HomeMy WebLinkAbout20978-zFORM NO. 4
ToWN OF SOUTHOLD
BUILDING bEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22152
Date FEBRUARY 22, 1993
THIS CERTIFIES that the buildin~
Location of Property 2170 THE STRAND
House No.
County Tax Map No. 1000 Section 30
Subdivision
ACCESSORY
EAST MARION~ N.Y.
Street Hamlet
Block 2 Lot 53
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 30~ 1992 pursuant to which
Building Permit No. 20978-Z dated SEPTEMBER 24, 1992
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 ACCESSORY CIRCULAR DECK AS APPLIED FOR & AS PER ZBA ~4114.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
GEORGE & SUSAN TSAVARIS
N-262230 - JANUARY 7r 1993
~ilding Inspector
Rev. 1/81
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~To, 20978Z
Permission is hereby granted to:
.~.~..~.~ ....... /~....~~ ...........................
...~.~.~..,..~~.....~.:.~.:. ...................
.~...~.~..~..~.!.:.~ ............................................................................................................ , .................
County Tax Map No. 1000 Section ..... ~..,D,, .......... Block ....... ,,(~..,,'~.. ..... Lot No....,.~,,'~,.,.~, ............
pursuant to application dated ........ ~.~...~.........,.~... ......... , 19..~/....~., and approved by the
/
Building inspector.
Building Inspector
Rev, 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hail
Southold, N.Y. 11971'
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OB ink, and submitted m ~mmm~ to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal)~
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3.Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory ,~10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. %~ ~ $ 50.00 Date ..........................
NewCOns t~uction. ~ ... Old or Pre-existing Building ............ Vacant Land .............
Location of Property . ~)~.i
House No. Street Nam/et
Owner or Owners of Property
County Tax Map No. 1000 Section ...............
Subdivision ................................. Filed Map No ........... Lot No ..............
Perm it No..~.~.?.-/?. · .~-Date o f, Permit ' ?./,~..ur/'..~App licant .... .~ .~..~.%%. ~ ·
t % .....
HeathDept Approva
...... · 1' .............. Laoor uepL /~pproval .........
Underwriters Approval .....
Request for Temporary Certificate ..................... Final Certificate ... ~ ................
Fee Submitted $ .............................
Construction on above described building andre
rmit meets all applicable codes and regulations.
Applicant .?~.,/. ,~~/'' ..................
Rev. 10-10-78
INSPECTORS . ·
Victor Lessard
Principal Building InSpector
· ' Curtis Horton
Senior Building Inspector
Thomas Fisher
Buikting Inspector
Gary Fish
Building Inspector
Vincent R. Wieezorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
993
L. HARRIS, Supervisor
tall
9, 33095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
,FEBRUARY 5, 1993
To Whom This May Concern:
We are unable to ~complete your Certificate of Occupancy
because of the following reasons:
x~x An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is i~a~K/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 ~ 20978-Z
Please contact cur office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~.0¢') 107 '[ BUREAU OF ELECTRICITY
B5 JOHN STREET, NEW YORK, NEW YORK 10038
Date t~J~lJ~Y ~7~ Application No. onfile e3986893/9~ t~ :~(~223e
Lot
FIXTURE
OUTLETS
DRYERS
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
IECEPTACLES SWITCHES ~tUORESCENT OTHER
FURNACE MOTORS EUTUI~E APPUANC~E FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
$ERVIC~ DISCONNECT
OTHER APPARATUS:
S E R
A. WO
OF CC, CONO
I C E
~JO OF HI-LEG
G & 8 CONg'RAPA'0R
BOX 215
GENERAL MANAGER
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.
Ox ~ APPEALS BOARD MEMBERS
>Gerard P. Goehringer, Chairman
5
~ ~ Serge Do);en, Jr.
~ -~' James Dinizio, Jr.
~ \ Robert A. Villa
Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
ACTION OF THE BOARD OF APPEALS
SCOqFI? L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Appl. No. 4114.
Upon Application of GEORGE TSAVARIS. A Variance to the
Zoning Ordinance, Article XXIII, Section 100-239.4 for approval
of deck area as exists at the top of bluff stairway along the
L.I. Sound. Location of Property: 2170 The Strand Lane, East
Marion, NY; Pebble Beach Farms Filed Map No. 6266, Kot 111;
Parcel ID No. 1000-30-2-53.
WHEREAS, a public hearing was held on September 10, i992, at
which time all those 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;
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. This is an application appealing a Notice of Disapproval
issued on April 1, 1992 by the Town Building Inspector on the
grounds that the subject "accessory deck...is less than 100 feet
from the bluff," and requesting a setback variance under Article
XXIII, Section 100-239.4 for approval, as exists.
2. The premises is known as Lot No. 111 on the "Map of
Pebble Beach Farms" and is improved with a single-family,
two-story dwelling with porch situated at 55-1/2 feet from the
closest distance to the top of the bluff line and located 100
feet from the average top of bluff shown on the filed subdivision
map. Also existing at the premises is the subject antenna dish
structure, barbeque "burner," play area and (subject) deck
landward of the top of the bluff. There are steps sloping down
the bluff to the beach area at the bottom of the bluff.
4. Article XXlII, Section 100-239.4A of the Zoning Code
requires all buildings and structures located on lots upon which
there exists a bluff or bank landward of the shore or beach of
Page 2 - Appl. No. 4114
Matter of GEORGE TSAVARIS
Decision Rendered September 10, 1992
shall be set back not less than one hundred (100) feet from the
top of such bluff or bank.
5. Correspondence dated June 18, 1992 has been received
from the office of the Town Trustees confirming that the subject
deck is beyond their jurisdiction under the Coastal Erosion
Hazard Ordinance adopted in November 1991 (Ch. 37) and the Town
Wetland Ordinance (Ch. 97).
6. The applicants have indicated that they have
communicated with the N.Y.S. Department of Environmental
Conservation and have been assured that the structures are
not in violation of the permit issued August 18, 1989 under DEC
No. 10-89-0394.
noted:
For the record,
the following additional information is
(a) the height of the accessory deck is approximately
18 inches from ground to top of deck, and the posts are
approximately four ft. deep in the ground;
(b) the diameter of this deck is 25 feet, and there is
an outer stairway with three steps from ground level;
(c) there are cedar trees existing along the easterly
side property for screening purposes -- additional screening
would limit waterviews for the property owner and adjacent
property owners;
(d) this application is strictly for the accessory
deck at the top of the bluff stairs and is not and will not be
physically attached to the house or any other structure.
8~ It is the position of this Board that in considering
this application:
(a) the relief requested is in this ~pplication is not
substantial in relation to similarities existing generally in the
neighborhood and along the Long Island Sound bluff;
(b) stairs and platform/deck areas are necessary to
gain access to the beach and water area below the bluff for which
N.YoS. Department of Environmental Conservation approval was
issued;
(c) it is not uncommon for parcels along the Sound
bluff to require variances for a minor accessory structure or
stair accessways within 100 feet of the bluf;
Page 3 - Appl. No. 4114
Matter of GEORGE TSAVARIS
Decision Rendered September 10,
1992
(d) prior to the enactment of Section 100-239.4
(previously 100-119.2 under the old zoning code) {Spring 1985},
Notices of Disapproval and/or building permits were not issued by
the Building Department and therefore no appeal process was
followed for variances under this provision of the zoning code;
(e) the difficulties are uniquely related to the
property and its topography, and the difficulties claimed are
not personal to the landowner;
(f) the amount of relief requested will not in turn be
adverse to the safety, health, welfare, comfort, convenience or
order of the town, nor will it prevent neighboring properties
from enjoyment of their properties;
(g) there is no alternative feasible for appellants to
pursue other than a variance;
(h) the amount of relief requested will not in turn be
adverse to the safety, health, welfare, comfort, convenience or
order of the town, or be adverse to neighboring properties;
(i) the variance will not cause a substantial effect
on governmental facilities;
(j) in view of all the above, the interests of justice
will be served by granting relief, as conditionally noted below.
9. Upon inspection, it is was noted that the bluff is
heavily vegetated, some of which is weed growth. There are
shrubs, tree and viney growth throughout the bluff face. The
yard shopes south towards the dwelling and is well vegetated in
turf grasses. The bluff areas for this property and other
properties to the east and west have no toe stabilization. It
does not appear tht the high tide reaches the toe area of the
bluff. In the event bare spots should become visible, then they
should be planted to 'Cape' American beachgrass, making sure not
to disturb any other existing vegetation as per report of the
Suffolk County Soil and Water Conservation District Office dated
July 29, 1992.
10. For the record, it is noted that this determination
shall not affect the validity of, or more stringent requirements
by, other agencies (Town Trustees, DEC, etc.).
Accordingly, on motion by Mr. Goehringer, seconded by
Mr. villa, it was
Page 4 - Appl. No. 4114
Matter of GEORGE TSAVARIS
Decision Rendered September 10, 1992
RESOLVED, to grant the relief as requested under Appl. No.
4114 in the Matter of the Application of GEORGE TSAVARIS, SUBJECT
TO THE FOLLOWING CONDITIONS:
1. That there be no adverse physical disturbance to or
close to the bluff areas;
2. That there be no change in location or structural
modification of the existing sun deck -- deck shall remain the
same o
3. That there be no canopy or roof;
4. That there be no pole lighting (only shaded fixtures
when needed for lighting-safety purposes}.
Vote of the Board: Ayes: Messrs. Goehringer, Dinizio,
Doyen, and Villa. This resolution was duly ~d6pted.
lk
GOEI-IRINGER,
FORM NO. 3
ToWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date ..~ .................. , 19 ?.~-
To ~/~ . . ~.,~--r4.,ff,.,,"~4~....~.....~5~4ff~ ~Z ~'~-~?-47
.... ~..~.. ~.~.~ ~ .....
..... ~~~.. ....
PLEASE TAKE NOTICE t~a~ your a~lioatio~ ~al~ ....~ ............... ,1~ ~.
~o~nl~ T~x ~F ~. l~OO ~lion ..... d.~ ..... Block ..... ~ ...... Lot . .~ .......
Subdivision ................. Filed Map No ................. Lot No ..................
is return'ed herewith and disapproved on the following grounds. ~.,at~-d~ .... ~...~...~
. ~..~.....~.~_..-,.: ~.....;~...,-~.. ~,.: ..... ~
..~' ~'""~:'x ........ '~ ........... : .... ~'"~ ...... .----~. .
,.~..~o.~.~.~.. :..a~ .m&~_~ ....................
RV 1/80
APPEALS BOARD MEMBERS
Gerard P. Goehringer, Chairman
Serge Doyen, Jr.
James Dinizio, Jr.
Robert A. Villa
Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
September 14, 1992
SCOTI' L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Mr. and Mrs. George Tsavaris
2170 The Strand
East Marion, NY 11939
Re: Appl. No. 4114 (Deck at Top of Bluff Stairs)
Dear Mr. and Mrs. Tsavaris:
Please find attached a copy of the Findings and Deter-
mination rendered by the Board at our Regular Meeting held
Thursday, September 10, 1992 concerning your variance application.
Please be sure to return to the Town Building Department to
reactivate the building permit and/or issuance as deemed
appropriate by his office. Copies of this determination have
also been furnished this date to the Building Department and the
Town Trustees for their update and permanent recordkeeping.
Very truly yours,
Enclosure
Copies of Decision to:
Southold Town Building Department
Southold Town Trustees
Suffolk County Department of Planning
APPEALS BOARD MEMBERS
Gerard P. Goehringer, Chairman
Serge Doyen, J'r.
Jaraes Dinizio, Jr.
Robert A. Villa
Telephone (516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
ACTION OF THE BOARD OF APPEALS
SCOTT L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P,O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Appl. No. 4114.
Upon Application of GEORGE TSAVARIS. A Variance to the
Zoning Ordinance, Article XXIII, Section 100-239.4 for approval
of deck area as exists at the top of bluff stairway along the
L.I. Sound. Location of Property: 2170 The Strand Lane, East
Marion, NY; Pebble Beach Farms Filed Map No. 6266, Kot 111;
Parcel ID No. 1000-30-2-53.
WHEREAS, a public hearing was held on Septe~aber 10, 1992, at
which time all those 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;
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. This is an application appealing a Notice of Disapproval
issued on April 1, 1992 by the Town Building Inspector on the
grounds that the subject "accessory deck...is less than 100 feet
from the bluff," and requesting a setback variance under Article
XXIII, Section 100-239.4 for approval, as exists.
2. The premises is known as Lot No. 111 on the "Map of
Pebble Beach Farms" and is improved with a single-family,
two-story dwelling With porch situated at 55-1/2 'feet from the
closest distance to the top of the bluff line and located 100
feet from the average top of bluff shown on the filed subdivision
map. Also existing at the premises is the subject antenna dish
structure, barbeque "burner," play area and (subject) deck
landward of the top of the bluff. There are steps sloping down
the bluff to the beach area at the bottom of the bluff.
3. Article XXIII, Section 100-239.4A of the Zoning Code
requires all buildings and structures located on lots upon which
there exists a bluff or bank landward of the shore or beach of
'P~ge 2 - Appl. No. 4114
Matter of GEORGE TSAVARIS
Decision Rendered September 10,
1992
shall be set back not less than one hundred (100) feet from the
top of such bluff or bank.
4. Correspondence dated June 18, 1992 has been received
from the office of the Town Trustees confirming that the subject
deck is beyond their jurisdiction under the Coastal Erosion
Hazard Ordinance adopted in November 1991 (Ch. 37) and the Town
Wetland Ordinance (Ch. 97).
5. The applicants have indicated that they have
communicated with the N.Y.S. Department of Environmental
Conservation and have been assured that the structures are
not in violation of the permit issued August 18, 1989 under DEC
No. 10-89-0394.
e
noted:
For the record,
the following additional information is
(a) the height of the accessory deck is approximately
18 inches from ground to top of deck, and the posts are
approximately four ft. deep in the ground;
(b) the diameter of this deck is 25 feet, and there is
'an outer stairway with three steps from ground level;
(c) there are cedar trees existing along the easterly
side property for screening purposes -- additional screening
would limit waterviews for the property owner and adjacent
property owners;
(d) this application is strictly for the accessory
deck at the top of the bluff stairs and is not and will not be
physically attached to the house or any other structure..
?. It is the position of this Board that in considering
this application:
(a) the relief requested is in this application is not
substantial in relation to similarities existing generally in the
neighborhood and along the Long Island Sound bluff;
(b) stairs and platform/deck areas are necessary to
gain access to the beach and water area below the bluff for which
N.Y.S. Department of Environmental Conservation approval was
issued;
(c) it is not uncommon for parcels along the Sound
bluff to require variances for a minor accessory structure or
stair accessways within 100 feet of the bluf;
'Page 3 - Appl. No. 4114
M~tter of GEORGE TSAVARIS
Decision Rendered September 10,
1992
(d) prior to the enactment of Section 100-239.4
(previously 100-119.2 under the old zoning code) {Spring 1985},
Notices of Disapproval and/or building permits were not issued by
the Building Department and therefore no appeal process was
followed for variances under this provision'of the zoning code;
(e) the difficulties are uniquely related to the
property and its topography, and the difficulties claimed are
not personal to the landowner;
(f) the amount of relief requested will not in turn be
adverse to the safety, health, welfare, comfort, convenience or
order of the town, nor will it prevent neighboring properties
from enjoyment of their properties;
(g) there is no alternative feasible for appellants to
pursue other than a variance; ....
(h) the amount of relief requested will not in turn be
adverse to the safety, health, welfare, comfort, convenience or
order of the town, or be adverse to neighboring properties;
(i) the variance will not cause a substantial effect
on governmental facilities;
'(j) in view of all the above, the interests of justice
will be served by granting relief, as conditionally noted below.
8. Upon inspection, it is was noted that the bluff is
heavily vegetated, some of which is weed growth. There are
shrubs, tree and viney growth throughout the bluff face. The
yard shopes south towards the dwelling and is well vegetated in
turf grasses. The bluff areas for this property and other
properties to the east and west have no toe stabilization. It
does not appear tht the high tide reaches the toe area of the
bluff. In the event bare spots should become visible, then they
should be planted to 'Cape' American beachgrass¢ making sure not
to disturb any other existing vegetation as per report of the
Suffolk County Soil. and Water Conservation District Office dated
July 29, 1992.
9.~ For the record, it is noted that this determination
shall not affect the validity of, or more stringent requirements
by, other agencies (Town Trustees, DEC, etc.).
Accordingly, on motion by Mr. Goehringer, seconded by
Mr. Villa, it was
~P~ge 4 - Appl.~ No. 4114
Matter of GEORGE TSAVARIS
Decision Rendered September 10,
1992
RESOLVED, to grant the relief as requested under Appl. No.
4114 in the Matter of the Application of GEORGE TSAVARIS, SUBJECT
TO THE FOLLOWING CONDITIONS:
I.' That there be no adverse physical disturbance to or
close to the bluff areas;
2. That there be no change in location or structural
modification of the existing sun deck -- deck shall remain the
same o
3. That there be no canopy or roof;
4. That there be no pole lighting (only shaded fixtures
when needed for lighting-safety purposes).
Vote of the Board: Ayes: Messrs. Goehringer, Dinizio,
Doyen, and Villa. This resolution was duly ~ddpted.
lk
10-89-0394.
EACILITY/PROGRAM NUMBER(s)
N/A
OF ENVIRONMENTAL CONSERVATION
P'ERMIT
Under ~he Environmental Conservation
Law
August 18, 1989
August 31, 1991
Article 15, Title 3; 6NYCRR 327,
__ 328, 329: Aquatic Pesticides
Article 15, Title 5:
__ Protection of Water
J Article 15, Title 15:
Water Supply
q Article 15, Title 1'5:
Water Transport
I Article 15, Title 15:
Long Island Wells
J Article 15, Title 27:
Wild, Scenic and Recreational
Rivers
J------J 6NYCRR 608:
Water Quality Certification
~ Article 17, Titles 7, 8:
SPDES
I----~ Article 24:
Freshwater Wetlands
N--New, R--Renewal, M--Modification,
C--Construct (*only), O--Operate (*only)
Article 19:
Air Pollution Control*
Article 23, Title 27:
Mined Land Reclamation
J--~-~ Article 25:
Tidal Wetlands
J'-----~ Article 27, Title 7; 6NYORR 360:
Solid Waste Management*
J----~ Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
[~ Article 34:
Coastal Erosion Management
~-] Article 36:
Floodplain Management
[~'-] Articles 1, 3, 17, 19. 27, 37;
6NYCRR 380: Radiation Control
PERMIT ISSUED TO
George A. Tsavaris
ADDRESS OF PERMITTEE
2170 The Strand, East Marion, N.Y. 11939
AGENT FOR PERMITTEE/CONTACT PERSON
· Thomas Crowley, 195 East Gillette Ave.,East Marion,NY 11939
NAME AND ADDRESS OF PROJECT/FACILITY (If different from Perm~ttee)
Long Island Sound SCTM 1000-030-2-53
TELEPHONE NUMBER
~OCATIONOFPROJECT/PACILITY /COUNTY TOWNJ~T~k'~ UTMCOORDINATES
East Marion ~ Suffolk Southold
DESCRIPTION OF AUTHORIZED ACTIVITY
Construct
stairway down bluff face as shown on the attached NYSDEC aDoroved
GENERAL CONDITIONS.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli-
ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto.
A___uRUSt 18. 19Fq :?b(:_rt~.,~.~:reene ; '.~DRI~ Bldg'40,SI~Y,Rm. 219
~ .......... t Page 1 of
3
I
765~1802
BUILDING DEPT.
INSPECTION
FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING ~FINAL
REMARKS:
DATE
INSPECTOR
OUNDA~ION
'OUNDATION
:OUGH FRAME
·PLUMBING
(2nd)
iNSULATION PER N.
STATE ENERGY
CODE
FI;;AL
o ·
//
ADDITIONA'L COMMENTS:
Examined
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
. (Bui171iffg Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
80,\KD OF HEALTiI ........ .
3 SETS OF PLANo ..........
SURV£Y ...................
ctl c . ............
SEPTIC ;O H ...... .
a. Tiffs application must be completely filled in by Wpewr/ter or in ink and submitted to the Building Inspector, with 3
;ts of plans, accurate plot plan to scale. Fee according t9 schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or punic streets
r areas, and giving a detailed description of layout of property must be drawn on tim diagram which is part of this appli-
ttion.
c. The work covered by thik application may not be cbmmenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
'.all 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
mil 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
fiilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
egulations, for the construction of buildings, additions or alterations,.or for removal or demolition, as herein described.
he applicant agrees to comply with all applicable Iaws, ordihances, building code~ housing code, and regulations, and to
:mit author/zed inspectors on premises and in building for necessaw insnections.
...... ...........
( '= ature of applicant, br name, if a corporation) '
(Mailing address of applicant)
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............................ .e.!9.ff. R.&L,... C:.O T ACTo .Ig,
~me of owner of premises .~..~2.0.~. '4""-5U3,,~.~
(as on the t,xx ro 1 or atest deed)
applicant is a corporation, signature of duly authorized officer.
..... ii~/;me ~nci title of c;;porate officer)
Builder's License No .... j~..y .c/.?.~..'7. J'{~. ......
lumber s Lmense No .........................
Electrician's License No.
Other Trade's License No ......................
Location orland on which proposed work wlil be done..
................
~ouse Number Street HamIet ........
Subdivision ..................................... Filed Map No.
(Name) .............. Lot ...............
~ate existing use and occupascy of prcm~ses and in~ended use and occupancy of proposed construction:
3. Nature of work (check which applicable): New Bui ding .......... Addition ...........
Repa/r .............. Remolval .......... Demolition ............. O t h e r.'~'W o r k.'~/~..' ......
...... l),~.. ? ~ (Description)
4. Estimated Cost ,,
5. Ifdwellin- hum . · ~ . ' .
~, ber of dwethn,, units . ~ ~ - '"1- .(to bc paid on filim~ this application)
. If garage, number of cars . ~ g~'~'.. Number of dwclhng units on each floor .
6. If business comme~.;~ ~. ~:.. ,~ '~;"-' ~ ........................
..... ~' '"','enloccupancy, specify nature and extent of each tyne of t se ' ' .....
7. Dimensions of existing stmctures~ if any: Front ......... ..... Rear ...... Depth ......
igl , . ,
He it .... ; .......... NumOerofStorics ......... ' ..... · ........
Dimensions oI same structure w ~ alterations or additions: Front .................
Depth. ,. ,
.... ' ............ i. He 1hi ..... ' ' ' ~ ..... i ..... ~xear ..................
8. u~mensJonsot,~n,tirenewconstmbt;n.,'~.~., ~)2 .............. ~nmb~Sm, hc~.,~ . ~ .
Wei,.h~ ~O" I .. , ............. ';l~ .... v. .. ~ '~ ........
9. Sizeoflor r-~-, ~S ~ J~erorStonas..~/~ .... ~. ~~~~e~h .......
10. Date of Purchase ~P~ fgg~;~ 'i '/~ ~r ...... cd.,.~ .... Depth $5&,~ ''
~ . · ''' ,u,~,..i.,.w./~.9 , Nam~c~ ~ ' ...............
11. ~oneorusedlstrJctJnwb;~h..~ ,. ~.. ~- '~ ~ ~mrqnneruwner .........
. .... ...............
12. uoes proposed Construcnon violate any zoning law, ordinan ~. ' .....................
13. W~llot beregraded . . ~
14. Nme of Owner ofnremise~ ~]j/_]X .... Wdl e~cess fill be removgd from remises' Yes
Nme of Architect ~1~. ~ ~ s~ ~ ~..'~.~{~e No. S~. UYTF~l ~..
Nme of Contractor .~J~'~¢~: ..... Address ~~~ .~,~,. Phone No ............ ~...
.5. Is th~s property wS~hSn'bbb' ~' ~;',' 5ddress~'~B~-~pS- .9~[O~hone No .$&~Z~ ¢ ..-
....' , PLOT DIAG~
Locate clearly and distinctly ~1 buildings, whether existing or proposed, and, indicate ~I set-back d~ensions from
nt~dor or co.er ~ot. ~ to deed, and show street n~es and ~d~ca~e whether
· .(Name of individ ua,l~igning con tract)
,,e named. . · i
being duly sworn, deposes a'nd says that lie is the applicant
is the ! . .
· ' , il (Co.qtract~ ............
orporate officer, etc.) .................
.aid OWner or owners, and ~s duly authorized to per£orm'~'m- o-6~ror tiave performed the said work and to make and file this
marion: that all statements contained ~n this application are true to the best of his knowledge and belief;and that the
k will be pcrfomed in the manner set forth in the application flied therewith.
m to before me this
_ NO. ~79506 ~ ~ ' ' ' ' ;
"' ~ln~n ~ ~m ,~ & 19~
C~
,q
j/
J
N{~'~FY BUILDING DEPARTMENT AT
7e;5-I8~2 9 AM TO 4 PM FOR THE
FOL.LOW~[~(~
ALL CONGTRUC'ftON SHALL ~EET
STATE CO~ST~UC'~ IO~
OOC~JPAi~C¥ O~
W~THOUT
OF OCCUPANCY