Loading...
HomeMy WebLinkAbout20143-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20220 Date SEPTEMBER 16~ .1991 THIS CERTIFIES that the building. Location of Property 2435 CEDAR LANE House No. County Tax Map No. 1000 Section 37 Subdivision ADDITION EAST MARION~ N.Y. Street Hamlet Block 4 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office date~ JULY 2~. ~99t pursuant to which Building Permit No. 20143-Z dated SEPTEMBER 16, 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. WOOD DECK ADDITION. TO.DW~.~I_NG AS BUILT & TO ZBA CONDITIONS APPEAL ~4044. The certificate is issued to WILLIAM, AILEEN ~ JOHN PARROTT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMF~T OF HEALTH APPROVAL N/A. UNDERWRITERS CERTIFICATE NO. H-022028 - MAY 10, 1991 PLUMBERS CERTIFICATION DATED N/A . Rev. 1/Sl Building Inspector T~N OF BUILDING D~:PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 20143 Z Permission is hereby grant/e,~to,: . ...~.~.,.~..>~.~:..~..~. .... ~../.....~...~½..~...._.~.. ~_ _~'~'~' ...... ~.~ ........ ~~. ~¢ ~ at premises located at ...~.~.....~....~...~.......~1~...~..~ .................................................................. ~.~.... ~.~..~~......~ ~. ....... ~ .¢.......z...~z ~..~ ~ /meoo/..-- 0 Co-.~ Tax Mop No. 1000 Sec~io. ....... ~....7.. ........ Block ...... ./.... ......... Lot .o...~.. .................. pursuant to application dated ......... ~../...~m. .................................. , 19.~.~.., and approved by the Building Inspector. ~bilcling InsDector Rev. 6/30/80 Form No. 6 TO~N OF SOUTIIOLD BUILDINC DEPARTMENT TOWN I~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUFANCY \. 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 featnres. 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 I% lead. ' 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code C,~pliance from archiuect or engineer responsible for the building· 6. Submi~ Planning Board Approval of completed site plan requirements. ;- For existing buildings (prior to April 9 1957) non-conforming uses, or buzldlngs and "pre-exzst%ng land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ;. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelliag $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 Buildfng - $I00.00 3.Copy of Certificate of Occupancy - $5.00 OVer 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $I5.00, Con~ercial $15.O0 House No. Street '' ' '' '~wer or Owners of Property ., .............. ,unty Ta~ Map No 1000, Section .... ~.?. ...... Block .. ~bdivision .................................... Filed Map ............ Lot .... :reit No ................ Date Of Permit .... ' ............ Applicant ~/[ .~.'; ~'"''' 'alth Dept Approval · ' ............ . .Underwriters Approval arming Board Approval ..... quest for: Temporary Certificnte ..... Final Certicate .......... e Submitted: $ ....... , ....... co % b .............. APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Grigonis, Jr. Serge Doyen, Jr. James Dinizio, .Ir. Robert A. Villa Telephone (516) 765-1809 BOARD OF APPEALS TOWN O~ SOUTHOLD SCOTI' L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 September 20, 1991 Mr. John Parrott Creative Retirement Planning Inc. 30 Rockefeller'Plaza Suite 4336 New York, ~ 10112 Re: Appl. No. 4044 - Variance for Deck Dear Mr. Parrott: Attached please find a copy of the determination recently rendered by the Board o~ 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 Inspectors for their files and update. Very truly yours, Linda Kowalski Enclosure / Copy of Decision to: Southold Town Building Department APPEALS 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 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 Appl. No. 4044. Upon application of WILLIAM, AILEEN AND JOHN PARROTT. Variance to the Zoning Ordinance, Article XXIII, Section 100-239.4B and Article XXIV, Section 100-244B for approval of deck construction at less than 75 feet from the bulkhead and in excess of the 20% lot coverage limitation for all structures. The subject parcel is substandard in size and is located in the R-40 Zone District. Location of Property: 2435 Cedar Lane, East Marion; County Tax Map No. 1000-37-4-9. WHEREAS, a public hearing was held on September 12, 1991, and at said hearing, all those who desired to be heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and docu]mentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in q~estion, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. By this application, appellant seeks a variance under Article XXIII, Section 100-239.4B for permission to construct an 500 sq. ft. open deck extension 16.2 feet from the rear (easterly end) of the existing dwelling. 2. The premises in question is identified on the Suffolk County Tax Maps as District 1000, Section 37, Block 4, Lot 9 and contains a total lot area of 7,336 sq. ft. 3. The dwelling as exists presently has nonconforming sideyards totaling 29-1/2 fe~t (7 and 12-1/2), a nonconforming front yard setback at 24 feet, .a nonconforming setback from the bulkhead at 56 feet, and nonconforming lot coverage at 24% (1754 sq. ft.). The parcel as exists is substandard with 7,336 sq. ft. in total lot area and a width (frontage) of 56.0 feet. Page 2 - ZBA Appl. No. 4044 Matter of JOHN PARROTT and OTHERS Decision Rendered September 12, 1991 4. Article XXIII, Section 100-239.4B of the Zoning Code requires all buildings and structures located on lots upon which a bulkhead, concrete wall, rip-rap or similar structure exists and which is adjacent to tidal water bodies other than the Long Island Sound to be set back not less than seventy-five (75) feet from the bulkhead. 5. Article XXIV, Section 100-244B limits lotsin a nonconforming status to a maximum lot coverage for all buildings at 20 percent of the total lot area. The increase of the lot coverage over the existing dwelling is 500 sq. ft., or 7%, for a total of 31%. 6. For th~ record it is noted that similar relief has been granted for other parcels in the area, along Sigsbee Road, etc. 7. In considering this application, the Board finds: (a) the relief requested is substantial in relation to the code requirements although the square footage of construction over that which exists is minimal; (b) the relief requested is the minimum necessary to afford relief; the construction is for an open, unroofed addition without a foundation or basement and without a roof or full enclosure; (c) the relief as requested will not alter the essential character of the neighborhood; (d) the practical difficulties imposed are uniquely related to the property and are not personal; (e) the grant of the relief as requested will not in turn be adverse to the safety, health, welfare, comfort, convenience or order of the town, or be adverse to the neighboring properties; (f) in view of all the above, the interests of justice will be served by granting the relief as requested and conditionally noted below. Accordingly, on motion by Mr. Dinizio, seconded by Mr. Villa, it was RESOLVED, to GRANT a variance for a 500 sq. ft. open deck addition at the rear (east end).of dwelling with a reduced 16.2' setback, for a minimum distance from the bulkhead at 39.5+-feet, SUBJECT TO THE FOLLOWING CONDITIONS: Page 3 - Appl. No. 4044 Matter of JOHN PARROTT and OTHERS Decision Rendered September 12, 1991 1. The southerly (side) yard shall remain open and free of obstructions (with the exceptio~ of the existing flagstone area). as applied. 2. The deck addition remain open and unroofed, (All roof runoff must be retained on site.) Vote of the Board: Ayes: Messrs. Goehringer, villa. (Members Grigonis and Doyen were absent.) resolution was duly adopted. lk Dinizio and This GERARD P. GOEHRINGER, 7AIRMAN APPEALS 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 O~F 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 Appl. No. 4044. Upon application of WILLIAM, AILEEN AND JOHN PARROTT. Variance to the Zoning Ordinance, Article XXIII, Section 100-239.4B and Article XXIV, Section 100-244B for approval of deck construction at less than 75 feet from the bulkhead and in excess of the 20% lot coverage limitation for all structures. The subject parcel is substandard in size and is located in the R-40 Zone District. Location of Property: 2435 Cedar Lane, East Marion; County Tax Map No. 1000-37-4-9. WHEREAS, a public hearing was held on September 12, 1991, and at said hearing, all those who desired to be heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, the surrounding areas; and and WHEREAS, the Board made the following findings of fact: 1. By this application, appellant seeks a variance under Article XXIII, Section 100-239.4B for permission to construct an 500 sq. ft. open deck extension 16.2 feet from the rear (easterly end) of the existing dwelling. 2. The premises in question is identified on the Suffolk County Tax Maps as District 1000, Section 37, Block 4, Lot 9 and contains a total lot area of 7,336 sq. ft. 3. The dwelling as exists presently has nonconforming sideyards totaling 29-1/2 feet (7 and 12-1/2), a nonconforming front yard setback at 24 feet, a nonconforming setback from the bulkhead at 56 feet, and nonconforming lot coverage at 24% (1754 sq. ft.). The parcel as exists is substandard with 7,336 sq. ft. in total lot area and a width (frontage) of 56.0 feet. Page 2 - ZBA Appl. No. 4044 Matter of JOHN PARROTT and OTHERS Decision Rendered September 12, 1991 4. Article XXIII, Section 100-239.4B of the Zoning Code requires all buildings and structures located on lots upon which a bulkhead, concrete wall, rip-rap or similar structure exists and which is adjacent to tidal water bodies other than the Long Island Sound to be set back not less than seventy-five 175) feet from the bulkhead. 5. Article XXIV, Section 100-244B limits lotsin a nonconforming status to a maximum lot coverage for all buildings at 20 percent of the total lot area. The increase of the lot coverage over the existing dwelling is 500 sq. ft., or 7%, for a total of 31%. 6. For the record it is noted that similar relief has been granted for other parcels in the area, along Sigsbee Road, etc. 7. In considering this application, the Board finds: (a) the relief requested is substantial in relation to the code requirements although the square footage of construction over that which exists is minimal; (b) the relief requested is the minimum necessary to afford relief; the construction is for an open, unroofed addition without a foundation or basement and without a roof or full enclosure; (c) the relief as requested will not alter the essential character of the neighborhood; (d) the practical difficulties imposed are uniquely related to the property and are not personal; (e) the grant of the relief as requested will not in turn be adverse to the safety, health, welfare, comfort, convenience or order of the town, er be adverse to the neighboring properties; (f) in view of all the above, the interests of justice will be served by granting the relief as requested and conditionally noted below. Accordingly, on motion by Mro Dinizio, seconded by Mr. Villa, it was RESOLVED, to GRANT a Variance for a 500 sq. ft. open deck addition at the rear (east end) of dwelling with a reduced 16.2' setback, for a minimum distance from the bulkhead at 39.5+-feet, SUBJECT TO THE FOLLOWING CONDITIONS: Page 3 - Appl. No. 4044 Matter of JOHN PARROTT and OTHERS Decision Rendered September 12, 1991 1. The southerly (side) yard shall remain open and free of obstructions (with the exceptio~ of the existing flagstone area). 2. The deck addition remain open and unroofed, as applied. (All roof runoff must be retained on site.) Vote of the Board: Ayes: Messrs. Goehringer, Dinizio and Villa. (Members Grigonis and Doyen were absent.) This resolution was duly adopted. GERARD P. GOEHRINGER'TAIRMAN THE NEW YORK BOARD OF FIRE UNDERWRITERS PA E 1 8024319 BUREAU OF ELECTRICITY ~-~ 85 JOHN STREET, NEW YORK, NEW YORK 1003B D,,e MAY 10,1991 Appllc, Ho, Mo, on,file 73125591/91 H 022028 THIS CERTIFIES THAT JOHN 5. PARROTT, CEDAR SANE, EAST MARION, N.Y. in .hefoBowing Iocaeion; [] B~setnent [] Ist FI. [] 2nd FL OUT Section Block Lot tc~s exmnl,edo, MAY 06,1991 FIXTURE OUTLETS DRYERS a,td found to be in compliance t~'ith the relluirements qf this Board. OTHER ~ _,_ FU_~r~_RNRNACE MOTORS I FUTURE A~UANCE ~tED[~$ RAN~oOglNG OECK~; I OVENS I DISH WASHERS SERVICE DISCONNECT } NO. OF R V I C E EXHAUST FANS DIMMERS *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. 18-75 CPL. KINNEDY ST. AP APT$1 O OENE~At ~N.*,aE~ BA¥SIDE, NY, 11360 11 ~d · . Per~ ___ C ~ ~~ r~u~o the office of the Board if inco,rect )nspectors ma be identified b their credentia,s. Y . y y TRUSTEES John M. Bredemeyer, HI, President Henry P. Smith, Vice President Albert J. Kmpski, Jr. John L. Bednoski, Ir. 3ohn B. Tuthill Telephone (516) 765 - 1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR scOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 May 3, 1991 John Parrott 18-75 CPL Kennedy St. Bayside, New York 11360 RE: SCTM 01000-37-4-9 Dear Mr. Parrott: The following action was taken by the Board of Town Trustees during its regular meeting held on May 2, 1991: RESOLVED that the Town Trustees APPROVE the request for a waiver for a deck attached to the dwelling located at Cedar Lane, East Marion. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Very truly yours, John M. Bredemeyer, III President, Board of Town Trustees JMB:jt cc: Bldg. Dept. CAC File From The Desk of JOHN L. PARROTT CREATIVE RETIREMENT PLANNING, INC. 30 Rockefeller Plaza, Suite 4336 New York, NY 10112 (212) 974-0160 L~ TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL · Date 0. ? .~./. o 19 To ~.~..,~....~.~~...~.~, . .'~ ...................... · .~..~~~..~~ ~ .. ~~.,. ~...,...~. PLEAS~TAKE NOTICE that~ your application dated ~ __ ~ ,.....~: .................. 19,.~. House ~o. Street ......... County Tax Map No. 1000 Section ..... ~.~'. , . . Block .... ~ ....... Lot .. ~ .......... Subdivision Filed Map No Lot No ' is returned herewith and disapproved on the following grounds ~.~...~.'...z.~..~.-..~.~..~. .... ..4~ .~..~.' ~....~....~..~:.. .- ~.;.~'~_ ..... ~..~: ........... ~.~..~ ~?- '2')' ............................................ J-ncl~ n s~Se~ ~o~' RV 1/80 FORM NO. a TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL . Date ~/./. O 19 ~-) / · ./. ....................., 7/... PLEASE TAKE NOTICE that your application dated ~'/-'-.Q ~ .... ...~.:~ ..................,19..Z. ~oeation o~rop~r,y ....~ .~'.~.-:......c~../.~.. ~..~ ~, House No. ' Street .......... County Vax Map No. 1000 Section ..... ~....~..'... · Block .... .~. ....... Lot ...~. .......... Subdivision ................. Filed Map No ................. Lot No ........ ' .......... is returned herewith and disapproved on the following grounds..g~/./~... ~..z~...~ ~.-~?..~.'.../..~.~ .~ ~¢... ~. ~_ ~~~ ~... ~..~:-. ~n~I nsiSecto~ RV 1/80 From The Desk of JOHN L. PARROTT CREATIVE RETIREMENT PLANNING, INC. 30 Rockefeller Plaza, Suite 4336 New York, NY 10112 (212) 974-0160 ~New York 5tare Department ot Environmental Conservation · Building 40--SUNY, Stony Brook, New York 11790-2356 D~r Mr. - A review has been made of your proposal to: ~OD3~£b~¢,~- -~];~-~ ~ec~~ c~ per .~h~ s~r~ b7 Sod~r w~ 7u~.l dated .z/~/Tq 5CT~ ~/ooo -37- ~ -~ Based-on-'th-e infozmation you ha'ye submitted, ~he New York State Department of~Env~onmental Conservation has determined that the parcel %~project is: . ".. Greater than 300' from inventoried tidal wetlands. .n war a greater than 100' in length which was constructea prior to 9/20/77. Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographi~ crest without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection of a temporary fence, barrier, or hay bale berm. Please note that any additional ,work, or modification to described, may require authorization by_this Department. this office if such are contemplated. the project as Please contact Please be further advised that this letter does' not relieve you of the responsibility of obtaining any necessary permits or approgals from other agencies. : .~.. - .:-- .  ~F~"[ ~[: Veery t rul¥~yo~_s.: -~ _~f ! 5~!~1~ i! Deputy Regzonat Permit Administrator FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Appro ed . .~.~..~ y ....... lng APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH 3 SETS OF PLANS .......... SURVEY ................... CI1ECK .................... SEPTIC FORM .............. CALL ................... MAIL TO: Date ..... '.Y.~..R. ......... 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 cbmmec~ced 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 admitauthorizedinspectorsonpremisesandLubuildingfcrnecessaryinsp~ ~ · / . I/ .(Mailing ~ddress of appli_cant) . iv.Y, /o o ig.o State whetber applicant is owner, lessee, agent, architect, engineer, general con~ractor, electrician, plumber or builder. Name of owner of prem!ses..~..~.~.~ .-'.~..~..., .~~. ?.. · .~.~..ff~.., Z'~.. ,/~'-,..0~. · ......................... (as on the tqtx roll or latest deed) If applicant is a corporation, ~ignature*of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... 5.~../-: .~. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .......................... , ....................... .................. . .,¢. .... .. .... //737. ............. House Number Street Hamlet 9 County Tax Map No. 1000 Section Block Lot. '" ' · Subdivision ..................................... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construatiOm E i ti nd o a. x s ng use a ccupancy ............. ............... b. Intended use and occupancy ............................................................ 3. Nature of work (check which applicab!le): New Building .....~..... Addition Repak ............ Removal 4. Estimated Cost ..7o~.~...~.. ........ ....... Alteration .......... ....... Demolition .............. Other Work ............... ' (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units .~ ............. Number of dwelling units on each floor ................ · If garage, number of cars .......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, ifafiy: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations ~)r additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number o~ Stories ....................................................... si ooflot: Front .'. , .,. . , ...... Rear :. , : : t0. Date of Purchase .... i ..... Name of Former Owner ................. 1 1. Zone or use district in which premises]are situated... ~',~..J~.~~ .............................. 12, Does proposed construction violate ,~r~y zoning law, ordinance or regulation: ..... /,k/fO ....................... 13. Will lot bo regraded ...... ~,x-_:,./~¥~. · .,~,. _. _..: ~:~... Will excess fill be removedjrom premises:' Ye, s No 14. Name of Owner of premises ,v,~,tt-.~,, .~.,. ,~..6~...Crff. Address 3~P ,~a~i'~ .~4}74~hone No.d~/~-%~. ? Name of Architect ... i.: ...... Address . .t~?.I . .Ar~..../.~..&.O.. Phone No... Name of Contractor ..... ~r~.~.,. ,! ............. Address ............... ,,... Phone No ................ 15. Is this property within 300 ~eet of a tidal wetland? *Yes....~... No ......... · If yes, Southold TowniTrustees Permit may be requiredv, i PLOT DtAOmm f/ z£ Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block numl interior or corner lot. STATE OF NEW YORK, t country OF .............. :k ,... (Name of individual signing contract) above named. ,er or descriptioh according to deed, and show street names and indicate whether ,RPPt O)JED AS NOTEO 785-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPE~IONS: ~, FOUNDATION ~ ~O REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & P~MBING 3. INSU~TION 4. FINAL CONSTRU~ION MUST BE COMPLETE FOR C.O. ALL CONSTRU~ON S~LL ME~ ~E REQUIREME~ OF THE N.Y. STATE CONS~U~ON & ENERGY CODES. N~ RESPQNSlB~ FOR DESIGN OR CONS~U~ION ERRORS ·.. being duly sworn, deposes and says that he is the applicant He is the ............ ,. ' (Contractor agent corporate officer eta) of smd owner or owners, and ~s duly a~th. orized to perform or have performed the said work and to make and file this application; that all statements containe,d m this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith, Swam to before me this No lar~b.~li i of 'Now York Notary N~, '1950 Qualified in (Signature of applicant)