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28562-Z
FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPD~TMENT office of the Building inspector Town Hall Southold, N.Y. CERTIFICatE OF OCCUPANCY No: Z-30275 Date: 07/01/04 TN_IS CERTIFIES that the buildin~ Location of Property: 22950 MAIN RD (HOUSE NO.) County Tax Map MO. 473889 Section 18 ACCESSORY ORIENT (STREET) (~24LET) Block 5 Lot 10 Su]~d/vi~ion Filed M~p Mo. __ LOt No. __ conforms substantially to the Applicasicn for Building Permit heretofore filed in this office dated JuLY 12, 2002 pursuant to which Building Permit No. 28562 Z dated JwJLY 17, 2002 was issued, and conforms to all of the requirements of the applicable provisions of the law_ The occupancy for which 5his certificate is issued i~ ACCESSORY SA!qAGE AS APPLIED FOR PER ZBA #5132 DATED 6/20/02. The certificate is issued to JOSE & IVONNE ~EP~NANDEZ of the aforesaid building. ~uuFOLK COURT, DEPARTMEnT OF ~LTHA~I~ROVAL N/A ELE~-r]~ICAL CFa~TIFICATE NO. 1098883 12/13/02 PLUMBERS CERTIFICATION D~r~u N/A Rev_ 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PEP~MIT MUST BE ICEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ~ITHO9IZED) PERMIT NO. 28562 Z Date JULY 17, 2002 Permission is hereby granted to: JOSE & IVOR~E HERNANDEZ 22950 MAIN RD ORIENT,NY 11957 for ~ CONSTRUCTION OF AN ACCESSORY G~RAGE AS APPLIED FOR AND AS PER ZBA CONDITIONS at premises located at 22950 MAIN RD County Ta~¢ Map No. 473889 Section 018 pursuant to application dated JULY ORIENT Block 0005 Lot No. 010 12, 2002 and approved by the Building Inspector to expire on JANUARY 17, 2004. Fee $ 112.20 ~ Rev. 5/8/02 ORIGINAL Form No. 6 TOWH OF SOUTHOLI) BUILDING DEPARTI¥[ENT TOVWN HALL 765-1802 APPLICATION FOR CERTI~ICA'rE OF OCCUPANCY This application must be filled in by typex~qqter or ink and submitted to the Bu/lding Department with the following: For new building or new use: l. Fina~ survey ~f pr~erty with accm`ate ~cati~n ~f a~ bui~dings~ ~r~perty ~ines~ streets~ and m~usua~ natura~ ~r topographic features. 2. Final Approval fi:om Health Dept. of wamr supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwritem 4. Sw~m statement ~:om ph~tnber ~ertifying that the s~der used in system ~ntains ~css than 2/~ ~ ~f ~ % ~ad. 5. Commercial building, industrial building, multiple residences aud similar buildings and installations, a certificate of Code Compliauce fi:om architect or cng/neet responsible for the building. 6. Submit Planning Board Approval of completed site plan requkemcats. For existing building~ (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing ail property_ lines, streets, building and unusual rmturai or topogXaphic features. 2 A properly completed applicariox~ and consent to inspect signed by the applicant. If at Certificate of Occupancy is dcaic-xL the Building Inspector shal/state the reasons therefor in writing to the applicant. 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 bui/ding $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 ofOocupanc7 - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15_00 Old or Prc--existi~_g Building: Street New Constxuction: Location of Property: c~-& ~ House O~er or ~n~rs of Prope~: S~o~ Co~ Tm~ Map No 1000, Date. (check one) Block Subdivision Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Subm/tted: $ '~ ~-, 0 F) Filed Map. __ DateofPermit, ~ I i~ IoZ[ Applicant: Undcrvaiters Approval: Final Certificate: Hamlet Lot (check one) Apphcant ,_ignature ~h~.. )kPPEXLS BOARD MEMBERS ~/~/~n/Gerard P. Goehringer, Chairman Ruth D. Oliva XAncent Orlando BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 ZBA Fax (631) 765-9064 Telephone (631) 765-1809 http://southo[dtown.northfork, net FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JUNE 20, 2002 Appl. No. 5132 - Jose and Ivomte Heruandez. Property Location: 22950 Main Road, Orient; Parcel 18.-5-10. BASIS OF APPLICATION: Building Department's March 21, 20112 Notice of Disapproval for the reason that applicants' proposed aceessory garage in an area other than a rear yard. AREA VARIANCE REQUESTED: Applicants are requesting a Variance under Section 100-33to locate an accessory garage in the southerly yard behind the rear of the dwelling at least 10 feet from the southerly property line and at least 30 feet from the westerly property line_ The size of the garage is 24' x 26'_ (Also, please see maps disapproved by the Building Department for more details_) FINDI~rGS OF FACT The Zoning Board of Appeals held a public hearing on this applicatiou on Jmte 20, 2002, at which time written and oral evidence was presented. Based upon all testimony, documentation, personal inspection of the property and the area, and other evidence, the Zoning Board finds thc following facts to be true and relevant. PROPERTY DESCRIPTION: The appllcaat's property is located on the south side of Route 25 (Main Road) in Orient and is improved with a one-story dwelling and small accessory shed structure in the westerly yard area. The lot consists of 26,251_42 sq. fi_ in area, 125 fL of lot depth, and 171 fL along the Main Road. REASONS FOR BOARD ACTION: In accordance with the review standards set forth in Town Law 267b-3 "area variances," the Board has considered the benefit to the applicant if the variance is granted, as weighed against the detriment to thc health, safc.ty and welfare of the neighborhood and community by such grant, and determines that: 1. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or detriment to nearby properties. A major portion of the garage is behind the existing dwelling. The 15' right-ot~way easement area to the west of the garage is not a necessary front yard for the applicants since their access driveway extends from the Main Road (northerly front yard). 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 definition of the code for right-of-way easement areas creates a second front yard for many properties. The yard behind the house is the most logical place to place a garage, and gives the appearance of a rear yard. 3. The variance granted herein is not substantial. 4. The variance granted will not have mi adverse effect or impact on the physical or environmental conditions in the neighborhood or district. No evidence has been submitted to suggest that this minor variance wi0 have an adverse impact on physical or em~ironmental conditions in the neighborhood. Page 2 - J'uae 20, 2002 .... / EBA Appl. No. 5132 - J. [Ieruaadcz Pamel 18.-5-10 at Orient 5. Grant of the requested variance is Ihe mininlun! action necessary and adequate to enable applicant to enjoy the benefit of an accessory garage/storage building, while preserving and protecting the character of the neighborhood and the health, safety, and welfare of the community. BOARD RESOLUTION ACTION OF THE BOARD: In considering all of the above factors, and applying the balancing test under New York To~n Law, nmtlon was offered by Member Tortora, seconded by Member Horning, and duly carried, to GRANT the variance as applied for, subject to the following CONDITIONS: 1. The garage shall be a minimum setback from the southecly property line at 10 feet (as proposed); and 2. The garage shall not be rented. This action does not authorize or condone any current or fi~ture use, setback or other feature of the subject property that violates the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Goehringer (Chairman), Tortora, Horning, Oliva, and Orlando. This Resolution was daly adopted (5-O). /'/ ~-'~ / ,~/ '/~"~ / ~ard ~Goehringer, Ch~rman ~-26-02 RECEIVED AND F LED BY Tic~-~ SOUT~OTD TO%TH D~_TE ~/zT/o ~ ~Ob~ I. _ .... Town ~rk, Town c~ Ry THIS CERTIFICATE OF COMPLIANCE THE NEW YORk BOARD Of FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by JOSE HERNANDEZ P.O. BOX 1304 ROUTE 25 JACOBS' GLEN JAMESPORT, NY 11947, ORIENT, NY 11957 Located at ROUTE 25 ORIENT, NY 11957 Application Number: 1098883 Certificate Number: 1098883 Section: Block: Lot: Building Permit: BDO: NS11 Described as a Resident/at occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Basement Detached Gaxa,z_e, Outside. Afdc. was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 13th Day of December, 2002. Name QTY Rare Rafin~ Circuit Tx~e Panels 1 70 11 Wiring and Devices Receptacle 12 0 General Ptmpose Switch 5 0 General Purpose Fixtuze .[0 0 Incandescent Receptacle 2 0 GFCI Serxice I Phase 3W Service Rating 200 Amperes Sen,ice Discozmect: t 200 cb Meters: ! seal l of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I rJi rJi rJirJi J.~ Jr~ ~r2,~r._~ 1%rmit Number Checked By/Date MECcheck Compliance Report New York State Energy Conservation Construction Code MECcheck Sofr~vare Versioa 3.3 Release 1 c Data filename: C:~rogram triles\CheckWIE Ccheckthemandez. cck ~111 LE: Hem~.ndez COUNTY: Suffolk STATE: New York III)D: 5750 CONSTRUCTION TYPE: Detached 1. or 2 Family HEATING TYPE: Non-Electric DATE: 01/15)03 DATE OF PLANS: Sept 16, 2002 PROJECT INFORMATION: COMPANY INFORMATION: Fah-weathes- Bro,,xm D e.qign NOTES: Homed first floor COIvIPLIANCE: Passes Maximum UA = 214 Your Home = 196 8,4% Be~er Titan Code Gross Glazing Area or Cav/ty Cent or Door Perimeter R-Valu~ R-Value U-Factor UA Ceiling I: Flat Coiling or Scissor Tress Wall 1: Wood Frame, 16" o.c. Window 1: Wood Frame, Double Pane with Low-E Door 1: Solid Door 2: Solid Floor 1: Unheated Slab-On-Grade, 2.0' Maul. 624 30.0 0.0 22 900 11.0 0.0 65 20 0.340 7 126 0.116 15 19 0,540 10 1 oo I 1.0 77 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plmis, specification& and other calculations submitied with this permit application_ The proposed systems have been designed to meet the New York State Eanrgy Conservation Cons~a'ucrion Code requirements W'hen a Registered Design Professional · they are attesling that to the best of his/her knowledge, belief, and professional judgment liance with this Code. has stamped and sig~ned..this p~a~..~ey such plans or spe~ Table 1: ,If in#tram Insulation Thiclo~ess for Circulating Hot FI~ter Pipes. Insulation Thickness in Inches by Ptpe Sizes Heated Wa'rer N-on_-Circulating Runouts Temperature (F~ Upto 1" Upto 1.25" 170 lg0 0.5 i 0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Circulatin~ Ivlains and Runouts 1.5" to 2.0" Over 2" Table 2: ~$litdrttutn Insulation Tltickness for HT/AC Pipes- Fluid Temp. Insulation Thickness in Ymehes by Pipe Sizes Piuing Syste=m T3~pes ~ 2" RurlouLq l" and Less I 25" to 2" 2.5" to 4" Heating Systems Low Pr~sure/Tempemture 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1 0 1.0 1 5 2.0 Cooling Systems Chilled Water, R~fiSgeraat, 40-55 0.5 0.5 0.75 1.0 and Brine Below40 l 0 1.0 1.5 1 5 NOTES TO FIELD (Building Department Use Only) MECcheclc Inspection Checklist New York State Energy Conservation Construction Code IvlECcheck SoFavare Version 3.3 Release lc DATE: 01/15/03 TITLE: Hernandez Bldg. Dept_ Use [ ] [ ] [ ] [ l [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Ceiling~: 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation CommentS: Above-Grade Walls: 1. Wall 1: Wood Frame, 16" o.c., R-I 1.0 cavity insulation Comments: Windows: 1. V~rindow 1: Wood Frame, Double Pane with Low-E, U-t~.ctor: 0.340 For windows without labeled U-~acturs, describe f~atures: # Panes Frame Type Thermal Break? [ ] Yes [ Comments: ]No 1. Door 1: Solid, U-~ctor 0 116 Comments: 2. Door 2: Solid, U-factor: 0.540 Comments: 1. Floor l: Unheated Slab-On-Grade, 2.0' insula'aon depth, R-I 1.0 continuous insulation Comments: Slab insulation to extend down from the top of the slab to at least 2.0 ff OR. down to at least the bottom of the slab then horizontally for a total distance of 2.0 ii Exterior hzsulation must have a rigid, opaque, weather-resistant protevtive covenng that covers the exposed (above-grade) insulation aud emends at leaat 6 in. below gsade. Air Leakage: Inmts. penetrations, and all other such openings in the bu/Mfag envelope that are sources of air leakage must be scaled. Recessed lights must be 1) Type IC sated, or 2) in,relied inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials. If non-IC rated, the fixture must be installed with a Y' clearance from insuIatio~ Vapor Retarder: Reqmred on the wanm-m-wmter side of all non-vetoed framed ceilings, mils. and floors. Materials Identification: Materials and equipment must be ir~teiled in accordance -.ruth the manufacemrer's installation instructions. Materials and equipment must be ~danufied so that compliance can be detertmned. Manufacturer manuals for all installed heating and cooling equipment and set,dee water heating equipment mu~t be provided. , Insulation R-values and glazing U-factora must be clearly marked on the building plans or sp~ifications. Duct Insulation: Supply ducts in unconditioned attire or outside the building must be insulated to Remm ductS in unconditioned attics or outside the braiding must be insulated to R-4. Supply ducts in unconditioned spaces must be insulated m R-8. Return ducts in unconditional spaces (except bas*m~nts) must bo insulated t~ R-2. Insulation is not requked on rem~ ducts in basements. Duct Construction: AIl joints, seams, and comaecttons mu.st be s~curely fastened wSth welds, gaskets, mastics (m:lheaivcs), mastic-pins-embedded-fabric, or tapas. Duct tape is not permitted. Exception: Cuntmanusly welded and lock/rig-type lon~tudmal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). Ducts shall be supported every 10 feet or in accordance w~th the manufacturer's instructions. Cooling duc~s with e~etior insulation must be covered with a vapor retarder. Ak filt~rs axe required in the remm air system. The HVAC system must provide a means for balancing air and xmter systems. Temperature Controls: Each dwelling unit has at lasat one thermostat capable of antomatically adjushng the space temperature set point of the largest zone. Electric Systems: Separate electric meters are required for each dwelling unit. Fireplaces: Fireplaces must be installed with tight fitting non~combustible fireplace doom Fifeplacas must be provided with a ~oume of combustion air, as requtred by the Fireplace couswaction provisions of the Buffdtng Code of Nan, York Stat~, the Residential Code of Nero, York State or th~ Nmv York Ctt~, Building Code, as apphcable Service Water Heating: Water heaterS with vertical pipe risers must have a heat trap on both ~e inlet and outlet unless the water heater has an integral hast trap or is part ora circulating system. Irmnlate cimulating hot water pipes to the levels in Table l: Circulating Hot Water Systems: l~ulate circulating hot water pipes ~ the levels in Table Swimming Pools: All b~ated sw4mming pools mus[ have an on/offheater switch and require a cover unless over 20% of the he. ag energy ts fxom non-deplatable sources. Pool pumps require a time clock. l:[eafing and Cooling Piping Insulation: I-IVAC piping conveying fluids above 10~ °F or chilled fluids below 55 °F must be insulated to the levels in Table 2. TO~/H OF $OUTHOLD PROPERTY Ri~COI~D CARD OWNER ~(ORM,, ER OWNER STREET ~ - :'~,/,.., ,-~ S LAND i IMP', TOTAL FARM DATE AGE NEW FARM TillabJe Woodland Meadowlond NORMAL BUILDING CONDITION BELOW ABOVE VI LLAG E / Value Per Value Acre COMM. REMARKS D;ST. S U B. LOT ,/ ., A. CR. , ~o~ [ C ri b 2 '.)..~)]~ 5 'TYPE OF BUILDING FRONTAGE ON WATER ~ r~u ~ u"r ) House Plot BULl(HEAD T°tal"~¢ ~ DOCK FRONTAGE ON ROAD DEPTH CB. MiCS. Mkt. Value -., .~ /" .../ COLOR ' TRIM M. BMg. Extension Extension Extension F~rch P~rch" Breezeway Garage Total Foundation Ext. Wo[[s Fire Place Type Roof Recreodon Room Domner 'Both Floor~ Interior Finish I H eot Rooms 1st Floor IRooms 2nd Floor ~ Dri~veway Dinette K. LR, I DR. ~- FIN. BUILDING PERMIT EXA3,~NER CHECK LEST DATE RE\.rlEyVED: _~/~_,0 DATE SLrB ~¥LITTE D :~; ~L~_/0 SCTM# DISTRICT: 1,000, SECTION: /~ _, BLOCK: ~"~, LOT: STREET.kDDRESS:22q<7~) ~1,~ ~r~3 CITY:~ SUBDB~rON: PROJECT DESC~TION: ~c~-~, ~_~ k ~F Z~a ESTmLkTED PROJECT COST:~OE ~NGmEER: ~ FAST Tm~CK?~o S~GLE & SEP~TE CERT~ICATION-~Q~D? /[0 NOTES: LOT5 40,0005F -~o0 24. ~t reco~ition fC~ATED before June 30, 198J). ~rDE~ED I OTS FD,DM J~.1997 [00 25. Mergcr.(~ger ZONING DISTRICT: ~- ~:> CONFOR2¥L1NG? ,X/O 5 P, EQ. LOT S[7E: ~,,ooo ACT. LOT SLZE~Q. LO~70¥. r:~o ACT. LOI COl'. P, EQ. FRONT ' ./,~' PROP. ERONT '-,5" 13dEQ SIDE/t~dd~' ACT. SIDE_ ~ REQ. REAR_ t It~r't PROP..P,~. A~. -./ ,. P, TEQ. I-[EIGHT PROP. I-[E1GHT WATER FRONT? jV~ DESCRIPTION: ~ ' ~ PANEL ~: ~'~q FLOOD ZONe:_ rK APPROVALS REQUIRED SUFFOLK COUNTY HEALTH.rD~T: YES oM_.~, (BED TOWN SEPTIC RECEIPT: Y NEW YORK STATE DEC: em~-vrcwv?s YES or~-'~. SOUTHOLD TOe, tN TRUSTEES: YES or(~ __ zo G BO. PPROV^ TOWN PL~. BOAP, D APPROVAL: YES or{~ TOWNI-HSTORICAL PRE (SPEIA): YES DTE: / / PERMIT #:RI0- NYS ENERGY: YES OR NO : ~ EGRESS (18 H rain ? 4 sq total) ----VENT (SQ. FF. x 4%). ~- BUILDING PERMrI'S OPENfEXPIRED: BP -Z / C/0 Z- I-LkVE PILE CO'S: Y OR N BP -Z / C/0 Z- NOTES: LIGHT (SQ. FT. x 8%) FISE STRUCTURE: FOU2NDATION: FIRST FLOOR: SECOND FLOOR: OTHER: SF SF SF SF SF 1.( ~=574 SF)-( 3~-~DSF)= /o9-Of~ SFX$ ,7oD =$ INII' OTHER TOT .AL FEE FEE FEE 2. ( SF)- ( SF)= SF X $ -$ 4 $ +$ = $ BUII~DING PEREMIT EXAMINER CHECK LIST SCTM# DIST~CT: 1.000, SECTION: ~ , BLOCK: ~ , LOT: ~O ST~ET ~O~S S: ~o M~. CIT~~ PROJECT DESC~TION: ~ EST~iATED PROJECT COST: ~' IO ~ ~CH~ECT. ENG~ER: S~GLE & SEP.~TE CERTNI~ATION-~QU~D? ~ NOTES: DAlE ISSUED: DATE, REVIEWED: .~_~! ..'02 DAT~*$UBIx'[ITTED: ..~ 'i'~ :02 SUBDIVISION: EAST TtL~CK? LOIS 40~0,5~3SF -100-24. Lc, r recognlfion.(CREATED kelore lune _,0, 1983). LZgDEkS[ZED LOTS z=RC, M Jk~.1997 1,30-25 Merger (A noncanfc~rming ar an!, rime after 7'D83 ZONING DISTR2[CT: ~-l~. CONFORMING? REQ. LOT SIZE: ?~e,,. ACT. LOT SIZE~,.2JJ REQ. LOT COV. ~o~9~ ACT. LOT COV. REQ. FRONT ~'"" PROP. FRONT .~.. KEQSDE REQ. REAR J"-/ PROP. REAR WATER FRONT? DESCP,~TION: PANEL #: FLOOD ZONE: ., APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): TOWN SEPTIC RECEIPT: Y or N NEW YORKSTATE DEC: em~-I~Cg/u?5 YES orNO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: x/ES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO DTE: / / PERMIT #:Ri0- NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) VENT (SQ. FT. x 4%)_ BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: LIGHT (SQ. FT. x 8% FEE STRUCTLFPdS: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTIIER: TOT.KL: SF SF SF SF SF 1. ( SF)- ( SF)= SF X $__ 1NIT OTHER FEE FEE =$ +$ +$ 2.( SF)-( SF)= SF X$__=$ +$ +$ TOTAl_ FEE $ =$ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTIV[ENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL TO: Jose Hemandez 22950 Main Road Orient, NY 11957 Please take notice that yom- application dated March 19. 2002 For permit fox- consmtction of an accessory garage at Location of property: 22950 Main Road, Orient, NY County Tax Map No_ 1000 - Section 18 Block 5~ Is returned herewith and disapproved on the following grom~ds: DATE: March 21, 2002 Lot I0 Thee proposed construction, on this 26,267 square foot lot in the R-80 District, is not permitted pursuant to Article Ili Section 100-33. which states; "In the Am-ieultural-Conservation District and Low-Density Residential R-80. R-120. R-200 and R-400 Districts, accessory builcfmgs and structures or other accessory uses shall be located in thc requ'n'ed rear var&" The proposed accessory gm-axe is located in the front yard of the property. Note to Applicant: Any change or deviation to the above referenced application, ma)' require further review by the Southold Town Building Department. .~, . Cc: ZBA, File Authorized Signature 765-1802 BUILDING DEPT, ./,I SPECTION [ ~/FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY 76S-].1102 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION FOUND~ION 1ST [ ] ROUGH PLBG. ] FO~I~ATION 2ND [ ]INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: (/'~,~' - ~'/, ~ . . ~,/~ / DAT~¢W INSPEC~Z~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] IN/SULATION [ t,~INAL FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION 765-1802 BUILDING DEPT. INSPECTION [ ] FIRI~PLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: CO~ YOIJNI)_~_TIO~ F OU2qI)ATION ~.2ND) ROUGH I~/SUL.~.TION PER N_ Y. ~T.2kI'E ENJ~RGY CODE F12q_a_L _4DDI'I'J_ONAI~ C O_M2~l~q'qTS TOX'~N OF SOUTHOLD BUILDING D EP'ARTM~_N TOWN HA~-L SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: 11631) 765-9502 PImMaT c¢ BI~ILDING PERMIT APPLICATION CHECKLIST Do you have or need the follovang, before applying? Board of Heahh 3 sets of Building Pla.ns pl~nnln~ Board appmx ~l Survey Check Septic Form N.Y.S.D.k.C. Trustees Con£act: Mall to: Building Inspector Phone: .... i ~ APPLICATION FOR BUILDING PERMIT ~ / ,, :, .... -~/ ...... Z' ".7;'C''.:p- Date__ /I ~' ....... INSTRUCTIONS / ,20¢5 a./kis apphcanon MUST be completely filled in by typewriter or in ink and submitted [o the Bu/]ding Inspector ;x ith sets ct plans, accurate plot plan to scale. Fee according to schedule. b. ?let plan shexxing location oflot and of buildings on premise% relationship to adjoining prcm/scs or public streets c. The work co,, ered by this application may not be commenced before issuance of B~.filding Pemuk. ~. LTpon approval of this application, the Building Inspector will issue a BuiMi,g Pernzit [o Lhc applicant. Such a penni ;halt be kept on the prermses ax'affable tbr mspectmn thron*~aout the work. e. No building shall be occupied or used La whole or in part for an_,,' purpose what so ever until the Building Inspector ~- =~e~- .~ C¢~rik~cate 0£ Occupancy. 1:. Eve?: building permit shall expxre ii'the work authorized has not commenced withl:n I ? m*nths a~er the date of :~£uance ,or J~:~ not been completed witkLn 18 months fi-om such date. If no zoning amendments or other regulatious affecting ?re. pen5 have been enacted in the interim, the Building Inspector maYlauthonze, m ~ri~.g, the extension o£the permit for an addition six months. Therea~reL a new permit shall be required. ~PPLIC.&TION IS I:IIhREBY I~L~)E to the Buildhxg Depmlmcnt for thc i~suance of a Building Permit pursuant to the ~uildm~ Zone Ordnance of the Town of Southold, Suffolk Count5.', New York, and other applicable Laws. Ordinances or F.egui'~nons, for the const, mchon of buildLags, additions, or akerations or for removal or demolition aa herein described. The :t?pl~cuzz[ a~ees to comply with al/applicable laws, ordinances, bul]dipg code, housing code, and regulations, and to arhrdt aarhor/zed h~speetors on premises and in building for necessary- inspections. :- '~'~ (Signature of applicant or nam~r~a corporalS, on) (2vrmlmg address of applicant) Store .x h¢the~ applicant is ownex, lessee, agent, arch/tcct, engineer, general contractor, electrician, plumber or builder Nan-~e o£o;;ner ofprem/ses '~o~ e. % ~ c'o~n e ' /~,le~ tLr¢c~ ri t) C (As on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer: (Name and rifle of corporate officer) Builde:s License No. Plumbers License No. Eiectficians License No. Other Trade's k~eense No. Location of land on which proposed work will be done: ci 5,:9 ood Hc, u~e Number Street On / ' Hamlet Count3,_' Tax Map No. 1000 Section Subdivision (N -ne) Block d 0 Filed, Map No. Lot Lot State existing use and occupancy of premises a~.d intended use and occupancy of proposed construction:' a. Existing use and occupancy /3003 ~. b. lntendeduscandoccupaucy ~C~ra~ ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition ~,4. EstimatedCost ¢/O/~,., 5. If dwelling, number of dwellmg umts If garage, number of cars ~ Addition A[terati,>n Other Work Fee Description} (To be paid on filing t_hls application) Number of dwelling milts on each floor 6 If business, comntercial or mLxed occupancy, specify nature and extent of each type oftrse. Dimensions of existing structmcs, if any: Front Height Number of Stories Rear _Depth Dimensions of same structure with alterations or additions: Front ".,: *, Rear Depth Height. Number of Stories $. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rem .Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate an5' zoning laxv, ordinance or regulation? YES__ NO_~ ] ",. Will lot be re-graded? YES NO ~c Will excess fill be removed from premises? alES NO .~ l <':N~es of ex. er of pre~ses~d&ess ~q SO ~ ~-rnone /'-- ~e of _~c~tect Address Phone No ' N~e of Con.actor Ad.ess Phone No_ [5 a. Is this property v~Sthin 100 feet of a tidal wetland or a freshwater wediad? *YES__ * IF YES, SOUTHOLD TO%2q TRUSTEES & D.E_C. PERMITS IYL&Y BE REQU'i~.ED. b. Is this property within 300 feet of a tidal wetland? * YES ~ NO__ ~ IF YES, D.E.C. PEP,5,I[TS MAY BE REQUIRED. NO ~,- 1.6. Provide survey, Lo scale, with accurate foundation plan and distances to property lines. 7 If elevation at a%' po[rtL oit property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNIY OF ) .~-'~l../--oFiiq/.o ~/,o ~/q~_~ C~ ~_~- beLngdulyswom, deposes and says that (s)hei~ ~t~e applicam (Name of i~dw:'-~ctuM s'ig¥~g contract) above named, I,S)He is thc OL~ ~q ~ (Contractor. Agent, Corporate Officer, ete.l c,f said owner or owners, and is duly author/zed to per[om or have performed the said work and to make and isle tits ap~hcarK, rc tlxaz ail statements conralned in this application are tree to the best of his knowledge and belief; amd that the work will be perfum~cd i2 the manor set forth in the application fi[ed therewith. S:[ otn to before me this · ~'~' ' da5' of Notary Public DJ lO00-i8-O$-lO N£ANTEED TO H£~NAND£~ HE~NANDEZ '~B~E OO~ANy / iN? PAPANTONt© 86' 54' 20" L51' 89' 53' 07' 40" E 171.0' 1-ABOR I STORY z~' RES. 21J 4~ SURVEY oF 1ESCR/SED PROPER FY SI TUA rE' ORI£N 7:, TOWIV OF SOU FHOLD SUFFOLK COUNT'f, N. K SURVEYED FOR JOSE HERNANDEZ .I/ONNE HERNANDEZ ORIENT CEM~ N/F LA THAM 2 3 4 5 G 7 8 9 I0 II 12 13 14 '15 IG 51DE ELEVATION FRONT ELEVATION J2 SECTION (~ JULY ~ 5, 2062 F'O U N E) ~'T J 0 N:' P LAiN ~ ?, FL-OOR PLAN CLIENT / OWN EP-. HERNANDEZ RESIDENCE STREET TOWNSHIP~ STATE ADDITION FIP~T FLOOR, PLAN DATE SEP 23 G F E 'D C 1/4',!= I'-0' DIRECTION ~~ oo~' I'/ 02003 J2 .SIDE ELEVATION SCALE ~ I/4"= I 0" ]1 f "11 ]1 FRONT ELEVATION y 8'Th', FOUNDATION WALL5 Z--O'f [ .SECTION CONTROL JOINT i L]-~''~- ,~ ~,'q'lfl POUNDATION ~ I~. PULL-DOWN 0- 2 F 0 U N D A T I O N P L A N ff L O O RP L A N ?~ EG'~ON OFAU~ ANY WAY. ANY &LllltOR~'~m~ CLIENT / OWNER HERNANDEZ REDIDENCE STREET TOWNSHIP, ~TATE ADDITION FLOOR, PLAN 0000 K J H G D A E