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HomeMy WebLinkAbout27101-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27834 Date: 07/25/01 THIS CERTIFIES that the building ACCESSORY Location of Property: 6850 ALDRICH LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 120 Block 3 Lot 8.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 14, 2000 pursuant to which Building Permit No. 27101-Z dated MARCH 5, 2001 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to THOMAS A DICKERSON & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 48980 12/26/00 PLUMBERS CERTIFICATION DATED N/A Au orized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27101 Z Date MARCH 5, 2001 Permission is hereby granted to: THOMAS A & WF DICKERSON PO BOX 268 MATTITUCK,NY 11952 for INSTALLATION OF A NEW INGROUND SWIMMING POOL IN THE REAR YARD AS APPLIED FOR. at premises located at 6850 ALDRICH LA MATTITUCK County Tax Map No. 473889 Section 120 Block 0003 Lot No. 008 . 002 pursuant to application dated NOVEMBER 14 , 2000 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 v '2r_R' .?!i}�. `!•(.;A' wYA, w'tA ^w;� w�rw' "+41+' ^./'.•.��..',:]G'... .,,,.� >!;. Electrical Inspection Certificate _ V. Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 r� (831)286-6842 'u t; Date: 12/26/2000 Application No. : 48980 m' - ' Issued to: Tom-Dickerson ca. " rLr`s . -' Street: 6850 Aldrich Lane metal}.. Village: Maitituck Zip: 11952 Town:Southold rr„ Section: 120 Block: 3 Lot: 8.2 Introduced by: Hank's Electric Inc. Lic.# 2675-E /•j n�`i was examined and found to be In compliance with the National Electrical Code 'f�"•-,�.s� v' ❑Att/c 01st Floor ❑ O/S Residential ©Pool ❑ Det. Garage ,? / ❑ Basement ❑2nd Floor ❑ O/S Commercial ❑ Hot Tub ❑ NV Defects "`•`f' Switches Receptacles Fixtures GFI Heaters A/C Fans �„>•; 2 1 1 n Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal Furnace Oil Gas Circulator Smoke Detector Bell Transformer c. . Meter Amps Phase UG/OH Telephone Television Carbon Monoxide �• : , Other Equipment: POOLltrmer Hugo S. Surdi President amt This certificate must not be altered In any manner Building Permit No. vI• Inspectors may be Identified by their credentials !' � �•h� '^ 4; • :i, "i:.'�'_; / : "_/; 1� ::ei�.. �' :i'-7,: - <"s !•, � -Jf !4' f�.�"`.1, sff h:: 7�4 :i L_ ^� }f:; •a :s,.t. ,t i tl�z..• Jm,. � i ° � tl ,;.;,�t 1 kt iry•,,; c. .,c ,f .tti'�:i=��;f:i`; ''tl fi?•, s..l#�: f .:� �L,; ,�: •.� •=-a: 'i'' :. ' ' '�, rt;c '� �;r i' , �� •1l��.� '!'; ; r>;��;ty�r::y, k��i;�q '�,,ikygg �•? ss'* ��str����' fi? .� � >s � 1 � : ! '• �,tt �jt. '�'1 l�I ti�:=:L Ab.:t��• k%rkH' o��gUfFO[kcOG o� y� N Town Hall,53095 Main Road 0 Fax(631)765-1823 P.O. Box 1179 .f. `� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 16, 2001 Thomas Dickerson PO Box 268 Mattituck, NY 11952 RE: 6850 Aldrich Lane To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file• (Enclosed) xx No Underwriters Certificate on file• xx The check is ()$25.00 No Health Department Approval on file• No final inspection has been made• No Plumber Solder Certificate on file• (All permits involving plumbing being issued after April 1, 1984) • BUILDING PERMIT # 27101-Z Please contact our office on this matter• Thank you for cooperation• SOUTHOLD TOWN BUILDING DEPT• o�®gOFFOL�cGG o� y� Town Hall,53095 Main Road y Z Fax(631)765-1823 P.O. Box 1179 O • Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Office of the Building Inspector March 5, 2001 Mr. &Mrs. Dickerson PO Box 268 Mattituck, NY 11952 Dear Mr. &Mrs. Dickerson, Please take notice that in review of your permit application dated January 26, 2001 for a New Addition to your Single Family Dwelling to the property located at 6850 Aldrich Lane, Mattituck, N.Y. County Tax Map Number 1000 - Section 120 Block 3 Lot 8.2 The shed shown on the survey requires a building permit, certificate of occupancy and is in Violation of Town Code. Please submit the required items to take care of the Shed issue. The following is required to be submitted: 1) Copy of survey showing location. 2) Three new sets of certified construction drawings reflecting the construction of the shed. 3) Permit application and check for fee. The shed may be added to an existing permit if you desire. If there are any questions you can contact us at(631) 765-1802 between the hours of 8:00 a.m. and 4:00 p.m. Respe lly you , ru S on Building Inspector CC:file t1Form No. 6 TOWN OF DEPARTMENT � BUILDING TOWN HALL 765-1802 �I, APPLICATION FOR.CERTIFICATE OF OCCUPA '1 ttFrq'] A This application must be filled in by typewriter OR ink an suLttted_-to.,_t4--- 2. Ing inspector with the following: for new building or new use:g 1. Final survey of property with accurate location of all buildings;=pY 'opes, streets, and unusual natural or topographic features.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, in building, multiple residences and similar buildingf 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 a unusual natural or topographic features. 2. A properly completed application and a.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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25ip 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15. 10, Commercial $15.00 Date . . . I.�Y1. �� . . . . . . .. . . . .. . .. . . . . . . . . . . New Construction. . .': ./.�.��.//. old Or Pre-existing Building. . . . . . . . . . . . . . ... ®® �•- . �4 Y.Y.�. . S'`�'.b' lGt1. . .�: :. .M:QT.`T.4IV.r, -.N .:.Y:. ( � . J.7r. . . Location of Property . . �, _ House No. Street H •et Onwer or. Owners of Property-.—r-N1PM.44..�. . , ./�TH�. P-cr.�s1.� ?1GK.G� P./�. . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . .Block. . .C)QQ.-4 . . . .Lot. QQ� e .(QQ.Z . .. . . Subdivision. . .. . ..4 . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . .. . . . . . . . . . . Permit No, 2-, 0 Date Of Permit. . �.��C�C?.� .Appllcant� UJ1J)5.. . C.A��f,' kg.)Z Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . .. . . . . . . . . . . . Planning Board Approval.. . . . . . . . . 4 .. . . . .. .. . . . .. Request for: Temporary Certificate. . . .. . . . . . . Final Certicate. . . . . . . . . Fee Sub it ed: $. «. . . . . . . . .. . . . . . . . �461404 * . . . . . i A.1ni rn A 6mm' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: - i DATE 7 4-21 INSPECTOR "'" LELD INSPECTION RISPORT= DATE rCOt3S�} =_______________ FOUNDATION OST) II II i I <n C7 FOUNDATION 2ND) II � I ROUGH FRAME 6 it PLUMBING I u i � �' s# INSOLATION PER N. Y. H STATE ENERGY �i \N CODE I�I II IIS- I _ l I H --moi V, �1 FINAL l ADDITIONAL COMMENTS; � POOP a u 0 L H ro H May-01-01 12: 3SP P•01 ROY H . REEVE AGENCY , INC . INSURANCE. FACSIMILE TRANSMITTAL SHEET Til: FROM: , BRUNO SEMON Thomas Dickerson COMPANY: DATE:: SOU71'1101-D TOWN BLDG DEPT May 1,2001 FAX NUMBER: TOTAL.NO.OF PAGES INCLUDING COVER: 765.1823 4 PI IONS NUMBER: SENDER'S RF.FRRENCE• NUMBER: 765-1802 (631)298.4700 X34 RE: YOUR RKFF,RENCE NUMBER: BLDG PERMIT 'I Y1ICKERSONQK(-)YREE V F'..(:oM ❑ URGENT O FOR REVIF.W ❑ PI.);ASE COMMFNT ❑ PLEASE REPLY O MMF: RECYCI.F. N CITES/COM M FNTS: HI BRUNO, THANK YOU FOR CALLING AND LI?AVING A MESSAGE ABOUT'THF:SHED INFORMATION THAT WE DROPPED OFF TO YOUR OFFICE YESTERDAY MORNING, T11E.SF. ARE THE BUILDING PIRMITS T1IAT WE I IA VE GOING PRESENTLY. PO BOX 54, 13400 MAIN ROAD • MATTITUCK, NY • 11952 0054 PHONE: (631) 298-4700 • PAX: (631) 29B-3850 071Ww.RU YR fi fiV k.,CUM May-01-01 12 :35P P.02 �guFFoc, 4,. Town hall,53095 Main!toad y x Fax(631)765-1823 P.O. Box 1179 O .1c Telephone(631)705-1802 Southold,New York 11971.0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Office of the Building Inspector March 5, 2001 Mr. & Mrs. Dickerson PO Box 268 Mattituck, NY 11952 Dear Mr. & Mrs. Dickerson, Please take notice that in review of your permit application dated January 26, 2001 for a New Addition to your Single Family Dwelling to the property located at 6850 Aldrich Lane, Mattituck, N.Y, County Tax Map Number 1000- Section 120 Block 3 Lot 8.2 The shed shown on the survey requires a building permit, certificate of occupancy and is in Violation of Town Code. Please submit the required items to take care of-the Shed issue. The following is required to be submitted: 1) Copy of survey showing location. 2) Three new sots of certified construction drawings rcilecting the construction of the shed. 3) Pernmit application and check for fee. The shed may he added to an existing permit if- you fyou desires If there arc any questions you can contact us at(631)765-1802 between the hours of 8:00 a.m. and 4:00 p.m. Rcspe• 1111ontoe'l— Building n1 S Inspector CC:tilc May-01-01 12! 36P P.03 FORM NO. r 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. 27102 Z Date MARCH 5, 2001 Permission is hereby granted to: THOMAS A & WF DICKERSON PO BOX 268 MATTITUCK NY 11952 _ for NEW DECK AND FAMILY ROOM ADDITION WITH ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. _. at premises located at 6850 ALDRICH LA .— MATTITUCK County Tax Map No. 473889 Section 120 Block 0003 Lot No. 008 . 002 pursuant to application dated JANUARY 26, 2001 and approved by the Building inspector. Fee $ 102 .60 Authorized Signature COPY R,-.v. 2/19/98 I ®�®BUFFO(,fc0 o� Gyp Town Hall,53095 Main Road H = Fax(631)765-1823 P.O.Box 1179 ' .lC Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Office of the Building Inspector March 5, 2001 Mr. &Mrs. Dickerson PO Box 268 Mattituck,NY 11952 Dear Mr. &Mrs. Dickerson, Please take notice that in review of your permit application dated January 26, 2001 for a New Addition to your Single Family Dwelling to the property located at 6850 Aldrich Lane, Mattituck, N.Y. County Tax Map Number 1000 - Section 120 Block 3 Lot 8.2 The shed shown on the survey requires a building permit, certificate of occupancy and is in Violation of Town Code. Please submit the required items to take care of the Shed issue. The following is required to be submitted: 1) Copy of survey showing location. 2)Three new sets of certified construction drawings reflecting the construction of the shed. 3) Permit application and check for fee. The shed may be added to an existing permit if you desire. If there are any questions you can contact us at(631) 765-1802 between the hours of 8:00 a.m. and 4:00 p.m. Respe lly you , ru S on Building Inspector CC:file 7y+. w }/� may . Vr a.• . W SVS :V�J•�' \2�,y mg .•�ti >:$A,;.:S'r• (fl,¢Yii. •••!! f,1 .?2 $! It` pk. { lja;. •iJ�N}S}., . "'J��.,��lls.. •.y4':?,�t�4% ..;?:?1�.A'Sie:. '17(iJ�'ii;%)h. td�iii'E=7. wt, ,i,. r.•r Ir •,l ssrs. .ti h t ••Y{ •y� ct•, l�rr,;.:y;}it•:. Itxr.J gin, ydy,A}147�;ff;;:.:3S+lh•S9;?„9 u•r:,.'• i -•7.rs,}•..;Eihppr'�};'itF: rll.rt{{djr,...\,I,rl tsy pp S;SS . �.r?I ,i,'/ •^•,.pi• rr\,.D\. j{r, . I,r,.r rpt ,rSy:.$•. n'.?,,., ,v.,>7. :.s. .,,f,»5.,, �;a�„l,l,.. ,x ,r `.U,,.t i•..t"na:: .s•, 3� .,.,,vs,-.:.'t'.�.o-f%�rt, •-:l,,,A.b' .,t.t =,rr;•:.,.{,,v.f;:� ,mx ,•,�>.;p... ;aEs, •fa.• s;, r^r< :.� .�, sn , s •l. ✓, ,a\;ii: :•�.. s\. ,o.,. ,.:.:•, a'•r'�; t:•.' .•s'�' .rsa .:�•�:,rs E ^:.j�':> r, R i' ,f; ,Y ..., r;pn ;, ,,,A>`i;� S ./iLll`., 7r^M.;::i•1:. 2 ,`'f ,ii�4:\•t' f::i�i_, \_. , s,:i! l $.. �j,q Z�y fff 1:.iv.../� 71'.�C *1 r�� �1 A.... '+v `�Tz••L? \����•' t ,xl Electrical Inspection Cerh ficAte c�K�l$fSiS. Electrical Inspection Service, Inc. 375 Dunton Avenue -' ��•' � East Patchogue, New York 11772 ,•�i (631)286.6642 Date: 12/26/2000 Application No. : 48980 ac(a' Issued to: Tom Dickerson _;= >:..• 7--"-, Street: 6850 Aldrich Lane _- ��ff�. <« Village: Mattituck Zip: 11952 Town:Southold Section: 120 Block: 3 Lot: 8.2 Introduced by: Hanks• Electric Inc. Lic.# 2675-E �t(?'• was examined and found to be in compliance with the National Electrical Code ❑Attic ❑1st Floor ❑ O/S Residential ❑O Pool ❑ Det. Garage ❑ Basement ❑2nd Floor ❑ O/S Commercial Hot Tub ❑ NV Defects Switches Receptacles Fixtures GFI Heaters A/C Fans Dishwashet Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal Furnace Oil Gas Circulator Smoke Detector Bell Transformer �=�;;• %•�:--.<,.'�. ,:-'-:rid{ Meter Amps Phase UG/OH Telephone Television Carbon Monoxide tt(`” .:i•. ., 's;;moi. Other Equipment: POOL ItImer `-r`>-- Hugo S. Surdi ~f :.r<ttp: President =` atti'/S ,»»5'tt• Building Permit No. This certificate must not be altered in any manner I• \,,%.;ft \ Inspectors may be identified by their credentials •n r IS:�.. � ti•. i\\..= .\ \. � ., i:Y� „ t•,r .`\-..y, •a..-,;.. i'�'�„R”\.'.,/f"� ”f7f,`;.t1'l\..-..,^11„11':.�'ihii�-/_ w3 •\.�•i , ecs: ...'4s,,,r.`;:. •a'�st, :;�, r.i.,,iiFvyv., j:'S`, .:�„! :C:...,.\.,, ::�,,,, .;ivfr . ::�,,,,,..., .\�f•.r. .j„�, ._.;. vff4.., ,.,Si.v.,,,nA'1••• nf!„ V•i i4rn.rn, r:.i.''6 td Pi.. E•i..ts �f•: i,C^• h+ n5.'':1n'• f,( y r. '•"•�':F. .h��"�Y:.?� "lS PC..... >r(r .>S. °>.Jr \ h'f. ISr rN'; lr,;r•;:`:•r J ru .l „7•;F<�G:f?�;�"-. , tF" „•u�E:'. rf.,rk't,,. i;1,,!'Z ,r rnrM .rt`r ,i;, rr, rlrw::•; .,i;ir= :r'ri -rit'r ..t. ^s• ,1,. 'rrr "yr;';! ,n . •,'•„•r::, d;•! r.fi,;i .r,r. ,�.: '•!'JiiF i;:••r:�•.: : f'Si..J,i,,. dgl•;.`ir' r,ii/;.;{::r : ia '•14er aj,;r,}•t;i::i ,.gJ•vta. a.ir:,..Eps,. .,<tJ•.:Nn'1 \^:i:{`:L3�=" i!,•�,!I.� 'at.,y.�t:. .,sE�1 r:•f=r .:�'S:�Jhi � ``�Ysi�,. ':::yij•.r�a!•'F.4:o �'ss'�y,.wt s•.y/1. 'a t.8,� o J. •:•"N.'off.;• saG.:. BOARD OF ARAL,YH �0 FORM NO. 1 3 SETS OF .PLANS` . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . L—r'mf L0!'SO OTHOLD TOWN HALL SEPTIC FORM . . . . . . . . . . . .. . . . . . . SOUTHOLD, N.Y. 11971 DEC . . . . . . . .. . . . ... . . . . . . . TEI.: 765-1802 TRUSTEES . . . . . . . . . . . . ... . .. . . . . NOTIFY: CALL . . . . . . . . . . . . . . . . . . Ermdned.....�).2........ 20.41•. MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.....:/- ........ Aool . Permit No. ' P/ ...... ................................... Disapproveda/c .................................. ................................... (Building inspector) APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 20. . . . INSTRUCTIONS a. 'Ibis application must be ec6pletely filled in by typewriter or in innlc and submitted to the Building Inspector wi 3 sets of plans, accurate plot,plan to scale. Fee according to schedule. I I , . 11 b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be conenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throng1iout the work. . e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grantedlby the Building Inspector. APPLICATICN IS HEREBY MALE t 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, ordi s, buildi ode, housing code, and regulations, and to admit authorized inspectors on premises and in build' r e spect' s. Signs a applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, architect, engineer, general contractor, electrician, plumber or builder .............................�?S�'.f�..V. ................................................................................. .- f� Name of owner of premises ...f. OM. i.S.....01C.* SOA).......................................................... (as on the tax roll or latest deed) If applicant is a corporation, signalise of duly authorized officer. .......................................................... (Nave and title of corporate officer) Builders Liccose No. .d I Wg /'f..L ...... . Plumbers License No. .... fi.)VA...... /. Electricians License No. S.2 ....... Other Trade's License No. .................... 1. Location of land on which proposed work will he donne.............................................................. .....6.g6.d....................AJ.DFS.iC.rl..............................ff11.77.;-7-(X .................... House Nurber Street ^^ f//Hamlet ContyTaxMapNo. 1000 Sectio1R..o......... Block �J......... Lot, . ...... , Subdivision ...................................... Filed Map No. '............... Int ............... (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 0.X. ...J kCJt i?..Pte..(0 .rCAXE..10.e od C•......... J. rvaumre or worx rcmmecK aturtm applicable): New lkmilding .......... Addition .......... Alteratio .......... Repair ............ Removal .. I.......... Demolition Other Work ,F.Il.�Q0,UAA ..P00 (Description) 4. Estimated Cost .7, ot- Z ......... fee ............................. ............... (to be paid on filing this application) 5. If duelling, nunirer of dwelling units ............ Umber of dwelling units on each floor Ifgarage, number of cars ...................................... 6. If business, commercial or mi occupancy, specify nature and extent of each type of use...................... SW1HHfu4 Pool 7. Dimensions of existingstructut' es, if any: Front.. ....l Q.... Ttear ............... Depth ................. llei nt .......... Nnber of Stories ...................... Depth bel with alterations or additions: Front ............... Rear ............... Dimensions o. sae......... D fiht .................... Number of Stories ............... R. Dimensions of entire new construction: Frmt ................ Rear ............... Depth .............. llei8lrt ........................,. Number of Stories ..................... 9. Size of lot: Front I......... Rear .................... Depth .................... 10. Date of Purchase ..............�� ...... Name of Former Owner ........................................ I1. Zone or use district in whichplemises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ..... .... ......... Will excess fill be removed from premises: YES NO 14. Names of Owner of �n �t.�lC199 A9?V.... Address 9.�)4.IY. p. � 1fR�•„(A.% Ptmorme No•Qp�/ -flu Name of ArdmitectGepa(xcf1i.0�lA_I�.-.'.................. Address W.�.FaI T.Q�J(71V...P-VQif... Phone No. 7�A�ras57 property '^.OGS Vim.......... Address !Y7J.. 2.f.►;45h............Phnne No. 7 q:1160.. 15. Is this contractorwithin 300 fee of a tidal wetland? * YCS .......... NO , r� *Ii' YLS, SOIria” TOWN TR qM-3 PERMrr MAY RC REQUIRED. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or, proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. Sb2uGy SI'A•Ll; Of NSW Y1GC, sS O"f'Y OC ......0 �J4 ......• �• ••t `+.� 4.�i Y........being duly sworn, deposes and says that he is the applicant Mare r( individual sfining contra�L) above named, lieis Lhe ................. .n..l..................................... ............................... (Contractor, ag lit, corporate of.Eicer., 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 (rest of his knowledge and belief.; and that the work will be perfonme1d in the'1imanner set forth in the application filed therewith. tob Sworn .. I 11 s .day oE Notary Public ........ .�.:.r� •. �f "....../. :. .. NQREEN HALER (S' , tAnre o App cant) NOTARY PUBLIC, ATEOFNEWYOU OUAIJFICD IN SU�FOLK COUNDf REG.NO.01 HA4526433 1 COMMISSION EXPIRES Y'4l !i - .. Q � - �07i;S i ox�.y wlr.•t NZ'S�C .¢.saD /i-•..� �e�cs .f5 /_e4u..�re�. O / xc iisi� CG65c w�Tfi sxFc'LaSc^V; iS✓pfiy+,.a.e /+ SKIMMERS _ _ . .�;•.ar. „ 3>Leecre rk. K y c� ra cera ?tea a .— _-- •��:A-+ / Q�`��. RETURNS w='r:y Y . %OAW IFARi / G DIVING BOARD p"�_`-",;,_ �1.:A� •D I + I SLOPE 'f Q f 38 BARS - TO FILTER ' , � ,I t II OC OO O 8 FORM TIES FROM SKIMMERS C E f FILTERend PUMP _ FROM FILTER .. O TO RETURNS 3TO WASTE ROLLED.. AM O BE'Y`EEI� 'NER` PIPING ARRANGEMENT VINYL LINER Q CONCItE'(E SIDE DR ENO 3SOOIb B STEPS OPTIONAL 6•+ 16•cowc. P L'-A N POURED CONCRETE r r1[es VINYL Ll ER' t —I.' . /Ii21 1 w I �. DIVING BOARD 8�0 j •i •,.", -•r- �-� _.i (SEE DETAIL SHEETI $�q^ i j '�.•" a •; , 1{ - 1 .e:...o.» !it%.m FIBERGLASS MOULDED 4' SAND 1.0'1 ev i PIECE 'SECTION . ' " • '•` • • '• '• SEE TYPICAL WALL 1 " u DETAIL 27% 4'SANO • BOTTOh( FORM TIE 43- 6'-0'---� ! S 4C 24" MAX _ s;S,•5-'i F:'$§ mo3i8BAasT1N BSB OPTIONAL IOPAL STEP w`. _ te � 1. �(GTow- r r ORT IN GRADE i .•': �•�. C. OOr�N6 4 B. O. I G f 3 STEPS * P LANto 6•. 16� - -•, come a rt, PIERS1 e • TYPICAL WALL =.T_ SECTION. A- A I<:D- ------ 12- °F "£wr OPTIONAL STEP T__ TYPE 2. 5 IZE A B C 0 E I F G AREA CAP ORGE �L'y EET rT. rt rt. IT.- VT, rt rL so r[ r AL. * IF :30' ' 1 1 e e NOTES__ t. CONTRACTOR -1g• �A 7 'l I12 LI •A /�2J'11o,tep r w WALKS TO ^BE• _ SMOOTrt - NON SKID TYPE. SLOPED P ' _� AWAY FROM POOL ee� 4' 6 C� WATER DISPOSAL SHA RANDY T. RODECKER, INC. k 3e I6 L.8 I B ( 12 4 I 4 1 .512 ka'SOO' 405610 t PROPERTY T0. SUIT" LL 8E LIMITED TO.OWNERS SWIM KING POOLS ii O �Q. LOCAL REGULATIONS ' z 36 116 136 112 18 112 14 I 4 1 576 1 201i0O �uffS>itO�� +6 ' _ ' � ROUTE 25A _ 'z 40' 20 140 12 10 112 ( 6 b BOO 124,000 ROCKY POINT, NY 11778 SQUNp S-81034'go"e. AVENUE • "'�---. 192,83' - 2 Nom. N 00' �0 61. 00. to Q 7 S 01 r "' A L J e\0.'�� �\ VL,��•L ��• � ''E C� �} /aF1'r,F� O x qe? e.,y�� �� •, V 1 �,2,209 eg Pc�e P< • �, '1 t�✓�na^��,z 2 l . h � � J i� V �Z I• 1 l� Y r \ 1 � 1 1 L�S1. 1 1 \ 1 610 11 tr 1 ,1 Ow 1 SZAG25y � �RegVB \ � Ray DEC. 4, 1987 SURVEY FOR SUFFOLK COUNTY DEPARTMENT OF;HEIIIN YICFS THOMAS A..DICKE,RSON a CATHERINE M. DICK"ERSON n t1.Y DWELLING ONLY FEB. 316,1986. 18 1988 , DATEL�CH.S. EC .S. REF. N0. _,S` .'.?�q AT MATTITUCK DATES JUNE 8,1888 �NL (� I The sewage disposal and water supply facilities for this TOWN OF SOUTHOLD SCALE 6D' 86-488 location have been inspected by this Departmentand/Or SUFFOLK COUNTY, NEW YORK No. 8G other nci and fxd t sati ory. " (1 M SURVEY 15 A VIOLATION ALTERATION OR ADDITION ro THIS GUARANTEED W SURVEY O A VIOlAT10N OF SECTION 7209 OF TME SOUTH .t A6'6r'10yLa K Chief f Bureau of Wastewa er Management NEW YORK STATE EDUCATION LAW N COPIES OF THIS SURVEY NOT BEARING TME LAND EQUI •/ SURVEYORS INKED SEAL OR EMBOSSED SEAL SMALL �A�D IY, $ NOT BE CONSIDERED TO BE A VALID TRUE COPY 0 TME MNEHEREON SMALL RUN Y 70PERSOFOR WHOM THE ISPRE PREPARED fiO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUC T AMC ON HIS SEHALF TO THE TITLE COMPANY,GOVERN— N NEAREST WATER LAIN MI. NSOURCE OF WATER, PRIMITE PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED HE LENDING M SUFP CO. TAX MAP pST�-SECTION IE4._BLOCK-DII._LOT ' IHEREON, E TAOII, GUARANTEES ND TO THE GAPESNOT OF TTRANSFERABLE M THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OTHER THAN THOSE SHOWN HEREON, O OWNERS M THE WATER SUPPLY AMD SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE *DISTANCES SHOWN HEREON FROM PROPERTY LINES WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC OF HEALTH SERVICES. PURPOSE AND ARE NOT TO BE USED TO ESTABLISH LAND sl►R APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS TEL. YOUNG a YOUNG RIIVVERHEAD�,NEW YORK DER E NOTE, *=MONUMENT &=STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.UCENSE NO.12845 HOWARD W.YOUNG, LAND SURVEYOR N THE LOGITMM OF WILL(Y},SEPTIC TAHN(ST)M CESSPOOLS(CP)SHOWN""RON N.Y.S.LICENSE NO.45893 ARE FROM FIELD OBSEMMTIONS AND OR DATA OBTAINED FROM OTHERS :y5 BRANDIS A SONS INC 2048 SOUND S.81°34'3b"e• AVENUE 192.83' 00. �0 It �Q 7� yN P A 1 lY•�y A� _ Vf.v�/f k a 4-, � 11; I%2.209 pcCes N }� * h 11 {P a �P M1 t kk: W d"� i 1 1 1 � 1 �a 1 !2V !r i. 11 L 1 i6S� 1 ' 5 Z Ow 11 \ \STko 5 Ray DEC.eve DEC. 4, 1987 SURVEY FOR SUFFOLK COUNTY DEPARTMENT OFNEALTH SERVICES THOMAS A. DICKERSON & CATHERINE M. DICKERSONFEB. 3,1987 STAN L (tY DWELLING ONLY DEC. 16, 1996 DATJI ��_,.,.H S � • . REF. NO. "W =4&T AT MATTITUCK DATE JUNE ,19e6 � The sewage disposal and water supply facilities for this TOWN OF SOUTHOLD SCALE r"= 6 location have been inspected by this Department and/or SUFFOLK COUNTY, NEW YORK No. 66-46a other amen 01 and foo nd t saU ory. Y R UNAUTHORIZED ALTERATION OR ADDITION 10 THIS GUARANTEED Tti —, ^k12Y1i1M.__fJv $ = SURVEY IS A VIOLATION OF SECTION 7200 OF THE SOUTH A6'6UV0^�r K Chief f Bureau of Wastewater Management NEW YORK STATE EDUCATION LAW N cOPIEs M THIS s,RlvEr NOT s£+Rwo THE /ANO EQU) SEAL SNAIL 0 SURVEYORS INKED SEAL OR EMBOSSED SEAT11D P1; a +6_ NOT BE CONSIDERED TO BEA VALID TRUE COPY KGUARANTEES INDICATED HEREON SMALL RUN ONLY 10 O THE PERSON FOR WHOM THE SURVEY IS PREPARED �• Z HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND ON HIS BEHALF TO THE TITLE COMPANY,OOVERN- M NEAREST WATER IIIA NLI *SOURCE Of WATERS MiM1TE PUBLIC.-,. RENTAL AGENCY AND LENDING INSTITUTION LISTED N SUPF CO. TAX MAP MST'I' � CTION JAQ_BLOCK-3L LOTS-? HEREON,AND GUARANTEES ARE OF THE LENDING NOT TRANSFERABLE *THERE ARE NO DWELUNOS WITHIN 100 FEET OF THIS PROPERTY TO ADDITIONAL INSTITUTIONS OR SUSSEQUE14T OTHER THAN THOSE SHOWN HEREON. OWNERS 4O• N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RRStOEMOE *DISTANCES SHOWN HEREON FROM PROPERTY LINES WILL CONFORM 10 THE STANDARDS Of TME SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC OF HEALTH SERVICES. PURPOSE AMC ARE NOT TO BE USED TO ESTABLISH tApO 5Va� APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS 4000STRANDER AVENUE TEL, YOUNG Ek YOUNG RIVERHEAD, NEW YORK NOTE *=MONUMENT 6=STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.UCENSE NO.12045 HOWARD W.YOUNG, LAND SURVEYOR *THE LWATpMOFWELL(W),SEPTICTANK(ST)SCESEMOLS(CP)ENO14N HEREON N.Y.S.LICENSE NO.45893 ARE FROM FIELD OSSERWTIONS AND OR'DATA OSTAIMED FROM OTHERS a BRANDIS A SONS INC. 1046 y 1 r SOUND S.81D3413011E. AVENUE 192-5.31 N ti L � o CN U Z -p 0f O� DIT•\X\hi 4� w. p . R.I ` a z, � w% A� T; rAL o 0 P�eQ/ZZOg s � ` N � a y. 1 I ,6838 S.TA021 W 4 I nr \Roy H R66V6 DEC. 4, 1987 SURVEY FOR SUfP0UiC0UNT1 DEPAItTMENTOFHfALTHSfRYICE3 THOMAS A..DICKERSON 8 CATHERINE M. DICKERSON L ILY DWELLING ONLY FEB. 3,1987 DAT6�EC � H.S. REF. N0. �- /9' AT MATTITUCK DEC. 16, I9B6 DATE JUNE 6,1986 The sewage disposal and water supply facilities for this TOWN OF SOUTHOLD SCALE: I"= so' location have been inspected by this Department and/or other i and f nd t sSUFFOLK COUNTY, NEW YORK No. 66-468 ncti �FtDry. a. {�, N UNAUTHORIZED ALTERATION R ADDITION TD THIS GUARANTEED I SURVEY M A VIOLATION OF SECTION mo OF THE Chief f Bureau of Wastewa r Management NEW YORK STATE EDUCATION LAI SOUTH ��p R COPIES OF THIS "VEY NOT KANNO THE LAND EQUI yRCt SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SMALL •�O NOT BE CONSIDERED TO BE A VALID TRUE COPT ro�P•RD N'• 60G 'P�• MNIARAMTEES INDICATED HEREON SHALL RUN ONLY TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERN- eg ■ NEAREST W MAIM MI.! MSOURCE Of WATER. PRIyTE ►URLIC_ MENTAL AGENCY AND LENDN. INSTITUTION LISTED E� N SUPF CO. TAX WP OST 9 SECTION-10—BLOCK JOA—LOT=yE HEREON,AND TO THE ASSIGNEES OF THE LENDING *THERE ARE NO OWELLMNf WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE iI OTHER TRAM THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT M THE WATER SUPPLY AND SWAGE DISPOSAL SYSTEM PON THIS RESIDENCE OWNERS WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LIMES �i h0" OF HEALTH SERVICES. TO EXISTING STRUCTURES ARE FOR ASPECIFIC ASH PROPERTY ALINES ND RORRF ROT TTHEEERECTION OF FENUSED TO CES LARD svav ADDRESS DDIIESS YOUNG a YOUNG RRRHTEL. 400 EAD, NEW YORK NOTE, *=MONUMENT p=STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.LICENSE NO.12845 HOWARD W.YOUNG, LAND SURVEYOR R THE LOCATOIOF MSL(W),SE►TIC TANK(ST)IS f EMPOOLS(V)SHOMM HEREON N.Y.S.LICENSE NO.43893 ME FROM FH[lD OMEHMITIONS AND OR DATA OBTAH ED FMM OTHERS OMANDIS A SONS IMO. 10" 2,;>/©,/ BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: 3 /S APPLICANT NAME: LC&-cv-_s0_j DATE SUBMITTED: /'f lC6 SCTM# --- DISTRICT: 1,000 SECTION: 120 BLOCK: 3 LOT: PROJECT LOCATION AND TYPE OF PROPOSED WORK: PROJECT DESCRIPTION: ADD ALT ACC N/D: 7sD ?O 'x f0' STREET: CITY: /U�n�r��.r SUBDIV. NAME: ARCHITECT/ENGINEER: �/C FAST TRACK: YES N SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83 ZONING: PERMIT ESTIMATE AMOUNT:—$— .00 PERMIT USE: EXISTING: INTENDED: � 5 -{pd ZONING DISTRICT: R40 R80 CONFORMING: YES o N REQUIRED LOT SIZE: __ &0,,r SQFT. WH,�RE ACTUAL LOT SIZE FROM?TAX CARD S��+r. Yow Yo. ACTUAL LOT SIZE: 96?Z¢ SQFT. WH, REQUIRED REQUIRED REQUIRED FRONT:'PROPOSED: SIDE YD: ZO '/�,�' PROPOSED: '/ REAR: 2S 'PROPOSED: ' LOT COVE E: ALLOWED: ,26 % EXMESO�RDESCRIPTION: sf % NEW: sf % TOTAL:-3/2,6 sf2. % CORNER? E R NO WAT ER FRONT? FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: ¢7 7 FLOOD ZONE: , AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPLICATION TOWN SPETIC PERMIT: YES or NO SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE:—/—/ PERMIT #:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL YES o NO-- NYS ENERGY: �ORNO /''4 EGRESS: VENT: LIGHT:NOTES: �..__ -._..__ __. ._..__._ .-_..._�..___._._._..--- r l wt d V1 first C aJ S2IJl1O,, C q TlCvd ' T I04 I' a r w FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE T( SF)- ( SF)= SFX $ =$ +$ /S1/ +$ _ $ ��4