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HomeMy WebLinkAbout21204-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24745 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ADDITION Location of Property 200 WILLOW POINT RD. SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 32 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26, 1993 pursuant to which Building Permit No. 21204-Z dated JANUARY 29, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEVE & MARICA DONADIC (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-396694 - SEPTEMBER 10, 1996 PLUMBERS CERTIFICATION DATED N/A if X'~ it ing Inspector Rev. 1/81 FORK NO. S 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) N°-M 212042 Date 9 Permission is hereby grant d to: ..w ~~NN . 10.r.~2 V-rza to r, tea . at premises located at .::*q . C /md, r0.~11/ ~~.~Yl G ....................................................O r.............................................................................. . County Tax Map No. 1000 Section ~......."-3Z Block Lot No... 3..Z " pursuant to application dated ......L~ 19.93 and approved by the Building Inspector. i Fee B i Inspector Rev. 6/30/80 Form No. b TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1302 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 525.00, Alterations to dwelling $25.00, Swimming pool 525.00, Accessory building $25.00, Additions to accessary building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $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-existin Building 2-0 Wk1_i.U~ 5' ' r slit kFcl Location of Property....... House No. Street Hamlet Onwer or Owners of Property...... • • • IZ\~_~1 . k~ a7 k L County Tax Map No 1000, section Block. ? .............Lot...'.................. Subdivision......... ............................Filed Map............ Lot...................... °ermit ~Io..~~•~....Date Of Permit ...Applicant.Ci?vC..4~.......C(._~SIJ.~~~C. Health Dept. Approval.....' .....................Underwriters Approval........................ 21_anning Board Approval / 3eauest for: Temporary Certificate........... Final Certicate........... cee Submitted: 1~~ U 4 ne APPLICANT co~4~4 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date SEPTEMBER 10,1996 ApplirotionNo.anfile 12421296/96 N 396694 THIS CERTIFIES THAT 1 T N0, 212042 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of STVE DONADI:C, 200 WILLOW POINT ROAD, SOUTHOLD, N.Y. in thefollowinq location; ? Basement ® IRE Fl. ? 2nd Fl, Section Dlock Lot 5EF]ITI iBER 05,1996 and uws examined on found to be in compliance with the National Electrical Code. FIXTURE ECEPTACEES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT. K. W. AMr. K,W. AMT K.W RDIMMERS 3 6 C, 3 j DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET IJ AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W G. AMT. AMP, MIT. AMPS, TRANS, AMT H. p, SYSTEMS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E H 5W 3, 4W NO, OF CC. COND. A. W G. NO. W H4WG A. to G. NO. OF NEUTRALS A' W G' AMT, AMP, ttPE MF1ER 110 tW 1 ,B. 3W 1 e" EQUIP. PER a Of CC. COND. OF HbIEG OF NEUTRAL OTHER APPARATUS: i IF G & S CONTRACTOR LIC,##578-E ~ ~ ~oLJX BOX 215 ANN SOUTHOLD, NY, 11971 GENERAL MANAGER 11. a5 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by then credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE,MUS:T NOT BE ALTERED IN ANY MANNER. o~~g0FFOI/C o~ Gym Z Go Town Hall, 53095 Main Road O • Fax (516) 765-1823 y'11p1 Telephone (516) 765-1802 P. 0. Box ewYork 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 8, 1996 Mr. & Mrs. Steve Donadic 189-25 45th Drive Flushing, N.Y. 11358 Re: Building Permit #21204-Z, 21937-Z & 22309-Z Premises @ 200 Willow Point Rd., Southold, N.Y. Suff. Co. Tax Map #1000-56-5-32 Dear Mr. & Mrs. Donadic: We have received the Underwriters Certificates for the electrical work done at the above premises. However, we still cannot issued the Certificates of Occupancy because your checks are outdated. I am returning your checks #5940, 5994, 5995, & 5996. Since we now have all the necessary paper work, please send us one check in the amount of $75.00 and we will be able to issue the Certificates of Occupancy. Sincerely, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish Building Inspector GJF:gar encl. O~~gUFFOIkr o~ Gyp x Town Hall, 53095 Main Road p e Fax (516) 765-1823 P. 0. Box 91971 Telephone (516) 765-1802 Southold, Newoth 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 6, 1995 Mr. & Mrs. Steve Donadic 189-24 45 Drive Flushing, NY 11358 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) xx 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. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984).1 BUILDING PERMIT # 22390-Z, 21204-Z & 21937-Z~ Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~,%gOFF0jjt h ~ Town Hall, 53095 Main Road p + Fax (516) 765-1823 P. 0. Box 91971 y?l0~ ~~0~ Telephone (516) 765-1802 Southold, Now York 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 6, 1995 Mr. & Mrs. Steve Donadic 189-24 45 Drive Flushing, NY 11358 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) xx 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. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22390-Z. 21204-Z & 21937-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR FELJ:%i::S:'c 71 a FOUNDATION 1st ) i~ FOUNDATION (2nd) 4 F z 0 O J~IDUGH FRAME & I 02 -PLUMBING m rt n _IISULATZ0;1 PER N. Y. • • O v ~ t STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: x r M x\ G2lI~CLLc9 - ~ l09 ' H • O _ H O, W co ^v H 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU N [ ] FRAMING INAL REMARKS: _ Lx;ll %~~'r~ DDATE- 9 INSPECTO 9K 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ] FINAL REMARKS: e~ Yarl~G~--- DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ] ROUGH PLBG. [ ZIFO NDA TION 2ND [ ] INSULATION [ MING [ ] FINAL REMARKS: DATE INSPECTOR V- 765.1802 BUILDING DEPT. SPECTION [ FOUNDATION 1ST [ I ROUGH PLBG. ( J FOUNDATION 2ND [ J INSULATION [ ] FRAMING [ J FINAL REMARKS: DATE INSPECTOR APPEALS BOARD MEMBERS =O~OS~FFO(~ COGy~ SCOTT L. HARRIS Supervisor Gerard P. Goehrmger, Chairman co C=z x Serge Doyen, Jr. p Town Hall, 53095 Main Road James Dinizio, Jr. 'y~ • p~~ P.O. Box 1179 Robert A. Villa Southold, New York 11971 Richard C. Wilton Fax (516) 765-1823 Telephone (516) 765-1809 BOARD OF APPEALS Telephone (516) 765-1800 r= TOWN OF SOUTHOLD'f"44 March 31, 1993 AT Mr. and Mrs. Steve Donadic 189-25 45th Drive Flushing, NY 11358 Re: Appl. No. 4158 - Addition (Sideyard and Total Sides) Dear Mr. and Mrs. Donadic: Enclosed please find a copy of the findings and determination rendered by the Board of Appeals at our March 18, 1993 Regular Meeting. Please note that the Board did not allow the 14-ft. addition as requested; but did, however, grant alternative relief for a side yard setback at eight (81) from the easterly side property line, and for total sideyards at 21.7 feet. Please be sure to return to the Building Department and any other agency which may have jurisdiction in this project for issuance of all permit(s) or other approvals deemed necessary for the construction of these two additions. We have furnished copies of this alternative approval to the Building Department for their update and record, and 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, Linda Kowalski Enclosure Copies of Decision to: Building Department Suffolk County Department of Planning ~z APPEALS BOARD MEMBERS -01 SCOTT L. HARRIS y~ Supervisor Gerard P. Goehringer, Chairman 'n F'4 Serge Doyen, Jr. Town Hall, 53095 Main Road @James Dinizio, Jr. P.O. Box 1179 Robert A. Villa Southold, New York 11971 Richard C. Wilton Fax (516) 765-1823 Telephone (516) 765-1809 Telephope.,(516) 765-1800 BOARD OF APPEALS. TOWN OF SOUTHOLD~`` FINDINGS AND DETERMINATION 1 Upon Application of STEVE DONADIC for a Variance to the Zoning Ordinance, Article ILIA, Section 100-30A.3 for permission to construct dining room addition with a reduced side yard setback at less than the required ten (10) feet. Location of Property: 200 Willow Point Road, at Arshamomaque, Southold, NY; Willow Point Subdivision Lot No. 28; County Tax Map Parcel ID No. 1000-56-5-32. WHEREAS, after due notice, a public hearing was held on March 18, 1993, and all persons who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has 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, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located in the "Low-Density Residential R-40" Zone District and is referred to as District 100^, Section 56, Block _f r0. 32. 2. The subject lot is nonconforming as to total lot area at 26,260+- square feet and lot width at 99.73 feet (along Willow Point Road), the lot's area, width and depth do conform to the provisions of Section 100-244B for substandard lots (legally preexisting prior to the enactment of one-acre zoning in 1971 and two-acre zoning in 1983). This lot is known as Lot No. 28 on the Map of Willow Point, which subdivision was Town approved and filed with the Suffolk County Clerk's Office in June 1966. 3. The subject premises is presently improved with a single-family dwelling, as more particularly shown on survey dated October 26, 1978 prepared by Young & Young, and separate sketch prepared by the applicant-owners. Page 3 - Appl. No. 4158 Matter of STEVE and MARICA DONADIC Decision Rendered March 18, 1993 view of the manner in which the difficulties arose, and in considering all the above factors, the interests of justice will be served by denying the relief requested, and granting alternative relief, as noted below. Accordingly, on motion by Member Wilton, seconded by Member Dinizio, it was RESOLVED, to DENY the relief requested, and BE IT FURTHER RESOLVED, to GRANT ALTERNATIVE RELIEF for a reduction in easterly side yard. from 15 to not Tese than, eight (8) feet, including all overhangs), and for a total of both side yards from the required 35 feet to a total of 21.9 feet. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio, and Wilton. Nay: Member Villa. This resolution was duly adopted (4-1). lk G/ f GERARD P. GOEHRINGER, CHA N Page 2 - Appl,. No. ;4158 Matter of STEVE an4 MARICA DONADIC Decision Rendered March 18, 1993 rr 4. The side yard distances between the foundation of tfie . dwelling as exist are shown at 13.9 feet at its closest point to, the westerly side property line and at 19.1 feet at its closest point to the easterly side property line. The distance between the existing greenhouse addition to the easterly property line is shown to be 13'6" (=19.1 less 5.6 feet). 5. Article ITIA, section 100-30A of the current zoning code (as amended January 10, 1989) provides for minimum side yards at 15 and 20,feet, inclusive of automatic relief provided by Article XXIV, Section 100-244 pertaining to nonconforming lots having less than 40,000 sq. ft. of land area and greater than 20,000 sq. ft. This property contains 26,260+- sq. ft. of land area and due to its property size does not qualify for a reduction under Section 100-244 for 10 and 15 ft. side yards. 6. In this application, a variance is requested for a proposed dining room addition at the east side of the dwelling with a setback at 3-1/2 to 4 feet from the side property line which will include',removal of the existing greenhouse addition. 7. For the record, it is noted that: (a) the buildings and structures presently conform in all respects to Article XXIV, Section 100-244B of the Zoning Code and Article XXIII, Section 100-230A, except that the existing total of ',both side yards with the greenhouse addition does not meet the135 ft. requirement (total: 15 & 20); (b) the proposed 14 ft. extension leaving a 3-1/2 ft. setback into the side yard is substantial in relation to the requirement and would set a precedent for the neighborhood; (c) thejrelief requested is not the minimum necessary; (d) the'Idifficulty claimed is self-created; (e) thee is an alternative feasible for appellant with a greater setback (lesser variance relief), which is noted below. 8. In considering this application, the Board also finds and determines: ;(a) the relief as alternatively granted will not in turn increase dwelling unit density, since only one - principal dwelling use will continue as exists; (b) inspection of theisite and neighborhood and review of the record _ find that the practical difficulties claimed, are sufficient to warrant a grant of limited alternative relief; (c) there will be no substantial change in the character of the immediate neighborhood or detriment to adjoining properties; (d) that in ~I O~~gOFFO(,~-~O o~ Gym N Z Town Hall. 63095 Main Road p Fax (516) 765-1823 P. 0. Box 91971 y'lIQ~ ~.a0~ Telephone (516) 765-1802 Southold, NewYork 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 27, 1995 Mr. Steve Donadic 189-25 45th Drive Flushing, NY 11300 Re: Building Permit #21204-Z Premises: 200 Willow Point Road Suff. Co. Tax Map #1000-56-5-32 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector E C6619ZW ow ELeIrV4 N,.li i.';?~. cc "ITH I I OwuLIN4 'Ell _ _ - ~G WNiER MR,N , %C1 _ 7.5 111.87-r-19% ROAD Ty 700_- a, y3. e.7 29.73' Not Or + L-LR J .NA 5.0 es ` It CIO, 7*1 0 ~ /0 . ~Q @W ..I~••~ a_FI F e . e .`a~Jr R• 28.00' 00, ' I LA 89.27' ~e0 CIO Ci 4~5 'pogo /col ' i `\`oc Rye \~o 7. ~ J cy Of. y' O Ve~~yC e ~ 6Vt ~ ~ eR ~ G 0 _ i .~---r--t-~:---r-+-+n~r-.+-~-,-.- ~.-...~-amp..-----'1...,~.-~~._- Ij' 5-21-82 KINaL ~ 11. 2• b or-ALfll 'DE^P1 BATA SUaWXl SUFFOLK COUNTY HEALTH DEPARTMENT. SURVEY FOR STEVE DONADIC & MARICA DONADIC ATE_ MAY 1_LW#,- D. Er:F. # -56- o LOT 28 "WILLOW POINT° D ' _ - Y, „ 'Rr AT ARSHAMOMAOUE DATE OCT. 26, 1978 :i ecti: EunPly TOWN OF SOUTHOLD SCALE: 1"=60' r^,._-I " ?.evo been Zcat SUFFOLK COUNTY, NEW YORK NO. : 78-648 _ and found to be sctiztactorp., O Ruxaur A VI 'ZED euNRE OR ADDITION TO THIS GUARANTEED LTO: E 4.G-.."f Q uW YO Is a Umunory 01 of SECTION 1209 >zos of THE AMERICAN TITLE IN URANCE CO. NEIHE9 IS FTHIS EOUCVr10N LAW Chief Of General Engineering P .CORE OF SUAVE' NOT BEARING THE LAND SE OF NgR, SURVEYOR' SIR ED BfGL OR EN BOSSED SEAL SHALL .(r y SBTViCBB NOT BE CONSIDERED TO BE A VAL ID TRUE COPY S O YOU ARAN T S PERSON FOR WHOM HEREON $1 AL PREPARED ONLY, TO `LL~FD W- r 4r HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AHD ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- 30 d~ 00. M HUR93T WATER MAIN MI.!*WORSE OF WATER, PRIVATE PUBLICY MENTAL AGExCYAND LENDING INSTITUTION LISTED ,y p1AL P •SUFF.CO.TAX MR DOT.'O"SECTION Cj4BLOCN c5 LOT, HEREON, AND TO THE ASSIGNEES OF THE LENDING §}~V,' M THERE ARE NO OWELLINTWITMIN 160 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT MTME"TER SUPPLYAND SEWAGE DISPOSALSYSTEM"TMKRESIDENCE OWNERS. WILL CIXIFORN TOTHF STANDAROSOFTHE SUFFOLK COUNTY DEPARTMENT M DISTANCES SHOWN HEREON FROM PROPERTY LINES b OF HEALTH SERVICES. TO EXISTING STRUCTURES ARE FOR A SPECIFIC (r_ O, 4,J 'Li APPLICANT- PURPOSE AND ARE NOT TO BE USED TO ESTABLISH W PROPERTY LINES OR FOR TILE ERECTION OF FENCES. _ SIR ADDRESS 400 OSTRANDER TEL. YOUNG a YOUNG R IIVERHEAD, NEW YORK E 'MONUMENT FOUND SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG,PROFESSIONAL ENGINEER SUFFOLK COUNTY ON JUNE 16, 1966 AS FILE NO. 4652. AND LAND SURVEYOR N.Y.S. LICENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR MTHE LOCATION OF WELL/W1,SEPTIC TANK(ST)6 CESSPOOLS(CPISNOWII MEREON N.Y.S. LICENSE NO. 45893 -141 ARE FROM FIELD OBSERVATIONS AND OR DATA OSTAINE D FROM OTHERS =2 BOARD OF HEALTH P~'OPMNO.1 3 SETS OF PLANS E6619 Z OVV 15 DI F `,O~ SOUTHOLD BU.ILDIN?`IDEPARTMENT /C11CC1 . . . . . . . . NHALL SEPTIC FORA 1T .:'i6U 7b'LD, N.Y. 11971 TEL.: 765-1802 NOT I FY ; CALL Examined . . . 19 T.22:3 PIAIL TO: • • • . Approved 1914-3Permit No.!.~F Jo y` . Disapproved a/c / L-470 ¢tS. -ifs 3Cor °7B i O~.r.......... '1(g 3~3 237 (Building Inspector) 1 APPL ATION FOR BUILDING PERMIT Date . (°..a~:.., 1993 INSTRUCTIONS VV 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- cati n. 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 it 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 2egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. fhe applicant agrees to comply with all applicable laws, ordinances, buildin c housin code, and regulations, and to admit authorized inspectors on premises and in building for necessary insP ::ti n y (Signature of applicant, or name, if a corporation) (Mailing address of applican ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. b.'! ?Z . tFe Jame of owner of premises ?7-6 Vc5~ (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) BuildeY's License No. ...ow~~ AA// Plumber's License No. ..IYp , ,~VlT7 r R • /3 ~7GearRft ~ o Electrician's License No. Other Trade's License No . Location of land on which proposed work will be done. (~v,~ WIUv(l Pm7NT RD- SOU-r*o House Number Street Hamlet County Tax Map No. 1000 Section 5.6 Block ; Lot Subdivision Filed Map No. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S11V&r1,E' ~!L1!A2ee -b'e-Itt, b. Intended use and occupancy , , , , , , , , , , , ,.M!L~/ , Nature o work Repair (check • • R which Removal New Building Addition . Alteration p oval Demolition Other Work . QQ (Description) 4. Estimated Cost............; Fee...................... g o ' o (to be paid on filing this application) • e number of cars units Number of dwelling emits on each floor If araa 6. If business commercial or mixed occupancy, specify natyarc Vd extent of each type of use 7. Dimensions of e~.isting structures, if any: Front /r7-1.rl, , , , , ,Rear ' ' ' ' ' Height ,B.4'Z. „ Number of Stories . Depth 7 , Dimensions of sarjte structure with alterations or addipons: Front . ' ' ' ' ' D epth ensi • s . f Sarre stn f .T- fk....... Rear . . ~f n ' Height . , • • • • • Rear .Nu. .m. .be.r..of. ....Storie.s ....'t9 .1c: $ HemhCsions of a5tine new w construction: Front k ;f . Depth .../.Q ,.",e?.. ~ tuber of Stories ~•C ~ , 9. Size of lot: Front Rear, 10. Date of Purchase " " " Depth pth Name of Former Owner • . . ' ' 11. Zone or use district in which premises are situated . • ' • • ' • ' ' ' ' ' ' ' " • ' • . • • • • . • 12. Does proposed construction violate any zoning law, ordinance or regulation: ' 13. Will lot be regraded Will excess fill be removed from premises: Yes 14. Name of Owner of premises E,V,rT ~O/X%y Ij Address No Name of Architect t • • • • • Phone No. Name of Contractor . Address Phone No. 7./$ Address YCn 15. Is this property within 3,00 feet of a tidal wetland?YPhone No.............. Yes........ No......... *If yes, Southold Town Trustees Permit may be required. ' PLAT-nt rAdM6 w uccu,-w,uanuw sued aVrwa anu tnutoate wnet er r ~l~Lt ° Nt- Poir1T kc PA'7D _ •-ti',_ ._warc~ ~.rs sllooel 7, 5 +7, 5 0 p tt ~.E• x.223.75 7o,aol ~ 1 %\O LC29.73' $ p 8.7 w IP? 8. 1 c,q 1s ti 0 P-4 Eti C ~'rr s4 0~ f di R-ze.o~. ' A y I , y yr 9 y ms 0'V -AA "N ~S %v~ 0 tip ' / oT ~3, 4. V V G 6.6 o~ r1F NEW YORK, • • • • • / x``7a 7,1 pP hCa°`~y~°/ :OUN OF N1 p~(Zp~~~ 1 / S .S I "1ning duly sworn, depo tys that te is the am ttn~~« :OUNTY Sri' l~,l~~0 .h( l 6v'n~'C`Y ( C g . • • • being duly sworn, deposes and says that he is the applicant (Name of individual si ning 'ontract) bove named. e is the t~~. tr (Contractor, agent, corporate officer, etc,) " " " " " " said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'Plication; that all statements contained', in this application are true to the best of his knowledge and belief; and that the ork will be perforned in the manner set forth in the application filed therewith. vom to before me his day of.. 19.T3 , ~L. 'tart Public, ` County CLAIRE L. QLEW Notary Public, State of NOW York Noi 879506 Qualified n Suffolk County ~}Z[ (Signature of applicant) Commission Expires December 10.4-1 \ " + ' r p ~ 4 y,• R I ~,:C - TC S Y, t'I tl ~ ' ~ f I kA Ri.' ~,V -0 I f ~c ~ ~ gl i~-0v ~ ~ d ~ ''1 4 arryfl D G h .T , jai i/• f + ~ b dG W I i'i r. j' ~ V ll~':~ f'I~i J ! J q^' ly ~ Rly~a 7 i 'r t / n~~ ~,I i Y 5 " N II. I y J-EFTEI-F~VA TI a t SE i~ ~3 I i I I UNbERWRITERSCERTIFICATE a S! REQUIRED - n ,.}~•.1 pp EI AS NOTED 9.r1x ~ DAT~ S ~ ]j 5Y: AT v'~ ~lil FEE QEPAR. c. NOTIFY',, IL ' . PM FOR THE z '785 78P NG iNS,~ CT ONS: iFOLLOyQ TWO REQUIRED '7. FOONBATIgN ONCR&t +r.r FOR POURE,O p UM91NG r rl% b 2. ROJGH,~ FRAMING R., INSULATION I . r r' n a 4 FIN L I^ ONSTRUCTlpN MUST r ,ji 1~ a i A t FOP"C.O. „ PLC E l 1 ALL~ECWSTRUCTION 'SHALL MEET r ENTS OF,"rTHE NY I' ' ,,;•:l THE FIEOUIREM ENEdGY . SfATfi ^CONSTR as IPONSIBLE FOR,..;+ r CODES. N". 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