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28633-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29399 Date: 04/29/03 THIS CERTIFIES that the building ADDITIONS Location of Property: 2520 BEEBE DR CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 3 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 1, 2002 pursuant to which Building Permit No. 28633-Z dated AUGUST 6, 2002 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 SECOND STORY DECK ADDITION, RAISED DECK ADDITION AND PERGOLA ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & MARGARET SLIFKIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authkfized Sign ure Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28633 Z Date AUGUST 6, 2002 Permission is hereby granted to : ROBERT & MARGARET SLIFKIN 1234 THE KNOLL UPPER BROOKVILLE,NY 11771 for CONSTRUCTION OF A 2ND FLOOR DECK & RAISED DECK & PERGOLA AS APPLIED FOR; FLOOD PMT INCLUDED at premises located at 2520 BEEBE DR CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0003 Lot No. 011 pursuant to application dated AUGUST 1 , 2002 and approved by the Building Inspector to expire on FEBRUARY 6 , 2004 . Fee $ 250 . 00 Authorized Signature COPY Rev. 5/8/02 � L . Form No.6 j Z3 L/ " (H t• ISN �- TOWN OF SOUTHOLD BUILDING DEPARTMENT 5 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$25,00, Additions to dwelling$25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building$25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy 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. 4� i New Construction: Old or Pre-existing Building:�_(check one; Location of Property: ISI-( E�� (L1V�e COT-CMp60� House Noo reef 1 - Hamlet Owner or Owners of Property: l W aE a_T- Suffolk County Tax Map No 1000, Section Q Block 3 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: I/ (check one) Fee Submitted: $ Applicant Sign re 33 ' v I_ Tn.en hall. $1(Iu5 . • ,JtfT3d"{'id T. TERRY T�� �7.-•'. : hlam RoaJ ` TOWN CLERK o `•. R P O. R,,, 1 n() cn S( ulLuld- N"- 1 ork I I971 IIEGISTRAR OF VITA. STATISTICS �✓� (G��' �- F as (S 1 61 )65- R'i NIARRIAGE OFFICER TcicRhanc (}IA176t IH(11 MANAGEMENT MANAGEMET OFTICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold : "Floodplain Development Permit Application" (FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93) ) . f� J 1 KEG. Gc?T. TOWN OF SO J�1OLn �h � Southold Town Clerk August 25, 1993 APPLICATION _ PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxcs) A STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPL- O New Structure O Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) Cl Alteration ❑ Noo-residenual (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) cmoutiod - t: ❑ Manufactured (Mobile) Home (In Manu- Replacement OF factured Home Park? ❑ Yes) DE� t��oS�Pac pp,��,,, ESTIMATED COST OF PROJECTS -70,40, B. OTHER DEVELOPMENT ACTIVITIES: O Fill ❑ Mining 0 Drilling 0 Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) • Road, Street or Bridge Construction O Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3: FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: - FL NGVD (MSL) ❑ Unavailable O The proposed development is located in a floodway. FBFM Pancl No. Dated Sec Section 4 for additional iustructio❑s. SIGNED DATE • APPLICATIGN s PAGE 1 of a TOWN OF SOUTHOLD FLOODPL-klN DEVELOPMENT PE"IFT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sienI 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made bcrcin. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTREIN AND W ATTACHMENTS TO THIS APPLICATION ARE,TO TH OF MY iQd DGE TRUE AND ACCO TE. % D �y (APPLICANT'S SIGNATURE) DATE a d L SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICA-N'TI NAMEADDRESS TFLEP E17 � APPLICANT � _ r TL, 1A) �L�t( ,IIE //rBLL KUf 11-7'77 /W y-7 BUILD cA0 GArJaofv A=t,' NO&MEAJ &Vb /( sI 04 (� N� 1 ti ENGINEER A2ur y k PC S S Ep1IM AVE �LLM C Ny �g���6oss3 PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. -1 i 0 &-Q0,1-0v(5 Q)Tr-M66J1C 035 G31-13V - 63-0 FDP(93) ` APPLICATION a PAGE 3 OF a SECTION 4: ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicam must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale, and spccificatipns, including where applicable:details for anchoring structures, proposed elevation of lowest Boor (including basement), types of water resistant materials used below the fust Boor, details of Boodproofmg of utilities located below the fust Boor and details of enclosures below the first Boor. Also ❑ Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg protection level (non-residential only) Ft.NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or - architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other. SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B. ❑ Is not in conformance with provisions of Local Law # , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the focal Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION a PAGE a OF n APPEALS: Appealed to Board of Appeals? O Yes O No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Coodiuoas SECTION 6 AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certifi wtcof Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. L Actual (As-Built) Elevation of the top of the lowest floor, including basement fin Coastal High Hazard Areas bottom of lowest structural member of the lowest floor, excluding piling and columns) is: Fr. NGVD (MSL). 2. Actual (As-Bulk) Elevation of floodproofmg protection is FI. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention- INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? OYES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCEfTo be comnle(ed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #_, 19v SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: C(C(g3 ) Applicant/ Date Owners Name��6P � r -amu - — _ Reviewed ��0 k Architc� t' Date knpiiuci _ _S Ya^ _ SubitlitIccl �5����_� SlIMi, Diss ( 1,000 103 Projcc� r Subdivision Location: � 5�..�0 eR�Y�.e� �✓ a��.— Name: Single d- separate Rcquired caitifi¢auon. "Yes/No' _ -- Re a . /ening cisu is�< I f� tl eft Ray. �--�I Raq (Sii. iaJ Pi aq ,s^d Q-�f [Prnr lard , _ propa-ad Project Description: �� AGGNCX4LrRNLLTS I'e.tmi REDURRED r0 RI±VL«' V.A. No VIS Numb Suffolk County Health Dept. ✓ New York State D. E. C. Town Trustees _ Town 7.oning Board approval: Town Plataring Board approval: .�— Flood Plane Elevation ??? Flood Zone: � ��_ �( /r. Notes: NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1.4738-02988/00001 0 July 1,2002 FACILITY/PROGRAMNUMBER(S) PERMIT EXPIRATIONDATE(S) Under the Environmental Conservation Law July 1, 2012 TYPE OF PERMIT■New ❑ Renewal ❑Modification❑Permit to Construct ❑ Permit to Operate ❑ Article 15,Title 5: Protection of Waters ❑ Article 17,Titles 7,8: SPDES ❑ Article 27,Title 9; 6NYCRR 373: Hazardous Waste Management ❑ Article 15,Title 15:Water Supply ❑ Article 19:Air Pollution Control ❑ Article 34:Coastal Erosion ❑ Article 15,Title 15:Water Transport ❑ Article 23,Title 27: Mined Land Management Reclamation ❑ Article 15,Title 15: Long Island Wells ❑ Article 36: Floodplain Management ❑ Article 24: Freshwater Wetlands ❑ Article 15,Title 27: Wild,Scenic and ❑ Articles 1,3, 17, 19, 27,37;6NYCRR Recreational Rivers ■ Article 25:Tidal Wetlands 380: Radiation Control ❑6NYCRR 608:Water Quality Certification ❑ Article 27,Title 7; 6NYCRR 360: Solid Waste Management PERMIT ISSUED TO TELEPHONE NUMBER Robert F. Slifkin 516 626-8947 ADDRESS OF PERMITTEE 1234 The Knoll, Upper Brookville, NY 11771-4400 CONTACT PERSON FOR PERMITTED WORK 7516) ELEPHONE NUMBER Ireland Gannon Associates, P.O. Box 180, East Norwich, NY 11732922-4800 x205 NAME AND ADDRESS OF PROJECT/FACILITY Slifkin property, 2520 Beebe Drive, East Cutcho ue, NY 11935 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk I Southold I East Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Remove two existing decks. Replace with an 18' x 24' deck and an 8' x 12' deck. Remove a 36' x 6' portion of the paved driveway. All work must be done in accordance with the attached plans prepared by Ireland Gannon Associates last revised June 6, 2002 and stamped approved by NYSDEC on July 1, 2002. By acceptance of this perm it, the perm ittee agrees that the perm it is contingent upon strict com pliance with the ECL, all applicable regulations, the General Conditions specif ied (see page 2 8 3)and any Special Conditions (see page 4+) included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS Region 1 Headquarters Roger Evans SLA Bldg. #40, SUNY72, 2002 ook, NY 11790-2356 AUTHORIZED SIGN RE�n E Page 1 of 4 2W3 Harvey P. Stark, P.E., P.0 Consulting Engineers Civil Design Structural 535 Bedford Avenue Construction Architectural Bellmore,New York 11710-3544 Reports Tel: (516)785-6053 Fax: (516)785-6163 April 5, 2003 Southold Department of Buildings Southold Town Hall Main Road P. O. Box 1179 Southold,New York 11971 - 1179 Attention: Mr. Bruno Semon, Building Inspector RE: B P No 28633Z„ Slifkin Residence. 2520 Beebe Dr East Cutchogue New York November 21, 2002 Final Inspection Request for Engineer's Certification Gentlepersons: We hereby certify that the undersigned has investigated the design and construction of the rear wood deck and stairs of the above referenced residence and that such construction is in full compliance with the New York State Building Code. Following are the responses to the final inspection request comments. 1. The stairs have been rebuilt so that all risers are presently within a one eight inch tolerance in accordance with the New York State Building Code. 2. The handrail on the stairs has been redesigned as shown on the attached "Typical Handrail Detail". This handrail has been improved by the installation of a 2'/z inch diameter mahogany rail which provides improved grasping, in accordance with the New York State Building Code. We trust this certification satisfies your requirements at this time. Please do not hesitate to call if you have any questions or require any further assistance. OV;f SION OQ�JEY R� ST Zc Very truly yours, m m y — s Harvey P. Stark M. C. E., P. E. R� 40399 0+ cc Ireland Gannon __ K� tr� ICS Z.x,b r�lailac�R►�`� 1f -�- N -rte Cie. 5bj-O .4x) �J,V- pc 3a W i V, m e 40399 TAT -to f OF NE APR-14-2003 09 :29 AM PT PJ. DMHMEPGMG 516 7256169 P. 01 Z-?*4. Nla4o A l F[, I.�PnDP.AsL•. ,�.�.G�.�TS � 3(o�0•C, OP JL�l 4-All all �AL Pe. -511rwr-jxl 4�rl�J ?� ��'� �U'f' ChGC7!/l.'r/ IV•�- I1.q.3J� 40399 c �Tt oi'N• 765-1802 BUILDING DEPT. NSPECTION [ ZFOUNDATION i ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMAS: 3 DATE Z' INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU N [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE Z,91-31le INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ) FRAMING FINAL, [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR F1ELD INSPECTION REPORT DATE COA' mum ✓ Z' - - _ w FOUNDATION (IST. � z L _"--------.--_'-__----""""'-- I � i FOUNDATION (.ND (n L O - f A ROUGH FR NWNG 3 r pLUbISING I I x L`+SULATIOiV FERN. Y. STATE ENERGY CODE FINAL, Q if ADDITIONAL CObIIYTENTS h It o - — - - .a✓s - _ rxr o z m 69 II I s I T z 21 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 3 sets of Building flans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. 2 � ' Check Septic Fonn N.Y.S.D.E.C. Trustees_ Examined �- 20._(� Contact Appi oved_ 20 e�)_ Mail to:--- D i approv ed o:Di,approved aic Phone: Expiration � � ,206 tf Building Inspector II a APPLICATION FOR BUILDING PERMIT 1 20012 i , 1 L Date_ '710 ' 2002— INSTRUCTIONS 20©- INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building htspector 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 applica or name,if a corporation) 1L3 �,0t.L �n 71 (Mailing ad ess of applic tt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder QwloE2 Name of owner of premisesAct APft•f oFKt (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 106r — lq2 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be don House Number Street Hamlet County Tax Map No. 1000 Section Block _Lot 1 Subdivisions\ h\Nvt �k�p� Filed Map No._ Lot I (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy A b. Intended use and occupancy_ 3. Nature of work(check which applicable): New Building Addition Alteration Repair J Removal Demolition Other Work (Description) 4. Estimated Cost Q�'�`-�' tD Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 4[-\ Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. _ 7. Dimensions of xisting structures, if any: Front Rear Depth Nh Height A _Number of Stories_ NP— Dimensionsf same structure with alteration or additions: Front Rear Alm Depth N� x Height Ll Number of Stories N A 8. Dimensions of entire new construction: Front rl Rear- __Depth Height Number of Stories N P\ 9. Size of lot: Front 15 a' Rear �1 t Depth 10. Date of Purchase G eQ Name of Former Owner 64m-, t emuL4 K otJOlt(; C05 i S 11. Zone or use district in which premises are situated IlEsk Di )A i-- 12. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES_NO /Will excess till be removed from premises? YES NO 14. Names of Owner of premises �&. R. 14� Address Phone No. Name of Architect Address Phone No Name of Contractot 6CP_ Address �moge No.V%N $R-Ot 11 a nN.l$Z4GaC �\1V0 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. N 1 STATE OF NEW YORK) SS: COUNTY OF __) 11FO aeQY' 1-• 4 t F/�tn being duly swom, deposes and says that(s)he is the applicant (Name of individual siding contract) above named; (S)He is the l IP 2 (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicat ion: 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. Swo to before me r _day 20 J2 CJ otar c Signature of p ' ant JORDAN S. KATZ Notary Public,State of New York No.02KA5073606 Qualified in Nassau County Commission Expires February 24, — �" � Ove2At— La-T- 5u.-CL F:--r" - 3316 a • E>U5T114C, GOvEK.AC.�E OF - STF-L uR-E-5 + _fAVlucl 9,004 sF OF E>cl!E;ng� Cc�vE 4� _, a5.73 • DPOS ED CDYER-L�CfE OF irCOPELTY OF : S. izJUBANY \� ST`ucTUP�S -t �auiN4 8,9:7-5 5.F :APF EHT HqH \,/A-rEp, Uurp 2se.69 ;6 C7F PROPOSED GthE(ZAt�� _ '.25.70 '/, V64E-rA-re D �[ Exi�lu• 6uiL-0iu � yi. 6� ti ti F�7pei�tr' \0 7 255 BEEBE per. E X95 �. P POs � C> QTY off : , o N 76• tQ p++l u Ps D�. .p�D�E�ir SLIFKII I r� 'ti 3 PeoPoS D 9CNE LANE. 10 SEEK E. �RivE. ._- �b \ i.� . p¢avEwtiY 'fD Be- .52. •✓/ J ��% �'�srt vFPeDw R a) Dip• Gu fuioGUE , NY 11435 (J \ �1 - S0' S0 9 EXiSTJWC, ASPH kLT DRivewaY. k .y PROPOSED DECK (5FtADEP) / tiV?� �r a67.44�� Ex 5T1µ4 PECK(s) (PA5ED) 74 BEE. RENAIED. Y L Tjj frC V ����v) zoo BeEaE DR. YE�rETA'7BD �-'fi.,PNPS j'R_OPEQ_T`{ 6F� J,OwrAvrL{. �eLlcat� y7EVNE�-fED 6l' gu4iAK �oH A$ft�ri5 I SII t,c IIJ I t? ESID GE r�azcs} yoO2. _ _ � •,•�-t'+..'r.,Ds.I I E_J- I / /� PHOTO vi P.�4=nON _ YP-1:I'4r-!:D g-( : IKELA017 c,.s.F-{i-Iou ASSOGIAT✓=S ,,: i; s.:�::.: I���11. O Aego,"I `,.r/ Nur'IbEF. A~PRO',"tUi`S {' MAS RE EwED f�'r : \,M/5H . AND CONDITIONS OF P4-m_: I / ,F/01 5CALE-: i" = 50' PERMIT NO. /-�f73�-OL9 ldodal TAW MAP ##5 : 1000 - 103 - 03 -11 QATE ReviSea,. 3txv\e lob 2.,M2 LOT 56 FILED 8130160 0 32g0 \` F OF MOOSE CpyE FILErF 228.89' �K "� „Ma U� 78'24,40" N 106.67 o r1 20 y N 76� ' LOT Q.: WETLANDS FLAGS BY RON ABRAMS (Mor. 2002) AR l� ( sus\ b •� /- CERTIFIED TO : AR COMMONWEALTH LAND TITLE INSURANCE COMPANY •�\ �iuo PECK ROBERT SLIFKINP. MARGARET SLIFKIN ti 'sr� ROAp3 0"v go 0 267.94 , EMORY SURVEY OF `'' LOT _ m MAP OF SUNNY SHORES �P��oF Nfw�a W FILED AUG. 30, 1980 FILE NO. 3231 ANY ALTERATION OR ADDITION TO SURVEY IS A VIOLATION �, �`' Morro 9 m A T EAST CUTCHOGUE OF SECTION 7209 of THE NEW YORK STATE EDUCATION LAW. F EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONSHEREON ARE ;F'a- F ONLY F TO WN OF SOUTHOL D SAV MAP OR COPS BEAFOR R THEA/MPR SEDP AND PS Ai OF ES TIE SURVEYOR * .KS. LIC. NO. 44 SUFFOLK COUNTY, N. Y. WHOSE SIGNATURE APPEARS HEREON. 1000 - 103 - 03 - 11 ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' s X65 5 i63/) 765 - 1797 MUST BE Scale 1" - 50 r OF ANOTHELRSSUtVEY BY ANY �TERMS SURVEYORS LIZNG CTED'AAV e ' STPEET April 9, 2002 BROUGHT - TO - DATE'ARE NOT N CCWLIANCE W/TH THE LAM SOUTHOLD, N.Y. I19" 89 - 266 A O i r I LOT 8o F00 610FILE 9?� �} n LIJ 6 ku02j DOSE �� "', o OF "n c OLD 1 i A 1 m t M IES tl < z_ , tY A FN 300306 514198 �E y � d N �� k 0 NE ABR ®°-QETLA=FLAO BY N wor 00 LOT d` K°" 000 � Z X RO IN A116 W. EM 3GIo3Go164-6 5�+�46 � ' Z EI M ` �Y�4 ;� ` ONE q el of rr. � CCO�AMION TWEEA`LTH LAND TITLE \ P's X INSPANCE,FxCMOANYROWU SL Y q j°P S ""�"Y • 'v p MARGARET SLAWIN �� y ti l g z -fes d• ���- � / W ROAD �.. s OR LD SURVEY .OF LOT ! m MAP OF SUNNY SHORES W N FLED AUG 90, 1880 FILE NO. 9291 ANY AL LT OR AMM r0 SLRVEY Ai A WEA V LA m N AT EAST CUTCHOGUE OF sM avyAs sEc THEAENYOMIfsraT£EOLGITAIAw . EXCEPT AS PEN SECTA7N 7209 SL901NS1AIV Z Au CERTItTA71BS MWW ARc VALO FOR TRS NAP AND OWES 11EAEOF011Y Fm TOWN OF SOUTHOLO s�Ai of DE SueYEra? / NY.S LK Na 49618 SUFFOLK COUNTY, N. Y. 3 1000 - 103 - 03 - 11 AOAgA'ANALLY TO aW Y IM SAG LAN Now'AL MO Bw (631) 7V=4 &CM) w -097 AWT BE UN BY ANY AND ALL MOM UMM A CWYP A BON 909 N Scale 1" = 50' LF ANDIS SiBVEYAR'S W, rE W SINN AS 7KipE MF AAD 30 TRAYELEB STAEFT April 91 2,002 SAO W• TO-DATE"AAE MIDI N COMM MOE 10 17ELAAO SOUrw, KY. 11971 A!I. rh 2002 IFrood Zongs) Do — ORA N) LL o & i . 1 0 TU P�� �F�JSEP - 8 Z .. �EMo E 3 FTIX y � 't, � 0' b viii GI� � 31 or oyr N oc I I X. �K, ro h/�I-! I-`_ �o\NSER `� ``oLJNI� L��I�L �L4IV I I' I �� `=�-XIlcl�C �if♦ T��, � '� m z p� j�c71�F i= 0 p�" �ll�l1 Wry _ °�SNaOn Z�lo l ll7 Q U r FLOOD ZONB I R�-8" F-XI,rTL1 - z�l� - CONIFLYWRHCHAPTER"46" 0 0 - I FLOOD DAMAGE PREVENTION I�GKI IoN oF- Z J P SOUTHOLD' TOWN CODE V1 Zxlo nL �E�. ! 'A P OVEDASNOTED A L I%,LTL ET- o r DATE: ov .2p� 33�. — _J B.P.• L1 TO ,y.�-fIOTIFY BUILDING DE ARTMENT AT FOLLOWING INSPECTIONS:4 PM FOR THE 765-1602 9 AM NNNAft 5/4xColJ�I�KGI. p I�JaI QJ 7. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE I ROUGH - FRAMING A PLUMBING .� I INSULATION 1- v > 4. FINAL - CONSTRUCTION MUST & N1 BE COMPLETE FOR C.O. 7, N = 4xCo p � TS �j r �` S / OI,I IZ° pI�.M XA-P> ALL CONSTRUCTION SHALL MEET N _ I THE REQUIREMENTS OF THE N.Y. beE� PG �joLlarlj�� STATE CO( STR.s Ti;'h 6 ENERGY n yy CODES. NOT RESPf':Siu�E FOR t \ � , I r) DESIGN OR CONSTRLCTION ERAORS UNDERWRITERS CERTIFICATE a` - (7--)Z>< 10 v C�IKI7E#�- 1 rIC`�� L1�1J'� d•���1� f/E II�F-Ii REQUIRED _� ILT. U IN Go�� �crtlU�--- rl a Z4 sj � h �Y I��LnNa ��rINoN occUPA27 DT �. A�o�Ia tis, IfJG USE IS L""" v T,!T` ,nIJT CERTIFIC AAE ut N 4 He,-O;,Ojky g Mr1 �g iy u _ `` A zxio r�J's� l�'G,_ zg ej Lid E- PATI o — :>Kcx C�K JOE ���N«R orFe+ N I-T Boll I�IaM.xde,�" IL ALNtlTd, 1 L Tu --- UW AO efdbtfid wo o d pbl t,ded oe 4. provWe robdbrumma of**types dkmm IM dnVp. wd eom*bl oki. wtM xfw..� SrU7hv'd ! WbYtls Mlollidap(e,f ,r• rUf esMaef to"wa aK beR ded wkb i13TM Ad13.au+k da'..w. bWkefd. �. 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