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HomeMy WebLinkAbout29224-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29754 Date: 10/02/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 985 BAY SHORE RD GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block 3 Lot 13 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 22, 2002 pursuant to which Building Permit No. 29224-Z dated MARCH 19, 2003 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 ACCESSORY GARAGE WITH UNFINSHED 2ND FLOOR AS APPLIED FOR & AS PER ZBA #5222 . The certificate is issued to ROBERT E & BARBARA HOLLEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 77093C 07/22/03 PLUMBERS CERTIFICATION DATED N/A Authorized Signatur 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. 29224 Z Date MARCH 19, 2003 Permission is hereby granted to : ROBERT E & BARBARA HOLLEY 1085 BAY SHORE RD GREENPORT,NY 11944 for CONSTRUCTION OF AN ACCESSORY GARAGE AS PER ZBA W/ FLOOD PERMIT AS APPLIED FOR at premises located at 985 BAY SHORE RD GREENPORT County Tax Map No. 473889 Section 053 Block 0003 Lot No. 013 . 001 pursuant to application dated AUGUST 22 , 2002 and approved by the Building Inspector to expire on SEPTEMBER 19 2004 . Fee $ 284 . 20 uthori zfed Sig ature COPY Rev. 5/8/02 i Form No.6 ... ... .. . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 2 5 2(ln? APPLICATION FOR CERTIFICATE OF OCCUPANCY i 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 I% 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: I. Accurate survey of property showing all property lines, streets, building and inusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant_ If a CCrllficale 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&'G /3, �G'o 3 New Construction: Old or Pre-existing Building: (check one) ,.ovation of Property: -- _I A y5 �_Je�,4 fiep � #tINV&1 {f iV y ((9J/4./ House No. Street Q Hamlet Owner or Owners of Property: ��j(J'r J5 lle�4 1 /��)���/� r Ne,L L y ZZ _ , Suffolk County Tax Map No 1000, Section J5 J Block Q 3 _ Lot / Subdivision _ Filed Map, Lot: Permit No. /1 / _Date ofPermit. ley" - i�'3 Applicant: 864/11 � f/0< 4t� Health Dept. Approval: Underwriters Approval: / Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Z3oi Fee Submitted: $ Applicant Signature 7�9,3 Cc -?_ o? 9 75 y 1' APPEALS BOARD MEMBERS �SUFFO(Irc 4Gy Southold Town Hall Lydia A. Tortora, Chairwoman _ 53095 Main Road Gerard P. Goehringer coo P.O. Box 1179 George Horning O Southold,New York 11971-0959 Ruth D. Olivay O� ZBA Fax (631) 765-9064 Vincent Orlando X41 '�a Telephone(631)765-1809 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 23, 2003 Appeal No. 5222 - Robert & Barbara Hollev. Property Location: 1085 Bay Shore Rd., Greenport 53-3-13.1 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicants' parcel consists of approximately 23,392 sq, ft., comprising of Nos. 12, 13, 14, 15 shown on the Amended Map "A" of Peconic Bay Estates in Greenport. The property has 180 ft. frontage along the north side of Bay Shore Road, a depth of 157.12 ft. along the west side and 151 ft. along the east lot line, and frontage along Pipes Creek. The property is improved with a one-story frame house as shown on a survey dated February 4, 1997, updated October 23, 2002 prepared by Joseph A. Ingegno, L.S. BASIS OF APPLICATION: Building Department's August 28, 2002 Notice of Disapproval denying a permit under Section 100-33C for the location of an accessory garage with a front yard setback at less than 40 feet. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 16, 2004, which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: Applicant wishes to locate an accessory garage, 36' wide by 24' deep, in a front yard location at 35 feet from the front lot line instead of the code required 40 ft. setback. The property has two yards facing a road and road easements, and two remaining yards with restricted wetland areas, delineated by the NYS DEC Bureau of Marine Habitat. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The property is nonconforming with +- 23,392 sq. ft. according to a survey prepared by Joseph A. Ingegno, L.S. dated Page 2—January 23,2003 Appl. No. 5222—Robert and Barbara Holley 53-3-13.1 at Greenport October 23, 2002. Other properties in the neighborhood are also developed on small nonconforming lots. 2. The benefit sought by the applicant cannot be achieved by some other method, feasible for the applicant to pursue other than a variance. The property is a waterfront parcel containing wetland and restricted areas. The applicants have no other alternative and desire to build a garage as an accessory use in this yard location southwest of the house, at 35 ft. instead of 40 feet from the front line. Without variance relief, the proposed garage in a reasonable location, and their rear yard is very close in proximity to the wetlands and restricted buffer area. The proposed garage is 24 feet by 36 feet with the entrance to the east. The front yard setback pursuant to Article XXIV, Section 100-244 is 40 feet, the proposed structure is shown at 35 feet from the front yard line. The proposed garage will be heavily screened from the north and west by dense woods and a non-disturbance buffer, and from the south by heavy vegetation along Bay Shore Road. 3. The variance is not substantial in relation to the code requirement, representing a reduction of 12.5% of the code requirement. 4. The alleged difficulty has been self- created because the applicants were aware of the limitations of the nonconforming size of the lot when it was purchased. 5. No evidence has been submitted to suggest that the relief granted will have an adverse impact on physical or environmental conditions in the neighborhood. 6. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a garage while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Oliva, seconded by Member Orlando, and duly carried to Grant the setback variance as applied for, with the Condition that the only utility be electricity. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, Page 3—January 23,2003 Appl. No. 5222—Robert and Barbara Holley 53-3-13.1 at Greenport setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Tortora (Chairwoman), Goehringer, Oliva, and Orlando. (Member Horning of Fishers Island was absent.) This Resolution was duly adopted (4-0). Lydi . Tortora, Chairwoman —Approved for Filing 3/ /03 Allk J Electrical Inspection Cern icate Issue Date Electrical inspection Service,Inc. Application Number 7/23/03 375 Dunton Avenue 77093C East Patchogue, New York 11772 (631)288.8642 Issued To: Robert Holley Street: 1085 Bayshore Road Village: Greenport Zip: 11944 Town: Southold Section: Block: Lot: Contractor: Lademann Electric Inc. Lic.# 4141-E Was examined and found to be in compliance with the National Electrical Cods. _. ❑ Commercial ❑ NV Defects ❑ Pool ® 1st Floor x❑ Indoor ❑ Basement ❑ Hot Tub ® Residential ® Det.Garage ❑ Attic ® 2nd Floor ® Outdoor ❑ Addition ❑ Survey switches Receptacles Fixtures GR Heaters A/C Pans 9 16 14 2 Dishwasher Washer/Amps Dryer/Amps Oven Ronge/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer 3 Meter Amps Phase UG/OH Jacuuf Television CO Detector 1 100 1 59 / 1 Bldg. Permit: Other Equipment d Hugo S. Surdi President Rough Inspection: 06/24/1003 Inspector: Ed Seavelli Final Inspection: 07/22/2003 Inspector: Jerome Damioo This certificate must not be ahered in any manner. Inspectors may be Identified by their credentials. • ��9 APPLICATION a PAGE I of i —� TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sien)' I. No work may start until a permit is issued. 2- The permit may be revoked if any false statements are made berci❑_ 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Ccrtircate of Compliance is issued. S. 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 ieasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL S ATE QENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE,TO IE BESTTM f OtVLEDGI ,TRUE AND ACC RATE. (APPLICANTS SIGNATUR DATE SECTION 2• PROPOSED DEVELOPMENT (To be completed by APPLICAV"n NAME ADDRESS TELEPHONE APPLICANT B;%% A. Ander$on PO Box 2003 63}� 9 7-5160 Suffnik Fncrirnn ('OI1SUltlnc 3.nC Bridgehampton BUILDER ENGINEER ( 631) 477v04YY Lawrence Tuthill (c/o Penny Lumber) PO Box 2067 • Greenport . 944 PROJECT LOC&TION: To ovoid delay in processing the application, please provide enough information to easily identify tbe,projeetye;r • location. Provide the street address, lot number or legal description (attach) and, outside urban'sreas�b distance to the ucarest intersecting road or well-known landmark A sketch attached to this application showtrlg the project location would be helpful. 1085 Bayshore Road; Greenport, NY SCTM # : 1000-053-03-012 FDP(93) 1 r •,_��.,„ APPLICATION A . i: PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes)' f A. STRUCTURAL DEVELOPMENT ZN VIT STRUCTURE TYPE Structure ❑ Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration Noo-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition' P ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park?. ❑ Yes) !� ESTIMATED COST OF PROJECT S 35, 000 B. OTHER DEVELOPMENT ACTIVITIES: W14 ❑ Fill O Mining ❑ Drilling ❑ 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 ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 7 APPLICANT should submit form to Local Administrator for review. t SECTION 3• FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) 3 The proposed developmeut is located on FUZ-M Panel No. . Dated 9 The Proposed Development i ❑ IsI(M located in a Special Flood Hazard Area (Notify the applicant that the applicatiou review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). :. ❑ Is located in a Special Flood Hazard Arca. FIRM zone designation is 100-Year Rood elevation at the site is: Ft. NGVD (MSL) ❑ Uuavailablc O Tbc proposed development is located in a Roodway. FBFM Pancl No. Dated ❑ Sec Section 4 (or additional instructious. SIGNED DATE 'vl APPLICATION yx PAGE 3 OF 4 SECTION 4 ADDITIONAL INFORMATION REOUIR6D (To he comnlctcd by LOCAL ADMINISTRATORI The appticaml must submit the documents checked below before the application can be processed; ❑ A site plan showing (be location of aJl existing structures, water bodies, adjacent roads, lot dimensions and proposed development. I O Development plans, drawn to scale, and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the first floor, details of floodproofmg of utilities located below the first floor and details of endosures below the fust floor. + Also i O Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the appficanl must provide 100-year flood elevations if they arc not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. j O Top of new fill elevation Ft. NGVD (MSL). ` l O Floodproofing protection level (non-residential only) til:NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or - architect. d 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. d Other: •t SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. 0 Is B. 0 Is not in conformance with provisions of Local Law W_, 19 . The permit is issued subject to the conditions A attached to and made part of this permit. SIGNED , DATE if BOX A is checked, the Local 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 a APPEALS: Appealed to Board of Appeals? ❑ Ycs ❑ No Hearing date: Appeals Board Decuioo --- Approved? ❑ Yes ❑ No Conditions SECTION G: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued) The following information must be provided for project structures. This section must be completed by a registered professional engineer or a Caused land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement(in Coastal High Hazard Areasbottom of lowest structural member of the lowest floor, excluding piling and columns) is: Fr. NGVD (MSL). 1 i ' 2 Actual (As-Built) Elevation of floodproofmg protection is FT. 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 comphana with the community's local law for flood damage prevention. INSPI=CYTONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8: CERTIFICATE OF OMPLIANCEfTo be completed by LOCAL ADMINISTRATOR) Certificate of Comphana issued: DATE--_ BY: s s' i! 4� i3 �y _ 00 D S J_ 3 TOWN ,OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET / S VILLAGE DIST. SUB. 1/ LOT FORMER OWFR M C,' NAJ tV 7-, . 4 1.1/ N E ACR. fj S W TYPE OF BUILDING t RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS f' d /0 FA'a 2f4 66 holdze!-, a v e o o e? Ge0 000 3 a8 7 la/! 8o S LE G`jSao j."08 tNz ' awl R. IoL r 4WF L 3 9 ) 4 O o ¢ 20 a (0 00 /1 30/p/ I P; I l Z G o� u / 13 L,e I$d a00 20 a 20 B ✓ I 4 8 0? l8c(6 • 7Penoy I k mo bzo,a 7 Is 9s8P�aaroa� , s� sin le or A� �q w Il�h 5 �g 5; a VSs AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per VclueAcre Tillable FRONTAGE ON WATER 62y 4 D= o �� �,= I Woodland FRONTAGE ON ROAD Meadowland f �Yr�x DEPTH House Plot BULKHEAD Tote&_� v ''■" ,w DOCK 14o0-�?`3- 3-/2 TOWN "OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET �r VILLAGE DIST. SUB. LOT 7,1t v , FORMER OWNER;' N E ACR. yi O y ki< S W TYPE OF BUILDING as , RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 6 p 6 6 d V21sQ/d sa 29 gat,-fet` T it � 110 �7L ori�1'3�4L'Kr T -,'(2O E Lr Q425 �348 __ "448 le $ o AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Vclue Acre Tillable FRONTAGE ON WATER y a Woodland FRONTAGE ON ROAD 106 Meadowland DEPTHl � , House Plot BULKHEAD Total DOCK DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-01006/00005 _ July 30,2002 FACILITY/PROGRAMNUMBER(S) PERMIT EXPIRATIONDATE(S) Under the Environmental July 30, 2007 Conservation Law 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 and Barbara Holley 631 477-2861 ADDRESS OF PERMITTEE 1085 Ba shore Road, Greenport, NY 11944 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Suffolk Environmental ConsultingInc., P.O. Box 2003, Brid eham ton, NY 631 537-5160 NAME AND ADDRESS OF PROJECT/FACILITY Holley ro ert , 1085 Ba shore Road, Greenport COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Pipes Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct garage and pervious driveway in lieu of dwelling, driveway and sanitary system approved under permit#1-4738-00594/00002. Remove existing shed. All work must be done in accordance with the attached plans stamped NYSDEC approved. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMITINISTRATOR: ADDRE S Region 1 eadquarters John A. ieland LJS Bldg. #40 SUNY, Stony Brook, NY 11790-2356 A RIZ ED SIGNATUR DATE C Page 1 of 4 July 30, 2002 Jbert J. Krupski, President Town Hall James King,Vice-Presidento�� FOO 53095 Route 25 Artie Foster a P.O.Box 1179 Ken Poliwoda y� Southold, New York 11971-0959 Peggy A. Dickerson H Z Telephone (631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 23. 2002 Mr. Matt D. Ivan Suffolk Environmental Inc. PO Box 2003 Bridgehampton, NY 11932 RE: SCTM#53-03-12 985 Bayshore Road Greenport, NY Robert E. & Barbara Holley Dear Mr. Ivans: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, May 22, 2002. RESOLVED, that the Southold Town Board of Trustees Approve an Amendment to Permit #5238 to construct a detached garage 24'x36' in the exact same location and eliminate the proposal for a septic system. If you have any questions, please call our office at 765-1892. ncerely, Alberti. Krupski, Jr. President, Board of Trustees AJK:cjc cc: Building Department I ms Board Of Southold , Town Trustees * K SOUTHOLD, NEW YORK PERMIT NO. DATE: October 30, 2000 '. ELLEN A. GROPPE -s ISSUED TO ....................._. _............................................ ..................................................... .. ,�u#I�nxi�tt#inn C 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 State of New York 1952; and the Southold Town Ordinance an. 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 ..... ct...... 25, 1000end in consideration of the sum of 6.....15...0. paid by Suffolk Environmental Consulting, Inc. for Ellen A. Groppe ......................... .... .. ........ of ..... Brfdgehampton ... ... ......... N. Y. and subject to the Terms end Condifions listed on the reverse side hereof, of Souf hold Town Trustees authorizes and permits the following: Welland Permit to construct a single-family dwelling, driveway, and septic system. The 24'X76' proposed dwelling le to be built on piles and located 47'H- from the �f wetlands with a 40' hon-disturbance buffer adjacent to the tidal wetland line, all Y s with the condition that there be no turf and no fill placed on the north or on the fi west side of the house or on the west side of the proposed driveway, and no fill or turf on the east side of the house. The only fill that will be brought In will be for the septic system on the mouth side of the house. Native species should be In a planted after construction and that there be a staked row of hay bales at the 40' non-dleturbance buffer line during construction. �9 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 date. Rt u a.14- Ln (ABSENT) ,'(• 1 Ixt Trwlses I FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: August 28, 2002 TO: Suffolk Environmental A/C Holley PO Box 2003 Brid ehamtpon, NY 11932-2003 Please take notice that your application dated August 22, 2002 For permit for construction of an accessory garage at Location of property 1085 Bay Shore Road, Greenport, NY County Tax Map No. 1000 - Section 53 Block 3 Lot 13.1 Is returned herewith and disapproved on the following grounds: The proposed construction not permitted pursuant to Article III Section 100-33C which states; In the case of a waterfront parcel, accessory buildings and structures may be located in the front yard, provided that such buildings and structures meet the front-yard setback requirements as set forth by this Code. Front yard setback on parcel, +/- 23,392 sq. ft., pursuant to Article XXIV, Section 100-244, is 40 feet. Proposed structure is shown at 35 feet from the front lot line. �a_/ ------------ Aut orized Signature Cc: ZBA, File Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. New York State Department of Environmental Conservation Division of Errvironmantal Permits Building 40 - SUNY, Stony Brook, NY 11790-2356 AM Telephone (631) 444-0365 Facsimile (631) 444-0360 Erin M. Crotty Commissioner July 30, 2002 Robert & Barbara Holley 1085 Bayshore Road Greenport, NY 11944 RE: 1-4738-01006/00003 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely Laura J. Scovazzo Environmental Analyst LJS/ls Enclosure NEW YORK STATE DEPARTMENT 0 ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-01006100005 S July 30, 2002 FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental July 30,2007 Conservation Law TYPE OF PERMIT t 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 and Barbara Holley 631 477-2861 ADDRESS OF PERMITTEE 1085 Ba shore Road, Greenport, NY 11944 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Suffolk Environmental ConsultingInc., P.O. Box 2003, Brid eham ton, NY 631 537-5160 NAME AND ADDRESS OF PROJECT/FACILITY Holley ro ert , 1085 Ba shore Road, Green ort COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold I Pipes Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct garage and pervious driveway in lieu of dwelling, driveway and sanitary system approved under permit#1-4738-00594/00002. Remove existing shed. All work must be done in accordance with the attached plans stamped NYSDEC approved. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMITrAINISTRATOR: AB[dg. DDRE Segion 1 eadquartersJohnA. nd LJS #40 SUNY, Ston Brook, NY 11790-2356 A tRIZED SIGNATUR DATE 30, 2002 C Page 1 of 4 Jul NEW YORK STATE DEPARTMENT OFZNVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives,employees,and agents("DEC")for all claims,suits, actions,and damages,to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department)to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps,drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal,modification ortransfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System(SPDES), Hazardous j Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management i Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions,relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions,orders of the commissioner,any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUMBER 1-4738-01006/00003 PAGE 2 OF 4 NEW YORK STATE DEPARTMENT OF E14VIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLES), 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work,obstructions,or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State,and to such extent and in such time and manneras the Departmentof Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S.Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly,without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 8. If granted under 6NYCRR Part 608,the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977(PL 95-217)provided that all of the conditions listed herein are met. t 9. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by Suffolk Environmental Consulting Inc. dated 7/1/02. DEC PERMIT NUMBER PAGE 3 OF 4 1-4738-01006/00003 NEW YORK STATE DEPARTMENT Of ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 2. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 3. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. 4. Necessary erosion control measures i.e., haybales, silt fencing, etc. are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until thick vegetative cover is established. 5. Roof runoff shall be directed to drywells a minimum of 50 feet landward of the tidal wetland boundary for immediate on-site recharge. 6. Driveways and parking areas shall be constructed of pervious material. I� 1 DEC PERMIT NUMBER PAGE 4 Of 4 1-4738-01006/00003 Albert J. Krupski, President Town Hall James King,Vice-PresidentoFFOI, C' 53095 Route 25 Artie Foster ��j P.O.Box 1179 Ken Poliwoda C y.2 Southold, New York 11971-0959 Peggy A. Dickerson y = Telephone (631) 765-1892 Fax(631) 765-1366 �yol � dao BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 23. 2002 Mr. Matt D. Ivans Suffolk Environmental Inc. PO Box 2003 Bridgehampton, NY 11932 RE: SCTM#53-03-12 985 Bayshore Road Greenport, NY Robert E. & Barbara Holley Dear Mr. Ivans: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, May 22, 2002. RESOLVED, that the Southold Town Board of Trustees Approve an Amendment to Permit #5238 to construct a detached garage 24'x36' in the exact same location and eliminate the proposal for a septic system. If you have any questions, please call our office at 765-1892. nce�reiy, Albert J. Krupski, Jr. President, Board of Trustees AJK:cjc cc: Building Department OWNER'S ENDORSEMENT (TO BE SIGNED IF APPLICANT IS NOT OWNER) STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: Robert and Barbara Holley , being duly sworn, deposes and says, I reside at 1085 Bayshore Road; Greenport; Town of Southold, NY In the County of Suffolk and the state of New York, and I am the (owner in fee) (officer of the Corporation which is owner in fee) of the premises described in the foregoing application and that I have authorized Suffolk Environmental Consulting, Inc. to make the foregoing application as described herein. Signature �I Signature If Corporation, name of corporation and Officers Title Officer's Title Before me, this y day of lu T — 2002 Notary Public Me"hew D. Ivens Rotary Public of New York No. Ol IV6053859 Qualified in Suffolk County Commission Expires January b 2005 August 23, 2002 Damon Rallis C/o Southold Town Assessors Southold Town Building Department P.O. Box 1179 Southold,NY 11971 Re: Holley Property Situate: 1985 Bayshore Road, Greenport SCTM#: 1000-53-3-12,13 Dear Sirs; Please be advised that my wife and I own the two adjacent tax map parcels referenced above. We have merged the two parcels in Title and propose to construct a detached garaged in a required front yard. In order to do so a zoning variance is required. In order to make a zoning application a notice of disapproval from the building inspector is required. In order to obtain the notice of disapproval, we are required to obtain a singular tax block number encompassing both properties now merged. Kindly assign the two merged parcels a singular tax lot number so that we may obtain our notice of disapproval. Thank you in advance for your cooperation. Sincerely, Pv/A"'� Robert Holley Barbara Holley jC (M r i o 4%%jFFO(,(co 0 H 2 Town Hall,53095 Main Road • Fax(631)765-1823 ly�0,( � Telephone(631)765-1802 Southold,New Yorkl 971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 15, 2002 Suffolk Environmental Consulting A/C Holley PO Box 2003 Bridgehampton, NY 11932-2003 To Whom It May Concern, As per our recent conversation,we cannot process your application for a notice of disapproval for the construction of an accessory garage at 985 Bayshore Road, Greenport, NY, SCTM# 1000-53-3-12, until you proof of merger has been submitted to this office. Because you have failed to respond to this request in a timely fashion, we are returning the application as incomplete. Please feel free to re-submit your application once you have the above referenced information. If you have any questions, please contact this office at(631) 765-1802 between the hours of 8:00 a.m. and 4:00 p.m. /(72 / L rized afore - BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: 3 /4/03 APPLICANT:'-Rob' 44 DATE SUBMITTED: $ a-Q/0& SCTM# �7 q DISTRICT: 1,000, SECTION: FJ3 BLOCK: 3 , LOT: /3• / SUBDIVISION: /QccH7ic t�1 ADDRESS: AF5 IS,ho�P ��. CITY: ZONING DISTRICT:RAP CONFORMING? Yes BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- ,INFO /BP _-Z/C/0 Z- INFO BP -Z/ C/0 Z- INFO /BP -Z/C/0 Z- INFO PRE CO: Y OR N BP -Z / C/0 Z- SINGLE & SEPARATE CERTIFICATION-REQUIRED /yam NOTES: 04 a y LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.199771100-25.Mergen(A nonconforming at any time after 711182 REQ, LOT SIZE:410 000 ACT, LOT SIZE:142.�e�REQ. LOT COV. 0?0/o ACT. LOT COV. REQ. FRONT 03MD PROP. FRONT REQ SIDE ACT. SIDE REQ. REAR PROP. REAR HT�PROP. HEIGHTPep-z- PROJECT DESCRIPTION:&ancp17 0A .� �uh�jp p� 'A ESTIMATED PROJECT COST: ARCHITECT VK��'� g H 1,- FAST TRACK N 0 WATERFRONT? yES DESCRIPTION: YPqES c n e - PANEL #: FLOOD ZONE: COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or0 /J, (BED #): _DTE: /_/ PERMIT #: TOWN SEPTIC RECEIPT: Y ol� NEW YORK STATE DEC: PRE-o8C gni4 YyrS r NO 2 SOUTHOLD TOWN TRUSTEES: or NO TOWN ZONING BOARD APPROVAL r NO TOWN PLAN. BOARD APPROVAL: YE5or O TOWN HISTORICAL PRE (SPLIA): YES or NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or® N 0 2a c- NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE I. (—'60+ SF)- ASF)=3&t SF X $ •30=$ 10g22 +$ '75 +$ _$ 15420 FWOV> 2. ( SF)- ( _SF)= SFX $ _$ +$ +$ =$ I F'�7Lr Ir 20 3. ( SF)- LSF)= SFX FINAL TOTAL: $ 41ag } .o1-0 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B. DeNo. ember 31, Expires December 31, 2005 ELEVATION CERTIFICATE Im ortant: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION Fpr41) iaariy BUILDING OWNER'S NAME Qlft .,tntr�, p K,vE .1 6Aoe4 oofc BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg. No.)OR P.O. ROUTE AND BOX NO. CITY �• STATE / ZIP CODE PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Ly Coro -- 53-03 - /3 : / BUILDING USE(e.g., Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) (>A2QFrE LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: L_1 GPS(Type): or 1kq.itk°) _i NAD 1927 _1 NAD 1983 LJ USGS Quad Map 1-1 Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE loco. o'- 3G,901 3 S07( 4)11- B .MAP AND PANEL B5.SUFFIX 86.FIRM INDEX B7.FIRM PANEL B8. FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVEIREVISED DATE ZONE(S) (Zone AO,use depth of flooding) /15-9 G 'PH 'H1R9p tie— - O B10. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in B9. 1_1 FIS Profile 1-1 FIRM 1_1 Community Determined L1 Other(Describe): 1311. Indicate the elevation datum used for the BFE in 139: 1-1 NGVD 1929 1_ NAVD 1988 1-1 Other(Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area (OPA)? 1-1 Yes 1-1 No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings' 1_JBuilding Under Construction' KFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2,Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3. Elevations–Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different fronli�'.., the datum used for the BFE in Section B,convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate,to document the datum conversion. Datum}.l(,JAx W Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 1_1 Yes No Ela)Top of bottom floor(including basement or enclosure) G!Eft.(eP) ❑ b)Top of next higher floor ( ft.(e+) C ❑ c)Bottom of lowest horizontal structural member(V zones only) _f/�A _ft.(m) o o ❑ d)Attached garage(top of slab) /A _ft.(a) W� �h� A. ❑ e)Lowest elevation of machinery and/or equipment - V spy Q servicing the building(Describe in a Comments area.) E a+ ❑ f) Lowest adjacent(finished)grade(LAG) ft.(o) 2 4 • • ❑ g)Highest adjacent(finished)grade(HAG) �� I ft•(� 8 � O,q96 El h)No. of permanent openings(flood vents)within 1 ft. above adjacent grade n 9 LIi)Total area of all permanent openings(flood vents)in C3.h—W&sq. in.(sq.cm) OF td SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify that the information in Sections A, B,and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001. CER"fIFS �hME A /n pG KU G, S LICENSE NUMBER I.7 7 U qAl. 'Ly TITLE / OMPANY NAME �Aw�/ dlr/Lc 02 O$ N ��1 ti(J A.-r7 d 2 Rr✓ ADDRESS/,ei Cl STA E ZIP CODE SIGNATURE DATE © Z 3 03 TELE 6 3/ 72 7-2090 FEMA Form 81-31,January 200 See reverse side for continuation. Replaces all previous editions i IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS(Including Apt., Unit,Suite,and/or Bldg. No)OR P.O: ROUTE AND BOX NO. Policy Number /C 4'S 054 4,tfr" 9 11� CITY ISTATE ZIP CODE Company NAIC Number CrL.k-e"Oe 0-a ti. G . !/yyH SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official, (2) insurance agent/company, and (3) building owner. COMMENTS 1_1 Check here if attachment: SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE),complete Items Et.through E5. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed- see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2.The top of the bottom floor(including basement or enclosure)of the building is 1-1-1 ft. (m) 1J-1 in. (cm)1_1 above or 1_1 below (check one)the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7),the next higher floor or elevated floor(elevation b)of the building is 1-1-1 ft. (m) 1-1—lin. (cm)above the highest adjacent grade. Complete Items C3.h and C3J on front of form. E4.The top of the platform of machinery and/or equipment servicing the building is 1-1-1 ft. (m) 1_I-1 in. (cm)1-1 above or 1_1 below (check one)the highest adjacent grade. (Use natural grade, if available.) E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?1_ Yes I_ I No I- I Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community-issued BFE)or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. PR PERTY OWNER' OR OWNER'$ s�THORIZED REPRESE ATIV 'S N, E 1�K>i/3 T } b f� {I l7 N �c� w t� A D Dr E S_ CITY ST TES ZIP COD IgNtA URF Y - DAT T EPHONE, COMMENTS I_I Check here if attachment SECTION G -COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Gt. 1_1 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer,or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the .•elevation data in the Comments area below.) G2. 1_1 A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.1_1 The following information (Items G4-G9)is provided for community floodplain management purposes. G4.PE MIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for: 1_1 New Construction 1_1 Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building is: —ft. (m) Datum: G9. BFE or(in Zone AO)depth of flooding at the building site is: —ft. (m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS I_ Check here if attachmen FEMA Form 81-31, January 2003 Replaces all previous edition: M-1802 BUILDING DEPT. INSPECTION [ ] FOU TION IST [ ] ROUGH PLBG. UNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMN FY REMARKS //b� GU DATE INS OR I 7651802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 SOLATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ..n i , / DATE D INSPECTO 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDA JON IST [ ] ROUGH PLBG. [ ] FO ATION 2ND [ ] INSULATION [ RAMING [ ] FINAL [ ] FIREPLACEHIMNEY REMARK : v DATE INSPECT FIELD INSPECTION REPORT DAT COMMENTS FOUNDATION(IST) y ---------------------------------- - % a FOUNDATION(2ND) z D � o ROUGH FRAMING& — PLUMBING H INSULATION PER N.Y. y STATE ENERGY CODE U � FINAL f1 ADDITIONAL COMMENTS I G Z m - -- � y — Sc z CC C i TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIS] BUILDING DEPARTMENT Do you have or need the following,before applying' TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502Survey PERMIT NO. 07 IO )a 4 :i-L Check Septic Form N.Y.S.D.E.C. Trustees Examined , 20 3 Contact: Approved 20_3- - Mail to: Disapproved a,c Phone: Expiration-V-1 20 Building Inspector AUG 2 , nil ( i 1 4 � ', 'AJ?PLICATION FOR BUILDING PE IT i Date 2(PL 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 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, housin code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) 5'FF�CxK FN JI rl tlJ- CQIJfv�TIJ(- /,c. o. 3or Zao3 ZY I pC&( PmAJ i 1143Z (1�14iling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder AGgul A-1 Name of owner of premises 7315(2 r 15 ] �,a,2'6ogA d6C(6-,Lf (As on the tax roll or lat,6st 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: /05,5- 3AVf-a) f— TZcmAo G��+ �1Po;z House Number Stleet Hamlet r„ County Tax Ma No. 1000 Section S 3 Block 03 y` Lot 3 Subdivision Court. A. LIA -� a 7 5 PF "d" Filed Map No. 0 Lot (7, (3,:j 4 4 /S (Name)— ^ . i 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy T'iZI�o E SiN� r4M c.4 LJt a i N G- b. Intended use and occupancy I(U/A czZ rAAIL4 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 3 S, D0 Fee (To be paid on filing-this application) 5. If dwelling, number of dwelling unit _ " Number of dwelling units on each floor If garage, number of cars'f 2 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. - q5,0 7. Dimensions of existing structures, if any: Front -73,() +/- Re ]3,0 f/ Depth {� Height 4 3 2, O Number of Stories 0'j F_ Dimensions of same structure with alterations or additions: Front Rear Depth I Height Number of Stories r 8. Dimensions of entire new construction: Front 36,0 Rear 36.0 ` Depth 2 Height <,/ 3Z'0 ' Number of Stories ONS T 9. Size of lot: Front 0' 4�- Rear 300,0 f/- Depth f0'0' t� 10. Date of Purchase — Name of Former Owner 0I7oPPi 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES _V NO 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES NO 300 EAsr y�sTjAP;. 25 Z- 14. Names of Owner ofremises oct< Address N�A N 100f6 Phone No. ZI2 986- 46 S Name of Architect t�i<«N er o awe a ddress NIA 6.'56­mao�Phone No q71-01f 00 Name of Contractor Address Phone o. 15 a. Is this property within 100 feet of a tidal wetland or a freshwat etland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS AY 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. STATE OF NEW YORK) SS: CO Y OF `5vrRXL ) pr-r T)_ VA+- being duly swom, deposes and says that(s)he is the applicant Name of individual signing con ct) above named, (S)He is the �6EN - ✓��AC(L rAJIJ I�O J"',1�1 + C �� vLa7 ✓Iz (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. Sworn to before me thi (4W day of 20 6)Z_". Notary Public S' ature f A cant LYNDA M.BOHN NOTARY PUBLIC,State of New York No.01806020932 Qualified in Suffolk Cour_ Term Expires March 8, 2 piPES CREEK MAP OF -__fr_ . -- TOWNOFOF SERWATEOULANo)LD (UNLOT 12 , 13 , 14 & 15 `'I'`� N 8250'D AMENDED MAP `A " OF MAR 17 2003 13.9 5' PECONIC BAY ESTATES FILE No. 1124 FILED MAY 19, 1933 SITUATED AT ° LINE OF su'COUN ETMROND^L 4'49s F \ TAGS AS DETERMINED BY ARSHAMOMAQUE ryp� ''u` 2 EHrALDDNSPLTNG, ,NG \ TOWN OF SOUTHOLD piO 6tip _ I FLAG ' 3 i — BY ITE gPPLICgNT kHOELINMEn"aTEO Try POTATION PA�CRFAiED SUFFOLK COUNTY, NEW YORK / DdG-- '"NOW"'. ED „ S.C. TAX No. 1000-53-03- 13. 1 83'06' F _ -- SU DN ENM FTA, r coNsuLnNGTMNCHON DECEMBER E, „as SCALE 1 "=20' 5rjti�` , _ FEBRUARY 4, 1997 _ — — _ I i MARCH 30, 2001 ADDED NO TURF ZONE - — -- — _ FEBRUARY 1JANUARY 24, 2002 8, 2002 ADDEDEDOSITE4P&N 5 N 7 42Aj1 E INE / i illlc y O --- --ILL atRu ooEnicx v �T'iDus su _ Ma 1�_ •z�' AS SHOWN ON PR MAY 22, 2002 REVISED PROPOSED GARAGE LOCATION TIE i x �ow I AN tan ON MANun�In _ SEPTEMBER 5, 2002 REVISED PROPOSED GARAGE LOCATION `i wn ` I �o Is9E a OCTOBER 23, 2002 REVISED PROPOSED GARAGE LOCATION FE Pv^ A ,99TH ,. og}/ y I uc ML n ART TIDPLI_ - W NDS �� O AL 'ILL 1 ,�llL ,� '> apo �, h 1s p� p 1 ,Ir — — og ' DEQ I AL I / iIAGGEO 1 1 9,L O aT MW wENjdOi PaoTECTIVIT O n U++°w�evaE M°ramE :.I ?Jst /ROMP OIL = MONS DOGS P aT 3 311E SILL tet. 5 H Q CERTIFIED TO, A Alf, ,T� y AFF ROBERT E. HOLLEY O BARBARA C. HOLLEYN COMMONWEALTH LAND TITLE INSURANCE COMPANY SL �W I �S E ^ �L ilLc 11¢ NG,D1sNRenM m EU , � a r / Olr7'C PC LINE sEvnTALINK CID \F ZONE .a •• • 4 "0 !, x TEST HOLE DATA Y y OL o 4 / O rj T_ 1. e 9E I (TEST HOLE DUG BY Mc00NALD GEOSCIENCE ON JANUARY 21, 1997) t� �• • 1 • Wik BRDWX 9L1T l➢.W j � F�pP05ED 6hD 0yr, , E ••1 nA p5LA1'� ELbJ � •� o e9owN Loner SILT � O'L aL - ) 07' cR00N0WnTFa BFawMEDIUM TO eau FSE e6 s"NoMH I CESSPO LOCATION ,y ,Illi / IN OCeI MEDIUM J, 1 W I Er ro COURSE EARD wIM TOS OIUVEL i �uNo j NO TURF ZONE _ -- A, 1 N D — `S E `'y TEST HDL; -- 1� IrtT UNAUTHORIZED ALTERATION OR ADDITION �� 6g•??SU E, \795.j 1, ,5a,00'x_ W_ _ a ^ J TO THIS su0VEr Is A vNEW YO OF ELL, SECTION 7209 OF THE NEW YORK STATE p PE" EpPGTON LAW 16)� N 5400" E COU Is o5E S 79 DTILm' POLE knvEUEM E°GE Of' q�,:; COPIES OF THIS SURVEY IMP NOT BEARING ?. 79• y2 ty,T THE SSE BEAT SHR's INKED SEAL SI h _ • -• •WJ / ,p EMBOSSED VALID SHALL NOT BE CONSIDERED y�� TO BE A VALID TRUE COPY NOTES: b \ y p A CERTIFICATIONS INDICATED HEREON SHALL III JIII/Y ONLY TO THE PERSON FOR WHOM hlE SURVEY 1 . ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM ^ °_• �^ .'H • I A w IS PREPARED, AND ON HIS BEHALF TO THE .,�1 -1�Ky TITLE COMPANY, GOVERNMENTAL AGENCY AND EXISTING SPOT ELEVATIONS ARE SHOWN THUS: ss _ '\ M ^ JL �' — LENDING INsrITUDON LISTED HEREON. AND EXISTING CONTOURS ARE SHOWN THUS: _— — -- 9— — -- JV 1 TD THE ASSII;NEES OF THE LENDING NOT T°TION. CERTIFICATIONS ARE NOT TRANSFERABLE. PROPOSED SPOT ELEVATIONS ARE SHOWN THUS: 2 FLOOD ZONE FLOOD INSURANCE RATED FROM:N TAKEN MAP No. 36103CO159 G PUB WATER IN STREET) THE EXISTENCE OF RIGHTS OF WAY LIC AND/OR EASEMENTS OF RECORD, IF ZONE AE BASE FLOOD ELEVATIONS DETERMINED ANY, NOT SHOWN ARE NOT GUARANTEED. ZONE X': AREAS OF 500—YEAR FLOOD; AREAS OF 100—YEAR FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100—YEAR FLOOD. 1 PREPARED IN ACCORDANCE WITH THE MINIMUM STAN°AR°S FOR TITLESTRAYS AS ESTABLISHED Joseph A. Ingegno 3. S.C. TAX LOT No. 1000-53-03-13 WAS DRAWN FROM PREVIOUS SURVEY 9Y THE LIALS AND FOR SUCH USE BY THE NEW r°Rrc srnrE no BY RODERICK VAN TUYL LAST DATED JANUARY 17, 1996. I TFE ASSOCIATE I ��O AIN�p Land Surveyor I �ore F x I 4K � Title Surveys — Subdivisions — Site PlDns — Construction Layout T t" O PHONE (631)727-2090 Farc (631)727-1727 �FQ OFFICES LOCATED AT MAILING ADDRESS C N NY S UG NO 49668 1390 ROANOKE AVENUE P.O. Be. 1931 RIVERHEAD, New York 11901 Riverhead, New York 11901-0965 21-571 n1 PIPES CREEK MAP OF "?1Y 13 2004 TOWN OF SOUTHOLD (UNDERWATER LAND) LOT 12 , 13 , 14 & 15 8750.05" E AMENDED MAYA OF -- - O� 0 13,95' PECONIC BAY ESTATES FILE No. 1 _ FILED MAY 19, 1933 15' –�_� SITUATED AT ,� ARSHAMOMAQUE � ,I AL � s �° �% �ao�9 n�B�RMIN� TOWN OF SOUTHOLD IN — '" 'k } \ SUFFOLK COUNTY, NEW YORK e / / I 7 , � l _ _ "G / ° �aE °H \ S.C. TAX o. 1000—E 1 53-03-13.1 C119 !J/ 2A 6 / ' / / S' 83'06' 1. B e. 1999 FEBRUARY 4, 1997 N 655g g9 / / / / I / — a� _ _ — \ MARCH 30, 2001 ADDED NO TURF ZONE � JI zFj� i = _ —_ __ I •� JANUARY 24, 2002 REVISED SITE PLAN / $ _ MAY 22. 2002FEBRUARYREVISED 2002REVISEDADDEDOT GARAGE&LOCATION N042518 UNE / / / / O IIE�uNE,�Sf10 F10 ' b$'�' SEPTEMBER 5, 2002 REVISED PROPOSED GARAGE LOCATION `�- MAae / 9�L / 'IIIA / F F0p°P1Cw °ATUN-",N M',suR,�' — _ OCTOBER 23, 2002 REVISED PROPOSED GARAGE LOCATION / / I y 1 '> 1999 4 MAY S. 2003 FOUNDATION LOCATION --_ � �1' 9 / eE _a i ,IL '� 'IIIA —�T10PLIW��ND � ✓ �o i FUD — / -AL AL Ck 'IIIA p �� � ,J1A , �ARo��� H�°� 9LA ; I /— —Ij CT! 'J4 '11L Tax,,*µA'MNWl P"°TEGn / / 2; TORY Fq C5 � EGAD �C ^� / `F< 44"' 'dl jO NrsaEa ` NODaF sf 3 AL IL 'IIIA NN I Caac ALL JW yl / 9 CERTIFIED TO: -44- o / kkY� / g � � Q ROBERT E. HOLLEY Y� y % I �JFFY / O A / A, BARBARA C. HOLLEY p COMMONWEALTH LAND TITLE INSURANCE COMPANY aVR AL 0,0 / BMS o 0 TURF ZONE \ -Te TEST HOLE DATA Z1 O (TEST HOLE DUG BY McpONA ON JANUARY 21, 1997) -�.-- sal_ , m \ - OU I NEAT NDATIEL0NIA e80 ✓� V °�. 6° o• J. I / CO �r/ TOP OF / „a 1 \ uwx KNOWN 5ttt u'w It q \-/,KAil, / , / e?_� \ ��-w / \ O exawH own axT �o / / CESSPw Uxwnox I / / .� \ R�aNN 9EOMM m cauRse N��T /'' EtEv. t.e wm N11x lax clow. Y �cn\ 11 I/ (^� f / Aa p) OWUND WATEN ye,* l 'IIIA / 1 II .jf 1 \ / \ / / / f t1/ 4 / / 1 y 1 II O "�" ff--OGIN E ImNxwRH l/ b' 1 I I�' / •9• I 1 \ mora,= swo WTm lo: aRAwn ZONE TEST xalE = / ?�^ IA� CJ S 68 ZZ SO„ 54ep0' `.I _ — — — / a, + - -/ / UNAUTHORIZED ALTERATION OR MORON /Y� "1y r0 THIS BURJEY IS A VIOIATION OF Ts7 E FOD 0,'E. 5 79•f '� ry' AVEMENr • / EDUCATIOSECTION N 09 LAW F THE NEW YORK STATE .32• N 79'5400" x° i i UIYRyR 11 � . . - ��y/ / COPIES OF THIS SURVEY MAP NOT BEARING THE IAND SURVEYOR'S INKED SELL OR % \ / ' _ • • • / 'A+ / \O EMBOSSED SEAL SH NOT HE CONSIDERED \� Ni TO BE A VAUO TRUE COPY. NOTES: 6 / _ • A / //�, / CMFICATONS INDICATED IS PREPARED, AND ON H5 BEHALF TO THE HEREON SHALL RUN 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM - a• _ ONLY TO THE PERSON MR WHOM THE SURVEY EXISTING SPOT ELEVATIONS ARE SHOWN THUS: a• . ',A A` - • O TITLE GING MSRNI O VERN ENTAL AGENCY AND AND EXISTING CONTOURS ARE SHOWN THUS: — —B— — — �� 9J _ TO THE ASSIGNEES OF THE TENDING INST- EXISTING SPOT ELEVATIONS AND CONTOURS ARE AS PRIOR TO CONSTRUCTION _ TUIION. ASSIGN NOF ARE NOT TRINSFERABTE 2. FLOOD ZONE INFORMATION TAKEN FROM: /l-�� " — — gTREET) FLOOD INSURANCE RATE MAP No. 3$103CO159 G � '" PUBUC WATER 1N THE EXISTENCE OF RIGHTS OF WAY ZONE AE: BASE FLOOD ELEVATIONS DETERMINED AND/OR EASEMENTS OF RECORD, IF ZONE X`: AREAS OF 500–YEAR FLOOD; AREAS OF 100–YEAR FLOOD WITH AVERAGE ANY, NOT SHOWN ARE NOT GUARANTEED. DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100–YEAR FLOOD, 1 PREPARED IN ACCORDANCE E MINIMUM I BY THE LI FDR TRITE SU ASD ADOPTED Joseph A. Ingegno 3. S.C. TAX LOT No. 1000-53-03-13 WAS DRAWN FROM PREVIOUS SURVEY RT THE DS MR. AND S AND ABUSH) MR SUCH USE BY TH N YORK STATE TANG Y RODERICK VAN TUYL LAST DATED JANUARY 17, 1886, 1 Wali AS Land Surveyor i�cT„�,4pH A.1 ��9 I 1 l O TRI, Surveys - SubdImmms - Sitd Plans - C.Struction Layout PHONE (631)727-2090 Fax (631)727-1727 2FD/AND . OFFTCES LOCATED AT MAILING ADDRESS 49668 1380 ROANOKE AVENUE P.O. Box 1931 RIVERHEAD, New York 11901 Riverhead, New York 11901-0965 21-57 F 4Comp'L, WJ1,) MLi/all ext nlc Town zL�h rn�lcem�r Ise d r' � 4 4com?" FEW, slo is e o.. $' of 1 ro�i�e L[ow Tin QDc.`S:Ins r 4U w� 3 RS CERTIFICATE REQUIRED I � DO NOT PROCEED WITH p1 0 A P OVEDASNOTED FRAMING UNTIL SURVEY OCCUPANCY OR OF FOUNDATION LOCATION USE IS UNLAWFUL L) d' I Da��B'R# HAS BEEN APPROVED. VIT"OUT CER7IFICWTE bmo a��n�n OF OCCUPANCY \ FEE: BY: T 3 NOTIFY BUILDING DEPARTMENT AT � `j\ � 3 '� r• _ _, �_ _-___,,,,,.,_-„.._.._..__..,._.__ -- - •---• -- FOLLOWING NS TO 4 S: FOR THE - - FOLLOWINGINSPECTIONS: R. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN�.i a INSULATION 0. FINAL CONS TRUCJJA'flM BE COMPLETE FO ALl CONSTR ALL MEET THE REQ MENS OF THE N.Y. Ii ------- --- ST .. _� .�_._ STATE N UCTION & ENERGY —""—”' ""'--� CODES. RESPONSIBLE FORI- _ DESIGN OR NSTRUCTION ERRORS - i jj 10 I i } — II I-_ f I _ ....... – . ._ . ._ _ . .. _ .... _ - -- a Lu °a > R W o i ✓h 2 f .. I I i 'i II i I OP NEW Y i cJ�`p'EN�E T rn i i _asA I LES__ o — o� r L li P9�FFSSIONP +�` ' a I n c3 � Ls 666 14 ' 3 � a � M 04I _ - LVL :1 � , ,?, i - "?x4 pxq, W '- - ' l F-1 I � 6 Q 2- f�/axIrY8 Lv1L, CD IiNE I'.i4II I I ' I . .�f.I)F NEW)0 EW)0 1 GE ` .. oaz.s¢, / O - IL i i 0 q N ! I � I O i c�✓za " I �l � , � I-�� y:, Cx"�'?t`IfC#ZX ',.•L`,F1�re�) 0 I i _ - -- g r� xB' LED4Ez - - ' ulj ewe 2,x4 N'16'aG ,i' �I}�17Gou-'Til- a i b i L LI lLE p Lu cam' Jti_ s t 4Lp�,j;t,F l I i I '3r� Ha�1�Rnl� t" '^•4'I� I .•y� J tE OF NEW JO, FM, Sx•44,NCE 9 W 4 IiaI f r rJ ,I' 0J2254-IJe- s 9GFESSIONPv l � v3 ti ,