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HomeMy WebLinkAbout33665-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32877 Date: 02/11/08 THIS CERTIFIES that the building ADDITIONS Location of Property: 7940 INDIAN (HOUSE NO.) County Tax Map No. 473889 Section 86 NECK LA (STREET) Block 2-- PECONIC (HAMLET) Lot 7.2 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 25, 2008 pursuant to which Building Permit No. 33665-Z dated FEBRUARY 4, 2008 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 "AS BUILT" PORCH & DECK ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #6101 DATED 1/10/08. The certificate is issued to PATRICIA DAWSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPAR'l'MEIlT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~ ~ Signature Rev. 1/81 Form No.6 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN HALL 765-1802 ) I. JAN 2 5 og .J -;/ I L.. _ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. Final 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. 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 nses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 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 Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 " ,) I ., 4 ,~. ?}(.v<...Dr New Construction: Date. )- R 3 Ok' Old or Pre-existing Building: '71 '10 ~dtC71? Nt' C Ie La ne House No. Street ' Owner or Owners of Propcliy: ~ fr.z De./ VtEk-f#:.55?""\.. Suffolk County Tax Map No I 000, Section '?? (,:, Block '7 (check one) .K./ l'1/hUr , Hamlet Location of Property: Lot 7.:.2.. Suhdivisioll Filed Map. Lot: Permit No. Date of Permit. Applicant Health Dept: Approval: Underwriters Approval: Planning Board Approval: Requcst f()f: Temporary Certificate ____.__ Final Certificate: __.~ (check one) Fee Snbmitted: $ -~ ?~ L.../ 'Applicant Signature co c3J~77 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. 4, 2008 33665 Z Date FEBRUARY permission is hereby granted to: PATRICIA DAWSON 92 BERGEN ST WESTWARD,NJ 07675 for "AS BUILT" PORCH & DECK ADDITION AS APPLIED FOR TO THE CONDITIONS OF ZBA DECISION #6101 & TRUSTEES PERMIT at premises located at 7940 INDIAN NECK LA PECONIC County Tax Map No. 473889 Section 086 Block 0007 Lot No. 007.002 pursuant to application dated JANUARY 25, 2008 and approved by the Building Inspector to expire on AUGUST 4, 2009. Fee $ 400.00 R.lv..u ~ C {R- ! Authorized Signature ORIGINAL Rev. 5/8/02 ~) . APPEALS BOARD MEMBERS James Dinizio, Jr Gerard P. Goehringer, Gla:iJ:rran Ruth D. Oliva Michael A. Simon Leslie Kanes Weisman http://southoldtown.northfork.net . "\ \ ~) ;'1'\ '.'\\ ..' ZONING BOARD OF APPEALS TOWN OF SOUTH OLD Tel. (631) 765-1809 . Fax (631) 765-9064 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 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING HELD JANUARY 10, 2008 ZBA# 6101- PATRICIA DAWSON, Applicant Property Location: 7940 Indian Neck Lane, Peconic CTM 86-7-7.2 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review faIls under the Type II category of the State's List of Actions, without further steps under SEQRA. BASIS OF APPLICATION: Request for Variances under Section 280-114 and 280-116B, based on the Building Inspector's October 11, 2007 Notice of Disapproval concerning proposed as. built additions and alterations to the existing dwelling, which construction is less than 75 feet from the bulkhead and less than 20 feet on a single side yard. PROPERTY FACTS: The applicant's 72,960 sq. ft. conforming parcel in the R-80 District with 161.10 ft. along Peconic Bay and 150 ft. along Indian Neck Road, is improved with an existing two-story frame dwelling as shown on survey prepared by John C. Ehlers, Land Surveyor dated 7/10/2007 last updated 9/28/2007. This property is also shown on the Subdivision Map of High House Woods as Lot 2. ZONING CHAPTER 280 OF TOWN CODE (formerlv Chapter 100): Zoning code Section 280- 116 B states that non-conforming lots measuring between 20,000 and 39,999 square feet in total size shaIl be setback not less than 75 feet from the bulkhead. Section 280-114 states that non-conforming lots measuring between 20,000 and 39,999 square feet in total size require a minimum single side yard setback of 20 feet. LWRP DETERMINATION: The applicants are requesting a variance for an as-built porch and deck set back less than the code-required75 feet from the bulkhead. In a determination issued December 17, 2007, inconsistency was found related to the construction of a porch and deck 42.3 feet from the bulkhead under Chapter 268, Waterfront Consistency Review of the Town of Southold Code and Local Waterfront Revitalization Program (LWRP) standards. A minimum setback distance of 100 feet from the wetland line is required pursuant to Chapter 275-3. In addition, a minimum setback requirement of 100 feet is required from the top of the bank. Page 2 - January 10, 2008 \ ZBA # 6101 - Patricia Dawson CTM 86-7-7.2 The LWRP Coordinator recommends that the applicant be required to accept to the following conditions: 1. Establish a non-turf, native vegetation buffer landward of the top of the bank. 2. Attach gutters, downspouts, and sub-surface drywells to contain roof runoff on the house and porch. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on December 20, 2007, 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 requests a variance for the construction of a deck and covered porch addition to an existing residence, with a setback 42.3 feet from the bulkhead at its closest point where the code requires 75 feet, and an 18.3 foot side setback where the code requires 20 feet. ADDITIONAL INFORMATION: The house and deck were constructed in 1980-81. A Certificate of Occupancy was issued in 1981. Later, a 15' x 15' addition was constructed to the west of the existing deck resulting in an 18.3' side setback, and a 10' x 10' enclosed screen porch was added over the existing deck. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Town Law ~267-b(3)(b)(3)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The westward addition to the deck extends no closer towards the slope than does the existing deck, and the covered porch is within the area of the original deck. The property is wooded, and the deck is not readily visible from the neighboring properties. 2. Town Law ~267-b(3)(b)(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 house and deck were constructed in 1980 and 1981, and a Certificate of Occupancy was granted. The slope toward the bulkhead is stable and well-vegetated. Removal of the original deck to increase the setback would pose a considerable hardship. :3. Town Law ~267-b(3)(b)(3). The relief with respect to the side setback is not substantial, amounting to a variance of less than ten (10) percent. The relief with respect the bulkhead is also not substantial, given the approvals that were given when the deck was built. 4. Town Law ~267-b(3)(b)(5). The difficulty with respect to the deck's distance from the bulkhead was not self-created insofar as it dates back to the issuance of the 1981 building ~ Page 3 - January 10, 2008 ZBA # 6101- Patricia Dawson CTM 86-7-7.2 permit. The difficulty with respect to the side setback was created when the applicant chose to extend the deck in a westerly direction to connect with an existing shower. 5. Town Law ~267-b(3)(b)(4). 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. 6. Grant of the relief requested is the minimum action necessary and adequate to enable the applicant to enjoy the benefits of this property, 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 Simon, seconded by Member Oliva, and duly carried, to GRANT the variance as applied for, as shown on the 7/10/2007 survey revised 9/28/2007 by John C. Ehlers, and subject to the following Conditions: 1. The applicant shall establish a non-turf, native vegetation buffer landward of the top of the bank. 2. The applicant shall attach gutters and downspouts, on the house and porch and sub- surface drywells to contain roof runoff on the property. 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 GOehr..ing"r_.(~.. ..'rman. Di~va, Si ThIS ResolutIOn was duly adopted (5-0). /..~t?2 GERARD P. GOEHRINGER, CH MAN / ..Approved for Filing Januarylp' 2008 ~/ n, and Weisman. 33 ~!osz. TOWN OF SOUTHOlD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PlBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING N FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ;1/~ Rf) rl-rE ~ ~ ~ .I ;;....~{,-t)g DATE -r~ /- Z- Bft ~t2.(O ~, INSPECTOR ~ ~ 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 # 0300C Date Februarv 8, 2008 THIS CERTIFIES that the dwelling, deck, steps down slope, concrete retaining wall, deck extension to west, screened porch and outdoor shower At 7940 Indian Neck Lane, Peconic Suffolk County Tax Map # 86-7-7.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/26/07 pursuant to which Trustees Wetland Permit #6753Dated 10/17/07 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 a dwelling, deck, steps down slope, concrete retaining walL deck extension to west, screened porch and outdoor shower. The certificate is issued to PATRICIA DAWSON owner of the F";;"2;r Authorized Signature \ \3 o'i; \ c. PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold, New York 11971 Tel: (516) 765-4330 Fax: (516) 765-4643 Margaret Rutkowski ffetsey Perkins Secretaries February 8, 2008 Southold Town Building Department Southold Town Hall 53095 Main Road Southold, NY 11971 att: Gus Gillan Re: patricia Dawson 1000-86-7-7.2 Dear Gus Gillan: Pursuant to your inspection, enclosed is a certification prepared by the architect for deck rails, footings and framing of deck addit~on (other part of deck has CO) and roof over screened in portion of existing deck. Also enclosed is a compliance certificate from the Trustees. The Zoning Board granted structure. The two conditions the decision: the variance for the "as built" were satisfied prior to receipt of (1) Natural Images installed two dry wells and connected the existing gutters and leaders to the dry wells. This work was completed on or about January 8th, 2008. (2) The existing house has a non-turf native buffer landward of the top of the bluff. The ZBA said that if you need anything further please send them an interoffice request. If you need anything else please do not hesitate to contact me. vex:)':_t~y yours, ./~~ L..:P-af;:'icia C. Moore cc: Zoning Board I I - ~ 8 D'is - \' .I "';".- l ANGELB. CHORNO ARCHITECT 51020 MAIN ROAD SOUTH OLD . NY 11971 (631) 765- 6530 FAX (631) 765- 4643 .February 7th, 2008 Town of Southold Building Department - South old - NY Re: Dawson Residence 1000-86-7-7.2 Dear Sir: I have visited the site and verified that the existing deck, and covered screened porch are in sound condition and built in accordance with the regulations of the time in which they were built. Rails were added to the deck in areas more then 2 ft from the ground, and done as per drawings and complying with the present code. Sincerely, M~~ Angel B. Chomo, AlA .j-\ s o~ \ '\..- - L FIELD INSPECTION REPORT DATE I FOUNDATION (1ST) ------------------------------------ FOUNDATION (2ND) ROUGH FRA1\1ING & PLUMBING ---- L,SULATION PER N, y, --- STATE ENERGY CODE FINAL !;).-~ -1)~ COMMENTS III --, R If- b'\... rF~ M^:J-:r... y, -r; , ~ rr~).. 'A J.... 11,1f! LV rJ- v 1\ .v .J 1l.JJ ~ ~ ~ A'. n , -r;,!",d7)~ Ii- :::;L~'A ~,- An --.-,,~ fVA '-.AJ ./'-5rL 1. 7' / / V ADDITIONAL COMMENTS f-~~f1 (e~" -.!:l. +k- . A J... 4.no -r-A;,-. - ~ /J - C';r-PL/ ~ ?.a..A olo(..~ 1.<:.j lY\ ~ tl -A"f>AlJ -l-Y-IJ ".-1 lj ~ 1 ^ ~ ( Ii I. I,~ r h. 'I ) 1';,.~ 1/ 1 ~ ~n e--b? /1{( :- ...... -J -" ----- -- - -- -- - '- ... vJ", vJi"J I~ ~ v\ "" l\J ~~~ ~ ~~SJ [s:r t , ..J~ ,5>' ..t"- O UJ ,.., r\~ j ,.., ~ p. :) :2.. ~ :z: ~~ t'1 ,.., f !<:>' I ,I-':V ~\) ~ -' ') r LA 3 ~ ~ ~ -. ~. S> 00", \ i:d 7-~ .=6g :z :z: ~ ~;.., -. :z: I;j '" '" ~ 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 October 17, 2007 Patricia C. Moore, Esq. 51020 Main Rd. Southold, NY 11971 RE: PATRICIA DAWSON 7940 INDIAN NECK LANE, PECONIC SCTM#86-7-7.2 Dear Ms. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wed., October 17, 2007 regarding the above matter: WHEREAS, Patricia C. Moore, Esq. on behalf of PATRICIA DAWSON applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 26,2007, and, WHEREAS, said application was referred to the South old Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent practical through the imposition of the following Best Management Practice requirement: the structures are all existing and functional, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 17, 2007, at which time all interested persons were given an opportunity to be heard, and, 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, thatthe Board ofTrustees approve the application of PATRICIA DAWSON for the existing dwelling and deck, steps down slope, concrete retaining wall, 15'X 15 'deck extension to west, screened porch, and outdoor shower, with the condition that this permit must be amended to reconstruct and/or repair the deck, and as depicted on the survey prepared by John C. Ehlers last dated September 25,2007. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: None Very truly yours, JamE:g,C;:s6r Board of Trustees JFK:lms Examined 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 ~ S~~<;,y Check Septic Form N.Y.S:D.E.C. Trustees Contact: Mail to: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoId/ PERMIT NO. Approved Disapproved ale Expiration J~ tiuilding Irisp~tl)r . ~,- Phone: c) ~ r' I(-r~ ~\ff f~~ APPLICA nON FOR BUILD~G PERMIT \ \ ~ r- ~ ~: 28 2~ - 1 W \ Date '9- d-l , 20 fl I L _~~ INSTRU~TIONS I CcU ~ DEP-. L_TQll'if:IJi!lS.a " T 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 Pennit. d. Upon approval of this application, the Building Inspector will issue a Building Pennit to the applicant. Such a pennit shajj 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 pennit 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 pennit for an addition six months. Thereafter, a new pennit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pennit pursuant to the Building Zone Ordinance ofthe 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. /~ (Signature of applicant or name, if a cOrPoration) 71o"W /J'lq//l'R.o,,-,d S.ot.dl?/J/cL /lY/t'97J (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~- U l)-uAj,) b7'L-> ~ /-r;~ ~ Name of owner of premises Da,f,v50/l.... (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer ~ /1..JU2 d /16 leu 1 d(sa.lr~ (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land o~hich.proposed work will be done: Jnd<.~ /l/U% L~ House Number Street 0~o/J Hamlet County Tax Map No. 1000 Section ?(:, Subdivision Block 7 Filed Map No. ~t:: "7:-,JK::.' ,- ."Lot ,,'~ ,?a ....,...,..._.,._~_,f:1 ,_~L J;.,....." .'- (Name) 'i.,' '0' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy" ui.-tI- II d. :f ~'"'"' ~d &a2 I 0 'l< Ie' a.rfd< frc" *:' 0"~ d"d.::: /' Oyc- . S~ . - I ~,:3 .>b >cU y"..,d. .- Ma,tt!r>i" yr,./u...'j ~IIaJ H } LU 1tA.t<<CI. . b. Intended use and occupancy 0...- 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front Rear Depth 10. Date ofpurchase 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_ 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address Phone No. Phone No 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 ~ fly ;:; ~.-tC< c.. e /JJ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contr tor, 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. tary Pub IC __ IIllIv A._NIl -___Ill...... .... O1PE .'3Oll3I ~In_c.....,~q o.''''~.e.or........ f Signature of Applicant ~ ~' ....., ..J' TOWN OF SOUTHOLD PROPERTY JlEjCORD CARD -- ;' /Oc;o - it - ? - 7..L OWNER /1- z.J- STREET .:i/VJ,.." Me/{' j~ N I ' 10c.!uH<. .S ,J VILLAGE Ie. DIST, 7$"' ACR. /.ta/) CODE ,;2l tJ SUB. LOT ~c .' /' E :Jl'/d'/'J->i:lli'K If-.4_ S W DATE OF CONSTRUCTION 5"1 '" ~ €/ jJ. , " /tPI.' W,f1. J7l. mo,V/C, .~'rlo PRedwIz.... LAND IMP. TOTAL REMARKS ''11 4 -roC /.2)...(J .:10/ /2 '/00 r, ......""1""" Tillable FRONTAGE ON WATER .,(. I Woodland FRONTAGE ON ROAD , r,,' Meadowland DEPTH House Plot BULKHEAD Total -) ~ ~ . I /1 A\I',t fi p:/,- L ;:0 -"~OWN' -r- r-, ~._- '- f- '" , I " K.; I I<' "0 " n. ~o I i' t'1 .-,. Il, ~ If' I.." clo.~; ,,., r i-'" ..." t~ ,~ ~ . I>> n<> 'I , >0 I I'" '" I~ 1..4 G If-. ~v , d\,~'7 'f S.[!!. flc- o 'i . Id.ll'e "2-U2J.. :: "7t. ..J 7/,fJ Foundation Bath ~,.", ~t,?~~n / '1y" l-- :>- .fa? 3;;::: /"0 I Basement f'" II Floors /J/l;! ~te,q~W.~1 -'0)0. t/- ,. /,tEI'J J.?j- /hjQ Ext. Walls V€~':"~( .<\L. Interior F in ish .s/>? ~tension Fire Place / Heat /I.A i/"rr;" ., \ )rch Pool Attic , 6Jr1(J, - '0 C ~ If",r 'F/Jllt!r..__ eck IJ;.2X~o':: '),;tc 770 ,2[ 192- . 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F-,-, JoY,. .--. .:r .LI.. r~'CTiFYS~"'"_: : ~. ~5cs. .: , i);:' 2)J~":" - RETAIN STORM WATER RUNOFF r.,. f/~_ PURSUANT TO CHAPTER 236 ,. '. .';1 OF THE TOWN CODE. , "~:,' c: ,'-, ,,)>.- :-.. 0, ,. 'Ih ~".I ,...} .,'- \ "~I SHALL :\3 OF THE , .. '.1' 'STATE ~k) '....r l..r_" I ,)h,\ . . ~O i' 1], ,. . "J! 76~-:,:?~,\,~.i-,"'~ ~ ,~: FO:"'L,_.,:.I.,.., ....". i~::::QL:\PED F~"I'''~,t'LO'~ - i '",-> r..... 1. -~.it.J><I_ir.", ..-'.:",-.,E...E FeR pounED C" .vh l 'n ' ' H F~hA'I'I~,G & PLut,,~!NG 2 ROUG. . " . , . I 3 INSULATION MUST 4'. FINAL . CO!iST~~CTIO~ BE COMPL[T~ '.,R C,~, _ T THE 1',1-'_ C0r-.1::,"<T: ,,' "'>';':.:..~ \l,:..~r: >:EW c. " - ',. cr'.R r. '_ , J ~C.E TIFICA TION OF " NAlti G & CONNECTIO 't- REQUIRED. I . DAWSON A!SJDENCE AS aULT'DECK ADD'fJQN ANO ICftEENED PORCH PECONtC NY CHORNG ASSOCIATES - architects. , SOUTHOLD, NEW YORK SK-1 Uh . , '. I'"..J"'" :,....\ :::h,:~()RS. 1000 . Be . 7 - 7. Z. .s;;x / s: J761G.-_..D.::~ j ! -.--f>LAM