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HomeMy WebLinkAbout17767-z r ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18991 Date APRIL 26, 1990 THIS CERTIFIES that the building ALTERATION Location of Property 480 GRISSOM LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 078 Block O1 Lot 10.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 1988 pursuant to which Building Permit No. 17767-Z dated JANUARY 19, 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 ALTERATION TO CONVERT EXISTING ATTACHED GARAGE TO AN ACCESSORY APARTMENT AS APPLIED FOR & TO CONDITIONS OF ZBA #3760. The certificate is issued to ELSIE D. YOUNG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-015399-APRIL 18, 1990 PLUMBERS CERTIFICATION DATED APRIL 23, 1990-OWNER B g Inspector Rev. 1/81 rows xo. s TOWN Of SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CfHIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ 017 7 67 Z Date ..1..,1/..9 t 9.k:'~ Permission is hereby granted to: ~~o ~ f . ~7j..~..~.~..:.~..g,~.......~~~......G..a ....~~c.- Caunty Tax Map No. 1000 Section .......78......... Block Lot No.......~D .e. pursuant to application dated 19........, and approved by the Building Inspector. ~ O~ Fee 4C..C~ c="~~ • . ~r.. ..I. Y~.~ Builds I ector ~~~i' Rev. 6/30/80 ~i~ r-'~ c? / Form No. 6 lea C~ C~ CI~V [ ~I ~ ~yy TOWN OF SOUTHOLD ~maApR 4`v8`I~JV BUILDING DEPARTMENT TOWN HALL ~„a.,f31_DG• DEO'Y. 765-1802 TOWN OF SOUTNOLb APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer ' responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. c 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 - $50.00 5. Temporary Certificate of Occupancy - Residential/n',$,,,1'S.00,~fgC~ommercial $15.00 Date Y[ C! t 1~. New Construction..... Old Or Pre-expisting,-,r~Build(i~ng...l........... _ Location of Property.... ~g~.......... ~ h~a~©": 1 ~:r7~~ ..............:?"`'1 ! .,.'Ot':~........ . House No. I Stree~J/ Hamlet Onwer or Owners of Property..........~l~.l-e..:.~:.../.@`~~.t~ County Tax Map No 1000, SectIi'o~n..:!~.~ ......Block.....~!........Lot...i..~~:~............ Subdivision...... ~ I~~~y... T'[d~ ~........File'd1 Map... ~.5..~..Lot # 1, ~`~/y(~ Permit No...~.~~ ~.7.Z~.Date Of Permit...I~.~Q~r:1~~~~pplicant..~,~~:e-.~;.~1~~~~...... Health Dept. Approval ..........................Under//writers Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ /7 . Q~pc .3 9 3 7 " . CO ~I ~ APPLICANT . O~Oc~~FF O~'C~~s TEL. 7G5-1802 / To~vrr or so~~goa,~ ti L::~" Lytix`!Y.~{r ~c OFFICE OF BUILDII~IG INSPECTOR P.O. BOX 728 ~ ry,. '~.~i rirn ~ ~ ~ -c TOWN HALL ~ ~ ~ p!- SOUTHOLD, N.Y. 11971 '~9p1 ~ yn C E R T I F I C A T I O N Date ' ~ Building Permit No. " , Owner ~Icjl~ ~`(.~,`~~Gr s'~~,r~~ please pri~ ) ~ ~~~~I ApR ~ Q 19~ Plu.,~er ,cj ~ ~ ~ ~ ~t ~g~ 4sit (please print) ^,fV6~vs~s~!`.'- I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's sig ture) Sworn .ylb before me this 23~day of ~~„~l Notary Pu is notary Public, ,S;y~~u~/L County RICNApp M. COiFlN NOIAl1Y PuKlc, sra. a Nrw Yak G1~I81e ca,my ~ Cominialon Erpir~s Juos 30, 18~ t 1cLD I::S;i SiiU;: IIUAiC. ~ ~Ot~tMENTS , fY v m ~ 1. a ~ H V FOUtdDATION (1st) c~~~ ~ rOUNDATIOW (2nd) _ -"y~~ 4 2 . ~ ` )2 z 0 ROUGH FRAME & ~ _ o PLUMBING ti H 7J 3. m rn y IIJSULATION PER N. Y. STATE ENERGY CODE x } r ~p ~ 4. ~ ~ r FIidAL D , o ADDITIOPIAL COMMENTS: x d ra ' x H roa a~ H O 9 • r H - ~ b m ro H • ~ o~oS~FFOLt~~~y ~y f. 'y` ~ ; ~ ~ ~ Southold Town Board of Appeals 1 ~ ~ MAIN ROAD- STATE ROAD 25 SOUTHOLD, L.L, N.Y. 11971 TE.1.,(~„PHONE (576) 765-7809 APPEALS BOARD u~ I~ ~"q~,,~~~QO~.~ ~ + GERARD P. GOEH RINGER, CHAIRMAN 1 ~ ~ 1~ 2 ~ I CHARLES GRIGONIS, JR. SERGE DOYEN, JR. JOSEPH H. SAWICKI T®wN~OF sour~o~a JAMES DINIZIO, 1R. ACTION OF THE BOARD OF APPEALS - -."..-,1 Application of~ELSIE D. YOUNG,-for a Special Exception to the Zoning Ordinance for permission to establish Accessory Apartment in an existing dwelling structure in accordance with the requirements of Article III, Section 100-30B, subsection 15. Location of Property: 480 Grissom Lane, Southold, NY; County Tax Map Parcel No. 1000-78-1-10.3. WHEREAS, a public hearing was held and concluded on Octo- ber 6, 1988 in the Matter of the Application of ELSIE D. YOUNG under Application No. 3760; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and - WHEREAS, the Board made the following findings of fact: 1. By this application, appellant requests a Special Exception to the Zoning Ordinance, Article III, Section 100-30, Subsection B(15} for permission to establish a new "Accessory Apartment" within the existing principal (dwelling with garage) structure, as more particularly shown on the sketched plans submitted with the application prepared by William Young. 2. The premises in question is located in the "A-40" Residential and Agricultural Zoning District, containing a total area of approximately 40,000 sq. ft. and road frontage of 135f- feet along Grissom Lane. 3. The subject premises is improved with a single-family dwelling structure with attached garage as more particularly shown on the survey prepared by Roderick VanTuyl, P.C., revised April 8, 1985. Page 2 - App1. No. 3760 Matter of ELSIE D. YOUNG Decision Rendered November 16, 1988 4. The area to be occupied as an "Accessory Apartment" is at the northerly end of the existing structure and will contain a living area of approximately 528 square feet (within an area 24'6" x 22') as shown on the sketch floor plan submitted with this application. The remaining floor area will continue to be used as the principal single-family residence of the owner. 5. Article III, Section 100-30(B} permits the establishment of such use, subject to conditions (a) through (p} thereof. 6. Subsection "m" thereof provides that "...the building which is converted to permit an accessory apartment shall be in existence and have a valid Certificate of Occupancy issued prior to 3anuary 1, 1984." Although a Certificate of Occupancy was not validated until after January 1, 1984, it is hereby determined that the documentation submitted is sufficient and the applicant has complied with this specific requirement, entitling her to same. 7. It is noted for the record that under Appeal No. 3761, a Variance has also been filed and processed simultaneously herewith requesting relief from Condition "m" under Article III, Section 100-3)(B){15}. (The subject variance was dismissed since the Board is without jurisdiction to vary the conditions of a Special Exception--see paragraph #6, supra, alternatively; Knadle v. ZBA of Huntington, 121 A.D. 2d 447 (1986); Roginski v. Rose, et al., 63 N.Y. 2d 735 (1984). 8. A parking plan has been submitted in behalf of the applicant depicting the area immediately east along the front section of the dwelling. The Bulk and Parking Schedule of the Code requires two spaces for the one-family principal use, and the Accessory Apartment will be required to have two parking spaces, for a total of four. (Each available garage space would be permitted as one parking space, when appropriate.) In considering this application, the Board finds and determines that: (a} the use requested will not prevent the orderly and reasonable use of adjacent properties or of properties in adjacent use districts; (b) the use will not adversely affect the safety, welfare, comfort, convenience or order of the town; (c} the use is in harmony with and will promote the general purposes and intent of zoning. The Board has also considered subsections {a} through {1} of Article XII, Section 100-121{C){2} of the Zoning Code. Page 3 - Appl. No. 3760 .Matter of ELSIE D. YOUNG Decision Rendered November 16, 1988 Accordingly, on motion by Mr. Sawicki, seconded by Mr. Goehringe=, it was RESOLVED, that a Special Exception for an "Accessory Apartment" as provided in Article III, Section 100-30(B){15} of the Zoning Code, in the Matter of ELSIE D. YOUNG under Appl. No. 3760, BE AND HEREBY IS APPROVED SUBJECT TO COMPLIANCE WITH SUBSECTIONS (a) through (p) of the Zoning Code, as applied. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Sawicki and Dinizio. (Absent was: Member Grigonis (out o€ state). This resolution was duly adopted. lk GERARD P. GOEHRINGER, CHAIRMAN e - ~ - u c~VF F Q(/(~~~~ Southold Town Board of Appeals ~ ~ ~~0~ ~,~t' MAIN ROAD - STATE ROAD 25 SOUTHOLD, L.I., N.Y. 11971 TELEPHONE (516) 765-1809 APPEALS BOARD MEMBERS GERARD P. GOEHRING ER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. December 2, 1988 JOSEPH H. SAWICKI JAMES D{N lZIO, JR. Mrs. Elsie D. Young 480 Grissom Lane Southold, NY 11971 Re: Appeal No. 3760 - Special Exception (Ace'y Apartment) Dear Mrs. Young: Transmitted herewith for your file and perusal is a copy of the determination rendered by the Board of Appeals recently concerning the above application. Please be sure to return to the Building Department for issuance of additional documents which may be necessary. A copy of this decision has also been furnished to the Building Department Office to update their files. Yours very truly, GERARD P. GOEHRINGER C IRMAN p.r,~~c/C y ~~da owalski , Enclosure Copy of Decision to: Office of the Building Inspectors Suffolk County Department of Planning 1 I[[ull~ ' ~0 S~FFQ(;~~ rn South®ld Town Foard ®f ,A eels PP ~i'? MAIN ROAD - STATE ROAD 25 SOUTHOLD, L.I., N.Y. 11971 o~~l TELEPHONE 1576) 765-1809 APPEALS BOARD MEMBERS GERARD P. GOEH RINGER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. JOSEPH H. SAWIC KI JAMES DINIZIO, JR. ACTION OF THE BOARD OF APPEALS Application of ELSIE D. YOUNG for a Special Exception to the Zoning Ordinance for permission to establish Accessory Apartment in an existing dwelling structure in accordance with the requirements of Article III, Section 100-30B, subsection 15. Location of Property: 480 Grissom Lane, Southold, NY; County Tax Map Parcel No. 1000-78-1-10.3. WHEREAS, a public hearing was held and concluded on Octo- ber 6, 1988 in the Matter of the Application of ELSIE D. YOUNG under Application No. 3760; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the Board made the following findings of fact: 1. By this application, appellant requests a Special Exception to the Zoning Ordinance, Article III, Section 100-30, Subsection B{15} for permission to establish a new "Accessory Apartment" within the existing principal (dwelling with garage) structure, as more particularly shown on the sketched plans submitted with the application prepared by William Young. 2. The premises in question is located in the "A-40" Residential and Agricultural Zoning District, containing a total area of approximately 40,000 sq. ft. and road frontage of 135+- feet along Grissom Lane. 3. The subject premises is improved with a single-family dwelling structure with attached garage as more particularly shown on the survey prepared by Roderick VanTuyl, P.C., revised April 8, 1985. Page 2 - Appl. No. 3760 ':°.Matter of ELSIE D. YOUNG Decision Rendered November 16, 1988 4. The area to be occupied as an "Accessory Apartment" is at the northerly end of the existing structure and will contain a living area of approximately 528 square feet (within an area 24'6" x 22') as shown on the sketch floor plan submitted with this application. The remaining floor area will continue to be used as the principal single-family residence of the owner. 5. Article III, Section 100-30(B) permits the establishment of such use, subject to conditions (a) through (p) thereof. 6. Subsection "m" thereof provides that "...the building which is converted to permit an accessory apartment shall be in existence and have a valid Certificate of Occupancy issued prior to January 1, 1984." Although a Certificate of Occupancy was not validated until after January 1, 1984, it is hereby determined that the documentation submitted is sufficient and the applicant has complied with this specific requirement, entitling her to same. 7. It is noted for the record that under Appeal No. 3761, a Variance has also been filed and processed simultaneously herewith requesting relief from Condition "m" under Article III, Section 100-3)(B){15}, (The subject variance was dismissed since the Board is without jurisdiction to vary the conditions of a Special Exception--see paragraph #6, supra, alternatively; Knadle v. ZBA of Huntington, 121 A.D. 2d 447 (1986); Roginski v. Rose, et al., 63 N.Y. 2d 735 (1984). 8. A parking plan has been submitted in behalf of the applicant depicting the area immediately east along the front section of the dwelling. The Bulk and Parking Schedule of the Code requires two spaces for the one-family principal use, and the Accessory Apartment will be required to have two parking spaces, for a total of four. (Each available garage space would be permitted as one parking space, when appropriate.) In considering this application, the Board finds and determines that: (a) the use requested will not prevent the orderly and reasonable use of adjacent properties or of properties in adjacent use districts; (b) the use will not adversely affect the safety, welfare, comfort, convenience or order of the town; (c} the use is in harmony with and will promote the general purposes and intent of zoning. The Board has also considered subsections {a} through {1} of Article XII, Section 100-121(C){2} of the Zoning Code. Page 3 - Appl. No. 3760 ~'~Matter of ELSIE D. YOUNG Decision Rendered November 16, 1988 Accordingly, on motion by Mr. Sawicki, seconded by Mr. Goehringer, it was RESOLVED, that a Special Exception for an "Accessory Apartment" as provided in Article III, Section 100-30(B){15} of the Zoning Code, in the Matter of ELSIE D. YOUNG under Appl. No. 3760, BE AND HEREBY IS APPROVED SUBJECT TO COMPLIANCE WITH SUBSECTIONS (a) through (p) of the Zoning Code, as applied. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Sawicki and Dinizio. (Absent was: Member Grigonis (out of state). This resolution was duly adopted. * x 1k ~~i,~ .r/ GERARD P. GOEHRINGER, ~/CH}AIRMAN FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No.. 213387 Apri1..23 I~.85 Date THIS CERTIFIES that the building ,New ,Dwelling, , , , , , , , , , , , , , , , , , , , , , , Location of Property ...480 Grissom Lane Southold House/VO.~~~~~~~~~~~~~~~~~~~~~~~St~eei ~~~~~~~~~~~~~~~~~~~~~~~NamJet County Tax Map No. 1000 Section ...078......Block ...~1..........Lot , 010.3 Subdivision . ,Sleepy Hollow. , , , , , , , .Filed Map No. 6351 , ,Lot No. 1......... . conforms substantially to the Application for Building Permit heretofore filed in this office dated April 11 , , , , 19 83 pursuant to which Building Permit No. ...12,3012 date) .....May, , . , , 9, . , , , , , , . , . , 19 83, was issued, and conforms to all of th^.~requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . New Private One Fami1X Dwelling The certificate is issued to . ELSIE XOUNG (owner, l~ssecertenantl of the aforesaid building. Suffolk County Department of health Approval 13-SO-28 UNDERWRITERS CERTIFICATE NO .................N624650, ,N624652, . , , _ . . . 1,lVU?~~ / W (/1/v 9 Building Inspector Rov. 1/ai FOAM NO. ~ T04YN OC' SOUTHOLD BUILDING DEPARTMEN'T' 'TOWN CLERIC'S OFFICE SOU1'IIOLD, N.Y, NUTICE OF DISAPPROVAL Idle No . I)atc ....~.~^e':"`'?...a~~.?......., 19 r !~80~ G . ; o~.~~........ . .cam .>-...~R.r:~6~- . A? ~ y ! 9. `7.1........ . 1'I,f;ASE'I'AKF NOTICE that your application dated ...~~!+?A:...~T.'~........, 19 .g 8 . for permit to construct 4AM ..n~....~.A?oWQ at Location of 1'ropcrty y 8 , ~.,t,.~-ary~'+~.. ~p,~R~}....... W _ ~n . n~ . Hnusc No. Srrcot ~^t H.vrrler County Tax Map No. 1000 Section ..•..D.7.g Bluck Lot( .~s7•. ~ . Subdivitiion . Piled hlap No. ~A.~.~~..~. _..,.q.., pL_ot No. .pr~l:`••-~........... . is returned here1wi-th :utd disanppr(~ov~ed on the fi~llowing grounds .U(~4~tG~, ~ . oy~.e~v..~~:~`?~~U- Lr/S~ j~,QaM....w,o~. v , V a..u~.cx-. ~a (J.`~. r~-!uP..~`-y,. 3.,. (L : ~ •..~!~•r4.. Si1°~c,~..~.,.+. 30 4 Y. ~~v,.... . Building Inspector Av vco G~ ~ ~ ~ ~ ~ ~ Q' z'.Bi9~ ~y;y~ ~ 3 ?G o c ~ 2 ~ ~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] R UGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ]FRAMING ~ [ ]FINAL ~ REMARKS: `J~Q~-,~ d~.~ DATE INSPECTOR BUILDING DEPT. a ~ INSPECTION [ ]FOUNDATION 1ST ( ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: DATE INSPECTOR M f,., r ~i ~ Z~~ D n k k ~ ~ ITl ~ s, : ~ ~ D ` ~ ~ (p I ~ -c ~~~~Al1~MpW ~~j{ Q.c'. ~ A .w ~ ~ ? ~ p p ~r > ~ ~ Sy ka{,c tilt' ~ ~ ~ `t(, ~~jj i { ~ \1 ' k • c0 ~ ~ - i ~ ~p ~ ~ ~ ~~t`, _ 1 i { f!r1 _ ~ ' ~~J « ~ Y b ~ a ; }p~ E O ~E~ t~ , M ~ ~ ~ J+ ? h ~ i i t , ~ ~LL. t~5~h~f~'k '.n ~ ~ 'l. +7 V ~ ~ ' V ` t 1 M ~U kY V. Y Iy~ I.. IJ \ ~ ~ i Y Y ~ s ~r> ~ r ~ { F 4 L 3 ~ 11 ~ ~ ~ ~ ~ _ ~ S ~ Ste- ~ -e, o~. A µ x ~ jr P ~ ) p { k I i. - \ 4 I" pry {~~,Y i }~'~A~ ~ ~'t ~ ro ~ j~ i~ ,(Y tr ~ S v z ~ rg ~,L't ~ ~ ~ J _ ~ Q a 't SL ~ W ! ~ A •`IQI. 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V-.= r I b ~ _ o - - - z 4 `G J~ ~ ,A 0 - ~ o - ~ - - - m t ` ~ i°~iti~ O O r- - - ---~s~ „0---- - - - - - - - mo r?-------~`', ro r ~ - - - ! - - G ~ ~~E3® ----z r . . m --t- - - - - --e~'~-- mop!` ~ - ~ ~ 1 T ; _ _ - ~a m~d ~ - --~o - m„ r T - y`! - - _ _ - - - - ~r - - - ~ ~ D ~ ~ r -moo ~ _ ~>a cb ~ X Q oq ~4, b ~z~k,w~ ~~~~L~1~"JI"~~~ BOARD OF HEALTH ~•rp 3 SETS OF PLANS . JU1~ 3 O ~95~ 4 FORM N0. 1 SURVEY . TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM B,®„u„,,...-.,,.4..._,.r.,.,.....,., TOWN HALL t3LOr. i!i_~ TOWN OP•SOll-1't'OLi> SOUTHOLD, N.Y. 11971 NOTIFY ~~.~~,a rM ' 76.5"° d 5~~3 TEL.: 765-1802 CALL MAIL T0: Examined 19 Q~~}~ Approved ~ 19 Permit No.~~~~p. 7~ Disapproved a/c ?~~e'~...1~.~p.Q-v.. L~ci;,l.i.c~,1c-,~:.../. f r (Buildi nspector) APPLICATION FOR BUILDING PERMIT Date , , 2 3 June . - • 19 g8 INSTRUCTIONS a. This 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 application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature oi" applicant, or name, if a corporation) 480 Grissom Lane, Southold, NY 11971 . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner Name of owner of premises ...,Elsie,D..,,Younq,,,,,,,,,,,,,,,,, (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 . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . I. Location of land on which proposed work will be done . . .....480 ............................G'GCssom ,Lane..............Southold.............. House Number Street Hamlet County Tax Map No. 1000 Section ......078. _ . , . • , , , Block Lot 10 ' 3 Slee y Hollow,,,,•,,,,,,..... Filed Map No. 6351•,,,,, Lot...,#,1,,,,,,,,• Subdivision (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Single ,family, ~w.@1~~x1g ,with ,attached two, car, garage. , , , , . _ , b. Intended use and occupancy Same except ,gax'.age. k1eG9mes ,an, accessary, apartment, ,st3itdble for~Yiabitation by one or a maximum of~two adults. 3 Nature of work (check which applicable): New Building Addition , Alteration ,XX, , , , , Repair Removal , Demolition , Other Work . . I (Description) 4. Estimated Cost ....undex'..~ 1i,5.,.t1Q 0. A,O . . Fee . (to be paid on filing this application) 5. If dwelling, number of dwellfn ~yrnits ...°ne , Number of dwelling units on each floor . ,single, family If garage, number of cars .....;wo . c , . 6. If business, commercial or mixed occupancy, specify~,nature and extent of each t pe,of use , , NA... , . , 7. Dimensions of existing structurcls, if any: Front ~ ~ ~ '6,',, , ,Rear 6 r6 Depth , , 4 6 -6 Height 23' Numlber of Storics two . . Dimensio 1ts'of same structure wi th alterations or additions: Front , , ,same , , , , , , , , , Rear ,same De th ,same . • ~ ,Height . , , ,same , , , . Number of Stories ,same " 8. Dimensions of entire new const ction: Front ,same , , , Rear . , , , same ,Depth S~RI@ . Height .Num!berofStories. 9. Size of lot: Front ..1.5 Q , Rear . , $1. ~ Depth , 345 i 10. Date of Purchase April, 1,983„ , , , , , , , • • • , , , , ,Name of Former Owner , , , ,Ann 1?. 'Kwa'sneski' ' • ' ' ' 11. Zone or use district in which premises are situated . , , ,residential 12. Does proposed construction violte any zoning law, ordinance or regulation: F?4 . 13. Will lot be regraded ~R . ...Will excess fill be removed from premises: Yes (No ) 14. Name of Owner of premises , ,,',Elsie D Young Address 480 . GrissomLa , , ,phone No. 765=2483 Name of Architect I, , .Address Southold , , , .Phone No............... . Name of Contractor .Address . , , . .Phone No..... r. IS.Is this ro ert loca' p p y ted within 100 feet of a tidal wetland? *YES,...NO XX, w *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all I buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block 'number or description according to deed, and show street names and indicate whether interior or corner lot. *See attached sheet', I STATE OF NEW YORK, S.S COUNTY OF . ...........................g .Ing contract) (Name of individual si n l' ~ ~ ~ ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in t}te manned set forth in the application filed therewith. Sworn to before me this . 97.,~ ~....~day oflj..... 19 Notary Public, . , , ~J ~'.~r~r.S!~-:..... County f lv~~ _ _S8t1 NEIEN K DE WE NOTANY PUBLIC, Stele of New Yak . 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