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Home My WebLink About31916-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32174 Date: 02/01/07 THIS CERTIFIES that the building AGRICULTURAL BUILDING Location of Property: 37325 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 85 (STREET) Block 2 PECONIC (HAMLET) Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 18, 2006 pursuant to which Building Permit No. 31916-Z dated APRIL 18, 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 WINERY STORAGE BUILDING AS APPLIED FOR. The certificate is issued to PINDAR ASSOCIATES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 60503C 10/23/02 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Rue:; 08 06 02:57p Pindar Vine~ard (631)331-7317 p.2 ''''''_'f U...'i '--'-n...... UU. '..L ____'u.__.__.__.._____._ _.. ,-'I,'." -.J"u. U..' w..,,'--'....,,"".... 7?'C-f- 0Jfr0 O~ qJG- 8Lf80- - f01 JG ,10 i I I __.~l Form No. , TOWN OF SOUTROLD BtJlLDlNG DEPARTMENT TOWN HALL 76'-1802 W1.. I L L Y. ,;-!(;Lf'\ ..I.PPLlCAnON FOR CERTIfICATE OFOCCUl'ANCY ThIS sppllCation must be filled in hy tyPewriter or ink and submitted to the Building Dep.rtment with the followmg: G>or new buDding or Dew un: 1. Final survey of property with aCC'Jrate location of all buildings, property lines, streets, and unusual natural or '../ topograpruc features 2 Final Approval from Health D"P' of W.Ler supply .nd sewer.ge-disposal (S-9 fonn). "3. Approval of electncal inst.lI.t,on from Board of Fire Underwriters. '-4 Sworn <latement from plumber certifymg that the solder used in system cont.ms less than 2/10 of I % lead, S. Commercial building, industrial building. multiple residences and similar buildings and installations, a certificate of Code Comphanee from .rchltect or engllleer responsible for the buildIng, 6, Submit Plannmg Board Approval of compleled SIte plan requirements, . B. For uisting buildings (prior to April 9, 1957) non-conforming u"., or buDding. and "pre-exitllng" land usu: 1 Accurate 5-urvq> of property shoYl'lng all proprrty lines, streets, building and unusual n2lultal or topographic featw-~~ 2, A prop...ly completed application and consent to in.pect signed by the applicant. If a CertificlllC of Occupancy;' denied, the Building Inspector shall stale the reasons therefor in writing to the .pplicant. @ Fees I, Certificate of Occupancy - New dwelling 525.00, Addirion. to dwelling $25,00, Alt....llons to dweUina 525,00, s-."~;+1HGIl~ I"'~..,IIJ ~~ ~"..m"y nI111111"g~'t;.OO, Additions to accessory bulldina $25.00, Businesses 550.00 2, Certificate ofOcoupancy on Pre-e'tstmg Building. 5100,00 3 Copy of CertIficate of Occupancy - $,25 4, Updated Certificate of Occupancy - 550,00 5, Temporary Certificale of Occupancy. Residenti.1 $15.00, Commercial $15,00 'l/<f; h(/1 Dale, . >< Old ,or Pre-e"stmg Bulldmg, Location of Property: _ua1 :~.;IS ~~ uk. House No. Owner or Owners of Property: _fuda r Suffoll< County Tax Map No 1000, Section New Construction: (check one) PeQon; ~ Hamlet dlS Street /tSs" a.. ia-h C)~5 Bloclc .;z.... Lot I if SubdlV1SlOn Filed M.p, t./ I,g };ltd.....pplicallt: Lot: PI nAIl.r ft:>SO<lI'a.-.-Ie 5 Pemut No, -llq J to Z Date of Perm,!. Health Dept Approval. Planning Board Approval:__ Underwriters Approval: RC:4Ul:st for: Temporary Certificate Fee Subnutted: $ < F5() OC) Flllal Cenificat Applicant Signature Gu-;(75) CO't?'J'J.I/Y 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. 31916 Z Date APRIL 18, 2006 Permission is hereby granted to: PINDAR ASSOCIATES 591 BICYCLE PATH-SUITE A PORT JEFFERSON STA,NY 11776 for : WINERY STORAGE BUILDING. THIS PERMIT REPLACES BP 30235 at premises located at 37325 MAIN RD PECONIC County Tax Map No. 473889 Section 085 Block 0002 Lot No. 014 pursuant to application dated APRIL 18, 2006 and approved by the Building Inspector to expire on OCTOBER 18, 2007. Fee $ 8,850.00 .~ CiL. I Authorized Signature ORIGINAL Rev. 5/8/02 .. .' '. '." ~l(.o'~~ao L~;4~ O~O't(LO~"., I-'A(;j~ m ~ '. ~7/05/20B6 08:81 51G-472-5148 :! 87Ie!lize.~ 11'" ~.22" t 5.J. RUGGIERO. INC. <<1.1 WOTlUC- PAAF 01 ...,... - -To&. ~. ~ ~ ,:' ~', 1: r: ~:i f: . I' , ~ ~ ! fi it ~. J.:" fi. ~ ~ ,. 1. ~ r . i-:- i, I t. f ~. ~ .~ ~; . I~ r " ! f, ~ 0, f:. t: ,. .. t . l " , I': KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND MAIliNG ADDRESS: P.O. Box II79 Southold, NY II9711 OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631765-1938 Fax: 631 765-3136 PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair January 24, 2007 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Dr. Herodotus Darnianos Pindar Vineyards 591ABicycle Path Port Jefferson Station, New York 11776 Re: Pindar Vineyards Storage Building 37325 NYS Road 25, Peconic SCIM #: 1000-85-2-14 Dear Mr. Darnianos: At the written request of Alexander Darnianos, dated January 17,2007, requesting final site plan inspection, Planning Department staff performed a site visit on January 19, 2007. In reference to the above, the Planning Board held a work session on January 22, 2007 to discuss the approved site plan prepared by Charles W. Southard dated May 12, 2001 and last revised January 3,2007, the resolution dated January 9, 2007 and staff site visit comments regarding the above referenced site plan. In reference to the above, the Planning Board has determined the site plan requirements have been satisfied and include the following items: · All handicap parking stalls, access aisles and signage must comply with New York State Code and ADA requirements. TIlls letter does not condone any changes from the as- built site plan and approvals from other agencies if required. Respectfully yours, C' - flvJ -~P.~ JefJyn B. Wo~dhouse Chairperson Ce: File Building Department Town Engineer Charles W. Southard Jr. REGlSTEREJ) ARCHITECT 4400 Veterans Highway Suite #207 Holbrook, New York 11741 Phone (631) 471-5228 Fax (631) 471-5229 JAN I 3 ' ^^'; January 7, 2005 Building Inspector Office Town of Southold Southhold, New York 11971 RE: Proposed Storage Building for Pindar Vineyards 37325 Main Road, Peconic, New York Town of Southold Building Permit #26934Z ~ 3 \ q I \., Dear Sir, This is to certify that I have inspected the completed facility and have reviewed the Pre Engineered Butler Building drawings, which have been signed and sealed by a Professional Engineer, the "Letter of Certification of Erection" by S.J. Ruggiero, and the "Bolt Inspection Report", provided by All Island Testing Associates, Inc., and find that they provide sufficient information to verify that the structure has been designed and erected in accordance with the requirements of the New York State Building Code. I have also visually inspected the building insulation and heating system and find that it is in substancial conformance with the New York State Building Code. 9 (~'U! ~S ut ar Jr. Registered Architec attached; SJRuggiero letter All Island Testing letter .IAN 13 ..r; ALL ISLAND TESTING ASSOCIATES, INC. 758 Pine Aire Drive Bay Shore, NY 11706 Phone (631) 273.5717 Fax (631) 273.2457 .".................................................................................................. S.J. Ruggerio 163 Kensington Avenue Bayport, N.Y. 11705 Re: Pindar Vineyards/Bolt Inspection taken 8/12/04 INSPECTOR: OM Quick (8-4:30) The bolts are being installed by S.J. Ruaaerio and have been approved by the ~oard of Standards and Appeals of the City of New York. ' Each bolt accepted shows the following data: three (3) radial lines at 1200 togeter with identification on the top of the bolt head and is manufactured by -11.. Size of Bolt (H.S.): A325 7/8 Installed: 100% Inspected: ~ A325 % 100% 10% LOCATION: Due to Multiple Obstructions (Cases of Wind, Holding Tanks, etc.), All Connections could not be checked for torque. Random Connections were Inspected using higher torque ranges due to the bolts being rusted. All Bolts checked met the mimimum required torque. Respectfully Submitted, ALL ISLAND TESTING ^ t'" / .., ;;' (L()..-? 'il/. r/L Doug Ouic ill S.oJ. RUGGIERO. INC. GENERAL CONTRACTORS 163 Kensington Avenue. Bayport, NY I 1705 Tel: (631) 472-4167. Fax: (631) 472-5748 www.sjruggiero.com JAM , 3 r,^c\ BUTLER ) October 27,2004 Town of South old Building Department Town Hall Southold, New York 11971 Attn: Mr. Gary Fish, Building Inspector Re: Pindar Associates 37325 Main Road, Peconic SCTM #473889 - Section 085 - Block 0002 - Lot # 014 Permit # 26934Z i2e.n "3 \ q \ ~ Dear Mr. Fish, As per your request, we are submitting this steel certification affidavit for this project. Please accept this letter as certification by SJ. Ruggiero, Inc, that to the best of our . professional knowledge and abilities, the Butler Manufacturing Company furnished pre-engineered metal building system has been erected in strict conformance to the Erection Drawings and Specifications as designed and furnished by Butler Manufacturing Company. As authorized Butler Builders, we have erected this structure with our own in-house erection crew to maintain the quality control required for proper erection of this system. As an additional quality control measure, we have retained All Island Testing Associates, Inc. to perform a random bolt inspection, to insure proper torque values were achieved. Please find a copy of the bolt inspection report attached herewith. Sworn to before me this ./1.:-2..... day of ./VP../.............. 20t?':!. NOtaryPUbliC~~ GW4'A JIt-~G NO~'-/Pu6L-,c.. 6ri/-rco/,:;.,..)Y do: Ou.1 A (, 1/ ?f/~ ()l.f IJ-t.-, F7 t:D I J 6U rYe) tAC.- QM J'oi r'/ tv "-1 A,f/ 6 IV,.) Ii'/. fl II/I I Jvt> ( . Charles W. Southard Jr. REGISIERED ARCHITECT 4400 Veterans HighwayAuite #207 Holbrook,Hew York 11741 Phone (631) 471-5228 Fax (631) 471-5229 April18,2001 Building Inspector Office Town of Southold Southhold, New York 11971 RE: Proposed Storage Building for Pindar Vineyards 37325 Main Road, Peconic, New York '6 q Town of Southold Building Permit #26934Z ~ \ \ )0 Dear Sir, This is to certify that the footing reinforcing as shown on the drawings prepared by me for the above noted project, has been installed as shown. Charles W. Southard Jr. Registered Architect TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING ~INAL [ ] FIREPLACE & CHIMNEY ~RE SAFETY INSPECTION REMARKS: (i;kU~ 1.' ~;~ '~CJnluN ~... IIV..;v~J rrl'(I~I"'-=fU,",, -:n-')I.... It,v'-, 1-....,,1..:;'. C2J ZU:::c.., tJ fJ i::;>o=-vl2.W ~.1?'7J_ C ~~ \}J \1'7-. 'IV ~ IA..)Dcz...tL i>o~€" @ +to LeS j"u\[ A-f"~~ ~~ ~eE ~,'-=c: rL- lZ> p.,l:Z ~-Pfr; o-D . DATE 5 . , Lo. 00 . INSPECTO~-h~ -*" i)j,Q c.wc:OC IV- ~ \~v\'--' ~. 0,lL. O(<.L~ NOT. ~ NOT;;:: ()JILL IIS~~ ~. ~~ SofMt?:Bub . 3:;2.3r;;- 765.1802 ~-11 31 Cj IJo BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [~IRE SAFETY INSPECTION REMARKS: ~ILbJtV6 ~--2iUll t-\.p,s" -F::SL\>I~~ t f;U,lo-J6, PH\lUI' '(,4;€ ~~-h 7AV~ PLAnJ, &1L.:0 DATE=! -12-- Db INSPECTOR J 191 Co-c TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] I,.uLATION [ ] FRAMING I STRAPPING [ t1FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ~~ DATE INSPECTOR ~73Y~ k 3\~IL -:::;:r . 765.1802 BUILDING DEPT. INSPECTION ~NDAnON1sT [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL REMARKS: r~~ <?;;7hr I I ; DATE I. ___ INSPECTOR dJ.o 9 ~ ~-c- ~-" "3)C) \ 10 765-1802 BUILDING DEPT. [~N~~~~EC~~~~H PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: r: ,. ~t~AN' INSPECTOR ~ . . :KtD INSPECTION REPORT DATE ._=_=_=~-----==-==-----=r_=_==_--c-----c------------ . ----- ----- ~ Y:fr~-- _>7//2?;::---- II , II . ... II II II II II II -~------- If II II ~,!!~.~!.12!._1t.-.1 II II II II I! II II II 11 1" [ II II II II II II II I I II II II -----..JI II II II .====================t= II " II II ~ II II lI-- II II II II II II II II 11 '. II =======================t========t=== II 1/ 0. II II II COMMENTS =============~============== JUNDATION (1ST) 'UGH FRAME & PLUMBING iSOLATION PER N. Y. STATE ENERGY CODE -==========================================-=====- . . FINAL II II II I 11-------1 II II II II II ~ ~ II II II -===================-==!_=====~=====~-=-=== --==--============================== ADDITIONAL COMMENTS: ==================================================-===================================== - FlfGE .....N'SPc:CT10,.J - F,f<.E Ail.Ep., i\J~.s~ ~t; c€ll\1r.~ 612..... c:ceeE -,00 ............(2..{...e N~"\C> C.e.12-'\1 F'-( uSE of- '&.l1c....~leJ<:, ll'i0T S O...J M:.ANS Y\^"2€ fHl-I:> V<->n ....G.,ul.i. ~ , CUVTl Ft1 VAA>12.. ~'U7- ,. As b,),L.-'T ,.:v.r.ss: '6 ~f. L.~~ R. "',...,""""i..D '" ~ o<.f . ~ 4~ 12. -0'= 'T L-b '7'I-n:""" ~E\'<.~\.IK~B'NA1.- IS R~u\\2.i:;l) -l2-i.~ V'Acz.10i')\3~ P~5 ( i2~ \~!) C'IG ()l, Sin:: 'PaAlO -" 4S ILT pLA1J'jI\ - ok. A::: 1,v')/~ oJ pjl2t{l" P, l-E. tl/fv::-' SL.eL I f-b(l/"r:nc,v wtt'if'J DOAJ~ uJ -:n+t-JI( "'ctll.4" \}J '.J': .. t>: ~ ~ '0 ::; {\l ... --'-'--- . , .~ ? ~ ~ ~ .~ to:! >-l f ~ ~r f' ~ f r ('\ l"l_ ~ 9 ,.. , ~ .... ~ Or\ . ,.., reS ~~ 6l ~ [;l ..., >-l Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD April 19, 2001 Charles W. Southard, II. Registered Architect 440 Veterans Highway Suite #207 Holbrook, N.Y. 11741 Re: BP #26934-2 - Proposed Storage Building for Pindar Vineyards Premises @37325 Main Rd. Peconic, N.Y. Suffolk Co. Tax Map #1000-85-2-14 Dear MI. Southard: Fax (631) 765-1823 Telephone (631) 765-1802 Upon reviewing the plans during a recent I" foundation inspection I found the plans to be insufficient in content, particular to the HV AC System, which I am aware, is going to be installed by word of the contractor, and a New York State Code Energy Calculation as it pertains to this use. Also, indicate all uses of the areas as divided in your submission.. If you have any questions regarding this request, do not hesitate to contact me at this office. Thank you for your cooperation regarding this matter, Respectfully, Gary I. Fish, Building Inspector GJF:gar (Cett.Mail) -,-- ~ '. WILLIAM J, CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATHAM, JR. RICHARD CAGGIANO Town Hall, 53095 State 'Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1938 Fax (631) 765-3136 PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Chairman PLANNING BOARD OFFICE TOWN OF SOUTHOLD r--.-------- -'..__ ___._ .,_ ,~r;:- r:-. ,. r' I':' I 1 I: I' : [ r ::-". ; r-" 'n I ~Uf: 7 (':;D! :J [iD~..:- -r-J' May 30, 2001 i'~,'. . .:l Dr. Herodotus Damianos c/o Pindar Vineyards P.O. Box 332 Main Road Peconic, NY 11958 RE: Proposed Site Plan for Pindar Vineyards SCTM # 1000-85-2-14 Dear Dr. Damianos: The following resolutions were adopted by the Southold Town Planning Board at a Special Meeting held on Monday, May 29, 2001: BE IT RESOLVED that the Southold Town Planning Board, acting under the State Environmental Quality Review Act, do an uncoordinated review of this unlisted action. The Planning Board established itself as Lead Agency, and as Lead Agency, makes a determination of non-significance and grants a Negative Declaration. WHEREAS, this proposed site plan, to be known as site plan for Pindar Vineyards, is to construct a 34,000 square foot storage building; and WHEREAS, Dr. Herodotus Damianos is the owner of the property known and designated as Pindar Vineyards, Route 25, Peconic, SCTM#1000-85-2-14; and WHEREAS, a formal application for the approval of this site plan was submitted on May 14,2001; and WHEREAS, this site plan was certified by the Building Inspector on May 14, 2001; and WHEREAS, this storage building will be used to store wine and wine and farm equipment; and . - Pindar Vinevards - Pace Two ~ Mav 30. 2001 WHEREAS, the Architectural Review Committee has reviewed the elevation drawings and the Planning Board has accepted their recommendation for approval; and WHEREAS, the Town Engineer has reviewed the drainage calculations and the Planning Board has accepted his recommendation for approval; and WHEREAS, the Southold Town Planning Board, pursuant to Chapter 58, Notice of Public Hearing, has received affidavits that the applicant has complied with the notification provisions; and WHEREAS, all the requirements of the Site Plan Regulations of the Town of Southold have been met; be it therefore RESOLVED that the Southold Town Planning Board authorize the Chairman to endors~ the final survey, dated May 22, 2001, subject to a one year review from date of buildingl permit. Enclosed please find a copy of the Negative Declaration and two copies of the approved site plan; one for your records and one to be submitted to the Building Department when you apply for your building permit. Please contact this office if you have any questions regarding the above. Bennett Orlowski, Jr. Chairman encls. cc: Building Dept. Tax Assessors . . J PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATHAM, JR. RICHARD CAGGIANO Town Hall, 53095 State Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1938 Fax (631) 765-3136 PLANNING BOARD OFFICE TOWN OF SOUTHOLD State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination Non-Significant May 29, 2001 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Law. The Southold Town Planning Board, as lead agency, has determined that the proposed action described below will not have a significant effect on the environment and a Draft Environmental Impact Statement will not be prepared. Name of Action: Proposed site plan for Pindar Vineyards SCTM#: 1000-85-2-14 Location: Route 25, Peconic SEQR Status: Type I Unlisted ( ) (X) Conditioned Negative Declaration: Yes ( ) No (X) Description of Action: This proposed site plan is to construct a 34,000 square foot storage building. Reasons Supporting This Determination: An Environmental Assessment Form has been submitted and reviewed, and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. . i , . . SEQR Necative Declaration - Pace Two For Further Information: Contact Person: Robert G, Kassner Address: Planning Board Telephone Number: (631)765-1938 cc: Roger Evans, DEC Stony Brook Elizabeth Neville, Town Clerk Southold Town Building Dept. Applicant ;f , --~"-""""---"_.._~~-....-,- .-" m @~, 0 ~j ~ i ,'j i....._..,..~"w- .-.-- ",~,i!:! , :, ,FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~l~I~L: 765-1802 ~ 3C:<35.:c:- :;~:::illii:::::::i:~~ Pennit li>. ~.r.J.f.?:!.' - NO\! - 8 ?ono .(... Quarto U~ .tu~t\.LJ.t1 ............... 3 SETS OF PLANS ............... SURVEy........................ CHECK ......................... SEPTIC FORM ................... DEC ........................... TRUSTEES..................... . 'NOTIFY: CALL .................. MAIL TO:................... ~ Disapproved alc .................................. . . . . . . . . . . . . . .. . . . . . . . . . ~ . . . . . . . . . .~ ........ ~d . Date t).q\l..6. . . . .. . . ., 20.Op. . INSTRUCTIONS a. .Ibis application DUSt be CClqlletely filled in by typewriter or in ink and subnitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of h,1ildings on premises, relationship to adjoining pre:nises or )1Jblic streets or areas, and giving a detailed description of layrot of property DUSt be drawn on the diagran ~ich is part of this application. c. The \IOn covered by this application may not be CCJ1Irenced before issuaoce of Building Pennit. d. Upon approI181 of ,this application, the Building In$pector will.isSue a Bui,lding Pennit to the applicant. Sucli pennit shall be kept on the premises available for inspection thraJghoot the \IOn. e. li> h.1ilding shall be ocaJpied or used in Yiole or in part for any purpose ~tever until a Certificate of O::cupancy shall hage been granted by'.the llrllding Inspector.'-' 'o, APPLICATIlJI IS lEREBY MAlE to the Building Ilepartment for the issuaoce of a Building Pennit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yon, and other applicable Laws, Ordinsncesor Regulations, for the construction of wildings, additions or alterations, or for reIOO\1al or daoolition, ... herein described. The applicant agrees to CClqlly with all applicable laws, ordiqaooes, wilding code, hoosing code, and regulations, and to acbit authorized inspectors on premises and in wilding for necessary inspections. ..~.,~.~~~\~.l~.~:.................. (Signsture of applicant, or nane, if a corporation) .l(o.~.\.<;~~\~~b!.<?~~I..~Y: . <Ma~Of applicant) \no~ State.ther applicant is owner, lessee, agent, architect, engineer,~ contractor electrician, pll.llber or wild .......................................................................................................................... NaIe of owner of premises............................................................................................. (as on the tax roll or latest deed) tion, signsture of duly authorized officer. ../n~\Q~ t officer) / Builders License li>. Pll.IIbers License No. ......................... .......................... Electricians LiCE9>Oe li>. ..................... Other Trade's LiCE9>Oe li>. .................... I. location of land 00 .Dich proposed \IOn will be dooe........H~.~...r.a~.......~i.<;;::............ ........................................................................................................................ 1bJse lbJber Street lIaDlet County Tax Map li>. UXXl Section... g.G!J...... Block ... 2r.......... IDt ..14:.......... &Jbd. . . '.' lV1Slon ...................................... FlIed Map li>. ............... IDt ............... (Nme) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .' a. Existing use and ""'"''1''''''>' ....... \,{'H~....... ~t:t~.................................... b. Intended use and occupancy .......WJ}..)e.H.....~1Q~.l;i...\).UJ~J.!~........................ \ ./ 1 .._______u..__n...._ ".atllre of work (check ..lid. applicable): NelllUilding ./.... llddition .......... Alteration .......... ' Repair ............ Removal............. Demolition ............ Other WOrk .................................. ~Deseription) . Esti...ted Cost........ ....~............ fee .............................................. (to be paid on filing this application) If Boelling. romer of Boelling IInits ..~..... tluber of Boelling units on each floor ................ . ^ If gar~. number of cars .............~...................... . If hllsiness. ~,dcial or mheed ""~. specify nawre and extent of each type of use.Wj~..$.1rt..~.t;:: D. . f" 'f jDES lmanslons 0 ex:t.Stlllg structures. I any: Front... ... j...... Rear ...........,.,. Depth ................. I~ight ......................... Number of Stories ... .~................ Dimensions of _ structure with alterations or additions: Front........ ~". Rear............... Depth.................... Height .................... ~r of Stories \ ..t.if.:J-...... \ Dimensions of entire ~ coostruction: Front ..4S.C;>;,\,,, Rear ~.......... Depth ..B.l?....... l~ight ...........7.-:1:-......... Number of Stories ..ct.\.)............. I I Size of lot: Front ...1-],}.\............ Rear ..~}.e.............. Depth 33.a~.::::..~ 3. Date of ~,ase ..................... Name of Fo~r Owner ........................................ 3. 4. Zone or use district in widt prenilieS are situated . n. .... .. . ... . .. .. . . .. .. . "~:i V.... .. ... .. .. . . .. .. .. ...... .. Doe. proposed constructiCX1 violate any zoning 1..... ordinance or regulation: ........................ will lot be regraded .......~~........ will """"ss fill be remved fron prenises: YES Gi:> Hams of Omer of prenises .t\~~':I.~.~!~llddress 'M~!Y.~..~(...... Phone lb. :l2~;,tP..?:= Ham of Architect 9~.V"..1.~9.~.J.R--llddress ~.q99.~SA~.~...P.P.l.-~lfhone lb. i:l7.J.'.~. Ham of Contractor .~...l::E~\@d~.c....... llddress 1~'?..~~~M.~e~ lb.4:~:A:\{PJ '. ./ Is tllis property within 300 feet of a tidal wetland? * YES .......... Rl.......... \ I. "J *IF YES. &lIltIID 'l'ati '1'RIJSl1iIlS PIlItnT MI\Y m R&pmIlD. 1:F-' PLOT DIAGRAM I Locate clearly and distinctly all buildings. Wether existing or proposed. and indicate all set-back dimen~ions TaD property lines. Give street and.block numbet or description according to deed, and shcJwo street OBI'eS and indicate hether interior or corner lot. . 5. I. 2. <sa:: h.'>"l7\." Ud":\ '. ".' ~11~rp.,...t , .'. TAlE CX' \I;;W '.lOOK. 55 OONIY CX' ....................... o -,-,-n,t. ~ " :.r .'\2~(.{", I ~ be' d 1 de and tha I . tI l' .. . ...":rJ. \C; ~.. ."<<':-.-< .. . .. .. . .. .. .. .. .. .. . .. .. . .. .. .. . .. .. lllg II Y sworn. poses says t te IS te app Icsnt Ham of individual signiug contract) bove 11a1I?d. e is the..... .~~~: .~~;;,.;;~~~ '~ffi~;: .~~~:)................................................ r said owner or owners. and is duly authorized to perfonn or have perfurmed tlte said work and to...ke and file this pplieation; that all statemmts contained in this application are true to the best of his knowledge and belief; and hat the work will be per[urmed in tlte manner set [urth in the application filed therewith. I.oorn tp;; f lie this ... j",__ :,\Q~:;:.:~. .. N9~::".~ :.' \-< (:-qOUCHER ,^-,TAL ';;'.;t': 01 ~'aw York >;~) 1:';{)i'O~:;3 QlJiU'-.:<d i,1 Nassau County I ,:ommk"ion Expires Oct. 2, '-00 f