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Home My WebLink About30281-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32353 Date: 05/15/07 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS (STREET) Block 2 CUTCHOGUE (HAMLET) Location of Property: 31025 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 102 Lot 23.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 2, 2004 pursuant to which Building Permit No. 30281-Z dated MAY 3, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5480 DATED 3/4/04. The certificate is issued to SANDRA MEYER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1202322 09/03/06 PLUMBERS CERTIFICATION DATED N/A ~h~=' Rev. 1/81 ... Form No.6 TOWN OF SOUfnOLD 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 fallowing: 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. Approvai of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certitying that the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate bf 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: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic featun,s. ' 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 l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Access.ory 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 Date. . lUll (/ AI UJ /;('e-elC/f1"/P'(; New Construction: Old or Pre-exi!ti~g Building: J/fJ;Ls (check one) p( lifc?.r Hamlet Location of Property: II/lid AI). 1//~iItJ W//J'j / House No. Street Owner or Owners of Property: "f .4/f/ J1/f 11 \1,. J( g r I:? I?, Suffolk County Tax Map No 1000, Section /fJJ- Block,;L . Lot ..2 7. 6 Subdivision ~ Filed Map. Applicant___ Lot: .;Sf) m -P--8aten~f Permit , /I/O '( /(j n-xJtr,() .t/ Permit No,-' IIlJllltb.J2ept. Approval: _ Underwriters Approval: J Planning Board Approval: Fee Submitted: $ Temporary Certificate __ 0- r ---- Final Certificate: / J:.~ /i{1~ (check one) Request for: ~ll ~S?Js. , () z-- W--D ... APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. <,Joelirlhger Lydia A. Tortora Vincent Orlando James Dinizio, Jr. Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 Tel. (631) 765-1809 Fax (631) 765-9064 bllp:/ /soutboldtown. nortbfork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MARCH 4, 2004 ZBA No. 5480 - JOHN SCOTT and SANDRA TUFFY Property Location: 31025 Main Road, Cutchogue; CTM 102-2-23.4 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 II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. -lRlZ- PROPERTY FACTS/DESCRIPTION: The applicant's 43.2548 acre parcel has 370 feet along the north side of the Main Road in Cutchogue, and is improved with a two-story, single-family dwelling and barns as shown on the October 28, 2003 survey, amended November 11, 2003 by Peconic Surveyors, P.C. BASIS OF APPLICATION: Building Department's November 17, 2003 Notice of Disapproval, citing Section 100-30A.3 in its denial of a building permit application concerning proposed addition at less than 50 feet from the front lot line. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on February 26, 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 two additions at the front of their existing dwelling. The addition is proposed to extend 18 feet at the west side of the dwelling leaving a 28+- ft. front setback; the easterly 18 ft. extension is proposed with a 43+- feet front setback. Both side yard setbacks will be conforming to code. 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 proposed new additions at both sides of the existing dwelling measure approximately 18 feet by 20 feet each. The additions will be single story, and will have a 28.9 ft. and 43+- feet from the closest respective front lot lines. The proposed setbacks are greater than the established 21.9 ft. setback of the existing house at its closest point. 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 dwelling has remained in its present nonconforming location for many years, with a setback of 21.9 feet. P'-.le 2 - March 4, 2004 ZBA #5480 - John Scott and S. Tully CTM 1000-102-2-23.4 at Cutchogue . 3. ~fteS',rif,"ce granted herein is not substantial and provides a greater setback than that which eXists. . 4. The difficulty is related to the placement of the dwelling many years ago with a nonconforming setback of 21.9 feet from the front property line. 5. No evidence has been submitted to suggest that a variance in this community of mixed uses (agricultural, residential and business) 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 to the dwelling, 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.B, motion was offered by Member Orlando, seconded by Member Tortora, and duly carried, to GRANT the variance as applied for, as shown on the October 28, 2003 survey, amended November 11, 2003 by Peconic Surveyors, P.C. and diagrams submitted 1/6/2004, prepared by James J. Deerkoski, P.E. 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, Tortora, Orlando, and Dlnlzio. This Resolution was duly adopted (5-0). a .ri., ~ .G>\1\J~ Ruth D. Oliva, C airwoman 3/11/04 Approved for Filing 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. 30281 Z Date MAY 3, 2004 permission is hereby granted to: SANDRA MEYER BOX 1168 CUTCHOGUE,NY 11935 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER ZBA DECISION #5480 at premises located at 31025 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0002 Lot No. 023.004 2, 2004 and approved by the ('53 y pursuant to application dated APRIL Building Inspector to expire on NOVEMBER Fee $ 294.60 ORIGINAL Rev. 5/8/02 I!I ~im!ffi! ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ ~ Application Number: I Section: ~ Described as a Re~idential occupancy, wherein the premises electrical system consisting of I electrical devices and wIring, described below, located in/on the premises at: ~ First Floor, additions, 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 9th Day of March,2006. ~ Name OTY Rate Ratin. Circuit ful< ~ Miseellaneous ~ addition on east & west end ~ of house + kitchen renovation ~ Alarm and Emergency Equipment ~ Sensor ~ Sensor ~ Appliances and Aecessories ~ Dish Washer ~ Exhaust Fan ~ Wiring and Devices ~ Outlet ~ Fixture ~ Outlet ~ Receptacle ~ Switch ~ Paddle Fan ~ Receptacle mI Service ~ ~ 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!I~~ im!ffi! ii!IE! ii!ffi!Iii!IE!IE!lE!lE!Iil!ii!IE! ii!IE!IE! BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by GOODALE ELECTRIC CONT INC P. O. BOX 1190 MATTITUCK, NY 11952, SANDRA TUFFY 31025 MAIN RD (ROUTE 25) CUTCHOGUE, NY 11935 31025 MAIN RD (ROUTE 25) CUTCHOGUE, NY 11935 1202322 Certificate Number: 1202322 Block: Lot: BDC: ns11 Building Permit: 1 0 2 0 Carbon Monoxide Smoke I 0 2 0 1.2 KW F.H.P. 18 0 18 0 33 0 20 0 13 0 2 0 8 0 Fixture Incandescent General Purpose General Purpose General Purpose GFCI sea! Continued on Next Page I of 2 im!ffi! I!I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1!I~ii!ffi! ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: 1202322 I Section: ~ ~ ~ First Floor, additions, 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 9th Day of F.!I March, 2006. ~ Name Ory Rate Ratine Circuit ~ ~ 1 Phase 3 W Service Rating 200 Amperes ~ Service Disconnect: ~ Meters: 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I l!I~ii!Iii!ffi!Iiilii!ffi!E!IBIii! ii!ffi!~~1!I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the appl ication of upon premises owned by GOODALE ELECTRIC CO NT INC P. O. BOX 1190 MATTITUCK, NY 11952, SANDRA TUFFY 31025 MAIN RD (ROUTE 25) CUTCHOGUE, NY 11935 31025 MAIN RD (ROUTE 25) CUTCHOGUE, NY 11935 Certificate Number: 1202322 Block: Lot: Building Permit: BDC: n511 Described as a Re~idential occupancy, wherein the premises electrical system consisting of electrical devices and wIring, described below, located in/on the premises at: 200 cb seal 2 of 2 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 , ~'- Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: ! . \>-!\~ Jos Building Pennit No. ~()~S2;' \;). Owner: ~~'t'c>.. 's- \'v'\e.y<< (Please print) \, Plumber: -II- ,1" 6' c) k. "2.. 1-- /1 ^ q (Please print) I eerti fy that the solder used in the water supply system contains less than 2/1 0 of 1% lead. ;~~~' (Plumbers SIgnature) Sworn to before me this 16+<""" dayof '~<--~ , 20C'J~ County ROBERT I. SCUtT. .!K. Notary Public, State of New York Qualified in Suffolk County No.01SC47250B9 Term Expires May 31, Z!Wl 0. ~ peeonie eeJJpoot SEWER & DRAIN SERVICE P.O. BOX 972 BRAY AVENUE MATTlTUCK, NEW YORK 11952 (631) 298-9658 April 19, 2004 Ms. Sandra Scott P. O. Box 1168 Cutchogue, New York 11935 Re: Main Road Cutchogue, N. Y. Tax Map No.1 02-2-2.3 Dear Ms. Scott: This is to certifY that the cesspool system for the above premise consists of a round septic tank and two overflow pools. One of the overflow pools is a block pool, which needs to be replaced with a modern precast pool. The system presently holds over 5,000 gallons. It needs to be cleaned out but is in working condition. Very truly yours, PECONIC CESSPOOL ~~~~t/}t:; Richard Magill Owner \,~ . ", '\. '. , , RM:lm \., "- >''-::::'JJI')\' "'...--..-;..,' -'~ ':"r)t:"t~ ,...,~~tf '>., Suffolk County License Number 039L W ~::"'l .+':"\~< " c, , i1PR21. JAMES J. DEERKOSKl, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-5506 To: Town of Southold Building Dept. Re: Meyer Main Rd. Cutchouge, NY 11935 Permit# 30281 To Whom It May Concern: After an inspection was preformed on the above property, it is deemed that all Strapping was installed correctly, and meets all building codes. Any other questions please call. .~~ , SlJx;erely 524 JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-5506 To: Town of South old Building Dept. Re: First & Second Foundation Inspection Sandra Meyer Main Road Cutchouge, NY 11935 Permit# 3028lz To Whom It May Concern: A first and Second Foundation inspection was preformed at the above-mentioned 1:onstruction site, and the damp-proofing was installed correctly and meets all state and local building codes. Any other questions please call. .::,.;... //;, c C/', J'c, \,i/' ".,'" . iIf '" '\ , \ \\, \", ,\ , ."~ ~inCerelY '. es\',,~ "'.\ " . \ \. \\ ~ P~,",", ~n':' , 9 Ll,h }o;}-r/ L TOWN OF SOUTH OLD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PlBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [,><fFINAl [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: rh.--"a. &rO/_ W-O,f- < DATE 1')- r?-o - b S- INSPECTOR ~ ~ :3 o/}-Y I z. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND ~NSULATION R t, [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~~ t4-. 0 k: ~ ~~~ ~J~ /t~ ~{)r;J-<L- 4 ~K ~, ~ ~ ~~.M DATE ?-~N- oS- INSPECTOR ~~ . 30f.-z/ Z TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND N" INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ 6V-- W.Pd--~ \4-- 01<, ~ e:~ ~ ~~~~ ~L, DATE ~-:?-+-- DS- INSPECTOR~' ~ L 3o~'g I z- 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST P<f ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION M FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: /~ ~ -t+- ~ ~~?~.. F-::::t \1-- ~_;D~~.7.- oJ\.JL 0 I W~ ~ r7- ~. ~. ~iJL-e. ~- aJ\e 0 k I Ok-6c-'~ t DATE I-It-os INSPECTOR~~ 3 0 1-'0 I z- 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST DQ ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMA.JJKS: ~~~<p;C, ~~h~' DATE 1:2--7 ~ C) 'f INSPECTO~~ I 70'- B I~ 765.1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] ~UNDATION 2ND [] INSULATION [vl FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~"r._/ a - p~ ~...4/~"""'~~ ~.fi_~. ~ , , -r-t::. -//l~ ~ azedoi. A~ ~~;<: CJ.r--e ~ --~ _~""'-=-::e-~-~~.. ~~ ;:::::~1:J;:,-.~~ ;~;;: '. ~&_If!":..... , . DATE /11s-/u'l I I INSPECTOR~/'~ \ \ 4 FIELD INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ) DATE COMMENTS I'. 7# / ~ rI',)..,w:;. .- .~ "-IC7 VA.. ~. ~~~, - '.1&- =-:A ,~ \JJ 0;;1 ....r:~ ~ - ~-:;;; \ ~ '"" , " ~ ~ 'Z I" /_L.. '" (~, ~~ ~ h~ _ I' ../_~ 7', " \)J 9 "~ r (; -..&.. ,.. ..p' L7 ~"~.A..v,' ..g. A' ~,~~ _ ' V~ ....' __ _ . ~\ ~ ~.A:;:4.V -I. ."p ~. <.re: ~ . H ~ , " ~ A .'- A'''' 4 - I, -A <,e: ~ _ h .., "....,. ~. . fL ~I.N-#J,~ ,~~ ~ ~,. ..... K"," ~ S' 1:J-.-7~o~ b~ -;; Pd' ~ J~, ;ll/g-{ .l'~. 1/ -'/7 # I/-II-os APt. ~~. .V"",'ed6' (~ /';; _ .+-:17,,,'J/ v/. ~' >._Jl' ";;./.:f/. r ~- '':'' rI- P _J Pc. ~o.lI..e(jf"", '-<L. ~ P r-J ~fj'.. 77/)_ v nJ ~ ,. ,." -k..i:- /711 ~ /.lK ...~~ L .U...1-J? ~ -:1'/7 &; I-If~() - ;VfYG ~n..JJ I /~?,nr/ ..., ~-~-o~.l O.-i'--. O\---~. .;,()" L4- of2. Y r...) ~ ]; .~",.::./I4 ~ ,'~ Co' :;.,~ (I/ U/ ~ J.JS6-" II.~ ~~ 07t:..;v.!A D' i/IL..~{) ~~~, ~ An '-, "'- J.o ,,1/, A, C"/} {) V L_.:.... .~ ..4: -f~1z1 1?-'Tr7A~ j';;-r. ~J a. . ~ tJ/( /0:.1 ~v ,,- ~ , JJ~ e: o. ~ d- f:.,0 I' CM..C ~ H~ <:, .. 'O'An/... _ .., !Ji.. ortt. ADDmONAL COMMENTS ,d~ tl.1' .1 D>-ti IP. .. "'-_._._ r"l.,. /J. .. 0 . ,..& ~j J 'r11;:;,~_r; v. V IO/,./O<{ : 4,-. , l~ . b C~ ~lv , / 11 //~ /1 <,p I/. -I /() S- /Ze..c'd .J::? "....,. ..-? ...... ~ /~ d (.,v- _ t2 - -<.. J")- RII OeA..t,.k.. ~ ,v /) r_ LL . // 1? r . " P' -';;::i"l - \~ - , ~ ~::! 61i \ == l~ \ '-" ~ '.' 0 i"l ~ :-l RES. I:? t> LAND JM;V", T'/-IWLile.;z SEAS. =:az; ~d ~ . $ coTT ~ kJ." FORMER OWNER ,r: _2:-3.4 TOWN OF SOUTHOLD P~PERTY RECORD. CARD STREET 3 0 2~' ~dd " VILLAGE DIST. SUB. LOT N lie. '3 S . ~..; 1'/ .~ ~aJ-:l;;e FARM E - .;2id.A.u- . VL IMP. TOTAL DATE NEW FARM NORMAL BELOW ABOVE Acre '::> Value Per Acre Value Tillable 1 Tillable 2 .'\1/~1....) Tillable 3 Woodland Swampland House Plot 'y' ....~~.., / t'e' FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD /1) t3 .~~j -./t1u F f1 7 Brushland -- - fatal ~~ .~ VI. Bldg. 7-0 l( ;l g :Al'<'?-'~ ~xtension ~tension Extension fa 'J( 17 / / 'i'J..,'::,/ Porch Porch .,:--\~ " ' .'.....'. '-'","-I >/' ~OLOR ~. -I- ',-~ / ........ T~ il../ .v' , r( // " \ 1.../ ~, .' t I'Y" (. 1'2.-- ~ -::; Ll ...,... ,,1-1" , Foundation . j' +vl\!..9- Bath / V...... Dinette - Basement P4 1<.-'1 Floors ~/R K. i1J" () tj ft, 'f ~ IVt. Walls I" AAr~ Interi~i$'h'fh if{ t- LR. F,ire Place /7L.o Heat tfJil_ .i) L {.lv!ni/) DR. Type Roof ~,j-L Rooms 1 st Floor ~ 14- BR. 'Vto ~ if ~~creation RoolY i7 Rooms 2nd Floo 5 FIN. B. ~(po L-fqtf 10 till I 0 ,... J7S ~ 7 7 Breezeway ..... oU' V -II " I~~ ,..t.-~\J<IV' /"f() liS-€...- ~ll J-- c-f.- t;\ tA({ 0-, 1~81 U -, G 0 "/(/ ... ...,..,(tj_ I-f iJ f ,~ L) c; i "~I ,)" Garage Patio O. B. Toto I '~.,.- ~ '1'/7 /7' 1uvl./ rr.".., ;tr1'....1-.;.t.~ Dormer "Y' 0 rJ Drivewoy 'Yov' ~o'-foll/ w:rl.-, _tI Y::..i' / ., Examined PERMIT No.30 J- ?;/.:&- BUILDING PERMIT APPLICA~O~:LI~ Do you have or need the following, before applying? Board of Health A/U 3 sets of Building Plans Planning Board approval Survey Check Septic Form )//) N.Y.S.D.E.C. j.AJJ Trustees W Contact: TOWN OF-80UTHOLD BUlL*G DEPARTMENT TOWNHALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netiouthold/ Approved Disapproved ale 1/ /1 ~t'" \L r,\oJ I. Mail to: J'1I,1MI?f1 J't~l( /)..11. IIU' 11/11# !<(). MTt/lodlJ Phone: 11'1 (, ).1.P Expiration ,20~ \' ~u,j \ 3 APPLICATION FOR BUILDING PERMIT Date /1 /;)- .. , 20 () J' INSTRUCTIONS a. This "lfpplication 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 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 of the 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 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. 11 i (" //udu. It #- (Signature of applic1\'l or name, if a corporation) /fL))C 1/6? #/1/,) tfd {{/-1'/I(l~tllr ;L~Y: , (Mailing address of applicant) ( State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises "V[J/(,<./ ,PCO(/ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer to ll/t/IJ){ ,Jllp(j,f/l (Name and title of corporate officer) Builders License No. fJt).{j; Plumbers License No. Electricians License No. Other Trade's License No. -At! tJf) L IfNI c .JW- (jY' ud 151"1,411 -it-t . r (},(Bl:I< (j)~(/r;.:'t/ (~OLJ I. Location ofland on which proposed work wiU be done: .:J O' 11/# I?tJ. House Number Street U1 ftil cJ 01 IT Hamlet /', County Tax Map No. 1000 Section Subdivision P!J.va- (Name) It) .i, Block () ~ C 0 Filed Map No. ~3. IIIl.t~l' ]f~"^' Lot "". . '?-0i!t:!,,~r.'~" --"....... 8"""'''0,0 K ~.";IlU~. A",..r,:; .J~\J,O _Ot.t~lul,,~'q~3 ",,:!T ~ " . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: . a. Existing use and occupancy OPe t/!lFIIL,/" tJt./b7~1 v{. , b. Intended use and occupancy /7 ,tJ,IJ/7?tJu/fL- J'//lC"t; m/1 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration r' \ 4. Estimated Cost " (Description) , ''If), tJ1JO,of) Fee . (To be paid on ~r6i this application) 5. If dwelling, number of dwelling units Number of dwelling units oh ~ach l1'6b}il If garage, number of cars 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front :J 6( Height .:L'fl' Number of Stories Rear 2- ":';6. f Depth ..?? Dimensions of same structure with alterations or additions: Front 7 ) I Depth .'{AlI Height ;y' Number of Stories , 8. Dimensions of entire new construction: Front /JJ.JO' J;/f tjJtRear 6-7ICIf IPI Height 11- /.r I /?.;. /-.1 Number of Stories 9. Size oflot: Front lIlY, J(:: I Rear SCJel./tJ ~fI1< ~ 10. Date of Purchase '" _~ Name of Former Owner J C-//iUle" f Rear 2- Depth ,4-,-}tlf 11-(.1)1 7,)1 Depth ,J (J(., tfJ- fJA iJvt.( e 2J//, I 11. Zone or use district in which premises are situated J( -l{ 0 / ,ro 1 .s E7'tl1.1C/c:. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES ~ NO_ 13. Will lot be re-graded? YES_ NO t/Will excess fill be removed from premises? YES_ NO J 14. Names of Owner of premises :fptltJ t(1tfi/lJt~tf..J'tt'itess//lf? I-ttfo-' /1.4 ' Phone No. }?L/_C 2-- ? F Name of Architect Address U(!I'dtfJti(1.T Phone No Name of Contractor Address Phone No. 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 OF ) J)1J<1tJli ;( J' (j)Y( being duly sworn, deposes anI' says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (}/~lUb7\ (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. 20~ J~jJa#- Signature(if Applicant otary Public 10 J. DlIROSII IIlIllIry Public, Stall Of...... 110. 01006095321. 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