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HomeMy WebLinkAbout30072-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30877 Date: 04/25/05 THIS CERTIFIES that the building ADDITIONS Location of Property: 1500 GRATHWOHL RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 4 Lot 5 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 5, 2004 pursuant to which Building Permit No. 30072-Z dated FEBRUARY 5, 2004 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 DECK ADDITION & BILCO ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5107 DATED 5/16/02 . The certificate is issued to JAMES A BLACKLEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uthorized Signature Rev. 1/81 Form No.6 l� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 �\ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application m t 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 too 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 Planting 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: L 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 550.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- S.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.//00 Date. New Construction: 1 /Old or Pre-existing Building_:) y (checkone) Location of Property: l �S lJ rxHl yoJ �(.y �J e w _'�✓t House No. Street Hamlet Owner or Owners of Property: �( 01 t Fir`( Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Pennit No. 300 7Z — ii Date of Permit. Applicant: Health Dept. Approval: _ _Underwriters Approval: Planting Board Appro\at: Request for: Temporary Certificate Final Certificate: (check(check one) Fee Submitted: $ J .Applicant Signature c6 -, 308 i 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. 30072 Z Date FEBRUARY 5 , 2004 Permission is hereby granted to: JAMES A BLACKLEY 2457 FOXDALE AVE OCEANSIDE,NY 11572 for CONSTRUCT DECK ADDITION & BILCO ADDITION AS APPLIED FOR PER ZBA #5107 DATED 5/16/02 . THIS PERMIT REPLACES BP#28790 . at premises located at 1500 GRATHWOHL RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0004 Lot No. 005 pursuant to application dated FEBRUARY 5 , 2004 and approved by the Building Inspector to expire on AUGUST 5 , 2005 . Fee $ 150 . 00 Au ori* d Signature A ORIGINAL Rev. 5/8/02 APPEALS BOARD MEMBERS Southold Town Hall VX Gerard P. Goehringer, Chairman 53095 Main Road Lydia A. Tortora o N P.O. Box 1179 George Horning _ • Southold, New York 11971-0959 Ruth D. Oliva ZBA Fax (631) 765-9064 Vincent Orlando l �a Telephone (631) 765-1809 http:i/southoldto%vn.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MAY 16, 2002 Appl. No. 5107 —JAMES and KATHLEEN BLACKLEY Property Location: 1455 Grathwohl Road, New Suffolk; CTM 117.4-5. BASIS OF APPLICATION: Building Department's February 4, 2002 Notice of Disapproval, under Zoning Code Section 100-244B, for the reason that applicants' construction of a deck addition at the front (west side) of the house is less than 35 feet from the rear lot line. AREA VARIANCE REQUESTED: Applicants request a Variance for an open, one-story deck addition to the existing dwelling. Originally, the deck was proposed at 28 feet at its closest point to the front line. On 3/21/02, the applicants amended the map to show a setback at 30 feet for a 16 ft. or 17 ft. extension from the house, dimensions shown by applicant for 42+- feet wide by 16 ft. deep, without the step area(s). FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on May 16, 2002, at which time written and oral evidence was 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. PROPERTY DESCRIPTION: The applicants' property contains approximately 15,000 sq. ft. of land area, 100 feet along Grathwohl Road, and average lot depth of 151 feet. The property is improved with a one-story, single-family dwelling frame house, as shown on the Peconic Surveyors' map dated January 7, 1988. 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 the health, safety 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. The applicant is utilizing an existing brick patio and areas near the existing dwelling area. The front yard deck is in keeping with other houses in the area, some of which are two story or raised decks. The applicant is proposed a first story deck slightly raised above grade. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. Applicants dwelling is positioned on a substandard-size lot which requires reduced setbacks. The requested setback meets or exceeds front decks on adjacent lots along Grathwohl Road and is within keeping of similar additions in the well established, older community. 3. The relief requested is not substantial as it relates to this community of nonconforming lots. Page 2- May 16, 2002 ZBA#5107—J. and K. Blackley Parcel 117.4-5 at New Suffolk 4. The variance granted will not have an 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 will have an adverse impact on physical or environmental conditions in the neighborhood. 5. Grant of the requested variance is the minimum action necessary and adequate to enable applicant to enjoy the benefit of the additions, 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 Town Law, motion was offered by Member Orlando, seconded by Chairman Goehringer, and duly carried, to APPROVE the variance at 30 ft. from the front property line, SUBJECT TO the condition that the deck remain open to the sky as applied for. This action does not authorize or condone any current or future 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 Goehri alrm ), T ra, Horning, and Orlando. (Member Oliva was absent due to illne This Res do as d d (4-0). erard P. Goehringer, Chairm 6/11/02 FORM NO. 3 NOTICE OF DISAPPROVAL DATE: February 4, 2002 TO: James Blackley 2457 Foxdale Avenue Oceanside, NY 11572 Please take notice that your application dated January 3, 2001 For permit to construct a front deck addition to an existing single family dwelling at Location of property 1455 Grathwohl Road, New Suffolk, County Tax Map No. 1000 - Section 117 Block 4 Lot 5 Is returned herewith and disapproved on the following grounds: The proposed addition to an existing single family dwelling, on a non-conforming 14,374 square foot parcel in the R-40 District, is not permitted pursuant to Article XXIV Section 100-244B which states that, on non-conforming lots that measure less than 20,000 square feet in size, require a front yard setback of at least 35 feet. The proposed construction notes a front yard setback of+/- 28 feet. Total lot coverage, following the proposed addition is twenty 20percent. Authorized Signature CC: file, Z.B.A. • •jVp4-11 T. TERRY I �= ` - - =� I n,�n Hall 1(P�S M,,., Road TOWN CLERK � � P O Rr�, I I)o LO CI -r 11.)71 REGISFRAR OF VI TAI. STAFI S17C5 `+�- IC-0 �-- Fd, 151(,, MARRIAG R; OrrICI:A ��nn� y�� Tcicphrrnc 1`•I(.I 71,5. IN(II RECORVs 6W4AGEMEW 01T-ICEII FREEDOM OF INFORIAAT10N OFFICEf? 6111 IY' 4�-CNV C� OFFICE OF THE. TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93) ] . 6' 13 CIE " TOWN OF SOS'10LD �h � Southold Town Clerk August 25 , 1993 . APPLICA"flOr4 s PACTE. I nl 1 TOWN Of- SOUT HOLD FLOODPLAIN DFVELOPMLNT PLIZA11-I APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and si 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. 4 THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE,TO THE BEST /OF MY KNOWLE/GE, TRUE AND ACCURATE. (APPLICANTS SIGNATURE) DATE U SECTION 2: PROPOSED DEVELOPMENT (To be completed by AP LICAR O NAMEDD ADDRES TELEPHONE APPLICANT rthe . 5( I V s S �V�ti I -73 V/J1 BUILDER ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. L � J% ul�� ,�g FDP(93) APPLICATIvr. _ PAGE ? OF .: DESCRIPTION OF WORE: (Check all appbeablc boxeS) A. STRUCTURAL DE_VEI,OPMEKI r PI�'ITl I' UCTURE TYPE New Structure ResidenUal (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Noo-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Dcmobtioo P ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S 5 O d B. OTHER DEVELOPMENT ACTIVITIES: N r1l t ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) , ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) 0 Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3: FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development ❑ Is NOT located is a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable O The proposed development is looted in a floodway. FBFM Pancl No. Dated ❑ See Section 4 for additional instructions SIGNED DATE APPLICATION s PAGE 3 OF a SECTION a: ADDITI NAL INF_OR AATION_PLEOUI RED (To he completed by LOCAL AI)MlNISTRATOR) The applicant must submit the documents checked below before the apphcation ran be processed: O A site plan showing the location of all cais Un F, structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Development plans, drawn to scale, and specifications, including where apphcablc:details for anchoring structures, proposed elevation of lowest floor (induding basement), types of water resistant materials used below the fust floor, dctaik of Doodproofmg of utilities located below the fust Door and details of endostues below the fust floor. Also ❑ Subdivision or other development plans (If the subdivision or other dcvelopmem exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). C3 Plans showing the extent of watercourse relocation and/or landform alterations. 13 Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg protection level (non-residential only) Ft.NGVD (MSL). For Doodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory Doodway will not result in Aano increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other. SECTION 5: PERMIT DE'fF"RMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A- 0 Is B. O Is not in conformance with provisions of Local Law W_, 19_. The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION a P.At—,F a CF a -- APPGA.LS A ppealcd to Eoard of AppcalO ❑ Yc� ❑ No Hrarmg date. Appeals Eoard Decuioo --- Approved' ❑ Yes ❑ NG Conditions _ SE TION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard Areas bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete (his section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPP-C-nONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES O NO DATE BY DEFICIENCIES? 0 YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE---- BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOIITHOLD CERTIFICATE OF COMPLIANCE 1.OR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER NIUST RETAIN THIS CERTIFICATE) PRENIISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACAIN"I' LAND THE LOCAL ADMINISTRATOR ISTO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #_, 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: C/C(93) 30<D7,2--� 765.1802 BUILDING DEPT. INSPECTION [ NDATION i ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ) FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �� © t C INSPECTO 3 0 0 7a- 7 765.1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [_ ] FI/R, E SAFETY INSPECTION REM RKS: 7k , DATE /� ���� o � INSPECTOR / 7654 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION" OUNDATION ND [ ] INSULATION [ FRAMING b EC�) [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: l 'f�1 - G � DATE / �/ °2 �S INSPECTOR 0 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL Cb�c{C) [ J FIREPLACE & CHIMNEY [ ]]QFIR-E,SAFETY INSPECTION REMARKS: o DATE `� INSPECTOR ' 10 FIELD INSPECTION REPORT DATE, COMMENTS o A v live Z4 FOUNDATION(1ST) 3 ' p,# 0- 6 1 ---------------------- ---------- / o- y FOUNDATION(2ND) 2 - Ewa ROUGH FRAMING& y PLUMBING INSULATION PER N.Y. STATE ENERGY CODE oS CQ fJ FINAL ADDITIONAL COMMENTS O z z m m aJ G z � x z 0 TON14 OF SOUTHOLA BUILuuNU rbt(Ml i AYrLI(;A f lute CHECK-LIS BUILDING DEPARTMENT 9 .,)I Do you have or need the following,before applying TOWN HALL APR 3 '� -Board of Health SOUTHOLD, NY 11971 -/ 3 sets of Building Plans TEL: 765-1802 :30 Check y Survey PERMIT NO. 3 Check Septic Form N.Y.S.D.E.C. 7- Trustees Exanuned S Z , 206/_ Contact: Approved 20_ Mail to: Disapproved a;'c hA Phone: 57(� `� tri c O� Building Inspector APPLICATION FOR BUILDING PERMIT Date 1Q,,1 200/ { INSTRUCTIONS :!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 a Certificate of Occupan is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) _�2 57 /-�uXt4uIC- rC /�vf .t� ��/ UCt's�rtS0eL , '" J //J 7 )-- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises l a m e S a h GL 1(A' VP f n /5 la e � le (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed,work /ass .-mM wot will be done: GoaA Akty S,419calkz y House Number Street ? Hamlet County Tax Map No. 1000 Section Block 0 Lot Lol3 3 . Subdivision Filed Map No. t (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Si� %u 4iy7 i u r'P(l d r N u b. Intended use and occupancy S// jl MM"j, r-eg1d e'h c L i. Nature of work (check which applicable): New Building Addition ✓ Alteration Repair Removal Demolition Other Work (Description) Estimated Cost $ ,3000 Fee (to be paid on filing this application) ? If dwelling, number of dwelling units / Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Se e P/uhs tr�616t /4rchifF/' 7`J Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth U. Date of Purchase/a' 9 8 Name of Former Owner 1(:'�a nim e r ? L Zone or use district in which premises are situated '. Does proposed construction violate any zoning law, ordinance or regulation: /Vo 3. Will lot be re-graded Will excess fill be removed from premises: 5)763 - NO Ka6rfo 4tYips 76.2F c! 4. Names of Owner of premises 3-1a ck(!:! _Address/`/ff A4 4 woks 0 Phone No.X44/ - 73 y Name of Architect mQo 6�er ��yf u 6 v i– Address 1/76 C ev-rsSwA4 Phone No 6 3/ r;S'l rt S/y Name of Contractor S-l'CVP /.Z o rh Address ?7e) L e w6 acf Dr Phone No. (-3 74 9- ' 3 30 3 SdaAf lf'(, 5. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN N TRUSTEES PERMITS MAY BE REQUIltED o. Provide survey, to scale, with accurate foundation plan and distances to property lines. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEN YORK) SS 'OUNTY OF j /�'A 1/7 if ep /3 /G C k 1-G being duly swom, deposes and says that(s)he is the applicant (Name of individual signing con act) above named, )He is the (Contractor, Agent, Corporate Officer, etc.) C said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; tat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the application filed therewith. worn to before me this .30 day of 200/ Notary Public Signature of Applicant J ELIZABETH A STATHIS NOTARY PUBLIC.State of New York No.01 ST6008173,Suffolk County Term Expires June 8,20.Q.g. BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED:�k/01 0119..J�jVj i/(G y7e '1//610, APPLICANT NAME: BLACKLEY DATE SUBMITTED" : 6/06/00 SCTM#--- DISTRICT: 1,000 SECTION: 117 BLOCK:_4 LOT: 5 PROJECT LOCATION AND TYPE OF PROPOSED WORK: PROJECT DESCRIPTION AD ALT ACC OR N/D: 6ecA, T�o "� 0 4 STREET: 1455 GRATHWOHL CITY: NEW SUFFOLK SUBDIV. NAME: ARCHITECT/ENGINEER: FAST TRACK: YESRNO SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o N NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LO F M JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83) ZONING: PERMIT ESTIMATE AMOUNT:_$ -.00 PERMIT USE: EXISTING: SSD INTENDED: SfW'`� ZONING DISTRICTR40 R80 AC CONFORMING: YES oR NO REQUIRED LOT SIZE: SQFT. WHERE ACTUAL LOT SIZE FROM?TAX CARD ACTUAL LOT SIZE: / f3>4 SQFT. REQUIRED REQUIRED REQUIRED FRONT:3S 'PROPOSED: SIDE YD: /o '/,2,S_' PROPOSED: '/ ' REAR: :'PROPOSED: ' LOT COVERAGE: LOWED:zO % EXISTING: ---sf % NEW: sf % TOTAL: , Sf_% CORNER? YES o NO WAT ER FRONT? YES o DESCRIPTION: FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: _SC)/ FLOOD ZONFi.065-& , AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPMATION TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES or N (BED#): DTE: / / PERMIT#:R10- AP VALS RE UIRED: NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or �F,n,,_ 74714-- SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAYES r - ar TOWN PLAN. BOARD APPROVAL: S o�n NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: BUILDING PERMITS OPEN/EXPIRED: BP 's,Gs -Z/ C/0 AV- .JP-.,l 'F^ BP 1464 NOTES: `�r+ �o��:, ,�Ut...�-. � � — �t•> � _Sema;c > -Z C/O A 074,4) i . c �a�.rte . I� acvs� ✓c f .. Yr . >?3 �Z e ii FEE STR CTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE FOT( SF)- SF)= SFX $ =$ +$ +$ $ i BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: 6 /Zr /02 APPLICANT: .1�s I�wTF11Fku bAtKLGu DATE SUBMITTED: 6 /Z�/02 SCTM# DISTRICT: 1,000, SECTION: II- , BLOCK: 4 , LOT: 6 STREET ADDRESS: INU6 GROw1whot, QtA- CITY: NEW S►FFOt f- SUBDIVISION: "A PROJECT DESCRIPTION: Dacv-' -7oO91L/F'L910U T�t4 ESTIMATED PROJECT COST: 8K— ARCHITEC NG �iaNrr� FAST TRACK? N� SINGLE & SEPARATE CERTIFICATION-REQUIRED? ntv NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/: ZONING DISTRICT: Pqo CONFORMING? N' REQ. LOT SIZE: Jk,000 ACT. LOT SIZE: 1q 3 Q. LOT COV. Is'), ACT. LOT COV. REQ. FRONT SE PROP. FRONT Q SIDE Ib zf ACT. SIDE REQ. REAR 35 PROP. REAR REQ. HEIGHT PROP. HEIGHT ch-eie� d k (-.0.v- ' " WATER FRONT? DESCRIPTION: PANEL FLOOD ZONE:,, APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DPT: YES or , (BED #): DTE:_/_/ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y o X- EC NEW YORK STATE DEC: PR 9/1/75 YES or SOUTHOLD TOWN TRUSTEES: YE or TOWN ZONING BOARD APPROVAL. or NO �� y TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES or g$ NYS ENERGY: YES OR NO : -,11 "4 EGRESS (18 H min.? 4 sq total) I — VENT(SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE -fLo,p9m. 1. ( SF)- ( _SF)= SFX $ =$ +$ +$ = $ 2. ( SF)- ( SF)= SFX $ =$ +$ +$ = $ BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: / /,3 /02 DATE SUBMITTED: / 1a2 /02 APPLICANT NAME: SCTM# DISTRICT: 1,000 SECTION:BLOCK: LOT: STREET: I�S��Lc�OL ��- CITY: 6 v c SUBDIV. NAME: A10 PROJECT DESCRIPTION• T�Fc4ca or-J S S ESTIMATED PROJECT COST: ,:j, ARCHITECT/ENGINEER: Al 1,4 FAST TRACK? tiy SINGLE & SEPARATE CERTIFICATION-REQUIRED? /✓y NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83: I TOq ExIs-rZg3� ZONING DISTRICT: A�(/o CONFORMING?_/, 12,ZNeLO °� °� x/31/ a9 7 aq b REQ. LOT SIZE: ACT. LOT SIZE: LOT CO ACT. LOT COV. p REQ. FRONT PROP. FRONT Q E 2S ACT. SIDE i s REQ. REAR PROP. REAR f" / ,v o - WATER FRONT? %ES DESCRIPTION: __PANEL #: FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE:—/—/ PERMIT #:R10- TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) VENT (SQ. FT. 'x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE COT( SF)- ( SF)= SF X $ =$ +$ +$ = $ Fall .} u OnoC[IeNS "4I'l A s !� � W ? ry, kR111 A y- r �, r 11 it sWAas low sm xv � srr �. Ir ,° 't ' I' rA" wr"r� �A�R r, OTIFY BUILDINGG DE R MENT A arty ,', « rS hr Y- " ' - M/ rtr\ Z�ZKI'« 70B•1SOY 1 AM TO 0 PM FOR TNR v�, �01F.OFOUNDATIONECTWO REQUIRED Y FORPOUREDCONCRETE be \ 2 ROUGH - FRAMING A PLUMBING�S� IG1 nl yfi oSG, 3 INSULATION ? + 'yYodc'atlrxnlnted`IP I y y O ._.�iu� -_ !l FI POMP ETEFORC.O.ION MUST -�AC�€_CONSTRUCTION SHALL MEET -THE" HE,SUI0EMENTS OF THE N.Y. 04bTRUCTION A ENERGY III CODE " NIDT RESPONSIBLE FOR (Z)ZX I O CLG - _ .. . .... _ bo.g91 "'� 0� DESI N PT ERROflB . ZXP� I.EV4T EO OCCUPANCY OR ' T UNLAWFUL I H!N � USE IS r I k CJ �Ne L WITHOUT CERTIFICATE KATE I I I J N ti OF OCCUPANCY 33� L , r f Czl 2� 10 GG/k e u o.pp, �� DO NOT PROCEED WITH +� 1 - —�---- — -- �— - — --(�--_ o nl i ? _ FRAMING UNTIL SURVEY ,- =o' OF FOUNDATION LOCATION � i (iT'gP X j �." �� rJ ! p r �:( .W 31SIo '�H SEN APPROVED. I 2 r H U) - ° " N p. z f k I r' Y � a.- . , � � ' I � of ! I o 4.z ap � a - �,.J� r 14 q, 01 �- "r E464 r OE , ''"�'f '� , „� w 4„ yr���il�" S,II�nE!' "�h►+r -._t- -,_�. _� - '�—�'--�'-' �� - � h MCN VIII { III "Y $' s e ^': ' t ` 1TIT -_ -- ._.__— _ ---____. IF TT X X4'7 Y It V' - > - I IT . . f WW o f FSRp�YY+�T'1iMo IL . III i `,� A!W"•t I a I�Au� ri i , I �« � I piv I � . �, ' h' s',�,r t ��� , � ,x u� I , '' �_ ' � � � ti� � �✓� it - 'n.. ,s _ _ aE �'s Yt t e ' r P- ) +. 5 V �5„ � 4z r.+�'b �F �'' -.',,: I• 4 �. : � , 17 ,I _. - __ - - - __ .__ ' __ .-___ - _. .. - I (1', I -- ,rJ�A{'rX�/ I�F'.Ii'�' ia I I, a sS be AS, G�110 �ALII/ - AA 0i Iva x PSP =` I ` 'yXl �7 N w : �A2dIY �lU � � r I kTO pA ZIAV4 ,: --- 'V, W r I( I I y4 _01 r' a wa y 2 L -1 4� _ 'IIA I VJ x s� �Ui�M'�PONw. � G o N 4.' �" r te- c"n �• �/�I- II �� I "� -� SII Or _ - o y) r r To WM1I vLD Y b `: A' r �` -. ,4 - ---- -- -- -- G G�46 E % : -� ' ), u. ` N + l k wr , s+ . p80FES510Nq< 9! 'p"4�« I Ias/G v II tb ; , � If T�.zfT, I' o , x s rf �,`, r "-, - I ' ' •_ +�' a :p r HP•, . "' -k �� tall f +,4 miall ]S .g ,,; V � t I rs�d .NplY4+ rx. „},a ' tt 4 I'� 'wr t•J.�*� 1 ., Y1'ra ,�bhen a ' n - I � e — _-_ zr. G h�VL , � r r r — re. +, _ r Y I� 4fNWa s, n�, w �4`I- ' wr -.l_' ,�� (�/A r6 S- I�7) «r- y Ii ., 4uuN. a_ITM >_ -�' ILo'I EI o ,c ea iR.' II r- .:N P ,4 ., V I P I. ALL CONSTRUCTION SMALL RE IN CONFORMANCE WITH NA-S SUILDING CODE, M.T.C. ENERGY CONSERVATION CODE AND ALL LOCAL CODES RAVING JURISDICTION. E. ALL CONCRETE SHALL RE MINIMUM Fu'R5DO PSI AT ER DAY TEST ALL I YININUM SSEARING L PACITTROF S TONS ON SPER 9E ; SOIL HAVING i I� Wo C�isf tA* T� I � n Nx/s,-y` o.R/ /6 '- ±K Q I n� c i jEpED ARCry/ ' VuiE i pOO �Ellc 4I.rvir-` @ @ PROVED t/BcV'. N«✓ JDRAWN REVISED DATE '/-e:>4:) 1BJ CY�Kf;yJ'(✓.=Y�.yJLJ . .. J. Gruber Architect 3 13571 0' 476 Expresswo4 Dnve so Medford. NY, 11763 516654 4949 DRAWING NUMBER D f Oe MEW /CGGi�� /�G9.+,/jfi✓Gylf�B/Lez ------------ i M i