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HomeMy WebLinkAbout19947-z i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of. the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 20631 Date APRIL 7, 1992 THIS CERTIFIES that the building ADDITION Location of Property 1425 KIMBERLY LANE SOUTHOLD N.Y. House No, Street Hamlet County Tax Map No. 1000 Section 70 Block I3 Lot 20.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29 1991 pursuant to which Building Permit No. 19947-Z dated JUNE 17 1991 was issued, and confarms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is INGROUND SWIMMING POOL, SPA DECKING & FENCING ADDITION TO _ EXISTING ONE FAMILY DWELLING AS PER ZBA #4629. The certificate is issued to CHARLES 5~ ANGELA KYRIAKOUDES (owners) of the aforesaid building. BUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-230259 - MARCH 31, 1992 PLUMBERS CERTIFICATION DATED N/A Bu'.ldi~ctor Rev. 1/81 roes xo. s 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) N°- 1997 Z Date .........~........~..7 ls`~..1. Permission Is hereby gront~: r n ~y.9.. q to ~~:.4r:x,...f!::::°~?t~r~!~...'~4??'G.;....r~.~!?.sa..r...1.~P...'l~'...~.~~:'.:~~?^~!<1 Q,~Q~:~L,...~:,:....wm.....~-u..u/~~.-::~:.~....~l..a.. 11...,~:s..ca-~,..~'!~...~?~~..1#yoa9 of premises located ot .~.~.5~..~~.......f..!:'~::1........ ..~.:!:13,.........~ ".1......~.....K.~aka:~.~ County Tox Map No. 1000 Section ......4.~.~....... Block Lot No...s~~:9........... Pursuant to application doted .....~~~q~'L~at~~...~9 19.`~.~..., and opproved by the Building Inspector. U -S? _ _ Fee 5....t~T. ~..r~..:..~.-. ...~G..°.:i Iding Inspector Rev, b/30/80 Form ^;o. 6 TOWN 01: SOUTIIOLD r ? r3_ ~ ' ~ BUILDING DEPARTMENT TOWN HALL ' 765-1802 i N~~ z s ~C.7~~1 .`th.. fir,;;„-. - ;,t APPLICATION FOR CEItTIFICATI; OF OCCUPANCY _.,~~~Cii'~.`~' ` " This application must be filled in by typewriter OF, 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. G. Submit Planning Board Approval of completed site plan requirements. .i. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. ,lccurate 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 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 J. 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 $15.000 Date ..ehJ. ~~1. ~ ! 7!........ ':cw Construction......I/~~// Oldf/OrIAP/re-existing Build/i~ng. !.ocation of Property.!:/. Z.S...Kl~~~2~.Y.... ~-~'ieU ~......~~.C1'Ti-~C~.~.~ . House (N~~o. pp Street Hamlet .;nw~r or Owners of Property.4E"~':Cr.:~:~~, fi ~~~~t--~....L~~l.~;(-~~=;QC1~l_~; 5...,.,,,... ~:uunty Tax Map No 1000, Section,. ,,,,,Block... ~,~.........Lot., ~;,;1,_.,,,,... ;ubdivisionJ.p.....-7 .Fiilegd Map............Lot.. Be[mlt ;;o././~~!;~.Z...Date Of Permit... ~.~~~,`.,`.~..Applicant.~~.~AQ:C-~~..t~;y~;16;~Kt;)t1~~5 ':c:iltli Dcpt. A~~proval ..........................Underwriters Approval......................... •':.nuiing Board Approval .:equcst for: Temporary Certificate........... Final erticate.. "cc Submitted: $ c~oc, y3s~~ . q-~.'~r . Cfl ~ X063 j r1.1cAr,T THE NEW YORK BOARD OF FIRE UNDERWRITERS z ~tl~~Ab~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~Af((',~ J1, 14$2 Application No. on file %/~~i2Gr37,14t fl L~QYZ~~ THIS CERTIFIES THAT only the electrical equipment as described helots and introduced by the applicant Homed on the above application numher in the premiaea of ClififtLflS ,YiYkt7:AKIJ(ItJh'S, 7 'aS:CNtil"[2GY ROAllt SC1U~'Ht}GDr PI. X, in thefollouing Grcation> ? Basement ? Ist Fl. ? 2nd Fl. f)UT 3ertion Block Lot uqa exornined art ~fi ~(7 (I ~(k~' ~7 L],3~~ andfound to be in compliance with the rwyuirernents of this Roard. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT RUOREECENT OTHEH bNi K W AMi K W. AMT KW qMi. K W AMi. H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMC K. W. OLL H. P. GAS H. P. AMT. NO. q W. G. AMi. AMP AMT AMPS TRANS. AMi. N P SYSTEMS AMi. WATTS NO.OF FEET SERVICE DISCONNECT NOAF METER $ E R V I C E AMT. AMP. 1YPE EOUtP 1 q ]W i A 3W ~ 9 3W 3,a' 4W NO OF CC COND. A. W. G. NO. OF HLLEG A W G. NO. OF NFUTRAlS A W. G PER a' Of [C COND. OF MbLEG OF NEUTRAL OTHER APPARATUS: I: mac; ray a truelliE~~xt peT~t;on, I I b I L~z~E~ AR9'l1UR Cl. JUNGE I',XC.&2i.42~~ G//~~ P.0 BOR 7613 CU!'CHOGtI>;'r NY, J 193!'t GENERAL MANAG@R t1 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. c COPY FOR BUILDING DEPARTMENT. THIS CAPY OF CERTIFICATE MUST NAT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS r~c~ a aC(~Q~}Pi t~ BUREAU OF ELECTRICITY II 88 JOHN STREET. NEW YORK, NEW YORK 10038 Dote 4tA[t(`.}a 31ra.r.~4?, Application No. onfde 't4d22E'?1/91, ~ i~~2!~y THIS CERTIFIES THAT only the electricol equipment as described 6ebTV and introduced 6y the applicpnt homed on the above application number in the promises of CHi1.ItC,@;5 KV,RTAR4tYi?~;a{-,4 KI~BPftJ:`l RQ€kll, ~t3114'I~tQ1~DT N,y, in Ihefollowing Iocnti~o}n> a Aasement ? /xt Fl. ? 2nd F'l. I?tl `i' .Section Block Lot uws exmnured an r~l'I ittritrtY "L % t a 9!) 2 and found to be in compliance with the reyuirernenta of this Roard. flXTURE ECEPTACIE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W. AMT N.W AMT KW AMT. K.W AMT. H.P. 1} DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CIOCN$ gEll UNIT HEATERS MULTI-OUTLET DIMMERS qMT. N. W. Oll H. P GAS M. P. AMT. NO. A. W. G. AMi. AMP. AMT. AMPS. TRANS. AMT H P SYSTEMS AMi. WAITS NO, OF FEET 2 % v X10 SERVICE DISCONNECT NO.OF 5 E R V 1 C E MIT. AMP. TYPE METER ~ A, ]W ~ ~ 3W 3,a 3W 3 q 4W NO OF CC COND. A. W G. NO. OF MbLEG A' W O NO OF NEUTRALS A W G' EQUIP. PER% OF Cf. COND OF HbLEG OF NEUTRAL OTHER APPARATUS: swrt~rta:HC er~orr a. MG'1'OC2 i°af,r' ti.~~/G. F.C. T,-1-2 P4UT4R913-7 H. P. ,1 (~.'i.ri k?.iL, PANR1,iSQARitSt1-v} CTP. 1`L!i '(~JWI'NHiNG FQUGj T'tlis cectiticrat.e covexa comi~ii.anee at the rtut.e cat ip;ipeol:ion only, Because aE urlusua9. _ tnvix•onmenta .it, iu ,irlvi.aab:l.e to L!C~%~C~~~~~~~ have frequent terlC and/or. ra~~etira Cuu#.9nueL1 on Page 1 6ENERAI MANAO@R Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. A ERED IN ANY MANNER. ' t b ~ APPEALS BOARD MEMBERS SCOTTL.HARRIS Gerard P. Goehringer, Chairman ~ ~ Supervisor Charles Grigonis, Jr. ~ Serge Doyen, Jr. a ~ , Town Hall, 53095 Main Road James Dinizio, Jr. ~ ~ , .~T, " P.O. Box 1179 Robert A. Villa ~ ' ~ 'rte Southold, New York 11971 Fax (516)765-1823 Telephone (516) 765-1809 ~ Telephone (516) 765-1800 BOARD OF APPEALS ~ , TOWN OF SOUTHOLD t ~ t.?;1 r~ F, ~ ' d ~~P ~ i . JUN I ~ it)~11 ? _ ACTION OF THE BOARD e Appl. No. 4029. Upon application of CHARLES AND ANGELA KYRIAKOUDES. Request for Variance to the Zoning Ordinance, Article XXIII, Section 100-239.4B for permission to locate portion of inground pool with fence enclosure and portion of decking and other construction within 75 feet from the existing bulkhead, and with a distance shown at 75 feet from the rip-rap which is between the bulkhead and the mean highwater mark of Southold Bay. Or, an Interpretation as to which structural point the 75 ft. setback requirement shall be from (particularly where more than one structure exists.) Zone District: R-40. Location of Property: 1425 Kimberly Lane, Southold, NY; County Tax Map No. 1000- ' 70-13-20.9. WHEREAS, a public hearing was held on June 7, 1991, all those who desired to be heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. By this application, appellant seeks a variance under Article XXIII, Section 100-239.4E for that area of construction located less than 75 feet from the existing bulkhead, which includes a portion of the inground pool construction, portion of the decking and fence areas, and whirlpool spa structure, all as shown on Project Plan #9013 revised April 29, 1991, prepared by Michel & Associates. 2. The premises in question is identified on the Suffolk County Tax Maps as District 1000, Section 70, Block 13, Lot 20.9 and contains a total lot area of 41,596 sq. ft. Page 2 - Appl. No. 4029 Appl. of CHARLES AND ANGELA KYRIAKOUDES Decision Rendered June 7, 1991 3. The dwelling under construction (by Building Permit #19005) is shown to be in conformity with all setback provisions of the zoning code, exclusive of the accessory pool and whirlpool structures, which are shown to be 65 feet from the bulkhead at its closest points. 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. An interpretation has been requested as part of the review of this project concerning the actual measurement for the purposes of determining sufficient setback from the structure closest to the highwater mark, such as exists with both a rip-rap and bulkhead at close but different boundaries. It is the interpretation of this Board that distances shall continue to be measured (as was done in the past under the previous zoning code regulations where applicable), from the bulkhead structure when there is more than one structure landward of the high or low water marks. In this case, the'rip-rap structure is at and below •the high water mark, and the bulkhead is above the high water mark (landward of the rip-rap). 6. In considering this application, the Board finds: (a) the relief requested is not substantial in relation to the code requirements and the percentage of actual building construction is minimal; (b) the relief requested is the minimum necessary to afford relief; (c) •the applicant has furnished proof of conditional approvals from the N.Y.S. Department of Environmental Conservation, the Southold Town Trustees and the Town Building Department. (d) the relief as requested will not alter the essential character of the neighborhood; (e) the practical difficulties imposed are uniquely related to the property and are not personal; (f) 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.age 3 - Appl. No. 4029 Appl. of CHARLES AND ANGELA KYRIAKOUDES Decision Rendered June 7, 1991 (g) 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. Goehringer, seconded by Mr. Grigonis, it was RESOLVED, to GRANT a variance in the Matter of the Application of CHARLES AND ANGELA KRYIAKOUDES under Appl. No. 4029 for permission to construct open deck, inground pool and whirlpool structure as applied and more particularly shown on the plans prepared by Michel & Associates, as revised April 29, 1991 SUBJECT TO THE FOLLOWING CONDITIONS: 1. That during construction, straw (hay) bales be placed along the periphery of the entire construction, three feet from structure, to prevent drainage or run-off into the bay areas; 2. That all conditions under the N.Y.S. Department of Environmental Conservation be complied with; 3. That there be no other construction or other land alterations within 65 feet of the bulkhead, with the exception of live plantings or possible future retainers authorized by the Town Trustees. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis. Doyen and Villa. (Member Dinizio was absent. This resolution was duly adopted. * * lk GERARD P. GOEHRINGER, C AIRMAN INSPECTORS r~~~. Principal Building Inspector ~~~~~F1=a(®(dp Curtis Horton ti~O ~q ~ SCOTT L. HARRIS, Supervtisor Senior Building Inspectorc~~ P, ~ en ~ Southold Town Hall Thomas Fisher ~ " ~ P.O. Box 1179, 53095 Main Road Building Inspector ~ `'~t~g{ „ Gary Fish ~~¢~@ So Fax 516) 765-1823971 Building Inspector ~H Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD NOVEMBER 22, 1991 F j S. pp + ji` y A1JI~ l,~.a cxnR>.ES xeRlnxounns <;.`,''i~ 2 6 J~.c~/ ; ~'j 31 CENTER DRIVE ~ MALBA, NY 11357 ~Y To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %Rx An application for Certificate of Occupancy is not on file. (Enclosed) xRx No Underwriters Certificate on file. xxx 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. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19947-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. c'LELD I::SPECTiU;I ~~UnS ~ C MMGNTS a ~ 1 ~ H - - - H ~ FOU1iDATION , (1st) Z c FOUNDATIOtJ (2nd) m ~AJ~ 2. - - - ~ K z ~ o P,OUGH FRAME & PLUMBING ti~ y 3. ~ ~ IIJSULATIOfI PER N. Y. "3 STATE ENERGY S_ CODE x c, 4 . ,Q,c,,, .P'1 ~ ~ FIidAL 1t - `~C z ADDIT ONAL COMMENTS: x 8 X 1 H ~ b H J H O ~ z N ~ ca a ' r ~ ' x ~ ~ . m -o H . - ~ _ .;..r,..__.'Lk:.i~aa,~-Psv,~M~S„~':+~CSu'zoaL~a.x.»N a:...=:ditit._-~~.~~N,:J f ~ ~ flN C~ Michel & Associates June 14, 1991 Mr. Vincent Lessard Director of Building Department Town of Southold 53095 Main Road P. O. Box 1179 Southold, N. Y. 11971 Re: Kyriakoudes Residence Kimberly Lane Southold, N. Y. Dear Mr. Lessard: We are enclosing herewith two copies of the plan for the site and landscape construction at the home of Mr. Charles and Angela Kyriakoudes. This follows the receipt of the decision from the Board of Zoning Appeals granting the owner the variance requested. This is noted in resolution 1029. We will comply with ali conditions noted within the resolution. The owner and contractor have been forwarded copies of the resolution and alerted as such. Within the next two weeks we will forward the final permit from the N.Y.S. Dept. of Environmental Conservation. We are also submitting a copy of a letter received from the Board of Trustee granting approval of this project. We believe you have a completed application and fees from our previous application. Both pool and deck contractors will file any required insurances and alert your office of dates for town building inspector inspections. Landscape Architecture Site Planning 9 Village Square Glen Cave, New York 11542 516.676.0072 Fax 676.0596 Mr. Vincent Lessard -2- June 14, 1991 Mr. Mario Critelli of Forevergreen landscapes will be the liason between the Owner and the Building Department during the construction process. His number is 516-765-1900. If you have any questions regarding the submittal of these plans, the variance, or permit please do not hesitate to call. Resp tful , Mich ichel :cb encs: cc: Charles & Anglea Kyriakoudes Mr. Gerald P. Goehringer, Chairman s, JUN I f 19RI 9013.23 ~F~f m ar k. a. m : 3'7,-+l~r.... zs yrx~, s 3 v .r p s. xy'4 r ~p a a o s s 'icy v t ¢ fit. r ~ may, xa~~~~! k!~' yy ~F x. * 1 ~ ~ F,~ / ~ x s to c ~ ~ et~,£,, iK ~.,.yH x ~ z w.ti y n +»F~t +7 ~a t bt 't 3.~a P +1 ~ .TM n..~yy ~ sass 4R ~ ~o- s.~ f ;~.4 '3,^ ti ~~~~~i-"~'1?~ ~ t?'t ^y""'~wyw~~ .W4'~ 'R' Qk' - ~ '"'£ft Y '9 ~~f ~ F 4 € a" fi 'F~ 3~ 2a .e Ma- 1~9~, v.~ a a f a ~ ~9 ~ 5 ~W~ r i 3,.q a +e r z ~ n ~ai~~~ >s r 'IRUbFELB ~Y~~~ i~~y. Tohq IvT. Bredemeyer, I[I, Presidcnt ~ ~ ~'s : SUP~`RY?~~?R Henry P. Smith, Vice President ~ ~ ~ °j ; „ ~ ~ ~ ~ SCOTS', t,,. iiE~tCFtIS ~ - , John L T3ednosln, Jx "~~lJ,~ ~b~' 1'o,cn Halt,. ' ~ ~ John B. T6ttv~1 ' ' _ ~ ~ 36451',-iainRoad ~ 21, .,1 , t, 1'elephone(~ib)ib~-1b92 ~,.i:ax«i~;:a d~±vl"f li ~s ::io Sockhcld,_<<e=a~ Cork i3y71 FaY (5l5) 755-582' TOWN OP SOUTHOLD 7ttne 11 , 1991 f;l;,~~lel & Associates 9 Village Sgtaare Glen Cove, NY 11542 RE: Charles Kyriakoudes SCTM '1000-70-13-20.9 Deax: 47r C~iuhel: 'Phe Following actions were taken by the Soard o£ Town Trustees during its kegular meeting held on June 6, 7.991: RESOLVED that the Town Trustees APPROVE the request For a ~,aaiver for the following: . 1. Construction of a deck, pool and timber wall, not to be closer then 50' to the existing bulkhead. 2. To remove concrete rubble. 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 youis, ~i~~~ ~ ~ John M. Bredemeyer, III President, Board of Town Trustees r ~{~~f ~ ;ttct !i t r ~ t,r.~~ JMB:jt cc B~.dg Dept Qy~ < ~ 'aa- r ZMS7j~~yJ ~ 1i 4. x ~ b) f£: ik # - rr. S o-r~'ver' mYp. r }1 as ~ ft a "Eb~'~'~H~iz~+~d'>.R~°^'~+v ~y +"'rrX~r>~ 9q:.~ w ~~~~a^*+~~ 1~~~, ~~~X'7;> ' ~ k~ _'v3"y'`f`<r ~a -r~i-i 'n'~ t ~ y 5 4 ~~'5~~ afs Yd '`~4 "'4 ~ r~~~yA~ t C/J~6S~ . } 4. ..4 t y ~ e'~, ~ :t.~b.~, " a 1 ~t ( 'u S 4 i r _ - _ - " r , ~ ~-,emu ~a__ _ . ~ . ;?b.~ ~t._ s~.~~ :a.4: . ~.y.._-.~„ ,__>u.. ,t... ~,.~~c. _ _ , FORM N0.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date 19.~.~.. n rr To . l~Yi.°utr~4.. l l !~.IC;?+;~O~v,•'~..... 3... . PLEASE TAKE NOTICE that your application dated ~ ~ ~ (n1 ~:~:P ...a 9.........,19 q.~.. . for permit to C~-woJ~c~ . ahn. A!NQ,~..O~nOt. , , , ,1~j ¢ 1..... ..............at Location of Property ~.~v1.~.....~~!^.'~ 111--~7 ~J4 C~~ . House No. ~ ~ Street ~ ~Nsmlet County Tax Map No. 1000 Section Q.Zo, . , , , .Block 1 Lot ..d.o,..`1 . Subdivision Filed Map No. Lot No. . pp~~ /va is returned Herewith and disapproved on the following grounds . exR, , K l,1...~?,~,3.9• ~'S~ -~z~,..n..S~~c~tnacQ....C1~.,:~tQn u....o~p.c.1o,;,-;_3a..~«.. . Bu~' ~ ding Inspector RV 1/80 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: v 6 2 / G DATE l © ~J INSPECTOR BOAFD OF HEALTH FORM NO. t 3 SETS OF PL.\NS , TOWN OF SOUTHOLD SURVEY _ . . . . BUILDING DEPARTMENT CIIGCI; . TOWN HALL SEPTIC Foart . , SOUTHOLO, N.Y. 11971 TEL.: 765-1802 t:oT I FY ; CALL Examined ,tka~{., 17.. , 199.1, hIAIL T0: Approved i.~.< . ~ 7.., 199 Permit No............ . Disapproved a/c ! _ . t , ...15.9~^.Sa-A:.;c~i;'".r.Rr~:..°~:. ~~7:~..(r'%k3~r'etiod~4'~:....... 0 J4cll f~-~- . ..A!~o.!~ ~v...0 (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~ 19~~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets .r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c, The work covered by this application may not be commenced befoY•e issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :egulations, for the cons±ruction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspe ons. .pP Si nat re of a licant, or nam , if a corporation) ® cam. (Mailing address of applicant) 1197 ~ Mate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QGr/NE/LS... f1.4'rC'iv. T...~ . ~P~ r'2 /d.~=:~7/~ . Jame of owner of premises ~ E S..... ~.(..~.I f~,K C7t,~ D~„F„ . . . . . . . . . (as on the tai toll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . . . Location of land on which proposed work will be e. House Number J Street Hamlet County Tax Map No. 1000 Section .......Q, ~ , , . Block ~ , , , , , , , , , , Lot 2Q. c .1 • . Subdivision . L .Q~!?~! . , ,1:F-rL; , , , Filed Map No. . l; ,2~, , , . Lot . (Name State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~4•!-~. ,7 . ~~'I b. Intended use and occupancy ~jlJ~ ...,t~/~./t!1. l.L.`?~, , 9 ~ y r LcJ r" n G...r'NazS@.rL~a,.,v~ ..u. '0 w ws'4~. x.,a~.~~.3+!t«a`' M. vc,.,M„. aWe .a.-o-tE~w..r.,. ~a'~.,k~#-- ~"a~`w~~m4~t'd~eY~~°. 3. Nature of work (check which applicable): New Building Additi~.. , Alteration . emo, Repair val Demolition Other Work .WPQA. L?~.~r!L' . 1~e. • . • . ~ ~j' • da (Description) 4. EstimatedCost~ ice,,,,,,,,,,,,,,,,,,,,,,,, Fe (to be paid on filing this application) g 5. If dwelling, number of dwellin 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. Di ~ensions of existing stru Num$~ if any: Front , ' .Rear .Depth . Hei ht ber of Stories . . Dimensions of same structure wit 8. Dimensions of entire new constnih alterations or additions; Front Rear . p ; .Height Number of Stories . ction:Front Rear............... Depth Height • • • • • Number of Stories . . .........p.;.......'... Rear.........' Depth 10. Date of Pu~r hale . . .........Name of Former Owner, . 1 1. Zone or use district in which remises are situated , , , , , , , , , , , , , , , , • , , . . , , , 12. Does proposed construction viol to any zoning law, ordinance or regulation: ...~tlo . r~_.-...... 13. Will lot be regraded tV,p, , ~ , , , , , , , , , , , , , , , , , ,Will excess fill be removed rom premises• ~ Ycs No 14. Name of Owner of premise K.YR i. Kov~,ES Address 3/.C.eti~~i,;U=, / Phone i~To: Z/.B..7,!{,(~, Name of Architect .~'yfi: ~~%1;,~, , , , ,Address ;~!..Y,., Phone No..~~ , oo p,~, Name of Ifr~esrtS~~ hboT Address ~:e..tF~e-. ~i.P44?~N:~ Phone No. TG. rte'.:-/9~'!0 15. Is this * y Q feet of a tidal wetland? ~yes,,,V(„ No......... y pwn Trustees Permit may be required. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. I S~IE -,~'L. ,~1 NS - ~i i I I n i i STATE OF NEW O/2EU'EaC CrI~EEN COUNTY OI' /PJ ,1 e ~ C c , ~V/ ~~Name of~d~dual~ ~ ~ / ~ ~ ' ' ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant ( gmng contract) above named. i He is the...~r.~l~.~~~}.GT~!~...... _ (Contractor, agent, corporate officer, etc.) ~ ~ ~f said owner or owners, and is duly i<utfiorized to perform or have performed the said work and to make and file this application; that all statements contain~d in this application are true to the best of his knowledge and belief; and that the Nork will be performed in the manner sGt forth in the application filed therewith. iworn to before me this .h.':... ..day f ..~JV ~rE.... 19~~ . c~~ Votary Public, ~I- ~ t~\~ , . . • County • • (Sign tore of applfcant) ? • '=uu1.~,na;.~.3 a.-..'.-.. , wk,~u, ...,F.~m~.tit a" ~ . ,ter-~.- m,ne rr~aasrnde7LS~:a ixll.,.7a sm`;~l,~aa mm~.-5 teF. x,luMi.4,k:~~`1