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HomeMy WebLinkAbout18580-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219792 Date MARCH 14, 1991 THIS CERTIFIES that the building ALTERATION Location of Property I50 LAKEVIEW TERRACE EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 031 Block 09 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 17, 1989 pursuant to which Building Permit No. 185802 dated OCTOBER 20, 1989 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 CONVERT SEASONAL DWELLING TO YEAR ROUND DWELLING. The certificate is issued to ROBERT T. BAYLEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N144194 AUG. 3, 1990 PLUMBERS CERTIFICATION DATED LISO PLUMBING MARCH 11, 1991 i^~L Building Inspector Rev. 1/81 FOEM NO. D TOWN OP 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) ~.8~80 ND Z Date ....~?..~......P~d 19..~~ Permission is hereby granted ta: to ~?.:a-~....~.a:~?:n u~c.~.u-:~...`~:~......~...a,~,..~.....s~.~... yy~~ , at premises located at ~ fl..d...... ~~,W:S~~'u:'Z'•0.'•~••••••~•a••'1~•~~~~•• O County Tax Map No. 1000 Section .....Q.3.~......... Block Lot No.......~...R............ pursuant to application doted ...©.~.Ch~N~^r.....~:..~ 19.~~., and approved by the Building Inspector. Fee 5.. ~.~7t..:1.~..... ........(.ciY..~J-( Bu ding Inspector Rev. 6/30/80 Form No. 6 aI }1~~a ~'C~~l~1L ~a,~_ ~ TOWN OF SOUTIIOLD t, ~ y~ S~" ~w~^~~.,~. BUILDING DEPARTMENT Min ~ ~ y1 _ S `JS TOWN HALL ' ` riMf1 ~ q t '}Y~ . ~ ~ 1 ~ ~ 765-1802 (~~1 ~j o e , APPLICATION FOR CERTIFICATE OF OCCUPAN~Y"°°~ ~ ~ 7F. Ct 1. This application must be filled in by Cypewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-O. form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. ' S. 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. 3. 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. 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 7 Date ~~v~~~~~. ~:?.~.1~~.~ f .ew Construction........... Old Or Pre-existing Building: m.~CQ1~~U~B~:{:.~ep,5~na~ '-1~"G~ Y' ;'DZI~vtC/~ ~ p ~ ~ ~1QIA[,~ .ocation of Pro ert ~;lA~c°_~~C'UJ„ TC'~'~(kLC;;.,,, ~i~..?vtvt' P Y.. ..~.GJ. L LQ.~.. House No, Street Hamlet. ~nwer or Owners of Property... ~ ounty Tax Map No 1000, Section..., U ...Block.... ..........Lot..~~.'.~®~............ ubdivision..pp.,,.CC..' ..............................Filed Map............Lot...{-.~............... ermit No..~Y..J.~~~'-....Date Of Permit.~~~2Of~y.`1....Applicant.~p~l~.. ~~~:Q::~~~~... l r~ ~O~EP~tfliir~. ealth Dept. ApprovalCG~~/~11~.~nn~l1.b~,...~F'/~Y1~f.~.Underwriters Approval .C!/~~~~.~IC~~~~~~~.... Tanning Board Approval...N.~/T ~ /~~r~ y 'quest for: Temporary Certificate........... Final Certic e. , 'e Submitted: ~ ; ~ U yf3~s- ~ ~ 3/iy y~7~9?-- .arrLxcArtx f THE NEW YORK BOARD OF FIRE UNDERWRITERS FAfE ) 10007C)8 BUREAU OF ELECTRICITY 8S JOHN STREET. NEW YORK. NEW YORK 10038 Dote AUGl15i 03,944U APPlicationNo.onJile 6'20R390(4U N ]h414h THIS CERTIFIES THAT only the electrical equipment w dsacrihed 6elote end introduced 6y the applicant named on the shoos applitetion number irs the premises of ROBERT BAYLEY, 150 LAKEVIEW TFRI2ACk, EAST MAR)UN, N. Y. iE 0111' ~ in the following locution; ®Bwemen[ ® Ixt Fl. ? Ynd Fl. SKrtion Bloek Lot J171. Y 1 9 . 9 490 and ound to 6e in corn ponce with the r airementx o thin Board. waa examined on J P a1 J px>Va AGES SWITI]IES RXTURES RANOES Ct10KIN6 DECKS OVBK DISN WASMlRS EXNAUST FANS t)1[ftETS INCANDESCENT fIUDaESCENi aTNEa AMT. K. W. AMT. K. W. AMT. R.W. AMT. K. W. AMf. N. P. 'L6 38 25 2b F DRYERS RlRNAC! MOTORS NTUM ANUAftCR fiRDMS SFECIAI REC'FT TRAE CLOCKS Eltl' UIaT 1EAiRf AEULi40Ui1RT gA1MER5 AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. AAV. AMT. AMPS TRANS. AMT. N. P. ~ p AMT. WAITS a i 9 ~u SlRVK7 DISCONNECT NO.OF S E R V I C E e` AMT. AMP. 1TPt p pR. 1 A tW t / Jw S M Sw 3 AAw ~jER 1COND. OF CC COMD. ND.OF MI-IEG OF~MI "IEO NO. Gi NEU1RA15 Oi ~NWEUfGRAI 95U CB 9 X 1 hlfi ] '1/U oTfrER AFFArArus: j M9iORS;9-II2 H. F, ,.y 6. F.C. I:_4 - „ i 1 SMOKE DEiE'C]"OR:-i " IC l/~~~~~ i,1~ -tiA1.VA)ORY C. PRATO I.IC..k9tJh9-E WISC•TN9 LANE' R.R. Box, rna BEN~AI MANAGER GRFFNFORT, NY, 1949h 11 Per y This certificaM must not ba aherad in any mannery return to the office of file Board if imorrM: Impactors may he identified by tFyir crodsaliah. c AL N AMf TEL. 7G5-1802 ~ ~~~~rfl[jj TOWN QI~' SOYJ'TH4~,37 ,a:.. l ~ a: i'. ,i .b~i ;u;' ~ pFFICE OF BUILDING INSPECTOR , ! ~ ~ _ . ~ ~ " ' ~ P.O. I30X 728 ~ ; } ~i"'~"~ O'~~! SOU HOLD, N Y 11971 j,~,+4 L' ( 3,19~~._._,_.<. ' i ~t"1 ~k.C°t~a. Lr~,.• ~.y a C E R T I F I CAT I O N Date ~ / 8uildinq Permit No. ~pj~- 8CJ Owner qr ~o~ (p ease print) Plumber ~~.i~ ~~m/ it - o~li ~9~ (please prin I certify that the solder used in the water supply system contains less than 2/1Q o£ 1~ lead. c ~ d'a`y (plumber signature) Sworn to before me this ~ day of h%i~-~•~ ~ dG~ ~ ~~o- .L_.. 19.x_• Notary Public notary Public, County • pOLORES L. LISO Notary Public, Stan of Nea York &uEfalk Coany • Na. 4841022 Comnii,sior, Gx~rea Oct.39,~ r~~L~ I;:S.cC:iv~• „ nT~ , ~~~~~NI~ = - H H Cti c0Ut1DATI0"I (1st) c~ ti m~cc :'OUNDATIOtJ (2nd) r 2. - z o ~ ROUGH FRAME & PLUMBING Y G ~ d2 /lP ~ rv y 3. " h IIdSULATI0t1 PER N. ~ / STATE ENERGY CODE t`0 n s r 3 ~ ` 4. FIiJAL o m ADDITIOIIAL COMMEI)TS: m • ' ' ~I ~xp .,G H A U > S a H ~ I m ~ ~ ! .~T. ~ 0 • ~ b .a ~a d, W ~~6.,..a~-_ w a= ~,...._m....m STATE OF NEW YORK t MAY-1990 DEPARTMENT OF STATE AL.eANV, N.Y. 1 223 1-000 1 _ GAIL S. SHAFFER SECRETARY OF STATE April 27, 1990 Mr. Robert T. Bailey 150 Lakeview Terrace PO Box 595 East Marion, NY 11939 RE: Petition No. 126-90-52 150 Lakeview Terrace Dear Mr. Bailey: Please be advised that we have reviewed your petition to the Uniform Code Board of Review and the following additional information and/or documents are required to further process the petition: - You have submitted an application without an original signature. Please resign Page 4 in ink and submit to us. - Your check for $25 does not fully cover the petition fee of $50. Please submit another check for $25 made payable to "NYS Dept. of State". - Provide documentation, substantiated with dollar figures, why compliance would cause an economic burden; what are your alternatives to compliance and how compliance would be a "change so slight". Refer to the above petition number in your response and, if you need any help or clarifications, I may be reached at (518) 474-4073. BE ADVISED that the Department of State may dismiss the petition if additional information is not received within 90 days. Our mailing address is: NYS Dept. of State, Codes Division, 162 Washington Avenue, Albany, NY 12231. /Sf/~/i'~n\c ere ly , l ` ~iA'~ . j f Kumar Vijaykumar, P.E. Sr. Bldg. Mechanical Engineer Codes Division KV:rr cc: Gary Fish h Y P~ ' ? / NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 WORKSHEET THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS BUILDING 1..~~U~~.~ Tom' GROSS fL00R AREA rAG(~7`.~i2~T• ADDRESS t~~,~~, NUMBER OF STORIES ~ ~ ~ DEGREE DAYS dC9~ CONTRACTOR, ARCHITECT OR ENGINEER ~p~~ ~A~~-~~"~« -V_.-- i 5 O 1.~.1~I~ V f is K! T~ TELEPHONE 7 ~ ~ ~ If the building does not meet the following pre-qualifying conditions, Part 6 of the Energy Code may not be used. YES NO Building is one- or two-family residential. Building is detached. _ Building is less than 5,000 gross square feet. _ Building is three stories or less in height. _ Entrance doors have a storm door or certified U value of .40 or less. Glazing area/gross wall area is equal to or less than: 247> if 5,000 degree days 237 if 6,000 degree days 207 if 7,000 degree days 187 if 8,000 degree days 167 if 9,000 degree days If all of the above conditions are not met, either PART 3, PART 4 or PART 5 of the Energy Code must be used. 41 ti-r , a...~ a ~ , ~ DIRECTIONS: For each component of the proposed building design enter the design information requested such as Areas, "U" or "R" Values. Additional lines are provided or designs with more than one component construction type. Obtain themal ratings for each item by consulting the appropriate Tables. A. ROOF/CEILING Obtain Thermal Ratings from Table 6_1. 6-2,16-1E or 6-2E depending upon degree daysand heating type. G„ >aA°ns -1-7 Areal (,5(~ U-Vailue: ,U3~} 2" 2lGtiD Square Ft. I E'rG. Thermal Rating iZ=31+ Area: U-Vailue: Square Ft. Thermal Rating i B. NET WALLS Obtain Thermal Ratings from Table 6-1 or 6-1 Eldepending upon heating type. Area: U-Value: ,~g2~ 3~/T`G -25 Square Ft. Thermal Rating Area: U-Value: Square Ft. ~ Thermal Rating Note: Net Wall Area = Gross Wall Area minus Basement/Cellar Walls, Glazing Areas and Door Areas. i C. GLAZING Obtain Thermal Ratings from Table 6-3 or 6-3E depending upon heating type. WINDOWS ~4-l.. NEW M,,\~ILUTAI IIUSuL. wtl~DOWS Area of Glazing: ~~'d U-Value: VG1=,~~ Square Ft. Thermal Rating C 2 2°Io~ Area of Glazing: U-Value: Square Ft. Thermal Rating SKYLIGHTS Area of Glazing: U-Value: Square Ft. Thermal Rating 42 i D1. FLOORS Obtain Thermal Ratings from Table 6-1, 6-lE or 6-4E depending upon degree days and heating type. w ~ Floor Area: U-Value: ~yf~~ Sq. Ft. Thermal Rating ~K~~1~:~ D2. BASEMENT/CELLAR WALLS Obtain Thermal Ratings from 0511.1 2u P~GYST'tR,tN~- Table 6-5, 6-6 or 6-5E ~UI.t~I>EPTn dF'WA~.LS depending upon degree days C and heating type. R- ZU~ Wal l Perimeter: ~f g .G Linear Feet Exposure Above Grade: Feet U-Value of Wall: ,C9~j 2 Depth of Wall U-Value 8 ~G, + Below Grade: Inches Thermal Rating Note: Use the above grade U-Value of the wall. The Thermal Rating Tables have been designed to take into account the insulating effect of the earth. D3. SLAB INSULATION Obtain Thermal Ratings from Table 6-7 or 6-6E depending upon heating type. Slab Perimeter: Linear Feet j~ Insulation R-Value: - - r`~ ' Thermal Rating z 43 . _ _ ~ . , w. ~ ~ ~ E. INFILTRATION CONTROL Obtain Thermal Ratings from Table 6-8 or 6-7E depending upon heating type. If the building does not meet the following conditions, enter NA (Nct Applicable) for Thermal Rating. YES NO _ All windows have an air leakage rate of 0.35 cfm or less per linear foot of operable sash crack; _ All net wall areas have an infiltration barrier; and _ A heat recovery ventilator, which transfers heat between the outgoing airstream and the airstream entering from the outside, is installed. Conditioned Floor Area: A~ (Shall not include Square Ft. Thermal Rating basement/cellar floor area) F. SOUTN FACING GLAZING Obtain Thermal Ratings from Table 6-9 or 6-8E depending upon heating type. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES NO The building is no less than 1,250 square feet in conditioned floor area; At least 45 percent of all glazing faces within 30 degrees of true south; ? _ All glazed areas in buildings are no more than U(glazing) = 0.58; ? - South facing glazed areas are free of any site obstructions during the heating season; and An area of four-inch thick concrete or masonry is exposed to direct sunlight from south facing glazing. The area of this concrete or masonry shall be no less than three times the area of south facing glazing. Conditioned South Glass/Total Glass: 7 floor Area: Square Ft. (See Above) ~ ) Glass Area/Gross Wall Area: 7 ~ ~ ~ Thermal Rating 44 SUMMARY OF TOTAL THERMAL RATING If the Total Thermal Rating is zero (0) or greater, the proposed design for the building envelope complies with the Energy Code, THERMAL TABLE AREA U-VALUE RATING USED A. ROOF/CEILING G5d .0~5 t'7 ~"'I B. NE7 WALLS G 2U .fJ82` "25 6_ 1 _ r C. GLAZING . Window t•fC~ O 6"~ Window Skylights D1. FLOORS D2. BASEMENT/CELLAR WALLS Wall Perimeter 9 ~,(a Feet Exposure Above Grade 1.5 Feet Wall U-Value ,O$2 Depth of Wall U-Value ~ 2 U Below Grade Inches 6'~ D3. SLAB INSULATION Slab Perimeter Feet Insulation R-Value N~A, E. INFILTRATION CONTROL ~t A Conditioned Floor Area Sq. Ft. Iy,~?°~. F. SOUTH FACING GLAZING South Glass/Total Glass Percent G1. Area/Gross Wall Area Percent Conditioned Floor Area Sq. Ft. TOTAL THERMAL RATING 't Z Qk~. 45 NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 COMPLIANCE FORM THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS BUILDING I5O LAK(=VIFJ~({/ Z~.. GROSS FLOOR AREA ~'~G 5d'FT ADDRESS ~A5 4 I~GIA~LC9N NUMBER OF STORIES ~ ~'Y' ~ I~ ~9 DEGREE DAYS b(©~~ CONTRACTOR, ARCHITECT OR ENGINEER ~~T ~"I'A 650 1--~/kY-~UI~VJ TEf"L(ZAG~,. TELEPHONE 5E6 ~~7 -502( PRE-QUALIFYING CONDITIONS All pre-qualifying conditions for use of Part 6 have been met. Yes No I TOTAL THERMAL RATING The total Thermal Rating for this building design is -t' 2. The Worksheets that developed this Thermal Rating are attached. A Thermal Rating of zero or greater indicates that the building envelope complies with the Energy Code, PRESCRIPTIVE REQUIREMENTS INSULATION: 7815.5 Element Required Specified Vapor Barrier -where capable of Yes absorbing moisture Continuity - at plate lines, sill Yes Y.f° S lines and corners 47 x. ::n ""ter„,-~~e°-T~^--~~~~,, . _ _ w ~ ~ ~ AIR LEAKAGE: 7813.5 INFILTRATION RATE Element Required Specified Al1=W Windows .5 cfm/linear foot Y~i Sliding Glass Doors .5 cfm/square foot ,yam Wit?DGWS Swinging Doors 1.0 cfm/square foot K E~S CAULKING, WEATHERSTRIPPING AND SEALANTS Location Required Specified Exterior Joints - Windows Yes Y>:S Exterior Joints - Doors Yes Y~5 Openings at Walls - Roof/ceiling Yes YES Openings at Wall Panels Yes ~~5 Utility Service Protectors Yes 'f"c,5 FIREPLACE -N0T1~. Element Required Specified Outside Combustion Air Yes N A Infiltration Control: Yes .~1 I'~ _ 20 cfm flue damper, or or non-combustible doors N A I 48 I HVAC CONTROLS: 7813.13 THERMOSTAT Type Required Range Specified Heating Only 45 - 75 degrees min. ~'ES Cooling Only 70 - 85 degrees min. Heating and Cooling 45 - 85 degrees min. HUMIDISTAT Required Specified Type Relative Humidity R.H. Add Moisture 30~ maximum V~ S Remove Moisture 607 minimum Y~y TEMPERATURE ZONING Type Required Specified Thermostat Each System YES Thermostat Each Dwelling Unit Y E S Shut-off Each Zone Y ~ 5 Shut-off Each floor 7 ~ y WILL USE- 2-- 2c~~ G pl L-- ~I R.~ t~iPT w t~T~tC- FiG~T CONTROL SETBACK Type Required Specified Switch, or Clock, or Manual Yes ~.5 49 ' a s.. R° ant u . +•3#~ ~ ~ .:"ei?*- u x ar : ;.R c s HVAC EQUIPMENT PERFORMANCE REQUIREMENTS: 7813,23 Minimum Specified Equipment Performance Performance Gas Boiler 707 AFUE Gas Furnace 707 AFUE Oil Boiler 757 AFUE ~E-S Oil Furnace 75~ AFUE Heat Pump - Air Source High temp (47 deg.) 2.6 COP 1Jlk Low temp (17 deg.) 1.8 COP - Cooling 8.5 SEER - Heat Pump - Water Source 3.0 COP tl ~ Cooling 8.5 SEER Central Air Conditioner 9.5 SEER t~lr~ MECHANICAL SYSTEM INSULATION: 7813,19 and 7813.20 Hydronic Low Temp. Required Thickness Specified Pipe Size at 1" = R4 - R4,6 Thickness 1" and less 3/4" -MIN 1 1/4" to 2" 1'~ E~- N Forced Air Required Specified Duct Temperature R-Value R-Value d T of 52.5 Deg. F, or less 3.5 (Min.) Nf~ Q T of more than 52.5 Deg. F. D T(Deg.F.)(sq. ft.) Nl~ 15 btu hr 50 f i 3 v WATER HEATERS: 7813.33 Minimum Energy Specified Type Factor Required Energy Factor Electric Storage .93 - .0013V Gas .60 - .0019V - ` Oil .59 - .0019V k i f COMBINATION SERVICE WATER HEATING/SPACE HEATING Maximum Standby Loss Specified 13.3 pmd + 400 N~ n CONSERVATION OF HOT WATER: 7813.38 t Maximum Specified Fixture GPM GPM Lavatories 3 f=y Showers 3 7E5 i ELECTRICAL POWER: 7813.52 Does building comply with National ~ Yes _ No, Electric Code 51 _ . "eFbb ~ . :4y „ k Y 5'~. r.:°"lz' .,'4~`~{ ~5 . e . ~ ?a 'av. rr n i^ o r . ! .xN 20 ~ (1 ~ MEMORANDUM roWN of soYUTHOLD °~°-°-=~~5~ E OF NEW YORK - DEPARTMENT OF STATE T0: Gary Fish, Building Inspector DATE: June 18, 1990 FROM: Robin Quintin,Senior Clerk OFFICE: Codes Division SUBJECT:petition~i 126-90-52 (150 Lakeview Terrace) Enclosed please find additional information submitted for petition,~l 126-90-52 If you have any questions regarding this information, please contact Mr. Raymond Andrews of this office at (518) 474-4073. ~Zi38~Rf f. 3Al~£Y A.Q.A. ~ ~ ~rA w1s~s+1 - Architect D ~ ~ ~ a ~ 4e = = _ _ 150 Lakeview Terrace ~ ~ P.O. Box 595 LE7TEH EAST MARION, NEW YORK 11939 (516) 477.5024 ~ ~ v / DATE .~__r,7/__~L_ t~_~~,CQ TO: hh B -DG. DEPT. ___~v4.V'.,._~~4UMGVi1~.......I~.(J4.!~,.~_.. ~ _ oFSOUr Ecr~~'E'j.'~-(,~____~,0~.__126-90=5~ - ~!~5 • ~~~~,ctlca.ll__~('~-~ ~'P_-P•~ - ~0_ ~cE. ~U iew_Tef-~z~c~ ~r.a f ~ ~a~-~~~~~C~ -.._~v~..~......Fe~~o.~,~e,__~ ~v_ur ( dl ~,v~.0 2'~~ 1.~~0~_~-~-__~.U.~~_ _ ~ ~l!1.~..._.?.~.CCU..~~~n_ ~~c~e~~~~~~1r 1..~ca,Q__ ..5 ~~tn.cc ~w_c;-=--- rl __C'_.........._.__1....-...._.~C1 LLC,cst.~ ~i --~i~~'~~ u1_~~-_>_ v'~~~u~4ea__ U C..(~.c~<~,!~,e~1_au-P~.. - u.~~,c~-P a,~ ec~r~o~u i~__~_U.~r~.~-_______ ~.iM,._~ _a_~~yu.~l-~~ ' _ _...-------._.._3_.~.._~Muw____~r~l~~:c~-~?o,~.-~~~ ~c~c+.u~~e_so__~li~_~~ 1, 3 ~ ~~o ~ - - Please Reply ? No y Necessary L SIGNED YII%1:~~~~1'];I`.....~,-~~,~,p~1 rt..Oilil foC. ~Pf (`VEfCLL Fi~lf3n1'~.:]~J Robert Bayley House 5/28/90 Exhibit 5: Variance Statement 1. Strict compliance would create an undue economic burden for the reasons stated in this exhibit. , The undersized stair in question serves a small (514 square feet) new cellar under an existing small (but legal), under- sized house built on an undersized (but legal) lot. The location of the stair form the ground floor to the cellar is determined by the zoning setback requirements, the loca- tion of main framing girders, and the need to keep an existing bathroom and its associated piping connecting to an on site sewage-disposal system intact. The stair was located between 2 girders at the entry hall of the house. In this location it is located so it would give easy but only occaional use to the occupants and be remote from the main access to the cellar which consists of a Bilcn door and stair leading from the rear yard to the cellar. The Bilco steps are an ample 3'-8" wide. In order to accomodate the new stair within the above limitations and in order to avoid disturbing the girders supporting the first floor or to avoid disturbing the only existing bathroom, it was neces- sary to make the stair 2"-0" wide rather than 2'-6" as re- quired by code. the 2'-0" dimension allows for just the correct headroom as one passes beneath the adjacent girder. (See Dwg. 6.) To construct the stair 2'-6" wide to satisty the code would require demolishing a perfectly good functioning bathroom which is constructed precisely between existing girders and supported by those girders. (See Dwg. 6) The cost of relocating the pre-existing girder and floor framing and the subsequent reconstruction of the bathroom in order to provide space for a 2'-6" wide stair with all the necessary headroom clearances can be analyzed as follows: (See next page)...... I. Direct Costs: A.Demolition costs: 1. Disconnect bathroom fixtures for re-use, 1 plumber, 3 hr ~ $30 ............................$90 2. Remove 3 fixtures from bathroom for re-use, 1 carpenter, 3 hr ~ $30 90 3. Remove floor framing, girder, & interior wall brace roof rafters at wall, 2 carpenters, 8hrs ~ $30 .480 Subtotal A: $660 B.Construction costs: 1. Materials to rebuild girder, 2X6 floor joists, plywood .........................................$300 ' 2. Labor to build girder, floor framing to girder, decking, 2 carpenters, 8 hrs. ~ $30 ..............480 3. Install new vinyl floor the over plywood floor prior to setting fixtures, materials 40 sg, ft. ti1e..200 4. Labor to install floor tile, 1 man, 8 hr ~ $30 ................................240 5. Reinstall toilet, sink and shower in Herr bath; relocate plumbing roughing to suit new framing, 1 rnan, 16 hrs ~ $30 ..............................480 6. Finish, rebuild wails and ceiling with gypsum board, tape, spackle, caulk, 1 man, 16 hr ~ $30 ..............480 7. Reconnect airing to ceiling fixture, vanity light, outlet, 1 electritian, 4 hrs ~ $35 .......................140 8. Paint 2 walls and ceiling, apply trim and paint 1 carpenter, 8 hr ~ $30 ..........................240 9. Construct stair 2'-6" wide in lieu of 2'-0"...........200 Subtotal B: $2,760 II. Indirect Costs: 1. One month additional rent at apartment in Brooklyn because house is uninhabitable (no bathroom).........$980 2. One month travel cost to jobside each day .............300 3. One month winter delay in heating and cold weather related delays .220 $1,500 Summary of total estimated economic burden: I. Direct Costs: A. Demolition .$660 B. Construction 2,760 Subtotal: $3,420 II.Indirect Costs 1,500 Total: $4,920 Total estimated construction cost for entire renovation.......$40,000 Note that most of the total estimated construction costs are mandated expenditures required by code to upgrade the use of the house from seasonal to full time occupancy. ti Robert Bayley House 5/29/90 Exhibit 5; Variance Statement 5 My alternative to compliance is as follows: ~ a. I have provided two means of egress from the cellar instead of one. My second means of egress is an outside stair of ample width (3'-8") which is wide enough to allow two persons to exit at one time. The 3'-8" wide steps are pro- vided with a comfortable 6'-8" headroom (as seen in photo 3 of Exhibit 4) and metal Bilco cellar doors which are easily opened from the inside or outside. b. I have provided the mechanical room which contains an oil fired heating boiler and an oil fired hot water heater as well as other equipma~~t with a metal clad 3/4 hour rated door. (This is not a code requirement.) c. I will cover all partition walls and ceilings in the cellar with 1/2" gypsum board taped and spackled to increase fire protection. d. I will provide an additional direct-wired smoke detector at the foot of the stair in question. (There is already one at the top of the stair.) Robert Bayley House 5/28/90 Exhibit 5; Variance Statement 6 How compliance would be a "change so slight". According to Architectural Gra hic Standards, published by the American Institute of Architects, the standard "unit of measurement for exits is a certain increment of width, usually 22 inches, which has been determined as, the "average' shoulder width of a man." I am requesting approval for a stair of 24" width which would accomodate a man of average shoulder width. A stair of 2'-6" as required by code would still only accomodate 1 man. This is certainly a "change so slight." The graphic illustration of units of width for human passage is illustrated on page 7 of Architectural Graphic Standards where under "accesibility" we are shown illustra- tions of spaces required for passage. Although stairways are not specifically shown, illustrated is the space required for the passage of 1 person which is 21" minimum and 30" pre- fered. Under the illustration entitled "catwalk" the mini- mum width shown for one man is 22". Again, the difference between 24" (my stair) and 30" (code) is, in my opinion, "a change so slight." On the same page of Architectural Graphic Standards the minimum width for a passageway for 2 people is given as 38" and for a corridor is given as 42" minimum and 54" preferred. Based on these standards a stair of 24" (mine) or 30" (code) would still only accomodate 1 person at a time. For a stair to accomodate 2 people walking side by side the stair would have to be 42" wide which is way in excess of the code require- ment of 30". ~ - NEW YOFK STATE ` DEPAI7Il~,NP CF STATE UNIFORM FIRE PREVENPION AAD BUIIDING CODE SOAIiDS OF REVIEW ALBANY, NEW YORK 12231 ` a ~ _ R O No. I PETITION (office use only) , 1. Petitioner's name, address, and telephone number: 150 Lq,keviCu~~rrD,c~ l ~.0, l3OX 595 Fas~l- MaYiuN ~ New `i'vtk l l°J39 (5(G) `x'77- 50 2q- ~ ~ 2. Petitioner(s) relationship to the property in question: ~G1V1C'F' 3. Provide the follgyli0g for the proper y_,~glaestion• A. Street Address: IB.Coun u~ which located; I~b Lce,(«Utew Tc1-1`t4-CE I Su,~o6t~. f~ee,~t ~tce,ri~r N,~'. 1139 IC.city, Village, Town (if outside Vil.) ~ 1 (=cesf G~ha.rcwi I ID.Property name, if any: 4, State the na~ o the real party in interest, the person or firm aggrieved; EY-'f'~' T, ~Ct.NI~~ 5. Tax map number of the property in questions 3 ~ . 91~~ 6, Provide names, addresses and telephone as indicate9 below. Attach addi- tional sheets if necessary. See instructions for further clarification. A. Property Owner I B. Architect, or Engineer (if any) Ro~et-fi ~ , ~cv~le~ i lZoberfi ~ ~ ~'~le~l ~1,1,~4• (SCe,i~ne.. a~alovue> I ~5a.wi,e, a,~ abov I I C. Code Enforcement Agency I D. Fire Inspector or Fire Marshal arx3 Contact Person I ~ , S~vl~ Lo(,utn I 8u;( 7~e~xtr~~ue~l-" I t Cjav- I'sl~ I (5l~ 7G5-I~soa I I E. Fire Depaztment and I F. .gther Persons or Organizations ContactAAP11erson ( w,th an Interest in the Petition ~GQ,St l'V6GC{^tuv~ UO ~(~n~yr" I be. ~e~.v-l-tnn s~ ~ N ~ A , I I Check here it additional sheets are attached for this item. I I J .y 7. Project Description (Check and comQlet.e all statements which apply) A. Building Status: Tn punning Works in progress started on 1.(Z/~~ _ Worklcompleted on _ Does!not involve Construction, alteration or repair B. Building Description (Refer to the .listed parts of the Uniform Code: Occupancy Classification (Pazt 701):' ~f~ I Building Use (Part 703): SIN~r~P_.Gn",n Construction Type (Pazt 704) : 5 No. of Stories r.l_ Max.Height. 15 ./.Fe'I'" Area of floor with largest area: X75 squaze feet Gross floor area of the entire building; iIS~) square feet _ Incl~uEi~Lp ~Cllat' . C. Fire Limits,(Re~er to Part 706 of the Uniform Code; _ WitYip.n Fire Limits or .~,G Outside Fire Limits 8. Permit/Compliance Status (Check and/or coriplete all state~rents which aPP1Y>• A. Building Permit: _ A permit was applied for on .bQ/~~, and a cop, of the completed application form is attached as exhibit no. ~ _ A permit application was denied on and a copy of ' the denial is attached as exhibit no. _ A pe?:cnit was issued on and a copy is attached as exhibit no. No formal determination has been received on the application for ~ permit. ' ` _ No permit has been applied for B. Certificate', of Occupancy or'Conpliance (C.O.): _ A C.O. was applied for on __1__/_.._, arr3 a copy is attached as e~chibit no. _ A C.p. was denied on _J_/_, and a cop~+ is attached as exhibit no. A C.p. was issued on _J_~ , and a cop~+ is attached as exhibit no. _ No formal determination has been received to the application for C.o. No C~.O. was applied for . ~,Upy(G 'l5 ~w Prac~yey5 . C. Orders or Citations or Denials (Check and complete) 1. notice, appearance ticket, order or other citation has been issued alleging a violation of the Uniform Code at the property in question. A copy is attached as exhibit po. ~ 2. There is no official allegation of a violation of the pniform Code involving the property in question, but it appears to the petitioner that there is or may be a violation which is further described below: ' '~~~ctw~ ~ ~trsi~4uar -Ev ~-ll~e.r ~s 2~ U" w~dc, ~ o 2'--6" ,.w u2e I-egM.i~ erg 5 P~-~r'uy, 7 13 . I l d) A 3 9. zndicate if the petition is an appeal and/or a request for variance. (Check one or both as appropriate. See instructions for definitions.) Appeal Variance 10. zrdicate the specific code sections which are the subject of the appeal or variance request. ~j~-}.~;,y,~ 713. I (d) s`~telPS -IU ce GeIIC(.r or ~•~I~G ;>LaU tai- be Ic-~s-ft,.u.~ 2=G"clever- 6e-F'u,ee~ ~raw,P.1~'~IS,,." ~I,y ske~r is 2`-a" 11. Variance. (If applying for a variance, check and complete all statements rhich apply. If not seeking a variance, go to Ztem 12.) A variance from the sections described in Item 10 Hauld entail practical difficulties, unnesessary hardship, or would otherwise be unwarranted because strict compliance (check the statements which apply): L/ 1. would create an undue economic burden for the reasons stated in exhibit no. _ 2. would not achieve its intended objective for the reasons stated in exhibit no. 3. wvul.d inhibit achievement of some other State or Federal policy for the reasons stated in exhibit no. 9. would be physically or legally impossible for the reasons stated in exhibit no. ~ 5. would be unnecessary in light of alternatives which achieve the intended objective or which, without a loss in the level of safety, achieve the intended objective more efficiently, effectively, or econanically, alternatives which are described in exhibit no. S . ~ 6. would entail a change so slight as to produce a negligible additional benefit consonant with the purpose of the code for the reasons stated in exhibit no. ~ 12. Appeal. (Complete this item if making an appeal. If not making an appeal, go to Item 13.) A. The following described order or determination, or the failure to timely make the following described order or determination, or the failure to timely issue the following described permit, authorization or other documant is appealed: A copy of the order or determination i5 attached as exhibit no.~. B. The order or determination should be reversed or modified or other relief fashioned so as to do justice between the pazties for the reasons stated in exhibit no. -4- . i3. Documents: (Please npte Item 13 of P tition Instructions) .E1cH~~oi`r'~la I Su~6~iw~ ~~rr~f't- N(~~~l,tcc~-irn.inr~k Exhibit too. Site Plan ~~haw,w~ 1~ ~ Exhibit No. ~ ; Building Plans ~ YG~WeI,~s 2 ~ ~ i~ Exhibit zSo..~; Photographs ~ ~ho-tas) Exhibit No. Documentation of Historic Preservation Exhibit No. ~J ; Additional information described as follows ~ ~UGt,,hl,A.oLG'L~ ~R.'I~'-~u~wlt- ~ r 5~ 14. If a site plan or building plans are included, are they the same as ones which have been submitted to the code enforcement agency? Yes „ ~ No - if r}o, explain below. "~i~- Y'~ l5 ~"kR SaU.c~. d~G~~lc~aw~ ~/~~-,s ~A,ae be~~. Featy~cl. olr~ 5~.o-rv '71,n. ~~i~Gax ~ a- S`f"cGlr~;,.,V~ .~ii~tiV' ~lv~-~- ~o "Ile.;ceU.~,r. 15. Previous Action Has any previous application for relief related to the subject property been made to this or another board, administrative agency or officer, or court. _ Yes - If yes, describe the proceeding and include a copy of ,any determination issued. No 16. Enclose appropriate fee as per instructions and .indicate amount below. Checks should b~ made payable to the New York State Department of State. S c~5. 0~ I I, the petitioner in'~this proceeding make this application pursuant to 19 NYC12R 940 and aff~rm under penalty of perjury that the information furnished by me in s pport of this application is true and correct to the hest of my knvaledg Signed ~ ~ ~ Date ~~!v~ ~r~ I ~HU i Nine copies of the pgtition form and supporting documentation must be sulxnitted. Mail the ',material to the Codes Division, New York State Department of State, 162 Washington Avenue, Albany, NY, 12231. VARIANCE INFORMATION INQUIRY 126-90-52 PETITION N0. Return to: New York State Department of State Codes Div. Variance Unit 162 Washington Ave. Albany, NY '12231 PROPERTY LOCATION: 150 Lakeview Terrace East Marion, NY QUESTIONS 1) Were you previously aware that an application for relief from the Uniform Code was being made in reference to the above property? Yes ~ No 2) Are you familiar with this project? Yes ~ No 3) Is the information in the petition form concerning this property correct? Please check the following and supply the correct info: yeses no a. owner name & address _ b. inside fire limits (a or b) c. building construction type ? _ d. building occupancy ? _ mixed occupancy ? e. change of use what is the previous use? Are the enclosed drawings the same as those submitted for permit application? yes._ no Please provide any additional comments you wish to make concerning the accuracy and completeness of the information in the petition in the space provided below. .-~J . ~ A~ (attach additional sheets if necessary) 4/89 - 2 - 4) What actions, if any have you taken in regards to this property which may have a bearing on this pets ion? .}n2,},~.,u_. ~ Q 5) Please provide any other information or comments you feel are relevant. h1 .dxa,..r .io 01 - O ~ ~ ....o pis . / C~1 kR.~' ~ c2.Q.Qa.~- i v a (attach additional sheets if necessary or desired) 6) Please provide the name, title, address-and phone number of the person who completed this forma C~ 19uyv~ _,B,e~ ~i ~9,.-~2,c'..~. ~r`~l • ~ <s~v~ -inn z pie ~i r/ aN* ,i- ~ ~ t,~-mod STATE OF NEW YORK DEPARTMENT OF STATE ALBANY, N.Y. 1 223 1-000 1 GAIL S. SNAPPER S ECRETARY OF STATE M E M O R A N D U M ~,I I,- . T0: Gary Fish ASR ° 61990 FROM Carl R. Sager Director, Codes Division DATE: April 2, 1990 RE: Petition No. 126-9D-52 This is to advise you that we have received the above referenced petition requesting relief to enforcement of the Uniform Fire Prevention and Building Code in regard to a property in your jurisdiction. A copy of the completed petition form is attached for your review. This petition will be reviewed by a Board of Review pursuant to Title 19 NYCRR 450 in the matter of the relief being requested. You will be notified when a proceeding is to be scheduled. You will also be contacted regarding any written or oral testimony you wish to present. A copy of the written decision of the Board of Review will be transmitted to you subsequent to the proceeding. To assist us in preparing for this proceeding, we would appreciate your completion of the attached questionnaire. Please return it to us in the enclosed, self-addressed, stamped envelope. Completion of the questionnaire is purely voluntary, however, your assistance in this matter will be appreciated. If you have any questions concerning the above, please contact Mr. Raymond Andrews of my staff. He can be reached at (518) 474-4073. CRS:rr Attachment ~ c~VFFQLkC~G~ Town Hall, 53095 Main Road v% ~ P.O. Box 1179 ~1~,yQ~ ~ Southold; New York 11971 JUDITH T. TERRY FAX (516) 765-1823 TpwN cLERx ~ TELEPHONE (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTNOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1379-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner BAYLEY, ROBERT Mailing Address 1 P. O. BOX 595 Mailing Address 2 City St Zip EAST MARION NY 11939-0000 Property Address 1 150 LAKEVIEW TERRACE Property Address 2 City St Zip EAST MARION NY 11939-0000 Owner Telephone No. 516-477-5024 Tax Map No. section 31.00 block 9 lot 18.000 Cross Street BAY AVENUE - Date Of Last Pump Out 0/00/00 • Issue 'Date: 2/07/90 Judith T. Terr Southold Town Clerk (TOWN SEAL) JAN 171991 ~ u.. ~ ~ , ~-~~yv,~, PETITION N0. 126-90-52 ..,~.e-..,..,...a<.w,,..~ The persons below are advised to TAKE NOTICE of the attached notice or other document. The notice or document pertains to a petition to a Board of Review for relief related to the Uniform Fire Prevention and Building Code. There are ~ pages attached. If any are missing, call (518) 474-4073 and ask for the Variance Unit. U Robert T, Bayley, AIA 150 Lakeview Terrace P.O. Box 595 East Marion, NY 11939 ~'b~. Gary J. Fish, CEO Town of Southold Box 1179, Main Road Southold, NY 11971 N~69Il' Chief of Fire Department East Marion Fire Department 9245 Main Road East Marion, NY 11939 r D ~(~~~d~ ' JAN 17199f Nd BLDG. DEp'f. TOWN OF SOUTHOLp STATE OF NEW YORK DEPARTMENT OF STATE ALBANY, N.Y. 1 223 7-0001 GAIL S. SNAPPER SECRETARY OF STATE ST_1TE OF NEW YORK: DEPARTMENT OF STATE ALBANY UNIFORM CODE BOARD OF REVIEW In the Matter of the Petition of: INTERMEDIATE DECISION P.obert T. Bayley For a Variance to the New York state PETITION N0. 126-90-52 C-niform Fire Prevention and Building Code On reading and filing the petition made pursuant to 19 NYCRR 450 by Petitioner, at the meeting held at the Offices of the Uepartrnent of State, 41 State Street, Albany, New York, on December 18, 1990, the Board finding and concluding that strict compliance with 9 NYCRR Section 713.1(d) would entail px•actical difficulties or unnecessary hardship; would be unnecessary in Iight of alternatives which ensure the achievement of the code's intended objective or in light of alternatives which, without a loss in the level of safety, achieve the code's intended objective more efficiently, effecr_ively, or economically; and would entail a change so slight as to produce a negligible additional benefit consonant with the purposes of the code; the Board grants relief as follows: With respect to the renovation of a cellar area in an existing one-stcry structure of Al (single family) occupancy, of type 5 (frame) construction, having a gross floor area of 1,150 square feet, and located outside fire limits aL 150 Lakeview 'Terrace, P.O. Box 595, East Marion, New York, a variance is granted in 9 NYCRR 713.1(d) to permit 2'-0'" wide cellar stairs in Page 2 D Petition No. 126-90-52 JAN 17 1991 lieu of the 2'-6" width require by Code; with the oll wing conditions: ~it~©G. DEFT. - The basement areas shal notq~~~~~;trg~~~-~gµl~itab e space. The Board's decision is based on the following findings: 1, This area is owner occupied and the area is to be used as a work space and a laundry area. 2, There is a second means of egress or escape from the area by way of an exterior staircuay. 3. The structure has a hardwired smoke detection system. Furthermore, it should be noted that the decision of this Board is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give implied approval of any general plans or specifications presented in support of this application. This Intermediate Decision is to be deemed final by the Code Enforcement Agency and for purposes of the commencement of a proceeding under Article i8 of the Civil Practice Law and Rules by any aggrieved party. In the event of the commencement of such a proceeding, the final decision containing full findings of fact and conclusions of law Shall issue forthwith and shall be deemed to have been issued on the date below. Chairman John H. Flanigan and members William F. Weaver, Francis P. Ryan, and William Brayton all concur. `Sember William H. Stevens took no part in the decision. Albany tiniform Code Board of Review By: H. Flanigan, Ch irman Date l /9~~! ~~~~o 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ FINAL REMARKS: - \ DATE INSPECTOR 765-1802 BUILDING DEPT. ` INSPECTION [ ]FOUNDATION 1ST f ] ROUGH PLBG. [ ] FOUNDATION 2ND [ NSULATION [ ]FRAMING [ ]FINAL RE~RKS: DATE c~ INSPECTOR C(~~0 ~ 765.18®2 BUILDING DEPT. 1 NSPE~TION [ ]FOUNDATION 1ST- _ROUGH PLBG. ( ] FOUNDATION 2ND [ ]INSULATION [~RAMING ( }FINAL REMARKS: ~.u,~e__ l1~- . DATE I ~ ~ CJ INSPECTOR ~'U ~ _ _ _ _ ........T-.~_ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. 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(_F~YOI~T+(<G.~GTb21C KEG/, 2/`t/9o-~S~%~°r0 ISO LAKt: vII..` W TF it,r-. n-,T MARION (c,L-"{a'IIG.^~ AIA,AIICillltvc.T II/G~C~ BOARD OF HEALTH 3 SETS OF PLANS .4sKt.: ` FORM NO. 1 SURVEY , . , ~i t~~ TOWVOFSOUTHOLD CHECK •#J4~.-- BUILD.INGDEPARTMENT SEPTIC FORti BLDG.DEP1: TOWN HALL NOTIFY S~r~ FSOLRHOLD SOUTHOLD, N.Y. 11971 CALL _ y77-S^_°aY . TEL.: 765.1802 MAIL TO Examined . Q.~e~~~.?-.1~... ~q.., 19 Approved . QS~.?'~~ ~q.., 19~. Permit No. 1 $ S"~'SU Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT ' Date . OCt 1`1........., 199. 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 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 applicat}'iin 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 he 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 hfADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re=ulations, for the construction of buildings, additions or alterations, or 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 ins j~ nos. 7 (S'gnature of applica t, name, if a corporation) 150 LCLJSC'Ut~W T~t17tC,r_°. faS~~PiO~..11939 (bfailing address of applicant) State'gwhether applicant.lis owner, lesseee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~~beY-.1:.. I.L :i?~.~... . ~as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .r . (Name and title of corporate officer) ALL COttTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . Plumber's License No. .~.I~.'I..P~.UM.7~t~ Orte%(~ Electrician's License No. !~0~:.5~~cc:l-eol..~e;fi~. OtltcrTradc's License No. in;~f..Se~~°C°~er~ `~GT I. Location of land on which proposed work will be done . . ..1.50 .......................t~akevi~w..T~rrace..........~~.-~a.4t Mahtv~.......:....... House Number Street Hamlet County Tax Afap No. 1000 Section ~ Block Lot r,~, , , , , , , , , , , , , Subdivision Filed ~Iap No. Lot . (Namcj State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......t`7.~~°G4.~.~-.~..CD~Cf ~L°, , ,(At,lf(n , P.l'I~i;Elly, Ci'~111~(G°5 . b. intended use and occupancy .....t.~A/.1:.b.()7.kH~ .li~.,~'rG, • ~~~.~-..........r . 3, Nature of work (check which applicable): New Building Addition i;~ • Repair .Removal Demolition . er 1' k rj~, . r riew a~tlar i•n~w i~4ertorl~t~~lefe Iu.~sulct~v,.t r new elecriKC seru(c~t; ~~(riplrf•'i~ 4. Estimated Cost ..~:.3D~ 00O Fee j1` (to be ai~ on film th"s{ ~'I on 5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor . If garage,numbcrofcars 6. If business, commercial or mixed',occupancy, specify n~turc and extent of each type of use . i g Rif any: Front ...Z~l.:`+'. , Rear Z3..~....... Depth . 7, pimensrons of existin struchues' Hctght ~ Number of Stories ~ . Dimensions of same structure with alterations or additions: Front ...`~.Q•N54'.-........ Rear Depth I. Height Number of Stories g. Dimensions of entire new construction: Front . Gi.GG.IM~ Rear ...............Depth Height Number of Stories...... ~ 9. Size of lot: Front ...Z~... Rear 15.r,7p7;Y, , ; ,1 ? , Depth . 0. Date of Purchase, . ,~LtN~.l.lq.~ 7 Name of Former Owner Qa:~7.vCicv..T'J'tahd:l:........... . ' 1. Zorte or use district in which premises are situated ,~.:.`(4 . 2. Does proposed construction violaFe any zoning law, ordinance or regulation: p,YE:4kly'~I,u~.lln,'~(Nr,Ql~.h~{SE. ~/4~-.. . 3. \l ill lot be re radedp ~ • . • • • • \Vill excess fill be removed from premises: Ye No ' ~ . c1111. b 4. Name of Owner of, remises . OIDG't~': S.I~G4~Iv°.~.... Address ifO.l.a.kfiU14W TC't'•..~•AQ. Phone No.si.lb. y.7,2 .54~'y.. . Name of Architect ....'~4t.Vnv°.~; ...............Address ....~a4R~.......... Phone No.. Name of Contractor ....Address ........Phone No.. , - 5. Is this property located within 300 feet of a tigidal wetland? *Yes No ..I...`' *If yes, Southold Town Trustees PermitPLOTDIAG1ZAMed. 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 ~terior or corner lot. WU~E s ~ i W f>CJb~~ '~O ~i ~ e3 S / . 1. ~ ~0 pPS~~ ~ ~ ~ g e ' ~TotL~~W a; ~ ~0 4 . ~ ~ L EtZ~~kG~ .3 ~ N ~ ~cF•O FT N ~ X13°~~r~~rrw. _~g_ IN~ ! l'ATL• OF NE«' YOR ~i S.$ OGi'TY OF . . • . • • , , , , , , , , , , , , , , , , ,,,I being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) %ovc named. I :isthc (Contractor, agent, corporate officer, etc.) said owner ar owners, and is duly authorized to perform or have performed the said work and to make and file this plication: that all sta[ements contained in this application are true to the best of Itis knowledge and belief; and that the irk will be performed in the manner sFt forth in the application filed therewith. :orn to before me this ~.7... ..day~~//of . . ~r~i 19~/. . Mary Public, .....LIfS1:~:`;'. •lJ:. JIi!~-"•~ti°....... County NEtENK.tlEVOE (S, natureoCapplicant) NOTARY PUBLIC, Stote of New York Na A707878, SuNolk County Tum Expires Nlrx 30,19