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Home My WebLink About26743-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28074 Date: 11119101 THIS CERTIFIES that the building ADDITIONS & ALTERATION Location of Property: 495 ELIZABETH LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 5 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 7, 2000 pursuant to which Building Permit No. 26743-Z dated AUGUST 29, 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 ADDITIONS DECK ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ZBA #4861 DATED 9/14/00. The certificate is issued to LESLIE C GAZZOLA JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 567409 08/21/01 PLUMBERS CERTIFICATION DATED 08/01/01 MIKE JACOBI c tho ized Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28075 Date: 11119101 THIS CERTIFIES that the building ACCESSORY Location of Property: 495 ELIZABETH LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 5 Lot 2 Subdivision Filed Map No. Lot No. , conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 7, 2000 pursuant to which Building Permit No. 26743-Z dated AUGUST 29, 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 ACCESSORY ONE CAR GARAGE AS APPLIED FOR. ZBA #4861 DATED 10/19/00. The certificate is issued to LESLIE C GAZZOLA JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A rizeo 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. 26743 Z Date AUGUST 29, 2000 Permission is hereby granted to: LESLIE C GAZZOLA JR BOX 722 SOUTHOLD,NY 11971 for CONSTRUCT ENTRY ADDITION WITH DECK, 2ND FLOOR ADD & ALTERATION AND AGCY GARAGE PER CH 46 OF TOWN CODE & ZBA 4861 9/14/00 & 10/26/00 . Two Certificates of Occupancy required at premises located at 495 ELIZABETH LA SOUTHOLD County Tax Map No. 473889 Section 078 Block 0005 Lot No. 002 pursuant to application dated JUNE 7, 2000 and approved by the Building Inspector. Fee $ 363 . 00 $100.00 flood permit included Authori d Signa ure COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL a 765-1802 L ';',.iy - 9 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG.Dr T. HO This application must be filled in by typewriter or ink and submitted to the Building Department 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 I%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$1,5.100 U Date. )U i � 1 l� � New Construction: Old or Pre-existing Building: (check one) Location of Property: 05- GLI 74 8FT�-1 1-4 tie5 15007p6z,n House No. Street Hamlet Owner or Owners of Property: &A Z 2OL.r4- Suffolk County Tax Map No 1000, Section Block 5 Lot 02 Subdivision Filed Map. Lot: Permit No. 0216 74 3 7- Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ c2,5,0L) _ J ��16 � � �X75 L , � AppIc Si t �e G. CvoSS°I i APPEALS BOARD MEMBERS o��S13FF0J/r G Southold Town Hall Gerard P. Goehringer, Chairman y� 53095 Main Road James Dinizio,Jr. ti r P.O. Box 1179 Lydia A. Tortora 5 Southold, New York 11971 Lora S. Collinsd �! ZBA Fax(631)765-9064 George Horning �Ol �a Telephone(631)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS, and DETERMINATION ' MEETING HELD OCTOBER 26, 2000 Appl. No. 4861 —LESLIE GAZZOLA . 1000-78-5-2 Street and Location: 495 Elizabeth Lane, Southold Date of Public Hearing: October 19, 2000 FINDINGS OF FACT PROPERTY FACTS: The subject property consists of 22,798 sq. ft. with 192.13 ft. frontage on Elizabeth Lane (a private right-of-way) in Southold. The lot is improved with a dwelling situated with the following setbacks: (a) 35.3 feet from the front property line at Elizabeth Lane; (b) 46.1 ft. from the northeast property line (stone driveway); (c) 32.5 ft. from the southeast property line (A. Gazzola); 53+- ft. from the bulkhead. BASIS OF APPLICATION: Building Inspector's Notice of Disapproval dated September 29, 2000 states that the accessory garage(building permit#26743Z)is disapproved for the reason that the garage is placed within side yard of property, at variance to Article III, Section 100-33 which requires an accessory building to be located in a rear yard. AREA VARIANCE RELIEF REQUESTED: Applicant requests a variance authorizing re- location of a 19x23 ft. one-story accessory garage at 10 feet from the northerly property line and 21 feet from the easterly property line. REASONS FOR BOARD ACTION, DESCRIBED BELOW: On the basis of testimony presented, materials submitted and personal inspection, the Board makes the following findings: 1. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or be a detriment to nearby properties. The proposed location of the garage is partially in the required rear yard area. Because of the angled placement of the principal building on the lot, the garage will for all intent and purposes appear to be in a conforming rear yard area, and will be in keeping with other properties in the neighborhood. 2. The benefit sought by the applicant cannot be achieved by some method feasible for the applicant to pursue other than area variance because the lot is in a flood plain zone and is constrained by wetlands on the south and southwest side of the property, leaving an insufficient conforming area to locate an accessory garage without infringing upon the wetland area. 3. The area variance relief is not substantial. Page 2—October 26, 2000 Appl. No. 4861 —L. Gazzola 1000-78-5-2 at Southold 4. The proposed variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. No evidence has been submitted to suggest that the proposed partial side yard location of the accessory garage will have an adverse impact on physical or environmental conditions. 5. The action set forth below is the minimum necessary and adequate to enable applicant to enjoy the benefit of an accessory building in a desirable location on his flood plain zone and is constrained property,while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION/ACTION: On motion by Member Tortora, seconded by Member Collins, it was RESOLVED, to GRANT the variance as applied for. VOTE OF THE BOARD: Ayes: Members Goehringer (Chairman), Dinizio, Tortora, Collins. (Absent as agreed was: Member George Horning, 7FFiand.) This Resolution was duly adopted (4-0). GERARD P. GOEHRINGER CHAIRMAN O��$�FFOI�COG y� Town Hall, 53095 Main Road y Z Fax(516)765-1823 P. O. Box 1179 �O • .F Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN'OF SOUTHOLD C E R T I F I C A T I O N DATE: 3 lol Building Permit No. 6 y 3 Owner: L S C,Cc_z Z o (q (please print) Plumber: ( E c.o , (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers ignature) Sworn to beforem this ( � day of 14-CqQ , Notary Public, Count LYNDA M. BOHN dr, NOTARY PUBLIC,State of i\jew York No.01B06020932 Oualified In Suffolk County Term Expires March 8,200 THE NEW YORK BOARD 0 V ' 1001071 ;SU0EAU OF ELECtTRICiT"i" 40 FULTON BTOIEET, NEW YORK,4Y.10038' Date AUGUST 21,2001 Application No. on fde 12175101101 N 567409 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above lappacat qh number It in'a the j";IF, es LESLIE GAZZOLA, ELIZABETH LANE (END) SOUTHOLD, NY in the following location; ❑ Basement [2 1st Fl. 2nd Ft. OUT Section was examined on AUGUST 03,2001 and"found to be trt,complisnce,.with tAe Nata�a�pl { FIXTUREFIXTURES R GES IgG` Ec U OUTLETSf CEPTACLES SWITCHES W-AWSCE0 FLUORESCENT OTHER AMT, IIW 33 36 33 33 1' DRYERS FURNACE MOTOR$ FUTURE APPLIANCE FEEDERS S+ C+A411fC.'Pi.."TIQ4KS, �I AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A W.G. AMT. W-4 AMr:, �iP a, AiiT IMA "i 3 F 2 6 SERVICE DISCONNECTNO.OF S E' V 1 METER AMT. AMP. TYPE' EQUIP. i•21 If 3W 3•3W 3 0 4W NO.Of CC COND. I A.-WG` PER/ ..SCC 6w NO." #440 1 200 CB 1 X 1 4/0 OTHER APPARATUS: F CO DETECTORS-2 e PADDLE PANS F-3 re WHIRLPOOL BATH-1 G.F.C.I:-9 SMOKE DETECTOR:-6 TRACK LIGHTING:-8 1,2 y ,A k G & S CONTRACTOR LIC'.#578=$° y BOX 215 This cerfitkate must riot b*after d fn any7manner,return to Mo offtoo of", ao f'#j 0 # �t I r ELEVATION CERTIFICATE O.M.B.Expires May 31, 1077 31, 1993 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION:Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to determine the proper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision(LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER Les Gazzola STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER Elizabeth Lane OTHER DESCRIPTION(Lot and Block Numbers,etc.) 1000-78-05-02 CITY STATE ZIP CODE Southold, NY 11A71 SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM(See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 1 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION (in AO Zones,use depth) 360813 0166 G 05/04/98 AE El. 8 -='7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): x❑NGVD'29 El Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site,indicate the community's BFE:I I I I I I.LJ feet NGVD(or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 8 2(a).FIRM Zones Al-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of[ 1 1 1 191.0 feet NGVD(or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30,VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram,is at an elevation of feet NGVD(or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is W.W feet above® or below❑ (check one) the highest grade adjacent to the building. (d).FIRM Zone AO. The floor used as the reference level from the selected diagram is W.U feet above❑ or below❑(check one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference i, level)elevated in accordance with the community's floodplain management ordinance? ElYes E] No El unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:® NGVD'29 0 Other(describe under Comments on Page.2). (NOTE. If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 71,then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes ®No (See Instructions on Page 4) 5.The reference level elevation is based on: 3 actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place,in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6.The elevation of the lowest grade immediately adjacent to the building is:I I I I R 1.121 feet NGVD(or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: I I I I I I.U feet NGVD(or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31,MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION I SECTION E CERTIFICATION This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30,AE,AH,A(with BFE),V1—V30,VE,and V(with BFE)is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building official,a property owner,or an owner's representative may also sign the certification. Reference level diagrams 6,7 and 8-Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment,area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not included in the certification under Comments below. The diagram number,Section C, Item 1,must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) John T. Metzger 49618 TITLE COMPANY NAME President Peconic Surveyors , P.C. ADDRESS CITY STATE ZIP P.O. Box 90A. Southold NY 119 71 SIGNATURE 1028"/99 Cj28/99 PHONE (516) 765-5020 Copies should a ade of th Icate for:1)community official,2)Insurance agent/company,and 3)building owner. COMMENTS: ON WITH ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A v A A v ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE BASE LEVEL REFERENCE LEVEL - FLOOD LEVEL ELEVATION BASE ir.:.. . _ BASE BASEFLOOD •ApdAOEN►:?. REFERENCE SASE OOD ELEVATION REFERENCE ADJACENT GRADE LEVEL ELEVATION LEVEL GRADE �i1:i is :•f:��.:f::... ... r•;;:.:,t••i;. 1.ADJACENT • :•::;i GRADE °. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 FORM NO. 3 TOWN OF SOUTHOLD BUELDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; September 20, 2000 TO Leslie Gazzola Jr. Box 722 Southold NY 11971 Please take notice that your permit dated August 292000 Fot accessory game itx'rear yard (rpermit#26743Z) at Location of property 495 Elizabeth La. Southold County Tax Map No. 1000- Section 78 Block-5 Lot 2 Subdivision Filed Map# Lot# Is returned herewith and disapproved on the following grounds garage placed within side Yard of pMp ty, not in compliance with Article III Section 100-33 which states; In the Agricultural Conservation District and Low-Density Residential R-80 R-120, R-200 and R-400 Districts. accessory buildings and structures or other accessory uses shall be located in the required rear yard -- ----------`----: 6----------- Authorized Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE; August 29, 2000 TO Les Gazzola 825 Cedar Drive Southold N.Y. 11971 Please take notice that your application dated May 4, 2000 For permit for addition to one family dwelling at Location of property 495 Elizabeth La. Southold NY County Tax Map No. 1000- Section 78 Block 5 Lot 2 Subdivision Filed Map # Lot# Is returned herewith and disapproved on the following grounds proposed construction not permitted pursuant to Article=11 Section 100-239.4B which states; All buildinjzs located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than seveOV-five(75)feet from the bulkhead. Proposed addition shown within+/-46 feet of existing bilkhead. -� Authorized nature JUDITH T. TERRY Tota-n Hall. 53(wS += slam IZc1a<1 L P.O. Roo 1174 TOWN CLERK N ;� � ' t;:.: •-=, Southold. Nc%k York 1 1'17 1 Fax (5161 76_ IR_., REC15fRAi2 OF VITA1,STAT1511CS �%R (C� � �� _ ,, MARRIAGE OFFICER _ Tcicrh<"u (S 1(,1 7(,S_I RECORI)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) ] . -, - R � - TOWN OF S01jTNOLD �h T. Terry Southold Town Clerk August 25, 1993 APPLICATION _ PAGE I of 4 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 herby 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. 1,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE,TO B TOF M OIVVLEDGE,TRUE AND ACCQU TE. (APPLICANT'S SIGNATURE) DATE l Q SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANiI NAME ADDRESS �r -11, y� / TELEPHONE APPLICANT / _t fry � /r FL 4 a>"'�► 7 t0 BUILDER h ,�� Al ENGINEER C Ad ta I ..._sem ,PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily idem� the 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. � Wil; FDP(93) APPLICATION r PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL. DEVELOPMENT ACTIVITY STRUCTURE TYPE O New Structure ❑ Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodprooftng? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECTS B. OTHER DEVELOPMENT ACTIVITIES. ❑ Fill ❑ Mining O Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) O Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements (Including Culvert Work) O Road, Street or Bridge Construction O Subdivision (New or Expansion) O Individual Water or Sewer System O Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (jo be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: O Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). O Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) O Unavailable O The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE 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 dimensions 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 first floor,details of floodproofing 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 s�4f they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg 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 any 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.L PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A- ❑ Is B.❑ Is not in conformance with provisions of Local Law # , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the 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 4OF4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ 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 bcl�'V. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement in Coastal High Hazard Areas, 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? ❑ YES ONO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? OYES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCEfTo 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 �y 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_1 AS MODIFIED BY VARLkNCE # , DATED SIGNED: DATED: C/C(93) BUILDINGTIT l Applicant/ � Date Owners Name: e- )aCJ- Reviewed: Architect/ Date Engineer: Submitted: SCTM #: G�__.�Q District: 1.000 Section: _1_ Block: 5 Lot: Projectr I� Subdivision Location: �.S5 2S&L��-A ( Name: Single&separate Required certification: (Yes/No) _ Req. Req. �/�f Zoning District: [Lot size: � Actual: �''Zi�l [Lot coverage �roposed: !� �J Req. Req. �s Req. [Front Yard Proposed: [Side Yard Proposed: 1 [Rear Yard d Proposed: j Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. `�'G Vic. Town Trustees A�,;�x-. Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Notes: , NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-02109/00007 May 30 2000 FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental May 30, 2003 Conservation Law TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to operate I ❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Duality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply ❑ Article 19: Air Pollution 373:• Hazardous Waste Management ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER !; Leslie Gazzola (631) 765-1482 ADDRESS OF PERMITTEE 825 Cedar Drive Southold NY 11971 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Architechnologies PO Box 93 Mattituck NY 11952 (631) 298-1129 NAME AND ADDRESS OF PROJECT/FACILITY Gazzola Property i 495 Elizabeth Lane LOCATION OF PROJECT/FACILITY I Southold COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Canal E: 716.4 N: 4546.2 DESCRIPTION OF AUTHORIZED ACTIVITY: i I Construct a 19 foot by 23 foot garage, 8.5 foot by 13.5 foot deck on the south side of dwelling, and an irregular shaped deck on the west side of the dwelling. All work shall be performed in accordance with the plans stamped NYSDEC approved on 5/25/00. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 $ 3) and any Special Conditions included as part of this permit. PERMIT ADMI 1STRATOR: ADD_RE John land MRP Bl #40, SUNY Stony Brook, NY 11790-2356 I AUTH Z SIGNATURE / / D 0 ATE Page 1 of 4 May 30 200 i Albert J.Krupski,President �Qg�FFU(/( Town Hall James King,Vice-President �O ea�j 53095 Main Road Henry Smith j yet P.O. Box 1179 Artie Foster COD Southold,New York 11971 Ken Poliwoda p y • �� Telephone (516) 765-1892 �lJ�l �a0 Fax(516) 765-1823 BOARD OF TOWN TRUSTEES - TOWN OF SOUTHOLD January 26 , 2000 Frank Notaro Architechnologies 13405 Main Road Mattituck NY 11952 RE: LES GAZZOLA SCTM #78-5-2 Dear Mr. Notaro, The following action was taken by the Southold Town Board of Trustees at their Regular Meeting on January 26, 2000 : RESOLVED, that the Southold Town Board of Trustees grant a Waiver to add a small deck and revise the entrance way. Located; 495 Elizabeth Lane, Southold. However, this determination is not a determination from any other agency. If you have any questions, please call our office at 765-1892 . Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldh. Dept. BUILDING oma. INSPECTION FOUNDATION IST R GH PLBG. I 1 I ] � I [ ] FOUNDATION 2ND [ v]INSULATION [ ] FRAMING [ J FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE IN8PECT0 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ vj-FINAL —Ile� 14T 14& [ J FIREPLACE A CHIMNEY REMARKS: e- os :6;Z oz 2 e le-oa4a-i a-e- DATE L/ , INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE FAI&I IN8PECTOR JCaZi, ,es.1ea BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSTION [ ] FRAMING [ FINAL [i ] FIREPLACE & CHIMNEY f ARKS- DATE INSPECTO �j IELD ZNSPE(,—f LON ZFPORT �—IIlITE —_=_---COMMENTS -------- — —_ -------------------- —___ ) 9-7 )UNDAT ION I ST) u u u u ---DATIONND) ------ ii OUGH FRAME & u II 11I II n-----a -- PLUMBING u ice_ u m ________-- -- ----- ------------------ NSULATION PER N. Y. 41if ` STATE ENERGY -- �� CODE a II N u u a _ u II 8�"/2/O/moi�s/c ,ca eG►G .ts'1F � -- FINAL ADDITIONAL COMMENTS:__ O looll H p � O z � r � rzj ro 1 BOARD OF HEALTH . .. . . . . . . . . . . . . FORM NO. I 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . . . . . EYamined. ' _.y �_ --. MAIL TO: . . . . . . . . . . . . . . . . . . . . Approve: .._ Permit No. - .. ................................... Disapproved :i/c,: .................................. ...............................:... ...................................................... ,j Q " .. Ve ... .(Building Inspector) APPLICATION FOR BUILDING PERMIT Date/��./y� . . . . . . . .. , 20.00 _ Al .i) INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 application. c. The work covered by this application may not be coamnced 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 MM to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Torah 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 iildi, for necessary inapecti .... ...eicant,..... � � ...(Signa• •e o •, if a corporation) /a4o !..i>:• 7lrx,�- (Mailing address ofpapplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildei ........................!4.�f�-�../ ....................................................................................... Name of owner of premises ... � .. . . . -�.... p:� ......................... . ..................................... (as on the tax roll or latest deed) Ikzppl1��i t is a corporation signature of duly authorized officer. ....Y. .a....... ..................... (Name ••e• f corporate of •r) 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........... ................................................... ........ ..`.��r.............................. :...... �. .q�.1?........................... House Number Street Hamlet County Tax Map No. 1000 Section .......4!�...... Block .a.......... Lot ...?......... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occm a. Existing use and ...$�� C;�...�f17�1/!.� / 8,60)i .... �OSd tOrON .. occupancy .� .. ..M,,,,,,,K,1� b. Intended use and occupancy ...`�...11 ...... �... �.......................................... UL wviK %uw%;K vmicm gppiicsbtel: New building .......... Addition ..,Y Mtweraii'on .7....... Repair ............ Removal ............. Dewlition ............ Other Work `. .. ............ (Description) Estimated Cost 1p .......... fee ............................................... (to be paid on filing this application) If dwelling, number of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, number of cars ....o.��...CA....................... If business, oamnercial'or mixed occupancy, specify nature and extent of each type of use...................... / / Dimensions of existing structures, if acryz Front....5�....... Rear ..��..�J......... Depth ... 9.......... 1 D fi Height .....1.. ................ Number of Stories ............... .. , Dimensions of same aFructure with Iterat��or additions: Front ....�3... Rear ..`'3......... Depth ................ Beight .......T11 I........ Number of Stories .....4........ Dimensions of entire new construction: Font .....4�4....... Rear ... 31........ Depth ...& ....... 1 Height ............/10 ......... Number of Stories ...../.........•...... Size of lot: Front ............. Rear ...1i;TQ ............ Depth .................... _ ). Date of Purcimse . ............ Name of Former OwnerIL.5C4.e............... .................. I. Zone or use district in which premises are situated .... . ........ O .1 .. ................. '.. Does proposed construction violate any zoning law, ordinance or regulation: .. ........P '..... `��' I. Will lot be regraded ..... ............ Will excess fill be removed from premises: YES L Names of Owner of premises ......... Address825 () J 50( 01No. Name of Ardiitect rl 1�JL!�- c%,(1( G. lChdress .r?q: -'.�.`..�7.��.. �''.�:... Phone No. Name of Contractor 1 10 V-- .it.0.�Address ... ........ ....Phone No. ......... i. Is this property within 300 feet of a tidal wetland? * YES ...x.... NO .......... *IF YES, SOITIMD Im 1RUSIFF.S PM41T MAY BE,MQAFM. A"&dSt---t) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions -om property lines. Give street and block number or description according to deed, and show street names and indicate nether interior or corner lot. �t,q,,VS � �u�v� ititCUJne�j k1E or N;W Yom SS 1N(Y'Or �Q ............ ` "'2�.. ..:!: "• ..........................being duly sworn, deposes and says that he is the applicant me of individda.l signit contract) roe named, isClie ... ................................................... (Contractor, agent, corporate officer, etc.) said owner or owners, aml is duly authorized to perform or have performed the said work and to make and file this )lication; that all statements contained in this application are true to the best of his knowledge and belief.; and it the Work will be performed in the manner set forth in the application filed therewith. ,rn to before me this .......... .. ..... .y of :2o gni lotaiy Public .�� .......6:...�......... (Signa vii icant) o NYSDEC # 1-4738-21 09/10000 7 a •i� ANY AL TERAT/ON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, k EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY /F ` SAID MAP OR CO PIES BEAR THE MPRESSED SEAL OF TMESURVEYO Rvpj G / \ WHOSE SIGNATURE APPEARS HEREON. kk b ,D A ADDI TIONALL Y TO COWL Y WITH SAID LAW THE TERM AL TERED BY' f �0 \, MUST BE USED BY ANY AND ALL SURVEYORS UTILIZANG A COPY oda �� s. OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS INSPECTED' AMD , 'BROUGHT-TO-DATE" ARE NOT AN COWLIANC£ WYTH THE LAN. .41 p 3. �S1206 C11 0 p' V QLN Cf / / � k tiP 0' s - °.r �_,� SURVEY OF PROPERTY WOOD ,holf AT BA YV/EW ry yILe TOWN OF SOUTHOLD SUFFOLK COUNTY , N. Y. •h� 0� ,�• �`°� 1000 - 78 - 05 - 02 •�� '� o,� SCALE 1" = 30' o � � SEPT. 17, 1998 OCT. 22, 1999 ( topo. ) DEC. )AAL 1/ 2�99 rnPgarage C R. DECKS s ADDI � ) l I JAN. 26, 2000 (notes) S,9• DlD ( e APRIL 26, 2000 (prop. garage 1 TIDAL WETLANDS �r \ \ - s �� NE BOUNDARY AS s '�T l '� Q RECON VEYORS '— 7/ ash _��'��;.MertQ� k c 4 ON SEPT. 15, I998 C A �� N'9 /soO CO. O� N.Y.S. LIC. NO. 49618 E S RS PC 61. 7 � FLOOD ZONE AE (e% 8) FROM FIRM 36103C0166 MAY 4,1998 s\� COASTAL BARRIER IDENTIFIED AFTER 1990 r1REA 22 798 S ft. to deed Irne ER STREET 0 q SO , N.Y. 11971 98 - 306 ( 1 ) IL NYSDEC # 1-4738-,2109100007 4 J ANY ALTERATOW OR ADDITIAN TO THIS VEY IS A VIOLA TM nn OF SECTION 7209 OF THE NEW YORK STATE MACATION LAW, Ila EXCEPT AS PER SECTM 7209-SUBDIVISION L ALL CERTIFICATIONS HEREON ARE VALO FOR THS MAP ANO COPME'S TOF AML Y �FSAO MAP OR COPES BEAR THE MOWSSED SEAL OF T)`IE SURVEYOR JG WM W S16NATURE APPEARS HEREON'� 00 � ADO/Tl"LL Y TO COWL Y IWTN SAID LAW THE TOW 'AL TEMW BY' 4=.}' ��"p: �j��9 OF ANOTH'R SLKVEA"T BE USED DY YOR�S MAP. L TEI�uS S� AS CUTXMW CTV AAO OF§&ftMQr �+ bl10UBMT--TO-GATE'ARE NOT NV COAN'LWUCE IMTH 1?E LAN: ,, A � r v 0 8j Q`o 6 � 1pi/ app, . P ,� sp• ��. µFS. -, �}. PQy v� Ila ' d� SURVEY OF PROPERTY AT BA YVIEW Wc A ,� •. TO VI N OF SOUTHOL.D SUFFOLK COU V T Y, N. Y wo - 78 - 05 — JvM ltb sc" r" z 30 OW SAFT 17, MM OCT. 229 1999 t Mpo.1 _ . I DEC. l5, /999 Pr� docks d 9a� 1 JAM ll. 2000 I STIP d041R tJ$IjiFS! At0/T. I JAN. 261 2000 (rtai APRT! M 2000 tprgp. qwop7 / �•�Z)o �� '�t�_ b ' NOV.10, 2000 (s/k. gar. 1 SEPT 3�8 e MAIL NETLANOS �`!�, �` � � \� � � -ib� 0.4 Tel 22� � �AI' A � x 'cc Y S r. P . R w \ sem" PEC SVI: AMSC AR �•. ON SEPT. q N .4 � /Sp 00, � NOTE► LIC Ma 4�6t� BOTTOM OF Oil TANK FL _ � 1 X !63{1 765 - !T97 COASTAL BARRIER IDENTIFIED AFTER a� �Y 4,J 998 � �;�j y ,E/4 STAT A = 227M 8 sq. ft. to doe l e SOUTHOLD, M Y • 1107Y gig — 06 2�� p F '� coy'' ' �y�• F i=" �(/� Vol ot lose n OP ve Z74, o n 't /sr �. 4.. .o. ny.Ile MOL d 0zb S31l�OlON�911H� _ 1 '117- •kAdwo'J :oj T -CI 82TT 862 TEs QW oNuiow dd e6S :oT o2 9T TnC