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Home My WebLink About22147-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24615 Date SEPTEMBER 11, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property PRIVATE RD. OFF EAST END RD. FISHERS ISLAND, MY House No. Street Hamlet County Tax Map No. 1000 Section 3 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1994 pursuant to which Building Permit No. 22147-Z dated JUNE 23, 1994 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 INGROUND SWIMMING POOL WITH FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to ROBERT & JEAN CALHOUN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-358115 - JULY 17, 1955 PLUMBERS CERTIFICATION DATED N/A Bu' ing Inspect 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) Date ... ................................................ N® 22147 Z Permission Is hereby granted to: I .. ....... .. ..... ................................................. to s',% Q9PGGGC ....... r/ ...�..... . �..... �...... . ................. ` .� UGC ..... .. at premises located at... ..�. ......... .. /.... .............. . ...................... ................................... ,... . .... •••..................................................... f County Tax Map No. 1000 Section ...../.....`7.............. Block.......fir............... Lot No. .................... ( pursuant to appllcation dated .......�it�/..� .................................. 19.��.,7�:....... and approved by the Building Inspector, dZ> Fee S• ... � : ....o....................... Building Inspector I Rev. 6/30180 Form No. 6 TOWN OF SOUTHOLD I � C e BUILDING DEPARTMENT TOWN HALL i65-1s02 SEP .I 5 1995 I APPLICATION FOR CERTIFICATE OF OCCUPANCY __T WN OFSOUT, This application must be filled in by typewriter OR ink and submitted to the building 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. 15. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. + 6. Submit Planning Board Approval of completed site plan requirements. __" For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-existing land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. 'A properly completed application and 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. -2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .VI;195. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Construction. . . . .:. . . . . 0ld Or Pre-existing Building. . . . . . ation of Property, .Pyt;Rd. off East end road, Fishers Island,N.Y. House No. . . . . . . . . . . . . . . . . . . .Street. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hamlet cr or Owners of Property. .Robert & Jean Calhoun . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . my Tax Map No 1000, Section. . .3. . . . . . . . . .Block. . ?. . . . . . . . . . . . .Lot. . . . � . . livision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . nit No. .?2 4.7. .4. . . . . .Date Of Permit. 6/23./. . .94 . . ' Applicant. AS. Contracting Inc. . . . . . . . . . . . LthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . fining Board Approval. . . . . . . . . . . . . . . . . . . . . . . . iest for: Temporary Certificate. . . . . . . . . . . Final Certicate. A . . . . . . . . Submitted: $25.AO . . . . . . . . .. . . . . . . . . . . . . . . . ..�m . . .. ., . . . . . . . .. . . . . . . . . izos . . . .. . . . . . ' �o a4 to (5 APPLICANT 6 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 656 r BUREAU OF ELECTRICITY �w ^�2. 88 JOHN STREET. NEW YORK. NEW YORK 10038 ate fJULY 17,1995` Application No.on file 84953794/94 N 358115 THIS kERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ROBERT CALHOUN, EAST END ROAD, PRIVATE END OF ISLAND, FISHERS ISLAND, N.Y. in thefollowinq locatigp,;, , 4Bgtp.Q> at ❑ 1st Fl. ❑ 2nd Ft. OUT .Section Block Lot was examined on JUU1I 111 17yb and found to be in compliance with the National Electrical Code. FIXTURE ECE►TACIES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCE Tj FLUORESCENT OTHER AMT. K.W. WT. K.W T. K.W. T. K.W DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCKS BELL I UNIT HEATERS I MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. On H.P. GAS H.P. AMT. NO. A.W.G. I AMT. I AMP. AMT. AMPS, TRANS. AMT. H,p. NO.OF FEET �f. WAIIs SERVICE DISCONNECT NO.OF S E R V I C E METER NO OF CC COND.I A,w G A.W.G. MIT. AMP. TYPE EQUIP. 1-e RW I,F 3W 3,e'SW 3,e'�W PER d OF CC.COND. NO.OF HIdEG OF HIAEO NO.Of NEVTRAlS Of NEUTRAL OTHER APPARATUS: have frequent test/and or repairs made by a qualified person. Z & S CONTRS, INC. LIC.#924-E P.O. Box 202 FISHERS ISLAND, NY, 06390 GENERAL MANAGER 11 Per This certificate 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 MUST.NOT 8E ALTERED IN ANY WANNER.. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000696 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date JULY 17,1995 Application No.on file 84953794194 N 358115 THI (CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ROBERT CALHOUN, EAST END ROAD, PRIVATE END OF ISLAND, FISHERS ISLAND, N.Y. f in thefollowing locati n• 1 L��, B4.s nt ❑ 1st Fl. ❑ 2" Fl. OUT Section Block Lot was examined ore SULY 14'lya and found to be in compliance with the National Electrical Code. l P FIXTURE FIXTURES RANGES COOX)NO DECKS OVENS DISH WASHERS EXNAUSi FANS OUTLETS ECEPTACLES SWITCHES IIKAND95CENTI FLUORESCENT OTHER I AMT I K.W. I AMT. K,W, AMT. I K.W. T. K.W AMT. H P 5 1 1 1 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS SEll UNITHEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. %.W, 011 H.P. GAS H.P. AMT. NO. A.W.G. AMT, AMP AMI. AMPS. TRANS. AMT. H.P NO.OF FEET AMi. WAITS 1 F' SERVICE DISCONNECT NO.Of S E R V 1 C E AMT. AMP. TYPE EQUIP. 19 2W 1 0 3W 3 A 3W 30/W N0.09ER Q'COND OF CC COND. NO.OF HIAEG mA,�H1 LEG NO.OF NEUlRAlS pFA'NEUTNAI OTHER APPARATUS: SWIMMING POOL-1 TIME CLOCKS-AMP.40-1 G.F.C.I-1 PANE'LBOARDSil.-4 CIR. 100 G.F.C.II-1 *(SWIMMING POOL) This certificate -covers compliance at the date of inspection only. Because of unusual p environments it is advisable to j r« Continued on Page 2 >>> ! 06MERM MANAGER Per This certificate must not be altered in any manner; return to the office of the Eoard if incorrect. Inspectors may be identified by their credentials. COPY FOR RUIL DING DEPARTMENT.THIS COPY OF CERTIRCATE MUST NOT,BE ALTERED IN ANY FANNER. Albert J. Krupski,President �O�pS�FfO(�-COG Town Hall John Holzapfel, Vice President yj 53095 Main Road William G. Albertson y x P.O. Box 1179 Martin H. Garrell O e .g Southold, New York 11971 Peter Wenzel y�ol �.�� Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 27, 1994 C/ J4 r J.M.O. Consulting '_ ro BIAG. DEFT P.O. Box 1 G% N OF souT�so-o Quogue, NY 1959-0447 — Re: ROBERT CALHOUN SCTM #3-2-3 Dear Mr. Just, The following action was taken by the Board of Town Trustees during its regular meeting held on May 26, 1994 regarding the above matter: WHEREAS, ROBERT CALHOUN applied to the Southold Town Trustees for a permit under the provisions of the Wetland ordinance of the Town of Southold, application dated May 19, 1994, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 26, 1994 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approves the application of ROBERT B. CALHOUN JR. to construct a swimming pool, terrace, stairs, decking and pool backwash, & sanitary system as per Suffolk County Dept. of Health�Services permit. Truck in approx. 200 c.y. of clean fill"Aiegrading and installation of stone parking areas on what is now dirt, approx. 40' from existing tidal wetlands line. Reconstruct existing catch basin if necessary. A row of staked hay bales will be kept in place. All as per plans dated 12/14/93. Located East End Road, Fishers Island. Permit will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None RR ry� R Very truly yours, 2 1994 8LDG. DEPT Albert J. Krupski, Jr. TOWN OFSOUTHOLE President, Board of Trustees AJK/djh cc. CAC Bldg. Dept. , ��ilFrt3('j SUPERVISOR TRUSTEES 0. John M. Bredemeyer, III, President SCOTT L.HARRIS Albert J. Krupski, Jr.,Vice President Henry P. Smith i :i T Town Hall John B. Tuthill �`�-�, ` �� 53095 Main Road William G. Albertson ��[:.y; RO. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Office Use Only: ` PATE REC. : Coastal Erosion Permit Application �•• �• u( .� Coastal Erosion Variance Application =- 5 Wetland Permit ApplicationWaiver from Chapter 97(Application/pe I Trustee Lands Permit Application Grandfather Permit Application Completed Apps. Dar-e: y-s=9y TOWN CIF SOUTHOLD nspection date: 3J2�+9L-' ^ CAC comments-Date: ' Sent //S e Variance Required: (Y/N) Zco ighbors notified-Date: QEQRA Type. : Date sent: N'19 2y CSEQRA Determin./date: i Public Hearing/date: [— Findings: Approved (YIN) i Special Conditions: (YIN) ( see file) Application Fee: i Permits) issued-date: Application Number;SCTM#1000- 003-2-2 Date- March 25 , 1994 Applicant: J .M. O . Consulting for Robert B. Calhoun Jr. & Jean N. Calhoun Address: P .O. Box 447 Quogue , NY 11959-0447 Phone ( ) 516-653-0607 Interest: (owner, consultant,lessee,etc. ) -consultant Owner of Property: Robert B. Calhoun & Jean N. Calhoun Address 205 Round Hill Road Greenwich, Ct . 06381 Phone ( ) c/o 212-215-5701 Subject Property Location: East End Road, Fishers Island Location map enclosed (Provide LILCO Pole #, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Page 1' •'?ds. to be excavated: 0 Yds., to be filled: 200c .y. Manner in which material will be removed or deposited: Trucked in from an upland site and regraded with a bulldoz r Width of canal, creek or bay fronting property— n/a aw � r -G Depth at low tide: 0 Aver. rise in tide: In a 0� i OR Oo G� a Distance to nearest channel: n/a Distance project a° extends beyond similar projects in area: Area zoning: R-120 Land area in acres:_ Is project for private or business use: _ 2 . 11 acres �. Intended use of property: existing single family dwetlingt construct - Describe known prior operations conducted on premises: Please see enclosed survey for past construction activities at project sit Has any prior license or permit been issued to erect structures•, I dredge, or deposit fill on said premises: unknown Has any license or permit ever been revoked or suspended by a Governmental Agency:Not to my knowledge Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e. , pipeline and septic system; make additional attachments if necessary) . "PLEASE SEE ATTACHED" THIS IS NOT A PERMIT -Page 2 A t• PROJECT DESCRIPTION Applicant proposes to construct a swimming pool , terrace" stairs, decking and pool backwash all at a point greater than 75' from existing tidal wetlands line" To install a sanitary system as per S^C°D"H^S^ standards at a point greater than 125' from existing tidal wetlands line. To truck in approximately 200c "y" of clean fill for regrading and the installation of a stone ( pervious) parking area on what is now a dirt parking area approximately 40' from existing tidal wetlands line proposed parking area shall be in the same footprint as existing parting area, existing catch basin shall he utilized or reconstructed " Entire limits of construction shall be enveoped by a continuous line of staked hay hales which shall be installed prior to and maintained during all periods of construction activity. All work in accordance with plans prepared by Chanlder Palmer & King last dated 12/14/93, ' ' \ PART 1—PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance. NAME OF ACTION LOCATION OF ACTION(Include Street Address, Municipality and CountyL East End Road, Fishers Island, Suffolk NAME OF APPLICANT/SPONSOR BUSINESS TELEPHONE Glenn E. Just/i .M.O . Consulting (516 ) 653-0607 ADDRESS P. O. Box 447 CITY/PO STATE ZIP CODE uo ue NY 11959-04 7 NAME OF OWNER(If different) BUSIN SS TEL NE Peter B. Calhoun Jr. & Jean N. Calhoun c/o 21 ) -5701 ADDRESS 205 Round Hill Road CITY/PO STAT •E Z1F'LS?0.E1 Greenwich (( 110 i25 DESCRIPTION OF ACTION "PLEASE SEE ATTACHED" Please Complete Each Question—Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ❑Urban ❑Industrial ❑Commercial f)Residential (suburban) ❑Rural (non-farm) ❑Forest ❑Agriculture ❑Other 2. Total acreage of project area: 2 . 11 acres. APPROXIMATE ACREAGE PRESENTLY AFTF? COMPLETION Meadow or Brushland (Non-agricultural) 0. 358 acres 0 1 acres Forested 0/ acres 0 acres Agricultural (Includes orchards, cropland, pasture, etc.) 0 acres �— acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) 0. 575 acres 0. 575 acres Water Surface Area 0_=i acres 0 acres Unvegetated (Rock, earth or fill) 0 . 293 acres 0 •2q'1 acres Roads, buildings and other paved surfaces 0 - 10 5 acres 0. 160 acres Other (Indicate type) lawn 0. 277 acres 0 . 222 acres 3. What is predominant soil type(s) on project site? sand—see test hole a. Soil drainage: , laWell drained 100 % of site ❑Moderately well drained % of site ❑Poorly drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification .System? n/a acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? Dyes .<No a. What is depth to bedrock? 600 ' (in feet) 2 ia' .__. 5. Approximate percentage of proposed project site with slopes: 20-10% 100 % 010-15% 015% or greater % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? Dyes IRNo 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? Dyes XlNo 8. What is the depth of the water table? 10 ' (in feet) 9. Is site located over a primary, principal, or sole source aquifer? Dyes C'lo 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? OYes ❑No only for 11. Does project site contain any species of plant or animal life that is identified as threatened or en8Ag9red? Dyes Elko According to self Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) Dyes ONo Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? Dyes QNo If yes, explain 14. Does the present site include scenic views known to be important to the community? Dyes CJJo 15. Streams within or contiguous to project area: n/a a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name Un—named Marsh & Fishers o b. Size (In acres) n/a un 17. Is the site served by existing public utilities? PYes ❑No a) If Yes, does sufficient capacity exist to allow connection? X❑Yes ❑No b) if Yes, will improvements be necessary to allow connection? Dyes _�E7No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? Dyes ®No 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? ( Yes ❑No 20. Has the site ever been used for the disposal of solid or hazardous wastes? Dyes �UNO B. Project Description 1, Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor 2 - 11 acres. b. Project acreage to be developed: 0, 055 acres initially; 0. 160 acres ultimately. c. Project acreage to remain undeveloped 1 . 95 acres. d. Length of project, in miles: n/a (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed n/a f. Number of off-street parking spaces existing 0 proposed 0 g. Maximum vehicular trips generated per hour 1 (upon, completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condominium Initially one Ultimately onp i. Dimensions (in feet) of largest proposed structure n I p height; na width; n/a length. j. Linear feet of frontage along a public thoroughfare project will occupy is? n/a ft. 3 i i 2. How much natural material (i.e., rock, earth, etc.) will be removed from the site? 0 tons/cubic yards 3. Will disturbed areas be reclaimed? Dyes [-]No QN/A a. If yes, for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ❑Yes ❑No c. Will upper subsoil be stockpiled for reclamation? Dyes ❑No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0. 55 ac4awn) 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? Dyes @No 6. If single phase project: Anticipated period of construction 2 months, (including demolition). 7. If multi-phased: n/a a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month year, (including demolition). c. Approximate completion date of final phase month year. d. Is phase 1 functionally dependent on subsequent phases? Dyes ❑No 8. Will blasting occur during construction? Dyes C:JNo 9. Number of jobs generated: during construction 10 ; after project is complete 0 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facilities? Dyes f7No If yes, explain 12. Is surface liquid waste disposal involved? Dyes ❑No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13, Is subsurface liquid waste disposal involved? IRYes ❑No Type sewage 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes IRNo Explain 15. Is project or any portion of project located in a 100 year flood plain? Dyes lKINo 16. Will the project generate solid waste? )CIYes ❑No a. If yes, what is the amount per month 0. 35 tons b. If yes, will an existing solid waste facility be used? 50Yes ❑No c. If yes, give name Fishers Island Transfer . location Equestion Avenue d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes )CO No e. If Yes, explain 17. Will the project involve the disposal of solid waste? C3;Yes ❑No a. If yes, what is the anticipated rate of disposal? 0 . 35 tons/month. b. If yes, what is the anticipated site life? n/a years. 18. Will project use herbicides or pesticides? Dyes =®No 19. Will project routinely produce odors (more than one hour per day)? ❑Yes KlNo 20. Will project produce operating noise exceeding the local ambient noise levels? Eyes ❑No 21. Will project result in an increase in energy use? Oyes ONO If yes , indicate type(s) electrical 22. If water supply is from wells, indicate pumping capacity n/a gallons/minute. 23. Total anticipated water usage per day 900 gallons/day. 24. Does project involve Local, State or Federal funding? Dyes gNo If Yes, explain 4 25. Approvals Required: Submittal Type Date City, Town, Villdge Board Oyes ❑No wetlands 2/94 City, Town, Village Planning Board Dyes IRNo City, Town Zoning Board Dyes [�No City, County Heath Department ❑Yes ❑No sanitary system SFD 3/94 Other Local Agencies Dyes IJNo Other Regional Agencies Dyes IRNo i State Agencies IRYes ❑No N.Y. S.D.E.0 Tidal Wetlands 3/94 Federal Agencies Dyes IRNo _ i C. Zoning and Planning Information 1 . Does proposed action involve a planning or zoning decision? Dyes IIgNo J If Yes, indicate decision required: { Ozoning amendment ❑zoning variance ❑special use permit ❑subdivision Osite plan Onew/revision of master plan ❑resource management plan ❑other i j 2. What is the zoning classification(s)of the site? R-120 3. What is the maximum potential development of the site if developed as permitted by the present zoning? same { 4. What is the proposed zoning of the site? n/a 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? same 6 Is the proposed action consistent with the recommended uses in adopted local land use plans? ®Yes ❑No 7. What are the predominant land use(s) and zoning classifications within a '/a mile radius of proposed action? gamy i 8. Is the proposed action compatible with adjoining/surrounding land uses within a '/a mile? IRYes ❑No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? n/a 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? Dyes ENo 11 . Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? Dyes klNo a. If yes, is existing capacity sufficient to handle projected demand? ❑Yes 97No 12. Will the proposed action result in the generation of traffic significantly above present levels? Dyes ❑No a. If yes, is the existing road network adequate to handle the additional traffic? Dyes ❑No D. Informational Details Attach an additional information as may be needed to clarify y y y your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or i avoid them. E. Verification I certify that tq* r4. U rue to the best of my knowledge. Applicant/Sponsor as a ent Date March 29 , 1994 Signature Title President, J.M.O. Consulting If the action is in thagency, complete the Coastal Assessment Form before proceeding with this assessment. 5 New York State Department of Environmental Conservation Building 40—SUNY, Stony Brook, New York 11790-2356 (516) 444-0365 FAX (51.6) "444,-0373 7 Thomas C. Jorling Commissioner April 27, 1994 Robert & dean Calhoun 205 Round Hill Road Greenwich, CT 06381 RE: 1-4738-00927/00001-0 Dear Permittees: 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 f 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, Laura Scovazzo Environmental Analyst I LJS/nw enclosure i 1 SnOF.o �19� T to C `�odnled en recYcbd pepnr . NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-09927/00001-0 __ April 27 1994 FACILITY/PROdRAM NUMBERS) ��' �'�" EXPIRATION DATE(8) April 30, 1997 Under the Environmental f Conservation Law TYPE OF PERMIT N New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to operate 0 Articte 15, Title 5: Protection 0 6NYCRR 608: Water Quality 0 Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management 0 Article 15, Title 15: Water 0 Article 17, Tittes 7, 8: SPIES 0' Article 27, Title 9; 6NYCRR 373: Supply Hazardous Waste Management 0 Article 191 Air Pollution 0 Article 15, Title 15: Water Control 0 Article 34: Coastal Erosion Transport Management 0 Article 23, Title 27: Mined Land 0 Article 15, Title IS: Long Reclamation 0 Article 36: Floodplain Island Wells Management 0 Article 24: Freshwater Wetlands 0 Article 15, Title 27: Wild, 0 Articles 1, 3, 17, 19, 27, 37; Scento and Recreational Rivers N Article 25: Tidet Wetlands 6NYCRR 380: Radiation Control 0 Other; PERMIT ISSUED TO TELEPHONE NUMBER Robert B. $ Jean N. Calhoun ADDRESS OF PERMITTEE 205 Round Hill Rd., Creenwich, CT 06381 i CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER JMO Consulting: P.O. Box 447 Quogue, NY 11959 (516) 653-0607 NAME AND ADDRESS OF PROJECT/FACILITY Calhoun Property - East End Rd., Fishers Island - . . � LOCATION OF PROJECT/FACILITY SCTM 01000-003-2-2 COUNTY TOWN WATERCWRSE NYTM COORDINATES I Suffolk Southold Fishers Island Sound D 9CR'Pr'w aF FU1 MIZ® ACTIVITY Construct pool, patio, sanitary system, cobblestone parking area, stone parking area and place approximately 200 cubic yards of clean aan:d and fill for regrading. All work shall be in accordance With the attached NYSDEC approved plan., i By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, ell applicable regulations, the General Conditions specified (see page 2) and any Special Conditions included as part of this,permit. REGIONAL PERMIT ADMINISTRATOR: ADDRESS ' Robert A. Greene Bldg, 400 SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED S1G ATURE DATE April 27, 1994 �/ Page 1 of 5 ` G9V3V . ODDITICT6 Inspections 1. The permitted site or facility, including relevant records, is subject to in- Inspection at reasonable hours and intervals by an authorized representative of the Department of EnviromentaI Conservation (the Dieparurent) r to determine Mother- the permittee is complying with this permit and the 13CL. Such represen- tative may order the vork suspended pursuant to ECL 71-0301 and SQPA 401 (3) . copy of this permit, Including all referenced raps, draivings and special conditions, rrust be available for inspection by the Departmnt at all times at the, project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Pere ais 2. The Department reserves the right to modify, suspend or revoke this permit Men: 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 regula- tions is found; b) .,the permit was obtained by misrepresentation or failure to disclose relevant facts; c) nenrreterial information is discovered; or d) environmental conditions, relevant technology,' or applicable lam or regulation have rreterially changed since the permit was issued. 3. The permittee rust submit a separate written application to the Department for renenal , mod iflcatIon or transfer of this permit. Such application crust include zany formes, fees or supplemental information the Department requires. Any H< renam 1 , modification or transfer granted by the Department rrust be in writing. 4. The permittee rust submit a renewal application at least: a) 180 days before expiration of permits for 'State Pollutant Discharge Elimination System (SR)ES) , Hazardous, Vlbste IVbnagerent Facilities (PVWP) , major Air Pollution Control (APC) and Solid Vlbste Nbnagermnt Facilities (SIW ) ; and b) 30 days before expiration of all other permit types. 5. 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. Other Legal Cllmligations of Pennittee 6. The permittee has accepted expressly, by the execution of the application, the p full legal responsibility for all damages, direct or Indirect, of whatever nature and by v%hwver suffered, arising out of the project described in this permit and has agreed to indermify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. Th i s permit does riot convey to the permittee any r i ght 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. B. The permittee is responsible for obtaining any other permits, approvals, lands, easermnts and rights-of v%ay that may be required for this project. Page 2of5 i 95.206a(7/92T-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( Tidal Wetlands ) . 9. That, if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration In the position of the structure or work herein authorized,or project. if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of thework herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridges across waters or flood f16Ws or endinger the health, safely or welfare of the bed of a waterway or floodplain or deep holes that may have a -- the people of the Stale, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State,the owner may be ordered by the Department to a waterway. remove or alter the structural work,obstructions, or hazards caused thereby without expense to the Stale, and if, upon the expiration or 14, There shall be no unreasonable interference with navigation by the work revocation of this permit, the structure, fill, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be court. 15. If upon the expiration or revocation,61'this permit,the project hereby pleted, the owners, shall, without expense to the Stale, and to such authorized has not been completed,the applicant shall,without expense extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the Conservation may require,remove all or any portion of the uncompleted Department of Environmental Conservation may require,remove all of structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse.No claim shall be made against to its former condition. No claim shall be made against the State of the State of New York on account of any such removal or alteration. New York on account of any such removal or alteration. ' 10 That the State of New York shall in no case be liable for any damage 16, If granted under 6 NYCRR Part 608, the NYS Department of Environ. or Injury to the structure or work herein authorized which may be caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or Improvement of navigation,or for other purposes,and Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977,no claim or right to compensation shall accrue from any such damage. (PL 95.217)provided that all of the conditions listed herein are met. .11. Granting of this permit does not relieve the applicant of the responsi. 17 All activities authorized by this permit must be in strict conformance bility of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part the U.S.Army Corps of Engineers, U.S Coast Guard, New York State of the permit application. Office of General Services or local government which may be required. 12. All neessar Such approved plans were prepared by CPK dater? S y precautions shall be taken to preclude contamination 14 of any wetland or waterway by suspended solids, sediments, fuels, 12/ /93,revised on 4/18/94 solvent4„lubricants,epoxy coatings,paints,concrete,leachate or any SPECIAL CONDITIONS 1. All parking areas must be constructed' of pervious material. . 2. During construction, no wet or fresh concrete or leachate shall be allowed to escape or be discharged, nor shall washings from transit mix trucks, mixers, or other. .devices be allowed to enter tidal wetlands. 3. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. 4. If seeding or soil stabilization is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed, at the earliest opportunity when weather conditions favor germination and growth, but not more , than six months after project completion. 5. Roof runoff shall be directed to drywells a minimum of 75' landward of the tidal wetland boundary for immediate on-site recharge. , 6. Dry wells for pool filter backwash shall be located a minimum of 100' landward of the tidal wetland 'boundary. DEC PERMIT NUMBER 1-4738-00927/011001-0 PROGRAM/FACILITY NUMBER ' Page of � Albert J. Krupski,President =�O� OG�� Town Hall John Holzapfel, Vice President 53095 Main Road P.O. Box 1179 William G. Albertson Southold, New York 11971 Martin H. Garrell • Peter Wenczel y'JJp .a0� Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD D'� p MAY _ )994 LEAD AGENCY COORDINATION REQUEST 70 BOG ��wN OF SOUPZ TO: WHOM IT MAY CONCERN DATE: 4-29,94 THOCO Enclosed is a permit application and a completed part I of the Environmental Assessment Form. Southold Town Trustees are interested in your ageny' s comments in acting as SEQRA Lead Agency for: NAME: ROBERT B. CALHOUN LOCATION: EAST END ROAD, FISHERS ISLAND TAX MAP: 1000-3-2-2 PERMIT # Pending DESCRPTN: See attached PERMIT REQUIRED: (A TOWN WETLAND ( ) OTHER CEHA SEQRA CLASSIFICATION: (,ta Type I ( ) Type II ( ) UNLISTED ( ) CEA Please contact .Albert J. Krupski, Jr. , _Trustee . within 30 days and be advised that the Southold Town Trustees (WANT)/(DO NOT WANT) to assume lead agency. SENT TO: DOS (x) DEC (X) DOH %) PB ( ) ZBA ( ) BLD (x) ACE ( ) CAC (X) Please complete, detach and return this form to expedite processing. Involved Agency: Project Name: Location: SCTM: We at (Have/No) objection to Southold Town AGENCY Trustees assuming Lead Agency. Comments/Reasons: Signature of Authorized Representative MW is 4 Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 43.215 DATE: ..5126/94 ISSUED TO ..... ROBERT....CALHOUN. Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance an- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 5/26194.. . 1q,,,94..., and in consideration of the sum of $ 150,OQ paid by J.M.P., Consulting for. ROBERT CALHOUN........... of .........Fishers...Island........ .. ....... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, i of Southold Town Trustees authorizes and permits the following: pool To constr. swimming pool, terrace, stairs, decking & backwash & sanitary system as per SCHD permit, truck in appro 200 cy of clean fill for regrading & installation of stone parking areas approx. 401 from exist. igal we i land area, recons�t, catch basiA l in accordance with the aetaie speci icaflons as presented in if the originating application. necessary, staked hay bales kept in place, as er�,,Ians dated 12 F*J)ier I land I & iWooarg of Iruste N %e sa as hors- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. �f0j��_ 4/. .......... I ..... R ........ ............ O .......................................................................................... Trustee is Am R. a Albert J. Krupski,President h�O�pS�fFO[�`,OGy ( Town Hall John Holzapfel,Vice President 53095 Main Road William G. Albertson y x P.O. Box 1179 Martin H. Garrell O� Southold, New York 11971 Peter Wenzel 'fJpl �a0 Telephone(516)765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD May 27, 1994 J.M.O. Consulting P.O. Box 447 Quogue, NY 11959-0447 Re: ROBERT CALHOUN SCTM #3-2-3 Dear Mr. Just, The following action was taken by the Board of Town Trustees during its regular meeting held on May 26, 1994 regarding the above matter: WHEREAS, ROBERT CALHOUN applied to the Southold, Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated May 19, 1994, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 26, 1994 at which time ally interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, .the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, 1 / a RESOLVED, that the Board of Trustees approves the application of stairs B. CALHOUN JR. to construct a swimming pool, terrace, Suffstairs, decking and pool backwash, & sanitary system as per olk 20oounty Dept, of Healthf Services permit. Truck in Of stone parking areas onean whatlis�nowrdirtg and d installation of existing tidal wetlx. 401 from ands line. Reconstruct ifcatch basin if necessary. A row of staked hay bales will existing kept in place. All as per plans dated 12/14/93. ' Located East End Road, Fishers Island. Permit will expire two years from the date it is signed. Fees must be paid, if applicable and months of th within e date o— f�notification.Perit 1STWO dinspectisi required and the Trustees are t are o be notified upon completion of said project. Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. CAC Bldg. Dept. 1 LD I;:S:Er: U;) pu„: I codK�lcursg FOUNDATION ( 1st ) FOUNDATION ( 2nd ) 2 . z 0 ?OUCH FRAME & PLUMBING y y� _ 3 , ca ' m IIISULATIOII PER N . Y. • • '� STATE ENERGY CODE x —a c^ 4 . ca yf FINAL ADDITIONAL COMMENTS : x ' ro cv H x H O(, a 1 • x [*1 • A p y y N w - MCK i 95-106f(;/07)-45c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS Fpr Article 25 Tidal Wetlands ( � 1 7. There will be no draining of swimming 'pool water directly or indirectly into tidal wetlands. 8. ' Road, driveway, and/or parking areas shall be graded to direct runoff away from tidal wetlands: 9. ' No decks, accessory structures, or additions will be permitted without further approval of the Department. 10. A11 fill shall consist of "clean" gravel and soil (not asphalt, slag, flyash, broken concrete. or, demolition debris) . 11. There shall be no disturbance to vegetated tidal wetlands as a result of the permitted activity. 12. A row of staked hay bales or approvable erosion ,control devices shall be placed as shown on approved plans at commencement of regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation. Haybales must be properly maintained and trapped sediments removed to a suitable upland site before the bales themselves are removed. 13. There shall be no disturbance to vegetation seaward of the existing edge of lawn. 14 . All rocks removed as a result of installation of the rose garden shall be removed to a suitable upland site. Supplementary Special conditions (A) thru (F) attached. FopJUN �] � 199� . IV OF So T DEC PERMIT NUMBER 1-4738-00927/00001-0 FACILITY IE)NUMBER PROGRAM NUMBER Page 4 of 5 I { • SUPPLEMENTARY SPECIAL CONDITIONS The fo4Xbwin4.conditions apply to all permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has -been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a -violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page one,or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for 'approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new l application for permit. D. 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 the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General ' Services, Tower Building, Empire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. y, Ss '• i .` 100ij � i @ .oL E.DEQr. / p TOWN OF SOUTHOLD ,DEC Permit•No. �{�3c7 `�U9,� /OUQ� Paged of j� i RETURN Tills FORM To: Reglonal Manager Bureau of Marine Habitat Protection New York State Department.of Environmental Conservation Bldg. 40, SUNY, Room 223 Stony Brook, N. Y. 11790.2356 Thomo.C.Jo,Anq ' _ 7 CornnJ.,lonx '. PERMIT NO.: ISSUEDTO: CONTRACTOR NAME: ADDRESS TELEPHONE I Dear Sir.- Pursuant to Supplelntlnfary SPOCial Condition D of the referenced permit, you are hereby notified that the authorized activity 'shall commence on We certify that we havo road the referenced permit and approved plans, and fully understand the authorized project and all permit conditions. We have inspected the project site and can complete the project as described in file permit and depicted on The approved plans in full compliance with all plan notes and permit conditions. The Permit sign, permit, and appnwed plans will be available at the site for Inspection in accordance with General Condition No. 1. PERMITTEE DATE - I I CONTRACTOR DATE 71fIS NOME MUST BE SRNr W 771E ABOVE ADINF-TS AT IMASr two luYs LN ADVANCE OF COuuBNI:HI xW OF 171E rR0lELT. FAIIJlRE 70 RKIVRN 1711S N077CR, PAST 771M rEEgrlr SICK, OA IIAVE 771E PERMIT AND APPROVKD PIAN.S AVAIIAB7J7 Ar 777R Wt/RR SITE MAY SUBIECr 771E PERMlnNE ANIIVOR C0N7EACwx Jr0 APPIJCAff x SANC710NS AND rENAL77ES FOR N0*C0usfjANCR WI771 PERM/rCOMMON& ' pda/or&Abs(bee........................................................... NQTICE Qf COMPLETION•QE(IMMUCT/ON ��7 RETURN Title FORM TO: , Regional Manager `"-''`''' Bureau of Marine Habitat Protection .. - New York State Department of Environmental Conservation Bldg. 40, SUNY, Room 223 Stony Brook, N. Y. 11790-2356 Thom"C.Jo&a Camml..law, PERMIT NO.: ISSUEDTO: CONTRACTOR NAME: ' ADDRESS j TELEPHONE Dear Sir: � � � t� � Pursuant to Supplementary Speclal Condition D of the referenced permit, you are hereby notified the � p j authorized activity was completed on mo --- m :M a We have fully complied with the terms and conditions of the permit and approved plans. o 6 r� PERMITTEE DATE -.• 6'V '~ CONTRACTOR DATE lilts NOIleg W177I PDOIDCA,IPIIS OF COMI' MED WOAI:MOW*A COMnBIMD sUAVEY',AS APPROPRUIE, MUST BE SRNr 7U 771E ABOVE Al)LWX 3 WI7711N 31 LUYS OF cojerIJr170N OF777g PROJECT. FAMMUT W DO SO WILL ANSUd IN A C011PIiMes 1NSPEt.77ON BY NYSW STAFF. •bulkheads ds anas-d surrey i rrquhrd jorlbr uritueing eafegorltr Of now eonruuellon;single family dwellings and addi(lonr,repels ryrrsmr,drebr,pooh, 1 • buUhradr aad other rhonlfar rfobUkalka llruNunr. f i , i z PATIO (2)-2'x2'X3' STAKES v EACH BALE POOL 'ROPOSED GRADE F i " nag ' a s o a a n C O CROSS SECTION "A" SCALES: HORIZ. 8 VERT. I"=4' HAYS BARRIER NOTT T0 SCALE O 4 g �- — t- 12 16 20 _Z' TEST HOLE DATA -SITE PLAN StGZE cF ticpy yo, PREPARED POR 0"-8" TOPSOIL FRDN.ST N 9 0"-14 SANDY SUBSOIL � � �. h .r <3 "SAND CHOUN, VR WATER !O <^ JEAN N. CALHOUN 20 10 0 20 BLOCK 25 LOT I GRAPHIC SCALE IN FEET FISHERS 15LANO, MEW PORK REVISIONS AW CHANDLER, PALMER ae KING DATE DESCRIPTION - r�7 _— th thG staukr& for opproval aid 4118194 REVISED' POOL _ Architects. Engineers Ond Survayora t 110 BROADWAY NORMW, CT 06360 203-Eap-3N7 FAX 203-8R6-78M %bawlme 3ewo-qe d�sposa "Stmft Ill reslckwze amd wits d*se by the forth ftriWv and on the pormft to _ - N T S p F. C - APPROVED AS PER TERIM - - DATE: DECEMBER.- 14, 1993 AND CONDITIONS OF .4f�L�GtsNT SCALE: 1"=20' PEM-11T I.O. ` SHEET 1 OF 1 DATE v Y d, i1R• (� (i ' BOARD OF HEAL Tit . . . . . . . . . T I FOHMNO. 1 3 SETS OF PL.\2iS71ju�Nj EiI TOWN OF- SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . 1g94 BUILDING DEPARTMENT CHcct TOWN HALL SEPTIc FORM . . . . . . . . . . . . . ..LT 13LDti.DEPT. SOUTHOLD, N.Y. 11971 ; TOWN FS 1THOLD ' TEL.: 7651II02 NOT IF'f ; . . ... . . . . . . . ., IY .T. cALL . . . . . . . . . . . . . . . . . . . Examined NAIL TO : Approved . .. . . . . . . . ., 10�Permit No. � � . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�01MMEDIA .. . . . . . . . . . . . . . . . . . . . ENCLOSE POOL TO CODE UPON COMPLETION �� . . . . BEFORE- . . . . (13 din ns)ector) APPLICATION FOR BUILDING PERMIT 6/14�!94 Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely,filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans,accurate plot plan to scale. Feb according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets nr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 permit hall 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ]wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. [lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to idmit authorized inspectors on premises and in building for necessary inspections. ' Z&-B-Contr-actin^. -.Tn�-r:. . .�.-.-. :-: :- - -. -- - - . . . . . . . . . . . . . . . . . . . . . . . . a . . . . (Signature of applicant, or name, if a corporation) Bo�c 202 , . Fishers Is.N.Y. 06390 , , . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises $4hert , B., .4. Jean ,N., Calhoun, , , , • , , , , • , , (as on the tax roll or latest deed) If appli corporati 1, signa a of my authorized officer. President (Name an title of corporate officer) UNDERWRITERS CERTIFICATE REQUIRED Builder's License No • , 13242HI Plumber's License No. 554-P .E U QM O�q�� ElcctriciP40cense No924.. . . . . . . . ,�a®1� ®Ci(a " rCa& wAT M 0ther-Trade's License No. . . .2 $r.AR. . . . . . . . . . . Location of land on which proposed work will be done. . . . . East, end• road, , , , , , . . . , , , • , , , , , , ;, , , , , , , , , Fishers ISland,N:Y. 06390. . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . , . . I(ousc Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . _. . ._Block . . . .? . .ti._. Lot . .i2_. . . . . . . . . Su6itivisio�i, . . . . . . . . . . . . . . . . . . . . . . . . .�. . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . ... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . .single, fargily, dwelling. . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . .S11 -9.1A . f amiIY- AWgI-?Ag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Naturp 3. Repair.of work (check which a > >li�1icah 10: New Building Addition . . . . . . . . . . Alteration . , . . . . . . . . . . emoval . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . , 4, Estimated Cost . . . . . . , , 50. 00T.00 . . . . . . . . . . . . . . . . (Description) . Foe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . garage,dwelling,number of cars , , , (to be paid on filidg this application) dwellingIf lts . . . . . . . . . . . . . . . Number of dwelling units on each floor. . . . . . . . . , . . . . . . C. If business, co mer calormixcd o l'pcupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . • , , 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Sleight . Number of Stories . Dimensions,of same structure with alterations or additions: Front Depth . . . . . . . . . . . . . . . . . . . . . . . . .. Rear , . . i n:F . . Number of Stories . . 8. Dimensions of entire new constriction: Front . b ' )'`"i. ' ' Height Rear . . . . . . . . . . . . . . . 3:'9.;...rat?a . . . . . Number! of Stories 3 r-". s,]y;;r{i 9. Size of lot: Front . . . . . . . . . . . . . : . . . . ., ,s.. . . . . Rear . . . . . . . '+s r•:•r 0, Date of Purchase • • • • • • • • • • • • • • • Depth . . . . . . . . . :.'; . . . . . . . . . . . " w • • � - I • • • • • • • • . . . . . . Name of Former Owner ' 2.I. Zone or use district in which premises are situated . . . . . . . . . . . . . ' . ' • . . Does proposed construction violate!,my zoning law, ordinance or regulation: 3. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . ' • • • • • • • • . . . . . . , . Will excess fill be removed from premises: Yes No 4. Name of Owner of premises . . . , Address . . . . . . . . . . . . . . . . . . . Phone No. . Name of Architect . , , , , , , , . • , . Address . . . . . . . . . . . . . . . . . . . Phone No. . Nanie of Contractor Address Phone No. . i. Is this property within 300lfeet of a tidnl wetland? �*y * No. . i . x. . . . . . . . . . . *If yes, Southold Iown Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly,all buildings, whether existing or proposed, and,indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether iterior or corner lot. it AP , 0 AS NOTED IIAT E:�' B.P•# -G-7 _._ FEE: SY:. N a r I F Y 9L DEP�FORTTAIT5 765.1802 S AM T(. �& FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REOUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING R PLUMBING J. INSUI-ATION A• FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET .r THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS . IUNfY OF .. YORK . . . . . . . . ' ' ' ' ' ' ' • • • • . . . . . . . . • • . . . . . . . . being duly sworn, deposes and says that he is the applicant Thomas J. Shi la (Name of individual signing contract) we named.' is the . . . . . , General contractor (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ilication; that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set Forth in the application filed therewith. orn to before me this . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . . ., 19gy. tary Public, . . . . . \ . . . . . County �,o x3lottwu:, r4' . . . . . . bl tttMm — owsze-zs TO (Signature of applicant) tllr?t nl u da flak V10fid utvuna ZMM313 NWI '8 A8VIN