HomeMy WebLinkAbout19430-z
' FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N. Y.
CERTIFICATE OF OCCUPANCY
No Z-19679 Date SANUARY 24, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 1945 BAYVIEW AVE. MATTITUCK, N.Y. _
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 6 Lot 37
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 1990 pursuant to which
Building Permit No. 19430-Z dated OCTOBER 1~ 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 ACCESSORY SHED AS APPLIED FOR.
The certificate is issued to PHILIP SALICE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
B ilding Inspector
Rev. 1/81
lOB.M NO. f
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Na ~ 9 43"~ Z Date ......1.o~ 19...r~..b
~ moo, ~ ,
Permission is hereby granted t
at premises located at l:,~.~.f;lf... ~ i r~~..~/~
i
County Tox Map No. 1000 Section Block
~ .........rr.......... Lot No........ 3..........
pursuant to application doted 19.~~, and approved by the
Building Inspector.
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Rev. 6/30/80
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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-19680 Date JANUARY 24, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 1945 BAYVIEW AVENUE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section I06 Block 6 Lot 37
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 1990 pursuant to which
Building Permit No. 19430-Z dated OCTOBER 1, 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 ACCESSORY DECK WITH GAZEBO ADDITION AS BUILT & AS PER
BOARD OF APPEALS #3954.
The certificate is issued to PHILIP SAUCE i
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-003237 - JAN. 26, 1988
PLUMBERS CERTIFICATION DATED N/A
. ~vliov
Building Inspector
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 17, lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from ax chitect 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 o£ 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 ..JAN: 24, 1991
New Construction........... Old Or Pre-existing Building
Location of Property... 1945.BAYVIEW AVE: MATTITUCR: N:Y: .
House No.• Street Hamlet ,
Onwer or Owners of Property.......,,,,PHILIP.SALICE . .
County Tax Map No 1000, Section..... 106......Block....6...........Lot.....37
Subdivision ....................................Filed Map............Lot......................
Permit No..~9430,-Z. .,,,,Date Of Permit.,~0/I/90 .,Applicant..PHiLIP SAUCE .
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $...25.000. ,
PHILIP SAUCE
~ex...~I~3~ ...............APPLICANT.......
coy 196gb
' Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 „ JAN: 24: 1991
New Construction........... Old Or Pre-existing Building
Location of Property... 1945.BAYVIEW AVE. MATTITUCK: N.Y..
House No. Street Hamlet
Onwer or Owners of Property........,,,PHILIP SAUCE
County Tax Map No 1000, Section..... 106......Block....6...........Lot.....37
Subdivision ....................................Filed Map............Lot......................
Permit No., 19430~Z.. ,,,,Date Of Permit..~O~1~90.......Applicant„ PHILIP SALICS.
Health Dept, Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate.........,, Final Certicate...........
Fee Submitted: $...ZS,.o00,
Q1~.c,. 4 j ~3 ~ PHILIP SAUCE .
~ Q ~ ~ q6 ~q APPLICANT - '
(516) 765 802 o~OgUFFO(kco
~`Z Gy SCOTT L. HARRIS, Supervisor
VICTOR LES5ARD, Principal ~
CURTIS HORTON, Senior °y x Southold Town Hatl
VINCENT R.'WIECZOREK, Ordinance p P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire y ~ Southold, New York 11971
Building Inspectors '~0,~ ~ ~0 Fax (516) 765-1823
Telephone (516) 765-1800
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 24, 1991
Mr. Philip 5alice
244 Woodhull Ave.
Port Jefferson Station, N.Y. 11776
Re: Building Permit #19430-Z Co Z-19679 & 2-19680
Premises: 1945 Bayview Ave., Mattituck, N.Y.
Suff. Co. Tax Map #1000-106-6-37
Dear Mr. Sauce:
Enclosed please find herewith the above Certificate of
Occupancies for the Accessory Shed, and Accessary Deck with
Gazebo addition.
Also enclosed are copies of correspondence with Lynch Homes
in reference to the CO's for the House.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Georgia Rudder,
Secretary
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APPEALS BOARD MEMBEidS ° ` SCOTT L. HARRIS
- ~ Supervisor
Gerazd P. Goehringer, Chairman ~ ~~Z'
Chazles Grigonis, Jr. "ii Town Hall, 53095 Main Road
Serge Doyen, Jr. P.O. Box 1179
Joseph H. Sawicki Southold, New York 11971
James Dinizio, 7r. BOARD OF APPEALS Fax (516) 765-1823
Telephone (516) 765-1$09 TOWN OF SOUTHOLD Telephone (516) 765-1800
~ ~ s SEP 191990 ~ ~ ~
x
ACTION OF THE BOARD OF APPEAL
g~UC. ~~ur ~~,l;~fl
~TpVdfV OF St7±~TW F
Appl. No. 3954: m t3r.~„„
Matter of PHILIP SALICE. Variance to the Zoninq Ordinance,
Article TII A, Section 100-30A.4 (100-33}, Article XXIII,
Section 100-239.4 B, for permission to construct an accessory
shed and deck with gazebo. Accessory shed is less than 3 ft.
from a lot line, gazebo is located in the front yard and the
gazebo and deck are less than 75 ft. from the bulkhead.
Property Location: 1945 Bayview Avenue, Mattituck, County tax
Map No. 1000, Section 106, Block 06, Lot 37.
WHEREAS, a public hearing was held and concluded on
July 25, 1990 in the matter of the Application of PHILIP SALICE
under Appeal No. 3954; and
WHEREAS, at said hearing all those who desired to be heard
wee heard and their testimony recorded; 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 north
side of Bayview Avenue, Hamlet of Mattituck and is identified on
the Suffolk County Tax Maps as District 1000, Section 106, Block
06, Lot 37.
2: This is an application for Variances fron the Zoning
Code Article III A, Section 100-30A.4,'Article XXIII, section
100-239.4 B, for permission to construct an accessory shed and
deck with gazebo. Accessory shed is less than 3 ft. from the
lot line, the .gazebo and deck is located in the front yard and
is less than 75 ft. from the bulkhead.
Page 2 - Appl. No. 3954
Matter of PHILIP SAUCE
Decision rendered August 8, 1990
3. As of July 25, 1990 the application of PHILIP SAUCE
has been amended, the shed has been moved and is no longer
within 3 feet from the property line, the applicant does not
require a variance from this Board.
4. Article XXIII, section 100-239.4 B, Notwithstanding
any other provisions of this chapter, the following setback
requirements shall apply to all buildings located on lots
adjacent to water bodies and setlands: B. Buildings located on
lots upon which a bulkhead, concrete wall, riprap or similar
structure exists and which are adjacent to tidal water bodies
other than sounds shall be set back not less than seventy-five
(75) feet from the bulkhead.
5. In considering this application, the Board finds and
determines;
(a) that the circumstances of this application are
uniquely related to the premises and its established
nonconformities;
(b) that there is no other method for appellants to
puruse; and placing the proposed gazebo and deck in any other
location on the premises will require other variance relief;
(c) that the area chosen for the gazebo and deck is not
unreasonably located;
(d) that the variance will not in turn cause a substantial
effect on the safety, health, welfare, comfort, convneinece
and/or order of the Town;
(e) that in carefully considering the record and all the
above factors the interests of justice will be served by
granting the variance, as applied and conditionally noted below.
Accordingly, on motion by Mr. Doyen, seconded by
Mr. Goehrigner, it was
Page 3 - Appl. No. 3954
Matter of PHILIP SALICE
Decison rendered August 8, 1990
RESOLVED, to GRANT a Variance in the matter of the
application of PHILIP SALICE as applied under Appeal No. 3954,
AND SUBJECT TO THE FOLLOWING CONDITIONS:
l.. That the gazebo and deck (platform) construction be
located as shown on the survey by I2. Y,an Tuyl dated March 28,
1990.
2. That the application for an accessory structure
was amended so that the building will not be any closer than 3
ft. from the property line. (Variance for accessory building not required.)
3. Any and all lighting must be shielded to the property
and not adversely affect other properties in the area.
Vote of the Board: Ayes: Messrs. Goehringer, Doyen and
Dinizio. (Members Sawicki and Grigonis due to serious
illness.) This resolution was duly adopted.
' GERARD P. GOEH'INGER
CHAIRMAN
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FORM NO. 3
TOtiVN OF SOUTHOLD
BUILDING DEPARTI4IENT
TOWN CLERK'S OFFICE ;
50UTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date !+/.1$/ 19 .
TO .PHILIP SALICB
244 WOODHULL AV1=-
.
PORT JEFFERSON STATION, N.Y.
PLEASE TAKE NOTICE that your application dated 4/9 19 90.. .
for permit to ,CONSTRUCT ACCESSORY SHED AND DECK WITH GAZEBO „ at
Location of Property ...,,1945 BAYVIEW AVE. MATTITIIC&
Nouse No. Street Hamlet
County Tax Map No. 1000 Saction .....106....... Block 0fi.......... Lot 3?......... .
Subdivision Filed Map No. Lot No. .
is returned ]terewith and disapproved on the following grounds Under, Article IIIA Section
100-30A.4 (100-33) accessory shed is less than 3 ft. from a lot line, gazebo
is in the front yard and under Article %%III Section 100-239.4B accessory deck
.and.gazebO.are.leSS.t11~n,75,ft; from the bulkhead.
,gttion required by the-Zoning Board of-Appeals - - - - . - . - - . - • • - . - -
d?-
c--~~~~ uildi- Insp/~r
RV 1/80
FORM NO. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
Date June 19 19..9A..
Philip Salice
TO
(owner or authorized agent of owner)
244 Woo~l~ull Av~
Port Je erson iation, N.Y. 11776
(address of owner or authorized agent of owner)
PLEASE TAKE NOTICE there exists o violation of:
Zoning Ordinonce CBAPTER 100
Other Applicable Laws, Ordinances'or Regulations
at premises hereinafter described in that Accessory Shed, Gazebo and Deck, constructed
(state character of violation)
without a building permit.
ARTICLE %RVIII 100-281
in violation of
(State section or paragraph of applicable low, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned IMMEDIATELY
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
1945 BAYVIEW AVE; T MATTITUCK~„,,,,,,,,,,,,,,,,,,,County of Suffolk, New York.
SUFFOLK COUNTY TA% MAP X1000-106-6-37
Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law
may constitute an offense punishable by fine or imprisonment or both.
!.~l~ Bui mg {nspecTOr
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPRO//VI!AL
Date . T~~ 19~~.~ .
PLEASE TAKE NOTICE that your application dated ...7` . 9 19~~.v. .
/e
for permit to ,a~~ ~~Gk/.~.. i
Location of Progerty ~ t-ri//. L?...........~,'yy{~Q~GfccG~s--
House No. Street 3 7 Nam/et
County Tax Map No. 1000 Section ~ Q ~ ......Block ..............Lot
Subdivision Filed Map No. Lot No. .
is returned herewith and disapproved on the following grounds . v~.~/.L
.a~?~~~ ......as. .~J... ~~a.-:2:3.9-. 5~ .l3
Bu'~din Inspector
Rv 11so
o~~FfOIKCOG
VICTOR LESSARD a' ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR ~ z P.O. Box 1179
Southold, New York 1 1971
(516) 765-1802 ~
FAX (516) 765-1823 yo7"'Q ~ ~~0~
I
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 18, 1990
Philip Salice
244 Woodhull AVe.
Port Jefferson Sta., N.Y.
Dear Mr. Salice:
Enclosed you will find a Notice of Disapproval. A
variance is required from the Zoning Board of Appeals before
building permits can be issued for these structures, deck
gazebo and shed.
We are returning your checks to avoid misplacement.
If you have any questions please call.
Very truly yours,
Thom~'`a
``'v~sflf
F i she~~
TF:hkd
Enc.
Z.B.A. PHONE #765-1809
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE ,
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date 19 .
To .PHILIP SALICE
244 WOODHULL A~
PORT JEFFERSON STATION, N.Y.
PLEASE TAKE NOTICE that your application dated 4/9 19 80.. .
for permit to CONSTRUCT ACCESSORY SEED AND DECK WITH GAZEBO
.............................................................at
Location of Property , , X945 BAYVIEW AVE. MATTITUCR
House No. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Street ~ ~ ~ ~ ~ ~ Hamlet
County Tax Map No. 1000 Section .....106 Block 06.......... Lot 37......... .
Subdivision Filed Map No. Lot No. .
is returned herewith and disapproved on the following grounds Under Article IIIA Section
100-30A.4 (100-33) accessory shed is less than 3 ft. from a lot line, gazebo
is in the front yard and under Article %%III Section 100-239.4B accessory deck
.and.gazebo.aie .~eSS .ttlan ,75 ,l;t., ,from the bulkhead . . .
,Action required• by the • Zoning Board of. Appeals : • • • • • • • • • • . • • ' • • • . - `
B a.ldin nspect~
RV 1/80
FORM SdO. v
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
Date ...ra.,/...~~' 19./...(~J.
TO . ~ . ..~~.G~.>`
(owner dr authorized agent of owner)
(address of owner or autho~gent of caner) ~ ~
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance ~.........~Q.o..
Other Applicable Laws, Ordinances'or Regulations
at premises hereinafter described in that .
/ ~ state character of viol o
in violation of .......X.Y,F ~~)..0.:-:.z.C~l.•
(State section or paragra~1~plicable law, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned IMMEDIATELY
T/he premises to w/hich this ORDER TO REMEDY VIOLATION refers are situated at
......,C.l>°...~0
................~t........:.........~....7..........County of Suffolk, New York.
SUFFOLK COUNTY TAR MAP IF
Failure to remedy the conditions aforesaid and to comply with the app(icoble provisions of law
may constitute an offense punishable by fine or imprisonment ar both.
.~l.......
B ding f pector
' ~ BOARD OF HEALTH
3 SETS OF PL.1NS
FORM NO. t SURVEY .
TOWN OF SOUTHOLD CHECK l/.. J~~.` .
BUILDING DEPARTMENT SEPTIC PORrI
TOWN HALL
$OUTHOLD,N.Y.11971 NOTIFY'<
TEL.:7G5.1802 CALL
~~aa ~ rfAIL T0:
Examined . • 19 a
~~11
Approved I9 Permit No./.~~7.~, , .
/q~, ~y-~ ~ ir93
, i
Disapproved a/c ....y~~~: /.1~.':.. C.fL/~........ ~ /7 ~ ,i.
`~I
l ;<< ~ ~ ~ ~ t
,G,.,_... l ~ ~ APR 12 i~ ~ ; ~ i=
( dmg Inspector) ~~j1~t _ - ~
~ryi:l ~ `r ~ t,J ~ ev .
APPLICA N FOR BUILDING PERMIT= ~ 1 c~
Date 191.v
~
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ~
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of tot 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 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
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of"applicant, or name, if a corporatton)
o?~~-.//~, .GJo ~.~;~cr ~ L.. ~'..P~~.~?`17.c~ sib, !!/l`
(Mailing address of applicants _ _ _
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
-
,f.k,,.,~ .
Name of owner of premises S~_L /
" ''tar' ~ ~ .•••••••.••(asanthetaxroll,orlatestdeed)
If a licant i -a._oor t ~o; ~ re.'pE cjuh .authorized officer.
PP isl P~A.!''atr. 4r~$)g~At>'lt. Y
.........•.r..:3~1~3• ~ •.V1,47!'•':•ltt!1'iHt.,:.:L;:.
(Tlagne~g~~1,fi~t;}}}tt~(;ryrp~';~orpop~te officer)
>fl,~'fi-1;F 1'y~P,i .~~~i ..~~i~i 4. l~At~r,
Builder's License No . .
t/
Plumber's License No . .
Electrician's License No . .
~i
OtlterTradc's License No .
1. Location of land nn which nroposcd v:crk vrill ba done:
House Number Street- Hamlet
County Tax Atop No. 1000 Section ~ ~.~.6. • . • Bock ~ Lot . ~C~..'~. ~ . ~ . ,
Subdivision . C L(.. C.V Filed Map No . Lot .
j~ame)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
0
a. Existing use and occupancy ~//~~~~'~...p...'S ~~~w~... ~~`LC
b. Intended use and occupancy • • .l%'.`~ ZC~1~' .
' ' 'L' /~~7 • 57?? 5, j , .
dditicn Ntaration .
3. Nature of work (check which applicable): New Building A ,
Repair R~moWal Demolition ..............Swimming pool............
Tennis Court ~ Accessory Building..........Fehce .......Other Work
~ f/1) J
4. Estimated Cost Sf~~7 ....~i~ Fee ............~~,~'/.('.GU/3G'.~9.'z ~ , • ,
~e6,~ 7~ Gfj24-~d - (to be paid on filing this application)
5. If dwelling, number of dwelling whits Number of dwelling units on each floor
If garage, number of cars .
. .
6. if business, commercial or mixed'ioccupancy, specify nature and extent of each type of use . .
7. Dimensions of existing structures if any: Front / Rear Depth . .
Height Number of Stories . .
Dimensions of same structure with alterations or.additions: Front Rear . .
Depth Iicight . Number of Stories .
.
Dimensions of entire nett' constriction: Front .s~~..a~'.~-~.~Rear Depth .
Height u tier of Stories .
9. Size of lot: Front /.Q.~`1~ Rear Depth ..~.~5..........
10. Date of Purchase Name of Former Oevncr . .
/.D~'~!TifJ~
1 1. Zone or use district in which premises are situated . . .
12. Does proposed construction v~io} to any zoning law, ordinance or regulation: ~ .
13. 1Vil1 lot be regraded 1Vill exce~§ fill be removed from premises: Yes Nom
1~}. Name of Owner of premises ../`,?7".rL!p ~J~~:< C~dress ..f'a!~' . !J~
:f'.r
:....Phone No..~~.~ . 75.~. ,
Name of Architect . ................Address e .............Phone No................ .
Name of Contractor . ...Address ......Phone No. . ~ .
IS.Is this property located within 100 feet of a tidal wetland? *Y):S~C..NO....
*If yes, Southold Town'I Trustees Permit may be required.~~~/~/- fJ-L-/~L-:'~1~ y
PLOT DIAGRAM C~QF~iNED •.~Zrfs°/~~-~ S
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
~u~G~A/11C~ ~b~~~Y` ~L7Grs'~~~ /``~li-~z~~-~
~'/t/~ ~ ~ ~S'7F~0 GcJ
~yq 2•~a ~ ~I~ pc 773 ~ d~.~ f r`~~--7~'~,-- /c~a .~'r
Sr'~~ ~ S ~C/~ dir. ~P o ED AS NOTF.n~o
t7ATE~ B.I° ~
0
' ~ F~~:~ ~ BY:
NCITIFY BUIL ING DEPART TAT
7~iS-1802 9 AM TO 4 PM FOR THE
e, ~I FULt.JWING INSPECTIONS:
r~,~e ~j 1, FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
L
~ 2. ROUGH -FRAMING & PLUMBING
~~~jT"~ 4. FINALA~O CONSTRUCTION MUST
~ b FOR C.O.
PLETE
r ~j,~ BE CAM
~ ~ ALL CONSTRUCTION ' $HAU. MEET
~ THE REQUIREMENTS Of THE N.Y.
STATE CONBTRUCTION ENERGY
~ CODES. NOT REBpONSIBLE FOR
DESI43N OR CONSTRUCTION ERRORS
STATE OF NE1 Y
COUNTY OFS ~!1.:~~:"~... ''S.S
, . . { being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) •
above named.
Ffcistlte
(Contractor, agent, corpgratc officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file 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 tiled therewith.
Swom to before me this
tl7 - /
Notary Public r~........... • • • • • • • • • County f~ ~//L 'es~'
K ETH 5MCL9Y ~,Gr . 6~.. .
Pdo'ce, oboe, Sttste of tJelk YountY
C2ual. m Su4 t)
No.48'19a9~ . us q7t, (Signature of aPplican
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