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Home My WebLink About19627-z I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z20046 Date JULY 2, 1991 THIS CERTIFIES that the building BEACH CABANA Location of Property 800 STROHSON RD. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 10 Lot 23 Subdivision Filed Map No. Lot No. onforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 18, 1991 pursuant to which Building Permit No. 19627Z dated JAN. 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 RE CONSTRUCT A BEACH CABANA AS APPLIED FOR (INCLUDES PARTIAL DEMOLITION) The certificate is issued to MICA MC CANN PANZARINO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N191829 JUNE 14, 1991 PLUMBERS CERTIFICATION DATED HENRY J. SMITH & SON INC. 6/6/91 TOWN TRUSTEES #3755 AMENDED 1/18/91--D.E.C.PERMIT #10-88-0744 ; /-ZZ4r Building Inspector FORK NO. 3 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 1962 7 2 Date .1. 19.1,1 Permission i here y g ed tt2., o n ~2?~~ to ^....~t7fr... . .~......J. ...d~..~...-/ at premises located at P..IJ.. a Ct l~G4..! . 7$~ ........................................:~....YJ.. County Tax Map No. 1000 Section 0....~3 Block /0....... Lot No:...a~ pursuant to application dated ......1/ .~j 0 19.1, and approved by the Building Inspector. Fee oa . Bull g toP Rev. 6/30/80 >aupcsre~rat , r r sa;K* reur•se+.:_etk+.n * ,urram xia s * rte, 1 . HENRY J. SMITH & SON, Inc. PLUMBING. HEATING 8, FUEL OIL MAIN ROAD SOUTHOLD. N.Y. 11971 (516) 765-3690 , C E _R T_I F'I C A T I O N Date Tune 6 1991 Building Permit No.-_--- OwnerAnthony Fanzarino- Plumber Henry_J__Smith_&_Son=_Inc_ I certify that the solder used in the water supply system contains less than 2/10 of 19 lead. M• r"y P mith H n ~ ~ Sworn to before me this _ 6th_day of. June ______s 19_ 91_. Notary Pub is Notary"Public,'Suffolk County 3ERNADETtE L. TAPLIN 'QTARY PUBLIC #4844893 Stste of New York "'Residing in Su#o)k C,oWt Commission_EI(gres seotlo,, I&J- Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 3 S 765-1802 JW - 61991 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date New Construction....! Old Or Pre-existing Building Location of Property..... yDU 1 11.19ty_.4....IQ0.4 0......... ~iciT.... E...... House No. Str,eset 6 ,r1~~ Hamlet Onwer or Owners of Property XAXA:p../16 a4.~...PF..~(z !'2i County Tax Map No 1000, Section...../JO:? Block .../v...........Lot..... 3 Subdivision ....................................F/ill~ed Map............ LLot...................... Permit No...I9i?A1...... Date Of Permit ...Applicant... offawal..&tC4ww.zic Health Dept. Approval u//A ...............U///nderwriters Approval......................... Planning Board Approval..... t~A Request for: Temporary Certificate........... Final Certicate.... Fee Submitted: $ '/d I~/ APPLICANT 1ELD v 1 . ~ ~ ~ 9J 3\(Tv~' FOUNDATION (1st) co FOUNDATION (2nd) m 2. O a, o ROUGH FRAME v C PLUMBING C H 3. m r~ INSULATION PER 11. Y. STATE ENERGY CODE r 4. - --~y FINAL o E z ADDITIONAL COMMENTS: x ' x H 9 H \ H O Z ' T m a\ ' r H T d m H M-1802 BUILDING DEPT. 1 NSPECTION [ J FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ AL REMARKS: C 2 DATE INSPECTOR --c/ / / - I e M-1802 BUILDING INSPECTION [ ] FOUNDATION I ST L G. [ ] FOUNDATION 2ND [ I INSULATION [ RAMING [ ] FINAL REMARKS: A~'1 r ATE INSPECT a M t. f L- /A ic. {Ny S ` 20 , i ~pce , 5 19.0 Z_.. r y! y{~ Y ~ terr, BlAC147 o.P t 5*FS.E_EV 'yl 4. / dV t 1,~lN OF 1;-O Ftft v iJY V Oi J V y. t1 - i t, i ST I ?P;Li qtr G w `--]a•J~~~{_ • 4~~. t.~ i i - ~ 14~ •J I j L Y „ Law. C ES Cy INS Survey map it h..ased sari Glatt na' Fe r, ak ad M iW a. valid true copy.. i .v. _f rl •~V fiua:antaaa Fefceted her,.n `%,i sto I - i i y m the ya•san fm v amav W P[AYNOJi E 1 rrc arad, and an h to t _ J-1 f eeor a, ~r in. y:ndrlan 1. v a,^.d ALL-. w s Z L~ F1EGraE.l 1:. U v (T t, :e a ..ssa 1 iii i'•.[ ~C_ ` ~,1..':u :,~c W. (70.0 av..,er,. t t, JE F, C(1,1"~'X MAP tiATn r•: i"a1 i if; MAP AtiiMAQ.V i 991 i i ' I (.a z < t CITi$AN{Cit A A`.SU(Z.V't YL L? ittir cii9Cb t r - ry Cz~ E i / ! t / ItV j _I_ UY i,.., °_j L.. . } a m o 1, t r, I ELR~f t.QtvSTE2 TO MEAN SEA LEVEL. ..:w i- ; xY ] w ~F..r ~ +ta Ir,:j?°~ Fr^4`'h1 r~tiff.'F~~.F,',>.r(:: , •n~i w: r,.i_r~.~. r'~'~rd a•,r'.. ~:~en~~ PI"R4 _ PAGE ,1 THE NEW YORK BOARD OF FIRE UNDERWRITER w 1001071 BUREAU OF ELECTRICITY x F- 88 JOHN STREET. NEW YORK. NEW YORK 10038 JUNE 14 ,1991. Application No. on file 72418991/91 N 191829 Date THIS CERTIFIES THAT only the sleetrleal "eipment as described below and introduced by the applicant named on the above application number in the promises of ANTHONY PANZARINO, 800 STROHSON ROAD, CUTCHOGUE, N.Y. in thefollowinK location; ? Barement A /st Fl. ? Y,.d F7. OUT Section Block Lot ? was examined on JUNE 06 , 1991 and found to be in compliance with the requirement, of this Board. a s R%TIN1 ACISS fYTITCNK RXT 000KKtO GtCKS OVENS 011101 EXHAUST FANS- OunSTS 146 NNSCIWT nUOKt7CWT OTHER NAT. K. W. NAT. X. W. NAi. K.W. NAT. K. W. AMT. N. P. ash 7 1 4 6 1 F is OEYEE$ RINIACE MOTORS IUTIN! AFNIAN011111Yt fMQAIIBCFt tMMi:IOClIf SM0 UIKi IIfATNi ssum~ OBAMEIIS AMT. K. W. Oll H. P. GAS H. P. AMT. No. A. W, c. NAf. AMP. I1MT. MAK. TRANS. AMT. H. P. 004~- WATTS SERVIM B$=*d= NO. OF 1 E E V 1 C E AMt. AMP. TnE OITXenF. 1 / tw j1 X aw j3 X tVI j3 ,W Ave NO. OF C;coNO. w c~ c°' No. of HI.uc a'WLEG t o. or N *UT A. i t OTIUR A}?AUITUS: - ELEC. ROOM HEATERS:1-1.5 K.W. PANELBOARDS-1-8 CIR. 100 ELEC. WATER HEATERS::1-4.5 K.W. G & S CONTRACTOR LIC.1578E 'Y BOA 215 SOUTHOLD, NY, 1.1971 f1tlERAt M%NAM - 11 per 1 • This certili ate-In q not be offered in any manna; rNurn to die office of the bard if iscorred. InWLtdors may be_idonws11 Ily IWW credentials. : CWY FOR BUMS DEPARTMENT. THIS COPY OF CERTMATE MWlST Nllllf W ALTERED M AM WA M. t. n 95 -6 0189N5c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 10-88-0744 lw 9/11/89 FACILITY/PROGRAM NUMBLR(s) PERMIT EXPIRATION DATL(s) Under the Environmental Conservation Law N/A 9/30/91 Article 327, R 328, Certification Tidal Wetlands 329 Aquatic Pesticides I Water Qua~y Article 15, Title 5: Article 17, Titles 7, 8: Article 27, Title 7; 6NYCRR 360: Protection of Water SPDES Solid Waste Management* Article 15, Article Water Supplytle 15: Air pollution Control* Hazardous Waste Management 3 Article 15, Title 15: Article 23, Title 27: Article 34: Water Transport Mined Land Reclamation Coastal Erosion Management Article 15, Title 15: Article 24: Article 36: Long Island Wells Freshwater Wetlands Floodplain Management Article 15, Title 27: N-New, R-Renewal, M-Modification, Articles 1, 3, 17, 19, 27, 37; Wild, Scenic and Recreational C-Construct (*only), 0-Operate (*only) 6NYCRR 380: Radiation Control Rivers PERMIT ISSUED TO Anthony Panzarino ADDRESS OF PERMITTF.L 43 West 94th Street, New York, NY 10011 AGENT FOR PERMITTEEICONTACT PERSON TELEPHONE NUMBER En-Consultants, 1329 North Sea Rd., Southampton, NY 11968 NAME AND ADDRESS OF PROJECT/FACILITY (If different from Permittee) Mud Creek; 800 Strohson Rd. SCTM 1000-1-3-10-23 LOCATION OF PROJECT/FACILITY COUNTY TOWNICITYIVILLAGE UTM COORDINATES Cutchogue Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY Reconstruct an existing beach houe and decks and install concrete pad for pool filter. Construct catwalk, ramp, and float. All work shall be in accordance with the attached NYSDEC approved plans. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli• ante with the ECL, all applicable regulations and the conditions specified herein or attached hereto. 1 The permitteeshall file intheofficeof the appropriate regional permit administrator, or other office designated mthespeual conditions, a noticeof intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him/her promptly in writing of the completion of the work 2 The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public interest so requires pursuant to ECL §710301 and SAPA §401(3) 3 The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descnp Uon resulting from the said project. 4 The Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when a) the scope of the project is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found, or b) the permit was obtained by misrepresentation or failure to disclose relevent facts, or c) newly discovered information or significant physical changes are discovered since the permit was issued 5 To maintain a valid permit, the permittee must submit a renewal application, including any forms, fees or supplemental information, which may be required by the Department, at least 30 days prior to the expiration date of the existing permit (180 days prior for State pollution discharge elimination system permits (SPDES). Solid waste management facilities permits (SWMF), or Hazardous waste management facilities permits (HWMH) 6 This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit 7 The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way which may be required for this project 8 Issuance of this permit by the Department does not, unless expressly provided for, modify, supersede or rescind an order on consent or determination by the Commissioner Issued heretofore by the Department or any of the terms, conditions, or requirements contained in such order or determination 9 Any modification of this permit granted by the Department must be in writing and attached hereto STR017LATORY AI+PAI" PERMIT ISSUANCE DATE PERMIT ADMINISTRATOR ADDRESS BUILDING 40 9/ 11/89 Robert A. Greene S'T'ATE UNIVEg8ITy Cip NEW YClitir AUTHORIZED SIGNATURE 1 a T{, N Yf)RK t t 7914 .-/fPage 1 of 3 cc: BMHP 1 95-20ba (1/86)-25c ADDITIORAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 ( ) ~0. That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized, or project. if, in the opinion of the Department of Environmental Conservation 14 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly, without leaving large refuse piles, ridges across waters or flood flogs or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State, the owner may be ordered by the Department to a waterway. remove or alter the structural work, obstructions, or hazards caused 15. There shall be no unreasonable interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein authorized. revocation of this permit, the structure, fill, excavation, or other 16. If upon the expiration or revocation of this permit, the project hereby modification of the watercourse hereby authorized shall not be com- authorized has not been completed, the applicant shall, without expense pleted, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental Department of Environmental Conservation may require, remove all or Conservation may require, remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its former condition. No claim shall be made against the State of and flood capacity of the watercourse. No claim shall be made against New York on account of any such removal or alteration. the State of New York on account of any such removal or alteration. 17 If granted under Article 36, this permit does not signify in any way 11 That the State of New York shall in no case be liable for any damage that the project will be free from flooding. or injury to the structure or work herein authorized which maybe caused 18. If granted under 6 NYCRR Part 608, the NYS Department of Environ- by or result from future operations undertaken by the State for the mental Conservation hereby certifies that the subject project will not conservation or improvement of navigation, or for other purposes, and contravene effluent limitations or other limitations or standards under no claim or right to compensation shall accrue from any such damage. Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 12 Granting of this permit does not relieve the applicant of the responsi- (PL 95-217) provided that all of the conditions listed herein are met, bility of obtaining any other permission, consent or approval from 19. All activities authorized by this permit must be in strict conformance the U.S. Army Corps of Engineers, U.S. Coast Guard, Ndw York State with the, approved plans submitted by the applicant or his agent as part Office of General Services or local government which may be required. of the permit application. 13. All necessary precautions shall be taken to preclude contamination 2 sheets, site & of any wetland or waterway by suspended solids, sediments, fuels, Such approved plans were prepared by solvents, lubricants, epoxy coatings, paints, concrete, leachateor any profile view prepared by En-eClonsultants dated as revise 9 SPECIAL CONDITIONS 1. The beach house and decks shall be reconstructed in-kind, in-place with no change in configuration or size. 2. No construction material or debris shall enter the tidal wetlands adjacent to the beach house. 3. There shall be no disturbance to tidal wetland vegetation during dock and deck construction. 4. The catwalk shall be a minimum of 3.5' above the grade of the marsh. Supplementary Special Conditions (A) through (J) attached. DEC PERMIT NUMBER 10-88-0744 PROGRAMIFACILITY NUMBER N/A ' Page of _ . r ~ J1 ~1 ~0'l2dLG~wruy ~'/2CGU12eP//ti 4 Bezel LaneOO O Smithtown, N.Y. 11788 516-724-7888 Town of Southold Building Dept. Sept. 19, 1990 Main Road Southold, NY Re: Panzarino Beach House Dear Sir, This letter is to clarify the pump system on the above named project. The contractor is going to install a "Quick Jon" sewage removal system (model WM262 by Zoeller Co.) in the beach house. It willlpump effluent from the beach house to a secondary lift station 45 feet away. This lift station will then lift the effluent to the existing house trap, which leads to the existing septic system. The Suffolk County Health Dept. has seen the proposal, and informed us that we would not need approval from them on this project. If you have any questions, do not hesitate to call. Very Truly Yourss~, x Thpmas D. Reilly TDR:ls . Y I ' ~ti EASP r ~•'J~~ do !-e _~Wit;:, ,l, CUT`.H-OGUEI o K -7 Oe .c' v10f'I -9Pt! ~ x ~ `a ~ At/ sn'4 RT/N/d /jLT~RN/FLO Rf~ '4 ~ Z wt ~ /?oos N y dl k j E V /0! Su FFotK Co, ~e o obi /-J/-~GaTRol7 ntlPa3 / 3000 Ce N pp fcK O„q Su/HHi NG <4K U %I uJ Ij~"`~ r N u// ;,lf 0 PaaLH-1, /01 STo RY No Esc n/oTE 5 OaTUn:~~w NYSDEC Pc~F1P0SE /GOOD CoNTRoL APPROVED flp~AcENT ocaNERS' F°.l C R os DATE _ I a. J. s o /S 30 PRO Po5c"0 ~{~2o PoSc'D ~/~/1 Yw6~L Fat OOGK iz AIV-r"ONy P,RNZARINo SrRoHSO~I ROAD or M"o CR~~K a f CU Tc Hd 6UG/ 5V/KF0G/< Co.p At.. Y. sa~E-r l ~f~ y/8/s8 Rev //u/a9 i 1 Y i Q Q 7 0 ~V ca ~ NyS1 a r APPROVED DATE o o ~ ro ~S-o~~/y a a ? o ~i e Y O O X d ~ k ; Q I Ag0po ScQ Hir rrloNY PfrNLA R/No on Mvp CREED a f Cv7-cHvGUL~ f .SUFFOLK n/. y~ S-v c. c' -ra Uca Q6v y/Itle'l 88 •vl. JC. JOB SHEET NO. 5'~4 OF THOMAS D. REILLY, P.E. Consulting Engineer CALCULATED BY DATE 4 Bezel Lane 1 SMITHTOWN, NY 11787 CHECKED BY DATE_ SCALE i •Ad P. . + , : i ' i I : MsxTlw.: niM r.... n~.r~ f ~ ~~$UFFO(,~C 0~0 OGy~ TRUSTEES SCOTT L. HARRIS John M. Bredemeyer, 111, President Supervisor Henry P. Smith, Vice President Jr. Town Hall, 53095 Main Road Albert J. Krupski, P.O. L. Bednoski, Jr. . Box 11 k 11971 John B. Tuthill Southold, New York BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 January 18, 1991 John Bertani Builder Inc. 1380 Oakwood Drive Southold, NY 11971 Re: Amendment of Permit No. -3755 Dear Mr. Bertani: The following action was taken by the Board of Town Trustees during their regular meeting held on January 17, 1991 regarding your request to amend the above permit. RESOLVED that the Town Trustees Approve the request of John Bertani on behalf of Anthony Panzarino to amend permit number 3755 to rebuild the boat house inkind/inplace. Please note that in addition to upgrading the system, all runoff must be contained in drywells. All other terms and conditions in the original permit granted shall remain. The amended permit shall take effect upon receipt of payment of the following fees: Very truly yo?urs',,, y~,~ L~ . , John M. Bredemeyer, III President, Board of Trustees cc: CAC Bldg. Dept. JMB:jmt i~ ~IA Ilia r Board Of Southold Town Trustees SOUTHOLD, NEW YORK "I 1, gyp:. Z »j .a' Its < PERMIT NO. 3755 DATE: June 23, 1989 ISSUED TO ANTHONY PANZARINO ~ r ,~111t~Dxt~MttAri b` Pursuant to the provisions of Chapter 615 of the Laws of I' the State of New York, 1893; and Chapter 404 of the Laws of the ti'; State of New York 1952; and the Southold Town Ordinance en- "J titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the !fti REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on June 22, 14~ 19 89.., and in consideration of the sum of paid by of N. Y. and subject to the . d Terms and Conditions listed on the reverse side hereof, It al of Southold Town Trustees authorizes and permits the following: To construct 4' x 60' catwalk, 4' x 16' ramp, 8' x 24' float, 4' x T concrete pad, drywell, install 14 pilings. Property located at 800 Strohson Rd., Cutchogue, N.Y. all in accordance with the detailed specifications as presented in'' ' Y the originating application. IN WITNESS WHEREOF The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of th aid Board as of this date. G \ 005 FFOC~-~o ~ a i^ n fI) ~ ~Fa ~ ~ ~ +J«,tli~„ us'A 2`,eL"r'av..~'„`~.,.r~ °,w ~-~"^~S.9 ,r'!r .z +T~a ax '^9r7se»',uRiT T a,r~^'sjetuL,n,.c4'~ 1 x' I l r , . x464~1~' . 4 ,i.,'H~ ' ~ .z',;r:~ 'r/ • t~. Y TERMS and CONDITIONS The Permittee Anthony Panzarino residing at 43; West 9th street, New York N. Y. as part of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. The ISouthold Town Trustees Permit must be prominently displayed on premises effected during period of work. 1. That the said Hoard of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to', the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 24 mos. which is considered to be the estimated time required' to complete the work involved,, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 5. That there wilt be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shah be no interference with the right of the public to pass and repass along the beach between high', and low water marks, i 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of,the work auth- orized. I 9. That the Pernjittee will obtain all other permits and consents that may be required sup- plemental to this perm#t which may be subject to revoke upon failure to obtain same. !M>o/~'.d'J."«: S4".'J(PnS4icctt vi-~{^. 'Im •y.3, _ ,:I?'A'aa?~.K^^ ,-~'.a~Jft"F',, s,.R=,'}q_?.exq~r~, aCo'aTi C?1-1SON_....' CnrzivA~"e '~LOacr}~~ 1507,0. Cd' G9L s• ~ 'I1.Py F ~ ~ ~ n y AA N : > O -M M A Z . ~ ~ tJT PCH. r - o ° q°q~ ORUIN~RY HIM - ~t4o, . ~.F1 gig wgx c~ ~ a r7 i Iz YI C A~~ _i~ fl f ~~Gl x~ D Li _ BOARD OF HEALTH p j FonrAN0.1 3 SETS OF PLANS A SURVEY TOWN OF SOUTHOLD CIIECI . BUILDING DEPARTMENT SEPTIC FORM BLDG. DETT. TOWN HALL T WNOF SOUTHOLD , SOUTHOLD. N.Y. 11971 NOTIFY: TEL.: 7G5.1802 CALL l/ 19 Examined MAIL TO: Approved .Y......, 19--~/Permit No..~,74?•a . Disapproved a/c . (Sttildin^ sector) APPLICATION FOR BUILDING PERMIT Date 0190- , Is91. INSTRUCTIONS a. This application must be completely filled in b 'l sets of plans, accurate plot plan to scale. Fee according typewriter or in ink and submitted to the Buildir=irupector, with 3 to schedule. Plot plan showing location of lot and of buildf or areas, and giving g ps pe premises, relationship to adjoining premises or public streets a detailed description of layout of property must be drawn on the diag cation. ram which is put of this appli. 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 shall have been granted by the Building Inspector. whatever until a CertiSgte of Occupancy 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 Lam. 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, housinl- code, and reot:lations, and to admit authorized inspectors on premises and in building for necessary inspections. • . `Y:........ ~r~F.G (Signature of applicant, or name, if a corpora;son) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. z {C AE?~ Name of owner of premises ....!y!G~cC'A v tJ (~~4itlZA ~2 ( (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and &L J` title of corpora[' a officer) Builder's License No. .(,y )q.1717 t.-........ Plumber's License No. . 4m~'':•Wt, q , Electrician's License No. .1,°l.~(,1, ,r~; cx e~ fit? Other Trade's License No. i• Location of land on which proposed work will be done: JOAJ tie house Number Street ' Hamlet County Tax i%tap No. 1000 Section ~D BI'uck , , , lv Lot 3 1" ..i~'.. Subdivision Filed eta p No. . Lot • State existing use and occupancy of premises and intended use and Occupancy of proposed construction: ' use and occupancy ......Q~~...~t$iK!...CC-. b.Intended (e r f fr•:.`~;Cc;~.f use and occupancy 3. Nature of work (check which applicable): New Ouilding Additicn ,utcrattn . . Repair RFmovial DemolitionPR/2r/,qG . , , .Swimmin Tennis Court•..J Accessory Building Fence .......Other Work. • ~lrL~. 4. Estimated Cost l.~ .~Cl~ Fce ...............19~ a p~~y (to be paid on filing this applichlfoh) 5. If dwelling, number of dwelling units • Number of dwelling units on each floor. If garage, number of cars , . . 6. If business. commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimension of i ing ructures! if any: Front A F, .6 f ; . , Rear C-W e...... Depth ~ Height . Number of Stories j ,a, , Dimensions of same structure with alterations or additipps• Front f' Rear r¢....? Depth r oe 1A • • • • IIcight .11K. Number of Stones . S. Dimensions of ant c new constnwtion: Front , . (I~~.. Rear Depth ...,;i ' Hei ht , , , , , , , Number of Storks • . • • . . 9. Size of lot: Front ...../Z't :..1.......... Rear ..../,;5 Depth fZ4................ . 10. Data of Purchase . , , , Name of Former Owner 11. Zone or use district in which pre ices are situated . 12. Does proposed construction violme any zoning law, ordinance or regulation: Ua • • . 13, Will lot be regraded , 0 Will excess fill be removed from premises: Yes No?( 14. Name of Owner of premises f~(~{~(((G$, , igt/Z,~g (O, Address X10, , ,14P .W JL~ ...Phone No. Name of Architect , Address 4~ve1 , , Phone No. Name of Contractor-.7e fw , Address,/40. Phone No. IS.Is this property locat'ied within 100 feet of a et land? *YES. HO.... *If yes, Southold TowniTrustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all setback 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. (51 Ul2f/d4~ I r I I i STATEOFNEWY RI:, SIIS COUNTY OF iJFFo.4 K . B • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named.. He is the ...6iVrf~72s9...~1 (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly huthorized to Perform or have performed the said work and to make and ile this application: that all statements contained in 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. Sworn to before me this ......................day of. 'i .....A;.... 19 .Q1 a Votary Public . County ~I , HELEN K DE VOE N0TI1IlV PUBLIC, State of New Y No. 4707878, Suffolk C •'i • tO~ + • ~f Term Coon W Expires Mamh d0,1 (Signature of applicant) I FALSE Gl~. - 2~'4 S y.F=OCK E , Fn t \ {2E-ftFx-¢. $>uh~T~NG ?acp WR'k1 IZ 1 u! NIP F~ ov= w/ z}« COY -Ii Ks WOCIP I ` r !_l LE l I SllawAw ~ ' ' .1 lz _---.14 ' ~ - - N~-~( c~0A2 SH11Jbl6L IIpI~ I _ - i w~. f~oora ' I 11, -I F= 11, _ BAST 5 ~TI0 Y A -A 7 j f I i I r r -LL I HI-1,7, i 1' 7 F-T ~IU~gCAI~G ~I.C~ ` T- T I LL 7~ _ LT. - f ~i I Ilil - II Ir l i II, EX1hT. M/•.<ib r.-12Y WF~1.V, -may ~ - r 6OUTH I \ NEWI '3~0L NEW 3o 6-AL. N.v*• IaTZ - - EJEG'(lo TAMtit. _ ~ uw r' uN. f' L `l~Y j -24 i L 49 I ~ SUu~"J~6? ` I ~ i.1 ~ FaE rK!-0 v L_---f - f _ poFfc .::5 LAS- I N i- LL • L _ ~~4 17.N. W~MiaoWS ~ 2~-G„ i t 1 1.r=C . ('GNkI. r-- ' F~'M.V?wY P !4 2-C.,xG-9 C2•o~ I 1k11~.4, t-qP. 'CdYcW. PLUMBER CERTIFICATION UNDE1WRITERSCBiTIFlCAIE - - - ON LEAD CONTENT BEFORE aEpwaEo o - ~I s CERTIFICATE OF OCCUPANCY I SOLDER USED IN WATER SUPPLY SYSTEM CANNOT j EXCEED 2110 Of I% LEAD. ALL PLUMBING M &VAMUMMMED ` TESMG DOME COMING Roof- WvTt7 t tV--W 4;P P-d ~F 111 b i bn~~~ A OUCUPANCY OR PATE:/ lX90ASNOTED6a I IJpp USE IS UNLAWFUL FEE BY: - 1 ` ^ \ NOTIFY U VP;FG- OEPART TAT b -j'-r OWING `IITH®UT CERTIFICATE76L FOL -1 L02 9 9 NS TO A PM FOR THE INSPECTIONS: ]771 ~S ` OF OCCUPANCY tl FOUNDATION - rWOREQUIRED FOR POURED CONCRETE I i 2. ROUGH - FRAMING & PLUMBING f b 3. INSULATION I- L11PTi Wt~ Polak - - - - - 1 VYv 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. I---4 To K~-rAiN 1~~~~b~~0 CAF X I ALL CONSTRUCTION SHALL MEET aF C x1TINC~ 1 THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION B ENERGY PLUMBING CODES. NOT RESPONSIBLE FOR 1 i 1 Il II ( -r-.~- ALL PLUMBING WASTE DESIGN OR CONSTRUCTION ERRORS 8 WATER LINES NEED - I ~ ` TESTING BEFORE COVERING -AL