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HomeMy WebLinkAbout18901-z M FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CEATIFICATE OF OCCUPANCY No Z-19439 Date OCTOBER 11, 1990 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 2225 NORTH SEA DRIVE SOIITHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 4 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1990 pursuant to which Building Permit No. 18901-Z dated MARCH 21, 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 WINDOW & DOOR REPLACEMENT & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS TO CONDITIONS OF ZBA #3894. The certificate is issued to LAWRENCE & JOSEPHINE PEARLSTEIN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-143385 - JULY 30 1990 PLUMBERS CERTIFICATION DATED N/A . ~~'L _ uilding Inspector Rev. 1/81 FoBas xo. s TO1NN 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) 1801 N? Z Date ~9~'®. Permission is hereby ranted tp: 1 rp ~~?~.~...~'~J......~?:.....~.rs°:...~~~~~e~r....,.~~..~. tel. . !z~:.. . a1 . • r of premises located at ....°.~...%l.r~?:.:~..... ......~......~:?.~:~19/.z .............................................Y./..Q2G~~:r.••• G~........................................................... . County Tax Map No. 1000 Section .........?.''.7"...... Block ..........~.....~+Lot No.....~...-~.~ pursuant to application da~.....ll~.r....~ 19.1...., and approved by the Building Inspector. ~/q~~ ao Fee .Gf.7~.cQ 3~.. a~ uil g Inspector Rev. 6/30/80 W Form No. 6 ~ ~ ~ TOWN OF SOUTHOLD IVI ~y~. BUILDING DEPARTMENT Y1r1 TOWN HALL 765-1802 8 DEPT: TOWN OF ~OlITF9QLQ ' 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. G. 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 Build' g cy , Location of Property.. ~.:~i~:S...~d~:1./.~..: rya, . lJiLll~A........... ~J.~K'1l.°IOI~........ House No./ Street QC ~ Hamlet ~ Onwer or Owners of Property....4 /J:~Y.~/~,~G~:.~~~+5 t~! ?~~7~?~. • • :~.~•~.~.C:S~ lr: • • • " County Tax Map No 1000, Section...`5.:/.......Block...7............Lot...~.5~ Subdivision// ....................................FilepdpMap............Lot.......,.. Permit No.4~~~.~.......Date Of Permit~~:y.~~~F?•~•Applicant.P~i9'i ~~~1'Y Health Dept. Approval ..........................Underwriters Approval.. Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: o~.~ APPLICANT Co i. l9 y39 tff.!-1~ 2NSi'~TI~~ Ilb>~7E ~I CO`t;'~t~.vT.S q', a ~ O ~ ~ H OU11?ATY0:1 (1st) 4 c~ m 'OU11?AT20;1 i 2nd) © h'~ ~ A~ ~ ~ I o ,,°,OUGA FRAilE & .PLUMBING y H 3. `-j I2ISULRTI0/1 PER N. Y. STnTE EilERGY 1 ~ ' 1 CO?E M .~~~~jj H 4. ` F:aAL I ~ . ADDITIOPIAL COtnMEPlTS: . _ ~ • • ~ I x r' ~ \ o ~ m a • r x - ~ ~ m ' -o a :i'i fyi~ ,':V r.._,~_, 3i x ,w ` ~ 1. JY I W ~ i A Y ©,G ~ , ~f - - - . ~ ; ~ 7 ME xi' ~ J ~ ~ ~ ~ P.~~D ~ ~ `1 ~ ~rar~' ~ dU~ r, r~ b j e a ;ad . x x ~ ' ~ '.,E~`n~~~ - ~ i 1 ~ ! ~t 7` t a < ~ e~ 4 F 4 t 4 ~ 4 g ~`~Ye .e~ r` ~ ` r' z / ~ ` FEE: ~:f/7 v _._._._...w ._.__._w. _ _ ......FY ILD G DEPARTM/~- _ - ''7G~-7$0„ 2_„~, AM-Tb a p1~A cna TuE~ _ FQOrlOtNBNG INSPECTIONS: ~_..,1,...E,AiINDAX1Od~•-,..~1V0-RE@t1FRE@'^"'"-~. w._......_ -FOR POUREDCON6RETE 2wl¢ _ .._.....,2.::'.~AU6~-•-fR~cM1A16-~gr-Ptt1MBiNG"''_^...__ 3 'INSULATION >a',d - ~ ~ k ~t ~ ~ BE COMPLETE~hAR C.O. ~ _ ~ HAIL MEET _ ,,;j;~; ' YHE REQUIREMENTS OF T -,_N,,y r STA7E"""4x" STRUCTION" & ENERGY CODES. N(ZT kiESeONSIRI F_~~' F9R_....-_.._____-.....~_.,~.N. r - - -~yDESIC~N QR C.ONSTRUCTION ERRORS -=.r, s~ ;;,y"_ x, ~St6) X66-bu8 s~-~s3o - -Tames _ pea_r~S~e -l-~ 7 6 S- 7--56 _ _ _ _ _ ~-Y_Z,~lil.., .5_ea _LrI,~VZ ~_Sy~I ~01~ - - ~11- n 1 - Ql ct----..I-t"Cc-W~e_WD r~ - W cIS _-F'b ~~d`_ -w ~T~--- n o ~ ea c~erfi- - ---fib``' QeC_ sLll_-~--p~._ _~Ink'oWS----were v~lL~_aoU. - -~hA2PfeN ?in~¢rl ¢k -~nQe.Rr. AH ~e~ ,7via I~.u~~. 30N1 ~Y111~ Rn~2rSek 3y~2- l~l.V1(.- - - FwG - gobs b v~ ~e - - - - - - - ~.~ackS - - --~J--~ l-J---------- - J . - e W - - / - _ .,~:r~. ~ To p ld 2X15'(: ~ouse - ~ ~t~ //-oor~ `r - - S I K - ~ - - I - - - ~_DX' P Woa ~b, d,~. ~-X~ -weaQ e hallens-- _ _ L c'~~o h - - - - - - - - - t~ - - - - UewfQ~ ~ ~o ~ Fozcnc xo. s TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .NOVStt`>$ER,.~r 19.89.. TO .LAWRENCE N...PEARLSTEIN, 6 WF l~owner or authorized agent of oppw~~ner) ,~j 1 1570 K~>;? ~ ~ 4-l.~' '~Y--'f`Cr ~ (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: CHAP. 100 Zoning Ordinance Other Applicable Laws, Ordinances•or Regulations at premises hereinafter described in that A DECK ADDITION IS BEING CONSTRUCTED WITHOUT (state character of violation) A BUILDING PERMIT. IN ADDITION BUILDING PERMIT #142632 HAS ERPIRED AND A CERTIFICATE OF OCCUPANCY HAS NOT BEEN APPLIED FOR. in violation of ARTICLE %%VIII, CHAP. 100-281 6 100-284 (Stnte section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the low and to remedy the conditions above mentioned IMMEDIATELY DO NOT CONTINUB WITH CONSTRUCTION. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 2225 NORTH SEA DRIVE, SOUTHOLD County of Suffolk, New Yark. SUFFOLK COUNTY TAX MAP 1000-54-04-23 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low may constitute on offense punishable by fine or imprisonment or both. .......rf..~~..~:.. ORDINANCE INSPE OR FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date .......~0(~./Z,LI[tPi?!e; f,3 19 g~. To SgSFc,4H T k~W 9L~e-~~, . , .1~.~~lZL.ST~ta`t z. i !Lo ~a~.lR1 Y . lLo~l~ u ~ L tr.. c-'~.o.4~, ~ 4. ~•l: Y, t l S7o PLEASE TAKE NOOTICE that your application dated j~.~ 19 .g~. A7 ~ n~GlC 7 l ,1,1 O IV at for permit to • '015 ~1lUdZTN rze4- 4~tU SOuTt~O~.~ Location of Property . v~ ~ r .................tiam%ei House No. Street r~ County Tax Map No. 1000 Section S~'1, .....Block ~.:I........ Lot ~ 3 . Subdivision Filed Map No. Lot No. . . Akr; zic~ @t?2-Q t ~1 C.~....~. is returned herecwlith and disapproved on the following grounds jt • • t OD . ~ `f. t ~ ~"...Ttf rs, , S o v'T c-(v ~5~ ~.Q ~o, u (af. ~ Co ar_~. t~(..S.V rrc~t.fie-c:?~..1=i2o~;c!...Y~.'~~. SI?: ~...t3F?Glc Zo K r ac,C~.. 30.x- 2~ r ~ c~~ ~ ~ : ~ ~ i r. au ~.5.... . ~l.u.~ 2:~~ Building Insp~ for RV 1/80 Qp.a'~" ~r y ,~,A -.~-ti-, ~2t c. cvFFOl~r~r U $~'~~E~ ~ Southold T®wn Board of A eats u~, ~Y,, m PP o~~ ~ ,r MAIN ROAD- STATE ROAD 25 SOUTHOLD, L.L, N. Y'. 11971 TELEPHONE (516) 765-1809 ,~ti ~ - APPEALS BOARD MEMBERS ~ ~ yy~ GERARD P. GOEHRINGER, CHAIRMAN ~ ti~ J~ CHARLES GRIGONIS, JR. HI CG ~k~:;~~•m.- SERGE DDYEN, JR. 1'E1NV~1 CF ~=j~jl fi,f.,l-~~ JOSEPH H. SAWICKI JAMES DINIZID, JR. t?CTION OF THE BOARD OF APPEALS App1. No. 3894 Matter. of >•.,?~..WBF*,.1,:F J_,_.g„ ~SEPH ~P~®I~IPE, IN, Variance to the Zoning ordinance, Article XXIV, Section 100-244B, for permission to construct eck addition with ff;c;Pnt front yard setback. Property ocation: 2225 North Sea Drive, Southold, C'oun~y"Tax Map 1000, Section 54, Block 04, Lot 23. WHEREAS, a public hearing was held and concluded on December 19, 1989 in the matter of the Application of LAWRENCE AND JOSEPH PEARLSTEIN, under Appeal No. 3894; and WHEREAS, 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 area; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the north side of North Sea Drive, Town of Southold and is identified on the Suffolk County Tax Maps as District 1000, Section 54, block 04, lot 23. 2. This is an application for Variances from the Zoning Code Article XXIV, Section 100-244B, for permission to construct a deck addition, proposed deck addition will have insufficient front yard setback. Page 2 - Appl. No. 3894 Matter of LAWRENCE AND JOSEPH PEARLSTEIN Decision rendered January 22, 1990 3. Article XXIV, Section 100-244B, 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 the changes of title to said lot which abstract shall be in the usual form, shall be certified by an attorney or a company regularly doing such work in Suffolk County or by a corporation duly 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. Such lot shall be granted relief for front side and rear yard dimensions as follows: 4. In considering this application, the Board finds and determines: 1a) that the circumstances of this application are uniquely related to the premises and its established nonconformities; Ib) that there is no other method for appellants to pursue; and placing the proposed deck in any other location in the front yard area will require other variance relief; (c) that the area chosen for the deck is not unreasonably located; (d) that the variance will not in turn cause a substantial effect on the safety, health, welfare, comfort, convenience and/or order of the Town; (e) that in carefully considering the record and all the above factors, the interest of justice will be served by granting the variance, as applied conditionally noted below. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Grigonis, it was Page 3 - Appl. No. 3894 Matter of LAWRENCE AND JOSEPH PEARLSTEIN Decision rendered January 22, 1990 RESOLVED, to GRANT a Variance in the matter of the application of LAWRENCE AND JOSEPH PEARLSTEIN as applied under Appeal No. 3894, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That the deck not be any closer than 33 ft. of North Sea Drive. 2. That the deck remain unroofed and open. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, and Dinizio (absent Serge Doyen and Joseph Sawicki). This resolution was duly adopted. df , GF,RARD P. GOEHRINGER / CHAIRMAN o~~F~ou~~o VICTOR LESSARD ~ < Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~ P.O. Box 1179 (516) 765-1802 y ~ ~ Southold, New York 11971 FAX (516) 765-1823 001 ~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 2, 1990 Lawrence & Josephine Pearlstein 121 Broadway Rockville Centre, N.Y. 11570 Re: 2225 North Sea Drive, Southold, N.Y. Suff. Co. Tax Map #1000-54-04-23 Dear Mr. & Mrs. Pearlstein We have received notice from the Zoning Board of Appeals that your application for a variance fqr a deck addition with insufficient front yard setback has been approved. Please submit your check to this office in the amount of $50.00 so that the building permit may be issued. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUIL~ING DEPT. Vincent R. Wieczorek, Ordinance Inspector VRW:gar i , w_.. ~ .____..__...~..r. ~ ~ ~ ~ ~ ~ ~ ~L t Ar k jk yNNN~ R V . i, ~ ~ j/~~ Y sc ~p .mss h 3 < ~ .,4. N sK "vt}yV ~w+~'/'V' ?f5?L ~tFr~ l~lY ` - r! +.y ~ jR 5r1++ V % 1 { { ~y ' ~ ~ ~ ~ t ~ l~ ~ sr +ib L ~ kY T G r ~ ' ~ ~ ~ ~ g ; k . . ~ ~ ~ i ti ~ ~ W td 1 ,f ~ • Y yi -b,0. , . ~ ~ ~ ~ ~ ~ d ~ ' ~ fl~ Z ~,y~ h, LY S{1~.y yn,: t fYiCA'~F"S'yi Y 4)f ; X • .:N y\ * , 1, y k 'S <SV1 ate ~ S„ ~ : C~ r~r ~~~'~y~'`~ ~y~~r,~..~~., 1 ? 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C~ 3~a ~ r~~ ~ }r+!R "r^a. ~ , ~1 'v la d t s kL k, e.~~` r `yt y'?+e. ~ ~{~3 . k.: V'" } f ~~v {k $ ~ ~ ~•Nn-~~y~e~ b ~f k~e5p;~=)~+yrjr .`s _ ~ -,f~~ `r : n u, ,t. h' '1. .k.~ a A` Lx" 4 4Y ~'~,j ry T ~ s'txa sh ~ G rA _ ~y 1? ~~S 7 ~ } y"aK ~}y ~v".'~~' gygy~~ _ . A-". y~A~t ~etL ~...A~~° ~~y Y"h~'P•xW'2~h' 1yi :f'i l~~r 4 , ~ 3~( k~~~~~900~~~~ ~f r Sr s ~ H 1 '.v'~ ~ .eta"`' _ + ~ ~ ~ ,d,¢fn ~"6'~ t~d~ ~v 4 ~ ~ R ~1 ~ 1~~i6>a~~ ~-~~Q~, 7 ~ ~ ~ ~ ~y # ~ ~ aC r.~ ~Ol~1 THE NEW YORK BOARD OF FIRE UNDERWRITERS P"('~ ' lnolr.ss BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 ,IUI_Y 3Ci, 149(1 [~955919(1/9U N 7lt 3;SRti Date Application No. on Jile TNIS CERTIFIES THAT only the elactricd equipment as descrihed 6ebw and introduced 6y the applicant nomad on the eftooe opp/icotian namher in the premisA of Mk.I,.AWRENCk' PE:AKI.ST[{TN, 22?`. N..iFk pft, SpUTNOLp, N. Y. (I(I7 _ in thefollowinq loco i ~ e ant ~ lot FL ? Ynd Fl. .Section Block Lot ~i4rti l.t, ~ was exomined on and found to be in compliancy with the reyuirementA of Chia Buord. AXTUR! RXTURES RANGES COOKING DECKS OVENS DISH WASNlRS EXNAUST FANS OUTLETS [CEFTAClES SWITCHES INCANDESCENT.PlUp1ESCENT OTHER AMT. K.W. AMT. N.W. NAT. K.W. AMt. K.W. AMT. N.P. t} DRYERS ' il1RNAGE MOTORS NTURE AMl1ANCE REDERS SMK:IAL REC'FT TIME I;lOCK4 EEII UNIT HEATERS MULTI.OUTLET DIMMERS EYSTMLS AMT. N. W. Oll N. P. GAS N. I. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N. P. ~ tdT AMT. WATTS SERVIC! dECONNECT NO.Oi S E R V 1 C E AMT. AMY• rypt METER 11 tW t / ]W ] I ]W ] / AW NO.OP CC. COND. A. W.O. NO. OF NLIEG A. W. G. NO. O/ NFUTIIAl3 A. W. G. EGUI?. NR / OF CC. COND. OP NLIEG OP NEUIMI ~ too ca 1 x a ~/a 1 1/ei OTHER AFMRATUk G_t.t;.T:-1 l 711DMA5 .7. BAI. t. P.O. BOt 17q& SOU1'HGL1), NY, 11971 OHIMAI MAIEATiER Al Per This urtifico» must not be altered in any manner; return to the office of the Board if irworrsd. InspsNOrs may bs identified by their cn antiak. g ~I~-I ~ ~ ~o~'~ SnU tk4 L~ rss-iso2 BUILDING DEPT. i NSPECTION [ ] F DATION i5T [ ] U6 PLB [ OUN ION 2 [ ] N TI N ] MI (a [ FI 21t~~,t~ tom, REMARKS: t ~ ~u~~~ DATE~~INSPECTOR i ' 76S-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: _r ~'t-' i-U DATE ~ INSPECTOR ~"''~'~p"- { ` ' BOARD OF HEgLTH t~~ t.z~"'il~7~F ~,L"~•' { 3 SETS OF PLANS ` I~ FORM NO. 1 SUKVEY . . . li ~ TOWN OFSOUTHOLD CHECK t MAY 1 01990 1 is _ . , , g~~~, BUILDING DEPARTMENT SEPTIC FORPt .~9L~Jf TOWN HALL F3LDt°,. DENT'. $OUTHOLD, N.Y. 11971 NOTIPY'o S ~ 1~6 TOWN OF50U1NC71_PJ TEL.:765-1802 CALL d ~ MAIL T 0 ~ 0 i~ - . Examined • l.! • • ~7 . 19 9. 7E 6-0 ll8 Approved 19~~. Permit No....... . . ~ c~et.:. ~t (Building Inspector) APPLICATION FOR BUILDING PERMIT ~f~ / Date ../.'.1.9... 15~~ I INSTRUCTIONS / Y a. Tltis 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 lot and of buildings on premises, relationship to adjoining premises ar 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. e. 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 tb 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 Lativs, 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 authotized inspectors on premises and in building for necessary inspections. `P -,f- (Signal a of applicant, `~9~ orporarion) (Mailing address of /applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~w~?h.... ©?.....~'1.4Y~.~S.....5. G!~........... Name of owner of premises rV (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ......D ~ N F~ Plumber's License No . . Electrician's License No . . Other Trade's License No . . I. Location of land on which proposed work will be done; ' Flouse Number Strcet • • • • ~ ' • ' ' " Hamlet County Tax :0tap No. 1000 Section ...:5.~~ Block Lot 3....... Subdivision Filed t<1ap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: o l~l A. F',xisting use and occupancy.........5:'.~?:h.e::...~;~ S.~' B. Intended use and occupancy............ ~.Ci.tr~a.rn O~:S~'... • • • • . • • • i ~ . 3. Nature of w (check which applicable): New Building , Addition Alteration . f...... . ,Swimming ool. Repair Removal Demolition ~ P • • • • • . • • Tennis ourt•......... Accessory Building..........Fehce .......Other'Warkr.:.......... 4. Estimated Cost .........a~..gU.`f Fee • 5. If dwelling, number of dwelling un (to be paid on filing this applications its , . Number of dwelling units on each floor . ~ , • If garage, number of cars . . • . 6. If business, commercial or mixed pecupancy, specify nature and extent of each t pe of use . 7. Dimensions of exi ling structures; if any: Front 3 Rear 3 Depth , ~ , t , , , , , , . , , Height .....a.. ~ Number of Stories . . , . . Dimensions of sarr1e structure with alterations or additions: Front .....-S a: e..: , . Rear fit, t~,~, . . Depth a, rv;N......I. Height ....-f.~.~": p... .....Number of Stories .......~R.. . 8. Dimensions of entire new constnrction: Front .S, y;; w e. , Rear sg•~;rL.e, Depth g, , Height .....Saw; . ~,lumb'er of Stories . 9. Size of tot: Front j>. ~~p P..:`. `Rear Depth- , !0. Date of Purchase ~ .Name of Former Owner . l 1. Zone or use district in which premises are situated . . . . . 12. Does proposed construction viola-te any zoning law, ordinance or regulation: .....h: ° . . 13. Nill lot be regraded , ~ ~ . ,Will excess till be removed from premises: Yes , No . . 14. Name of Otvner of pzemises C;aiVrFn~C,~f/; ~~gr(~t~rn• Address . (?t 6`waty 7 U. C., ,Phone No..~b.6: A.t ~8 , . Name of Architect . . .Address ...................Phone No................ . ame of Contractor . ~ .Address ..Phone No. `~^t 15,Is this property located within 100 feet of a tidal wetland? *YLrSJ :.NO.... ' *If yes, Southold Townl,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 r4umber or description according to deed, and show street names and indicate whether interior or corner tot. ~ ~ l sous e 30 . N ~ Sew ~rf V{~ STATE OF NE1V YORE, ~~cc f COUNTYOF.....~~!.X.t.v1~. ~S.S • • • • • • • • • • • • • • • • • •~i D ~ ~'~2~v ~ being duly sworn, deposes and says that he is the applicant (Name of divrdual si~tling contract) , about named. Fie is the .................©.f~/'h .2rf . .4.4'4 . (Contractor, agent, corporate officer, etc.) ~ ~ • • • of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file this application; that all statements con(ained 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. ~ Swom to bctorcr me this/ i' .......~.V1 vrSct~c/~~n..dayo'f../}..f 6.~.~.~~., 19 Notary Public, , ,9J~tlpf; , County Q NEtEN K. DE YOE c~t/~~-r~-~ NOTARY PUBLIC, State of ryewYark (Signature oC applicant) No. 4707878, Suffolk County. Term EKpirea March 30,1 ,tt 7~.~ = ga~"G N~ BOARD OF HEALTH . _ 3 SETS OF PLANS . ~~J ~ FORM NO. 1 SURVEY r/ q~v- TOWN OF SOUTHOLD CHECK - t~'.:I+~~~ . s~'p.,_J~2•~_ BUILDI-NG DEPARTMENT SEPTIC FORM TOWN HALL 'j// SOUTEOLDH518021971 NOCALL MAIL T0: Gxamincd 1..17. C~ C ~ ~ ~ Approved ...~.?L......., 19 Permit No..~~.! 6~. / D y DisaPProved a/c ~ ~ FSLDG. DEPT. e TO\M1~N OF SOUTHOL-D (Buil ng Inspector) APPLI//CATION FOR BUILDING PERMIT Date ! 15 s~. INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 public streets ~r~ areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Petmit 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 inspe Lions. C~ . N :....f211+~'~ . (Sig ature of applicant, or name, if a corporatton) ...(.XJ..~.~6~J~'~~....~o~~C?11~a;~. ~T~ N.~. (Mailing address of applicant) ~ 0 State whether applicant is owner,,^lfes's~ele,,/,agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~b ~ ~ l!N~ ...°F A C"~ ...~,~~1~•)--~"~~l ~ . (as on the tax roll or latest deed) !C applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. ~lv~~~1~.. ~ ~~1 Y ~ • , • , , • . ...............................................................5~~~ ~z^~>............. Elouse Number Street. Hamlet ~j County Tax Alap No. 1000 Section • • • • • • ~ • • • Block •-.I Lot • Subdivision Filed Map No. Lot . . (Name) State existing use and occupancy of premises a~nnd intended use andt~occbupancyPofp~ro-+posed construction: a. Existing use and occupancy . ~ Tt.~/)!.L,~~..... J ~ t'~~Y~~ :...es O I J ~ ~ . b. Intended use and occupancy ~ • • • • • • • • - 3. Nature of work (check which' applicable): New Building Addition V....... Alteration , . Repair Removal . Demolition Other 1Vork . (Description) 4. Estimated Cost.. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, num ber of cars . 6. If business, commercial or miYCd occupancy, specify na~,ttrc and extent of.c~h ty~{ic of use mil' 7. Dimensions of existing•sxiuct' res, if any: Front . Rear Depth , , , , , , , , Height ....:...F......N~mberofStories Dimensions of same structurc~i`with alterations or additions: Front . Rcae, . Depth Height ......................Number of Stories . . • Dimensions of enure new construction: Front Rear Depth , Hci;ltt Ntmber of Stories . m 9. Size of lot: Front 8-~....... Rear . e the . . 10. Date of Purchase ~~~....l ~ ..................Name of Former Owner . S~~Q , 1 1. Zone ar use district in which premises are situated . 12. Does proposed construction violate any zoning ]aw, ordinance or regulation : . 13. \Vill lot be regraded . o Nill exc@@ss fill be remov d from premises: Ye c 14. Ow r of premises?'S~'~N(/~~~L~+11/tf~~~, Address . y~) B~°~1Aw~N .Phone No..~/~~ "t/4~ 611 ct tPl'.AlEyS'~IY~ .Address Rbl~'i'/il-tt': ~'~12..)~Iry.. Phone No Name of Contractor ...rte. ~k. ~ , , , , , , , , , , , ,Address .Phone No.. . . IS.Is this property located with in~00 feet of a tidal wetland? *yES....NO.QG. *If yes, Southold Torn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions ft~rr property fines. Give street and block number or descri/p/tio~nQaccording to deed,,/aJn/d/ys-h w~stJreet nam s a tnd~dica~te wttet~le: interior or cornrr lot. ~~5 A,~~1 //G~/ G67~Y/ j/~ , ~~wCr ~T~sr/_/9 ",I"~~ rX2 / d~~~~D U rt- .~i C(iS / J I U~L° ~h~x~l2~hci het. Gcec~I ~ J 1) 61- (nom{Se Q,w~ l~lcLl~ Way-. q.~^ovhd .SOrl7~T ' S~cP~ Q ~ ~~v~~ . Cif 11~~~ r I - ~ o v ~ ~'e ~ ~ ~ ~ o ~ 6 ~s ~X ~ L b O, it , PI ~h ~ I~ - s'~y x 6 hea~er~ -~-~~©e~ f~ Jellyer, J D 1'S'J's re c oeo~ ~ o ~i ~ gofers O r ~ e c~g •~f', STATE OF NE1V YORE, iS.S COUNTY OF o being duly sworn, deposes and says that he is the applicant (Name of individual si^ning contract) above named. licistlte (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pFrform or have performed the said work and to make and 61e 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 manne{'set forth in tltc application filed there'wi[h. Sworn to before me this ' d• Notary Public, ...~U:.,)"...'~~!r!.~-....... County HELEN K. DF. VDE ' ' ' ' ' y~ °G~~"`t~4/•'p/l/^f . . HDTARYPUBLtC,StataotNowYark (Signature of applicant) • No. 4767x/8, Suffolk County q ~ Term Expires Pdlareh 80,19.--i