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HomeMy WebLinkAbout20036-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTZFICATE OF OCCOPANCY No Z-22450 Date JULY 12, 1993 THIS CERTIFIES that the building NEW DWELLING Location of Property 615 HARBOR LIGHTS DRIVE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 71 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 27, 1985 pursuant to which Building Permit No. 20036-Z dated JULY 22, 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 ATTACHED GARAGE & DECK AS APPLIED FOR The certificate is issued to KENNETH & ERNA PETERSON (owners) of the aforesaid building. ' SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL AUG. 21, 1990- 9-SO-104 UNDERWRITERS CERTIFICATE NO. N-147156 - JULY 23 1991 PLUMBERS CERTIFICATION DATED MARCH 16 1991 - MICHAEL DAWSON ' di g Inspector Rev. 1/Sl ~ , 1081[ NO. ~ , TOWN OF SOUTHOLD BUILDING DEPAQTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) k N~ Z Date ....~~e'?.~~..~ i9.(.l. ~ Permission is hereby granted to: l~.t".r~.X24;~~....`~...,~~kxlc~t...~..,t.~~~.~?~.... i to ..~r.~~i.....1,...~cRzz~c... .......~.....Gn~i~t~ ~ ~ f~~ ~ ot~ premises located at .....~p..~~?~.s............• ....:F.......~~( ~ County Tox Map No. 1000 Section .........7.,1....... Block Lot No..:'~ I pursuant to application doted /~.7 19.~. and approved by the k Building Inspector. Fee S.• " r{y,7; i E ~ o~._ uildi for ~ Rev. 6/30/80 , . _ . _ ~ ~ _ '°s sosat xo. ~ 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) 19R. N°- 18110 Z Date ....:~.1./ Permission is hereby grunted to: ~:s`~ to ...~~x~.~~-r.~..ca..... ................~~......c~~~x'~-:.....~....~...... ofremises located at .....SPI.~ .......1: ..~,....~if:............................................... .......................................................................oo.yy......................................................................................... County Tax Map No. 1000 Section ..........l.,l........ Block Lot No......~~ pursuant to application doted ~~~7.C/5.......y.~ 19~~~.._, and approved by the Building Inspector. ~ Fee ~~i~~rc~~ /3~~3~ ~==~~~r~.... SIN uildi Inspector Rev. 6/30/80 FOEM NO. A 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) ~~.yN"" Q! ` ,3~gFl N° 15 7 5 0 Z Date t'}~u'.-~-~.....~. 19?~..7 Permission is hereby granted to: - ~L~ ~:.?.~.~..a. ~ • ~ ...t..c.~.,s to. .~r~Jv~.....9.......t~"1~4.~. ~ .j.. lJ vU s...................................... at premises located at ~............f.. T.:'.•.^:.:::'.:`:'~... • ~p"`^w!-e'~v~-- County Tax Map No. 1000 Section Block Lot No...... a... . n 2 pursuant to application dated ....~.~S.V1....~.!~i 19.~..(., and approved by the Building Inspector. Fee ~~:9.: s~.... ~ 4.~.~ , ilding Inspector Rev. 6/30/80 ~ ~ ir~T~ FOH.M NO. E 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) 15750 Z Date ~~-~.....1.,~ t9~.~ Permission Is hereby granted to: s.~........ ~ s...................................... at premises located of .............1.=.~:~:~:~:.........~...'~:............d'Q;~--;..... County Tax Map No. 1000 Section Q~~........ Biock Lot No...... pursuant to application doted ....~.4V?:4.V.1...~.!~ 19.~~., and approved by the Bullding Ingspector. Fee $..~~:9 : g~.... i ding Inspector C~KSL~.~,c) ~ 7 (o S~'L Rev. 6/30/80 f FOBM NO. D 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° 13 7 6 5 Z Date ..~.~,.~:~-Qi....~.~ 19.~.~~ Permission is hereby gronted(~to: * ~ ,j._ ...~...7..!~ a? ...N~-......-.4~!.................... II .~`l...QSc4~.3.~ .R........l~.1.:...:...~..~.~.,~..~. oI ~ 1 _-A ..~....3Sr .C?~......' .IrV`%s{rtvf.:tAi~.q.../r.1:a.... Q.:.. ..))./~(f' • ~I premises located of ~ .5-..... ~ a`~~ County Tax Mop No. 1000 Section Block ......a............ tLot No......sa~. pursuant to application doted ..~4rnfc!'5 .....0~..7.............., 19.~.~1:, and approved by the Buildfng Inspector. Fee 5...~a.`.I. J'D.. ~ C~ ~-G~-.--+ Building Inspector Rev. 6/30/80 ~ _ _ k T w Form No. ~jf~_;~~ TOIJN OP SOUTIIOLD ~ ~l~~ BUILDING DGPARTPiENT ~f • TOIJN BALL ~Z~- 765-1802 i APPLICATION FOR C1;RTIPICAT); 01'~000UPANCY //7~r/ 1. This application must be filled in by typewriter OF, inlc and submitted to the building inspector with the follocaing: for new building or neca use: 1. Final survey of property caith 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 C~;mpliaace from architect or engineer responsible for the building. • p 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and `,r "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. Zf 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, ~\dditions 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 - Residen~~t77i////pp~~1 $15.00, Commercial $15.00 Date .,V~}~1~~, ^_w Construction....... Old Or Pre-ex ~ " fistitng Building. , ocation of Property, • • ,lQ,~,~j, , • ~„~f~,j'~~~ Y~~ ~ • • 1 House No. S. »11=~....~j, pvy~~:;U'..~... • Street Hamlet ewer or Owners of Property.. ~F~i;1.N5~. ~~~-t.\ ~ • y~ t' T. A. ;.unty Tax Clap No 1000, Section.. ~.G.,~ • ......Bloclc....~'. .......Lot....... baivisio.~a0 3 .Piled Pfap•...........Lot......... rmit No.;-(~^••• „Date Of Pcrmi.t.. ..............Applicant........... .filth Dept. Approval....... ••••••••••••••.....Underwriters Approval I=nning Board Approval .uost for: Temporary Certificate........... Final Certicate........... aY,oo ' -Submitted: , c o ~ a ~~~s ~ APPLI~,\NT' . ~ THE NEW YORK BOARD OF EIRE UNDERWRITERS i',kc.~'. 1,gQl)77R ETUREA4 OF ELECTFfICITY, ~ ' 88 JOHN STREET. NEW YORK, N~W '~fSRK 11©038- ~ _ ~ , Date ,Tt'tl?f ;)3x7.99'( APPlicatian No. on file '~~)9O~$,9{k4 fi) ;{!a'i);~h _ THIS CERTIFIES THAT ' H only the electrtcol equipment as deacrihed below and introduced 6y the applicorit homed On the shove application numher in the premises of IiFNNii'I'f[ A.N)ti9'ts~:SQi~; [4iL;tBCtR f:i.~f1"C O~It~E, 5U~f"!'NOLI'J, ftii:Y. in thefollowinR location; ~y ~~-~yy vgRllt7"+r'~C~(Z7I3~I" LJ BgsQment LJ /st FL ~ 2nd F'l. .Section Blcek Lot ,rul,v a>~: i sty 1. '.i was examined on andfourzd w be in coriEplianre u~it.h the reyuirernent.4 of this Roard. 4? la FIXTURE FIXTURES RANGES COOKING DECKS - OVENS DISHWASHERS EXHAUST FANS ° ECEPTAGLES SWITCHES OUTLETS INCANDESCENT FWORESCENi OTHER AMT. K.W. .AMT N.W AMT. K.W. AML K.W. AML M. P. S i . ~ .l ~ / E~ I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCNS BELL UNIT HEATERS MUITI-QUTLET DIMMERS AML K. W. Oll H. P. GAS N. P AMT NO. A W. G. AMT. AMP MIT. ~ AMPS TRANS. AMT: H p SYSTEMS qMT WATTS I NO.OF FEET SERVICE DISCONNECT NO.Of S E ~ R~ V I C ~ E PMT. AMP. LYPE METER ~ TW ~ ~ ]W 3 ~ BW J$ AW NO. OF CC. COND. A. ,W. G. NO. Of HbIEG q' W NO OF NEVTRAlS A. W. G' G EQUIP. PER B - OF ~fp COND. OF HbtEG OF NEUTRAL OTNFR APPARATUS: S11'ai~>?CHt HY O 7"Y,r;R~.a MO'I'i)ieS:1-~.~i kf,.i~., L-1. fi.N. TRA('tf L-LGH'l'XNt:t _7.7, *iV0'1'k~; '1'h.i s a pal'f.iaa , TLtTt .a c~amft?eCe t;c+r$i.£i.c>tl;ei. S•r>;vx's ,;l,bt(1/f~.Ai,t3Mt~t'!'sYJM l~ltr.~$` exb3d--~ ~ P.O. BOX 1JF,fl , SOiTi'({Cj(~X)x FlYx '),q.9ryt ~ OENFRAIMANAGER ' Per l~~i , ' This certificate must not be altered in any manner; return to the office of the Board if incorrect Inspectors may be identified by then credentials CQRY FOR BUILDING DEPARTM~NT.'tN15 COPY OF CERTI~SICAT IJST; NOT,~E ALTERED IN,ANY MANNER ~ _ is. TEL. 765-1802 o5~Ff01k~~ TOWN OF SOUTIIOLD G ~ ~ OFFICE OF BUILDING INSPECTOR z P.O. BOX 728 yr ~ TOWN HALL yO~y~~ ~ SOUTHOLD, N.Y. 11971 ' 1 C E R T I F I C A T I O N Date March 16, 1gg1 Building Permit No. Owner Kenneth Peterson (please print) Plumber Michael Dawson (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. ~i/i/~ (plumber's signature) Sworn to before me this 16th day of March 19 91 ,k ~C ..r ~,r1 g~ , Notary Public Notary Public, Suffolk County LINDA K.DAWSON " Notary Pu61ic, State of New York No. 4694698 Qualified in 5uffalk County , Tsrm Expi-.es March 30, 19..~a° INSPECTORS Victor Lessard $UFFO(,f- Principal Building Inspector OVO BOG Curtis Horton y~ SCOTT L. HARRIS, Supervisor Senior Building Inspector o Thomas Fisher x Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector ~,j, ~ O~~ Southold, New Yotk 11971 Build ng IFnspector ~O~ ~ ~a Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD July 15, 1991 Kenneth & Erna Peterson 146 John Street Hauppauge, N.Y. 11787 Dear Mr. & Mrs. Peterson: Re: Building Permit #18110-Z Premises: 615 Harbor Light Dr., Southold, N.Y. Suff. Co. Tax Map #1000-71-2-2 Dear Mr. & Mrs. Peterson: Please be advised that the above building permit has expired and a renewal of the permit is required. Kindly submit your check in the amount of $468.25 and a new building permit will be issued. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gar Fish, Building Inspector GJF:gar INSPECTION DATE COMf4liNTS ro z H FOUNDATION (1st) zs. J/ ~ K ~U ~ J~G K -tip G~ FOUNDATION ~ (2nd) l/ - 2. z r O p, ROUGH FRAME B~ / PLUMBING? ~ L H 3. ~ ~ ~ 6 INSULATION PER N. Y. y v STATE ENERGY CODE ~ ~ x ~ a r 4 . - '3 i FINP~. ~ J J G ` l ADDITIONAL COMMENTS; d'. ~ o - . , eLcd~ o off. ~ ~ x ~ H 9 y z 6' I . • /f/Y/T/"C,~ O ~ ,3 ~ w v.. , x D ra q" 1• 9 1 r'{ c r ,v, w, x G ? H d ~ ~ p ro~ ,d. ~ ~ \JL~ ~ 8/fOZ p o ~ ~r ~ MAY 3 0199 ~ ~ ~ - U L%~ ~ ~~3~~g~ /`f ~ TOWN OF SOU7HOLD ~~NNL.: 1 .j' - Ora~aG~a Cgcva~ ~ , Q ~u bu%lahecd ,0 5.64°05liy"E. ~ ~tOOQ ~ ~V , a: i o ~ o ~ ~ ~ z n a° oaf ~ ~ ~ - , X4'7: ~ a ~ ,_ti J ' ` `jurrJer ccx+sa*'~} ~ ~ (vaCarrt! pools 'r" ~~i ~ - ~ r frame hours Q! ~e~_ ~ ~3' ~ . ts" ~ ' Q N q~r ' N . l~fr:@r. ra.r ~ N N tasenrerr+ e1.3.5 ~ f (V ~ 4 Y NYR!!' i . ~ ~ ~ ~ ~ ~ Q! I (vc~ca~n~h~ (rceidartce) i (rc3iden t ~ ~ SUFFOLK CO. HEALTH DEPT. APPRO.VA4 " ' H. S. NO. g- so-!O4 S~ 5u~2v~YE0 ~ STATEMENT OF INTENT A7' THE WATER SUPPLY AND SEWAGE DISPOSAL MBAYV[~VO/~ SYSTEMS FOR THIS RESIDENCE WILL ~W[Y Off' SOCJ77-K~L..O,N.Y. CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (SI APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL QF CONSTRUCTION ONLY DATE: H. S. REF. NO.: 9- 50-144 APPROVED: (Yof+e: („o-f- numbers shown rmfer ~fo "Ma~ of Harbor Lights Frs~t'a.- Sec.2," L!!4d rn 'Fhe 4.~:,,[[c Cou Clerks SUFFOLK CO. TAX MAP DESIGNATION: J JJ _ ~ DIST. SECT_ BLOCK PCL. - of~r"ae ds More nfo.468f. f0o0 C3'TI 2 rn.° ' E'leva+ion~ r~~r ~ mer4n spa level. .OWNERS ADDRESS: PErG-~23oN ~ f4lo JOHN 5T. (-r®t.9'z'9-6'74}° ' ~ ANed:p 20, 0300 sq. f~F. DEED: L.~N/A~ P. 0 =Iron ~bi6it? TEST HOLE STAMP _ ' ~ - ^ .'.':er'?+ob or ad^litinn " J" :i1B T'3w }'Or'M1 §j.32Q _.Y~ i.. :dW. `q +h~3 s+irveY man not iraanng r~ Q~ ~ t „cyrv9YO/3 Inged Sea{ M ss{ 01:311 nbt ttB Wneld¢red ~tn ~ r J JJLC true cony, ~ 7i ~u"ab{eHS ir. ~ca!po hereon shall run \ ~ $e ' cr? xo -na nerspn ?Qr whom tho eurvt>1• , ~:-a,ai.,,; >^b pn has behalf to the \ .C!!ed +~~i'.~nv. gpvernman;al ap¢npy anQ ' Jma~7~ ~ ~ a~ruuon bci¢d hproan and , t° i^~" =>=~•,~aaes of the landing ipeii- ,uacn. <3oanmteas are not uanst®rehle t.~caViaeef Jerr1.2B 1985 ip..a:r.~ona+'nstitutronsnrautrs ¢qu¢nt r rr...;.~a. Marl 23 , !5£39 SEAL /oF na~~ ,~p~cP~CK ~4y O 9 a' ~OY~~`r3'~ , < s ~~,'(.IrVQfd'Cl OCT. [g7~ r d:i:=e~.~, r R ~~RI-CjC~ TUI~., P. ~,~Zp®~a:a~~'-"w ""T_. o ~~~'L o d~.V r SJP r! LICENSED LAND SURV YORS , } l3REENPOR7 NEW YORK t ~ N vv _ G.v~Z 11.x,,, ~e`~° ~sfl•-, (a l-F-y-+ b~- art.. ~r~ ~•~.~d~--°b e 1I Kenneth A. Peterson II 146 Jahn Street c Hauppauge, NY 11787 x.: ~ ~ - ~ ~ ~11 ~ ~I ~ ` ~ ~ ~ ~ ~ ~ ~ -i: ~ 0~1 ~ z ~ 1 ~ I ~ M1d f R' d ~ ~ _ _ 1~ z~ dz,""" y 9 .r w. .rv~~ ~3 t ~',:r! ha, ..Y Vr..~='x "Gi'f, a, VICTOR LESSARD i• ? i'i EXECUTIVE ADMINISTRATOR CJ9 ~ I ~ ~ ~°~~'+s ~ TOWri Hall, 53095 Main Road 4 (°~'t"°-"~~',~'~ P.O. Box 1179 (516) 765-1802 ' . Southold, New York 1 1971 'y.a~ 'j1~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 24, 1988 Erna & Kenneth Peterson 146 John Street Hauppauge, N.Y. 11788 Re: Suffolk County Tax 161000-071-02-02 615 Harbor Lights Drive, Southold, N.Y. Building Permit /6157502 Dear Mr. and Mrs. Peterson: We have received complaints that the above building is being used without a Certificate of Occupancy. This is a violation of the Code of the Town of Southold, Chapter 100 Article XIV Paragraph 100-144. Upon inspection of your file for the above Building Permit it was noted that the permit has expired on Sept- ember ]3, 1988 and that there has not been any inspections made since 1]/4/85 although it is obvious that the fram- ing seems complete. The above is also a violation of Chapter 100 Article XIV Paragraph 100-141. In order to avoid any legal action these violations must be resolved immediately. Thank you for your cooperation. ~ p~~~N Very truly yours, l~~$f~~- / c:o4'~'2X~ po-2 Southold Town Building Department `'I ~i NSW'' i'~/W`~?`~~t~'N Xn~„ . _ a V ~.ti-C~~iV ~-r/) 1~::~R~ ~k~zL~~~`~ ?`"`ZJJ < Vincent R. Wieczorek _ ~ , ---eeeNNN X~ Ordinance Inspector _,~z ----T-~~~- ^ ice. - - - - _ , - - - - - TOWN OF SOUTHOLD Memorandum from . BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, BOX 728, SOUTHOLD, N.Y. 11971 765-1802 f r c ~.u- ~ tee. ~ ~ ~ Z~ u ~ ~ ,fie r ~ - ~ ~ _ ~ _ f ~?atiua`ry ~9, 1'98 t Kenne~hsA FetersQn;-,; " ~~46 ~'t~hn Str~~t . f7 _ tl _ - _ ~ ~aL3pp9.Llgre7 y r1.~ z~' w ~ ~ w 3 ;f .Dear Sir,' ~ ~ y Please find enclosed.:an appla~~s~t~on fias~a bui~~1rig;pex'mi't. ~ s ,Included with this appli"catzon ~is a copy of the"der`~ifi~ate of:: ~ Oocupancy `dated' 12-11 79 .and a c"oDy 4~~'a i~~L' ~let~'te~ &.atE~T l0 2~ 85 ind~,~ating ..that ,no :permit is ~e,s~uirec~:j Also ~,x~.cluded a.sta a -plot survey = s1~ow~ng ~ia;ffolk=Count~~DeptY Rf. He~lt~ appcsv`dl" and ~ r~vased :plot ~ . 3 f ~ - " n.f - ~ ~ ~fr a m~ - survey. Tn`~aclditior>~ to, the above, three sets o.£y cozlstruction p~:ans are ° included-. .Set~f~1 ;is maxkedf Yn ~e ' . ~ ~.ndica~~rig tk~e "~,o1~,owing -changes ; . a) the sec-ond floor=will, be unfin,is$ed-:_pzxtil; future ex ;;.pension ` x ~ b) a_.poure~." "foundaton wzl~, rep2"_~ce the C,oticrete :blocks tY~at are presently shown a '°;c). 'the.:"main beam walk: be c~;~.ngerl;.from steel to wood' eon } strutted o°f.:three,pieces ;o#' 2"~~2" fastened --together 4 d) the exterior siding w211, be c~~n~ed from plyweod'to . `1;'x6'", tongue and ~;roov~e cedar, t your comments andyor corrections ;~whia~i ire ~e.e~~~,r8d. to ~Yielp.~ne t'o -meet the buil~.a~ag code:; are appr;eciatect. ShoL~1d any que~ta.ons `need t.o o ~3e an"sweredy please feel-"free ,to contact me;; _ Sincerely"yours; , E 5 g w.> e pp s~ Myth {3 r ~ ¢3~~ f I _ S 17EW YORt. SZ'A22: D''.1'AT224tffNT OF Fs34l34TAL cxx~xOrt L~gulatory Affairs Bldg. 40, SUNY - Roam 219 Stony Brook, New York 11794 (516) 751-7900 PA1~2' F• (kxrmissioner ' October 25, 1979 Kenneth A. Peterson 146 John Street Hauppauge, NY 11787 Re: 247 15276-0325, Fredrick Reese, Construction of a one family dwelling on lot 48, Map of Harbor Lights, Bayview, Zbwn of Southold. Dear Sir: As a result of your inr.~uiry ooncerninB the above referenced T~aroel, this Department has conducted ar. on-site inspection. 47e have found the parcel or (pzDj~) tp be entirely bulkhPaded in excess of 100'. 24~erefore, pursuant to Part 661, Official Compilation of Codes, Rules and Regulations of the State of New York, Section 661.4(b), no permit under Article 25 ('Tidal 5~7etlands} of the FS~virarare2xtal Conservatic~ Law is required. Very truly yours, f 1 iL~NTFy J. I,ARKTT1 Regional Permit AclnisListrator DJ7~cr ,i Memorandum from . BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, Box 728, SOUTHOLD, N.Y. 11971 765-1802 ~~Q~ e~~.~ . bad.- ~v\ 5 a~-~c~~cr . ~P?~ ~ 1_ ~ 765-1802 ' BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL REMARKS: ~w_ r ` ~ ~ i ~ . ~ / ~ DATE ~ ~G ~ INSPECTOR d~ `i ~ ~ / ~ ~ V 765-1802 BUILDING DEPT. INSi~ECT10N [ ]FOUNDATION i5T ~~GH PLBG. FOUNDATION 2ND [ INSULATION [ ]FRAMING ( ]FINAL REMARKS: d" ~ /G4We-~:- DATE INSPECTOR r' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND IN CATION [ ]FRAMING [ FI AL REMARKS: ~ ~ A J l/~- d ~ ~Z - DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS~• DATE INSPECTOR ~ ~ o rss-1802 T~yG~~ BUILDING DEPT. INSPECTI~JN [ ]FOUNDATION 1ST (~'1 ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ 7 FINAL REMARKS: iLVJ k ` E ~ ~ €s f ` ~J ~ DATE ~ ~ INSPECTOR ?V iv~ G _ ~ _ ~ - ~~r~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ] ROUGH PLBG. % [ ] FOUNDATION 2ND [ ] INSULATIO [ ]FRAMING [Y] FIN ~p_ REMARKS: __~~~d~- ~ - ~ DATE D ~ I INSPECTOR .~V 1 p~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: C,Q_ t F k DATE ~ 0 INSPECTOR t s ~ r_., _ _ ~ ~ l~~~o 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING INAL I REMARKS: C'o~,__ n ~¢r- t e 3 { ~ r/ f DATE I INSPECTOR { i i a, FORM N0. PO TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P,O. BOX .728 TOWN FiALL SOUTHOLD, NY MAIN ROAD 11971 SOUTHOLD, NY " - APPLICATION FOR DEVELOPMENT PERId;T " Instructions: The application to •che Building Inspector includes (each. in dup icate) 1. b'orm No. 10 filled out in ink or typewritten, 2, Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed ca.n comply to the Local Law No, 1-1980, Chapter La.6 of'th© Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 1}6-17 of the law to minimize flood damage: A. Anchoring of structures, including tanks and mobile homes B, Use of construction material and methods C. Design and location of utilities D. Subdivision proposal with drainage, public utilities design and base flood elevations _S ec~ifi~c~~Standards as required in Section Ia"6-18; iA~. Rosiden~ial construction I B, Non-residential construction C. Mobile homes ( The applicant must submit plans and specifications as well as any other _ information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevaticn or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such ` manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3, applicant must submit certification by a registered professional engineer or architect that the standards set ? forth in Section L}b-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazzard area (V Zone) L}6-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that :hkte provisions of ' L~.6-19 are complied with, Mobile homes are prohibited. The lowest portion of the structural members of the lowest floa.r cannot be lower than the base flood elevation with all space below open except breakaway walls. Sand dunes, Tf sand dunes exist on the premises and the applicant pro- , poses to alter same, plans and specification must be shotirn in detailed ' nature of any alteration submitted. Buildin Permit. A Building Permit is also required for any structure. Botha eve opment and a Building Permit must be issued before any work cmn start in n special flood hazzard .zone. -A writ-ten -di-sapproval or_a permit must bo issued within ten (10) working days. ' During construction, the inspector shall be notified in time so he may make the required inspections. , Upon completion, the required certification fo the final elevations and work must be submitted before the approval to use or occupy can be approved. ~r (Fill out the form on the back of this sheet) 4/eo ,s 3, Application Received Disapproval Issued i Permit ~ 19....._ I 19~.. i 19 ~ FORM N0. 10 APPLICATION N'OR DEVELOPMENT PERMIT Ira th© Town of Southold ...._a.~.._____.--- i9~ 1. Type of Development: Proposed: Now Structure (inc.ludirrp storage tanlts~ Addition and/or AltarationL'~ Flood Proof Below Base Flood Elevation p Other (specify) 2. Elevation DAI:A in, relation to above mean sea lavel of: (a) Lowest floor plevation, including baaement ~ f©et ~ inches (b) In a V Zono, bottom of lowest structural member. ~ f'c~ec _ inches 3. FIRM--Flood Insur~rnce Itato Map,( Zone desig-ln-ati(Co~~ns /-1 - ~ Owner of Premises', ~FNDJ~ f-rN1~,~`~~-CFC"S~~1~ 5. Location of Prope¢~ty: NODS k" f# u'Y'fi~E ~'T Id~l HAMh.e f'~'~-~'-'~~ County Tax Map No,., District, 1000, S©ction N Block M~ Lot(s) Subdivisions°t I~ ~Wt' o }'c~,,,,~.c{',• Filed Map ~ Lot{ s)~ 6. Permission to be '~grAnted: ~ lOwrrer as above~~ Now Owner - Under Contract; ~ Losseo~ Contractor ~~q' Z - pHOnF HuM OFr NAM C•' /f"MnT GtvE',Y 'N~'vt /aN 1? NI AfLWG A i2=r$ 7. Approval from ether(s) beforll© Pel1rmit is issued: . ~CMf~I' Ndl' DEC~`~-I`~a~~-•~~ ~r~_ v, wL~rLANDS (Yawn Board)___ - xEALTx sERVxcE q-'~ ;0-In~l olaoll3 zBA BUTLDTNG PERMIT _ ' _ PLANNING BOARD~~~ 8. I, ~F~ ~~SQ the applicant, am the Owner Co- Owner` , New Owr}er~ , Undo.r Contract~~, Lessee Agents Con- tractor ~7, and r~groe to comply with a17' applicable sections of the Code of the Town of Southold; County, and, State and to admit authorized in» epect°,ors to premises autharized to. perform or have performed the said work and to make ',and file this application, that all etatam®nts contain- ed 3n this application are true to t2ae hest of my knowledge and b©lief and that the work will be perfa.rnned in the mannerset forth in the application filed thRrewith. • STATE OF NL'W X RFC COUNTI' OF S5 ~'r Signrr£ur. e SWORN TO TIIIS ~ DAY OF5.9~ Notary Pu~d~aaoT,M ~ Natary PubIIC, Sta4e of New York Nb. 52.4607853 SR1:0111.€7cpIrOS March 3Count _ Applicantts maiYin addr©ss and phone ~ if nat given above: 4~so Nom', qr D`' .QQ~_ ~?~u.-~..~ - ti.~--, FORM NO. 1 D D THOL SOU T WN OF O BUILDING DEPARTMENT ~ "5~ TOWN HALL SOUTHOLD, N.Y. 11971 Q •SpE~O~ TEL.: 765.1802 Examined . • 195• Received , 1 9 . Approved ~ c?.~•c~,~r, ao • 19d~~~Permit No.~ b,s~Z~. - 3 ~R/-•~-~ e-p U ~ _ Disapproved a/c ~ C.D• D.e.C. {Building Inspector) oYe•T.~X, ~e„v /~e.Li~z.aaw- APPLICATION FOR BUILDING PERMIT Date .Sf1h~.."~?q..:..., I9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets , or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessairy~ inspections. ~t (Signature of applicant, or name, if a corporation) (Mailing address of applidant) ~1`j~•~ State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. ........~`tyn1~.~.....'.1.........J Name of owner of premises S 1 ~ r~N~~;v~ . A ~c~ S`!~h~ ..~i=-~F.~.u04~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Buiider's License No . . Plumber's License No . ; ; . ~p C.~k ~F"~•trMr I~F~ ~ ~I ~I RF J n 9' , i ' I `Electrician's License No . pc°a~eit~~~~ p`~ -i•{~y~ (p~~pn~ ~f~o~eunl , y Other Trade's License No . . 1. Location of land on which proposed wlork willL be done . . House Number ~ Street Hamlet County Tax Map No. 1000 Sectti~on 0.7) Block a:........... Lot . ~ . . Subdivision ..I'!l3r;~.~ ~:~~l,~s • ~~Sta{~s • • .Jl~~ Filed Map No. ..~b.U1 Lot • • • • • • • ~l (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....uN.ll.Sw.~ . ` ~ . t-,~ b.lntendeduseandoccupancy ...~~:1Y!':~:~',~!':gid,k"'ptG.~,,;,,,,,•,,,,,,,,,•, ; b - 3, Nature of wor~ (~chec~w~liic~ plicnole): New Building ...x Addition Alteration . Repair sss ~qDD`` val r Demolition ..............Other Work C~ ~ S (Description) ~ lff''f~ 4. E hma"ted Gost; ti,,.,,t~~,~ Fee , . ~~nv (to be paid on filing this application) 5. If dwellmg,~number of dwelling units , , , Number of dwelling units on each floor ..1~~~ . If garage, number of cars ~ . R~? s=~ . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structure, if any: Front NJ~.... , ..Rear , . N~.kl........ Depth N . Height N , Number of Stories N~ A . Dimensions of same structure with alterations or additions: Front , N Rear . A . Depth ly/J•~.......... .Height 1~b~F1... , Number of~~Stories N~A....... i . 8 HemhYsion~~f entire new construction: Front r.>2~ Rear ..~y.~. ~ Depth ; : Sy , . g . Number of Stories ~ . iSr s . 9.'Size of lot: Front ...19n ~ . Rear 1PO~ Depth ..:~.4Q~............. . ....a.Ja~~7. 10. Date of Purchase 1 . ~ .Name of Former Owner r, ~c~,~ cl~.k ~S~ • • • 11. Zone or use district in which reTitises are situated . tCF ra i~nl'~iFl ~ . f~,ror~.l~~c i,c„v,.l')'v~r.~.~ . . 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be re raded y - S • . • . . . .........Will excess fill be remo ed from remises: Yes "J P Name of Architect r~'~rx~tJ, • • • ' ' ' ' • Address Jy1o,~9hN S-k . • Phone No.9~'lq.-.b'~tJ~,..... . 14. Name of Owner of premises . • • . • . • . • • • • • • • Address ...................Phone No............... . Name of Contractor ................Address Phone No........ . / PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block n}~mber or description according to deed, and show street names and indicate whether interior or corner lot. i ~I • i ' r STATE OF N]X COUNTY OF S.S F N.N F~Y.\ . C-SC9.f~ . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..................'.......L............................. (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 this application; that all statements container} in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set'iforth in the application filed therewith. Sworn to before me this I n''',,' .,dayof.. ...........,19~~ Notary Public,`"~~~~N.~b~ County THOMAS DAVIryO NOT~Fr - ,'c , ~ vew YnA . . 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