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Home My WebLink About23543-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 24536-Z Date July 30, 1996 THIS CERTIFIES that the building addition Location of Property 1030 Broadwaters Road, Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 09 Lot 01 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 6, 1996 pursuant to which Building Permit No. 23543-Z dated June 28, 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued isdeck addition to single family dwelling as applied & to ZBA#4322 The certificate is issued to William L. & Victoria A. Gordon (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A �.Gc / _ ztw Building Inspector Rev. 1/61 "ILM NO. 2 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) N4 23543 Z Date ............J ...�..... ......... 19/...!!� Permission is hereby granted to. t� .... ...n.... 9..a... .... :. V.., to ....... .... ... .. at premises located at ................6V..3o..... JJ �c �tL�'/ .. ....................:..................�// .................................................................. .7lLQ ............................................. ................................................................................................................................................/................... County Tax Map No. 1000 Section ... /o. .... Block .......9.. ...... Lot No. ...../............... pursuant to application dated ..................-f1 �... ........... 19./...Y and approved by the Building Inspector. 6115 Fee $•••7�f....•• ... .......... L...6f.1..�.. ...................... Building i r Rev. 6/30/80 —� Form No. 6 7�('q TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 U 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25i�. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential �j$15.00,C�Commercial $15.00 ++��((,�� Date . . . .! /l.Y . . . . . . . . . . . . . . . . . . . . . . . . New Cons truction�. r�:'.` . . Old Or Pr(k-existing Build'ng. . . . . . . Location of Property. Q. , .��19( `.Il�C1AQ(a. . . .IT . . , . , , . , . . ,{!✓, 5. lC°�ve House No. Street / r ,S/t/reet (//J �� Hamlet � Onwer or Owners of PropertyL/.[/! �I . L(.((4,: .L-l.Ur.�t!"c . .;AlC�:". .!!.! /YL• •. . .��l �N County Tax Map No 1000, Section. . . )�. 1 . . . . . .Block. . . . . . .1 . . . . . . . .Lot. . . . . .�C . . . . . . . . . . . . . . . Subdivision. . . . . . .LUa.� 1>. . .�C�� . . . . . . . . .Filed Map. . A . . . . . . / r} q�+ r Permit No �.! ! . . . .Date Of Permit.lC/�f. . l.YI. . . .Applicant.� \ . . . J.l1�a 1ht' C0n[-�NC ' Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $ 4.4. . . . . . . . . . . . . . . . . . . . . C�c ,51707 . . . . . . ��. . . . . . . . . . . . . . . . APPLICANT APPEALS BOARD MEMBERS �O�SpFfO(,�Co p • Southold Town Hall Gerard E Goehringer, Chairman 53095 Main Road Serge Doyen, Jr. y x P.O. Box 1179 James Dinizio,Jr. O Southold, New York 11971 Robert A. Villa y'�fpl �a0� Fax (516) 765-1823 Lydia A. Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD July 19, 1995 Mr. Robert I. Brown, Architect P.O. Box 521 Greenport, NY 11944-0521 Re: Appl. No. 4322 - William and Victoria Brown (Variances) Dear Mr. Brown: Please find enclosed a copy of the determination rendered by the Board of Appeals and filed today concerning your variance application. A copy of this determination has also been furnished to the Southold Town Building Department pertaining to your pending building permit application request. However, it will be necessary for you to submit the final drawings and location map with the Building Department before your building permit will be further processed by their office, with a final copy to our office for the permanent file. If you have any questions, please feel free to call either our office or that of the Building Department at 765-1802. Very truly yours, Linda Kowalski Enclosure �cc: Building Department L� JUL 9 1995 APPEALS BOARD MEMBERS h�O��gUFFO(,) COGy Southold Town Hall Gerard P. Goehringer, Chairman c 1 53095 Main Road Serge Doyen,Jr. ca x P.O. Box 1179 James Dinizio,Jr. �O Southold, New York 11971 Robert A. Villa d�lfpl �.�0� Fax(516) 765-1823 Lydia A. Tortora Telephone (516) 765-1809 TBOAARRDpgOF APPEALS ACTION OF THE SBOARDOOF APPEALS DATE OF ACTION: July 12, 1995 APPL. #4322. APPLICANT: WILLIAM and VICTORIA GORDON. LOCATION OF PROPERTY: 1030 Broadwaters Road, Cutchogue. COUNTY TAX MAP DISTRICT 1000, SECTION 104, BLOCK 9, LOT 1. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector dated May 24, 1995. "Insufficient front yard setback as set forth in the Zoning; Code . . . 100-30A.3." PROVISIONS APPEALED FROM: Article III, Section 100-30A.3. RELIEF REQUESTED: Plan issued June 20, 1995 by Fairweather/Brown Architects shows proposed reduction in the presently nonconforming front yard setbacks to less than that established for a proposed wood deck to 15 feet and proposed relocation of attached gurage from 9.8 feet to 5+- feet at its closest point. The subject front yard area faces a paper road referred to as "North Pond Road" which extends northerly to Broadwaters Cove. MOTION MADE BY: Gerard P. Goehringer, Chairman SECONDED BY: James Dinizio, Jr. , Member ACTION/RESOLUTION ADOPTED: Denied setback for proposed garage, and granted alternative relief with a setback of not less than 716" at its closest point in the front yard along Broadwaters Road. Setback for deck proposed at not less than 15 feet from the front property line granted as applied. REASONS/FINDINGS: Denial necessary due to substantial increase in present nonconformity at approximately 45% closer to Broadwaters Road, a town street. Requirement is to maintain existing nonconformity, or comply with bulk schedule for a 40 ft. front yard setback. House is presented situated on neighboring property of Lot #252 to the west, and shifting onto the this property is without a doubt necessary. VOTE OF THE BOARD: Ayes: Serge J. Doyen, Member James Dinizio, Jr. , Member Robert A. Villa, Member Lydia A. Tortora, Member Gerard P. Goehringer, Chairman-Member This resolution was unanimously adopted. lk GERAR OE' HRINGER, CHAIRMAN C FIELD MSPE(.%''ION REPORT DATE COMMENTS 4 I� -----.....--- --------- FOUNDATION -------FOUNDATION ( 1ST) I �� n °-------------------------------- ---- . . . ------- FOUNDATION (2ND) _ O — ------ --------- ------ �� 11 II II ROUGH FRAME & II-------------- PLUMBING ------------PLUMRING I II 11------.-�.-__-_--__--------'----"--------_- ITt--------- INSULATION ____.___INSULATION PER N. Y. ii td STATE ENERGY ii it ii------ --it------ ---------- CODE I�--------ii---- -° ------ ----------- FINAL -------_____-___FINAL n n I ADDITIONAL. COMMENTS: ------------ H O x • r - --------------------------- ----------- --- --------------- - --- --- e r� 't � ( 030 -�i, .le•ch er,.d_ CUSTOM VIEW CUSTOMER -- DATE 08/23/86 REF JW ¢PPR O ED AS R - DATE:�j 3 B.P.6 - FEE: Y: NOTIFY BUILDING DEP TM 785-1802 9 AM TO 4 M FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO-REQUIRED FOR POURED CONCRETE - 2. ROUGH - FRAMING & PLUMBING z l 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. 6v-,J ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. c ,�� 4l��"' STATE CONSTRUCTION & ENERGY UL CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS a'3,I ,UT � $ i *.A�� /�rl • YWR566 M..-MY r . ...gar _ iP , r n ... __ _ -..•—�. _• __. .*]�,.-' X[ BEAM LAYOUT CUSTOMER -- DATE 08/23/95 REF JW NN m iN N z AE� I I 11' 6 13/16' iLl i 311 1S/16' �� a in n N Y BEAM BEAM POST POST LABEL LENGTH COUNT SPACING A 5' 10 1/8" 2 4' 5 5/8" B 15' 6 3/4" 3 7' 2 3/4" C 13' 5 1/2" 4 4' 4 II/16" D 31' 9" 7 5' 2 15/16" ( -- E 13' 9" 4 4' 5 13/16" F 13' 9" 4 4' 5 13/16" j G 13' 9" 4 4' 5 13/16" _ �cf Post spacing is measured center-to-center. � �y i• _ Depth of post-in-concrete footers --- 36 inches. wt ' �So�IcX I B10 Com:fi.j'I Q PLAN VIEW CUSTOMER -- DATE 08/23/95 REF JW 3z• ' s• s• _ T` NJ vv m I 1 a N I 4' c8' LOAD AND SUPPORT: Your deck will support a 45 PSF live load. Posts have 36" below-ground post support. DECK AND POST HEIGHT: You selected a height of 36" from the top of decking to level ground. The top of the deck support posts will therefore be 27.25" above ground level. Your salesperson can provide information for uneven or sloped ground. JOISTS: Set joists on top of beams, 16" center to center. NOTE: The design may require knee braces and bridging between joists. Your materials list includes the necessary items. The suggested design is not a finished building plan. You are responsible for all measurements being correct, for verifying that the design (and any substitutions or modifications that you make) meets all local building codes and requirements. To verify that the suggested design, and any substitutions or modifications, is consistent with conditions at the construction site, review the design with your architect. Also consult your architect for proper construction and use of materials in the structure. Be sure to follow the deck construction detail available from your store salesperson. BILA OF }9ATERIALS --- LUMBER CUSTOMER: DATE: 08/23/95 REF: JW SALESMAN # ------ --------------------------------------------------------------------- COMPONENT SKU QUANTITY DESCRIPTION WOOD TYPE -------- - - ----------------------------------------------------------------- DECKING 654X06X12 19 EA 5/4X6 12' ST CONST CEDAR DECKING 654X06X08 21 EA 5/4X6 8' STK CONST CEDAR DECKING 654X06X10 48 EA 5/4X6 10' ST CONST CEDAR DECKING 654X06X14 19 EA 5/4X6 14' ST CONST CEDAR DECKING 654X06X16 14 EA 5/4X6 16' ST CONST CEDAR APRON FRAME 52X04X14 8 EA 2X4 14' S4S CLEAR CEDAR APRON FRAME 52X04X16 3 EA 2X4 16' S4S CLEAR CEDAR APRON FRAME 52X04X12 1 EA 2X4 12' S4S CLEAR CEDAR APRON FRAME 52X04X08 2 EA 2X4 8' S4S CLEAR CEDAR APRON FRAME 52X04X10 5 EA 2X4 10' S4S CLEAR CEDAR RAIL CAP 62X06XO8 5 EA 2X6 8' CONST CONST CEDAR RAIL CAP 62X06X12 3 EA 2X6 12' CONST CONST CEDAR HORIZONTAL RAILS 62X04X16 6 EA 2X4 16' CONST CONST CEDAR HORIZONTAL RAILS 62X04X12 6 EA 2X4 12' CONST CONST CEDAR HORIZONTAL RAILS 61X06X16 3 EA 1X6 16' S1S R CONST CEDAR HORIZONTAL RAILS 61X06X12 3 EA 1X6 12 ' SIS R CONST CEDAR RAIL POST 64X04X16 8 EA 4X4 16' CON CONST CEDAR STAIR POST 64X04X16 1 EA 4X4 16' CON CONST CEDAR STAIR STRINGER 702X12X18 2 EA 2X12X18 CCA CCA STAIR TREAD 654X06X08 10 EA 5/4X6 8' STK CONST CEDAR BEAMS 702X08X12 1 EA 2X8X12 CCA CCA BEAMS 702XOSX16 6 EA 2XSX16 CCA CCA BEAMS 702X08X14 8 EA 2X8X14 CCA CCA JOISTS 702X08X20 7 EA 2X8X20 CCA CCA JOISTS 702XO8X18 2 EA 2X8X18 CCA CCA JOISTS 702X08X14 14 EA 2X8X14 CCA CCA JOISTS 702XO8X16 1 EA 2X8X16 CCA CCA JOISTS 702XO8X10 3 EA 2X8X10 CCA CCA JOISTS 702XO8X12 2 EA 2X8X12 CCA CCA JOISTS 702X08X08 3 EA 2X8X8 CCA CCA J-SPLICE 702X08X12 1 EA 2X8X12 CCA CCA FASCIA 62X08X16 2 EA 2X8 16' CON CONST CEDAR FASCIA 62X08X18 1 EA 2X8 18' CON CONST CEDAR FASCIA 62X08X08 4 EA 2X8 8' CON CONST CEDAR FASCIA 62X08X14 2 EA 2X8 14' CON CONST CEDAR FASCIA 62X08X10 1 EA 2X8 10' CON CONST CEDAR FASCIA 62X08X20 1 EA 2X8 20' CON CONST CEDAR LEDGER 702X08X16 1 EA 2X8X16 CCA CCA LEDGER 702XO8X18 2 EA 2XSX18 CCA CCA LEDGER 702X08X08 4 EA 2X8X8 CCA CCA LEDGER 702XO8X14 3 EA 2X8X14 CCA CCA LEDGER 702X08X10 1 EA 2X8X10 CCA CCA STAIR HANDRAIL/CAP 62X06X12 2 EA 2X6 12' CONST CONST CEDAR HORZ . STAIR RAILS 62X04X16 4 F.A. 2X4 16' CONST CONST CEDAR HORZ . STAIR RAILS 61X06X16 2 EA 1X6 16' S1S R CONST CEDAR GROUND POSTS 704X04X12 14 EA 4X4X12 CCA CCA --------------------------------------------------------------------------- w BILL OF MATERIALS --- OTHER MATERIALS CUSTOMER: DATE: 08/23/95 REF: JW SALESMAN # --------------------------------------------------------------------------- COMPONENT I SKU QUANTITY DESCRIPTION --------------------------------------------------------------------------- BEAM BRACKET 40257A 14 EA PB44 4X4 POST BEAM CAP 16D NAILS 50055 32 LBS 16D GALV. NAILS 10D NAILS 50051 10 LBS 10D GALV. NAILS 8D NAILS 50049 19 LBS 8D GALV. NAILS LAG SCREW 861270L 11 EA 1/21IX7" LAG SCREW WASHER 8612W 151 EA 1/2" WASHER TIE-DOWN STRAP 40236 102 EA JOIST TIE-DOWN STRAP JOIST HANGER NAILS 50275 2 BAGS KANT SAG NAILS LATTICE 4X8 2814OG 12 EA LATTICE 4 'X8 ' CCA RAILING BOLT, 6IN 861260C 70 EA 1/21IX6" BOLT NUT 8612N 70 EA 1/2" NUT - ----------------------------------------------------------------------- WOOD TYPES USED IN DECK DECK PLANKS CONSTRUCTION CEDAR STAIR TREAD CONSTRUCTION CEDAR STRINGERS .40 CCA JOISTS .40 CCR FASCIA CONSTRUCTION CEDAR LEDGERS .40 CCA BEAMS .40 CCA GROUND POSTS .40 CCA RAIL POSTS CONSTRUCTION CEDAR RAIL CAPS CONSTRUCTION CEDAR RAIL SPINDLES CONSTRUCTION CEDAR OTHER RAIL MEMBERS CONSTRUCTION CEDAR FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT �.. SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL. DATE: . . ..MAY 23j 1995. . . . . . . . . . To . , ROBERT BROWN A/C WILLIAM 6 VICTORIA GORDON P.O. BOK 521 . .. . . . . .. . . . .. . . . .. . . . .. . . . . . . . . . . . . . . . . GREENPORT a NY - . 11944 . . . .. . .. . . . . . . . . . PLEASE TAKE NOTICE that your application dated . . .W.9r. . .. . . .. . .. 19.95. . . for permit to CONSTRUCT. . . . . . A GARAGE ADDITION AND DECK ADDITION. . . ... . . . . .. . . . . . at . .. . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . Location of Property . . . 1030 BROADWATERS ROAD CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 - Section . . . 104. . . . . BLOCK . . . . . 9. . . .. LOT . . . . . . . . . . . . Subdivision . .. . . . . .. . . . . .. . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . .Lot No. . . .. . . . is returned herewith and disapproved on the following grounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . INSUFFICIENT FRONT YARD SETBACK AS SET FORTH IN THE ZONING CODE OF THE TOWN OF . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . SOUTHOLD ARTICLE IIIA CHAPTER 100-30 A.3 .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . .. . . . . . . . . . . .. . . .. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . .. . .. . .. . . . . . . .. . . . . . . . . . . . . . .. .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . .. .. .. . . . . . . ... .. . . . . . . . . . . . . .. . . .. . . . . . . .. . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . ... ... .. . ... . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . • - .. . . . . .. - - ... . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • - - • - - - - . . . . . . . . . . . . .. . . . . . . . . . . . . - - . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . /. . . .. . . . . . . . . . . BU NG INSPECTOR RV 1/80 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION i ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C DATE O INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATEINSPECTOR La• � o N l rte= I o V� m 0 Ln Ja m 4.t'uwLLt N 10 Him, CDZ La �lV . -7..,.- .. O ;26i t� N - Q- project title. ICA �n o t T1p drawing title. a%15f• ENt • \ O aeon ARC m e RO`.y ' LAJ drawing M. e�..�Or;e�lx^Sr�f.� _ _� i`J j �„{7 -��COt�41G, �P,N�YDP:•'�,PSG. �Q�z;�l Q S Nwvtc, ,4R4 -LIJs . !o n Lai. Asst BROAD WA TERS Nc `F ��. N. 83051'20" E. S' 6.6•. D 51.64' i �j 230 o� r ry ti yr o pl; Q� o Qp r Q� ti �. ti LOT CERTIFIED TO: I ! oQ WILLIAM L. GORDON as' 41 VICTORIA A. D. GORDON MERRILL LYNCH CREDIT CORP. !r �6 c� STEWART TITLE INSURANCE COMPANY oo��er ��p� 0 40 s AREA = 23, 156 sq. ft 0 to tie lines 0' �� PO FIRM ZONE= A4 (el 6) 6 Zi a . O 0 S. 'ago P SURVEY OF LOT 251 & P/O LOT 252 "AMUVED MAP -A'OF NASSAU P08VT, NASSAUPOWT CLUB PROPERTE$ M. FLEDAUG 1AX71 FLENO X5'6 A T NASSAU POINT TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 104 - 09 - 01 Scale: 1"-40' fi May 6, 1994 MAY - 9 1995 N.Y4. Ir1C. NO. 49618 Prepared in accordance with the mkimm standards for file surveys as estaNkhed ECONIC kL P.C. (516) 765 - by the L.I.A.L.S. and approved andodopled P. O. BOX 909 r. lar such use by The New York Stale Land MAIN ROAD Idle Assocfolon SOUTHOLD, N. Y. 11971 FM ZONE 617/94 94 - 181 BOARD OF IIRAL'fll . . . . . . . . . . . . . . . volut N0, 1 &-' I 81c.'I'S OF PLANS . . . . . . . . . . . . . . . TOWN OF fO0,1'1101.1) IRvl?y . . . . . . . . . . . . . . . . . . . . . . . . 8111 1.1)1 N(: I)F.1'A g'IME,N'i' CI IIKCK TOWN IIALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . ;OWHIOIA, N.Y . 11971 '1'F.I.: 765-- 1802 NO'T'IFY: \ 49 L CAL . .7c ... . ?!. . . I?x;miixecL.Y."flh4.y C., 19 (.. MALI. TO: . . . . . . . Algarrved.Y.42--A, .. ... 19% Penuil tb ✓, .C. . .. ... ... ..... ...... ............ .. ..... Aiilding Du;lxsa os) AI' .I CA TI ON FOR 111111.01 NO N"..RlllT bate. . . . . . . . . . . . . . . . . 19. . . . I NS'1'It11C'1'IONS n, 'Illi. nlgd icatAoo aunt- foe culldel ely filled in by lylxnal iter or in ink aiwl milmliI teal to the IAri lding Inspect-or wi 71sets of plans, accurate plot plait to scale. Fee according to schedule. 6. flat plan ;dfraiog ltwiticxl of lot aril of ixlildiogn off premises, relaliouship to aljoiniog prexni ser, or IxiLlic Ia leeln or suers, a1xl givitg; n detailed descr iptioo of Ispmt of ptolietty alis( Ile drown fm llre diagram wlliclt is flat( of this application. c.. 'life Work covered by This nlgdical is At eery lf)t Ix cumrr Wed Ilefole isMIMWe of IAII tafing permit . d. lllxxl alyrwval of This algrl ical ion, file Iloi lding Inslreclor will issue a Ilei lding Permit to file appl icanl:. Such Ixnfli t. shall ire Jeep( on life prerni seh avni hibie for inslxtcl ioo ll ncugifxit the fmlk. e. No Ixli ld int-, shall Ire occupi ml of used in w1iole nr ill lou t for any Inn fx,se Meal ever till[ it a Cert,if icale of fkculsuxy shall Nave Ixaeo granted by lire NO lding Insl>ec.tur. A1'19.ICAT1(N IS IVAT'tY ME to Ute M%ildioi; Iklxrrmul for fire issualn'e of a lkwildiog PelIMIL fea!Zmulto the Mlilding 7xroe Oldimme of LiteTotal of :xxllhulrl, "xrffolk (ixinly, rka+ Yolk, alwl other applicable Ewes, Oldittooces of Itegul nl irnls, for the costriwLiat of )xrildirv,s, ml,lil ices or alleral inns, or for Iearvel or de!rolition, as herein tlescrilreel. 'the applicant agrees to casgly wills all alndicable liras, ordinames, IndIding ccxle, lfntsnlg cele, 91xl I etpd al i(x is, aixl to akai 1, aulh)HM. I[ insllec�luss 011 pt culmen aiwI io Ixei ld it for rxacessnry iospec.L ions. .. . .. ... ... ... ... ... .................... .......... ... f (Si Istat-ore of aill)l icaut , or sale, if it corIfo rnt.i(n l) ................................................... Mliling mldless of applicant ) Slate rAmIlrer :qgd iconI. 's txa ler Ipasee, agent , al chi reel , engineer, gerreraI coot act or, el ectwiden, pt-little.t or Inti Ides .. ........ ..(„�1%d. .. ...j.. ......... .. ...... ... ... ...r............... ... ... ........ ............. ..... .... Nam of owner of prt'rni:ea ... ..... .. ... (as cal file lnx loll or iMest deed) If sq If ice It in a corixr at itx r, sif;Ilsl[ole of duly and lfrri7ed officer. 7px u ' (N.nr. awl title of (:Of officer) p 1 1F7,Ut 6 ��° i {Atilders Eireose f1 L-rI..f . ...... .. r�ln Btfi/� j Pludfnn License No. ...... ... ... ... . .,. nc ;'ern Elect I iciaas Liruu:e Ikr. ...... . ... ...... . .... .J OLlfer Trifle's License No. .... ...... ..... ..... 1. Imalitxt of larwl al width prwlxrsed work will be (Iooe.. .. . ... ... .. ...... . ........ ................ ... ..... .......... /.030 ....$QoA.....y�r...... . ROAD ..... cupwo4gf� Ilorere Mnlxtr Stree��ltt ((ff Q Itallet. QxaLLy 'fall Abg) Mr.. IO(D Scala .../}!.!. ... .... Ill wit. . . .. . ./.. . ... ... lot . . .A. ......... Sldwlivisitxi ...41& Irew.?,ww7. . . . .. .. . . .. . . Filed My fb. .4 . . .. ... . .... Ia)L .. 9.'f .0 �.Z (Niall) Y' 2. Slate existing use awl mcagraswy of jvtenises awl iuLetwled us aril cx:cu fy of p Jewel ,coonslrucliou: :I. Exiscing use aowl mculuawy . ..A-.l. (.''.'j. le, . . >�Cc Yj/i . .. . ... . ../. . �. �rt_........ ...... . b. Int-erwkxl use arwl rxs:rgxnwy .... ... ... ...: a.G(.5,... .. . ,!/, . ..................... !. It It nue of link 6IN:(k %Ali(11 gild is all e): Ik,! IkII lel ilgl . . . . . .. . . . Nklit ion . . . . . . .. Att�ey til loll) . . . . . . . . . . Ik!lutio . .. . . . . . . . . . Itmerval . ... . . . . .. . . . ik'uni illon . . . . . . . . . . . . 016e1 Iknk . . . K . ... a g� 0 (Doncr ipl text) �. sw ^y � it . EMl7 adled (bsl .. . x4p2. ... . ....... fen. . . . . . .. . . . ... . ... . . . . .... ..... ... ... .... . ... .. (lo Ix: paid o" Ill iog Ihi;l appl ical ion) 'i. If ikn:lliult, lumber of lbn!lliog "nils . . . . . . . . . . .. limber of &,ai ling "till; ext ear, floor .. . . . . . . ... . . . . . If gnllelge, lxmlxet of Cnle . .. . . . .. . . . . .. . . . . . . .. . .. . . . .. . . . . . .. . G. If Ixwinx!ss, ruwelcial or m&xed occi Nancy, n1mcify na[ure mut hmteol of earh type of Use.. , . . .`.. . . . . . . . . . ... . . 1. I1W"minos of existing nil rou:lonno, if. auy: It"xd . . . . . I . . . . . ... . . holtr . . . . . . . . . . . . _ 0,11lh . . . .. . . . . . . . . . . . . Ik:ight . . ... . .. .. .. . . ... ... . .. .. Ikmix!t of 8101 ''". . . . . . . . . . . . . . . . . . . . . . . Ilinu:n;iexo; of nqw- Of 6ru:lure with at teiat luta or laldil io"s; Roel. . . . . . . .. .. . . . . . Itear . ...... .. . .. .. . Ik!pth . ... ... . ..... .. .... . Ikight . . . . . . ... .. . . . . . . . . . Ikmbet of alorl"a . . . . . . . .. .... . . If. Illau:oa into; of ent its! lux+ l'onst "W:1 !on: 1'r'no . . . . . . . . . . . . .. .. Ifeill- . . . . . . . . . .. . .. . Ile IN 11 . . . . . . . .. ... .. 14:ii;h! .. .. . . . .. . ... ... ... .. ... . IA nil x!r of S[no On . . ./. . . . . . . . . . . . . . . . . 9. :line of 101.: Vloot .. ... ... . . .pp. . .�.J. ... . . Ikam . . . . . . . . . . . . . . . . .. . . 1k:plh . . .. ./... . . . . . ... .... . Ill. lkele of 1lorhnse , `"IUL�. . .. .tl y. ... IBM! of Frnu+a Rawl .S�SSz'GH .(/' .Z.S.. . .. ... . . .. . 11. yltxd ur oetl! (fill[ 1icl ilk tAoiv, pi nnisoa aoe silo;"ed . . . 'jP�Q.hI�L(�iy? . . . .,�.. .// . . .... . .... ... . .. . .. . ... . . . . . . 12. floes plulat;ed ceamlrtua incl violnle omy Z(Mdlg tete, I"d•In:nu:e uo legulallo o: . .1/./.(1.. .. ... . .. . ... ... .. 11. Will lot. nue lenra,61 .. .AY. L/.. . ... . .. .. wili,,exccn; fill ,a ivawed ronin Aplanines: Yf9 til 14. H:nua of (k+o ter of prernl ne:��f�✓2. '1 . .f7.8Y"�Q1L... .. . +4klr ea;0�/.�Q. ,p ..,L(�l�T^'4!`LL.+ . . .. .. . Noceo tko. . . . . . . . . i1/owau-i�T Gui�cErvJv° �3Y f ' Il:mm of Aechltend . ././. . .... ...... . .. .. . ... .. . .. .. . .. . .. A,kII esu . . . . . . . .. . .�.i. . .. ..... . .. ..../.�. .�11�n1 x! Iko yet tilmx! of (itrirm:lor'ltfr.•t•Lfx �!:tr. +T �'�G+IC-.44$ Mk,es; �y-7. . . rJ t". . i!( G4i`>!. .1l Done ikt./P • ' . 1'i. IN this I""IWIIy Within J(l) feet of n l.ldal wotAan,17 A WS Air. . . . . t1U . . .. . .. .. . *If lw3' I➢fllllllll) 'Iml -limsiviii 11i1+f11`l• HAY 1111 IUPIj.11111e.11. V1.01' DIAGIUH locale. Wally aid dintloclly n11 holitlinita, %Aa!Ihcr exiea ing or prulxtsed, mut hulicole alt set-,ark dlnv!n;iu"s tum piolx!rly lines. Give slkect mxl ,lock iumbol of (lemn iplion rl[rold Inlg to elee4, mul eJnx.r street natio; nix[ il.lira oAoelhe.t inial ink Or cotnel lot, e f .. 80,IRD OF HEALTH . . . . . FORM NO. 1 J SETS OF PL.-tNS . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . MAY — 9 1995 BUILDING DEPARTMENT CHECK: . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FOR:I . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 7651802 NOTIPYi CALL . . . . . Examined . . . . . . . . . . . . . . . .. 19 . . . MAIL TO : Approved . . . . . . . . . . , 19 . . . Permit No. . . . . . . . . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . /f12 . . . . . . . . . . . ., 11 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wii sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public stir or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap 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 per 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 Occupar 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary ins ' ns. G�. . . . . . . .'1 . . . . . . . . . . . . . . - (Signature of applicant,or name, if a corporation) . . . . . . �t,52i �l�s'(.�Pi�.T,.,N•'1.°. Il?.`1`.'r. . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, age t, architect engineer, general contractor, electrician, plumber or build; . . . . . . . . . . . . . . . . . . . . . . . . . . . . .n. .'..,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . .. . . . . Name of owner of premises . ��1`. .}.1 w> . �/� l�.l((itt .6y&.V`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . j 0 . . . . . . . . . ..4>n KLOQ AS. . . .. . . . . . . . . . . . . . . . !l I s�l�.t . .L. . . . . . . ... . . . . . . . . . . . . . Ilouse Number Street Hamlet County Tax Map/No. 100000 Scction . . . : . .�01 . . . . . . . Block . . . . .G f(. . . . . . : . . . Lot . . . . . . . . . . . . Subdivision Filcd Map No. . �y�? . . . . . . . . . Lot ?. State existing use and occupancy of premises aril intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . 5: 1�2.°. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �' . . . W'"'F w•. . . . . . . . . . . - -__el e A 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . �• • • , Alteration .✓ . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . : . . . . . . . . . Other Work gt�'A Teo4 (De?ep0n) 4. Estimated Cost . . . . . . . . . . odU . . t. . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . .l. . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . :v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . , . E . . . . . Rear .0. . . . . . . . . . , . Depth . .3°. . . . . . . . . Height . . . . . � i�*. . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . f! e . . . . . . . Rear . . . . . . . . . . . . . . . . Depth . . . . . ... . . . . . . . . . . . . . . . Height . . . . . . . . . Number of Stories . . . . . . . .. . . . . . . 8. Dimensions of entire new construction: Front , . 1 , . 'c `?wear`?SQL. R1-iF`��:. . . . . . Depth , , , , , , height . . . . . . . . . . . . . . . Number of Stories . . . I ... . . .. . .S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . Depth .4-. �!.$R.t:. . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . jam CPormer Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . t`' . . .0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation `. . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . ..td:.. . . . . . .. . . . . . . . . . Will excess fill be removed from premises: Yes h 14. Name of Owner of premises l , , Address tM( tNU qt(.- LsPhone No. . Name of Architect (!L tt C? to . . . . . . . . . . . . . . . Address Phone No.4.77 ,7.7$Z, , Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . , . . . . . . . �. .�r.. . Phone No. . . . . . . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? *yes. Y. . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions froi property lines. Give street and block number or description according to deed, and show street names and indicate whethc interior or corner lot. FATE OF NE R f S.S OUNTYOF . . ' . • . . * . . . . . . . ` fir. ems . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that lie is the applicar (Name of individual signing contract) )ovc named, s the 7"r _1� � f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th plication; that all statements contained hi this application are true to the best of his knowledge and belief;and that th )rk will be performed in the mannerset forth in the application filed therewith. rorn to before m this . . . . . . . . .day of . . . . . . . . . . . . . . ., 19 `l 'tart' Publi . . . . . County CLAIREL.CLEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC,State of New York (Signature o f a,^plica n No.4879505 Qualified in Suffolk Coun &Mntissrnn t t-rnwr �n Ieauea/ravlsldna Call LM o� a 27. 73 x'16 ra" — �,�r LAJ z J H erl X C W Z oa tr � d Z W W IN C9 Z �n p C7 I 1 W Q-� H laaar i0 L U U. ? N ' IQ I L`.'= '_, rl cllenVowner. I o Ly o rl coccN N a pj rxLn a� N =' m no K MVia Mme. ',VIA G "YJN IN�un, pr-ovasen e� I c�LLl C 7N�vkn,VAT�ip-OPa7 �f Worn oec� !I r -- F1 y 2t;TN1 ICt4-04 O9 of - u� Car N 9_— y m 0 pralecl title Z Iy' rR..riz ..a R. �a rlo�'w C� ,��ah4x7�5l.loVA-�o�ls tle LIN. W ewsr. Iww-r e"� pXq = drawing title Oo M �9 A�� [ IvryA Odale, scale. I ✓•,-kcIJ nS� ijkE0 A&, m Issue. 4996 ,y� �' err..en ari anxu�,' rte/ m W Clea ng O` , NiA14R4 P�VGNOPY>, Y'G, _ . :. i �� AVib4s 3,i.,o Z7 ('(J iia uhlb'i� 'i= -„ Q JP r�vFtwle A.L(eLa) 3 1.s / Q�� F SNE yoe Qree.na. ', NASSAU SUFFOLK 1141JEMITINg L CPWI