HomeMy WebLinkAbout28704-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29635 Date: 08/12/03
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 715 MONSELL LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 8 Lot 25
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 6, 2002 pursuant to which
Building Permit No. 28704-Z dated AUGUST 28, 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 ONE FAMILY DWELLING WITH REAR DECK AS APPLIED FOR.
The certificate is issued to JP MODULAR HOMES INC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-0145 08/11/03
ELECTRICAL CERTIFICATE NO. 3368 04/21/03
PLUMBERS CERTIFICATION DATED 05/29/03 HI-TECH PLUMBING
c
A thor zed Signature
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. 28704 Z Date AUGUST 28 , 2002
Permission is hereby granted to :
CHARLES J WHALEN
11 LEEWARD CIRCLE
TEQUESTA FL, 33469
for
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH REAR DECK AS APPLIED
FOR
at premises located at 715 MONSELL LA CUTCHOGUE
County Tax Map No. 473889 Section 097 Block 0008 Lot No. 025
pursuant to application dated AUGUST 6, 2002 and approved by the
Building Inspector to expire on FEBRUARY 28 , 2004 .
Fee $ 834 . 60
or ' zed Signature
ORIGINAL
Rev. 5/8/02
FormNo.6 -"-"
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL I I Tol
765-1802
t �
APPLICATION FOR CERTIFICATE OF OCCUPA Cy
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. F�Ar 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.
Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
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-$25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.000
Date.���/(' 3
New Construction: �_Old or Pre-existing Building: (check one).
Location of Property: —716— 4/2tn5--// 40x eo"Qe_ =
House No. Street —t7 Hamlet
Owner or Owners of Property: MAn Al2C&nK-'7
Suffolk County Tax Map No 1000, Section 9 Block 8 Lot _2 E
Subdivision Filed Map. Lot: /
Permit No. 28'7n Date of Permit. 2 Applicant:
n
Health Dept. Approval: /\ In— 7I—CSI yS Underwriters Approval:
Planning Board Approvab
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 1
b � D91035- 414-j fhh.,, ge!A
A plicant Signature
UF
Town Hall,53095 Main Road Fax(631)765.9502
P.O. Box 1179a Telephone(631)765.1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No.
Owner: c4Ain YC.eJ
(please print)
Plumber. A
(please print)
I certify that the solder used in the water supply system contains leas than 2/10 of 1%
lead.
(Plumb Signature)
Sworn to before me this
day of M&Y 200-3
ALLAN B.YOUNGS
Notary Public, J G/f County NOTARY
IC, ATE OF N.V.
OUALIFIED IN SUFFOLK COUN11/
COMMISSION EXPIRES 7.91,4L1p6
EO 39Vd NI S31VI00SSV 113ON39 ESL7ZdLTE9 EE :OT E00,,l8' 10
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street • Center Moriches,New York 11934 • Tel: 631-878-3500 •Fax: 631-878-3764
Application: 3368 Date: 4/21/03
Issued to: Gendot Homes
Address:. 75 Munsell Lane
Village: Southold Introduced By: DeLane Electric Lic#:4354-E
was examined and approved up to the above date and was in compliance with the NEC
Pttic 0 1st Floor NI Residential❑X Pod Det Cerage
Baserrent❑x 2nd floor El Ca nn3rdal HotTtb Pddticn
Switches Receptacles Fixtures G.F.I. Microwave Whirlpool
18 34 21 4 1
Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
1-Ex Bath 1 20A 30A 1
Furnace Oil Gas Heat Zones Smoke Bell
Detectors Transformers
yes 1 5 1
Meter Amps Phase Motors
1 200A UG 1
Other Equipment:
Out,Res
r /
This certificate must not be altered
in any manner
ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501
Detached One and Two Family Design Criteria 5750 Degree Days
(For Non-Electric Heat) Zone 1113
For: d a h ti Pra e m rA Per:
Dated: f 1 D
DESIGN CODE DESIGN CODE
SUBSYSTEM AREA ecu„ "U" UA UA
Exterior Walls /tyr2 (� ./3q 0.14 /!t` / Q2 / 9q•�`�
Ceiling Roof r3C. •030 0.031 42. 19
Floor Over Unheated Space /$ 6/ ,65-' 0.05 (,8, at 6 6. 05/
Heated Slab On tirade 6.5
Unheated Slab On Grade 4.5
Basement Wall 0.1
Crawl Space Wall 0.06
NOTES: 3 D O , B D 3 a f,8 8
Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage
Building Envelope Systems to meet requirements of Section 501
Ile mechanical systems and equipment including:
HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems to meet
requirements of Section 503
Service Water Heating Systems&Equipment to meet requirements of Section 504
Electrical&Lighting Systems&Equipment to meet requirements of Section 505
Ps�of
w ! 4C
To the best of my knowledge,
belief, & professional judgement,
these plans are in compliance os4a
with the code. A9�F�sstoN�� L
Y �
L
Board Of Southold Town Trustees
�„ SOUTHOLD, NEW YORK
t PERMIT NO. / DATE: .. Sept. 19, 2001 d 4
} _ John Prizeman r
ISSUED TO ..._.._
•y� ..�y '� f k� 41*
yn Pursuant to the provisions of Chapter 615 of the Laws of '
the State of New York, 1893; and Chapter 404 of the Laws of the a
State of New York 1952; and the Southold Town Ordinance en-
titled . REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;'.': and in accordance with the
Resolution of The Board adopted at a meeting held on ....Sep.t,,.19.,..
�
5... ..20000, . 2.0.0.1, and in consideration of the sum of paid by
_...John..Prizeman __ _. _ _..____ _... _.._.... �
+ 4F Q1.
of ......Brooklyn,- _.. N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
`i Wetland Permit to build one family house with staked haybales j
['. :at the 50 foot contour, roof drainsas shown on plans for roof
and drive-way run-off (resubmit survey to show staked haybale '
all in accordance with the detailed specifications as presented in
.the originating application.
c
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this data.
Z F0(,f-�o
k lryea—
o
Trustees
a�
_ t
F
New York State Department of Environmental Conservation Am
Division of Environmental Permits
Building 40 -SUNY,Stony Brook, New York 11790-2356 Iowa
Telephone(631)444-0365 _
Facsimile (631)444-0360
Erin M. Crotty
Commissioner
LETTER OF NON-JURISDICTION
July 13, 2001
Mr. John Prizeman
JP Modular Homes,Inc.
131 Hicks Street
Brooklyn,New York 11201
Re: 1-4738-02904/00001 (SCTM# 1000-97-8-25)
715 Monsell Lane
Cutchogue,New York 11955
Dear Mr Prizeman:
Based on the information you have submitted,the New York State Department of Environmental Conservation
has determined that: The portion of property located landward of the 10'contour on a gradual natural slope is
beyond the jurisdiction of Article 25 (Tidal Wetlands) as shown on the survey by John C. Ehlers dated 6/5/01
last revised 7/11/01. Additionally, the parcel is located more than 100' from a regulated Fresh Water Wetland
(SO 53)and is beyond the jurisdiction of Article 24 (Fresh Water Wetlands).
Therefore,in accordance with the current Tidal Wetlands Land Use Regulations(6NYCRR Part 661)no permit
is required under the Tidal Wetlands Act. Please be advised,however, that no construction, sedimentation, or
disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary,as indicated above,
without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any
sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands
jurisdiction which may result from your project. Such precautions may include maintaining adequate work area
between the tidal wetland jurisdictional boundary and your project(i.e. a 15'to 20'wide construction area) or
erecting a temporary fence,barrier, or hay bale berm.
Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary
permits or approvals from other agencies.
Very truly yours,
a"A00
Roe Evans
Permit Administrator
cc: BMHP/mep
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: 8 /2�
APPLICANT: �� � �i�r Iw J DATE SUBMITTED:a /G
SCTM# DISTRICT: 1y0, SECTION: _'A}__, BLO(-:K: 8 , LOT: aS
STREET ADDRESS: h)O)-n� L-�NX_ CITY LVTC{{p�u£=SUBDIVISION nletRu-oob
PROJECT DESCRIPTION:
ESTIMATED PROJECT COST: + 1(,,v- ARCHITECT1F9=45ER:i,, r FAST TRACK?A
SINGLE & SEPARATE CERTIFICATION-REQUIRED? lits NOTES:
LATS 40,000SF-100-24. Lot recognition.(C RE-AT CD before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25- erger.(A nonconforming at any time at
ZONING DISTRICT: 'RL10 CONFORIAING? _ _n°
REQ. LOT SIZE: �o�000 ACT. LOT SIZE: i 68 REQ. LOT COV. 2o°7a ACT. LOT COV. _
REQ. FRONT 55 _ PROP. FRONTS REQ SIDE 101 ACT. SIDE 6)1/45
REQ. REAR 56 PROP. REAR '/_ 86 REQ. HEIGHT =PROP. HEIGHT -
WATER FRONT? YES DESCRIPTION: CRE-CK-
7
PANEL #: FLOOD ZONE: —���
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: 4�or NO, (BED #): '` DTE: 7 /90 / Z PERMIT #:R10-
TOWN SEPTIC RECEIPT:(SDr N
NEW YORK STATE DEC: PRE-DEC9/1/75(S!E$ or NO x) / P-rrrg 13� 2ooa
SOUTHOLD TOWN TRUSTEES: (ID or NO
TOWN ZONING BOARD APPROVAL: YES ori
TOWN PLAN. BOARD APPROVAL: YES or610
TOWN HISTORICAL PRE (SPLIA): YES or
NYS ENERGY:69 OR NO
EGRESS (18 H min.? 4 sq total) VENT (SQ. FT, x 4%) LIGHT (SQ. FT. x 8%)
BUILDING PERMITS OPEN/EXPIRED: BP -Z 1 C/0 Z-
HAVE PRE CO'S : Y OR N BP -Z/ C/0 Z-
NOTES:
FEE STRUCTURE: FOUNDATION: 3qp SF
FIRST FLOOR: 6-XYZ SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: g,/,3y SF FEE FEE FEE
1. 31 a SF)- ( 860 SF)-_a89 SF X =S6S ba +S
2. ( SF)- ( SF)= SF X $—=$—+$—+$—= $
M-1802
BUILDING DEPT.
NSPECTIQN
FOUNDATION IST ( ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ) FRAMING [ ] FINAL
[ ) FIREPLACE A CHIMNEY
REMARKS: G�2G'
DATE D INSPE
V4 7° v�e-
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
ti
DATE m INSPECTOR � ,�
FIELD INSPECTION REPORTK DAT COMMENTS
FOUNDATIONT) ® -
u
--- z
FOUNDATION(2ND)
z
ROUGH FRAMING& -�"`---- �
PLUMBING
a
r
INSULATION PER N.Y. — y
STATE ENERGY CODE
c.
CIO
-� -.
FINAL
ADDITIONAL COMMENTS s
0
z
m
z
to
r
0
- z
r
y
o v
— - m
y
TOWN OF SOUTH ? -= - BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEP } ' Do you have or need the.:ollowidg,before applying?
TOWN HALL 4' '�*+� 6 2002 i Board of Health
SOUTHOLD,NY 1 971 __� __ j 3 sets of Building Plans
Blrr r
TEL: (631) 765-180 j Planning Board approval
TCV1'r � "QLD
FAX: (631) 765-954 Survey
PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
/� Trustees
Examined v�� 20 C9 Contact:
Approved 0//� ZJ ,20� Mail to: To H h 1 PK 1 Z-t 1w,)1�
Disapproved a//cc 7�' 173
Phone:7/94-Z 63`36 N`TI �Zo
Expiation 20y
Building inspector
APPLICATION FOR BUILDING PERMIT /
Date ( 6 200-'-
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 pyblic 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. "I
(Signature of applicafor name,if a corporation)
l3 41Gr5 2T SkooK&ytu Ny / 12 01
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
owN6p-
Name of owner of premises roH N PlZ(L L d�/�4 nl
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
7i3 MooUWI GAME C 117—C 14 QGQAF AJ "i
House Number Street Hamlet C
County Tax Map No. 1000 Section -7 Block lx•, * Lot 7 ri
Subdivision /`' AP OF K W Filed Map No. Lot
(Name) __
t
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 tAM icy/N®y��
3. Nature of work(check which applicable): New Building �/ Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost T/�D �, (,' Q 0 r 4 0 _ Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars f�--
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front _Rear Depth
Height Number of Stories - —
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire yew construction: Front Rear
7 Z Depth 34 /
Height Number of Stories ONF
9. Size of lot: Front
--L!!?�• Sr� Rear ����•46 Depth
r
10. Date of Purchase Name of Former Owner CRARLES W A LrEN
w
11. Zone or use district in which premises are situated 0
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_NO
14. Names of Owner of premises7O NN P"rPOViddress l31 RI C AT T7- Phone No.71 y 4f a 0 j jV6
Name o Architect G�_�jE /t�• /�/SIfER AddressBO�f Qrf�5ptr1E10tDPhone No 4
N of Contractor3E Q[LY S l MON _Address Phone No. Q
R NDoT f 3 Z 3,ao�7
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. PERMrV MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES vv 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.
STATE OF NEW YORK)
S:
COUNTY Ol '
.) 0 H l;1 A r R ( �.�:`�/4 (U being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the 0 W N 9:-�'F
(Contractor, Agent,Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are 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.
Swom.to before me this
i'Q( e day of 2004--
A-1,
064--
r
Notary Public Signature of ApP11 ant
LYNDA M.BOHN d
NOTARY PUBLIC,State of Now York
No.01B06020932
Qualified in Suffolk county-
Term Expires March 8,20 L.LJ
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 08/06/02 Receipt#: 0
Transaction(s): Subtotal
1 Septic Permit-Construct-Resid. $10.00
Check#: 2343 Total Paid: $10.00
Name: Prizeman,John
131 Hicks Street
Brooklyn, NY 11201
Clerk ID: JOYCEW Intemal ID:61044
NORTH STAR TITLE AGENCY, INC.
301 East Main Street
Riverhead, New York 11901
VARIANCE SEARCH
TITLE NO.: 712-S-0940-SS
STATE OF NEW YORK)
SS:
COUNTY OF SUFFOLK)
Patricia A. Judd being duly sworn, deposes and says:
That she resides at 301 East Main Street, Riverhead, New York 11901 and is over the
age of 21 years and that she is President of NORTH STAR TITLE AGENCY, INC.
That under her direction, title was examined to the parcels of land described on the
annexed Schedule and labeled Parcels
A, B, C, D and E
That said examination, dated March I, 2002 discloses a chain of Title to determine if
any contiguous property was owned by an owner of property involved since the date of
any previously applicable Zoning Ordinance as of January 1, 1983.
And, that this Affidavit is made to assist the Board of Zoning Appeals to the Town of
Southold to reach any determination which requires as a basis therefore the information
set forth herein and knowing full well that said Board will rely upon the truth thereof.
The liability of the Company under this Variance Search is limited to Twenty-
Five Thousand ($25,000.00) Dollars for any reason.
NORTH STAR TITLE AGENCY, INC.
B
Patricia A. Judd
President
Sworn to before me this
13°i day of Ju 2
IONN a.TANDY
Notary Publi6 RAW of New Yak
No.§-4693220 ry i
Qualified in ember 36,20,j
fommissbn Expires
TITLE NO.: 712-S-00940-SS
DESCRIPTIONS
PARCEL "A": (SUBJECT PREMIS":
ALL that certain plot, piece or parcel of land, situate, lying and being near
Cutchogue, in the Town of Southold, County of Suffolk and State of New York, known
and designated as Lot Nos. 39 and 40, on map entitled, "Map of Norwold", filed in the
Office of the Clerk of the County of Suffolk on March 13, 1939 as Map No. 1939.
ALSO, known and designated on the Real Property Tax Map as:
DIST. 1000 SEC: 097.00 BLK: 08.00 LOT: 025.000
PARCEL "B": (ADJACENT NORTH):
Lot Nos. 36, 37 and 38 on the aforesaid map.
DIST: 1000 SEC: 097.00 BLK: 08.00 LOT: 026.000
PARCEL "C": (ADJACENT EAST):
Canal
DIST: 1000 SEC: 103.00 BLK: 06.00 LOT: 008.001
PARCEL "D": (ADJACENT SOUTH):
Lot Nos. 41, 42 and 43 on the above mentioned map
DIST: 1000 SEC 138.00 SLK: 01.00 LOT: 005.000
PARCEL "E": (ADJACENT WEST):
Monsell Lane
STATE OF NEW YORK)
SS:
COUNTY OF SUFFOLK)
Patricia A. Judd being duly sworn, deposes and says that she resides at 301 East
Main Street, Riverhead, New York 11901 and is over the age of 21 years and that she is
President of NORTH STAR TITLE AGENCY, INC.
That the above is the true description of the subject premises and of the adjoining
premises as shown on the record in the variance search made under the above captioned
title number.
NORTH STAR TITLE AGENCY, INC.
B _
Patricia A. Judd
President
Sworn to before m this
13 day Jun
;7
)"B.TANDY
Notary Public,State of New Yak
No.52-4693220
Qualified in Suffolk County
Commission Expires Nownba 30 20,1Lf
TITLE NO.: 712-5-00940-SS
CHAIN OF TITLE FOR PARCEL "A
Elizabeth A. Whalen, as surviving tenant Liber: 9016 cp 299
to Dated: 5/26/81
Charles Whalen Rec'd: 6/11/81
LAST OWNER OF RECORD
CHAIN OF TITLE FOR PARCEL "B
Hattie E. Monsell Liber: 3329 cp 202
to Dated: 3/12/52
Harry M. Monsell Rec'd: 3/12/52
Harry M. Monsell died 2/4/69 Suffolk County Surrogates Court File No. 506P69, leaving
Estate to wife, Amy Monsell.
Amy Monsell died 11/18/78, Suffolk County Surrogates Court File No. 917A78, leaving
three sons, Thomas O. Monsell, George E. Monsell and James I. Monsell.
George Monsell Liber: 9018 cp 145
to Dated: 5/11/81
Sidney Price Rec'd: 6/16/81
Sidney Price Liber: 9384 cp 527
to Dated: 5/25/83
George Monsell Rec'd: 7/11/83
James I. Monsell, Liber: 9489 cp 151
Thomas O. Monsell and Dated: 11/30/83
George Monsell Rec'd: 1/5/84
as next of kin of Amy Monsell
(died 11/18/78,
Suffolk County Surrogates Court File No. 917A78
to
George Monsell
George Monsell Liber: 10656 cp 293
to Dated: 6/27/88
James 1. Monsell Rec'd: 7/29/88
LAST OWNER OF RECORD
STATE OF NEW YORK)
SS:
COUNTY OF SUFFOLK)
Patricia A. Judd being duly sworn, deposes and says that she resides at 301 East
Main Street, Riverhead, New York 11901 and is over the age of 21 years and that she is
President of NORTH STAR TITLE AGENCY, INC.
That the above are the true chains of title as shown on the record in the variance
search made under the above captioned title number.
NORTH STAR TITLE AGENCY, INC.
B
YYY Patricia A. Judd
President
orn to b f re this
m Pay Ju , 002
J"A.TANDY
Notary Public,State of New Yak
No.52-4693220
0ualified in Suffolk Cour.
Commission Expires November 30,20�
TITLE NO.: 712-S-00940-SS
CHAIN OF TITLE FOR PARCEL "Cr':
Hattie E. Monsell Liber: 3329 cp 202
to Dated: 3/12/52
Harry M. Monsell Rec'd: 3/12/52
Harry M. Monsell died 2/4/69 Suffolk County Surrogates Court File No. 506P69, leaving
Estate to wife, Amy Monsell.
Amy Monsell died 11/18/78, Suffolk County Surrogates Court File No. 917A78, leaving
three sons, Thomas O. Monsell, George E. Monsell and James 1. Monsell.
LAST OWNER OF RECORD.
CHAIN OF TITLE FOR PARCEL "D
Hattie E. Monsell Liber: 5385 cp 519
to Dated: 7/23/63
Gerald S. Wells and Rec'd: 7/25/63
Betty J. Wells, his wife
Gerald S. Wells and Liber: 11317 cp 24
Betty J. Wells, his wife Dated: 8/5/91
to Rec'd: 8/15/91
Pearl B. Stewart,
Donald A. Stewart and
Nancy Muller, as joint tenants with
rights of survivorship
LAST OWNER OF RECORD
CHAIN OF TITLE FOR PARCEL "E":
Monsell Lane
STATE OF NEW YORK)
SS:
COUNTY OF SUFFOLK)
Patricia A. Judd being duly sworn, deposes and says that she resides at 301 East
Main Street, Riverhead, New York 11901 and is over the age of 21 years and that she is
President of NORTH STAR TITLE AGENCY, INC.
That the above are the true chains of title as shown on the record in the variance
search made under the above captioned title number.
NORTH STAR TITLE AGENCY, INC.
B :'Y:
Patricia A. Judd
President
Sw rn to befor me this
1 � of ,2002
B.TANDY
Notary Puwi State of New York
No.52-4693220
Qualified in SuffA County
C4 alftal r Expires November 3 ,20,_
SURVEY OF LOTS # 39 4 40
"MAP OF NORWOLD" n - N
5eat`yp�d - , : L J
FILED MARCH 13, Ia3a AS #1275 e _
SITUATE: GUTGHOC�UE ` >f �o��0W E
—
TOM SOUTHOLD -
4 1 .
0 Lk
S`
SUFFOLK GOUNTY, NY
SURVEYED 06-05-0I
AMENDED 01-1 1-01, SUFFOLK COUNTY DEPARTMENTOF HEALTH SERVICES
01-24-01, 08-09-01, o.
1 Oa-24-o1, 10-30-01, c PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
12-28-01 SINGLE FAMILY RESIDENCE ONLY j
5GT# 1000-91-8-25
Q i DATE �'" S REF.NO.1f(0 - O/ (yff
CERTIFIED TO: I� .y�, V. I APPROVED
0
eta ro sePnc a'Y�
JOHN PRIZEMAN mega �__ _ t`� n ;t
OR MAXIMUM OF BEDROOMS
C,
QI EXPIRES THREE YEARS FROM DATE OF APPROVAL
o� �m Z`
lot
Nr - --- —�
�0, a
TESL HOP.
@ high tide,
SEPTIG DETAIL ' tos ;�o. E. �
not to Scale oca°P° +s° /� ��J G�' V' aQo Q� m ro,X11
N o roam
,t' i 1' so„ay 9
K I' Inv.. corer - n_a �h t % Q CO
0 ¢Lv"° 1 �, •�' IIm 3.
cover �,, 161 1000 I - _ 40t t Q
ba�Yq 165P1 _—_ toNc tt e���� / �QIV Q� M O a •j t N
tleeP � �
n.
eepretbn gaM rater _. / w
SUBJECTTO CCNVENANTS&RESTRICTIONS U8 Coo) ! /j�
PAGE 3 �O�e , -` °v�''r >#` �•
/oo�,'
ed in accordance with Bo of Revi �: 6(0%0
o�
APIA' o
NOTES O �' Y
0
x/
dB�IDlna�Ori dated ,
■ MONUMENT
O
PIPE `S
'
AREA = 16,068 5F OR 0.31 AGRE5 4
ADJAGENT AREA = 12,500 5F, PROP05ED16,E o�
HOUSE G DEG< = 1105 5F OR 13.1% GOVERA6E ��/F< ��Ooh •QO,; N CO
ELEVATIONS REFER TO M5L N6VD'29 /NG ,02 0`
BUILDING ENVELOPE A5 PER "PRE-EXISTING
NON-GONFORMIN6" LOT5 - 5EGTION 100-244 obis 0202 o
IA
SUBDIVISION WAS APPROVED FOR WATER SERVICE NO
AND 5EWA6E DISPOSAL BY THE NY5 DEPT. OF HEALTH -
WELL AND SEPTIG LOGATIONS PROVIDED BY OTHERS `
JOHN C. EHLERS LAND SURVEYOR
GRAPHIC, 5GALE 1 30 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901
= 369-8288 Fac 369-8287
REF.-\\Hp server\d\PROS\01-193g.pro
SURVEY OF LOTS # 3cf 40
"MAP OF NORWOLD"
FILED MARCH 13, la3a A5 #1215
51TUATE: CUTGHOGUE
TOWN: 5OUTHOLD
5UFFOLK COUNTY, NY
5GT# 1000-9"1-8-25
SURVEYED 06-05-01
AMENDED 0-7-II-01, P -�
01-24-01, 08-09-01, -
09-24-01, 10-30-01,
12-28-01, 10-2Q-02
ati
m
CERTRUD• O:
JOHN PREU MAN C dot#
" 8
S
3
0°3
g
ro� cu�
0 0
�o
Q �
40
3S h r i
p
�6p°��
411
•Op,
C F_
H i
NOTES
■ MONUMENT fig_
O�
O PIPE �r01ANO$V
AREA = 16,068 5F OR 0.3-1 ACRES
JOHN C. EHLERS LAND SURVEYOR
6RAPHIG SGALE 1"= 30' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901
-- 369-8288 Fac 369-8287 REF.-\U-Ip server\d\PROS\01-193h.po
SURVEY OF LOTS # 3cl 4.0 -
"MAP OF NORWOLD" N
FILED MARCH 13, 193a A5 #1275
SITUATE: W E
: C
TOM- SOUTHOLD
SUFFOLK COUNTY, NY F�« " s
SGT# 1000-91-b-25
SURVEYED 06-05-01
AMENDED 01-II-01, r 1
01-24-01, Ob-09-01, -
09-24-01, 10-30-01, �o
12-2b-01, 10-2G-02,
I final 04-14-03 �ry
Nell 06-20-03
SUFFOLK COUNTY REFERENCE # `"e/� (Ot
RIO-010145
v cQ
CERTIIMTO:
JOAN PRffiMAN
NORTH STAR TrnZ COMPANY '
DAVID SMDONS
O �• 0 X36 " � G � ` `` ` k oil
CO
0F0P ss, zot
NQ
o �
s i
H / w
_ a b
Pei 40 �p Q
so
�j 0 l
�0�
3
00.,� _ w
s, i\ -.
i
Cor��
/
n_ n
7�S
.. `�
NOTES
■ MONUMENT
p PIPE r 4LAND
AREA = 16,065 sF OR 0.31 ACRES JOHN C. EHLERS LAND SURVEYOR
GRAPHI G SCALE 1"= 30' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RWERHEAD,N.Y.11901
369-8288 Fax 369-8287
REF.—\\Hp serverW\PROS\01-193h.pro
r,' • ';i i 4 a,}}x.;aN.�U'RW�Wf3kuy� cd, i r,':; ,r,.. ",'_ s .i -,. .,:' ..
. OCCUPANCY OR
�L USE IS UNLAWFUL
RTIFICATIE
Y
�- - F OCCU AppRpVEDASNOTED
Zw
DAte:fll$La� -
NOTIFY UILDINO DEPART AT
s _
PM FOR THL
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FORPOUREDCONCREIE
2 ROUGH • FRAMING i PLUMBINGINSU ' '
r • FINALICCONSTRUCTION MUT '
_ ,— FOR C.O,
CONSTRUCTION ALL SHALL MEET
�u4 ,
ON
�..� Z"I �.._ - . .__ - � ,.. ti - �,.--'— _ _ SCO
TA TSC NOTT RESPONSIBLEFOR
DESIGN OR CONSTRUCTION EIIIIOEIS
If copper tubing is used
7 �- for waterdistributin
_ e
System; piping shall b
- - - . .- � - - - - - ---- of types K or L only
UNDERWRITERS CERTIFICATE
REQUIRED
' 0PROVIDE ANTI-SCALD AND/OR .
k THERMAL SHOCK PREVENTING'
i
DEVICES AS TO PAMT.901
N.Y. STATE BUILOff�G CODE..
PROVIDE OPENINGS FOR PLUMBI,NCi
EMERGENCYALL PLUMBING WASTE
ESCAPE'A
S
' &WATER LINES NEED. '
REQUIRED BY PART. 714 OF TESTING BEFORE COVERING
N.Y. STATE BUILDING CODE.
PROVIDE SMOKE-DETECTING
ALARM DEVICES PLUMBER CERTIFICATION
AS TO PART. 721.1 ON LEAD CONTENT BEFORE
N.Y.S BUILDING CODE. CERTIFICATE OF OCCUPANCY
UNDERWRITERS CERTIFICATE SOLDER USED IN WATER
REQUIRED SUPPLY SYSTEM CANNOT
XCEED 2/10 of I% LEAD.
�T
I
r DO NOT PROCEED WITH
FRAMING UNTIL SURVEY
" OF FOUNDATION LOCATION
HAS BEEN APPROVED.
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