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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY 7910 Date MARCH 30, 1989 THIS CERTIFIES that the building ADDITION Location of Property 55415 MAIN ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 62 Block 1 Lot 12 Subdivis Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1988 pursuant to which Building Permit No. 17075-Z dated JUNE 8, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING FOR A RESIDENT RENTAL APARTMENT ON SECOND FLOOR AS APPROVED BY ZBA #3896. The certificate is issued to JERRY GAMBONE & KESTUTIS ZAPKUS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-051524 - DECEMBER 22, 1988 PLUMBERS CERTIFICATION DATED 3/16/89-INOVATIONS PLUMBING & HEATING _ Nil./ _ B ilding Inspector Rev. 1/81 gosai< xo. s 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) N°_ 017075 Z Date .......~..,~-na~.....~ ................. 19.:8.$ Permission is hereby granted to: .... ~w~.~....:..kslr.~?:!s~~...~.....?a! ................ ....~.rw1. ,.....l.. ~.0.1..x- :....................... to ....a!!1......4'i..~.l .....................~ia.....a.~....~5~.!^.^..~.s~:4.... -1:~............... 4 ~ ct premises located at ..a`Z.e~..:T.~.4~..........Y.rt.f{c!~n....1.~-4 ::............4.,2°"r.!%:::~'s:.~.................... ....... .................................................................................................................................................... /.... Caun Tax Ma No. 1000 Section ~?.~P..Z:. Block ........ ~.~. Lot No.....~ ................... ty p ........... ...... ~- pursuant to application dated .............~.4!-•~+.~3•.•.•.•.•...., 19.i1.1J., and opproved by the Building Inspector. Fee $..L~~.'~/.. ....../.~. ~~.: ........Q.'C .. ...... Buil ng Inspector Rev. 6/30/80 I4 ' TOWN OF SOUTIIOLD BUILDING DEPARTTfENT TOWN HALL SOUTIIOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE..~~ ? I J f O~ ... . NEW CONSTRUCTION ......OLD OR PRE-E%ISTING BUILDING......VACANT LAND..._.... Location of Property-.~.~~~~•!~_tf~~_N.~,~..~~ ................~o~~o`i~ ......... HOUSE N0. STREET •• HAMLET. Owner or Owners of Pro ert ~~~ ~RM~ON~ d- ~c~STVT\ ~ ~'~(~~VS P y...... ~ .............. .......... County Tax Map No. 1000 Section ~~ °~. Block ...~ ... Lot .. ~.~ :... Subdivision ....................... Filed Map ........Lot.......... ©170'75 Z ~.I•g./$. ~.Applicant~~.~ ~SPcM6Ol.~~ Permit No. ..........Date of Permit ~,_..__,_•.._• Health Dept. Approval .................. Underwriters Approval.............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... APPLICANT....,#'~.'::;,.~:.. ................. e~~-~~~~ rev. 10/ 14/88 ~~~- ~~~~~ ~""" ~-~c. crw~ e'er QS~FF~(;~f:~ ~, ~•o o;~x,, ~~_ t.~ ~` South®1d Town Board of A eats o`'=+~`~=~`~` ~ ~~ MAIN ROAD -STATE ROAD 25 P.O. BOX 1179 SOUTHOLD, L.1., N.Y. 11971 y ,F/~~~ "~4 ~~ TELEPHONE (676) 765-7809 FAX No. (516) 765-1823 APPEALS BOARO MEMBERS GERARD P. GOEHRING ER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. JOSEPH H. SAWICKI JAMES DINIZIO, JR. ACTION OF THE BOARD OF APPEALS Appl. No. 3896 Matter of JERRY GAMBONE AND KES ZAPKUS. to the Zoning Ordinance, Article IX, Section permission to have Office/Retail business on residential rental apartment on second floor Location: 55415 Main Road, Southold, County Section 62, Block 1, Lot 12. Special Exception 100-91, for first floor and Property Tax map No. 1000, WHEREAS, a public hearing was held and concluded on December 19, 1989 in the matter of the Application of JERRY GAMBONE AND KES ZAPKUS under Appeal No. 3896; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning,•and the surrounding area; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the north side of Main Road, Route 25, Hamlet of Southold, and is identified on the Suffolk County Tax Maps as District 1000, Section 62, Block 1, Lot 12. 2. This is an application for Special Exception from the Zoning Code Article IX, Section 100-91, for permission to have Office/Retail business on first floor and residential rental apartment on second floor. E Page 2 - Appl. No. 3896 Platter of JERRY GAMBONE AND KES ZAPKUS Decision rendered January 9, 1990 3. Article IX, Section 100-91, in the HB District, no building or premises shall be used and no building or part of a building shall be erected or altered which is arranged, intended or designed to be used, in whole or in part, for any uses. 4. In considering this application, the Board finds and determines; (a) that there is no other method for appellants to pursue; and changes or alterations on the premises will require a Special Exception. (b) that the Special Exception will not in turn cause a substantial effect on the safety, health, welfare, comfort, convenience, and/or order of the Town; (c) that in carefully considering the record and all the above factors, the interests of justice will be served by granting the Special Exception, as applied conditionally noted below. Accordingly on motion by Mr. Dinizio, Seconded by Mr. Goehringer, it was RESOLVED, to GRANT a Special Exception in the matter of the application of JERRX GAMBONE AND KES ZAPKUS under Appeal No. 3896, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That there only be cooking facilities for one apartment. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Doyen and Dinizio (Absent Joseph Sawicki). This resolution was duly adopted. df GERARD P. GOE INGER, AIRMAN P~ ~ Southold Town Board of Appeals Town Hall Main Road Southold, 11971 Attn: Mr. Gerard P, Goehringer, Chairman Dear Mr. Goehringer: We have been advised by Mr. Bob Kassner, of the Planning Board Office, and Mr. Victor Lessard, of the Building Department, to apply for a Special Exception for permission to have an apartment over office space or a..retail store,in the Hamlet Business District. Mr. Kassner has reviewed our preliminary site plan and based on his comments, we will be submitting a formal Site P1an~Application to the Planning Board for approval to change the usage of the first floor of our residential building to business or professional offices or a retail store. In support of our application for Special Exception, enclosed you tiaill find the following documents: 1) three - notarized copies of the completed Application. 2) one - notarized copy of the Adjoining Property Owners Form {completed as sent out to neighbors with an attached copy of the property's survey) with Certified Mail Receipts. 3) one - completed Environmental Assessment Form (Short). 4) one - completed ZBA Questionnaire. 5) one - copy of the C of 0 (non-conforming premises, dated 10/25/85). 6) one - copy of the C of 0 (addition, dated 3/30/89). 7) four - original prints, architect stamped, which includes the existing site plan, building's floor plan, etc. 8) a $150.00 filing fee (our check # 593) payable to the Southold Town Clerk. 9) one - copy of our Deed to the property Sincerely Yours, " erry one Kes Zapkus ec: Bob Kassner, Planning Board Office Victor Lessard, Building Department 4860 Rocky Point Road East Marion, N.Y. 11939 November, 29, 1989 roc - r ~w ,8 Re: Application for Special Exception for ~ . SCTM# 1000 -62 - 1 - 12 ~.~c ~'F' figf~~. f ~~FFO(/{~pG TOWN OF SOUTHOLD Y~ ,~f ,e ~~ OFFICE OF BUILDING INSPECTOR o rn P.O. BOX 728 v' -~ ' g TOWN HALL ~~"O~. ~ ~ SOUTHOLD, N.Y. 11971 '~~Ql ~. ~,a0 C E R T I F I C A T I O N TEL. 765-1802 Date March 16.1989 Building Permit No. n~~07sZ Jerry Gambone Owner (please print) Plumber Innovations hliimhina&heatinn inc. (please print )T P I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) VEROidICA F. CIDOiVE $WOrn t0 befor me this NOTARY PUBLIC, State of New York No. 52.4661406 ° day Of ~' ^ Qualified In Suffolk County ~ Commission Expires Dec. 31, f9~/ 19~• ~ ~ Notary Public Notary Public County -- THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 ~~ 1 BUREAU OF ELECTRICITY ~ 1 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date DECEMBER 22,1988 ApplirationNo.onfile 58090088/88 N 051524 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant homed on the above npp/icotion number in the premises of JERRY GAMBONE & KESTUTIS, MAIN RD., SOUROLD, N.Y. in the folfmcing location; ®Rotement ^ /st F7. ^ 2nd FL OUT SerNon Bfock Lot was examined orr DECEMBER 16,1988 and found to be in conEplianro mifh the requirements q(this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT M V v vRFOM AMl K W. AMT K.W. AMT KW AMT, K W AMT. N P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS PMT. K. W. Oll H P. GAS H. P AMT. NO A W G AMT. AMP MKt. AMPS raANS. AMT H p SYSTEMS NO. OF FEET AML WATTS SERVICE DISCONNECT NO.OF S E R V I C E AM1. AMP. TYPE METER EQUIP 1 ff 7W 1 A 3W $,e 3W 3,e' 4W NO.OF CC COND pER B A W G. Of CC COND. NO. OF HI-lEG A W G. OF MI-LEG NO OF NEUTgglS A W G. OF NEVFRAI 2 100 CB 1 X 1 3/0 1 2/0 OTHER APPARATUS: _ /y~ ~ C . ~ ~7G"~ PAUL R. BURNS G~/ 275 TOWN HARBOR LANE SOUTHOLD, NY, 11971 GENERAL MANAGER 11 LICENSE N0. 282E L'eY This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by t eir credentials. ~ FIELD INSPECTION DATE COMMENTS _.__ ~J ~ -- m ~ o FOUNDATION ( 1 st`~ ~ ~ '~ ~ _. _ -, ~ -- f.~ ~ f ~ ~ FOUNDATION (2nd) 0 " 2 . z V, o i ~ ROUGH FRAME & PLUMBING O~ 1/ y ~ ~ H `il 3. - ~ y INSULATION PER N. Y. STATE ENERGY CSODE a r !n H 1 4. .c.... .~,.- -~ FINAL - 0 ,'E z ADDITIONAL COMMENTS: ~~ ~ - ~ \ ~_ M ~..• x ~u .. ~r ~~ H H "~ O ob z ,,.o ~• x a L %: r.... H b x d C+7 ro H Ziz- ~l~o -°3~~ 1 ~0 7~'" 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] FOUNDATION 2ND [ ]FRAMING f ]ROUGH PLBG. [ ]INSULATION [ FINAL REMARKS: ~ ~a ~~ ~~~ ~~ . DATE d ~/ INSPECTOR I'~~~~" 765-1802 IgU1LDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2N [ ' _j INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~~~~ Z DATE ~~ INSPECTOR ~-~6~~ 765-1802 BUILDING DEPT. IN~PECTIC~N [) FO DATiON i5T [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION (/ ~~4 DATE ~I o 0 INSPECTOR ~ ~"y4~,..~ n a _._. h~~,. ~... [ ]FRAMING [ ]FINAL ~~0 7S~ 765-1802 GUILDING DEPT. INSPECTeON [FOUNDATION 1ST' ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS~C~ ~(D J ~~4-~-~ ~i L C.~ ~' DATE __,~~ ~~ INSPECTOIR ~~ i jZ©Z5 765-1802 BUILDING DEPT. fi:b3] ~~i iT~I:I [ ]FOUNDATION 1ST [f5 R~JGH PLBG. (]FOUNDATION 2ND [ /INSULATION [ ]FRAMING [~ FINAL REMARKS: .~..r~~~j r~It.Z~~.. DATE / ~ ~ INSPECTOR .~/,r ~ ~°~~-" 7sS-1802 BUILDING DEPT. n~~~r~~~rrri [ ]FOUNDATION iST [Vj ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / [ ]FINAL (~ REMARKS: 4 ~~ V_i~'..!lJ,'~ ~ f~' i DATE ~ O"~ INSPECTOR ~~ ~~~~ FORM NO. 1 TOWN OF SOUTHOLD 6UILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..~.tr!'.t?~ .~...., 19g$. Approved .. ~r4~~'4Q.. S ..., 19g$. Permit No.. ~ 7 U 75r~ Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ..,, / ,,,,, SURVEY ............. ....... CHECK ..............V ...... SEPTIC FORM ................ NOTIFY ~~E(~~,~-p G~+i`^C~a^'~ CALL c'Z\a; -; ~12.0._QR`3`3S...pQ~ MAIL T0: ~~'(6.-(tl'~_~~~~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ...~`.~3........, 15~5.~ 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 perrhit 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 all 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, housinh code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Sig ture of applica , or name, if a corporatton) 35 `~dNo ~st~~~C Inx"-~l~as?~-,N,v\ Ids la. ....................... ......,-1 .. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C~~.owNev-5 a~ `~~-o~~U`Cv~ ...... ........ .................................................................. Name of owner of premises~~~~~'~ ~RM6or.~~ ~}- ~;=~~~~5 ~ `~F}~`~U~ .................................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of corporate officer) Builder's License No . ........................ . Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Location of land on which proposed work will be done . .............................. . .................. House Number Street Hamlet County Tax Map No. 1000 Section ~~'~' 1 ~ ( .................. Block .................. Lot................. Subdivision ..................................... Filed Map No. .............. Lot............... (Name) 2. State existing use and occupanc of premises and intended use and occupancy of proposed construction: ~4c~ -~i s"C t w~ / a. Existing use and occupancy .N4N ;-, C>:~~.~:~•~°.~J.. -.~1N~`e {'FtM<l~t ~S i D.~~~.F~ C. C \ /~ .... b. Intended use and occupancy ... `~i~~~~' ~~M<~~ ~e_5 i pc__.,~r'~ i_ i~ ~ .t-~pp t'~~ cif `'1,f it ~'' 3. Nature of work (check which',applicable): New Building .. , , ,', , , ~ ` .. Altera ' `~ .. Addition .... x ..........:. 'r . .; r . . Repair .?~........... Rejnoval X... , ....... , Demolition 0~~~~. , ,t~' , , , , ¢¢~~ s ~, '~"1 4~ 000 , ....,~.... .. .., (De$C~4ption) 4. Estimated Cost .. ........................... Fee .........;....... , ..._t ,_ ~ q i ~3 ft,rt ~E7"''i,S Gt,~,'r1j""t""" (to be paid oti~filing-flits application) g, g units ..... ~ ......... Number of dwelling units on each floor ............... . 5 If darallennumbeber of dwellirJ ' g g , ofcas .. ................... 6. If business, commercial or mixed occupancy, specif~ na'tu~e and extent of each type of use .......: . .. ... Dimensions of existing structt~ ~' ' ' ' ' Hei Itt .. r7,4 ! .. `,`, , , ... Nures, if any: Front . 5~ ............. Rear , a.`} , :S.`~.... Depth .~-~.°, , g. ~, , , , , ° 8 tuber of Stories ... ~..... . Dimensions of same structure ;with alterations or additions: Front a 3.`.~ `,`......... Rear .aa ~ S,`~, , , , , , , , Height ~..! ..'l.. , • • .. Nu ...Height .v16! ~!!, , , , , , • , , , , , ,Number of Stories .....~ .............. . 8. Dimensions of entire new con Depth ... ~.. ~ • • • traction: Front ........,....... Rear ...............Depth ...... . ........ 9. Size of lot: Front,,,. ° mberofStories....... ,,,,,,, ,,,,,, ~S ........ Rear..~."~~.¢...~... .......•Depth 1.~ 9r~w'~,?~'~`.~:SJ 10. Date of Purchase N,a~,, ! p$S, , , , , , , , ,, , , , , , , ,Name of Former Owner ~R-5...~.~:~. S ~ ~`y.~ s,a~, , , . 11. Zone or use district in which ,remises are situated .. ~,- J , 12. Does' proposed construction violate any zoning law, ordinance or regulation: . N©. 13. Will lot be regraded Du ®. ,Will excess Fill be removed from premises: ® No 14. Name of Owner of premises ~y ~~~°'"~, , , , Address'~.a.$oNP.>`~..~.'" L phon o~-va--`E?-o -033, Name of Architect l..WQ}1e;-, , , , ~, .. , e~ pne ~-c(.~? :qy.~s ' ' . Addressa:\~ i`?awTt. 5't.q Name of Contractor ~~?rtN~, ~'Ti;-n~1.; Rti N arraw g~tb -3 a3° h ( 6 ..Address ~4-.`)~~ ,,~,,PPhhone No. . 15.Is this property located within 100 feet of a tidal we~Crantl? *YBS... NO . *If yes, 'Southold Town Trustees Permit may be required, I PLOT DIAGRAM 1',ocate cleazly and distinctly III buildings, whether existing or proposed, and, indicate all set-back dimensions from g~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. . ~~~ s~~~~~~a 5 ~w~~~ ~.~l.,o~s S~~ ~~~ru~ ~S_N~P.dZi OPti ~V~ I C~~'f~5~ 'Ot- -F'~ R~C ~R~M~)~ ~~W2P h1 ~OIIN C{S ~` e STATE OF NEW YORK, ~ S.S COUNTY OF ................. ' ' ' '~~'~ L~' ' ~~•' • • ~~~~~~• • • • • • .. • • .... being duly sworn, deposes and says that he is the applicant (Name of individual sig{ting contract) above named. I .. He is the ... Ow!y~~.......j ............................................................. (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 conXained in this application are true to the best of ]tis knowledge and belief; and that the work will be performed in the mann~r set forth in the application filed therewith. Swont to before me this ..........w~. 3..........day of ...~~, .a.~y .......... 1 ~~. Notary Public, .........b~~~~............ County ~~ry P~c, StateStete of~ .... .......... .......... pp ... . L DA J. CO ER York ~ ~ (Signa~ licant) No. 4822b68, Suffolk CoJnty Term Expires December 81,19_ I ;?- ~--i 1l~ ~` ~~ ~~ ~~J ~~ ~-. ttt C.1.. ~ 1.~. ~1 c;~ ~_ ~ i;, N f~ ~... ~ a.~ ~ b. r t -' i ~.i .<... ~.~ ::1.. `' ~i. ~~ +' ~ ~.~_~ ~v+~A .,<~ `14~ { rvy y ~ Y r y ~ -..-..L:~-~r.r--"` Y m ~# 3 - t ~ ' k 2 f v, - n'. ~ w~'t - ~o }~ + 1'i a ~ ~{ s ~ - s- o- ~ ~ ' 4 a~ - ~ {'~..~~ i'y ~:'' ~d y~j \/' x ~, is ~".. ,} 3v > fi ~' I~' s a fir. i ~ < .i .. e ..,~ ~ y 4~:, v r ,~ a ~ ~~ ' h.. y ' ~~ a .. 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