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FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-21021 Date SEPTEMBER 15, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 40 OLD SHIPYARD LA.&500 L`KOMMEDIEU LA SOUTAOLD,NY
House No. Street Hamlet
County Tax Map No. 1000 Section 64 Block 2 Lot 53
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 9, 1490 pursuant to which
Building Permit No. 19517-Z dated NOVEMBER 15, 1990
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPROVED
BY ZBA #3966.
The certificate is issued to PETER L. $LOOM
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
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Bui 'ng nspe or
Rev. 1/81
TOEffi NO. f
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°_ 1 9 517 Z Date ...W. a:!%`.°.'':".!:!:~4.....C.a~ i9.l..v.
Permission is hereby gran ed to:
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ro ..~WM~n~+eAlith..s.SQ'...G~......dCA..ck~...GL~~x~~vtvs,.tM......t~.....
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of premises located at ...T. ~.....i!:~-. 41.t.Gl:......~Q...................
4,F•c....1 ~~..A.-~...... J
County Tax Map No. 1000 Section ~ ~...t.,. -Block Lot No.....,5.~...........
pursuant to application doted ......../M.`.:`.~`^~,:.....9.........., 19..E a., and approved by the
Building Inspector.
Fee $...b~.~......:
Bui ding Inspector
Rev. 8/30/80
_ Form No. b --7A,/~ l) ~ A,C"/ ,
~`9 , ~fs , ,
~ TOWN OF SOUTHOLD ~j~n_ /~/J~~~ y//,,
j BUILDING DEPARTMENT lG.l~,~%~~~~~Y~f~~~~'*" C9~-
SEP ~ ~ ~:>;:I_. TOWN HALL ~L'-~„%l''.."
765-1802
6
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-O, 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 19 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.
H. For existing buildings (prior to April 4, 1457) 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
CQ eG Date ~i~oZ
Flew Construction., Old Or Pre-existing Building
n
Location of Prope~ ~e3.~x~/1r~4::°~..~Ace!G......~etarT..t'j~/,
House No. Street Hamlet
Onwer or Owners of Property.:
~~:1. ~iG.f!'.~ :fit 7:~. ,~'.~4'+oiP'f .
County Tax Map No 1000, Section..~ea.~! ......Block...r~...........Lot..~:~
Subdivision ....................................Filed Map............Lot......................
Permit No./..~~
7:..~...Date Of Permit. ~~~?.....Applicant.tf%T~•e~iRTlt.N'.Rfl~lT!€. ~J~~o~~~
}Iealth Dept. Approval.....l1~R9
.................Underwriters Approval.../.dll~..................
Planning Board Approval...yv0
Request for: Temporary Certificate........... Final Certicate..~,.......
Fee Submitted: '
~C.( APPL .
INSPECTORS
Victor Lessard OcoUFFO(~- Y2~
Principal Building Inspector m. Cp
Curtis Horton ~ SCOTT L. HARRIS, Supervisor
~ r~, <
Senior Building Inspector ~
Thomas Fisher E ° x Southold Town Hall
Building Inspector d ~ ~ P.O. Box 1179, 53095 Main Road
Gary Fish ~il~~ ' .aOt' Southold, New York 11971
Building Inspector 1 Fax (516) 765-1823
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
SEPTEMBER 9, 1992
R. T. ~RATHWOHL, JR.
WILLOW POND LANE
SODTHOLD, NY 11971
RE: PETER 6 JANET BLOOM
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
x%% An application for Certificate of Occupancy is
not on £ile. (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.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 19517-Z
Please contact our office on this matter. Thank you for
cooperation.
50UTHOLD TOWN BUILDING DEPT.
CC: PETER 6 JANET BLOOM
=~.'tlFt t" WI 2~5~~ OTT L. HARRIS
APPEALS BOARD MEMBERS .t ~ t
,~~=.'~t~d`.:; Supervisor
Gerazd P. Goehringer, Chairman .n e~l.'"h~
BLDG. DEPT.
Charles Grigonis, Jr. '~~I 70WR O~ 'D~~~~~"~i%n~all, 53095 Main Road
Serge Doyen, Jr. P.O. Box 1179
Joseph H. Sawicki Southold, New York 11971
James Dinizio, Jr. BOARD OF APPEALS Fax (516) 765-1823
Telephone (516) 765-1809 TOWN OF SOUTHOLD Telephone (516) 765-1800
October 25. 1990
Mr. K.T. Grathwohl, Jr.
Willow Pond Lane
Southold, NY 11971
Re: Appl. No. 3966 - Bloom
Dear Mr. Grathwohl:
Transmitted for your records is a copy of the determination
rendered by the Board of Appeals at our October 17, 1990 Special
Meeting concerning the above application.
Please be sure to return to all involved agencies for
approvals and permits as deemed necessary. Copies of this
decision have simultaneously been transmitted to the Building
Inspectors' Office for their files and update.
Yours very truly,
GERARD P. GOEHRINGER
CHAIRMAN
By Linda Kowalski
Enclosure
Copy of Decision to:
Building Inspectors' Office
Suffolk County Planning Commission
:r;< ~
t r~ ,
~ ' , w~ r,.. SCOTT L. HARRIS
APPEALS BOARD MEMBERS cf9 t ~ ~ ~
~ Supervisor
Gerard P. Goehringer, Chairman i
Charles Grigonis, Jr. Town Hall, 53095 Main Road
Serge Doyen, ]r. P.O. Box 1179
Joseph H. Sawicki Southold, New York 11971
lames Dinizio, 7r. BOARD OF APPEALS Fax (516) 765-1823
Telephone (516) 765-1809 TOWN OF SOUTHOLD Telephone (516) 765-1800
ACTION OF THE BOARD OF APPEALS
Appeal No. 3966:
Application for PETER BLOOM for a Variance to the Zoning
Ordinance, Articll IIIA, Section 100-30A.3, as disapproved, for
permission to construct a deck addition to existing residence
with insufficient sideyard setbacks. Location of Property: 40
Old Shipyard Lane and 580 L'Hommedieu, Southold; County Tax Map
District 1000, Section 64, Block 2, Lot 53.
WHEREAS, a public hearing was held on September 26, 1990 in
the Matter of the Application of PETER BLOOM under Appeal No.
3966; and
WHEREAS, 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. The premises in question is located along the southerly
side of L'Hommedieu Lane in the Hamlet and Town of Southold, is
also known as Lot X71 on the "Map of Founders Estates" filed in
the Suffolk County Clerk's Office as Map No. 834, and is
moreparticularly identified on the Suffolk County Tax Maps as
District 1000, Section 64, Block 2, Lot 53.
v
Page 2 - Appl. No.-3966
Matter of PETER BLOOM
Decision Rendered October 17, 1990
2. The subjegt premises is a substandard parcel containing
a total lot area of approximately 7,500 square feet, and is a
corner lot with two street frontages: 49.79 feet along Old
Shipyard Lane and 150.13 feet along L'AommeDieu Lane.
3. The subject premises:
(a) is improved with a one-and-one-half store
single-family dwelling set back at its closest point from the
northerly {front} property line 14 feet, exclusive of stoop
area, 12+- feet from its closest point to the southerly property
line, and 36 feet from the easterly {front} property line;
(b) is 1Ccated in the R-40 Zone District which
requires a minimumiside yard at 15 feet.
4. Appellants are requesting permission to construct
raised deck encompassing the existing flagstone patio area and a
partial raised deck around the west side of the house adjacent
to the garage. The width of the proposed deck at its widest
point is to be 11 feet, and the depth 33'6" (west to east).
The setback of thel!proposed deck will be the same as the
existing flagstone, patio at approximately 1-1/2 feet from
the southerly property line.
5. In considering this application, the Board also finds
and determines:
(a) that the grant of the variance will not be
adverse to the essential character of the neighborhood;
(b) thevariance will not in turn be adverse to the
safety, health, welfare, comfort, convenience or order of the
town, or be adverse to neighboring properties;
(c) thel!,grant of the variance will not increase
dwelling unit density or cause a substantial effect on available
governmental facil;ti.ties;
(d) thelrelief is the minimum necessary to afford
relief; !
(e) the!practical difficulties claimed are sufficient;
~ -
Page 3 - Appl. No. 3966
Matter of PETER BLOOM
Decision Rendered October 17, 1990
(f) the difficulties cannot be obviated by some,
method feasible to appellant to pursue, other than a variance;
(g) in considering all of the above factors, the
interests of justice will be served by granting the variance, as
conditionally noted below.
Accordingly, on motion by Mr. Grigonis, seconded by
Mr. Doyen, it was
RESOLVED, to GRANT the relief requested under Appeal
No. 3966 in the Matter of PETER BLOOM for a new deck addition as
described above, SUBJECT TO THE FOLLOWING CONDITIONS:
1. That the deck construction be not closer than eighteen
(18") inches to the southerly (side) property line;
2. That the deck not exceed sixteen (16") inches above
grade;
3. That the deck construction remain open and unroofed,
and not be enclosed, as proposed;
4. That any ligts be ground lighting shielded to the
ground.
5. That the deck construction not be converted for livable
floor area (as proposed).
Vote of the Board: Ayes: Messrs. Goehringer, Doyen,
Grigonis and Dinizio. (Member Sawicki was absent.) This
resolution was duly adopted.
lk
GERARD P. GOEHRINGER, CHAIRMAN
?I::Lb I;:SPE`C;IU;! ~~UnTc ~ CONMENT~
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FORM NO, 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOVYN CLERK'S OFFICE
SO[JTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date 19
PLEASE TAKE NOTICE that you~,rs~ap~pplic~a ion dated ; . , . a...~~............p.~19 ~ .
for permit to C~9~Lp~.~`i-G."..~.!.4/.~`:":~; •4~`c2F~~.~ ..~.-f.'~~L!at
O
O~ U
Location of Property .
H~~No. St
eet ~ ~ ~ Ham/et
County Tax Map No. 1000 Section .......~i.,z`:... Block ,Lot .3 .
Subdivision Filed Map No. , Lot No. .
is returned herewith and disapproved on the fotiowin; grounds !
G:~7.. ~!T
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Bu' ding spect~r
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`I ~ry''~ BOARD OF HEALTH • • • • . • . • •
it 3 SETS OP PL.\NS
4,i~ FORrnN0.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDINGOEPARTMENT SEPTIG r•oart -
6LUG• DEPT' TOWN HALL
TOWN OF SOU7HOLD o~~ 7IJ - Z~p.a• .~XT~~~.
$OUTNOLD, N.Y. }}97} 130TIFY ; d'
TEL.:7G5.1802 CALL _
Examined • 1'V.t)"'l~'!~!~~.5 , 19~.~ MAIL TO'
rrv?x•.Instit, l S~ 9U (.~.).i Q9.Oatp.~R'Y~rrrQ~~,,.d~G•.~rA. .
Approved , 19 ..Permit No. 1.9 S r~ ~J.~ .I.G47~
DisaPProved a/c .
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• • D ~ ,
. I i
(Building Inspector)
APPLICATION FOR BUILDIN(U PERMIT gLDG. oEPT. LO
- 15 9.c~
INSTRUCTIONS
}
a. Tlus application must be completely filled in by typewriter or jn ink and submitted to the Building Inspector, with ~
sets of plans, accurate piot plan to scale. Fee according to schedule.
r b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
+ c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION I5 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
Re;ulations, for the construction of buildings, additions or alterations, or fo[• removal or demolition, as herein described-
' The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulaYons, and to
admit authorized inspectors on premises and in building for necessary inspections-
(Signature of applicant, or name, if a co p rai[on)
- (M/ailing address of applicant)//.
CqJ~~/~C~[..J ~ON CA.i/L~~ ~SOU/~~tJ /t~% y_ //97/
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
........czc~r~r.-.~z
Name of owner of premises T.~"tC..~., x'In et.fl? .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Buildei s License No. .
Plumber's License No . .
Electrician's License No . .
Otl[cr Trades License No .
1. Location of land on which proposed work tvjll be done; y ~ Q (,~Q t U ICY o..~[•-+--
Ll........~..~i~o.-n.~1CF7.!/-;(?...~i4.~C.. P.~.?%,la-,D,
house Number Street Hamlet
County Tax A1ap No.,1000 $flctip,r~~...~4a.7.......... Block 02 Lot
N 4.' w: p,t .,n s•r~ ~.4•.,C~ . .
Subdivision ./~v,~„a~e,,r'...5':_~'~at±"a~~.'r./~~.~.......... C~il~d Dtap No. Lot .
State exis[ing use and occupancy of premises and intended u/~se and occupancy of proposed construction:
a. Existing use and occupancy .~c~ira.~ad,~'• • 1'>?~s"i7-I`t°r,!CG .
b.lntended ~ /
use and occupancy ~,?C3.. ,1'i.'.~.G.ri .
~
3. Natpure of work (checl. which apP(,~icable): New t3uilding , , Addition • • • • Altera ~ 5
Re atr Removal Demolition ..........Swimning po... ~ .
Tennis Court Accessory Building ,Fence .Other Sdork..O/= C./S .
4. Estimated Cost ..~$!?C~4 C7C7 . . Fee ~..1~•a
¢o be paid on filing this application)
5. If dwelling, number of dwelling units ~ .I g sr
Numbcrof dtvcllin units on each Cloor~',y......aZ.... .
If garage.numbcrofcars
6. If business, commercial or mixed pccupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures,, if any: Front . ..?..8.' ~6.~:. , Rear b.:'..... Depth .:z,4!.',~4 ;
: , , , , , , .
Height a•~svc Numbcrof Stories • . .
Dimensions of same structure with alterations or additions: Front . ,~$.'.d Rear •.t:':`~3.: ~ . .
Depth .3.•S•..!a . Iicight .S."9.tr/.".. Nuntbcr of Stories l..z`.... .
Dimensions of entire ncly consEntFtion: Front , ....~3. ~b Rear ..3~ :6::.... , .Depth . .
Hcigitt ,rb• Nuinfber of Stories . , . N..-R, .
9, Size of tot: Front ./.~1.9i.;1,}3.:....... Rear . P . . Depth ~!~>%.9..', . - , • , , • , , , , , , ,
]0. Date of Pu e~ ; , . :.................Name of Potmer Owner .
l 1. Zone or use distract in whic~t premises are situated !Z.:6!~ . .
l Does proposed construction violate any zoning law, ordinance or regulation: , rirl,.t~aw•aC............:... .
13. Hill lot be regraded .:..:...,tV.p excess fill be removed from premises: Yes , NoX.
l4. Name of Owner of premises Pte: rr==,e , ~/,~o„~ , . , AiTdre~s'4.`: X':~ s!: X~kly.:+.•.~J/ ~
% Phone No, 71Sl.':S.z.2 :.i2.7$.
Name of Architect .Address .Phone No.... .
Name of Contractor ........f~^',Ir•.. ...Address ..Phone No.. .
IS.Is this property loca[,ed within 100 feet of a tidal wetland? *YES._..NO.x..
*If yes, Southold Town~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 r}umber or description according to deed, and show street names and indicate whether
. interior or corner lot. ,S//_~ A~T,Q~~ec~.~'~„emery ~~~y3
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STATE OF NEw YORK
COUNTY OF ..fF! ~'':v/./~ , , • S.S
• l! (loam of ir~~ dui n • • • • • ' ' • ' ' ' • • being duly sworn, deposes and says that he is the applicant
~ ' g king contract) ,
above named. ~ ,
He is the ..Cot~J
.~i~1c/a~.:.b~!;vete
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Gle this
application; that alI statements contained in this application arc trot to the best of his knowledge and belief; and that the
work will be perforned in the manneir set forth in the application filed thcrewiith• DRA 4 6ERppY
Sworn to before me this, ~Y ktlitr sdN~wYa1t •
a
In Nh~~l~~~,
.day oG.. 19 lJ L
Notary Public, , . • • • • : • • • • . County
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