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HomeMy WebLinkAbout32538-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No• Z-33038 Date- 05/21/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 8110 NORTH BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 7 Lot 53 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 27, 2006 pursuant to which Building Permit No. 32538-Z dated DECEMBER 1, 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 ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to DAVID & LAUREN KOLLEN (OWNER) of the aforesaid building. SIIFPOLR CODNT9C DBPARTMENT OF HEAI,TN APPROVAIa N/A BLSCTRICAL CERTIFICATE NO. 3029093 11/02/07 PLDMIDSRS DATBD utho~ zed"\ignature Rev. 1/81 ~~ qq ~ T w r;~ r -----~ _ _ r;ap~ p Corm No. 6 TOWN OF 5OUTHOLD BUILDING DEPARTMENT TO~iriV HALL 765-1802 y33--13vy APPLICATION FOR CERTR~ KATE OF OCCUPANCY This application must be filled in by typewriter or irllc and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natwal on 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 Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. S. 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. BI For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud uses: 1. Accurate survey of property showing all property lines, sn-eels, building and unusual natural or topographic features. A properly completed application and consent to inspect signed by the applicant If a Certificate of Occupancy denied; [be Building L~spector shall state the reasons therefor in writing to the applicant. C. Fees 1. Cedificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $2S.OQ, 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 Ocarpancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Corrunereial $15.00 Date. ~OVQ,VY17)~ ~ ~ t ~QQ`f New Construction: / _ Old or Pre-existing Building: Location of Property: Owner or Owners of Property: ~ ~ \) 1 ~ N~p~ (,~ r Suffolk County Tax Map No ] 000, Section ~ ~ 3 pgg (check one) Hamlet Block ~~ Lot__~5 3 Subdivision _- piled Ivf tP __ Lot. -- - - -- Perntit No- ~ ~~~ Z bate of Perm~l ~a~ (~~~p_ Applicant ~(~ -- ._.. tt ~~ Hea10~ i)epf Approval- __ Underwri(ers Approval. / Planning Board Approval. Request Coc Temporary Certificate _ Fee Submitted, $ __~~ , t~0 C! ~' ~- 3 3 ~3~ Final Certificate: _ ~ (check one) a~~~ Applicant Signature _~ BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET -NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PLATINUM EAST ELECTRIC 1320 KENNEY'S RD SOUTHOLD, NY 11971, Located at 8110 N BAYVIEW RD SOUTHOLD, NY 11971 Application Number: 3029093 DAVID COLLENS 8110 N BAYVIEW RD SOUTHOLD, NY 11971 Certificate Number: 3029093 Section: Block: Lot: Building Permit: ~~ ~ ~ BDC. ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Attached Garage, Detached 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 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 2nd Day of November, 2007. Name QTY Ra[e Ratine Circuit Tvoe Miscellaneous new service + detached garage Panels 100 2 Wiring and Devices Fixture Outlet Receptacle Switch Receptacle Service I Phase 3 W Service Rating 200 Amperes Service Disconnect: Meters: I 1 0 Incandescent 6 0 General Purpose 4 0 General Purpose 1 0 General Purpose 1 0 GFCI 1 200 cb seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. r Aided PC. ~: May 5, 2008 , " ~ s _ 5 ! J o .J ~--~ -_~ Town of Southold Building Dept.. ? T~ _ ~' ~ T`:o~_~ _ Southold, NY RE: on k'~l l erg - 30'Wx 14'H:x45'L Utility Building MBI Job #..128-078 Huilding Permit 253 Dear Sirs: - Please be-advised. that I am receipt of verification from Morton Building's Construction Superintendenttliat the referenced job has been constructed insubstantial compliance to my design dated"OS-23=0b without known defect ordeviation. This. building was designed fox a 29P$F roof snow load and a 120MPH wind speed considering exposure category C. The construction verification specifically states that the wind lead structural '.provisions including fasteners, hurricane strapping, RT4 clips and shear walls were ..installed Per Plans. Also, the verification confirms that the footings and concrete were constructed to plan specifications. If you have further questions concerning this matter, please advise: . Yours truly, Allied Design A & E Group, PC ~~,~ wnrv~ a~~0~ € ~~. ~W~+Gf , Ronald L: S n; d President - •^b.~~ f 3Z538~ May 7, 2007 Town of Southold Building Dept. Southold; NY RE; Robert & Nancie son ka 1 ~e~ 30'W x 14'H x 45'L Gazage Southold, NY MBI"# 128-0788 ~. MAY 1 7 -Dear Sirs: Please find enclosed truss design for the truss that was used for this job. I am also writing to confirm and advise that the footings and foundation were observed to have been installed in accordance to my plans dated 01-12-07. 1.) Footings were placed 4' 10" below grade and ~ivere drilled the diameter specified on the plans. 2.) 11/4" x 1114"x 14' Ga column stilts were attached to each column corner with (3) 0.148" da. X 2" stainless nails. 3.) Concrete for each footing was placed in accordance with the plans. Yours truly, Allied Design A & E Group, PC 2hcJLd ~ ~ ..°`'r 1 o Ronald L. Sutton P 40 ~"'~G~ ~f- President * ~ '~~ r a :~ srrP r. ,,, ~2s~c~' ~~ 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. 32538 Z Date DECEMBER 1, 200 Permission is hereby granted to: KOLLEN 8110 NORTH BAYVIEW ROAD SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 8110 NORTH BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 079 Block 0007 Lot No. 053 pursuant to application dated NOVEMBER 27, 2006 and approved by the Building Inspector to expire on Fee $ 330.00 ORIGINAL Rev. 5/8/02 3 ~5 ~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND ( ] 1 CATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUC'i10N [ ]FIRE RESISTANT PENETRATION REMARKS: DATE ~ ,INSPECTOR ~ ~~3 ~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND ~RAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: Rl~-l~-7,f~~~ ~ i - -. _ ~ ' °~1 /i~ ;~-, • ~ DATE -'~' '~ INSPECTOR r.. FIND INSPECTION REPORT DATE COMMENTS 1 FOUNDATION (1ST) ~ ~ ~ .3 - -- OUNDATION (2ND) - -- - -_ -- -- -_- ~ ~ r - - n ~ z -.,/ ~~ o ----_. ---.. _ ~, H ROUGH FRAMING & --- ~ - r O PLUMBING _ - n . J . - - - <- INSULATION PER N Y ~ y . . STATE ENERGY CODE /~/c~ f ~,/ pct !./ C~ FINAL ~ - ~ ,~ - ~. ADDITIONAL COMMENTS ~ - - r ~ (~1 0 ~ z _ -- - m -_ _ _ ~ ~ - - ~ -- i _ - - v`v O z _ -- - -- - -- -- - - x ---_ -- _- ---- - - -____ y x 0 b sL Is-a-z HO I-3-8 SL EP ]-I1- 2 ]- 6- 4 ]- 9- 0 Id-10-8 #]x9 = C T 6- 3- 0 12H I eG-Ru I`-1 K BC nn - EP ° SL o0 0 6- 9- I 8- 4-I S 6- 9- I 6- 3-13 I I 6- 3-13 14-8-12 ~ o ~ 21-4-I 6-3-13 ~ b-3-13 29- 9- 0 30' S.C. 2090 TRUSS SCALE: I!a"= 1'-0" ~. Tj. ~` . ~' ~~ BI 0.05202 I H #Sn] _ #18G-RL8H-]x12= ]-I 1- 2 29- 9- 0 G 6G F #Sz] = ]- 9- 0 22- 2-12 b Y- I I 28-I-2 °_ b-9-I a sLls-e-z HO I-3-8 IGxl4 ~~ OfFICf: \ CUTCHOGUE, N.Y. JOB NO. 128-0788 Z O } ~_" ~ Z ~~ O ~a w ~ z r d J ~ Q 0 w ~ 'Z_^ V U ~ z F- Z w ~ ~ Za U= ao F /1/ z o LLI I I `i lNilo O Q Q8 DeA wN er 8, HAYES DATE: 5-7-07 CHECKED BY.' DATE: REVISED DATE.' SCALE: SNEET NO. OF OFFICE CUTCHOGUE, N.Y. JOB NO. 128-0788 TRUSS DESIGN LOAD = 288 PLF REQUIRED TRUSS LOAD = 33 PSF AT 7'-6" O.C. =247.5 PLF LIVE LOAD 29 PSF DEAD LOAD 4 PSF CEILING LOAD - PSF TOTAL LOAD 33 PSF 30' S.C. 2090 TRUSS ReDD lna En9lnee[ina. Inc.~Onl ine Plua a' MPROI. iRVJD L6I4Xi: L'11.9 LDD 0213001 -------------~~'------------ Tresses Manutactuxed by: B -J O. It 1291 C Moxtow Bu11d11uIS, Inc. Online~us -- Version 1f .0.01t J -C 1.25 1015 T Analwis Con tornm To: tRDi DA I1-MAY-06 M -C LOf 42f T ANSI/TPI 95 6 02 C -G 1.25 161E T Run vertical thru bottom chord CSI -S1 Re- ----LVldle r---- G -D t. It 1891 C Joint M YC 0.95 2x P SP-2401 -----------Slider------------ Prevent truss rat ration rat all BC 0.09 2x f SP-2401 A -K 1.03 1351 C beariw locatio w. HB 0.25 2x 4 SP-M1 F -E 1.15 1351 C Tress is des igwed iar w 9. 0.03 2x10 SP-M1 ceiling load. TL De tl -1.40" iw J -H L/T35 NOTE: USER MODIFIED PLATES Brace truss as Eollow: LL De El -0.39" in J -H L/OBI TAis design m0y Aave plates O.C. From To Shear // Grain in N -H 0.70 aelec ted through a plntc TC 2- 0- 1 0- 0- t 29- 9- 0 monitor. BC T- f- 0 0- 0- t R9- 1- 0 Plates Eor each ply eacA face. Nex con@. force 7693 Lbs PLATING CONFORMS TO TPI. Quality Cont rgl Factor L 01 Loatli rag Live Dead (p sib 7C 2f.0 1.1 BC t.0 2.1 Total 2f.0 6,t 32.0 Spacing IO B. O• Lumbex Dux etion Pact or 1.15 Plate Dux ation Lact or 1.15 SC Fb=1.00 Fc=1.00 Ft-1.10 BC Fb=1.00 Pc=1.00 Ft'1.10 Jt React Unltt Size Req'd Lbs Lbx In-Sx In-Sz A 4204 0 5- t 3- f E 4289 0 0- t 3- f NeLb[ CSI P Lbs Axl-CSI-Brad __________Top Chords __________ A -B 1.95 1693 C 8.13 1. d2 B -C 1.75 7171 C 0.11 1.69 C -D 0.75 1171 C 0.11 L69 D -E 0.95 7693 C 0.13 L t2 --------Ba ttam CMrds--------- M -J 0.09 7388 T 0.99 1.50 J -N 0.59 5566 T 0.30 I.R9 H -G 0.59 5566 T 0.30 t.R9 G -F 0.89 7188 T 0.39 1.50 11[YNn L19n,e11~9. I,eA ~IDe Pln a'a 1~6¢(DS Y1 n 01 n.0 PLATE VALllES NAY BC VERIFIED WI7H R®INB ENGIINBRING. GRIP VALIA:S HAS ED ON SP USING GROSS AREA TEST. Plate - LOIX 20 Gn, Groae Area Plate - IBlS 20 Ga, GCO11 Area Plate - W,BN 2/ Ga, Gross Area Jt Type Plt Si se X Y JSI A W.W 10.0x14.011.0 1.7 1.91 B LOCK 3. Ox 5.0 Ctr Ctr 1.43 CN LOCK 7.Ox 9.0 CtC-0.5 1.93 D LOCK 3. Ox 5.0 Ctr Ctr 1.93 E RL tM 10.0x14.0-1.i T.0 1.94 K LOCK S. Ox 7.0-0.5 Ctr 1.06 JN LOCK 3.Ox T.0 Ctr Ctx 1.7T NN fa. en T.Dnz.1 ctr D.e 1. Te GY LOCK S.Ox 7.0 Ctr Ctx 1.64 F LOCK S.0% T.0 0.3 Ctr 1.06 Y -Plate Monitor wed RF1'ER 70 ROHBINS ENG. GENERAL NOTES AND SYO®OLS SHEET FOR ADDITIONAL SPEC IFICATI UNS. NOTES: Ile L,9buuq-roRir SEI e)Ela la, nll 1~ la] ~~ lO~ P a "~~,'L IJ rO. ,6~ ~ n Z ~~ O } ~ ~ Z O= O ~ a O Z_ ~ C1 Q 0 w Z U ~ d Z W 1- Z `~' U CY O F /7/ Z o W -./Q o O ~ z W Q8 ORAwNBr. g. HAYES DATE: 5-7-07 CHECKED BY.' DATE: REVISED DATE.' SCALE.' SHEET NO. 2oF2 ~' TOWN OF SOUTHOLD P OPERTY /~sUa- ~~ 7-J:3 RECORD CARD V r r /~ ~' OWNER STREET VILLAGE DIST.' SUB. LOTpfaJ _j ~' `~~ ~B~'~•~`"~ '~.a~.__ 5~ , ' C FORMER NER~GI~/Qh2Yi N E ..., , -t ~ ~ C- ,rt ~,.; ~ • j}~ ~ ~. l,J ' S W PE OF BUILDING i i „ RES. ~~ ~ SEAS. VL. FARM COMM. CB. MICS. Mkt. Valu r _. ..~,~, ~~... LAND IMP. TOTAL DATE REMARKS 7G-o 70 0 / 26 ~ ~ 30 '?~ 7 oa-~ - o-v ~-r~ ~ Z~ >;-, , ~ L ~ 39Y ~ vc~l~ ~ s~- ~ O od lU 4Cx~ S l ~# €3:~~ ~h~ ~ a -tv ~`~I ~ ~C U ~ w ye ~ ~©®© ,~j, ~s ~ Ira ~_ ~ s ~ ~g~~.l ~o~k~ . i~ ~~ 7 3~Ofn-Lla~f~ ~F- ~n ah r; ~ I~o1~Pn ~u1~- ~5e2D ljDD lwO ~ , 00 C~• ICU y , ~ ~ <;~ -i C`i U ~i YS~ / ~ C l ~ U'U ~` g/ CJ-z~ j r U-C~ _-- cSt~ c~c-%o 0 7 fillobie FRONTAGE ON WATER Noodlgrtd FRONTAGE ON ROAD Neadow(ae-d DEPTH '~~ Plat BULKHEAD otol ~~~ COLOR N ~~ TRIM lU ~a~ - - '1'IhL~Y i~5x2~.~(c~CU ~ - ~~ c~~_ _ , Ext i' r, *"' ~ 1 ~; x 30 = ~+'Sc~ -__ 3: a o 19 3 vl~_ _ ~.L _ -_ - I cpu f "7 - Ioa. X52 _~~... i I I -' 1 - - Extension ExTensinn ~ .. ..... . , . 3 • SO ~ i - I Foundation ~ 7 ~ LBoth _ ~ 3 1~-- Dinette c -- f Floors _ i u u x\1 .. lr7c> _ C_o38 ~~'.~~ I 7 `~~ (Basement I ~uLL_ I L c7.,a~ 1K. I _(._. 1Z~C L - ~~oa _ - P~ ~ l I ~ I ~ (Ext. Walls ~~ uZT ~~Interior Finish I S ~_ LR_ I f Breezeway ~ f (Fire Place ~ Heat I BR. I ro e . ZZ.k2Z=~F8'-~ _ Type Roof _-- 1 6,0.(-~~ (Rooms lst Floor a t ~ Z.. ~ IQJ __- J - - t Patio I I (Recreation Room I 1Rooms 2nd Floor L_~ FIN. B I ' O. B. ~, I (Dormer I IDnvewoy I ~ __ i I i _ --_. - .. - - --- _ _ Total - ---- cam, _._ _ _ _ ~ _ - '- --- _ ~ :__ i _ f _.~ 7 3 8 ~ ~,~ w Z 3 _J Q V) a 0 SURVEY OF LOT 2 .N MAP OF LEEWARD ACRES AT BAYVIEW SITUATE -HOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: DAVID KOLLEN LAUREN KOLLEN FMJ/ 5599 DATE FILED JUNE 4, 1977 iM~ 1000-079-07-053 GUARANTEED T0: DAVID KOLLEN LAUREN KOLLEN COMMONWEALTH LAND TITLE INS. CO. WILMINGTON FINANCE, INC. ~~ I ...'-".. `~ ~ , ,~I,!~ ~~ 2 9 ~'~ ~, ,~_ .~ ~ SURVEYED: 19 JULY 2006 SCALE 1'"= 40' AREA = 40,000 SF. OR 0.918 ACRES GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO ME PERSON FOR WHOM THE SURVEY IS PREPARED, AND OlJ HIS BEHALF TO ME ATLE COMPANY, GOKRNMENTAL AGENCY. LENDING lNSP17/PON, IF LISTED HEREON, AND TO ME ASSIGNEES OF ME CENOING INSTINRON. GVARANIEfS ARE N07 TRANSFERABLE TO ADDITIONAL INS DTU710N5 OR SUBSfOUENT OWNERS. SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW S FFOLK. N.Y. 11 631-7 4-5835 UNAUMORlIED ALTERATION OR AODNION TO M!S SURVEY IS A NOLATION OF SECTION ]109 Of THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING ME LANG SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO Bf A VALlO TRUE COPY. eICtNSt .LAND 3dARVEYOR NYS Li No. 49273 06R1511 1. 17 MVt D7 ADD METAL &/1LDING. 1~ORTII ~~YVIEW K®AD TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20 Approved ,20 Disapproved a/c Expiration , 20 .'1 ~__ ~,. ;~~,, TION FOR BUILDING PERMIT Date ~ ~' Z7 , 20GYo INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f Every building pernut shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. State whether applicant is owner, Name of owner of premises les ee, agent, ' ect, engineer (Sig a ap ican r na e, if a corporation) (Mailing address of applicant) general contractor, electrician, plumber or builder (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. ! ~j ?j~~ ^ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Boazd approval~_ Survey PERMIT NO. ~ ~ Check Septic Form N.Y.S.D.E.C. Trustees ~,R Contact: Mail to: f d ~x ~~ ~L77NQ' !~ !U(.I f~5'I Phone: ~?j~'7jy-~{Q~[~ Buil g Inspector County Tax Map No. 1000 Section Block ~ Lot S 7j Subdivision Filed Map No.rjS~j~f L,ot (Name) 2. State existing use and occupancy of premises and intended use and a. Existing use and occupancy ~~~ b ~}}p,~(Tl l~ b. Intended use and occupancy ~-a-nu(,r L~ i~ / I,~/~~' 3. 4. Nature of work (check which applicable): New Building_~~Addition Alteration Repair Removal Demolition Other Work (Description) Estimated Co zg, ~~~ Fee _ ' (To be paid on filing this application) If dwelling, number of dwelling units~_Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /~{ ,} 7. Dimensions Dimensions of same if any: -wltl-alterations or additions: Front Height Number of 8. Dimensions of entire new construction: Front ~J' b ` Rear ~ ` Depth Height Z.G~' ~`~ Number of Stories 9. Size of lot: Front~da t Reaz ~ ~ ~ Depth z~ I 10. Date of Purchase- ~l ' d~ Name of Former Owner _ Y~~~~ct 11. Zone or use district in which premises are situated ~'- L'( 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO~ 13. Will lot be re-graded? YES_ NO~WiII excess fill be removed from premises? YES_ NO 14. Names of Owner of remises ~ Address~c LTT ~4-1~ Phone No. ~(' ~' 0/Z Name of Architect AddressCU7Gl~Q'(JfZ Phone No - Name of Contractor AddressC~/~t( ft Phone No. ~' ~-z//~`lA 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) S COUNTY O /L' ~~( }-7~L-LS.~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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. Swom to before me this dayof vpirn, 20 ~D (O -~ Notary Public r O/MO~(~'!v/lo~od ~=,7c /Jr nez (p//(c//o of proposed construction: -L-. ,e. - - ' 3 _ ~ , „, -' ~ ~ w ~ ~ -„~v ~ , rev:. Q \ \~ ~' 1 Lei ,7 ~_ _ _ .~.. .. i_ ~ ~ 1. 5 7~ 59'3d"c IOd.dd' ~~: ~ ~. - 3 o ~ d >_ -~ ~~ - O o O '° 'n O O I '? ~ r= . R - MCY~O FN?Ar k >tFF j r _~ _„ s '~~.. .,_ .. _ .. i ~'~RS Gr iP LOT 2 ~h, MAP OF LEEWARD ACRES AT BAYVIEW i?L~AIE SOUTHOLD, TOWN OF SOUTHt SUFFOLK COUNTY, N.Y. SJRVFYED fOR: D/1VfD KOLLEN t_oT f LAUREN KOLL~'. ~~~ ~ tai 7~ as yig c .., ~ - _. ---'" ~1 ~~ 7~~ i. Gt~a~gN?EED ~": DAviG ki?Li.F_r: avFCra k„.i_cti ~(;M,r~~rJWE Ai_rh a ~D iiiff i"n O ~ ~~ ~ ~ O ~ p _ ~ A O ~ ' th - z ~_ - -_ - I v~ GRASS A1AiM iNEL? rHtS AREA r -'-, t %E C!: ]U ~LI(Y ~_._." _ ~`~ ,- ~ ~. ... -~~ -- _____ ' ___ CONC FIOn N 72'593 t00 d0 . ar:~c = ~_~.,,~,,, _;, ?QT 43 ~. _r: