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HomeMy WebLinkAbout32553-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 08/31/07 No: Z-32572 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 1855 (HOUSE NO.) County Tax Map No. 473889 Section 107 WESTVIEW DR (STREET) Block 7 MATTI TUCK (HAMLET) Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 2006 pursuant to which Building Permit No. 32553-Z dated DECEMBER 6, 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 2ND STORY ADDITION, NEW DECK ADDITION & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5969 DATED 11/9/06. The certificate is issued to JOSEPH & BARBARA ISABELLA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-06-0046 08/24/07 ELECTRICAL CERTIFICATE NO. 115276C 06/29/07 PLUMBERS CERTIFICATION DATED 06/27/07 PECONIC PLUMBING & HEAT. ~ ~4-- uthorized Signature Rev. 1/81 08/27/2007 09:49 516-766-7934 sruTH SIDE HS PAGE 03/05 1/?S-13r;,?- FQt'\n N9. () TOWN OF SOUTHOL.D BUILDING DEPARTMENT TOWN HALL 765-1802 APPLlCA nON FOR CERTIFTCA TE OF OCCUPANC\' This applre~ti()l1 must. be filled in by t.ypewriter or ink and submitted to the Building Department with the following: A. F\)( new building or new use: I, Final survey of property with aCCurate loeation of all buildings. property lines, streets. ,,,,d unusual natl>ral or topograp.hic features, 2. Final Approval from Healtb Depl. of water supply and sewe(aglXlisposal (S-9 fonn}. 3, Approval ofeleetJical in.stallation from Board of Fire Underwriters, 4, SWom slaternenl from plumber certifying thatthe solder IlSed in sysl em contains less than 2/1 0 of I % lead. 5, Conutlcrcial building,. industrial building, multiple tesidroc.es and simil aT buildings and installations, a certificate of Code Complianee from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed sile plan requirements. B. For exi.ting buildings (prior to April 9, 1957) non-conforming uses, or buildillgS ADd "pre-existing" land uses: 1, Accurate survey of property showing all property lines, streets, buildin!'; and lUlUsual n.tural or topographic features, 2. A properly completed application and consent 10 insp...ct signed by tlle applicant.lf a Certificate of Occupancy i. denied; the Building Inspector shall .Iate the reason,< therefor in writin)! 10 Ihe applicant. c. Fcc. 1. Ce,tifiealc of Occupancy. New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming 1'00] $25.00. Accessory building $25.00, Additiom to .ccessory building $25.00, Businesses $50.00, 2, CertJ ficate of Occ.tlpaney on Pre-existing Building _ $100,00 3. Copy "I' CeJ1ificatc of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporar)' Certificate of Occupancy - Rc.5idential $15.00. Commercial $]5.00 ff'<2ff-{)7 ._-~~ ,- New Comtruction: ~...__ Old or Pre-existing Building-: . _.. _ (check one) Loc.tionofh<,'p<wty: _ /[-S's-:, If/LS-Iv;.ew ?'r;'v.(, ~ !';f;( C/ House No, Street ' \TOJ~/,/ _ 2S4.4L__, I ::::~:~:):ntYZ;~::~l:2S~~~rl ~ ,_:ill::kMa;~OO 7. ~::_..~o L Perm;1 No,;?? 5',)'32 Date or;:ermit.~~ Applicant:__. .. H..lth DepL Approv"/; ---.f'~s;,~.,~ _-.,__lJnderwriters Approval: 4 ~A ? Plaruling Board Approval: , _~. _ Date. Haml'" O\\'t1.cr or Owners (':If PrOpetly: Final Certificate: _Y_ (check <?ne) R cqucst for; Temporary Celti fJ c~t~ __ ,_ Pee Suhmil1ed; $ . ,;?5..~ h-- ~u. 7J..').L{( Cd-z. 3;1572 Applicant Signature~ . / J,/J Cl ?~/-Lrc ,C """.4 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. 32553 Z Date DECEMBER 6, 2006 permission is hereby granted to: JOSEPH ISABELLA 49 DARTMOUTH STREET ROCKVILLE CENTRE,NY 11970 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER ZBA, TRUSTEES AND DEC 1855 WESTVIEW DR MATTI TUCK at premises located at County Tax Map No. 473889 Section 107 Block 0007 Lot No. 006 pursuant to application dated JULY 12, 2006 and approved by the Building Inspector to expire on JUNE 6,2008. Fee $ 336.00 I L- ORIGINAL Rev. 5/8/02 Electrical Inspection Certificate Issue Date 6/29/07 Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue. New York 11772 (631) ~2 Application 115276C Issued To: Street: Village: Section: Mr. Joseph Isabella 1855 West View Drive Mattituck 107 Block: 0007 Zip: 11952 Lot: 006 Town: Southold Contractor: Kevco Electrical Contr. Corporation Lic. # 32431ME Was examined and found to be in compliance with the National Eleclrical Code. U Commercial D NV Defects D Pool 00 1st Floor 00 Indoor 00 Basement LJ Hot Tub IKI Residential [1 Del Garage IKI Attic IKI 2nd Aoor IXJ Outdoor [j] AddItion D Survey --- .- ------- Switches Receplac/es Fixtures GFI Heaters AlC Fans 21 36 15 12 1 12 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves 1/20a 1 20 1 30 1 40 1/20a Furnace Oil Gas Circulators Smoke Detector Bell Transformer X 4 7 Meter Amps Phase UG/OH Jacuzzi Television CO Detector /Ixl 2 Bldg. Permit: 32553 Other Equipment ,-- _0_ _0_ H~~J,~ President Rough Inspection: 0312112007 Inspector: John Me Mahon III Rnallnspection: 0612712007 Inspector: John Me Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Town Hall, 53095 Main Road P.O. Box 1179 Soulhold, New York 11971-0959 ~. Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: ~/';;J7 / ~ 7 Building Permit No. 3;:l S ~ 3 Z Owner: .J" s u Pl4. 1$ "" \pel-l... Po (please print) Plumber: 'PecoYl 1('_ W!-f /' (please print) L.,C'o~e-:f. 3e<r-r'f::f,.z I certifY that the solder used in the water suPpJy system contains less than 2/10 of I % lead. ,ti?'~ ~ ~ bers Sign~ . "7/' /7/ Sworn to before me this~ 'i of JVN~ , 2~s,L U LC-~ tA &~, Notary Public, ~ () \ Ie County 'l\CKll. LOPER Notary Public, Slat. of New York No.OIL06070081 ~eJ:"oIk~/ 1.-/0 .... APPEAL,S BOARD MEMBERS ~utli D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman 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 http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809' Fax (631) 765-9064 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF NOVEMBER 9, 2006 ZB File No. 5969 - Joseph and Barbara Isabella Property Location: 1855 Westview Drive, Mattituck CTM 107-7-6 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's 13,559.11 sq. ft. non-conforming lot is located in R-40 Zone with 75' along Westview Drive and lot depth of 167.31 feet along the southerly property line. The property Is improved with a single-family, one-story, as shown on June 17,2002 survey amended January 12, 2006 by Joseph A. Ingegno, Land Surveyor. BASIS OF APPLICATION: Based on the applicants' request for a building permit to construct additions and alterations to the existing dwelling, and the Building Inspector's Juiy 17, 2006 Notice of Disapproval citing Sections 280-122 (100-242A, ZBA Interpretation No. 5039) and 280-124 (100-244), variances are requested for a new second-story addition over the existing first floor of the dwelling, and deck additions, which new construction will constitute an increase in the degree of nonconformance when located less than 10 feet on a single side yard. It is also noted in the Building Inspector's letter dated September 6, 2006 in response to inquiry by the ZBA, that the 71.6 ft. setback to the bulkhead along the neighbor's property line will not require an appeal to the ZBA for a variance and stating that an amended Notice of Disapproval is not required. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on October 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 wishes to construct a second-story addition over the existing first floor of the dwelling and to construct a new deck portions of which are proposed at less than a minimum 10 ft. single side yard setback. ~------RERSeNs-fflftij()ARD ACTIOI~. Orl11Te1Jasls of resllmony presemea, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The property size is less than 14,000 square feet and the new construction will be for a second-story over the existing first-floor of the home, and new deck construction after removai of the existing deck. Page 2- November g. 2006 .ZB File No. 5969 - Joseph & Barbara Isabella CTM No. 107-7-6 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. This 13,559 sq. ft. parcel has frontage along a waterway with +/-4.400 square feet of area that may not be disturbed and is protected as a buffer between the house and the high water mark. The remainder of the property is covered by a new sanitary system (proposed), an abandoned sanitary system, septic tank, dwelling with walkways, deck and stoops, underground water service, and numerous drywells, which makes it difficult to expand the house otherwise. 3. The variance granted herein is not substantial, resulting in a side yard setback at 9.3 feet instead of the code required 10 feet. 4. The difficuity has not been self-created. 5. No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant has obtained, or is in the process, of obtaining approvals under the wetland codes of the Town, County, and State. 6. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a deck and second-story addition over the existing 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 Dlnizlo, seconded by Member Oliva, and duly carried, to GRANT the variance as applied for, as shown on the June 17, 2002 survey prepared by Joseph A. Ingegno, amended January 12, 2006, and shown on the March 14,2005 diagrams prepared by Penny Lumber (pages 1-10 of 2676), subject to the following Condition: That the side yard to the south remain open and unobstructed. 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. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board: Ayes: Members Oliv Resolution was duly adopted (5-0). hairwoman), Goehringer, Dinizio, Simon, and Weisman. This Ruth D. Oliva, Chairwoman 11/17/06 Approved for Filing James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0236C Date: August 10, 2007 THIS CERTIFIES that the construct a second stOry addition, remove/replace deck & walk with new deck & two sets of stairs, and upgraded sanitary svstem At 1855 Westview Drive, Mattituck, New York Suffolk County Tax Map # 107-7-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 09/28/05 pursuant to which Trustees Permit # 6222 Dated 10119/05. Was issued, and conforms to all ofthe requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a second stOry addition, remove/replace deck & walk with new deck & two sets of stairs, and upgraded sanitary svstem. The certificate is issued to Barbara & Joseph Isabella owner of the aforesaid property. r-G<~ Authorized Signature NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT EFFECTIVE DATE March 23, 2006 EXPIRATION DATE(S) DEC PERMIT NUMBER 1-4738-03077100007 FACILITY/PROGRAM NUMBER(S) . Under the Environmental Conservation Law March 23, 2011 TYPE OF PERMIT. New 0 Renewal 0 Modification. Permit to Construct 0 Permit to Operate o Article 15, Title 5: Protection of Waters o Article 17, Titles 7, 8: SPDES o Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management o Article 15, Title 15: Water Supply o Article 19: Air Pollution Control o Article 34: Coastal Erosion Management o Article 15, Title 15: Water Transport o Article 23, Title 27: Mined Land Reclamation o Article 36: Floodplain Management o Article 15, Title 15: Long Island Wells o Article 24: Freshwater Wetlands o Articles 1, 3, 17, 19, 27,37; 6NYCRR 380: Radiation Control o Article 15. Title 27: Wild, Scenic and Recreational Rivers . Article 25: Tidal Wetlands o 6NYCRR 608: Water Quality Certifica- o Article 27. Title 7; 6NYCRR 360: S I'dW M t tion 01 aste anaaemen PERMIT ISSUED TO TELEPHONE NUMBER Joseph Isabella (516) 764-1054 ADDRESS OF PERMITTEE 49 Dartmouth Street, Rockville Centre, NY 11570 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER EnConsultants, Inc., 1319 North Sea Road, Southampton, NY 11968 (631) 283-6360 NAME AND ADDRESS OF PROJECT/FACILITY Isabella DropertV. 1855 Westview Drive, Mattituck SCTM # 1000-107-7-6 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffoik South old Mattituck Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct second story addition to existing single family dwelling, remove existing deck, stoop and walk, install decks, steps and porch, abandon existing septic system and install new septic system. All work must be done in accordance with the attached plans stamped NYSDEC approved on 3/23/06. By acceptance of this permit. the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the Generai Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS ~ Brook, NY 11790-2356 Mark Carrara March 23, 2006 Page 1 of 4 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0237C Date: August 10, 2007 THIS CERTIFIES that the existing bulkhead, construction of a fixed dock, fixed catwalk, hinged ramp, float, and steps to beach At 1855 Westview Drive, Mattituck, New York Suffolk County Tax Map # 107-7-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 09/09/02 pursuant to which Trustees Permit # 5626 Dated 09/25/02. Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law, The project for which this certificate is being issued is for the existing bulkhead, construction of a fixed dock, fixed catwalk, hinged ramp, float, and steps to beach. The certificate is issued to Barbara & Joseph Isabella owner of the aforesaid property. (~o?~ Authorized Signature ):7--SS 3 z... TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: _ II~ ~ L.L- 01- ~ DATE 7'-71-07 INSPECTOR ~~ ';?-S""S3 7' TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION .. DATE 6 --;;...r -tJ 7 3;;LSS3~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [;q FOUNDATION 1 ST [ ] ROUGH PLBG. 7iFOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~~ -ib '~ ~ ole L;-- ~.. DATE I'd- ~ 9-10- 06 INSPECTOR ~ ~ 3J.SS3 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS~ 4AA.J or- r;L ~ 01\" DATE 7-> - 0 7 INSPECTOR ~~ Date: March 15,2007 JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 To: Town of South old Building Dept. 1 0 -.- ._, r Framing! Strapping/ Plumbing Inspections IsabeUa 1855 Westview Dr. Mattituck, NY 11952 Permit#32553 To Whom It May Concern: MAR , 5 2007 After a Framing, Strapping, Plumbing inspection was preformed on the above mentioned property, it is deemed that aU work performed was completed to plans and meets aU state and local codes. A pressure test was also performed on the entire plumbing system. Any other questions please call. '\ \~ \ "'" 1 ~~cere y James ,h. ~oski \\ Date: February 13, 2007 JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 To: Town of Southold Building Dept. Framing! Strapping Inspections Isabella 1855 Westview Ave. Mattituck, NY 11952 Permit#32553 To Whom It May Concern: After a Framing and Strapping inspection was preformed on the above mentioned property, it is deemed that all work performed was completed to plans and meets all state and local codes. Any other questions please call. ~:>--;. <~~~'C. ,.;i~ J;.~t/;;'-" ~,.o( 'li"- ..-......-:- .......... 1,.-, "\/<) IJI=::....", '0...... l' l:~, " 1... t::l~ ..>.... A'\-' , -:-(" i/~" -U:'\i;.. ",' . '0 Fj ~. "":, -f\j ;'-'-,~;k. '\; ~.- . \:', .,>r~:,._ ~ 1 g ~ ,:.":'/\\><:"-,,}~;:;-/"': ,lLl; Cl \ \,...." ."..'.'..c.".'..... ..^,J..:i., ~\<)\:". ,>> .ii:'/ . ~OF'" '~.':"-fr'.: '..' '''..'''S;'\;);..~..;'~~;~. ;y,''';~ .". ?'::~S~IO!l-" ," ~-,,_,...;..,;~:_,:;..:,,__.c""P' J efa I 5 ? ~"""'IY ~'J~"'~ \ \ JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 To: Town of South old Building Dept. Date: March 23, 2007 Re: Insulation Inspection Isabella 1855 West View Dr. Mattituck, NY 11952 Permit #32553 To Whom It May Concern: After an Insulation inspection was performed on the above property, it is deemed that all Insulation was installed correctly, and meets all building codes. Any other questions please call. ,'" '\ ., ~ffirerelY Jarnei~eerkoski '\ Date: December 6, 2006 JAMES 1. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. Il952 (631) 298-7Il6 IJEC . 2pr" To: Town of South old Building Dept. Re: Not A Story Isabella 1855 Westview Dr Mattituck, NY 11952 To Whom It May Concern: After a elevation study was performed on the above mentioned structure, it is deemed that the basement (Is Not A Story) since the average height out of the ground is less than 6' -0". Any other questions please call. \\ \ \ Sincerely \ \ ... ~ . .' FOUNDATION (1ST) COMMENTS FIELD INSPECTION REPORT DATE l4...-- D FOUNDATION (2ND) 0.eL- ),..J.*.. 2: P INSULATION PERN. Y. STATE ENERGY CODE ~ -~--~ ~~~-- - -- eX) \)'\ V\~ 1:; r~ p. 1-.. < t Ri !'j .., ROUGH FRAMING & PLUMBING FINAL '. , ' ~li\ _ ~J( h ~, -BI\<J- :t::-j) 0"1' , \ V A:t- : 'oL 'P 3 -/J f9E ~,J\L' . II u!-~~N-~ ~~ o u_~..<J...{J ~("'A'3 aL - """~_(... ~ (\' .0 ::E z m ;u ADDITIONAL COMMENTS t'j (';'~ "d ~~ \ .., C'jS ~2: := t'j ~ ( ~ '=' t'j --l;:.."d " :-l PERMIT NO. :S~9h;36 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the f~, before applying? Board of Health /' 4 sets of Building Plans /' Plannin~d approval Survey Check-rt I '!,T1 Sepl1c Form __ NYS,D-E-C, ,/ Trustees ./ Contact: Mail to: LAI1Il~/ L/~ . TOWN OF SOUTHOLD BUILDING DEPARTMEN:f TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southofiir NOV 2 1 20CB Approved Disapproved alc Examined C-Gt.'- "-- Phone: 1..3 /- tjq,f'- 'ffi'!J-CJ-. , I ''_'~_,2LC)__1APPLICA TION FOR BUILDING PERMIT Date 7//;;). ,20 0 (P INSTRUCTIONS a, This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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 ofthe Town of South old, 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, '- \ oS <> C"I-<-~ C t.> A f . (Signature of aPl?liyant or name, if a corporation) t>o ~. -/ '-t'3.'( J A.....~ ~P""/Ll, N.Y 111<17 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder o c:;: 'H--F; P-A- L <:-o..=< ,q.,... ~ /L - corporation Name of owner of premises (Name and title of corporate Builders License No, ~ '1 ~ 0 ~I Plumbers License No. 7 u 7,1/i Electricians License No, Other Trade's License No. I. Location of land on which proposed work will be done: J'il5S tv~lnt7u..1 DR House Number Street M A-ITZl I/o::.. t=- Hamlet \--l.'{ _ \ I ctS .).., !.,: ........ ~ ',"," .' "-9 County Tax Map No. 1000 Section /07 Subdivision -g rt" ...... .: tJ- ,;;. ....."" ~ j, (Name) Block 07 Filed Map No. ~t oC,' fLot :," - 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy (;) l'{ e: ~,=>~...L V j}~;~T>~ N~~ b. Intended use and occupancy 0 r--{ E- ~ A.... .L-'-{ -;< is s-,l">~>-<-,,-E. 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work ../ Alteration / ;217t:),,,,, eJ (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units :8 If garage, number of cars / C- A 12- (To be paid on filing this application) Number of dwelling units on each floor ~ 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 3Q' (l" Rear 3q' H" Depth,25 "IIi- 'I Height /7 ' Number of Stories I sqpfJ- Y Dimensions of same structure with alterations or additions: Front 301 II .\ Rear 34:1 I ( I , Depth '3,' s I I Height .3 0 l 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 - 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 / .Jo;:~'i1"A""'''''~ 'fer j)...~,..,,":<H sT 14. Names ofO~er of premises I' !>Pb.:(..LA. Address ~""""'LL.& c:.e_...~ Phone No.5/~-76-L/-I:!~ Name of Architect"l~....o!'<;' v..~ 1<.", "'" ( Address j)e;"j{ 1M - Mt.:WT,,"'i?~ne No 77</- :7 3 ~ b Name of Contractor L..\.5 0 c....\L~ Address "1:':::~-::. Phon~o.t:. 1I- t.j<:;5 -Lff?Sd-... 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. PERMIT~ Y BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES LNo_ * 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 ) L ~I>.\~c;..~ L, ~ tJ ~ ~ ;p fLE.> being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the c,~..."-/I..l. C-",,:::c~,,~,p_ (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~ ~ - -~~;;t ;L- -- ~ Signature of A#!llicant Public BONNIE SKI Nolary Public, State Of New \\lit No.0I006095328,Suffol~n\r Term Expires July 7, 20 ~ /000 - OWNER _ t'- TOWN OF SOUTHOLD PROPERTY RECORD CARD M-/Y ~ FORMER OWNER Gaebel FARM LAND IMP. TOTAL DATE ht9 0 00 00 AGE BUILDING CONDITION, NEW FARM NORMAL BELOW ABOVE Value Per Acre Value Acre Tillable 1 Tillable 2 fjllable 3 Naadland ;wampland 3rushland :-lause Plat ~ r'_ fatal == -- VILLAGE DIST. SUB. LOT I ~. -t'FI j .. ,A ,.{t. ~ t . tit . - - ( . k (' E 1t.iM-:?t:...,.~ k w, I 9 ~cc. . ACR.yy TY~E OF BUILDING lA, j ~ U/l~ S; 0;- fV&4Q / f-~M R t ror.le?:" 19;~'- I .f; Q ~~'~:.~~. -= -' COMM. CB. MISe. Mkt. Value REMARKS t/rio dO 0 ~ .(AShliJ~ Co ~N1 Y FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD 1j-"/ 7J s-r c... #.,2,7. - k Co DOCK ..., ,"~ ....-, --,;, " ::.'= "f~;~I<':"I\~: , ",. -/ .." ".", .J.l'/ " < , - - --" ~~~;;~~~~~:. ~ --'~, ,s-' ~~' "--'<. 107.-7-6 3/06 ./,....;,~J:y M:.JlJ:i'~' it, xYo"/O<!o Extension Extension Extension Porch Porch Breezewoy Garage ~~?~ f' X IS - 120 o. B. Total } \ " ;'\ f,v LOR <tJro/ , ad. iM '7~ " I 3 ~ :3 3 ~'6 Foundation :?-s Basement Ext. Wolls Fire Place ~ ype Roof fl,ecreation Room pormer Driveway 3D 2.f/fJ / ". I 11>' III ri/ ,.....' ~ ~b . . IlJl . fU PO<l;-;~ Both j 1/'4 Dinette ...ni- h/I Floors OaK K. V1160d J'A. Interior Finish S)"I[OCI( LR. NtJt1e Heat I R. g II.I.V. DR. Gd..bJe Rooms 1st Floor BR. Rooms 2nd Floor FIN. B