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HomeMy WebLinkAbout20409-z w':, FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 ' Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21108 Date OCTOBER 23, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 8460 PECONIC HAY BLVD. LAUREL, N.Y. House No. Street Hamlet ~ County Tax Map No. 1000 Section 126 B1oek 11 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 23, 1992 pursuant to which Building Permit No. 20409-Z dated JANUARY 28, 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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to LAWRENCE J. CERVON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - SEPTEMBER 21, 1992 PLUMBERS CERTIFICATION DATED OCTOBER 19 1992 - MATTITUCK PLUMB.&HEAT. uild'n~~ttspector Rev. 1/81 s~oaaa loo. f TOWN OF SOUTHOLD BUILDING bEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT !THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Na ~Q~~9 Z Dote i9.d.~ Permission is y granted f 3~ ..~rrt.. ~ ~ ~ I~ to ~~s'%rGcF.~t~r~.:~~Pr~f~~'h~:..:...~7....~~~.~..~~.... ...~/~YP~.~ ~~~~=~o~..~~:.....c:...... .....a : ( . . at premises located of ~°..~......'`.F~FG...szS?.~~'.....:.~.~.'Gi/~..~ C~"' County Tox Map No. 1000 Section .....~in....£s~....... Block .......1~........ Lot No.......~-~..~......... pursuant to application dated .......1~..~ i9..~?^and approved by the Building Inspector. Fee S~-~`~.~•• ~~.t.. .....~"~/.~t Bui1)T1ng Inspector Rev. b/30/80 Form No, 6 ct ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 o€ 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. ' S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. b. 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 Building - $100,00 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 - Residenti~~a`l $15.00, Commercial $15.00 Date ..r7~~.1~'~~~ !ew Construction.........., Old Or Pre-existing Building.... `,ocation of Property House No. Street ( .p. ..•....•..Hamlet.••.••....•.. lnwer or Owners of Property..~l.,~j,,,~e~-gf~~„~~,~.)~~l r .~.-~1~~•:.•.. 'ounty Tax Map No 1000, Section... !.~~,;,,,,,Block...`./........,.Lot„ ubdivision .Filed Map............Lot.~.Jg ermit No.... ~0~,~„Date•Of.Permit... ~L~;°,/„~~,Applicantfi~:?s;. ~ , ealth DepC, Approval ..........................Underwriters Approval......................... lanning Board Approval r quest far: Temporary Certificate........... Final Certicate,,,,/...... ee S/u~,bmitted: $ 1~,,,,,,,,,,,,,,,,, ".:A~ . ~5 ~ b - S . ~~•APPLI .ANT • •~C~-lt~-r~9r~~ ~ . APPEALS BOARD MEMBERS ~~',s='-"~~%!',o ~ SCOTTL.HARRIS yr ' ~ ~ Supervisor - Gerard P. Goehringer, Chairman , ,y, ~g~ CharlesGrigonis,Jr. Ser a Do en, Jt. ~ Town Hall, 53095 Main Road g Y ~ P.O. Box 1179 James Dinizio, Jr. - ~ Southold, New York 11971 Robert A. Villa " ~ ~ ~`°-~~i~ ~,;y~~ Fax (516) 765-1823 Telephone (516} 765-1809 ` ~ Telephone (516) 765-1800 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD App1. No. 4042: Upon Application of LAWRENCE CERVON. Variance to the Zoning Ordinance, Article XXIII, Section 100-239.4B for permission to construct addition to dwelling with a setback at less than the required 75 feet from the bulkhead. Location of Property: 8460 Peconic Bay Boulevard, Laurel, NY; County Tax Map Parcel No. 1000-126-11-21. The subject parcel is substandard in size and is located in the R-40 Zone District. WHEREAS, a public hearing was held on August 15, 1991, and at said hearing all those who desired to be heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and - WHEREAS, the Board made the following findings of tact: 1. By this application, appellant seeks a variance under Article XXIII, Section 100-239.4B for permission to construct 12'8" living/dining room addition to the existing dwelling with an insufficient setback from the bulkhead at 42 feet at its closest point, all as more particularly shown on the site and floor plans prepared by Thomas C. Samuels, R.A. dated 7/9/91. 2. The premises in question is identified on the Suffolk County Tax Maps as District 1000, Section 126, Block 11, Lot Z1, contains a total lot area of approximately 24,373 sq. ft. and lot width of 70.0 feet. 3. The dwelling which exists is presently set back approximately 52 feet from the southeast corner of the house to the second retaining wall (bulkhead structure) along Great Peconic Bay and 39+- feet to the first retaining wall. This existing dwelling contains a first floor area of 2061 sq. ft., exclusive of porches, patios, steps. ~i rrdrr~2~x~ 'xxo = x~oo •a a$~tux~ xT / ~ .~a-- •pagdopE d;np sEM uo?qn;osax s?uy (•quasgE azaM uadoQ puE s?uob?xO szagway~) •E;;?A puE o?z?utQ '!xaburxuao0 •sxssaW :sad~d :pxeog auq ~o agoA 'QNSAISQ st dgazau puE aq Np~gSO ~0~32iMKZ ~o zaggEy~ auq u? 2606 'off TEaddr~ zapun pagsanbaz ~a?;az auq 'Q~ZOS~2i li, 5EM qt 'OTZSUTQ 'xy~ dq papuooas 'e;;tA •xy~ dq uoxgam uo '~i;bu?p.zooa~ •pagsanbax sE ~a?;ax auq bu?quezb qou ~Iq panxas aq tt?M ao?gsnC ;o sgsa.~aqu? auq 'anogE auq ;te qo Ma?n ur (a) ~ :sa?gzadoxd burxoqub?au puE uMOq auq ~o zapzo', xo aoua?uanuoa 'gzo~u~oo 'azE~teM 'uq;Eau '~Iga~es aqq oq asxanpE aq uznq u? p;noM aouErxEn auq (p) :azngeu u? ;EUOSZad axE puE dgxadoxd aqq oq page;az d;anb?un,~I;axrqua qou axE sa?q;no?3~?p auq (o) :poouzoqub?au auq qo zagoESeua '[E?quassa aqq ugTM quags?suga qou s? pagsanbax se ';a?;az aqq (q) :pa?tilde spzspuegs aqq mox~ ~a?taz ssat ,puE s~oEq gas zageaxb ugTM 'ansznd oq squettaddE zoo atgEt?;enE san?geuxagte axe azagq pue '~a?tax pxol;E oq dxessaoau umuc?u?Iu auq qou s? pagsanbaz ;a?tax aqq (E) :uo?gEOttddE s?qq bu?xap?suoa u? gEgq ~xe0$ s?uq ~o uotq?sod auq ostE s? q= •pxepuegs auq ~o oSb Ataq~uz?xozddE bu?aq 'te?quEgsgns sr pagsanbax ~a?taz ~o qunoiuE auq geuq pzaoq auq ?o uo?q?sod auq s? q2 •9 'PEauxin4 auq moz~ azotu xo qaa~ SL agengx~s 'gsaM auq oq bu?ttaMp u?qEO Got aqq 5u?pntaur 'saxngonsgs bu?ttaMp zaugo axE azauq geuq pagou s? q2 'S •gaaq (S~) an?~-dquanas uEuq ssat qou XoEq gas aq oq punog poets= buoZ auq uEuq zaugo sa?poq zagEM tep?q oq quaoECpe s? u3?uM puE sgsrxa axngonxgs xe;?tors xo dez-d?z ';tEM agaxauoa 'peauxtnq e uo?tIM uodn sgot up pageoot saznganzgs puE sbu?pt?nq ttE saz?nbaz apo0 buruoZ auq. qo gb'6EZ-OOt uotq~aS `IIIXX eto?qx'd '6 ail d I NOA?I~O SONS2IM~i'I - 2606 'oN •tddt~ ~o :zaggeyl bu?gaay~ tE?aadS steaddt~ }o pzeog i66T 'Zt zagmagdaS - Z absa, ~ i THE NEW YORK BOARD OF F[RE UNDERWRITERS w~+c~. 3 11.25~6~' BUREAU OF ELECTRICITY .~i 85 JOHN STREET, NEW YORK, NEW YORK 10038 V Date OC'S{)S[s'13 27,1995 Application No. on fife 786LtA692192 ~ 251k~54. :i THIS CERTIFIES THAT } only the efectrtcal equipment os described below and introduced 6y the opplicwnt named on the above applicotson number in the premises of a L~x(dR>aNCG CFIRVQN, S~f~d7 @[;CO+aTC t1AY HY.tIb., M~.~'Y'7TUCR, N,Y. © Basement ~ ]st Fl. ? 2nd Fl. Ser[ioa Block Lot in the follouinR Iocattun, ~ uos exorroined on ~f 1."L'FI PIFjCIt 27, 17.992 andfound to 6e in cmr:plionce roith the rerluirerraents of this Roard. FIXTURE ECEPTACLES SWITCHES i1XTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K. W. AMT. K. W AML K W AMi K W AMT N P 33 27, 4 ;4s T t,5 1, 7.2 DRYERS FURNACE MOTORS fUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI~OUTLET DIMMER5 II 1 AMT. N. W. Oll H. P. GAS H. P AMT. NO. A. W.O AMT. AMP. AMT, AMPS. TRANS. AMT H P. SYSTEMS AMi WAiiS ' NO.OF FEET ~ t. ~ s SERWCE DISCONNECT NO.OF 5 E R V 1 C E ? AMT. AMP. LrPE METER I ]W ~ ~ RW 3 9 3W 3 q dW NO. Or CG COND. A W G. NO. OF NbIEG A W' G' NO OF NEUTRAW A' W' EQUIP. PER a OF CG COND OF H4lEG OF NEVTRAL OTHER APPARATUS: hfl?SORSt7-3 H.I%. C;.P.C.It-G ~ SMQKB 1~~'['l3CPOtlI 1 tf d _ LAKE EL~;CR[f7C [,IC.#t.R45-S C. 17 POBC39' 'PRA2L fd7.DC.E, YaYT 77951. GENERAL MANAGER ~7 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. ' r COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED tN ANY MANNER. , ~i S~FFOLh'~, ~ TEL.7G5-1802 o d~ TORN OI' SOi1~'F30d.D • . ~c OFFICE OF BUII,DI?4G INSPECTOR ~1,~~~ P.O. BOX 728 ~c?s~ r "r TOWN IfAI.L ~ ~ SOUTHOLD, N.Y. 11971 #~,i ~ C E R T I F I C A T I O N Date ~ Building Permit No.~o~0`~ " Owner a ~Y, G' ~ ~ Jo r Ip ease print] Plum',ae Q, r,4 I (pleasE print) ~ '~/~a'7~np ~o~(~. I certify that the solder used in the water supply system contains less than 2/10 of l~ lead. (plumber's sign xe) Sworn to beforre~tme tk:is ~~A/~j~day of ~fd~~,~ Not Public Hotar7 Public, ~'cl'Fi~O.~ County " ~11HF.JACK90M QuMNd h Sulbpt PM~r Yak twm E~res Feb.16~t mY99~ INSPECTORS ?lic~~r Victor Lessard "~uFfD(, ` Principal Building Inspector ,yAO~ ~ ~^p~i Curtis Horton r.~ SCOTT L. HARRIS, Supervisor Senior Building Inspector o v~ ; F`z:A~ Southold Town Hall Thomas Fisher ~ T ~ P.O. Box 1179, 53095 Main Road Building Inspector O,r' ~ ~ Gary Fish ~`d:'fo s'^ ' .~"J~,~'` Southold, New York 11971 ~ d Fax (516) 765-1823 Building Inspector ~~zv-d~ Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD SEPTEMBER 30, 1992 THOMAS SAMUELS, ARCHITECT 25235 MAIN ROAD CDTCHOGUE, NY 11935 RE: LAWRENCE J. CERVON 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) %7CR 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. xxx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20409-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: LAWRENCE J. CERVON ~1cLD is:S:~.S.=J;i ~~Jn:c I~ ii:Yi4kNL^, d M`-- , . ! ~ d 'OUtIDATIO^I ~ H (1st) _ I c 'OUNDATI0IJ ( 2nd ) _ 3 ~ 9 z of ~ z 0 ;OUCH FRAME & s7i i • O PLUMBING • H ~ 3. ~ C~ :11SULATIOi1 PER N. Y. y STATE Ef1ERGY I CODE I i . ~ y I e FI;1AL I a ADDITIOPIAL COMMEPJTS; x _ ~ ro • X H H Q x - M c- '-1 a i ~ ro ; v H `.J ~ U ~ G J John M. BredemeyerEIII, President o°~ y~ " SUPERVISOR ' Henry P. Smith, Vice President .yi- SCOTT L. HARRIS " Albert J. Krupski, Jr. ~,f, a John L. Bednoski, Jr. 'jl~l ~~O Town Hall John B. Tuthill ~ 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 ' - Fax (516) 765-1823 TOWN OF SOUTHOLD ur . . " July 12, 1991 Samuels & Stee"lman Architects 25235 Main Road Cutchogue, NY 11935 " RE: Waiver-Lawrence J. Cervon SCTM#1000-126-11-21 s Dear Mr. Talgart: The following action was taken by the Board of Town Trustees during its regular meeting held on July 11, 1991: RESOLVED that the Town Trustees APPROVE the request for a waiver for the following: To add onto existing residence and relocate existing septic tank and storm drain rings as per survey dated June 14, 1991. Enclosed please find a check in the amount of $115.00 representing the difference between the full permit fee and the waiver fee. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Very truly yours, John M. Bredemeyer, IIT~ President, Board of Town Trustees JMB:jt enc. cc: Bldq. Dept. CAC New York State Department of Environmental Conservation _ FY Building 40-SUNY, Stony Broo'~,,,Aew Yark 11790-2356 - n - - " ~er+io'>'t DATE: ?eCl'nn~fr ~u) ~ ~ I ' - - ~70 =~.tnCOth' ~i11-~(~' - Re: ~:~73`d(r''~~~~' ~~`~J3'~"G-:_ Thomas G Jorling 3d ~ Mod-c.r(CG.'~ t a)1 Commissloner G2 .tneY~ Z I- a - ~PfoPer}Y _ $~6o Pecovi+c C~u~ 31va. - - Dear e21n(Or~ , l•.Au~e~) N`r it rF~ ~ ` A review has been made.-of your proposal to:_L.QY+~p'(,ec7~ A _(~1~+~eWQ.YI ~~Id. (A.Y~ ~.i~.\k~y ~9 well As ene.[osc Sul 2xis-~+n~ bTeez~~.y a.~ +11e ~~U~-~/'-~y f~e~e~'evtc~ a~~e And as peg- -the. Sl}c. plan p!'eparer.~ by Sa~:ue s a~ ~5-Feeln~ X17 7~f a"c( file{ survey by Au~'as-~ NaPP' d~fcd //~~/Sx a"~( l~s~ reins-erg Based on the information., you have submitted, the New York State Department Qf F„nvironmental Conservation has determined that the parcel project is: ' ' Greater than 300' from inventoried tidal wetlands.. _ 'Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9 20 77. Landward of the 10' abo mean sea level elevation contour on a gradual, natural slo e.~~lf~iyy9~~e-- be ~J~S201 -tht~-~- `{-he ~('CC~ oh fi!'115 /r!Cf.' w1~~eh i5 ou,~}- of DE~ jv,~tlsalc~toV~ is +h~+ area far~lt..~~ d~+h~e 1 ~ele(r~~ ' Landward of the topographic crest: of a bluff, cliff 'or dune which is greater than 10' in elevation above mean sea level. Therefore~'no permit is required~under'the Tidal Wetlands Act,(Article 25'- - `of.the Environmental Conservation,Law). Please be advised, howeder,-that ' no construction,..sedimentation or disturbance of•any kind may take place •.'seaward of• the 10' •contour or'topographic, crest without a permit.. It_:is _ ;:':your =responsibility to -ensure "that all- neces'sa'ry ptecautibns~~'are"taken"to' prevent any 'sedimentation .or other alteration or disturbance to the - ;..ground,surface or .vegetation in this area as a result of .your 'project.--: Such precautions may 'include providing adequate work area between the - 10' contour or topographic crest and the project (i.e. a 15' to 20''wide construction area) or erection of a temporary fence, barrier, or hay bale berm.. ~ - Please note that any additional work,. or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that. this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies.. - . - V~e//ry truly ~yoIur/~s, CC-Sav+e,~S ~S~et~?~G(h T7~!'~O~-S Dep~~R~ onal Permit Administrator } - ' ~ IJayi D~R`,dde,- - ~s~ ,=z;.' ,IM! Z 4 I~Z ~ , . -_k_ -....r- . . o~~S~FFO~~-~o G John M. Bred meyTerE I, President c~ y~ SUPERVISOR 4 Henty P. Smith, Vice President W SCOTT L. HARRIS Albert J. Ktupski, Jr. ~ • 'F John L. Bednoski, Jr. y~~l ~ 53095 Main Road John B. Tuthill P.O. Box 1179 Telephone (S 16) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD July 12, 1991 ~ ~ Samuels & Steelman Architects i~~ ~ ~ 2( 25235 Main Road Cutchogue, NY 11935 _ f RE: Waiver-Lawrence J. Cervon ~ SCTM#1000-126-11-21 Dear Mr. Talgart: The following action was taken by the Board of Town Trustees during its regular meeting held on July 11, 1991: RESOLVED that the Town Trustees APPROVE the request for a waiver for the following: To add onto existing residence and relocate existing septic tank and storm drain rings as per survey dated June 14, 1991. Enclosed please find a check in the amount of $115.00 representing the difference between the full permit fee and the waiver fee. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Very truly yours, ~i~~~ ~~i~6~t John M. Bredemeyer, III President, Board of Town Trustees JMB:jt enc. cc: Bldg. Dept. CAC FORM NO. a ~ j T05VN OF SOUTIIOLD BUILDING DEPARTb[ENT TOWN CLERK'S OFFICE , . SOUTIlOLD, N.Y. NOTICE OF DISAPPROVAL Date June 28.x 19 9.~ To „ Thomas C. Samuels, Architect (Lawrence J. Cervon ) 25235 Main Road Cutchogue, N.Y. 11935 PLEASE TAKE NOTICE that your application dated , . June 27 19 9 I for permit to CONSTRUCT AN ADDITION TO `DWELLING ........................................................at Location of Property ,,,.$460 Peconic Bay Blvd: Laurel, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section .....126...... Block 1 Lot ~ Subdivision Filed Map No. Lot No. . is returned Herewith and disapproved on the following grounds ,Under .Article, XXIII. Section 100-239.4 B. proposed construction is less that 75 feet from the bulkhead. Action required by the Zoning Board of Appeals, N.Y. State Dept. of Environmental Conservation and Board of Town Trustees. Bu'ildin Inspector RV 1/g0 FORM NO. a r T05VN OF SOUTlIOLD BUILDING DEPARTMENT TO1VN CLERK'S OFFICE SOUTIIOLD, N.Y. ~ U NOTICE OF DISAPPROVAL Date June 28.> 19 9.~ To .,Thomas C. Samuels, Architect (Lawrence J. Cervon ) 25235 Main Road Cutchogue, N.Y. 11935 PLEASE TAKE NOTICE that your application dated , , ;?une 2 7 , 19 9 1 for permit [o CONSTRUCT AN ADDITION TO DWELLING ........................................................at Location ofProper[y .,,.8460 Peconic Bay Blvd. Laurel, N.Y, House No. Sheet Ham/e[ County Tax Dlap No, 1000 Section 12b...... Block 1 ).......Lot 1 Subdivision Filed Map No. Lot No. is returned herewith and disapproved on the following grounds ....Under .Article XXIII Section 100-239.4 B. proposed construction is less that 75 feet from the bulkhead. . Action required by the Zoning Board of Appeals, N.Y. State Dept. of Environmental Conservation and Board of Town Trustees. s Bu'ildin Inspector RV 1/$0 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICI~ ~ SOUTIIOLD, N.Y. NOTICE OF DISAPPROVAL/ Date ../6~./~.~~p 19~~.. To`~j.~ . u~e; ii ///~e%e~/E//-P.~1 !~e'e t/ rte'/ PLEASE TARE NOT~IC~E~that your applic~ati~on dated 19 . for permit to ~Z~~r4~~r+/! • • ~..~~;%xe~'~r%`.'?2 ~G2G~%'L'-C~,Y~ . at Location of Property . ~s`.~°..~ , .r "`777 House No. Str ec~~ Hamlet County Tax Map No. 1000 Section , , .Block Lot Q`~ Subdivision Filed Map No. , Lot No. , is returned herewith and disapprov2ed~on~t/he followin; Groundfs .~.,U~.~,CC~/,1r.. . .,~:.1~ ..~ryru~ ~~~~Bui ding I ctor RV 1/g0 765-1802 BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST [ ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ 7 FINAL REMARKS: ~ ~.,7~~I ~j _ l~Pifi GA.sL/? __~~t,.~v t'~ t~ s~ DATE ~ ~ INSPECTOR ~ ~ _ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ SULATION [ ]FRAMING [ ]FINAL REMARKS. 2n.•u,~~a.~.i~,_~..., r~~ ~~n~~ -m--- ~ DATE oL-~ - Z~HSPECTOR ~ 3. A'ature of work (check which applicable): New Building Addition ; Alteration° . Repair Removal Demolition er kW • Js ~ . (Description) 4. Estimated Cost Fee (to be paid on filing this application) S. If dwelling, numberof dwelling units , , ~ , , , , , , Number of dwelling units on each floor , , • • If garage, number of cars • • • • • 6. If business, commercial or mixed.o~ccupancy, specify nature and extent of each tyke of use • 7• Dimensions of ex'stint; structures, if any: Front , ~ ~~~7 ~j~'~' ' ' • • • C77®t,J .....Rear Depth Height , , Number of Stories . Dimensions'Qf same strucfgre with alterations or adcJitions: Front , !~j-.~% , ' • ' ' ' Depth ~ .....Rear . J . .............Height ~ , ~~~T• • , • • • • Number of Stories . 8. Dimensions of entire new construction: Front . , , , , • • • ' ' ' ' ' ' • Height Rear m:':........ Depth . . ®Numbgf~9~Stories 9. Size of lot: Front , rlL.~t~ ~ Rear !~C?.. f 'Z L . 10. Date of Purchase De th ~ • , , • ~ ' ""'•'••••••~•••••••••..NameofFormerOwner Zone or use djstrict in which premises are situated i'~.?~f''~~~~~ ,:Q 12, Does proposed construction violate any zoning law, ordinance or regulation: r , ~ • ~ • • • 13. 1Yi111otberegraded ~ • 14. Name of Owner of remises ~:.~~,?,~s~ ~ • ' ' ' ' • • • Will excess fill be removed from premises: Yes No P 7 Address ~i~.'r~. ~e~*..~~9LC~ F",. Phone No. ~~~?~•L Name of Architect vU,~~ • Address ,~'~bAA ~'~?r-rJ, ~ phone No. ~~g Pe~?~• Name of Contractor ~~,~'~!k,?~ e~sJr.G;Uic? c~~ ~,,~goyt /9~~ ,bi~4~yt~Pf~ .~"1/~i ~~rp ~ ~ . • • :~~Address hone No... 15. Is this property within 300 feet of a tidal wetland? ~ye3•;t!•~.,. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEW YORK, S S OUNTY OF . ' ' • ' ' //'t ~~~~~`"r~ • . • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~ovc named, a is the (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 placation; that all statements contained in this application are true to the best of his knowledge and belief; and that the irk will be performed in the manner set forth in the application filed therewith. -orn to before me this ~:3.~`~.... .....day of .........19ypp Y tary Publi~!``~ " ~/~L°`"a_` e~ r:~~GyountyNr i LRVA L:OROSICH ~ • . , . NOptyP1Al10, State of Nev vork • , • • . • • • • _ • . • • • •PP j NO.~B5883,SuItolkCmNty ~ (Signatureofa Iicant Tara E,~tra Sept. s, t y9a . ~ ~ I r ~ ~~t „li~~js BOAC.O OF NEALTIi ( l' ~ FORMN0.1 ~ SETS OF PL\NS I; ~~Q Is~~tl~~ TOWN OFSOUTHOLD 1/S'URVEY ~ _ ~ ~ BUILDING DEPARTMENT ~CIICC~I`, _ . _ . I ToWNHALL serrlc~FOarl r ~ ?'`'i - SOUTHOLD, N.Y. 11971 - • - . • . • • • • . ' , , TEL.. 765.1802 ttt)TIFY .~3,/ _ ry' _p CALL • Jo Examined.,(,/~~I,..,...,19~~ hinIL To: Approved 19~~IPermit No. ~.~09.~ . Disapproved a/c I . .i. ' ~ ~ ' i . • (Buildi o Insp ) 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 ;ets 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 it areas, and giving a detailed description of layout 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 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 .hall be kept on the premises available fob inspection throughout the work. e. No building shall be occupied ors, 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 3uildin~ Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. fhe applicant agrees to comply with all',appticable laws, ordinances, building code, housing code, and regulations, and to i mit aut torized ins ectors on remises a p p ~ nd in building for necessary ins ~ti~oyns,. A I (Signature of applicant; or name, if a corporation) (Mailing address of applicant) !i ~~a State whether applicant is owner, lessee? agent, architect, engineer, general contractor, electrician, plumber or builder. \ame of owner of premises , , , , , (as on the t~rx roll or latest deed) if applicant is a corporation, signature of duly authorized officer. (Name and title of~~cjjorporate of~cer) Builder's License No. .,Q.~.~,1. , , , , ./.'f e~~/~~?~rf~ Plumber's License No. I , , . , , Electrician's License No . . Other Trade's License No. , , ~ I , Location of land on which proposed work will be done. (louse Number rS~treet Hamlet County Tax Map No. ] 000 Section ~y. °.f"......... Block , , , , , , , , , , , Lot . . Subdivision Filed Map No. Lot . (Name) State existing use and occupancy of premis/e~s and intended use and occupancy of proposed construction: a. Existing use,and occupancy , ,~!u,~,r'~. , . , , , ~'~~i~-°,~, , . , , . b. Intended use and occupancy ../!>,~.~1~ S/!L~~~.~ , , , , ~~n ' aa,r.{x 1 mwi r . o 3. Nature of work (check which applicable): Ncw f1uilJing AJJiticn ..l!• • • • • • ~Utcration . Repair , Removal Demolition ..............Swimming pool. , _ _ Tennis Court~~....,.. Accessory•Buildin ~ 8•• .Fence .Other Work,. 4. Estimated Cast . , ...~5?.~©~ Fee . (tn he paid on filing this apptication~ 5. IC dwelling, number oC dwelling units ~ . , Number of dwelling units on each [loor . IC garacc, number oC cars .......'z:.... ~ " ~ " 6. ltbusiness, commercial or mixed occupancy, specify natu/re~ and extent oCeacl[ ype of use 7. Dimensions of Gxistin^ structures, if any: Front . , tc~, ,F% , Rcar , .i~~. Depth . , , ~r% Hcigltt „ , , , Number a C Stories . , ~ ~ . , , , , , , , ' Dimensions of same s[nrcturc with alterations or adf~jtsons: Front , ,•`~~j, , , , , Rcar .~j.'.(<Q, ; , , Depth , .~Q'r~, , , , , lIcight . ! Nuntbcr of Stories . . ~ ~ ~ • 8, Dimensions of entire new constnuction: Front,.. Rcar , G-~',~~, Depth ....J~ , Hci;ht ; , Number of Stories . , ~ , • 9. Size of let: Front ~T . Rcar (,Q, , .~T.. D P[h ..~:~1! Z r . , t0, Date of Purchase 't.,,,,~~~,~,,,,,NameofFo crOwner ~~?U,~G-T....~41.'~~.c'~,,,,, 11. Zone or use district in which premises are situated L;f.~W, ,mss`./.~Y . ,~~ia,~ 7//f ~i~_ 12. Does proposed construction violate any zoning law, ordinance or rc~utation: L3. 1VitI lot be ze;raded !t'r® .1Vill excess fill be removed fro premises- 'bra 14, Name of Owner of premises e; c9/l>` . _ Address ~ ~/-~S Ff3~honc No.2l'~' ~LZ,q~~ Name of Architect s.~~1t;r't8 f~$'Z~~G.~ij/frtJ_ , ,Address Z~"23`°~..l~e?,~y2/~, phone No.`.~~~: r~~~~s~ Name of Contractor . : - ; .Address . .Phone No. . IS_is this grogertq located with in~300 feet of~a Cida1 wetland? =YES....tto.... *lf yes, Southold Town TrusCees Permit rosy be required. PLOT DIAGRA\1 Locate cleazly and distinetty alt buildings, whether existing or proposed, and. indicate all setback dimer:sior.; property Lines. Give street and block number or description according to deed, and show street names and indicate ts•;:_::. interior or corner lot. STATI: OF tiEtV YORt:, S S COU; ITY OF . ,Suffolk , , , , , , , , Thomas. C.. Samuels . , . being duly sworn, deposes and says that he is the apptic~: (Name oC indivtdua( si~nirtg contract) about named. Flt is tltc , architect, , , , , , , • . (Contractor, agent, corporate officer, etc.)• ~ ~ • ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ' of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tl: application: that all statements contained in this application arc true to the best of his knowledge and belief; anJ ttrat t:: work will be perlomted in the manner set forth in the application (fled therewith, Swom to before me this • ...27th ...............day of....June ............19.91 'r`otary Public, ~ i ,County tlo.+tb351.?5 C QjwSl{~; la Stsllalt r.,,,/.!'z . ~t>reii}rs~nt~y~ (Signature oCappliean' i • BOdFD OF HEALTH , • FoRrvtN0.1 3 SETS OF PLANS • SURVEY " " TowN of 5OUTHOLD ctiech ~ ~ ~ ~ ~ • " " " ` BUILDING DEPARTMENT SEPrIC FoRrl • • ~ ~ ~ ~ ~ ' TOWN HALL " " " • $OUTHQLD,,,N,Y_11ff71 tr'pTIFY; y, / TEL.:7G5.1II02 CALL 7~.~.-~~C7~ Examined . rP. 2 ~ 9~ . • • • • . !9' MAIL T0: Approved . • . , . 1'3~ F . Disapproved n/c /Z-.~~~.. . ...G;~r~\/ . ii • - • • . (Building Inspector) ~ ~ • • ~ ~ ~ • • ! APPLICATION FDR BUILDING PERMIT y~~' ' Date ..~~2•',` j/- • t 79 . . INSTRU CTIONS I a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building sets of plans, accurate plot plan to sca)e. Fee according to schedule. b. Plot plan showing location ofilot and of building ~InsFector,uritt or areas, and giving a detailed description of layout of property mustsbecdra~ n otn the diagram which is parz oC thissapf 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 a lie shall be kept on the premises available ~'or inspection throughout the work. e. No building Pp ant. Such pear shall be occupied pr used in whole or in part for any purpose whatever until a Certificate oC Occupant 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 t} Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances < Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with a4l applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises~and in building for necessary inspecvtni~osn~~st.`, Ii •(Signature pT a ant~.•... . . r name if a corporatron) ! C(~?~~~~i~ a/v ss f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contracto/r,~electric an,~um~r or builder r~r-G'-~.1..~,~C . Name of ownerofpremises ...~~ri~/.~,~~J~'` (as on the tax roll or laces[ deed) If applicant is a corporatton si nature of duly authorized officer. • {Name and title of corporate officer) Builder's Liccnsc Na_ , , I! Plurnbcr's Liccnsc No. Electrician's License No. ~I Otbcr Trade's Liccnsc No. , , , , ; , , , , , 1. Location of land on which proposed wor1~ will be done; .~~,,,~d f louse Number , , . ~.L:vQ..... "fY~L •~St^reet. . ~.7*. Hamlet • . County Tas Map No. 1000 Section /l . Block 6 Lot . Subdivision • • • . • • • • • . . 1=.ilcd ~fap No. r (N;unc) .Lot • Stztc existing use and occupancy of prcmisos and intended use and Deco • • . ' pantyo~P(aF?D;~ ,p,tltsintction: A, t:xistin u ~a~y 9j g sc and occupancy. ~4?'::~Y~;~, ~ R •~.:°I'~~`r~-~x ,ice„ B. 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