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HomeMy WebLinkAbout20025-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21172 Date NOVEMBER 25, 1992 THIS CERT'IFIE5 that the building NEW DWELLING Location of Property 1425 MIDDLETON ROAD GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 4.1 Block 2 Lot I2.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 29, 1991 pursuant to which Building Permit No. 20025-Z dated JULY 13, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH GARAGE UNDER AS APPLIED FOR & AS PER ZBA #4027. * The certificate is issued to HALSEY A. STAPLES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-22-MAY 13, 1992 UNDERWRITERS CERTIFICATE NO. PENDING - OCTOBER 22 1992 PLUMBERS CERTIFICATION DATED NOVEMBER 19 1992 - ROBERT VANETTEN *THIS CO IS FOR THE FIRST FLOOR ONLY. BUILDING PERMIT REQUIRED TO FINISH 2ND FLOOR. ui ding Inspector Rev. 1j81 TOIBa[ NO. • TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT € (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL € CQMPLETION OF THE WORK AUTHORIZED) `s N° Z Date 19.4!. ? i f Permission is hereby granted to: ~ 4 to ~s...~.M0. ..4:~ f k Jn~ e~~ JJ at premises located at ..f!..`1.~:~~ ....5.~~~:?......[t~ ~.,.~:QA.`1;.1.9 f County Tax Map No. 1000 Section .....Q.~ Bloak Lot No......~..~•.:...~..... ` pursuant to application dated Y.7...'.!X1..'::~'t. pp y I 19..`.j..~. and a roved b the Building Inspector. i f Fee S. °~.9~:. ..r~:S: TD,t j B g Inspector i f i i Rev. 6/30/80 Form No. 6 ~6~~lC.~~ .`,~1~ TOWN OF SOUTHOLD BUILDING DEPARTMENT p ti ' TOWN HALL ° ~ NOV 191992 q~~ ~ 765-1802 j S!.;'.<. i;EP''d. MOWN US° SUU'TFiULd'! `APPLICATION FOR CERTIFICATE OF OCCUPANCY . r~ µ,e,a,,~„„.~,,a..~~ 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 17 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 `e 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 - Residential $15.00, Commercial $15.00 'y Date 1?!~?Y.... ~.9.f..1~9.Z New Construction...,!,...... Old Or Pre-exisht~>ing Building......... Location of Property N.).i.QD~~~JV Rp:..... ~:!rE'~[Y!~ House Nos./ d Street Hamlet Onwer or Owners of Property..N.~G,~~,l,. ~...J~,Z~/,~L~f County Tax Map No 1000, Section ..............Block................Lot...................... Subdivision ....................................Filed Nap........../.~.Lot...................... Permit No. ~ ~ ~.d?`.~ .....Date Of Permit ................Applicant. JI ~L/L~y.~j ~ S%.~~~~5.. Health Dept. Approval ..........Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... ~J D n Fee Submitted: ° Q 2Z ~ / ~ / 1~~~~!~• • •APPL~ AN1 . `~L'-7 c~~FF~(/~•C' TEL. 765-802 ~O O,, TORN OF SOTtTTB(O~.D ti~ < OFFICE OF BUILDING INSPECTOR ~,I. ,I~ P.O. BOX 1179 ~ ~ ~ ~ ~e TOWN HALL ' O/~a.~ ~~p~ SOUTHOLD, N.Y. 11971 ~7 C E R T I F I C A T I O N s ~ ~ ~ ..9..1992 Date ®y . l9 l9 q~ • / Building Permit No. a. Owner ~i7~lr,E~ ,R, $r/~~(,~'y (please print) Plumber~o.~e~i ,~~=11`c,~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of la lead. ' G~nv C/~ (plumber's signature) Sworn to before me this day of No ary Public Rotary Public, County N~~JpO~YCE M. WILKiN3 No.1t96?2~46. Stu k~Co~un~ Term Expfnas June 12,1$.3 r1c:LD I.:S:'°O;iUf1 I~Ue,:n ~ i;ONM€NTS ~ .~;J. ' ~ 0 H FOUIJDATZON s t) v~ FOUNDATIOtJ (2nd) _ ~ _ 1 m 2, y s z o~ P,OUGH FRAME & vt PLUMBING 3. ~ ~ y IIJSULATIOPI PER N. Y. ~ y STATE ENERGY - Cry CODE . a°.Oq. 4 . / 3 i H ~ FI;JAL _ ,~I ADDITIOPJAL COMMENTS: ~ - ~ a M - x ~ \ x ~ a H H o '~O 2 ~ m o0 > .:o r ~ • - y h x _a w - H APPEALS BOARD MEMBERS j%:~~ii~te-19,(;~n ~ SCOTTL.HARRIS Gerard P. Goehringer, Chairman ~ 1 Supervisor Charles Grigonis, Jr. ~ r~'' ~ ~ Town Hall, 53095 Main Road Serge Doyen, Jr. r{ ~ ~ re ~ ° i~p P.O. Box 1179 James Dinizio, Jr. ~_,w~ ' ,y~;~ ~ F Southold, New York 11971 Robert A. Villa r"+~ ; , ~ Fax (516) 765-1823 Telephone (516) 765-1809 ~ Telephone (516) 765-1800 -.<r~ BOARD OF APPEALS TOWN OiF SOUTHOLD July 16, 1991 Mr. Halsey A. Staples 29 Middleton Road Greenport, NY 11944 Re: Appl. No. 4027 - Variance Application Dear Mr. Staples: Transmitted for your records is a copy of the determination rendered by the Board of Appeals concerning the above application. Please be sure to return to the Building Department and any other agency for permits or other approvals which are appropriate for this project. A copy of this decision has simultaneously herewith been transmitted to the Building Department for its file and update. Very truly yours, Linda Kowalski Enclosure Copy of Decision to: Southold Town Building Department Suffolk County Department of Planning ^ SC02TL.HARRIS APPEALS BOARD MEMBERS iy r, t ~ Supervisor Gerard P. Goehrin er, Chairman ~ ~ W e~ Charles Grigonis, Jr. ~ Y~ ~ I Town Hall, 53095 Main Road Serge Doyen, Jr. ' ` ~ ~s; P.O. Box 1179 James Dinizio, Jr. a, e ~ Southold, New York 11912 RoberC A. Villa al. ~`''?r ,,~~~~M ' Fax (51~ 765-1823 Tele hone 516 765-1809 ~ ~ ' ~ Telephone (516) 765-1800 P ( ) '~?-i~zr~zl BOARD OF APPEALS TOWN O~ SOUTHOLD ACTION OF THE BOARD OF APPEALS Appl. No. 4027. Upon Application of HALSEY A. STAPLES. Request for variance to the Zoning Ordinance, Article XXVIII, Section 100-281A(7) for permission to construct new principal dwelling structure upon premises which is nonconforming and has not been held in single and separate ownership as exists since April 9, 1957. Lot is nonconforming, having a total lot area of 22,668 sq. ft. and 25 ft. frontage (width) along Middle Road in the Hamlet of Greenport, Tawn of Southold, NY; County Tax Map Designation 1000-41-2-12.1. WHEREAS, a public hearing was held on June 7, 1991, and 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, and the surrounding areas; and WHEREAS, the Board made the following Findings of Fact: 1. By this application, applicant seeks a variance for approval or recognition of the subject lot, having a total nonconforming lot area of 22,668 sq. ft, and nonconforming road frontage of 25 feet along Middle Road, Greenport, Town of Southold in this R-40 Zone District. 2. The premises in question is identified on the Suffolk County Tax Maps as No. 1000-41-2-12.1, located near "Fleetfield," a 1942 (preexisting) subdivision filed by Clarence C. Fleet and Henry L. Fleet. 3. The record shows the following conveyances of land within this block (located along the easterly side of Middleton Extension and the southerly side of Washington Avenue) immediately surrounding and including this parcel as follows: FORM NO. 3 TOW1V OF SOUTHOLD BUILDING DEPARTbiENT TOtiVN CLERK'S OFFICE , SOUTHOLD, N.Y. NOTICE OF DISAPPROV'/AL Date 19 ~ 9...~.l. qtr! PLEASE TA~K~E,N~O,T~ICE that your application dated , 19 . for permit to ` •°;~~~/,G~?i~, ,Ll....6't!~ . 4~ • e~i.:...... at Location of Property . ~y`.!1~l r Qom,, , _ „ i v ....,~f........ ~q! House No. Street .ll.Q~ let County Tax Map No. 1000 Section ,7~ ......Block Lot ~ . Subdivision Filed Map No. , ~Lo~t No. /f.~..~...,Q....... , is returned herewith and disapproved on the following grounds .(/~~.`~~....`v,~:/~'. ~.~~r~~ .,d., ,/DD- 8 7 std-~.`." : i a~-~~.. . ...........n..~..o Bu' ~ di~ Inspector ~ • ~ M V RV 1/g0 ' 95-70~fi (10190)-25c ~ NEW YOHK STATF DF.PARTM[NT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBFR ~ tFFECTIVE DATE 1-4738-00218/00001-0 + Februar 19 199 FACILITYIPROGRAM NUMOE R[s) PERMIT EXPIRATION DATE Under the Environmental Conservation Law (ECL) March 31, 1994 TYIPI---E-yyOF PCRMIT (Check All Apphcahle Ooxesl L_INJew ?ftenewz ?Modificalion ?Permil to Construct ?Permit to Operate P oltect on oiltWater ~ SPDES 17, Titles 7, 8: ~ Hazardous Walste Management 3. Article 15, Title 15: Article 19: Article 34: Water Supply ~ Air Pollution Control ~ Coastal Erosion Management Article 15, Title 15: ~ Article 23, Title 27: ~ Article 36: Water Transport Mined Lantl Reclamation Flootlplain Management Lotngelsland WellsS~ ~ Frelshwate~r Wetlands ~ 6NYCRRI3 0: Radation Control Article 15, Title 27: ~ Article 25: a Other: Wild, Scenic and Recreational Tidal Wetlands Rivers Article 27, Title 7; 6NYCRR 360: 6NYCRR 608: ~ Solid Waste Management Water Quality Certification PERMIT ISSUED TO TELEPHONE NUMOFR Halse A. Sta les c 1 ADDRESS OF PERMITTEE 919 Main Street G een CONTACT PERSON FOR PERMITTED WORK TF LFPHONF NUMBER Ro L. Ha'e En-Consul ( ) NAME AND ADDHt55 OF PHOIt CT/FACILITY 29 Middleton Road Gre LOCATION OF PROIFCTIFACILITY reen ort COUNTY TOWNICITYIVILLAGE WATERCOURSEIWCTLAND NO NYTM COORDINATES uffolk E _ N4 _ DESCRIPTION OF AUTHORIZrD ACTIVITY onstru si0g]e family dwP7lin~ rani++Ary~y~~~_d.r-i-,veway e in accordance with the attached NYSDEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (See Reverse Side) and any Special D Conditions included as part of this permit. RRCtrLATORX Ai:FAIRB PERMIT ADMINISTRATOR ADDRESS REGION DUILD1NCi 40 D STATE UNI V'ER51'I'Y OP NEI~V XORK AUTHORIZED SIGNATURE / S rd~>t u2%19%91 ~ Pa e 1 of g a 1 GENERAL CONDITIONS Inspections 1. The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an aythorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee Is complying with this permit and the ECL. Such representative may odder the work suspended pursuant to ECL 71.0301 and SAPA 401(3). A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify, suspend or revoke this permit when: a) the scope of thg permitted activity is exceeded or a violation of any condition of the permit or provisions of, the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since khe permit was issued. 3. The permittee must submit a separate written application to the Department for renewal, modifica- tion or transfer of this permit. Such application must include any forms, fees or supplemental infor- mation the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. 4. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order qr determination previously issued by the Department or any of the terms, con- ditions or requirements contained in such order or determination. Other Legal Obligations of Permittee 6. The permittee has accepted expressly, by the execution of the application, the,full legal responsibili- ty for all damages, d,rect or indirect, of whatever nature and by whomever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not ,convey to the permittee any right to trespass upon the lands or Interfere with the riparian rights of ;others in order to perform the permitted work nor does it authorize the impair- ment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. " 8. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights- of•way that may be required for this project. i Page 2 of~ ~ 95-20-6a (10190)-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 ( 1 9 That if future operations by the State of Now York require an al- other environmentally deleterious materials associated with the teration in the position of the ~Iructu re or work herein authorized, or protect. if, in the opinion of the Department of f.nvuunmm~tal Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruUtmt to the fwe navigatron of said shall be removed evenly, without leaving large refuse piles, ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplam or deep holes [Fiat may have a the people of the State, or cause loss or de>trucuon of the natural tendency to cause damage to navigable channels or to the banks of resources of the State, the owner Inay be ordered by the Department to a waterway remove or alter the structural work, ob>[rucuons, or hazards caused 14 There shall be no unreasonable interference with navigation by the work - thereby without expense to the State, and if, upon the expration or herein authorized. revocation of this permit, the structure, fill, excavation, or other 15 If upon the expiration or revocation of this permit, the protect hereby modification of [he watercourse hereby authorized shall not be coin- authorized has not been completed, the applicant shall, without expense ple[ed, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental Department of Environmental Conservation may require, remove all or Conservation may require, remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its former condition. No claim shall be made against the State of and flood capacity of [he watercourse No claim shall be made against New York on account of any such removal or alteration. the State of New York on account of any such removal or alteration. 16. If granted under Article 36, this permit does not signdy m any way 10 That the State of New York shall in no case be liable for any damage that the project will be free from flooding or injury to the structure or work herein authorized which may be caused 17 If granted under 6 NYCRR Part 60R, the NYS Department of Environ- by or result from future opemlions undertaken by the State for the mental Conservation hereby certifies that the subject protect will not conservation or improvement of navigation, or for other purposes, and contravene effluent limitations or other limitations or standards under no claim or right to compensation shall accrue from any such damage Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 11 . Granting of this permit does not relieve the applicant of the response- (PL 95-217) provided that all of the conditions listed herein are met. bihty of obtainin6 any other permission, consent or approval from 18. All activities authorized by this permit must be in strict conformance the U.S. Army Corps of Engineers, U.S. Coast Cuard, New York State with the approved plans submitted by the applicant or his agent as part Office of General Services or local government which may be required. of the permit application. 12. All necessary precautions shall be taken to preclude contamination Roderick VariTuyl of any wetland or waterway by suspended solids, sediments, fuels, . Such approved plans were prepared by solvents, lubricants, epoxy coatings, paints, concrete, leachate or any on 10/ 16/ 90 SPECIAL CONDITIONS The permittee shall require that any contractor, project engineer, or ocher person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its special conditions. 2. Hay bales shall be staked end to end on the downslope edge of any areas of filling, grading or excavation. They shall be maintained in place until all disturbed areas are permanently vegetated. Trapped sediments shall be removed to a suitable upland site before the bales themselves are removed. 3. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass and mulched with hay or straw within two days of final grading. Mulch shall be maintained until a suitable vegetative cover is established. 4. If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed as soon as weather conditions favor germination and growth. 5. The permittee shall allow access to Department personnel at all reasonable times during normal business days, and after reasonable notification to the permittee and proper identification as Department employees, for the purpose of conducting inspections o-r investigations in the regular course of their duties pursuant to the Environmental Conservation Law, notwithstanding signs or other notices purporting to limit access to the property. Supplementary Special Conditions (A) thru (J) attached. DEC PERMIT NUMOER I-4738-00218/00001-0 PROCRAMIEACILITY NUMOER Page 3 of 4 e 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FO DATION 2ND [ ]INSULATION r [ FRAMING [ ]FINAL f REMARKS: ~~~~r-r--~ CO i ..it,0.~l.A f ~ ~ DATE ~ INSPECTOR /Z~ ti ;m 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION i5T ~ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] IN5ULATION [ ]FRAMING [ ]FINAL E REMARKS: ~ i F r k x E 11 ~ DATE ! INSPECTOR 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] RO PLBG. [ ~ FOUNDATION 2ND INSULATION [ ]FRAMING ~ [ ]FINAL B / REMARKS: `~v~~°t~i ~lL.~ DATE v~ ~ '/_INSPECTOR o~os~~~oc~.~ 0 Gy< TRUSTEES r°ia ~ SCOTT L. HARRIS John M. Bredemeyer. III, President O ~ .tC Supervisor Henry P. Smith, Vice President y4p~ a0~ Albers J. Krupski, Jr. 1 l~I Town Hall, 53095 Main Road P,O. Box 1179 John L. Bednoski, Jr. Southold, New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES ~ Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF 50UTHOLD Telephone (516) 765-1800 October 24, 1990 Mr. Halsey A. Staples 919 Main Street Greenport, NY 11944 RE: Waiver/SCTM #1000-41-2-12.1 Dear Mr. Staples: On November 19, 1990 the Trustees inspected the above referenced lot as to the placement of hay bales and found everything in order. Therefore, you may go ahead with the construction of a single-family dwelling. If you have any questions, please do not hesitate to contact this office. Sincerely, John M. Bredemeyer, III President, Board of Trustees JMB:jmt 1 • SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all permits: A. If any of the permit conditions are unclear the permittee shall con- tact the Division of Regulatory Affairs at the address and telephone noted below. B. A copy of this permit with supplementary conditions and approved plans shall be available at the project site whenever authorized work is in progress. C. The permit sign enclosed with the'permit or a copy of letter of approval shall be protected from the weather and posted in a con- spicuous location at the work site until completion of authorized work. D. At least 48 hours prior to commencement of the^project, the permittee '"sha 1 comp ete an return he top portion of the e`n'clo~'ed receipt~o`rm certi in at a is u-Yly-a~i3re o an_, unders an s-a33 provisions-_a~td con itions of this perms Within one week of completion of tie perm e_ work, the bottom portion o t a orm s a a so a com- oleted anrd returnees E. For projects involving activities Co be accomplished over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to the commencement of resumptipn of work each year. t F. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by i the Regional Permit Administrator prior to undertaking any such mods- - fications. The permittee is advised that substantial modification may require submission of a new application for permit. G. All necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. H. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, New York, NY 10278, (Attention: Regulatory Functions Branch), prior to commencement of work authorized herein. J. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General ' Services, Tower Building, Empire State Plaza, Albany, NY 12242, which may be required for any encroachment upon State-owned lands underwater. Regional Permit Administrator,,, ' NYS Dept. of Environmental Conservation Bldg. 40, SUNY-Room 219 Stony Brook, NY 11790-2356 (516) 751-7900 DEC # ~~~1~?~S~~~oai~~o~~o'~ Page ~of Lf _ _ 'v` ' ~ 1 y ~ i; d,Lbr,r ) - : -i O.ST. ~'dnN Yn•[,6ylltp`OM •F 2/'562 a u p yv~ l v / zr . ~ ~ G ~ ~ o is C f.~ . _ __"1 i o tRi - - 1 ~ 'tii-• ' Y ~ N' D i S p. Y' V 2 hl ~ o Gl h I , i _ I. * tP R f i ~ C " ~ ~ ~ ~ WI q ~ r+op.rnP uor•rap~d ~ _ ~ •tV ~ \ IIG t 'ice: 2 _ ~ I~~O I N qy nl,.a ~ ~ Boo ~ ~,,p o ~ to IZ I• @ i~ q- o~ z { ~ "ti~`C' + IC i7 t b I °m ~ ~ ~ ~ ~ C -q ~ tJ ~ V 1 ~ ~ ~ -X05--- ~ tt ~x ~ ~ `C7 ~ ~ a b ~ jfi ~ _ . ~ ~ ~ ~ oa/oq ~e+y ~s.7~O~' auq 0 fG~ y~ a - - -,5..~ v -1-s . _ s. ~ ~ _ 41 r z ~ i 'C .1`' u' A ~ ~ { O .r ~ A m C ~ a L~ r O L*~ J~ ~ ~5. 2 m ~A ~ e i Z N~ ,/~C ~ ~ M~. m b(l~ a o n b bW . Sq C• gyp- `~o ITl $ a ~ ry ~ .l_ ^t ~ ^ 3 m N~ v=nOmc C OAS ti m wz OGin vveyz m zv~m 0: la R q \ 4 -NI O W ~ 7 A ~ 1 O A m H< O N O O E r m ^fi 4 W A ri ~ m i4 f .On ~ O z ~ m~ y ~ 3 N m ' m P. •p Ci ti p n O -~~'n ~ O-~rA-~+ ~ y J 't ~'m ~ m ~ z ~ ~ n p ~ ~ ~ y ti ~ n t~ o ~ O O z z ' m ~ c o n v x Z~ m" o a 0.. x'" N A ~aoDm %li' . :r~~ ~ 4 z x t~nzm-zi ~ i - ~ z ~ n ti~ R o ~ m x r R l:~a:.~.~ r ~•Lt , BOARD OF HEALTH . • • , • 4, " 3 SETS OF PLANS j: ~~~p •'I A FORMNO.1 SURVEY •P~~ ~ Ciw~ L J . II~~~`', i; TOWN OFSOUTHOLD CHECK (ltS~,..,..__ BUILDINGDEPARTMENT SEPTIC FORM f..l.::;,. t. ~ TOWN HALL TOWfu U€~ StsU ~+d~ vOl1THOLD,N.Y.11971 NOTIFY - TEL.: 765-1802 CALL (516 .~7.7.-0.~7.~ • , , • , Examined . I.'~.., 19 9 ~ MAIL T0: Halsey A. Staples Approved . ,t.~, „ 1991, permit No. c~v.~ ~ 29 Middleton Rd. Greenport, Disapproved a/c N.Y. 11944 1,.};c. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......March 28, , ly 91 INSTRUCTIONS a. Tltis app]ication 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- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described- Tlte applicant agrees to comply with all applicable laws, ordinances, building code, housinti code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 29 Middleton Rd. ,Greenport, N. Y. 11944 (Mailing address of applicant) , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises .,HALSEY ,A. • STAPLES (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. _ _ _ _ (Name and title of corporate officer) Builder's License No. . . Plumber's License No. ~Q~/, , , , , , , , , , , , , Electrician's License No. ..,Rl~!.......... Other Trade's License No . . 1. Location of land on which proposed work will be done. • • Middleton Road, Greenport, N.Y. 11944 HouseNumbcr Street, ~ Hamlet 2 County Tax Map No. 1000 Section Block , . , , Lot 12 •,1 Subdivision Filed ~1ap No. Lot . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacant Lot b. Intended use and occupancy ...single • family, residence - ,-'v! 3. Nature of work (check which' applicable): New IIuildin Re air ~ g Addition • • • • •~h ~1€e,(atiort . P Re ` moval Demolition er Woi~`~.' . 4. Estimated Cost , •50, 000 • (Description) Fee..................................... l P g • dwelling, number of dwelli • • • • Number of dwelling units on eachlflo This application) If ara~e, number of cars ng units ,One • s ~ 6. Tf business commercial or mi,~ed occupancy, specify nature and extent of each type.of use,, , , , , , . , . • • • 7. Dimensions of existing structures, if any: Front , , Rear ' ' Height Number of Stories . ' ' ' ' ' ' • • ' • • • ,Depth , Dimensions of same structure',with alterations or additions: Front ~ ` ~ ` ~ ' ' ' ' ' ' ' Depth Rear................. ...Height , , , , , , , , , . Num ber of Stories . a, 8. Dimensions of entire new construction: Front , Jtear . ~ ~ ~ ~ ~ ' ' ' ' Height . Number of Stories Depth . 9. Size of lot: Front. z.l•1.~49, Rear.1.5.~:17,;•'"'•""""..Depth .~45.ana;iz;~;6i""• 10. Date of Purchase , 1968 ~ • • • • • • • • • • • ' Jose h Diaz ...............NameofFormer Owner 1 1. Zone or use district in w}ticlt premises are situated ..residential ' ' ' ' ' ' ' ' ' 12. Does proposed construction violate any zoning law, ordinance or regulation: , NO , , , , • ` 13. Will lot be regraded A~;gtJn~l, house , ,Will excess (ill b removed from premises: • ...Yes • ~ ~ ..No 14 Name of Architect remises Hlalsey A.• ;StaplesAddr~ss2.9 Nl?dd~eton Rd. L1.7 0 P .....Phone No... .57~, , •••••••••••......Add'ress .PhoneNo.. • IS.Isnthisont=aocterrt•'loo••••~"~••""....Address .......PhoneNo........,, P P Y ated within 300 feet of a tidal wetland? * If yes, Southold Torrn Trustees Permit may be required. r+A'1'~'~~ See attached Trustee••and D.E.C.permitDIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. i VI ~~qG.~ of rNev~ - ~~R~~~~~PO~, M•_~ ,f ~ PROPof~p ~ i Nous~ , ~ ~ , 1\ o--~o-v.-n---~u 101 ~ SF6VT ~I~fiZ. F~9J~ q p15T - JQAD 1 ( I Si~cT 0 ~-1 B~.ocN - ~ J U~9V/ No~s~ II, ~cC ~,~,1 STATE OF NEW YORK, COUNTY F...... 'IS.S g' • ' being duly sworn, deposes and says that he is the applicant ( ame of individual si n'ing contract) above named. He is the (Contractor, agent, corporate officer, etc.) ~ ~ ~ • ~ ~ ' ' of said owner or owners, and is duly authorized to pe~rfc~m or have performed the said work and to make and fi(e this aPPlication; that all statements contacted in this applic~[y~on are true to the best of his knowledge and belief; and that the work will be performed in the manned set forth in the application filed therewith. Sworn to before me this Notary Public, ,~~sc./,'l(, ; , , ~GL!f-~~County NELEN R DE VOE No. 4767875, Suflalk County ~ ~ ~ • . 7 mRExPi~es A4a cth 30, 9ow~ A (Signature of applicant) 8 ~~wu; xw > 7 W ~ 'o-1 ~U 9 °~a~ p N W ~ j. 1 ~ ~ i n c". ci z ° M o r a ~ ff .5~" v~ ~,u-e dai io u~ . 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I £:?L.f: P ~~yy / i ban; aF; i ,L?E,~ V y i ~ A j - ~ ~ ES ~ D;. ' ~ - - 1 D ! STATEMENT OF INTENT ~ _ ? JOp O ~ j THE WATER SUPPLY AND SEWAGE DISPOSAL ~ +v 14 r„",t ~l 1{~:rt.l'JI Oi'ii`ckLl li $ENI~ICES ~r"/yab, SYSTEMS FOR THIS RESIDENCE WILL 'J ~ ~ ' ~ CONFORM TO THE STANDARDS OF THE e 1 ~r~'m~ao',,ntlwca'~' SOa~ a ci~p iM~AY .A'..~-- ~ ;;IL4, N•~l_, _ _ _ SUFFOLK CO. DEPT OF HEALTH SERVICES. 1998'-' o ~ ' - ~ r, ~I'=wd •+a Ur supply fa'tlAles im' Ib1s w ~ 8~- ! l51 ~',;.n•~ar,.en^rru i~:':f'~."'r"!.rl ;~cPaapl~nenY antlPor fessaoo ~s '9 ~3~; ~ ' V P • o0'r-+ eg~:o:: •s a~i! Ruud t~ be sGh;ta~COr . e~ ~ W f d /r ~ ~ / la- Q ; t~j' 0 //d/ SUFFOLK COUNTY DEPT. OF HEALTH Chest ni~r~oi Wastewater na6ement i +<x D ~ ~ I SERVICES - FOR APPROVAL OF ~ ~ t rV / CONSTRUCTION ONLY i _ r ~ \ a. ~ ~ ti ~I DATE: ~ _ ~ ti~ p~ {S. LY. ~ ~ H. S. REF. NO.. BB~SO^ZL 4 _ j I APPROVED' ~ p t i SUFFOLK CO. TAX MAP DESIGNATION: ~ ~ a N } 1i 0. I II2 STORY -"II`Z` 4~ ,p. - A o. / 1 ~ DIST. SECT. BLOCK PCL ' to I - / FR.HO. IrC J/~ U 1 ~ 1040 U'/. Z !%.1 y, N ~ ~ ,a ~ f I ~ ~ ~ , ~ ~ ~ OWNERS ADDRESS: ~ 4 L-- h m l1a 2~ tilid~/e f-o,~ /z~r7d ~ y ~`-rs---' D I Gr~eefe <~rt k. Y_ /I94# G Oi o ) ~ FUruRE ~ ~ J ~r STOOP >s , \ Cu ~ ' 01 z'"~ N. 73 °5~8'!O°E. /I+'~.Gd ~ . ~ '~4,~ '1 .,7 fie.,! ~7"I-' 059 - r - 7 ,rJ U _ . _ _ _ _ _ / 5} Q / DEED: L. 66$•i P. 2$4 ' ~ D N ~rrnf5o3'cu' uJ'u ter /irfe ' < % ~ tq - - LJ ~ ~ TEST HOLE STA P . ~ D 1 ar rvE ..eia r/-, ~ ~ ~ 141 ,.r~ y D w- A / f'GH- fYON! ~ } I. 1, f ira ..}C + lr WOSHiirq'Fysr>• A?6. tnf•-Fur( r, a i ' 5, 73 'S~'!o"a^,'. 22215 ~l ' n ~ ~ !e 'G/9Gr Alt ~Bt~G t9 '*'J m"Y rtWro rM t,ortmry ~ ~ ~ /o.?ur d [r, i ~urgvorm irko, us3Va ,Q; xr FI'lJ 7`%~ !""J d}~c~ ~~yi tJr rYE't1 Io C~:~voiia nuo ~vct Be amoldu~ro'J ' b 1 - - - _ $ f u-rrn.eso inNcet •tl he+roan ehrl! mvn / I~ - - .:,n=tofhe pnr¢an futiwhmn tau e,•~~..; i/ Ilf A,C_E_A: ZZ,d68 .S_B. N'Y: i~r,},. ,gin. ann on hm mEr~i:wrr~ G. r++•r nnl h~ i ho. ~ _1~'1 '3 :_1 f"' _ 1-~{~:C7;=i_ Itii'J-y~' sand ~ 0 Ld ~9 c~-y, ; Amsndcn' Man 7, l'c~89 j rr.~k,.. f..U !~'OX~: Oct. r6,l49Q h~av« JAN.7 1992 r ,SEAL ~"'7 v C Y ~~3. ~7 A1'i_. t=_'.~ JAN.13+1992 grd?2l . ,4.' _ .,r - - - - T p>G1C Vgti ~ A7" , ~"'~~n e'jn ~ v+rl ! I - - - RODERICK VAN,7UYL,~.C, o tsra ~frP rC 1 "~~~Zo'"'`-"""' 'co'tl p ~ rrlon<r rrt8 rrt` _7'(_J_?v rf VF--' wS°JU:'NU., i:,r N.'Y'. a'1.. r p ~"~<,S 25j ~rb~ LICENSED LAND SURVEYORS I7 ~~'LP.,~Pp} GREENPORT NEW YORK Tl1lOYNI kMf Mr]]f