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Home My WebLink About40837-Z ��otip��'F��'�� Town of Southold 7/27/2016 � � P.O.Box 1179 0 �'" � 53095 Main Rd ��',,�Q� �� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38413 Date: 7/27/2016 THIS CERTIFIES that the building AS BiJILT ADDITION Location of Property: 880 Old Orchard Ln, East Marion SCTM#: 473889 Sec/S1ocklLot: 31.-6-23 Subdivision: Filed Map No. Lot No. conforxns substantially to the Application for Building Permit�eretofore filed in this office dated 6/27/2016 pursuant to which Building Permit No. 40837 dated 7/18/2016 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"ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Dzenkowski,Mary Ann of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUIV�ERS CERTIFICATION DATED . A orized Si ure 1 � � TOWN OF SOUTHOLD ��o`g��G� BUILDING DEPARTiVIENT ` �� `s, TOWN CLERK'S OFFICE o • � _ SOUTHOLD, NY , ��o�� . � BUILDING PERiVIIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 40837 Date: 7/18/2016 Permission is hereby granted to: Dzenkowski, Mary Ann PO BOX 84 East Marion, NY 11939 To: legalize "as built" addition to existing single-family dwelling and swimming pool demolition as applied for. Adclitional certification will be required. At premises located at: 880 Old Orchard Ln, East Marion � SCTM # 473889 Sec/Block/Lot# 31.-6-23 � Pursuant to application dated 6/27/2016 and approved by the Building Inspector. To expire on 1/17/2018. Fees: � AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $451.20 CO -ADDITION TO DWELLING $50.00 DEMOLITION $100.00 Total: $601.20 B � din pector � ',' , Fo�m i�:o 6 �co��v or soU�rr�o�.� BU(L�[NG DCPAEZTMEN"f TO�'��N E{ALL ' 765-180z APPC,[CAICION �'OR CERT[FICATE OF OCCUP�NCY This application must be filled in by typewriter or ti�k and submitted to the Building Departtnent with the Co(lo��ing: A_ I�or new bui(ding or ne�v use: " 1. Final survey of property with accurate location of a11 buildings, property lines, streets, and unusual natural or topograpliic features. 2_ Final Approval from Health Dept. of water suppiy and sewerage-disposat(S-9 form). 3. Approval of electncal installation from Board of Fire Underwriters_ 4. Sworn statement from plumber certifying tiiat the solder used in system contains iess than 2/l0 of 1% lead_ S_ Commercial buiiding, industrial building, multiple residences and similar buildings and installations,a certificate of Code Compliance from architece or engineer responsible for the building. S. 5ubmit Pianning Board Approva1 csr cornpleted site pl�n requirPments_ .:. B. For existing buildings (prior to A.pril 9, 1957) noa-conforming uses, or bueldings aad"pre-existing" land uses: l. Accurate survey of property showing all property Iines, streets,building and unusual natural or topographic features. . � 2. A properly completed applicaeion 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 - 1. Certificate_of Occupancy-New dweliing$50.00,Additions to dwelling$50.00,Aleerations to dwelling$50.00, Swimming pool$50:40,Accessory building$50.00,Addi�ions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existin�Building- $100.00 • _ • .__._ ..... .. _ . . . . 3. Copy o�Certi�'icate of Occupancy-�23��t��=- 4. Updated Certificaee of Occupancy- $50.00 , 5. Temporary Certificate of Occupancy-Residential$15.00, Gommercial$15.00 • " Date. w` (Jl�� ?i3 �L�' , ' New Construction: Old or Pre-existing Builcl.ing: � (check one) � Loca.tion of Property: �� -C�� =��_ (n�-(�� ' House No. Street Hamlet Owner or Owners of Property: � ��-Y�1 v .b Z��c�K'� ' Suffolk County Tax Map No 1000, Section � � Block_ � 'Lot ?-' 3 ' Subdivision Filed Map. Lot: Pernut No. �(��J� Date of Permit. Applicant: Health Dept_ Approval: Underwriters Approval: Planning Board Approval: Request for: Ternporary Certificate Final Certificate: ✓ (check one) —�--------------- ----------------------- --- - - --- ----- ---- - ------ ---- - -- - - ------ - --- Fee Submitted: $ �) APp![cant Sigr�.t«i-� -_� __ ' _ � • _ , - \�i �� /1 �o��OE SOUlyolo o LlJ li` # # � • �o . �'�courm,��' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION � � [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [� ] FIRE SAFETIf IN�PECTIOR! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTi4NT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIfVAL) REMARKS: D�� e• d- . 07 �� DATE � INSPECTOR � ,. � 'y • , � K ��..., � FIELD 11�5`P��Q�`T��''0��' AA't� . . C�� . . . • , • � � . , . � � �`OYTND,��'SO�i(XS'� , , , , � � � � � � � r� ��' r rw� � w��Y��Y� ' � ' � . `�� • �`•��Q� �2�� . , , � � � . , , , • , O � , � . . ' ' • ' � , ' � � � � � . ' � � � H � & � . , . � � � � � , .� � � � � ROU��S��G , �� a PLUNZf3Sl�i'G '' , � , , , � � ' . ,� � , • . . � ; " ' � � ' ' ',' , , . ,. , , • , ' ' ' � � - . � INS7JLATZON•I'E1�N,'�. , , � � � ' � y STATE�I�'ER;GY C�01�� , . , , , ' � , .. , , � � .., , � � Q � �� • . . . . , � • , . � • , �� , • • . . . � . . ; • , ' .. . , . , .. � • , • � , � . • � 'A.�)�`�'� I :"C'c� � , ,, , . , , � ' , � , � .�, . � �-a- , , , . .. , , ' ' ' .: � ; � � , , . , • � . . . �, � � ,• , ' � � � � �� /� s � • a�� -� l G�:°�'L,/�'� ' '! 9��'s �-L. �*�ti � , ' , � I . , , . , . , , I . , • , 1 � � � � • � � . . . . ' ' � � . � . � , � ' . ' � , . ' , � '* y � � � ,� ' ' �� y1 • ' �"'/ �.. . , r � � �� TOWN OF SOUTHOLD _ BUILDING PERMIT APPLICATIOI�CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL �, � - � Board of Health SOUTHOLD, NY 1197.1��„-; , : � - -� . , ' •-� ,.. , }, , � 4 sets of Building Plans TEL: (631) 765-1802., ,,� . . . . ' � _ Planning Board approval � -, , FAX: (631) 7b5-9502 �� ' � = ✓ " ' �� ' � `� -' -Survey- - ' n Sou"'tholdTown.NorthFork.net�� ' -PERMIT•NO. ` �� ' ��'' • Check ' _ , � ' . Septic Form . N.Y.S.D.E.C. � - _ � ,- � ' . � = ' Trustees - � � . ` , � C.O.Application Flood Permit � Examined � ,20� . Single&Separate � , ' � � � Storm-Wa'ter Assessment Form � ... 1 - , - _ , , �Contact: �� • , Approved ,20� Mail to: V �� ' Disapproved a/c , �� K 4-4 �sd�'�C� ' : , ' :- ` � � �� - • Phone: �3� —ZC��'�'� � Expiration - ,20 �, � � � � � _ , , � . �, , B i 'ng 's`ector • �. . �. .,� - ,� � - . .� ,, / ,��1 . � \ , �'1.5�O�A� ' � : �,. . �_ � ,--�. , D � TION OR BUILDING PERMIT � r , . . � • ` P ' . ,gU� 2 7, ,2D96 , , � - . Date, J V l� (� 2� , 20� � , � � 'INSTRUCTIONS . - . a. This applicati�'['�I,I?�I�e� y filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurat T�o��cording to schedule. � � � . . . b. Plot plan show�'ation of lot and of buildings on premises,relationship to adjoining premises or public streets ar " 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 lcept on the premises availaBle for inspection throughout the work. � � . e.No building shall be�occupied or used in whole or in part foY any purpose what so ever until the Building Inspector .issues a Certificate'of Occupancy. _ -� �, ; ��_ , , � '` f. Every buil'ding permit sliall expire'if the'work authorized has not commenced within 12 months after the date of . issuance or has not been completed witfiin`"18 month`s from such date. If no zoning amendments or other regulations affecting the properiy 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 cod'e, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. � � - • (Sign e of applicant or name,if a corporation) , , ' , " � � � � (Mailing address of applicant) ' . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ��'�' ' - , Name of owner"of prerriises � ��-�( � � � �N Y-0 t1�kS'�-� � � " ' ' ' � (As on the tax roll or latest deed) ' " ' If applicant is a corporation, signature of duly authorized officer � � ' � � . � � (Name and title of corpo"rate offi'cer) " _ . , - y ,� � � Builders License No. ' � ` � � � � Plumbers L' icense No. � ' ' .. � � . � Electricians License No. � ' � � " '. Other Trade's License No. - - - � ° ' � 1:.;;-:Locati,ori,of larid"ori"wh�cl�proposed work will be done: L -1 - , �CJCJ=��';'.:'� e'+t; ��;�.� �U�� u\' —� `Gi• ':..� ` j"��l�N /v� . Hou{s��`Nu�iibtler�'`�`-`=`�-�,��'•�g'=Street ` ' � - ` - � Hamlet - _ " M.,._. �>'o.'' ,.-��t:' , �'s�.��t;''iHtl'r�i�4 ' ' � � • � County Tax Map No. 1000 Section - � , Block r0 Lot � F2 3' ` � - � . % � , f . � Subdivision Filed Map No. Lot ' 2. State existing use and occupancy,of premises arid intended use and occupancy of proposed construction: a. Existing use and occupancy S l(V G�t.� �M,((�"� fZ,�LO�C� - b. Intended use and occupancy S�m�' �/ r`�S—g U��T « �NTiR-� ��cS 11S f�3 c� , . tT 3. Nature of work(check which applicable): New Building. - Addition ✓ Alteration ✓ , Repair Removal Demolition Other Work (��'Ma� -S'uJ�f'Vl • .�pUG (Description) 4. Estimated Cost � � Fee - � (To be paid on filing this application) 5. If dwelling, number of dwelling units N A Number of dwelling units on each floor If garage, number of cars � N l� � 6. `�If business,'commercial or mixed occupancy, specify nature and extent of each type of use. N� • ' 7. ,'Dimensions,'�of.existing•structures, if any: Front Z�p•� t Rear � 6 '� ' Depth 2 g� a� Ta Height �2��1� � Number of Stories 1 , � �� . �' Dimensions of same structure with alterations or.addifions: Front � �o •�' � - Rear 7�v-�'r� Depth � Zg�3�-� 3q•3 � Height l2�—� (�� Num�.er of Stories 1 . � S��cS` ��c'��i'or��;�CZ?.;��,�7�Ti:��`l C' (�R 8. Dimensions of entire new construction: Front � Rear: ; f , �= x--E:.�ID.eptl�•!s ; �t � Height . Number of Stories �-�-! I fydI � � . . 'ic � � +c�I A.s F �$ � i 9. Size of lot: Front ��'� Rear �� '� , Depth �i��F��•�3 (`'''°'` �� y o-��z,� 5^ly, Y�#n*n�,�; � Nla E'P'l�ri�ieY,i';��'�.n:'W;��i1Pf,`rlt 10. Date of Purchase " Name of Former Owner - .� , , �t��a i��;{c�'��.�'`��` 1,1. Zone or use district in which premises are situated � —�� ' 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO o� 13. Will lot be re-graded? YES NO ✓ Will excess fill be removed from premises? YES NO , , � 14.Names of Owner of premises pZC-iv�( Address $D. 4C.O a�CHr�ne No. ��-9'Z 7-�'�'�8' Name of Architect � Address ��!� �ON• phone No " Name of Contractor � Address � 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO 1� � ' * IF YES, PROVIDE A COPY. � STATE OF NEW YORK) _ ' SS: , . . .. �; -- ^ , �'" ;. ;'i ' COUNTY OF�� ..e— - --- --- -- - -- ----- :�t.' -, ,. - . °, �, : .� ,, , , , , �, � � C'{��YYI.�� being duly sworn, deposes and says tllat(s)he is the applicant (Name of individual signing contract)above named, � , ' � , , (S)He is the ��1 ' . �, ' � (Contractor,Agent, Corporate Officer,�etc.) � `", � of,said owner ar owners, and is duly authorized to perform or have performed the said wark and to make and file this application; tha�,:�ll.statements contained in this application are true to the best of his knowledge and belief; and that the work will be , � ,e,"1' '1i, perforrried`i�;-tl�e manner set forth in the application filed therewith. � � -, '� '�, �, '�..� - • , Sworn to be ore me�this� ' '`' � TRACEY L.DWYER � � �.*., - � - ` i � � •NOTARY PUBLIC,STATE OF NEW YORK day of .,t��,)9'Lf'�' .20_r� . _ , , , . ; . � � ° -: � � , , . . � � � - 1 - " � _ °' �` , , NO.O1DW6306900� . � QUALIFIED IN SUFFOLK COUNTY � � . MISSION EXPIRES JUNE 30,20✓ Notary P ic � , �-' Signature of Applicant �` � } - � � _ , � . , � .�u : _ - . - � i - , � Scott 1�. Russell �O��FF� ,�� C't0�]E�I��IC\�vA\'7C']E�E�. � sU�ERvisoR � � I�vl[At1�A\cG�)EI��I[]E�'7[' � SOUTHOLD TOWN HALL-P.O.Box 1179 � � 53095MainRoad-SOUTHOLD,NEWYORK 11971 � Town of Southold �i�� ,�' - CHA.PTER 236 - S�'ORIVIWATER MANAGElV![ENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) . . - - - -- -. .�lE� 'g'�-��S PROJ�C'Y' I�OI,i77E t�1�11' ��' '�'�-�E F'OI,�,OW�1�TG: , YCS NO (CHECK ALL 7NA'f APPLY) ; ❑[�A. Clearing, grubbing, grading or stripping of land which affects more . than 5,000 square feet of ground surface. � ' : ❑�B. Excavation or filling involving more than 200 cubic yards of material : within any parcel or any contiguous area. , ; ❑�. Site preparation on slopes which exceed 10 feet vertical rise to ; 100 feet of horizontal distance. : ❑�D. Site preparation within 100 feet of wetlands, beach, bluff or coastal , - erosion hazard area. • � ❑[�E. Site preparation within the one-hundred-year floodplain as depicted �. - �`- � - � - �on��'I�1�-1'�/Iap-�af--any w�tercours�:- - - - --- � ❑�. Installation of new or resurfaced impervious surfaces of 1,000 square = : feet or more, unless prior approval of a Stormwater Management � : Control Plan was received by the Town and the proposal includes = in-kind replacement of impervious surfaces. � If you answered NO to all of the questions above,�STO�! Complete the Applicant section below with your Name, Signature, Coniact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. � If yau answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLiCANT: (Property Owner,Design Professionai,Agent,Contractor,Other) S.C.T.M. #: 1000 Date ' � De7rict ^� ` ,��` �� NAME: � � J �� Ctt�m� w,�n Section Block Lot � "��j� � �( �::" I�OR$L�iL�1\G D�:P�-;RT��EtiT I:�� O;�L1' ''-: Conmct Infomut�oa 1G/�C !� V `�� Ta.�trone u,,,nxri Rev►ewed By: Date: Property Address /Location of Construction Work: — — — — — — — — — — — — — — — — — � O) � ��(�h�,^�� Approved for proce��ing Building Perm�t. �-�/ _�`�f Stormwater Management Control Plan Not Reqwred. v/�l l 1 r ��a� N Stormwater Ivlanagement Control Plan ��Peyu�red O (Forward to Engineering llepartment for Review) Fc�RM � SMCP-TOS MAY 2014 �s:...s.,u.:r:rn•.;' . '._,., - �_i..'�r, Ak�-.� ;r-'='.,-.,..,--'�-•__..�..�-._-".-..e�.,.,,�-- - -*,,..... --^--"-�-...�,,.,y-,'.-..r.�r--�,y-.�� ,_.�...„,.,�,. _ . . "' . . ' - - _ t;d. � . • � ...- 4�' � ,_ . ., •�• h �f \} _ _ , � • '�_�, ♦:±^'"� _. � : � � �Y • _ E : �� .:1j'� fp . .__ "T` . w a �a' � �~��t...:.^�" . .. � . f � -e � i � • 1"a'� � �Z 1� ��-. �%��`:��1-=- � -��,,� TOWI�1� OF� ;SOUTHOLD��: �PROPER7'1r �RECORD C�►RD � � : ' OWNER STREET ��'� � � VILLAGE DIST. SUB. LOT � �F� 1 � G.li�'�/��C/�t.I��i• ./�t_}'"�..t�..J".�4..�.r..••t...A�'� �'' ��'.�t�t�'_ . �� J,�'--�'��-s�:�`` � VJ �o t_--- FORM R OWNER �-'� �-' � '�I^-� � ' ACR, ,� � N ' lJ,,_' .-"��' c?, G@ lr"S, E � ��`'ld��-�� '�?g1�`Qr I�. �I� l �„�Z�J1 �r� I�.St�'( �(�� S p ,,,,� �� ' � - ,��; �,� TYPE OF BU I LDI NG y�' �� ,�. °�� ..� '.. �,�.�--�--�' ��`��``_� ! ".,� R� �� SEAS. VL. FARM COMM. CB. MISC. Mkt. Value .7'0 �.� .e; . LAND IMP. TOTAL DATE REMARKS R ` ,� e � ..�'..�,�� `I��,e'� �,� .' .Lf�1�,�"f.�...�.,�.✓� ,� t�.{..�-��',- ��.--� � ,3 �"� � y��-� �, ,��fy/y /f1 U �,� � . �` 1( �'ds+.+ ,! V "��A 1ZF�t � C+1 Gi � c � � ��' �� .�� ,��-,�� - . 1�� .� � � � r� � . u, �►w�✓ Q� � ��,�a�r�.� � c' d�/ � � �` � u�—� ��l r,�—�l � � - � �f . i�, ,� �a o .� o � 7 � ,� s�-z2/�.� � � . { ;` � �}' 4 . � � . /6 o v�90 o ¢. Q s o �(��l? � �5�,.. � ;-.-� �� `',� � � � B I G C N� I �'�� N ;A�:,.,r �ac '� �`6 FARM Acre Valu�e Per al /� � o � �o ra—�c. » �z-.�i-��''�� Tillable 1 Tillable 2 `�w,, Tiilabie 3 � u�*' ..� , '°,y't� � ,` Woodland � •� '� Swampl.and FRONTAGE ON WATER Brushland FRONTAGE ON ROAD �,�a"'� �`�, � �'��-U =;;��'�'? House Plot DEPTH �-''��,,,� j� � �� BULKHEAD Total DOCK . 3 }�� .��... ' �5 tF.t�.`� ■■■■�■■ ■�■�� ' . . • ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ..�T( f. ■■■■■■■■■■■■■■■■■■■■�■■■■■■ � 's e f�.:� y r ■■■■■■■■■.■■■■■■■■■■■■■■■■■ r,� . ��,� ��{'`�,. � / , �r.✓ • ,,� . � �� 1�!�� " �" � �� ` � ,,: � �� i�i��4�� . �:� � .�� '� ■■��i�� i�i7��■�fl��■■■■■�■ :. `� � � �� I��l�� . . .-�. �.-�__�.�-��:.,�,_.. .�,, �.� . . �A�� E��J��:��o,��tT�■■�■��■ .,��.� ��-- A �� JJ�: ��II�� i��l��■�� . .• �.�. .s„„�, � . ,.. '+ . . . . . . . . , . , � �. - �� , �� t�� . .,,. �,, , "" . . • , .N �� ' �� !'��r��f�� . � � � �;:•.��, .� � ;� � ,�, �� . � . ' �� : .. __ . .. . :. . - , - . �� : : � � _ ��" ' � .. � � ' �� ' - . � - . �� " � ' " ' ' � __ .- �.. �.. .. :� �' __ '- -. . -.. �.. . .. � .� ; : �, � �3 � �. - : -- - . � ; ��. - . � . .._ , 1 � , , � � �� » J, �. � .. , �� _ : � i � / � "� i /4 - • . � f ,r, � _ •": ' 3. r Notoro of work(check whkh opplicoble?: New 8uilding ...v'..... Addition .................. Alt�eration .....`........., � Repoir .................. Remov�l .................. Demolition..............,..... Othe�Work .................. ... ... .... .. •- ...... ... .... .. .. � (De�cripti�ra) 4. Estimated Cost ............................................................F�e ...��.:��.................................................................... (7o be pald on fipng thts nppfication) 5. If dweiltng, �mbe�of dwelling units .............«.............I�urr�ber cf dwelling units on each floor..1..,...................... Ifgarage,number of cors........�.................................:.............»........................................................................�...... 6. If �usireess, oommerzial or mixed occuPa^cY. sPecify noture and sxtent of each type ot use ............................ 7. Dir�sions of e�xisting stn,�cte�r�,if crsy:Front............................ Rsar ..............»................ D�th .................... . H�igh4 ........................ idumber af 5tories ..............._.................................................e.............................................. Dimaris�ons of�ome�tructure with altsrati�s or additloa�s: �'raret,........<........................... Rear ............................ • pepth ................................ Height ............................Number of Stories .............................. 8. Oimensi�i�of e�tire new ion: Front . /..d�!�..s................Rear......�!f.............Depth....f�..�..�....... Heigh4!/....1�rS�..��d�car�St4orles ..........d................................................................................... ............. 9. Size of lot: Front ..�..J...........�,�.Q............................. Rear.......lsi.�.�........................ D ..��.�.Pa1.............. T0. Dat� of Purehas� .!7��....f.�.»...�.9�.�............IVame of Fonner Owner ..��..��/.�.et�'.�r.Q.,�. .�.,�{...G'�:3"'.�C f 1. �ane or use distrect in wh[th premises are sitvated ........................................................... ............................. ............ 12. Does�roposed construction violate aery aoning law,ordinance or regulatia�: ...............�d............................... la. wb�[ lor be ►�rad�».....��..�:........lnrlu excess fi1� ae removea fron,pr�nis�s: c' ) Y�� c� tao b� 14. Nome of U�rner of premises....................................................Addres�...........................»... Fta�fe�!Va ......��'/�%��$ , Nama of Architett ..............................................................Acklr�s........«...................... Phoe�e Na ...................... Name of Coretroc4or ............................................................Add�s................................Pha�O i�, ...«......»»....... PI.iDT DIAGRAM Lxcte clearly and distinctly ail buiidin9s, wheth�r existing or pro�d, a�d ic�icate ali set-bcck dimensions from propeAy Nn�.s. Give stne�t nnd biock number or description according to demd, and �hax aheet rtames and tndicate wheth�r interior or wrrt�r lot. . . /f�EA��er� ��'t" m � � . f . . � . � ''� �?��N�� 40 °��M l`r" Q ' . _. ' � ¢ � i � � o � � ��r�':a..�.�,.. ��ov�� ae o -. � ,- - + � .�'�' .�_. r�oo t i � � ,. � _ w�l � � �.�.. . �..� . �R�oiwr►�/ ` Qd1r?i?QiE •� � � ` r � �• • �, _�ga� � ��i _._ — _ — �� .�. _ -- — — — — — � _ _ • ',�! ' � . j o • � ;: .CflUMY OF � Qr S'S � va. ��:'�•'•`•5.., .being duly sworn,depos�and(�ys that ha is the cpplicont�. ,.................t of individtml� tng contr�t� ...... dbave nomed. C��: r �� . F�e is the ......................»,.. ....... ......... ............ ......................,...................................... ..(COnI'f�aCtbl'�Og[int,COq?OlOt@ OffltB�,@tC.).. of said owner or owners, and is duly authorized to perfarm or hava.psrformed the safd work and to make and fite this applfcaYioh; thot ntl statements contained in this'cpplication are tnie to the best of his kee�+ledpe and belief; and that the worfc will be perforrrsed n the manner set forth in the upplturtion filed therowitl�. Swrom to beforo me thia ...:...............� .v;_y.. .., 19....[.� ,,,f�..l... 5��.. Notcry Public,... . ..... .. . ..... ..... ISignotu af appltvar�t) .»••.•..•............. JU�ITH T.90KEN P10tary Fublit,Stale CE Ne�Yotk . Na.92•0944963��]9�� Comtnisoior.6�p��_ , . ,'�;"- - .� li0�1[210. 1�G��'d'`�./�.� 'R�� , . �/"� �� , , '1+OWN OP a��4. �K C9.' . � � �°� -�6 - T aptHo��s�i�t 7 � .w'-.cw ''�i� � SO�lJ7NOLD, N. Y. Exomined .... .....�......., 19.�/.. Appltcot(on No.7�d�'�'�".... App�ored °�._.� ......, 19��Permit No. l '�Da�.r - pisa�proved a/c ..»...... ............. ... ' r�............�......•�..��.�� i��ti��H��«�.�. �� •�h��.r . .................. . ........(Bulldirg.l�pect+or) ............�................ OS� 0� _ 11'�WCATION FQR �l11LOINB ►ERMIT ' � C • • ., . " Date.:K�!�Al�.......!�:................... 19.1'�.�... � iNsrRucrtoNs . , � O, . . . , .. . r a 7hi�Qpp�icnNon_rnnst ba.comFlete�Y.f)qqd in bY tY9evr[lteryr m�urtk.and.su6mitted.in triplioad� to iM 8uildir�. lnspe�tor,with sets of�l�s,occut+otr plot pion fio accle.Fee accdr�din�to schedu�, b.- -pfahp!ari sisdi�'virig acatiortof•lat•ondvf•buildiiigs on-premises,•relationship tandjcining promis�ot public streets oid - areas,cruJytviny m detailed de�ripti�of layoat ofproperty must be drawn on 3he dia�mm whkh fs portaf this applicotFon. c. The vrork cavered by this npplicctlon m�not be commenced before issuance of�uiidi�P�rmit. d• opp+�ol of'thls'nPPlicction:'the•$uildirq� InspeSior will'i�ue n&tilding Permi#to Hu opplic.ant.Such permit ' �wil be�on the'prernises availabte far insp�etion throu�hovt the work. e. No 6ulldirtg shall be awpied or used in whole or in part for a�y purpase whatever untii a Certifttate af Occupmncy aholl have baeR granted by the Building In�ector. � APPLICATION iS HEREBY MADE to the Bulld'eng bepartment for the issaaance of a Buildirig Permlt purs�wr�t to th� Buiiding Zone Qrdinance of the Town of 5outhotd, Suffolk Courdy_, New York„and other appfFcable LaWs,Ordinanca or Re�ulntla�s,for the eonstnacHon o6 iwi�dings,additiorm or atterotions; or fbr oemoiral or demolition,as her�ein descri6ed.� The epplicant agrees to comply wlth all appliccble'laV�rs,adina�ces,,building�oode�,houalrtg calo,end regutottons,ad'tct�� edmit authorized lr►apectcrs as premises and ir�tsuitdin�s�or nee�ssary tr�speettans. . _\71e . • ....J��iA+�.�.��.. ... . .�........ .... . ... .. ...........» . - . , {Stgnoture of upplic ,or reome, if o�rpo�aticx� , . ., ' ....��...��.�:e�ral.l�....................»........... : (Addrq�of applicant) . , �a�"r1a�i.Q.u.o:.� r'�,� t►4 3� State whether applicant is owner, lessee,agent,orchitect,engineer, geneml conirnctor, etectric an, p0umber or buiMer. ..............4�{�1..u!F!�'.':`.:..�?�!v€�,R�e;/....�d1!��t.r.�7!'a a;c ............. .................................. Name of ovmer of pramises..��!4I��...�!7..:..�:...:.l.�R�ttN,v....�Z�Nko.�Skl............................................. If epplicarrt is a corporofe, signature of duly autlwrtzed offteer. ' ..................fEVame�and titte�of�aorpor�ata�officer)�....... • � - Builders Licenke Plo. ..............�...t....�........................... , . , � Piur»ber's Iroense Na .......................... .......»...... . E , Electr�ci�'s Licensa tVo. ..........................».............«. . OtE�er Trade's License Nb.............................................. . . . • _ 1. Location of tand on which prnposed work wi11 bo done. MaP No.• .......................... Lo1��a�,, ................... Stroet mtd Number ..................Qj�s.....��4'r�tl�//�......�i1:4.�(�.......,............�.�.�.�i�"�I.�SY..�.. ....... - _ - M�i�Oltty . 2. State existing use and acupanry of premises and in�ended use ared oceuponey of propos,ed eo�truc�tion; a. 6xisiting use and oecupanry ....�1l�a��d;Edt1�A�/........................................ ............................................... _ b. Irrtended use ond accupancy.....�.�..�.°.��........................�...........................................»........»...............» . - . - • � . . � I ` �.._..:.y _..... ._ _ . . ._ .. . _...._� _.- - -- - -. .� _ .. , , i I ' • MAIN ROAD S.C.T.M, N0. DISTRICT: 1000 SECTION: 31 BLOCK: 6 LOT(S):23 , - , i � �' � op LAND N/F ^ OF pj JOHN G. SCOTT 111 � '- � � PIPE 282.93' "' FE m I � 0.2'S I � o LOT 1 3 g� 3.B' " N57"33'40"E 4' CHNNUNK fENCE J � I m — —PIPE 67.5' - _ -_- _ J - - - y I FC =---_-- _ == , 0.4'E -=_-___==- -__ 0.1'S -_==_- -- o :--:.-_'=-:---39.3'-.=;- --=-_-_ -'=-=-c`-.� -=--- z _ . -: :- ""'_=s:_- -c=_--- O ___ _-_" ' __ n -A'='_-<" -' _'__ A I -_:':-:--'-':'_.._ G::-__'=;,7--__=__-(iARACE=_W ASPHALT DRNEWAY A'-= _- c c _' ""' r_ __ __ �=--:=-_=--_=:___ - - -. -----:: :.,-_-- r :- FRM. -`= = -s=:24.6'-==_ =-=- 0,7' � - - -- � � O - -c^rt_^-.cE :-"__ 4 - --� U.P. I O ----=_=_ =_-= -_ ---V � _-==___ -=-= i ni""-<-__"r:10.3': O � °° `- _-__= W.M.O ( v _ .'"24.2'- -_-_:- 1 0°--__--_ . -'�-_ � � N � '__---_°-----= /� Q � '_'_ _-'_ = l 1 �- c' -==--=-____----- � O O ? %� - � ( ' � C - :-'1 STY FRM.=:�' o m_12.0';:::'-'DWELLING -°: � � f- � Z 1 Z _ o f,,,� � o---_' :- /880 � � � `a "-12.0'-_:--,_____:::--=�- z 0 � U m --: ° ;=_'_---___= n O � �ON. � � 'd' o M.i-l� -----=___-::--- _ � -+T1 ' Z r Af:' :-=---=-== N� Q„�1 0 �n:-__=_;,-:"-==--4.0' � ��Iu.P. Z �^ � ' u"_'�=� -- --==_� � F `"^ LOT 2 � D BILCO__ ---_--;-- ::::_:=_m Vl O� i I O � — ---__-28.3�--°;_;; 42.3' O oa � O � � ' � � I � � o �� I � � � o �� STONE/OIL DRNEM�tY - f Z FE MON. 7•3�W I a' CHNNLINK FENCE i 2Qn,93e I 7JlE WATER SUPPLY, WFLLS, DRYWFLLS AND CESSPOOL . �pTE u�� LOCAAONS SHOWN ARE FROM FIELD OBSERVAI)ONS �,7E I AND OR DATA OBTA/NED FROM O7NER� 0.4'E MAP OF CARDINERS BAY ESTATES �5083 I ;i � Srj"r"33�4'D��w L07 173 AREA: 42,2i72.58 SQ.FT. or 0.97 ACRES EL£VATION DATUM: ________________ MAP OF LOT LINE MODIFICATION I UNAUTHOR/ZED AL TERA AON OR ADD/AON TO 7H/S SURVEY/S A V/OLA AON OF SECAON 7209 OF TH£ N£W YORK STA TE EDUCA AON LA W. COP/£S OF TH/S SURVEY I FOR MICHAEL AND EMANUEL NAIMONITAKIS MAP NOT B��)R/NG THE LAND SURVEYORS EMBOSSED SEAG SHALL NOT BE CONSID£REO TO BE A VAL/D TRUE COPY, GUARANT£ES INDICATED HEREON SNALL RUN f/11133 ONLY TO THE;PERSON FOR WHOM THE SURVFY lS PREPARED ANO ON HlS B£HALF TO THE ATLE COMPANY, GOVERNMENTAL AGENCY AND LENDINC /NSATUTION ILISTED HEREON, AND TO THE ASSIGNEES OF THE LENDlNG INSAIilAON, GUARANTEES ARE NOT TRANSF£RABLE. LOT 3 THE OFFSETS(OR DIMENSIONS SHOWN HER£ON FROM TH£ PROPERTY L/NES TO THE STRUCTUR£5 ARE FOR A SPEC/FlC PURPOSE AND USE THEREFORE IHEY ARE NOT lNT£NDEt� TO MONUMENT IHE PROPERTY LlN£S OR TO GUIDE THE ERECAON OF FENCES, ADDITIONAL STRUCTURES OR AND 01HER /MPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRU�TURES RECORDED OR UNRECORDED ARf NOT GUARANTEED UNLESS PHYSICALLY fV10£NT ON THE PREMISES AT THE AME OF SURVEY suRVEY oF: OcSCRIBED PROPERN CERTIFIED T0: JACQUEUNE A. McKEE; MAP OF: i FIDELIN NATIONAL TITLE INSURANCE SERVICES, LLC; � FILED: � ' Si7UA7ED nT: EAST MARION TOWN OF: SOI�;rHO�D KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK CdUNTY, NEW YORK Professional Land Surveying and Design P.O. Box 153 Aquebogue, New York 11931 I� ��f � PHONB (831)29B-ISBB FAX (831) 298-I588 FILE # 16-6�5 SCALE: 1"=3Q' DATE: MAY 21, 2016 N.Y,$ Ll$C ND. 050882 melntalninj the rccorda of Robert]. Henneasy k Kenneth )1. No�chuk r f � i� � � o�� ; � �I � i � ._o. � ._o. i ''' ' '"""" ' ! ' � " • � � - . PLUMBWG RISER DIAGRAM 24" X 38' ,I zxa�is•ac F� aoisrs\ WC I >- 2X4 @ 16" OC STUD WALLS >- z1/2" CDX PLYWD SHEATHING z - ^ W �q R-15 BATT INSUL W J S WER � �1 CEDAR SHAKE SIDING , � , m m � 7/2" GYP BD. @ INTERIOR �m � � CONCRETE BLOCK FOUNDATION , ¢ Q e WASHER RAILING 2X8 @ 16' OC FLOOR JOIS 5 o. O �0 O HD ZW � ZW - W� � W� ��_ ""' � } � � �X Q DRYER z 'X Q , ----- w•• � W•• ¢ -, � , OPEN TO CRAWL PACE EXISTING RESIDENCE - NO CHANGES EXISTING CELLAR - NO CHANGES PLAN • FOUNDATION .P�UMBER'C�l;�TlF1�ATlON ONlEAD CONTEIVT BEFORE � , , ,aa � APP�iOVED AS ��f ED �-CERTIFICATE OF OECUPANCY A�I�B�6 n('A,� �,�4��C�P �� 7 � SOLDER US�D lN I��ATER � � DATE: .Q.# SUPPLY SYS1 Elvl C/11�7VOT �� - � �� ` ELECTRICAL, j�` � FEE: �d � BY: �E`XCEEQ?Ji0 OF 1% LE�D. iVOTIFY BUILDiNG DEPAR AT INSPECTION REQUIRED � -� - �' � ° 765-1802 8 AM TO 4 PM �OR THE , 4" X 3 FOLLOWING INSPECTIONS: - � PLAN & ELEVATION OF AS-BUILT ENTRY POWDER ROOM 1. FOUNDATION - TINO REQUIRED FOR POI�RED COPICRETE � 1 /4" = 1�-0" 6.2 3. 16 WROUGHT IRON 2. ROUGH - FRAf�1!NG & PLUMBlNG ' RAI LI NG ; 3. INSULATION Cp(�j�pLY WITH ALL CODES OF CEDAR SHAKE SHINGLES D,. FINAL - CONSTRUCi'!�P! MUST „z" PLYWD. SHEATHING DZENKOWSKI RESIDENCE R-15 BATT INSUL. BE CO�PLETE FGR C.o. NEW 1'ORK$T�1TE 8 TOWN CODES 1/2" GYP6^BDCINTER ORS ALL CONS7t�UGT�ON SNALL ME�T THE AS REC�UIRED AND CONDITIONS OF OF N RECUiAEh1EN7S �F 1'HE C4DES OF NEW � 8 8 0 O L D O R C H AR D LA �(E FGv YORK STATE. NO? RE�PONSiBLE FOR �, ^ T _ EAST MARION, NY �P S,' DEFR�-NO�� ESIGN OR CONSTRUCTION ERRORS. ��.+^�^ �unu Ai e��a�t;�pppp � fi • ,- �.— ,� - � � � OCCUPANCIF � ._ . _ _ . .- m ��c�-�• — � � � .�.,, ,r� �'�'ll�iliBlll��"�' z ;�.. , �., ELEVATION {� ! i, � i,`.1:�^I 1[ ; .ALL�LU�IBING WASTE _ N�pA�o.�-�` O`� � USE �� ,.-: d _,. � ' �;_:,F&WATER LINES IVEED '�''�..�' 0�25 e' �rlTt-I�V� ��"• f `� -.� �i Tr RETAIN ST�RM `�#��1.`INC�BEFOR�CO�J�E�iNG�� FFSSIONP`�' WATER RtJNOFF ��' � `�`''�" `�` � PACV�:'1`� P�RS,UANT TO CHAPTER 236 � ��u OF THE TOWN CODE. � � , , , ,