HomeMy WebLinkAbout26867-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28205 Date: 02/08/02
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 2190 LONG CREEK DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 7 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 18, 2000 pursuant to which
Building Permit No. 26867-Z dated OCTOBER 24, 2000
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 COVERED FRONT PORCH, REAR DECK, SUNROOM AND
ATTACHED TWO CAR GARAGE AS APPLIED FOR.
The certificate is issued to GERARD & SHARON MCELROY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0171 02/07/02
ELEC.'TRICAL CERTIFICATE NO. N 573825 10/23/01
PLUMBERS CERTIFICATION DATED 08/29/01 PECONIC PLUMBING & HEAT.
r
ori 7d Si nature
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. 26867 Z Date OCTOBER 24 , 2000
Permission is hereby granted to:
GERARD MCELROY
1170 HENRYS LANE
PECONIC,NY 11958
for
X
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR
r
GARAGE, COVERED F ONT PORCH, REAR DECK AND COVERED SCREENED PORCH AS APPLIED F
at premises located at 2190 LONG CREEK DR SOUTHOLD
County Tax Map No. 473889 Section 055 Block 0007 Lot No. 006
pursuant to application dated SEPTEMBER 18 , 2000 and approved by the
Building Inspector.
Fee $ 1, 383 . 20
Authori d Sign ure
COPY
Rev. 2/19/98
f ,
Form No.61L)0
Lt! °"AN 8 2002 I�� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
F .�G fi f nT. 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 I%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. // .13/ OQ
New Construction: V Old or Pre-existing Building: (check one)
Location of Property:
House No. Street Hamlet
Owner or Owners of Property: eiI JA1�y0 t' 5/(tno/1 10c
Suffolk County Tax Map No 1000, Section Block 07 Lot CJ6
Subdivision p�T�G,�,C/(� ��io�P S Filed Map. 3) e� ot:
Permit No.a.6. 6 Date of Permit. OGT 6t,� aW6 Applicant:6p 6!�,,l 4
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: -v (check one)
Fee Submitted: $
Applicant Signatur
THE NEW YORK BOARD OF FIRE "OERWRITERS PAGE '
1000121 BUREAU OF ELECTRICITY
I' 40 FULTON STREET, NEW YORK, NY 10038
Date OCTOBER 23,2001 Application No. on file 12'384fi�i1/01 N 573825
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number isin the premises of
.t
GERARD & SHARON MCELORY, 2190 LONGCREEK DR, SOUTHOLD,. NY
in the following location; ® Basement IN Ist Fl. ® 2nd Fl. GAR/ATTIC/OUT Section Block Lot
was examined on OCTOBER 12,2001 and found to be in compliance with the National Electrical Code.
6
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCENJ FLUORESCENT OTHER AMT. K.W. I AMT. K.W. AMT. K.W. ' AMT. K.W. AMT. N.P.
57 67 69 44 13 i 1 5.3 1 9.0 1 1.2 4 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS tiEll UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
!T!
OIL H.P. 6A5 H.P. AMT. NO. A.W.G. AMT. AMR AMT. AMPS. TRANS. AMT. N.P. NO.OF FEET AMT, WATTS
5 F 2 50 1
SERVICE DISCONNECT NO.OF S E R V 1 C E
METER
AMT. AMP. TYPE EQUIP. 1 0 2WJI 0 JW S 0 3W13 0 4W NO.OF CC COND. A.W.G. A A.n G.
PER R OF CC. NO.OF HI•LEO NO.OF NOIITRAIf OF N
2 150 CB 1 X 2 1/0 -T 2 1/0
OTHER APPARATUS:
CO DETECTORS-2
PADDLE FANS F-7
WIRLPOOL BATH-1
200A TRANSFER SWITCH-1 Y .
AIR CONDITIONERS 1-3 TON 1-4 TON-2
MOTORS:1-3 H.P. ,1-4 H.P. ,2-F H.P.
ANELBOARDS:2-1 CIR. 60
G.F.C.It-8
SMOKE DETECTOR:-7 1
<<< Continued on Page 2 >>>
GENERAL MANAGER
Per
This cerittIcato must not be altered In any manner;return to the office of the Board It Incbrroct,) be Identified by their cred n Is.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU$T NC1T;-RE,'ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 2
1000121 BUREAU OF ELECTRICITY
F - 40 FULTON STREET, NEW YORK, NY 10038
Date OCTOBER 23,2001 Application No. on file 12384601/01 N 573825
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
GERARD & SHARON MCELORY, 2190 LONGCREEK DR, SOUTHOLD, .NY
in the following location; ® Basement ® Ist Fl. ® 2nd Fl. GAR/ATTIC/OUT Section Block Lot
was examined on OCTOBER 12,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXTURES RANGES COOKING DECKS OVENS ISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCENJ FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REc,Fr.1 TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AM". TRANS. AMT. H.P. NOSTEEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C f
METER
AMT. AMP. TYPE ECUIP. 1 0 zW 1•3W 3 1 3W 3•4W NO.OF CC COND. A.W.G. p,
PER a OF CC. NO.OF HI•UG M NO.OF.NEUIRAW OF NEUTRAL
OTHER APPARATUS:
PAUL R. BURNS LIC.#3897—E
PO BOX 1061
SOUTHOLD, NY, 11971-0932 GENERAL MANAGER
11
per
This certHkate must not be altered In ony manner;return to the office of the bard It Incofhclr 16$006tmA5 y be klenlNled by their CMAnkils.
COPY FO BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE:'MUST'NOT BE,ALTERED IN ANY MANNER.
� � ru
Town Hall,53095 Main Road '- `UTNOLD
65-1823
P. O. Box 1179 0-0 Telephone(516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: x..19 a o0 /
Building Permit No. oZ
Owner: (� d Anl Ar,
lease print)
Plumber: f"Al/L-
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
A�zz�� J
(Pluikbeff Sign re
Sworn to before me this
-- — day o �.c.
S�'p
Notary Public County BARB RA fa
f.
d Not^./Public,State Now York
No.01ST4344io2
Qualified in Suffolk Couna&
Commission Eqm Sep.30,
! I SEP 2 0 4-i
� -_= I
wr�<OF
STATE OF NEW YORK )
) ss:
COUNTY OF SUFFOLK )
being duly sworn, deposes and says:
That deponent is over the age of 18 years and resides at
i 2 r S fh lel .t e4 a Gr ire!ew/ IV Y
K
That on the 20 day of S`/��"' , 2000 deponent /engineer,
licensed by the State of New York, hereby states that i/he accepts full
responsibility for the accompanying plans compliance with the New York State
Fire Prevention and Building Code (9 NYCRR); said plans pertain to property
located at SCTM# 1000- 155 — 07 — D(a ,
street address c 19D Monte Cree-k Dri V-0—
A�FEngineer
Sworn to before me this
Q0 day of " 2000. SOF NEWp.
EILEEN Q�
NOTARY PUBLIC,State,of New Y0* aCE
No.30.1916018
Qualified In ue y y
Commission Expires
ac
Notary Public a
�Fo osrlrA•1 ave
�g0 ESSIONR��.
cc: Applicant
7777 ''
SCWA
SUFFOLK COUNTY WATER AUTHORITY
624 Old Riverhead Road,Westhampton Beach, New York 11978-7407
(631)288-1034
Fax (631)288-7937
Date 1/11/02
SUFFOLK COUNTY DEPARTMENT OF HEALTH
COUNTY CENTER
RIVERHEAD, NEW YORK 11901
To Whom It May Concern:
This is to certify that the Suffolk County Water Authority has installed Public Water
Service at the following location:
2190 Long Creek Drive
Southold, NY
A water meter was installed on
June 29, 2001
Very truly yours,
Dona Roberts
Eastern Regional Manager
SUFFOLK COUNTY WATER AUTHORITY
DR:ba
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
-------------
a H.S. REF. NO. S118114
COMPLETION REPORT — LONG ISLAND WELL Well No.
WNER
GERARD McELROY „ LOC
A S _
1170 HENRYS LANE, PECONIC NY 11958 Ground Surface
LOCATION OF WELL El• ft,above sea
LONGCREEK DRIVE SOUTHOLD V ft.
DEPTH OF WELL BELOW SU FACE DEPTH TO GROUND WATER FROM SURFACE
49' ft, 11� TOP OF WELL
-------------
ft.
DIAMETER CASINGS
4" PVC in. In, r n
LENGTH In, in. 4 0
45' ft, ft. 20' 0" 24' 0"
SEALING ft, ft.
CASINGS REMOVF-D 20' 0" 44' O"
SCREENS
5' 0" 49' 0"
MAKE OPENINGS
NAGAOKA 12
DIAMETER
5 i n.
LENGTH �n �n• in.
4 ft. ft. ft.
DEPTH TO TOP FROM TpP OF CASING ft.
PUMPING TEST
DATE TEST OR PERMANENT PUMPi
DURATION OF TEST MAXIMUM DISCHARGE
days hours
STATIC LEVEL PRIOR TO T ST LEVEL DURING MAXIMUM gallons per min.
in.below PUMPING
ft, top of casing ft. in.below
MAXIMUM DRAWDOWN top of casing
Approximate time of return to norm I level after cessation of pumping
ft, hrs.
min.
TYPE PUMP INSTALLED
MAKE MODEL N0,
SUBMERSIBLE MYERS SS1535
MOTIVE POWER MAKE
H.P.
ELECTRIC 1
CAPACITY
25 g.p.m.against
MBER BOWLS OR STAGES ft.of discharge head
DROP LINE
ft.of total head DIAMETER SUCTION LINE
DIAMETER
1 " PVC in.
LENGTH LENGTH In.
ft.
METHOD OF D ILLING ft.
USE OF WATER
❑rotary 0 cable tool [3 other —AUf.E] ' IRRIGATION
WORK STARTED COMPLETED
05 16 01 05/17/01
DATE DRILLER
05 18/01 KREIGER WELL & PUMP CORP,. LICENSE N10
*NOTE: Show Ipg of well - materials encountered,with depth below ground surface,
water bearing beds and water levels in each, casings, screens, pump,
additional pumping tests and other matters of interest.Describe repair job.
See Instructions as to Well Drillers' Licenses and Reports. Pages 5 - 7.
1 of 2
18-1359:7186
Well Yield: 25
g.p.m.
Casing: Type of Materiij PVC
Drop Line: Type of Material PVC
If plastic,
was torque arrestor used? YES
3/16" S.S. cable installed? NO
Sanitary Seal : Type Used WELL SEAL
Storage Tanks: Size N/A gals. ; Type
Inside Material N/A
Type of Tank Drain N/A
Pressure Gauge Installed N�A
Shut-Off Valve Prior to Tank N/A
Sampling Tap Provided N/A
Shut-Off Valve With Bleeder Line
Installed on Outflow of Tank N/A
Method of Disinfection:
Well Lateral : Depth Below Grade SLA
Material _ N 9
Water Treatment Equipment Installed
For Treatment of
Make
Type
Model Number
Well Driller' s Signature r
Print Name ROBERT G. LAURIGUET
Print Company Name
Mailing Address PO.8ox101 -N.MainRoad
Y 11982
Telephone Number (631)298-4141
18-1359 :7/86
2 of 2
BUILDING PERMIT REVIEW CHECK LIST
Applicant/ C Date
Owners Name: Reviewed:
Architect/ Date c+
Engineer: Submitted: / ao
SCTM #:
District: 1,000 Section: —Block: Lot: Jv
Project /� ubdivision /
Location: a�K• 44* Name:
Single&separate Required
certification: (Yes/No)
Req. �Q Y� 570. Req t
Zoning District:_�� [Lot size: Actua]: [Lot coverageroposed:
Req. Req. 20 Req.
6-� / /
[Front Yard�Proposed: 1 [Side Yard Proposed: & 1 [Rear Yard �/� Proposed: /07j
Project Description:
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES/ Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees I
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation??? �tit
Flood Zone:
Notes•
I NI"s3tGY CODE CALCULATIONS
(For Non-Electric Iieat) Design Criteria G , uuo Degree'.Da}'s
O.A. 1OOF I .A. 70°F
FOR:
DESIGN TT1C,,RHE L REMARKS
SUBSYSTEM AREA "U" RATING
u,xLeriot: Walls (Opaque) � �f711 os fi26 �-
A r►-.
(31azilly /,�_$ 370 •3 2 - 70 v+- epuq
Doors 9 7 ---
_ r
Ceilil'y/Hoof (Opaque) x '78 S O
Skylights _ %
Floor t 7 , Os- v
i'oundat•ion Walls
Slab Insulation
TOTAL
Notes:
I3uilding Envelope Systems to meet requirements of 7915. 2
IiVAC Equi.pement to meet requirements of 7U15 . 11
IlVAC SysL-ems to meet requirements of 7015 . r2
Duct Systems to meet requirements of 701.5 . 13
Ventilat-iont3 Systems to meet requirements of 7015. 11
lnsulat•ion of pipir'y Systems to meet requiremenLs of 7U15 . 15
Service Water IIeaLing Systems & EquipmenL to meet requirements of '7015 - 21
Electrical & Lighting SysL•ems & Equipment to meet requiremet't-s of 7U1.5 . 31
.�tof NEWT
To the best of my knowledge, �1P��aCE J,
belief, & professional
jUdyeme"L, L-ltese plat's are In
comylianc:e with the code . a
032254.1
v�
A9�FESSIBNP� 0
M-1802
BUILDING DEPT.
INSPECTION
�Zj FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMAR
y
,DATE ` 716l' INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOU ATION 1ST [ ] ROUGH PLBG.
[ UNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREP CE & C IMNEY
REMARKS:
,DATE2/
/ INSPECTOR
suiwiNc DEPT.
INSPECTIO"
[ ] FOUNDATION IST [ ROUGR PLBG.
[ ] F NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMA KS: 4/aaz�79" IL�
ppm "'v
y DGfvi� d
,DATE J'� 0 INSPECTOR t9��
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] R H PLBG.
[ ] FOUNDATION 2ND [ ' INSULATION I
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
,DATE O INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CFIIMNEY
REMARKS: Z `-`
DATE / INSPECTO ��
ol
ice= mow' RM
(v _
WMWA
11 '
• 11 1 1 II'
�4
i ~
` BOARD OF HEALTH . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . .,. . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . .:. . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . .
TOWN'HALL SEPTIC FORM . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971 DEC . . . .. ...... . . .. . .
TEL: 765-1802 TRUSTEES . . . .. ... . . . . .
NOTIFY• �. -
CALL .-... .
Examuned .., 20 MAIL TO: . . . . . . . . . . . .
Approved. :a�..., �!:°O Permit No. �O.C)�..(. .........................
Disapproved a/c .................................. ........................
......................................................
(Building Inspec or
, '; )'APPLICATION FOR BUILDING PERMIT y //
j + Date.! .�-5�. . . . . . . . .
SEPQ
g INSTRUCTIONS
a. This applicatiou'mist,bcompl tely filled in by typewriter or in ink and submitted to the Building I
3 sets of plans, accurate plot pl scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or
streets or areas, and giving a detailed description of layout of property mist be drawn on the diagram which i
this application.
c. The work covered by this application may not be conienced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector dill issue a Building Permit to the applica
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 Certificat
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS HEMMY MAD- to the Building Department for the issuance of a Building Permit pursuant to t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as her
described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code,
regulations, amu to admit authorized inspectors on premises and in building for necessary inspections.
.............0.................
(Signature of appli , or name, if a corF
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluabei
............................................................
Name of owner of premises .�,,4./ 'dx.............................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No. ../ .�..... .........
Plumbers License No. .6�7Zz.
..�%1&/... rElectricians License No. ��i�,C1.f.... I� /
Other Trade's License No. ....................
I. Location of land on which proposed work will be done....................................................
....a.l.?a.............. ......................... Id ............
lbuse Number Street Hamlet
County Tax Map No. 1000 Section .,1'........... Block lot
Subdivision L..Q!�{.�llke�:.�5<.. !r.�.......... Filed Map No. . ..... Lot .J 1...........
(Name)
2. State existing use and occupancy
of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancyA .l.....1:G7...................................................
b. Intended use and occupancy ../.�l�?:`1 ,�•.�l•- ............1 ........... ..........................
re of work (check which applicable): .. `
. lyP ): New building ... Addition '.......... Alteration .........
lr ............ Removal ............. Demolition ............ Other Work ......
mated Cost ...:.
(Description)
y..lis ��......... fee ..............................................
(to be paid on filing this application)
.selling, number of dwelling units lfio�)hd)r tkmber of dwelling units on each floor ........
arage, number of cars ...a............................ ...
usiness, commercial or mixed occupacicy, specify nature and extent of each type of use.... .......
nsions of existing structures, if any: Front..._ ...... Rear ............ Depth ......i 1.....
ht ............... ........ umber of Stories .....�:--� ...........
nsions of same structure with alterations or additions: Front
:i .................... height ......... Rear ...............
nn Number of Stories ...............
isions of entire new construction: Front ....go.. Rear ..90 . Depth ..�� .
it .�f!.�............. Nud*r of Stories ... ..............
of lot: Front PIX91.9.5.3...... Rear aW.-I S........ Depth
of Purc�iase '//.aIC�.oD...... Name of Former Owners. ��!.�!4 5. '.. tA,Yjx.. !A.e' ....
or use district in which premises are situated
Proposed construction violate any zoning law, ordinance or regulation: ............•....
lot be regraded ;5 Will excess fill be removed from y�
`l /� preruses:
s of Owner of premises �����,(rA.GY...... Address .1i 2p.&1,2-)a' � a.�i...11-,-�Ib ne No. -7.
ofArchitect .................................... Address .............................. Plume No.
of Contractor .I f,/.�............................ Address .......... .............
.....................Phone No. .............
lis property within 300 feet of a tidal wetland? * YES .. NO ...
*IF YES, SOI1Il11aD Tt7Ia TBiJSlms Pmu MAY BC R gmizFD. ..
PLOT DIAGRAM
to clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
rty lines. Give street and block cumber or description according to deed, and show street nares and indicate
terior or corner lot.
sT 2 y 1y Y61
ST��cfia2r �S � Id�f.. �
r Still v e✓ ec
l
tc ^ ra
W YORK,
SS
......................being (July sworn, deposes and says that tie is the applicant
dividual signing contract)
f
'• .agent,•corporate.officer,'etc.).- •.•.
(Contractor,
er or owners, and is duly authorized to perform or have performed the said work and to mke and file this
that all statements contained in this application are true to the best of his knowledge arxJ lieJ.ief; arxJ
,rk will be performed in the manner set forth in the application filed therewith.
fore me this
........day o .. . . ......20 G o
rblilL
IZABETH A STATHIS (Signature of Applicant)
NOTARY PUBLIC,State of New York
No.01 ST6008173.Suffolk County
Term Expires June 8,2l.D`Z
u
POP
SURVEY OF
'kCQ
arm F1
LONG POND ESTATES
SECTION ONE
FILE No. 8037 FIND DECEMBER 27, 1985
r
SITUATED AT
'� v SOUTHOLD
Y L �,• `pA S TOWN OF SOUTHOLD £a
00 r • �
SUFFOLK COUNTY, NEW YORK
N. S.C. TAX No. 1000-55-07-06
JUNE 27, 2000
I`+ JULY 9. 2000 PLOT PLAN
,AREA — 42,570.88 sq. ft.
4. . $ 0.977Ab oc.
,. • a CERTIF'= TO•
uoy
FIDELITY MATIO14AL TITLE INSURANCE COMPANY OF NEW YORK
TITLE No. 28433
o GERARD McELROY
,M• SHARON McELROY
t
� � r �L H
. ., ,ELEYATON ANEREiplfllCED TO AN ASSUMED DATUM
EU MS ELEYA110M4 ARI SHOW ANIS: 7BP
£ 0 � 2. IKFflI To n= W W FOR TEST HOLE DATA.
3. MONK MI SIR TANK CAPA9 M MR A 1 TO 4 BEDROOM HOUSE IS 1,000 CALLOW&
1 TANK; Or LONG. 4'-S' WOE, 6'-7'-DEEP
/� 4 MRAEMRI LEACHNIN STSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 p ft SRMWALL AREA.
6. OW. 8' dk.
yyy n ��j TNOIbfED ERPAM" POOL -
y GYlrt PROPOSED LEACIMK POOL i
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THE ONTING[ OF NOW OF WAYS OFRM LOD=AT AXIM
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R(r@N". "m Y" Itsot li7L th" *W, i10(►1-4/Bb
S
yOT O
SURVEY OF
LOT
ASAP OFl
LONG POND ESTATES
,��;►1 SECTION ONE
FILE No. 3037 FILED DECEMBER 27, 1985
+M'4`. _- SITUATED AT
vO `'��
•
' ` SOUTHOLD
. a1'' ,O�g'I
•: • TOWN OF SOUTHOLD
;:� : ' �g5p E Wit•'` �, `� SUFFOLK COUNTY, NEW YORK
' N 0 S.C. TAX No. 1000-55-07-06
3 t
SCALE 1"=50'
JUNE 27, 2000
JULY 9. 2000 PLOT PLAN
n DECEMBER 12. 2000 FOUNDATION LOCATION
AREA = 42,570.88 sq. ft.
0.977 cc.
°C CERTIFIED T0:
FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK
•Z TITLE No. 28435
�. GERARD McELROY
SHARON McELROY
.. A6
O
'f LOT
J
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gUBD ,l1U F'wo 0q lof t0 aeras a ns SWAY W«or WAS �Se� A. ��
��G s iv�"" "` °„ .M 3M r K 0 aR Land Surveyor
a�owm WL alvei wor a aaaoean
10 E A IND/A�aarY.
N EpFA QM nRE oovAln.sww�wL Assld AIO 19b Savep — &**Aimr — Sib From — Camrucum Dart
18O10 I1lI®I�1,AM
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TIE err Cola moo.
n as yS o�LOWED AT MMM A001ESS
AM. NK lI6a11 A
A �EA1,ryM NOT gyp• 1390 IbA11010E AIMRIE PA. Bou 1931
WA3* A0. Nw Yak 11901 0 1- d. Nw Yak 11901-01W
t
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Si i RVEY OF
_ LOT 11
L°T ��� °N°M` MAP OF
i � _nNr
fi
LONG POND ESTATES,
SE C'TION ONE
r 'S FILE No. 8037FILED DECEMBER 27, 1985
0� 56
v1�cD�5SITUATED AT
coi* 10� 6�. A�5 °3 v SOUTHOLD
TOWN OF SOUTHOLD
a So °"0Gx SUFFOLK COUNTY, NEW YORK
• I 1�1N,
S.C. TAX No. 1000-55-07-06
jib) p SCALE 1"=50'
(� / � 10`1�N �S I• � lP -
M _ JUNE 27, 2000
• JULI 9, 2000 PLOT PLAN
DE,-EMBER !, 2000 F UNDATION LOCATION
`�'•. fTT JANUARY 11� 200- FINAL SUPVEI
AREA = 42,570.88 sq. ff.
oe 0.977 ac.
S.C.D.H.S. REFERENCE No. R10-00-0171
CERTIFIED T0,_
\~ z z r 25< 1-- E FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK
FEN, TITLE No. 28435
O i �pD— ow
� RAMR W E GERARD McELROY
'I .• N ,TEP
SHARON McELROY
L
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SPACE r NY S Lic No 49668
PEN N4AF
Of ` UNAUTHORIZED ALTERATION OR ADDITION ---
01?
�ON mAi psl�� C,OVNSY \ SECTION 72 9TO THIS E Of STHEVNEWTION OF
ORi, STATE
1<l�_ DIV[S ��S uFFO�3� EDUCATION LAW
St,e ,,`� wo F s Jose h A. Ingegno
lvIO S rLRs��E No, THE LANOF SURveroa'r,INKED NOT BEARING
eOER Surveyor
� �
SCO
OF SN 990 P ` TOBBE�A VALDLTRUE LONPOT BE CONSIDERED Land Surve or
tNE OFe R 29 CERTIFICATIONS INDICATED HEREON SHALL RUN ----
2 ( \N OAF' ONLY TO THE PERSON FOR WHOM THE SURVEY" ------- .---
No' ��EO Op M IS PREPARED AND ON HIS BEHALF TO THE
1 BASIN -�e F TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys Subdivisions - Site Plans - Construction Layout
IjGI; - LENDING INSTITUTION LISTED HEREON, AND
RECHA TUT ONE CERTIISIGFICATIONS AEES Of RE LENDING TRANSFERABLE PHONE (631)727-2090 Fax (631)727-1 727
\� AND/OR SEASEMENTSOF RIGH
OF TRECORD,OF YIf OFFICES LOCATED AT MAILING ADDRESS
• ANY. NOT SHOWN ARE NOT GUARANTEED. 1380 ROANOKE AVENUE P.O. Box 1931
RIVERHEAD, New York 11901 Riverhead, New York 11901-0965
Town Of Southold
P.0 Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 09/18/00 Receipt#: 0
Transaction(s): Subtotal
1 Septic Permit-Construct- Resid. $10.00
Total Paid: $10.00
Name: Mcelroy, Gerard
1170 Henry Lane
Peconic, NY 11958
Clerk ID: JOYCEW Internal ID: 17993
IF
APPROVED AS NOTED
DATE-LQ-A-i-z--' jLR f ra(,
FEE 1
6tEPAR EN AT
[Ni
NOTIFY Bull.
765-1802 9 AM TO 4 PM FOR HE
FOLLOWING INSPECTIONS: x
1. FOUNDATION m TWO REQUIRED
FOR POURED CONCRETE
Z ROUGH - FRAMING & PLUMBING
3. INSULATION
IL FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SMALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
L
OCCUPANCY OR PROVIDE SMOKE-DETECTING
ALARM DEVICES
USE IS UNLAWFUL AS TO PART 721.1
WITHOUT CERTIFICATE NYS BUILDING CODE.
OF OCCUPANCY
�71 Z
PROVIDE'A MR.FIRE
ELEVATE HEATING
APPLIANCES 19'AS RATED SEPARATION TO
REQUIRED BY PART. PART.7173 M(1)OF
N.Y. STAT ow
--IEMMS:::------ _7
PROVIDE OPENINGS EPA
-VMEWENICY ESGAFE-k;
-714
REOUIRED:BY PART.
wmm- =BUILDING CODE
----------
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