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HomeMy WebLinkAbout29159-Z I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29753 Date: 10/02/03 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 1935 LAUREL WAY MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 121 Block 4 Lot 22 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 2002 pursuant to which Building Permit No_ 29159-Z dated FEBRUARY 21, 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5246. The certificate is issued to NAMROG HOLDING CORP. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1134089 09/10/03 PLUMBERS CERTIFICATION DATED 07/28/03 PERFECTION PLUMB.&HEATING Aut o zed Sign ture 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. 29159 Z Date FEBRUARY 21, 2003 Permission is hereby granted to: HOLDING CORP NAMROG PO BOX 988 CUTCHOGUE,NY 11935 for CONSTRUCTION OF ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING WITHOUT FRONT PORCH AS APPLIED FOR PER ZBA, DEC AND TRUSTEES at premises located at 1935 LAUREL WAY MATTITUCK County Tax Map No. 473889 Section 121 Block 0004 Lot No. 022 pursuant to application dated OCTOBER 2 , 2002 and approved by the Building Inspector to expire on AUGUST 19, 2004 . Fee $ 175 . 80 " zed Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy -New dwelling $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. Z/, G New Construction: Old or Pre-existing Building: // (check one) Location of Property: / 9 Ss leuyre! I,�/e House No. Street /� Hamlet Owner or Owners of Property: J�5'i/n ✓ G G /Y6 L-11;,C4 C..cY/,� Suffolk County Tax Map No 1000, Section/G a O , / / Block `7' Lot Z Z Subdivision Filed Map. Lot: Permit No.1 < / S Date of Permit. - / O Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Q U Fee Submitted: .✓tip-' �%/ Applicant Signature %UFFOt4, y Town Hall; 53095 Main Road 0 T Fax(631)765-1823 P.O. Box 1179 ,�i �� Telephone(631) 765-18C Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION r r Date: Building Permit No. Owner: yGLr1 ✓U g ec✓� (ple se print) j�.1 Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of 1. ,( 2,0� Notary Public, County JOYCE M.WILKINS Natary Public,State of Now York No.4952246,Suffolk County Term Expires June 12, 01-0 p El rlrJrJcnrJrJ�r�rJ�L3 E 111 I'�nc iiiiii r�rJ'rJR110 i�r nrJ�rP101 , ;!Hl PrPiffi E! 0! 3r3 :1 VIErJ�rJrJrJrJr�rPrJ�r�rJcnr racnrJ�rJ�rJrJ�rJrJ�rJ�r�rsr frJ�rJ�rJrJ o 5 BY THIS CERTIFICATE OF COMPLIANCE THE: 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 5rj 40 FULTON STREET — NEW YORK, NY 10038 r5j 7� CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 5 THREE BROTHERS ELEC., INC. * NAMROG HOLDINGS 5 6 ENTERPRISE DR. SUITE A 1935 LAUREL WAY 5 r�CCj E. SETAUKET, NY 11733-3746, MATTITUCK, NY 11952 5 �c Located at 1935 LAUREL WAY MATTITUCK, NY 11952 5 Application Number: 1134089 Certificate Number: 1134089 Section: Block: Lot: Building Permit: BDC: NS11 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Basement,First Floor, Second Floor,Outside,Attic, 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was S rj found to be in compliance therewith on the 10th Day of September, 2003. rj 5 Name QTY Rate Rating Circuit Tyne 5 5 Alarm and Emergency Equipment 5 5 Sensor 2 0 Carbon Monoxide 5 5 Sensor 5 0 Smoke 5 5 rj Wiring and Devices rej Receptacle 14 0 General Purpose 5 5 Switch 8 0 General Purpose 5 5 Fixture 10 0 Incandescent 5 5 Receptacle 1 0 30 amp Dryer 5 Arc Fault Circuit Interrupter 1 0 15 amp 5 5 Receptacle 1 0 GFC1 5 rj Service C5 1 Phase 3W Service Rating 200 Amperes 5 5 5 Service Disconnect: 1 200 cb C5 Meters: 1 LTJ 5 seal 5 5 I of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 o rJ�rJ�rJ'arJ�rJr.PrJ'AJ�rJ�r..frJ�rJ'arJ�rJ�rJ'arJ'a�J'ar�r�rJ'arJ�rJ�rJ�rJ'a rJ�rnrJ'arJ'a�J'rPr.PrJ'ar�rJ�r�rJ'�J'rJ�rJ�rJ�rJ'arJ�r_!'acPrJ'arJ'arJ�cPr.PrJ'arJ'r�rJ�r�'t:Pr�cP�Pr�'r�rJ� O5 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DISTT� sa SUB. LOT amrvd N o Edi' / 9 FORME OWNER NE ACR. / C. Wr,S kR�3r CK CtJa< TYPE OF BUILDING S�T- — W /0 SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 200 &-6 a 0© L Z-36 6 0 Q 6 .2 g6 �.?1 €jT- ) Z ) G - ¢ ur r 2 a /(o L) sit/ o 0 f)QMC J Ho diniqCmv_dao 2. 5o o T 00 2 0 0 5 j 7 4419,7 - P _ Cg aE%n ra AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total v ✓ DOCK APPEALS BOARD MEMBERS SUFF01.f Southold Town Hall Lydia A. Tortora, Chairwoman y� 53095 Main Road Gerard P. Goehringer rx P.O. Box 1179 George Horning O .>c Southold, New York 11971-0959 Ruth D. Oliva y?j�l �a0� ZBA Fax (631)765-9064 Vincent Orlando Telephone(631)765-1809 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUT'HOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 23, 2003 Appl. No. 5246 — NAMROG HOLDING CORP. ! rd Property Location: 1935 Laurel Way, Mattituck 121-4-22 j SEQRA DETERMINATION: The Zoning Board of Appeals has visited 4ge-1 roperfy under ---5 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 applicant's property is a 30,058 sq. ft. parcel with frontage of 72.03 feet along the west side of Crescent Drive (an earth roadway). The lot is improved with a one-story frame house with wood deck, as shown on the survey prepared by Young & Young, L.S. dated September 13, 2002. BASIS OF APPLICATION: Building Department's October 2, 2002 Notice of Disapproval concerning a proposed second-story addition and porch addition, portions of which will be less than 15 feet at its closest point to the southerly (side) property line. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 16, 2003, at 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: A Variance is requested under Section 100- 244B for a second-story addition maintaining the existing 1.1 setback north of the side lot line. Also requested in the original application is a small porch with a zero setback from the side lot line. 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 area variance will not produce an undesirable change in the character of the neighborhood or detriment to nearby properties. This proposed second-story addition, without the proposed porch extension, will not increase the existing nonconforming side yard setback of one foot one inch (1'1"). The second-story addition will not be obtrusive or undesirable because of the low topography of the land where the house is, compared to the neighboring topography. Page 2 -January 23, 2003 Appl. No. 5246-Namrog Holding Corp. 1000-121-3-22 at Mattituck 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The topography of the land and nearness to the wetlands restricts the area for an addition, and an addition over the existing first floor building is the most feasible location for more livable floor area. 3. Grant of the requested variance is the minimum action necessary and adequate to enable applicant to enjoy the benefit of an addition over the first floor of the existing dwelling, while preserving and protecting the character of the neighborhood and the health, safety, and welfare of the community. 4. The difficulty was self-createAause the lot and one-story house were purchased with the preexisting and nonconforming setbacks. 5. No evidence has been submitted to suggest that this minor variance will have an adverse impact on physical or environmental conditions in the neighborhood. The property is located on Laurel Lake, which is a secluded private community with a challenging terrain to build upon. No additional plantings or vegetation will be required to be disturbed, and no further excavation necessary. RESOLUTION/ACTION OF THE BOARD: In considering all of the above factors, and applying the balancing test under New York Town Law, motion was offered by Member Orlando, seconded by Member Goehringer, and duly carried, to DENY the zero setback requested for a porch addition, and to GRANT the variance for a proposed two-story addition maintaining the existing nonconforming print at 11"from the south (side) property line, as applied for, and shown on the September 13, 2002 survey prepared by Young &Young, L.S. This action does not authorize or condone any current or future use, setback or other feature of the subject property that violates the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Tortora (Chairwoman), Goehringer, Oliva, and Orlando. (Member Homing of Fishers Island was absent.) This Resolution was duly adopted (4-0). Lydi . Tortora, Chairwoman 2// /03 'IPaL. FORM NO. 3 NOTICE OF DISAPPROVAL DATE: October 2, 2002 TO: Namrod Holding Corp. 1935 Laurel Way Mattituck,NY 11952 Please take notice that your application dated October 2, 2002 For permit for construction of a second story and porch addition to an existing dwelling at Location of property: 1935 Laurel Way, Mattituck, NY County Tax Map No. 1000—Section 121 Block 4 Lot 22 Is returned herewith and disapproved on the following grounds: The additions and alterations to this existing single-family dwelling, located on a non-conforming 30,058 square foot parcel in the Residential R-40 District, is not permitted pursuant to Article XXIV Section 100-244B which states that on parcels measuring between 20,000 and 39,999 square feet in total size a minimum single side yard setback of 15 feet is required The proposed additions and alterations will Maintain the existing,non-conforming total side yard setback of+/- 0 feet. Total lot coverage is +/- 4 percent. C Ath Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A. Permit Number MECcheck Compliance Report Checked By/Date New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc Data filename:Untitled COUNTY: Suffolk STATE:New York HDD: 5750 CONSTRUCTION TYPE: Detached 1 or 2 Family HEATING TYPE:Non-Electric DATE: 04/03/03 DATE OF PLANS:4/3/03 PROJECT INFORMATION: Gorman Residence Crescent Drive Laurel,N.Y. COMPANY INFORMATION: Stephen Rossetti-Architect 30 Warfield Way Southampton,N.Y. COMPLIANCE: Passes Maximum UA= 163 Your Home= 153 6.1%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling L Flat Ceiling or Scissor Truss 862 38.0 0.0 26 Wall 1: Wood Frame, 16"o.c. 1081 19.0 0.0 52 Window 1: Wood Frame,Double Pane 212 0.350 74 Floor 1:All-Wood Joist/Truss,Over Outside Air 38 38.0 0.0 1 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications,and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this page,they are attesting that to the best of his/her knowledge,belief,and professio ent, such plans or specifications are in compliance with this Code. Builder/Designer Date I 09 4k pg� t MECcheck Inspection Checklist New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc DATE: 04/03/03 Bldg. Dept. Use Ceilings: [ J 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: I Above-Grade Walls: [ ] 1. Wall 1: Wood Frame, 16"o.c., R-19.0 cavity insulation Comments: _. I Windows: [ ] 1. Window 1: Wood Frame, Double Pane,U-factor:0.350 For windows without labeled U-factors,describe features: 4 Panes_Frame Type Thermal Break? [ ] Yes [ ]No Comments: Floors: [ ] I. Floor 1: All-Wood Joist/Truss,Over Outside Air, R-38.0 cavity insulation Comments: I Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials. If non-IC rated,the fixture must be installed with a 3"clearance from insulation. I Vapor Retarder: [ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] Supply duds in unconditioned attics or outside the building must be insulated to R-8. [ ] Return duds in unconditioned attics or outside the building must be insulated to R-4. [ ] Supply duds in unconditioned spaces must be insulated to R-8. [ ] Return ducts in unconditioned spaces(except basements)must be insulated to R-2. Insulation is not required on return duds in basements. I Duct Construction: [ ] I All joints, seams, and connections must be securely fastened with welds,gaskets,mastics I (adhesives),mastic-plus-embedded-fabric,or tapes. Dud tape is not permitted. Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g. (500 Pa). [ ] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [ ] Cooling ducts with exterior insulation must be covered with a vapor retarder. [ ] Air filters are required in the return air system. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: [ ] Separate electric meters are required for each dwelling unit. Fireplaces: [ ) Fireplaces must be installed with tight fitting non-combustible fireplace doors. [ ] Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction provisions of the Building Code of New York State,the Residential Code of New York State or the New York City Building Code,as applicable. Service Water Heating: [ ] Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. [ ] Insulate circulating hot water pipes to the levels in Table 1. I Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 105 °F or chilled fluids below 55°F must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25' 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts 1"and Less 1.25'to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-03053/00001 September 25, 2002 FACILITY/PROGRAM NUMBER(S) PA—IT EXPIRATION DATE(S) Under the Environmental Conservation Lam September 24, 2005 —� TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate I _ ❑ Article 15, Title 5: Pro- ❑ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; tection of Waters Certification 6NYCRR 360: Solid Waste Management ❑ Article 15, Title 15: ❑ Article 17, Titles 7, 8: Water SPDES ❑ Article 27, Title 9; Supply 6NYCRR 373: ❑ Article 19: Air Pollution Hazardous Waste Management ❑ Article 15, Title 15: Control Water Transport ❑ Article 34: Coastal ❑ Article 23, Title 27: Erosion ❑ Article 15, Title 15: Mined Land Reclama- Management Long tion Island Wells ❑ Article 36: Floodplain ■ Article 24: Freshwater Management ❑ Article 15, Title 27: Wetlands Wild, ❑ Articles 1, 3, 17, 19, Scenic and Recreational ❑ Article 25: Tidal 27, 37; 6NYCRR 380: Rivers Wetlands Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Namrog Holding Corp. (631) 298-8478 ADDRESS OF PERMITTEE P.O. Box 988, Cutcho ue NY 11935 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Stephen Rossetti, 30 Warfield Way, Southampton NY 11968 (631) 283-5352 NAME AND ADDRESS OF PROJECT/FACILITY Namrog Holding Corp. Property, Crescent Drive (aka 1935 Laurel Way) , Laurel NY LOCATION OF PROJECT/FACILITY SCTM # 1000-121-4-22 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold NYSFWW 14T-2 E:705.5 N:4539.4 Description of Authorized Activity Construct a second story addition and porch onto the existing single family dwelling. All work shall be performed in accordance with the plans stamped NYSDEC approved on 9/25/02. 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. PERMIT AD NISTRATOR: RESS B1 . #40, SUNY, Stony Brook, MY 11790-2356 JO eland P AUT OR D SIGNS DATE l/. Page 1 of 4 September 25 2002 New York State Department of Environmental Conservation Division of Environmental Permits Rm 121, Building 40-SUNY Stony Brook, New York 11790-2356 Telephone631) 444-0365 _ Facsimile 631)444-0360 Erin M. Crotty Commissioner September 25, 2002 Namrog Holding Corp. P.O. Box 988 Cutchogue NY 11935 RE: Permit# 1-4738-03053/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6 NYCRR, 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. Very truly yours, 114.�"Pxo - Matthew R. Penski Encon Program Aide MRP Enclosure NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL 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 or transfer 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 Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management 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 <> <street>, <City>, <state><zip>, telephone: <> 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 PAGE 2 OF 4 1-4738-03053/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5),24,25,34 AND 6NYCRR PART 608 ( FRESHWATER 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 manner as the Department of 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. 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: Howard W. Youna last revised on 9/13/02 D 1-4738-03053/00001 EC PERMIT NUMBER PAGE 3 OF 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. Any work, disturbance, and storage of construction materials shall be confined to within the "Limit of clearing, grading, and ground disturbance"as shown on the approved plan. 2. Prior to commencement of any construction activities,a continuous row of straw bales shall be staked end to end along the limit of clearing, grading and ground disturbance line as shown on the approved plan. The bales shall be maintained, repaired and replaced as often as necessary to ensure proper function, until all disturbed areas are permanently vegetated. The average useful life of a bale is approximately 3-4 months. Sediments trapped by the bales shall be removed to an approved upland location before the bales themselves are removed. 3. Straw bales shall be recessed two to four inches into the ground. 4. All fill shall consist of clean soil, sand and/or gravel that is free of the following substances: asphalt, slag, flyash, broken concrete, demolition debris, garbage, household refuse, tires, woody materials including tree or landscape debris, and metal objects. The introduction of materials toxic to aquatic life is expressly prohibited. 5. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass, and mulched with straw immediately upon completion of the project,within two(2)days of final grading,or bythe expiration of the permit,whichever is first. Mulch shall be maintained until a suitable vegetative cover is established. If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed as soon as weather conditions favor germination and growth. 6. Suitable vegetative cover is defined as a minimum of 85% area vegetative cover with contiguous unvegetated areas no larger than 1 square foot in size. 7. Any demolition debris,excess construction materials,and/or excess excavated materials shall be immediately and completely disposed of on an approved upland site more than 100 feet from any regulated freshwater wetland. These materials shall be suitably stabilized so as not to re-enter any water body, wetland, or wetland adjacent area. 8. All equipment and machinery shall be stored and safely contained greater than 100 feet landward of the regulated wetland or water body at the end of each work day. This will serve to avoid the inadvertent leakage of deleterious substances into the regulated area. Fuel or other chemical storage tanks shall be contained and located at all times in an area greater than 100 feet landward of the regulated wetland or water body. If the above requirement cannot be met by the permittee,then the storage areas must be designed to completely contain any and all potential leakage. Such a containment system must be approved by NYSDEC staff prior to equipment,machinery or tank storage within 100 feet of the regulated wetland or water body. 9. This permit does not authorize the cutting or removal of natural vegetation. 10. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated freshwater wetlands associated with MT-2 are located on/near the properties of Namrog Holding Corp. and their heirs,assigns or successors. This property is subject to the provisions of Environmental Conservation Law (ECL)Article 24, and the conduct of regulated activities may occur only pursuant to ECL Article 24 if prior approval is given by the New York State Department of Environmental Conservation(NYSDEC)or its successor(s). Regulated activities include,but are not limited to clearing of vegetation;application of chemicals;excavation;grading and filling; and erection of any structure(s)." This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager Bureau of Habitat, SUNY Building 40, Stony Brook, New York 11790-2356. DE-4738-0 305 3/00 001 C PERMIT NUMBER PAGE 4 OF 4 1 NYSDEC Commencement Notice Bureau of Habitat SUNY, Bldg. 40 NEW Stony Brook, NY 11790-2356 Permit No: 1- -1738 - 03053,000a/ Issued To: NAMIqo6 IkOIAIG Core?, Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to the above referenced permit you are hereby notified that the authorized activity shall commence on . The permit sign will be posted at the site and copy of permit will be available at site for inspection. Submitted by: This notice must be sent at least 2 days in advance of commencement of the project. Failure to notify or post will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. Cut along this line NYSDEC Completion Notice AIM Bureau of Habitat = SUNY, Bldg. #40 Stony Brook, NY 11790-2356 Permit No: 1- Issued To: Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to the above referenced permit you are hereby notified that the authorized activity was completed on Submitted by: This notice, with photos of completed work and/or completed survey, must be sent to above address promptly upon completion of project. Failure to notify will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. 95-Ml (M7)-9d New York State Department of Environmental Conservation vNOTICE v The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. (f71?,P03053 OQO/ Regional Permit Administrator Permit Number JOHN w• PAVACIC Expiration Date NOTE: This notice is NOT a permit Albert J. Krupski, President -airTown Hall James King,Vice-President �WVFOi/( 53095 Route 25 Artie Foster 0 P.O.Box 1179 Ken Poliwoda �� � Southold, New York 11971-0959 Peggy A. Dickerson y Z Telephone (631) 765-1892 5 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 10, 2002 j Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: SCTM# 121-4-22 Namrog Holding Corp. 1935 Laurel Way Mattituck, NY Dear Ms. Moore: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on November 20th, 2002 regarding the above matter. WHEREAS, Patricia Moore, Esq.. on behalf of Namrog Holding Corp. applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated October 22, 2002 WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on November 20th 2002 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code. z WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town. NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of Namrog Holding Corp. for a Wetland Permit for a second story addition over existing structure—replacement of sanitary(only if required by Health Department ) with the stipulation of drywells for roof run- off, BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Fee must be paid, if applicable and permit issued within six months of the date of this notification. If inspections are required, at a fee of$5.00 per inspection (See attached schedule). FEES: None V1 � Ga:�r,otrl�,C: Y YOY � L Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc DEC Building Department NI Board Of Southold Town Trusteesg 1 h SOUTHOLD, NEW YORK PERMIT NO. DATE: Nov. 20th,-'2oo2 d < NAMROG HOLDING. _C __ . _ _ .ORP... .... ......._.._.... ..... . ISSUED TO ._............_.. ....._.. ._........:.. ._....._..... Aut4nrizatinn y; 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 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 P Resolution of The Board adopted at a meeting held on ..Novemb.er. 20 2002 and in consideration of the sum of S-2,(}:00-- ' paid by z ...Patricia C 'Moore, Esqori b haIf of Nsmro Holdin Corp +J of Southold N. Y. and su�jecf tote Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit for a second story additon over existing structure - replacement of sanitary system (only if required by Health Dept. ) with the situulations of drywellsffo roof all in accordance with the detailed specifications as presentedr in .the originating application. run—oik WITNESS WHEREOF, The said Board of Trustees Mere- by causes its Corporate Seal to be affixed, and thesepresents to be subscribed by a majority of the said Board as of this date. 4 �p5�F F 0 O SCD 0 1 .1L rar:ear ,y ♦- N `t _ TERMS and CONDITIONS c : The Permittee Narntag Hal.ding Corp. residing at 1935 Laurel Way, Mattituck, N Y., as part of the consideration for the issuance of the Permit does undersand and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold ate released from any and all damages, or rlaias for damages, of suits arising directly or indirectly as a result of say open atioa performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suitsinitiated by third parties, and the said Permittee assuaxs fall liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 24 sews. which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Boatel at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that andt- orizatlon was originally obtained 4. That the work involved will be subject to the inspection and approval of the Board or In agents, and non-compliance with.the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board 5. That there will be no unreasonable interference with navigation as a result of the work herein airhorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Soutbold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the, work shall muse unreasonable .obstruction to free navigation, the said Permittee will be required, upon due nod&, to remove or alter this work or project herein stated without expenses to the Town of Southold 8. That the said Board will be notified by the Permittee of the completion of the work auth- orized 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. BUILDING PERMIT EXAMINER CHECK LIST - ' // DATE REVIEWED: !x/03 APPLICANT: ADAM DATE SUBMITTED: fp(�l(l3 SCTM# DISTRICT: J,000, SECTION: Jam/ BLOCK: �{1 , LOT: �� SUBDIVISION:_ N4 ADDRESS: 1Q� ij(pI (I - Lv1l�CI�C'Il CITY: ZONING DISTRICT: CONFORMING? A0_ BUILDING PERMITS OPEN/EXPIRED: BPO390 -Z/CIO Z- , INFODffl-At_!BP -Z I C(0 Z- , INFO BP__ Z I CIO Z- , INFO /BP -Z 1 CIO Z- _, INFO _ PRE C Y R N Q 98 — BP -Z/ C/0 Z_ SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition-(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at anytime after 7/1413 REQ. LOT SIZE: *x_- LOT SIZE,%-4 REQ. LOT COV.,o ACT. LOT COV. REQ. FRONT PROP. FRONT REQ SIDE (`5r3v:5-_ACT. SIDE REQ. REAR j o PROP. REAR- REQ. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: ESTIMATED PROJECT COST: [ /ENGINEERoss C-rr f FAST TRACK 11� WATER FROW19_ DESCRIPTION: PANEL #: /fr��{B FLOOD ZONE: COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES oj,< aDBED #): i DTE: 1 f PERMIT #: TOWN SEPTIC RECEIPT: Y ore) (B NEW YORK STATE DEC: rae-uEc 9ni7r NO 1�5 -4 OC�Gt71 �L SOUTHOLD TOWN TRUSTEES: Y r NO ✓ TOWN ZONING BOARD APPROVAL: E or NO /,/ ' / �/a✓ TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES or O NEW YORK STATE CODE COMPLIANCE (SEEPAG 2): YESCr NO NOTES: FEE STRUCTURE: FOUNDATION: SF o ,j ) ` )c FIRST FLOOR: SF SECOND FLOOR: $6 SF OTHER: SF INIT OTHER TOTAL TOTAL: p3 SF FEE FEE FEE eo $O ( / SF)- ©( �`U SF)= SFX $ _$ Z�/+$ +$ (—SF)- ( —SF)= SF X (!_SF)- SF)= SF X FINAL TOTAL: $ `., ( STEPHEN ROSSETTI ARCHITECT 30 WARFIELD WAY SOUTHAMPTON,NY TELEPHONE:631-253-5352 n, g February 4, 2003 Town of Southold Re: Namrog Holding Corp. Building Department Crescent Drive 53095 Main Road Laurel, N.Y. Box 1t79 SCTM 1000-121-4-22 Southold,N.Y. 11971 Dear Sir, With regards to the application for a building permit before you for the above property we wish to amend the drawings to delete the proposed porch as shown on the plans on the East wall, South end. If there are any questions you may have please call me at 631-283-5352 Respectfully bmitted, Stephen Rossetti- Architect z NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: HEADERS: Y/N WALL STUDS: Y/N GIRDERS: YIN CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LIVE,DEAD,SNOW,SEISMIC.'.ND WIND(INCLUDING UPLIFT AND EXPOSURE) WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS, LIGHT, VENT: Y/N LOAD PATHS: Y/N ROOF TO FOUNDATION NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALLS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) M-iso2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ /FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 423 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ' ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �"-71 DATE �T �3 INSPECTOR: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: - - DATE 3 INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS Ui FOUNDATION(1ST) y as -------------------------------------- FOUNDATION(2ND) ------ z s o s� _ y ROUGH FRAMING& _ PLUMBING r INSULATION PER N.Y. 7j y STATE ENERGY CODE _ FINAL ADDITIONAL COMMENTS 3 r I O 1 D m QN 70 � y z x y x d b H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 ) Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form ,,,N.Y.S.D.E. . Trustees•^ Wrl sw ! Examined 20 Contact: Approved ,201 Mail to:6I 3 C Disapproved a/c Phone: aBuh(Vng Expiration 20 pector APPLICATION FOR BUILDING PERMIT Date O 20 Z 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,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ff/(Signgnature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder J II Name of owner of premises ///?t,177 YO 6- //G J���r CG✓ (As on the tax roll or latest deed) If applicantisa c oragn a of duly authorized officer (Name and title of corporate officer) Builders License No. /-1/ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section /Z Block LI Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ���� o a U Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units----,L _Number of dwelling units on each floor If garage, number of cars Ncn­'<� 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 f Z I Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth SC-rtee Height ;7-G Number of Stories 7 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated /;�" 0/U 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO-1- 13. Will lot be re-graded?YES_NO a Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address.5'0 Phone No Name of Contractor Ca�fAddress 0 3 P 5v-ti oWL— Phone No. hc-77'r 'o k. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES A 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: COUNTY OF ) <f f �Lbeing duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract)above named, (S)He is the CGlvfiG(moi/O (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 this day of 20o�— of Public Signature of Applicant JOYCE M.WILKINS Notary Public,State of New York No.4952246,Suffolk County Term Expires June IZ aco3 Lo o Young & Young, Land Surveyors 'y✓ �NU� 400 Ostrander Avenue, Riverhead New York 11901 r aE ng ° SOUND 631-727-2303sa Alden W. Young, P.E & L.S. (1908-1994) gag Dllttg 8z% 'S.� ° Howard W. Young, Land Surveyor "s$ %% \\ Thomas C. Wotpert, Projesnonat Engimer Robert C. T.t, Architect Fvgineering �[`` s f 71% eve mao; mm^ \ �mJ A o MEN P N om s � C\ s o .w a. / Lags 4d \\\ IN e g '�.,� pyp. •v � c3�3 t: 2m "fig N 4or mei Ito el II a (Yoh °�\. Shopop�f° R=14125` gUo Sh 24981 > ^ n\m L=n.96' GoR°god P' 2p3�$ `IL91 0\ ' 'I` gm' �' m R=112 ' N n � mf to L=175.9J' \NG J U `4 m ow fmnMy 0 y 16 GAG O �• \\ �f1 ? Fm�ri6Y�Frvat b'" ,DD ;{o WOQC WPLK N yO0 1� �pWA\y. , W O �dk� VP O \ O 966 G AHNO4.a�6e a \ r4, Hak wcOD (\ E DOCK CP QE - o ♦ Q ESF E• 5 y OIEAN\N NRBA pJ V a�6 N5TOR \ O 675 UL 2358 Zp b2 ; �\N\s G°Ln°0No E Gpo4D _ _ 2715 .\ e UL 5A , Q' LOCATION MAP Pea I .� G- ONE DgEwAY \ SCALE 1'=200' as £ 'Y S8, ^' O 1 15 22+I 1, , ftO10' SJ – 1`LIL 4 N??O 39 16 C 11LR NO—.5 Z � AI AD THE 11� `,LP 0 ?5+�• , ANP cARA¢ NOTE:13.71 25 ROoocP 61 P�O� 1. ■ = MONUMENT FOUND 2. TRAVELED EARTH ROADWAY FROM SUBJECT PARCEL THE N.Ys FRESHWATER vt=aANo f r< "xz11 30j - i20�6 \ �y� 4�'° � TO SOUND AVENUE IS NOT SHOWN HEREON, BOUNDARY IS EQUAL TO THE ?�• t ¢ a 3. VERTICAL DATUM = N.G.V. DATUM (M.S.L. 1929) BDLKHEA° AS VERIFIED BY AS AND R MARSH ON 09/6/o2B5y?18v BS "• 3 20'yW j7 G� �1S' Got,fV�� s Q 16.00 zoa' / y Byp O W ° s36w yyry�e SWmf o 210 01�1 SURVEY FOR �g 2ryh 1009 apo issA ¢ \� is m Qac oo y' poi <e NAMROG HOLDING CORP. g �9 �� Sys\5o °( At: LAUREL Town of: SOUTHOLD Arypry. P° oo� Suffolk County, New York h 1 1I°1 � a"" 2 06 NZ \ �� NEwr Suff. Co. Tax Map: nmtnd 4 22 SecQon BIoaLoi 0 b. \ W y QP CERTIFIED TO: o NAMROG HOLDING CORP. FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK f 2 %%-�a�.I n' TITLE NO. 615 S 4815 mU t JAN. 28, 2003 s�A SEPT. 13, 2002 002 Fs§ �4c 45893 yF, �"A'y• MAY s1 [zoe JAN. , 997 �SF�LANDS�P I DATE : DEC. 24, 1996 pain SCALE : 1" = 40' p'8. JOB NO. : 96-1103 110 SHEET NO. : 1 OF 1 OO OO 60407 (00961103.DWG) .,i 432 „ Iq z- a l'z) 1j - } ozw;Q� 2V L it �"T1 67yi C4 771 11" - , W - Xr17t�� fi ? PLUMBED' ERTIFICATIO ON LEAD C NTENT BEFO CERTIFICAT OF 0 PROVIDE OPENINGS FOR w _ EHERGENCY ESCAPE AS . . SOLDER USED IN WATER REQUIRED BY PART. 714 0f M » SUPPLY SYSTEM CANNOT . ,. � .aYt ; � CEED 2/10.of 17o LE D. ING - J , ...Y . . . , ,.. Itcnj,-;r, tib is Used - STATE - 7D DE f 1 WI? I sy, ch, ,, piping a1I bB PROVIDE ANTI-SCALD ANjo4' . ,. O l.,•Es it or L I - - I , UNDERWRITERS CE THERMAL SHOCKPREVENTINr Fr EISUNF ' REQUIRED. . TE' DEVICES AS TO PART. 902.6(K) l."IT'HOUT CFo, ,r ltl ATR - N.Y. STATE BUILDING CODE. OF OCCUPANCY 03NIOD3N PROV@F. SNDKE-DETECTU{G A P OVEDASNOTED_ ,. 31V01i11N30SN3118MN30No ALARM UE49CES AS TO PART,721.1 — �� I Pp L . " - N.Y.S BUILD{PJG CODE: qp FY ILDIN DEPARTMENT AT �. • ' " - T _ 7fi5.1802 0 AM PMrFOR HE FOLLOWING INSPECTIONS: ^� PLUMBING TWO REQUIRED ../ 7. FOUNDATION - ALL PLUMBING WASTE FOR POURED CONCRETE - _ BY WATER LINES NEED 2 ROUGH - FRAM ING &,PLUMBING TESTING BEFORE COVERING - & INSULATION DO NOT PROCEED WITH a FINAL : CONSTRUCTION MUST BE COMPLETE FOR C.O. fft ^ " „ FRAMING UNTIL SURVEY ALL CONSTRUCTIONSHALL MEET , OF FOUNDATION LOCATION .THE REQUIR,EMENTs. of THE N.Y. -sW..+..Y »a+•--+�-. -sn---•y-+ -'� STATE CONSTRUCTION & ENERGY HAS BEEN APPROVED. _. CODES. NOT RESPONSIBLE FOR' . a Y _ " .m^•+ DESIGN,OR,CONSTRUCTION ERRORS r. 1 I -'t:J ''. ."r , .. -,�i { J � -ri ',; {;q •,. v, .,,; _ �y'3, , .;fix. .� _ 1 .�-...: bh r�vLi,y...�sx�: _>...,.-L,.a,_3_3�.du•`�. i.. l,. ,':� '. ._ �_ _ _ __'__ __ _m_ + , _ _J. l ., nl N « " ' ti•YI nikNrnllR ,># 12 4did'ilgdrlp rP MAWrtl end wJtl qot br{+wpo{NdpNq,t'wriMgcn J :Wi11.wrW, Amtr1:'ri �a00"mi�wt��.oi�awa . p'a�iMeuirca4anlr�pY.+dtlhl'kiHe "' 19.A1N1iiw�MW„tralgv''dl4w<I�si'tliliw.. 1. 'fke +h+�itda+0"wNawr# Y' +ui(tim�lOm+Mw. . $a la* MtPn+!aatwatnnp�otmrpnwl� wltpwt u rraa:9�l�a! .. W4+aplii?Y1FNpnM�ngN�'dfiY li.A6nnf IM0 iM rAea�mitat +nlbyVrnnpysykr ctietllpq �xnnaElh#aMlih. - �+. tt�aw��"rw+� 2. (imieP'Mld'dEiMdOi�Yddpity�oq A6W 4NMlowYkd'ArCtt jR IfMma dO% t�E.All R�'F' 'MWh+Fi411 br ” wuid.rp gw.RQlndle Wpti Matlk40t+tk' ► • �u^ 17 AtlalopriaMmkailMoallfotam-wrtar. nd�'Wutmd wimuhliyisttNigiptdw ofilHeNiliuw{8i�atrklad�." ' wmMini 6hm dlcPq'Rew�lioiufdlY+lak ti. Alkphy�iui{wrk Yudl oaiipatrp6 WYi ," ' proNMdibjl[my�Mbc ' '�InyRlumiS w"pow(lyiftgldbp1wfo III }�. KttdiYt Wh'4g14Ci1�IM�e4wpr' i WwY�rkYMMdh�wakiMWAir'�oinilry N1I&> Y� '. ' ma Myrpaiup aflwhil' 20.(JiMmld'hdl wN+r lY�FI, AJmhYlim4 tluw#w MvrlcgWlgiacNly,f�iK'bi�aF hyWwX: ' ' - ' w�rrWky{fhip�hA+�(R,�ig11�dN 21 ►�gvidaClapy� r ' nC{�pmlbAaYmlat�Yi81`rNdddkN��,'Yi1li'MiM�' . . --- — - w�itrnap my �'doWttWaaginYl w, tinlyd dnlwan dtlw 22 �{Ml�M96 wwnMddty 40 py'M+h3+�p�mist �'h'�I,ArMimslryrtYl7. b➢tlh ?` 7 �`,'�M.g1t1aM`�,PMYrdIMeMi� 9'., A114a�unipp'�Mtpprdttilf9'iullgri '' R6 1w+!T1F"�Pf W)jidpt1YIlItaY�IpiOi" C�'tYT°�"� _._Vrl1Y��3�r�: �s2,lj�—G�1I7"..i ::.�`. �`�c7hr tba►+�Ygr�ra�rH1 '.la' . . Ail 2? L�m4o4mLY1M . 4, .Ala� naM.uoba><mM A.ODG�Ta�W21 oMltU. Wi ' s.-AifradunWa6a�rinW��'�1!,Pnww.. -:, aooYsatlMm5rtA4Mo�t — A114wMamA:twmiatwC6.ymM1# T AI -pwl8im.a hev mdaM1M mpllb, 'IIm Y1lY .nYW,hRrr . �. - ry 'ioorjaTiitranal; ♦ mga*10 i i '.i�ml dNlinY'1MWbe�Wlw'FG, 10 41 fid' i w mpe ?km�wmwo. �+wW'n2mw#dd +r } ��Y. � "� . 9. -.tp miriootaAyflmu beCu%16!''ale. a9..AfObN�tlpq i-iM•1IMm'ip , . / ow"I 702111 - UV - _—. - .,.�..1.�...�:e�.d:u�cic7�s !-L. ..... s„i..,,, ...a.a s i ,..�e-i�-..n�''� 4.`-4 ..,.�,.�....�-..�._S.'_w.......-�:.e.-r. —. �- : .� _t::..�._.....�-.—.- — _ .,�_.�'. _ , _,�_' - -�.- ._. y _• __ _ '.-_ _ . ___ _. _.__ - - —. _ . . _ ...,._ .. _.. _ ... ,... _ �, - ,. �� .. �. .. qfC 1 ,:'^alz' �3 � f Gu . Ift, .FGL'S,uW 6 All ELI 021, ' R , d �' � .F:,: Y �+h - }•e, I' _ _ _ .- ._ �. -.__ ._ .._�_�....._. �_.___. �L,�. y .-_e.�..,.ue,'h� "Y. +Cw4� -R Y�� .y_._.....� u i l 4k 0 7'o PFD A ROS�yi! ro , µ E • Al ?14 ti L_ k 6AY 47" V T- 4111m All f ll,-:�Z oo12 IPZA ,�V D cc 2 6211 77 C:TY L4 PSCC fRfLzS y G1��- pa /t'x Ef, 1. oly / A— . ,, /, 1 Z E - � l M� `F /w i s � r� A GENERAL NOTES. 711YArchkact will no Mwa arts aehmgaf 12,ididtloottng abW Mpsavided fun all mawill not banclawihh for=inastim phlga.:Wplk amid Pahl.AgawY air mnf%methods,malud sr ampow 'and - apgeforma prognoses in ov nrtim with We wark., 13.All Inde"mmivumin.a(5;I6Dply. T��- — -- 1. 7110 popmotor shall give all notion No a out sold angel. amply with at law,urdlnaaata.mer, 14.AN 8urh vmtid oonnastra ba frlwad _ .—. ------- ryuletions and law&I m4tasofanyppblie wlgirmd gslvbiW aoo . _ nOwilybrrin6mftpmklrp►oaOifine wart and'shpll prmttahrib)M iiT i : 'O area iftlie dmwin )3. Nhlus widtp vm:11,01=1Time fm' w and spadtastima dawn mesa ash. a5au yrawnm thrawidn. - I I C >p 2. Dmler and anuwaf Ymil kdnnWb.ea Id. All " ppnn haps humlen the Architect andtlwe Pw arsSpeihrions. NJ insuilld.prmfg.BprotEeMlpr. j 0ampand employees lien s8ahhli 17.Nl almink wast shall 0mafam r Issue rev. damages,limithatsaMeimsorklas notong udt tet lhnuad to sdarney frx'aridnpp amafa ofgw YlatiarmLBhenbCada rewiring than the puformanm at"work Ii:Ni�plwbkg wgk ritau map*with HY6 - _ --T--- � �/1., __ .,,I.�I7tl(:y'•.t� ... l `-' _- J-- or ex sheknea attributable is btduy 19. Y _ yr`;. ' �,•-i.: -` _ �, _ pm kltd maty such claim,damage.ler dui and both lehaW exhaust io pant _� ll&dkWg OW tow destruction ofu gbh property catmint 20.DamtalkMpwrapgwsmdkrd islet than rhe xnrlt itielO Llcludiog tlu hp'of heukhd. use mwhing rhmirom and he mead m 21. Protide clecktypedgYtalgkr u..mwt. _.. __ .... __...E7-- whole a In put M any nsglyant act of 22. Drharaahnl wlndoxem Yipu4W�4rs. omisamm alone contrecta arty 23.8ntrom donor to oa//wr m NV\i6 gran subeemmana.. piny byopyytih dimab or indirectly Code. r"ar ` 24. Prarlda mwke dasmarwrpa hYYf employed by my of them a an)par far ButWkg Cade. T7� what acts anYOPthanmryha gnabM425.migonlosswhmher ane it is naagia pre a,Ipdow rad dor apadp tmkmdltprWaltby s party indemnified hrmnilk, noted, .. � , 3. Nlao'dp.ed regnMiaw ofNYg BnlhWhg Co k shall gown tnxrati amlmm{ai nwd 26.All Mrdpn 6`ar Ir6v mualYuW'dmtbla ' installation. support pada. 4, All tannase m be a min.3,666 pair 26 27.All Lothar plywdmhmum unylds - 11-_ -- ,I,PK , da"' 28.Opmhgikrmuroo mosMallbolook S. All Ghmhge to bear m virgin tom, law doom a opus*poor dM9rdewl.k> ownedhearingngapacity Ohimil tang p+aapyy�dnabiplia.dY6rahitoYY�d Ail fnMing and rhesthmg shall M I<rads _ open�p Wu.Baab opuhiyt 9WsOW *A \, 5. Ali inhaler psslitious tobw an double ` y i, doarjaisteapn0lpl. w dm("arkoil°t hatam( . `'x 8: Plapr,neiangjclwwM Dpoil",Pir.Pb- &with or mbihpapttimfnsim )i"..riilt Mem, Path rL 6758-I.60Aor Trp Jain 6nif6eiiopt in 41 ahpin'Madp . , 9. A8 stlb8oarin6 flaru,MC00f)5"aria 29.Architect is not eopysd fur JA- ^�--}' 6ledEhY 611W,dg1l mails, 30.N)ilswvdtlsn)>i"a(6aWwF u �,..L....-- .,.......�._�......-.— _...... - .- --.-�— !0.Wall e6sYhing shall be 7/16"With. be rhfsY,lhM --- 9hrl6kg'o Wlbenajkl 4A*6DmuhQ . . ��.� 1perlitger and4tJQIIua'� . (1 � 7 I � �0N Cgil. 3 Ta LiL17,QJ MA t. l Ir A NO