HomeMy WebLinkAbout31487-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32777
Date: 12/06/07
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 5655 NASSAU
(HOUSE NO.)
County Tax Map No. 473889 Section III
POINT RD
(STREET)
Block 13
CUTCHOGUE
(HAMLET)
Lot 3
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 22, 2005 pursuant to which
Building PeImit No. 31487-Z
dated
OCTOBER 3, 2005
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.
The certificate is issued to ROBERT D & MARY SENA
(OWNER)
of the aforesaid building.
SUFFOLK CuUN' -L DBPARTMERT OF REALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
2074946
06/05/07
PLUMBERS CERTIFICATI01II DATED
06/25/07 KEVIN REMPE PLUMB.&HEAT.
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Rev. 1/81
Forni No.6
TOWN OF SOUTHOLD
nun,DlNG DEPARTMENT
TOWN HALL
765-1802
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APPLlCA TION FOR CERTIFICATE OF OCCUPANCY ~
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TIus application must be filled in by typewriter or ink and submitted to the Building Department with thq~lIL~ng: .
A. For new building or new use: 11 ''''!'''dS~
I. Final survey of property with accurate location of all buildings, property lines, streets, and unus
topograpmc 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. Sworn statement from plumber certifying 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
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
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B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. Accurate survey of plOper1y showing all property lines, streets, building and unusual natural or topograpruc
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Cettificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
I. Certificate o(Occupal1cy .. New dwelling 125.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00. Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary (;ertificate of Occupancy - Residential $15.00, Commercial $15.00
Date. . {pI (P / 0..--,
X
5~5S-
Houne No.
New Construction:
Old or Pre-existing Building:
PO,,,'/-
(check one)
f2d., Cu+c..t, 04 ~e..
Ha;;-g;.
Location of Property:
/lJCA..5Sa...u..
Street
kberf" ..$el1t:L
III
Block
/3
Owner or Owners of Property:
Suffolk Couoty T"f Map No 1000, Section__
Lot
0'3
Subdivision
Permit No. _ 3/ tf (7 2 Dale of PCIIIlJt.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ Z5 . 0 ()
Filed Map.~_
_.._ Applicant: Fred
Lol:
Se. .(e;+
_ Undenv,.;ters Approval:
Final Certificate:
X' (check one)
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Applicant Signature
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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.
31487 Z
Date OCTOBER
3, 2005
permission is hereby granted to:
ROBERT D & MARY SENA
68 2ND STREET
GARDEN CITY,NY 11530
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
5655 NASSAU POINT RD
CUTCHOGUE
County Tax Map No. 473889 Section 111
Block 0013
Lot No. 003
pursuant to application dated SEPTEMBER 22, 2005 and approved by the
Building Inspector to expire on APRIL
3, 2007.
Fee $
1,252.20
'zed/Signa
ORIGINAL
Rev. 5/8/02
/ JI, - 13, 3
l!I.~l!I
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
I NEW YORK BOARD OF FIRE UNDERWRITERS I
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ G & S ELECTRICAL CONTR. . SENA ~
lID P.O. BOX 215 5655 NASSAU PT. RD ~
I SOUTHOLD, NY 11971, CUTCHOGUE, NY 11935 I
~ Located at 5655 NASSAU PT. RD CUTCHOGUE, NY 11935 ~
~ ~
~ Application Number: 2074946 Certificate Number: 2074946 ~
I Section: Block: Lot: Building perm; I <+'8 '/ BDC: ns11 I
lID Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of lID
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Attached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
lID promulgated by the State of New York, Department of State Code Enforcement and Administration, or other lID
~ authority having jurisdiction, and found to be in compliance therewith on the 5th Day of June, 2007. ~
~ Name OTY Rate Ratin. Circuit !xnl< ~
~ Outlet 171 0 General Purpose ~
~ Receptacle 90 0 General Purpose ~
~ Switch 102 0 General Purpose ~
~ Dimmers 19 0 lID
~ Receptacle 18 0 GFCI ~
~ Paddle Fan 8 0 ~
~ Heat, Light, Vent I 0 ~
~ GFCI Circuit Breaker I 0 20a ~
~ Disconnect 4 0 60a Air Conditioner lID
~ Receptacle 3 0 20a PooV Spa ~
~ Service ~
~ I Phase 3 W Service Rating 400 Amperes ~
~ Service Disconnect: 2 200 cb ~
~ Meters: I ~
~ ~
~ seal ~
~ ~
~ 2 of 2 ~
I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I
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I BY THIS CERTIFICATE OF COMPLIANCE THE I
i NEW YORK BOARD OF FIRE UNDERWRITERS i
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ G & S ELECTRICAL CONTR. . SENA ~
~ P.O. BOX 215 5655 NASSAU PT. RD ~
~ SOUTHOLD, NY 11971, CUTCHOGUE, NY 11935 ~
~ Located at 5655 NASSAU PT. RD CUTCHOGUE, NY 11935 ~
I Application Number: 2074946 Certificate Number: 2074946 I
I Section: Block: . Lot: Building permi31lfe / BDC: n511 I
~ Described as a Resldenl1a13000-4000 square ft. occupancy, wherein the premises electrical system consisting of ~
i electrical devices and wiring, described below, located in/on the premises at: i
~ Basement, First Floor, Second Floor, Attached Garage, Outside, ~
I ~e~~~~~1 ;:~ec~~onnd~~t~~e ~~em~~~~r~~enc~~ca~i~~stet~~ li~i~~~ret~ee~~~tri~:1 ~~~ic:sp;I~~a~~in~o~e th:n~~~~nt s~:~~~~~ I
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 5th Day of June, 2007. ~
~ Name OTY Rate Rating Circuit IYns< ~
~ Alarm and Emergency Equipment ~
~ Sensor 3 0 Carbon Monoxide ~
~~~~~ ~
iffi Oven 2 0 40 Amps ~
~ Hydro Massage Tub (Therapeutic) 1 0 =
~ Exhaust Fan 6 0 F.H.P. ~
~ Furnace 1 0 Oil ~
~ Stearn Unit/Sauna 1 0 40 Amps ~
= Dish Washer 2 0 1.2 KW =
= Air Conditioner 1 0 24.000 BTU =
~ Air Conditioner 1 0 36.000 BTU ~
~ Air Conditioner 1 0 48.000 BTU ~
iffi Air Conditioner 1 0 60.000 BTU iffi
~ Pool Heater 1 0 Gas ~
~ Pooll Spa Bonding 1 0 ~
~~~~ ~
~ Outlet 142 0 Fixture seal ~
~ Fixture 142 0 Incandescent ~
I Continued on Next Page 1 of 2 I
~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~
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"02005 J;
.==.: ~~::. Schwartz, AIA - Architect, PLLC
.~. Cutchogue,NewYork 11935
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Phone: (631) 734-4185
Fax: (631) 734 - 2110
TRANSMITT AL
Date:
September 29, 2005
To:
Southold Building Department
Main Road
Southold, New York 11971
Attn: Damon Rallis
From:
Mark Schwartz
Fax number:
765-9502
Phone number:
765-1802
Re:
Sena House
5655 Nassau Point Road
Cutchogue, New York
(~#1000-111.13-03)
Pages:
1 (including cover sheet)
Comments:
The proposed construction shall not have basement wall with 6 feet above the finished
ground level for more than 50% of the total building perimeter and therefore meets the
code requirements.
Please call this office if you have questions or require additional information.
"
SenaBIdgDeptl.doc
.
-
Mark K. Schwartz, AlA -Architect, PLLC
P.O. Box 933
Cutchogue. New York 11935
Phone: (631) 734 - 4185
Fax: (631) 734 - 4185
TRANSMITT AL
Date:
September 07, 2005
To:
Southold Building Department
Main Road
Southold, New York 11971
Attn: Damon Rallis
Fax number:
765-9502
Phone number:
765-1802
From:
Mark Schwartz
Re:
Sena House
5655 Nassau Point Road
Cutcltogue, New York
(SCTM#1~111-1~3)
Pages:
1 (including cover sheet)
Comments:
I allev inspected the septic system at the aforementioned premises and find it to be in
proper working condition and has recently been pumped out. The existing residence
has four bedrooms and the proposed structure shall also have four bedrooms. The flow
rate has not increased and I hereby certify that the capacity is adequate and the working
service of this system will not be adversely affected by the proposed addition.
Please call this office if you have questions or require additional information.
Sena1.doc
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3 'Lf~7 Z-
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
)Xl. FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
-
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INSPECTOR ~ ~
DATE
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31~?J7 2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONS1RucnoN
[ ] ROUGH PLBG.
[ ] INSULATION
lXJ FINAL k;
[ ] FIRE SAFETY INSPEcnON
[ ] FIRE RESISTANT PENETRATION
REMARKS:7:k
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DATE )/~/~-()7 INSPECTOR #: ~
:3 ILfl7 Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [XFINAL Ii:
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRucnON [ ] FIRE RESISTANT PENETRATION
REMARKS: ;'lid a.c-<"~~I!f'- 1:ir- ~
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DATE !o-I? -01 INSPECTOR ~ ~
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [pq, FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
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DATE
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [~LATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE
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TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ~ PlBG.
[ ] FOUNDATION 2ND [v(lNSUlATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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INSPECTOR
)1+17 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST M ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
M.- F.RAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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DATE G-~-O'
INSPECTOR ~.~
3)Lf-~7 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
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DATE ) ~} /~t)(,
INSPECTOR ~~
31'f~7 z
TOWN OF SOUTH OLD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PlBG.
KJ FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS'
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DATE 17~'r!--()S- INSPECTOR ~~
]ltf9, 7 z-
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[p(J FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE I'J.--- n-o:>
INSPECTOR ~ ~
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FIELDJNSPECTION REPORT DATE
COMMENTS
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FOUNDATION (2ND)
ROUGH FRAMING &
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INSULATION PERN. Y.
STATE ENERGY CODE
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Albert J. Krupski, President
James King, Vice-President
.-
Artie Foster
Ken Poliwoda
,
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Soutbold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
September 15, 2005
Mr. James E. Fitzgerald, Jr.
Proper-T Permit Services
P.O. Box 617
Cutchogue, NY 11935
RE: ROBERT SENA
5655 NASSAU POINT RD., CUTCHOGUE
SCTM#111-13-3
Dear Mr. Fitzgerald:
The Southold Town Board of Trustees reviewed the survey prepared by Joseph A.
Ingegno dated September 14, 2005 and determined the proposed deck, screened
porch, and on-grade patio to be out of the Wetland jurisdiction under Chapter 97 of the
Town Wetland Code and Chapter 37 of the Town Code.
Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the
Coastal Erosion Hazard Area (Chapter 37) no permitis required. Please be advised;
however, that no construction, sedimentation, or disturbance of any kind may take place
seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion
hazard area as indicated above, or within 25' landward from the top of the bluff, without
further authorization from the Southold Town Board of Trustees pursuant to Chapter 97
and/or Chapter 37 of the Town Code. It is your responsibility to ensure that all
necessary precautions are taken to prevent any sedimentation or other alteration or
disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and
. n n n Coastcir Erosion Hazard Area, which -mayresuff fro-ril-yo-urproject:-Such.precautions .. .
may include maintaining adequate work area between the tidal wetland jurisdictional
boundary and the coastal erosion hazard area and your project or erecting a temporary
fence, barrier, or hay bale berm.
.
2
H.ovlever" any activity within 100' of a Wetland line or seaward of the Coastal Erosion
'Ha~ard Area would require permits from this office.
This determination is not a determination from any other agency.
If you have any further questions, please do not hesitate to call.
Sincerely,
1h~.1 9- ~. ys.J... ~.
AlbertJ. Krupski, Jr., President
Board of Trustees
AJK:lms
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
OEC PERMIT NUMBER
1-473B-02B78/00001
FACILITyiPROGRAM NUMBERCS)
.
PERMIT
EFFECTIVE DATE
J..... II, 2001
EXPIRATION OATECS)
Under the Environnental
Conservation Law
June II, 2006
'I TYPE OF PERMIT . New o RenewaL o Modification o Permit to Construct o Permit to Operate "
I I
0 Article 15, Title 5: Protection 0 6NYCRR 608: Water Quality 0 Article 27, Title 7; 6NYCRR
of Waters Certification 360: Solid Waste Management
0 Article 15, Title 15: Water 0 Article 17, Titles 7, 8: SPOES 0 Article 27, Title 9; 6NYCRR
Supply 373: Hazardous Waste Management
0 Article 19: Air Pollution
0 Article 15, Title 15: Water Control 0 Article 34: Coastal Erosion
Transport Management
0 Article 23, Title 27: Mined
0 Article 15, Title 15: long Land Reclamation 0 Article 36: Floodplain
Island Wells Management
0 Article 24: Freshwater Wetlands
0 Article 15, Title 27: Wild, 0 Articles 1, 3, 17, 19, 27, 37;
Scenic and Recreational Rivers . Article 25: Tidsl Wetlands 6NYCRR 380: Radiation Control
PERMIT ISSUED TO TELEPHONE NUMBER
Patricia Astarita (516) 845-4599
ADDRESS OF PERMITTEE
7 Parkvi ew Court Farmingdale, NY 11735
CONTACT PERSON FOR PERMITTEO WORK TELEPHONE NUMBER
EnConsultants Inc., 1329 North Sea Road, Southannton, NY 11968 (631) 283-6360
NAME AND ADDRESS OF PROJECT/FACILITY
Astarfta property. 5655 'Nassau Point Road Cutchogue NY
LOCATION OF PROJECT/FACILITY
SCTM #1000-111-13-3
COUNTY TOWN WATERCOURSE NYTM CooROINATES
Suffolk Southold Little Peconic Bay E:715.1 N:542.1
DeSCRIPTION OF AUTHORIZED ACTIVITY:
Construct 76 linear feet of vinyl bulkhead within 18 inches of the existing bulkhead and construct 24 linear feet of vinyl bulkhead within 18
inches and 12 inches higher than the existing bulkhead. Place 45 cu. yds. of clean upland sand as backfill and plant beach grass.
Reconstruct the existing steps to the beach and install two (2) 10 inch diameter support pilings for the deck. The property landward of the
existing functional bulkhead greater than 100 feet in length and constructed prior to 8120n7. is beyond the jurisdiction of Article 25 (Tidal
-
Wetlands). All work is to be done in accordance with the attached plans stamped NYSDEC approved.
By acceptance of this permit, the permittee agrees that the penmit is contingent upon strict compliance with the
ECL, all applicable regulations, the General Conditions specified Csee page 2 & 3) and any Special Conditions Included as
part of this permit.
ldg. #40 SUNY Ston Brook NY 11790-2356
DATE
June 11 2001
Pagel of 4
-,
SOUTHOLD, N):' 1 tllL . "j
TEL: (631) 76~-180 - - ,. f lLD
FAX: (631) 765-950 .-!-oW-- "_~c t.. g-:r;-
www.northfork.net!outholdl PERMIT NO. 3 I I
Examined
BUILDING PERMIT APPLICA nON CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans /
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C. /
Trustees ./
Contact:
Approved
Disapproved ale
...-
,
,20_,.......--
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Expiration
,20
Mail to:
DO NOT NiAIL
Phone: . 734-5800
APPLICATION FOR BUILDING PERMIT
,
Date
9/21/05
,20_
INSTRUCTIONS
a. This application Ml,JST be completely filled in by !ypewriter or in ink and subnVtted fO the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee accordmg 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 exterlsion of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the 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 lations, and to admit
authorized inspectors on premises and in building for necessary inspections. ("
PROPER-T PERMIT SERVICES
Post Office Box 617
Cutc:hogae, NY 11935-0617
.
ration)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
6g"nt
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
Robert Sena
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
S6SS Nassau Point Road, Cutchogue
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
."
,
Lot
Lot
,~ -I
J',:;:;,'.,j!"'"
111
Block 1 3
Filed Map No.
;4iJ/",
. I..,
,:...-1
2. State existing use and occupancy of premisC?s and intend~d use and oc,:upancy of proposed construction:
a. Existing use and occupancy s lngle- famlly dwe lllng
b. Intended use and occupancy
single-family dwelling
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
xx
Alteration
4. Estimated Cost
$150,000
(Description)
Fee
(To be paid on filing this application)
Number of dwelling units on each floor N I A
5. If dwelling, number of dwelling units one
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 58 '
Height Number of Stories
Dimensions of same structure with alterations or additions: Front 58 '
Depth 80' Height NlViT 1 S ' Number of Stories
Rear
58'
Depth
52'
one
Rear
two
58'
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
100'
Rear
100'
Depth
)62' <"11 approx)
10. Date of Purchase
Name of Former Owner
I I. Zone or use district in which premises are situated
R-40
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~X
13. Will lot be re-graded? YES ~ NO_Will excess fill be removed from premises? YES ~ NO_
Robert Sena, 68 Second Street, Garden City NY 115)0
14. Names of Owner of premises Address
Name of Architect Mark Schwartz Address
Name of Contractor Address
Phone No.
Phone No
Phone No.
714-418<;
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)
S8:
COUNTY O~ ){0)~~ )
James E. Fitzgerald, Jr. being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
agent
(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.
Swora to before me th~
- day of Qphwl,-tv.
200(
MELANIE OOROSKl
NOTARY PUBLIC, State of New ~
No. 01004634870
Qualified in Suffolk County "'>-1\1"\",
Commission Expires September 30~
I.