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TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 41647 Date: 5/18/2017 Permission is hereby granted to: Ameen, Carolyn 755 Lupton Pt Rd Mattituck, NY 11952 To: construct accessory in ground swimming pool as applied for. At premises located at: '\ �� � � � �� y-7'`� 755 Lupton Pt Rd, Mattitucky SCTM # 473889 Sec/Block/Lot# 115.-11-4.1 Pursuant to application dated 1/1/1900 and approved by the Building Inspector. To expire on 11/17/2018. Fees: ACCESSORY $250.00 CO - SWIMMING POOL $50.00 Tota : $300.00 Building Insp TOWN OF SOUTHOLD �o o� BUILDING DEPARTMENT s TOWN CLERK'S OFFICE' O o . SOUTHOLD, NY Ole y�pl �s 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#: 40846 Date: 7/21/2016 Permission is hereby granted to, Ameen, Carolyn 755 Lupton Pt Rd Mattituck, NY 11952 To: construct accessory in-ground swimming pool as applied for. At premises located at: 755 Lupton Pt Rd., Mattituck SCTM #473889 Sec/Block/Lot# 115.-11-4.1 Pursuant to application dated 7/12/2016 and approved by the Building Inspector. To expire on 1/20/2018. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE- $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Buil In pe r Form No. 6 -rov N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 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 oCi;rticate of Occupancy= :�5 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 ` Date. !0t �D New Construction: i 5(5�" Old or Pre-existing Building: (check one) Location of Property: �J 1 U_k/0.0 (0 6'4j 141/4) House No.n ©Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section H5 5 Block. // Lot Subdivision 9,iL47 Filed Map. Lot: Permit No. 0 Date of Permit. Applicant: �` �� lv� �� ¢✓� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �" r v Applicant Signature �i 1 t �• 0. . • •� w 1 !� � �c 1 • ec t STATE BNEROY CODB i err—MM ---� -- w;, s o 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 \ 6 1� �7 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Suryey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application D Flood Permit Examined ,21_t � Single&Separate D Storm-Water Assessment Form JUL 1 2 2016 Contact: Approved —7111_,2& Mail to: 92oo /o/wo � Disapproved a/c D1�QD1�°' ��?�iu-G/� 1�,1'• /�Y,�� TOWN OF SO OLD pp�� Phone: Expiration (J ,20 :0 Bu din spector APPLICATION FOR BUILDING PERMIT Date}/ /C% 520/6 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building 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 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) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ui der Name of owner of premisesQL_ y�, � (As on the tax roll or latest deed) If applicant is a co ration, si ature 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'larid'on which proposed work will be do e: House Number Street Hamlet County Tax Map No. 1000 Section //S Block `l Lot � Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work �Pc, 1 (Description) 4. Estimated Cost r' � n (,To be paid on filing this application) 5. If dwelling, number of dwelling units , Number of dwelling units on each floor �°` :, i a� �_t If garage, number of cars .Fly,,�,, 6. If business, commercial or mixed occupancy, speciq,,y4Wj ,�c at of each type of use. 7. Dimensions of existing structures, if any: Front 199 Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES_j_/NO 14. Names of Owner of premises(2A1-pL10>C=Ay/,e-rOAddress 7KLu-/'`W A,07- Phone No. Name of Architect Address Phone No Name of Contractor s �7/� ?L Address '?7ool.4,0 Phone No. d1/l,v�Tlr''ru r�l 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES r/'NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS 1�1AY 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 —Z * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF&RC r/ �*t'Q� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (Contracto Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 Sworn to before me this QUALIFIED IN SUFFOLK COUNTY /2:1" day of `ToILA 20i(oMMISS[ON EXPIRES JUNE 30,2ba-p Aklrl'u pe 1"K otary Public Signature of Applicant _ x BOARD OF SOUTHOLD TOWN TRUSTEES .SOUTHOLD,NEW YORK `.: PERMIT.NO. 8372 DATE: FEBRUARY 19.201.4 ISSUED TO: CAROLYN R. AMEEN PROPERTY ADDRESS: 755 LUPTON POINT ROAD,MATTITUCK SCTM# 115-11-4.1 AUTHORIZATION ' Pursuant to the provisions of Chapter 275 of the;Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 19,2014,ands in consideration of application fee in the sum of$250.00 paid by Glenn E.Just and subject to the Terms and Conditions as stated in the Resolution,the Southord Town Board of Trustees authorizes and permits the following: ` Wetland Permit to construct an 8'x38' second-story deck above'an existing first I .- floor.deck; construct a 101x12' first floor addition,.5'x7' steps, and a 61x44' two-story j �q` ^ addition onto existing dwellin •-construct an 18 x35 pool with pool a ui merit area on � I - g g�_ P P 9 P landward side of dwelling; construct a 25'x28' garage; and install gutters to leaders to +` drywells to contain roof runoff; with the condition to establish and subsequently maintain a 20' wide landscaped buffer landward of wetland boundary; and the addition of a drywell on seaward side of house connected to gutters and leaders; and as = depicted on the survey prepared by John T. Metzger,Land Surveyor, last dated February 25,2014 and stamped approved on March 25,2014. T° IN WITNESS WHEREOF;the said Board of Trustees hereby causes its Corporate Seal to be affixed, a and these presents to be subscribed by a majority of the said Board as of this date. :'t i I N i �p r rT • iIM� f z.T I s r ASS,- 00 SS, 0 C{ yQ A` CC STOIRIMMATIEK Scott A. Russell " A ��l�A\1�A\(G]EM LENT SUPERVISOR �, ,� SOUTHOLD TOWN HALL-P.O_Box 1179 ,� 1 y t� a 53095 Main Road-SOUTHOLD,NEW YORK 11971O' _ Town of Southold Y CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOTHISPROJECT ENVOLVIE ANY Off' THE FOLLOWING: (CHECK ALL THAT APPLY) Yes No ❑ . Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ " B- Excavation or f illing involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ C. 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. ❑l 2 F.. ite preparation within the one-hundred-year floodplain as depicted _gin_=E1Ma-p�of-a-ny-=wateFeeuur-sE:.. ❑ 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! Chapter 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 with your Building Permit Application. S.C.T.M. 1000 Date- APPLICANT: ate APPLICANT: (Property Owner,Design Professional.Agen Contractor Other) District NAME r' Se"ction Block Lot mFC,"' BUILDING DL-'P -PART. GSH ONLY"" Contact Inforation fO/ _7dcvb^c tumMr. Reviewed By: — — — — — — — — — — — — — — — — — — Date: PropertyPrope'rty Address / Location of Constructioi Work: — — — — — — — — — — — — — Approved for processing Building Permit. 75'15' La-7'&,J ©�W Ft _ — Stormwater Management Control Plan Not Required. F] (Forward Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM ° SMCP -TOS MAY 2014 LO Ew TNGOVERAGE SURVEY OF PROPERTY -HOUSE N - 1.007 sq.fl.r-,DECK - .3fI6s+IL A T M�1 TTl�'UCK 'BRICK - 360 aq:ff.. SHED - 86 sq.1 TOWN OF .SO UTHOLD ,_� l. 186x3 aq:ft ... . • 1866122570 - 82% MAR 2 4 2014 PROPOSED SUFFOLK COUNTY, N. Y. HOUSE - 1570 sq.ff. _.�:_. DECK – � .fr. 1000-115-11-4.1 38s FaaR1 i ;Ova;; BRICK - 360 sq,11. SCALE.• V 30' Boardf Trustees POOL - 630 sq.ft. , GARAGE - 700 sq.-M .,�,�ARCq 12, 201 -- — 3646-s-.ff.--• 3646/22570 w IBJ% AUG. 14, 2013 (PROPOSED ADDTNS) AUG. 28, 2013 (ADDTNS) O _ OCTOBER 22 2013(T(Topography) NOV. 21i 2013 LOT 0 JAN. 9, 2Of4 !SEPTIC SYSTEMI APPROVED BY FEB. 25, 2014 (rwlNons) W ARD,OF TRUSTEES 4Z. l CF .SUFFOl1.l< 1 0 sg. A COON .4T�O�Eo. a 0 ,6 7 - J ►� N �� � \•'� �����.. s� ��Nr IGH 1 hi PROP. 2nd: t« aao FUR DECK (8') 6:); ?oNf I)O 2STY. e,�,� OVER EXISTNG ,p \`0, .�o� eyH°s W PROP.\ '�. F 10��. ADDITION ��`� ,y�o T•:`f 0VE 26.3' �\ \A>rTl '���yOGRr 235, ,� \ 2STY. a oy 15.2' s�v - ' PROP. Z -0 1 STY. w 0;0 �• ADDITION °� �N �•(As' RAIN RUNOFF CONTAINMENT ow �y m $ 8� O g, DWELLING: 1,528 Sq. Ft. 1,528 x 0.17 x 1 = 260 Cu.Ft. Z � .. , Provide S DWs. 6'fix 6' Deep Z Connected by Gutters & Leaders O a 20 zs•o Uun POLE Iv `� PROP. 000 \ 9- GARAGE CL z C7 Gc1AVEL DRIV);WAY �^ r rn g ITI �0 \� 0.4E C C \ 4� o `7d0 j20• \I679 EDGE OF PAVEMENT OAD ON p01NT R .. - /V23 85 ; .LuPTION RIGHT OF WAY 4.X6.0 !y 20 ' VADE CERTIFIED TO: CAROLYN R. AMEEN FIRST AMERICAN TITLE INSURANCE COMPANY ELEVATIONS AND CONTOUR LINES ARE REFERENCED TITLE # SP 29126—S TO N.G.V.D. DATUM. OF NEt � FLOOD ZONE FROM FIRM RATES T •J ER 36103C04a2H SEPTEMBER 25, 2009 nY' '`��' AREA=22 570 SO. FT. TO TIE LINE ,, ry j 100% OF LOT -CLEARED `' r ' • Y.S. LIC. NO. 496.18 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA77ON y f 4' t?S, P.C. OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. (63- f 'b FAX (631) 765-1797 EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FICA77ONS P.O. Lj -909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRA VELER STREET Z -1,29 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 APR VED AS NOTED DATE: �.P.# axu-2-- RETAIN STORM WATER RUNOFF FEE. BY:._ PURSUANT TO CHAPTER 236 PAR NOTIFY BUILDING DE " T AT OF THE TOWN CODE. 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ELECTRICAL 2. ROUGH - FRAMING & PLUMBING 3. INSULATION INSPECTION REQUIRED 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR �� ` j = -',�R;�-} • DESIGN OR CONSTRUCTION ERRORS. 'EE.NCLOSEa'OOL TO CODE UPON COMPLETION `BEFORE VATER COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF �6t1fik8tB�9W OHUW=.,Tr�r. �'SU OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY r Cil &W eta 3 d �a� ,��; T qqll TW6 To 5A ,�rra - + SIZE. SHAPE, SWIDE t PATTERN..-... pP WALL PAT AI* FLOOR PATTERN: CORNERS: DEPTH: HUNG OVERLAP (drde one) .f. 2Q GAUGE 27 GAUGE (drd® one) ,® ILA- Ll .