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Home My WebLink About31816-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No, Z-32297 Date, 04/17/07 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property, 2700 VANSTON (HOUSE NO.) County Tax Map No. 473889 Section III RD (STREET) Block 5 CUTCHOGUE (HAMLET) Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 23, 2006 pursuant to which Building Permit No. 3l816-Z dated FEBRUARY 27, 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5518 DATED 6/3/2004. The certificate is issued to ALAN BRAVERMANN & DEBRA A. ORYZSYN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 110748C 08/22/06 PLUMBERS CERTIFICATION DATED N/A ~~ Authorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION 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 slU"Vey 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. Swam 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, Swinuning 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 ofCe11ificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporal)' Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Conslruction: TOOL Location of Property: 27-00 House No. Date. 4P€:.IL g ,2.CflC?7- , Old or Pre-existing Building: (check one) V 4;(J<6TOt.<J' 20~O Street CI/T"'4!I ObUt=: Hamlet Owner or Owners of Property: ,,?;)L,q D /3~ VFl? ~ t'9 U Suffolk County Tax Map No 1000, Section / 1/ Block 000 G Lot oOcf Subdivision Filed Map. Lot: Pennit No. :3/ Bib - 2:- Date ofpermit. Q!Z:l(tJ& Applicant 9ibut:: t:I&/,(th.d'e?c:,( Health Dept. Approval: Underwriters Approval: Request for: Temporary Certificate Final Cerlificate: (check one) Planning Board Approval: Fee Submitted: $ ~- . Applicant ignature ~. (d--D1.5 c-o :c.3;)d. ~ ( 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. 31816 Z Date FEBRUARY 27, 2006 Permission is hereby granted to: ALAN BRA VERMANN NEW YORK,NY 10012 for : CONSTRUCTION OF AN IN-GROUND SWIMMING POOL PER ZBA APPROVAL #5518 CUTCHOGUE at premises located at 2700 VANS TON RD County Tax Map No. 473889 Section III Block 0005 Lot No. 004 pursuant to application dated FEBRUARY 23, 2006 and approved by the Fee $ 150.00 ~ Building Inspector to expire on AUGUST ORIGINAL Rev. 5/8/02 '-.. "- 31g/~L TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION ~~ REMARKS: [ ] ROUGH PLBG. [ ] INSULATION (><] FINAL Ii., [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION ~~ DATE If -9 -07 INSPECTOR ~ ~ 3/Y/~ ~ TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING c><i FINAL A " [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: j> o-r{. ~, t:~ tf ~ (. t:j--- ~ ~ ~) /" \ DATE 11- '3 0 ~ () ~ INSPECTOR ~~~ 3llt/to z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING v< FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS. /"".,.e ~ ~ ~ ~.~ fR. W~ ~ ~ --t:vrr- ~ ~d-4!. ~ d:- ('5~.).~~' ~. ~d-(, i.ct ~ ~_ , jlI ~ J ~i-, (j ;1-. r-"L... ~'.;f ~) ~ ~-4r/~ ~.a.Jt~" 11-/6 - <? '- At>>. 10 b' 4:..-... ' DATE INSPECTOR ~~ /~d 311/' :2-- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING J?<\ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REM~ ~~ ~~ -~ -- ;::: M/..;/ DATE /O'-3/-o~ 3 ~~ )'1j2.~{\ dL/ INSPECTOR ~~ ~ ,/ " FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) I FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL .\J0~ _l"l oO~ ?~ 1-1 (s'::-5J 'f Ip l"l "". z p V -.J o CIl Cl .., [;; l"l .., <. S"J ::> if.' - 3 K'~ rt"' l"l .., ,-" n '~ /Jl .--- f/ f .fI r---qz(T ~ d)-A I jI _ ~ / ~ A...Jl./..n o~n - "l/A> ;;;- c.,.--. 'vY::)A,-/T../J / /~ \2 _ .'..c- 'l ~h b ;-, .-P /I )(- J, 'iJ ~ ~ 1>-/ /3 I J- n"l~ '" 1. .&<n~~~/~l' A ~~)~ IIIf -' j iHU; j1I -n V 6tAJQ ~.-?r fl./)<;b//h- .... /J . ~A/:;'" ,(/ ~ /"/--'1'0' f/o-IfI( I~ ~ 6{'(, "F:. rJ. To ~ ~ -' ~ ADDITIONAL COMMENTS ~ r lJ /3) AII?L n JP?L ,,, Ad 1/.... tJ1V ~-'" ./J U p ~ t 0' ;;. [0 . , /'.A' l' l' 'fj--; ~ -, <. f~ ;;m )::0 2. ::;:> l"l ". oO~ , ~ - e.--:~ ~.., \ - , 0 ---"Z .' IIi l"l L~ ........., -_IIi h.. e< -r !;J :-3 ~ ~-----~ /, \ / ~ \ / ~" I / ~~ ~ I ~O\~\. ~o P% I / ,.\\f\\f\s~ ~cs.~\.~~~<< t'<' //' ~~~~o~g~~ ~p.. \ ) / 'O~<( Ii>> / r /// . // / " / ,/ / / / // " / /// ~\j~ /" C\~~ \J\)~ /,,/ ~'0 "- / ~ .~(}~ // /,,/ \S ~\\ //~" / /~,f'! j,r-'A ./ /~'" If \, / / r -,','\ .' -'" / /, \. ("\ /'::( // /,(,~\j "" //->, / /' \'i,; 'I'-""\." /' / {, " '-).~ ') // ).fC' ''-:' '~ECK /' ...j,~ ~t ') " '~'----~~~ I '--Z.ji / //~\.~~ // /~~\. )/ "^''--. 0'Q ',:;/1 /J. ".{4'C(, ....... ".. ".. ,.~..... ..... '--., ~ ....... ........ ~.... \\,~,,\, '--. ....... .......... ..... ......... ......... .... \,\SHp>'\.l ~E~{~~~~~~~i~:i~iO~ i. E COOES 0 /I 'r1'\,'1l.1'l1' - Q COMPL Y WITH ALL CODES OF ~OO~'1lkj\.'\!:J iER"4r6 NEW YanK STATE & TOWN CODES WlPI..'f \Nlirl ~ f\E\lE~,.\O}i\ls REG'",RED A~') COND:TIONS OF CO" D/l>.WlAG COOE. .#bti/fS f\J?~~O\..O iO'i'J , . :L~~~ $(": . <~L TOWN Z5A ~ $" ^'LTI"\' I ~-".' "L '~:,N PLANNING BOARD SOU iHOLO TOWN TRUSTEES I I I I I I I Cj~ 60 0:::- .$ -C' <.S!' a -C' i----=.- C/)~ <0 ~~ -------- I I I APP .ov D AS NOTED DATE: -2 Zr, '- 8 p, # ~I ~ /-6.;tfE, FEE: ._' . Cf)~~ NOTI BUiLD!i,~ ," "c:TMENT AT 765-1802 8 AM TC 4 PM FOR THE FOLLOWING INSPECTiONS: 1. FOUNDATION. TWO REQUIRED FOR POURED CCCRETE 2. ROUGH - FRAMING & PLUfABING 3, INSULATION 4. FINAL - CONSTRUCT'ON MUST BE COMPLETE 'G.', e.o, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBL~ FOR DESIGN OR CONSTRUCTION i:RR08S. ~ I \I r .. ':1\ " OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERT~FiCATE OF OCCUPANCY ...\f"\""~~,": f"~ pO.,) ......-:...:.c.-:-, ,. \l~i~;:;('~~Q~\'f,l(.\) N fB SCALE: 1/32" = l' -0" SITEPLAN SCTM# = 1 000-111 ~05-04 TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ~ Z PROPOSED ~ .. ADDITIONS ;::E TO THE ~II: II ~III 2 ~ RESIDENCE '" ~ NASSAU PT ~ = = ~ = = ~ os ARCHITECT ~ ~ FRANK UElLENOAHl ~ P.O,BOX 316 ;;; GRITNPORT, NY 11944 -< TEL: 63H77 8624 ~ FAIl: 631-477 2997 ~ OWNER = i::J = '" ~ ~ ;;;I ~ - i ~ lE (jj = = = ~~ ~i" -'1<1 ~~ :z: I..L.l DATE: ~!1i' SCAlf' ~~ ' == = iiC~ ~~ ~= ~'" 8~ ~s ~ ~ OWG, NANE U 9;;;1 ow<:. NO ~ ~ 32:E "5.S = = = ~ :58 ~ ~ ~ = ~ - ~ ~ <> = 02/23/1006 1/3)" 1'-0' SITE PU\N A-I _..~_.._.~ GENERAL NOTES ~ . THE Or.5IG~ IS eASED ON 4l.P".~0,'(jt <,i)IL tit 'H. 100:" <; ~T GROUNQ WATER SH4Ll NO": ()l,:>f 'tII;"IHI'" f.'f i'Mll" 'If l"if [XCAvAlION IF'CiIiilOUNC'N41EP(.")IS oIl"T....jf, (J flf.l(I....r;l.J1l1r SPECIAl O(WATfRlMv.,.o.CIt.l1lf S W'll lir 'Jflj" fll( wr.'!"f.I DISPOSAL IS U"'ITfO TO QW....(AS PROI[fJ~f '(,"'~"'lll.:..jH :(~" 2 HO SURCHARGE .aLLowED WITH ~j 4 U ^..r 'i'1/1ll.C'" [...[ o'ND 6'-0" OF DEEP END :\ THE PNEU...AT1CAlLT APPLIEO cr:Ni.fH TEIGUNII(1 ~"'AlL hf t. I 4 MI. WITH A .....)(I...U... Or ~'2 G^'-l..O....S (Ir "'AI[U Pt ~ SAC" OF Cn.,l[ N T 4 REIHFORCtHCi STEEL SHALL bE IN1l.RMf.(J,r.~[ t,"'A~I[ Ij'Ld r STEEL, WITH A MINIMU'" LAP or 3() ALR (liA"'l T(~S 5 POOL WATER SuPPcv By QWN( R 'S GI\R'JEN HCSE P(:Ctl T, fH I<E"T FUL.l DURlhG FREEZI....G -.arEATHER PUMP CAPArIT, 8E SUfFICIENT TO E~PT y POe-'L :P<I 74 HO.IRS . ALL PIPING SliOW.... IS DIAGRA~MAT,C u....LESS ("'~H(Q..... <,1 NOTED. PIPING SH"LL BE POL(TH[LEf,E. 7. WALKS TO BE NON SLIP, ANO TO SLoPE AWAt F~O'" POOL I. NO DIVING 80ARD SHALL BE I....STALlED UNLfSS POO,- A"O IOARO CONrORM TO l-AT(ST ~IN STA....OARDS OF' THE NATIONAL SWIMMING POOL INSTITUTE 9 LOCATIO'" or OVERHEAD WIRfS TO IoI[[T REQUIPEMENTS or IOARD Of fIRE UNDERWRITER') to THIS DRAWING FOR STRUCTURAL SHll.L ONlf ALL .. ) ACCESSORIES 8 APPURTE....ANCES ')HALl bE tlf OTHE"S. ALL WORK SHALL (ONFO~'" '0 lH[ ;... LATEST STANDARDS OF THE NATIONAL ">WIM"olIt.<G POOL INSTITUTE AND LOClll ~DDfS o PUMP _.-J 12 RADIUS [T y P ) 1l1'vlt>lG 806RO ( (OPTIONAL) '- " c:*AT ER liNE __~__t!!::______ UND[ QWAT r R ;.(,..p WAIN DR"IN SCHEMATIC PIPING ARRANGMENT ~ ALAU BEA'-l.il2.P\D.U ~ 2100 \j/:;).J.<;'tCJu. ~D, . .. . . UDTf.S 'l '@- G\STU...\06uE. B -t",,1.1 I.,.... SIl;lIl,ll"'l.R 1 i co...eIN"f ION "..CUU'" ll....f \'~L[ t SI(1...",(A II " GUNIT F STEPS 36 lIIIo'lN suc TIO"" ,s PRECASl (OPING WALl( (OPTIONAL I NlE,T/ MAIN (lRAIN ;;:....t.>>.I~. B ". LA ,,~ l ',.1 PLAN PAf(IIlST COP'NG ~, "-<;I(I',UHR ~Ikl(l SHp lADDER [OPT,ONAl) r-12'~ A ALL AROV~D TtES 12" OC WALL SECTION SEE ....Ll SECTION DE T"I L :I 0 -J .. '0 \! ~ .. '", ~ > K .. :I ij ~:;1 ~ 1 ,i-.l ':",i RADIUS "ARIES 6" TO 24" SHALLOW INO 2'" uP ON DEE' END WATER LINE ~ OF TILE .....\.1.,- .-;.,-=- _UNDERWATER LIGHT \ (OPTIONAL) ~A01US z'. I" TO 5' -0" --@---- SECTION A-A "- -' /,"" .."., .;.",,- fr. .:-.~" -. -l (~rO~, '~?,~.),' {i t.' . 4-,. '\,1: . -...:~\ i ~ ... . ~ I . , ! ',~\ 1\ .. 'I'; I,. r, I ! v'!. : -, \ (j i I. . \ .~, 1 /..... .Ii \ ~ .j :/ [fuIi] ffi\ 11 [PJ n ~ [p (Q) (Q) [L ~ [N] [Q) ~ [p) ffi\ i 11 Wooded Lane I PO Box 1033 Hampton Bays, NY 11946 (631) 728-1777 if 1i ," ,1 WAIN DRAIN L SECTION B-B :It, STEEL REINFORCEO ......, DEPTH '" 5" 0" >!l' - 0" I / HOfUl " oc 12" ac vERT 12"OC ..OC 12 n 0": (ACHWA'" 0" FlOOflt IrIlESI'4 EOUIVAlENT ,I '-i ':;1 " . , \, Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 Tel. (631) 765-1809 Fax (631) 765-9064 APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer Lydia A. Tortora Vincent Orlando James Dinizio, Jr. http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JUNE 3, 2004 ZBA #5518 - ALAN BRAVERMAN Property Location: 2700 Vanston Road, Cutchogue; CTM 111-5-4. 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" category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 13,500 sq. ft. lot is a triangular shaped lot with frontage along Vanston Road and Old Cove Road, Nassau Point, Cutchogue. The property is improved with a single-family 1-1/2 story frame dwelling with porch and an accessory garage, as shown on the March 18, 1976 survey prepared by Roderick VanTuyl, P.C. BASIS OF APPLICATION: Building Department's March 5, 2004, Notice of Disapproval, citing Code Sections 100-242A, 100-244, 100-33 in its denial of a building permit application concerning proposed additions to the dwelling with setbacks less than 35 feet from the front lot line, and proposed swimming pool and new addition to garage, both of which will be in partly in a front yard, rather than a rear yard. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on May 20, 2004, 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: Applicant wishes to construct a second-floor addition above the existing sunroorn, raising the roof to obtain legal ceiling heights, to add an extension to the existing accessory garage for work ana storage areas, and the addition of an in-ground swimming pool with trellis and wood deck. The setbacks of the new construction are proposed as follows: (al the 12' x 35' swimming pool and wood deck will be at least 6 ft. from the front line along Old Cove Road and at least 5' from the westerly rear lot line, (b) the 160 sq. ft. garage extension will be at the north end of the garage, 8 feet from the house and with a much greater setback than the existing 5' rear setback and greater than 32' to the easterly front line, (c) the 195 sq. ft. second floor addition will be approximately 18 feet from the westerly front line at its closest point. ADDITIONAL INFORMATION: During the May 20,2004 public hearing, the applicant agreed to not occupy or use the area above the second-story. Pagl';! - June 3. 2004 ZBA No. 5518 - Alan Braverman CTM 1000-111-5-4 REASONS FOR BOARD ACTION: On the basis of testimony presented. materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the relief requested will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The applicant has an existing 1-1/2 story home and wishes to construct a full second story with partial flat roof. 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 property is only 13,500 sq. ft. with an irregular triangular shape, and provides a limited yard area for new construction as requested. There is no other alternative. 3. The variance granted herein is substantial and the maximum that the Board would approve. ~ 4. The difficulty was self-created, and is related to the placement of the home as exists, and the small size and irregular shape of the property with two street frontages. 5. No evidence has been submitted to suggest that a variance in this community of single-family residences will have an adverse impact on the physical or environmental conditions in the neighborhood. 6. Grant of this relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of additions and a swimmingpool, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-8, motion was offered by Member Goehringer, seconded by Chairwoman Oliva, and duly carried, to GRANT the variance as applied for, as shown on the 3/17/04 plan prepared by Frank Uellendahl, Architect, subject to the following conditions: 1. There shall be no use of the area above the proposed second-story addition to dwelling. 2. No backing out of vehicles onto Vanston Road. 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 ~. . I . Pag,,'iJ- June 3, 2004 ZBA No. 5518 -Alan Braverman CTM 100Q.111-5-4 addressed in this action. Vote of the Board: Ayes: Members Oliva (Chairwoman), Orlando, Goehringer, Tortora, and Dinizio. This Resolution was duly adopted (5-0tL lli, ~, Q)0~~ Ruth D. Oliva, Chairwoman 6/16/04 Approved for Filing ~ PROPOSED CONSTRUCTION PHASES ~~~ \.,~\. \~r::,~ "'~ ..,..,~~ '\J ~\~ f2\ EXTENSION OF EXISTING GARA W TO INCLUDE WORKSHOP ORAGE IN 2005 AOOED COVERAGE: 160 SF ~ :Ii PROPOSED I D PROPOSED CONSTRUCTION :g ADDITION ;:E TO THE ~a: '3 . EXISTING STRUCTURE Ii ~. ! RESIDENCE <= ~ NASSAU PT. ~ '" ~ z '" '" ARCHITECT ~ = i2 FRANK UEUINDAHL is P.O.BOX 316 '" GREENPORT. NY 11944 ~ TEL: 631-477 8614 '" "" FAX: 631-477 1997 = ~ OWNER z a AlAN BRAVER~AN ~ 1700 VANSTON RD. '" CUTCHOGUE. NY 11935 ~ TEL: 917-733 3637 ~ ~ '" c;:,~ ~ C30 ~ 0::3:: ~ ..c:: 'OJ <::.S?'> '" o..c:: ~ ,.::;;; :g ~~ ~ s...9 ,., ~ '-'- = '" 1<3 = = '" ~ 3 ~ ~ z '" ~ ~ co ~ ~ N ~ !O: ~ ~ flJ ~ ~ ~ ~ E5 !::: = z ~ ~ = ..,IE =~ 03/17/1004 SITEPLAN ~1f DATE: ~!Ii SCALE: 1/31' = 1'-0' ~~ ~z = SCTM# = 1000-111-05-04 ~~ SITEPLAN ~gj ~= TOWN OF SOUTH OLD ~'" SUFFOLK COUNlY, NEW YORK ~ ~ DWG. NAME ~~ "'= A - 1 ~~ DWG NO Q;;I TOWN OF SOUTHOLD BUILDING DEPAR?ME~T TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoId/ PERMIT NO. 3rcrl {,-b BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Fonn N.Y.S.D.E.C. Trustees Contact: Mail to: ;::eRIJk U~lJ .f;tJtJ{lHL Examined Approved Disapproved ale Phone: (;M 477. ~6t4 Expiration ~1'"--.L n '--, r ~. [L : \ j '~': r " ;''-.1 ~;I .' "Ijli! : c.., FEB 2 3, '0' AP~LICATION FOR BUILDING PERMIT I L. --f:' " .;-:, _: I Date 2..l,"2. - 0 6 L.:r2Y~ ","":;" ~CU INSTRUCTIONS ,20 <,6 a. 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 oflot 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 th: work. e. No building shall be occupied or used in whole or in part 'i~any purpose what so ever until the Building Inspector , issues a Certificate of Occupancy.~' f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension ofthe permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a 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 e ition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder /7l2Ci-If7'C"Ci Name of owner of premises K<2._ Al AU BeAI.JfQt-\AU (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (N ame and title of corporate officer) Builders License No. /-;? /.?lEI X POOL- ( 5J"',...zr Plumbers License No. . Electricians License No. Other Trade's License No. 1. Location ofland on which proposed work will be done: '2.100 V(::..\.lS't"o0. \2.\). House Number Street c..Ll"'! (.WO 6- uE.. Hamlet County Tax Map No. 1000 Section Subdivision III Block C? 5 Filed Map No. 'r#\"""~fl ~ ",e'~",~ .,..v. .t~i ',:',' 0:1-.:, t'~~._.: C".: ,LOt' .' .~ (Name) _V~I~ "':";~:".., .~'-'d~' X 2. State existing use and occupancy of premises and intended use and occupancy ofproposed~onstruction: a. Existing use and occupancy c:::::; \ul,.L!.. "f"Av-lIL'-l '21-.$"\ ~C:f.. b. Intended use and occupancy eLSII::>f..U-t\ 'A-L. 5",-, \.....>-\ 114(,.. C>oc L 3. Nature of work (check which applicable): New Building' Repair Removal Demolition Addition Alteration Other Work S<.ulv-\"IIU.(,., PoeL (Description) <&i 4. Estimated Cost 30\ DO 0 , Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated !Z -40 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ./' 13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES_NO ':f-.. 27/ ,qui hdr~ 6i':. t!rfJi'i({ Address.-(/vc /170/ . . - Phone No. 212.2./4- lP6/,2 Address ?t713 8/~ ~ft/744-Phone No ::'- 477. &ft62<f Address 9_C.t)o.[ 0'33 PhoneN{! \)Tl1l-ITll u~c--l '!j\O>o\S \..Lt-l. 11'\46 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _ NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFYJPFffL.I::L. ".',,- ......... ~A.J'k U8..i.E:J.... Jt?7N+( bein~ duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the /!?f2CI-II t'Gc... ( (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me tljis L . ~ da \e.:CXU GL~ ~- ary Public BONNIEJ. DOROSKI Notary Public, State Of New'l'brll No.Ol006095328,Suffol~Co~ Term Expires July 7. 20....:D....\. 20 6/0