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HomeMy WebLinkAbout28183-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29901 Date: 12/10/03 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 420 MILL CREEK DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 135 Block 3 Lot 45 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 2002 pursuant to which Building Permit No_ 28183-Z dated MARCH 14, 2002 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 FRONT AND REAR DECK ADDITIONS AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOEL D PERELMUTH & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1120849 08/01/03 PLUMBERS CERTIFICATION DATED N/A J Authorized Signatur 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. 28183 Z Date MARCH 14 , 2002 Permission is hereby granted to: JOEL D PERELMUTH 440 WEST 22ND STREET NEW YORK,NY 10011 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 420 MILL CREEK DR SOUTHOLD County Tax Map No. 473889 Section 135 Block 0003 Lot No. 045 pursuant to application dated MARCH 12 , 2002 and approved by the Building Inspector. Fee $ 264 . 60 r uthorize Si e COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 4 3 APPLICATION FOR CERTIFICATE OF OCCUPANCY i_ 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and"pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and 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. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 Date. New Construction: Old or Prete-/existing Building: n check one) Location of Property: zy0 House No. Street Hamlet Owner or Owners of Property: �),q t L �&P/��V/�Zx ? t Suffolk County Tax Map No 1000, Section /3 } Block / Lot y 7 Subdivision Filed Map. Lot: Permit No. fl 3 Date of Permit. Applicant: Health Dept. Approval: / Underwriters Approval: Planning Board Approval: Z(checkone)Request for: Temporary Certificate Final Certificate: 1 Fee Submitted: $ � , J r � �� 69 Applicant Signature O rJ�r�r�rJ�PcP�nrJ�cPrJ�rJ�rJ�rJ�r�rJ@PrJ�rJ@nrJ�rJ�rJ�rJ�rJ�rJ�rJrJrJ�rJ�r nc l@nrJ�rJ�rJ=r��lrJ�rJrJ�r�rJ@ncn�nrPcPr�rlrJrJrJ�rJ@PrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ� o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 rj BUREAU OF ELECTRICITY S 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT Upon the application of upon premises owned by 5 5 C-CAT CO. JOEL PERELMUTH 5 5 9280 SOUND AVE. 420 MILL CREEK DRIVE MATTITUCK, NY 11952, MATTITUCK, NY 11952 5 Located at 420 MILL CREEK DRIVE MATTITUCK, NY 11952 eS 5 Application Number: 1120849 Certificate Number: 1120849 55 5 Section: Block: Lot: Building Permit: BDC: NS11 S Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring,described below, located in/on the premises at: 5 First Floor,Outside, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 1st Day of August, 2003. C5 5 Name OTY Rate Rating Circuit Type 5 5 1j Alarm and Emergency Equipment �5+ Sensor 1 0 Carbon Monoxide 5 5 5 Sensor 1 0 Smoke 5 Appliances and Accessories 5 Dish Washer 1 0 1.2 KW 5 5 Range 1 0 6.5 KW �5 5 Electric Heater Baseboard 3 0 .75 KW 5 Electric Heater Baseboard 2 0 .25 KW 5 Exhaust Fan 2 0 F.H.P. 5 5 Wiring and Devices C5 Receptacle 9 0 General Purpose lj 5 5 Switch 10 0 General Purpose Fixture 8 0 Incandescent 5 Fixture 2 0 Fluorescent 5 Cj Dimmers 1 0 S� 5 Paddle Fan 1 0 5 5 Multi Outlet System 5 0 FT seal 5 Receptacle 3 0 GFCI S 5 I of I 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. o cncn�nrnrJcnrJ�rJ�rJ arJr:11 :1 �rJr�r�r:rJ�rJrJ2ncnrJr 111 rE I- - -I-J:cPrJZ1cn�nrJ@PrJarJrJrJ arJrJfl it irJ�rJr�rJfflMPLLrL3r�cPL3rL3 PrJ@ncnr Prr PLP El APPEALS BOARD MEMBERS �pS�FFU(,�c Southold Town Hall �d Lydia A. Tortora, Chairwoman o y� 53095 Main Road Gerard P. Goehringer H = P.O. Box 1179 George Horning O .1c Southold, New York 11971-0959 Ruth D. Oliva _0� ZBA Fax (631) 765-9064 Vincent Orlando Telephone(631) 765-1809 http://soutlioldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 23, 2003 Appl. No. 5252 - Patricia Jaeger (J. Perlemuth) Property Location: 420 Mill Creek Drive, Southold Parcel No. 135-3-45 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 14,897.11 sq. ft. parcel is located on the south side of Mill Creek Drive in Southold and is improved with a one-story frame house and garage, as shown on the July 30, 1997 survey prepared by Joseph A. Ingegno, L.S. BASIS OF APPLICATION: Building Department's October 9, 2002 Notice of Disapproval denying a permit to construct front stoop additions at less than 35 feet from the front property line. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 16, 2003, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: Applicant wishes to construct a new front stoop areas 66" x 9' and new roof on a 5' x 8' porch, at 11 feet from the front property line, at its closest point. The dwelling is presently 10'5" from the front line at the most westerly comer. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, 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 a detriment to nearby properties. The existing enclosed entrance will be replaced with this newly renovated entrance as shown on the sketch dated 1/13/03 by Elizabeth Thompson, Architect. The setback of the new entrance is in line with the established front yard setback of the house as exists, and is parallel to Mill Creek Drive. Page 2 -Januan 23.2001 nppl. No. 5252 -P. Jaeger 115-145 at SOuthold 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The survey dated 7/30/97 prepared by Joseph A. Inegegno, L.S. shows the existing setback of the house at 107' and 10'5", and the new entry areas are proposed at 11 feet. 3. The variance granted herein is not substantial because the home already has an established setback of 107' from the front lot line, and this established front setback is not being reduced. 4. The difficulty has been self-created because the property was purchased with knowledge of the nonconforming closeness to the front lot line and the code requirement of 35 feet. 5. No evidence has been submitted to suggest that the proposed additions will have an adverse impact on physical or environmental conditions in the neighborhood because the small renovations/alterations do not change the character of the dwelling or residential area. 6. Grant of the requested variance is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of new front entrance stoops, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Chairman Goehringer, seconded by Member Oliva, and duly carried to GRANT the Variances as applied for and shown on the plan prepared by Elizabeth Thompson, Architect dated 1/13/03 (as revised). This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Tortora (Chairwoman), Goehringer, Oliva, and Orlando. (Member Homing of Fishers Island was absent.) This Resolution was duly adopted (4-0). LydiffA. Tortora, Chairwoman 31 .7 /03 o�gUFFO(,�co Town Hall,53095 Main Road Fax(631)765-9502 P.O. Box 1179 • Telephone(631) 765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Building Permit No. C2 a 3 Owner: /-)0"/ (Please print) VA p _ L/L Plumber: VAIy Chu✓ fbe/1 7oe8—tf (Please print) I certifv that the solder used in the water supply system contains less than 2/10 of 1% lead. /�- (Plumbers Signature) Sworn to before me this day of / 1�, 20_ Notary Publi ounty JANET E .^TAPLES No!27 PLSL c.'Nov,Por, No.4331 Cs s:oGt Cowty �/ �lnuukn E.�4es July 31.20d•7 Elizabeth Thompson, Architect 250 Mercer Street, Suite B 806 Tel/Fax 212-614-7180 New York, New York 10012 ETArchitectQnyc.rr.com. 314C)s �i4x To : >*Ou �r✓Dcr . Ae�f' Z �� �Ct.Crt7t u t�L► — �C 2C"LA4 u Tt!- RCS t D G Gt1 - Tl4tLS 4S P�sZ t�>✓ � �Rtfs�N14'C . Go PI 'r6 -Fot,cow g'7 MAIL- e, t mew fW" poemt To � wf.*t4A 4 PI'ff.1 M. To MIS Wi ►.l�N 1}�4DgIZS Z-2x12 Iw Z rr PIFPgiogb X046 G,u1rs ', WRY .9"M p�.r� Ex1�r.sNu�f�a To MA�t.N pclsT, vDW. Aoe;g- MTM L� Fj { THOMPSON 'f,�t 3/11/031/4 u,1,o 1 ARCHRECT paviaeb sj;z/c3 iso YodeMY. 0012 New reAc, Nr 10012 Tel/Fax2l2-614-7180 _ 3- s TOWN OF SOUTH QOPERTY RECORD CARD OWNER STREET VILLAGE DISTRICT SUB. LOT t 1r LT FO EROW RCS-rte C✓t.a ✓cF� ; E ra ff S t e +t i V i c ACREAGE Os tt- Y. _3 6 S W TYPE OF Burt-DING Y RES. SEAS. VL ^ FARM COMM. I IND. I CB. I MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS Z — dQns .Est to Sa rsle Iv AB O/V FR NT R ori. tip 4w n5 �sf ><v Sr�P�s�eC2Lc1 Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 I b p BULKHEAD Tillable 2 DOCK Tillable 3 g � 0/7& P a3O3 -addLler�� � rt�� lt;;.� Woodland A 4 S Bu,Cf� Swampland $ g 8� ' i Brushlov d House Plot oe,v O %L 3 N 6P# P8183 - l�r(�}�"a„ /alter✓ Total ■■■�- ,��; N�s�■�■ate , �'�� NSI■Nr�__ Foundation: .. 77976 T� Both P • :• Floors f•'�L�i e .xtension X Ext. Walls Interior Finish PorchiRoof Type Porch Rooms 1st Floor x 2z ®® •• • Rooms 2nd Floor ® Driveway Dormer B. -_ ft ® fi _ ----APP Sx(o 156LM 19)(611W4 21D64 f05WAdt, 14 PLACS � 41l.06 It�'D.6,ou�e 51DE f UPK PL& PAFT 7h iib"o.G IZ ApQy/vE4orEseoR Iusut..sPAtr: to fl E'SNawcG- ,fit H1DeSBAW t 1/Za MAW U6 Bo1�S W/ Veetic�+. Zxeo w DUE SUP E UHOVGco ZKIe Cil."o,c GlG , R4Ftr�S �I1(IW4 5P a �t 12SI lOW INMJ IhTo�Y "P�GdCa�1F.L11 . . J/ EUZAS tf'H THOMPsON li/�(oZ 250 Memw St.08M Newyork,NY 10012 Tel/Fax 212-6147180 T CO - - s W64 am poefist10 ?o HAVki --=•� N6�Y suurr�s P.E►,atn Ex�s'f.sµutfE� _� Ta HATe44 EXIST, u'RSV. n4� /r6pjL6 ELIZABETH THOMPSON ?l/II fo�7 11¢11"Ol) ARCHITECT 250 Mercer St.#6806 New York, NY 10012 Tel/Fax 212-614-7180 FORM NO. 3 NOTICE OF DISAPPROVAL DATE: October 9, 2002 TO: Joel Perelmuth & Patricia Jaeger 420 Mill Creek Drive Southold, NY 11971 Please take notice that your application dated September 20, 2002 For permit to construct a front entry addition to a single family dwelling, currently under construction at Location of property: 420 Mill Creek Drive, Southold, NY County Tax Map No. 1000 - Section 135 Block 3 Lot 45 Is returned herewith and disapproved on the following grounds: The proposed front entry addition on this non-conforming 16,988 square foot parcel in the Residential R-40 District, is not permitted pursuant to Article XXVI Section 100-244 which states that non- conforming lots, measuring less than 20,000 square feet in total size, require a minimum front yard setback of 35 feet. Plans note a proposed setback of 33 feet. Currently, the applicant has an open building permit application to construct additions and alterations to a single family dwelling with a front yard setback of 37 feet. Total lot coverage, following construction, will be +/- 12 percent. 2 Au orized Sign Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A. BUILDING PERMIT EXAMINER CHECK LIST DATE ISSUED: /02 DATE REVIEWED: :E:/�/02 APPLICANT: E i���_�s����c DATE"•SUBMITTED: ? ',-' /02 SCTM# DISTRICT: 1,000, SECTION: _L55, BLOCK: _�, LOT: �S Mrt� STREET ADDRESS: ALO I`- , 4 cicy k' CITY: t.to1.T7 SUBDIVISION: ClLQ?llN i PROJECT DESCRIPTION: � ��r G.F r'rC,PI m� zsl tL.ri.Ca ettilt� ESTIMATED PROJECT COST4 10 K RCHITEC /ENGINEER: 1+>cxv1P 5c 5N FAST TRACK? No SINGLE & SEPARATE CERTIFICATION-REQUIRED? n/c, NOTES: LOTS 40,000SF-100-24.t.ot recognitfon.(('REATED before June 30, 1983),IJNDERSIZED LOTS FROM JAN.]997 100-25-Merger.(A nonconforming at any time after 7/1/83) ZONING DISTRICT: R-tlo CONFORMING? REQ. LOT SIZE: w�ACT. LOT SIZE: ISI ,8`493 REQ. LOT COV. t:''o 01, ACT. LOT COV. REQ. FRONT 5 PROP. FRONT REQ SIDE o(&- ACT. SIDE _ REQ. REAR 3'S PROP. REAR NU CN�VN�-E /N JPO vT i?�'/NT -- WATER FRONT? NO DESCRIPTION: ZV4-Ae.. 1,;wwAex �iY�- PANEL #: /SQA FLOOD ZONE:__ , — APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES o1 10 (BED #):_DTE:—/_/ PERMIT #:R10- TOWN SEPTIC RECEIPT: Y or® NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or O SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or O TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES ot O NYS ENERGYerCDOR NO : EGRESS (18 H min.? 4 sq total) VENT (SQ. FT. x 4%) LIGHT(SQ. FT. x 8%) BUILDING PERMI PEN/EXPIRED: BP qS"o -Z/C/0 Z-r5 3( IJ /-D HAVE PRECO'S(YN 2Ll6rj I BP 6*4Z/C/0 Z-Qy6'SD As» IkL, " A-T I3tT " NOTES: / ' NfEpS NyS >rt.i c L i FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: /232 SF FEE FEE FEE 1. ( ' ?-5 2 SF)- ( a-IV SF)= Je.-2 SF X$ , ?J=$ I do +$ /,;O +$ _ $ .7C V. 6' 2. ( SF)- (_ SF)= SF X$—=$—+$—+$—= $ M-1802 BUILDING DEPT. INSPECTION j [ ] FOUNDATION IST [ - ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION [ FRAMING FINAL [ ] FIRE & CHIMNEY REMARKS:(, '>/% � i DATE !/ INSPECT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO H PLBG. ( ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE j INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU7ATION PLBG. [ ] FOUNDATION 2ND [ ] INS [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIM I Y REMARKS: AW DATE i�) 1 INSPECT l M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO=LATION LOG. [ ] FOUNDATION 2ND [ ] IN [ ] FRAMING FINAL [ ] FIREPLA HIMN REMAR DATE �� v INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS SL% 0 ro FOUNDATION(1ST) - — -- -- _ u -------------------------------------- FOUNDATION ---------------------------------FOUNDATION(2ND) — - - -- —_ � O - 7 ROUGH FRAMING& PLUMBING /���"��������tis, ✓— � y r INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS -ill/3zo m - 17 r ` b m r b TOWN OF $OUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502G2 survey PERMIT NO. O 0-s Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 20 Mail to: Disapproved a/c Phone: Expiration ,20_ f� 7 !t I��?___� �� ` I n I Building Inspector {�rl; NIAR I ? 7.002 J APPLICATION FOR BUILDING PERMIT Date 3/if 20 OZ 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 n e,if a corporation) e5O WtEPcg(Z ST. iS go6 N`f N`f 1vo�2 " (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder �eetlltcCx- Name of owner of premisesM�RTvt! n (tg o (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. T Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 4&0 Mlu C--MEV= bVA E SOUTR %,'L*'5 House Number Street Hamlet County Tax Map No. 1000 Section 13 S Block b-ZLot 4 ei Subdivision HtL4- 6AMIt-0ti!1 Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy SI u e ya- f-AM i t,ti bwE u..t ti c b. Intended use and occupancy S1wGLee; T:*ftts!t( 1>wI-ylA n1 C. 3. Nature of work(check which applicable): New Building Addition Alteration___ Repair Removal Demolition Other Work (Description) 4. Estimated Cost 1010MV 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front `5 t, " Rear toy'-`" Depth 9-4 ' Height 15' Number of Stories I Dimensions of same structure with alterations or additions: Front 6S -`" Rear Depth A41 Height IT, Number of Stories I S. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front IZ4.,54 Rear 121 .C,-s' Depth 145 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 law, ordinance or regulation? YES_NO X 13. Will lot be re-graded? YES_NO--X-Will excess fill be removed from premises? YES_NO__Y Paratcu a Ye 6Er- 979'\V6sT Coil, 406 14. Names of Owner of premises Peeec Address wv mf Inoz,S Phone No. ZIZ -%6-877 ' Name of Architect Eu7,45en1 Address ZsY ha�es2. BSo(o Phone No 2lz -61 1 -"ll Ko cEUTaE s Name of Contractor_ DAnt Finir.�E Address�Ee„?eoT, .�� Phone No. [s31 ­411- 4790 11149 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO — • IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ^/� Eft z A2PT'I F Tikm spo l 4 thi IT tT being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe AeCAIT'rC-T (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 q � day of, 7leic�, 2002-1 ,/1 tary Publhic JOYCE M.WILKINS Signature of pplicaht Notary public,State of New York N. 4952246,Suffolk County �617kt.M�q� C 6SI SAX$ y��� it J tiV EuzABETH THOMPSON ARCHITECT 250 Mercer St.#8806 New York,NY 10012 Tel/Fax 212-6147180 uT9�t DEUR TO 0Atc, �1 � DINT M bio ` , �v io LPtii' 4,0 Sl 30 :. ° • Ike ADO �^- �%= � +� ' :� ,�' • . ' • �..''- " -�-'�_ o��(' Ao vt ,p� s OZ. Sam O �: .. �• '� � r.,. s -,�� .`.� '.. Qom' /` ,};// Y '?y ` 'l�n•..\ *-.�' .ft`•1 / o. h '• �i. 'I��.1. '`.si J .c to ' '�~* ..� .• � .._ ra.r,-.....vim...__`...-v..�. - _� �. _J_'^ L O . 4('U-7nk OFF/CE OCCUPAN -- " USE IS UNLAMUL R C ERS RI UNDERWTENFlCATE OF OCCUPANCY v1THOUTCERTIFICATE REQUIREDr , ". F µew EI11PV( paZm,- f- 100 - ' Pw4w I"U" 6610f4p GxIS1, LAAVG OT N POLLOWINOINSPEC I•ON& Poi F SHl UG ES UNDATION . TWO REGMM{0 PI (G1 11a HA16 - PO UREDCONCRETE GXl�yrl l�5 i NSUUITIONRANING i PLUMMNN CTION Im ALL CONST UCTION SHALL NW ❑ THE REOUI TRUCTIN OF EN W STATE CONSTRUCTION i ENE116Y dl-I DESIGN OR STRUCTNACODES, Nor ILFA M \ \ pECoPd1lvE �ouD HG\VsNUTTERs PXIs1,SµU1f6Es' Imre. P xFAB P�r� 1e; M kfG V EXIST PROVIDE OPENINGS FOR EIRCAPE S REQUIRED BYPART.714 of PLUMBER CERTIFICATION N.Y. STATE BUILDING CODE.ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USFI) IN ` IATER SUPPC.Y ow wNOT EXCEErj 2i LEAD. \ PLUMBINGALL PLUMBING &WATER LINES NEED , TESTING BEFORE COVERING \ �E� T I JK 3-> PROVIDE ANTI-SCALD AND/OR jNERMALSHOCK PREVENTING P2v6 DEVICES T TE To BU Aw�ODE- N.Y.STATE BUILDING CODE. I I l l I �2� Vy `v6 DN P flt=hl4 QI R- � It copper tubing is used sNw2, N1Arc 1a\\ svrwater distping Shell I I stn of types K or Lonly GuEk�.ouf >S Nom, \ UNDERWRITrkSCERTIFICATE PROVIDES OItE-DETECTING kCQUIRED ALA M DEVICES AS TO PART.721.1 N.Y.S BUILDING CODE. DO NOT PROCEED WITH FRAMING UNTIL SURVEY 3 I'I UMF�I �IG ��E2 PIOG M /i hltu PLA14 I.0 ( lox - 135 o3 -q5 OF FOUNDATION LOCATION I U T `� �I,T,S 3AZ �Gtz6S HAS BEEN APPROVED. r; , 01 � rr Job Date Elizabeth Thompson . 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Architect AZa NIu C EK PWVE VbIll r 250 Mercer St. Suite 8 806 Tlue scale New York, NY 212-614-7180 ! , 10012 ETAichitect@nye.rr.com I'',o©R... Pl.�ll l I/IUrI'-Lq - 3�IS�ov EuZABE H THoMPsoN ARCHI=T 250 Mercer St.56806 ' New York.NY 10012 z Tel/Fax 212-6147180 N'I' t14R�t PEU%- 'fv hA1� a 8 2002 fV13o9L _ _ A1N i a 4 — — — ��. 3 iSlibN �LL P,4UE. VN yo . Plink 40, rr N