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HomeMy WebLinkAbout30006-ZFOpdvi NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMEN~ Office of the Building Inspecuor Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30106 Date: 03/23/04 T~IS C~ERTIFIEE t~at the building ALTERATION Loeatlon of Pr~y: 2110 VILI~GELA (HOUSE NO.) (STREET) Co%uaty Tax Map No. 473889 Section 24 Block 2 Subdivision Filed Map No. __ ~ot No. ORIENT Lot 28.1 (~ET) conforms substantially co the Application for Building Permit heretofor~ filed in this office dated JDd~3A~Y 5, 2004 p~suant to which Buildin~ Pez~ult No. 30006-Z dated JAk~JANY 13, 2004 was issued, and conforms uo all of the requirements of the applicable provisions of the law. The Occupancy for which this certificaue is issued is NEW FOUNDATION FOR AN EXISTING BUILDING AS APPLIED FOR. CONSTRUCTION CERTIFIED BY LAWRENCE M. TUTHILL, P.E. The certificate is issued to ORIENT WHARF CO INC (OWNER) of the aforesaid building. S~FOLK COIIN~i~fDEPART~ENTOF~F~%LT~tAPPRO%q%L ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA~'~U3 NJA N/A N/A Authorized 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) P~mq~TN0. 30006 z Date JA_A!UAItY 13~, 2Q04 Permission is hereby granted to: WHARF CO INC ORIENT PO BOX 243 ORIENT.NY 11957 for FOUNDATION ALTERATION/REPLACEMENT TO EXISTING BUILDING AS APPLIED FOR PER DEC & TRUSTEE APPROVALS W/ FLOOD PERMIT - NOT A SUBSTANTIAL IMPROVEMENT at premises located at County Tax Map No. 473889 Section 024 pursuant to application dated JAI~JARY Building Inspector to expire on JULY Fee $ 588.00 2110 VILLAGE LA ORIENT Block 0002 Lot NO. 028.001 5, 2004 and approved by the 13, 2005. / Au~horgzed Signature ORIGINAL Rev. 5/8/02 ~LOG. DEPi. Form No~ 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be ~ed in by typewriter or ink and submitted to the Building Department with the following: A. For new bu'flding or new use: 1. Final survey of property with accurate location of all build/rigs, property lines, streets, and mmsual natural or topographic features. 2. Final Approval from Health Dept. of water supply aud sewerage-disposal (S-9 form). 3. Approval o£ electrical installation from Board ofFire Underwfiter~ 4. Swora ~mm,ment,from plumber ce~3dng 'that the solder used ia,system contains less than 2/10 of 1% lead. 5. Commerciai bdldihg~ indnstrialbui~ding, multiple residences and similar buildings anti installations, a ceaificme of Code Comp ~liarte¢ fi~0m arch~teqt pr eJagm,eer responsible for the building. 6. Submit. Plau_r~g Board Approval of completed site plan requirements. For existing, 10,nil,dings (prior to April 9, 1,957) non-conforming uses, or buildings and "pre-existing?' land uses: 1. Accurate survey of property showing all property lines, streets, bm-lding and unusual natnral or t~pographic features, 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy ~s denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 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 $ l 5.00 ate. New Construction: Location of Property: Ho{tse No. Old or Pre-existing Building: Icheck one) Street Ha~et Subdivision _ Permit No. -.3 ~_t~G Health Dept. Approval: Date ofPerrrdt. ~/.~¢/.9~tD? Block .,~ t~O ~-"- Lot FiledMap.. Applicant: ~/¢~ Underwriters Approval: Plarming Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ,~"~O Final Certificate: ~ Icheck one') New York State Department of EnvJ, ro~m,en~l, Conservation 'Buil~ lng 40 - SUNY, Stony Brook, New York 1'~790~23~ Telephone (5'16} 444-0365 'Facsimile (516) Erin M. Crotty __NO ~R)J!T NE,C~L$SAR? - TIDAL WETLAND~ ACT AugUSt !9, 2003 Orient Wharf Company Mr, Thomas Murray P.O. Box 243 Orien,~ New York 11957 Application LD, 1-4738-03228/00001 Orient Wharf- 2110 Vffiage Lane, Orient Dear Mr. Muxay: A rewew has been made of yoar proposal to saw approximately fifteen 3'x 3' inspechon pons in the existing concrete floor located inside the building in order to inspect and evaluate the existing foundation BaSed on the information you have submitted, the New Ycrk Sta~e Department of Environmental Cdnservanon has determined that ~e project is listed in Part 661.5 of,~6NYCRR (Tidal Wetlands Land Uae Regulations) as a use not requiring a permi[ or notifica~on letter of approval. Therefore~ no permit is required under the Tidal Wetlands Act (Article 25 ~fthe Envirommema! Conservation Law), Please note that any additio'nal work or modification to the prolec~ as described, including repairs to the foundation or the installation of steel beams, pilings or other support structures. may require authorization bythis Department. Please contact this office if such are contemplated, Please be further advised that this leper does not relieve you of the resTonsibility of obtaimng any necessary permks or approvals from other agencies. Sincerely,,~ ,~ ~/{ George W. Hammarth Deputy Permit Administrator cc: Costello Marine Contracting Corp File Board Of $outhO/d Town Trustees SOUTHOLD, NEW YORK DATE: ,~:g,.gu~ 2 Q.._ ~ oo 3 ISSUED TO ORIEl. fhe Sfa~ o~ New YorE, J893~ and ~apfer ~ of fha ?~ ~ Slate of Ne~ Yor~ 1952; and fhe Soufhdd ToWn Otd,nance eh- rifled ."RE~U~TING AND ~E P~CING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC ~DS and REMOVAL OF SAND, ~RAVEL-OR OTHER MATERIALS LANDS UNDER TOWN' WA~RS~[L and in accor&.ce wiJ~ Re~o~ufJon ~ The B~r~ a~opfea afa meef~g held on g0~,~...., ~.~ in c~n~id.raflo, o~ fha sum o~ $_. ~.~.:.~ ..... p~Jd ~ostello M~ne Contrac~n~ G~rD, fo~ Q~i~/ e m~ ~.diCond,hons i,~ed .on the revere side her~f, o~ Sough°Id Town TrusSes aUf~or~Zes and perm~ {he Wetland Permit & Coastal Erosion Permit ~o saw between 12 to 15 3~X3~ inspection ports in the exist', concrete floor in order to inspect and e~ and aS depi~te¢ fhe orJglnafln Contracting Co! IN w by cause~, its be subsC.be, lUate the exist, £oundation then repair as needed on the site pl~ prepa, r, ed by Costel}o Mar!ne' with fhe deta,{ed spec {'c~tlons as pre~nted m appJicafiom - dated June 1~, 2003, TNESS WHERE., The sald Boe~ of Tin.tees Mre- Corporafe See to be ef~xed, an~ fhese ~[ese~fs fo Iby a'majori~ of fha said ~e~d es of fhts dele. ' TERMS end C,O~D|T~O~S The P~ak~e Orien: Wharf Co. Inc. ~a~_ .... P.O, ~Ox 243~ Orient NY i1957 N, Y~ ~ 4, '~b~t ~fie wodc involve ks agent~ and ao~'-eomp~h~ re~oc~tio~ of d~ P~i~ b~ t That the~ That ~ said Bo~d will be notified by the PeanI~ee oI {t~e a:~l~leg~ o~ the wodl ~udio LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER P.O. BOX 162 GREENPORT, N.Y, 11944 (631) 477-1652 Harch 23, 2004 Mr. Michael J. Southold ToWn ~in Road Southold, NY Verity, Building 1971 Department Head De~artmnet Re: 0r~ent Yacht Club Orient Wharf Village Lane Orient, NY 11957 Permit No. 30006 Z To whom it may concern: I have made several inspections, including a final inspection on March 21, 2004, in the matter of Southold Town Permit no. 30006 Z for the above mentioned premises and found all work has been com- pleted according to the plams submitted to the Southold Building Department and meet bhe requirements o~ the Southold Town Building Department and the New Y6rk State Building Code. ence M. Tu~hill, P.E. President .._~tie F~st _er Ken Poliwoda Peggy A. Diekerson Telephone (681) 765-1892 Fax (aB1) 765-t866 August 20, 2003 BOARD OF TOV, rN TRUSTEES TOV~CN OF SOUTHOLD Mr. John Costello Costello Marine Contracting Corp. P.O Box 2124 Greenpon, N~F 1 1944 ORIENT WHARF CO. INC. 2110 VILLAGE LANE, ORIENT SCTM#24-2-28.1 Dear Mr. Costello: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 20, 2003 regarding the above matter: WHEREAS. Costello Marine Contracting Corp. on behalf of ORIENT WHARF CO, INC. applied to the Southotd Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code. the Wetland Ordinance of the Town ofSouthoId, application dated July 25, 2003, and, WHEP, EAS, said application was referred to the Souhhold Town Conservation Advisory COuncil for their findings and recommendations, and, WHEREAS, a Public Hearing was he. id by the Town Trustees with respect to said application on August 20, 2003, at which time all interested persons were given an opportunity to be heard, and, WHEREAS; }he Board members have personally viewed and are familiar with the premises in question and the surrounding area~ and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and,' WHEP, EAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, safety and general welfare of the people of the town~ NOW THEREFORE BE iT, RESOLVED. that the Board of Trustees approve the application of ORIENT WHARF CO. INC, to saw between t2 rot 5, 3'X 3' inspection ports in the existing concrete floor in order ro inspect and evaluate, the existing foundation then repmr as needed, a~d as depicted on the site plan prepared by Costello Mar/ne Contracting dated June 12, 2003. Permit to construct and complete proi ect will expire two years from the date the permit is signed. Fees must be pa/d, if applicable, and permit issued withia six months of the date o f this notificatton inspections are required at a fee of $5.00 per inspection. (See attached schedule.) Fees: None VeD~ truly yours, Alber'~ J, Krupski, Jr. President, Board of Trustees AJFG'tms P.O. Box 1179 ~fie Foster ~ ~ ~ ~ Souehotd, NeTM York 11971-0959 Ken PoHwoda ~ ~ ~ Telephene (631) 765-1892 (68l) 765-I366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT Permit #5796 Date: August 20, 2003 SCTM~24-2-28,1 Name of Applicant/Agent: Costello Marine Contracting Corp. Name of Permittee: ORIENT WHARF CO. 1NC. Address ofPermittee: P~O. Box 243, Orient, NY 11957 Property Located: 2110 Village Lane, Orient, NY 11957 DESCRIPTION OF ACTIVITY: To saw between 12 to 15, 3'X 3' inspection ports in the existing concrete floor in order to inspect and evaluate the existing foundation then repair as needed, and as depicted on the site plan prepared by Costello Marine Contracting dated June 12, 2003. Permit to construct and complete project will expire two years from the date the permit is signed. SPECIA~L CONDITIONS: (apply if marked) __ Bluffrestoration through a re-vegetation plan is a necessary special condition of this permit. __ A relocation agreement is attached hereto and is a necessary special condition of this permit. __ A maintenance agreement is attached with application and is a necessary special condition of this permit. 26, 2003 SUBJECT: Joint Appllca_lon with New York State Department Environmental Conservation of edoThomasMurray 'P.O. Box 2~3 Orient, N~ 11957 Dear. H~. Nurray: . We have_recently received a copy of the Joint Application for permit you filed with the New York State Department of Environmental Conservation (NYSDEC). Please be advised we have reviewed the copy of ~he Joint Application sent uo this office by NYSDEC. Based solely upon the information provided, it appears that a Department of the Army permit is not required for your proposal. The Department of the Army regulates construction activities in navigable waterways and discharges of dredged or fill material into waters of the Un, ted States, including inland and coastal wetlands. If your proposal would involve such work, and has'not been portrayed as such in your Joint Application, you should contact this office immediately so that a project-specific determination can be made as to whether a Department of the Army p~rmit will be required. Any isquiries can be directed to thif office at (212) 264- 3912~ 3913, 6730, or 6731. Since rely, Marc 34elman Acting Chief, Eastern Permits Section DEC Appltcatiog~No,: 1-~738-03228/1 PROPERTY RECORD CARD OWNER STREET ~ ',)J ~) VILLAGE , . SUB. LOT~ ', ~ORMER OWNER ~" ;' J '~ ~ RES. SEAS, VL. ~ Value , LAND IMP. TOTAL DATE REMA AGE BUILDING COND TION FARM Acre Value Per Value Tillobie 3 . Woodlond '~wompt,ond . ~ FRONTAGE_ 0N WATER Brus~lond FRONTAGE ON ROAD House Plot. DEPTH ' BULKHEAD Total , DOCK. ........ , 24=2-28.1 9/00 tndation Both M. Bldg. ~ /g&O Extension ('T~.~-~ ~ ~ Basement h/~ Extension ~0 Ext. Wails interior Finish -- ~. t 0¢) ~ Place Heat ~ ~OrO Type Roof Rooms 1st Floor Rqoms'2nd Extension Porch Porch Breezeway Garage Patio Total Dormer Driveway Dinette BR, ORIENT HARBOR THE ORIENT WHARF ORIENT HARBOR SITE PLAN PREPARED BY: I JOB 1 SITE ADDRESS APPLICANT: OOSTELLO MARINE CONTRACTING CORP. ORIENT WHARF COMPANY, !NC, P,O, B, OX 2"[24 GRI~ENPOR~ NY-11944" P~O. EiOX ?,43 (2110 VILLAGE LN.)j OFtlENT WHARF 631-4,77-!~99 ~ ORIENT, NY 11957 COMPANY, INC. · , ~,. ~IT. Y ? TO~/ CLEI'LK ' THIS SOUT OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD is TO GERTI~ TliAT THE FOLLOWING RESOLUTION WAS ADOPTED BY TIlE ~IOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST Z~, t993: ~ZSOLVED that the Town Board of the Town of Southold hereby adopts (2) new forms to be used under ti-in Flood Damage Prevent. regulations the Code of the Town of ~outhold: ,,"Floodplain Developmen3 Permit plication" [FDP(93)], and "Certificate .~F/ Compliance for Development in )ecial Flood Hazard Area [C/C(93)]. Judith T. l:err¥~' Southold Town Clerk August 2~, 1993 TOWN OF $OUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. ~ECTIQN 1: G_ENEL.~---L PROVISIO_N~AP?LICANT to mad and ~ __ L No work may start until a permit is issued. 2. The permit may b~ revoked ff any false ~tatement. s are made herein. 3. ffrevoked, all work must cease tmtil peter ix r*-ksued. ~}. DeveloFment shall not be ttsed or occupied until a Certificate of Compliance ix issued_ 5. The permit, will expir~ if hO work is commenced wltkin six moaths of 6. Apph~eant ix hereby informed that other permilx may be required to ful~,ll local, stare and federal regulatory requiremen~ 7~. Appllcant hereby glve~ co~tsent to the Local Administrator or his/her repr~eatadv¢ to make ~:easonable insl3ecfion~ required to verify complLance~ - 8. I, THE. ApPLICMdNT, CLeSR~ THAT ALL STATEMENTS HEREIN AND IN A'I'TACI-IM .IE~qT$ TO . 'IT-lIS APPL2C_.ATION ~ TO THE BEST OF MY KNOWI.,EDGE, TRUE AND ACCURATE. (AJ'P LIC-ANT? SIGNATURE) ' ' DATE SEC?ION 2: P..gOPOSED D_EVELOPME_~k[~FFo be completed .by APFLICA/~W) NAME AJQ_DRES. S TELEPHONE _.PRO/ECl' LOCATION__: Fo ~void delay in preceding the application, please provide enough information to easily identify the ?reject alien. Provide the ~treet address, lot ~umber or legal d~cription (attach) and, outside urban areas, the ~Nt~aca to the nearest intersecting road or va:Il-known l~dm~rk. A sketch attached to d2N application sho~i-ng thc project loc. alien would be helpful. FDP(93) APPLICATION PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): STRUCTURAL DEVELOPMENT ~,CTIV1TY El New $£ructur¢ [] Addltior, Er'~teratioo [] Relocatiou IZI Demus[i~oo: ' ~TRUCTUR~ ~c~E 0 Residential (1-4 Family) 0 Residential (More than 4 Family) [] Non-residential (FloodprooFmg? ID Yes) ID Combined Uae (R.~idential & Commercial) FI Manufactured (Mobile) Home (In Manu- fattured Home P~k?- ID Yes) ESTIiVL~TED COST OF PROJECT DEVELOPMENT ACTIVITIES: {3 Ftll 151 Mining O Drilling 1~3radlng IZ1 Exoneration (Except for Structmal Development Checked Above) -- ID Watercotu-ze Alteration (Including Dredging and Chamael Modificatior~) 0 Draimtge Improvemen~ (Indudlng Culvert Work) [] Road, Street or Bridge Com~truction [] Subdivision (New or Expansion) ~'Other (Please Specify) ,~,..~ ~'~a,o~- _ ~ ter complethag SECTION Z, AJ>PL[CANT should submit form to Local Administrator for remco,. Cq'ION 3: Fw.X)ODPLAIN DETERMINATION (To be completed bv LOCAL ADMINI$_TRATOR__)_ T lc proposed development ks lo<eared on ~ Pa~¢[ No.__ , Dated Tie Pzopo}ed Development: [] L~ NOT_ located in a Special Flood H~.ard A~ea (Notify the applicant that the application review ix complete and NO FLOODPL.A.D~ DEVELOPMENT PEartMiT IS REQUIRED). [] Ls located in a Spedal Flood Hazard Ar~.a. FTRM Zone designation is 100-Year flood cleva6ou at Lbo site ks: ' Ft. NGVD (MSL) O Unavailable [] The proposed dcveiopmem is located ia a floodway. FqgFM Pamcl No. Dated Sec Section 4 (or additional instructions SIGNED DATE APPLICATION PAGE 3 OF 4 ~ECTION 4: ADDITIONAL INFORMATION REOUIRED (To hc completed by LOCAL ADMINISTRA~TORj Thc applJc&nl must submit the documents checked below before the app[icaoon cram be pro;essed: site plum showing thc location of all existing structures, water bodies, adj3ccat roads, lot dimonsious and proposed development. 1:21 Development plans, th-awn to scale, and spedfications, including where applicable: details for amchoring structures, proposed elevation of lowest floor (indudlng b~sement), type~ of water resistant materials used below the first floor, detailx of floodproo£mg of utilities Ioca ted below the ~'st floor and details of enclosures below thc: fu-st floor. [] Subdivision or other development pla.us (If the subdivision or other development exceeds 50 lots qr 5 acres, whichever is the lesser, the gpplicant must provide 1.00~ye~ flood elevatiohs if they a~c eot otherwise avadlable). FI Pla~ showing the extent of watercourse relocation and/gr landform alterations. [] Top of new £dl elevation Ft. OVD [] Floodproof'mg protectlon level (non-residential only) Ft.;NG~ (MSL). For floodproored structures, appticant mnst attach certification from registered englnee{., or [3 Certification from a rcg:kstercd engineer that the proposed activity in a re~gUJatoryj~oodway will not result in .a~0g increase in the height of the 100-year flood. A colby of all data and calmflatiorm supporting~ this finding must also be submietcd. [] Other. SECTION 5: PERMIT DETERMIHATIOH (To t~e completed bY' LOCAL ADMIN[~qTF, KTQR) I h~ve determined that the proposed activity:. A_ [3 Es B. [] Is not in conformance with provisions of Local Law ~ ,19 . The permit is issued subjecti tothe conditions attached to and made part o£ this permit. SIGNED , DX'~E f[[~O× A i~ checked, thc Local Adminhtrator may issue a Development Permit upon payment of designated fee.. If BOX B i5 checked, th: Local Admirtlstrator will provide a ',witten summm7 of d¢ficiencic-s. Applicant may r=vis¢ and resubmit a~ appl~cat on to th~ Locml Administrator or may request a beackng fr6m the Boasd of AppeaJs. AFFEA.LS: Appealed to Board of Appeals? O Yes {2 No H ~axing date: Appeals Board DeCision _2_ Approved? {J Yes Conditioas APPLICATION PAGE 4 OF 4 ~CTION 6.~ A~d~UILT ELEVATIONS {To be subm ~ed by APPLICANT b~forc Certificate of ~5 fo~o~g ~o~a~on m~c be pro,ded for project st~ct~. ~ s~on m~t be ~mpl~t=d hY a r~st~red pkof~i0n. M ~n~cr or a ~c~ed [~d s~eyor (0r atta~ a ~r~on to ~ apportion). C~mplete 1 Or 2 b~ow. L ~ctu~ (~.Bu~) ~fioa of ~e top of ~e lower fl~t, hda~ b~e~.~n ~astal High ] ~eas, ~tom 0f loW~ S~~ mem~r of the lo~t fl~r, ~du~g p~g ~d c~) L [ ' A~u~ (~*BuOt) Elevation of fl~prooFmg prote~ion ~ ~. NG~ (MSL). NOTE: ~y w~rk performed prior to submittM of ~e aboTe ~ ation ~ at the r~k of ~e Applier. ~ION 7: COMPL~CE A~QN ~ be com¢leted~ ~C~ ~LO~ ~M[~I~TOR ~ complete t~ se~ion ~ app~ble b~ed ou ~pe~ioa o~ ~e cnmp~ Mth ~e ~mm~s 1~ law for flood d~e preventioa. DA~ BY DE~CIENC~ ~ ~ ~ NO DA~ BY DE~C~N~7 ~ ~ ~ NO SE ~E~'ION Ii: CERTIFICATE OF q/OMPLIANCE{To be completed b,~ LOCAL ADMINI:~;TRATOR~. ~ficate of CompUance i~ued: DATE: BY: Attachment B ~A/<PLE CERTIFICATE OF CO~PLIA/~CE for Developmgn~ in a Special Flood Hazard Areh TO~N OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECL&L FLOOD HA.ZAJLD A_REA (O~rt'tER MUST RET.kIN THIS CERTIFICA~) 'PREMISES LOCATED AT: PERMIT NO, PERMIT DATE !w Rs NAME AND ADDRESS: THE LOC,iL ADMINISTRATOR CHECK vi NEW BUILDING [] EXISTINg' BUILDING [] VACANT LAND IS TO COMPLETE A~ OR B. BELOW:, COMPLIANCE IS HEREBY CERTIFIED WITH THE REQuIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: COMPLIANCE IS HEREBY CERTIFIED WITH THE P,~QUIREMENTS LOCAL LAW # , 19__, AS MODIFIED BY VARJA. NCE DA. TED SIGNED: DATED: OF C!/C(93) ~O~DA~ON OST~ FOUNDATION D) ROUG~ F~G & ~S~ATION PER N. Y. STATE ENERGY CODE _ , NY 1'1971 TEL: (631),765~1802 (631) 7 75o2 , northfork:net/Southold/ Examined Approved_ Disapproved a/c Exp~aff6fi_ PERMIT NO. 3o,=o 6 ~_. -'"'~,'UELDING PERMIT APPLICATI0~ CI~. CI~IST Do you have or need the i'allow~g, .bcfo;e alyply/ng? Board ofHealtb' Af~ _ 3 sets of Building Plans planning Board approval Survey Check septic Fo/m N.Y.S.D.~.C. Tnisfees Contact: Mail to: APPLICATION FOR BUILDING PERMIT . T0W'~ '~= ~';~OLO INSTRUCTIONS Date _, 20 a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, acenra~e plot plan t0 scal~. Fee according to schedule. b. Plot plan showing location ofiot and of buildings on prem/ses, 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 btdlding 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 nmy 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 Bulrding 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 re comply with all applicable laws, ordinances, building code, housing code, and regkdafions, and to admit authorized inspectors on premises and/ri.building for necessary inspections. c2,e! ,T P z-fir (Signature of applicant or name, ~f a cor~oratio(a) (Iv~aili~g address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises fg]~ / '_~N/- {.Z.)/4ft~i~ f~ '.~,'~/71R~N\/, . ~ Nd (As on the tax roll or~atest dged} ' I.f-a~rolicant isa comoration~gnature of duty author/zed officer (Nalne and titYe of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which ,proposed worli will be done: House Number Street / T Hamlet County Tax Map No. 1000 Section Subdivision _ /,//'~ (Name) loci & · o1 / Filed Map No. ~./~ Lot "-pz//// St~/te ~5~isting use and occupancy ofpr~em~ses and mtended use and,occupancy of pr. opos.~_~ c~s.~ct~o~, 2~ a~ Existinguseand-o~¢upancy ])/1~11t~[-~- ~ g. t)~ ~OIJ&F~l ~l~-~g/ff~Tl~d~-~l'~ ~~' b. hntended use and occupancy .'5'~),~/-2- AS ,~/30//'~- Nature of work (check which applicable): New Building_ Repair ~' Removal DemolStion Estimated Cost ~ ~,~ ? If dwelling, number of dwelling units ~/~//At If garage, number of cars /'///4 Addition Alteration Other Work Fee (DescrilYdon) (To be paid on filing this application) Number of dwelling units on each floor A/~ Ii [fbUsiness, commereial or mixed occupancy, specify nature and extent of each type of use. ~ ?~,/~ i[. /¢z~o~ ~- Dimensions of same structure with alterations or additions: Front Depth ~t,,~t~ Height Dimensions of entire new construction: Front A/J/~ Height ~?-~ Number of Stories Size of lot: Front .,~'-, ~q Rear /.~), _~ Rear Number of Stories ..~ Depth ). Date of Purchase ~t~ ~ Name of Former Owner Zone or use district in wb/ch premises are situated Does proposed construction violate any zoning law>,~ordinance or regulation? YES__ NO / Will lot be re-graded? YES__ NO 1/ Will excess fill be removed from premises? YES NO [. Names of Owner of premises O-~l~lVT I,~P~)~.'~ &. Address O~t~'~'F~7, ~Z-~( Phone No. Name of Architect ~¢¢~5L.'~// - Address_~&,~.~½,~,V~. Phone No ~3}-~- Name of COntractor ~r~J~ ,l~t,.~llryp/~ Address d~r~f~r;P'-' Phone No.da$/-~ 11 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. Isthispropertywithin300feetofatidalwetland?*YES b'r NO Provide survey to scale, with accurate fouqdation plan and distances to property lines. , e. tion any p :nt on is : ee;or e o ¢ de tupograp ¢al d ta on P~ being duly sworn, deposes and says that (s)he is the appfigam (Name of individual sivn~ug contr~4~St))above named, said owner or owners, and is duly authorized to perform or hav'~ performed the said work and to make and file this application; ontained in this application are tree to the best of his knowledge and belief; and that the work ~ill be e mann?, r set forth in the application filed therewith. 2oOc, Notary Public Claire k. Glew ' Notary Public, State of New No. 01GL4879505 Qualified in Suffo k County Commission Expires Dec, SignatUre o~-~ ~pplicant "THE ORIENT I, NHARP" 51TUATt=: ORIENT TOI~IN: 50UTHOLD ,50FFOLK C, OUN'T'¢, N'r' N · ......... PILIN® ®F~-APHIC SCALE r"= 5o' JOHN C. EH[,ERS LAND SURVEYOR 6 F~ST MAIN STREET N.Y.S. L[C. NO. 50202 RIVERHEAD, N,Y. 11901 369-8288 Fax 369-8287 REF.-\~ItP SERVER~D~ROS~99-246.pm PPROVED AS NOTED DATE: th~ J~ B.P. # ,:z,-%.-~.~.~ ~ NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE NEW "©~K STATE & TOWN CODES AS REC ,,;gEE ~'.'2 CONDiT:ONS OF .'.D TOWN ZB'- FOLLOWING INSPECTIONS: ,. FOUNDATION - TWO REQUIRED 2.3. INSULATIoNROUGH' FRAMING I PLUMBING BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR USE tS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY CERTIFICATION OF NAILING & CONNECTIONS REQUIRED, ALL C©?- .... LIALL MEET THE RLub, , -, .... o OF THE CODES OF NEW YORK STATE. , ('T') ,£ v-" slab £ ~co/e :~ g G ~ I°