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26034-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27337 Date: 10/02/00 THIS CERTIFIES that the building DWELLING Location of Property: 520 RABBIT LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 18 Lot 11 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1999 pursuant to which Building Permit No. 26034-Z dated OCTOBER 18, 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 RECONSTRUCTION OF AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROY & JOAN BERMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTNENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-536870 09/21/00 PLUMBERS CERTIFICATION DATED 09/21/00 HARDY PLUMBING & HEATING —xL - / tho zed Signiture 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. 26034 Z Date OCTOBER 18, 1999 Permission is hereby granted to: ROY & JOAN BERMAN 79 MACKEY AVE PORT WASHINGTON,NY 11050 for DEMO & RECONSTRUCTION OF AN EXISTING ONE FAMILY DWELLING IN SAME FOOTPRINT AS APPLIED FOR & TO CONDITIONS OF TRUSTEES & DEC. All construction must comply with Chapter 46 of the Town Code. at premises located at 520 RABBIT LA EAST MARION County Tax Map No. 473889 Section 031 Block 0018 Lot No. 011 pursuant to application dated JULY 12 1999 and approved by the Building Inspector. Fee $ 343 . 00 Above fee includes $ 100.00 Flood Permit Autho zed Sig ature ORIGINAL Rev. 2/19/98 BuiLoiN4 uLPAHTHh NNL TOWN HALL y( � 765-1802 F APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the b, inspector with the following: for new building or new use : 1 . Final survey of property with accurate location of all buildings , property streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-° 3. Approval of electrical installation from Board of Fire Underwriters. 4 . Sworn statement from plumber certifying that the solder used in system cont less than 2/10 of 12 lead. 5. Commercial building, industrial building, multiple residences and similar t and installations, a certificate of Code Compliance from architect or engir responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 4-1 B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildi '.'pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, building e __unusual natural or topographic features. A.' properly completed application and a consent to inspect signed by the app If'a Certificate of Occupancy is denied, the Building Inspector shall state reasons therefor in writing to the applicant. C. Fees 1. Certifidate of Occupancy - New dwelling $25.00, Additions to dwelling $25.0 Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $? 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 - .25p. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .1. .0/2. . ./00 . . . . . . . . . . . . . . . . . . . . . . New Construction. ,XXX Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Pro erty. . .520. . . . . . . . . . . . .RABBIT LANE . . . . . . . . . . . . . . . . .F.,'�ST. MARION. . . . House No. Street Hamlet Onwer or Owners of Property.. ROY. . TOA. GERMAN County Tax Map No 1000, Section. 31 . . . . . . . . . .Block. . . . .i$. . . . . . . . .Lot. . 11. . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . 26034 10/18/99 RICH ARE, SAETTA. . . Permit No. . . . . . . . . .�. . . . .Date Of Permit. . Health Dept. Approval. . . .•••. . . . .. . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . , , Planning Board Approval. . .NA XXX Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . .= aA*PLIWANT . . . . . . . . . . . . . . Qom, �ssz ce -;a- a7337 TEL. 765-1802 b z , TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN HALL SOUTHOLD, NY 11971 CERTIFICATION 1 Date:" Building Permit No. 2t`0O� —1 7 Owner: TOV -&X rnQ n ri Plumber:(p " L (please rint) I Sq 3 r I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. I also certify that I installed an anti-scold and/or thermal shock preventing device at all bathing and/or showering fixtures in conformance with part 902.6(k) of the N.Y.S.F.P.A.B.C. (plumber's signature) Swom to before me this 2 I day of nOT_ jag , 2000 (N Notary Public, �f I�L/<_ (Notary Public)County NOTARY PUBLIC,s:!'. ow Yoh No.03ECE5:: - .' ftwoQuaal1 in Suft'c •�rinty THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY IE F— 40 FULTON STREET, NEW YORK, NY 10038 - SEP'1EMSER 21,2000 10152700/00 N 536870 Date A��luation No. on e THIS CERTIFIES THAT �''+ ITa,NO. 6@34 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ROY BROMAN, 520 RABBIT LANE, E. MARION, NY in the following location- ❑ Basement El 1st FL ® 2nd FL OUT Section Block Lot was examined on SE$TEMBER 12,2000 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT OTHER AM1. 1 K.W. I AMT. I K.W. I AMT. I K.W. I AMT. I K.W. AMT. I H.P. 18 20 25 18 1 14.1 1 1 1 1 1 1 1 1.2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT, !ME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. SYSTEMS TRANS. AMT. X.P. NO,OF FEET AMT. I WATTS - 1 F 1 20 Z 600 SERVICE DISCONNECT NO.OF S E R V I C E METER NO.Oi CC GOND. A.W.G. A.W.G. A.W.O. AMT. AMP. TYPE EQUIP. 1 R RW 1 R JW 1 R JW 3 IW PER R WCC.GOND. NO.OF HIAEG OF NI•LEG NO.OF NEDTRAIS OF NEImAL 1 20J CB 1 % 1 4/0 1 2/0 ��FE OTHER APPARATUS: PADDLE FANS-4 3 TON AIR CONDITIONER-1 MOTOR8:1-3 H.P. ,1-F H.P. F PANELSOARDS:1-1 CIR. 60 E ELEC. WATER HEATERSt :1-4.5 K."K. � G.F.C.Ie -5 E SHOKE DETECTOR r-4 (k� LL V' I F <<< Continued on Page 2 >>> r GENERAL MANAGER G r. per i This certificate must not be attend 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 MUST NOT BE ALTERED IN ANY MANNER. r u95099 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date SEPTEtER 22,2000 A¢�lication No. o7216'034 to L0152700/00 N 536870 THIS CERTIFIES THAT rGRMTT NO. 26034 r only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of v r. ROY BRONNAN. 520 RABBIT LANE, E. tfARION, NY s in the following location; ❑ Basement ® lst Fl. El 2nd Fl. OUT Section Block Lot n SEPTEMBER 12 2000 P was examined on F and found to be in compliance with the National Electrical Code. v r. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES $WITCHES INCANDESCE FWORESCENi OTHER AMT. K.W. ANTI. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 6 n v M1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS M SYS OMTSLET DIMMERS G AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMi. H.P. NO.OF FEET AMT. WATTS KM1 G SERVICE DISCONNECT NO.OF S E R V I C E _ METER NO.OF CL GOND. A.W.G .W.G. A.W.G. AMT. AMP. NPF ECUIP. 1 2W I 0 SW ]0 JW J R IW PER a OF CC.COND. NO.OF HI-LEG OA HI-TEG NO.OF NFUIRALS OF NftNRAL Ll E OTHER APPARATUS: p� G cv cPc 7 v v _ vv 6 JIM SAGE ELEC. INC. LIC.#3635-E ___ td,w.- _ L Q PO B1X 38 GREENPORT, NY, 11944-0038 GENERAL MANAGER B 11 r� ry� Per 6 This certlRaate 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 61JILDiNC DEPARTMENT. THi:. COPY OF CEFTI:=IGATE MU01 NOT uE ALTERED IN ANY MANNER. FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BU DING OWNER'SN�-yp-ME Policy Number F'o d- Joey 34se.ntan/ BUILDI G STREET ADDRESS(Including Apt., Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number Sao CITY &-AQ r r'7A�2/OBJ STATE U` ZIP CODE//93 9 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) /OD0 - 3/ - /�-// BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) ?,-S L LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_1 GPS(Type): ( ##°-##'-##.##" or Hp.;CNflN#°) IJ NAD 1927 Li NAD 1983 L1 USGS Quad Map iJ Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.COUNTY NAME B3.STATE wN of So lwlf/ 60 /3 �v><'f`v11 N , V- B4.MAP AND PANEL I B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL B8.FLOOD B9. BASE FLOOD ELEVATIONS) NUMBER© DATE EFFECTIVEIREVISED DATE ZONE(S) (Zone AO,use depth of flooding) Ma t41 f 5 y E 9 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 89. JJ FIS Profile P!5� FIRM LJ Community Determined JJ Other(Describe): B11. Indicate the elevation datum used for the BFE in B9: Lj NGVD 1929 U NAVD 1988 U Other(Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area(OPA)? 1J Yes 1XI No Designation Date: SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: J_lConstruction Drawings" )JBuilding Under Construction" .Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2.Building Diagram Number C-3 (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1 430,V(with BFE),AR,ARIA,ARAE,AR/AI-A30,AR/AH,AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the tRVr?1_j Yes-:JAZ No ❑ a)Top of bottom floor(including basement or enclosure) S fton) rOF ❑ b)Top of next higher floor g . S ft.(ra) m * ❑ c)Bottom of lowest horizontal structural member(V zones only) — =ft.(f) ❑ d)Attached garage(top of slab) — =ft.(Ir1) e g ( u4 o v ❑ e) Lowest elevation of machinery and/or equipment servicing the building 9 . .Y ft.(sr) S ` ❑ f)Lowest adjacent grade(LAG) S. J ft.(ro) Z , ❑ g) Highest adjacent grade(HAG) .S . 7 ft.(m) ❑ h)No.of permanent openings(flood vents)within 1 it.above adjacent grade 3 ❑ i)Total area of all permanent openings(flood vents)in C31n �13) sq.in. ( p) SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER JoSe N 4 /ti a 'Vo P, e.S TITLE / C COMPANY NAME S, �AN.OI JU2V' diG JOS M '4ueW oe ADDRESS CI ST TE CODE /q3! P1(/&yrZ'yS A 5,c,/ - o yW SIGNATURE DATE TELEPHONE,,;-?/-63i-7zJ-zoso FEMA Form 81-31,AUG SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS O��S11FF0(,(-c °Gym Town Hall,53095 Main Road p .4 Fax(5 16)765-1823 P.O. Box 1179 Telephone (516)765-1802 Southold,New York 11971-0959 O �. BUILDING DEPARTMENT TOWN OF SOUTHOLD September 21, 2000 Richard Saetta General Contractor Inc. P.O.Box 2047 Greenport, NY 11944 RE : Berman, 520 Rabbit Lane, East Marion NOTE: AN ELEVATION CERTIFICATE IS ALSO REQUIRED CATTO 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 (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 # 26034-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. DEPARTMENT OF THE ARMY NEW YORK DISTRICT,CORPS OF ENGINEERS JACOB K.DAVITS FEDERAL BUILDING ' NEW YORK,N.Y.10278--0090 FI.PItlR May 11, 1999 ArromON OR Eastern Permits *Section SUBJECT : Joint Application with New York State Department of Environmental Conservation ' Richard Saetta General Contractor Inc. ' P.O. Boa 2047 Greenport, NY 11944 Dear Gentlemen: We have recently received a copy of the Joint Application for permit you filed with the New York State Department of Environmental Conservation (NYSDEC) . Please be advised we have reviewed the copy of the Joint Application sent to this office by NYSDEC. Based solely upon the information provided, it appears that a Department of the Army permit is not required for your proposal. The Department of the Army regulates construction activities 'in navigable waterways and discharges of dredged or fill material, into waters of the United States, including inland and coastal wetlands . If your proposal would involve such work, and has not been portrayed as such in your Joint Application, you should contact this office immediately so that a project-specific determination can be made as to whether a Department of the Army permit will be required. .Pny *inquiries can be directed to this office at (212) 264- 3.912, 3913 , 6730, or 6731 . Sincerely, Jaes W. I3aggerty C ief, Eastern Permits Section Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. IS 00 DATE: May, 26, _1999 ISSUED TO ...... ....JOAN-I-B.E.R.M.A.N. ....... ...... . ... I.......... ... 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;"t and in accordance with the Resolution of The Board adopted at a meeting held on May...2.6......1.999 19-99...., and in consideration of the sum of $..150,00 - ... paid by ._Richar.d...5aeta...for- ROY., & JOAN...BERMAN..................... ................... of .........East...Marion......... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to remove an existing house and replace with a new house in the same footprint. all in accordance With the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and those presents to be subscribed by a majority of the said Board as of this data. 1VI. • ...................... Ln VS, ......... ................... I I I I I I I I I I ...... ..............I.................. rallees t SOUTHOLD TRUSTEES No. :! "D 0 p E R M I T DACRARA)Issued To -- Date t Address g :go khA B it iA . r a m ._ THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE.TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 ?� NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-02277/00001 ■ duty 2 1999 FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental Conservation Law July 30, 2004 TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ 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: Floodplain 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 Roy W. Berman (516) 883-9531 ADDRESS OF PERMITTEE 79 Mackey Avenue Port Washington NY 11050 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Richard Saetta General Contractor Inc. P.O. Box 2047 Green ort NY 11944 (516) 765-4900 NAME AND ADDRESS OF PROJECT/FACILITY Berman property, 520 Rabbit Lane East Marion NY 11939 LOCATION OF PROJECT/FACILITY SCTM #1000-31-18-11 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Peconic Ba E:723.9 N:4555.9 DESCRIPTION OF AUTHORIZED ACTIVITY: Remove existing one story single family dwelling and construct a new two story single family in the same footprint. All work shall be performed in accordance with the attached plan stamped NYSDEC approved on 7/2/99. 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 John A. i and (MRP) Bld #40, SUNY, Stony Br k, NY 11790-2356 AUTHORIZ D NATURE DATE Jul 2 1999 Page 1 of 4 9S2P7 (8187)-8d New York State ' Department of Environmental Conservation NOTICE 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 JOHN W. PAVACIC _ Expiration Date Q a� NOTE: This notice is NOT a permit _ a JUDITH T. TERRY li E,`. -=. .'� Town Hall, 53095 blain Road I TOWN CLERK C+. c,<, P.O. R< r 1179 c: Southold. Nc%% N'ork 11'171 REGISMAR OF VITAL.STATISTICS .+% ie��`^", Fax (516) 765-1923 MARRIAGE OFFICER _ . ��`' �b�` Tcicphonc (516) 70. 1X(11 RECOFL)S MANAGEMEM-OFFICER FREEDOM OF INFORMA71ON OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93)) . Dil r '�f BLL: i. CETT. � TOWN OF SO'c1TfiOLD Southold Town Clerk August 25, 1993 APPLICATION PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and si¢nl: 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein_ 3. If revoked, all work must cease until permit is reissued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE TO THE B MY OWLED TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) DATE /O SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANTI NAME ADDRESS TELEPHONE APPLICANT BUILDER ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enouv_h information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION n PAGE 2 OF a DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure ❑ Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES: O Fill D Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) 0 Individual Water or Sewer System 0 Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (To be comoleted by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: ❑ Is VM located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). 0 Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF a SECTION a- ADDITIONAL INFORMATION REOUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Development plans,drawn to scale, and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the first floor,details of floodproofng of utilities located below the fust Door and details of enclosures below the first floor. Also ❑ Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg protection level (non-residential only) Ft. NGVD (MSL). For Doodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory Doodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. O Is B. ❑ Is not in conformance with provisions of Local Law #—, 19_. The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION a PAGE a OF a APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Comoliance is issued) The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest Boor, including basement (in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of Boodproormg protection is FT. NGVD (MSL)" NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8: CERTIFICATE OF OMP IAN E(To be comnleted by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECL4L FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # 19_ SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENT'S OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) 3q� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R UGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP CE & CHIMNEYY REMARKS- DATE AlJ INSPE 1.65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE &,CHIMNEY R MARKS: DATE INSPECTO f�� aha 3� � 7GS-1802 BUILDING DEPT. INSPECTIQ [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ V] F ING [ ] FINAL [ ]`� FIREPLACE S CHIMNEY �- REMARKS: 7� DATEo7/ eb INSPECT 03 765-1502 BUILDING DEPT. NS�ECTION [/FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC.jEE& CHIMNEY REMARKS: Yl/ � ,Gri, . � DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] IN,StlLATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR COUNTY OF. SUFFOLK ROBERT J. GAFFNEY Surro ( COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES CURE B. BRADLEY, M.D., M.P: ACTINO COMMISSIONER September 22, 1997 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFFICE OF WASTEWATER MANAGEMENT GENERAL GUIDANCE MEMORANDUM#S GUIDELINES FOR THE APPROVAL OF SEWAGE DISPOSAL SYSTEMS FOR EXISTING, RENOVATED,OR RELOCATED SINGLE FAMILY RESIDENCES AUTHORITY The Suffolk County Sanitary Code sets forth requirements for approval of water supplies and sewage disposal systems. The statutory authority for these guidelines can be found in Article 5 Section 760-502,Article 6 Section 760-603,and Article 7 Section 760-705A. Detailed specifications can be found in Standards for Approval of Pians and construction- Sewage Systems for Single-Family Residences. PURPOSE A. This document is to be used to determine: 1. When an application for a permit to construct a sewage disposal system is required. 2. The design of such systems and the evaluation of the capacity of the existing system. 3. The application fee. DEPARTMENT APPROVAL REQUIRED The Department will require approval of existing or modified sewage disposal systems for single family residence under the following circumstances: A. RELOCATED SYSTEMS: 1. When a septic tank,leaching pool,or waste line of a sanitary system is to be relocated for any reason, such as, but not limited to, total or partial reconstruction of the building, additions to the building, relocations due municipal zoning changes or regulations,reconstruction after fires, or washouts. 2. When a new and separate sanitary system or new exterior waste line is to be installed for any reason, such as, but not limited to, total or partial reconstruction of the building, addition to the building, relocation due to municipal zoning changes or regulations,reconstruction after fires,or washouts. 3. When a new and separate sanitary System or new exterior waste line is to be installed due to construction of additions or accessory buildings. B. EXISTING SYSTEMS: 1. When existing systems, regardless of previous Department approvals, are proposed to be used after reconstruction of a residence due to fire,demolition,or other destruction. 2. When existing systems, regardless of previous Department approval, are proposed to be used after building relocation or elevation. DIVISION OF ENVIRONMENTAL 0U 1-17Y RIVERHEAD COUNTY CENTER RIVERH EAD. NY I 1 DO I 852- 2100 DEPARTMENTAL APPROVAL NOT REQUIRED A. The Department will not require approval of existing or modified sewage disposal systems for single family residence under the following circumstances: I. When a sewage disposal system is replaced or when expansion pools are installed solely as the result of failure of the system and not related to building modifications. 2. When additional plumbing fixtures are installed and piped through the existing waste line ,and there is no increase in the footprint or gross floor area of the building. 3. When the footprint or gross floor area of the residence is increased, with no additional plumbing fixtures,and the increase does not affect the location of sewage disposal or water supply systems. CRITERIA FOR APPROVAL OF EXISTING SYSTEMS A. The following criteria shall be used for evaluating existing sewage disposal systems: 1. The design flow of a replaced dwelling shall be based upon current standards. 2. No credit shall be given for the existing system unless a structural evaluation of the system has been made by a design professional,and a report certifying its status has been submitted to the department. Such a review shall require that : a. All septic tanks and leaching pools be pumped dry or to the water table whichever occurs first. b. The leaching surface area and the depth below the outlet invert be calculated. c. Foran WWM-073 be completed,signed and stamped by the design professional. 3. Design credit: a. No credit will be given to a leaching pool structure located under water. b. Precast leaching pools, installed after 1972 and more than ten(10)years old shalt receive no more than sixty six (66)percent credit. c. Precast leaching pools,installed prior to 1972,shall receive no more than fifty (50)percent credit. d. Block leaching pools shall not receive credit towards the design flow, however they can remain part of the system if they are certified as sound by a design professional. WATER SUPPLIES A. The following criteria shall be used for evaluating existing water supply systems: 1. The design of the water supply system for replacement dwellings shall be based on current standards. 2 . Existing wells shall meet current quality standards for water supplies. 3. Where public water supplies are available,hook up will be required. 4. Existing wells and new or expanded sanitary system for residential facilities: a. Shall be separated a distance no less than that which existed prior to the construction of the new system, and their placement shall be in accordance with good public health practice. b. Which have existing excess separation above the current standards may be reduced to current standards. APPLICATION FEES A. The following fees shall be applied: 1. Initial application: $ 50.00 2. New sanitary systems with public water: $ 220.00 3. New sam y system with well: $ 330.00 Issued by Stephen Costa,P.E., Chief Office of Water and Wastewater Management LD INSPECTION_RF,PORT__ COMMENTS AT --------{� — �2�G� , -- � ----- y 'NBATION it - n Z IHDATION (2ND) II __ __________ Ir==== _-__________=___---- ----------------- r",/� /y -- ------ ---- IGH FRAME & ii It PLUMBING I� it I (- II9001-171, ii >ULATION PER N. Y. STATE ENERGY II u--- -I CODE ii f u--- N S — ii N �I L It III II � N FINAL II It N +Z/7q ADDITIONAL COMMENTS: V N DhY IJ*� fOUND41TiDIV Lptriol T85 Heuj + - p RIGfIJ L d � 3 . � O'F OJIvpR�'�Tiv � GGIDA7 ZO�vG EL �I NIS+1 �� J l H H ,.y C O - z �i a r en ro D S BOARD OF HEALTH . . . . . . 3 SETS OF PLANS - FORM NO. t SURVEY i 2 PA LTOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . : nr-DE " TOWN HALL NOTIFY T r S0k=D SOUTHOLD, N.Y. 11971 CALL . . . . . . . . . . . . . . . . TEL.: 765-1802 �j'q MAIL TO : Examined . . . . " .. . . . . . . ., 19`qt / f Approved . . . . . . . . . . . ... . ., 19f7 Permit No. a- Al)���. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./pe . . . . . .Buildingr APPLICATION FOR BUILDING PERMIT Ski l� Date ftb-09RY-.-ft. . 1999. ., 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit 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 strt or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap cation. 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 issued a Building Permit to the applicant. Such per 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 Occupat shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance: Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descril The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. RICHARD SAEITA GENERAL CONTRACTOR INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) BOX. 2047 G.REENPORT NY .1.1944 • . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or built: GENERAL CONTRACTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . ROX A JOAN. BBR W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is orporation, nature of du authorized officer. . . . . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. 13086 HI . . . . . . . . . . . . . . . . . . Plumber's License No. 1593P . . . . . . . . . . . . . . . . . . Electrician's License No. 3635E . . . . . . . . . . �; Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . i. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520 RABBIT LANE EAST MARION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . .31 . . . . . . . . . . . . . Block . . . . .1$ . . . . . . . . . . . Lot . . AX . . . . . . . . . . . . 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 . . .RESIDENTIAL , , , , , , , , , , , - „ . , , , , , „ - - , , . , - „ _ , , , , , , , , - • , - • • „ b. Intended use and occupancy . . .USZI)ENTIAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nature of work (check which applicable): New Building XX . Addition . . . . . . . . . . Al ration. l Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . .X.X . . . . . . . . Other ` (Description) Estimated Cost . . .$12Q,.QQQ.QQ . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . ` (to be paid on Pilin 1,117Tf�3RZ"1TP08)'�'—� If dwelling, number of dwelling units . . . .QIYB . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage, number of cars . . . .NA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If business, commercial or mixed occupancy, specify nature and extent of each type of use . . &k . Dimensions of existing structures, if any: Front . . . .7.4'. . . . . . . . . Rear . . . .L6`. . . . . . . . Depth . . .37.' Height . . .15'. . . . . . . . . . Number of Stories . . . . .ONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . 16'. . . . . . . . . . . Rear . . . 16', , , , , , , , , , , Depth . . .3Z'3V . . . . . . . . . . . . . . . . height . . .30`. . . . . . . • • . . • . . • . . Number of Stories . TWO . . . . . . . . . . . . . . . . . Dimensions of entire new construction: Front . . .L6'. . . . . . . . . . Rear . . . . . . .16,. • . • • • Depth . . . .37... . . . . . . . . Height . . .30t . . . . . . . . . Number of Stories . . .TWO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Size of lot: Front . . .25 L . . . . . . . . . . . . . . . . Rear . . . . . . .2S'. . . . . . . . . . . . . Depth . . . . . . . .122'. . . . . . . . . . . Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zone or use district in which premises are situated . . . .USIRENTTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Does proposed construction violate any zoning law, ordinance or regulation: .NQ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will lot be regraded . . . .NQ . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes XX No Name of Owner of premises RQX A .JQAN .1114RM0 . . . Address . . .P,QRT RASHINGTQN . Phone No. .883—A531 . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor .RICHARD .SAETTA .GC .INC . . . . Address . . .GREENP.ORT . . . . . . . Phone No. .47.7-1633 Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No . . . . . *If yes, Southold Town Trustees Permit ma DIAGRAM ed. Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from perty lines. Give street and block number or description according to deed, and show street names and indicate whether ,rior or corner lot. ATTCHED y TE OF NEW YORK, S.S INTY OF . SUFFOLK. . . . . . . . . . . . . . . . . . . . . .9TM1'P.SAETTA. . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ,e named. GENERAL.CONTRACTOR . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) iid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ication; that all statements contained in this application are true to the best of his knowledge and belief;and that the c will be performed in the manner set forth in the application filed therewith. rn to before me this . . . . . . . . . . . 7 . . . .day of . . 41 � . . . . . . ., 19 . try Public. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County PETER M. COLEMAN NOTARY PUBLIC, Stowe of Now Yar! . . . . . . . . No. 52.5758570 (Signature of applicant) Qualified in Suffolk County Commission Expires March 30, 2040 I SURVEY OF PROPERTY 4Qp� SITUATED AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-31 - 18- 11 5 SCALE 1 "= 10' \ NOVEMBER 10, 1998 MARCH 15, 1999 UPTADE SURVEY & ADDED PROPOSED ADDITION DECEMBER 2, 1999 FOUNDTION LOCATION b oF C1 �, vo, AREA = 2,995.88 sq. ft. 0.069 ac. 4O,A4, `'Eotis CC• 4 Q.Q`" 0 eye�lG Sp 9 NOTE WOOD BULKHEAD m� a5 4i ELEVATION SHOWN THUS: FFE Im ARE REFERENCED TO N.G.V.D. 1929 DATUM s � °"Ai- Oe Q / b`Oy�1.IH� rOUN0AT10N LOGA-flow IS 2 `ti 1zo, Gs "lac 99." "T W(It LN 'THE LRIGINaL fiDaVPRINY cT 6 6 F. y e�a` 5665. m� 'JP, I s KY. 3O i a G sa Tib s,^ i o i q 00ic Wp y'Pw G � d 0 6 4y £�' \\�\ £$ 2m' mpy mo mt n 0 P o TH O O a \\4 Ooti. \pP bO f \�pi^p Q2 4 p \\ wc'F 4 J P�LfY ,Kl s. .AdjOo4,e 'V / 170 m� 4 p m�GTp �O f0 �P Y N Eli i Ilk Y. bRNO� / i� CERTIFIED TO. PREPARED IN ACCORDANCE WITH THE MINIMUM ROY BERMAN ssYAiIDiER0inFKs nrvli�I=PaIrvEDAnNoswoalrco JOAN BERMAN FOR SUCH USE BY THE NEW YORK STATE LAND TITL£�SSDCIATION �sP LnMb I s 0- :reHA G co os IN 41 a Vf 569 P�-A [N� NYS Li, N. 49666 NOTE. UNAU HORIZED ALTERATION OR ADDITION FLOOD ZONE INFORMATION TAKEN FROM: TO THIS 720.OFSTHE NEW YORK STATE FLOOD INSURANCE RATE MAP No. 36103CO177 G EDUCATION LAW. Joseph A. Ingegno COPIES OF THIS SURJEY MAP NOT BEARING ZONE AE (EL 9)) BASE FLOOD ELEVATIONS DETERMINED THE LAND SURVEYOWS INKED SEAL OR ZONE VE EL 11 COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION), EMBOSSED EA NOT BE CONSIDERED BASE FLOOD ELEVATIONS DETERMINED Land Surveyor TO BE n VAUD TRUE C Copt CERPFCATIONS INDICATED HEREON SL-AUL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLECOMPANY, GOVERNMENTAL AGENCY AND Title SuNe s — Subdivisions — Site Plans — Construction La out LENDING INSTITUTION LISTED HEREON. AND y Y TO THE ASSIGNEES OF THE LENDING INSD- TOUGH. CERTIFICATIONS ARE N07 TRANSFERABLE PHONE (516)727-2090 Rai (516)722-5D93 OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY One Union Square P,0 Box 1971 AND/OR EASEMENTS OF RECORD, IF Aquebague, New York 11931 Riverhead, New York 11901 ANY. NOT SHOWN ARE NOT GUARANTEED. SURVEY OF PROPERTY SITUATED AT EAST MARION TOWN OF SOUTHOLD 0� 41SUFFOLK COUNTY, NEW YORK o S.C. TAX No. 1000-31 - 18- 11 '14 SCALE 1 "= 10' ° �� NOVEMBER 10, 1998 MARCH 15, 1999 UPTADE SURVEY & ADDED PROPOSED ADDITION AREA = 2,995.88 sq. ft. [fid . TzQ++ 0.069 °D. Q CO- �a Z ° opo` 9yd, v F / AX waoD euLNHuo 661� i�s�^�'Qp'�' NOTE: y 39� ELEVATION SHOWN THUS: FIFE. z.aa ARE REFERENCED TO N.G.V.D. 1929 DATUM 70, eG A' d 1,5100 N w' VV� 125' yti "� f yOL'I'f � 4 p O l , q: °a 01 2s �' °Gs r IA' �•0� n•,y ^� i�, o °M1 c `d L`3 +i9i cR�b It 4A, Q/�O� Z !' 1 5 5$`L0 p CERTIFIED T0: PREPARED IN ACCORDANCE WITH THE MINIMUM ROY GERMAN STANDARDS FOR TIRE SURVEYS AS MASUSHED ROAN GERMAN BY THE WA."' AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LWD SEAS n Ui,• p it q �� c .,,�y J4'3 O y C EVI N Y.S. Lic. No. 49668 � UNAUTHORIZED ALTERATION OR PDORWN NOTE. TO THISSURVEY Is A mounON OF FLOOD ZONE INFORMATION TAKEN FROM: SECTION 72M OF THE NEW YORK STATE FLOOD INSURANCE RATE MAP No. 36103CO177 G EDUCATION LAW. Joseph A. Ingegno COPIES OF THIS %Rl MAP NO BEARING ZONE AE (EL 9): BASE FLOOD ELEVATIONS DETERMINED LANTHE SSD SURVEYORS INNED SEAL SI ZONE VE (EL 11): COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); Land Surveyor EMBOSSED SEAL SMALL NO BE CONSIDERED To BE A veuD TRUE cow. BASE FLOOD ELEVATIONS DETERMINED CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY Is PREPARED, AND ON HIS BEHALF TO THE TILE COMPANY, GOVERNMEWAL AGENCY AND Title Sur ys — Subdivisions — Site Plane — ConstNction Layout TO THE ASSON ES OF THE LENREON.IANDD- MION. CERNFlCATIONS ARE NOT TRANSFERABLE PHONE (616)727-2090 Fax (516)722-5093 OF CES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY One Union Square P.O. Box 1931 AND/OR EASEMENTS OF RECORD, IF Aqueboque, New York 11931 Riverhwd, New Yark 11901 ANY, NOT SHOWN ARE NOT GUARANTEED. tp 1 T — [n-7p MR TTI Fz; lu GI w ! U %l IN u , � iJa PROVIDE_- E SM08 E DETEC TIN G ALARM DEVICES AS TO PART. 721.1 N.Y.S BUILDING CODE. - - APPROVED AS NOTED DATE:-a10I1'�15-19 B.P.$ a 3`f�" FEE LBBB@-R� PROVIDE ANTI-SCALD AND/OR NOTIFY BUILDING DEPART T T — 765 FOLLOWING 9 AM 4 INSPECTIONS: FOR E THERMAL SHOCK PREVENTING PROVIDE OPENINGS F R I FOUNDAION - TWODEVICES AS TO PART. 902.6(8) I FOUNDATION - TWO REQUIRED N.Y. STATE BUILDING CODE. EMERGENCY ESCAPE 5 FOR POURED CONCRETE REQUIRED BY PART 71j OF 2 ROUGH - FRAMING t PLUMBING till a. INSULATION N.Y. STATE BUILDING C DE. 4 FINAL - CONSTRUCTION MUST o _ E.k'/5.77A1e�1 oEGIC BE coMC FOR pu CONSTRUCTION SHALL MEET PLUMBER CERTIFICATION H : REQUIREMENTS OF THE N.Y. ON LEAD CONTENT BEFORE TNI STATF CONSTRUCTION h ENERGY CERTIFICATE OF OCCUPANCY CODES NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS SOLDER USED /At In1ATER PLUMBING 'P P - 4 0 �. I ", ,. ,:. ` F��=%� .. ,t.: ��' ':/ - � . _ ., :ter- ALL PLUMBING WAS f- SUPPLY SYSTEM CANNOT &WATER LINES NEEL) Ip!I EXCEED 2110 Of 1% LEAD. TESTING BEFORE COVEF ING OCCUPANCY OR USE IS UNLAWFUL Ncopper tubing Isused for water distribu WITHOUT CERTIFICATE DO NOT PROCEED WITH System; piping Bhatll be OF OCCUPANCY FRAMING UNTIL SURVEY of types K or L only OF FOUNDATION LOCATION UNDERWRITERS CERTIFICATE HAS BEEN APPROVED. REQUIRED RICHARD SAETTA TITLE n a General Contractor l s 5g e a ■ LOCATION_F'jtYL -- - - i 3 _ - No4� o Designs N1�'•r0�',i hR51 O norsd SCALE JOB DRAWING Q/"V. II' mob o 1 800 - 439 - :1633 DATE N No. No. 1 .1 1 `Y L> r� Gt2o5h I-letc�IknL�'-�4 _ � je I,U blcnT�S n>::cKSro ) . Ile, Al 0 �a ��b�ta{I.oA Go�L1;cl FI�Ati1E � N�r� � IT T. pt{O`fEb t�. '4 WWUUn D�I� . /?U 2�Ivj41tJ � � 6 �iYnCGR iuA �$aXF '- 1 q --ryp PyetrONu/9LLSTf'p--- - :, 1` •. � _.� - I g.o"x z'-� ' - �• I �sr���� � � . I. . 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TKi7 �iaGfzY�K, pp e v,,o I wx1w, _ _ IJP f ItrI-III _ ,a f1r— zit u 1 �,)6, �`9s No.23P oc y°F N�STP� i vI 1�(InNS ENEg�� ((For Non-_�eoTrlc Hee+) Richard Saetta Designs per: Ray & Joan Berman For: Lane 520 Rabbit East Marion, New York Uated 10/11/99 6,000 Degree Days Design Criteria: A t0 Degrees Fahrenheit LA,70 Degrees Fahrenheit 'Ct1EKMAL- KEMAKKS AREA DESIGN ---- U.. SUDSYS'fEbl „ RATING R-13 Insulation -- .077 +100 -- 1467 Andersen Insulated Glass Balcrior W alts-- _74 99 .49 Glazing U40 Rated Doors 40 40 8 — f)W f9 A N Ceiling(67at) - +9 R-30 Insulation 628 .033 Insulated Glass — CeilinglCalhedral) 14 Andersen Skylights 21 48 3 R-19 SnsulatiO Hour -----'- 980 .053 __.---- Fouadatum Walls NA Shah lasulaliml NA TOTAL:_+10 Llolev+ S stems to meet requirements of 7815.2 E uglding Em'clopo 7 uircmcntsof78t51h �S M6V N HVAC Egwpurent to mcet req Is stems to nrecl reymremenls oC 7815 12 r o HVAC Sy F Duel Systems to meet requocmenls of 7815.13 Ventilations Systems to meet reclwrements of 78ts of 0 � Piping systems to meet nafca mems meet re cements of 7815 2l -� lnsulaaon of Pip g Y ur ment to meet req Service Water H uln'S'stemstomeet requirements of 7815 31 Electrical&.Lighting y 'fa We best of Illy kno"I dgt' belief,dt professional ludgn these plans Brain coalpliunce 6rgacd� tmth the code Dated BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: Reviewed: Architect/ Date Engineer: Lr<'C Submitted: SCTM #: District: 1,000 Section: Block: Lot: l� Project 01 Subdivision Location: /! Name: de Sin&le&separate Required certification: (Yes/No) _ Req. Req. y Hing District:/� [Lot size: Actual: 1 [Lot coverage Proposed: Req. Req. Req. [Front Yard Proposed:_J [Side Yard Proposed: 1 [Rear Yard Proposed: Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO Y-E S Number Suffolk County Health Dept. 1/ pt New York State D. E. C. ✓ �' y738"aZ�7 /.Poop/ Town Trustees 500 Town Zoning Board approval: Town Planning Board approval: Flood Plajlq Elevation ??? Flood Zone: CiC �C Motes: � t0 ----------- a",00,4-