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HomeMy WebLinkAbout20683-zFOP34 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20978 Date AUGUST 17, 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 6010 SOUNDVIEW AVENUE SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 8 Lot 5.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 1, 1992 pursuant to which Building Permit No. 20683-Z dated JUNE 2~ 1992 was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is 14'x14' ACCESSORY STORAGE BUILDING IN FRONT YARD Aa APPLIED FOR & AS PER ZBA #4095. The certificate is issued to DENNIS & JANICE DAVIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOR,Bi NO. o TOWN OF SOUTHOLD 0UILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~N? 30~83Z Permission is hereby granted to: .n ........ .~.~.:...~...~.~. ................................ ......... ../..~ ........ ~,....c/,. ....... ~..,..~.~z. ,o ....... at premises~/~ated at ......... .~..~.l.~. ........... ~.q~...~.~..l...:g~.. ......... ~.I..'~... ....................................... County Tax Map No. i000 Section ...~ .......... [3lock .... ...~..~, .......... Lot No. ,.,~.// pursuant to application dated ........ ....~.../. .......................... 19..?..,'~., and approved by the Building Inspector. · Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN 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 shewing 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. * Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging pool $25.00, Accessory building $25.00, Additions to accessory building $25,00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $i00.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction ........... Old Or Pre-existing Building.~ ocation of Property ........ f~.~q... ~/~6/ .................... . ~ .... -. ~ . .~up , ~0 V' House No. Street Hamlet' ewer or Owners of Property.. . . . untyNo 1000, ....... .... ........ ............. ~bdivision .................. .................. Filed Map ........... Lot ...................... ~rmit No..~..~....Date Of Permit...~/.,.J~ ..... ~ ~ 7,~ ...Applicant..~.~7~f.~.~ ~¢~g ... 'alth Dcp~. Approva~ ........ ~!~ ................. Underwriters Approval ......... arming Board Approval. . quest for: Temporary Certificate ........... Final Certicate ........... e Submitted: $ .~.~. ,..~. ~0~ ........................... CO ~PLTC^~ 'OUNDA'TION ( 1 st) 'OUNDATIOU (2nd) tOUGH FRAME & .PLUMBING ]. INSULATION PER N. Y. STATE ENERGY CODE FI;IAL ADDITIO~;~'L COMMENTS: ~'95 Page 2 - Appl. No. Matter of DENNIS DAVIS Decision Rendered April 2, 1992 4. The location of this accessory storage building is proposed to be located close to the paved driveway area and at least 75 feet from the front (easterly) property line and at least 149 feet from the front property line along Sound View Avenue. 5. For the record the dimensions of the proposed building is 14 ft. by 14 ft. (excluding permissible overhangs) and will be one-story in height {less than 18 feet total from ground to peak}. 6. It is the position of the Board in considering this application that: (a) the circumstances Are uniquely related to the preperty particularly since it is a corner lot with two front yard areas; (b) the relief is not substantial in relation to the requirements; (c) the variance requested does not involve any increase of dwelling unity density; (d) the relief requested will not cause a substantial effect on available governmental facilities since the structure is for enclosed parking and storage of the owner's own equipment and other items; (e) the relief requested is not unreasonable due to the uniqueness of the property and the immediate area; (f) the variance will not in turn be adverse to the safety, health, welfare, comfort, convenience, or order of the town, or be adverse to neighboring properties since the proposed building will be substantially setback from the front property lines at 75 feet or more. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Dinizio, it was RESOLVED, to GRANT a Variance to locate a 14 ft. by 14 ft. accessory storage building in the front yard area as applied SUBJECT TO THE FOLLOWING CONDITIONS: J. That the front yard setback be not less than 75 feet, as proposed, from the easterly front property line along Private Road; Matter of DENNIS DAVIS Decision Rendered April 2, 1992 2. That the front yard setback be not less than 145 feet from the northerly front property line along Sound View Avenue, as proposed; 3. That the building be limited to an accessory use for storage purposes incidental and related to the principal dwelling use of the owner and not be operated for gainful purposes (not for rental storage or other separate business purposes), etc. 4. That the building height from ground to top (peak) not exceed 18 feet; 5. That there be no cooking facilities or utilities other than electric; 6. That there be no sleeping or living quarters, as restricted by the accessory provisions of the code in this R-80 Zone District. Vote of the Board: Ayes: Messrs. Doyen, Grigonis, Dinizio, villa and Goehringer. This resolution was duly adopted. lk · GERARD P. GOEHRINGER~, CHAIRMAN RECEIVED A} D FILED BY IH;~, SOUT][~2©LD TOWN OLEBK 3. Nature of work (check which a!pplicable)~~'~ Addition 't '; Alt'er"*'-- Repa/r .. . . . . Removal ~ --~, .......... ''~ ~ .. -,u. ....... ...... ~ .................. ~aemolition .... ~' 'Other Work ' ' 4. Estimated Cost .~0~.~-~-'' ' ikon' f'* ~ ~escri,'ption) ,~ ......... Fee ........... [... ~ .... ~.,., 5 Tt,t .......... ' ~ (to be p~id o~]~,-,ttiis.avplicatiodl'~,''' . If garage, number ofc~s ... ~..'J'~ J' ' i ..... j j...~ l~uaoer ofawelhng umts,owenCh fl0o~ ................ 6. Ir business, commercial or mixgd occupancy s~ecif,, n2,.~-~' ' L' ' '. ..... ~' ' ' j ............................... ...... ~ v It ~uic ann extent et eaCll t e of 7. ~l¢~slon~ stmctur¢~, i f any: Front ./~7~ ..... ~, /ai~ '&' ' :' ' ';~'5'Y~5 ....... ~gn[ ... g..e ......... Nmnber or Stories .... / ....... ' ....... ,~.... r ....... ~epm ./e..~.~ ....... ~ensmns of same structure ~ith alterations or additio-~. ~ ' 2 ......................................... Uepth ................. Rear ................ · ~.. Height ...................... Number of Stories .............. 8. Dim~hsi~ng', ruction: Front .... [~2~ . · ....... mi¢,t .. .... Z. : .... 5.4 ..... ¢pth ........ 9. ,Siz~ o~ ~ ..,,, m~ ............... Rear. , .... Depth,. 10. Da e o~rchase .... ,... ' ............... I I.' Zo~or-use d t4n ~hic · .................. Name of Foyer Owner ........ ' ................... . premises are situated.. · .................... ~e a .......~- · ~,,,L* ~' Z' ']2,* ' ';' ~' · · Will excess fi~l be removed from uremises' 14. N~e ~ ~w~c~ u~premlses ~ ,. g q~t~/~,~, z, ......... Yes OI ArClllreCt .... . a~ ~. - ...... 'hone No .......... N~e of Contractor .......................... Address ................... Phone No ......... 15. Is chis properey within ~00 feet of a tidal wetland? ~xyes ........ No ...... · If yes, Southold Town 'Trustees Permit may be required. ' ' ' .... PLOT DIAG~ Locate clearly and distinctly ~I Ibuild~gs, whether existing or proposed, ~d. indicate al set-back d~ensions from property Hnes. Give street ~d block number or description accord~g to deed, and show street nines and indicate whethe~ interior or comer lot. TATE OF NEW YORK, ' ou,~rry OF.. e'o .......... ly .................... ' ........... ~ ........ being du sworn, deposes and says that he is the applicant (Nam f nd v dual signin~ contract) )eve named. ' ~* is the ' ' (Contractor agent corporate officer etc ) ................. said owner or owners, and is duly aithorized to perform or have performed the said work ~nd to make and file this l)lication; that all statements contain&l in this application are true to the best of his knowledge and belief; )rk will be performed in the manner s~t forth in the application filed therewith, and that the 'om to before me this JOYCE M. WILKIN$ i . N?,m~. Publk~ State of N~Yo~k [ ." ' ............ ~o, 496224~, Sufl~Coumv ] (Signature of applicant) APPEALS BOARD MEMBERS Gerard P. Goehrlnger, Chairman Charles Grigonis, Jr. Serge Doyen, James Dinizio, Jr. Robert A. Villa Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD May 1, 1992 Mr. and Mrs. Dennis A. Davis P.O. Box 226 Peconic, NY 11958 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 Re: Appl. No. 4095 (Variance 'for Accessory Storage Building) Dear Mr. and Mrs. Davis: Please find attached for your permanent records a copy of the Findings and Determination rendered by the Board of Appeals in the above matter. Please be sure to return to the Building Department and any other agency which may be involved for issuance of appropriate permits before commencing construction activities. We are providing a copy of the Board's determination to the Building Department for their update and recordkeeping. Very truly yours, Linda Kowalski Enclosure Copy of Decision to: Building Department Suffolk County Planning Coramission APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Chartes Grigonis, Ir. Serge Doyen, Jr. James 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. 4095: Matter of DENNIS DAVIS. Variance to the Zoning ordinance, Article III, Section 100-33 for permission to tea-ate a detached, accessory building in the front yard area. L~d~tion of Property: 6010 Soundview Avenue, Hamlet and Town of Southold, NY; County Tax Map Parcel No. 1000-59-8-5.11. WHEREAS, after due notice, a public hearing was held on April 2, 1992, and at said hearing 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; and WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, the surrounding areas; and and WHEREAS, the Board made the following findings of fact: 1. This is an appeal of the November 29, 1991 Notice of Disapproval by the Building Inspector for a variance to construct an accessory barn in the front yard (rather than the required rear yard). 2. The premises in question is located in the R-80 Zone District and contains a total area of approximately 97,700+- sq. ft. A copy of a portion of a survey has been submitted with this application which shows that this parcel is improved with a two-story frame house set back 138 feet from the front property line along a private road and 163 feet from the front property line along Sound View Avenue in Southold. 3. The subject building is not a barn, per se, for agricultural purposes but it's use is for storage of the owner's own equipment and miscellaneous items. The use of this building is limited to an accessory use incidental to the principal dwelling use and may not be operated for business or similar gainful purposes. This building may not, of course, be used as a separate principal use. ~ · "'~age 2 - Appl. No. Matter of DENNIS DAVIS Decision Rendered April 2, 1992 4. The location of this accessory storage building is proposed to be located close to the paved driveway area and at least 75 feet from the front (easterly) property line and at least 149 feet from the front property line along Sound View Avenue. 5. For the record the dimensions of the proposed building is 14 ft. by 14 ft. (excluding permissible overhangs) and will be one-story in height {less than 18 feet total from ground to peak}. 6. It is the position of the Board in considering this application that: (a) the circumstances Are uniquely related to the property particularly since it is a corner lot with two front yard areas; (b) the relief is not substantial in relation to the requirements; (c) the variance requested does not involve any increase of dwelling unity density; (d) the relief requested will not cause a substantial effect on available governmental facilities since the structure is for enclosed parking and storage of the owner's own equipment and other items; (e) the relief requested is not unreasonable due to the uniqueness of the property and the immediate area; (f) the variance will not in turn be adverse to the safety, health, welfare, comfort, convenience, or order of the town, or be adverse to neighboring properties since the proposed building will be substantially setback from the front property lines at 75 feet or more. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Dinizio, it was RESOLVED, to GRANT a Variance to locate a 14 ft. accessory storage building in the front yard area as SUBJECT TO THE FOLLOWING CONDITIONS: by 14 ft. applied J. That the front yard setback be not less than 75 feet, as proposed, from the easterly front property line along Private Road; '~Page 3 - Appl. No. 95 Matter of DENNIS DAVIS Decision Rendered April 2, 1992 2. That the front yard setback be not less than 145 feet from the northerly front property line along Sound View Avenue, as proposed; 3. That the building be limited to an accessory use for storage purposes incidental and related to the principal dwelling use of the owner and not be operated for gainful purposes (not for rental storage or other separate business purposes), etc. 4. That the building height from ground to top (peak) not exceed 18 feet; 5. That there be no cooking facilities or utilities other than electric; 6. That there be no sleeping or living quarters, as restricted by the accessory provisions of the code in this R-80 Zone District. Vote of the Board: Ayes: Messrs. Doyen, Grigonis, Dinizio, Villa and Goehringer. This resolution was duly adopted. lk GERARD P. GOEHRINGE~/, CHAIRMAN RECEIVED AND FILED BY lIt,.~ SOUTHOLD TOWN CLERK DATE ~ ~ ~ . FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL 5."ii ~.~,~ ...~.~. ~....~ .~ ...... PLEASE TAKE NOTICE that your application dated ............... .~-..~ ......19 .~. l.. for pe~it to ~~. ~...~.. ~..~ at ~o~o~ o~ ~o~, ~'~o~" '~ ~' ~ ~ . . .~.~;~; . . .~ ~.~~ . . ~ :~ County Tax Map No. 1000 Section .... ~.~ ..... Block ..... ~ ...... Lot .. ~. ~ .I.I ..... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproves on the following grounds. ~'~. ~.~.~..4 ~ 7. ~ ~ ...... .... .................................. ..... Rv 1/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE iNSPE 3. Nature of work (check which ~pplicable)~--~ Additio ;~ [ '' Alteration ........ Repair .............. Removal .............. Demolition ....... .i:~ .~ 10ther Work 4. Estimated Cost .... ~.~---T..i ........................ Fee ....... ,.. ~ (to be p, ~d o~j{~;[hi~'a~plication) 5. If dwelling, number of dwelling units ................ ' ~ p, ,., Number of dwellin: units, bn,'each floor .......... , If garage, number of c~s .... : ...... . ..... . . . . . .... 6. If business, commerc:-~ ~---:-~ .. ' .................................... . . ,~. u~ ..~?u occupancy, specuy, ngture and extent of each t e ' ' ' 7. D~mensmns ~l~stmctu~e~,ifan,,. Fron* /3~ /~ ~ of use ......... >' "~ ........ D~ensions of same structure ~ith alterations or additions: Front ......................... ~..... HeiSt ...................... Number of Stories ...................... Height · ' ~ber of Stories .... /. ...... · ....... .... · ..... Depth ....... 10.~ D~}e of~flr6h'h}e*~ ...... ' ....... Rear 11.~ Zoa*-or.~}~ district-qn,~ tic ' ' ' '" ........... ' .....Name of Fo~er Owner .. ' ...... 12., Do~ grO~,o~d=cQna~¢ctiot · · · ' ............................... 13. Wfli lot ~b~'~g: ~lo~ate any zoning law, ordinance or reoulation ......... .... .D~ '5' ,_..j .... ;. ~... Will excess fill be removd from rem's Nme oi~rcnlrec[ . · ....... ~u. ~7~ ~ ...... .................. Address ................... Phone No ................ Nme of Contractor ......... 2 ................. Address ................... Phone No ......... . 15. Is th~s property wlthin 300 feet o~ a t~.dal wetland? }~Yes ........ No ........ · if yes, Southold Town Trustees Permit may be required. .. PLOT DIAG~ Locate clearly and distinctly dl~buildNgs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions fro~ prope~y Hnes Give street ~d bl humber ~ · ock ~- ......... description accord~g to deed, and show street nines and indicate whether interior or comer lot. ' I'ATE OF NEW YORK, OUN'Ty OF ................. ........................... . · '. ..................... being duly sworn, deposes and says that he is the applicant (Name of individual s~gmn~ contract) )eve named. ~ is the ~ , ' (Contractor agent corporate officer ere ) said owner or owners, and is duly aluthorized to perfom~ or have performed the said work ~nd to make and file this plication; that al/ statements contained in this application are true to the best of his knowledge and belief; and that the ~rk wdl be performed in the manner s~t forth in the application filed therewith. 'om to before me this · ". County , · JOYCE M. wILKffi$ ': ~ . ....... , ~'~ (Signature of applicant)  -- BOARD OF HEALTH ......... FORMNO. 1 3 SETS OF PLA~S .......... TOWN OFSOUTHOLD SURV£Y ................... BUILDING DEPARTMENT ClIECK'., .................. TOWN HALL SEPTIC FORH .............. _ ~g~.,,.~,, SOUTHOLD, N.Y. 11971 -- TEL.: 765-1802 ,.O,,Ft 0 EX ' ' Z /~ --' n., CALL · aramco .... .,<-//..,~--. ....... , 19777-. . ~ TO: Disapproved a/c .... . -~"~/~'/--'~3~:'(-~'' ;'/~'_;. '~ .... " ' ................. . ./(~'ilding hrspcctor) i.,~l APPLICATION FOR BUILDING PERMIT /~ '"h ,TOV~'~'~)~I~IOLO ~.1 a. This application must be completely filled in bytypewriter orin ink and submitted to the Building Inspector, with 3 ,ets of plans, accur0te 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 3f'areas, and giving a detailed description of lay6ut of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this 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 .hall 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 .hall 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 luilding 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. fhe applicant agrees to. comply with ali applicable laws,' ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspeations (Signature of applicant, or name, if a corporation) .-., ....... /_ ..... ~. ...... : ................ (Mailino address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera] contractor, electrician, plumber or builder. (Name and title of corporate officer) Builder's License No ........ 2 ................. Plumber's License No ........ ~. ................ Electrician's License No ....................... Other Trade's License No ...................... ............... / - ,~' '~ .... APPI0VI~D AS ~IOTED Name of owner of premises ,Z}.~"A/M/..5 ,z/.. {. d4¢t¢~..-... ~/.~..- --,.~~. 77d]~,~ ~ ,g~ .~ (as on the t= roll or lates~'~~'R'~ ~o It' applicant is a corporation, signature of duly authorized officer. ] FEE:~~ BY:.~ ' ~ NOTI~ BUILDING DEPARTMENT AT 785-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE 2, EOUGH -FRAMING & P~MBING 3. INSU~TION 4. FINA~ CONSTRUCTION MUST 8E CO~PL~TE FOR C.O, ' ALL CONSTEU~ON SHALL ME~ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Location of land on which proposed work will be done .................... D.E~IGN.O~.~QNSI'RUCIIQN E~OB~.. IIouse Number Street Hamlqt County Tax Map No. I000 Section ~// . ....... ....... Block ....... ~. ......... Lot ............... .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) , Slate ex/sting use and occupancy of premises and intended use and occupancy ofproposed construction: ................................. .~ ~33 ~<~,. 4,; ,~ .; ~.,; ,4 3. Nature of work (check which hpplicable)~ ....... Add tion ~: ~ ~ i~ Alt'er Repair ............ Remov · ''' "*~ ,' ? · etlon ....... i ad .............. Demohtlon ............ ii !~Other Work ........ . . 4. ~stimated wast .... ,~0o.... 4 .................. Fee [ ~ ........ 5. Ifdwelling, number of dwe lin~ units ' ~, , 0, , (t°bep!]d°~!~!{~li~a'ti~)i''' · If garage, number of cars .... : ............... ~umoer oI aweuing units Om'ca'ch' fl6or ............. 6. IDfib. b,u?2~n,e,,s,s; c~,rn~.n.._e,r, cml or m~xpd o. ccupancy, speclf,y, n~ture an'd'eit'ent o'r each t;u;'of use ...................... 7.., .... ....... s~°/~,,~*~;~structute~ finny: Front /J.. r~t.~. ~, /,;L2~ -- '~, ......;O'~'Y;'~ ....... nmght .. ~-:~,. ....... Nu~nber of Stories . / .............. ,','..'..'- .......~Jepth ./,P.-:ff/.< ....... Dimensions of sa - ' ' · ".'. ................................ ...... me structur~ with alterahons or addmons. Front - ' ............ 'tJepm.~ ~ ' · ................ ~ear .................. ~ I ,1 I- eight ................... Number of Stories .............. 8. Dimehsi6n ~mction:Front .... /~.q.~i. .~ /' , , ........ ' ' " [i ...... Depth /~. ~. ~ ......... Hmght . i Stories .... /...i..i Rea .../....~. 9. ~Siz~ of~t~ri~. · · i. 10.: D,~e o}~urch~se~'.a~. ~ ........... Rear .... pth ........ · - .' .... ' .....Name of Former Owner 11 ? Zoa's~or.j,l~e:distri~t~in,,~hic ~rbmises are situated ................ 12.: Do~ ~gO~:d ,CrOn~l;~gctior any zoning law, ordinance or regulation: ............ 13. Wili iot b~ *f ...................... 14. Name ~ ......... ; .......... Will excess fill be removgd from premises o f Owner o f premises ~.' .~/'/.'s .d~ ~..,/.~.r/.~.~..,C L~q;~ d _ : Yes Name of Architect ..... i...: .. . ' ...................... .............. Address ................... Phone No ................ Name of Contractor ........ i ...... Address ................... Phone No ......... 15. Is this property within ~00 feet of a tidal wetland? ~Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ali! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and mdmate whether interior or comerlot. ' ' TATE OF NEW YORK, ouNrTy OF ........ S. .................... ' ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )eve named. ~' is the ' . ~ (Contractor, agent, corpoyat¢ officer, etc.) said owner or owners, and is duly duthorized to perform or have performed the said work ,~nd to make and file this plication: that all statements containdd in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the manner s~t forth in tim application filed therewith. 'om to before me this ' tary Public ........... 'J~": .~..~'. County , JOYCE M. WILKIN8 '; ' . ......... ~.[. N~ery Publlo, State of New mo, 4962240, 8ufl~lt ~C~=~,~ (Signature of applicant) Term Expifel June 1~, IA.,,~: