HomeMy WebLinkAbout32315-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32772
Date: 12/03/07
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 1195 GOOSE
(HOUSE NO.)
county Tax Map No. 473889 Section 78
CREEK LA
(STREET)
Block 8
SOUTHOLD
(HAMLET)
Lot 8
SUbdivision
Filed MaP No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
AUGUST 21, 2006 pursuant to which
Building Permit Il1o. 32315-Z
dated
AUGUST 24, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR & AS PER CONDITIONS OF ZBA #5630 DATED 12/29/04.
The certificate is issued to MORTIMER M & KATHLEEN KELLY
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COUNTY DEPAR'l.'MKNT OF HEALTH APPROVAL
06/05/07
ELECTRICAL CERTIFICATE NO.
3022589
09/06/07 CUTCHOGUE EAST PLUMBING
PLUMBERS CERTIFICATIOI!l' DATED
horized Signature
Rev. 1/81
eel
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TOWN ~;I~~U~HOLD. -/-(B-f{jjS~"~J'\
BUILDING DEPART \ T\s ~,,_-- \,
TOWN HALL \\\.\.r \ '?J J
765-1802 \' \
\ .~
APPLICATION FOR CERTIFICATE O~ ObANCY'<'
,
. \ Cl.~,
This application must be filled in by typewriter or i~ and submitted to the Building Department with the following:
~..-----"I.,
,
'/3 IS'
A. For new building or new Use:
I. Final survey of propeliy 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. Sworn 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 Impector shall state the reasons tIlerefor in wIiting to the applicant.
C. Fees
New Construction:
I. Certificate of Occupancy - New dwelling $25.00, 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 Celiificate of Occupancy - $50.00
5. Temporal)' COliificate of Occupancy - Residential $15.00, Commercial $15.00 /
Date. /1 t 3 f{17
'__ Old or Pre-existing Building: ~ (check ~ne)
<-t~~l~
Street
Location of Property: ~6CJOs~
House No.
Owner or Owners of Property: ___ J<;;../I<.../ __
Suffolk County Tax Map No 1000', Section __I '-;1 ~___ Block ---<6'
Hamlet
Lot
-~ -
Subdivision_________ _____________ Filed Map. _____ Lot: .________
Pennit No --3;lJ~_____ Date ofPermit________ AP]llicant__k~IIJL------------.--------
Health Dept Approval' --___._n_n_ ________________ Underwriters Approval_____.___________
Planning Board Approval _______________
Request for: Temporary CeJiificate
Fee Submitted $ ;J- S; Cl::7
Final Certificate: ~.__ (check one)
~ 7 }11 7~
CO.::l3:J- /1;2..,
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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.
32315 Z
Date AUGUST
24, 2006
permission is hereby granted to:
MORTIMER M III KELLY
157 SOUTHARD AVE
ROCKVILLE CENTRE,NY 11570
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR PER ZBA
at premises located at
1195 GOOSE CREEK LA
SOUTHOLD
County Tax Map No. 473889 Section 078
Block 0008
Lot No. 008
pursuant to application dated AUGUST
21, 2006 and approved by the
Building Inspector to expire on FEBRUARY
Fee $
898.50
ORIGINAL
Rev. 5/8/02
APPEALS BOARD MEMBERS
Ruth D. Oliva, Chairwoman
Gerard P. Goehringer
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
hUp:/ /southoldtown.northfork. net
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF DECEMBER 29, 2004
ZB Ref. No. 5630 - MORTIMER and KATHLEEN KELLY
Property Location: 1145 Goose Creek Lane, Southold; CTM 78-8-8.
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.
PROPERTY FACTS/DESCRIPTION: The applicant's 18,502+- sq. ft. parcel has 75 feet along the
south side of a 20 ft. wide right-of-way known as Goose Creek Lane, 72.50 feet along the southerly
rear line, and 250 feet in depth. The property is improved with a single-story frame dwelling as
shown on the November 6, 1987 survey prepared by John T. Metzger, L.S., revised November 20,
2004.
BASIS OF APPLICATION: Building Department's August 16, 2004 Notice of Disapproval, citing
Sections 100-242A and 100-244, in its denial of a building permit to construct additions with
alterations, for the reasons that the new construction will be less than 10 feet on a single side and
less than 25 feet for both side yards.
/
FINDINGS OF FACT
The Zoning Board of Appeals held a public hearing on this application on December 16, 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: The applicant wishes to construct a second-story over
the existing first floor of their home, an addition at the front of the dwelling, and enclosure of a
screened porch, with setbacks at 7.8 feet (existing) at the east side and 10.5 feet (proposed) at the
west side, for a total combined setback area of 18.3 feet. The height to the top of the ridge of the
new addition is proposed at approximately 26 feet.
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 variance will not produce an undesirable change in the character of the
neighborhood or a detriment to nearby properties. The applicant wishes to enclose a screened
Page 2 - December 29, 2004
ZBA Ref. 5630 - Mortimer and Kathleen Kelly
CTM Id: 78-8-8
porch and the addition will remain within the footprint of the house, which has nonconforming side
yards at 10.5 feet on the west side and 7.8 feet on the east side. The additions are at least 140 feet
from the front lot line facing Goose Creek Lane, and the dwelling is skewed on an angle, bringing the
corners of the dwelling closest to the sides of this 75 ft. wide lot.
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 existing location (footprint) of the applicant's
home will not be increased and will not create a new nonconformance beyond the existing
non conformities of 10.5 feet on the west side and 7.8 feet on the east side.
3. The relief requested is the maximum that the Board would approve.
4. The difficulty was self-created in that the home is skewed on an angle toward the sides of the lot,
which creates a side yard setback nonconformities on the corners at its closest points.
5. No evidence has been submitted to suggest that a variance in this residential community will
hi:lve an adverse impact on the physical or environmental conditions in the neighborhood.
(
/6. Grant of the requested relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of additions, 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 Goehringer, seconded by
Member Dinizio, and duly carried, to
GRANT the variances as applied for, as shown on the November 6, 1987 plan prepared by
John T. Metzger, L.S., amended November 30, 2004.
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 Orlando (Ac ng
were Chairwoman Oliva and Member Tortora. IS
Absent
1I~r;05
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I BY THIS CERTIFICATE OF COMPLIANCE THE I
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ ALAN HUBBARD ELEC. MRlMRS KELLY ~
~ PO BOX 2241 1145 GOOSE CREEK LANE ~
~ 126 CLOVER PLACE SOUTHOLD, NY 11971 ~
~ AQUEBOGUE, NY 11931, ~
~ Located at 1145 GOOSE CREEK LANE SOUTHOLD, NY 11971 ~
I Application Number: 3022589 Certificate Number: 3022589 I
I Section: Block: Lot: Building permS.:2 IS-- BDC: n511 I
~ Described as a occupancy, wherein the premises ~ectrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Outside, Attic, ~
~ 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 5th Day of June, 2007. ~
~ Name OTY Rate Ratin. Circuit ~ ~
~ Alarm and Emergency Equipment ~
~ Sensor 2 0 Carbon Monoxide ~
~ Sensor 6 0 Smoke ~
~ Appliances and Accessories ~
~ Exhaust Fan 4 0 F.H.P. ~
~ Range I 0 50 Amps ~
~ Dish Washer I 0 1.2 KW ~
~ Stearn Unit/Sauna I 0 50 Amps ~
~ Air Conditioner I 0 20a Amps ~
~ Air Conditioner I 0 40 Amps ~
~ Pump Motor I 0 F.H.P. ~
~~~~ ~
rnJ Receptacle 45 0 General Purpose rnJ
~ Switch 44 0 General Purpose ~
~ Fixture 46 0 Incandescent ~
~ Receptacle I 0 30a Dryer ~
~ ~:::;:~le 1 ~ ~ GFCI seal ~
I Continued on Next Page 1 of 2 I
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 Located at
~ Application Number:
~
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~ 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 andlor 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 5th Day of June, 2007.
~ Name OTY Rate Ratin. Circuit ~
~ Paddle Fan 4 0
~ Service
~ t Phase 3W Service Rating 200 Amperes
~ Service Disconnect:
~ Meters: 1
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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
ALAN HUBBARD ELEC.
PO BOX 2241
126 CLOVER PLACE
AQUEBOGUE, NY 11931,
1145 GOOSE CREEK LANE SOUTHOLD, NY 11971
MR/MRS KELLY
1145 GOOSE CREEK LANE
SOUTHOLD, NY 11971
3022589
Certificate Number:
3022589
Section: Block: Lot: Building Permit: BDC: n511
.b d h . th ~;2.311S;t-1 .. f
Descn e as a occupancy, w ereln e premises e ec nca system consisting 0
electrical devices and wiring, described below, located inion the premises at:
Basement, First Floor, Second Floor, Outside, Attic,
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.
~~~
T own Hall, 53095 !.lam Road
PO. Box \179
SouthOk1, New YOrK" 1971
Fax (5\6) 765-1fZ3
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I FIe A T ION
DATE:
94 h)
,
Owner:
Building Permit No. 3:J '3 IS
/-fori- Kdlt/
(please prInt) .
Plumber :;J~c ~L G IS me J ; / ~
(please print) / _.-
(vlcl"":Jue t
f- H ~ "Ie
I certify that the solder used in the water supply system
contains less than 2/10 of It lead.
s signature)
count.y
'i!JSAN J, NAGY
~~~~~~~c State of New Yor~
gualffi,!d in Suffolk County
ommrssion Expires May 20.LL
~'9rd?J
Sworn to before
/po... day of
Notary Public,
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CERTIFIED'
TITlE: USA INSURANCE CORPORA TlON OF
NEW YORK
WESTMfNfSTER BANK
LEONARD LERER
GERTIE LERER
TITlE NO. 8752-61747
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SURV~FOR
LEONARD LERER 6: GERTIE LERER
AT BA YVIEW
TOWN OF SOUTHOLO
SUFFOLK COUNTY, N. Y.
1000- 78- 08 -08
SCALE: 1"= 30'
NOV. 6, 1987
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Ie. NO. 496/ 8
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FL 000 ZONES FROM FIRM
MAP NO. 36103COl88 (]
MA y 4, 1998
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ELEVA TlON /S REFERENCED
ro MG. V.Dtllum.
SURVEY FOR
MORTIMER KELL Y & KA THLEEN KELL Y
A T BA YVIEW
TOWN OF SOUTHOLD.
SUFFOLK COUNTY, N. Y.
1000- 78- 08 -08
SCALE: I": 30' \
NOV. 6, /987
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. NO. 496'8
ECONK: SUR EYO ENGINEERS, P.C:
1516) 765 - 5QZL _._.
P:O. BOX 909 .
MAIN ROAD .
SOUTHOLD,N. Y. 1/97/
Dec. 3, 200/ (flood 10flU lidded)
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87-868
3 ';-3 {S- C
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[q1iNAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
,f/7ii t4::-"j k
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DATE
11/?/o7
I I
INSPECTOR
3 r3/->'2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
!p<tFOUNDATION 1ST [] ROUGH PLBG.
~OUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE /o-H-Ob
INSPECTOR ~ ~
32--31~ ~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUN I'ION 1 ST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSULATION
[ FRAMING (frRAPPlNV [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION
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REMARKS:
DATE I I f) 0
INSPECTOR
- --
--
5L31S2:-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
-'INSPECTION
~J~~NDATIDN 1ST [ ] RDUGH PLBG.
/ [] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUC11ON [ ] FIRE RESISTANT PENETRAnON
DATE /)Ir~
INSPECTOR
-
3J-3 ;s-- 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
t><( FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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DATE
INSPECTOR ~~
JL5/Sc:-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[~:~ATION 1ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
REMARKS:
DATE
INSPECTOR
-
- ~ --
3 23 { s6
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FJMi.iDATION 2ND
[A'FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISt CONS1RUCTION
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRAnON
.~
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DATE
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./ Vv<
INSPECTOR'
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3-):3/~ .
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5~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] ROUGH PLBG.
~ATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ~ESlSTANT PENE1'RAnON
dL-
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMI~~NG)
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
DATE
~!rj(J 7
INSPECTOR
~.32-3/~G
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [ri'FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPEC'nON
[ ] FIRE RESISTANT CONSTRlJCnON [ ] FIRE RESISTANT PENETRATION
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REMARKS: UA'!91 J:-rwL /1) k j,JSI14I/t!"4
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DATE
9//f1o 7
F { r
INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
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[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[~REPLACE & CHIMNEY
REMARKS:
DATlO 103/07 INSPECTOR ~)r h
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
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 F OrIn
N.Y.S.D.E.C.
Trustees
Contact:
v'
PERMIT NO. 3;13/S'c
/
v/
,/
~~i ,20~
5/7'1,20~
I
Examined
Approved
Disapproved ale
Expiration
,20_
Mail to: !1011,rnf?,r.} t'rn J{/'J
p:o~' ~~ ~ ~
II f)V
n{,-)~J. -(Olg
516. 7Jq- 8ot,J- oM
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APPLICATION FOR BUILDING PERMIT ~
Date (.)5 otl-
,2006
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 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 South old, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for remova or demolition as herei escribed. The
applicant agrees to comply with all applicable laws, ordinances, building code, hous' g code, and e it
authorized inspectors on premises and in building for necessary inspections.
o
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
.-
/:."12--
{? Kit
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(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:
) I Lf '\ ~e CUt=----1c LIh.F
House Number Street
'1'7"3&'81
County Tax Map No. 1000 Section
Subdivision
<)oqJ.o / h
Hamlet
I (C()/
'li?
,.', '.~~....
Block" . .<?.'
Filed Mal? No.
"....,,,(
W.
f
(Name)
-Lot
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 1 ~,' 0 TZt;<; f b er-c.-
b. Intended use and occupancy I 179m v ~ V2.t;:)/ b~
3. Nature of work (check which applicable): New Building
Repair emoval Demolition
Addition
Other Work
(<l
Alteration yJ
/
(Description)
. 4. Estimated Cost
. 5. If dwelling, num er of dwelling units I
If garage, number of cars ~
Fee
(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 L/ 8 I Rear?~ I Depth
Height /5 f Number of Stories-' .. <)mt01 JfJ4t:c..
1 (
me structure with alterationsP/r additions: Front '-10 R-,ar ~ 0
Depth ( Height :J.. " Number of Stories ?-.f.- ")mAl. iHfrc...
8. Dimensions of entire new construction: Front '1 at Rear '1. d Depth ~
Height ~ t f Number of Stories 2. + ")JYJ 1:)41 ~
~ f 11 ( ' /
9. Size oflot: Front 7 :> . ():) Rear" . '9:J Depth 1- SO. 01..(
. 10. Date ofpurchaseJqq?? Name of Former Owner n~ ,. y;,.., 11111'" ~/
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.
,
, II. Zone or use district in which premises are situated
~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO _ 5e:~ J9.
. 13. Will lot be re-graded? YES _ NO_Will excess fill be removed from l?~mises? YES_NO_
MorT"" <v rJ- flp4(VI //-< "'J-~ ;?
14. N,m~ "fOwn<<O~ ~011 Add=, Iq~1I'HJ Phoo' No. ~- n. -Jb/o
Name of Architect Address \ ~fl..b I Phone No t.r 77 - Of.{(p
Name of Contractor Address \ o~1 Phone No.
--:
IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO -)fL
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY ~~ 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 )
" K ITT J-J Lee"'; .p 1< &LL i being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above n,amed,
(S)He is the ('J Wlv~ fC
(Contractor, Agent, COlporate 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 this
cU dayof a"f~
~d'~~~
Notary Pu lie
20~
-
lINOA J COOPER
NOTARY PU6L1C. State 01 New York
NO, 01CQ4822563. Suffolk Coun~ fo
Term Expires December 31. 20.J.I.
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TOWN OF SOUTHOLD PltOPERTY RECORD CARD fi1 tp -.5-
OWNER
STREET
VIL~GE
DISTRICT SUB. LOT
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00
~-o-T::>
SeO
5tJO
AGE
NEW
Farm
Tillable 1
Tillable 2
I Tillable. 3
,
Oodland
Swampland
Brushlan~
House Plot
... .....
Total
VL.
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FARM COMM. I IND.
I CB.
I MISC.
I Est. Mkt. Value
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IMP.
,I
TOTAL
DATE
,ptJ
.3 ()~ 0
3 ;Z 0.-0
-;J cr<l
3~oo
NORMAL
BELOW
Acre
Value Per Acre
FRONTAGE ON ROAD
BULKHEAD 3 I 0 '0 ~
DOCK
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Garage
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Patio
Driveway
72-
352
?"j
Porch
Porch
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Interior Finish
Heat Otl.
Roof Type
Rooms 1 st Floor
Rooms 2nd Floor
Dormer
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ENERGY CODE CALCULATIONS
CHAPTER5
SECTION 501
Detached One and Two Family
(For Non-Electric Beat) .
For: K (./ /1
$ooJtk,!I
Design Criteria 5750 Degree Days
Zone lIB
It
Per: Pellll'1 /.j" ;c. '2.7/6
. I
Dated: 3/111' / {) ,
I
SUBSYSTEM AREA DESIGN CODE DESIGN CODE
'''U'' "D" UA VA
Exterior Walls 2587 D. 12 of 0.14 2 9'1.73 31,/. /8
.
Ceiling Roof '/'13 0.0)0 0.031 l.!lJ. J r .rO.O/J
Floor Over Unheated Space "13 /J.di 0.05 8(1." f" 80. '5
. 6.5
Heated Slab On Grade
Unheated Slab On Grade 4.5
.
Basement Wall 0.1
Crawl Space Wall 0.06
1f2J.77 l.f12.63
NOTES.
Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage
Building Envelope Systems to meet requirements of Section 50 I
The mechanical systems and equipment including:
HV AC Equipment, HV AC Systems, Duct Systems, Ventilation Systems and Insulation of Piping Systems to ~eet
requirements of Section 503
Service Water Heating Systems & Equipment to meet requirements of Section 504
Electrical & Lighting Systems & Equipment to meet requirements of Section 505
To the best of my knowledge,
belief, & professional judgement, .
these plans are in compliance
with ,the code.