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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 01/25/07
No: Z-32160
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: 13795 OREGON
(HOUSE NO.)
County Tax Map No. 473889 Section 83
RD
(STREET)
Block 2
CUTCHOGUE
(HAMLET)
10.16
Lot
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 29, 2006 pursuant to which
Building Permit No. 32522-Z
dated
NOVEMBER 29, 2006
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 ACCESSORY GARAGE AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5618
DATED 3/9/06.
The certificate is issued to TIMOTHY T STEELE
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
01/05/07
ELECTRICAL CERTIFICATE NO.
3019858
N/A
PLUMBERS CERTIFICATION DATED
~~
th iztignature
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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_~....3PLICA TION FOR CERTIFICATE OF OCCUPANCY
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:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval tram 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 2/1 0 of I % 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:
I. 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
New Construction: /"
Date.
1-)./{-07
Old or Pre-existing Building:
Location ofproperty: Ih 7<75 CJ ,.~__ ~
House No. 9rreet
Owner or Owners of Property: (-; ~ -f'l7 \. So: +~ e \ -e..
Suffolk County Tax Map No 1000, Section 83 2- I (), I h Block
(check one)
Cv~t
Lot
Subdivision ~. Filed Map. Lot:
Permit No. 3.2 57'2- Z- Date of Permit. 1-2'7-07 Applicant: ~e
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $
~9)
Applicant Signature
8-.<<. ) 17 :J.;J.
cO ~3d.{ ~O
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.
32522 Z
Date NOVEMBER 29, 2006
Permission is hereby granted to:
TIMOTHY T STEELE
13 7 9 5 OREGON RD
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN ACCESSORY GARAGE. THIS PERMIT REPLACES #30393Z.
at premises located at
13795 OREGON RD
CUTCHOGUE
County Tax Map No. 473889 Section 083
Block 0002
Lot No. 010.016
pursuant to application dated NOVEMBER 29, 2006 and approved by the
Building Inspector to expire on MAY 29, 2008.
Fee $
75.00
ORIGINAL
Rev. 5/8/02
l!I.l!I
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ TIMOTHY STEELE TIMOTHY STEELE ~
~ 13795 OREGON RD 13795 OREGON RD ~
I CUTCHOGUE, NY 11935 CUTCHOGUE, NY 11935 I
~ Located at 13795 OREGON RD CUTCHOGUE, NY 11935 ~
~ ~
~ Application Number: 3019858 Certificate Number: 3019858 ~
I Section: Block: Lot: Building Permit: BDC: ns11 I
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ First Floor, work shop, Detached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 5th Day of January, 2007, ~
ml Name OTY Rate Ratinl! Circuit ~ ~
~ Miscellaneous ~
~~~~ ~
~ as built 1998 ~
~ Appliances and Accessories ~
~ Furnace 1 0 Gas ~
~h~ ~
~ 1 100 7 ~
~WiringandD"i~ ~
~ Outlet 19 0 General Purpose ~
~ Receptacle 21 0 General Purpose ~
~ Switch 8 0 General Purpose ~
~ Outlet 21 0 Fixture ~
~ Fixture 10 0 Incandescent ~
~ Fixture II 0 Flourescent ~
~ Receptacle 3 0 GFCI ~
~ An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to ~
~ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring sYJf9111. ~
I Continued on Next Page 1 of 2 I
I 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
l!I.l!I
l!I.l!I
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ TIMOTHY STEELE TIMOTHY STEELE ~
~ 13795 OREGON RD 13795 OREGON RD ~
I CUTCHOGUE, NY 11935 CUTCHOGUE, NY 11935 I
~ Located at 13795 OREGON RD CUTCHOGUE, NY 11935 ~
~ ~
~ Application Number: 3019858 Certificate Number: 3019858 ~
I Section: Block: Lot: Building Permit: BDC: n511 I
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ First Floor, work shop, Detached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 5th Day of January, 2007. ~
ml Name Ory Rate Ratine: Circuit ~ ~
~ No visual defects: an elctrical survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory ~
~ condition was found. ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
I seal I
~ ~
~ 2 of 2 ~
I 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
l!I.l!I
/
APPpALS BOARD MEMBERS
Ruth D. dliva, Chairwoman
Gerard P. Goehringer
James Dinizio, Jr.
Michael A. Simon
Leslie Kanes Weisman
http://southoldtown.northfork.net
" ~ :
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
Tel. (631) 765-1809' Fax (631) 765-9064
3
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Mailing Address:
Southold Town Hall
53095 Main Road. P.O. Box 1179
Southold, NY 11971-0959
Office Location:
Town Annex /First Floor, North Fork Bank
54375 Main Road (at Youngs Avenue)
Southold, NY 11971
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF MARCH 9, 2006
ZB File No. 5618 - TIMOTHY STEELE
Property Location: 13795 Oregon Road, Cutchogue
CTM 83-2-10.16 and 10.18
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 further steps under SEQRA.
PROPERTY FACTS/DESCRIPTION: The applicant has submitted a survey prepared December 12,
1995, amended April 14, 2004 by John T. Metzger, L.S. of the entire 16.77 acre parcel, including the
location of their single-family, two-story home, accessory garage and swimming pool. Also shown
is an (as-built) accessory storage structure and proposed barn, proposed addition to the garage, and
proposed storage structure (container). The applicant has also submitted a second survey map,
prepared June 26, 2002, amended July 28, 2005 by John T. Metzger, L.S. concerning 2.93 acreage,
apart from the remaining acreage (farmland with Suffolk County Development Right Restrictions).
BASIS OF APPLICATION: Building Department's April 23, 2003 Notice of Disapproval, amended
May 20, 2004 and January 28, 2005 citing Sections 100-31A(2-c) concerning a barn (building #1)
proposed at 38 feet from the rear yard line instead of the code-required 75 feet. Also cited is the
accessory nonconforming garage (building #2) placed in a side and front yard location, and then a
proposed 16 ft. extension to the as-built garage in a side yard. (The building permit in 1996 under#
23399-Z allowed an accessory garage based on a request to built only in a rear yard location.). The
third and fourth buildings are for storage in a front yard location. All construction was requested in a
yard other than the code-~equired rear yard.
FINDINGS OF FACT
The Zoning Board of Appeals held public hearings on this application on March 31, 2005, June 2,
2005, and January 26, 2006, 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: The applicant is requesting variances concerning the
following: as-built 25.4 by 35.8 ft. accessory garage, proposed 16' x 25' addition to the as-built
accessory garage, 8' x 25' shed, 30' by 80' accessory barn building, and as-built location of an 8' x
fI
/
Page? - March 9, 2006
. ZB File No. 5618 - Timothy Steele
eTM No. 83-1-10/16 and 10.18
22.3' accessory shed, as shown on the survey prepared December 12, 1995, amended April 14,
2004 by John T. Metzger, L.S.
ADDITIONAL INFORMATION AND AMENDMENT: During the public hearings, numerous
discussions were held regarding the applicant's nonconforming locations of the storage container
structures and proposed 8' by 25' shed, as well as the proposed garage extension. Adjacent
landowner(s) representatives also spoke with concerns and objections to the requested variances
(please see hearing transcripts for detailed statements of verbatim testimony).
APPLICANT'S AMENDED SURVEY SITE MAP: On August 1, 2005, the applicant submitted an
amended survey site map, dated June 26, 2002, amended July 28, 2005, by Peconic Surveyors,
P.C. correcting the property boundary lines adjacent to the right-of-way, and relocating the 8' x 25'
accessory shed to the eastern yard area at the rear of the dwelling.
REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and
personal inspections, the Board makes the following findings:
1. Grant of relief will produce an undesirable change in the character of the neighborhood or a
detriment to nearby properties. The applicant's property contains buildings, of which only two
(dwelling and swimming pool) were issued certificates of occupancy on this 2.93 acres of residential
property. The applicant's residential property borders a separate, adjacent private road which
provides access to neighboring dwellings under construction near the Long Island Sound. The
applicant requests a variance for the as-built 8 fl. by 22.3 fl. storage container structure in a front
yard. Also proposed is an accessory 30 fl. by 80 ft. barn, 28 feet to the top of the ridge (midline at
22 feet), in a location at least 38 feet from the eastern lot line and 90 feet from the northern lot line
adjacent to the 50-fl. wide right-of-way as modified to be in a rear yard location. A new accessory 8
ft. by 25 fl. storage shed is also proposed, and applicant has modified the request for this shed in a
permitted rear yard location at a minimum of 52 feet from the eastern lot line (instead of the original
request near the right-of-way at the northern boundary line). The 16 fl. by 25 ft. addition is proposed
on the westerly side of the existing accessory garage which is a front yard and proposed to be only
20 feet from a 50-ft. wide right-of-way. No buildings or structures are permitted to be located in a
front yard area, as confirmed in the Building Inspector's Notices of Disapproval because they are
required to be in a rear yard. The rear yard is a large area available for placement of accessory
buildings as an alternative to the applicant's requests.
2. The benefit sought by the applicant can be achieved by some method, feasible for the applicant
to pursue, other than an area variance. The applicant's alternatives are: (a) to propose an addition
to a garage in a conforming rear yard location, or to locate an accessory garage building in a
conforming rear yard location, rather than a front yard, (b) to locate the accessory barn and other
accessory structures in the rear yard which is open area. The rear yard consists of over a half acre
of available land area for alternative locations of accessory buildings.
3. The variances requested are substantial. The buiidings are proposed in non-permitted yard
areas.
4. The difficulty has been self-created. The garage as exists, the addition as proposed to the
garage, and the metal storage container were built without written town approval.
i
Page 3 - March 9, 2006
. ZB File N\" 5618 - Timothy Steele
CTM No. 83-1-10/16 and 10.18
5. Evidence has been submitted to suggest that the requested variances in this residential
community will have an adverse impact visually on the physical or environmental conditions in the
neighborhood,
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 Chairwoman Oliva, seconded by
Member Simon, and duly carried, to
DENY the relief requested with respect to the addition to the garage and accessory container
and shed(s), as applied, and to
GRANT a variance with respect to the accessory barn, as shown on the survey amended
July 28, 2005 by Peconic Surveyors, P.C. and shown on the elevation and length/width
diagram prepared by The Tandy Farm revised 1/15/05, and to
GRANT relief for the as-built location shown on the survey amended July 28, 2005 by
Peconic Surveyors, P.C. of the 25.4 ft. by 35.8 ft. accessory garage (without extension),
shown on the 9-26-03 diagram prepared by The Tandy Farm except that the setbacks shall
remain as-built at a minimum of 20 feet from the northerly front yard lot line at its closest
point and 25 feet from the northerly front yard lot line at the opposite corner, subject to the
following Condition:
That a length of screening be planted and maintained for a minimum of 42 linear feet
on the north side of the existing garage.
Any deviation from the variance given such as extensions, or demolitions which are not shown on
the applicant's diagrams or survey site maps, are not authorized under this application when
involving nonconformities under the zoning code. 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 Oliva (Chairwoman), Goehringer, Simon, and Weisman.
Member Dinizio was absent. This Renio::as duK adopted (:-0).
~){:Y,~
Ruth D. Oliva, Chairwoman 1013' /06
Approved for Filing
av
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRlJCnON
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[~L
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE liyr;
INSPECTOR
FIELD INSPECTION REPORT I DATE ! COMMENTS l}!
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Iif'3 K: .....
rulable
I
BULKHEAD
.
M. aldg.
Extwwion
ExteNion
, Extension
Poioeh
Ion:h
Breezeway
Garage
Patio
0.8.
3"qtal
..
/
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PM::~ L LR.
. r'1::Fc- DR.
BR.
FIN. B
3."'0
.
1/0,/
I
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Foundation
,!; I=? / Bath
f",/ L- L Floors
W~/.l)/A( jJ>terior Finish
/~. Heat
I Rooms 1 st Floor
Basement
.;z l,j- Ext. Walls
Fire Place
Type Roof
Recreation Room
Rooms 2nd Floor
Driveway
r-J,.<)?Amf :S3X/J"d6) ~.- 7,)G Dormer
,j j J"'"SV
I
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FARM
CUi
lie.
CJ
FORMERiOWNER
~_~A/
E
SW/II-oclll7 - eZtl!~TI"f
W
ACREAGE ~.
;l~ qqt
TYPE OF BUILDING
,
RES.
SEAS,
VL
COMM.
I MISe.
'l I}~R ~
;I.:Z,OC:>C:>
LAND
IMP.
TOTAL
DATE
REMARKS
~'~<r""', /
!J. n/ ."
~
-;.,- .~
.
Cf ;c>;-Q 0 "
/.,-/~ .,. ,/,,'
........ '--,.",.
tt~:;;r
(eUlU c(,./ Cl Ci ( "'1('
, /" [/ J.
if>- c.. / '7' 7"',p II 'I ":2--cc 0 (};:C'
/.t//7~_}3Ll)9 f~~ #-&S?/~U.Lkf> a.B~e.~~
50(.?--1 ('" ,('(1-/ ~ Nt:. cJ~)
--
-
! - II
I, :J.3j""Z
7--o(f?
Tillable 2
.!::
II
Tillable 3
i
------.----------+--
I
I
/
Wcadland
Le - y/'//71- .CcL..-t: ~~
. I , (
Swampland
Brushland
~f~.
,s>.rf
· ".J1'-@ ;J f '... ~ t I . ,
r61'W fa'jiM.~ .. _I. 'G,,""O (J I
~ 5/0 . ~
1"'-1' /' ~ / f) 1,
u .
/..,_g~.QJAL..S.J2"'L IV b~ ~ 0 () _ .1., r: ,f 14 ~
I1c (1) ~So
~" It
'Ci. L____ 1,''-1
.--- -- -.- /
'17~
/_-
Hoyse Plat
Total
(
Extension
~C,{
Breezeway
~
...... ~_ (tt.,
..f.. '/ /
II:, Y,!t
2'( I. 3::-
2~ )( 13 .:... ~'1 :::. J C3
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3 I
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/
p/ IV ;;.::
<..0 () c 0
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--..iiia-- Bath
./ . Foundation
yft-
J.9fJ- II () Y
Basement
Floors
rt.-iL'-
Ext. Walls
Fire Place
Xli S
Healt
EI.Et..
Porch'
Attic
Porch
Rooms 1 st Floor
Patio
Rooms 2nd Floor
Driveway
/
.-..........-
\
L ,
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
---. . . . .. ~ .. --- ---.--- .-...
OWNER STREET VILLAGE DIST. SUB. LOT
.- --~~_.__.
--
ACR. REMARKS
TYPE OF BLD.
PROP. CLASS
_ u
LAND IMP. TOTAL DATE
-.
. ~--- - -
_.__u
-. ---- - - - - n -
- -~ n_
---- --
.
-
FRONTAGE ON WATER I TILLABLE I
------ - no ---- ------ J on_ -
FRONTAGE ON ROAD WOODLAND
-'--- ---------- MEADOWLANO[
DEPTH
-.
BULKHEAD HOUSE/LOT
_______nn ---- __~_m - -..-
J______ TOTAL
-_._.-.-..._--_.~--_.,-- ------ L.___.________.
~-,.
c, ......
,
I
,
I
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,
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"
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~.Bldg. 3~ 50;.j. Foundation Bath "3 , Dinette
\2 'l. \2-~ 14J.1 I?.
"II>! ""FULLJ
Extension " '(\(0" \1e. ioLj Basement ~l Floors ~v..J~ Kit.
SLAB
l~en~ion 02.0 'I s:..a 14'+0 Ex!. Walls >Nod) c\,t "Interior Finish G~.4.1l- L.R
lto 'K20 ~ """. .~"'"
, . . - -=.~~\ -
L~te~s).on I b Kilo ... 2S~ t I ()Q7 ~:o 5 75'1 Fire Place I 1l.l. ~. Q.~,^. Heat D.R.
. 5-
Patio ~'1l'c2q ~. IllI./I \ Wood stove BR.
Porch J1 x IL" 48 .~ 2..~ Dormer Fin. B.
-
Deck Attic .
Breezeway Rooms 1st Floor
Garage c.\1l, lot':> Driveway Rooms 2nd Floor
~'..
O.B.. ( , ~, .. \, L. \..,-4J; ,^^, VoQII ~aw..
:;:. ~,':JQn t1~[
I " \ ,
Pool - 1:'_.4-
3&r \ ~l\,,'" !>/ I'''llt'
A-c ='\l"'~ 4010 ~y'\4 ..4, 01/11.
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/
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THE TANDY FARM
15405 MAIN ROAD
MATTITUCK, NEW YORK 11952
TELEPHONE (516) 298-5485
FACSIMILE (516) 298-5485
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NO Doo rs / M Wi r>/()t!ifL&
..~ fE (; ~ n W fE r-
:a APR I 7 1996 J
I.
'J; BLDG. OEPT
"-. OWN OF SOUTHOLD
T~ Tandy FarH1l
13795 Oregon Road
Cutchogue, New York 11935
Tel.: (631) 734-5169
Fax: (631) 734-5174
Timothy T. Steele
Southold Town Building Dept.
1-11-07
The storage container under discussion is intended to be used for storage of agricultural
supplies, tools and other as needed in my nursery/gardens.
Thank you, sincerely
~~i ~f7
Timo . Stee e
St;/4~ ~ ,~~ ~
P-5 ~ -""'/
'~ryl SImons
IIolIry Publici State Of NewYollc
No. 31.4970341
OualUied In Suffolk County / r?
Commlsslon Expills February 4. 20.!.:./
..- <.-'
, -,- (~' I:';
~,
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---
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----..--
.rORM NO. I
TOliN ('"I' SOUTllOI.D
BUILDING DBPARTMENT
TOliN HALL
SOUTlIOLD, N.Y. 1197/
'mI.: 765-1802
....................
IJ:xzJnined...... ..,..... f.... ... 19.. to
ALL.. ............ ...'......
^1"PrOV.d................., 19.... Pennlt tb. ..,.............
Dll94ppl"C'Ye'd lJ/c. .............................:.. .................,.......
MAlL '1'0:...... ...........'.............
.....................................
....................................
...................................
..................
r
I
;
................................
it
(lluildlnB lnapector)
HAY _ 6 .
APPL ICM'10N FOR nUIL1)INc PEllliT'f
. Date... :1~/~1..... .19....
,
f._.___
00_",'<
INS'l'RUCTIONa
.
" i "
a, 'nIl' applicatiOllllUllt be~ etel)' filled in by typ!Writer Dr in illk nncl sulJnitted to the lluilclinll InG~etor witt
sets of plans, 4lCCUrGte plot plan to lleale. F.... according to 8d>e<lule.
h. Plot plan sl_it18 locetion of lot ancI of buildings on preni..... relations! ip to adjoining premlseR or tJ.~,1ic
tr....ts or oreas, and /li....ing 8 detail description of layoot of JlI'OPClrey "ust be rewn oti the diagr/lOl "'lieh is 1>1rt of
Ills apllliC'ltion.
c. 'nie \oo<)tk covered !>ythis appl catia;"",y not be ~'m...nceo.l before iS8UallCe f'llul1ding !.'emit.
d. Upon apprtll7alof this ..ppHcn ion, the llulldIng Inspiccnr wlit Issue a Dol Iding !.'emit to the applicant. Sudl
cnlllt shall be.kept on th.. prall!"". allable for inspection thmughout the work.
e, tb building sh.oll beoocupied or used' in "'lOle or In part for any OiUtPOse atever IIlltil a Certificate of
ccupsnc:y shall have been gr""ted by Ie ~u Idllljl Inspector.
AE'PI.IWYQI IS lERmlY w.m to the Iluitdi"llllepsrtmellt far tha isSWInca of a ildlna Permit pursuant to the
.dldlng :r.on.. Ordinance of the 'l'tM:I of South.,ld. Q,ffolk Count1", Now 'fork. end oth I' Bpplicable Laws, Ordil\llrlCOS or
egulatlons, for the construction of HlIinss, a<IcIltiOlls Or alterations, or fOT . 1 Or dmDlition, as herelll
eSeribed. n.. applicant agree. to ly with all applicable taws, ordi=s, i1ding C!ode. housing cod... nnd
egulations. and to ll<kuic authorized I ~to", QI )n'CIllses 8tld in building for ne ssary: s~ti~~7 Il /J .
. ......~. . ~;,;.j~~lf~
(~ture of. lic t, Dr name. If 8 corpo~~~
....~~.N.~l .:. .~)lY...I!I.?.L
~ilil'8" raIlS of applicant)
tate ..lieU.... applicant i
. agent, architect. engineer,' general cont actor, electrlci~, plumer <71" builder.
...................... .
.t.......................................... .....................................
. s.W>.If.. t:XIMlnf.-. .S!.~.
the tax roll or lllteRt deed)
of duly authorized oEfk..,r.
................................1....
(No~ and title of corporate officer)
..................................... ..................
nuilders l.lcense tb. ............
............
Ph.nt>ere 1.icenM No. ..... ........
.............
Electricians License No. ........
Other Trade', License tb. .......
.............
,
. ll.lCation Df Ian:! """',ieh p . work,.,ill be OOtl<!li'...L.................. .........../i....7................
. ';.;;;;;w,;;' ......~ ~..;....... .\Ml.Ci;'!M".... ..A!.Y.....~.. .............
Cooney 'l'DxMap No. IlXXl Section ....~........ Block ................. I .c?"'/.~' '.01.
SeJbdivision ...... ........... ..1. ,"....... ........ piled ~ lb. ...... ........
(Nmro )
...............
Stste exi stina WIl!! and llCaJP8rX:Y
a. Existl~ use and DCI:upllncy ',..
f pnmlMs and intend<ld "" and occupaney D propoMd CCllstrnctionl
.... .$.( r:......................;;.;...... OJ...........i................
,.. ,s.fr...~ .f1~~. ........... ~.. ~ .{MIf!(}.........
b. Intended uee and occ:upancy ...
~. .~,,I!,"''''~ A~~f.-1Ct]
'6wH W' ~." . ';~,'.du'l '(18IaIit
, ",. . '''1) 'it
....' ."''''ltnu . )-/.L~J"'~j ~,;.';:~.;:,;uO" ..... .".'~:;r'"
lDOl;,ar II"" "'''GJl3 tlo...".mnlO3
1,
I..
5.
6.
7.
n.
9.
10.
II.
12.
13.
II,.
.,:; -',"..' ,..-
,. '/ ,,'.'
:'i'
-';-fl"'"
,.,,,<li1'!:;!',~. ' ' ,
.'
..-..-..--.......
l'",ure of I.IOrk (d.eck whld. awl
Hapulr' ~#....... to. ~lIJ'Val . 00"
V
callie). Noow l~lllcllnll .......... IIddltloo
........ 1l3mll ~lon ............ Otl,IU \",
..................................
Alteration ..........
9J, SZJ2i6 0, '
E.st!lI~ted Cost .....Y'.,......... .......
~1l.Il.crj pt lOll)
fee ...... 0.... .... .....
.........................
(to 1"3 paid on rll 'nil this al'l'li",,~jon)
If d~l1lna, "..her of o.."l1Jna \ Its ............ tblher 'If l~..l Iina units I each floor................
It aerDGe, ,ulh"r of carll .....; ,...............................
If bUllnel., CQlll1:!rclal or miXl!!doccullAnCy. slleclfy MtU:tt al<tent of ea I type of use.........,............
uj"...nsiolls of ""tltlng ItTll<:ture, if eny' 1hOllt.~......:... Rear .,............. llt!pth. .................
Ilc:tight ........... I....... I...... tiJ1iler of ,Stories. ........ ..., ....... ...
n!nenaials of sane structure vit. olteratlons or IMlditloosl Front ............... ~.~...l.~.....
Il<lplh .................... llelllh' .................... ti.J.her of Stories ...............
nlllensiolls of entire new conlt tlol\: ll'rOflt ................ l1<>or ............... Ilef.th ..............
.....................
IktigllL: ............ .............. '.' "Jt.nl.>>r of Sterlo, ......................
.",.. Ilear ........."........... lleprh
l1tu"s of PurchsfMt ...................... ...... HaTe: Dr l'omll!r ~'8):; ............................................
Zona or use district in Whid. pr I... are situ.ted ...~................~~~.;~.~:J;.................... ...
Iloe. proposed construction vlot '. any zon1"ll 1.., ordl~. or nlaulltlo<1l .. ~~~. .... ....
Will lot be Tl!grlO(]ed ....... . . ........ win .......... fl11 be rl!ll'OYlld!Tan ""h..s: YItS ~ 13~~/1
Ha,el of Oomer or prero.llI/IS .... ..~t~ ......... Address .............................. HlOl. ~.. .. .
Na1e ot Architect: .......,......
0...... ........ ....... MIre.. ..........1.......... .......... ptQ'lQ'tb.
..........
~ of r..ontractor ..................................... hldress ...............................11lOne lb.
I~. 10 rhls propertywil1lin 300 feet of.. tl~ll..tland? II Y1tS .......... 10 ..........
IIIl' YItS, 9:l1I1nD 'l1:Ql1 "l'l!llll1'lltMn' Mt\Y IJll: RllQJlRlID.
1'1.0'1' DIAGRAM
locate clearly an:l distinctly at ~Udl"lls, loiJllthu ""I.tlns or proposed,
Froll prlll",rty 11"".. GtVQ .treet and' lock rlJ.ber or descripttal a<:conJina to
IAlCtlle, Interior or comer lot.
S'IWI1! ~r Il~ YIXlK, '
S<<.FPJLk 58
a~Il'Il'i ro .......................
.......... ....!Jj(C:?!ll ?..!J.... ...!. (;/(dA:/YJ. .bell~l duly swm.
(IInIC "f Individual .1Ilnl"8 centrs..t)
~llOVe rIOted,
He i. lho ....... ....'. ..d~f!:.~.-c~............ ...........................................................
((',()!ltroct~.r.!nllCl\t, j:~rporatl! omcu, .etc.) I
"r said OWl..r or ~rs. "rd'lft,duly . lhorlze<l to perfon. or hIM! I'"rfmned lllo "'1id W<;lrk Still to .aka ond rIl. lhf"
~Wll<'otloll: thol: oll .tatelll.nts <:ont 'lood In thl.. nl~ll\cutlon are true lo !J'G b"~.9 of hi.. klll~ledjlo Old IXIUflf'i ...1
,hot lhe work will be perron~l In th .II1IIOfler ""t forth I" tile application Hled t1rrllWith.
Hwonl to before llJ! this ,
........tP. ~ ..dsy DE ......,. ?::.~l
Indiclte sll set-back dimensions
. snd ahow street nares and IrcHcate
~. cdtQJ~
.
i
.1
<10lx"'''1 atlll r;.~y.
i "
U,ot he I R tile OWl, i ':>lIIt
Notary Public ...... ... .
DONNA M.
...., PubIIo. State NeW"
No. 01 MC485 451
GuaHtled In 8uffo eouncv.......
~1..1an Ixpl.... '1, _