HomeMy WebLinkAbout43745-Z �o�g11FF0ikcpG Town of Southold 3/2/2021
y P.O.Box 1179
0
o • 53095 Main Rd
off. Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41865 Date: 3/1/2021
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 3293 Grand Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 107.-1-10.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/20/2019 pursuant to which Building Permit No. 43745 dated 5/14/2019
1, 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:
One family dwelling with front and rear covered porches, attached two car garage and unfinished basement, as applied
for
The certificate is issued to 3293 Grand Ave Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF REA LTH APPROVAL R10-18-0034 01-05-2021
ELECTRICAL CERTIFICATE NO. 43745 10-06-2020
PLUMBERS CERTIFICATION DATED 10-07-2020aloirfTast Plunping
Aut d ignature
Tf TOWN OF SOUTHOLD
o�suFFoc,r�oG
BUILDING DEPARTMENT
ME TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 43745 Date: 5/14/2019
Permission is hereby granted to:
Richards, Heath
3060 Wading River Rd
Wading River, NY 11792
To: construct single-family dwelling as applied for per SCHD approval.
At premises located at:
3293 Grand Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 107.-1-10.2
Pursuant to application dated 3/20/2019 and approved by the Building Inspector.
To expire on 11/12/2020.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $3,340.40
CO -NEW DWELLING $50.00
Total: $3,390.40
Building nspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN BALL
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:
1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 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.
B. For existing buildings(prior to April 9,1957)non-conforming uses,or buildings and "pre-existing"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.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$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
Date.
New Construction: Old or Pre-existing Building:. (check one)
Location of Property: _ v��_9.3 n-a., a v&vty' Aa G/<
House No.: ll// _/Street ,C� Hamlet
Owner or Owners of Property: l7�A �r a �t / CA',W(
Suffolk County Tax Map No 1000, Section 1,97 Block / Lot /0- 2-
Subdivision
b• ZSubdivision Filed Map. Lot:
Permit No. ate of Permit. Applicant:
Health Dept. Approval:, Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate:_ �/_ (check one)
Fee Submitted: $
Applicant Signature
so
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 117
Southold,NY 11971-0959 ® �� sean.devlin(cD-town.southold.ny.us
�°
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: 3293 Grand Ave Corp
Address: 3293 Grand Ave city Mattituck st: NY zip: 11952
Building Permit#: 43745 Section: 107 Block 1 Lot. 10.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA. POB Electric License No: 4473ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service X
Commerical Outdoor X 1st Floor X Pool
New X Renovation 2nd Floor X Hot Tub
Addition Survey Attic X Garage X
INVENTORY
Service 1 ph X Heat Duplec Recpt 67 Ceiling Fixtures 44 Bath Exhaust Fan 4
Service 3 ph Hot Water GFCI Recpt 10 Wall Fixtures 14 Smoke Detectors 4
Main Panel 150x2 A/C Condenser 3 Single Recpt Recessed Fixtures 45 CO2 Detectors
Sub Panel A/C Blower 3 Range Recpt Ceding Fan 7 Combo Smoke/CO 4
Transformer UC Lights g' Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 6g 4'LED 1 Exit Fixtures 11 Pump 11
Other Equipment: Central Vac, Steam Oven, Hood, Cooktop, Fridge-2, Mini Fridge, Micro, DW, W/D,
Oven, Whirlpool Tub
Notes, New Two Story House w/ Garage
Inspector Signature: 5�7n � Date: October 6, 2020
S Devlin-Cert Electrical Compliance Form.xls
Town Hall Annex ' V Telephone(631)765-1802
54375 Main Road .� Fax(631)765-9502
P.O_Box 1179
Southold,NY 11971-0959 �Q Y
BUILDING DEPARTMENT
T(DVVN OF SOUTHOLD
f
CERTIFICATIION
Date: /06 / o 20
Building Permit No. 'q3 ) 55
Owner: Nta M Ric bar j s
(Please print)
Plumber: All Points Eas7 Pl um b;n A
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
R
lumbers Signal re)
Sworn to before me this ']TN
day of 0(-+o t r . 207-0
SUSAN A•RIZZO
Notary Public,State of New York
No.01816183459
Notary Public, c%!� G County Qualified in Se�arcounty 20
Commission Exp
U S0
�o��OF
* TOWN OF SOUTHOLD BUILDING DEPT.
'N
765-1802
INSPECTION
[%I/FOUNDATION IST ROUGH P.LBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [" ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: I ST f7b&4AM, ov_\/ O
l S11 I v 04Y h2-
DATE INSPECTOR
_J' Y
ho�aOE SOUlyo6
# # TOWN OF SOUTHOLD BUILDING DEPT.
`�courm, ' 765-1802
INSPECTION
[ ] F NDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND NP [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CA LKING
REMARKS: ,, ... 4a, 0 �-Jz-u
WveA (4�cb. U
\o- (
DATE �0 INSPECTOR
O�aOE SO(/T�o
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycou�m ' 765-1802
INSPECTION
YF] UNDATION 1ST [ ] ROUGH PL13G.
UNDATION 2ND [ ] INSULATION/CAULKING
AMING /STRAPPING [ ] FINAL
[ ] FIREPL=ACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ]"FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOL TION [ ] PRE Cl
REMARKS:
DATE D ! INSPECTOR
6 o�a0f SOOI�oI
# # TOWN-OF -SOUTHOLD BUILDING'DEPT.
765-1802
INSPECT-10-N
[ ] FOUNDATION 1ST [ ] . UGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY- [ ] -FIRE SAFETY INSPECTION
f ] FIRE,RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ]
-ELECTRICAL (ROUGH) - [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: SII ^ `l0
"OAA �� -0 1 Lio _�l M6
/ W�
(6jTV �kvl' i 0
4 h �c
L411 IOW6DATE � INSPECTOR
--
1
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
NSPEC ON
[ ] FOUNDATION 1ST- [ ROUGH PL13G.
[ r-FRAMING
UNDATION•2ND [ ] INSULATION/CAULKING[ /STRAPPING [ ] FINAL
[ ] FIREPLACE &CHIMNEY. [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ]`°FIRE RESISTANTPENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL-(FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: 0, 9SiV . a
r
DATE l a -- INSPECTOR
oF souTyo
# TOWN OF SOUTHOLD BUILDING DEPT.
`yco 765-1802
" INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ],INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
_DATE INSPECTOR �?IeC
��q�q� = _ _
oF soulyolo
# # TOWN- OF SOUTHOLD BUILDING DEPT.
�� • i0
`ycoutm��' 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATION/CAULKING
[ ] FRAMING/STRAPPING [ FINAL IV,6
[ ] FIREPLACE & CHIMNEY [ ] FIRE-SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE
REMARKS:
ow
DATE INSPECTOR
�3 ho�� F OIyOlo
# TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NS-PECTION" -
[ ] FOUNDATION ,1ST [ ] ROUGH PLBG.-
[ ] FOUNDATION 2ND [Vf"1 SULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
a S
AID
DATE INSPECTOR
hO�apE SOUIyOIo -
# TOWN OF SOUTHOLD BUILDING DEPT.,
courm,��`' 765-1802
INSPECTION
[ ]- FOUNDATION 1ST [ ] ROUGH PLBG.
["" ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[
]--FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O Heuse ¢ �
REMARKS: -
'c"ll
-A
DATE 120 INSPECTOR ;
Nsw Y,O'A',K,MrIGRO'UP B-;U.I,L D I N G
T£.0 N N.0 LO G Y
Affidavit Of 2015 IECC Compliance Date: 2/9/2021
Inspection Address: 3293 Grand Ave, Mattituck NY 11952
This is to Certify that on 2/2/2021 the above address has been tested in accordance with the provisions
of the 2015 IECC as amended by the 2016 New York State Supplement:
402.4.1.2 Building Envelope Tightness: (Blower Door) Building infiltration rate has been tested in accordance
with ASTM e1827 and meets the minimum standard of: 3ach50
Conditioned Floor Area: 3233 Blower Door Test Result: 4.1
Conditioned Volume: 1 46879 Leakage in ACH50: ff 2.07
402.4.1.2 2015 IECC Compliance: PASS 11 "
403.2.2 Duct Sealing: (Duct Blaster Test)The Building duct and plenum system has been tested by st con ruction
test in accordance with Appendix A of National Home Energy Rating Technical Guidelines and ASHRAE 152, and
meets the minimum requirement of: <4 cfm25pa per 100 Ft2 of conditioned floor area.
System 1: Cond Base Leakage CFM@25: na Supply R-value: Return R-value
System 2: Cond Base Leakage CFM@25: na Supply R-value: Return R-value
System 3: Cond Base Leakage CFM@25: na Supply R-value: Return R-value
Total Combined Leakage: ICFM@25
Leakage Limit: T7 129.3 CFM@25
*** EXCEPTION-All ductwork and air handler is located within the building thermal envelope.
403.3.3 2 2015 IECC Compliance:
Signature of Certified RESNET HERS Rater: HERS CIA Provider:
Performance Systems Development
ter- 124 Brindley Street, Ithaca NY 14850
Provider ID#: 1998-072
Tom Baccarella Certification #3587347 607-277-6240
Notice of independent Status.As per the requirements the 2015 Building Code of NYS, New York Building Technology Group Inc.and/or
it's Inspectors(Raters)are not and shall not be owned,controlled by,or have shared financial interest with the owner of the project,the
General Contractor,the subcontractors,or any entity responsible for the construction or management of any project inspected by this agency.I
further certify that as independent third party Inspectors(Raters),New York Building Technology Group Inc.and its employees shall avoid
conflicts of interest with regard to its professional activities.
159 Route 25A, Bldg 1 Suite B, Miller Place, NY 11764
Telephone: 631495 0289 Fax: 631509 4538 Email: NYBTGTB@gmail.com
Rocket Insulation, LLC(367) Job Number: 4537997
65 Air Park Drive
Suite B
RONKONKOMA,NY 11779
Insulation Certificate
Insulation is installed in the structure described below as follows
Work Area Item Installed Bags / Sq Feet
8.4'x 200'SC15100C 1 5M IL Poly
Fire Caulking Intumescent 814, Rockwool FPBOSS10-INT BOSS 814 Firestop
Intumescent
Fire Caulking Intumescent 814, Rockwool FPBOSS10-INT BOSS 814 Firestop
Intumescent
F-SCIF4800500P Radiant Shield 48"Perforated
Ignition Barrier No-Burn Plus Thermal Barrier(Sq Ft per Gallon)
Ignition Barrier No-Burn Plus Thermal Barrier(Sq Ft per Gallon)
R-11 15"x 93"- Unfaced-Wood Framing
Basement Stair Case Walls R-13 15"x 93"-Kraft-Batts
R-19 16"x 96"-Unfaced-Metal Framing
2X6 Exterior Walls R-21 15"x 93"-Kraft-Wood Framing
Garage Exterior Walls R-21 15"x 93"-Kraft-Wood Framing
Basement Ceiling W/17" Insulation R-30 16"x 48"-Kraft-Wood Framing
Supports
Garage Ceiling w/17" Insulation Supports R-30 16"x 48"-Kraft-Wood Framing
Garage Ceiling R-30 16"x 48"-Kraft-Wood Framing
Foam Seal Door And Windows SOUDALDW24 Soudal Foam Pro Door&
Window Gun Foam 24oz
Foam Seal Door And Windows SOUDALDW24 Soudal Foam Pro Door&
Window Gun Foam 24oz
Attic Gable Walls SWD Quik-Shield 104 Open-Cell 6.5"R-24.05
Roof Rafters SWD Quik-Shield 104 Open-Cell 8.5"R-31.45
'Fiberglass blow has no settling factor for R-values
Job Name: 3293 Grand Ave, Mattituck,NY 11952
Job Address' 3293 Grand Ave
Mattituck, NY 11952
Date Completed:
Insulation By:
• /
FOUNDATION (IST) Wff,
------------------------
ROUGHPA M fill
1
PLUMBING
1
r' N
INSULATION PER N. Y-.
• i
STATE ENERGY CODE
ft"Jim
wil
MWA/1 r.
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following before applying?
TOWN HALL Board of Health /
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL:(631)765-1802 Plamung Board approval�Jit-
FAX:(631)765-9502 Survey
Southoldtownny.gov PERMIT NO. Check ✓
Septic Form
NYSDEC
Trustees
1C.0 Application
v1' 744A74-
FloodPermit
Examined 20 Smgle&Separate q/
Truss Identification Form V1 A11,4—
Storm-Water Assessment Form
41q ,
Contact:
Approved 20� Mailto. /��h
Disapproved a/c y'D ��jY .$13 AlaC�r7� /C r /U�/
of 11 /7 Phone: ))6/3//- 7ZZ—3 0 d
Expiration— 20 C �l I (D�' _�SS 5 33�
Buil ' or
D
MAR 2 0 2019
PLICATION FOR BUILDING PERMIT
//
Date /U T!n a r>/ Z,�-20 /
INSTRUCTIONS
°y"� '? e completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans,accura e p o p 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 Budding 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 permit 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 i
Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections
(Signature of applicant or name,if a corporation)
�2d g�x S9? g Wt Ye.-- ry y 11-)S7_
(Mailing address of applicant)
State whether applicant is owner,lessee,a ent,architect,engineer,general contractor,electrician,plumber or builder
G P arm J (',rib //
Name of owner of premises �1L� ?eW iir/5
(As on the tax roll or latest deed)
If applicant is ,� ature of duly authorized officer
(Name and title of corporate officer)
Builders License No. ,3 0_-2/0 -14
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which propo ed work will be done:m ,, C j N
3a9 3 ¥ tt� k 7T1 Jc y
House Number Street Hamlet
County Tax Map No. 1000 Section /07 Block Lot / 0 , 2—
Subdivision 4/44 Filed Map No. Lot
2. State existing use and occupancy of premises and intended use,anoccupancy of proposed construction:
a. Existing use and occupancyyi C(.1'/11 ZZLI L
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building ✓ Addition Alteration
Repair Removal Demolition Other Work
Sp c v v (Description)
4. Estimated Cost / Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units y Number of dwelling units on each floor
If garage, number of cars a
6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. N),4-
7. Dimensions of exi ti g structures,if any:Front /V A Rear N Depth !U A
Height JU Number of Stories/
Dimensions of s me structure with alterations or additions: Front /y/ ger NIA-
Depth ff/ Height 411 A Number of Stories /V/
8. Dimensions of entire new construction:Front I'3 9 Rear 915 3 Depth 70 9
Height 17-S Number of Stories /
9. Size of lot:Front pJs� G S Rear 3-2 SG Depth/ 2 4/ 2 ` � 2—
10.Date of Purchase / Z� Z°/L Name of Former Owner /�ft 04 q Crq z-Z
11.Zone or use district in which premises are situated /
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO V
13.Will lot be re-graded?YES NO /Will excess fill be removed from premises?YES NO
14.Names of Owner of premises I�k44 411"'d Address 20kly-iv•Q Q1G( Phone No. of
Name of Architect rLi 0hA.� 4'-h Address -0 d ti Phone No 631 S�Z 3 58�7n
Name of Contractor J- )'AS--haj'--,3--- Address 0 BOX A-Adr, ArPhone No. 63/ 7Zz 3
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 y
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
S
COUNTY O
�411---htlY S being duly swom,deposes and says that(s)he is the applicant
(Name of individualsigning contract)above named,
`1wy�
(S)He is the < -/11G�
(Contractor,Agent,Corporate Officer,etc)
of said owner or owners,and is duly authori rhe a said ork and to make and file this application;
that all statements contained in this plication iNLW0vVJD*an belief,and that the work will be
performed in the manner set forth in e 101019FIS vo B5067458
Qualified in Suffolk County 2022
Sworn to before me this
sion Expires October 15,
� day of e�
o is Signature of Applicant
J
�gF(Itr _ y BUILDING; DEPARTMENT- Electrical Inspector
TOWN OFSOUTHOLD
'a z� ��C 2 Town Hall Annex - 54375 Main Road - PO Box 1179
' "•' -,-,.�.aSouthold, New York 11971-0959
.,
.,,.,,Telephone (631) 765-1802 - FAX (631) 765-9502
� roAerresoutholdtownn rygov — sea nd a southoldtownny.pov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali Information Required) Date: 12/20/29
Company Name: POB Electric,Inc.
Name: Philip Buonomo
License No.: 4473-E email: pobelectric@gmail.com
Address: PO Box 376 Port Jefferson 11777
Phone No.: 516-250-6308
JOB SITE INFORMATION (All Information Required)
Name: Richards
Address: 3293 Grand Ave.,Mattituck
Cross Street:
Phone No.:
Bldg.Permit#: 43745 email:
Tax Map District: 1000 Section: Block: Lot: 10,
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Wire new house with a 300 amp service
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Si1 P 3 Ph Size: 30' A # Meters 1 Old Meter#
,New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Lateral 1 2 H Frame/ Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION � Go
NIT
Request for Inspection FormAs T
Scott A. Russell °su p S'7['�0 R I��SMAT]ER,
v' t [ EN T
SUPERVISOR z I�ul[A\1�A\G]EI�v] J
SOUTHOLDTOWN HALL-P.O.Box 1179 Town of Southold
53095 Main Road-SOUTHOLD,NEW YORK 131971 01
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
(TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
(CHECK ALL THAT APPLY)
Yes No
®[j/ A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑ff B. Excavation or filling involving more than 200 cubic yards of material
.f within any parcel or any contiguous area.
❑dC. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑E2r D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
2�1erosion hazard area.
El F. Site preparation within the one-hundred-year f loodplain as depicted
1. 7 on FIRM Map of any watercourse.
$01 F. 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, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number'. Cbapter 236 does not apply to your project.
If you 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 wit�your Building Permit Application.
S.C.T.M. #: 1000 Date
APPLICANT- (Property Owner,Design Professional,Agent.Contractor.Other) Dlstrlct
��� �'aalf-A / 0-/ /0-L 3—/—/
NA. Section Block Lot
:»»» FOR BUILDING DEPARTMENT USE ONLY*"»'
Contact Information
Reviewed By: p
- - - - - - - - - - - - - - - - Date: -5'.�2-o � 7
Property Addres.5 / Location of Construction Work: — — — — — — — — — — — — — — -- -
-
nn
AP Ved for processing Building Permit.
�3 Uj d alit�w rmwater Management Control Plan Not Required.
�7 N`A/ �/o���� Stormwater Management Control Plan is Required.
(For,vard to Engineering Department for Review.)
FORM " SMCP-TOS MAY 2014
I
APPLICANT: S.C.T.M.": 1000 CHAPTER 236
(Pnvperry Owner,Desig�t Professional,Agent,Contractor,Otheri ��� —�— VS��
,� �d � �o.z Stormwater Management Control Plan CHECK LIST
NAME: section Block Lot S M C P -Plan Requirements: Provide ONE copy of the Building Permit Application.
N'"Fd Date:
c The applicant must provide a Complete Explanation and/or Reason for not providing
all Information that has been Required by the following Checklist?
�gnaimr 1=M.bu•
1. A Site Plan drawn to scale Not Less that 60'to the inch MUST YE NO NA If You answered No or NA to any Item,Please Provide Justification Here!
show all of the following items: If you need additional room for explanations,Please Provide additional Paper.
a, Location & Descri tion of Property Boundaries C
b. Total Site Acreage.
c. Existing-Natural &Man Made Features within 500 L.F.
of the Site Boundary as required by§236-17(CH21
d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water.
e. Limits of Clearing& Area of Proposed Land Disturbance. CTIONS A
f. Existing& Proposed Contours of the Site (Minimum 2'intervals) Provide
Engineering
g. Location of all existing &proposed structures,roads, c i . OR ProvideEngip@er's Ce,
driveways, sidewalks, drainage improvements&utilities, at the drain ilStdiled ion
h. Spot Grades& Finish Floor Elevations for al existing& °Code.
proposed structures.
ocation of proposed Swimming Pool and discharge ring.
j. Location of ry osed Soil Stockpile Area(s). EROSION & SEDIMENT CONTROLS
k. Location of proposed Construction Entrance/Staging Area(s). Shall include but not be limited to:
1. Location of proposed concrete washout areata. A well Mnintainpd Crincftruction Entrance,
m.Location of all proDosed erosion&sediment control measures.
2. Stormwater Management Control Plan must include Calculations showing r
that the stormwater improvements are sized to capture,store,and Infiltrate
on-site the run-off from all impervious surfaces generated by a two(7)inch
rainfall/storm event. .
3. Details&Sectional Drawings for stormwater practices are required for approval.
Items requiring details-shall include but not be limited to:
a. Erosion &Sediment Controls.
b. Construction Entrance&Site Access. 11,D
C. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.)
d. Leaching Structures (eq.infiltration basins,swales,etc.)
****FOR ENGIN ERI EPA R E USE ONLY ❑ Additional Information is Required.
Stormwater Management Control Plan is Not Complete.
Reviewed & —- - - - - - --- - - - - - - - - - - - - - - - -
I
Approved By: Stormwater Management Control Plan is Complete.
I SMCP has been approved by the Engineering Department.
Date: 3
FORM * SWCP Check List-TOS MAY 2014
.f
TEST HOLE i APPROVAL OF STORM
WATER GEOSCIENCE 11/4110 WATER MANAGEMENT
DRAINAGE CALCULATIONS. CONTROL P
a. +,6, �. -To Code C 236
CONTRIBUTING AREAS. I.& =^MC ZNWWN LQCOL.) I �0• Date: 3 Zq /q
% Approve by:
9Y9TSM .o
PAN D ' SPUX4N \'OILTSAND COM> �(.JO 1/"•
ROOFING. 1,994 SQ.FT. {` Ay % �•
REOL D STORAGE. 15.0' VGRY rALG BROWN �� x� �� av YIN.Fo+cc roar
1,994 9Q.FT. x 0.167 x 1.0 Biro CU.FT. CREQ'D) PING MND cgw> �/L T WVWZM WM r ' .mow 14 1/2
rnl Y' u�iellwl
PROVIDE. / ` �� iLTES'cLS'm"""�1 �l 10.e•NM a�e a pa•�-ry Y�VN.�I�Q►O�
� �\V � � QIOIINO.MN. 1•'M10
NO O.W.
DIA x 9' DEEP LEACHING POOL
887.9 CU.FT. STORAGE (PROVIDED) `��•�. / -;
C" / � ooY.we�tm wL
SYSTEM 'BAN// )� w`OW
ROOFING. 2,597 SQ.F . SOP Z3.O�\
TI /
REQ'D STORAGE. / SECTION PERSPECTIVE VIEW
N.T.S. N.T.S.
2,667 9Q.FT. x 0.167 x 1.0 — 452 CU.FT. CREQ'D) / /
_490NSTRUCfION NOTES FOR FAYAIC.TED LILT FENCE
PROVIDE. / / / I. � I.a.a1Lm.DiNRL.To I[YR,o„ DRAINAGE INSPECTIONS ARE REQUIRED
(1)-9' DIA x 12' DEEP LEACHING POOL 7�2�60 / / II�.�D•[W%VAV J3:'�N�a� Contact TOS Engineering at 765-1560 befor
So6.9 CU.FT: STORAGE (PROVIDED) / / �=`a R 04"POT rjWWR w armm
} 5• ;v+� Iia Backfill, OR Provide Engineers Certification
9Y9TEM ACA / / / / / a yO _ O �� . that the drainage has been installed to Cod .
DRIVE. 2,974 SQ.FT. / �V .M L
REQ'D 9T0RAGE. `�
' fy grcr` \ DLT.ow«.vAovm
24' DIAMETER CAST IRON COVER,
2,974 9Q.FT. x 0.167 x 1.0 497 CU.FT. CRFA'D) • D��' p��c sY
PATTERN NO. .If-OR E=IVALENT
PROVIDE. - DSI FlNISHED GRADE FLOcxNART FOUNDRr Car1PANr
(1)-9' DIA x 12' DEEP LEACHING POOL O ` 1 0
PR1 "O EROSION &SEDIMENT CONTROLS DIA cPP (ADJUST
TO FlNISH GRADE)
- 506.9 CU.FT. STORAGE (PROVIDED) L,y\s r DIN.
D 6 COURSES R BRICK C AST KT0
Shall include but not be limited OR REI4'--W) PRECAST EXTET191oN
T,•
QYS v \1'a g�ef N O' P.C. REINFORCED SU1B
v e gc T.H. A well maintained Construction En
N� EL. 48.6' 1 Cpl \ SELECT GRANULAR 901E
PPe Wire Backed Sift Fencing, stabili i BACKFILL FOR PERIPHERY AND
I Or inac p. BOTTOM L.EACiUNG
Seeding of exposed and/ (SEE NOTE)
IZ'1'1L%IMVM
�' WRAP WITH GOT (HIN.)
NONWOVEN go (FIFABRIGEOLTILL'
OOr���cpT -ALL WALL.SMALL E IN OF
1 \ Ply
IN
NOTES. 'p 1 �% ig
_ ___
ro
SITE INFORMATIONGROUND WATER
FROM SURVEY PREPARED G�I�
BY JOHN GALLACHER LAND SURVEYOR Z SiSRED q9
4'-O• MIN. - EXCWING A•d1L (SE WITH
LAST DATED DECEMBER 26,2017 1 P ��I\ PRD M C% '•y/� DRYWEL.L DETAACCEPTABLEL AIL N+OT TO SCALE TERNOTE)
ALL
LCT NUMBERS SHOWN ARE FROM MINOR SUBDIVISION MAP `
L.F.4CNING SOILSTRUCTURES
AS QED D THE PLACED
ENGINEER.
IN THE EVENTPOOR LEACHING MATERIAL 19 ENCOUNTERED,
PREPARED BY OTTOVAN TUYL LAND SURVEYORS EXCAVATION 19 TO BE CONTINUED TO SUITABLE MATERIAL•
AND APPROVED SY THE TOWN OF 9OUTHOLD / ` BACK FILLED AS DETAILED.
PLANNING BOARD ON FEBRUARY 14,1q56 y
MIC-AL Le-ACI-IITW POOL DI=TAtL
TOPO BASED ON A99UMED DATUM
*IN LICU Q O0'1G A O' TR.•IPPIC
+2o.o' EXISTING SPOT ELEVATION , s�'9 41861elARING aavoe TnAY ME 6kX561 Tura-
\ W`�! NTa
TAX MAP L •a MIN.
DISTRICT 1000 �-� -[ STORMWATER MANAGEMENT PLAN
SECTION 107 O [ PAVenorr
IXMTIMG
BLOCK 01 �? \ FOR THE
Lor 10.2 ` .. . .. .. a,
GROUND J 'IGLO./I
.. .... RICHARDS RESIDENCE
eM�tf...BLC
222ChS COrrlDwy
AREA. 106,102 SQ.FT. 0+� SITUATE
(2.4859 AG.) 1 A0;
• ; Ad MIM. Z
MATTITUCK
,yf RICHARD M. MATO o• •• zc
:=•=•: :• IrnIN- alv'cloJr TOWN OF SOUTHOLD — SUFFOLK COUNTY, N.Y.
A R C H I T E C T — SGALEs I" INCH NN GO' FEET
P.O.BOX 2284, Aquebogue N.Y. 11931 i b PREPAREDI 3/14/1q
(631)523-5879 email:rmatoarchitect@gmail.com
TEST HOLE APPROVAL OF STORMWATER MANAGEMENT
McDONALD GEOSCIENCE 11/4/10
DRAINAGE CALGUL�►TIONS� EL. �e.c1 CO�R®I'P T ®de(�
-� ®
CONTRIBUTING AREAS. I.a DARK BROWN Loan (oL7 O r• ®ate: Z9L
���
�� ¢• Approve by.
SYSTEM fAf 5. BROWN OILTr SAND (OM.) /f, D �� •&/
ROOFING. 1,094 SQ.FT. r 5 % �•
REQID STORAGE. yp
IS.01 VERY PALE ORO♦Y'1N x�� � a•'YIN.rolef Fofr
O
1,094 SFT. x 0.167 x 1.0 316 CU.FT. (REQ'D) FINK SAND
(SPI WOVOI WPM 1`04=(YIN. 14 1/2 owuoE
T YwIL•'YQN FACING)
��I��N • YON FwgY• 10.0'yy(,G 1•'YIM.IENp�►08iL
PROVIDE. G wml mYrw etal.l ov�l p•rypl
OROUNfY1N. 1• INro
_cov
DIA x 51 DEEP LEACHING POOL �3
337.9 CU.FT. STORAGE (PROVIDED) $ i��•�3 // A COYFACfm foL i
SYSTEM •Bf C Ile/ )� Y1N•�IIRO ww xn •' O' �E
ROOFING= 2,607 SQ.FT. (zOAP 00,
a
REQ'D STORAGE. a r// SENT ION PERSPECTIVE: VIEW
5.
2,557 SQ.FT. x 0.167 x 1.0 - 432 CU.FT. (RFA'D) / / / CONSTRUCTION NOTED FOR FABRICATEO SILT FENCE
PROVIDE. / / ,.wovfN�.+f�$rl�how FAsram.[CYIRLY To.[NCE Po DRAINAGE WSPECTOONS ARE REQUIRED
I —01 DIA X 12' DEEP LEACHING POOL �0 / / ' 14isa"�"xw"f�YiRrw' "Pwi`r`o"r a.�i°c 1c"'e"wM"`•"'a
N / 1NW11`y" °'ovu�w►1D rWir� 'ole° o1N ama nlcY g
C ) 74.2 Contact TOS Engineering at 765-1560 befor
306.9 CU.FT. STORAGE (PROVIDED) IN°c wLT nN •fl'I•L Backfill OR Provide Engineer's Certification
} gly� fORq�pI1� that the drainage has been installed to Cod .
SYSTEM 1G" / / $ L� L� �' '�OR Y NwRCWOOD°-
DRIVE. 2,974 SQ.FT. dl=III x.
w� ouAL
REQ'D STORAGE. �' —- - �� `\ Qscrwflnc.TcolwYw"ci mei�w ovco
2,974 SQ.FT. x 0.167 x 1.0 497 GU.FT. (RM'D) gPg Volk
IG 24• DIAMETER CAST IRON COVER,
PROVIDEt A \ / 1 ND
FINISHED GRADE PATTERNRNO.61128 OR EQUIVALENT
(1)-51 DIA x 121 DEEP LEACHING POOL $ ( C (ADJUST TO FINISH GRADE)
PR°Py [EROSION &SEDIIV ENT COh\9TI8®� Is• DIA CPP
Ea06.9 CU.FT. STORAGE (PROVIDED) wE r nIN.
o g'� COURSES OF BRICK(MAX. I'-O•)
Shall include but not be limited OR REINFORCED PRECAST EXTENSION
8• P.C. REINFORCED SLAB
GO P��O�gE T.H. 1 A well maintained Construction En ( T e SELECT GRANULAR 901E
Wire Backed Silt Fencing, stabili BACKFILL FOR PERIPHERY AND
Pe I
i BOTTOM LEACHING
gam' sig Seeding of exposed and/or inactd (SEE NOTE)
I]'MwxIF1UM
W A WRAP WITH 6- (MINNONWOVEN )
\ £�-Tt',`T�}R�-�`�-\ I ®4•®
(FILTER FABRIC)
ILS
ALL WALL SECTIONS t TOPS
9 SHALL BE SET IN A BED OF
(
MORTAR
POO.�YafY''
G
NOTES •p \. /��tg ro. x2�
GROUND WATER
BY .JOHN GALLAGHER LAND SURV
SITE INFORMATION FROM SURVEY PREPARED \ ZO1 c rF1E®� ^ 2'_0• MIN. - ExcAV arloN a BACKFILL WITH
EYOR ` ♦ ��rJ�G �c ACCEPTABLE LEACHING MATERIAL (SEE NOTE)
LAST DATED DECEMBER 26,2017 ` �y`• � A\r.-`pF1 44. -ol
�A DR1'14ELL DETAIL NOT TO SCALE
NOTE-
ALL DRAINAGE
LEAC14INGSOILS AS APPROVED B THE MUNICIPAL BE ED IN ABLE
NICIIPAL ENGINEER
LOT NUMBERS SHOWN ARE FROM MINOR SUBDIVISION MAP IN THE EVENT POOR LEACi(ING MATERIAL Is ENCOUNTERED,
PREPARED BY OTTOVAN TUYL LAND SURVEYORS
AND APPROVED BY THE TOWN OF SOUTHOLD \ . EXCAVATION 19 TO T w CONTINUED TO SUITABLE MATERIAL•
PLANNING BOARD ON FEBRUARY 14,Iq56 BACK FILLED A9 DETAILED.
TYPICAL L AC.#4IWw POOL D1=TAIL
TOPOIBASED ON ASSUMED DATUM
\ "IN LIW Or DOI'fE A OF TRMrIG
+20.01 EXISTING SPOT ELEVATION ` SJ`� 041861 MOANING COVEN MAY MO «,saTlnrr®•
OL- NTS
TAX MAP U1 ` fa nIN. L NEW
DISTRICT 1000 �-� m, STORMWATER MANAGEMENT PLAN
SECTION 107 O ` r PAVlMIIrf
onanNG
y FOR THE
BLOCK RICHARDS RESIDENCE
rILTDi ••
1 olmTlraG� cLonl r+wNrweLe
GROUND
l� (OtTIONAL)
AREA. 106,102 SQ.FT.
SITUATE
(2.4365 AC.)
• f0'1'IIN Z
GR b MA TTITUCK
RICHARD A MATO x�o o �`
[ "' IY M1N. ply'�Q,T. TOWN OF SOUTI--IDEM SUFFOLK COUNTY, N.Y.
A R C H I T E C T - scALl== III INCH - 60I FEET
P.O.BOX 2284, Aquebogue N.Y. 11931 PREPARED= 3/14/1°1
(631)523-5879 email:rmatoarchitect@gmail.com
I
SURVEY OF LOT # 3
SITUATE
MATTITUCK 9
TOWN OF SOUTHOLD I
SUFFOLK COUNTY, NEW YORK
MAP OF MINOR SUBDIVISION e 0 100 '
CONSISTING OF 4 LOTS a��on1%E1%-011!1
PREPARED BY OTTOVAN TUYL
LAND SURVEYORS,GREENPORT N.Y. /D���y/S� ■ = concrete monument set
APPROVED: FEBRUARY 14, 1986 l/ V
BY THE TOWN OF SOUTHOLD
a
PLANNING BOARD c
Do
SCTM # 1000 - 107 - 1 - 10.2 = '
AREA = 106,102 Sq.ft. now orf umann �'�
2.45 Acres. jam�ee�neum nn m �ant 3
km►chae%ttuma�n 577►6' ni
��
taxa ne OF WAY y
ani
Vacant L,+ RICgT _ -d '
i ulPole �° f�u tient
v /
�
x
l)( m OFWAY
30
o° _ r
V72°21'50"E 513.h
223.00' over m
SEP 2 7 2019 N72°21'50"E 219.41
u/pole Z
® c
1301E
6 ,23
x H
spike set 102.681 y
f a7 Z 25' RIGHT OF 11' Y in tree 2330'W CA
ti
1 y G1 N I y72°21'50"W C 22 59' S 98.99' iA Vacant O �j O'
c„ ((
o
o fa
`p
12j: U1 �a lot# CD
4 g e a
ovm) 0
9' m Qms. o
vacanto N
gravel 239 O o
drive I Z4Z.9' ', w 46 (I Ito
CDT lot#1 i� ' `! H = CID,
m
N� 1 S °
S W
iyi I � Ch7 5�
w C N 4 eV\1 (( ( y
Ii� c<etBt noovaa a¢de�a ty ( ( 7
ocan
aepo mac{tt
I m tp°°
vacant y oy1 s y
51
lot#2 k l W 3 w s�
V b
N51°49'30"E N I rn
1 a OF NFL
3
+. aobat. � � 01A0� "♦
487' 7 21 v �(1 Jr
D n in tree found 2 ' o�913p11 �f{oc ehar rty
6690 �SA3 �Y �Q' 1�C' .,LC'4E,
—1 551 Jefp�a a-at ae`e�a ,(
\�'AY chain Ink fence �� 1�
1 /490'+- ��"
�OF achain hnk 5¢fence hnk r
�, 0 4'north 23.95' 0,, fence
C) ,�„o O •T chain ICek
no &south ~' Q
T •'W �1! fen ort 3.West O
S64°35'10 y�,OOP g 07'north n.urN°RaE°uTER.na+°R�, ,TO, s„RYEY 0
OLL j1 D= sFo �5008�����.
oETws smvEruw narRE.wNCMELnnO�RYEroas
moo senLaa ENeossE°sEusNluNorsE cwsmERmro EE
.Yf)D—Y CU.R�NTEESOR[ERf6ttinatl M DNEREON �A s
n DLE oaYrONEPEREONfORWNONMEARYE sPREPWE° ND
ON ws eER,us ro rNErmEcamnm covEwwwaL�cEncr
sTmmw usrmNEREW r..mroME.<°crrEEs
OcrNE LENwnc'ETO aN cOWumEEs oR�RnEiaiwNSTaE
NOTTR.NSiFR�GROUNOOIRONILMSONpN5g5UB NOT JOHN GALLACHER
°WNERS°noERCRa.m 1�� �P0.ELo< aN��Nm
Rrn1 GU —OR NEMsuA 4suBwR SESn°mss UPDATED SEPTEMBER 26 ( ) LAND SURVEYOR
°E°°RNm°UANNREEDUMESR 9O.LLY 2019 hse. fnd. under construction
EwtOENr oN THE vRE"ises•YnFnNE ocrNE suavEr MEmvstr 1
sNONN NERC011IRONMESRNONRESTOMEPROPE40Y
UPDATED)APRIL 8, 2019 (prop. structures) 59 FLORENCE DRIVE
l
ooLs c�nos Runnnc,wEicmm�a+sToeuam+esilmoma,
CONSRiUOTION NOCERTIEC.1roNISYA0EA5TOMEEnsTENCEOR REDATED-,OCTOBER 81 2010 MANORVILLE N.Y.11949
N Ecf E.sENENf50RPoctRSOIFFECI"G n65
°RPRO—THE LO —OR R.Po—
-C „ .N —--- SURVE)'E.7: SEPTEMBER 1, 2009 (631)-874-0400
'SURVEY OF LOT # 3 SUFFOLK COUNTY HEALTH DEPARTMENT ENDORSEMENTS
�.� SITUATE
MATTITUCK NOTES: BUILDER TO PROVIDE
TOWN OF SOUTHOLD * ELEVATIONS IN ASSUMED DATUM. * 1 - 1,500 GALLON SEPTIC TANK.
SUFFOLK COUNTY, NEW YORK SUFFOLK COUNTY DEPARTMEIN T OF HEALTH SERVICES
*TEST BORING AS PER MCDONALD 1 - 8 ' 0 x 16 DEEP LEACH POOL. 0 100 ,
MAP OF MINOR SUBDIVISION
CONSISTING OF 4 LOTS PERMIT FOR APBRO':'AL OF CONSTRUCT]ON FOR A GEOSCIENCE DUG 11 I 04/ 10
* 1 - 8 ' 0 x 8 ' DEEP DRYWELL (D W.A)
PREPARED BY OTTOVAN TUYL SINGLE R®@r?II.Y RESIDENCE ONLY
LAND SURVEYORS,GREENPORT N Y. * PROPOSED HOUSE TO HAVE ■ = concrete monument set
APPROVED:FEBRUARY 14, 1986 5 BEDROOMS * 2 - 8 ' 0 x 12 ' DEEP DRYWELLS. (D.W. B & C).
BY THE TOWN OFSOUTHOLD DATE H.S. RE . SIO. l�ZL 0a3Y 0
PLANNING BOARD * 1 - POOL DRYWELL. 0
I APPROVED GtQ,
SCTM # 1000 - 107 - 1 - 10.2 1 FOR MA(IMU Or-.-- BEDROOMS erly <o
AREA =,-106,1-0, ' now of funtan" z;g
con
' Y vain euman" found j 3=
& y�— & 0
UPI FROM DATE OF APPROVAL ath►eenneuM monum `°
9§� ml to 3 neumann 577.78' m w 1'n
of tai ON V AY —
1t� ��n��
P3\r1cu�S� A ,13�I fl vacant z�, gICK =� -- - °frri
roa
M - ° ��" 'trete
d= ulp/olleyDM�°"� m�°u aent
toun
� S a 54 5'elv :/ ' ,,� , 1VAY 'I
0
elv 35 9' N72°21'50"E 53 3' N61°23'30"Ei� s-_`- °'^"head woes �, rICIiT Or 513.82 Z to � o
223.00' / �D•�° over 2� o i m
TEST BORING _ _ N72°21'50"E 2=9.41' -/ � -
u/pole Z - - ��^�° o rFC •y
ELEV=48.6' A a"--- �° —o-- _ --«� °z3,3p„E I
o'. elv 39 3 °N” spike set elv rI61 68' h, H
Qi —� 25' RIGHT —0 iWA7^in tree 53 9' 10 ' 30'^N � y
3
S72°21'50"W ! 226.49'
Sri.
9899' to t 7 01
Dark brown loam en 'N IA o ;� elecpse,v vacant p i
OL' :86, cn proposed f° e oof ver tp �Ot#4 H , y
O I A lPl/2 story ,,°—r°o �p�/5' j op n Irorch O � �I I o � n�i o
frame house �Qarage min 1 mm
m 127.0' i/,a, a 6+,, 0`" ��o m 4 o
vacant 'I m\
Brown silty sand gravel prop,drive O f E m A6Z39 m 3
drive tJ gas 1zaaas' W g ca
SM lot#1
110.0' a N m
�� II ptoposede—,W_� a m aaNI H N o
4 �i well Proposed , ;z U I m t0
(150'min to waterline a -L ®test O)
i� leach pools) \ b� boring ca p
Very pale brown R�F ., I.a L�\.� e elv=48 6' I o
fine sand �' oo�a �@_
SP ter Une(s) � Be Insp % TI Off' proposed w 930E Jaea"ti I
Suffolk County Dept. Of He- �I ,rv''=s pool � o N51°4 ei\y I 1 1
' C 852-5 01-3, 48 $�ourS iI I , vance CA of to \eha", AI 1 y
NO WATER ` O Schedule l �$i � a elv 281' to nom a•de a\eta I o
'o, c\doo'a C'%
d
ENCOUNTERED vacant R - 105• `"f°"" sea" N,
lot#2 I W 35 w P m
V W 11
N51°49'30'E Cl!) I rn
\ 31.89'
/
4B7,+. va°a"+ D 01 A0� F
ei\y 6690 7 £SA3 � Q°�� tt� e�
D nan found c49Y30••� of iae hexa
in a 20 1° \ a n� 'B +, I�+� � �®� C�'
–1 q fence 20 0' S5 V%0- a',. e\ V
y OF I`A chain link 490'+ \ aeooimai,tti d r`�i 1�1��s�1L
y N64°35'10"E Jr� RIGST chfenctin
ek Sean FINAL
C / ro 0 4'north S51° . 0 &ain
i a+<
2395,
WB 3�
'N"o W chfenaek north&vleslh
o� S64°35'10' OOT RO o7'north EN.°TH°R�zMD R"DON DR IDmIONTOTH156URVEY 03
1) C'_1OL=ON°F =ON,}OBOFNE OMSt.UEUW
\11\/ NOT T c°v�Es°f 1w55VRVEYRMN°TBEARWCTHE UN°SURVEYORS
LL INREO SEKdi ENBOs5E NOT8 NOTBE VN4°EREOTO S
V "RK°EES OR CERIiRGDONS WpGYED NEREON
"H—RVNONIYTOIHEFERS°NFONN'HO4THESURVEYISPRE D
` "N =G8EHKFTOTHETRLE CONPKry OOVERNMENfK"OENCT �/ ��V-
A I\ OF THENENDINX uno"us ON
=TO HEwsac EEs e�q
""�` RABETO" """�50"��`""°"_"� UPDATED: AMIL 8 2019 (prop. structures OH HER
KWSIRUIIIXISIXi SUBSEDVpIT
"DwnERS NNDERDROUIID URRiEEANO FDIELDGRDNEMENDT ' (p P• ) J
Fit °�""""T�E"�'"�`s _...""`"��'°` . REVISED : MAY 15, 2018 (s.c.h.d. info) LAND SURVEYOR
EV pN RUNRECORDEOMEnOi OUMMTEEDUME55 RIYSiGLLY
THETNEO ESURVEYTHEOFSET
°'"�"y°"="°""° °""� REVISED : NOVEMBER 8, 2010 (s.c.h.d. info) 59 FLORENCE DRIVE
LwEs NtE FORA SPEOFlOPUAP05£N9 VSE THEREFOREME NOT
POOLS pTOOUiD NEREYTONOFFENCES RET"MINO WKIS
=°"m° a "°"E�"°° ='°E '°"°_""°°"E" REDATED: OCTOBER 8, 2010
^wl�"„°E,�*°TMEE��EN��R MANORVILLE N.Y.11949
ENrs az wcHrsoF.w"r"FFEcmD Tws
°NPRO<CON °EDFE" sDFE�ENENTSDRaDH=DFW"°� SURVEYED: SEPTEMBER 1, 2009
RECORD ME SHOWN HEREON ONLY ff COAESOFTHE WSTRUNExrs '�
"RERR°,ry,EOTDTHE SUNYEYDR (631)-874-0400
'l} SUFFOLK COUNTY HEALTH DEPARTMENT E11DORSEMENTS NOTES :
SURVEY OF LOT# 3
SITUATE * BUILDER TO PROVIDE :
MATTITUCK SUFFOLK COUNTY DEPARTMENT OF 14EALrH SE9VICEs
TOWN OF SOUTHOLD PC`t�l�Yi F� sPPRCvA,Ot' �%CNSTRUCT`'DN AOR A * 1 -1500 GALLON SEPTIC TANK
SUFFOLK COUNTY, NEW YORK S1�ds s€a �l:i�91E�' EESI � I'C` �'�� * 1 -8 ' DIAMETER X 16 ' DEEP
LEACH POOL v o'
MAP OF MINOR SUBDIVISION 1 2 f
* ELEVATIONS IN ASSUMED DATUM
CONSISTING OF LOTS DATE I , �s° Nil° ��O ��� <
PREPARED BY OTTOVAN TUYL I 0 100'
�� ow or form a n *TEST BORING AS PER Mc DONALD ° m
LAND SURVEYORS, GREENPORT N. Y. PItiDVlwta
APPROVED :FEBRUARY 14 1986 � nam¢5"¢°roman^ GEOSCIENCE DUG 11104/10 c,ete 3
' D�:MAXIMUM iie �D _ �F.E3e�4t3M5 Kath,eenneumann m�o110ent N�c
BY THE TOWN OF SOUTHOLD tj
L eeu N ■ = concrete monument set
PLANNING BOARD �e�PIh�S �YEAI°sS FRO ®�� ® �I�P�® A� m►�ta�a — _ 5TT.Ta' m wo
- m RI
ratt
SCTM# 1000 - 107-1 -10.2 �aean 'RD'pp' mpPunt
Ge
AREA= 106,102 sq ft / 'i p�R� GR� Ate \1i fours
2.45 acre ! ��5:'R� WpY I I
0
head
Iv.
wires 5, R1G1tS OF 513 61 ? o I rn
jely.=53.3' s"` ever h 2 �0
o _I
1161°�3'3 Iv.- 4:5' o
2 �E"
"
_-{
I�"2,,.a,;SBILine(s) MUST � Inspected % N72°21'50"E
f p 23.10 "
—SUOI� COU� ®���. ®f Health 61g'
am 6
POL0I�
a
en rCtlf852-5-009 $ Hours In Advance WAY lv.=5
oAv.= . 25RItree
' a
TO Schedule In 101(6) 26.59' 98
to2---------
--------- -
N �
Na proposed \ _posed°/ I m I 20
well X150' `gyp _.5 pr�s�sg�e septic l Q°
WELL=LA I!�UST BE � �I �w\p,se AsIMy�.-gy �y/��•/ gq,gy,, ��gq���/py��gq@�� m d16,/rtl �60 .��.i g®Y 9 �T�J 1La'9 .Gt de CL M
\ I5 T' 6�''17 Z y�futuie fn 7 (D
'195' .9' �1,P
127'+-- 40. I, /� I N �
vacant gravel 40•'4 fe 128'+-
test boring drive I I proposed house ��:4• ,��, �^ w o I ,� m a
lot#1 N (6 bedrooms) N 13 s•"70 N �S q
T
IN I t33•�ta o• / ' ® I AI
elv.=48.6' / I I ly
_--- - 1.
Dark brown loam OL '�
122I proposed POOL--�_ / N �y
Brown silty sand SM I=I 20' x 50' fIU cc 30„� ,1011.
--------- 4'
I %` test ' � N51°p9 ��y, e<\`1
/ `®4, E°rte
bori dg ' yr o< aeteh rarity I
1-n elv ci 48.6' elv.=28.1' ete nos
a,`1r \ete
c°n°t m°nt aep mac
Very pale brown I �J O 'Irrl gears I
fine sand SP
vacant < I 351 ” I
r17' lot#2 W w
t70 w r
6.yd
No water encounteredN °j Ao tl
N51°49.30"E
31 89' 1 JaGar�
48T' 2T 2
Ni Rye<``1 ty gCf
tonna o�9,3p'• o"°r de01'a ao11 - F Q
\ nad tree ,' Srj`1 r ra 2• ae� ��. '
F chain encs 490'+- elv.=2
Q gean�c.. ��� �ONN�
WAC� •®
\ Y hn
/ chain 101— \
\ 25, RIGHT fence S51'49" 011w chat,link
1 Z A64-3510"F 0 W north 23 95' fenpe \
N l
p,ine
C w chain link north S1.south �^1
0 a. fence n 0.3'West
oS64°35'10"W OY gOAD 0.T'n°`t"
vV0
RC-3EMED 6000
� D S��
1 i11GALLACHE
2#--'-I .FHS �YCf CES i LANDS SURVEYOR
.�" REVISED : MAY 15 ':018 ( HEALTH DEPARTMENT INFO )
L 4 i.�•��,..'�� L��'S-:.��r r J I�T��Cni<-+ 59 FLORENCE DRIVE
2 - — _`ter 4 REVISED : NOVEMEER 8, 2010 ( HEALTH DEPARTMENT IN MANORL'ILLE,N.Y.11949
REDATED: OCTOBER 8 , 2010 (631)874-0400
SURVEYED: SEPTE ABER 1 , 2009
SURVEY OF LOT # 3
SITUATE '
MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
MAP OF MINOR SUBDIVISION NOTES: 0 100 '
CONSISTING OF 4 LOTS SEPTIC SYSTEM LOCATION:
PREPARED BY OTTOVAN TUYL A B
LAND SURVEYORS,GREENPORT N.Y. *S.C.H.D. REF# : R10- 18 -0034. SEPT.TANK : 27.5 59 ' ■ = concrete monument set
APPROVED' FEBRUARY 14, 1986
m
BY THE TOWN OFSOUTHOLD -SEPTIC SYSTEM, DRYWELLS, & UTILITIES LEACH POOL: 25 ' 71.5 '
PLANNING BOARD ARE AS PER INSTALLER. @0
SCTM # 1000 - 107 - 1 - 10.2 formerly =o
AREA = 106,102 Sq.ft. "owes�euma an" °°"cme;,t m m
2.45 Acres. James
eumann `"f°"d zt ��c
mttaraeneuman" 677.7a' n+
Nv H
OF wAY 4Po
Vacant
`- =t°a- �° ooncrete
d=- uIP°le i Monu,nent
SUFFOLIL COUNT'DEPARTMENT OF HEAD H SERVICES � —� «�`""—� � 1 � found
A®PF2C5V�11 C? GC��:�TR°JCTED k'�JCR.I�S FOR - — _
N72°21'5x0"E x161°23'30E� — / °""t head es 2�, gIc>Yr OF 613.62.' Z c �wxy
4 0
A SINGLE Ff' -LY RESMENCz 223.00' /" °� ove rri
rO® Nt72—°21'50"E2021 u/pole io®Zt� A m
N H
w"_°,.x_a"
Np — — °23,30L,E n ' y
The sewage disposal and water suppoy facl.itiea at this location have been o g � x161 w
F ,- 11 6, L5'W RIGHT d" OF \VAS" sin treet 102'8$' � H
inspected arts/or cartiFled b this Cepast eiyt cL clxr agencies and found to _� — -- 561°23'30'W N
sa9isiaoto F®Ft A 11MUM kX BEDROOMS. ,p r21'So'W — /0 22fi.:9' 98.99 a vacant � �r ! 7 a
be a N15 6'0 x 111
�� tp
f ,p o' ; underground ' _—A2'deep #A q
Ia elec Ime�J mm -d w. rA lot 111 o k d
�rY• r 5 4fis��a r °i °9 tsJ it O a - —
.J ' $ Well /
',10�.i tagc i dant � i � m ;�� � o B 104.9` � k
A d O
_ a�
0
�. §Z, 08'0x
vacant gravel
I 141.9' *�\+ o� Go Bddw m p8239 /II
CD
lot#1 it. water \R 1 �` �! m H a
ue line o
m� ^F 5, �.��. p 1,500 gallon ,A 0 7
I 0 min septic tank o I rti to
O dg,0 ne
4 dee 8 0 x x 16'deep w a
Z' oolp 12'deep leach pool 1 1 0 =�It �� I/I�p �'(J�
7 dw dw rV rn
d 41ECOE2ED
iyi l � !b p930 E �laGant �' 47
10 I o�tottnhanri
ky2-370
ncle a"t noo a s aeaeletnan� 1 1 DEC 15
mo o�^d aeon ntacCtc
I t Sea
vacant y' m >' �;`-•i o'�c
3y1 N r. SUFE.a-,�U.illtAt_i 9 e L.�hrtt�l,o
I0t#2 pt'`1p I,,, Yv a� � �.re�T9IRi'�^�oaa�-A^^4�1rO-
�
N51°431. 9 C12 - V
31. s N
cant � t 1A�K�
e�
Coca SAS 0 9 ��
asr
D nail found 27�1' 551°a9,3p„N1 now oa ae eha tH of �Q' N GAS 7�
in tree •
1 NAZ chain link fence a90'+. aeao \t<'New
y 1'9�
Sl or anm * ) 4
Z N64°35'10"E L3� gI(i chain lin Se I
C fence 551° s' 0' chaenlenk a t
N 0 4'"O�h 23.95' fence
(� c �O -T chaen link on line
664°35'10"W X11! 7'north nOp 3'west J
o ,■ 07' a�,mranaeo uTeRAnoRwwwnareTonas 9muEr
ll` �s�TOQY wI°unoR°F grnw rine ac raw YausrAn uw �� A
V� eoR�esoriwssuRYLrwrRmeEArm1oT�LArmaavErau OAC
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„ R°E°°RRRE „°T�°ARAREE°REss�eY REVISED : MAY 15 2018 (s.c.h.d. info) LAND SURVEYOR
°1McEM 0„T„E GRENrgSIRTHETME OFT+E svRVE'/nrE OFF'ET 1
I`1\/ ONN I�FEW RiON 1HE::fRVCN!¢ GREAPR0,4RlT
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EO,°O��OEIHEERECTOROFFERCET.—DW°Y,A� , 10 s.c.h.d. info
Ls RAnos,FLARnsOAREAs.w°mansTo suao°+cs"rm anrER
�EasFR�°R REDATED: OCTOBER 8, 2010 MANORVILLE N.Y.11949
Cn-QISiER°�OF EA�vENfS tle We„fsOF WAYAFFELfoVOTUS _
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