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Home My WebLink About18771-zTOWN OF $OUTHOLD 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_O 18771 Z Permission is hereby granted to: ~ a~..~...~...~._~~....~~ ~.z~..: ~,~F~.....~.~...., ........................... · ...o-.~~-.~..., ......................... . , .~....~.~. ...... ~~. ':~..,~....~~....~~,~ ,~....~z~'.~...~....~..~....:~,.~...~ ~t ~m,,., ,ocoted ~, ....~.Z~.~.....OJT. .~,.~.~ .................................................... ..... ~..~.~.....z'-,~,.,~..... F:"~Z.... ~..'~:~ ................................... County Tax Map No. I000 Section ....... .~...~. ...... Block ............. /. .... Lot No ........ /.l ........... pursuant to application doted ..... ~'./.~..~.. ................................... 10.,~., and approved by the Building Inspector. Fee Rev. 6~30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN }~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: I. 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 archiuect or engineer responsible for the buildiag. 6. Submi~ Planning Board Approval of completed site plan requirements. 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 i. 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 ........ ~ew Construction....~.. ..... ()id Or Pre-existing Building ................. Location of Property.. ~ ~.O.q: ..... .~.~.q.~.. ..~..~/~ ............ ..... ~.~.~..gO~_~.. ............ .. House No. Street Hamlet }nwer or Owners of Property.....~.f~.~...../.~.~.~.z?/.<'~'~ .................... . ...... . .. .. . ;ounty Tax Map No 1000, Section. 0..~.~. ....... Block .... ~ ........... Lot../l ................. ;ubdivision ................................... . Filed Map ............ Lot.......... ..... .. .. ... 'ermit No./ .......... Date Of Permit ................ Applicant.. 7~4~. ......... {ealth Dept. Approval.....~..~..~.~.~..~W ....... . .. Underwriters Approval ................. ... . ... . 'lanning Board Approval ...................... .. ~equest for: Temporary Certificate ........... Final Certicate...~z. ...... 'ce Submitted: $ ............................. .~ ~ ~} ~ APPL CAX TEL. 765-1802 TOWN OF SOUTHOLD C E R T,,,I F I C A T I 0 N Date Building Permit No. Owner/(~iv ~5 ' (please print) (please'print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. / ~fplum~er. s signature) Sworn to before me this /or~ day of ~l~ ~,~ ~u- Notary Public, ~%~p c- ~=~< County Notary PulPit, Stme of NewYork No. 4826942 Qualified in Suffolk County Commission Expire~ J~nuary 31, I 9.~.~ Notary Public .~ OUdD~T_O.I (1st) FOU:;DATIO:! 2. (2nd) ROUGH FRAHE & -PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ~DDITIONA'L CO.4ME~ITS. SCOTT L. HARRIS SUPERVISOR FAX (516) 765 - 1823 TELEPHONE (516) 765 - ! 800 OFFICE OF THE SUPERVISOR TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX COVER SHEET TO: FROM: Pages to follow: Additional Comments: IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL SOUTHOLD TOWN HALL at 765-1800 ROBERT AUGUST WILLIAM A I:~ C. H I T H E IN,S ~i,j .-. PROJECT LOCATION: , . DATE OF ISSUANCE OF PROJECT SPECIFICATIONS .v. eD ' ,;: REFER TO DRAWINGS NO. ' · DATED - " ' - .............................. T .............. GENERAL NOTES' RESIDENTIAL CONSTRUCTION (Items 1 - 47 inclusive)~ ~ GENERAL CONSTRUCTION: l. All construction shall strictly conform to the current New York State Energy ConServation Code and the Town or Village Building Department having Juris- diction and all other Federal, State, County, Town and/or Village codes and ~ ,, :. ~: ,ordinances applicable to the construction. The general contractor shall apply ~', ' ,' (', 4s agent on behalf of the owner for and obtain and pay all agency fees for all ,.~' gOn.=~.,i~equired project permits. All permits to be mailed to the owner. The owner " p~ovide to the architect and contractor a survey by a licensed New York i,;,.., ~ ~isS[ate surveyor locating the project and indicating all other data required by .... the applicable County Department of Health and other agencies havlng jurisdic- 7.; 'aon. ;,' Grade as indicated on the drawings relates to the floo~ level onlg and has no relation to any existing conditions or datum. .' < ;~.'" .~ , ,., 3. The general contractor shall verify all dimensions prior to construction and · ~ :'.: advise the architect of any discrepancies prior to construction. ':'}'!&"4, x,x SOL1 bearing assumed at two (2) tons per sq. ft. subject to actual, test and yeti- S' iication by the contractor. If certified bearing is less than two (2) tons, the ",'~' ~- architect shall be notified prior to construction. No footing work-shall be plaC~ .,-.. :,~. on beg, clay or in water without the architect's written approval. - , ; ::~5. All footings shall bear on undisturbed soil and when required step at the ratio of one vertical to two horizontal. ; ,, ',, .x~'. ~ AIl concrete shall be 3000 psi at 28 days with all concrete and reinforced con- crete work and material design and fabrication per the latest ACI specifications. 7. All concrete block material shall conform to ASTM C-90 for hollow load-bearing block or ASTM C-129 for hollow non-load-bearing block (see drawings). 8. The top 8" course of all concrete block 'shall be solid, grouted solid with [ndicatr ., ,,, anchor belts secured into the block work a minimum of 12". ROBERT AUGUST WILLIAM HEINS, A.I.A. A R C H I -I- E: C 'r' GENE RAL CONSTRUCTION: 21. 23. 24. 25. 26. 27. 28. RESIDENTIAL (continued) Use water resistant gypsum board and exterior glue-exterior grade plywood in and/or__.at all areas subject to exposure to water or moisture concentrations. All c°nstructionand ma nstruct on kconform to the N. ¥.S. Energy Conservation Construction Code effective January 1/' 1979 utilizing either Part 5 - Building Design by Acceptable Practice; Part 4 - Building Design by Component Performance Approach; Part 3 - Building Design by Subsystem Analysis, utiliz- ing either Part 5, 4, or $ for determination of mechanical systems and compo- nents criteria; insulation requirements; insulated glass requirements; weather stripping and vapor barrier requirements such that the complete building envel- ope and its mechanical and electrical subsystems conform to the intent and the specified requirements of the State Energy Conservation Construction Code. The architect has not been retained for engineering the mechanical and electrical system and subsystems of this project, and the general contractor shall assume full responsibility for engaging the services of those qualified for the design of such systems. The NYS Energy Conservation Construction Code Table 2-1 designates for Suffolk County, New York, that 6,000 degree days be utilized as the design base for code conformance. Nassau County requires a design base of 5,000 degree days. Moisture barrier shall be installed under all concrete slabs in basement and heated living spaces. Provide 6 x 6 10/10 wwm for all concrete slab work throughou~ project. Contractor shall check and verify all dimensions on the drawings and elevations and conditions at the job site prior to fabrication and erection of work. This contractor on total new construction shall furnish and install a sanitary system as required by the local County Department of Health. Domestic water supply on total new construction shall be in accordance with the local County Department of Health Standards. For alterations, rehabilitations and additions to existing residences, the contrac- tor shall ascertain, provide and pay for al/ tests and agency fees and install addi- tional sanitary system and domestic water supply work as required by the local County Dept. of Health. Also, the contractor shall ascertain, provide and install and pay all utility fees, except customer deposit for increasing the electric serv- ice to this p~oject. The contractor shall also ascertain, provide and install in his contract all insulating, storm windows, caulking, etc. work required on the existing residence to conform to the New York State Energy Conservation Con- struction Code as applicable. 29. All finishes and painting as directed by owner unless otherwise specified. ROBERT AUGUST WILLIAM HEINS, A.I.A. A R C H I T E C T GENERAL CONSTRUCTION: RESIDENTIAL (continued) 30. There shall be provLded in all habitable spaces windows providing 10% of the room areas for natural light and 5% of the room area for natural ventilation. In addition, there shall be a minimum of 5.7 sq. ft. of open area in windows in each habitable space for emergency fire exit in addition to the door or open- ings entering such habitable space. The sill of such window or windows shall be no higher than 3'-6". This note No. 30 shall take precedence over windows indicated on project drawings if applicable. The contractor shall verify this requirement for all room areas prior to application for project building permit. HEATING: 31. The contractor shall provide and install a heating system complete with con- trols and accessories which will maintain an interior temperature in conform- ance with the minimum design standards of the State Energy Conservation Construction Code and methods, with the requirements of the New York State Building Code and the ASME and ASttRAE Codes. The contractor 'shall certify that the installation of the mechanical system and ventilating exhaust fans, etc. strictly conform to the standards and requirements of the State Energy Con- servation Construction Code. 32. The mechanical systems to be incorporated into the house shall be selected by the contractor and approved by the owner with the selection of such com- ponents being based on the requirements of the State Energy Conservation Construction Code. PLUMBING: 33. Furnish and install a plumbing system complete with service and waste lines, valves, fittings and accessories in accordance with the National and New York State Plumbing Code as well as the requirements of the applicable building department having jurisdiction. 34. Plumbing fixtures and accessories shall be furnished and installed by the contractor as selected by'the owner, unless otherwise specified. ELECTRICAL: 35. Install an electrical system complete with service, conduit, wiring, panels, switches, receptacles and required facilities and service for owner's appli- ances and equipment in accordance with the NEC, NEMA, NBFU and LILCO specifications and requirements. The owner shall pay for all utility deposits. AIl other utility' fees shall be paid by the contractor. 36. Lighting fixtures and accessories shall be furnished and installed by the con- tractor as selected by the owner, unless otherwise specified. 37. All electric service and house wiring, busses, and connectors shall be solid copper per NEC specifications. Provide GFI protection per the NEC. -4- ROBERT AUGUST WILLIAM HEINS, A.I.A. A R C H I T E C T GENERAL CONSTRUGTION: RESIDENTIAL (continued) COMMON NOTES FOR ALL TRADES: 38. 170 NOT SGALE DRAWINGS: Use dimensions indicated after verification pr[or to construction. 39. The general contractor shall make arrangements with the owners to ass[st them in selecting a heating system, plumbing and lighting fixtures, built-ins, and specialties that are not indicated on the drawings in accordance with appli- cable codes. 40. Ail materials and equipment shall be installed as per manufacturer's specifi- cations or as indicated on the drawings. 41. In addition to items above, all construction shall strictly conform to the current New York State Building Code applicable to one and two-family dwellings includ- ing factory manufactured homes, including strict conformance to safety during construction and safety, during demolition. AIl work shall conform to all appli- cable construction and life safety requirements of the Federal OSHA Act cluding but not limited to construction fencing and protection of excavated areas to prevent injury to t he workmen and the public. 42. The contractor(s) performing work on this project shall be required to maintain Workmen's Compensation and Disability insurances per New York State Law and any other insurances (LLabiliw or Property Damage) required by any public agency. Any' additional liability and property damage insurance requirements shall be agreed to by the owner and contractor prior to construction. The owner shall consult hLs insurance broker to ascertain insurances he should carry and those that the contractor should carry; such insurance certificates being pre- sented or provided to all parties concerned pr[or to contract signing between the owners and con,ratter. 43. Those drawing with specification notes are instruments of service and shall re- main the prope, rty of Robert Aw W. He[ns, Architect, whether the project for which they are prepared is executed or not. They shall not be used on any' other project except by written authorization of the architect. 44. Unauthorized users of these documents without the written permission of the architect shall be liable for any damages as awarded by the courts. These drawings have been prepared for the site located or described on the project drawings and no permission is herein given for these drawings and notes to be used on any other project site by anyone without the written permission of the architect. 45. The arch[met has not been retained by the owner or contractor to review or in- spect the site this project is to be built upon, and the architect assumes no sponsibility for the suitability of the structural design to the proposed site other than assuming a two-ton sotl-bearing capacity, whose responstbtlity to check and and certify remains w£th the contractor. -5- ROBERT AUGUST WILLIAM HEINS, A.I.A. A R C H I T E C T GENERAL CONS 1 RU(J liON: RESIDENTD\L (continued) COMMON NOTES VOR ALL TRADES: 46. No provision in this project has been made for clay or bog subsurface or for any hydrallic surcharge against the foundation walls. The architect further does not assume responsibility for the project's conformance to any' ordinances or laws or covenants applicable to the sim other than a review of the size with respect to the required building setbacks and applicable zoning ordinances. 47. The architectural services on this project are terminated wi~h the preparation of ~hese drawings and specifications. No changes may be made by ~he owner or contractor to ~hose drawings without the written approval of the architect. The architect has not been retained for the bidding or negotiation phase of this project nor has the architect been retained for construction administra- tion or supervision of the project. THESE DRAWINGS i~JUMBERED Of DATED __ HAVE PREPARED FDR , , FOR TO DE ~DNSTRUCTED AT , . THESE I)RAWINOS ?~ALL BE USED CONJUNCTION WITH ATTAGHED NOTED NUM~RED , TO ,, B~, ~ 11713 -6- TELEPHONE (516) 765-1809 FAX NO. APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. JOSEPH H. SAWlCKI JAMES DINiZIO, JR. (516) 765-1823 i .. p~o. ~0~ 1179 BLDG, DEPT. TOWN OF $OOTHOLD L , ACTION OF THE BOARD OF APPEALS Appl. No. 3863 Matter of~/~--~L~As. Variance to the Zoning Ordinance, Article XXIV, Section 100-244, as disapproved, for permission to c~~!?oI~~~g-With' insufficient 40' frontyard setback in th~~%~i~ri~{. ~operty Location 2700 Sound Avenue, Greenport, County Tax Map No. 1000, Section 033, Block 01, Lot 11. %rHEREAS, a public hearing was held and concluded on September 21, 1989 in the matter of the Application of NICHOLAS TSIRKAS under Appeal No. 3863; and W~EREAS, at said hearing all those who desired to be heard were 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 Sound Drive, Greenport and is identified on the Suffolk County Tax Maps as District 1000, Section 033, Block 01, Lot 11. 2. This is an application for Variances from the Zoning Code Article XXIV, Section 100-2~4, for permission to construct a one family dwelling with an insufficient 40' frontyard setback. Page 2 - Appl. No. 3863 Matter of NICHOLAS TSIRKAS Decision rendered October 4, 1989 3. Article XXIV, Section 100-244, (B) A nonconforming lot separately owned and not adjoining any lot or land in the same ownership at the effective date of this Article and not adjoining any lot or land in the same ownership at any time subsequent to such date may be used, or a building or structure may be erected on such lot for use, in accordance with all the other applicable provisions of this chapter, provided that proof of such separate ownership is submitted in the form of an abstract of title showing changes of title to said lot, which abstract shall be in the usual form, shall be certified by an attorney or a company regularly licensed to examine and ensure title to real property in Suffolk County and shall contain a certification that no contiguous property was owned by an owner of the property involved since the date of any previously applicable Zoning Law. 4. The subject premises is vacant and consists of a total lot area of 25,250 sq. ft., lot width of 100 feet and total average depth of 261+- feet., The proposed dwelling will have insufficient 40' frontyard setback. 5. It is noted for the record that by a prior application under Appeal No. 3471 , a variance to locate a new single-family dwelling with an insufficient setback from the edge of bank along the Long Island Sound, was approved conditionalTy under the following stipulations. 6. It was the opinion of the~Q~rd that: (a) no construction be located closer than 50~eet at the nearest point from the top of the bank. 7. 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 fo~ appellants to pursue; and placing the proposed dwelling in any other location on the premises will require other variance relief; Page 3 - Appl. No. 3863 Matter of NICHOLAS TSIP/KAS Decision rendered October 4, 1989 (c) that the area chosen for this single-family dwelling is not unreasonably located; (d) that in carefully considering the record and all the above factors, the interests of justice will be served by granting the variance, as applied conditionally noted below. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Sawicki, it was RESOLVED, ~~ariance in the matter of the application of NICHOLAS TSKIRKA$ as applied under Appeal No. 3863 for the construction of a single-family dwelling (as described in the above Finding Paragraph 93), SUBJECT TO THE FOLLOWING CONDITIONS: 1. That the single-family dwelling be no closer than ~~o sound Drive. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Doyen, Sawicki and Dinizio. This Resolution was duly adopted. df /GERARD P. GOEHRINGER/ CHAIRM3kN .NRY P. SMITH, President jOHN M. BREDEMEYER, V/ce-Pres. PHILLIP J. GOUBEAUD ALBERT KRUPSKI, JR. ELLEN M. LARSEN BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town HaU, 53095 Main Road P.O. Box 728 Southold, New York [ 1971 August 29, 1986 'I'ELEPI1ONE (516) 765-1892 Ms. Patricia C. Moore Edson & Bruer Attorneys At Law Main Road Southold, New York 11971 Re: Nicholas Tsirkas - Sinsle Family Residence Dear MS. Moore: ' The following action was taken by the Board of Trustees during their regular meeting heid on August 28, 1986 regarding the above captioned matter. WHEREAS, Patricia C. Moore on behalf of Nicholas Tsirkas applied to the Southold Town Trustees for a Waiver of the Wetland Ordinance in accordance with Chapter 97, Article II, Section 97-22 for the construction of a single family residence on property located on the North side of Sound Avenue, Greenport, more particularly identified on the Suffolk County Tax Map as 1000-33-01-11, and WHEREAS the Trustees have personally viewed and are familiar with the subject property and the surrounding area, and WHEREAS, the Board has considered all the documentation submitted concering this request, and WHEREAS, the Board finds and detremines: 1. The project as proposed will not adversely ~ffect the wetlands of the Town. 2. The project as proposed will not adversely affect the health, safety and general welfare of the people of the Town. NOW, THEREFORE BE IT RESOLVED that Pacricfa C. Moore on behalf of Nicholas Tsirkas BE AND HEREBY IS GRANTED A WAIVER of the Wetland Ordinance of the Town of Southold all in accordance with the plans and specifications submitted subject to the following provisions: September 8, 1986 Mr. Nicholas Tsirkas 35-04 208th Street Bayside, New York 11361 Re: Variance w/Town of Southold Eastern Shores, Greenport Dear Mr. Tsirkas: Enclosed please find determination by Trustees to waive Jurisdiction over your property. Congratulations, you can now receive that long-awaited building permit. It has been a pleasure working with you. Very truly yours, Patricia C. Moore Legal Assistant PCM/cas Nicholas Tsirkas - Page 2. 1o Roof run off shall be discharged into dry well. 2. Parking areas within 75 ft. of the Wetlands shall be of porous construction. Blacktop shall not be used on this site. 3. Care is to be taken so as to preclude the entry of any construction material into adjacent waters. 4. Immediately following construction, ail areas of exposed soil shall be properly vegetated to prevent entry of soil into nearby waters. HPS:ip cc: Building Dept. Board of Appeals Trustees file Very truly yours, Henry P. Smith, President Board of To~n~ Trustees FORM NO, 3 TO~N OF SOUTIIOLD BUILDING DEPARTNIENT TOWN CLERK'S OFFICE SOUTHOLD, N,Y. NOTICE OF DISAPPROVAL Location of Property ~/~so~..~o.~.~.~. ......... ~. ~~... ~..~ ' County Tax Ivlap No. 1000 Section . ~....~.~.' .... Block . .~...~ ....... Lot .... ~./ ..... Subdivision ................. Filed Map No ................. Lot No. is returned herewittx and disapproved on tke following grounds ............................... .... 7~ ..... .~ .... ~.~ .... ~. ..... ..~M...t~.P...~~ ~.. ...... ~.a..a..-..~..~~.. ..... Building Inspector RV 1/80 765-1802 BUILDING DEPT. INSPECTION [~/~FOUNDATION 1ST [ ] ROUGH PLBG. [c,~FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE FOUNDATION 1ST [~/~OUGH PLBG. [ ] FOUNrIATION 2ND [ ] INSULATION [ ~RAMING FINAL DATE <~/~/~2 , .SPECTOR~~ 765-1802 BUILDING DEPT. INSPECTION [ F~OUNDAT~ON 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLDG. [ ] FOUNDATION 2ND [ ] INSU~.ATION FRAMING INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUND.~TION ZND [ ] INSULATION [ ] FRAMIN~ [~FINAL REMARKS: DATE INSPEG~I"OR~~'~ Disapproved a/c ............................. ... .. .. . APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 7G5-1802 BOARD OF HEALTH .% - - - SEPTIC FO.RM . .-~-. ........... NOTIFY; . ,$.02.: ......... MAIL TO: Date ................... 19 . . INSTRUCTIONS t;. This application must be completely filled in by typewriter or in ink and submitted to the Building t~pector, w[th. sets of plans, accurate plot plan to s~le. Fee according to schedule. b. Plot pl~ showing location of lot and 0f build~gs on premises, relationship to adjoining premiss or public street or areas, and givEg a detEIed description of layout of property must be drawn on the diagram which h p~ of t~s appl~ ca,on. ~. ~e work covered by t~s application may not be commenced before i~uance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Pc~it to the nppH~t Such peri shall be kept on the premises ava~ab[e for inspection throu~out the work. c. ' No bulldog shall be occupied or mod in whole or in part for n~y purpose whatever until a Ce~ifi~ of Occup~c shall have been granted by ~e Build~g Inspector. ~PPLICATION IS HEREBY MADE to the Bulldog Depmment for the issuance of a B~lding Pemit ~annt to th Building Zone O~dinance of the Town of Southotd, Suffolk County, New York, ~d other applicable ~. Ord~ccs o Regulations, for the construction of bu~d~gs, additions or alterations, or for 3emoval or demolition, as he~ desc~bed ~te applicant agrees to comply with all applicable laws, ordinances, bu~d~g code, housing code, and relations, and t~ admit autho~zcd ~spccto~ on premises and ~ bulldog for neces~ inspections. ~ . ~ ~, ' ......... ~I~ili~ ~dd;e~ ~f applic~t) A State wh~ther applicant is owner, tessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder (as on the tax roil or latest deed) applicant is a corporation, signature of duly authorized officer. Electrician's License No...-~..~2j.~. .............. Other Trade's License No../.-~. ~, .~. b ............. · Location of land on ~which proposed~ork will be do/ce~ ,, . Ilouse Number Street Hamlet County Tax Map No. 1000 Section . .~ ~.~..:'i .... 2 Block .... l .............. Lot..~. (Name) . :. State ~xisting use and occupancy of premises and intended use and occupancy or proposed conslrucfion: ntended usc and occup=ncy · · · · · ' ....... ................................. L Nature of work (check which applicable): New Building . ~ .... Addition .......... /alteration .......... Repair .............. R~movat .............. Demolition .............. Swimming pool... Tennis Court ......... Accessory Building .......... Fence ....... Otherl$$~ ....... I..Extimated Cost .. : ................. Fee .................................. ~ ~ ° (tO be paid on I :s alS~l~c,,at:' $- If dwelling, number of dwelling units .... Z ......... Number of dwelling units on;each,.~oor ;:~ ;~ If garage, number of cars .... I .................................................................. 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front.., ....... ~. .... Rear . .wv. ........... Depth .............. Height ............... Number of Stories ....................................................... Dimensions of Same structure with alterations 9~; ~d. ditjons: Front ................. Rear ........... Depth ...................... ' ' .'' Hmgt~t . .~ .......... '. Nun bar of Stories .. ~ .... 8. Dimensions ofentire new construction: Front .?..~'O.~. Rear .q.~..~..~.( ...... Depth .q~-..'¥j.:.~.. :'. .... Height . ;~9,.eq,...~..: .... .Number of Stones . .c~ ............ 0. Date of Purch~e ...... , ....................... Name of Former Owner ...................... - z : ...... 1. 7~one or use district in which premises are situated .................................................... 2. Does proposed Construction violate any zoning law, ordinance or regulation: . ~/O. ...................... 3. Will lot be regraded .. i~.O,-~ ................... Will excess t211 be removed frorO, premises: . Ye~ t,'C.. Na. Name of Arcl',iteot .~; j~.l.tV.~,, j.L,Lj.~.. ........... Addresslq,.~Tor.~i.O.L~., ~.~.~.~.cfq,£,~, hen .e, No..,q-..~.O. IS.Is this property located within [00 feet of a tidal wetlaud? ~YES.~.'~NO .... mEf yes, Southold Town Trustees permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and, indicate all set-back dimensions from ~roperty lines. Give street and block number or description accord'.mg to deed, and show street names and indicate whether nterior or comer lot. ~:RMIT ~NCLUDES TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY RTGRADING LOT D~VEWAY CONSTRUCTION CESSPOOL CONS't'RUCTION CEM.AR CONSTRUCTION _ STATE OF NEW YORK, S.S ..... ................... ~-....--:-'~..,c~..~.-~-...;. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above na~cd, (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 file this application: that all statements contained in this appliccttion are trn¢ to thc best of his knowledge and belief;and tlxat thc work w~l be perfonned in the m~ner set forth in the application filed therewith. ' Sworn to before mc this ............. day of .............. ,19 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1 I971 TEL.; 765.180:2 BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CtIECK ......... NOTIFY MAIL TO: \pprovcd ......... , 19... Pcrmil No ............ .... (Building In;;~ct~ri Date ............... I~ INSTRUCTIONS a. This application must be completely filled in by typewriter erin ink and submitted to the Building Inspector, w sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pubI/c st ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is par~ of this a zation. ¢. 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 pe ~hall be kept on the premises available for inspection throu2_hout the xvork. e. No building shall be occupied or used in whole or in part for a[w purpose whatever until a Certificate of Occup; shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depm-tment for the issuance of a Building Permit pursuant t~ 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc~ Regulations, for the construction of buildings, ad~ditlons or alterations, or for removal or demolition, as herein descr/ The applicant agrees to comply with all applicable laws. ordinances, building code, housin~ code, and regulations, an . (3ignature of applicant,Oar name, if a'" -Corporauon) .......... &ailing ildress o} appiicX;) State whether applicant is owner, lessee, agent, ~rchitect, engineer, general contractor, electrician, plumber or bull (as on the tax roil or latest deed) applicant i= a corporation, signature of duly authorized officer. (Name and t/tie of co rate cer Builder's License No Plumber's License No ......................... Electrician's License No ....................... Other Tradc's Licen:e No ............... proposed work will be done ' ' Location of land on which ............................. . ................. ..................................................... 7--- tlouse Number Street, Hamlet /y. County Tax Map No. IQ00 Section ...... Block ...~.I ............ Lot ........... Subdivision ..................................... Filed Map No ............ . . . Lot ........... . (Name) ~tate existing usc and occupancy of premises and i:ttendcd use arid occupancy of proposed construction: a. Existing usc and occupancy ................................................. b. Intended usc and occupancy ..... '~" ' 'zY'~' ' ' ' ' 3. Nature o£work (check which applicable): New Uuilding ........,,t/'f Addition ..o,. ..... .~"dterati°n . ~p~r Removal. Demolition Olhcr Wo~k 4 Esfimatld Cost ~-, ~ Fcc ...... (~o bc paid on If dwelling, number of dwclHn~ un,ts .. ~ Number ofdwclHn$ units on cnch floor ...... 6. If business, commcrmal o; m~xcd occupancy, specify nnu~re and cx:cnt oF each Wpa oF usc .............. 7. DimcnsionsofexistinDst~cmrcs, ifany: ~ront ............... Rcnr . .. ............ D~pth ........ Height Number of Stoics ....... Dimensions of same sl~ctur= wilh alterations or additions: Front.. ..............· Rear ......... . . Depth .................... tlei~t Number of Stories .... Dimensions of entire new con~tmctioa: Front ............... Rear ............... Depth ......... Heiaht Nmnbcr of StoNes · .... ~o ............ Depth ......... 9. Sizeoflot: Front i~Sf~ Rear ....... ~ ............. ~ ..... 10. Date of Purchase ................... Name f Foyer'Owner . ~:. ~t~. ........... I I. Zone or use district in which premises arc situated ................................................ 12. Does proposed construction violate any zoning law, ordinnnco or regulation: ........................... 13. Will lot be regraded ........,, ~E.' ~3t~2'5 ............ Will excess ~tI befemovcd from promi:es: . Yes N~= of Architect ......................... &=:ress ....... ; ........... lmon . N~e ag Comractor ....................... Addrgs$ ................... Phone No .... ~..' .... ~If yes, Sou~hold Tow~ Trustees Pcrm~ may be required. PLOT DIAG Locat= cle~ly ~d distLuctly ~1 bu~d~gs, whether existing or proposed, ~d, indicat= ~I set-back dLm:n=ions propc~Y Haas. Give stre=t ~d block number or description according to deed. ~d show street nmos and ~dicatc wh~ intcfior or corner lot. · 8. TATE OF NEW YORK, S.S DUNTY OF ................. ................................................ being duly sworn, deposes and says that he is the applic (Name ofindivid~aI signing contract) ~ove ;~am ed. : is the (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file qication: that all statements contained in this application are true to the best of his knowledge and belief; and that rk wdl he perfo~ed in tt~e m~ncr set forlh in the application filed th=rcwith. om to before me this ..... ~A~ ~t~ ~te ~ ~. Y~ (S ienature o f npplic: T~ ~r~ ~c~ ~ 19_ ~ ,