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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219209 Date JULY 11, 1990 THIS CERTIFIES that the building ACCESSORY SHED 4640 PINE NECK RD. & 135 NORTH BAYVIEW Location of Property & 90 KIMBERLY LANE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 13 Lot No. 20.20 Subdivision PARADISE BY THE BAYFiled Map No. 6463 Lot No. 20 conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 1, 1989 pursuant to which Building Permit No. 189212 dated MARCH 30, 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---Z,B,A. APPEAL 3902 The certificate is issued to HENRY & CATHERINE HUNSTEIN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~ ui ding nspector Rev. 1/81 nosas xo. s 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 0 .L $ J ~ 1 Z Date /c,'~~...Q 19~ / Permission is hereby granted t~:~~......~..~.? .q! ~•l17~.. '.1..: ~~.v~ d ~ s Q to l~.rinc~l. r~.....G~f.....~~.. ,.A~...~. v~~.....~~.. ..!~f. at premises located at .7:TP..7.Q....~~~i... ...r.G.lr~:lr.'/ . ..iC~`~..... ~7a Z' County Tox Map No. 1000 Section ........,fl..?J.......... Block ~~3......... Lot No..'~ ~ ~ ~ pursuant to application dated .......~.r~...~....~ 19.~., and approved by the 3/~7~cJa Buildfng Inspector, Fee $...~cr`.1.y.7.c.. ...5'•'.~.~ .1.~.~C.r g Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD ~ ~ 4w~~,:;s>i>~ BUILDING DEPARTMENT ~ 6 • TOWN HALL 81.Uf g0t~lM~L19 ~J ~6 765-1802 .~pWN ° . 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-4 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. 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 - Residentri/al $15/00, Commercial $15.00 Date ../.,:11..T.a New Construction L ~'0 1r yam;,,.--;.r~~~-,~~~.~~..~~~ g,,,,,,,,,,,,,,,, Location of Property.....~U.........!Ci~l.~'J~.r4L%. .Gffr/r .............::J,c?U~H44~_....... House Noff.// Street Hamlet Onwer or Owners of Property..l1.G~YRY A~d..~~T~~~~~~...~~Uh!S'T~;/~f! . County Tax Map No 1000, Section...~.~~......'..Block....~3//.....,...Lot..~.x.~:.°S.J......... Subdivision~~1A7JSe,',_„;~,~,~~G~.,',~~r....,.Filed Map ..w~.~:3..Lot., Permit No..~:~~~~~.....Date Of Permit..~~~~:f ~~...Applicant~~~n~/5',~;;~~(~ThE`/Z~AJE. j-7uv,~%C~i? Health Dept. Approval........ Underwriters Approval.. " . ; Planning Board Approval ~CCC,S,fo Rt~ ,~il I~IJ//vE~ Request for: Temporary Certificate........... Final Certicate........... , Fee Submitted: $ „~Tt~~ _ ~~j2/9p ~P icArrr ' . C o zl9~a~ - TZQ~ IWr~T~ i~ CD`(:ac.u1'.S ~ TNS+P~• ~ _ _ mllnario:l _ t1st) JU!IDATZO!I (2nd} z ~C ~ ' O F p • I W 5~.~- ,OUGH FRki•1E & S.' .PLUI4BING ~ • 3. 21lSULAT20iI PER 11. Y• STATE Ei1ERGY I ~ ~ y CODE r b "Tr k . _ ~ ~ FI;:AL • ~ x ADDITI0IIAL 00!^.ME41TS: cn .9 . H • x A 9 . ~ O \ • r1~ • H . - d ' m ro ~ C't iVi. TEL. 7G5-i 802 ~p~~FF~(k~ TOWN OF SOUTIIOLD ; ! ~c OTF]CE Or BUILDING INSPECTOR o v r P.O. BOX 728 v' ` ' ' ~ T01VN FIALL ~0,~~ ~a0~ SOUTEiOLp, N.Y. 11971 1~ JULY 10, 1990 HENRY HUNSTEIN 90 KIMBERLY LANE BO% 437 SOUTHOLD, NEW YORK 11971 To Whom This'.May Cok~cern, We are unable to complete your Certificate of Occupancy because of the following reasons. J~_V/ An application for Certificate of Occupancy is not on file. <ENCLOSED) / / No Underwriters Certificate on file. Tlie oheck is (~~i/not on file. ) $25.00 / / No ?calth Dept. T.pproval on file. No final inspection has been made. Pleaae contact our office on this matter. Thank you for your cooperation. Bui]di.ng Permit 1 8 4 2 1 2 Du.ildinq Dept. ***/J/ No Plumber Solder Certificate on file. ( all permits involving plumbing being iasucd after npril 1,198~I ) 0 5~FF0(prlrt~~ ~ Southold Town Board of Appeals o~~ ,ti~o ',~~t- MAIN ROAD - STATE ROAD 25 SOUTHOLD, L.L, N. Y'. 11971 ~ TELEPHONE (516) 765-1809 APPEALS BOARD 7 (.~,~'S, r°x ~ l~F r MEMBERS ~~7 ~1~ 'x, ~ ~~13, GERARD P. GOEH RINGER, CHAIRMAN m(~ CHARLES GRIGONIS, JR. ~ ~ ~ ~ ~~~u ~ SERGE DOYEN, JR. r~1` S JOSEPH H. SAWIC KI a P ~ # JAMES DINIZIO, JR. 1°""°°'v ~ ` .K~TC1Vti'r.i ~s ACTION OF THE BOARD OF APPEALS Appl. No. 3902 Matter of HENRY HUNSTEIN. Variance to the Zoning Ordinance, Article III A, Section 100-30.3 (100-33), as disapproved, for permission to construct an accessory building ` in frontyard area. Property Location: 90 Kimberly Lane and 135 North Bayview Road, Southold, County Tax Map No. 1000, Section 70, Block 13, Lot 20.20 WHEREAS, a public hearing was held and concluded on February 1, 1990 in the matter of the application of HENRY HUNSTEIN, under Appeal No. 3902; 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 areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the south side of Pine Neck Road, Town of Southold, and is identified on the Suffolk County Tax Maps as District 1000, Section 70, Block 3, Lot 20.20. 2. This is an application for Variances from the Zoning Code Article III A, Section 100-30.3 (100-33), for permission to construct accessory building in frontyard area. 1 t Page 2 - Appl. No. 3902 Matter of HENRY HUN5TEIN Decision rendered February 15, 1990 3. Article III A, Section 100-30.3 (100-33), No building or premises shall be used and no building or part thereof shall be erected or altered in the Low-Density Residential R-40 District unless the same conforms to the requirements of the bulk Schedule and for the Parking Schedule, with the same force and effect as if such regulations were set forth herein in full. \ Article III, Section 100-33, In the Agricultural- Conservation District and Law-Density Residential R-80, R-120, R-200 and R-900 Districts, accessory buildings and structures or other accessory uses may be located in the required rear yard, subject to the following requirements. 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 pursue; and placing the proposed accessory structure in any other location on the premises will require other variance relief; (c) that the area chosen for the accessory structure 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 interests 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 J Page 3 - Appl. No. 3902 Matter of HENRY HUNSTEIN Decision rendered February 15, 1990 RESOLVED, to GRANT a Variance in the matter of the application of HENRY HUNSTEIN as applied under Appeal No. 3902, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That the 16 by 20 ft. 1 story accessory structure not exceed 12 ft. in height. 2. That the accessory structure be 60+- ft. from the Pine Neck Road property line and 60+- ft. away from existing two story family dwelling excluding deck. 3. That the accessory structure only be used for storage ' purposes and only to have electricity. x df GERARD P. GOEHRIGNER, CHAIRMAN y i FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL //Date ~4// 19 3oa.. ~~..Q~-G%e...r~2 .........~,1.~.j.-tea., ..1~../~.,. , / PLEASE TAKE NOTICE thaPyour application dated ~o?: 19 . for permit to G'~"7~. G'C!e~°q G's~cf-~'.~`J:. ~ d[`:`.°'(.. ~!S-.... at Location of Property ~a.~/~.~~etio~~~ . /.~5. , . ,E~~~ Ouse No. Street Hamlet County Tax Map No. 1000 Section 7Q ....Block l~ ....Lot . ~.4r . Subdivision Filed Map No. Lot No. . is returned herewith and disapproved on the following grounds .//ix~l,~!/i ..~~f~(~~T~/.// c~ ~,~i-ter... /.o.o.-3a ~..3 a - 3.3~... Gztz-~ . ~~0 D ~ B ild' Inspe~ or RV 1/80 Door Assembly for 12' Wide Shed End Frame Assembly for 12' Wide Shed 1. Cut 4 pcs. (board A) 2x4-895/a" with notch cut. See 1. Cut 5 pcs. (board A) 2x4-895/8" with notch cut. ~e~ diagram 1 page 2 for cutting instructions. diagram 1 page 2 for cutting instructions. 2. Place board A into shed frame and nail into place 2. Place A boards into shed frame and nail into place using 16D sinkers. using 16D sinkers. b~ +7 l~' ~ 81i A- ~ -A A A -A A a A ( III 8" 6'0" IB" !6" 4~' ~ 2v^ I 4" 2 " 2Y" ~ " ~ + ~ I I 1 i ~ CUTTING IN57RUGtlONS DlA(>RA(~( 1 Door Assembly for 16' Wide Shed End Frame Assembly for 16' Wide Shed 1. Cut 6 pcs. (board A) 2x4-895/e" with notch cut. See 1. Cut 7 pcs. (board A) 2x4-895/e" with notch cut. See diagram 1 page 2 for cutting instructions. diagram 1 page 2 for cutting instructions. 2. Place A boards into shed frame and nail into place 2. Place A boards into end frame and nail into place using 16D sinkers. using 16D sinkers. it ~a 8 a A- a A A- -R- A- A -A 87Y~" 124' 2q" ~ t2 6'O" 1 124" 2q" I 12y" 24" 12 " 2H" 24" 2Y" 2Y" Z4'' `I i ~ ~ 49' I I I I ~g s~ POs#83 - 1-99 LUMBER Deluxe .Storage Building ji ~ ~ I . ~ , ~I ! f ,r""'"'w'"" ~ I. ytl~ f CONTENTS 12' and 16' Storage Building Assembly Page 1 12' and.16' Door and End Assembly Page 2 12'x12' Storage Building (POS #837-11-99) Page 3 12'x16' Storage Building (POS #837-12-99) Page 4 <,L I 16'x16' Storage Building (POS #837-14-99) Page 5 16'x20' Storage Building (POS #837-16-99) Page 6 Materials List Page 7 REVISION DATE ~ ®Copyright 1989. Eighty Four Lumber MAY 1989 ~ FAST, EASY ASSElIl1BLY!!! ENp Watt appF TRJSS ` goTTOM coRD? SITE to of TRU 55 waL muxs ~ t~R FRara~ i t SINGLE PLpiE I FgpNr V/tw ~ Zy ' 23yy' i ~ ' 4 Zy,. ~ ~ f 1~yz, 4 n ~ _,~i'R ~.1~ R'~ ! Instructions for 12' and 16' Shed 1. Cut 4x4 treated skids to 11'9" or 15'9" and space 24" NOTE: Pieces 1, 2, and 3 must be cut from a single on center. See diagram 2 page 7. piece of 4x8 Tt-11 siding. 2. Cut 2x4 ribbon boards to 11'11 15'11", or 19'11" and NOTE: Pieces 4, 7, 8, 9 and 10 must be cut from a nail to 4x4 treated skids using 16D sinkers. See single piece of 4x8 T1-11 siding. diagram 2 page 7. NOTE: Pieces 9, 5 and 6 must be cut from a single 3. Attach 5/8"x4'x8' floor sheathing using SD sinkers. piece of 4x8 T1-11 siding, 4. Cut single top and bottom plates to 11'11", 15'11", or NOTE: When applying front wall sheathing, you must 19'11" and nail to wall trusses (spaced 24" on center) leave 1 Yi' of bottom cord on truss exposed. As well as using 16D sinkers. See diagram top of page 1. '/a" of each door frame piece exposed. This will act as a door stop. 5. Stand wall trusses on end and attach flush with 13. Apply roof sheathing using 8D sinkers. outside edge of 5f8" CDX flooring using 16D sinkers. 6. Attach roof trusses (spaced 24" on center) to single 14. Cut and apply 1x4 trim to corners and rake edge top plates using 16D sinkers. See diagram top of page using SD galvanized nails. 1 15. Apply shingles to roof. 7. Cut door and end wall framing to length and nail in 16. Cut and apply 1x4 trim around door frame opening place using 16D sinkers. See diagram page 2 for using SD galvanized nails. cutting instructions. 17. Cut and apply 1x4 trim to door sheathing using 8. Cut roof and soffit sheathing. Nail soffit sheathing in drywall screws. place using 8D sinkers. See diagram 1 page 7 for 18. Attach hinges to 1x4 door trim using screws enclosed. soffit placement. Roof sheathing will be applied in 19. Place doors indoor opening and attach hinges to 1x4 I step 13. trim around door opening using screws enclosed. 9. Cut side wall sheathing and nail in place using 8D NOTE: Top of door sheathing should hit against 1'/z" galvanized nails. exposure on bottom cord of truss. 10. If building 12' wide building, go to step 11. If building 20. Attach hasp at center of doors using screws enclosed. 16' wide building go to step 12. 21. Attach barrel bolts to top of 1x4 door trim where 11. Cut front and end wall sheathing and nail in place doors meet in center using screws enclosed. using 8D galvanized nails. See diagram 1 page 7. 22. Apply shingles to roof. NOTE: Pieces 2, 3, 8 and 9 must be cut from a single 23. Paint or stain barn as desired. piece of 4x8 T1-11 siding. NOTE: Pieces 1, 7, 5 and 6 must be cut from a single piece of 4x8 Tt-11 siding. NOTE: When applying front wall sheathing, you must leave 1 ~/s" of bottom cord of truss exposed. As well as ~/a" of each door frame piece exposed. This will act as a door stop. 12. Cut front and end wall sheathing and nail in place using SD galvanized nails. See diagram 1 page 7. i Materials List Q i~2x16 Shed vos #a37-12-99 16x16 Shetl vos #837-14-99 16x20 Shed vos #837-16-99 9-4x4-12' Treated skids 9-4x4-16' Treated skids 11 -4x4-16' Treated skids 12x12 Shed vos #837-11-99 cut to 11'9" cut to 15'9" cut to 15'9" ' 7-4x4-12 Treated Skids 2-2x4-16' Treated ribbon 2- 2x4-t6' Treated ribbon 4-2x4-10' Treated cut to 11'9" boards cut 15'11" boards cut 15'11" ribbon boards 2-2x4-12 Treated ribbon 6-s/x"x4-8'floor 8-s/x"x4-8'floor 10-'/e"x4-8'floor boards cutto 11'11" sheathing sheathing sheathing 5-'/e"x4-8' floor 9- pr. Wall trusses 9 - pr. of wall trusses 24" 11 - pr. wall trusses 24" on sheathing 9 -12' trusses 4112 pitch on center center 7 - pr. Wall trusses spaced spaced 24" on center- 9 -16' Trusses 4/12 pitch 11 -16' Trusses 4/12 pitch 24" on center no overhang 24" on center - no spaced 24" on center- ? -12' Trusses 4/12 pitch 4 - 2x4-16' Single bottom overhang - no overhang 24" on center - no and top plates -sides 4 -2x4-16' Single bottom 8-2x4-10' Single bottom overhang and top plates and to lates -side walls 9- 2x4-8' Door and P P 4-2x4-12' Single bottom ? nd frame assembly 13' 2x4-6' Door and 13 _ 2x4-8' Door and and top plate end wall framin 13-,~"x4-8' Siding 15-s/e"x4'-8' Tt-11 Sidin end wall framing 9 - 2x4-8' Door and end g frame assembly 12-716"x4-8'roof 14-7/16"x4'-8'roof 16-s/x°x4'-8'T1-11 Siding s and soffit Sheathing and soffit sheathin 18-7/16"x4'-8'roof 12- /a"x4-8' Siding g 3.67 -square shingles for 9- 7116"x4-8' roof and roof 4.3-Square shingles for and soffit sheathing soffit sheathing 142 if. -1x4 Trim for doors, roof 5.67 -square shingles for 3 -square shingles for roof corners, and rake 1501f. -1x4 Trim for doors, roof 142 -1f. 1x4 Trim for doors, corners, and rake 150 tf. - 1x4 Trim for doors, rake, and corners Nails Nails corners, and rake 3.25 Ib. -16D Sinkers -framing 4 Ib. -16D Sinkers framin Nails Nails 4 Ib. -8D Sinkers -roof and g 5 Ib. -16D Sinkers-framing 2.5 Ib. - i6D Sinkers -framing 51b. -BD Sinkers roof and 6.25 Ib. - 8D Sinkers -floor 31b.-SD Sinkers-floor and floor sheathing floor sheathing roof sheathing 9 Ib. -8D Galvanized siding, 12 Ib. -80 Galvanized Sidin 15 Ib. -8D Galovanh eadthing trim, and soffit nails 7 Ib. - 8D Galvanized siding, g Ib. - Roofin nails trim, and soffit nabs siding, trim, and soffit trim, and soffit nails g 9 Ib. -Roofing nails 61b. -.Roofing nails 11b. -Drywall screws 11b. -Drywall screws nails tlb. - grywall screws Hardware Packa a 101b. -Roofing nails 9 Hardware Package 11b. -Drywall screws Hardware Package 3 pr. -5" T-hinges 3 pr. -5" T-hinges Hardware Package 3 pr. - 5" T-hinges 2 pcs. -Barrel bolts 2 pcs. -Barrel bolts 3 pr. -5" T-hinges 2 pcs. -Barrel bolts 1 -3l. Hasp 1 -3'/i' Hasp 2 pcs. -Barrel bolts 1 -3'/<" Hasp Misc. Misc. 1 -3'/:' Hasp Misc. 1 10 oz. -Tube caulking/siding 1 10 oz. -Tube caulking/sidi g Misc. seam seam 1 10 oz. -Tube caufkinglsiding 1 -t0oz. -Tube caulkingfsiding seam seam Optional and Extra 4 - 10' Drip edge Optional and Extra Optional antl Extra 1 -Roll felt paper 4 - 10' Drip edge Optional and Extra 3 - 10' Drip edge 4 -Gal. paint orstain/siding 1 -Roll felt paper 4 - 10' Drip edge 1 -Roll felt paper 1 -Gal. paint orstain/trim 4 -Gal. paint orstain/sidi g 2 -Roll felt paper 3 -Gal. paint orstain/siding 1 -Paint brush 1 -Gal. paint or stainltrim 4 -Gal, paint or stainJsiding 1 -Gal. paint orstain/trim 1 -Paint brush 1 -Gal, paint orstain/trim i 1 -Paint brush 1 -Paint brush TOP OfIRoOF ITRUSSxHELRE LONG y%9 TREATED TIMBERS If~ n TS-II SIDING tioM y~ tt'u y ' SHEET cagpoE 1°°nx~ 15'll oR sNOuLD TRUST - 19' II" END HERE _ IN31DE )_pOKINb ovr ~1 SoPFiT 5/B $IN61E T3-11 vto°R Bormm 31D1 6 sxdrnlwa pt~rEy R?%aP~OF' 2'/"r#K.N SPPGE - BOARD pIPbRRM z lNAbRAM f - BOARD OF HEALTH ~~n~~~ C~ ~ 3 SETS OF PLA\S `~1` fORMN0.1 SURVEY ' ~ TOWV OF SOUTNOLD CHEC'h • - BOIL-D.INGDEPARTM ENT SEPTIC FOR.1 1 TOWN HALL NOTII'Y BLDG. DEPT. EOUTHOLD, N. Y. 11971 . • • • ~ TCIW!'d Of SOUTHOLD TEL.: 7G5•1II02 CALL MAIL T0: .3Ua /)q~~ Examined . l.. 19 l~~~yy`/ f ~d Approved .~~Q,.. 19 /.~crmit No. f. :~J //fv/ Disapproved a/c ~Y~,/,~~', : , . , , - • (Building Inspector) . ~ . • ' APPLICATION FOR BUILDING PERMIT ` ' Date 1. , 19 . t, INSTRUCTIONS a. This application must be completely filled in by typewriter or iri ink and submitted to the Building Irispeetor, with 3 sets of plans, accurate plot plan to scale. Fee according to schedu]e. ` b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street 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 Buildin; 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 occuoied 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 hfADE to the Building Depaztment 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~tilations, for the construction of buildings, additions or alterations, or for removal.or demolition, as herein described. The applicant aerees to comply with all applicable laws, ordinances, building cod ,housing code, a, d regulations, and to admit authorized inspectors on premises and in building for necessary inspectio C'~:~ (Signature of ap ica t, or name,/i~f a corpy~o/fration) • . (hfailing address of applicant) /t. ~~St7/ State whether app]cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises , 1. {E~/!C'~ ...f/tyr~...~~,/~~L=/Z/lr~~..... ~v!`.f:PT.~//J (as on the tax roll or latest deed) !f applicant is a corporation, signature of duly authorized officer. (Name and title oC corporate officer} ALL CO27TRACTOR'S MUST B• UFFOLK COUNTY LICENSGD Builder's License No. Plumber's Liccnsc No . : . Electrician's License No . . Other Trade's License No : 1. Location of land on which proposed work will be done. ~~~~.~~:y <(.~13.~./..~ay~~~/?M~.C(/~.. House Number ~J Sheet Hamlet ~ ~ ~ - County Tax Dlap No. 1000 Section Block Lot ,~L~1; ~G , , ' , , Subdivision , r!`}2!4,~15~, ~ ~!`~Y.. Filed \fap No. Lot (Name) ' State existing i:se and occupancy of premises anJ intended use and occupancy of proposed construction: n r a. Existing use and occupancy CJ/.?~:. (11`.Z,r ~k'... ~ . ~'1~~~/;/,n,>/r. / b. Intended use and occupancy ..........~~-1~1~~..... ~t!~~~~?~_..... ~tJ///~/.lJ~ 3. Nature of work (check which (';applicable): New• Building V..... Addition Alteration Repair Removal Demolition , . Other 11'ork , , , . •1! .S'%~i2i4rr~ l~v~ r,vor ~ ~r 1 (Descript • . ion) 4. Estimated Cost ~ Fee . ' ~ (to be paid on filing this application) S. If dtt•eilinr, number of dtvellirig units Number of dwelling units on cacti floor , , ~Ifgarage,numbcrofcars 6, ' If business, commercial or miz';cd occupancy, specify nature and extent of each type of use . . 7, Dimensions of existing strucnrres, if any: Front ...............Rear Depth Hcigltt tuber of Stories . . . . . Nu Dimensions of same structure Fvith alterations or additions: Front • . Rear . ~ • ~ • Depth ...............:...Height .........Numb r of Stories , . 8. Dimensions of entire new construction: Front r~t~:.•..... Rear Depth . f . Height . , Nu+nber of Stories , 9. Size of lot: Front ~v~ Rear ~~/r~? s . .epth 0. DateoCPurchase.....~~.°,~ Name of Former Owner I ~Crfgl?~.,/3?grfR~~?cr.,E/r~T 1. Zone or use district in which pfcmises are situated . . P P f ~ late any zoning late, ordinance or regulation : Does ro osed consptruction v q lyill excess fill be removed from premises: Yes Nc 3, t1 ill lot be rebraded G , , , 4. flame of Owner of, remises . ................Address ...................Phone No...... , Name of Architect , . ...............Address ...................Phone No.. I~'ame of Contractor ....Address . .....Phone No.... 5. Is this property located'~within 300 feet of a tidal wetland? *Yes No *If yes, Southold Town Trµstees Permit may be req9u~ired. PLOT DIAG1cAM Locate clearly and distinctly a1~ buildings, whether existing or proposed, and indicate all set-back dimensions Crom roperty lines. Give street and block''number or description according to deed, and show street names and indicate whether nerior or corner lot. I, (J ~ r ~ IV • ~ 'ATE OF KEIl' PORK, S.S aG~TYOF (~amc oC indieidual si_ni I ~ ~ ' ~ ' ' ' ' ' ' • • bcinr duly sworn, deposes and says that he is the applicant !1,-^, contra CL) ot•c Warned. I ~isthc ! (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly'( authorized to perform or have performed t)te said work and to make and file this ~lication: that all statements contained in this application are true to the best of }tis knotvlcdge and belief; and that the •rl: will be pcriormcd in the martncr set forth in the application filed therewith. orn to before m~this I , tan• Public, .~~~?2! ; .~~5 .r!.~ County N4TgRYPUBLtC §tte'ofMewYork (Signature of applicant) I No. A767S78, Suwo~k Cauaty , Terri Expires March 30,19~~ r. P YVIE~ RpA NpR1'H BA. X50.05' m + W ~ Z . ~ N p5, 26 40" a. t J'f ~ ° ---r` c_, ~ ~ _ ~ m Z ~ m ~p r Tu x w h ~ Z m ~ ~ ~ y " ~ ~ ' ~ ~ o, ~ ~ > i w A~ e~ ~ ~ N m / a ~ s r O i O ~ x N ' m 00 00 1 v NN _ ~T l! v a D n ~ ! 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L- 70 (C EGEIVE Z° ~ -f-~'~- ~ ~ SECTION 4C (turned down slab) r %2 INSILATIO tJ ~ ~ _ ~ ~ _ hGALE c 'spa' = -0' - - . SHEATH InIV ,:m 'd` ~ - _ , OPrIONPt- ~ j_e O ~ m . _ J ~ 4. / fr - OIL 6ALILE)y / ~ ~ O ~ - ~"RAFi papE~ ~ ) - , a I I /a.0 z'b9° ba1`~®H PLP°f~ £LEv.7/c n1•oll = ~ ~ I' u z.a TIE PLAjE _ (TY~GA'(FA) .~''GOpIL.hLABgEI~F. Z"Xj01 ~ ~ ~ CZ)2",14i' m EL€,w.y/ Iµ.FLtz-®I-®° ~/!d''~/s°bl°/°o W.W.• Z'IFC(A3ACK~9°A1FRral? 4A6LE LE~vER ,f'I- ~ (1J2',.q'• I/a11~ ~ IL° hILFO¢ (~'oL'(h. 4a'GfP.eVEL b E (h64rION I'%~8'I oN LY) GoNflµuou5 - - ~I-^- ~ Y , ; i 4 Ne K f _ ~ ~ I _ B/8"-mill : ~JPD(E_ c\ - ~ u r., Y o_ N' - I NoTd~rop of 4'x4 W5( j- p, a eJ~ 'r~•>' ~ - t U:v'tiisv_-`~'' c~Ur+ I r TV RECeIVE Z"tl0" `ji- ~ - Z ~ ~ I/201 ~ IZ'I LONL1 " j - J (aGELE Lt~l.1Eq \ coNPµllolJh aN R T5 ~ .Qlw ~ o up- ILA" a`° xos ~ SECTION 4C (formed foundation) _ SECTION 4A ~ SECTIO±N 4B ~ ~ ~ ~ mw ~ ~''fSLEa/q•°I'.0 _ a } , . 1 DRAwN su ~ 'turned down •slob ~ formed*-foundation`;:;;,; 1 II f ~ . - - CkECKER ~,R'G• hG?LEe %Z°=V-r~1° hGALE yzn`'I' Cn' 4 I8~ i SHEE6rJrJ-~ w k' APPROVED / - ~ P TOTAL ' ~ ,x',r4' - DATE S-/-7B ~ r a>• -