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HomeMy WebLinkAbout33924-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33251 Date: 08/28/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 155 HALLS CREEK DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 116 Block 7 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21, 2008 pursuant to which Building Permit No. 33924-Z dated MAY 21, 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 ACCESSORY IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR PER ZBA #4940, DATED 5/3/01. The certificate is issued to FRANK & BRENDA L CICHANOWICZ (OWNER) of the aforesaid building. SIIFFOLK CODNTY DEPARTMENT OF HHALTH APPROVAI, N/A ELECTRICAL CERTIFICATE NO. 4005898 08/08/08 PLDIYIDERS CERTIFICATION DATED N/A c y Aut orized gnature Rev. 1/81 _ ~~V - Form No. 6 Rt (r? (~ ~ ~,i ~? TOWN OF SOUTHOLD I, -u=~ ~ ~ , BUILDING DEPARTMENT A~ 2 8 yY10 U~ TOWN HALL ~+ 765-1802 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 naturalor 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. Swom statement from plumber certifying that the solder usedin system contains less than 2/10 of 1% lead, 5. Cotnrnercial building, industrial building, multiple residences and similar buildings and installations, a cedificate 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) uou-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey oCpropert}~ showing all property lines, streets, building and unusual natural or topographic feahu es. 2 A properly complcted application and consent to inspect signled 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 1. Certificate of Occupacc} Ne~~~ dwelling $25.00, Additions to dn~elling $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 o^ Pre-existing Building - $L00.00 3. Copy of Certificate of Occupancy - $25 4 Updated Certificate of Occupancy $50.00 5 Temporary Certificate of Occupanc}~ -Residential $15.00, Conunereial $15.00 Date. ~~ Qg New Construption~. ~ Old or Pre-existing Duilding: (check one) Location ofProperty: /sb )-IQ~~S CYi°Cvl _ }~ /~'~ I~Gt e~k House No. Street Hamlet Owner or Owners of Property: _~~/.' ~, I ~Q f/fQ t,U(GZ ~~ ~ , ~rQn (,S~_ Suffolk County Tax Map No 1000, Section ~~~ Block ~ Lot Subdivision Filed Map. Lot: Permit No. ~3~~' Health Dept. Approval llale of Permit. ~~(~~ Applicant: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ q/,1 , ~' eau ~- 3~3~~ ~ ~ ~~u~~a Underwri[ersApproval: ~DUJ~~9~ - ~~~(~~ Final Certificate: (check one) Applicant Signature ~/ O cPrJ'zc1~rJ zr~r1'c.trJ'zcl~rJ~fr.PrJ'cl'rJ'zrJ'zrJ'zrJ'zrJ'zr~rJ'rJ'zc1'zcPrJ'zrJ'zrJ~r.J'zc1'zrJ'zcPrJ'zrJ'zrJ'rJ'zrJ'zrJ'zrJ'zrJ~rJ'zcl~ rJ~rJ'zr~rJ'zrJ~cJ~r1'zr.PFJ~r~rJ'zrJ'zrJ'zrJ'zrJ'zrJ'zrJ'zrJ'zcPrJ'zr.P c~ 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS S 40 FULTBON ST~REEOF NEWCYORIK,I NY 10038 C~ S CERTIFIES THAT 5 5 Upon the application of upon premises awned by 5 G & S ELECTRICAL CONTR. FRANK CICHANOWICZ C.1 5 P.O. BOX 215 155 HALLS CREEK DR. C5 SOUTHOLD, NY 11971, MOATTITUCK, NY 11952 5 c~ Located at 155 HALLS CREEK DR. MOATTITUCK, NY 11952 5 Application Number: 4005898 Certificate Number: 4005898 5 5 Section: Block: Lot: Building Permit: , BDC: ns11 5~ 5 Described as a Swimming Poot occupancy, wherein the premises electrical system consisting of 5 S electrical devices and wiring, described below, located in/on the premises at: 5 55 Outside, Pool/Spa, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the stn Day of August, zoos. 5 5 I ame 2C Rate Ratine Circui 1~pg 5 Appliances and Accessories Pool /Spa Bonding 1 0 5 Pool Heater 1 0 Gas 5 Panels 5 BB 4 5 5 Wiring And Devices 5 Fixture 3 0 pool Incandescent 5 f5 GFCI Circuit Breaker 1 0 5 Receptacle 3 0 20a-pool Special I twist lock 5 5 5 (Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 frequent test and/or repairs made by a qualified person. 5 5 5 5 I of t seal 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 o~~~s~~s~~~~~~~~ss~~~~ssss~~~~~~s~~~~~s~~~~~~~~~~~~~~s~~~~~s~s~~~ v APPEALS BOARD MEMBERS o~OSpFFO(,~c O Gerard P. Goehringer, Chairman ~ G'y~ James Dinizio, Jr. y Z Lydia A. Tortora ~ • Lora S. Collins ~' ~~ George Horning ~Ol ~j ~a BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 ZBA Fax (631) 765-9064 Telephone (631) 765-1809 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MAY 3, 2001 Appl. No. 4940 - FRANK CICHANOWICZ STREET 8 LOCATION: 50 Harborview Avenue, Mattituck 1000-116-7-1 DATE OF PUBLIC HEARING: May 3, 2001 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION Applicant's property consists of 49,540 sq. ft. in area with 187.51 ft. along the east side of Hall's Creek Drive and 277+- ft. along the south side of New Suffolk Avenue in Mattituck. The property is improved with atwo-story frame house located as shown on the foundation survey prepared by John C. Ehlers, L.S. dated August 3, 2000. BASIS OF APPLICATION: Building Inspector's December 26, 2000 Notice of Disapproval under Article III, Section 100-33, for the location of the proposed swimming pool partly in a side yard area rather than the rear yard. AREA VARIANCE RELIEF REQUESTED: Applicant is requesting a location of a proposed pool: 35' x 13' in size in a side yard location. The pool was originally requested in a side yard location, shown on the December 16, 2000 landscape diagram with a setback of 18'6' from the southerly side property line (and above the 10' elevation above mean sea level). On May 2, 2001, the landscape diagram was revised to show the pool and fence at a minimum of 75+- feet from the edge of wetlands and with two proposed dry wells to retain water runoff. REASONS FOR BOARD ACTION: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Applicant's pOroperty is a corner lot which borders on a wetland area. The rear yard is greatly diminished by an established NYS DEC building envelope, which limits the area for a pool to the side yard. There was no testimony or information received, or visual observation at times of inspection, to indicate that placement of the pool in a side yard as shown on the May 2, 2001 revised plan would have an adverse detriment or impact to nearby properties. 2. The benefit sought by applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance. There is no alternative yard area available. 3. The proposed variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. No evidence has been submitted to suggest that grant of the side yard location for a swimming pool will have an adverse effect or impact on the on environmental or physical conditions. Page 2 -May 3, 2001 ZBA Appl. No. 4940 -Frank Cichanowicz Parcel 1000-116-7-1 at Mattituck 4. Based on the information furnished in the new revised plan of May 2, 2001, the drainage from the upland areas will be contained, on site, by the use of dry wells. In considering this application, the Board deems this action to be the minimum necessary and adequate for the applicants to enjoy the benefit of a swimming pool structure in a side yard location, and that the grant of this variance will preserve the character of the neighborhood, and the health, safety, welfare of the community. BOARD RESOLUTION: On motion by Chairman Goehringer, seconded by Member Tortora, it was RESOLVED, to GRANT the variance as shown on the plan revised May 2, 2001, SUBJECT TO THE FOLLOWING CONDITIONS: 1. Outdoor lighting shall be shielded to the ground to prevent glare into neighboring areas. 2. This decision is subject to receiving any and all permits from New York State and the Town of Southold. VOTE OF THE BOARD: AYES: Members Goehringer (Chairman), Dinizio, Tortora. (Member Homing was absent during the adoption of this Resol Memb ins was absent.) This Resolution was duly adopted (3-0). ~ . . CHAIRMAN 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. 33924 Z Date MAY 21, 2008 Permission is hereby granted to: BRENDA & FRANK CICHANOWICZ 155 HALLS CREEK DRIVE MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY IN-GROUND SWIMMING POOL W/ FENCE TO CODE PER ZBA # 4940 DATED 5/3/O1.REPLACES BP# 30026 at premises located at 155 HALLS CREEK DR MATTITUCK County Tax Map No. 473889 Section 116 Block 0007 Lot No. 001 pursuant to application dated MAY Building Inspector to expire on Fee $ 150.00 21, 2008 and approved by the ORIGINAL Rev. 5/8/02 ~3 ~ ~-`~ 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. 30026 Z Permission is hereby granted to: FRANK CICPfANOWICZ Date JANUARY 22, 2004 155 HALLS CREEK DRIVE MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE PER ZBA #4940 DATED 5/3/01. THIS PERMIT REPLACES BP#27372-Z. at premises located at 155 HALLS CREEK DR MATTITUCK County Tax Map No. 473889 Section 116 Block 0007 Lot No. 001 pursuant to application dated JANUARY 22, 2004 and approved by the Building Inspector to expire on Fee $ 150.00 ORIGINAL Rev. 5/8/02 ;~~~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN CATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION DATE ~ °` ~ ~~ INSPECTOR ~~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ J FRAMING [ ] FIREPLACE A CHIMNEY REMARKS: fie... [ ]ROUGH PLBG. [ J INS TION [ FINAL °~~E ~S_ DATE ~ ~~j ~©~ INSPECTOR ~7 FIELD iNSPRCTTON RRPORT-- T1ATR - - i~~ FOUNDATION (1STJ - - - - - ~I C~ 1 n.^~ a C FOUNDATION (2ND)_ i ~ ~ - -_ --- _--- ----- --------------s=_=== ~ ~ ' < _ i i i - ROUGH FRAN6 ~ x e \ _~ PLi1MBING INSULATION PER N. Y. i~; STATE BNERGY F H f CODE i ~ .. FINAL °~- - - ADDITIO S: ~ s ,~ ~~ " ~~ y ~, .~ ~~ e Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 July 19`h, 2006 Frank Cichanowicz 155 Halls Creek Drive Mattituck, NY, 11952 RE: 155 Halls Creek Dr. SCTM# 116 0007 001 Dear Mr. Cichanowicz, ,~'.'~OF SOUryo~ '~11 'F G • ~~~,~ ~~~y~OUNi'1 ~.,~' BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (631) 765-9502 Telephone (631)765-IS02 Please be advised that your Building Permit #30026 issued January 22"d, 2004 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit, please submit a fee of $150.00 at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 April 3rd, 2008 Frank Cichnnowicz 155 Hnlls Creek Drive Mattituck, N.Y. 11952 RE: 155 Hnlls Creek Dr. SCTM # 116.-7-1 Deor Mr. Cichnnowicz, FINAL NOTICE Fax (631) 765-9502 Telephone (631) 765-1802 Please be advised that your Building Permit # 30026 issued Jnnuory 22nd, 2004 has expired. According to the Code of the Town of Southold, a Certificnte of Occupnncy must be issued prior to use of the structure. To renew your Building Permit, please submit o fee of $150.00; at that time we cnn schedule an inspection by one of our Building Inspector's. If you hnve any questions, please cnll us at 631-765-1802. ~o~~OF SOUIy~ #c 'F • ~O OI~C~Ul11 t ~~~ BUILDING DEPARTMENT TOWN OF SOUTHOLD Respectfully, SOUTHOLD TOWN BUILDING DEPT. tAPPEXLS BOARD MEMBERS o~~g~FFO(,~c ~ o~ Gerard P. Goehringer, Chairman ~ ~ James Dinizio, Jr. y ' r W Lydia A. Tortora ~ Lora S. Collins 'y ~ 0!~ George Horning ~~! #1 ~~ BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New Yotk 11971 ZBA Fax (631) 765-9064 Telephone (631) 765-1809 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MAY 3, 2001 Appl. No. 4940 - FRANK CICHANOWICZ STREET & LOCATION: 50 Harborview Avenue, Mattituck 1000-116-7-1 DATE OF PUBLIC HEARING: May 3, 2001 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: Applicant's property consists of 49,540 sq. ft. in area with 187.51 ft. along the east side of Hall's Creek Drive and 277+- ft. along the south side of New Suffolk Avenue in Mattituck. The property is improved with atwo-story frame house located as shown on the foundation survey prepared by John C. Ehlers, L.S. dated August 3, 2000. BASIS OF APPLICATION: Building Inspector's December 26, 2000 Notice of Disapproval under Article III, Section 100-33, for the location of the proposed swimming pool partly in a side yard area rather than the rear yard. AREA VARIANCE RELIEF REQUESTED: Applicant is requesting a location of a proposed pool. 35' x 13' in size in a side yard location. The pool was originally requested in a side yard location, shown on the December 16, 2000 landscape diagram with a setback of 18'6' from the southerly side property line (and above the 10' elevation above mean sea level). On May 2, 2001, the landscape diagram was revised to show the pool and fence at a minimum of 75+- feet from the edge of wetlands and with two proposed dry wells to retain water runoff. REASONS FOR BOARD ACTION: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. Grant of the area variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Applicant's pOroperty is a comer lot which borders on a wetland area. The rear yard is greatly diminished by an established NYS DEC building envelope, which limits the area for a pool to the side yard. There was no testimony or information received, or visual observation at times of inspection, to indicate that placement of the pool in a side yard as shown on the May 2, 2001 revised plan would have an adverse detriment or impact to nearby properties. 2. The benefit sought by applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance. There is no alternative yard area available. 3. The proposed variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. No evidence has been submitted to suggest that grant of the side yard location for a swimming pool will have an adverse effect or impact on the on environmental or physical conditions. Page 2 -May 3, 2001 ZBA Appl. No. 4940 - Frenk Cichanowicz Parcel 1000.11&7-1 at Mattftuck 4. Based on the information furnished in the new revised plan of May 2, 2001, the drainage from the upland areas will be contained, on site, by the use of dry wells. In considering this application, the Board deems this action to be the minimum necessary and . adequate for the applicants to enjoy the benefit of a swimming pool structure in-aside yard location, and that the grant of this variance will preserve the character of the neighborhood, and the health, safety, welfare of the community. BOARD RESOLUTION: On motion by Chairman Goehringer, seconded by Member Tortora, it was RESOLVED, to GRANT the variance as shown on the plan revised May 2, 2001, SUBJECT TO THE FOLLOWING CONDITIONS: 1. Outdoor lighting shall be shielded to the ground to prevent glare into neighboring areas. 2. This decision is subject to receiving any and all permits from New York State and the Town of Southold. VOTE OF THE BOARD: AYES: Members Goehringer (Chairman), Dinizio, Tortora. (Member Homing was absent during the adoption of this Reso Memb 'ns was absent.) This Resolution was duly adopted (3-0). s CHAIRMAN l si 1 1 (o - ~j __ ~ TOWN OF S U HOLD PROPERTY RECORD CARD X1'1 ~-~ i% STREET 4j ;=- ` VILLAGE DIST. SUB. LOT k ~- re.nda- ~ • i.~~u .. L ~ ~G - . ~ ~ ;;-, , I~. - • l ~ FORMER OWNF~R ~ 4 wf{- N E ACR. ~~F ve I~Pme S W TYPE OF BUILDING RES. SEAS. VL. 3i 3 FARM COMM. LAND IMP. TOTAL DATE REMARKS I^.J~.l (-'il i (~.~1,~ I ~:1 ~.], _ r ~ S C C~- _~~.. ~1~~ `1~,c° ~I.Y ~..I!~~1, ~.. _ 11 r r.~..~ L__r_~, Imo. r,c~ ~ t ~~ iaa~ o-L c c-i -NFP (~v, C~,. ~o -#77 0~ S"... ,~e ~ 3 ii 4~ ~ DO- LI DI ~~o- 2 Lq1 ~ vvF O u11LL~ !5"'/,~ Sc-~ ~ (Zfv ~5 cv -3 ~ ~r6 (oa - s~,ll la ~ ~ ~~ 2000 ~ ('./ Zoop s $ FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND - _++ BULKHEAD HOUSE/LOT %''~ COLOR TRIM a 660`6 y)e,W R~H/L~~iny, ~C~~3r0,rr~ M. Bldg. Foundation ce Bath Dinette Extension Basement FULL cnAwL SLAB Floors Kit. Extension Ext. Walls Interior Finish L.R. Extension Fire Place Heat D.R. Patio Woodstove BR. Porch Dormer Fin. B. Deck Attic Breezeway Rooms 1st Floor Garage Driveway Rooms 2nd Floor O.B. Pool rr ,. FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE; December 26, 2000 TO Frank Cichanowicz PO Box 592 Mattituck NY 11952 Please take notice that your application dated December 20, 2000 For permit for accessory swimming Wool at Location of property 155 Halls Creek Drive Mattituck County Tax Map No. 1000 -Section 116 Block 7 Lot 1 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds uroposed construction not permitted pursuant to Article III Section 100-33 which states; In the Agricultural-Conservation District and Low-Density Residential R-80, R-120, R-200 and R-400 Districts accessory buildines and structures or other accessory uses shall be located in the required rear yard ivwty yr a~uir~vLL BUILDING DEPARTMENT TOWN Z;IALL SOUTHOLD, NY 11971 TEL: 765-1802 tiUlLllllVli YbKNlll AYYLIC:AIIUN (;HJ_,(;KL1S Do you have or need the following, before applying ~~^oazd of Health 3D0alQ f sets of Building Plans r~ Survey PERMIT NO. ~~ 3 1 c~-- ~ Check ~~ 'Ir ~~ t _ _-_-~ ' t' + T t.D Examined /r 20 Approved r0 ~ , 20~ Disapproved a/c G Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 2-Zo- ea , 20_ 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 a Certificate of Occupan is issued by the Building Inspector. 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 cy~e, and regulations, and to admit authorized inspectors.on premises and in building for necessary inspections. ~ ~ ~~ n (Signature of applicant or A3cre, iT`aebrp ~~ sr2 MATT t~c(C, ~.N ll~~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises 129-~ K- ~ 3Q~~ Septic Form N.Y.S.D.E.C. Trustees Contact: ~f/~J~oc~~~~= (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title Builders License No corporate officer) Plumbers License No. Electricians License.No. Other Trade's License No 1. Location of land on posed work will be doTne: C fL~~ yl.QIV House Number' Street YY~ „~ i T ~T va;'lC Hamlet County Tax Map No. 1000 Section 100 Block ((.~,- -7 - Subdivision {) ~,a(~,~tol ¢~..> ,>a-r Irfl~i cr uWC Filed Map No._~ (Name) ~--~ 3`z ~ Z ?. State existing use and occupancy of premises d intended use and occupancy of proposed construc*~on: a. Existing use and occupancy b. Intended use and occupancy ~ i M „~,.P ~ ~p y,L_ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work Estimated Cost dS~C~Ou Fee (Description) (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 .. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Reaz Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories ~. Size of lot: Front Reaz Depth 0. Date of Purchase ~o 11~~~8 Name of Former Owner 1. Zone or use district in which premises are situated 6.._ - 7 ,,aD 2. Does proposed construction violate any zoning law, ordinance or regulation: "~ ~ ' 3. Will lot be re-graded ~ O _ Will excess fill be removed from premises: YES NO 4. Names of Owner of premises Address Phone No. Name of Architect Address Phone No_ Name of Contractor Address Phone No 5. Is this property within 100 feet of a tidal wetland? *YES ~ NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: 'OUNTY OF ) ~, '" M n~i'('' h r~.,-, ~, t~~ i' c Z being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, i)He is the (Contractor, Agent, Corporate Officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; ,at all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the application Filed therewith. worn to before me this z0~'dayof~rP~,-,h Pi 200)[1 Notary Public BHAR(?N L BAdE% liotarg Publiq 8tete of New Yoe. No. 48&?767 Qnnlified in Suffolk County ~..~,miseion Expire• Oct. 2U,yf ~.OOU 1 ~i Signature of Appli t SU~~EY OF LOT 32 M/~P OF HP~RBOR VIEW AT M~4TTITUGK SITUP~TE: MP~TTITUGK TOWN OF SOUTHOLD SUFFOLK COUNTY, NY \ MAP OF HARBOR VIEW AT MATTITUGK FILED AUG. 21, Ig8"i AS MAP # 8377 SURVEYEiJ AMENDED II-I6-gq, ' 12-23-qq, 02-18-00 SUFFOLK COUNTY TAX >< ' 1000-II6-~-I CERTIFIED TO: FRANK GIGHANOWIGZ BRENDA GIGHANOWIGZ FIRST AMERICAN TITLE INSURANCE COMPANY OF N.Y. NORTH FORK BANK NOTES: ^ MONUMENT FOUND AREA = 4q,540 S.F. OR Li4 ACRES ELEVATIONS REFER TO MSL NGVD '29 V• ~ }O ~;n N __ ~ ~i _->. u i-- -' tp -i.. I x.T o~'~.: 4-~ 3' ~ ' li [i ~O]aJ ~d~ ^ W 17"'4' v V u_ ' ~~ my O; ~o D d /`^,yT~ 'V _W Q . M;p h' o C~j O ei=!a ~~ f ~ ... '{tv:..3 ~ .L~t ` r -- l..iJ~RUV~:J -.... -..... ~_.. A=t ib ~v.E;,ti nip- i) 1; l: ~ u = "f d:5' EXPIRES ! [i[2Ec YcaRS PROM DA1E OF APPROVAL el=l1 i i ~` ~` y ~~<<r R'~~ a3, A'6~. ~~®~ ~,. DwEI!Inc~ with Public V~_[gr fie/~ce GRAPHIC SCALE I"= 40' -. --~_- ss ~~ ~ ~_~ __~- ~ ~ \ ~~ '~J i/ r i' wsr ~; ~'1 /.-_ asF `o .~ I ~, Ir:, ! ,~,. .. , O SEPTIC DETAIL ,~ not to scale inv.- inv.- f5.9 inv - 15.2 ~j15J 15 0 ~( _ _ \ 9 ~; v ~ ~~ ,~ yLi ~~~ ~~ / 663610 ~ _,_ ., \, o l .~ ~.- ~ - _ _ 1 , ~ -. ,~; ~~ ',~ , f./1 `..P -. ~~l ~ ~; \t , TEST HOLE ~~ W4iER ~~°~ 2 ~` gees s ~o 15' i]