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Home My WebLink About20216-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20675 Date APRIL 27, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 200 DEEP HOLE DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Black 12 Lot 3 Subdivision Filed Map No. Lot No. conforms substant5.ally to the Application for Building Permit heretofore filed in this office dated OCTOBER 15, 1991 pursuant to which Building Permit No. 20216-Z dated OCTOBER 21 1991 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE DECKS & PORCH AS APPLIED FOR. The certificate is issued to WILLIAM & DIANE EDGETT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-18-MARCH 18, 1992 UNDERWRITERS CERTIFICATE N0. N-23008 - MARCH 31, 1992 PLUMBERS CERTIFICATION DATED APRIL 14 1992 - ROBERT HOUSTON Building Inspector Rev. 1/81 1POIBM NO. A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N 2 0 21 6 Z Date ...f..Q,l~ 19.x'/.. Permission is hereby granted to: 7~ at premises located at ...s~...~ ...:~.~~..~......~............1.~G~...r~ County Tax Map No. 1000 Section .........~/.5... Block Lot No.....~ pursuant to application doted ......il®~{ 19. g~., and approved by the Building Insppector. Fee S.>.~~.t~!/~ fir ~:~r.':........................ tiding Inspector Rev. 6/30/80 w a q g-aa ~~~~~~yyyyyy nn (~7 t~ C' ~,~i!!1,~~l~`~'r ~ Form No. 6 ~~~~~,qQ~{.n~, ~~ggg TOIAN OP SOUTIIOLD 81982 BUILDING DEPARTMENT TOWN HALL -:°°~,~°•~,~y%~ 7 6 5-1802 E3L.DPa'. f~EI''i. ,q.ry k TOWPI OF SOOIFiC3LCF APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 17 lead. S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. ~ 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) uon-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. C. Fees ' 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over S years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~n Date New Construction........... Old Pre-existing Building ................I Location of Property....°.Z.G~n....hze,P..~~I~1~:.~~Y.?u.e'.....:,V~'C.2-~;~.r~e,C~„N6•........ House No.' Street Hamlet , Onwer or Owners of Property..~-(;.j.I~IC(,Y?~„°;',,,,,ICCYZ~CJ.,,,,~~~~.// County Tax Map No 1000, Section... /.`~,;,,,,.Block.. /.;~,.........Lot.....~ Subdivision .....Filed Map.......... .Lot.. Permit No...t?G:~:~.'/:...Date OC Permit..~.~..~tl..Applicant.Y.~%1 health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: C O ~a06 7,S APPLICANT , S~EFOC,{'`, TEL. 7G5-1802 0.~0/,~ ~ O~~ TOWN Or SOtJTIIO~.D L.~ OFFICE OF DUILDRQG INSPECTOR ~ c„ c°r, ~ cE~.;i~~~k; r., P.O. IIOX 728 .y c7 ~i TOtVN BALL ~%~ObQZ' SOUTEIOLD, N.Y. 11971 C E R T I F I C A T I O N Date ~Lv~- ~ T t c/ ~ ~ BuS.lding Permit No. Owner_ (phase 'p'rint) Plu.;.ber~oi3(;~~ tyou3ry-o~ iplease print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. . (plumber"s signature) Swor to befer^_ me this NO to L'y Public tlotary Public, ounty CAROL ANNFARiNACd Notary Pubik, State of New Ybrk ' QualiNed in SuH~gg(,pyr~y Commfaslon Expires Oolobar Z~ f 9 L THE NEW YORK SOARD OF FIRE UNDERWRITERS PAGE ~ 10250D8 6UREAU OF ELEGTRIGITY BS JOHN STREET, NEW XORK, NEW YORK 10038 Date NAACH 31,L992 Application No. on file 75079.191191 N 230130$ THIS CERTIFIES THAT only the el¢ctrical equipment as described below grid introduced by the gpplicgnt named on the gbov¢ gpp(ication number in the premiaea of EDGCfiT, 7.80 f}SCF HOIxt, DH3Vt;, PIA7'Ti~IpCK, N,Y. in thefoflouinq locations ? Basement L"I 1at Fl. ~ 2nd Fl, txx9lZlAi'~~4"fUI91' Section Block Lot mes examined art I{AIfCH 2 °i , 199$ and foand Lo be in cornptionee with the regnirerrrents q(thfs Board. N7(TURE ECEPTACtES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K.W AMT N.W AMT KW AMi K W. AML H.P g< 74 51 39. 1 1 13<9 1 1.2 9 F DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULT60UTlET DIMMERS AML K. W. Oll H. P. GAS H. P AMT. NO. A. W. G. AMT AMP AMT. AMPS. TRANS. AMT. N. p. SYSTEMS AMT WAITS NO.OF FEET pg x` C SERVICE DISCONNECT NO.Of S E R V 1 C E METER NO.Of CC. COND. A W. G. A. W. G. A W.G. AMT. AMP. TYPE tiQU1P. 1%YW 1,¢3W ]93W ~%4W PERK Of CC COND. NO. OF HI-LEG Of HLLEG NO. OF NEUTRALS OF NEUTRAL i 4961 CI9 1 ! 210 1 2f0 OTHER APPARATUS: MUTURSt1-0.33 H.P. U.F.C..L't-9 SNUK6 DHTRCI'URo-2 r a ki$xIiEL NLECTRiC I,TC.R2800-F: 329 MTI,II RUAp MANUttVTLLi:, NY, 119+59 GENERAL MANAGER 11 ~ y/ Per c certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may b¢ identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT 8E ALTF~~~~ I~I +II~I ~~1~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~~~~~t~ 3 - DATE r L INSPECTOR ~~z~~ 7sS-1802 BUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL , REMARKS: 9~ r ~ DATE ~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL ~ REMARKS: ' ~ F DATE .~L- INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ROUGH PLBG. , ~ ~ [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: 4 i l DATE INSPECTOR ~c~z./Co 765-1802 BUILDING DEPT. INSPECTION .,[~UNDATION 1ST [ ROUGH PLBG. ~ ` ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [)FINAL 'REMARKS: _ ~ c~- /~G,1C-~,.t,~ fem. t.h~t._~ ' DATE ~ INSPECTOR 765-1802 BUILDING DEPT. fNSPECTION [ ]FOUNDATION 1ST (~C]~ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]`INSULATION ~f FRAMING [ ]FINAL f, ' REMARKS: ~ ~ .F~ ~f' 0.Aed A~c., i 1/ DATE 2! ~R~INSPECTOR Y • . ~z`~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING D~ [ ]FINAL REMARKS: ~~r` ,f'l y- ~~~~..o i DATE ` L ~I fNSPECTOR l ~Q 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ) ROUGH PLBG. [ ]FOUNDATION 2ND [ ] jNSULATION [ ]FRAMING [/]/FINAL REMARKS: C DATE INSPECTOR lc~ J lu:,...~._~J i~~;.:~ q ~U:fdILNI~ 1. ~ m a FOUtJDATION ~(tst) - H~ ~ FOUttDATI01t (2nd) _ POUCH FRAi~fE & /Jf~ ~ o ~PLUMBINC ( ~ ~ f~1 ' ~ ~ ~ Cat ~.k ~ ~I)lSULATI08 PER N. Y. I y STATE EPJERGY ~ ~ ~ y CODE 4. ~ ` m / , FI;IAL 1 - _ • ADDITIOPIAL COMMENTS: m • ~ ~ ~ x~ ro ~ N ~ 1.Y 1 ~ y \ h~ ' ~ /1~aFiCi _ ~ \ e ~ '-7 S ~ 1 m v H a J YS~".ob n0:90i-1St NL11'YOFK$TATk Df I'ARLMf N7 OrL\VIRO~\~lEV 4L CO\$f KVATION BLt rLK,wT Nu.MeeK . I n I cuvl DAn 11-4738-00277/00001-0 ~ July 8, 1991 FACILI rY, PRi:GRAA1 NUti1(SE RIs) PERMIT EXPIRATION DATE Under the Environmental Conservation Law (ECL) Judy 31 , 1993 ; TYrfP~~E OF PEKMIT (Check All Applicable times) p{~Ner~~ ?Renewal ?MOd,hcation ?Perm,t to Construct ?Permrc to Operate a Pmtecton ofiWat r ~ SPDESI7, Titles 7, 8: ~ Hazardous Wafste~Management3 Article 15, Title 15: Article 19: Article 34: Water Supply ~ Air Pollution Control ~ Coastal Erosion Management Article 15, Title 15: Article 23, Title 27: Article 36: Water Transport ~ Mined Land Reclamation ~ Floodplain Management l.oogelslandTlWellsS~ ~ Frelshwater Wetlands ~ 6NYCRR1380:1Rada9lon Control Article 15, Title 27: Article 25: ~ Other: Wild, Scenic and Recreational ~ Tidal Wetlands Rivers Article 27, Title 7; 6NYCRR 360: 6NYCRR 608: ~ Solid Waste Management Water Quality Certification PERMIT I$$VED TO TELEPHONE RC'M(3EK Wenner L. Adel, Jr. t I ADDRESS OF PERMITTEE 12 Fox Meadow La., Huntington, NY 11743 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER ( 1 NAME AND AUDKL$$ OF PKOIECTIFACiLITY LOCATION OF PROJECTIFnCILITV Deep Hole Drive Lot 113, Mattituck' COUNTY TOWNICMSt'YBSLXt1SE WATEKCOURSE/WETLAND NO N1'TM COORDINATES Suffolk Southold Deep Hole Creek E_ _ Na__ DESCKIPTION OF AUTHORIZED ACTIVITY Construction of a single family dwelling, deck, private well and septic system. All work shall be in accordance with the attached NYSDEC approved plan. 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 Reverse Side) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR ADDRESS ~'~`Qr~~"`~Y9 David DeRidder ReSfon 1 ~ Stdg. ao SUN Y AVTHORIZED SIGNATURE DA y~~$~~k~ ~~s-~ 56 ~l/~ `~!~/>°e~c%v~ /8/91 Page 1 of S ~;~)O~ba I1 C:9J1-25c ' ADDITIONAL GC NCRAL CONDITIONS FOR ARTICLES 15 (T it lc s1, 24, 25, 14, 76 and b V CRR Part LOtI _ 9 That it future opera eons by tlm State of New York regwre an ab other er ..ronmentally deleterious matenzls associated with r~ teration in the position of the structure or work herein authoraed, or protect d, in the opinion of the Department of Environmental Conservation 13 Any ma;r:al dredged m the prosecution of Ih,~work hcrcm pennin:.: d shall cause unreasonable obstruction to the free navigation of said shall be removed evenly, without leaving large reruse piles, edges acrcn waters or flood (lows or endanger [he health, safety or welfare of the bed c> a waterway or floodplain or deep holes that may ha.c a the people of the State, or cause loss or destruction of the natural tendencx ;o cause damage to navigable char.^els or to the banks resources of the State, the owner may be ordered by the Department to a w aten. as remove or alter the structural work, obstructions, or hazards caused 14 There sha.. be no unreasonable interference wnF. navigation by the v, Iherebl' without expense to the State, and if, upon the expiration or herein a~..:nonzed. revocation of this permn, the structure, fill, excavation, or other 15 It upon ;-e expiration or revocation of this permit, the Protect here. modii ication of the watercourse hereby authorized shall not be coin- authorize' has not been completed, the applicant shall, without expe^:e pleted, the owners, shall, without expense to the State, and to such to the S:a_e, and to such extent and m such time and manner as :°a extent and in such lime and manner as the Departinent of Environmental Deparirr of Environmental Conservation mz, regwre, remove al I or Conservation may require, remove all or any portion of the uncompleted any por, ~n of the uncompleted structure or t,ll and restore the sre structure or fill and restore to its former condition the navigable to its for-er condition No claim shall be made against the State or and flood capacity of the watercourse No c4alm shall be made against Vie„ 1'or• on attount of any such removal o~ alteration the State of New York on account of any such removal or aheratioo 16 h grantee under Article 36, this permit does not signify in any ,+a~ 10 That the Stale of New fork shall in no case be liable for any damage that the e-otect wdl be free from flooding or mlury to the structure or work herein authoraed which may be caused 17 li grantee under 6 NYCRR Part 608, the NY$ Department of Envncn- by or result from future operations undertaken by the State for the mental Conservation hereby certifies that the sub{ect protect wdI not conservation or Improvement of navigation, or for other purposes, and contras ere effluent limdations or other Lineations or standards under no claim or right to compensation shall accrue from any such damage Sections 3J1, 302, 303, 306 and 307 of the Clean Water Act of 157 11 Granting of this permit does not relieve the applicant of the respond- (PL 9i-2"- provided that all of the condmons Lsted herein are met blhty of obtaining any other permission, consent or approval from 18 All actis.:.es authorized by this permit must be m strict conformar-e the U.S Army Corps of Engineers, U S Coast Guard, New fork State suth the approved plans submitted by the applicant or hIS agent as pzrt Office of General Services or local government which may be required of the pa-mi[ application. 12 All necessary precautions shall be taken to preclude contaminaUOn /On Survey Roderick VanTu':l Such ap~-oved plant were prepared by of any wetland or waterway by suspended solids, sediments, fuels, 2/ ]4/91 and last amended 4/ 16/91 solvents, lubricants, epoxy coatings, paints, concrete, leachate or any on - SPECIAL CONDITIONS 1. During construction, no wet or fresh concrete or :eachate 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. 2. Any debris or excess material fi"om construction of this project shall be completel;• removed from the adjacent area (upland) and placed in anuPPropriate upland area for disposal. Disposed material shall be suitably retained so as to not reenter any water body or tidal wetland area. No debris `_s permitted in tidal wetlands and protected buffer areas. 3. The storage of construction equipment and materia:s shall be confined to within the project work site and/or upland areas greater than 75' distant from the tidal wetland boundary. 4. If seeding or soil stabilization is impracticable due to the time of year, a temporary mulch shall be applied and final seedi^o shall be performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. 5. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay ~ straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. 6. A row of staked hay bales or approvable erosion control devices shall be placed at the seaward edge of the building envelope at com:.encement of regulated activities and remain in place until project is completed and all disturbed areas stabilized ~ with vegetation. 7. To protect the values of the tidal wetland, a per-_-anent vegetated buffer zone shall DEC PERMIT NUMOER be established. There sha.1 be no disturbance to the natural vegetation or too raphy ::ithin an area extending 75' 1-4738-00277/00001-0 landward of PROGRAM/FACILITY NVM(3ER (CONtINIIED) 3 Page of `s 45-N!!,~'78%1-tic NF N' 10RK STATE ULPARTM 6YT OE EN\'IRG'~~~'E ~i4l COMER\'A 710N SPECIAL CONDITIONS For Article 25 ~ Tidal Wetlands 8. Driveway and parking areas shall be construc~ed of pervious material. 9. Roof runoff shall be directed to drywells a =inimum of 100' landward of the tidal wetland boundary for immediate on-site recharge. 10. Project must comply with all local and federal floodplain regulations. 11. Septic system tank and cesspools shall be located a minimum of 2 feet above seasonal high ground water. 12. No fill shall be permitted at the project sire without prior approval from the Department. Supplementary Special Conditions (A) thru (J) attaGherl I I DEC PERMIT NUMBER 1-4738-00277/00001-0 FACIE ITY ID NUMDER PROGRAM NUMBER Page 4 of 5 ~ 1 die UbH nsurance l,orpora o a vea rorK 127 W Main Street Box 478 ~ F ~ ~ „ ~ i ~ ~ pJ 't,: - Riverhead, New York 11901-0208 ,a; ~ a- ~ 3 ~,a ~ ~ ! y ~ 7€ (516) 127-4140 Fax No. (516j 727-4239 ` j ! i'~ ~ ~ ~ ~ s ~ ~;T; ocr i 5 iss4 „ " ~ ~I ~ ~t~uv.~~ ~ ~z €s[:rsi~: ~:eE>€: USA L~ CRON & CRON, ESQS. MAIN ROAD, P.O.B. 953 CU`PCHOGUE, NY 11935 Re: Title 985267201 Premises: 2081 DEEP HOLE ROAD, MATTITUCK, tdY DIST #1000 SECT #115 BLK #12 LOT #3 WLY S/0 DEEP HOLE ROAD WHERE SAME IS INTERSECTED BY THE 5LY S/0 LAND N/F OF NELSON, SLY S/0 NEW SUFFOLK AVENUE, T/0 SOUTHOLO Gentlemen: Pursuant to your request of February 28, 1990 enclosed please find our report as referenced above. Due to the fact that this transaction will not result in the issuance of a title insurance policy our charges are due upon receipt of this report. The following represents the amount due: SUBDIVISION--SINGLE PARCEL $ 250.00 Total 258.08/ We thank you for your attention to this matter and look forward to the opportunity to continue servicing your title needs. Very truly yours, Branch Accounting GPS-4 ( ~ t /88~ l aye USA insurance Corporation of New Porn 127 W Main Street Box 478 ~ t°~ 7 -1 , l,t r Riverhead, New York 11901-0208 i ~ ~ ~C , 1 _ ~ ~ r E (516) 727-4140 Fax No. (516) 727-4239 D 1 , ~~t~ i k f, a3 ; OC7~ 15 6991 t1:~ ~ ; E7~TITLE USA March 7, 1990 Cron & Cron, Esqs. Main Road P.O. Box 953 Cutchogue, New York 11935 Re: Title Number 90-52-67201 Variance Search w/ Adel PREMISES: Described Herein Gentlemen: Title USA Insurance Corporation of New York certifies that it has searched the records of The Suffolk County Clerk and/or The Suffolk County Registrar for deeds affecting the captioned property and properties immediately adjoining and finds: SEE ATTACHED And the records of the Suffolk County Clerk and/or The Suffolk County Registrar disclose no other or further conveyances of any of the foregoing lots other than as above set forth. Title USA Insurance Corporation of New York certifies that the above captioned property is in single and separate ownership of Werner Adel, Jr. and his presecessors in title since 1947. The liability of the Company is limited to the amount of fee paid. Very truly yours, ~.e~~ Dougl s C. Staib Branch Manager Enc. DCS/shl GPS-< f ~ 1 /881 till 7 i ' 3 1 i,~f~ ~ ~ i'e 9~ _ I , OCT' 15 6991 ' ; TRW Real Estate Loan Services ~i ~ 9~ ~ 127 West Main Street „~r~a'y~~t,i!',, ~,{t,~}~~,3d=, - P.O.Box G78 RIVERHEAD, NEW YORK 11901 VARIANCE SEARCH - STATE OF NEW YORK: SS: COUNTY OF SUFFOLK: DOUGLAS C. STAIB, being duly sworn, deposes and says: That he has offices at 127 West Main Street, Riverhead, New York, and is over the age of 21 years and that he is Branch Manager of TRW Real Estate Loan Services. That under his direction, title was examined to the parcels of land described on the annexed schedule and labelled Parcels A, B, C, D, & E. That said examination, made to include 2/3/90 discloses that the subject premises has been in single and separate ownership since 1947 as appears from the chains of title annexed hereto. This Affidavit is made to assist the Broad of Zoning Appeals to the Town of Southold to reach any determination which requires as a basis therefore the information set forth herein and knowing full well that said Board will rely upon the truth thereof. TRW Real Estate Loan Services BY:_~~ C ~/7`~ • DOUG S C. STAIB Branch Manager Swore to before me this t~ Q 71H day of /YI~~C~1 ~ / EDWARD F EICHHORN Notary Public, State of New York No.52-1089612 Qualified in Suffolk County Commiss+on Expves December 31, 19 ~ ,l` ,~i~s_ ai. ~ ` is is e jy.: ; ~~'r I J T3-t le Number 905267201 , <i ~f.~ s~~~~:.~. _ , - ~a~.i~os. D E S C R I P T I O N S PARCEL A: SUBJECT PREMISES ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, at Mattituck, known and designated as a described parcel situate on the West side of Deep Hole Drive, 127' south of New Suffolk Ave. Also known and designated on the Real Property Tax Map as District 1000, Section 115.00, Block 12.00, Lot OC3.000. PARCEL B: ADJOINING ON THE NORTH 002.000 PARCEL C: ADJOINING ON THE SOUTH 004.000 PARCEL D: ADJOINING ON THE EAST Deep Hole Road PARCEL E: ADJOINING ON THE WEST Deep Hole Creek STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: Douglas C. Staib, being duly sworn, deposes and says; That he has offices at 127 West Main Street, Riverhead, New York, and is over the age 21 years, and that he is Branch Manager of TRW Real Estate Loan Services. That the above are the true description of the subject premises and of the adjoining premises as shown on the variance search under the above captioned title number. TRW Real Estate Loan Services Dougla C. Staib Branch Manager Swore to before me this 7 EDWARD F. EICHHORN day of /yj/a (~CtI 19 ~ Notary Public, State of New York R Nn.52-1089612 _ ~ ~ p Qualified in Suffolk County . , . , ~i. ~~~i'~.i• ~ ti,. ` s ~ ~ "t 't~ i;x ~~i ~ 5 ' Tale so. 9csz67zo1 ~ 9t'1 . f" { r }'E'~. CHAIN OF TITLE FOR PARCEL A: ` James A. Gildersleeve L: 2769 cp. 265 Sidney H. D: 9/17/47 Donald R. R: 10/29/47 - to George Titt¢nermann George Timmermann L: 9426 cp. 44 to D: 8/29/83 Donald G. Timmermann R: 9/16/83 Donald G. Timmermann L: 9657 cp. 293 to D: 10/2/84 Werner Adel, Jr. R: 10/12/84 LAST OWNER OF RECORD CHAIN OF TITLE FOR PARCEL B: - i James A. Torrey L: 1986 cp. 543 to D: 5/18/38 _ James A. Gildersleeve R: 6/6/38 Sidney H. - Donald R. " James A. Gildersleeve L: 4586 cp. 361 Sidney H. D: 12/31/58 , - Doanld R. R: 2/13/59 to ' C. Edward•Nelson. Grace E. itx. LAST OWNERS OF RECORD CHAIN OF TITLE FOR PARCEL C: James A. Gildersleeve L: 2769 cp. 261 Sidney H. D: 9/17/47 Donald R. R: 10/29/47 to Marjory T. Kalk LAST OWNER OF RECORD PARCEL D; Deep Hole Road PARCEL E: Deep Hole Creek _ STATE OF NEW YORK) SS: COUNTY OP SUFFOLK) DOUGLAS C. STAIB, being duly sworn, deposes and says: That he has offices at 127 West Main Street, Riverhead, New York, and is over the age of 21 years, and that he is Branch Manager of TRW Real Estate Loan Services. That the above are the true chains of title as shown on the record in the variance search under the above captioned title number. TRW eal Estate Loan Services ~ 1~~ D UGL C. STAIB Branch Manager Swore to before me this day ofM~2~H 19`~~ ~ NotaryPubRo StateoHNewYork D~/ No. 52-1089612 ~ ~-c~--~ Qualified in Suffolk County ~~T mission Expires December 31, 19~t , _ ~.~a - , . _ A p trl ~ 9 E:, ' I r l~ : l i i. 15~~3I .t' TRW Real Estate Loan Services 127 West Main Street Ii,r'~h~' P.O.Box 478 RIVERHEAD, NEW YORK 11901 VARIANCE SEARCH , STATE OF NEW YORK: SS: COUNTY OF SUFFOLK: DOUGLAS C. STAIB, being duly sworn, deposes and says: That he has offices at 127 West Main Street, Riverhead, New York, and is over the age of 21 years and that he is Branch Manager of TRW Real Estate Loan Services. That under his direction, title was examined to the parcels of land described on the annexed schedule and labelled Parcels A; B, C, D, & E. That said examination, made to include Z/3/90 discloses that the subject premises has been in single and separate ownership since 1947 as appears from the chains of title annexed hereto. This Affidavit is made to assist the Broad of Zoning Appeals to the Town of Southold to reach any determination which requires as a basis therefore the information set forth herein and knowing full well that said Board will rely upon the truth thereof. TRW Real Estate Loan Services SOUGL C. STAIB Branch Manager Swore to before me this % day of /J7 /I /c'C/{ ~ ~ % ~ NotaEDp ARD F. EICHHORN ry ublic, State of New York Qualified5n S ~ffolk County Commission Expires December 37, 19 I L ,.3 s t~;;ti ~ 51~~{ Title Number 905267201 g7,i~ D E S C R I P T I O N S PARCEL A: SUBJECT PREMISES ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, at Mattituck, known and designated as a described parcel situate on the West side of Deep Hole Drive, 127' south of New Suffolk Ave. Also known and designated on the Real Property Tax Map as District 1000, Section 115.00, Block 12.00, Lot OC3.000. PARCEL B: ADJOINING ON THE NORiH 002.000 PARCEL C: ADJOINING ON THE SOUTH 004.000 PARCEL D: ADJOINING ON THE EAST Deep Hole Road PARCEL E: ADJOINING ON TI-IE WEST Deep Hole Creek STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: Douglas C. Staib, being duly sworn, deposes and says; That he has offices at 127 West Main Street, Riverhead, New York, and is over the age 21 years, and that he is Branch Manager of TRW Real Estate Loan Services. That the above are the true description of the subject premises and of the adjoining premises as shown on the variance search under the above captioned title number. TRW Real Estate Loan Services Douglas Staib Branch Manager Swore to before me this EDWARD F EICHHORN !F~ Notary Public, State of New York day of ~~PC/7 19 q ~ No 52-7 0696 7 2 ~ n Qualified in Suffolk County ~ ~ i- _ ~ i ~ t • F ~ ~s OCR' 115 ~9i , z:~~le ~:o. 9cs267zo1 CHAIN OF TITLE FOR PARCEL A: ~ ' ~ ~l ~ £9° irtia G a.e~ .r . iCi~~ R 8 t °,3~ ~.i as James A. Gildersleeve ~ ~'~L '2769 cp.~2~5 Sidney H. D: 9/17/47 Donald R. R: 10/29/47 to George Tirmnermann George Timmermann L: 9426 cp. 44 to D: 8/29/83 Donald G. Timmermann R: 9/16/83 Donald G. Timmermann L: 9657 cp. 293 to D: 10/2/84 Werner Adel, Jr. R: 10/12/64 LAST OWNER OF RECORD CHAIN OF TITLE FOR PARCEL B: James A. Torrey L: 1986 cp. 543 to D: 5/18/38 . James A. Gildersleeve R: 6/6/38 Sidney H. Donald R. James A. Gildersleeve L: 4586 cp. 361 Sidney H. D: 12/31/58 , - Doanld R. R: 2/13/59 to C. Edward~Nelson. Grace E. ux. LAST OWNERS OF RECORD CHAIN OF TITLE FOR PARCEL C: James A. Gildersleeve L: 2769 cp. 261 Sidney H. D: 9/17/47 Donald R. R: 10/29/47 to Marjory T. Kalk LAST OWNER OF RECORD PARCEL D; Deep Hole Road PARCEL E: Deep Hole Creek _ STATE OF NEW YORK) SS: • COUNTY OF SUFFOLK) DOUGLAS C. STAIB, being duly sworn, deposes and says: That he has offices at 127 Wesr Main Street, Riverhead, New York, and is over the age of 21 years, and that he is Branch Manager of TRW Real Estate Loan Services. That the above are the true chains of title as shown on the record in the variance search under the above captioned title number. TRW eal Estate Loan Services DOUGLA C. STAIB Branch Manager Swore to before me this 7I~ ^ ~ y EDWARD F EICHHORN day Of R G 19 ~ ~ Notary Public, State of New York ~ No.52-1089612 Qualified in Suftolk County Commission Expves Oe^eml;er 31, 19~~, wait- w P5 ~,J a \ f ~ u ~ BOr1FD OF. HEALTH • • . • p ~ FORM NO. 1 3 SETS OF PL 1:rS ~ Q,('r ~ 519~I " TOWN OFSOUTHOLD SURVEY • 1 %I~~ BUILDING DEPARTMENT CIIECt: "{~~~.~,.`.."..,.°.°a°.°-,~.~~.as~vE-- TOWN HALL SEPTIC roaN _ , l31.Y1S.a. 4",C:H'1'. ,,,.~.nr.~ SOUTHOLD, N.Y. 11971 TOt+UIyJO& :(JUi~tlCS[.R5 L, „n ~ TEL: 765-1802 r:aTIFY,.4!~.7_ ~n~?~ /d/~/ CALL ! _ ~_7 . . Examined . 19 .9~ rtn I L T 0 ~ i /~Qg y.j A roved ~`,/2!,~9~ ~'l.~ ~ ~LLJ...~,_~.~ii1 jf~it"~ce fl l PP / , 19 Permit No... '7p/ , jJ y/~ ~-~(J. IT(sC Disapproved a/c ~tl 1r TSC + ~ ? - 1'IZ~'J . r...:~:`.. (B ilding pector) APPLICATION FOR BUILDING PERMIT Date . Q J:........, 19 .l. ~ 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. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets rr 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. c:. 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 3uilding 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. the applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. - (Signature of applicant, or name, if a corporation) (Mailing address of applicant) Mate whether applicant is ~wner, lessee, agent, architect, engineer, genera] contractor, electrician, plumber or builder. l/' / y Vame of owner of premises . l.l.[ ~~!Y), , ,L; 7` J~~~ .Q ~ / (as on the tax roll br latest deed) ff applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. .~G'L.1.1:1 ~L'? ~..~m~'r.`J Plumber's License No . . Electrician's License No . . Other Trade's License No . . Location of land on which proposed work will be done. . House Number Street Hamlet County Tax Map No. 1000 Section /'J Block . ~ Lot . Subdivision 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 ~-.~-~-.U4 : , - b. Intended use and occupancy COrvS'"1"I^e'C, 1^ IU~e~ ~ f, ~ ~ p ( PP / 3. Natpure of work check whiRemo'licable): New Building v Addition Alteration Re air yal Demolition OthemWprk . ~l / ~ (Description) 4. Estimated Cost / "'7'(//. DJ~ Fee 58 P ,3~..................... . (to be paid on filing this application) g, g 5. If 6 welglin number of dwellin units Number of dwelling units on each floor ~ . If ara a number of cazs , , , , , , . 6. If business commercial or mixed ,occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures if any: Front . . . . .Rear Depth , , , . , . . Height . Number of Stories . Dimensions of same structure wit~t alterations or additions: Front Rear . epth 8. Dimgensions of entire new c Nu b Height Number of Stories . ction:Front Rear............... Depth Hei ht ier of Stories , 9. Size of lot: Front i .r;:.....'~, Rear D.G ~ .ZJ~ Depth ! `/,t? e • ~ . 1 O. ZDone or usecdistrict in which prerp • ' ' ' ' ' ' • • Name of Former Owner G!/F~.?st!~ ..C:..ff-d.~t...JIIi~ . ices are situated . P p ~e any zoning law, ordinance or regulation: „ . . 13. Will lot be re dradedp ruction viola ~yill excess fill be removed from premises: Yes No g 14. Name of Owner of remises , ,Address Ph e yo. Name of Architect ~j,G Su7t p,e% • • • • , , , ,Address ~Z.FF.-~,'N~~'GE .~;~~h~e ~o !®~~t,~ ~66~ Name of Contractor . ~ .Address . .Phone No. . * y ~ 15. Is this ro ert within 3 P P y QO feet of a tidal wetland? eyes,,,,,... No......... If es, Southold Tgwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all Buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whethe3 interior or corner lot. I s I n 'OUNTY OFE~.:J:i: v.1.1~...... S• I' •~'~~r • • • • • ii • • being duly sworn, deposes and says that he is the applicant (Name of individual s/i'n~in g g contract) bove named. Ieisthe II (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly i~uthorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the cork will be performed in the manner sett forth in the application filed therewith. worn to before me this ....day of . . . , ~ 19.9.E votary Public, ~C` , , County ~ • CAROL. ANN PARINACCI I ~ NotaryPuNor490.3395NewYork ` Qualified in Suffolk Ceunttyy (Signature of applicant) Com scion Expirt~s~ potc~asr 241; (`t~(~ cESSPOD I-I ~ I _ SUFFOLK CO. HEALTH DEPT. APPROVAL i 1 I '~47 $i~ffwL{.4 o ~ 7 : "i~ :'ICES ~ H. 5. NO. 91' SO -18 .N ~ r ~ ~vEt_4 %t . II t ~ ~ i0 ~ ~C'Gf L`7{n r ~ j ~ 5 N 1~ r ~ o ~ ~ + ~4 ~ 8 h~ ,::iei ~ -;,is -gyp , ;_r.~ i STATEMENT OF INTENT P4PE I ~ ~ ~ ; w THE WATER SUPPLY AND SEWAGE DISPOSAL w ti`;.BQ'~7E, IR1NE 81 ~ ~ / ~ SYSTEMS FOR THIS RESIDENCE WILL 1- ~ .r---~~-~~ I i~ J ` ` ~ , ~ ~ ~ k~ CONFORM TO THE STANDARDS OF THE S 3 ~ ( ~~.D _ j~ ~ ~ SUFFOLK CO. DEPT. OF HEALTH SERVICES. ~ ~ r NHLLIN6 ~"-~y`il,~R1~~G - ~ (S) ' _ r ys~+----~ r ~ I 1~, :~d APPLICANT a 1_ N it T -7g - 1/ CE''SPOOLS±~ SUFFOLK COUNTY DEPT. OF HEALTH ~ ~ ~ ~ ~ ~'g ~ ~ SERVICES - FOR APPROVAL FOR ..1 w ~ ~ ---1a4'- _ 1 t~ ~ ~ CONSTRUCTION ONLY a h S!!~'1'~~KY 1 ~ ~ ! _ DATE. ( Q 1- :7 1, ~ 'r , I `"a ~ + i H. S. REF. NO.. 9 .50 IS ;i '~a~` ~ ~ r#pree+' ri lit-- ~ APPROVED: h °Q ~ ! jU[+~ DF FLAGS SET~®'r ~ ~ u i ~i _ N i - US$ ~ ~ SUFFOLK CO. TAX MAP DESIGNATION: s~ ~ WETLJ11iD5. L i ~ ~ ~ ~ ti D15T. SECT. BLOCK PCL. r + g~ b ' t' k ~ IOOC Its t2 3 - ~ a;--~~.___-t-_ . ~ e+ g OWNERS ADDRESS: `:.87 ~ y ?•'J 'v.' o ro G~•0 i ~ - uai ip66 QAiCNECK t20AD _ e _ i ~ . ~ j BPY SNQRE~N.`!. 11706 " -iPE 665476: " - STAk-= DEED: L.i 7E79 P. Z6~ f REF./ e _ wsLL~ i TES HOL STAMP CESSPQOL~ F~ yY-- ~.~{rC !"~-L{~! i Q1 E4'31i Le k..~ ~ ^J ~'dYt B20WN . c' J r ~ FJ le. N4T'is5 ~ coAr1Y SN+o , , ' , ~ 2 1992 ?~tc~,?a~[t+~G W&.L,Rc~;sv!:oL I atArpcnts ~wrt~tz`= 3' ~:r`V t t.._'_! t ~ s''j ~ ~ I;"~! ~fC. 1~>~~.. r ~ MAR 1 ~tarc?s~ ~v owatEr~------- PACt B$OWN - - - 2.Gi]NTOIJFLS ~ fLEVAYIOl~ig fc.EF~tt'^s Nit-I+t.~ :-'-A E'~: n v ~a': Fu~IE To _ - - P.T S.C. DEPT. 6F - - - tease sous HEpETH SERVICES 3,PROPEATY IS tN BUtLOfAiG ZOrttf R-~J. - ~:,F:.'.~..;.~..r IsT FL.EL ; : .aQl'sOtNG ?LAN - - _ 10.1 r ti , iY ! MiAX. SLOPE SEAL y~ f ' i2__ i0. 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