1809 BOAILD OF APPEALS TOWN OF SOUTHOLD ~CTION OF THE BOARD SCOq~f L. HARRIS Supervisor Town Hall, 53095 Main Road PO. Box 1179 Sou~hold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Appl. No. 4165. Upon application of SANFORD H. and ELIZABETH M. FRIEMANN. Request for a Variance to the Zoning Ordinance, Article XXIII, Section 100-239.4 for permission to construct addition and deck addition with spa within 75 feet of the existing bulkhead at 1165 Old Harbor Road, New Suffolk, NY; County Tax Map Parcel No. 1000-117-3-8.4. Subject premises is located in the R-80 Zone District. WHEREAS, a public hearing was held on May 20, 1993, at which time all those who desired to he heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present (R-80) zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. By this application, appellants seek a variance under Article XXIII, Section 100-239.4B for approval of an open deck addition/extension at the rear (easterly end) of the existing dwelling, all as shown on the sketch prepared by the applicants and survey dated March 9, 1993 prepared by Roderick VanTuyl, P.C. Proposed are: (a) a 14'6" wide by 10 ft. deep addition as shown on the plan prepared by R. Lehnert, Inc. (Design Drawing) dated March 24, 1993; (b) a six ft. open deck addition extending from the proposed 10 ft. addition (and extending 16 feet from the existing rear wall of the dwelling); (c) a spa addition with deck walkway. The decks and addition will be no closer than 48 feet to the outer edge of the existing bulkhead. 2. The premises in question is identified on the Suffolk County Tax Maps as District 1000, Section 117, Block 3, Lot 8.4 and contains a total lot area of 19,998 sq. ft. .Page 2 - Appl. No 4165 Matter of SANFORD i& ELIZABETH FRIEMAN Decision Rendered May 20, 1993 3. The dwell!lng as exists presently has the following nonconformities: (a) front yard at 24+-' at the westerly property line, (ib) southerly side yard at six feet. 4. Article XXIII, Section 100-239.4B of the Zoning Code requires all buildings and structures located on lots upon which a bulkhead, concrete wall, rip-rap or similar structure exists and which is adjacent to tidal water bodies other than the Long Island Sound to be set baek not less than seventy-five (75) feet from the bulkhead.i 5. In eonsidering this application, Board Members find: (a) the relief requested is not substantial in relation to the existing established nonconforming setbacks in the area of this ~horeline for "cabana-type" buildings; (b) the construction is for an open deck addition without a foundation or basement and without a screened or permanent-type enclosure - this type of construction is not major and will not affedt the stability of the soils seaward of the house; (c) th~ relief requested will not alter the essential character of the neighborhood - the t0Dography of parcels in the ir0mediate area ha~e significant differences in topography, shape and character in ~elation to the creek shorelines, however, each has natural bluff iareas between the improvements (buildings) and the bulkheads; i (d) th~ practical difficulties are uniquely related to the property and ~re not personal to ~he landowner; (e) th~ grant of the relief as requested will not in turn be adverse tO the safety, health, welfare, comfort, convenience or or~er of the town, or be adverse to the neighboring properties;, (f) the benefit to the property owner is minimal, and there will not beia detriment to the health, safety, and welfare of the neighborho6d or community by the grant of this variance;. (g) th~ benefit sought by the applicants cannot be achieved by some ~ther method, feasible for the applicant to pursue, other thah an area variance -- particularly in light of the established n~nconformities in this neighborhood; Page 3 - Appl. No. 4165 Matter of SANFORD & ELIZABETH FRIEMAN Decision Rendered May 20, 1993 (h) in view of all the above, the interests of justice will be served by the grant of the requested relief as requested and conditionally noted below. Accordingly, on motion by Member Villa, seconded by Member Dinizio, it was RESOLVED, to GRANT the relief as requested in the Matter of the Application of SANFORD AND ELIZABETH FRIEMANN under Appl. No. 4165.~ Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio, Villa and Wilton. This resolution was duly adopted. lk ~ P. GOEHRINGER, CHAIRMAN New York State Department of Envi~onmehtal Conservation Ruildln~ ~-~-~U~.S~gBrook, New York 11790-2356 Thomas C. Jorllng Date: ~//?~'~J~ Commissioner Re: /--~2~<~ - dk~gJ~/~d~,x~_'~ Based on the information you have submitted, the New York State Department of Environmental Conservation has detrained that: ~ Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wet~ands Act . Please be advised, however, that no construction, sedlmentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your' responsibility to ensure.that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Deputy Regional P~it ~dmini~trator TRUSTEES John M. Bredemeyer, III, President Albert J. Krupski, ,Ir., Vice President Henry E Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765-i823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L, HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 .April 2, 1993 Sanford Friemann Old Harbor Road New Suffolk, NY 11956 RE: SCTM 91000-117-3-8.4 Dear Mr. Friemann: After an inspection by a representative of the Board of Trustees, the proposed addition was found to be out of the: Trustees jurisdiction. ~ Please note that this does not constitute any approvals from any other agencies. If you have any other questions, please do not hesitate to contact this office. Member, Board of Trustees HPS: jd Albert J. Kmpski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 May 27, 1994 John Geideman P.O. Box 416 East Marion, NY 11939 Re: Sanford Frieman SCTM ~117-3-8.4 Dear Mr. Geideman, The following action was taken by the Board of Town Trustees during its regular meeting held on May 261 1994 regarding the above matter: WHEREAS, SANFORD FRIEMAN applied to the Southold Town Trustees for a permit under the provisions of the Wetland ordinance of the Town of $outhold, as per survey dated February 7, 1994, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 26, 1994 at which time all interested persons were given an opportunity to be heard~ and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the 'surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted con6erning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approves the Grandfather application of SANFORD FRIEMAN for an existing beach house, a 15' X 30' deck around beach house and a 85' X 4' existing dock, as per drawing dated as received Feb. 7, 1994. RESOLVED, that the Southold Town Board of Trustees DENIES the request to extend the dock 100 feet. Permit will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. CAC Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. DATE: ... 5./Z0 / 94 ISSUED TO ... SAr~F.ORP ..~!]~.gAN Authorizatio. Pursuant to {'he provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 5/26/94 19.9.4 , and in consideration of the sum of $ 100.00 paid by .2ohn Geideman.fo~.SAN.FORD FRIEMAN ........ of. .Ne.w,.Saffolk .................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Sou+hold Town Trustees authorizes end permits the following: Grandfather Permit for an existing beach house, a 15' X 30' deck around beach house and an 85' X 4' existing dock as per drawing dated as rec'd. 2/7/94. DENIES request to extend · ch arbor,. . doca3jl 100, n accoroancefeet~' w,t~ql'~e ~{~e~ spec,+,cat,on, as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Trustees FORM TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTIIOLD, N.Y. NOTICE OF DISAPPROVAL Date ...... /~..R.I.L..2.0., ..... : ....... 19.. ~). To .. s~reo~ E-..s..~.kx.z.~..~.~. FRI~ (ELIZ~E~a C. P.O.. BOX 968 CUTCEOOUE, l~t/ YORK 11935 PLEASE TAKE NOTICE that your ' - APRIL I, 1993, apphcanon dated ...................... 19. resul~mitted April 15, 1993" .... for permit to CONSTRUCT ADDITION AND DECK ADDITION t/ITH SPA Ldcation of Property 116_5 OLD HARBOR ROAD NEt/ SUFFOLK, N.Y. hi~,s'o hio~ ....................... 'S't,:ej ............................ Ham/er County Tax Map No. 1000 Section 117 ' BIock 3 ' 8.4 Subdivision Filed Map No Lot No is returned herewith and disapproved on the following grounds IlI~ER ARTICLE XXIII , SECTION 100-239.4 PROPOSED CONSTRUCTION IS LESS THAN 75 FEET FROM 'I--'HE BULKHEAD. ACTION REQUIRED BY 't'ffi/ ZONING BOARD OF APPEALS. ~Sui ~dyng Ifispector THOMRS J. FISHER ' RV 1/80 FORM NO. 3 ToWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date . ~..~.~;h~...:., .............. , 19 . .~.'~.. .~.,..~.~:~. ~.~..~ ................ ~ ...~~.,.~...//~ PLEASE TAKE NOTICE that your application dated ~~.~ ........ 19 ~. Location of Property ~o~o~ .... ~~'~'"~ ..... ~'~~ County Tax Map No. 1000 Section ../~2: ...... Block ..... ~ ....... Eot ... ~f~. .... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disappr;ved on the following grounds .~.~.~ .~- ..~.. ~~.~ · J.~/~..../.~..~..-. ~ .~. ~. ~ .... ~ ~~/.~.'.. ~ ..... · · ..A~...~... ~ ~.,. ~..~. :~ ~~~ ........... ~.... .............. ~ .... )"2'-' .......................... RV 1/80 NEW , TOV, J'NI Of-' LC~UI='E ¢--O,TA~ l/lAP DATA~ OOD-~I LB t ~2Z' :I 0 76SJ.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] ~SULATION / FRAMING [~]' FINAL REMARKS: DATE ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ir ] FOUNDATION :)ND [ ] INSUlaTION [ ] FRAMING [~'F'INAL 765-1~0Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION 2ND [ I-~NSULATION [ ,] FRAMING [ ] FINAL INSPECTOR 7GS.'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGfl PLBG. ]/~DATION ZND [ ] INSULATION FRAMING [ ] FINAL DATE ~//~ INSPECTOR/ 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [] ROUGH PLBG. [~J~0UNDATION /ND [ ]INSULATION FRAMING [ ] FINAL DATE THE NEW YORK BOARD OF FIRE UNDERWRITERS .t ! t 8 ~ 0'! 7 SUREAU OF ELECTRICITY ~- 35 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~y the e~¢ trtcal ~uipment ~ ~seri~ be~w and i~t~ced by t~ appffca~t ~d on t~ a~ve ~p~on n~ber i~ the prem~s of in the followlng h,cotion; ~ Basement ~ Ist F1. ~ 2~ FL (~J{/O~? Section Bilk Lot ~s examined on ~C ~]~{~ R ~9 ,~,993 and found to be in compliance ~th the Nafional Electdcal Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRY~R$ FURNACE MOTORS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E )THER APPARATUS= 200 AMP,DOIIBh~ THROW BOA? HOU~-I MOTORB~1-5 NO. OF CC, COND. A.W.O. PER ~' OF CC. COND, 1 2/0 NO. OF HI-LEG P~NgLBOARDSrt'28 CIR. 200,1.~1 CIR. 60 ~9~XO~E DETgCt'OR~t P.O.BOX C[I~'C}{O~UF,, NY, 11935 GENBRAL MANAOER P~r must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ~ COPYFOR BUILDING OEPARYMENT. THISCOP¥OFC~STIRCATEMUS~T~:?0T~EALT~REDINANYMANNER. , ; '~ FORM NO. 1 ,:4 ~ ~ TOWN OF SOUTHOLD ~. .BUILDING DEPARTMENT . c~tsq . z '~ , , TOWFI HALL APR I ,=,,,). .//,~ ~ / / SOUTHOLD, N.Y. 11971 Disapproved a/c i~..~ ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ao BOA'RD OF HEALTtt ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC PORH .............. Date .............. This _application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with. accurate plot plan to scale. Fee according to schedule. plan showing location of tot and of buildings on premises, relationship to adjoining premises or public streets and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- The work covered by this application may not be commenced before issuance of Building Permit. 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, ordil~ances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neces~ ...,.~~~ ~ . .' -- (Signature of-applicant, or name, if a corporation) (Mailing ~dd;e's~ of applicant) -- ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ! Name of owner of premises . .~.,'e)..'~..'~..~. J-e~.. h~...r~. ~..Z~./.~. ~.,~..~/?....,,~g... ~'.~{~.../.,~ .~...,~./.'~.z.~. .......... (as on the tax roll or latest deed) If applicant is a ~orporation,.signature of duly auth~orized officer. (Name and title of corporate officer) Builder's License No.../~.,. ~...~..-~...~..~...,, ..... Humber's License No.../~..~ ...... Electrician's License No ....... Other Trade's License No ...................... Location of land on which proposed work will be' done ................................................... ..... ................ .................................... House Number Street Hamlet County Tax Map No. 1000 Section .... //..'7 ......... Block ...... .~ ........... Lot .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .3. Nature of work (check which aiplicable): New Buildin~g ........... Addition..'~.. ..... Alteration v'~ ....... Repair .............. Remioval .............. Demolition ..... ~.' ......... Other Work .............. .. ,~ .,~--i .' ' ' '~ (Description)} 4. estimated Cost ........ .~.~.,. ~ ............. Fc~e. ~ ~ ~., .t~... ............ (to be paid on filing this application) 5. If dwelling, number o f dwelling! units ..... ./ ......... . Nuniber of dwelling units on each floor ................ If garage, humber of cars i · ~ ~ . id occupancy, spec a~ ....................... ' ........................ 6. If busine s commercial or mixe' · ify n ure and extent of each type of use . .' ........ ... f,e. xfis$ing structures, if any: Front a~.o. ~/? '--/~ ~. ~4, ........ 7. D~me~.~tonso .. '~ Rear ~ De.-*u · .Y'. ....... Number of Stones ..... ~. 'I,' ......... ~e structure w~ith alterations or additiens Front .'-~.t2t ~' .~( I~;,~' ~; ~ ............ Hmght ......... .~ ....... . 'Number of Stories.. . ~ . nensions or erttire new construction. Front [ ~. ' .n~. /~ / ~,~_',~' '/~ '/ ........ ~t tr- Nu ' . ...' ...... ' g .......... ~..,~ · m~er of Stories ..... .../.... · - ,,Jam orrurcnase ........... i ......... ' ......... Njm~e ofForm.e.r.Owner ~, ,e,.. <(~./ft~-..~..,~,~. ........... ~one or use district in which premises are situated 1.c~.,7 ~'~..~..~T~ ~ Does proposed construction violate any zoning law, ordinance or regulation: .../:'Z~ ...................... Will 10t be regraded ...... ~_.~,. ................... Will ex,,cess fill be removed fro~ premises: Yes Name of Owner of premises ~.~,...f'~..-.~'..~/¥.~t~ Address~'~. ~.~.~. 76~. ~7't-~h~,,~ ~,, '~,,~.~ ~---~O~,t_~ ' marne m ^rcmtect t*,..~.~..t .z~. f..~,t~: ........ Addressf_~4~ ~,~ '.,~t'.~, Phr~n~ Mr, ~,4~- . . ",~_"~,_~ ~omracmf-:,~.:.~.. ~,.~,~,~. "." ', ...... ...Address ~.~?'~. e77,'..~'¢ ...... PhoneNo. q~..q~..ZJ?...U. 7. >. ~s unzs proper~y wxcnzn 400 ree~ or a tida~ wetlanwt *Yes ....... No ../,'f.~.. · If yes, Southo~d ~own Trustees Permit may be required. ~ ~' PLOT DIAGRAM Locate clearly and distinctly all Ibuildings, whether existing or proposed, and, indicate all Set-back dimension: property lines. Give street and block ~tumber or description according to deed, and show street names and indicate whetl interior or corner lot. STATE OF NE%~"ORK~ I ~'/SJS ' ' COUNTY .OF...~:~.. c~..~..~. I · · · J~ ............. ¢ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) above named. i .(/(.C~!t'r~t'(~r]/~gent, corporate officer, etc.) · of said owner or owners, ~d is duly ~ut~rized to ~fom or have perfomed the said work and to m~e ~d file this application; that all statements contained ~icat~n are true to'the best of his knowledge and belief; and that the work w~l be perfomed in the manner s,et forth in the application filed therewith. Sworn to before me this i .x ............ dayof ' . .~,19 Nota~ Public, . ounty ~ ~bll~ State of N~Y~ .......................................... - NO. 4879505 I / (Signature of applicant) u~llfi~'in Surfak Cou~ ~ ~