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Home My WebLink About21794-z -r ti FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23852 Date SEPTEMBER 5, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 1390 BAYVIEW DRIVE EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 37 Block 5 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 10, 1993 pursuant to which Building Permit No. 21794-Z dated NOVEMBER 20, 1993 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 ONE FAMILY DWELLING WITH ATTACHED DECKS & GARAGE IN BASEMENT AS APPLIED FOR & AS PER ZBA #3864. The certificate is issued to JAMES A. & FLORENCE M. COPE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-81- AUG. 14, 1995 UNDERWRITERS CERTIFICATE NO. N-355843 - JUNE 22, 1995 PLUMBERS CERTIFICATION DATED SEPT. 26, 1994-CUTCHOGUE EAST PLUMB.&HEAT. (Joe- uildihg Inspecto 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°_ 21794 Z Permission is hereby granted to: !...s:... . 10 ...~..9?'~J ~cc e GL..... rel.... ..r??'i 41.C14K . . v X19....«.~~ yl~....F.'/.1..... 1E~' <Is......~L.rJx.~..... ~G?.......... ......:`'ztc........ ...........^"'"~ee 4lv..G T ~ y~ ~f T ..'/..`/,1.:...`.'!.!..`........:./..~C........°.`/`.xY'.C..'1...........`SS:~'/ 3 r at premises located at...~ County Tax Map No. 1000 Sectlon Block ? Lot No. . pursuant to application dated .....e / 19. and approved by the Building Inspector. Fee $...6.Qfi.... AZWD K. 7A / l Building Inspector Rev. 6/30/80 Form No. 6 ti TOWN OF SOUTHOLD 4 look BUILDING DEPARTMENT TOWN HALL 765-1802 TfIU fi! a0iS3bin 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. 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: 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00•, Commercial $15.00 Date New Construction......... Old Or Pre-existing Building Location of Property..lsjOO. XYe64W p2(?~ E ~YlA2%Oit/ House No. Street Hamlet Onwer or Owners of Property... ~/~/i1~U A,/FLOQENG~E M. 60110= County Tax Map No 1000, Section... . Block.? Lot. &A; Subdivision ....................................F.iled Map............ Lot...................... Permit No ................Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate...T! Fee Submitted: $ azc, Soot q eota N52 TrwAT T ~ ~ - ~ J a ~ -~3 3~. ~ ~ ~q ~ a ~ Q_c. v~~n~t~r~~' ~~A_ ~~j_. 1,- , 'S ek, I Memorandum from ASSESSORS OFFICE Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 765-1937 4N I s r~ 3 500 3 = 7 5 II to sG- t)u } t 1 Q5~FF01/t l TEL. 76S-1802 o~ mil' TOWN OF SOtiJTI30d,D Z a l6;' OFFICE OF BUILDING INSPECTOR P.O.BOX 1179 TOWNI-IALL ail ~O SOUTHOLD,N.y.11971 C E R T I F I C A T I O N . Date 26 ? i Building Permit No. 217---701 Z Owner C O Qe (please print) i Plumbe~~~ICrnOn, pl 1 r, ui ° L~~ L~AS~ Y~~n~' L~rnti , ~ i j I certify that the solder used in the water supply system contains,less than 2/10 of 1%-lead. I ?(plumber's signature) i Sworn to before me this d day of2(± t1otary Public Notary Public County MARYELLIN WHALEY Notary Public, State of New,VorR, ` No. 4795158 Suf[oly Coy, . THE NE,4W YORK BOARD OF FIRE UNDERWRITERS PAGE 1' F BUREAU OF•ELECTRICITY I i ,85 JOHN STREET. NEW YORK, NEW YORK 10038 Date JUNE 2,2 ,1995 Application No. on file 86785194/94 N 355843 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 A. COPE, S/V COR. OF-OLD ORCHARD & BAYVIEW, EAST MARION, N.Y. in thefollowing locatioon E Basement N ]At Fl. El 2nd Ft. G8R/ATTIC/OUT Section Block Lot eves examined on `l k 19,1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES' COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K.W. AML K.W AMT K.W. AMi K.W AMT. H P. 56 53 57 56 2 F ` DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNI7 HEATERS MULTI-OUTLET DIMMERS AMT. K. W. On H. P. GAS H. P. AMT. NO. A. W. G AMT. AMP. AMT. S. TRANS. AMT, H, P, SYSTEMS AMT. WATTS NO.OF FEET 1 F 2 - - t I SERVICE DISCONNECT NO.OF -S E R V 1 C E - AMT. AMP. TYPE METER 1.0 tW 10 3W 3.e 3w 3,e AW NO„OF CC, COND. A. W. G. NO OF HI-LEG A, W, G. NO. OF NEUTRALS A. W G. EQUIP. PER OF CC.COND OF HLIEG OF NEUTRAL 1 200 CB 1 X 1 2/0 1 2/0 OTHER APPARATUS: 200 AMP.DPDT TRANSFER SWITCH-1 MOTORSI3-1 H.P.,1-1.5 H.P.;4-F H.P. G.F.C.It-6 I f i x ~y(Q G & S CONTRACTOR LIC.#578-E SOX 215 SOUTHOLD, NY, 11971 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 MOT-NOT , BE ALTERED IN ANY MANNER. _ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ 1 INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY f 42 REMARKS: lei DATE INSPECTO 7 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( I ROUGH PLBG. [ ] FOU ATION 2ND [INSULATION ( RAMING [ ] FINAL REMARKS: I r i DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROU LBG. [ ] FO NDATION 2ND [ INSULATION [ FRAMING [ ] FINAL R MARKS: /r 8-11 O 12 ~ 4 8 DATE INSPECTOR / 7 M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ i RAMING [ ] FINAL REMARKS: CAW i !M! 1 f DATE INSPECTOR 6v 765-1802 BUILDING DEPT. INSPECTION [ J F NDATION 1ST [ }ROUGH PLBG. ( FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: i fi rF f f` f ATE INSPECTO x`77/ 765-1802 BUILDING DEPT. INSPECTION [ /FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING [ I FINAL ARKS:. Aba4.l , I F r € c;2 DATE 0 INSPECTO JUL-19-95 WED 4:00 PM SOUTHAMPTON BRICX & TILE FAX NO. 5162838349 P 1 "America's Largest Producer.: of Cast Iron Ash Dumps'' P, ASH DUMPS - SOLID CAST IRON dd Model OundMd ?NkaN ?irf No. 84a Ousntky WRlbs. Coda 49 4%" x 9" i 2 40. , - 2. 001 710 7" x 101' 6 35, ' + 24,002 60 loxes per pallet ASH DUMPS - ALL STEEL Medal Sandnd Hekaas Pan Ne. 81ze Ouwdity Wt.Lbs. .Ceda ~ . ST-49 49L" x 9" 12 20 24-002, 60 bdxea per pallet ASH PUMP WITH OUTSIDE AIR CAST IRON OR STEEL ":e (side e" Intake controlled by sliding shutter. Controls outside alr+adyree•teeri+'InsldA tFio`IiieplaN;;xelep1e cold air out when not in uas, easy installation. d model Bundled Paoka9r 1+ar4;:; ,t. ; i' Number Description 94CIOA Cast Iron ash dump with 1$ 45: ;rZarplS. . outside bit-4A X9 940A Steel ash dump with 8 28 24.010 ' oulske airaryr8 ' x ' ry 4 - ASH CADDY CAST IRON GRILLE - GALVANIZED INNER PAIL: a•.t :y, Pait Sin Sundofd Pedeair;^.. Ptlit.. '.,d . . Medal Top Gr81e No. Sin TOP Depth Quantlt Wt'.Lbi: Ceda . AC 914"x9V." 911x9" 7" 8 45 24.004 SOUTHAMPTON; BRICK & TILE, INC. 1540 North Highway Southampton, N.Y. 11968 i 283.8088 jJL 2 0 M VESTAL.MANUPAOTURINA 6weetweler, tN 37874 eP.e e~e.aa7~elas :'c'. . VESTAL MANUFACTURING COMPANY FROM: P.O.HOX 420 SWEETWATER, TENNESSEE 37874 SUBJEC : &&. 2ilif IaA (W I)Imif' PH (615) 337 -"a-5 o2a-kl FAX (615) 337-2803 )p/:? V,/Pr h''/R FAX TRANSMISSION .~~__===r_~=pT NO. OF PAGES DATE > TIME AM PM ? INCLUDING COVER TO; V COMPANY NAME: ADDRESS: l'f/& /~9/~ ATTENTION: If all pages not received or if you have a question, please call. FAX NO. REMARKS /(/lam-Zfi!~-~~° aN1 0%i 7a Syl/, t~ ~3S ,fso7h` /ESN ~a~r~ JUL-27-' 35 THU 13: 31 I L:: VESTA K 4$fI WF TL'R [ NG TEL hlL : FR>; Yt 615-33?-2013 k#443 F02 i Z K a Qf Cy Orom0 M CL CL (D }ti m ro D a;F m E 2m7w dN.wmamr 0 (a Z + o 3 a -C3 M O m ~rh :yw R1 O .Lta.aa] 'e - a w. tX. ID w ~a3wa rv c t y.n3 fl1 a a p N c N u c o w o O L7 n y C or n D m, = m C n 7 a ~,A ro ro a CD- a p ~E n v; co ~ 3 w .y Ri w ° n ' w ~ ID Z ~ o `'o c fD _~o a_.o c w c a m 3' worN z c r Co C/) m ti _ O t=ii ui tap to G (D m nr .s a \ti ~o°myma 2 U) n O _ C~ N 0 a a m p N Z ~ ~ y /ro/+ N, y N W l7 Al o m ti m ar :5 Z, O a Q a p C m row a H ° o 3 t " a m c ro 4 ~w.ris `m N 7 N 4] y ~ Li V /York State yuepanmen..,, ~14V,4~..... Z11din3A46j5 ''7'lSTggg rook, New York 11790-2356 1 Thomas C. nerling 277i( Commisslorier o`'~xrL Date: u s a 3i 02 3e Re. /-K-7,.3F, 690ffiA-//Odt/U~'6 . O~ S7`e- Dear Based on the information you have submitted, the New York State Department ofdy Environmenta~Conservation has determined that LC~2~LG-E=e~o~~C~~I~.C-~ G(/~'~..C-ei-sc//o~~•~ra_ ,-~`iL`°C7/`~!~°'`_' 'p/.`~~/f.(/" " SG7`7~7' ~a-U3 'S-ai fit'`/S AP- ~ VI-1 -7177 Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, 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, y -Repaat-y- Regional Permit Administrator ~ wnua a..scv~ua wo« All. o5~FF01,/~~® 01 Southold Town Board of Appeals MAIN ROAD - STATE ROAD 25 P.O. BOX 1179 SOUTHOLD, L.I., N.Y. 11971 TELEPHONE (516) 765.1809 r FAX No. (516) 765-1823 APPEALS RD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN IL11 °f CHARLES GRIGONIS, JR. SERGE DOYEN, JR. W f 9 JOSEPH H. SAWICKI 1 JAMES DINIZIO, JR. ACTION OF THE BOARD OF APPEALS 70WB OF. DEPT LD Appl. No. 3864: Matter of LEOPOLD STERN. Variance to the Zoning Ordinance, Article XXIII, Section 100-239d, B, (Article XXIV, Section 100-244, as disapproved) for permission to construct a one family dwelling with an insufficient rearyard setback, approximately 75 feet from the bulkhead in this R-40 Zone District. Property Location: 1390 Bayview Drive, East Marion, County Tax Map District 1000, Section 37, Block 5, Lot 22. WHEREAS, a public hearing was held and concluded on September 21, 1989 in the matter of the Application of LEOPOLD STERN. under Appeal 3864; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the south side of Bayview Drive, East Marion, and is identified on the Suffolk County Tax Maps as District 1000, Section 37, Block 5, Lot 22. 2. This is an application for Variances from the Zoning Code Article XXIII, Section 100-239d, B. (Article XXIV, Section 100-244) with insufficient rear yard setbacks, approximately 75 feet from the bulkhead. Page 2 - Appl. No. 3864 Matter of LEOPOLD STERN Decision rendered October 12, 1989 3. Article XXIII, Section 100-239d, B, all buildings located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than seventy five (75) feet from the bulkhead. Article XXIV Section 100-244 (A), this subsection is intended to provide minimum standards for granting of a building permit for lots made nonconforming or continued in a state of nonconformance by the adoption of this Article and that were singly and separately owned as of the effective date of this Article. 4. The subject premises is vacant and consists of a total lot area of .301+- acre, the proposed dwelling will have nonconforming setbacks, in front and rearyard areas. 5. In considering this application, the Board finds and determines: (a) that the circumstances of this application are uniquely related to the premises and its established nonconformities; (b) that the variance will not in turn cause a substantial effect on the safety, health, welfare, comfort, convenience and/or order of the Town; (c) that in carefully considering the record and all the above factors, the interests of justice will be served by granting the variance, as applied conditionally notes below. Accordingly, on motion by Mr. Dinizio, Seconded by Mr. Grigonis, it was R Page 3 - Appl. No. 3864 Matter of LEOPOLD STERN Decision rendered October 12, 1989 RESOLVED, to GRANT a Variance in the matter of the application of LEOPOLD STERN as applied under Appeal No. 3864 for the placement of a,a~ngle-family dwelling, SUBMCT TO THE FOLLOWING CONDITIONS: 1. That the existing setbacks remain the same, with the exception of the setback of Spring Pond which will be 21+- feet, as shown on survey; dated 9/26/89, prepared by R. Van Tuyle P.E. 2. A suggestion in the construction process that straw/hay bales be placed approximately 15 feet from the bulkhead, running the distance of the construction, during construction period so that there will be no soil intrusion into Spring Pond. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, (absent, Serge Doyen, Fishers Island and Joe Sawicki). This resolution was duly adopted. df i GERARD P. GOEHRINGER, (C AIRMAN APPEALS BOARD MEMBERS =o~OgOFFOt kekld SCOTT L. HARRIS Supervisor Gerard P. Goehringer, Chairman CA x Serge Doyen, Jr. p Town Hall, 53095 Main Road James Dinizio, Jr. T' p~ P.O. Box 1179 Robert A. Villa ~Ol *t as Southold, New York 11971 Richard C. Wilton Fax (516) 765-1823 Telephone (516) 765-1809 BOARD OF APPEALS Telephone (516) 765-1800 TOWN OF SOUTHOLD October 4, 1993 Mr. Leopold Stern, Jr. Bayview Drive, P.O. Box 263 East Marion, NY 11939-0263 Re: Appl. No. 3864 - Determination Rendered 10/12/89 Dear Mr. Stern: After speaking with the Chairman over the weekend, it was confirmed with me that the setback distance was apparently printed in error at Condition #1 in the above determination by the preparer. The Chairman has confirmed that the survey of September 26, 1989 made by Roderick VanTuyl, P.C. is the map approved by the Board. Therefore, Condition #1 should read " 19 feet as shown on the 9/26/89 survey"..., instead of 21+- feet. Please attach this letter to your copy of the 1989 determination for use when applying for the building permit. (A copy of this letter is also being transmitted to the building inspector's office for their record at this time.) Very truly yours, i da Kowa~2 / Clerk, Board of Appeals cc: Building Department Attn: Tom Fisher, Department Head o5~FF0(k~o FRANK A. KUJAWSKL JR., President TELEPHONE ALBERT J. KRUPSKI, JR., Vice-President TEL V'~ yC ( EL 765ONE JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOA'N TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 August 2, 1989 Peconic Associates PO Box 672 Greenport, N.Y. 11944 Re: Leopold Stern, East Marion, N.Y. Dear Mr. Wiggins: The following action was taken by the Board of Town Trustees during their regular meeting held on July 27, 1989 as follows: WHEREAS the Town Trustees have conducted an on site inspection of the subject property, RESOLVED that the Town Trustees approve the request made by Leopold Stern for a waiver to construct single family dwelling landward of existing bulkhead at above mentioned property. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. i Very truly yours, Frank A. Kujawski, Jr. President i Board of Town Trustees FAK:jas cc: Bldg. Dept. Board of Appeals file M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROU H PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACES CHIMNEY ~v REMARKS:/,e loor DATE INSPECTOR 77 117 4~4 004 1z:- 765-1802 BUILDING DEPT. INSPECTI [ ] FOUNDATION iST [ ] ROUGH PLBG. %r~ [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL fi ~ y ~ REMARKS. e-~ qyl k/ DATE INSPECTO07.7 1ELD 1QSPEC:1ON JJDAT- 11 CommE?4T° F15. v r FOUNDATION (1st) CAI , 12 FOUNDATION (2nd) s 2. O ~ ROUGH FRAME & / - L~O~f a PLUMBING co H 3. INSULATION PER N. Y. STATE ENERGY CODE x / 7 *5- 0 11 'Y 4. y 201y~ -lqz-z~ .2 A/ FINAL o~ fl/O L'C.llbe mom ADDITIONAL COMMENTS: / r H 31 J H\ H V(n~ a x q~~ x C..~ 0 0 `1 H 1 ELEVATION CERTIFICATE ' Expires May91,,'193 FEDORA'L EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM 1TENTION: Use of this certificate does notiprovlde a waiver of the flood Insurance purchase Oire ~ . This to is uned only to ovide elevation information necessary to ensure compliance with applicable community flotxlp In rha Tent o finances, to Itermine the proper insurance premium rats, and/or to support a request4dt a Letter of Map A endme~t or Ravisi In (LOMA or LOMR). Instructions for completing this form can be found on the folio Ing p s. SECTION A (PROPERTY INFORMATION i POq INSURJ E COnAPANr USE UILDING OWNERS NAME t ) ;Klcy NU R TREET ADDHESS (Incluane API., Unit Suite amPat Q*. Number) OR P.O. ROUTE AND BOX NUMBER OOMPANY N U0 NWKA Nfl~LY~ ~w Drive I I1BH DESCRIPTION (LOl and taockMYnlbere, etc.) ' 1000-37-95-22 ITV a ATE 911"JODE Mario SECTION B! FLOOD INSURANCE RATE MAP (FIRM) INFORMATION, wide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER P. PANEL NUMBER 3. sufflX 4. DATEOF FIRM INDEX 6.1`11PIPWNE S. BAS fLO06SLEVATI001 560813 0056 E 08/16/93 A i (M gw.dePle) Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 0 N40 ,21i Other scri.a on back) For Zones A or V, where no BFE is provided on the FIRM, and the community has established F BFE fD( this bull ing situ, indicate the community's BFE; l LLL L I . L_I feel NGVO (or other FIRM datum-see Section B, Item;?), SECTION C BUILDING ELEVATION INFORMATION Using the';Llevation ConiiCate Instructions Indicate the diagram number from the diagrams found on tlages 5 an 6 tha: oast ]ascribes the subject building's reference level 9_ , 1). FIRM Zones At •A30, AE, AN, and A (wl(h BFE). The top of the reference level floor from the selectoo diagram is at a i elevation Off 1 .11;L§.1 feet NGVD (or other ~IRM datum-See Section 13,1 gem 7). 1). FIRM zones M. 3o, ve, and v (with BFE). The bottom of the lowest horizontal structural t ornber bJ the refer We h uel from the selected diagram, is at an elevation of I_L_j_,L H.LJ feet NGVD (or other FIRM daturn-see Si*n B, Item 7). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is L-W.L) fee[ ove 1 or tralow 0 (check ono) file highest grade adjacent to inb oulloing. ~ I I), FIRM Zone AO. The floor used as the,r#feronee level from the selected diagram Is LJJ.LJ feel ah-nI~ve U of below "D (check one) the highest grade adjacent to the byitding. It no flood depth number is available, Is the ~rulWing^e lowest fit of (rolorence Ievol) elevated In accordance with the edmmunhy's noodplain management ordinance? Q Yes U:NO U U owe v -29 rldicate the elevation datum system used IO determining the above reference level elevations: Vu NO i C..I that t: leseribe under comments on Page 2). [NOTE: it f#o elevation datum used in measuring the alevatien4 Is dlpet~nl Thant r use=) on ow FIRM /see Section B, item 71, then convert the elevations m the datum system used on I6& F1RM!Rnd show, corverslon equation under Comments on Page 2.) j i' Elevation reference mark used appears on FIRM: 0 Yes ? NO (See instructions on Page 4) rho reference level elevaation Is based on,: M actual construction X.l construction dra=41640 8 (NOTE: Usti of construction drawings is only valid If the Dudding does not yet have the level level in P1414, in v,;Vch ease this canilkate will only uB valid for lho~bullding during the course or construction.. A post-cbnstruotibn Elevali Carl 'Were rill be required once consfruofloll is Gunryrle/e•) I ne elevation of the lowest grade Immedla{ely adjacent to the building Is: Lul-J10 feel;NGVD Cdr other FI 91M da um-see iuolion B; item 7), i SECTION D COMMUNITY INFORMATION I the community official responsible for verifying bunging elevations specifies that the reterenc 'level Ir~icalad in action C, II@m 1 s not the `lowest floor as defined in the co)nmunlty'a fio(tdpialn management ordinance, I 9~ifatlo110, o the build rig's 4L.-west Ivor as defined by the ordinance Is: l I I I I,LI feel NGVD (or other FIRM dalum-soo $action B Item 7)r Date of Illb mate of construction or substantial improvement i MArmmal-31, MAV 90 Nf.P1,ACt.SALLPHEVIOUS EDITIONS sEE,ffEVERSE sI EFOh 1411NUMION nn VJ i • BOARD OF HEALYH FORM NO.1 7 SETS OF PL . S _ TOWN OF SOUTHOLD SURVEY _ NU~ in ry. >y BUILD OWDEHARLMENT CuGCI °1t . 41. _ . . U 190 SEPTIC FORK _ ? SOUTHOLD, N.Y. 11971 AA Q(Y* 1qS 75~ TEL.: 765-1802 NOITIFY I CALL ..Ma:34QIi Examined 191-3 MAIL TO: Approved .i./.. , 19 ermit No. x/79 / _ . Disapproved. a/c / . . (Bu' ding nspector) APPLICATION FOR BUILDING PERMIT Date 19 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 stieets 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necess inspections. (Signature of applicant, or name, if a corporation) 711- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (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. do 1. Location of land on which proposed work will be done . . I-louse Number Street Hamlet County Tax Map No. 1000 Section Z Block ....5 Lot... Lot ~S....... Subdivision . ! :PUA.1i.. ~ cL~ 4= GZ 4: Filed Map No . . (Name) ' 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy C~Gc~wC : . b. Intended use and occupancy ; „k. y 0 3 Repair of work (r/ check whiRemoplli able): New Building k"' Addition Altera Demolition Other Work........ 4. Estimated Cost (Description) " I Fee....... .................Descri.... 5. If dwelling, number of dwelling 'iunits (to be paid on filing this application) If garage, number of cars . . . . Number of dwelling units on each floor • , c 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use . 7. Dimensions of existing structure's, if any: Front ' ' ' " ' ' ' ' ' ' ' ' Height Rear Depth............... ber of Stories . . . . . . . Dimensions of same structure with alterations or additi ons: Front ~ ~ ~ • ~ • ~ ' ~ ' ' ' ' ' ' ' ' ' ' ' ' ' . Rear........... . Depth . . . . . Height . . . . • • • Number of Stories . 8. Dimensions of entire new c rbction: Front , ' ' ' ' ' ' ' ' ' ' ' ' ' Rear De Height Number of Stories Pth . 9. Size of lot: Front Rear...................... Depth...................,.... 11. Zone or use district in which pre . . . . . . . . . ' • ' ' ' • • Name of Former Owner »d247/1y, , . 10. Date of Purchase / % , j anises are situated . . . : . . 12. Does proposed construction violate any zoning law, ordinance or regulation . 13. Will lot be regraded , Will excess fill be removed from remises: Yes 14. Name of Owner of premises Address />7 cyEdA2sT ii~~b premises: S No C ~c t. nFy...... Phone No.. ~f6, ; jo2 Name of Architect 0 P ~zwP4........... Address Phone No..7~ a S G . Name of Contractor ' ' ' ' ' • • Address Phone No. 15. Is this property within 3PO feet of a tidal wetland? *Yes " " " " ' ' / 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 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. SZ~-7 fl 7-7,4 I j I STATE OF NEW fl K, COUNTY OF Gfrp.-C .S being duly sworn, deposes and says that he is the applicant (Name of individual si ni contract) ontract) above named. He is the (Contract , agent, orporate officer, etc.) of said owner or owners, and is duly authorized to pe rm 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 se forth in the application filed therewith. Sworn to before me this day o c 19 I.~ Votary Public, County CLAIRE L. GLEW //>~a Notary Public, State of New York • No.4879505 tale of J (Signature of applicant) Cluallfted in Suffolk County .Commission Expires December 0, 78 ~ II J Tes+!~#r "'S i Ik Zo. Had IA 1]w~+:A[+m% l H.S.NQ. r dart: tt7oltt - 9' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1:5a„dy !oam i --.s.z FOR APPROVAL OF CONSTRUCTION OF -o Single Family Residence Only r Q.4 ' 3° DAB t 0'1992 HS F. s0-g APPROVED ? cute Tk.~ .rend EXPIRES_ YEARS FROM ATE F A OVAL 4~h Approved in accordance h Board f Review Lo S~'r Q919 ~+S /9 determinat+o dated J ..s- idG'-'~" a l 1, ¢.~ail 4 J Ij V eweU J (1 Ty I ~ 3 t. alb j T as J i ~ti _ 4' ~til O 'OAK 0-, \ Lw k 1 t 0, N+.M w . ,r i?'oM pips ' / t _ At-woo 11,9WS &+f#. F~A "Lone A-1.'eI-~) i s =-a ct ~ K, SINGLE FAMILY DWELLING ONLY EXPIRES,- Y .RS FROM DATE OFAPPRO L 4-~_1 -res~rr+~~ $ SUQVt yf 0 f'oe n,. wdfwr :i a++d os."M10 di nsd `+y fhim a wto w rw°ka 4W savn~~p006 QED ~ ,t 14110 64, Co. top#. aF ~-Jft M sWV1 & csc , tai - _ a? _ dVH+ llarW POP 1.&3 117 AWi"*4 - afvbrr 130 EA 5'`P MARAOk4 cm. YEbW" ;7F` SL'SLJ?r-ios..U / N'`a! ~ei~h{apriaa~ ~t • aaat~+od bCaFron3 ,NiM}P? S r / _ .4-4 Pt is, 44 ~S G#ION ~ 'trw" r .pit 411 e 0 H ifi ° ~i'i'"}TiN~k \.eViaei t1,. AIemY k s j p - NEby ha s. _ /z• P,c~r_,v4ti oP ~iuY V~idR Jd9Et~t..,~L'•P`, !9' _ , _ d" I '"t' 7 L QAtf rta. ,,i.° T GYdiHtesty F+ 1v~tf' Ry'"Cs'25EryP t~,~"~ t. a1?a1 t V4lYaK.C* i 4 19,5115 _ , n1moc ao o~y N Sra~ ~m2m~2y~i y 3 o'm r~ Wr ~y co 4 o y ?j N ti nZ~ d~. 7 h~ O yn _ ~ on 2 m0 m aw 2y1~ / 00 O l~D N mr ® ~ O (b ° ao o 096 / m ~CNJ $ m 4 a ~F- H .0 n i O v ~ p82• y y (J~p ACV/ ~d n `c N ni arri 'Ti "y n Q ea y~~ "8. ' C D ~ 31 O ~,VV ,n/ a' 0 .b v, 3z,o 2 fw 0v/ N 9 ~Ct! b Aa x 1 \ m m % 7,g• y 6ti m O1O o m 0 0 O "ipn Cl) 0 ~d CA to C) Q ON* -m, Or ~i I a n A m~ C c~ Q !R 13 V's C4 Z 4r „ o 2 ~6 Z o JapNyC~ ~ C ii O e; rti r\) Ilb r n n Z 0 co m I ~ 2 i~G 4~w 41v V f\ emu,. i .t U •I~4 ~ ~ ~ A~T 2 'f~JOVY?• s~•-bras!/__. ,.dIAGNf`II( t. { .rte-1~+"~:v`G~Ea 6+~ t9 • ~ %G I ~ -1 « GIF.IG. G~cG 2"~~~~ All V LL . ~GC- f~r F ~v ~I INEitll.• ~«1 1 ~ ILV - - G io- ,4/z ~v~''--yam - - - - - - .d. \ s t, rl- w 14 D + err !a!~l. ~Ctd~. i - ~ -f rt #S'W`~H GIM~rt.~ I ~ I ' ~ l 1 ~ ~ x.._, ~ r \ 7K` 1! . ~ 12.1 'smrui~r.612 /~6JIre Ltd `&"T" Ale ~ 1 f~ .,4 ~'I I ffh7 / 4 13 i 4 - I- I - 1 ~ _ ~ ,1` W v n ~i A ~ T1 ~ y 'f U~~ - TT x t' I 4(' y f`.. .Y. ,1'i i 1. 110 1 ~ '~P~/~ ~ vQ I ~ j/s~`~~•~^~ 11 ~'~a Ole ~ .(~~~4!g L! J~ I l ~-~nvK;iH _ Ei.v'~ Ma~~-4 N~? Yom?-~-- VVWA-fo*r 17/ 111-1;7 o UNDEBWR TERS CERTIFICATE v a^ r1a: Iha+r'~i 9 9GA6~~ DO NOT PROCEED (A) ITf? FIRAM/n1 G ~ yy4 n ~ c UNTIL OW SURVEY OF FOUNDATION LOCATION /{ND GLr--dgrronl HAS BEEN APPROVED €nrr~r rr rprsi~ S 'l'Jf~~4dl,~r06EF~[. ,<y~`~ v_ r1 F F- dI i" 1=r OF FM NJ,,, ell v, o p 4,n I V-Sc 4:()1, -AB jfTPOM1 8, FC ROY rVn F'"4 :c. itib'V NCSI'CGVISIS.I,p 11"iR ue 14'N; OH' GOf,1F;E'RCICA'WlEU l=RRt}igI! c-- . At DTI yt e: YL 7! C iN 'ei X 0* eAj . t't.woilJc. shall ,ccmp_ly_wiih fedora].,. State_and Local Building Codes and 4 dances. Y_~~~,C'aC( 4!1` „ . 2 x Cr - ~ Amna ~4.~iE~- 2. Before commencement of work, the Contractor shall furnish the Owner with e,~,/`,~M~ V) ~"w' y"-&-%1', i ela' Gpi Glzw~ ts~ copies of all required insurance certificates and names of all sub- V-r j0X fA4 ~ Af r--4" T19~{ I - contractors. =V wi of'7 .3. The Contractor shall be responsible for all dimensions and conditions on I uG,,j 1°.~Tf:2~°V?lt?P' A~J)Yi the job and the Architect must be notified of any variations from the PI/Opo Q ~+tv o t•~us%~r.aG ~,~va>?~a rr-1 I L'-G Cs?I -IA De, Try dimensions shown. At';Wt W ~tb c f~yC~~u~ ~d~~lt~ ai~-~ IN~rJ Ear}. a7A/L~. u* tool I ~ ~ 'NWn! 4L'~r>' -r,?aM,ivlG`I cr~n/. 4. The Contractor shall supply all labor and material shown on the drawings ~~/~a y~ - N~a -0- ~ A rs~. `I unless otherwise noted. w v W ~Y HAi2Vt VZ lWv .fV qeoQ 4Y-CT ~lT (~rNitia 4ut71kRC~AI~ G~ MI°>- O=T 5/fiGr i"Xf I~U k1~ 5. The Contractor shall be responsible for adequately bracing and protecting 1wR Gt/r-~'..~-Nd~l 6?~4x ~ •y Y.10.. I'91,C~P? V?^-CT'"WE'1 .+~7G't1Ali) JiRa Vr.• JT. ? Svl{57 all work during construction against damage, breakage, collapse, _ distortion and mis-alignment according to applicable codes. C~"'t'~~~•) ci 61 ,The Contractor shall pay for all permits, fees, and costs related to the s~ - rti-~~I~+-I- - ~ ~b~'-• -~kar~.• A2 l~ - ~..f,~K~~ - .cl.t~ i~~f~ow.~o work of this contract Contractors shall initiate all required r inspections of all work completed under this contract. I`fl , 7. The Contractor shall at all times keep the premises clean and shall be ~ v\ responsible for removal of all rubbish for all trades from the building. 0 fU~-VI AlA, 1,-IP-09G4-e- -I"~ iHl ~X+Iln~l ~~tir'~ir-r~r ~ ~~1~~ ~1q~--•-+6,+5i. M 1G 8 8. Any "extras" for changes or legitimate unforseen conditions shall be AT I~° h-tz~GA i9 G-1 "liii< drib-I 'h fi 0"T' V. Paz ,..I-~,:G~ O ~ • -`~`'~'Y rtv~(.TY i-{~ran/~ a~ documented With the cost for approval by the Owner or his Agent prior to e- starting the additional work. 9. The Contractor shall submit shop drawings for all special work (millwork, sprinkles, etc.) for Architect's approval before work is started. OGW I~-~J ®GWa~'G? O~ ~rf?I~ I+aHTJ ,4F ~'>t.f••L o all 0 5 3~5 I -----------Z, 5 hum Ddb ~I/ I~Y~ 5 ~ CY . )hC.9.°xl7i" GiIEF•/ j~ ~~'a"x12"A!A`/~~% 2'~,1v V ____'-_--__l~ ~11-Li"• O~ i~J"1111A'~~-Irn ~~I.G~I~'~"~) nN 12' •I j ~ ry~C/i , 17 L i i " o O KIZ!G' vIf* .18 _ i , D 71 i I, r x S1 1 5 ~ J 441 ti ~ ! PLUMBINqG~~p~~ j ALL PLUMBING WA87B ~ I 1 Ilk "TER LINES NEED - vii I 7ES WG BEFORE COVERINQ '+F I 1 f _ i ~di' I , PLUMBER CERTIFICATION j ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT fT y0 if FF ,r\ry i EXCEED 2110 OF 1% LEAD. i if copper tubing is used for water distributing system; piping shall be r- INA 9 \ of types K or A ~ 1 i i Cq~yv PLII fli' O 1~ n ~~``"r°P•o~~iiscSiual`a~•~Q h~~ `I 4- I Y :w r• 111 r! e Vim' N. 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