HomeMy WebLinkAbout36134-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
5/4/2011
CERTIFICATE OF OCCUPANCY
No: 34927
Date: 5/2/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ACCESSORY GARAGE
8680 New Suffolk Rd, New Suffolk, NY 11956,
Sec/Block/Lot: 117.-10-12.2
Filed Map No.
conforms substantially to the Application for Building Perm/t heretofore
12/23/2010 pursuant to which Building Permit No.
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:
non-habitable accessory two car garage with storage as applied for per ZBA #6423, dated 11/16/10.
(NOTE: This property is aka 8680 Fifth Street)
Lot No.
filed in this officed dated
36134 dated 1/10/2011
The certificate is issued to
Lyons, Elizabeth
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36134 5/2/11
Autl~rized Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL
COMPLETION OF THE WORK AUTHORIZED)
FULL
PERMIT NO. 36134 Z
Date JANUARY 10, 2011
Permission is hereby granted to:
ELIZABETH M LYONS
67 THAYER ROAD
MANHASSET,NY 11030
for :
CONSTRUCTION OF AN ACCESSORY GARAGE PER CONDITIONS OF ZBA DECISION
#6423 AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 117
pursuant to application dated DECEMBER
Building Inspector to expire on JULY
8680 NEW SUFFOLK RD
NEW SUFFOLK
Block 0010 Lot No. 012.002
23, 2010 and approved by the
10, 2012.
Fee $ 607.60
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765~1802
This application must be filled in by typewriter or ink and submitted to the Building Depa4~ith the following: III III
A. For new building or new use: I~ [[I. ~" 29 201] IL.~/I
1. Final survey of property with accurate location of all buildings, property lines, streets, an~l unusual natural or J
topographic features. / -- BLDG OEPI.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 for~. T0W~ 0[ S0[}IH0tl)
3. Approval of electrical installation from Board Of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existin~" land uses:
1. 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.
Co
Fees
Certificate of Occupancy - New dwelling $50.00, Additions to dw ~elling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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
New Construction:
Location of Prope-~. 006
House No.
Owner or Owners of Property.'~
Suffolk County Tax Map No 1000, Section
Subdivision
'~cmfit NO. ~'~96
Health Dept. Approval:
Old or Pre-existing Building:
Street
/
Block
Planning Board Approval:
Filed Map.
Date of Permit. ]~lo/il Applicant:
/ /
Underwriters Approval:
Request for: Temporary Certificate
Foe Submitted: $
(check one)
Final Certificate:
Hamlet
Lot:
__ (check one)
,~pplicant Signature
qk)m~ 1 lall Annex
3 ;37.5 Main l/oad
P.O. Box 1179
Southold, NY 119714)959
Tclcllhonc (631) 765-1862
(631) 765-9502
rofler, dchert~town.southo d nv us
B17ILDIN(; DEI'ARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Lyons
Address: 86 5th St City: New Suffolk St: NY Zip: 11956
Building Permit#: 36134 Section: 117 Block: 10 Lot: 12.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: RJ Corazzini Electric License No: 33419-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement [~ Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Pane~ NC Condenser Single Recpt
Sub Panel A/C Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: tVVO story detached garage
Ceiling Fixtures
Wall Fixtures
Recessed Fixtures
Fluorescent Fixture I_..
Emergency Fixtures~__
Exit Fixtures L
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Inspector Signature:
Date: May 2 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[i/] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONS'I'RUCTI~ [ ] FIRE RESISTANT PENETRATION
REMARk-' ~~'
DATE ~ INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUND ~AI'ION 1ST [ ] ROUGH PLBG.
[ ]FO~INDATION~---- 2ND [ ]INSULATION
[ ~FRAMING / STRAPPING [ ] FINAL
] FIRE SAFETY INSPECTION
] RRE RESlST4NT PBIETRATION
[ ] FIREPLACE & CHIMNEY [
[ ] FmEREmTANT~ [
REMARKS:
DATE ~ INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING
FIREPLACE & CHIMNEY
FIRE REmTANI' C0mTRUCn0.
[ ] ROUGH PLBG.
[ ] INSULATION
~'~FINAL
[ ] FIRE SAi-,., ~' INSPECTION
[ ] FII~nSI~I'AMTPr~ILrmATIOH
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ~ ELECTRICAL (FINAL)
REMARKS:
DATE
iNSPECTOR~~----~
PL~G
STA~ E~R~ cODE
~D~ON~ com~s
C~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAKL
SOUTHOLD, NY 11971
TEL: 0531) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthForLnet
Examined
Approved
Disapproved a/c /~-eL
pERMIT NO.
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 Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
Phone:
Expi..on
~ ~ ~ ~ ~ ~ ~ Buildinglns~ctor
~I~A~ON FoR B~DING PE~T
~ ~ ~[ ga~.A~G 6, 2010 ,20
~ / mS~UCTIONS
. ~
~ .... ~mpl~ly fill~ in by ~wfiter or in i~ ~d su~mi~ to ~c Building Ins~tor wi~ 4
s~ o~pl~s, ~c~m plot pl~ to s~le. F~ ~ording to schedule.
b. Plot pl~ showing Iocmion o~lot ~d o~buil~n~ on ~mi~s, mlafions~p to ~oi~ng p~mis~ or public s~ or
~, ~d wa~ays.
c. ~ work ~v~r~ by ~s application may not ~ co~cnc~ ~o~ iss~c~ of Buil~ng P~it.
d. U~n appmv~ o~s applicafio~ ~c ~uilding ~s~mr will issu~ a Build~g Pc~it to th~ applier. Such ~ ~it
sh~] ~ k~ on ~c premises av~lable for ins~fion ~u~out ~e wo~.
e. No b~ld~g s~l ~ o~upi~d or ~cd in whole or in p~ for ~y p~se wh~ so ewr ~til ~e Building Ins~or
issues a C~ficatc o~O~up~cy.
~ Eve~ building ~it shall expi~ i~c work au~ofiz~ h~ not co~enc~ wi~in 12 mon~ ~r ~c da~ o~
issu~ce or h~ not ~n complct~ wi~m 18 monks ~m such ~t~. ffno ~ning ~dmcnm or o~cr m~lafio~ a~c~ing ~e
p~ have ~n ~ac~ in ~c ~m~ ~ B~l~g ]~or ~y au~ofi~, ~ ~fing, ~ c~sion o~ ~ ~it ~or ~
~dition six monks. ~e~r, a n~w ~it sh~l ~ ~qui~.
~PLICATION [8 ~BY ~E to ~e Buil~g ~cnt ~or ~ iss~c~ o~a Bfilding P~it p~t to ~
Building ~nc ~ce of ~e Town of Sou~ol~ Suffolk Co~F, New Yor~ ~d o~ ~ppli~ble Laws, ~in~s or
R~lafio~, ~or ~ cons~on o~buildings, ~difio~, or alt~ons or ~or ~mov~ or d~olifion ~ hc~in d~cfi~d. ~c
applier a~s to comply wi~ all applic~lc l~ws, ord~c~, building c~, ho~ing ~d~lations, ~d m ~it
au~ofi~d ins~tom on pm~ses ~d in buil~ng for n~s~ ins~fi~. ~ ~~ ,~
~~7 /~ames E. Fitff~rald, Jr.
(M~ling M~ of ~pli~t)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Agent
Name of owner of premises Elizabeth Lyons
(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.
1. Location of land on which proposed work will be done:
8680 Fi£th Street, New Su£Folk
House Number Slxeet
County Tax Map No. 1000 Section
Subdivision
117
Hamlet
Block 10 Lot 12.2
Filed Mj3Bo~.]oaAo Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single family dwelling
b. Intended use and occupancy Single family dwelling with detached garage
3. Nature of work (check which applicable): New Building. X Addition
Repair Removal Demolition Other Work
4. Estimated Cost
$50,000 F~
5. If dwelling, number of dwelling units N/A
If garage, number of mrs 2
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor 'I~/A
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. N/A
7. Dimensions of existing structures, if any: Front N/A Rear
Height Number of Stories -
.Depth
Dimensions of same structure with alterations or additions: Front N/A
Depth Height Number of Stories
Rear
8. Dimensions ofentire new constmction: Front 31'-3" Rear 31'-3"
Height 22' Number of Stories 1-1/2~
Depth 24'-0"
9. Size oflot: Front 258' Rear 248' Depth' '100' var
10. Date of Purchase 5/21/96 Name of Former Owner Cappello
11. Zone or use district in which promises are situated R- 40
12. Does proposed construction violate any zoning law, ordinance or regulation? YES X NO__
13. Will lot be re-graded? YES__ NO X
Elizabeth Lyons,
14. Names of Owner of premises
Name of Architect
Name of Contractor
__Will excess fill be removed from premises? YES X NO__
67 ThaYer Road, Manhasset, NY 11030
Address Phone No.
Address Phone No
Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a f~eshwater wetland? *YES X 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 X 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.
18. Am there any covenants and restrictions with respect to this property? * YES__
· IF YES, PROVIDE A COPY.
NO X
STATE OF NEW YORK)
SS:
COUNTY OF SUFFOLK
James E. F i t z g e r a 1 d, Jr. being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Agent
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are hue 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.
~ ~ Applicanf
NO.
~o. ~,aEs o~ono. Z ~
Proper-T Permit Services
POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617
(631) 734-58OO
December 20, 20 ] 0
Chief Building Inspector
Southold Building Department
PO Box 1179
Southold, New York 11971
Re: Application for Building Permit for Elizabeth Lyons, SCTM #1000-117-10-12.2
Dear Sir:
Attached is a completed Application for Building Permit submitted on behalf of Elizabeth Lyons
for the construction of a detached garage on her property at 8680 Fifth Street, New Suffolk.
Also attached are a number of supporting documents.
If there are any questions, please call me.
Enclosures:
Application for Building Permit
Permit fee (partial) - Check $200
Sincerely,
Building plans (4 sets) (Feiler, Dwg No. A-1 of 1, dated 12/7/2010)
Survey (Corwin, last dated 28 Oct 10)
NYSDEC Letter of Non-Jurisdiction, dated August 25, 2006
ZBA Variance, Findings approved 11/17/2010
a subsidiary of
THE PECONIC EASTERN CORPORATION
TO:
James Fitzgerald for
Elizabeth Lyons
P O Box 617
Cutchogue, NY 11935
FORM NO. 3
NOTICE OF DISAPPROVAL
DATE: August 26,2010
Please take notice that your application dated August 11, 2010
For a permit for an accessory garage at
Location of property: 8680 New Suffolk Rd. (Fitth St.)
County Tax Map No. 1000 - Section 117 Block 10 Lot 12.2
Is returned herewith and disapproved on the following grounds:
The proposed accessory garage is not permitted pursuant to Article III, 280-15 which
states:
"In the case AC District & Low Density Residential R80 .... Districts, accessory
buildings & structures or other accessory uses shall be located in the required rear yard,
subiect to ..."
The site plan indicates the proposed accessory garage is located in a side yard.
~ Authorized Signature
BOARD MEMBERS
Leslie Kanes Weisman, Chairperson
James Dimzio
Gerard P. Goehringer
George Horoing
Ken Schneider
Southold Town Hall
53095 Main Road · P.O. Box 1179
Southold, NY 11971-0959
Office Location:
Town Annex/First Floor, Capital One Bank
54375 Main Road (at Youngs Avenue)
Southold, NY 11971
~IBERATIONS AND DETERMINATION
MEETING OF NOVEMBER 16, 2010
ZBA FILE: 6423
NAME OF APPLICANT: Elizabeth Lyons CTM 1000-117-10-12.2
PROPERTY LOCATION: 8680 New Suffolk Rd. (aka Fifth St.) (adj. to Great Peconic Bay), Cutchogue, NY
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
further steps under SEQRA.
SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk
County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its
reply dated September 30, 2010 stating that this application is considered a matter for local determination ms there
appears to be no significant county-wide or inter-community impact.
LWRP: This application was referred for reviewed under Chapter 268, Waterfront Consistency review of the
Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The
LWRP Coordinator issued his reply dated October 13, 2010, based upon the information provided on the LWRP
Consistency Assessment Form submitted to this depamnent, as well as the records available to us, it is our
recommendation that the proposed action is CONSISTENT with LWRP policy standards and therefore is
CONSISTENT with the LWRP.
PROPERTY FACTS/DESCRIPTION: The Applicant's property is a 24,471 sq. ft. non-conforming waterfront
pamel in the R-40 Zone. The northerly lot line measures 100.21 feet along adjacent property, the easterly lot line
measures 256.89 feet along Fifth St., the southerly lot line measures 99.30 feet along Great Peconic Bay, and the
westerly lot line measures 238.04 feet along adjacent property. The parcel is improved with an existing single
family dwelling, which is shown, along with a proposed new garage location, on the survey prepared by Nathan
Taft Corwin III Land Surveyor, dated Oct 28, 2010.
BASIS OF APPLICATION: Request for Variance from Article III, Code Section 280-I5, based on an application
for building permit and the Building Inspector's August 26, 2010 Notice of Disapproval, concerning construction
of an accessory garage; proposed location other than the code required mar yard, at: 8680 New Suffolk Rd. (aka
Fifth St.) (adj. to Great Peconic B ay) New Suffolk, NY. SCTM# 1000-117-10-12.2.
RELIEF REQUESTED: The applicant proposes to construct an accessory two-story garage in a side yard location
when Code requires such new construction to be located in a rear yard.
AMENDED APPLICATION: During the hearing, a neighbor stated an objection to the proposed location and
requested the garage be placed closer to the road. Mr. Lyons stated he would like to withdraw the current
Page 2 - November 16,2010
ZBA File#6423 - Lyons
CTM: I000-117-10-12.2
application and reapply with a new location for the garage. The new proposal would create a request for two
variances.
ADDITIONAL INFORMATION: A letter dated October 29, 2010 from the applicant's agent was received
requesting the garage stay in the side yard not closer to the road but closer to the house. An updated survey
prepared by Nathan Taft Corwin, III, LS dated October 28, 2010 was included with the letter showing the new
location which did not change or increase the number of variances requested.
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on Oct. 21, 2010, 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 and makes the following
findings:
On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following
findings:
1. Town Law §267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of
the neighborhood or a detriment to nearby properties. The garage will be screened from the street by a mature
hedgerow planted along the front yard of the property. Photo's provided by the applicant at the hearing showed
many garages with similar locations within the neighborhood.
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. Due to the narrow depth of this lot the applicant would
require a variance with any location proposed for the accessory structure. The Applicant did not want to alter an
entrance to the existing dwelling and eliminate bedroom windows in order to be able to attach a garage to the side
of the house.
3. Town Law §267-b(3)(b)(3). The variance granted herein is substantial since the garage will be located in a side
yard when Code requires an accessory building to be located in a rear yard. However, the Board finds that the
proposed side yard location is landward of the waterfront dwelling and therefore will have less of an impact on the
bay than a location in the conforming rear yard.
4. Town Law §267-bO)(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. All rain
water will be confined to the property by the use of gutters and leaders into drywells as per code. The construction
will be landward of the existing building and the waterfront.
5. Town Law §267-b(3)(b)(5). The difficulty has been self-created since the Applicant did not want to attach the
garage to the existing single family dwelling, which would not require the need of a variance.
6. Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of a detached garage located in the side yard, 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 Weisman (Chairperson), seconded by Member
Goehringer, and duly carried, to
GRANT, the variance as applied for, and shown on the site plan and survey prepared by Nathan Taft Corwin III,
Land Surveyor, and dated Oct. 28, 2010, subject to the following conditions;
Page 3-November 16,2010
ZBA File#6423 - Lyons
CTM: 1000-117-10-12.2
Conditions:
1. Provide gutters and leaders into drywells to maintain storm water runoffon site per code.
2. The hedgerow along the front of the property shall be preserved and maintained to semen the
garage from the road.
That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued
Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a
possible denial by the Building Department of a building permit, and may require a new application and public hearing before
the Zoning Board of Appeals.
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 furore 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 Weisman (Chairperson), Goehringer, Dinizio, Schneider.
(Member Horning by phone no voting right) This Resolution was duly adopted (4-0).
Leslie Kanes Weisman, Chairperso
Approved for filing ~//7/2010
Towfl Hall Annex
54375 Maia Road
P.O. Box 1179
Soulhold, NY 11971-09,59
Telephone (631) 765-1802
ro~er, richertdt~ (wn~!~o7 u~o~l.n¥.us
BUILDING DEPARTMENT
TOWN OF $OUTHO~
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
~,ddress:
iPhone No.:
Date: ~/,L/,~_//
JOBSITE INFORMATION:
*Name: ~ t/~,~ ~
*Address: f(~ ~o
*Cross Street:
(*Indicates required information)
*Phone No.:
Permit No.: 3 ~, / ~ 5/
TaxMap District: 1000 Section: i/'7
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Block: [dP Lot:
/
' (Please Circle All That Apply)
*Is job ready for inspectiOn:
*Do you need a Temp Certificate:
Temp Information (If. needed]
*Service Size: 1 Phase 3Phase
*New Service: Re-~onnect
Additional Information:
100
Underground
YES/(~
150 200 300 350 400 Other
Number of Meters Change of Service Overhead
PAYMENT DUE WITH APPLICATION
82>Request for InspeclJon Form
t2. --,z
TOWN OF SOUTHOLD PROPERTY RLK:eRD CARD ~),-~ '-'~'~.~. ~
tooo f/"/.t~
OWNER ;TREET '~j::) ~ VILLAGE. DIST. SUG. LOT
ACR. J
FORMER OWNER t N '~". i~./~/~',4////~ E ~ ~ $ '7"'~£k-
~', .~,,q.,t'~.'Op_..,~p~..J lo $ W 'I'Ypi: OF BUILDING
LAND IMP-. TOTAL DATE REMARKS
/--
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: '1 I ! ·
/¢oodlQn~ -FRONTAGE ON ROAD
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TOWN OF SOUTHOLD PROPERTY RECeRD CARD --.
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~ND IMP. TOTAL DATE R~S
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PROPOSED STAI
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NO TES:
SURVEY OF PROPERTY
$]TUA TED A T
NEW SUFFOLK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-117-10-12.2
SCALE 1 "=30'
NOVEMBER 26, 2004
AREA = 24,471 sq. ft. 0.561 ac.
CERTIFIED TO:
ELIZABETH M. LYONS
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM
RECEIVED
OCT ~9 Z013
BOARD OF APPEALS
ZBA FINAL MAP
SEE DECISION
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED,
N.Y.S Lic. No. 50467
Nathan-Taft Corwin III
Land Surveyor
PHONE (631)727-2090 Fox (651)727-1727
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