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HomeMy WebLinkAbout18993-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219486 Date NOVEMBER 5, T990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 3055 R.O.W. OFF KIRKUP LANE LAUREL House No. Street Hamlet County Tax Map No. 1000 Section 125 Block 01 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 27, 1490 Pursuant to which Building Permit No. 189932 dated MAY 1, 1990 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 AND DECKS. The certificate is issued to DANIEL & BETTY JACOBY (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-107 OCT. 4, 1990 UNDERWRITERS CERTIFICATE N0. PENDING 11/5j90 ERNIE PAPPAS PLUMBERS CERTIFICATION DATED GALE KASKE PLUNGING 9/19/90 Building Inspector Rev. 1/81 sows xo s 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) 18993 N ~ Z Date ~ 1 v.9.~ Permission is hereby granted t ~'...l~ ro . ).r.~`^..!x~:`~:~' ..°.5:....~?~I.Q. ~ ..!...J `a..s~s:~r^.. 4t.~Y~.~!'!.s~: ~ at premises located at ...w~.~.~.m~. ~5..:.°..:`'.?:. "j.~. ~t~-f~4~-.. County Tox Map No. 100`0 Sectio(n~.....~.4............ Block Lot No.....~:.. pursuant to application doted ...~..~4,{~X......~,...~1 19.9.4.., and approved by the building Inspector. v Fee S.~G~l~.:4~/.... 1 fit. V' K. et.L~ . uiiding Inspector Rev, 6/30/80 ;i, r _ . 1 ~ ~ rosai xa s' ~ , ~ r;' ~ ~ ~ ~ . TOWN OF SOUTHOLD ~ , 6UILDING DEPARTMENT„ . z;,';r... :TOWN HALL ~ ~ ~ ~ ~ SOUTHOLD, N. Y. ~ ' ~ o ~ BUILDING PERMIT ~ ~ (THIS PERMIT MUST BE KEPT ONE THE PREMISES UNTIL FULL " COMPLETION OF THE WORK AUTHORIZED) Z Date ~ 19.`,~.f? Permission i s hereby granted t : T c ,.°.hK,~~..~/.~.~.'.~..C.Y~ '~'~.~..:~~.:p.,.J. ~.Y.`1..~.~:..ny yam. , n \ 1 to .C:~::~:~:::~.:~:: ~ ..?.I.r?:.Y.?,r.C.':...~t..S:~:::~?::......a-C.Y.cz. c~v :,K" \.`~c4.c.:~~ . V V ...:4~........ . r " of premises locoted at ...q~.1.°.~..w~.......~k~:S'.:?C..:....~~..~....~:~;~ ...6x:?4~.......~T.....~.•..~"-.....~... ~ ~ 111 ~j County Tax Map No.. 1000 Section Block Lot No. pursuant,`to 'application doted ~ ,;,,,1,.;1,,,,,,,;,;,,",,,,,,,,,., 19.9.'.?., and opproved by the Building Inspector: ' . e Fee 3..201, .a?if y 1 - ~ " l~~ ~ ~ ~ti~ ~ ~ ~ ~ ~ ' ~ l~e_i ~ ; . Rev, 6/30/80 ~ ~ ~ .."F ~ ~ t TEL. 765-1802 SUFFOLkC ~p Op TOWN OF SOUTHOLD _ ti ~ OFFICE OF BUILDING INSPECTOR J r ~ ~~~4 o ~ ~J I~~( P.O. BOX 728 "'"~f ) 'YO~O~ ~ SOUTHOLD, NAY 11971 ~ ~ t TowN aF s~zvn,~,f D r ~~-.,._s C E R T I F I C A T I O N Date weptember 197990 Building Permit No.18993~ owner_ baniel dac©by (please print) Plumber Gale gae_ke d/b/a Gale Saske Plumbing & Heating, Tna. ''(1~1eas'e''priht) ~ ~ ~ ~ I certify that the solder used in the water supply system contains less than 2/10 of i~ lead. s ~ (plumber's signature) Gale gaske Swore to before this ~ day of j~ ~ 19 1 D . ~ J v~nM..C. S"?} Notary Public Notary Public, ~ COUrity ROSE N. DONNELI9 Notary Pu61ic, State o4 New York No. 52-462429b Suffolk County Term Expues ~ -3 . - g r 1 .s ~ 's.t"~"~.~, Form No. 6 ~J~-~! , ~~N..~'' I TOWN OF SOUTHOLD 8 ~ ~ BUILDING DEPARTMENT TOWN HALL 765-1802 BLDG. 0l:PT. 7bWN OF S~JTt~•q! p 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 1% lead. „ 5. 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) 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. 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 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .actober, 17,i,?994,,,,,,,,,,,,,,,,,,,,, New Construction.......... Old Or Pre-existing Building Location of Property.3O5Jr'..~.`O.7~h.©1'~.$frk711p.I/923e,.7~usm1,.AT..Y.. House No. Street Hamlet Onwer or Owners of Property..paAiCl. &.Betty..Jacsmb~r...• County Tax Map No 1000, Section..lc~„~i........Block....(',~,••••.....Lot....Fj.,.k Subdivision ....................................Filed Map............Lot...................... Permit No.1~~~3~+........Date Of Permit..~j~1,X90.......Applicant.~1~:~OME.~a~. ZNfs. Health Dept. Approval, lOf4~g0.. • . • , , ,Underwriters Approval • /~„JPr14:'f~c.'~-y. ` . ? tl /v .Ygtr~ Planning Board Approval Request for: Temporary Certificate//........... Final Certicate....$...... Fee Submitted: $...°.r.~....`.~'..r~IP.°?~.... _ C`~. ~1I~~9U Robert l~. Hi~tz ND HOME INC. C~ z ~9f~6 r 1::LD I,:S:'~CTIUN ~ UATE ~ OOMMENT~ ~ m ~ ~ ~ ~ ~ a H ~ _ H ~ fJ FOU1dDATIO:J (1st) - Sao ~ u~ p ~ 1 FOUNDATIOtd (2nd) ~ ~ 2 . u.` ' ~3 8 o P,OUGH FRAME & 1/~ _ vi ~ N PLUMBING ~ 0 y 3 . ~ ~ a~ IldSULATION PER N. Y. ~ ~ STATE ENERGY CODE m a yb r 4. m G .S'~• ~ y F I iJ A L ' ~ o E ADDITIOPJAL COMMENTS: x 9 DK. ' x ro H ~ ~ .a +0 H O z ~ ~ to a ..rv • r { .a t/~ v O m ) ~o y O ' a 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~ FRAMING J~j FINAL REMARKS: ` DATE ~?~~~INSPECTOR 1 ~~6 ~3 76S_1802 [ BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ~ FOUNDATION 2ND [ INSULATION [ ]FRAMING (]FINAL REMARKS: `-~`-~a~/~, DATE 'INSPECTOR 1 ~ 3 ~ rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGN PLBG. [y~FOUNDATION 2ND [ ]INSULATION [ ]FRAMING (]FINAL REMARKS: ~ (.r, a C ~ 64C../` ~ (L vi ~u2 G +4_ t~ S r~-~~' V~li?~ y ~t~ ~ ~ a ~v 5 f,~ D`~ l ~l~t ~~Y~ ~ ~~~.o~ G 2~~~ U,s~ ~~V~~ ~S ~-~i lZ~ v~~~ DATE ~ .,2~ ~_~INSPECTOR ~ ~y~~ 765-1802 BUILDING DEPT. NSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ii ~ v i DATE ~ INSPECTOR I' 765-1802 BUILDING DEPT. INSPECTIQN [ ]FOUNDATION 1ST ['ROUGH PLBG. [ }FOUNDATION 2ND [ ]INSULATION ~RAMING [ ]FINAL REMARKS: ~ t ! 07a- d) i r DATE INSPECT P Proper-T Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516) 734 - 5800 .December 20, 1989 s 1 `_1 { E~~~' =.ut. 3 Mr. Victor Lessard, Senior Building Inspector Building Department Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re• Application for Daniel Jacobv SCTM No. 1000-125-1-5.1 Dear Mr. Lessard: Enclosed is a copy of the survey of the property, approved and stamped by the Suffolk County Department of Health Services. Also enclosed is a statement of non-jurisdiction from the NYSDEC. I believe this completes the submission requirements of the application to your Department. If you need anything else please call me. regard a es E. Fi geral , Jr. a subsidiary of THE PECONIC EASTERN CORPORATION New York State Department of Environmental Conservation Building 40-SONY, Stony Brook, New York 11794 (5]6) 751-79UU RECEIVED DEC 13 7989 T C~C ~^1 / J.E. FITZGERALD Thomas C. Jorling `J A~n1Q5 L. 1"~.i-ZgL{,~t,~ R~ J"y. Commlesioner ~?D~3Zr -T SeYJiCes Date: 1~D1/.aR.~ /989 p,0.~~131ox (~1~ A( I'T 1 ~T(iV~-O p U-!- v y ~ ~ 9..35 R e: ~j~'~3GIr-4-~ ti-~ ~Q.Y1 i C I~ JQ.I'DbV J Gld i a P -Fv La u re I La/k ~ Fresh W afec~ I,~y~'1 avta~ 3t n1T- ~ 1-y938-ooosd~oooo/- o Dear ~y'. ~~i neV~,~a; Based on the information submitted for your proposal to: (ip~ri~u-t'~- 0. Sing1'e-(-ah+ily ressi~.~ce- wi•f'h wcll~5eu1 a disposal S~yys~m(as~o~ assacid~ed C(fYviv~ irlClu.di+~ fv~ ~a.~.dStarinq) as~aer ?okh Iri~i-z9.~r 3urvt~ rcv~s~Ja~u?~eq Location:~„q,ur LQ.ICG.Ctc'CPSSEC7 bJ Tax Map Number: /000-/~S-/-S./ So'R. W -From sou~d~+l-+-f-uc k the New York State Department of Environmental Conservation has determined that: The g~r`ce-1 rojec is more than 100' from regulated freshwater wetlands. Since the freshwater wetlands present are less than 12.5 acres in area and have not been designated by the State as having unusual local importance, they are not currently regulated by NYSDEC. Therefore, ne permit is required under the Freshwater Wetlands Act (Article 25 of the Environmental Conservation Law). Please note that any additional work, or modification to the project as described, may require authorization by this Department. Please contact t'r.is office if such are contemplated. Please be further advised that this letter does not relieve you o° the responsibility of obtaining any necessary permits or approvals from ether agencies. N_I ~1~4'C Wil~ ~ Vll7 very truL~~~h` _ ' rs~~ l11"~dis-lurban~e :off any kind ~ bw+sid~ ~ 'fie bu.ildin~ -env~elop~. _ - L'C ~ 17aniel ~"a.~ob~/, -~Trt3 Regional Permit Administrator 383 q-r~lrews >ld E. bU~l1~s-l-nn~ W~l llsgb ' ~ Proper-T Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516) 734 - 5800 p ~e~ .r.M..,., ~ ~ , l~ ~ ~ , ~ APR 2 i V99O September 22, 1989 ~ ~v.,,_.. p ~ ~ ~ Tt?4r-t~~ (;I _,v~ .r . . _ ~ ~ 2 5198.9 Mr. Victor Lessard, Senior Building Inspector Building Department SLOG DEPT Town of Southold ^^^-T~-- `4-~~.,.,._ Town Hall, 53095 Main Road Southold, New York 11971 Re: Application for Daniel Jacobv, SCTM No. 1000-125-1-5.1 Dear Mr. Lessard: As you requested, the following information is provided to clarify the referenced application, and should be made a part of that application. It is agreed that upon the issuance of a Certificate of Occupancy for the completed new residence, the question of the structure now existing on the lot will be resolved in one of the following ways: 1. A set-off will be made, putting the existing structure vn a separate lot, or 2. The kitchen will be removed from the existing structure and a variance will be obtained, permitting the exist- ence of the structure as an accessory structure 1or_ated in a side yard, or 3. The existing structure will be razed. As you requested, three sets of construction drawings will be furnished shortly, and we are awaiting Health Department ap- proval of the well and sewage disposal systems. If you need anything else, please call me. B st re ards, Japie~ E. Fitzgerald, Jr. / . a subsidiary of THE PECONIC EASTERN CORPORATION Proper-T Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516) 734 -5800 r~~~i\ ~ ~ I~:~U ~..,,,v.,,,~f51N[LVF~;~~',nir{„',:;,...,-__.~ September 26, 1989 Mr. Victor Lessard, Senior Building Inspector Building Department Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Application for Daniel Jacoby, SCTM No. 1000-125-1-5.1 Dear Mr. Lessard: Attached are three sets of construction drawings (Penny Lumber for Inland Homes, Plan No. 1141F, dated 10/3/88) for this project. Suffolk County Health Department approval of the proposed well and sewage disposal system has been applied for. I will let you know immediately when the approval is received. Be r gards, Jam Fitzgerald, Jr. ,i a subsidiary of THE PECONIC EASTERN CORPORATION 383 Andrews Road East Williston, New York 11596 September 14, 1989 Senior Building Inspector i ~ Building Department APR 2 7 ~ Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 ~s4'~.~ 5 .~.,R,',~~~~,~ZS~kn~6~'.,..,.. Dear Sir: Please be advised that I hereby designate and authorize James E. Fitzgerald, Jr. of Proper-T Services to act in my behalf as my agent in the submission and processing of a permit applica- tion for constrixction of a one-family private residence with private well and private sewage disposal system on my property located an a private right-of-way at Laurel Lake and designat- ed by Suffolk County Tax Map No. 1000-125-1-5.1, and to furn- ish, upon request, supplemental information in support of the application. Yours rely, Daniel Jac y 4 ~E:...~7 .ten 4 a.C~(~-~ ~~X..SC. 1 / kV Proper-T Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516) 734 -5800 May 14, 1990 Mr. Victor Lessard, Senior Building Inspector Building Department ~ ly9® Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Buildina Permit No. 189932: Daniel Jacoby Dear Mr. Lessard: Mr. Jacoby is concerned about what he perceives as being a vague agreement concerning the fate of the existing dwelling on his property after the Certificate of Occupancy is issued for the new home which is the subject of the present permit. T have explained to him that you and I discussed this matter fully on September 21, 1989, and the content of our 'phone conversation was confirmed the next day in my letter to you (a copy of which is attached). We understand, of course, that the wording of the issued Building Permit is not intended to be anything more than a notice that the situation of two dwellings on a single lot is not permitted use under the Town zoning regulations, and that the matter must be resolved upon completion of the new home. It is important however that we have your agreement that the resolution of the situation may take the form of any of the options listed in my 9/22/89 letter to you or. We just want to keep all the options open at this point, but we assure you that the matter will be resolved promptly upon the completion of the new home, and it will be resolved in an appropriate way in accordance with the laws of the Town. As always, I appreciate the cooperation of the Building Department and your interest in this project. Best regards, James E. Fitzgerald, Jr. a subsidiary of THE PECONIC EASTERN CORPORATION Proper-T Services POST Off/CE BOX 617, CUTCHOGUE, NEW YORK 11935 (516) 734 -5600 September 22, 1989 ' Mr. Victor Lessard, Senior Building Inspector Building Department Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re• Application for Daniel Jacoby SCTM No. 1000-125-1-5.1 Dear Mr. Lessard: As you requested, the following information is provided to clarify the referenced application, and should be made a part of that application. It is agreed that upon the issuance of a Certificate of Occupancy for the completed new residence, the question of the structure now existing on the lot will be resolved in one of the following ways: 1. A set-off will be made, putting the existing structure on a separate lot, or 2. The kitchen will be removed from the existing structure and a variance will be obtained, permitting the exist- ence of the structure as an accessory structure located in a side yard, or 3. The existing structure will be razed. As you requested, three sets of construction drawings will be furnished shortly, and we are awaiting Health Department ap- proval of the well and sewage disposal systems. If you need anything else, please call me. Befit re ards, ~ James E. Fitzgerald, Jr. a subsidiary of THE PECONIC EASTERN CORPORATION W ~ 1~1 ~ NMI Jim ~ ~ , ~ ~ ~ D 7.~I~W~~ I` r~. P ~ "t ~ iy3 ~ \ ~ ' 1 X11 J 1 ~ l ~ ~ C ~ ~ ~ ; ~a ~ a v ~ b D p . A ~ : ~ A v b ~ c W CG p r ~ ~ ~ ~ r ~n c ~ ~ N ~j ~ A 4 n c ~ ~ ~ v r'~. ,b ~ _ c ~ O G ~ ~ ~ ~ o 0 o b b o o M ~ , , G G ~ G c G L' ' ~ 1 ~ ~ ~ CD h ~ ~ o r o ~ ~ ~ ~ o ~ cq a~ ' r~ ~ o v 9F2 ~ l ~ D C.. m ~ m ° ~ ~M ~ N M 1J 1 2~~NBER ~ t' ~ a; ~ ~ ' „ BOARD OF HEALTH ~ 3 SETS O~LANS FORM N0.1 SURVEY TOWN OF SOUTHOLD CHECK '.:?S . BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL MAIL T0: Examined • l 19 7 ~ APProved . 199Q Permit No..l ~q9.~'~., ` . , ~ :F t i Disapproved a/c ~ ~ qq ~~4~~~ ~ b (Building Inspector) ' APPLICATION FOR BUILDING PERMIT , - Date .September 21 • • 1589- . _ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ' shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and of r licable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remov a lition, as herein described. The applicant agrees-to comply with all applicable laws, ordinance , uildin code si code, and re a ' s, and to admit authorized inspectors on premises and in building for necessa inspe s. (S• R ture of applica r name,~i a c poranon) James 3. fFtzgerald .J . P.O. Bex 617, Cutchesuo, 7 11935 (Mailing address of applicant) ' Pheno:(516) 734•S8G0 State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. Applicant is the agent of the owner. See attached letter. of. authorization.•• Name of owner of premises . ,Daniel Jacoby • • , • , , , , , , , , , , , , (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . ~ m!~'~'l Plumber's License No. • Not known Electrician's License No. Not known Other Trade's License No. N~A • , , , , , • . I. Location of land on which proposed work will be done . . 3 ohs' ..No number......... ROW, of~.~C~x'k~tP. Z7$r18 ................Ta~Rx@1......................... House Number Street Hamlet County Tax Map No. 1000 Section ?.2~ Block 1, • , , • , , , • , . • • Lot 1.......... . Subdivision N/A Filed Map Na:: Lot . .......(Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Private, xesirl.ence . b. Intended use and occupancy .....Priv,~t,~, x;QSid.epee 3 I Nature of work check which a + ( pplicable): New Building Addition Alteration , . Repair Removal , . , Demolition Other Work . D p .r ~ ( escri lion) 4. Estimated Cost X50„000............'............ Fee . 192, 50, 754, sf . (to be paid on filing this application) 5. If dwelling, number of dwelling ;units ....Qr36.... Number of dwelling units on each floor ,One , , , , , , , , If garage, number of cars N/. A . i 6. If business, commercial or mixed occupancy, specify'n~jturc artd extent of each type of use ....:.N~A.......... , 7. Dimensions of existing structures, if any: Front ...~,N? A:,~~ , ,,Rear Depth'.', , ; , , , , , , , , , Height ...............NumberofStorics........................................'......,......... Dimensions of same structure with alterations or additions: Front Rear . Depth . , L;;„~; :4. .Height Number of Stories , , , , , , , " 8. Dimensions of entire new construction: Front ....ZO Rear .....7~.'....... Depth 3,0,! , , , , , , , , Height ...1$ ~ Number of Stories Q?'1~. , i ' . . 9. Size of lot: ~'I:ca~€ ~ 0. ~,4x@e~..+......... Rear Depth , , . l0i Date of Purchase Name of Former Owner ....James, Mulvihill , . 11. Zone or use district in which re p miles are situated A-C . . , 12. Does proposed construction violate any zoning law, ordinance or regulation: .....~9 . . 13. Will lot be regraded ......X@5.,..~t}. s~al~, ,par;t,1Vi11 excess fill be removed from premises: Yes % No ~ 14. Name of Owner of premises .~~?~:1~1. J,~COby, , , ,Address 383 .Andrews, Rd, ,phone No..742^.3651, , , , , Name of Architect N~~ . . . . . . . . . . .Address , ,East Willistp~ne No.. . Name of Contractor .Inland Homes ,Address ..Phone No.. ~ . 15.Is this ro ert loco p p y led within 100 feet of a tidal wetland? *YES.X..NO.... *If yes, Southold Town 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 whether interior or corner lot. See attached survey.' A--rchitect's/construction d-ra~rings will be submitted upon request. A small building, left from the Camp MoMoWida days, is on the property now and is being used as a temporary residence, on a part-time basis, by the owner. It is proposed that the owner continue to use the existing structure until the riew residence is completed and a C/0 issued. At that time the now-existing building will have the kitchen facilities removed and be considered an ',accessory structure. The proposed construction, which will be wit~,in the building envelope indicated on the survey, is mare'than:100'-from the.freahwater wetlands, and thus is outside the jurisdiction o~ both .the NYSDEC and the Southold Board of Town Trustees. ~ ~ ' STATE OF NEW YORK, S S COUNTY OF ...SUf~.41t:..... . Jr. .................g...... James E. Fitz Brag d, . , , being duly sworn, deposes and says that he is the applicant (Flame of individual si n Ong contract) above named. He is the....agent............. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and be ief; and that the work will be performed in the manned set forth in the application filed therewith. Swom to bef/ore me this ...~1. ~ ......day o 19 Notary Public, iu~.. • County ~ _ SUSAN J. NAGY O ` Notary Public, Stato of New York . . . ` ~ . No. 41395'35 Qualified in Suffolk County {Sign lure applicant) Commleelon Expirao May 26,19x( L, ~ I ` ~ .f ' _ ~ THE WATER SUPPLY AND SEWAGE DISPOSAL FACILITIES \ \ ~ - FOR ALL LOTS IN THIS DE VELOPMENT CO MPLY WITH THE {nrbe~ 9.a~e \ ~~uu Q STANDARDS AND REQUIREMENTS OF THE SUFFOLK COUNTY\ DEPARTMENT OF HEALTH. °f9°/' \ r' ~ s%n~r L S. - S°LNO ~ 4LFN`e o' ' _[LYeund lvvleY , µ ' ~ i gIII 9fOA~V ~ ~ o \ ~tw ,6`ry\ ~ G,9 sy.p.m. _ KEY MAP w\ o1y ~ 9 ~ subme sib/e ° ` a ° ~ TYPICAL WELL DETAILP~mP I"= soo' 0 D o m owt ~ 0 23, t \~\~O ~ PECONI ~ ~`+o \ ~ ~ 02 p51 ~ o •Q N S C 0 y a. - ~ ``4 w °sh \ 1 ~ \ \ ` / 09 _ n N 9~ ~ deCC ~ ~~o~` /T' f r< / A I p9o'Y6~ \ 'q~q.18 \\'1` ~w s ~ we// e \ ~ \ ti \ ~oww weu I d- I \ n E O , .N ` \ ~ A\ ~ ~N.' home ~ \ -/o a s N, gz7 gT' ~ ooI°~ ~ I ~ N tio- ~ \r4'~e. ^~'"is o- 3 - 2$ ~ \ A N N: l ~ \ P ~ \ ~S ° {lOU3C 3 ~ 4 \ _ W IN \ / O ~ M ~r y 6$ 90 \ Z \ \ ~ N £ . m A ecte5l I ~ \ ~ T/,SPA ~ \ - i \C pa4~ii7 ~ ~3 ~ 1 ~ z '00. ~ \ ~ ~ zl .n ,p \\eut~lyE 11 \9 \'~,~~'1 E,pV id~A7~-~, O ~ 5mr.' sepfi'c {n..L'_ _ - 'm 0. ~ \ \ N u Po55100 F 1~;i 9ll>~~ I ~ 5 h s 3~ K I \ 1 4 ~ NOi lmo~'S~ I / 35,-'~ \ 'b I Ej b~ZS sni \ / - I \ \ w remchin ~ oh'~y m w' w m 5~ E ~ = ~ ~ \ ~ \ ~ poo/ 9 Pee/ / \ ~ \ wo_1\ 68D% OIL/ 1 1 I 'ry'3~ Z \ ~ ~ ~ 6eD 09i 1 1 \ T.H. \ key _y x/35 / ' ~ \ \ II l ~\`/I f ~C R O A D ~ / LQ~R F~ / ~ z~ m. \v v g60~3t~ote~ I II ~ ~I ~ b o ~ fl'~ il~ ~aKE _ ~ \ \ \ to t\e I I / I~ 4 ~ TYPICAL PLOT PLAN \ ' A A ~ ~V II ~ I ~ ~ ~~iih sd Yo-de • ~ \ \ \ ` / / I I ti 0 imm. /m.n ~ / 0. 2'max. 2'max / , C \ \ \ _ ~ v/ I / ~h p \ ~ a ~/s'~ lie/' ~ ~ \ ~ I ~ ' ~ ~ ~ _ , / 2\q ~ i~~y„qP,,, SUFFOI!( COUNIY DEPARTMENT OF HEALTH SERVICES }1 ~ ~ ~ \ y`~' TESr HOLE s Pn~i ~e ~ FOR APPROVAL OF CONSTRUCTION OF 9 \ J 2 ° mgle family Residence Only p 9\9 G~ DAPN DflOWN DATE ` SO- IO ~ \5p LOPM 6.. _ 2inL ~°uncC wo-/er F. N0. APPROVED m p \ wnowM suTr TYPICAL SEWAGE DISPOSAL SYSTEM ' m O \ LOAM E%PIRES TWO YEARS OM TE OF APPROVAL hh °5 ° 1 z' - -y 9POWN LOHMV 1 RECEIVED SILT ' ~ ~ PPLEaNDWX PROPOSED RESIDENCE ~EC197989 MEDI u M TD FOR ~ J'E• FITZGERgL p QI 3t SAHO+E ' ` ~2° iT DANIEL JACOBY I f;,~ pg° AT MATTITUCK 5 r TOWN OF SOUTHOLD BLDG. ZONE DISTRICT ~ A - C SUFFOLK COUNTY, N. Y_ 5'~ N 2 1000 - !25 - GI - 05 ' > ~5 OWNER: SCALE I° = 100' DANIEL S.JACOBY OCT. 29 , 1986 383 ANDREWS RD EAST WILLISTON PARK N Y sIU LY 2O, 1988 ~yOP OCT. 27+ 1988 , (PROP. SET OFF) _ }n~~ ~ P CONTOURS AND ELEVATIONS ARE TAKEN FROM'TOPOGR/DPHICMAP~ 'F' P\ FIVE EASTERN TOWNS" 6~/i~.~~J ~ N.Y. S. LIC NO. 49618 ~ ° r~1~ PE ~ ~ ~ RS 8 ENGINEERS, P. C - ~ ~ ~6,~ P BO zi ly .ym ~f ~ cw. MAlll' ~M. I ° ~ kEV/SCD 9/ B/~ 9 sFA~ q c G T 8011T ~ N~ 9 71 ~ REV/s EO / 9 ~'n0 ' x- a96 ~OQfvilep 2/9/87 ~ F 86 - 612 + ~ ~ f ~ ',i~~~:~i f~ ~ ' ;n ~ ' ~ ~ ~ ~ THE WATER SUPPLY AND SEWAGE DISPOSAL FACILl TIES W s - _ FOR ALL LOTS IN THIS DEVELOPMENT CO MPLY WITH THE \\\VVV{{{~'~'~' STANDARDS AND REOUfREMENTS OF THE SUFFOLK COUNTY {n'+haat qr`~`a-` Q - DEPARTMENT OF HEALT/HJ.~/~~j fo9a/q~e 9Q~~ D d Nl'E Aeon d /VO/B/ ~ _ G~ aw5 : \ ~A a ~ oyy \ X940 9~/ 59.P ~P KEY MAP s mbm ersib/e _ o y \ ~s o \ ~3S so TYPICAL WELL DETAI~B I"= soo' pECONIG ~?o _~~io&\ ~~~-\\02 05 000•, 4,4 , { a ~\t B ~ F kF . pl/0I F 0µP. ~,n e~f ~a y \ \ ~ S~Gga ' - HOME y^ ~ _ 2d \ I'~~. ~~~n~~\~(xddload - °~d' ~ !~2 /7'04~1r ' v~ / I ZBD.34\ q~q, 1B \ \ ,y. O ~j`~ ~ smrn~ M e \ ` \ ~ v'1/ / \GqQ WB// WaI/ ~ ° F ~ \ 1 ~ ~ sly \ / 'ir 0 \ ~ ' ~ _ _ _ e 23 59 \ ~i• o 1 ~ b/aye .ru"~, / '/o s~\ _ N' T6 ~ et' \ - o °a .To / ( /~~y\ N 'y~' o~\°//\\ / s, I TPA 30 ~`2 ~ ~ \ row IN N` - _ 5 1\~~ ^o-~c'1'o- / ~ 1 ~ - ^O hooye 3 r 5 ' a`b~. _ ~ ~ ~ 1• tie i~aE 1 1 ' ° I `Za smv, ~ ~ \ - ~ u W llS Y s. `e > ~ ~ ~ _ ^ ? u° ~g f I 52 y9 ~ y , o- ~ _ ° sepfc {ank- ~ s~n,r m_p. - c ti N \.POSS\00Ff 1 /~5z 9~ ~ ~~'1 N)~ ~ \2~~_ (0 yra- ) \ /L I` / - ~ \ m~lm o. 'S~ / 3 \ 'ro ~ o "TS - sb; .._/rmch.d9 ~ /anon.%+9 / ' \ \ ~ \ u,rv u.m o095%~ \ \ \ n~A~ ~ _N 3P poo/ Pee/ ~ \ \ w o_ eB/ 0 W. 1 1 \ _ / Z ~ ~ \ £ I \ 6Bo 09 5 1 1 7H., l ~ ` _y ~~35 ~ ~ z 'N 8.6p23i~etBg ~ )i ~ `f ~~h o /~~V~ _ R o A o I LLQKEe~ o \ \ \ tO t\e I I f"\ j I ~^a ~°j~'/JU ~ ~ TYPICAL PLOT PLAN '~f/` i mn. r ~ - ~v v,v 'r ~y/ ~ J~ Q ~ , ~ ~ ~ i/ \p/. o mde wN/anrn. 'P h- 2 R 4. /ea~hhq pool ~ 90o al ~ ! \ \ ~ TEST HOLE srp~~9~ ne i \ \~nd. a~92 onNx Bxowx ~ . p man o~ ° ~ ~o \~A LOAM, 6„ _ Z~mL /oond wo-1er ' m o ~ BBawx aLTY TYPICAL SEWAGE DISPOSAL SYSTEM ~ N ~ ~ ~ 1 l IOAM z, M5 ) ° BROWN LO<MY - ~ ~ d SILT ' ~ anLeBBawN PROPOSED RESIDENCE ' NEDIUN Ta ~ ~°„o'E ~ FOR ' 17 DANIEL JACOBY m i"°" A9° AT f1AATTfTUCK y. BLDG .ZONE DISTRICT ~ A C _ TOWN OF SOU THOL f) - SUFFOLK COUNTY , N. Y_ ' 25~ IOGO - 125 - 01 - OS N p y5 owNER: SCALE I° 1001 " DANIEL S.JACOBY OCT. 29 1986 `~a.~ O 383 ANDREWS RD AAitj . !f/"c,`~hc r"e 'SG9\, ~ p• EAST WILLISTON PARK,N Y. rTU LY 2O, 1988 ' '/4; o~`N F~ T~'CF, Lt<`t OCT. rLI s 1 988 , (PROP. SET OFF) 1 ;;a ~ A„~\",.,~~,p 9 ~ ,~n~. ~ CONTOURS AND'ELEVATIONS ARE TAKEN FROM~TOPOGR.4PHICMAP• MAY 3O, 1990 foundation location ' q ° ~ Q~ FI VE EASTERN TOWNSa 4 .Y. S. LfC.NO. 496f 8 ~ ' PECO OFS OR$ B ENGINEERS, P C. ~ ' (516') 765 5020 P.O. BOX 909 ~r.. MAIN ROAD IQEV/SC4 9129/89 SOUT HOLD, N,Y. 11971 $EVis ED 9/l8/8y - " r Rfvi3e0 2/9/87 ~ ' 86 - 612 ~s THE WATER SUPPLY AND SEWAGE DISPOSAL FACILITIES FOR ALL LOTS IN THIS DEVELOPMENTCOMPLY WITH THE w!n.+hed 9,- STANDARDS AND REQUIREMENTS OF THE SUFFOLK COUNTY - -� DEPARTMENT OF HEALTH. e2ya.n H. S. REF. NO. 89 - SO - 107 Sp`N O 4yFN`e 0 \ f 3' a P 7 F '9G�� subme sib/e KEY MAP TYPICAL WELL DETAI LPUmP "= soo' / FECON)C -aoyo`" � \ 1. -mss g02 p5 „ \ O°c�F g. C4kF N/0/ f CORP VU'�anl 68°Ogg / HOMES - 9^ --zo \ ' ��.-\ \ „gid �°°d , /52 /x,04 H o/X`: / ° o ° Ia w_ _ ` y < n _ I 10 e t -2a e° O O_ \� �p0, \ \ \ _ - mI•` w p5510 OFF 135 i�Zy�, .. ^' y^s a \\ ° 3 IF /ao.ah G 4 Iv� ry 2 \ \ \ \ m £ IVN>6. III II \\�THIH. II R o A 0 I / L a n a e '- z II LP KE TYPICAL PLOT PLAN to 12c" \ \ \ \\ I I 1 / •1\' �n.ihaow rade // �`.�-_-- J S:n.n Joo aq<r Iilh _ sides p \ 2.4 G\V TEST HOLE DARK BROWN 'xl m00 (19 ' G LOAM 't:mN lOUnd WP-{El' LINI SBtV}CES \ BROWN SILTY TYPICAL SEWAGE DISPOSAL SYSTEM Ln O° \ LOAM Z' \ BROWN LOAMY ILT PALE BROWN PROPOSED RESIDENCE MEDIUM TO FOR COARSE 1 1 V' SAMO DANIEL JACOBY 20 17 _ >0. Qa°Og AT MATTITUCK SUFFOLK COUNTY OLPARThAR f OF 101-11i �CdiiCES - �CT01nIGLgF�yuvoI�ELualcnaaa � . � TOWN OF SOUTHOLD vat s REF. rac. /'' j C7 BLDG . ZONE DISTRICT : A —I C The sewage disposal and water suorly fo.fl*0s for dns SUFFOLK COUNTY , N . Y_ location have been impEmed by U.,c Oep .Inventand/or g other egencle and {pund to Le se.tlstactory. - 'Z 10 G 0 - 125 - GI - 0 5 Chief of Ourkau o Waste a11t I _ 5 OWNER' SCALE I 100 DANIEL S.JACOEY OCT, 29 1986 393 ANDREWS RD �U LY 20, 1 988 p'O EAST WILLISTON PARK NY. ED f,AND Sel O OCT. 27 , 1988 , I PROP. SET OFF ) S. MET LFo „0' CONTOURS AND ELEVATIONS ARE TAKEN FROM � TOPOGRAPHICMAP - MAY .30, 1990 foundation I0001ion FIVE EASTERN TOWNS” Sept. 24, 199011 final) a + .Y. S . LIC . NO .� 49618 Al PECO �Z'^ 10 RSr. P F NE io 516 ) 76 a -_.. � 20 P. O . BOX 909 MAIN ' ROAD kEv/sG`D 9� ��9 SOUTHOLD , N Y . 11971 REws ED 9 ,¢fvi3ep 2/9/S7 86 - 612 a III 1 ID, oilz 8 PLUMBING OCCUPANCY OR ALL KAIMA W M+c APPROVED AS NOTED USE IS UNLAWFUL ammo DATE: o BR# ,y 3 a� WITHOUT CERTIFICATE NmIFy BUILDING DEPgRTM OF OCCUPANCY 765-1802 9 qM TO 4 PM FOR THE _ FOLLOWIN INSPECTIONS. t 9R.1 PLUMBER CERT/F/CAT/ON 1. FouNI ION ON LEAD CONTENT BEFORE I 1L � • - TWO REQUIRED .— ,�� � �' � - PQ FOR PO ED CONCRETE (I,j•r S'�f_,` CERTIfALA' TE�OCC(Oi1NCN 2. ROUGH . FRAMING & PLUMBING ! W W $O"W~AV 3. INSULAT1 N t_ ' `~�I 4. FINAL - CONSTRUCTION MUST Phone 4774)400 �. `` Main Road BE COMP ETE FOR C.O, EX fO�/N���rIQ ALL CONSTUCTION SHALL MEET GPMNPORT, N.Y. 11944 THE flEQUI EMENTS OF THE N.Y. STATE CO TRUCTION & ENERGY -= -iz-�p N - - CODES. RESPONSIBLE FOR - til- m 19 IIINy DESIGN ORC ONSTRUCTION ERRORS J o o * g 99 NSM Lori to %1 a O r ALLlE_-- - ---- -- - --- -- Tr lzt., I (,UT OJT' FoQ- $,•II- Io i ,Fr - 13( �,y°st�At I 4a cu r — ..- J - - 3- 2xlc — O $T�. - IL i 0 I _b _ � _ L - � 14 A]6 7 1 1 L l i "Z I - p Phone 477-0400 Main Road III GREENPORT, N.Y. 11944 I 9 _--.__—_.__ _ -_ -_-- - - ___. ___ -- -- - - DWG. r6 U N b -�< - - ---- --- -------�'t /n - - ' Zor. PLAN Nn _. I , I \ _240 am , FiDcr' _ _ ._ —_ DECK - - - - of ?'saa j I 1211' - — N Ali I , i1�ROVIut: VTER10K VE RFY per, DUCT INTO T(+E FI�,E Pc,nca b m r N MASTGF� BIC) KOOM � I �Inl a 7- .CIL 2-2X12 - _•_ ; .. II Z-y X40 Mgsrr_2 1 LL, U Szi - 3066 5�y' DECKING I :I' n , COUA�Tk� STOMA � _6 Y - - — z 1 N 126 L� — GvLN - o �n�14 CW14 �� � S i ubY 3, ^ ��0 r S-z I - � - .� m �41^'z ShiDWF2 Z 2'4+ cwl'1 � I GYPS�H � 3' 9 r -CJ_e) b- 16,49- Nuwy, r-eoe, I1, CEILING I N `2Al y Qvd LJ� I Phone 4 Z 2 p Main Road GREENPORT, N.Y. 11944 I CO Q oTC 777 I F I to - ni I .,.v- I1) t U NNO. I53 KI- SCALE f'C l St' It' `ig1', sh I J1 14 US*ge-o 5.. I I cE/. •CR d'DLE -- Q CL vt:11 `f0 - --a / SIN i o'. —--- - - -- I S\OiZAC�E 'vl � fTI m II i II I I j I I� r Phone 477-0400 I .., Main Road GREENPORT. N.Y. 11944 � I .I : �n� '•lir �o� � 3� ,j_ ni-� JNN, 2 0 FLR oJ� _ r� C /i'li i \ j I I t I � '� t'r--,cess Sfax �N2Ly I _ W MIT II I i ! / 2 - l J � UJ i LI ' I ' ��'FSUry CGILI hl6 � i D ' �� STUOV ID 9 gn.rs ' FlNliil x ,fz' I -i l:r r,• n_ SI,-: aA,. — - -- - � - ' �- - - - � - - -- - - . yll'j <'e�r l'r UI�,EhI�,<.,: SE5 r uUOA MM1 jL L J f: tlo i--�. IMP _ T, IN T W n L'. Phone 477.0400 a �p�' Main Road f--.ETC. COW. ok, I _ ' LA tJ- A4rb'I� - � !2' '-----� `_ GC,` . 1i944 -- 8 GREENPi)RT N.Y. - Ic ✓ � � �tv1-AIL=� - � 1 � JOB ,L 1 � IN(o --- PLANO � �� 1e GC'4r ' arcs