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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18078 Date JLINE 5, 1989 THIS CERTIFIES that the building INGROUND POOL Location of Property 1150 THE STRAND EAST MARION NEW YORK House No. Street Hamlet County Tax Map Na. 1000 Section 30 Block 2 Lot 74 Subdivision PEBBLE BEACH FARMS Filed Map No. 6266 Lot No. 124 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 1988 pursuant to which Building Permit No. 17056-Z dated JUNE 3 1988 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 INGROUND POOL WITH FENCE ENCLOSURES AS APPLIED FOR AND TO 3. The certificate is issued to NICK MIHALIOS (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-038806-OCTOBER 11, 1988 PLUMBERS CERTIFICATION DATED N/A CGGaI ~~ Building Inspector Rev. 1/81 rosai xo. a TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CAM?LETION OF THE WORK AUTHORIZED) Nfl 017056 Z Date ..~...:...~~ ............. ., 19.~4~ Permission is hereby gran~tend toy ' ,, ro r.,:~f~.w/.~~~....cs~.....y~-r<-~~.<....,:4v.:~he.....~/z.<<c.,..:.:.~~rcn. rrce4-er.......~--~..... ct premises located of ....1,~...1..~......~-.~L4....f i.. +d'l.'{.r.P~ .............................................. ................................................................................................................................................................ Caunty Tox Map No. 1000 Section .........~f~...... Block ..........~~..-........ Lot No.......7. ~`:,........ pursuant to application dated ....>;..r!..,1(.f~ ......................... ......... 19fJ..~ and approved by the Building Inspector. G cq Fee $. 1 ' ' Building I actor Rev. 6/30/80 S. ~. TOWN OF SOUTDOLD BUILDING DEPART2IENT TOWN HALL r SOUTUOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY l OO DATE. ~:: 1.. ~~9.~ ... NEW CONSTRUCTION .~ „OLD OR PRE-E%ISTING BUILDING.._...VACANT LAND....._.. Location of Property. ~j;S;t~,?'~/!?-: _ STRA.a_~. /i~/~~2...GS7~gj ~,~lp~ : L.~ ,/~!~ . HOUSE NO. ,. STREET UAMLET .. ~ e Ovner or Ovners of Property.~~(ClG'.,.~LSK!lZc~tat./r~~~f~~L4~ ...................... County Tax Map No. 1000 Section ,J{„~^',`~„ Block ~'Z_... LoC .1~...... Subdivision~LQ'~.4Y .:~'.~~C~~,~(aklN.) Filed Ma 1''2E~ 12.... p ........Lot... N ._. ,, Permit No.d~.~~-,,,,,Date of PermiC ./'..3.~~„Applicant ~/CK_Nl_il-Ev4LiaS... Health Dept. Approval .................. Underwriters Approval....,......... Planning Board Approval ................ Request for Temporary Certificate .:..... 'Final Certificate Fee Submitted: ,5~,~ ~ ............. APPLICANT.. 1!~!.`~ ................. d,~.cc,. ~7 y f19 rev. 10/14/88 MELD I•i~S:'~~':lU~i ~ ~Un I' ~UaKMLNT° \ t ~U . H H~ FOUNDATION (1st) _ p~ ~'M ~.! ~~c FOUNDATION (2nd) _ ~~ _ _ ~ 2. ~ o ROUGH FRAME & PLUMBING \' ~ ti H 3 . ~' m rh IIJSULATIOPI PER N. Y, •' y STATE ENERGY D CO E x ~ ~ ~ ~ ~ 4. ~ '~ FINAL o ADDITIOP7AL COMMENTS: ' ro x ~ H ~ y~ \ H O z • ~ 111~~~ d ro ~ v H 14U1n~17 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELEC:TRICIT' 83 JOHN STREET, NEW YORK, NaW RK 10038 Cx7TOBRR 11,1488 5739 .RA/Rk N o3Rit06 PAGK Date Applicatton No. on file TH13 CERTIFIES THAT only the electrical equipment m deacri6ed 6ebur and introduced 6y the opplicent named ors the efwea application number in the premiw of SfK ?91:Hi.A.[~T<)5, THR S'rNAND 1~fTr 12A,, RAS'r MAttIOM, N.y. in thefollowinp l« n ^ let Fl. ^ 2nd F'1. ~iij~i~ Sertion BI«k Lot 'I24 Pees examined on and found to 6e in rnntplionre with the reyuirernente of this Boord. gXTURE tXETIliS ECBTACUIS SWITCHES I RXIURK NCANDESCENT. PIDatESCENT v RA AMT. NOK K.W. COOIIIN AMi. O DECKS K. w. OVENS AMT. K.W. DISN W AMT. ASNlRS K.W. NAY AMT. ST F M. P. 7 f DRYlRS FURNACE MOTORS gtTUR! AMUANp gMOEES SMCIAI RICH TIMICIOCIIS pLL UNq NEATEK ANEL11.OIITIlT OYIIAEBRS AMT. K. W. dl N. I. WS N. P. AMT. NO. A. W. G. AMT. AMP. AAV. AAVS. TRANS. AMT, N. P. SYSTEMS NO.OF RNT AMT. WAT19 ~U ? h SERVICE DISCONNRCT NO.OF - S - E R V 1 C E AMT. AMP. TYPE l~.. 1 / ]W ~ / tW ] / TV S / ~W ~• KRCeCOND. W CC. COND. NO. OF NFLEG a~H1 ~~ NO. a NENMAIA ov t eillliAt f11ER ArPARATUS: G.F.C.It^7. *(SM7MY7IFIt; ptl(zt,) '.this certificate cnvers comgli.anctx at the date of inspection only. 8ecausY? of unusual environments it is advi,sabl,e to have frequent test/and or repsirs made by a qualified person. ~~ (. k S Ci?N?'RACT~R EigX 2.1 °i SO{ITNU7d). NV, 7,14'77 OWiRu 17 I,,7:CRNSF, N(J. °~'iA Y~ Per This prtificaN myN not be alterod in any manner; ratarn to the .office of the Board if incorrad. Impactors moy M identdied by fMir ctedentiak. CDPY ,lUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MAST NOt EE ALTERED IN ANY h1A. r l 70~~ 7ss-iso2 BUILDING DEPT, INSPECTION [ ~ FOUNDATION 1ST I ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING REMARKS: [ FINAL DATE (.~ INSPECTOR FORM NO. a TOWN OF SOUTHOLD BU[LDING .UGPAI2TMENT TOWN CLERK'S OFFICE SOUTIIOLD, N.Y. NOTICE OF DI5AP4'ROVAL Pile No . ............................... llate .. ~ V ~...........,19~~. PLFASE'I'AKE NOT1C1; that yo""""ur''''a""""p''''p''''l""""icat~~~~ion dated ..: ~.. ~.3........, 19 .~' ~. . Ibr permit to construct ...Or'!M..YY~.. ........... c~5~.•..• . • . • • • • . • • . at Location of Property .. // S?? , , , , .. ~; , ,~.ry~..~-..~r , ........ r~ ~.~ .. '?"!~+ ... . House No. Street ,, // Hamlet County Tax Map No. 1000 Section ..•...0. 3p ... Block .....O. ~-..... I,ot . ~ T........ . Subdivision .................. Piled Map No. ................ Loot No. ................ . is returyn-red herewith and disapproved on the following grounds .C~A.~ X ..chi... /.°v -1~9.2- (~' ~,~iwLC~n:,, l (1';i), ad`... ~ ~-~*,-!+-~~ ..?S~ .:.. U.O.rI.t 4~n !'A....... . ~~ ~' ~,~..~,.,~%~,-off..:-~..~a~-~,':~.~~... ~~ ..~~.?~t~s: ~ ....................... . Bw ding Inspector Rv ileo 7 ze"£ _.--- q. BY l6 ZI JI V~ m~ ~I q QI ~W N~q ~v CS x .~ J1 N a ~~ ~/ ~` ~ 1 235.56' o R Q B.a' P _._____ R X666-•~_ b „ ee.P H rc 1 0 m ~a a 20.0 +' _e_Sb __ _^ _ .I-., 344.04 Preoa aoeowo woema NNVa O ~' U W ~ff% as CF F <, o J` N >' ~ ' ~ ~ O iJ J .. a ~ ~ ~~~~. ~ ~~~L ~ Q ~ '!4._ ~' ~_. U ~ IIC ~ O= _ ~ u ~ ~ ~ Q ~ a ~ 2 p F W O~ F z o~ a Y x -~ ~ U ) ~~ ~'^n ~rc o'^Y _Z q Y ~ wQOZau-li ~ w m a Om e-NWKK3Y OJ n (~ V ~ ( te j+ a FW ~N UOJJ ~ N 2 N w C []F ~i lJ < ~~ti o „~ F CL Q J ~ ~ <YO .<oal~wu~,r Y m W Jti'~~aN ora ~y W I~ ~ SWJI-WIQNG V'W ~ N{ W I p ONZ YIX4WW 2Z Y x I -1 O OW x ZOO Cn~ ( Z ~o~> ~~e-O~JQ o d I ~ q ~ m/ y <>-O~ W~x LLj YWx Q ) ® ~ QJJW„WGO3~YF wZ O Q ~ LL S V WOFZEO <WUp NSF ~® NO ~ NW WO ~n ~eoi~i°a N ~ X I e ~ C x ~ ~',OWEWIK J aj> ~ >ma~T] ~ U O I ~ ) ~ ' a F ~~wu ~o~Wiaw ~ N Z J ~ 1 V x~z xvlY x <ix ,I u I- v U ~ r ~ e- 1 LIO V h zz ~ O gJ N U g O F 4 Y 1 wu 0 3m ~n a o. wo \; a u K ~ K p ~ NF U ~+ ye *W Q •I~ ~ Y ~ t O P i 1. _- !~, a m W r- < ~ ¢ ~1,:, z r , a x ltl ;h ~f=- ~ < ~.._..._._ .. ~ m z r ~n b m Z _~ Q ti 3 N Ory b I ~i I r e_1C ~ nrdG WAY FORM fd0. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD> N.Y. NOTICE OF DISAPPROVAL Date .S.J~-~-~{ :c!~a!~ .. ?Z.l?......, 19 ~ 7. . . .......... PLEASE TAKE NOTICE that your application da\ted~ .. ,rs~?~ .'~' .7 .. • •, 19 ?? 7 . for permit to construct .+~-+..`f^. ".'r_•^,p~• \l~y.~~ y~ • •"•+"` ~ • • •~ • • • • • • • • • • • • • • at Location of Property . /./. S4....~!'yi~~:Yv,~.:w,,!!-~........-~.'~a?".. -M W.ee4~M......... . House No. Sfreet ~~ // Hamlet County Tax Map Noa10_00 Section~....C'~.;+.~..... Block .... ~?.?' .....Lot .7.7.......... . Subdivision}~.b~l 1?~4~~. ~A Filed Map No . ............~..y.- L/ot No. . ~??.7.......... . is returned herewith and disapproved on the following grounds ..W!-I•iS••4R- ~..~R ~~ ~.'r~ File No . ............................... To ~..~ 4a.~Q.° c ~3 ~5'a....3 ~ g?:..S.T~.~..1~"....... . RV 7/80 Building Inspector I'. Y , ~c'~~,i~~1,~"n~~ a~ =z:. ..,,.~~ yJ~J ~a 4~ t 'R J,/ 6 Y~~ •~ ~ r s e ,`T9 ~~ i_~~..~~,1 ~~' 1~AIN ROAD- STATE ROAD 25 50UT!°IOL®, L.I., N.4'. i]"~7i TELEPHONE 1516) 7657809 ACTION OF TIIE ZONING BOARD OF APPEALS Appeal No. 3673 Application Dated September 17, 1987 TO: Mr. Nick Mihalios [Appellant(s)] 23-50 31st Street Astoria, NY 11105 At a Meeting of the Zoning Board of Appeals held on November 18, 1987, the above appeal was considered, and the action indicated below was taken on your ~ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article Section [X] Request for Variance to the Zoning Ordinance Article XI Section 100-119>2 [ ] Request for Application of NICK MIHALIOS for a Variance to the Zoning Ordi- nance, Article XI, Section 100-_119,2 for permission to locate inground swimmingpool, decks and fence enclosure with an insufficient setback from the top of bluff along the Long Island Sound. Location of Property: North Side of The strand, Lot #124, Map of Pebble Beach Farms, East Marion, NY; County Tax Map Parcel No. 1000-30-2-74. -_ WHEREAS, a public hearing was held and concluded on November 10, 1987 in the Matter of the Application of NICK MIHALIOS under Appl. No. 3673; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is known and referred to as Lot #124 as shown on the Map of Pebble Beach Farms Inc., No. 2, and designated on the Suffolk County Tax Maps as District 1000, Section 30, Block 2, Lot 74. 2. The subject premises contains a total lot area of .635 acre(s) and is improved with a single-family dwelling set back as shown by survey prepared by Young and Young dated May 2, 1987 48.9 feet at its closest point from the front property line along The Strand and 80 feet at its closest point from the average line of bluff. The sideyards are presently 10 feet at the east side and 20 feet from the foundation line at the west side (although 7.5 feet at the west side from the carport addition). 3. By this application, appellant appeals from a Notice of Disapproval from the Building Inspector issued August 26, 1987 (CONTINUED ON PAGE TWO) DATED: November 24, 1987. CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS Form ZB4 (rev. 12/81) Page 2 - Appl. No. 3673 Matter of NICK MIHALIOS- Decision Rendered November 18, 1987 for permission to locate inground swimmingpool with deck and fence enclosure as sketched on the May 2, 1987 survey. The pool is proposed with a setback at not less than 80 feet from the average line of bluff, and approximately 7? feet from the west side property line. The fence enclosure is proposed at 75 feet from the average line of bluff and three or more feet from the west side property line. 4. Article XI, Section 100-119.2, subparagraph A[1] of the Zoning Code requires all buildings proposed on lots adjacent to the Long Island Sound to be set back not less than one-hundred (100) feet from the top of the bluff. 5. It is noted that sections of the lot have been filled, and the rearyard area currently slopes toward the bluff. Along the western side of the property-and onto the adjoining lot, there is a low area (or drainage way) which also slopes toward the bluff. The bluff face is well vegetated with woody vegeta- tion, mostly of Bayberry, and appears stabile. It is the opinion of this Board that actions are necessary to reduce any possibilities of concentrated water flows from flowing down the bluff face, such as grading the rearyard area away from the bluff. Constructing the swimmingpool at an elevation sub- stantially lower than the top of the bluff and installing gutters, downspouts and drywells for roof runoff will also alleviate potential problems. 6. In considering this appeal, the Board also finds and determines that by locating the proposed construction as further noted below: (a) the variance will be minimal and will not be substantial in relation to the zoning requirement, being a variance 15 feet, or 15%; (b) there will be no substantial change in the character of the area since relief has been granted for simi.1ar bluff areas/properties- along the Long Island Sound; (c) the circumstances of the property are unique; (d) the practical difficulties claimed are sufficient to warrant the relief as alternatively granted; (e) there is no other method feasible for appellant to pursue other than a variance; (f) i.n view of_all the above factors, the interests of justice will be served. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Sawicki, it was RESOLVED, to GRANT the following-alternative relief in the Matter of the Application of-NICK MIHALIOS-under. Appeal No. 3673, and SUBJECT TO THE FOLLOWING CgNDITIONS; 1. That the pool be located not closer than 85 feet to the top of bluff ,and not be linked directly to the house; 2. That there be no excavation or disturbance of land within 80 of the average line of bluffs 3. That the pool be located not closer than seven feet and the deck not closer than three feet to the west side property line; 4. That the east sideyard area remain open and unob- structed the full width of ten feet at all times (including Page 3 - Appl. No. 3673 Matter of NICK MIHALIOS Decision Rendered November 18, 1987 bushes, trees, etc.); 5. That drywell(s) be installed, and leaders and gutters be piped (for proper drainage into the drywells); 6. That no surface water or other discharges flow over top of bluff, and the rearyard be regraded toward the house. 7. No lighting which may be adverse to neighboring properties; Vote of the Board: Ayes: Messrs< Goehringer, Grigonis, Douglass and Sawicki. (Member Doyen of fishers Island was absent.) This resolution was duly adopted ~~~ .~, GERARD P. GOEHRINGER, AIRMAN FORM N0. t TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined .~~`'~~..........., 19 f~~ ' Approved . ~ ........., 19 W Permit No.~7~J.6. Disapproved~a/c ..................................... BOARD OF HEALTH .. 3 SETS OF PLANS SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL T0: ~(Build'fng Inspector) ~~ ~ ~~~+~PC~S TION FOR BUILDING PERMIT X14 INSTRUCTIONS 6 Date ................... 19 .. . a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approvai of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. ' e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy Shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...................................... (Signature of applicant, or name, if a corporation) .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ../I,ICG-~.. ~~~!~`,1~~~ :~ ................................................ . (as on the tax roll or latest deed} If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of corporate officer) Builder's License No. ~-••••••••••••••• Plumber's License No. ~//''~.!~.•~~• • .~'~~~ ~~f~ SMi~ ~ cSDr( ~~ P Electrician's License No. 5~~5 .~~~C~I :ice. •~~•h Other Trade's License No . .................... . I. Location of land on which proposed work will be done . ...................; ............................ . House Number Street Hamlet r~ County Tax Map No. 1000 Section .... ~ Q .......... Block .... ~........... Lot ... `..~.J.......... . Subdivision ..................................... Filed Map No. ............... Lot .............. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ... ........~~~.d.-~~~-~.......,,~. Via,.. a. Existing use and occupancy ....p.t• . . .. ........................ b. Intended use and occupancy . • • • •S~~• • ~~•~~~• • •~~ • . • • .... 3. Nature of work (check which applicable); New Buiiding ...4!.'... , .Addition .......... Alteration ......... . Repair .............. Remgval ..... , . , .... , . Demolition .............. Other Work .............. . ,~,,,,,~y,~,~-•~~--yy..,, (Description) 4. Estimated Cost .....~.© ..I17i~.c! .................... Fee .. ~~. h~....... . ~ (to be paid on filing this application) 5. I1.' dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... . I1'garage, number of cars ....................................................................... . 6 ~; ~ ; ~ 1 l r.; ture occupancy, specify nature and extent of each type of use .................... . 7 ~ © s, if any: Front ............... Rear .............. Depth............... i~ht? ...':.... umber of Stories ....................................................... . 1 une s. f t e w i~ + epth , . , , , . , ~ nth alterations or additions: Front ................. Rear ................. . ~ ,~ .... ~ '!..Height ...................... Number of Stories ..................... . 8.. Drmensrons of enti struction: Front ............... Rear .. , ............Depth .............. . Height ~ •< =:at.;~=:,;'~[iT.. umber of Stories ......... ........................................... . 9. Size of lot: Front ..:....... .......... Rear....:................. Depth ...................... 10. Date of Purchase ............ ~ .................. Name of Former Owner ............................ . 11. Zone or use district in which premises are situated .................................................... . 12. Does proposed construction violate any zoning ]aw, ordinance or regulation : ............................... . 13. Will lot be regraded ..... "~ .Will excess fill bg rem ed frgm premises: Yes No 14. Name of Owner of premises . /. j.t-~~? ~L~~~. Address . ~« ~'~, ~ phone No. ~t:~, $. 3 z. 64DQ Name of Architect .. ~T.~&rN;4,-,Z,EO~1 , , ~-,~~'~, , , ,Address .. ~. !~, ,~',. , .. , .Phone I~~.('!•~.lP.,fY.". . Name of Contractor ........ ' ..... , . " .........Address ...................Phone No. ............... PLOT DIAGRAM Locate clearly and distinctly all I buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~~ ~ ~~ ! it ~~~I STATIi OF NEW YORK, S.S COUNTY OF ................ . i ; • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ~• • • • • • • . • • .......... being duly sworn, deposes and says that he is the applicant (Name of individual sign%ng contract) above named. He is the ..................... '~ ..... ........... .................. ........................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner' set forth in the application filed therewith. Sworn to before me this I .............. i' ~0.. ....day~~o//f I'.. J/~!',l.. ............, 19 Notary Public, ....~1~'~!. J.1.•.!. 4!~-~~.., ... , . County HELEN K DE YOE ~ , ` ~Ne~47078/8; SuHulkt~w York ..... ..~~~ .............. PP ... . Term Expires March 30,1l1~~ (Signature of a licant) BOARD OF HEALTH ... 3 SETS OF PLANS%•.... FORM NO. 1 SURVEY .. 1/ TOWN OF SOUTHOLD CHECK • • - `•~-~~-Tq$ BUILDING DEPARTMENT SEPTIC FORM .............: TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 ""~'~~~~~~~~~~ MAIL T0: Examined .................19... Approved ................. 19 ... Permit Disapproved a/c ...................... . .~/ ,i APPL ~ i~~sb .. ~~~ ...... , ..., I9 ~~ a. This application must be completely fi o the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee z b. Plot plan showing location of lot and oz ouuuu~go ~„ p,~.,.~~„~, ..,.~..,,,.,,...Y .., ..~,~ining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th ~ 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 alteration , or for removal or demolition, as herein describev The applicant agrees to comply with all applicable laws, ordinances, uilding code ousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i sp ctions ^ , ^~ ' f ff nature of app ican't`,'no`- name, if a corporation) ` - (Mailing address of applicant) I 1 I ° ~S State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................................ Name of owner of premises ..SJ \, C~ ....... M.l. ~ ~ L-.~. ~ .c--~ ........................................ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ............................................. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED 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 . ................................................ . House Number Street Hamlet County Tax Map No. 1000 Section .... ~ °?........... Block ....PL.-............. Lot .. ~ . ~ ............ . Subdivision $~F ...Q~4t'f ..'F.-4l~•M•S......... Filed Map No . .............. Lot . 4 `.~'1......... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~f .......:......~:...~.. ~ .? . .T-- b. Intended use and occupancy .Nti'N....~~~vC.`a'f`. N,~~, , , . ~L~U .. `~ µ (T Fo(Z , Sw~ M f:` ! h? Ca, , ~~ ~ ~ -. ~ ~. `~roL . TO .~. IJ .c.Qe,c.Q~ ,~,,..~ ~" ft 4 l9~7 t' ~ ,;? i ; 0 ' 'c /~ °~ //~ ~7 ~~,.~ ~.13 7.1.'~Y.~~ ~ /~vC ~'" VNIO~~SOU'4'tff~b 3. Nature of work (check wh~ applicable): New Building ..... . .... Addition .......... Alteration.:.. . .,... Re air Rempval .............. Demolition ..............OtherWork`-~~:Nl~.~~G `~o(, p ............. ~ (Description) 4. Estimated Cost ...z~~.~.OD,~ ......................... Fee ....................... ` (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... . If garage, number of cars ....1 ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... . 7. Dimensions of existing structures, if any: Front ...............Rear .............. Depth .............. . Height ...............Nu~berofStories..............................,......................... D pth sions'ofsa•' a s(, cture with alterations or additions: Front ................. Rear .......... , ...... . .. ~_ :.~ ......... ...Height ...................... Number of Stories ..................... . S. Dimensions of entire new construction: Front ... . ........... Rear . , . , ....... , ... Depth .............. . height ............... Nu~ber of Stories .............................................. , ........ . 9: Size of lot: Front .......... ........... Rear ...................... De th p ...................... ] 0. Date of Purchase ........ , . j .... . .............Name of Former Owner ............................. 11. Zone or use district in which premises are situated ........................... . ........................ . 12. Does proposed construction violate any zoning law, ordinance or regulation : .......... . .................... . 13. Will lot be regraded ........ y., ...................Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Nly.l~:..NSFEA~t4S.... Address'7: 32, ,'(o SNT , eRtsL~'i5-ne No. ~.~~..`~.~?:'.~! °.° Name of Architect .5`~AMA:tI Q.S ...LyICaS..... , dres M~~-BA Ny 1 ~35j phone No. . ~UI'~`1C.5'T""". Name of Contractor ........ ' .. Addres NewYoa~ ra,(, foaa~'hone No. ~~?: 2 ~`~ ! °.~r 15. ]:s this property located within 300 feet of a tigidal wetland? *Yes ..... No ..... *7:f yes, Southold Town Trustees PermitPLOXi'DIAGttAMed, So~~ tt-oL ~ -ro w ~ TRu s--~-~5 .~~~ia6Lo v r><~-- ~1~R E~4,~Y G ~ ~ ~~I-~ . Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. SSE f4TTA c-t-F ~ fl t~~~W t rJ G ~ . a STATE OF NEW YORK, I S.S COUNTY OF .'~T~P1-~t~k~.• ..... ....~'~.t-~?...`~e~o ~? ~ ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application'; that all statements contained in this application are true to the best of his knowledge and belief; and that thg work will be performed in the manner set forth in the application filed therewith. Sworn to beforppe me this ....... 2 L1 ... , ........day o'f .. ~~,V~T........., 19 ~? 6Not1aay Pub(l~ic~,L~~J .. ~..... ,~~G~ County C?'~~G~~J N ELIZABETH ANN ~VILLE ... .. ............ .. ............ . ota Pub1lc,StataofiNawVork (Signature of applicant) .. 7-- Examined .................19... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK •••••••••• SEPTIC FORM .. •, •.,•,••• „ NOTIFY CALL ................ MAIL T0: Approved ................. 19 ... Permit No........... . Disapproved a/c ..................................... ................................ (Building Inspector). APPLICATION FOR BUILDING PERMIT Date .... . ~..~........, 19~.~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp nsC (Sign ture of applicant, or name, if a corporation) .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~~C~ ~ C ~..~ ................................................. . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ..~.GU.(i],~~/?~ .......... . Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Location of land on which proposed work will be done . ................................................ . House Number Street Hamlet County Tax Map No. 1000 Section ~. ~ ............. Block ..°4 .............. Lot ..7 ~ ............ . Subdivision .. V:63~~-. S ... ~U~~~...~i~KM' Filed Ma No. ... Lot .L2• • ......... . ...~. p ........... (Name) 2. State existing use and occupancy of premises and intended rise and occupancy of proposed construction: a. Existing use and occupancy . .Q.~L:2,. 'H 'L . ~l~ ! ~ -~ , .. .~ :9 1~ 4~ 1 ....................................... . b. Intended use and occupancy .~:~:~. , ~ , ' / , , ..~~.. f ~ , g p ~~..Q~GVr ........................................... s~•~ r NtrvrGnt~- P 'o© 3. Nature of work (check which applicable): New Building .~/.. , , . Addition ...:...... Alteration ... .... . . Repair .............. Removal ..... , ........ Demolition ............ { .Other Work ........ ~...... . (Description) 4. Estimated Cost ..~.D..(9:6:~ ......................... Fee .~ Q,x.o~.~• ......................... I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units ion each floor .........'....... . If garage, number of cars ........................................................~............... 6. If business, commercial or mixed occupancy, specify nature and eRtent of each type'' of use ................... . . 7. Dimensions of existing structures, if any: Front ............... Rear ........ '...... Depth .............. . Height ...............Number of Stories.............................;........................... Dimensions'of same structure with alterations or additions: Front ............. .... Rear ................. . Depth ......................Height ......................Number of Stories ..................... . 8. Dimensions of entire new construction: Front ............... Rear ......... '; .....Depth .............. . Height ...............NumberofStories.............................!.......................... 9. Size of lot: Front ...................... Rear...................... Depth ...................... ............................. l0. Date of Purchase Name of Former Owner .. ' .......................... . 11. Zone or use district in which premises are situated .......................... ~...................... , ... . 2. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~ ......................... . l3. Will lot be regraded ............................Will excess fill be removed from premises: Yes No l4. Name of Owner of premises ....................Address ................ , ..Phone No................' Name of Architect ...........................Address ................ ''...Phone No............... . Name of Contractor ...... . ...................Address ....:...........:..Phone No................' 15. Is this property located within 300 feet of a tidal wetland4 *Yesl•.... No ..... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate al] set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether _nterior or corner lot. i iTATE OF NEW YORK, S S ...... ~OUNTY OF ~... . . . , , , , N,6~~, ~, ,rn /~f/!~,~;/ b S , , , , , , , , , , , , , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) I above named. QWiV~CO~ ieisthe ........................................................... ......................... (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said Work~~~'(id~to~:mal~~ and file this' application; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in the manner set forth in the application filed therewith. I Sworn to before me this n ...... ~.~./.t~1.~........dayoyf...C.~~!~-c~ ........., 1~.? i 1otlic, ...........~Q/ti% y ~ L ~ ........ Count... .. ................. UNDAJ. COOP9R ' /I ' ~~~~~~`""'~(Signature of applicant) Notary Publlo, State of New Yak ~/ No. 4822568, Suffolk County oQ Term Expires December 3t,19_._.