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26110-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-26977 Date: 03/13/00 THIS CERTIFIES that the building ADDITION Location of Property: 860 RABBIT LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 18 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1, 1999 pursuant to which Building Permit No. 26110-Z dated OCTOBER 29, 1999 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 ALTERATION AND COVERED FRONT ENTRY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD S.& VALERIE MICHELSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N516870 03/01/00 PLUMBERS CERTIFICATION DATED 02/14/00 ROBERT VANETTEN PLUMBING Authorized SicpTature 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. 26110 Z Date OCTOBER 29 , 1999 Permission is hereby granted to: HOWARD S MICHELSEN 30 LANDING RD GLEN COVE,NY 11542 for CONSTRUCTION OF A COVERED FRONT ENTRY ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 860 RABBIT LA EAST MARION County Tax Map No. 473889 Section 031 Block 0018 Lot No. 018 pursuant to application dated APRIL 1 1999 and approved by the Building Inspector. Fee $ 75 . 00 Authorize S 'gnature ORIGINAL Rev. 2/19/98 p TOWN OF SOUTHOLD BUILDING DEPARTMENT F�4�� 1-WX [�E TOWN HALL A9 765-1802 1 )DWARV d Y94e-elr L-------�_.. ___Qi 3o L4 i✓airv� Ido 9 a 4EPT. APPLICATION FOR CERTIFICATE OF OCCUPANCY L'vvi� F OOTI.OLf) _ ,_.! �L�N Cd✓eSJ✓✓•x !"Y A. This application must be filled in by typewriter OR ink and submitted to the buildinf inspector with the following: 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 buildir 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 ar "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 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 dweiiiaKAZLa0, 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 Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - .25V- 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . New Construction. . . V. . . Old Or Pre-existing Building. . . . . . . . . . . . . Location of Property. . .. . . �oU . .. . . .. . . . . . ... . . �.4.0., IKIAAA.6�. . . . . . . ;V4Rf/D/✓. . . . . . . . . . House No. p Street M Hamlet Onwer or Owners of Property. �ky Q?A . S. . S JIA 01fe : :•1 C q&etS�c • • • • • • • • • • • • • • • County Tax Map No 1000, Section.:J/. . . . . . . . . .Block.J� . . . . . . . . . . . .Lot.�� . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . Permit No. 26 '.(L. `.y:. . .Date Of Permit. . . . . . . . . . . . . . . .Applicant�7P.W.4Hio! Lw Health Dept. Approval. . A. . . . . . . . . .. . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. MA. . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . w $ . 4 . . . . . . . . . . . . . . . . . . &A-r, • S 7607 APPLICANT 1 S�FFOjh-� TEL. 765-1802 TOWN OF SOUT.HOLD f" < OFFICE OF BUILDING INSPECTOR �`y '3�. P.O. BOX 1179 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T -1 O N Date 00 Building Permit No. Owner 5e�riCer Plumber ICOva/y, E �'S`f�rl (please print) I certify that the solder used in the water supply system contains ,less than 2/10 of 1% lead. (plumber ' s signature) Swor to before me this day of �G`/3c?.I.th`Y ,• Z000 ` Notary Public Notary Public, v --%g)County ELIZABETH A STATHIS NOTARY PUBLIC,State of Now Yolk No.01 ST8008173,Suffolk County Tenn Expires June 8,20ZP THE NEW YORK BOAR® OF FIRE UNDERWRITERS PACE 1 1000121 BUREAU OF ELECTRICITY.• 40 FULTON STREET, NEW YORK,-NY 10038 te MARCH 01,2000 1976700./0@ N 516870 THIS CERTIFIES THAT A�tt�{T Nq.,on_ftlE 1�oNIRWAM nly the electrical equipment as described below and introduced bythe applicant named ontheabove,,applicafioa number is in the premises of HOWARD MICHELSEN, 860 RABBIT �LLryANE, EAST MARION, NY in the following location• ❑ Basement L-7 1st Fl. ❑ 2nd Fl. OUT Section Block Lot FE$RUARY 11,2000 was examined on and found to be in compliance with the National Electrical Code.- FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT RUORESCENT OTHER AMT. K.W. AMLK.W. AMT. K,W. AMT. I K.W. AMT. N.P. 3 7 5 3 1 1 7.6 1 1.2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC-PT.1 TIME„CLOCK$ BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMC K.W. OIL H.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. "AMT.^ 'AMPS. TRANS, AMT. H.P. NO.OF FEET AMT. WATTS 1 600 SERVICE DISCONNECT NO.OF $ E R -'V I', C E METER NO.Of CC COND. A W.G. A.W.G. A W.0 AMT. AMP. TYPE E61UIP. 1 0 RW 1 0 3W 3 D 3W 3 0 4W PER 0 Of C0.COND NO,OF NI-LEG' OF NI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: " G.F.C.It-3 :i PAUL R. BURNS LTC.#3897-EoWL PO BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER 11 �� Per ' �...�..._.. \�ertiflcote must not be altered In any manner; return to the office of the Board If Incorrect. Inspectors may be Identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ,MUS,T NOT BE ALTERED IN ANY MANNER. ppp- 65-1802 B ILDING DEPT. INS ION [G] V UNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _ D PLIo Aeev 0) DATE ZRQ INSPECTO LPI;_IN:;k-CTION—REPORT--_=DATE-- -------------=====COMMENTS_==== -____ — --- ----- it INDATION ( IST) II II II II _______________ ___ C RiDATION (2ND) n --- z o rA JGH FRAME S PLUMBINGTr— -------------- -- --- ________________ __ 1i r� o �—" 1 SULATION PER N. Y. ri y u— STATE ENERGY CODE u o 11I II II FINAL ( A('DDITIO(NAr/L_ COMMENTS: j/' l� ec7 o'" [E � s H O z is b g1dFF0j/( Town Hall,53095 Main Road o Fax(516)765-1523 P.O.Box 1179 W . Telephone(516)765-1802 Southold,New York 11971-0959 �Ol � Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD February 11, 2000 Mr. & Mrs . Howard Michelsen 30 Landing Rd. Glen Cove, NY 11542 RE : 860 Rabbit Lane, East Marion. NOTE : Before your Certificate of Occupancy can be issued an updated Elevation Certificate for the new construc£fon is required. To Whom This May Concern: /�J oz� 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) v XX No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT # 26110-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. 1 NSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE &�C/HIMNEY REMARKS: ( � v DATE J©IdO INSPECTO I e--P,611� 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: &4a DATE INSPECTOR 765-1802 BUILDING DEPT. SPECTION [ ] FNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTO �° PF M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA�RKS: , le-4z DATE / INSPE NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-02375/00001 October 12, 1999 FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental October 31, 2003 Conservation Law TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ■ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection ❑ 64YCRR 608: Water Duality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floociptain Island Wells Management ■ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ❑ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Howard S. Michelsen (516) 671-1683 ADDRESS OF PERMITTEE 30 Lending Road Glen Cove NY 11542 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Same as above NAME AND ADDRESS OF PROJECT/FACILITY Nicholson Property 860 Rabbit Lane LOCATION OF PROJECT/FACILITY SCTM #1000-31-17-19 and 1000-31-18-18 East Marion COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Marion Lake DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a 4- x 12.5' addition to existing single family dwelling. Note: The property that is landward of the pre- existing (prior to 8/20/77) bulkhead which is more than 100 feet in length is beyond the jurisdiction of Article 25 Tidal Wetlands. 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 ADMINISTRATOR: ADDRESS Mark C. Carrara CKW Bldg. #40, SUNY, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE DATE Page 1 of 4 October 12 1999 TOWN of SOUTHOLD f OFFICE OF BUILDING INSPECTOR Town Hall Receipt N° 57214 Southold, New York 11471 is- -� Date..........................................1......................."... �. Receivedof.. t-�S. .... .. .................1._1........................................................................................................................................ . P....... ........ - 0 Dollars ................ .... �.... �10 For................................................................... .Y....... ... ._...I.L�........ �................... t .. . •!.... ........................... Fee for Fee for Fee for Fee for Certificate ❑ Sign ❑ Flood Development Pmt Building Permit ❑ of Occupancy ❑ `❑ Cash 1 e L� Checl )- C n 6 ...........\..����....'......._.................. ................y.."' ...................................................................... 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MM■■M■■■M No 111 0 Emkimplolm Ir ■ MM M■r■ ■■i■■■i■■ is�■��■� ■■ ■■■■■■■■■■■■viii■Irm No 0 ■ii■■Li■■i �'i ■ ■■■ ■iii ■ an t�_.._ ,9fLt.ty�_._.�l■ ■i■ �i ft■�1�i■��ii ii■ n���■= �■sfii ' ■ ■�H■moi iii■■■ill ■ ■ ■■■ ■■iii■�#1■�!l�lli/'�,�i■■iti�i�1A�1!,�■■ ■■■■■■� �'' G� ■, hid■il����■■■ ■ iii■��� ��� ■ ■� ■■■ ■i■■ il "N' 0 Town Hall Alhort,l. Krup.�kj, pyesirlent 53095 Main Road.jarnes King, Vi(-0_P1,0Si(l0TA �A Henry Smith W-S P.O. Box 1179 Southold, New York 11971 Artie Foster [Con Poliwoda Telephone(516) 765-1812 Ij Fax (516) 765-1823 BOARD OF TOMIN TRUSTEES TOWN OF SOUT1fOLD June 24 , 1999 Mr. & Mrs . Michelsen 30 Landing Road Glen Cove, NY 11542 RE: SCTM ##31-18-18 Dear Mr. & Mrs . Michelson, The following action was taken by a poll of all the Southold Town Board of Trustees on June 23, 1999 : RESOLVED, that the Southold Town Board of Trustees grant the request for a Waiver to construct a 41 X 12 . 5 ' entrance-way on the front of the house . Located: 860 Rabbit Lane, East Marion. SCTM #31-18-1.8 However, this determination is not a determination from any other agency. If you have any questions, please call our office at 765-1892 . Sincerely, aae� Q Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept. =a SiiT{VF.Y OF PROPERTY' ,SITUATE.'P AT T'1AST MARION s N 4P TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX NO. 1000-31-17-19 1000-31-18-18 SCALE 191 MAY 22.. 199 •98 J rnsacN a±. IsopTn ELvveS+irtlr5li°loon„+",N�.ml IL. uLv. rcnrrruo ne '�� ♦� RIVOe iR9ET COR oYTION a'`P yT .P.K O> NEW TUPK RTOAOE OONFANf. ING. TITLE No. LZTela-% V..L..RRIE NICNBLSENSCN tl� M1 ' d t ARG'A UAl m...L�D,.v�.� i nes td S.C. TA% Ne. 19.95>.OS sR. rt, bb `J M I WI,I-±1-rY�,Y U.l35 ae. - S.C. TAX Ne. +u.O9.l.a. IOOO 31 IP IR o.ZJO Cc. EOTAL `R FLOOD ZONE INFORMATION TAKEN FROM: FLOOD IN9UMNCE RTfi noJ 1GS[1TUFWSC0�u1E»D O 8n3ROeUELEn.ON a.r. TYa Nu •ooG-ar-r>-re m_ S 2UNE VE U•AiLL iLWD WRM DET.... ET. KPEMD(W{yC eL1iOn) 6U'E ROOD SLE.'<nUNS ORECYW ED vp (` h•L N A v3.x /i "S cwR '• L • . h e �.ro°y• - n Tam t �� .+a' �•. - , ,:�^"��� '`� iH el,•Yi� �(F�T\P.p�9 � �a� a� • � 4 x 'LAN p '�6Y`�A To�.'f$.'anA 'f��.0 L h Q1� Jo ngegno Land Surveyor v1, ,VAWL r....N•n>n. !.RrtlLar�r H.n,.e p.a.uN.�LWw {+�^,,,�'�,y_rz rne.t(n.l•ar awe r..(a..t•s.-aea. n:m'� Sm' ufnN�ue un >J� R-.�vw ur�A.�9,W, r�H� °quo LniNu' r vu.rnuC. .. -. . . . ..89-'L Told 80:LT 6665—b0—hl�W +. WTT OdD. - Z"Ta=`-n'°J�'Z450"'E°"'�"""° �"' ' ,. .,r wt.ww .'u+r�p+.w*m«c+.ie.�....ua.w.....R•, 2f3.48' ' rases k 6g. RABBIT R. ,304e LANE: �, : s sf2a'So . RA IT LANE 12o.so (PRIMATE RICHT OF WAY \ '•v '24'50" 1 3 80 56.57' d . +E :v . ..:i . (PRIMATE RICHT OF WAY) m 165,y 1� N 46.59 50 E 51.24'50" E Knox aaa 133.52' rao 336.13' t94.775' Cg \ c $ i �', S mf p w 4 IF y 4; a+e ,zs o tew cv kp0 QV,Q e,q9 � �7 r�Oto '`t 4t,�Jri o �zs� 40W40Wy fir $ 4S W "4 Ai k m 89FN� . Zp11)S swo Kai p O *58'23" W 51,13' NOW 0 . 10 New York State Department of Environmental Conservation Aim Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, NY 11790-2356 Phone: (516) 444-0365 Fax : (516) 444-0360 - John P. Cahill Commissioner October 12, 1999 Mr. Howard S . Michelsen 30 Landing Road Glen Cove, NY 11542 RE: 1-4738-02375/00001 Dear Permittee : In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit . Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address . Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Cliue WPL"�� Claire K. Werner Environmental Analyst I CKW: cg enclosure If,' "II'.-ra, AlbertJ. Knipski, ]'resident �f�. � fQi�� Town Hall y9 53095 Main Road James Ring,Vice-President ` c.� _`. ; ,r -''i.,�� P.O. Box 1179 henry Smith Southold, New York 11971 Artie Foster Ken Poliwoda t + ��'�)S Telephone (516) 765-1892 Fax(516) 765-1823 ``Zaszu/1 � BO A13.D OF TOWN TRUSTEES TOWN OF SOUT1IOLD June 24 , 1999 Mr. & Mrs . Michelsen 30 Landing Road Glen Cove, NY 11542 RE: SCTM ##31-18-18 Dear Mr. & Mrs . Michelsen, The following action was taken by a poll of all the Southold Town Board of: Trustees on June 23, 1999 : RESOLVED, that the Southold Town Board of Trustees grant the request for a Waiver to construct a 4 ' X 12 . 5 ' entrance-way on the front of the house . Located: 860 Rabbit Lane, East Marion. SCTM #31-18-18 However, this determination is not a determination from any other agency. If you have any questions, please call our office at 765-1892 . Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept. i 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 Joseph A. Ingeeyno dated 5/22/98 last revised 7/9/99 DEC PERMIT NUMBER PAGE 3 OF 4 1-4738-02375/00001 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, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. 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 worjc 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 1, SUNY Bldg#40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. D1-4738-02375/000EC PERMIT NUMBER PAGE 2 OF 4 01 APPLICATION # PAGE t of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This fotrm is to be filled out in duplicate. SE QNy GENERAL PROVISIONS (APPLIS,AM to read and sim), L No Work may start until a permit is issued- 7- no permit may be revoked if any false statements are made herein. 3. It revoked, all work must cease until permit is reissued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. S. The,permit will Mire if no work is commenced within six months of issuance. 6. Appyicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory regpirements. 7. ApAUcant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. 1,TFIE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THXS APPLICATION ARE,TOE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE. (APPLICANTS SIGNATUR d J( A DATE /2 B SECMON 2: PROPOSED DEVELOPMENT (To be completed (x APPLICANT) TF-LEPHOtIF APPLI I C NC-LS E� i-I y-4A R v S M BUILOER ��t>ttei H�sc� v � S7 $5 Maty. 2a1 (o"7I- 1683 ENGINEER PRQJ$$ r LOCATION: To avoill delay in processing the application, please provide enough information to easily identify the project i0cati0A4 Provide the street address, lot number or legal description (attach) and, outside urban areas, the dlstance P to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the proj loeatlon would be/helpful. l , FDP(I ) TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOKED, AL: PERMIT NO. ` t 10"Z- 96 �t a6 bJ r n.¢_ PERMIT DATE OWNERS NAME ANP ADDRESS: CHECK ONES K o w a„-A 5 11,CW Ser, q NEW BUILDING 10 Lam o0. WEXISTING BUILDING a r oy Z N 0 VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMEIiUS OF LOCAL LAW #p_, Ig SIGNED: _ DATED: - B. COMPLIANCE 1S HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , I9„_, AS MODIFIED BY VARIANCE DATED SIGNED: DATED: C/C(93) 9&20-1 (0- 7)-90- New York State Department of Environmental Conservation NOTICE Am 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. Regional Permit Administrator Permit Number 1- 73F'0a37S OoQJOHN W. PAVACIC Expiration Date /0 -3 /-o2- o 03 NOTE: This notice is NOT a permit NYSDEC Commencement Notice Aft Bureau of Habitat SUNY, Bldg. 40 Stony Brook, NY 11790-2356 Permit No: ,73� �a 7r D7JOU Issued To: Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to Supplementary Special Condition D of 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 is to 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 noncompliance with permit conditions. Cut along this line NYSDEC Completion Notice Aft Bureau of Habitat tom/ SUNY, Bldg. 40 Stony Brook, NY 11790-2356 Permit No: / — 175?` Oa ezw/ Issued To: Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to Supplementary Special Condition D of 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, is to 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. ELEVATION CERTIFICATE O.M.B. No. 3067-OC I FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 191 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement.This form is used only to pr( vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request fora Letter of Map Amendment or Revision (LOMA or LOMR).You are 1 required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this fora Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER /�owNoD d l/9GAQt /z1rC ---n/ STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 8G0 Raab;1 1--AN,;- OTHER DESCRIPTION(Lot and Block Numbers,etc.) /000 - 3 /- / P -/B GYLY STATE ZIP CODE SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM XONE 6.BASE FLOOD ELEVATION (in AO zones,use depth) 3� /o3G ©/ 77 �iA y <f. l9�l 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE):S�NGVD'29 ❑Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site, indicate the community's BFE: Imo.❑feet NGVD (or other FIRM datum-see Section B, Item 7)• SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level Z 2(a). FIRM Zones Al-A30,AE,AH, and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of I—L❑ 13LU feet NGVD(or other FIRM datum-see Section B, Iters 7). (b). FIRM Zones V1 430, VE, and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram,is at an elevation of W I I .❑feet NGVD(or other FIRM datum-see Section B. Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is I I I.❑feet above❑ or below❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W.❑feet above❑ or below C_I (check one)the highest grade adjacent to the building if no flood depth number is available, is the building's lowest floor(reference level)elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: NGVD'29 ❑ Other(describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) ' 4. Elevation reference mark used appears on FIRM: ❑ Yes AND (See Instructions on Page 4) 5.The reference level elevation is based on: X actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which „ase this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6.Th-elevation of the lowest grade immediately adjacent to the building is: Z.0 feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: I I I I.❑ feet NGVD (or other FIRM datum-see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31,MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATIO`d SECTION E CERTIFICATION ' This certification is to be signed)by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30,AE, AH, A (with BFE),V1—V30,VE, and V(with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 And 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use,wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification and r Comments below. The diagram number, Section C, Item i must still be entered. I certify that the information in$actions B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statgment may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. i CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) } os&4P Q w er a9 K-© P L. S " Ile/ TITLE —� COMPANY NAME / 2a wO/ svp o,Q �JoS /iv ADDRESS CITY STATE ZIP 0 . 3o,c awl /11• //90/- crgG. SIGNATURE DATE PHONE 3-Zz-99 5/6 7Z7-00U Copies should be Lad 'of this Certificate for: 1)community official,2) insurance agent/company,and 3) building owner. COMMENTS: �,/e /+?arN �ivng �LaD2 o/z T1Jrsnc5¢ >S A7 �ZervA77aU c1 �v ON WITH ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A VI A A v ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE BASE LEVEL flEFERENCE LEVEL FLOOD LEVEL ELEVATION BASE EASEAOJACENT �';��;.� REFERENCE FLOOD FLOOD GRADE ;� LEVEL ELEVATION ELEVATION REFERENCE ADJACENT •\" L VEL GRADE ... l f;•+ ADJACENT';; GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zor should be measured at the top of the reference level floor. Elevations for all V Zones(should be measured at the bottom of the lowest horizontal structural member. Page 2 I t,P INS__e....—---=1 C—T——IO—N——R—F=PO—R—T—--- DATE_ —u ---- C—O— -- --- --- —____ INDATION i OST) ii ° ---- -------- ------------ --- ---------------------------- Irr------11 � INDATION (2ND) IGH FRAME S II------JI----- -- -- -- --- v, >r n PLUMBING li ii — -- 1�— II II II R _ 4,=v ---- til F I SULATION PER N. Y. STATE ENERGY i CODE n a 10, m — ----- ----- -------------------------------- II u it --a FINAL n— �N ---�I 75 ssz-s=sc=s=xx=xs=sxxx-x�xs=c=ss�css=a--css=xsss-==s=xs=s==ss=xs====s========xscc==s O -- ADDITIONAL COMMENTS: h — x im1 fl s y� U U ` BOARD OF HEALTH . . . . . . . . . . . . . . . s q ^� 17ORM N0. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . �� ... TOWN HALL SEPTIC F . . . . . . . . . . . . . . . . TOWN OFSOUTHOLD SOUTHOLD, N.Y. 11971 - � 765-I802 0 IFY: LL �. . . . . Examined.................. 19..... l� .LI�.. �Ow4rQ Approved....ID.I O....... 19.... Permit No. �d....a.........�ed� .......... Disapproveda/c .................................. .... .............a % ...... ...................................... .......... . c .... (ISuilding n 'tor) APPLICATION FOR BUILDING PERMIT Date. . . t�� . . , 19 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 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 commenced 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 throughout 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 granted by the Building Inspector. APPLICATION IS HEttC(3YBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building 7.one Oidinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or I�,gulations, 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. It !Fi.........lY ............................... (Signature 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. oNER.................................................................................................. None of owner of premises .. f)�✓�n�. y!l !p��...l �CyEGSd/✓ ............................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. .{,�'q! 3.. :...... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. location of land on which proposed work will be done.............................................................. ✓4..!UuM1sE!Z......... R4498i7 �QI✓E 6A1?J, , RXfh+7aF1✓BY �.'�l�/°/✓............. House Number Street m 8 ( m pUamlet County Tax Map No. 1000 Section .....✓!........ Block .....�7....... Let 9............ Subdivision ...................................... Filed Map No. ............... I.ot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...:5/iP 6-1- e- F':F/t!/Ly.... 1*ef lwevef............................. sa�,yE b. Intended use and occupancy ...................................... ftywem10sh,12.:XleutlYa ATe�N Ypsy}ci:.5�!(e)�t> ,k;'Cititl9i*Tb;rO,pi�fi 3. Nature of nxtik (checl( %,hick appIlicable)o skin minding .......... d(klitioff .... ......Alteration .......... lielmiir ............ Renewal ............. Damlitleft ..... ...... Other Work ................. Gonsd'+w-�/ �ya/grox �J�x/2!�i�' gdzlif�on on Puao,gins/enfPydW (Dew;ription) 4. Estisk-Ited Cost /2 O a v............... fee ......................... (to be paid on filing this application) 5. If (1f,01ing, nasiber of dwelling Iunits .../........ hooter of. (knelling units on each floor .�............ If. garage, timber of cars ..:�1*.............................. ve G. If liclsiness, conrcial or mt occupancy, specify nature soft extent of each type of use..//,,11............... /. Diions of extstg x.in stntur 's, if any: Front... °?'.'�r.......... Rear °�••� tglrtWiadi ai? -� lia- 1 uber of Stories ............. Dimensions ofsane s'nfure wt h alCeraClons or efkilions: Front: ....5 Rear 7.2............. ........ Ik Lh ..... i.7..•........ lkiglC ... . ........... Umber of Stories ............... B. Dinrinsions of entire new crastn�ct.loci: Proof .. g t n ?...... ar ............... Depth .............. Ikight ........................1 Nxiber of St.ories / ' / /02> ( Size of lotFront / 3� . Rear .. /2 3............ Il.plh ave✓..67 (76......... I(l. Iku'e of Hucheive ...�9/,C! i...... Ik-m of Forster Owner .......................................: II. Zane or use district in which premises are situated ............................ ........ .......................... 12. floes proposed construction viollte any zoning lean, ordinance or regulation: ................... 13. Will lot lie regrefled ...N�..C......... Will excess fill lie slaved Ernst premises: YES 14. [dams of Owner of premises !yo/�/:?o+{r,JGNZ/lC�Xlf6V �oLQad� �[�( a;le.41e,� ,'.�//S//Z . .............. tfklress ........:7........,........... Hide No. .............. Nam of Architec- ........... Arklress .............................. 111one No. .............. Name of Ointraclor -yJ;f'x4NZ I '/S</�F/C 58/7105P/AiNRD ORT IEN ................. A(klress .... . ....................I11one Nn.3zT-7B6�.... 15. is this property within 300 feeof a tidal wetland? * YE.S .......... M .......... D 'I *iF YES, stmillim lid)i ws 1111441'r MY lir li Cupid. PIAT DIAGRAM hx:ate clearly aril distinctly all lxtildings, wliedier existing or proposed, and inlicate all set-liack dimensions frcmi property lines. Give street awv4 block number or description according to (ked, and sliow street runes anti imlicate whether interior or corner lot. 1 Y�/Case ter XU 1111 -' a>'- Ael l SI'Rlli (F mm Yin, SSI (MulY OF .....................................L....................Ixainl; duw(i (Italy srn, dlxi eses alxl says LIwC he is Life algil near-. (Neem of irxlivi(hwl signing contract) alxove Itailvd, Ileit; Life ......................................,.......................... .................................. (Crni-rac Lor, agent, coo rale officer, etc.) of said (maer or Demers, arxl is duly sulhorized to perform or have performed [lie said work alxl to make six] file this application; -hsL. all stn-emnts con stated in (.his alfil.icaLi(m are Into Lo Lhe lies- of his kn(mledge soul belief; anal IhaL Life mirk will lie perfoned in Ll�e aknmer set forth in Lhe application filed therewith. :kxrrn In liefcfre ne this o l...s2...........day of��. 19.1,2 Rat ary IOlhl is �.� ..� s` .................................. EL ASTATNIS (Signal tire of Applicant) NOTARYPU SteteOfNOWYOlk N0.01 ST80Q81713.3utfo1k CawOv Term Expires Juste 8,20 i 0 SURVEY OF PROPERTY SITUATED AT EAST MARION TOWN OF SOUTHOLD ;UFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-31 - 17- 19 0 1000-31 - 18- 18 SCALE 1 "=20' Z MAY 22, 1998 d 23, 1999 ADDED PROPOSED ADDITION & 1st FL. ELEV. MAY 4, 1999 ADDED FLOOD ZONES JULY 9, 1999 LOCATED -EDGE OF PHRAGMITES ;l CERTIFIED TO: RIDGE ABSTRACT CORPORATION BANK OF NEW YORK MORTGAGE COMPANY, INC. TITLE No. L275144S HOWARD S. MICHELSEN VALARIE MICHELSEN p / 4p / LOT AREA DATA Y �, (AREA COMPUTED TO TIE LINES) Dc / ��� S.C. TAX No. 18,957.03 sq. ft. bro y � � PHRAGMITES 1000-31-17-19 0.435 cc. S.C. TAX No. 10,034.24 sq. ft. / m 1000-31 -18-18 0.230 ac. S.C. TAX No. 1000-31-17_19 TOTAL 28,991.27 sq. ft. 0.665 cc. / � m N 0 )OD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 361 0300 1 77 G T. ZONE AE: BASE FLOOD ELEVATIONS DETERMINED ti ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); BASE FLOOD ELEVATIONS DETERMINED ND X, O� VkG AD ��,c AG Of apOR,ceg ;�Rl fs fn SIQEO OdR <L, 'awls I's Opol, 979 �O � 4 ovETn VARES— <1 "3Z 00 3r. \4) bl�b 4 70, r N/ O,e v4 t Af PREPARED IN ACCORDANCE WITH THE MINIMUM ly STANDARDS FOR TITLE suRvEys As ESTABLISHED $. 4,--; By THE LIALS. AND APPROVED AND ADOPTED $0p X FOR SUCH USE BY THE NEW YORK STATE LAND 0 TITLE ASSOCIATION. *"'0 LAND11�3 0. 67 00 1p m (p 469 TFD 0 N.Y.S. Uc. No. 49668 UNATHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF I SECTION 7M Of THE NEW YORK STATE Joseph A. Ingegno EDUCATION LAW. a luli COPIES Or THIS SURVEY MAP NOT BEARING %pftUWTV M lPf* SURVEYOR'S INKED SEAL OR Land Surveyor Um SEAL SHALL NOT BE CONSIDERED Am comamns TO BE A VALID TRUE COPY, lomo I PBOMT p" :±UE CERTIFICATIONS INDICATED HEREON SWILL RUN 2 1 ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE e Surveys — SubdiWsidw — Site PlanS — Construction LaoutTITLE COMPNYRMENTAL AGEHEREONNCY A14D LENDING INASVffUT. GOVEN ION LISTED . AND TO THE ASSIGNEES OF THE LOOM INSTI- L IE (516)727-2090 Fax (516)722-5093 TUITION. CEMWICATONS ARE NOT TRANSFERABLE n li'M levwrn Ar - ------- I ti SURVEY OF PROPERTY SITUATED AT g �, EAST MARION 3 I N TOWN OF SOUTHOLD I SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-31 - 17- 19 1000-31 - 18- 18 aLO T^ SCALE 1 "=20' MAY 22, 1998 MARCH 23, 1999 ADDED PROPOSED ADDITION & 1st FL. ELEV. MAY 4, 1999 ADDED FLOOD ZONES JULY 9, 1999 LOCATED EDGE OF PHRAGMITES O / CERTIFIED TO: RIDGE ABSTRACT CORPORATION BANK OF NEW YORK MORTGAGE COMPANY, INC. TITLE No. L275144S HOWARD S. MICHELSEN VALARIE MICHELSEN LOT AREA DATA (AREA COMPUTED i0 TIE LINES) ' S.C. TAX No. 18,957.03 sq. ft. 1016 / , PHRAGMITES 1000-31-17-19 0.435 ac. I � ,p S.C. TAX No. 10,034.24 sq. ft. 1000-31 -18-18 0.230 Co. 5 / ox 1 0-31-17-19 S.C. TAX NO 100 �y2 TOTAL 28,991.27 sq. ft. 0.665 Co. mm m NOTE: �o FLOOD ZONE INFORMATION TAKEN FROM: o N FLOOD INSURANCE RATE MAP No. 3610300177 G Co. ZONE AE BASE FLOOD ELEVATIONS DETERMINED ZONE VB COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); oe-� 1 BASE FLOOD ELEVATIONS DETERMINED R xs YYY IT Ox Qi 01 6O T,Oa - �`'a�S L (� 0 JA PDC O\ CIA �£ VA N E o $ f D` zo lr fix: 4, w LO ryy h� FS 4j0 Y` ocrwwGc \4g :g O m (1 tr A15 n j DPNH ,Go vnREs v P fEa N�tD 4"S E / `\ Ilay,jy di M h6 `Lb V t� \� y\.�gA \v2 o f S 1 / N6'S�'6 Ir 0= N 69','01 61 4 Y2rG Na c% y 16y 'ry NN E F ,� ,e r 3 PREPARED IN ACCORDANCE WITH THE MINIMUM N ` rywa 1e ABLISHED BY THERLIA.LS. AND APPRCNEDAANDSADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATIONLANIO l '� H A. �o O \ h D] rF0- NJ yO N.V.S Lic No. 49668 UNATHORIZED ALTERATION OR ADDITION .. TO THIS SURVEY IS A VIOLATION OF Joseph A. In a no SECTION ]209 OF HE NEW YORK STATE a SECTIO 7 Law N Y e p e 4 P V COPIES OF Tws suR'S MAP NOT eURlnc S M IE AND 0 OND F�S orom$ THE SSE SURJEYOAL INKED SEAL SI t9 �j Land Surveyor EMBOSSED SEAL RUE C NOT RE CONSIDERED n I TO DE A wuD rpuE copr. 170�' 07 2] PERMIT NO ��L).73g -�a3)5 00001 CERTIFICATIONS INDICATED HEREON SHAUL RUN lllrl [ 11999 I I ' •u E ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO ME TINE $NIVE 9 - $aDdIVI610116 - $IIE Plans - COII6LNELial1 La 011E TITLE COMPANY, GOVERNMENTAL AGENCY AND Y Y LENDING INSTRURION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSD- PHONE (516)727-2090 Fax (516)722-5093 TUDON CERTIFICATIONS ARE NOT TRANSFERABLE _ OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY One Union Square P.O. Bax 1931 AND/OR EASEMENTS OF RECORD, IF Aquebogue, New York 11931 Riverhead, New York 11901 ANY. NOT SHOWN ARE NOT GUARANTEED. 98-2978 i 0 SURVEY OF PROPERTY 0 SITUATED AT EAST MARION 3 I l TOWN OF SOUTHOLD - I SUFFOLK COUNTY, NEW YORKM'� I . S.C. TAX No. 1000-31 - 17- 19 0� II 1000-31 - 18- 18 SCALE 1 "=20' MAY 22, 1998 MARCH 23, 1999 ADDED PROPOSED ADDITION & 1st FL. ELEV. CI / 1TO• / CERTIFIED TO: RIDGE ABSTRACT CORPORATION BANK OF NEW YORK MORTGAGE COMPANY, INC. TITLE No. L275144S HOWARD S. MICHELSEN VALARIE MICHELSEN '�� OF / l •Fh / LOT AREA DATA (AREA COMPUTED TO TIE LINES) dE' S.C. TAX No. 18,957.03 sq. ft. fo6� / / Ail 1000-31-17-19 0.435 cc. `� p do S.C. TAX No. 10,034.24 sq. ft. F' / / m 1000-31 -18-18 0.230 Cc. / x TOTAL 28,991 .27 sq. ft. 0.665 Cc. / m SC. TAX No. 1000-31-17-19 � �• t�P� N i� 70 ' f0p 00 -m w SN13 wry' rL k W� W w ° L LT' N°Ve60g5 z9 ONNM / / fry \,Lb Wdp FRHoa�E�"O, 9 a�� L N E � __ _ T� �avmHUD wwEs � .0 f 61e�tD • a v. a �\. 60 yra 6ti�g °� 9o'g^ 2 '£0 ,o / o� est. 5 11 3° E � 'zV°� N •, ' �0Do ��l11 69. 0N Y k a N �2� ¢�Q�yl4P o F, � b� w '�rG l 65'1 a` d�-a,�'�c.•y Lr =d PREPARED IN ACCORDANCE WITH THE MINIMUM tk 69\25 5° d,00�� M STANDABY THE L FOR TI 0 APPRWEOE SUROM AANDSAOODPTEOD FOR SUCH DSE E NEW YORK STATE LAND TITLE ASS-CM 10 $7 NO J 0 � �• > a . I , qT, O. 9686 yO4r OF NE`N N Y S Lc. No. 49668 UNITHORRED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 9309 OF THE NEW YORK STATE Joseph A. Ingegno COPIES OF UCATION aW COPIES OF THIS OOR'SSURVEY MAP NOT BEARING Land Surveyor TME S E SEALURVORS INKED SAL OR SI EMBOSSED SEAL RUESHAULC NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO ME Title —SurveysSubdivisions — Site Plan - Construction Layout MILE COMPANY, GOVERNMENTAL AGENCY AND Y LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES CF THE LENOING INSTI- PHONE (516)727-2090 FOX (516)722-5093 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE OFFlCES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY One Union Square P.O. Box 1931 AND/OR EASEMENTS OF RECORD, IF Aquebogue, New York 11931 Riverhead, New York 11901 ANY, NOT SHOWN ARE NOT GUARANTEED. 98-297A BUILDING PERMIT REVIEW CHECK LIST Application Name: Architect/Engineer: SCTM #: District: 1,000 Section: 3� Block: A8 Lot: /46 Subdivision Name: Rey. Req Zoning District: [Lot sim Proposed: J [Lot coverage Proposed: J Req. Req. Req. [Front Yard Proposed: j (Side Yard Proposed: ] [Rear Yard Proposed: J Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW �i,�/ ZIQ Y � Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: e-,Wl T�^�- (� / e • `N