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Home My WebLink About20101-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCf No Z-20931 Date AUGUST 12~ 1992 THIS CERTIFIES that the building ACCESORY Location of Property 700 JACKSON LANDING ROAD House No. Street County Tax Map No. 1000 Section 113 Block 4 Subdivision Filed Map No. r~ATTITUCK ~ N.Y. Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 14~ 1991 pursuant to which Building Permit No. 20101-Z dated SEPTEMBER 26~ 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 ACCESSORY GARAGE IN FRONT YARD AS APPLIED FOR AND AS PER ZBA #4038. The certificate is issued to of the aforesaid building. JOAN ZEISLER (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-235189 - MAY 13, 1992 PLUMBERS CERTIFICATION DATED N/A /f B~ilding Inspector Rev. 1/81 · O~.M NO. ~ TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N*_ 20101 Z Permission is hereby grant, ed to:, at prem,se, located at ...~..~:~.~~.~.~~......,~.~..~....~s~. ~.. ~ ~,/, .... .~.../ ....... County Tax Map No. 1000 Section ../.../....~... ......... Block ........ ..~.... ....... Lot No.....~... ............... pursuant to application dated .... ~.~.~..~... ...................................... , 19..~/., and approved by the Building Inspector. Fe. Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements.' For existing buildings (pr$or to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land ~ses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applicJtion an~'~ 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 i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pooi,$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 - $i0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .. August ~ 1992 New Construction ........... Old Or Pre-existing Building ................. Location of Property2... 700 Jacksons Landing Road Mattituck, N.~.. ... ~.0 House No. Street Hamlet )nwer or Owners of Property JOAN ZEISI~R . ~ounty Tax Map No I000, ' 113 ~ Section .............. Block ............. Lot. 9 ;ubdivision , .................................... Filed Map ............ Lot ..... 'ermit No 20101-Z .Date Of Permit ............... cant ROBERT BAYLEY ............... 9/26/91. Appli .................... ealth Dept Approval Underwriters Approval N-235189 fanning Board Approval .......... equest for: Temporary Certificate ..... Final Certicate .... 25 O0 Submitted: $ ....... ~ ..................... qqS . ....... ............................. aO 31 APe ic THE NEW YORK BOARD OF FIRE UNDERWRITERS t¢~0'~¢'~ BU..AU or ~-.CT"~C,TY ~- 85 JOHN STREET, NEW YORK, NEW YORK 100~8 Date H~ ~3~]~ Application No. on~ile 7~'/(~ ~ ~,~ / ~2 ~ THI~ CERTIFIE~ THAT only the electrical ~ulpmen~ ~ ~scribed be~w and intr~uced by t~ applicant ~med on the a~ve application number in the premises of in the fotlowlng location; ~ Basement ~ Ist Fl. ~ 2nd ~. ~a [{ / Oll~l' Section Bilk Lot tc~sexamlnedo~t [~ ~5 ~t) 9~ andfoundtobelncompllanceu, ith the requirements of this Board. RXTUR~ OUTLETS DRYERS RECEPTACLES SWITCHES RXTURES OVEN5 EXHAUST FANS FLUORESCENT OTHER SYSTEMS E OTHER APPARATUS= E R NO, OF CC, COND A W G, PER ,e' OF CC. COND~. C NO OF HI-[EG A'W'G' ina OF NEUTRALS A W'G' OF HI-LEG[ OF NEUTRAL P.O,BOS 817 RT 2S GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentiais. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. I~NSPECTORS ~- ~ctor Lessard Principc~t Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 28, 1992 Richard & Joan Zeisler P.O. Box 1260 Mattituck, N.Y. 11952 SCOTT L. HARRIS, Supervism Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 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) No Underwriters Certificate on file. The check is outdated. (Returned herewith Your check ~0179) Please submit new check in the amount of $25.00) No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plufabing being issued after April 1, 1984). BUILDING PERMIT % 20101-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. JOAN ZEISLER P.O. BOX 1260 MATTITUCK, NY 11952 PAY "~ ~. ~ ~ TO THE ~/~/ ~ o~__~ o~ ~ ll'OOOJ,?~JI1" ~.Opt. kO?Cg~,p~; ,.O].j,,,,pO?3,? 1il" -- ~ DOLLARS INSPECTORS Victor Lessard Principa! Building Inspector Curds Horton!: Senior Building I~spec~or Thomas Fisher Building Inspector ;'. ,,~ Gary Fi'ql3 ' Bmldmg InSpector Vincent R. V~iecz~Je~k' Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 28, 1992 SCOTT L. HARRIS, Superviso~ Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Richard & Joan Zeisler P.O. Box 1260 Mattituck, N.Y. 11952 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) No Underwriters Certificate on file. XX The check is outdated. (Returned herewith Your check $0179) Please submit new check in the amount of $25.00) No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20101-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD DECgMBER 6, 1991 ROBERT T. BAYLEY, ARCHITECT BOX 595 gASTHARION, NY 11939 JOAN ZEISLER 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) No Underwriters Certificate on file. The check is ~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20101-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: JOAN ZEISLER 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ]~ISULATION / FRAMING [~ FINAL REMARKS: DATE FIELD FOUNDATION (1st) FOUNDATIO~ 2. ( 2nd ) ROUGH FRAME & .PLUMBING I]~SULATIO~ PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION ~N 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL A~PEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Grigonis, Jr. Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Telephone (516) 765-1809 BOARD ,OF APPEALS TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (51.6) 765-1823 Telephone (516) 765-1800 July 23, 1991 Mr. Robert A. Bayley, A.I.A. 150 Lakeview Terrace P.O. Box 595 East Marion, NY 11939 Re: ApD1. No. 4038 - Zeisler (Variance for Garage) Dear Mr. Bayley: ~ 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 Mr. and Mrs. Richard M. Zeisler Suffol~ County Department of Planning APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Grigonis, Jr. Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Telephone (516) 765-1809 BOARD O1* APPEALS TOWN O~ SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 ACTION OF THE BOARD OF APPEALS Appl. No. 4038: Matter of JOi~N AND RICHAi~D ZEISLER. Variance to the Zoning Ordinance, Article IIIA, Section 100-30A.4 (100-33) for permis- sion to. located accessory two-car garage structure in an area other than the required rear yard at 700 Jackson's Landing Road, Mattituck, NY. Lot area is nonconforming in this R-40 Zone District; Map of Jackson's Landing, Lot 97, filed in the Suffolk County Clerk's Office as Map ~5280; also identified as County Tax Map Parcel ~1000-113-4-9. WHEREAS, a public hearing was held on July 12, 1991, and at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the 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, appellants request permission to locate a 20 ft. x 20 ft. two-car garage in the front yard area with setbacks approximately 30 feet from the curb along Jackson's Landing and nine (9' feet from the westerly side (property) line. 2. The premises in question is known as Lot #7 on the Subdivision Map of Jackson's Landing, filed in the Office of the Suffolk County Clerk as Map No. 5280, and is nonconforming as to total lot area of 23,495 sq. ft. and as to frontage (width) along Jackson's Landing of approximately 80 feet. 5. The subjegt premises is presently improved with a frame dwelling (BP %1077~) with setbacks as Shown on the survey prepared July 11, ~991 by Roderick VanTuyl, P.C. Also present at the site and shown on the survey are phragmites, wet meadow areas, with sloping elevations,¥to the'south of the dwelling (referred to as the required rear yard:area). For the record, it is noted that the dwelling was the subject of two prior appeals, under Zoning Appeal No. 2903 rendered November 5, 1981 and Flood ManagemeDt Appeal No. FL2 rendered July 1, 1980. 4. Article I!I-A, Section t00-30A.4, and Article III, Section 100-33, provide that accessory'buildings must be placed only in the required rear yard. 5. The garagE structure is proposed to be used only for garage or storage purposes which are accessory and incidental to the use of the principal dwelling structure. 6. ~ It is thei position of the Board in considering this application that: (a) thei land and buildingsi (b) the,' circurastances are uniquely related to the and are not personal in nature; relief is not substantial; (c) thel relief as granted will not be an increase of dwelling unit denslity or cause a substantial effect on available governmental faclllltles; (d) thel r~llef requested in not unreasonable, and there is no alternatIve for appellants to pursue other than a variance; ~ (e) th~ variance will not in turn be adverse to the 'safety, health, w~lfare, comfort, conVenience, or order of the town, be adverse ~o neighboring properlties, or alter the essential character of the neighborhood. Accordingly, ion motion by Mr. Goehringer, seconded by Mr. Dinizio, it w~s RESOLVED, to.iGRANT a Variance to locate a 20 ft by 20 ft. accessory garage ~n the front yard area as applied with a setback of 30 fee~ to the curb along Jackson's Landing and nine (9') feet from th~ westerly side property line, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That theiaccessorY garage structure be used strictly for storage and garage purposes, accessory and incidental to the principal dwelling use of the premises, and shall not be converted into residential, sleeping or habitable quarters; 2. That any increase in size to larger than applied for will require a separate application (if larger than the requested 20 ft. by 20 ft.); 3. That only electrical utilities may be installed; 4. That the garage structure not exceed the height provisions of the code (18 feet). Vote of the Board: Ayes: Messrs. Goehringer, Dinizio, Doyen and Villa. (Member Grigonis was absent due to serious illness. This resolution 'was duly adopted. Region 1 Headquarters ..... ~l i .... ~ ~ .'.. . ,SUNT, Building 40,' Slony BrooJ~ NY 11794 DAT£' ,';~/,':¢, /,/~/ " ~' ' '" '~"' ' ' , ~ -. ' - ~ - ' ,Thomas C. Jadng . ' ~/,~ ~/~ . . - . . .. . ... . . .. ,~ '~, .-'..-. ,~,. ,~.. ~-/~ . .... ' ......... ~ ~7 ~' .. ~ ~, ~:~... .... ' .. . .. -: : :::.-.--: ...... ................ ~ . .~;.~ .~..,~.. ...... ,, ,-,. . . . _. ·: · .. · ~"' ~ : ' " I " " ' ' ' "' '" , : .~ q . : ~-' . , // ~_. - ,.. , ~sea on the ~nEo:~atLon ~ou have subm~ttea, ~he ~e~ ~o~ State Depa:ement o~ Enviconmental Conservation has de~ermined ~hat the . parc'el _~ project is: ~ ~ ~ Greater than 300' ir. om ii%ventoried tidal wetlan.ds. Landward of the greater'than 10' 'Pherefore, no permit L~ndward of a substantial man-made structure .q~eater than 100' in leng.th which was constructed prior to 9/20/77. ' Landward of the 10' above mean sea'level elevation con'our on a gradual,' natural slope. top~graphic crest of a bluff, cliff or dune which is' in e. levation above mean sea level. is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no. construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest Qithout a p~rmit, it is your resDonsibilitv.to ensur'e that all necessary precautions are taken to orevent ~ny sedimentation or other alteration or disturbanc~ to the ~round surfac~ or vegetation in this area as a resul~ of your project. Such precautions may include.providing adequate.work a~e~ between the 10' contour or topqgraphi'c crest and the project (i.e. a 15' to 20' w%de construction area) or'erection of a temporary fence, barrier, or hay bale berm. the project as Please contact Please note that any additional work, or modification to described, may require authorization by this Department. this.office if such are contemplated. ; .. Please~be further advised that this lettem ds~s not relieve you of the -resp°nsibility of obtaining any necessary per~it.s, or..approvals from other ,:gencies' . . . ' .. ' ' 'i ' ." '- .'_" . . . '. ' · . ' · ":~.i::._ :. ~0..... ~ .n ~,,~.~,~i~¥W Regional ~m~t Adm~n~straJ;or ..... , · i".:"!--"r' ' ' . ....... '.:::- ~.~ .mw, OF... , ~ .,.~ SO~~ ' . .............. APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Grigonis, Jr. Serge Doyen, Jr. James Dinizio, J~. Robert A. Villa Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD July 23, 1991 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Mr. Robert A.. Bayley, A.I.A. 150 Lakeview Terrace P.O. Box 595 East Marion, NY 11939 Re: Appl. No. 4038 - Zeisler (Variance for Garage) Dear Mr. Bayley: 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 Mr. and Mrs.. Richard M. Zeisler Suffolk County Department of Planning Page 2 - Appl. No. 4038 Matter of RICHARD AND JOAN ZEISLER Decision Rendered July 12, 1991 3. The subject premises is presently improved with a frame dwelling (BP ~10773) with setbacks as shown on the survey prepared July 11, 1991 by Roderick VanTuyl, P.C. Also present at the site and shown on the survey are phragmites, wet meadow areas, with sloping elevations, to the south of the dwelling (referred to as the required rear yard area). For the record, it is noted that the dwelling was the subject of two prior appeals, under Zoning Appeal No. 2903 rendered November 5, 1981 and Flood Management Appeal No. FL2 rendered July 1, 1980. 4. Article III-A, Section 100-30A.4, and Article III, Section 100-33, provide that accessory buildings must be placed only in the required rear yard. 5. The garage structure is proposed to be used only for garage or storage purposes which are accessory and incidental to the use of the principal dwelling structure. 6. It is the position of the Board in considering this application that: (a) the circumstances are uniquely related to the land and buildings and are not personal in nature; (b) the relief is not substantial; (c) the relief as granted will not be an increase of dwelling unit density or cause a substantial effect on available governmental facilities; (d) the relief requested in not unreasonable, and there is no alternative for appellants to pursue other than a variance; (e) the variance will not in turn be adverse to the safety, health, welfare, comfort, convenience, or order of the town, be adverse to neighboring properties, or alter the essential character of the neighborhood. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Dinizio, it was RESOLVED, Lo GRANT a Variance to locate a 20 ft by 20 ft. accessory garage in the front yard area as applied with a setback of 30 feet to the curb along Jackson's Landing and nine (9') feet from the westerly side property line, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That the accessory garage structure be used strictly for storage and garage purposes, accessory and incidental to the APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Origonis, Jr. Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTtIOLD ~ SCOTT L. ,HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765.1800 AIcTION OF THE BOARD OF APPEALS Apl~i. No. 4038: Matter of JOA~ AND RICHARD ZEISLER. Variance to the Zoning Ordinance, Articlei IIIA, Section 100-30A.4 .(100-33) for permis- sion to located ac~c.essory two-oar garage structure in an area other than the required rear yard at 700 Jackson's Landing Road, Mattituck, NY. Lolt area is nonconforming in this R-40 Zone District; Map of i~ackson's Landing, Lot ~7, filed in the Suffolk County Clerk's Office as Map ~5280; also identified as County Tax Map Parlcel ~1000-113-4-9. WHEREAS, a public hearing was held on July 12, 1991, and at said hearing all t~ose who desired to be heard were heard and their testimony relcorded; and WHEREAS, the ~oard has carefully considered all testimony and documentation Isubmitted ~concerning this application; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding arlene; and WHEREAS, the iBoard made the following findings of fact: 1. By this aDplication, appellants request permission to locate a 20 ft. x !20 ft. two-car garage in the front yard area with setbacks apprloxlmately 30 feet from the curb along Jackson's Landing land nine (9') feet from the westerly side (property) linel 2. The premi!ses in question is known as Lot ~7 on the sSUb~d~ivision Map ofi Jackson's Landing, filed in the O'ffioe of the uz~olk County Clerk as Map No. 5280, and is nonconforming as to total lot area of 23,495 sq. ft. and as to frontage (width along Jackson's Landing of approximately 80 feet. Page 3 - Appl. No. 4038 Matter of RICHAP~ AIqD JOAI~ ZEISLE~ Decision Rendered July 12, 1991 principal dwelling use of the premises, and shall not be converted into residential, sleeping or habitable quarters; 2. That any increase in size to larger than applied for will require a separate application if larger than the requested 20 ft. by 20 ft.); 3. That only electrical utilities may be installed; 4. That the garage structure not exceed the height provisions of the code (18 feet). Vote of the Board: Ayes: Messrs. Goehringer, Dinizio, Doyen and Villa. (Member Grigonis was absent due to serious illness.) This resolution was duly adopted. lk GERARD P. GOEHRINGER, CHAIRMAN FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .,p pro.ed ......... ee.mit N Disapproved a/c ..................................... BOARD OF HEALTH ......... ] SETS OF PLANS .......... SURVEY ................... CIIECK ................. :... SEPTIC FORH .............. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~ a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts 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 ffareas, 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 cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Bui/ding Permit to the applicant. Such permit mil be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy mil have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings additions or alterations, or for re~.lKoval or demolition, as herein described. lie applicant agrees to comply with all applicable laws, ordinances, build, od.g, housing code, an~t regulations, and to Jmit authorized inspectors on premises and in building for necessaT, i:?~..~.....~ ............... " (~t~r'e'~f'~licant, or n~me,)g a corporation) .............. N..../1.~... (Mailing address of applicant) .tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ..................................................... . ........................ ;amc of owner of premises ~': .~.~ J~l'q. ~ OJX~ ~ ,~7-e~St~' "~ "" '~ (as on the t.wA roll or latest deed) :' applicant is a corpora{ibn%fiignatu,r~ of duly authorized officer. ' "' ' ' (Name and title of corporate officer) Builder's License No..[~ .~. c~l.eC--/r~...~d: ..... Plumber's License No ~A Other Trade's License No t, Location of land on which proposed work will be done ................................................. · -: .............................. ~.L .t. ...... House Nmnber Street Hamlet .................... County Tax No. 1000 Section . /15 Block Lot Subdivision... Q...0'~. ~.. '(Name) '-o ........ ~... Filed Map No .............. Lot ............. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy... I, e-.. ~g~ .. .0.'~6.~-~. .......... ....... y.t.:?, ...... ¢...~.,.,~ ........... b. Intended use and occupancy ...51 ~ .5~2CZ~..I... (J/d, ed...Qd~..qO[r~¢~:,, ,,,%/',": .: ;~.,.~?,t.,t..,,D .......... Repair ............ Removal .............. Demolition .............. Other Work '......./.,. ..... t~~ j ~. I (Description) 4. Estimated Cos IC~?" .,'......,. Fee .... ' ', ,.,..::f2,- ...... I (to be paid on filing this application) 5. *~u '~"'"- '" - -'-'-- ~_~lu_ng, nu.mber~o f dwelhn~g u~its...--: ~.6 ........ Number of dwelling units on each floor ............ 6.[.bus~nyss, co~mercial or mixed 6ccupancy, spegffy nature and extent of each type of use. ~ ........... 7.~menmons oI existingstmctures if any: ear .............. Height ............... Num N r of Stories.. ~ ............................................. D~ensions of same structure wiff alterations or additions: Front ['¢e~ ~i~ ~ Rear .... Depth ..................... HeiSt ...................... Number of Stores ...................... 8. Dimensions of entire new construe tion Fron't~5~, %~e ~) Rear .. . De-th Height ............... Numb{ r of Stories .............. 9. Sizeoflot Front lO.~ . Rear lES '¢5 ......... ~ '~ ';'Z;'~ d'fi ..... 10. Date fP ~ '''' ] ........................... oepm .~,~t...~.~.t .......... 11. o urcnase ............ ~ ....... , ......... Name of Fo~er Owner ~ghls..'.~ g~.~ ...... Zone or,use district in which prem?ses are situated.. ~ ~.~ .......................... , 12. Does proposed construction violate any zoning law, ordinance or regulation: X~;~.UO~; ~ 13. Will lot be regraded MO ' · ' . ...... , ......... : ....... W~ll exes ff~ ~ e from premises: Yes 14. N~e of Owner of premises ~c~¢~>~.~ff.l~l~r. Address~¢ ~~tl~h~ ~ ~me o[ ~rc~lte~t . .~. [ [~*~.[~. NI~ ..... Address ~OX. 5~ ~t. mv/~ehone No. ¢'16. ~.Zg ' · ~' ................... Address ..... vh~,~ u~ [5. Is th~ e ' ' · ' ............... ~ ................ s prop rty within 300 feet of a tidal wetland9 *Yes ~ *If yes, Southold To*n Trustees Permit may be requi~d. ~ .. PLOT DIAG~ Locate clearly md distinctly ~1 b*ild~gs, whether existing or proposed, an& indicate ~1 set-back d~ensions from property Hues. Give street ~d block n~ tuber or descfiptiofl accord~g to deed, and show street nines and indicate whether interior or comer lot. 7S5-'~802 ~ AM TO4 PM FOR THE FOL.LOW&N~ 1. FOUND~TIO~ - , '~0 ~EQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMIN~ & PLUMBIN~ 3. INSULATION ~. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION 5HALL T.E REOUffiE~ENTS OF THE N.Y. o. cO.ST.U ,O. ou gd¥ s.s ..... . ....... (Name of individual si~ningIcontract) .......... being duly sworn, deposes and says that he is the applicant I (Contractor, agent, corporate officer, etc.) ' said owner or owners, ~d is duly aCthorized to perform or have perfo~ed the said work and to m~e a , icat' · ..... nd file th~s P mn, that all statements continued ~n thru a h pp cat on are true to the best of his knowledge and belief; and that the ork will be perfomed in the m~ner se: forth in the application filed therewith. ~om to before me~ ~ ~3't . : ...... ..... ~~ ................. . ~ ~bll~ ____ , _ . ~.x: .'... r. < .~/.. 7~.~ ~... ............. No, ~79~ / ~ (Si~an - ........ ~ [J~ ,// ( i~ature of applicant) I ,/ 7£~''