HomeMy WebLinkAbout27461-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28191 Date: 01/29/02
THIS CERTIFIES that the building ADDITIONS
Location of Property: 3329 MANHANSET AVE GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 36 Block 2 Lot 23 .3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 27, 2001 pursuant to which
Building Permit No. 27461-Z dated JULY 10, 2001
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 DECK ADDITION WITH INGROUND SWIMMING POOL TO EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to THOMAS E. & PATRICIA F. KRAUS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-57964 12/27/01
PLUMBERS CERTIFICATION DATED N/A
Authorized gnature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 27461 Z Date JULY 10, 2001
Permission is hereby granted to:
THOMAS E KRAUS
PO BOX 336
GREENPORT,NY 11944
for
DECK ADDITION WITH AN INGROUND SWIMMING POOL AS APPLIED FOR WITH
TOWN TRUSTEE ' S AND NYS DEC APPROVALS ICLUDES FLOOD PERMIT FEE OF $100 . 00
at premises located at 3329 MANHANSET AVE GREENPORT
County Tax Map No. 473889 Section 036 Block 0002 Lot No. 023 . 003
pursuant to application dated JUNE 27, 2001 and approved by the
Building Inspector.
Fee $ 478 . 60
/YA2tho ' zed Signature
ORIGINAL
Rev. 2/19/98
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00
Date. JAA.1
New Construction. Old or Pre-existing Building: (check one)
Location of Property: ) S /� _ ���
ouse No. Street Hamlet
Owner or Owners of Property: l l o Af, A VS S
Suffolk County Tax Map No 1000, Section 34 Block Lot3.
Subdivision Filed Map. Lot:
Permit No. 2 ],�� Date of Permit. Applicant: p Wj, F. ye u C
Health Dept.Approval: Underwriters Approval:00 509
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ J5 00
b O 8 Q Applic Si ature
Co 2"� 19
TME NEW *YQRK BOARD OF FIRE UNDERWRITERS PAGE '
r1205089 BUREAU OF RL40TRICITY 3(,�- - A3,J
I 40 FU4TQN $T09fT, NOW YORK, NY 10038
Date
DECEMBER 27'2001 Application No. on file 13554001/01 N 579649
THIS CERTIFIES THAT �Iq(p I
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
TOM KRAUS, MANHASSET AE, GREENPORT, NY
in the following location; ❑ Basement ❑ 1st FL ❑ 2nd Fl. OUT Section Block Lot
was examined on DECEMBER 07,2001 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES F 8 AN 8 COOKING DECKS OV S OISH WASHERS EXHA ST FANS
OUTLETS L 5C(NT OTHER AML K.W. AMT. K.W. AMT. K.W. AML
1 2 1
DRYERS FURNACE MOTORS FUTURE 11PPLI.ANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYYSTEMs
AMT. K.W. OIL H.P. 4A$ H.P. AMT. NO. A.W.9. ALIT. AMIP. AMT. AMPS. TRANS. AMT. M.P. NO.OF FEET AMT. WATT$
1 20 1 40
SERVICE DISCONNECT NO.OF S E R V I C E
METES) NO. CC CONp. A.W.G. G.
AMT. AMP. TYPE EQUIP, to SMI 1 E$W 3 EJW 3 E aW PER• OF CC.CONO. NO.OF HI-LEG OF NI-LEG NO.OF NEUiRALE OF NEUiRAI
OTHER APPARATUS:
POOL-1
G.F.C.I:-1
*(SWIMMING POOL) This certificate
covers compliance at the date of
inspection only. Because of unusual
environments it is advisable to
have frequent test/and or repairs
made by a qualified person.
<<< Continued on Page 2 >>>
GENERAL MANAGER
Per
This C"ftgt•Mt not to oq*r"In any mgnfNlt�nitlrn tQ Ih QINO!of fl1A 40ard M Inaorroct.InlpRcfon may be Identified by ttwlr credenflCla.
-000Y 1014 BUILDING DEPAPITMIENT. THIS COPY 0, CERTIFICATE MUST NOT BE: ALTERED IN ANY MANNED.
i
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
1205089 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date DECEMBER 27,2001 Application No. on file 13584001/01 N 579649
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
TOM KRAUS, MANHASSET AE, GREENPORT, NY
in the following loegeion; ❑ Basement Elist Fl. El 2nd Fl. OUT Section Block Lot
was examined on DECEMBER 07,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXYURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES FNC-AMXS(XNI FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. M.P.
DRYERS FURNACE MQTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
AMT. K.W.' OIL N.P. GAE N.P. AMT. NO. A.W.G. AMT. AMP, AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT 10.OF S E R V I C E
METip. . .- NO.OF CC COND. A.W.G. A.W.0. A.W.G.
AMT. AMP'. TYPE EQUIP. 1/2W 1 �W a JW J 0 4W PER OF CC.GOND. NO.OF NI-LEG OF NIAEG NO.OF NELRRAIf OF NEUTRAL
OTHER APPARATUS:
TOP GUN ELECTRIC LIC.#5150E L L
P.O. BOX 1464
SOUTHOLD, NY, 11971 GENERAL MANAGER
11
Per
Thh 4RnM1199h mµRl not 91W90 U Qny mpnner,rgf4nT 19 th!*Meg 9!tli9 4ogtd If incorrectinapgcton may bo Idnntlfind by thtilr cndenticlE.
B E A ME THISCOPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
j
Board Of Southold Town Trustees _
SOUTHOLD. NEW YORK
+. PERMIT NO. ... .���e7. ..:. DATE: February.22, 20
THOMAS E. KRAUS
ISSUEDTO ........................................................................................................................................ =
r Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
State of New York 1952; and the Southold Town Ordinance en-
titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS t
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 Feb. 21, .
204.7., and in consideration of the sum of $....00.00 paid by
.. Thomas E,. Krau.&......................
.... ...... .... .... _.....
of ............Greenport................................................. N. Y. and. subject to the
Terms and Conditions listed on the reverse side hereof,
Y of Southold Town Trustees authorizes and permits the following : '
Wetland Permit to install an in-ground swimming pool and
decking. Pool will be 18'-20'X 36'-40' with. 4-6' of decking arou
it. Pool will be protected by child-proof safety fencing.
all in accordance with the detailed specifications as presented in
•the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this dafe.
t Albert J. Krupski, Jr.-Absent
S�FFo��o
Ln
z �
�A -Artie Foster - Absent
Tmsiees
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER EFFECTIVE DATE
r1.-473843613/00001 August 4, 2000
FACILITY/,PROGRAM.NUMBER(S) EXPIRATION DATE(S)
SAPP PERMIT August 7, 2004
Under the Environmental
Conservation Law
TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ■ Permit to Construct ❑ Permit to Operate
❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ Article 27. Title 7; 6NYCRR
of Waters Certification 360: Solid Waste Management
Q . Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9: 6NYCRR
i E Supply 373: Hazardous Waste Management
❑ Article 19: Air Pollution
b ; Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion
Transport Management
❑ Article 23, Title 27: Mined
b Article 15. Title 15: Long Land Reclamation ❑ Article 36: Floodplain
Island Wells Management,
o_._..Art-icle,2.4:. Freshwater.Wetlands..
C1 Article 15, Title 27• Wild, ❑ Articles 1, 3. 17, 19, 27, 37:
t' n
Scenic'And Recreaal Rivers ■ Article 25:. Tidal Wetlands 6NYCRR 380: Radiation Control
PERMIT .I�&Ea TO TELEPHONE NUMBER
Thomas Krrus..
(631) 477-0880
AODRESS'OF PERMITTEE i
;PO Box 336, Greenport, NY 11944
r .
CONTACT PERSON FOR -PERMITTED WORK - TELEPHONE NUMBER
'NAME,ANQ ADORESS OF PROJECT/FACILITY
j Kraus Property. 3329 Manhasset Avenue, Greenport, SCTM # 1000-36-2-23.3
{
f LQCATION OF PROJECT/FACILITY
GQUNTY _ TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold Peconic Bay
i
i 6 DESGR.II T-ION-OF AUTHORIZED,ACT4VITY: CONSTRUCT A GARAGE,A SWIMMING POOL,AND
'OECKINd MORE THAN 75 FEET FROM THE TIDAL WETLAND BOUNDARY.
i !
t
' 4 8y;acceptance off'this permit, the permittee agrees that the permit ins contingent upon strict compliance with the
ECL all :applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as
para`of this permit.
PERMIT ADMINISTRATOR: ADDRESS
Mark C Carrara Bldg. #40, SUNY, Stony Brook, NY 11790-2356
1
AUTHORIZED SIGNATURE DATE
August 4, 2000
r 1. Page 1 of 4
i
NN •
TOWN OF SOUTHOLD PROPERTY..,WORD CARD
OWNER STREET , '), VILLAGE DIST. SUB. LOT
'lOroas Pyr;c.IG Qts Na Cr le -epQ a a- .ie,
F RMER QWNER N = E ACR.
q& 19) �ro4Cos of c - v �� 6
fv_Irnon "ccrccAs S W TYPE OF BUILDING
ES. ,� SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS /z�
a rt d 7 Y r 7 Yf To l\o
1266 '" f.' /,2 a o : ,� u ? o/� 7,rJa1�..¢ J_M `'_ 17
3d r r-e env/
0 Z o o� z :340c) 1 T6 O - :f 6 F acq G 2 r, 3 5 " it'' .' Go
UCS ' I F37,1 an Q
zoo1300 c) 4 T�IInILU
�Ur ts..t Q4c�-
1 Q pvyhl_V L-StI 'k
1---- C6 5 07CCA-
y -L /z oo3 -Cc 7% rQcr s r�oc�
2-
liable FRONTAGE ON WATER27
i
'oodland FRONTAGE ON ROAD '
eadowland DEPT (/�Pt�.
Duse Plot BULKHEAD
rtal
- � �I- � � - iii■■®■■■■■■■■■■■■■■iu■�■■■■■■
• Interiorish
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS• Z,D
/�lizrs G�c
4t-
ZL
�f
a lr.�c
DATE O 2 INSPECTOR
70-1802
suaoINa DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU N
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
04- )4
e�
DATE � INSPECTO
FIEO INSPECTION REPORT BATE
COMMENTS
...n4�t'
FOUNDATION ( 1ST) H—
b �
FOUNDATION (2ND)
Z
ROUGH FRAME u;
PLUMBING
INSULATION PER N. Y.
STATE ENERGY '' H
CODE
H�
1 1-54
r
FINAL 00,
--- ___ ADDITIONAL COMMENTS: v.
1
U
H cl
O U'
H
TOWN OF SOUTROLD BUILDING PBRMIT APPLICATION CIMCKMT
BunMING DEPARTMENT Do you have or seed the following,beim apPly1gg?
TOWN HALL Bond of calth
SOUTHOLD,NY 11971 3 seta of Big Plan
rr�
TEL.7654802 PE Mn NO. v� Check
Sap*Foam
N.Y.S:JLQ
Tr=tees
wed 7 0 �,20 pL Contacts
Approved d 20�_ ., Man to.
Disapp Med a/c-
L31
/cG 3/ — 7 7—
RLdIding I"spwto
APPLICATION FOR BURMING PERMIT.
x
Date. V�✓ `" ��
INSTRUCTIONS
filled in by typewriter or in ink and submitted to the Building Inspector with 3
a.This application MUST be oompletely
sets of plans,accurate plot plan to sola 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 waterways.
o.The work oova vd by this application may not be oommmoed before issuance of Building Permit.
d.Upon approval of this application,the Building Inspector will issue a Building Parmit to the applicant.Such a P=*
shall be kept on the premises available for inspection throughout the work.
o.No binding shall be oocapied or used in whole or in part for any purpose what-so-ever until a C rdficate of Occupancy
is issued by the Building Inspector.
APPLICATION 1S EMMY 1viADB to the Budding Departmart for the issuance of a Building Pemtit pursuant to the
Budding Zone Ordinance of the Town of Southold,Suffolk County,Now York,and other applicable Laws,Ordinances or
Regulations,for the construction of buildings,additions,or altar ions or for removal or demolition as herein described.The
applicant agrees to comply with all applicable laws,ordinances,building code, code,end regulations,and to admit
authorized inspectors-on premises and in building for necessary inspections.
(Sigostme of or=w2e,if a cogwation)
QA*Uiag addreea of Brant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electuc ian,plumber.or builder
`ALAN S 6ww0
Name of owner of premise �IAOWAS Amb �i4(15
(as on.the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer
(Name and titre of corporate officer)
Builders License No.
Plumbers License No. ���
-T
Electricians License No--7-0,
Other Trade's License No. -rb L411.6- l
1. Location of land onmmosed work wAl be dope
whi
kO✓ sir w to
House Number Strood Iiarnl
Comity Tax Map No. 1000 Section � Block Lot 3•
Sub&vision Filed Map No. hot
(Name)
t. State e�nstmg use and occupancy of premises and' ded use o ;ups bf proposed oons�uction:
a. use sad ancy Edt r� �=
-E�ushng °�aP
n ►AfC,16 r-Axilki dWCWIA) d-
b. Iutended use and occapa. cy
3. Nature of work(check,which applicable):New Building Addition Alteration
Repan g emoval Demolition Other Work
p (Descriptio
4. Estimated Cost Fee
applicati°g)
(to be paid on filing this
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, c6mmercialor mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures,if any:Front Rear / Depth
Height to .
Number of Stories
Dimensions of same structure with alterations or additions: Front^ Rear
Height (
c •s Number of Stories;_/Y�
�� r Rear :S6 � Depth 3,;? 1
S. Dimensions of entire new construction.Front
Height /�-� Number of Stories
9. Size of lot Front . jRear
10.)axe of Purchase- _—Name of Former Owner U)/111A, eR ale u s
11.Zone or use district in which premises are situated
12.Doesln°P°sed construction violate any zoning law,ordinance or regulation: Na
13.Will lot be regradd AJ 0 Will excess fill be removed from premises:® NO-
411A 4S
O411A4S 3 Say r�lAwl�, r
14.Names of Owner 04remisp a�1� �r ' A44
e hone No.
Name of Architect AJJA Phone No------------
_____
Name of /A Address Phone No.
15.Is this property within 100 feet of a tidal wetland? *YES . NO
• IF YES, SOUTHOI D TOWN TRUSTEES PERMITS Y BE REQUIRED
e�-�J�J oT �6vT�ol/� ��7;E Ail& IV_ cjF/) 74h4!f) F�il�Giie•J
blFG 4-T
16.Provide survey,to scale,with accurate foundation plan and 4 stances to property lin
cces.
17. If elevation at any point on propetty is at 10 feet or below,must provide topographical data on survey.
STATE OF NEW YORK)
SS;
COUNTY OFF&)
J h 6 m A S , 1��A S being duly sworn;deposes and says that(s)he is the applicant
(Name of individual signing conhact)�a-bQove named,
(S)He is the
(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 belief,and that the work will be
performed in the manner set forth in the application-Mod therewith.
Swornto,l�efore me
160 day of 20.Q4—
j
Notary Public sip
i of licant
LYNDA M. BOHN
NOTARY PUBLIC,State of New York
No.01 806020932
Qualified in Suffolk Co
u
Term Expires March 8, 2016
Albert J.Krupsld,President g�FfQ[�► Town Hall
James King,Vice-President O� C 53095 Route 25
Henry Smith P.O.Box 1179
Artie Foster p _ Southold,New York 11971-0959
Ken Poliwoda y
p Telephone(631)765-1892
Fax(631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 20,2001
W. Thomas E. Knm
3329 Mudwaset Ave. -
Greenport,NY 11944
Re: 3329 Manhanset Ave.,Greenport
SCTM#36-2-23.3
Dear Mr. Kraus:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday,December 19,2001:
RESOLVED,that the Southold Town Board of Trustees APPROVE the Amendment to Permit
#5275 to erect a black chain-link fence(approx. 440'),4'high around the backyard for pool
safety.
This is not a determination from any other agency.
If you have any questions,please call our office at(631)765-1892.
S'ARK Tt y,
e9Z
J.Krupski,Jr.
Pres dent,Board of Trustees
"Ims
I
• Albert J. Krupski, President
0 STown Hall
� CG
James King,Vice-President 53095 Route 25
Henry Smith P.O.Box 1179
�
Artie Foster �� � Southold, New York 11971-0959
Ken Poliwoda �y �t
Telephone (631) 765-1892
'-1Q1 Fax(631) 765-1366
BOARD OF TOWN TRUSTEES
February 22, 2001 TOWN OF SOUTHOLD
Mr. Thomas E. Kraus
3329 Manhanset _Avenue
P.O. Box 336 '
Greenport, NY 11944
RE: 3329 Manhanset Ave., Greenport
SCTM#36-2-23.3
Dear Mr. Kraus:
The following action was taken by the Board of Town Trustees during its regular meeting held
on Wednesday, February 21, 2001 regarding the above matter:
WHEREAS, THOMAS E. KRAUS applied to the Southold Town Trustees for a permit under
the provisions of(he Wetland Ordinance of the Town of Southold, application dated February 1,
2001, and
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
February 21, 200-1. 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 structure complies with the standards set forth in Chapter 97 of the Southold
Town Code,
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 approve the application of THOMAS E. KRAUS to
install an in-ground swimming pool and decking. Pool will be 18'-20' X 36'-40' with 4-6' of
decking around it. Pool will be protected by child-proof safety fencing.
BE IT FURTHER RESOLVED that this determination should net be considered a detern.ination
made for any other Department or Agency which may also have in application p�,nding for the
same or simi l ar project.
Permit to construct and complete project 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 inspectijns ar,. required and the Trustees are to be noticed t.pon compietioi; of said )roject.
Fees: None
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/lms
cc: DEC
Building Dept.
1
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CONTOUR LINES ARE REFERENCED TO N.G.V.D. I ®F NEW YQ
. tt. to tie /ne SUFFOLK COUNTY,TOWN OF SOUTHDLD �
q N. Y. �P orMeT�
AREA = 43240 s
ANY ALTERATION OR ADDITION TO THIS SURVEY /S A VIOLATION 1000 - 36 - 02 - 23.3
OF SEC TOY 7209 OF THE NEW YORK STATE EDUCATION LAW. ,Scale 1" = 4p' * 4'���✓j'�' O
EXCEPT AS PER SECTION 7209 - SUBD/VISION 2. ALL CERTIFICATIONS Via_
r1FREON ARE VALD FQQR� THIS MAP AND COPIES THEREOF ONLY IF A,�
14
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR /V/a_/ ?Q, 1988 NAL Y4ig �` 0. 496/8
NHOSE S/GNA RE APPEARS HEREON.
MAR. 20, 2000 Geo 0 o Zc�Oe S �.o� F�rrn 3,610 3 o/Xo G ECON/C SUR te
uDITIONALL Y TO COMPLY WITH SAID LAW THE TERM AL TERED BY APRIL. 2I, 2000 (revlS/on 1 _ ,.
i JST :3E JSED BY ANY AND ALL SURVEYORS UTILIZING A COPY (63/) 765 - 5020 FAX (631) 765 - 1797
r -WOThER SURVEYOR'S MAP. TERMS SUCH AS 'INSPECTED, AND MAR. 19, 200/ (Prop, yor. SO set) P. O. BOX 909
��fOUGHT- O-.ne c aRE NOT IN COMPLIANCE WITH THE LAW. Apr# 9, 200/ (loundolionl /230 TRAVELER STREET
AP"' /2, Zcb!(aoroc, SOUTHOLD N.Y. 1/97/
88 - 337
I LABOR
TOPCAP RAIL �—— CCMPL,Y WMj CHAPTER ss it
RAIL glgii FLOOD DAMAGE
SOUTHOLD' TOWN COD TION
E
IST y .
RAILING r e
GUARDRAIL POST {
CLEAT— �' Cj• L ; �� ;Y ENDOIST
,sq v BRIDCI�( it^� >
RIBBON , �1�1���� �. ' BEAM r>` T J�
row ,T BOARD
STRINGER POST
\ CONCRETE
FOOTING
o. � / ✓��Y -'�'�C � r:. Vit+'"` .
"IMMEDIATELY"
ENCLOSE POOL TO CODE
AF'". " '�` AS NOTED UPON COMPLETION
DATE: �� � R a #
BEFORE'WATER'
FEE: !f so_ Ry.
NOT'FY .DEPARTMENT AT
76 4. PM FOR THE UNDERWRITERS CERTIFICATE
FO; 4' ; 7�ONS: REQUIRED
1 i ?NO REQUIRED
':RETE
2 : ,a :l i :3 & PLUMBING
3 �-
4 TRUCTION MUST
F R C.O.
L — SHALL MEET
,_S OF THE N.Y.
I 'ON & ENERGY
"'�NSIBLE FOR
;,,CTION ERRORS
�i /'�� S•"J� /��Ca tt.+.J �ui,rS /{� i!�far��rF,�,
/�f—�• T3f 1iZ t
APPLICATION #
PAGE 1 of 4
TOWN OF SOUTHOLD
FLOODPLAIN DEVELOPMENT PERMIT APPLICATION
This form is to be filled out in duplicate.
SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sign):
1. No work may start until a permit is issued.
2. The permit may be revoked if any false statements are made herein_
3. If revoked, all work must cease until permit is re-issued.
4. Development shall not be used or occupied until a Certificate of Compliance is issued.
5. The permit will expire if no work is commenced within six months of issuance.
6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory
requirements.
7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable
inspections required to verify compliance.
8. I,THE APPLICANT,CERTIFY ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO
THIS APPLICATION ARE, TO T OFO'�VLEDGE,TRUE AND ASU TE.qQ
(APPLICANT'S SIGNATURE) DAT U
SECTION 2: PROPOSED DEVELOPMENT e c LtedAPPLICAN
NAME ADDRESS TELEPH NE
APPLICANT,
I AAL336
BUILDER i &
ENGINEER T ^ ZAA
0 I)
-PROJECT LOCATION:
To avoid delay in processing the application, please provide enough information to easily identify the project
location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the
distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing
the project location would be helpful.
3 M ANSF fC �e? I U. /l�j `� 3
V ,HAR** AMc •
FDP(93)
' APPLICATION
'
PAGE 2OF4
DESCRIPTION OF WORK (Check all applicablc boxcs):
A. STRUCTURAL DEVELOPMENT
ACTIVITY STRUCTURE TYPE
❑ New Structure (Residential (1-4 Family)
(]/Addition ❑ Residential (More than 4 Family)
❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes)
❑ Relocation O Combined Use (Residential & Commercial)
O Demolition F ❑ Manufactured (Mobile) Home (In Manu-
0 Replacement factured Home Park? ❑ Yes)
ESTIMATED COST OF PROJECT S S06
B. OTHER DEVELOPMENT ACTIVITIES:
❑ Fill ❑ Mining ❑ Drilling O Grading
O Excavation (Except for Structural Development Checked Above)
❑ Watercourse Alteration (Including Dredging and Channel Modifications)
O Drainage Improvements (Including Culvert Work)
❑ Road, Street or $ridge Construction
O Subdivision (New or Expansion)
O Individual Water or Sevprr S cm I
Q Other (Please Specily A1
After completing SECTION 2, APPLICANT should submit for to Local Administrator for review.
ECTION 3 FLOODPLAIN DETERMINATION (To be completedby LOCAL ADMINISTRATOR)
The proposed development is located on FIRM Panel No. Dated
The Proposed Development:
❑ Is NM located in a Special Flood Hazard Area (Notify the applicant that the application
review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED).
❑ Is located in a Special Flood Hazard Area.
FIRM zone designation is
100-Year flood elevation at the site is: Ft. NGVD (MSL)
❑ Unavailable
O The proposed development is located in a floodway.
FBFM Panel No. Dated
❑ See Section 4 for additional instructions.
SIGNED DATE
APPLICATION
PAGE 3OF4
SECTION 4• ADDITIONAL INFORMATION REQUIRED (To be completed by LOCAL ADMINISTRATOR)
The applicant must submit the documents checked below before the application can be processed:
❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot
dimensions and proposed development.
❑ Development plans,drawn to scale, and specifications, including where applicable:details for
anchoring structures, proposed elevation of lowest floor (including basement), types of water
resistant materials used below the first floor,details of floodprooftng of utilities located below
the first floor and details of enclosures below the first floor.
Also
❑ Subdivision or other development plans (If the subdivision or other development exceeds 50
lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations
if they are not otherwise available).
❑ Plans showing the extent of watercourse relocation and/or landform alterations.
❑ Top of new fill elevation Ft. NGVD (MSL).
❑ Floodproofing protection level (non-residential only) Ft.•NGVD (MSL). For
floodproofed structures, applicant must attach certification from registered engineer or
architect.
❑ Certification from a registered engineer that the proposed activity in a regulatory floodway
will not result in any increase in the height of the 100-year flood. A copy of all data and
calculations supporting this finding must also be submitted.
❑ Other:
SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR)
I have determined that the proposed activity. A. ❑ Is
B.O Is not
in conformance with provisions of Local Law , 19 . The permit is issued subject to the conditions
attached to and made part of this permit.
SIGNED , DATE
If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated
fee.
If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may
revise and resubmit an application to the Local Administrator or may request a hearing from the Board of
Appeals.
APPLICATION
PAGE 4OF4
APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No
Hearing date:
Appeals Board Decision --- Approved? ❑ Yes ❑ No
Conditions
SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Comoliance
is issued
The following information must be provided for project structures. This section must be completed by a
registered professional engineer or a licensed land surveyor (or attach a certification to this application).
Complete 1 or 2 below.
1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard
Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is:
FT. NGVD (MSL).
2. Actual (As-Built) Elevation of floodproofing protection is FT. NGVD (MSL).
NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant.
SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR)
The LOCAL ADMINISTRATOR will complete this section as applicable based oa-inspection of the project to
ensure compliance with the community's local law for flood damage prevention.
INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO
DATE BY DEFICIENCIES? ❑ YES ONO
DATE BY DEFICIENCIES? ❑ YES ❑ NO
SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR)
Certificate of Compliance issued: DATE BY:
Attachment B
SAMPLE
CERTIFICATE OF COMPLIANCE
for Development in a Special Flood Hazard Area
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA
(ON NER MUST RETAIN THIS CERTIFICATE)
PREMISES LOCATED AT: PERMIT NO.
PERMIT DATE
OWNERS NAME AND ADDRESS: CHECK ONE:
❑ NEW BUILDING
❑ EXISTING BUILDING
❑ VACANT LAND
THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW:
A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19
SIGNED: DATED:
B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19 . AS MODIFIED BY VARIANCE # ,
DATED
SIGNED: DATED:
C/C(93)
BUILDING PERMIT REVIEW CHECKLIST
DATE REVIEWED: it l 9 /O1
DATE SUBMITTED: 4C/27 /01
APPLICANT NAME: r a vs.s
SCTM# --- DISTRICT: 1,000 SECTION: 3G BLOCK: 2- LOT: 23.3
STREET: 332-t �(a�..,�«, 04,jr CITY: ,_,, SUBDIV. NAME:
Al
PROJECT DESCRIPTIO : ADD ALT ACC OR N/D:_ -
Nir C ��Q«K
ARCHITECT/ENGINEER: /'-,d e-C FAST TRACK: YES o NO
SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES N OTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED TS F JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8
ZONING: PERMIT ESTIMATE AMOUNT:_$ ?2 K--.00 PERMIT USE: EXISTING: S' 46 INTENDEDrSf4
ZONING DISTRICT(o R80 AC CONFORMING oR NO REQUIRED LOT SIZE: 1 Ow SQFT.
WHERE ACTUAL LOT SIZE FROM?TAx CARD ACTUAL LOT SIZE: f-32-46 SQFT.
REQUIRED _ REQUIRED REQUIRED i
1ST FOUND:FRONT:Sy'PROPOSED:A2�6 SIDE YD: /S V .3S' PROPOSED;20 '/4e-,) ' REAR:S8 'PROPOSED; '
2ND FOUND:FRONT: ' ACTUAL: SIDE YD: '/ ' ACTUAL: '/ ' REAR: ' ACTUAL: '
LOT COVERAGE: ALLOWED:_% EXIST G:_Z,' sf/% NEW: /sf -4/o TOTAL: s %
CORNER? YES o4Q WAT ER FRONT? E OR NO DESCRIPTION:
FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 ANEL #:%� FLOOD ZONE: 14o!54 ,
AGENCY PERMITS REQUIRED FOR REVIEW
INCLUDED IN APPLICATION
TOWN SPETIC PERMIT: YES or
SUFFOLK COUNTY HEALTH DEPT: YES o BED#): DTE: / / PERMIT#:R10-
PPROVALS REOUIRh D:
NEW YORK STATE,DEC: PRE-DEC 9/1/75 ES or NO ,g oo _f2 8 "b26/ Doo
SOUTHOLD TOWN TRUSTEES: YE r N 2/5Z/00 S27S-
TOWN ZONING BOARD APPROVAL: S o
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES or
NYS ENERGY: YES ORO EGRESS: VENT: LIGHT:
BUILDING PERMITS OP /EXPIRED: BP -Z/C/0 Z- ,
HAVE PRE CO'S : Y OR N BP -Z/ C/0 Z- ,
NOTES: 7 -VK re Kravf.
Z T,V1.9 ,m r T t4 i Tf! /P eeeA0.~rXr_ �rJ* e' Gw^ W rel f�
.O'FY W 2rw�
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR 1112- SF
SECOND FLR : SF 1NIT OTHER TOTAL
TOTAL: ///Z SF FEE FEE FEE
rOT( ///Z SF)- Sr( 6 SF)= ZL',2- SF XLd +$ Z sa +$ /Oo = $ CO
iSo