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HomeMy WebLinkAbout26547-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28157 Date: 01/09/02 THIS CERTIFIES that the building ADDITION Location of Property: 1300 SOUND BEACH DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 1 Lot 37 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 2000 pursuant to which Building Permit No. 26547-Z dated JUNE 2, 2000 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 ROOF OVER AN EXISTING DECK ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ZBA #4803 DATED 4/6/00. The certificate is issued to CHRIS & JAMES MESKOURIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //ho ized Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26547 Z Date JUNE 2, 2000 Permission is hereby granted to: CHRIS JAMES MESKOURIS 127 BEVERLY RD DOUGLAS MANOR,NY 11362 for ROOF OVER EXISTING DECK PER ZBA #4803 . THIS INCLUDES FLOOD PERMIT. at premises located at 1300 SOUND BEACH DR MATTITUCK County Tax Map No. 473889 Section 106 Block 0001 Lot No. 037 pursuant to application dated MAY 2, 2000 and approved by the Building Inspector. Fee $ 175.00 Authori a Signature ORIGINAL Rev. 2/19/98 Form No.6 TOWN II. OF SOUT BUILDING DEPARr1' � TOWN HAL 765-1802 APPLICATION FOR CERTIFI AT OCCiJ ^SCD This application must be filled in by typewriter or ink and submitted to or hep en with the following: A. 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 1%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00 Date. Z New Construction: Old or Pre-exi ting Building: (check one) Location of Property: 130d A4_ ar c jiguse No. Street Hamlet ,f Owner or Owners of Property: q14 S Suffolk County Tax Map No 1000, Section ./o Block Lot 37 Subdivision C a e ✓ A Filed Map. Lot: Permit No. (o S Lf 7 2 Date of Permit. '1 2 -o Applicant: Health Dept.Approval: '1114 Underwriters Approval: r Planning Board Approval: Request for: Temporary Certificate Final Certificate: '� (check one) Fee Submitted: $ � U _ A Wicant Signature APPEALS BOARD MEMBERS OOSVFF01 Southold Town Hall Gerard P. Goehringer, Chairman Gym53095 Main Road James Dinizio,Jr. y - P.O. Box 1179 Lydia A.Tortora � Southold,New York 11971 Lora S. Collins Al- �l �� ZBA Fax(516)765-9064 George Horning �►a� Telephone(516)765-1809 - BOARD OF APPEALS r 'Yl r ' TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF APRIL 19, 2000 i Appi :N&:,14803 JAMES MESKOURIS&ORS. 1000-106-1-37 STREET& LOCATION: 1300 Sound Beach Drive, Mattituck DATE OF PUBLIC HEARING: April 6, 2000 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property is a 18,700 +- sq. ft. parcel improved with a single-family one-story dwelling with existing decks. The lot is a waterfront lot with 75.23 foot frontage along Sound Beach Drive and 254.46 foot lot depth along the easterly property line. BASIS OF APPLICATION: Building Inspector's January 25, 2000 Notice of Disapproval, amended March 8, 2000. The reason stated in the Disapproval is that the roof addition to existing deck was not permitted pursuant to Condition #2 of ZBA Appeal No. 3951. Condition #2 of ZBA Appl. No. 3951 dated October 17, 1990 states "the deck shall remain open, unroofed and unenclosed at all times (as proposed)." AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance for a roof addition over the existing deck as shown on the March 8, 2000 construction plan. REASONS FOR BOARD ACTION, DESCRIBED BELOW: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. An undesirable change will not be produced in the character of the neighborhood or a detriment to nearby properties, if granted because similar decks with roofs exist on several houses in this neighborhood. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance because various awning devices have been erected to no avail as these temporary structures have not been able to withstand the severe weather conditions on the area. 3. The amount of relief requested is not substantial because the proposed roof structure will only cover the existing deck. 4. The variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. Page 2-April 19, 2000 Appl. No. 4803-J. Meskouris& Ors. 1000-106-1-37 at Mattituck In considering this application, the Board deems this action to be the minimum necessary and adequate to enable the applicants to enjoy the benefit of a roof over the existing deck,while preserving and protecting the character of the neighborhood and the health, safety, welfare of the community. RESOLUTION/ACTION: On motion by Member Dinizio, seconded by Member Tortora, it was RESOLVED, to GRANT the variance as applied for, SUBJECT to the following CONDITIONS: 1. All construction including deck and roof overhang must remain landward (south) of the Coastal Erosion Hazard line. 2. The structure shall not be permanently enclosed (except for screens). VOTE OF THE BOARD: AYES: Membe rin n), Dinizio, Tortora. (Members Homing and Collins were abs ) This of ion wa y d ted (3-0). GERARD P. GOEHR GER, CH MAN April 21, 2000 FROM P 1 '� �.� ,'n,{���, �'� •,e^ car.,/;D':\.�•E�`*r� s-'�-.. .. ..r.:�. �.i,Y �y,, .� :�.:.,`,p• jr' � ':�•, �,•. • �. 'ms's ,yl � r Cp 0 •'r'i' •'. ,,•,r.•Py•�'4���'r,�•.,��A..rr;,#•j:�'.:.x�laA:��+�o;,•:s,�`` n +�;• ``y ti.:... r'k 4 +• 1 1 Y �: y M'!' Y t'`k _Vy'' r; ,; ti �+tC`y,J FFig Yr. i rI+ti'@��ii�lr iJlilir�y�u',,�, 4,- '•� ' r� b1spection G"erfii�`ica e =- Pater Electrical Inspection Service, 111c. 11/20/01 A_/�pl;�a tt# 375 Dunton Avenue -�?1 Fast Pat(7hogue,Now York 11772 (631)2$6.6642 -- ------------ - - _ --_ '• ' •'---_- ----- _ .. .. _--.... •y��': . . . --- ..---- - ., . .--- . Issued to; M! :,004S. . r,y 4yY', Street: 13 00 Sound Beach Drive VlliagC" Mottituck 7_iry I f952 Town:Southold gay Secilon; Block: dot; ...(1 Introduced by: Aztec Electric • • • r�' I_ic.lt 4173-E �; was erxomined curd found to Ge iir c0m,0&,n,:r w1th the Alet/onnl FlectrvcaJ recle z _ Commercial I NV bCtects t.. t P001 Iv;ist Floor VIndoor Basemont i Hot 7crlr r •, &6 Residential r••, Der, Garage _._Attic 2nd Floor '%',Outdoor Addition ! Stirvey Switches Receptacles tit es GFl Heaters AIC Fans )"� 2 5 4 Olshwasher Washor/Anl %?"' p U/yeNAtrtl.> Oven FZvngPlAmp G:Jrbaye Dispnsyt Furnace, Oil Gas Circulator Smoke Detector Bell Transformer j Meter Amps Phare UG/UH TelephorriFlevision Cnr2or Monoxide ... ... '' '• •="•...J.,4�....,•1•t.. .!C-•am' ;»1:u:' 'xl�.k:• ,+..:Yw„'.:a:.Y::}..,,....,.ca.:::.W.�... •r,f Other Equipment: Building Permit# r' r Hugo S. Surdi President `s' FV�JCttl Ir',cFn�Ct.i��•r: 1 I Yt i lUC • lr,soector: O:n:ntln Rcyrnlrl, , Flncl lnsportkn: 1(!2Ulpj__..._... .___.._.__. •,, :f+;E)�`(tAr. QU4•i:Ul� RGyrlc:{r!3 ,`S r This ct?rtititeke must not be nIG;mt1 in any R•131"rIcr. j jJg idertiF!rd by li,eir r.reKfEn(t;V15 ' . t��7!.t+iFT: �iil+j Iit.Uh/rlit �+lf��r'fTY+TTlsiti+lrilifliylilrfi:fii•i�TTiTtwi'tici:jlliTl:TliFliYiliii'{irl±irir,pra'*1r,litl�� ;ir�i71•�RIiri'' yUF O7� y' -.4 To-n Hall. 53095 blain Road I -. i JUDITH T. TERRY P.O.+— TOWN CLERK - Rox 117x1 ;4 i'a " ' Southold. New York 11'171 REGIs'rRAR OF vITAI.sTA-ns-"cs T. - Fax (516) 765-1923 MARRIAGE OFFICER _ Tcicphonc (5 16) 765-1 HO I RECOR()S MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93) ] . 'D V - ta � � I• TOWN OF SOJ7't+OLO ,�h T. Terr Y Southold Town Clerk August 25, 1993 APPLICATION #_ PAGE Iof4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE OF MY KNOWLEDGE, TRUE AND ACCURATE. " .s _o (APPLICANT'S SIGNATURE)�_ - DATE 4:"- G G SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANII NAME / / DR TELEPHONE APPLICANT /v,e,S, Zr Jt1fC� 30D �1oa.► �4� �/`. + �`�C a BUILDER �' .�� l�Ja,•.J�,.�%c r ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily idem RYthe project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION r PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE O New Structure rrrccsidential (1-4 Family) ddition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofing? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) � e+' ESTIMATED COST OF PROJECTS Z, o o d B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining O Drilling O Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction O Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: O Is MI located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). )4,1s` Is located in a Special Flood Hazard Area. �' FTRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable O The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Sectionfor additional ' ctions. 01 SIGNED DATE — T QC� APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: �A site plan showing the location of all existing structures, water bodies, adjacent roads, lot ensions and proposed development. ❑Development plans,drawn to scale, and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor (including basement), types of water resistant materials used below the fust floor,details of floodproof-ing of utilities located below the fust floor and details of enclosures below the first floor. Also ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in an increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A.C-5-- B.O Is not in conformance with provisions of Local Law # , 19 The permit is issued subject to the conditions attached to and ma part of this it. SIGNS IS -DATE If BOX A is checked, a Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION # PAGE 40F4 APPEALS: Appealed to Board of Appeals? 0<cs O No Hearing date: Appeals Board Decision --- Approved? 4T—Ycs ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard ea , bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? OYES ONO DATE BY DEFICIENCIES? OYES ONO DATE BY DEFICIENCIES? OYES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) I ' •F 1�3a l Kok AIL 0000 , �•k d�`� �I I r I � � i tit h► �- 3 w , t i a �a1II 4C c A x iA l 0 I o ! 0 �C P III l i � S 1 0 • w x I i 4 U i i i • 1 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. AMENDED NOTICE OF DISAPPROVAL DATE; March 8, 2000 TO Christine Rivera A/C Mescouris 250 Sound Beach Dr Mattituck NY 11952 Please take notice that your application dated November 18, 1999 For permit for roof addition to existing deck at Location of property 1300 Sound Beach Drive Mattituck County Tax Map No. 1000- Section 106 Block-1 Lot 37 Subdivision Filed Map # Lot# Is returned herewith and disapproved on the following grounds proposed construction not permitted pursuant to condition#2 ofZBA appeal #3951. Existing deck constructed under permit#18528 issued pursuant to Appeal # 3951. a "VL Authorized ignature gage 3 - Appl• No. 3957 = Matter of CHRIS MESKOURIS & OR1990 Decision Rendered October 17 , 1/ not only as (a) the subj ect premises are nonconforming roved with to lot area and width but is believed to have been imp a dwelling structure built during or before 1960; lots in the immediate vicinity of the subject (b) remises to the west and east are similar size in this Kidd Estates P subdivision of CP t• preexisting (c) the total lot area, to the ordinary highwater mark of the Long Island Sound, is shown to be 15,096 sq- ft. with the proposed (d) the total coverage of the lot,ary since the total deck, is 2320+- and a variance eis noisnlesssthan the maximum 20% coverage of the parcel by of lot area to the highwater mark. n the Board also finds 7. In considering this applicatio , (a) the relief as granted wilarce1 is believed and determines: ling unit density, since the P (b) the increase the dwel to have been improved with a dwelling before 1960; ctical difficulties claimed th evidence submitted and prathis variance; ) ere will sufficient to warrant a grant of the be no substantial change in the characte�ooert es; e(d)tthe neighborhood or detriment to adjoinSomeng pmethod feasible to the difficulties cannot botherobviated than ayvariance; (e) that similar appellant to pursue, Tax Map Lot 1000-106-1-35 relief was granted to County iately to the west of this (Subdivision Lot nlview of the manner in which theve factors, parcel; (f) and in considering all the difficulties arose, ranting the the interests of justice will be served by g variance, as conditionally noted below. Accordingly, on motion by Mr. Doyen, seconded by Mr. Grigonis, it was to GRANT the relief as requested (and noted in RESOLVED, Application of CHRIS, paragraph #5► supra) , in the Matter of the J AMES and PETER MESKOURIs under Appl. No. 3957 , SUBJECT TO THE FOLLOWING CONDITIONS: 1. That the deck be constructed at a height not to exceed 16 inches above grade; 2. That the deck remain open, unroofed and unenclosed at all times (as proposed) ; e7- M-1802 suu.uiNa DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: U �HAO(,etc KIK-�-fi✓t�t� '�v'►R-- �te�z-sr�h-•- ,��4'��S DATE � IN8PECTOR BUILDING PERMIT VJEW CHECK LIST Applicant/ nn Date Owners Name: l k r t S (YV5 kOu(zJ S ORS Reviewed: Architect/ Date Engineer: Submitted: SCTM#: District: x,000 Section: 1!�k Block: I Lot: Project13Q�_" Subdivision�p Location: �� o� � Lti(nGI'� Q�J\r-e- Name: M 0. Single&separate Requ � certification: (Yes ' Req. Req. Zoning District: [Lot size: Actual: j [Lot coverage Proposed: 1 Req. Req. Req. (Front Yard Proposed: (Side Yard Proposed: 1 [Rear Yard Proposed: ] Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW1.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: FIELD INSPECTION REPORT DATE COMMENTS AJ ________________________________ II II II � r\I Hy FOUNDATION OST) - - I 1 --ll FOUNDATION (2ND) u _________________________ ___ -----------------------------------------------T - Li to I B A4.1 z - ROUGH FRAME & jj q PLUMBING Imo_ U �t Its_ ii c II it - ------- H INSULATION PER N. Y. STATE ENERGY CODE II u it ----- ------------II==== ===2-- ===-- ---- - ------- -------------------- it — ---------------------------------- u u FINAL I¶ it aaaa=sasasaaasssxsssxxsssll sss----�asssssssssssssssssssssssssssssssaaaasasssssasssssssssss 0 �' ADDITIONAL COMMENTS: (V� `r H O \ z � ac r� ro H � • M BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . .. . . . . . . . . . . TOWN OF SOUTHOL.D SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL Examined.... 19.... - MAIL Approved....�k}..........?*.6. Permit No. W �C.� .................................... Disapproveda/c ......... .................................... ...................................................... ...S�A . . ......... (Building• tor) 1 2 APPLICATION FOR BUILDING PERMIT jDate. Ad �.(�. . . . . , 19.`. ,�• . . . . . . . . . INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 streers or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c.. The work covered by this application may not be cormienced before issuance of Building Permit. . d. Upon approval of this application, the Building Inspector will issue 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, ordi es, building code, housing code, and regulations, and to admit authorized inspectors on premises and in for a sary inspections. • •.. . .• . • . • . • 7 (Situneoficsnt, orname, ifacorporati�on) 001e.. ......... (Mailing addres •f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............O.w* .R.............................................................................................. Name of owner of premises ............................. (as on the tax roll or latest deed) If applicant is a corporation, sigpature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done... ....... .........�3c?°......S �n�.. l3ec�c�....�r:... ,i �1��.....ri!.�.......... .-` ..................... j. House Number Street Hamlet Canty TaxNo. 1000 Section ..�.�.�....... Block .....�.......... Lot ...3--.7........ Subdivision: Nature of work (check wlhicih applicable): New iiuIlding .......... Addition .......... Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work ............................ (Description) Estimated Cost A.10.00....... ..... fee .............................................. (to be paid on filing this application) If dwelling, number of dwelling units .....(-...... Ibmber of dwelling traits on each floor ....i........... Ifgarage, number of cars ...................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Aga r ' ,/ 3 Dimensions of existing structures, if any: Front......- .. Rear ..�. �...... Depth ..�.............. height .......................... Number of Stories .............I........ Dimensions of same structure with alterations or additions: Front ....5'........ Rear .............. Depth .................. Height .................... Number of Stories ............... Dimensions of entire new construction: Front ................ Rear ....3. ....... Depth .....i $- ---- sleight ........�... . � .. ........... Number of Stories ........r....V '.. ,j Y(, Size of lot: Front ... .rte.:�.7-....... Rear ....�.! .0.-40..... Depth ..�5.r.•........... .1. Date of Purchase ..................... Name of Former Owner ........................................ I. Zone or use district in which premises are situated ............................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ...!ve................ 3. Will lot be regraded .....A"11)....... Will exce�ss fill be removed from premises: YES NO 4. Nares of Owner of premises-► �...��!hi4. { ....f} �:`etAddress . 13 90St�v:` u;tl;-1��:. Phone No. ............. unit 4� Name of Architect .................................... Address .............................. Phone No. ............. Name of Contractor .�x... ?ov� :f::: 5... .. Address .�9:....`.'�..`�..................Phone No.7(!�:. aJ..�.. 5. is this property within 300 feet of a tidal wetland? * YES ...... NO .......... ' *IF YES, SO[1I1M 1UWN 1ffiISIMS PMWT MAY SG W!QLHRE.D. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions Tun property lines. Give street and block number or description according to deed, and show street names and indicate tether interior or corner lot. W) s\--e PC, �} o o o ek z�� 0 L)ems.h e n s n C C k cure s c w \� v� v� `zxc P �� fA.11's Or NI'M SS XMIY Or . . 11.................... .................being duly sworn, deposes and says that he is Che applicant ;Name of individual si ing contract) mbove named, leis the ................ ...................-..---.............................................. (Contrac r,•agen-,�corporale officer, etc.) )f: said owner or owners, and is duly authorized to perforin or have performed die said work mxl to make and f i le Chi s 3ppl.ication; that all statements contained in this application are true to the best of his knowledge and belief; arx] dial the work will be performed in the manner set forth in the application filed therewith. Sworn to befo a me this ......... . ..day of �).....f ... �..1 • yaw Notary Publ c i} ....A...P....--..". �,q� (Signature-of.... li.cant) Notary Public State of ew York Qualified in SLuffolk CDount commission Expires Dec,9, . �—, f► s �sNll � 0 C N 5U'14'22" E N 42, 0074.91 ' 50.02' 50.7 5 � I _ _... — , >�►��..►Ip►«�1 tura 1� zl `, 3w W I I w �V I`7 �� w o o I I g to b'1' o0 0 C; I I I o j I � I �, � i I N 55'00'00" E I Q I R 50,071 150.20- N 52'00'00' E S.C. T 5 ' X4.88' 0 . 1000-106-•01-33 0.07 � pGr1v p� I • - wow mw S.C. HP•WAlOpa_Iaq_Q1-,�4 I wo4'c;' TAX No. laool WOW WOOD wwa. I.iw. - WOOD WALL—...._ _ w�u o.2 ! DECK 1.0'E. oEKx at C°`s'Kmoso,NAZ4ft� SMI ' 2..1 •* n�•V �i .r ` w��t � � C - 0 •off lo.o• STOR��SME HOUSE 1 � 2a.K' 1.100 ..0. . 1 30.2' 04 soap �.0 3. 4L FON o 50.23• . � N� ,. � � ,';t'.. �•;,�:.• o S 57• 3 0' n . 50.2 soot nwr. � ,..,•••;.. I Cn 23 o . , �J Np }� r r• v i • .' .'•. ►. .• i w'DDD Q'p�IM•175 IF .69 x.27;. . I f P'r")vmASNotEn��� a,o•;�,:�_; , , :�.:•c_� 0' BB.P #' �;, on Avlq �'� BUILDING DE ARTM T AT _�'�--fir_ � • � 1 AM TO 4 PM FOR THE -^ l INSPECTIONS: v DATION - TWO REOUIP' J )R POURED CONC11m - - JUGH - FIUI"a RIIM � 2 -. - B 3 IPISULAMON A FINAL - CONSTRUCTION AI.IECONO S�TRU"ONOSHALL N a THE REQUIREMENTS OF TH STATE CONSTPUCTION 6 EI CODES, NOT RESPONSIBU DESIGN OR CONSTRUCTIUN Tei Z��� a' go3 OCCUPANCY OR v - r USE IS UNLAWFUL WITHOUT CERTIFICATE IC IZQ 1 OF OCCUPANCY 'I F11tD"F,c i �h 15 L.P�l MT >CpMP6r'"fN "mm 1 @ m V,000b� No0 o6 Q \ { 4 Pfd r m 17 CCA � i< tD 19 rl _ J - ctsiJc,�I('�i �7©ctL Tom Op 119 II t IT Ih Ll I ... y -evilo .. s